Morphometry of the thyroid cartilage, epiglottis and piriform sinus: An anatomical study.

Background: The goal was to measure the piriform sinus, epiglottis, and thyroid cartilage in our sample population. Methods: This study included 22 adult embalmed cadavers available in the Department of Anatomy. Dimensions were measured using a digital Vernier caliper. Results: The mean height of the thyroid laminae was 27 ± 1.4 mm at the right side and 25.5 ± 1.4 mm at the left side. Mean width of the thyroid lamina was 27.1 ± 1.3 mm at the right side and 27.4 ± 0.9 mm at the left side. The mean thickness of thyroid cartilage was found to be 4.4 ± 0.4 mm and 3.9 ± 0.5 mm over the right and left sides. The mean length, width and thickness of the epiglottis were 29.1 ± 0.5 mm, 22.2 ± 0.6 mm and 2.6 ± 0.3 mm correspondingly. The height, width and thickness of the right piriform sinus were 25 ± 0.5 mm, 14.2 ± 0.5 mm and 12.6 ± 0.5 mm, the same parameters were 25.3 ± 1.3 mm, 15.1 ± 0.7 mm and 13.3 ± 0.4 mm for the left side. Conclusions: The height and thickness of the thyroid cartilage were greater on the right side than on the left side (p<0.05). It was statistically observed that the width and thickness were greater on the left side than on the right side (p < 0.05). The data about the height, width and thickness of the thyroid cartilage, epiglottis and piriform sinus are essential during the laryngeal and other neck surgeries. They guide in the preoperative positioning, predicting the difficulty of intraoperative exposure and retractor pulling.

Comparison of standard weight-based and thenar eminence dimension-based selection of I-gel in pediatric patients - A randomized controlled study.

Background and Aim: Supraglottic airway devices are increasingly being used for airway management. I-gel is being widely used even for pediatric patients. Although the weight-based selection of the size of the device seems to be the standard technique, this method may not be possible in all patients. The aim of the study was to compare the standard weight-based method with the thenar eminence dimension-based method for I-gel selection. Material and Methods: A prospective randomized study was conducted on 74 pediatric patients of either sex, aged between 6 months and 15 years, belonging to American Society of Anesthesiologists (ASA) physical status I, II, and III and who were posted for various surgical procedures under general anesthesia. The study population was divided into two groups of 37 patients each. I-gel was inserted based on weight in group A patients and based on thenar eminence size in group B patients. Parameters like first attempt success rate, ease of insertion, and complications were compared between the two groups using Student's t-test and Chi-square test. Results: The demographic values between the groups were comparable. The first attempt success rate was 97.4% in group A and 91.7% in group B (P = 0.358). Insertion of I-gel was unsuccessful in two patients in group B. Two patients of group B had blood staining of the device. None of the patients had complications related to insertion. Conclusion: The thenar eminence dimension can be used instead of weight while choosing the size of I-gel in pediatric patients. None of the patients had complications related to device insertion.

Spontaneous Haemoperitoneum in Pregnancy with Placenta Percreta in Bicornuate Uterus with Successful Pregnancy Outcome: A case study.

Intraperitoneal haemorrhage during pregnancy or postpartum without any history of trauma (spontaneous haemoperitoneum in pregnancy [SHiP]) is a rare condition, causing significant morbidity and mortality for the mother and the neonate. We report a 27-year-old female patient with SHiP at 31 weeks of gestation who was referred to a tertiary care hospital in Muscat, Oman, in 2019, with right iliac fossa pain, pallor and tachycardia. Radiological investigations revealed intraperitoneal bleeding and a right adnexal haematoma. She was managed conservatively with blood transfusion and supportive care. At 36 weeks of gestation, lower segment caesarean section was done and a live baby with good Apgar score was delivered. Pre-operatively, she was found to have a bicornuate uterus, placenta percreta at the junction of the horns and a right adnexal haematoma. This case highlights the significance of thorough evaluation of acute abdominal pain in pregnancy in avoiding unnecessary surgical intervention and iatrogenic prematurity.

Thickness and width of the menisci of adult knee joint: a descriptive cross-sectional observational study in cadavers.

