Magnetic resonance angiography of hypoplastic A1 segment of anterior cerebral artery at 3.0-Tesla in Andhra Pradesh population of India.

Pre-communicating or A1 segment of anterior cerebral artery (A1ACA) hypoplasia can negotiate the anterior cerebral circulation. Not many studies have been examined the association of hypoplastic A1ACA and cerebral ischemic stroke (CIS). In this study the authors' want to accomplish the relationship between hypoplastic A1ACA and outcomes among the patients with CIS in Andhra Pradesh population of India. Retrospective review of prospectively identified 201 adult patients with CIS from 2015 to 2017 was achieved. Patients underwent 3.0T intracranial magnetic resonance angiography were compared with clinical and radiological aspects between male and female cases of A1ACA hypoplasia with associated variations in the circle of Willis. The obtained data was statistically analysed using SPSS software version 16.0 for Windows and P-value <0.05 was considered as significant. Chi-square test was applied to find out the association between the sex and incidence of hypoplastic A1ACA. Sixty-four of 201 patients with A1ACA hypoplasia with no aplastic cases were recorded. It was found to be more in males than females and common on right than left side. Frequent neurological indications such as headache, dizziness, visual instability, nausea, weakness of extremities and seizure were noted and most cases were associated with CIS. Hypoplastic A1ACA often associated with ischemia of terminal branches of ipsilateral ACA which is compromised by the blood flow via contralateral ACA. In this study, though the CIS is not directly related to hypoplastic A1ACA, any alterations in A1 segment is a considerable risk factor of stroke.

Incidence of Foramen of Huschke in South Andhra Population of India.

INTRODUCTION: Foramen of Huschke (FH) is an opening present in anteroinferior wall of External Acoustic Meatus (EAM) on the tympanic plate of temporal bone. The developing tympanic ring normally gets closed by the age of 5 years, if not, leads to the persistence of FH, shows a communication between the EAM and mandibular fossa of temporal bone. AIM: The aim of the present study was to report on the incidence of FH in adult skulls and individual temporal bones, belonging to South Coastal Andhra population. MATERIALS AND METHODS: Ninety three skulls and 34 temporal bones (18 right and 16 left) obtained from the Department of Anatomy and ENT respectively, irrespective of their sex were utilized. This Tympanic Plates (TP) was observed for the occurrence of FH. RESULTS: Incidence of FH was found in 18 (16.22%) on right and 24 (22.02%) on left side. Bilateral FH was seen in 13 (13.98%) and multiple FH was 13 (5.91%). Mostly it was situated on left than the right side. CONCLUSION: This study revealed that about 38% of South Coastal Andhra crania have FH. The presence of FH may render external and middle ear structures vulnerable to injury during arthroscopy of the Temporomandibular Joint (TMJ). Since FH can result in TMJ herniation and salivary gland fistulisation through the anterior wall of the bony EAM, surgeons working in this area must be cautious during surgical procedures. Also, data obtained from different populations, as observed from our study can be useful in racial and anthropological studies.

Histomorphological and morphometrical changes of placental terminal villi of normotensive and preeclamptic mothers.

Placental morphology and cellular arrangement are altered in maternal diseases such as preeclampsia (PE) in which oxygen delivery from the mother to the fetus is greatly disturbed, ultimately resulting in cellular oxidative stress. The present study was conducted at the Department of Anatomy and included 112 placentas (56 each from mothers with and without PE [controls]) collected at the Department of Obstetrics and Gynecology. A histological study was performed using hematoxylin and eosin staining. The morphology of stem and terminal villi (TV) was studied, and the surface area and diameter of TV and capillaries were measured. The gross placental morphometrical study revealed that the mean placental weight, thickness, diameter, and surface area were significantly lower in placentas with PE than in controls. The histomorphometrical findings of the villous surface area and diameter were lower in placentas with PE, whereas the TV density was higher in placentas with PE than in controls, and the differences were significant (P<0.0001). In these TV, the diameter and density of fetal blood vessels of placentas with PE were significantly lower than those of controls (P<0.05). In conclusion, the both morphological and histological changes in PE placentas are indicative of the pathogenesis of maternal and fetal morbidity and mortality in women with PE. The observed and comparative histomorphometrical changes indicate a decline in all aspects of the PE placenta, except the number of TV.

Bilateral absence of musculocutaneous nerve with unusual branching pattern of lateral cord and median nerve of brachial plexus.

A 43-year-old female cadaver showed a complete bilateral absence of the musculocutaneous nerve. The anterior compartment muscles of both arms were supplied by median nerve excepting the coracobrachialis which was innervated by a direct branch from the lateral cord of brachial plexus. The median nerve, after supplying the biceps and brachialis muscles, gave onto the lateral cutaneous nerve of the forearm. The median nerve also showed variation on the left side where it was formed by two lateral roots and one medial root. Variations of the brachial plexus are of great interest to anatomists, clinicians and surgeons, in that they may be incorporated in their day to day practice. Our present case may be noted for its clinical and surgical significance in the variations of brachial plexus which can be useful for diagnostic purposes.

Vasculosyncytial membrane in relation to syncytial knots complicates the placenta in preeclampsia: a histomorphometrical study.

