Neuroprotective potential of ocimum sanctum (Linn) leaf extract in preventing and attenuating stress induced substantia nigral neuronal damage in rats.

BACKGROUND: In Ayurveda; an Indian system of traditional medicine, Ocimum sanctum is said to have remedial effect on hriddaurbalya (problems affecting the mind), aakshepayukta vikara (nervous disorders) and shiroroga (diseases of head). Hence, in Ayurvedic practice, it is profoundly used as an antistress medicine. Stress is known to affect neurons of functionally significant brain regions like substantia nigra. However, experimental evidence showing its effect on morphology of substantia nigral neurons is lacking. In addition, whether the O. sanctum treatment attenuates stress induced substantia nigral neuronal structural changes is not known. OBJECTIVES: To know the effect of stress on morphology of substantia nigral neurons and the effect of O. sanctum fresh leaf extract (OSE) on substantia nigral neurons of stressed rats. MATERIAL AND METHODS: Present study included three experiments. Experiment I: To study the effect of 3 and 6 weeks of foot shock stress in rats; Experiment II- To study the effect of 3 weeks of OSE treatment on 3 week-stress undergoing rats and on 3 week-stressed rats; Experiment III- To study the effect of 6 weeks of OSE treatment in 6 week-stress undergoing rats and in 6 week-stressed rats. RESULTS: In experiment I, stress had significant deleterious effect on dendritic arborization of substantia nigral neurons. Experiments II and III showed prevention and attenuation of the stress induced dendritic atrophy of substantia nigral neurons in both 2 ml and 4 ml OSE treatment groups. Protective effect of OSE was more pronounced in rats which are treated for a longer duration. CONCLUSIONS: Foot shock stress induces neuronal damage in the substantia nigra of rats. Treatment with fresh leaf extract of O. sanctum could prevent and attenuate the foot shock stress induced behavioral deficit and substantia nigral neuronal damage.

Prevalence of Psychological Distress among Undergraduate Medical Students: A Cross-Sectional Study.

BACKGROUND: Stressful environment in medical school often has a negative effect on students' psychosocial well-being. An in-depth understanding of how medical students experience psychological distress and coping is necessary for the prospective students. OBJECTIVES: To estimate the prevalence of psychological distress among undergraduate medical students and its association with some demographic factors. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted among 380 medical students in the University of the West Indies, Saint Augustine. The questionnaires used in this study consisted of two components - (i) the demographic information that required participants to provide their gender, age, year of study, and nationality and (ii) Depression, Anxiety, and Stress Scale-21 items to measure the levels of psychological distress among participants. RESULTS: Anxiety was the most prevalent psychological distress among medical students, with 63% of them having anxiety symptoms. Depression was found to be the second most common psychological distress, with a prevalence of 51%, while 48% of the students suffered from stress. In further analysis, we found that Trinbagonian students were more depressed than the students from Caribbean Community and other nationality. Higher anxiety score was significantly associated with gender and age of the students. There was a significant association between students from different age groups and level of stress. CONCLUSIONS: A considerable number of students studying medicine are suffering from psychological distress. Intervention programs to address the mental health problems of such students should be initiated.

Medical students' perceptions of small group teaching effectiveness in hybrid curriculum.

OBJECTIVES: The objective of this study was designed to investigate medical students' perceptions of small group teaching effectiveness in a hybrid curriculum. MATERIALS AND METHODS: A cross-sectional, descriptive survey was conducted at the School of Medicine, The University of the West Indies, St. Augustine where we collected the data from 195 undergraduate students. A self-administered questionnaire consisting of 25 items was used to measure students' perception on the effectiveness of problem-based learning (PBL) with regard to learning experience, teamwork, confidence, communication skills, and role of the tutor. Statistical analyses included mean and standard deviation for the description of each item; t-test to compare the mean scores for gender and class year, and one-way analysis of variance between groups for age group comparisons. RESULTS: The students overall perceptions of small group teaching effectiveness showed that the PBL sessions were beneficial to their learning process (mean: 3.63 ± 0.46). Students have positive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.98 ± 0.63) and teamwork (mean: 3.67 ± 0.58). The mean scores, measuring teamwork, for 2nd year students was significantly higher than that for 1st year students (3.76 ± 0.55 and 3.55 ± 0.60 respectively, P = 013). A similar significant trend was observed between 2nd year and 1st year students on communication skills (3.48 ± 0.67 and 3.29 ± 0.55, respectively, P = 0.046). CONCLUSIONS: PBL is an effective small group teaching method for medical students. Faculty development and students' training programs are required before implementing PBL.