Background: The goal was to determine the thickness and width of the knee joint meniscus at their different regions. The objective was to compare the dimensions at these regions and over the right- and left-sided specimens. Methods: The present study included 50 adult cadaveric knee joints, and 100 menisci (50 medial menisci and 50 lateral menisci) were studied. The meniscus was distributed into anterior, middle and posterior parts. Thickness and width at the mid-point of these three parts were determined by using the Vernier caliper. Results: The breadth of the medial meniscus was 8.38 ± 1.64 mm, 7.68 ± 1.92 mm and 13.93 ± 2.69 mm at the anterior, middle and posterior one-third regions. Same measurements for the lateral menisci at these regions were 9.84 ± 1.78 mm, 8.82 ± 2.01 mm and 10.18 ± 2.23 mm, respectively. The thickness of the medial meniscus was 4.49 ± 0.78 mm, 4.07 ± 0.81 mm and 4.79 ± 0.93 mm at these regions. The lateral meniscus thickness was 3.82 ± 0.69 mm, 4.43 ± 0.98 mm and 4.36 ± 0.8 mm, respectively. Conclusion: It is believed that this data is enlightening to the arthroscopic surgeon during the meniscus transplantation either by using synthetic material or allograft as the proper sizing of the meniscus is important to prevent complications due to inaccurate sizing.

Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder.

Few studies have examined the neural mechanisms of change following social skills interventions for children with autism spectrum disorder (ASD). This study examined the neural effects of social cognitive skills groups during functional MRI (fMRI) tasks of irony comprehension and eye gaze processing in school-aged children with ASD. Verbally fluent children (ages 8-11) were randomized to social cognitive skills groups or facilitated play comparison groups. Behavioral assessments and fMRI scans were obtained at baseline and endpoint (12 weeks). During fMRI, children completed two separate tasks to engage social cognition circuitry: comprehension of potentially ironic scenarios (n = 34) and viewing emotionally expressive faces with direct or averted gaze (n = 24). Whole-brain analyses were conducted to examine neural changes following treatment. Regression analyses were also conducted to explore the relationship between neural and behavioral changes. When comparing the two groups directly, the social cognitive skills group showed greater increases in activity in the medial prefrontal cortex (mPFC), implicated in theory of mind, relative to the comparison group for both irony comprehension and gaze processing tasks. Increased mPFC activity during the irony task was associated with improvement in social functioning on the Social Responsiveness Scale across both groups. Findings indicate that social cognitive skills interventions may increase activity in regions associated with social cognition and mentalizing abilities. LAY SUMMARY: Social skills groups are a common intervention for school-aged children with ASD. However, few studies have examined the neural response to social skills groups in school-aged children with ASD. Here, we report on a study evaluating neural outcomes from an empirically supported social cognitive skills training curriculum using fMRI. This study seeks to understand the effects of targeting emotion recognition and theory of mind on the brain circuitry involved in social cognition in verbally fluent children ages 8-11. Results indicate increased neural activity in the mPFC, a region considered to be a central hub of the "social brain," in children randomized to social cognitive skills groups relative to a comparison group that received a high-quality, child-directed play approach. In addition, increased activation in the mPFC during an irony comprehension task was associated with gains in social functioning across both groups from pre- to post-treatment. This is the first fMRI study of social skills treatment outcomes following a randomized trial with an active treatment condition in school-aged children with ASD.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications.

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Exploring the Morphology of Anterior Interosseous Nerve and Relating It to Its Clinical Conditions.

AIM: To study topography and variability in the origin of anterior interosseous nerve; to identify the branching pattern of the anterior interosseous nerve supplying the flexor digitorum profundus, flexor pollicis longus, and pronator quadratus muscles. MATERIAL AND METHODS: The present study included 70 formalin-fixed upper limbs of adult human cadavers. The origin of the anterior interosseous nerve was categorized into 3 types. The morphometric data obtained in this study were represented as mean± SD and the dimensions were given in millimeter. The measurements were compared statistically by using 'EZR software, version 1.38, 2019'. The 'paired t-test' was applied and the 'p' value less than 0.05 was considered as statistically significant. RESULTS: It was observed that the origin of the anterior interosseous nerve was extremely variable. It was ranging from the midepicondylar point of the elbow joint up to as below as 86mm from it. The distance of its origin from the midpoint of the pronator teres muscle ranged between 70 mm above the pronator teres muscle to 22 mm below it. In one of the forearms, the median nerve supplied the medial two tendons of the FDP, instead of the ulnar nerve. CONCLUSION: The present study provided additional information about the origin, topography, and distribution of the anterior interosseous nerve. The data will provide further insight into the causes of nerve compression syndromes. It will also help in planning the surgical approach into the distal humerus, elbow joint, and proximal ends of radius and ulna, without causing any nerve injury.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Anatomical dimensions of the typical cervical vertebrae and their clinical implications

