Cadaveric Study of Berretini Communications in North Indian Population.

INTRODUCTION: Intercommunication between peripheral nerves deserves special attention in view of their clinical significance. Superficial palmar communication between the median nerve and ulnar nerve is referred to as Berrettini Anastomosis. The presence or absence of this communicating branch varies between individuals. Earlier, incidence of Berretini communication reported varied significantly (4-94%). AIM: The aim of this study was to find out the frequency with which Berretini communication is found in North Indians. MATERIALS AND METHODS: The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar. The whole course of the median nerve and the ulnar nerve was exposed. Communicating rami in the hand were identified, cleaned and photographed. RESULTS: In all the six (10%) variant limbs, the communicating branch originated from lateral common palmar digital branch of ulnar nerve and joined medial common palmar digital branch of median nerve. Single communication with oblique course was seen in all the variants. Further, its ontogeny and clinical implications have been discussed in detail. CONCLUSION: The Berretini anastomosis was seen in 10% upper limbs of the present study. Damage to the communicating branch or the severing of the branch might result in sensory loss which may be difficult to diagnose owing to the large number of variations in the origin of the communicating branch. The patterns of sensory impairment may vary depending upon the branch of median and ulnar nerve it is seen connecting.

Martin-Gruber Anastomosis- A Cadaveric Study in North Indian Population.

INTRODUCTION: Communications between peripheral nerves are important in the light of the fact that these are responsible for a myriad of clinical symptoms. Communication between the median nerve and ulnar nerve (Martin-Gruber anastomosis) is a frequent finding observed anatomically in 10%-30.6% subjects and physiologically in 5-40%. It may lead to exacerbated or attenuated clinical symptoms. AIMS & OBJECTIVES: To find out the incidence of Martin-Gruber anastomosis in North Indian population by cadaveric dissection. MATERIALS AND METHODS: The material comprised of 60 upper limbs belonging to 30 cadavers (M:F::28:2) which were dissected to find out incidence of Martin-Gruber anastomosis. RESULTS: Martin-Gruber anastomosis was encountered in 7(11.6%) limbs of the present study. It was seen more frequently unilaterally (16.6%) than bilaterally (3.3%) and only in males. Classification of limbs into various patterns and types was done. Further its ontogeny, phylogeny, genetic inheritance and clinical implications are discussed in detail. CONCLUSION: To conclude, in North Indian population, the Martin-Gruber anastomosis is encountered in 11.6% limbs.

Morphometric analysis of upper end of tibia.

INTRODUCTION: The present study aims to assess different morphometric parameters of condylar and intercondylar surface of tibia and to compile the results, analyze and formulate a baseline data for future studies with relevance to Indian population and also to compare the current data with accessible literature for pertinent surgical utilities. Morphometric parameters of upper end of tibia can be used to guide treatment and monitor outcome of total knee replacement surgeries. Information regarding morphometry of upper end of the tibia is vital as it provides reliable method of assessing knee deformity. MATERIALS AND METHODS: The study group comprised of 50 male and 50 female adult human tibiae. Morphometric measurements of medial condyle, lateral condyle and intercondylar area of tibiae were meticulously recorded with digital Vernier calipers with a least count of 0.01 mm. Student's t-test was used with significant level of p-value < 0.05 and 95% confidence interval. RESULTS: All measurements were found to be statistically significant when compared between the two sexes on both sides (p-value<0.05). Anteroposterior measurements were found to be greater than transverse measurements for both medial and lateral condyles. Furthermore, both anteroposterior and transverse measurements were greater in medial condyle than in lateral condyle on both sides and sexes. CONCLUSION: The present study is an endeavor to provide a base line data pertaining to morphometric details of upper end of tibia with reference to unicompartmental and total knee arthroplasty in Indian population. The results of the study assume special importance in view of the technical advancements in reconstructive surgical procedures in orthopedic practice.

A study of calcaneal enthesophytes (spurs) in Indian population.

INTRODUCTION: Calcaneus or os calcis forms a major component of the skeleton of foot providing posterior pillars for bony arches of the foot. It is largest of seven tarsal bones of foot and forms prominence of heel. Many times anterior to calcaneal tuberosity an osteophytic outgrowth has been observed (calcaneal or heel spur) extending along entire width, for about 2-2.5 cm. The apex of spur seen embedded in plantar fascia, directly anterior to its origin. Hence, the study of calcaneal spurs has been undertaken. MATERIALS AND METHODS: The material for the study consisted of 200 dry (100 right and 100 left), adult calcanei of unknown age and sex obtained from Department of Anatomy. The calcaneal enthesophytes/spurs were studied in detail and classified according to types of calcaneum. RESULTS: Maximum incidence of calcaneal spurs were found in Type I calcanei (11%) and no calcaneal spurs were found in Type III calcanei. Total incidence of dorsal calcaneal spurs in all types of calcanei was maximal (15.5%). The incidence of plantar spurs was 6.5% being highest in Type I calcanei (4%). The incidence and type of calcaneal spurs were compared with those of previous studies and etiology of heel pain has been discussed. Correlation between type of calcanei and spurs has been studied for the 1(st) time. CONCLUSION: Calcaneal spurs are related to type of calcanei with the highest frequency in Type I and least in Type III (no spurs seen in Type III and least in Type IV). Other factors, which contribute toward increase in incidence of spurs, are increasing age and weight, concurrent orthopedic diseases, and heel pain.