Multiple Heads of Gastrocnemius with Bipennate Fiber Arrangement- A Clinically Significant Variation.

It is common to have additional muscles or muscle slips in the extremities. Some of them may compress the nerves and vessels or restrict the movements, while others may enhance the muscular activity. However, a small number of them may go unnoticed. Knowledge of such variant muscles becomes important for plastic surgeons while performing various reconstructive surgeries and for clinicians while managing the pain. A case of multiple heads of gastrocnemius muscle was observed during routine dissection of the right lower limb of about 70-year-old male cadaver. It was observed that the medial head of gastrocnemius was attached to the femur with 3 thick heads and lateral head was arising from the lateral condyle of femur by 3 thick heads. All the heads of the muscles remained separate till they formed tendocalcaneus. Some of these heads showed bipinnate fiber arrangement. All the heads were innervated by the branches of tibial nerve. As the muscle heads passed down from their origin, they entrapped the sural nerve and sural nerve was seen emerging at the beginning of tendocalcaneus. Further, detailed literature and the clinical and surgical importance of the case are discussed.

Looped and Tortuous Ulnar Artery - An Erratic Unilateral Vascular Presentation in the Proximal Forearm.

Precise and detailed knowledge of possible anatomical variations of the arterial pattern in the upper extremity is vital during reparative surgery in this region. Scientific literatures witnessed several reports on variant origin and branching pattern of ulnar artery. But report on looped and tortuous ulnar artery is lacking in the literature. We report here a unique case of ulnar artery having double loop at its commencement giving it an appearance of sigmoid shape and its undue tortuous course in the forearm. Such an unusual and unpredictable variation of ulnar artery is vulnerable for life threatening hemorrhage during clinical approaches. It could also lead to misinterpretation of CT scans as presence of tumours. Awareness on such exceptional anatomical discrepancy of ulnar artery is important to clinicians, neuroradiologists and radiologists in general.

Primary Health Care: Expectations and Tasks for Public Health in Trinidad and Tobago.

The government of Trinidad and Tobago considers that the enjoyment of the highest attainable level of health is a basic right of every citizen and has a goal to achieve health for all by 2020. Thus it lays emphasis on caring and assures standards of excellence to promote, protect and improve the health status of the people of Trinidad and Tobago. To achieve these goals it is very important to increase curative services as well as preventive services in the country. In view of this situation there is a need to overcome the challenges the public health by involving community and individuals and self-reliance to achieve Health for all at 2020. Community participation is one of the domains of community capacity building in a small island country. It is one of the mechanisms to empower people to take part in community development. In this paper, the nature, the dimensions of community participation, and its role and scope in implementation of different components of primary health care have been described. The health services in public and remedial care have been discussed. The article highlights some important milestone achievements in the health sector in Trinidad.

Wound healing activity of the fruit skin of Punica granatum.