The aim of the present study was to study the dimensions of various parts of the typical cervical vertebrae in anatomical samples. This study included 100 cadaveric dried typical cervical vertebrae, which were obtained at the osteology sec-tion. This study lacks the information on sex and chronological number of cervical vertebrae being studied. The dimensions of different parts of vertebrae like the body, pedicle, spinous process, laminae and articular facets were measured. The data of the right and left sides were statistically analysed by using the software 'EZR' (version 1.38, 2019). The shapes of the superior and inferi-or articular facets were macroscopically observed. The mean height of the typical cervical vertebra was 10.92 ± 1.35 mm; the vertebral body antero-posterior length was 14.79 ± 1.96 mm and 15.56 ± 1.95 mm at the superior and inferior borders; the vertebral body transverse length was 23.22 ± 2.16 mm and 19.88 ± 2.38 mm at the superior and inferior borders respectively; the spinous process length was 15.25 ± 4.25 mm; the vertebral fora-men anteroposterior and transverse length were 12.33 ± 1.68 mm and 21.98 ± 1.82 mm respectively. The pedicle length was more (p > 0.05) at the right side than the left. In the remaining parameters of the paired structures, there was no statistically significant difference observed (p < 0.05). The morphometric data of the present study will enlighten the operating spine surgeon during procedures like internal fixation and decom-pression procedures of fracture spine. We believe that the surgical implants should be devised as per the morphometric data of the particular population

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Anatomical variations of the arrangement of structures at the pulmonary hilum: a cadaveric study.

PURPOSE: The aim was to study the anatomical variations of the arrangement of structures at the hilum of the lung. METHODS: The present study examined the hila of 110 cadaveric lung specimens of south Indian population. The anatomical variations of the arrangement of structures at the hilum were macroscopically observed. RESULTS: It was observed that the variations were higher in the left lung than in the right lung. The variations were observed in 16.1 % of right lungs and 48.2 % of the left lungs. There were some interesting anatomical variations like the two upper pulmonary veins, two pulmonary artery, two bronchi in the hilum of the left lung, three bronchi, four pulmonary veins and four bronchi. The present study was compared with a similar study from the same geographical location. It was observed that the frequency of variations and the hilar morphology of the arrangement of structures differ among the two separate studies from south India. CONCLUSIONS: The observations of the present study suggest that the pulmonary hilar morphology is extremely variable.

Erratum to: Neural selectivity for communicative auditory signals in Phelan-McDermid syndrome.

[This corrects the article DOI: 10.1186/s11689-016-9138-9.].

Neural selectivity for communicative auditory signals in Phelan-McDermid syndrome.