Human tibial torsion--morphometric assessment and clinical relevance.

BACKGROUND: Tibial torsion is an important anatomical parameter in clinical practice and displays variability among individuals. These variations are extremely significant in view of alignment guides such as those related to rotational landmarks of tibia in total knee arthroplasty. Further, precise knowledge and information pertaining to angle of tibial torsion also helps in correction of traumatic malunion or congenital maltorsion of tibia. METHODS: The present study was carried out to determine the angle of tibial torsion in 100 adult dry tibia bones in the Department of Anatomy, Government Medical College, Amritsar. The study group comprised 50 males and 50 females with equal number of right- and left-sided bones. The measurements were meticulously recorded and the data were subjected to statistical analysis. The results were analyzed and discussed in the light of existing literature. RESULTS: On the right side, it was found to be 29.84° ± 4.86°° (range = 22.00° -38.00°) in males and 28.92° ± 5.10°° (range = 15.00°-38.00°) in females. On the left side, it was found to be 28.00° ± 4.94°° (range = 20.00°-40.00°°) in males and 28.12° ± 4.28°° (range = 20.00°-37.00°°) in females. CONCLUSION: The present study is an endeavor to provide baseline data with reference to the angle of tibial torsion in the Indian population. The results of the study assume special importance in view of the technical advancements in reconstructive surgical procedures in orthopedic practice.

A cadaveric study of different angles of scapula and their role in kinesiometrics and muscle morphology.

INTRODUCTION: The bipedal gait and consequential freedom of the upper limb in human beings has made the movements of the shoulder joint a subject of extensive investigations. The scapular angles provide the base and leverage to various muscles and have been correlated with the different movements of the shoulder joint. METHODS: In the present study, different angles of scapula namely superior, inferior, lateral, medial, acromial and coracoid angles were measured in the North Indian population. The study was conducted on 100 scapulas (R:L=50:50) obtained from Department of Anatomy, Government Medical College, Amritsar. For measuring the angles, centimetre scales and protractor were used. RESULTS: The mean value of superior angle was observed to be 100.830 (R=100.320 : L=101.340); inferior angle was 63.620 (R=68.10:L=59.140); lateral angle was 61.720 (R=65.90 : L=57.540); medial angle was 147.640 (R=151.320 : L=143.960); acromial angle was 106.470 (R=107.680 : L=105.260) and coracoid angle was 83.30 (R=84.240:L=82.020). CONCLUSIONS: It was observed that all angles were higher in the right sided bones except superior angle. Also a wide range was seen in all the angles.

Bioremediation of pharmaceuticals, pesticides, and petrochemicals with gomeya/cow dung.

Use and misuse of pharmaceuticals, pesticides, and petrochemicals by man is causing havoc with nature, as they persist as such or as their toxic metabolites. These pollutants bioaccumulate in environment, and they ultimately reach man through various means. They are hazardous because of potential toxicity, mutagenicity, carcinogenicity, and genotoxicity. To rejuvenate nature, remediation methods currently available are usually expensive and might convert one toxic pollutant to another. Bioremediation methods use naturally occurring microorganisms to detoxify man-made pollutants so that they change pollutants to innocuous products that make soil fertile in the process. Taking cue from Ayurveda, Gomeya/cow dung is used as an excellent bioremediation method. Thus, utilizing freely available cow dung as slurry or after composting in rural areas, is a cheap and effective measure to bioremediate the harmful pollutants. Yet, more research in this direction is warranted to bioremediate nonbiodegradable, potentially toxic pollutants.

Bioenhancers from mother nature and their applicability in modern medicine.

Concept of bioenhancers or biopotentiators was first time reported in 1929 by Bose. A bioenhancer is an agent capable of enhancing bioavailability and efficacy of a drug with which it is co-administered, without any pharmacological activity of its own at therapeutic dose used. Development and consequent isolation of these molecules, such as piperine and quercetin, is considered as scientific breakthrough. A fixed drug combination (Risorine) of rifampicin, isoniazid, and piperine is the result of this research. It contains almost 60% less dose of rifampicin because of its increased bioavailability and it also prevents resistance. This concept is mentioned as yogvahi in ayurveda and was used to increase the effect of medicines by increasing oral bioavailability, decreasing adverse effects and to circumvent parenteral routes of drug administration. More such useful and economically viable drug combinations can be developed by integrating knowledge of time tested ayurveda with modern methods of research. This review is an account of these bioenhancers, available from the natural resources.