The vasculosyncytial membrane (VSM), primary site of fetomaternal exchange is formed when syncytiotrophoblast surrounds the terminal villi and make a close contact with capillaries. Some syncytiotrophoblast forms thin single layer of villous and some syncytial nuclei become piled up to form the syncytial knots (SKs). Undoubtedly there is a clear-cut inverse relation between villous VSM and fetal hypoxia. In preeclampsia (PE) the hypoxia injury disrupts the syncytial architecture which in turn initiates other complications of PE. Present study was designed to observe the morphological and histomorphometric features of 84 placentas from control and PE (42 each) collected from Department of Obstetrics and Gynecology. Neonatal weight and placental weight were reduced in PE than the controls but the feto-placental index did not differ. The SK density and VSM thickness was found to be increased and was statistically significant in PE cases. In relation to SKs, the VSM thickness was twofold increased than the controls and was statistically significant. The SKs in the present study were classified as type-1, 2a, 2b, and 3. Type 1 was found to be 62% in control and 47% in PE, type 2a and 2b were 38% in control and 37% in PE, and type 3 was in 8% of PE cases. All the parameters of present study reveal the adverse effects of PE influencing on both morphological and microscopical features of the placenta resulting in fetal hypoxia.

Interparietal and pre-interparietal bones in the population of south coastal Andhra Pradesh, India.

The squamous occipital bone consists of two parts: a cartilaginous supraoccipital part below and a membranous interparietal (IP) part above the highest nuchal line. The IP part develops from two pairs of ossification centres which form the two lateral plates and a median central piece. Any anomalous ossification of these centres gives rise to IP bones. Occasional separate ossified part of the IP region give rise pre-interparietal (PIP) bones which, when present, should be within the territory of the lambdoid suture. The present study was undertaken to observe the incidence of IP and PIP bones in skulls belonging to the south coastal population of Andhra Pradesh, India, hitherto unreported. In a total of 84 skulls, IP bones were found in 8 (9.5%) skulls and PIP bones in 6 (7.1%) skulls. The occurrence of IP and PIP bones can be correlated with the development of the squamous part of the occipital bones, and any alterations in the fusion of its ossification centres and its nuclei result in these anomalous bones. Knowledge of these bones may be important in dealing with situations resulting from fractures of occipital bones, and to rule out their incidence between races or populations in different parts of the world.

Incidence of agenesis of palmaris longus in the Andhra population of India.

BACKGROUND: The knowledge of Palmaris longus (PL) is a growing interest for its wide role in reconstructive plastic surgeries as a donor tendon for transfer or transplant. The prevalence of the PL agenesis has been well-documented by many authors in different ethnic groups or populations. Many conventional tests for determining the presence of the PL has been described, but lamentably there are many discrepancies in confirming its presence or absence. Slight modifications of the prevailing methods can still give authenticate results. AIM: This prospective study was conducted to determine the incidence of unilateral and bilateral agenesis of PL and its association with sex and side of the limb in the Andhra population of India. MATERIALS AND METHODS: A total of 942 subjects of both sexes belonging to 18-23 years were used to access the PL using various tendon examination techniques including our modified Schaeffer's test. The data collected were analyzed by Pearsons χ(2) test using SPSS software. RESULTS: Overall agenesis of muscle in both sexes was 264 (28.0%), out of which 40.2% was seen in females and 14.7% in males with the ratio of 3:1. The unilateral agenesis was seen in 70.5% and bilateral agenesis in 29.5% subjects. The left side agenesis was seen in 51.6% and right side in 48.4% subjects. CONCLUSIONS: The prevalence of bilateral and unilateral agenesis was more common on left side with a greater likelihood in the female subjects. The proposed technique could bring better results in all subjects and can be implemented in manual examination of PL.

Variant Anatomy of the Celiac Trunk and its Branches / Variación Anatómica del Tronco Celíaco y sus Ramas

The knowledge of abdominal vascular anatomy is very important for surgeons and radiologists to perform many of the clinical diagnostic evaluations. The celiac trunk, one of the branches of the abdominal aorta shows numerous variations in its branching pattern and its branches. The present study is to demonstrate the rare branching pattern of celiac trunk, into hepatogastric and hepatosplenic trunks. The hepatogastric trunk divided into left gastric and accessory left hepatic arteries and the hepatosplenic into common hepatic and splenic artery. The inferior phrenic artery was arising from left gastric artery. The gastroduodenal artery divided into right gastroepiploic artery and a common trunk for right gastric and anterior superior pancreaticoduodenal artery. The posterior superior pancreatico-duodenal artery was arising directly from the gastroduodenal artery and supraduodenal from proper hepatic artery. The variant anatomy of the celiac trunk as found in the present case may be clinically significant during invasive procedures like angiography, chemotherapy, chemoembolization and other surgical conditions of the abdomen.

El conocimiento de la anatomía vascular abdominal es importante para los cirujanos y radiólogos para realizar las evaluaciones de diagnóstico clínico. El tronco celíaco, una de las ramas de la parte abdominal de la aorta presenta numerosas variaciones en su patrón de ramificación y sus ramas colaterales. El presente estudio muestra un raro patrón de ramificación del tronco celíaco, en los troncos hepatogástrico y hepatoesplénico. El tronco hepatogástrico se dividió en las arterias gástrica izquierda y accesoria hepática izquierda, mientras que el hepatoesplénico en las arterias hepática común y esplénica. La arteria frénica inferior se originó desde la arteria gástrica izquierda. La arteria gastroduodenal se dividió en la arteria gastroepiploica derecha y en un tronco común para las arterias gástrica y pancreaticoduodenal anterosuperior. La arteria pancreaticoduodenal posterosuperior se originó directamente de la arteria gastroduodenal y la arteria supraduodenal de la arteria hepática. La variaciónanatómica del tronco celíaco presente en este caso puede ser clínicamente significativa durante procedimientos invasivos como la angiografía, quimioterapia, quimioembolización y afecciones quirúrgicas del abdomen.