BACKGROUND: Phelan-McDermid syndrome (PMS), a neurodevelopmental disorder caused by deletion or mutation in the SHANK3 gene, is one of the more common single-locus causes of autism spectrum disorder (ASD). PMS is characterized by global developmental delay, hypotonia, delayed or absent speech, increased risk of seizures, and minor dysmorphic features. Impairments in language and communication are one of the most consistent characteristics of PMS. Although there is considerable overlap in the social communicative deficits associated with PMS and ASD, there is a dearth of data on underlying abnormalities at the level of neural systems in PMS. No controlled neuroimaging studies of PMS have been reported to date. The goal of this study was to examine the neural circuitry supporting the perception of auditory communicative signals in children with PMS as compared to idiopathic ASD (iASD). METHODS: Eleven children with PMS and nine comparison children with iASD were scanned using functional magnetic resonance imaging (fMRI) under light sedation. The fMRI paradigm was a previously validated passive auditory task, which presented communicative (e.g., speech, sounds of agreement, disgust) and non-communicative vocalizations (e.g., sneezing, coughing, yawning). RESULTS: Previous research has shown that the superior temporal gyrus (STG) responds selectively to communicative vocal signals in typically developing children and adults. Here, selective activity for communicative relative to non-communicative vocalizations was detected in the right STG in the PMS group, but not in the iASD group. The PMS group also showed preferential activity for communicative vocalizations in a range of other brain regions associated with social cognition, such as the medial prefrontal cortex (MPFC), insula, and inferior frontal gyrus. Interestingly, better orienting toward social sounds was positively correlated with selective activity in the STG and other "social brain" regions, including the MPFC, in the PMS group. Finally, selective MPFC activity for communicative sounds was associated with receptive language level in the PMS group and expressive language in the iASD group. CONCLUSIONS: Despite shared behavioral features, children with PMS differed from children with iASD in their neural response to communicative vocal sounds and showed relative strengths in this area. Furthermore, the relationship between clinical characteristics and neural selectivity also differed between the two groups, suggesting that shared ASD features may partially reflect different neurofunctional abnormalities due to differing etiologies.

Evaluation of sublethal toxicity of zinc and chromium in Eudrilus eugeniae using biochemical and reproductive parameters.

Zinc (Zn) and chromium (Cr) act as essential nutrients; however, they can be toxic at higher concentrations. In this study, earthworm species Eudrilus eugeniae was studied for its sensitivity to sublethal doses of Cr (8 ppm) and Zn (350 ppm) in terms of alterations occurred in oxidative stress indices and reproductive parameters in the testis. A significant (p < 0.05) decrease in the rate of food intake was observed on 7, 14 and 21 days of Cr toxicity; while increased rate was evident upon 7 days of Zn exposure. Changes evident in the rate of cocoon production (-39.54 and +38.63 %), hatchability (-77.85 and +30.0 %) highlight higher toxic potential of Cr than Zn, respectively. Moderate to severe vacuolization in spermatic follicles and higher incidence of tailless (+52.6 % in Cr and 20.8 % in Zn), and head bent (+18.8 % in Cr and 0 % in Zn) sperms were evident in Cr(VI) exposed worms emphasizing the higher vulnerability of E. eugeniae to Cr toxicity. A significant (p < 0.05) increase observed in catalase activity (+13.29 % in Zn and +20.88 % in Cr) and glutathione (+52.09 % in Zn and -7.70 % in Cr) suggests a higher compensatory antioxidant response in Zn-exposed worms than Cr. Variations observed in the activities of superoxide dismutase (-9.40 % in Zn and +24.0 % in Cr) and glutathione-s-transferase (-39.39 % in Zn and +1.29 % in Cr) emphasize the metal specific antioxidant responses in testis. Therefore, it can be implied from results that excessive free radical production and inadequate antioxidant defenses have lead to morphological alterations in sperms which sequentially reduced the reproductive rate.

Assessment of craniometric traits in South Indian dry skulls for sex determination.

The skeleton plays an important role in sex determination in forensic anthropology. The skull bone is considered as the second best after the pelvic bone in sex determination due to its better retention of morphological features. Different populations have varying skeletal characteristics, making population specific analysis for sex determination essential. Hence the objective of this investigation is to obtain the accuracy of sex determination using cranial parameters of adult skulls to the highest percentage in South Indian population and to provide a baseline data for sex determination in South India. Seventy adult preserved human skulls were taken and based on the morphological traits were classified into 43 male skulls and 27 female skulls. A total of 26 craniometric parameters were studied. The data were analyzed by using the SPSS discriminant function. The analysis of stepwise, multivariate, and univariate discriminant function gave an accuracy of 77.1%, 85.7%, and 72.9% respectively. Multivariate direct discriminant function analysis classified skull bones into male and female with highest levels of accuracy. Using stepwise discriminant function analysis, the most dimorphic variable to determine sex of the skull, was biauricular breadth followed by weight. Subjecting the best dimorphic variables to univariate discriminant analysis, high levels of accuracy of sexual dimorphism was obtained. Percentage classification of high accuracies were obtained in this study indicating high level of sexual dimorphism in the crania, setting specific discriminant equations for the gender determination in South Indian people.