The skin of the fruit and the bark of Punica granatum are used as a traditional remedy against diarrhea, dysentery, and intestinal parasites. The fruit skin extract of P. granatum was tested for its wound healing activity in rats using an excision wound model. The animals were divided into three groups of six each. The experimental group of animals was topically treated with P. granatum at a dose of 100 mg/kg every day for 15 days, while the controls and standard group animals were treated with petroleum jelly and mupirocin ointment, respectively. Phytochemical analysis of the extract revealed the presence of saponins, triterpenes, tannins, alkaloids, flavonoids, and cardiac glycosides. Extract-treated animals exhibited 95% reduction in the wound area when compared with controls (84%), which was statistically significant (P<.01). The extract-treated wounds were found to epithelize faster compared with controls. The hydroxyproline content of extract-treated animals was significantly higher than controls (P<.05). The fruit skin extract did not show any antimicrobial activity against the microrganisms tested. P. granatum promotes significant wound healing in rats and further evaluation of this activity in humans is suggested.

Anomalous superficial peroneal nerve and variant cutaneous innervation of the sural nerve on the dorsum of the foot: a case report.

BACKGROUND: The superficial peroneal nerve is a branch of common peroneal nerve. There are reports about the variant course and distribution of this nerve. The sural nerve arises from the tibial nerve in the popliteal fossa. The variations of the above nerves described here are unique and provide significant information to surgeons dissecting lower limb. CASE PRESENTATION: The present case is about some important anatomic variations observed in left lower limb of approximately 55-year-old male cadaver. The variations were; high division of superficial peroneal nerve into medial and lateral branches, lateral branch descending in the anterior intermuscular septum in a peroneal tunnel before piercing the deep fascia and variant distribution of sural nerve on the dorsum of the foot. The probable clinical significances of the variation are discussed. CONCLUSION: Awareness of anatomical variations of superficial peroneal and sural nerves such as those presented here becomes important to avoid injury in real clinical situations.

Ulnar and humeral heads forming separate bellies: a rare case of digastric flexor carpi ulnaris muscle / Cabezas ulnar y humeral formando vientres separados: un caso raro del músculo flexor ulnar del carpo digástri

Proper knowledge of muscular variations is essential for both anatomists and surgeons. Variations of the flexor carpi ulnaris (FCU) are not very common. We are reporting an unusual case of FCU muscle with two bellies. The two heads (ulnar and humeral) of the muscle continued as two separate bellies and the tendons of which joined each other slightly proximal to the wrist before getting inserted to pisiform bone. Further, detailed literature review of variations of FCU muscle is done and the developmental basis for the variation and its surgical importance are discussed.

El correcto conocimiento de las variaciones musculares es esencial para anatomistas y cirujanos. Variaciones del músculo flexor ulnar del carpo (MFUC) no son muy comunes. Se reporta un caso inusual del MFUC con dos vientres. Las dos cabezas (ulnar y humeral) del músculo continuaron como dos vientres separados. Los tendones se unieron entre sí, ligeramente proximal a la muñeca, antes de llegar a su inserción en el hueso pisiforme. Se hace una detallada revisión de la literatura de las variaciones del MFUC y son discutidas las bases del desarrollo de las variaciones, destacándose además su importancia quirúrgica.

Abnormal muscle in the anterior compartment of the forearm: a case report.

During routine dissection for the undergraduate medical students, we encountered an unusual, additional muscle in the anterior compartment of the forearm. This muscle took origin from the anterior surface of the radius in common with the flexor digitorum superficialis muscle. It had a tendon of origin and a tendon of insertion. Its fleshy radial belly and the tendon of insertion, crossed superficial to the median nerve. The muscle was inserted partly to the flexor retinaculum and partly to the undersurface of palmar aponeurosis. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for hand surgeons as it could possibly compress the median nerve because of its close relationship to it.

Anatomical variation of obturator vessels and its practical risk: a case report from an anatomic study / Variação anatômica de vasos obturatórios e seu risco prático: relato de caso de um estudo anatômico

Obturator artery is frequently a branch of anterior division of the internal iliac artery. It has drawn attention of pelvic surgeons, anatomists and radiologists because of the high frequency of variations in its course and origin. The obturator vein is usually described as a tributary of the internal iliac vein. During routine dissection classes to undergraduate medical students we have observed obturator artery arising from external iliac artery, obturator vein draining into external iliac vein, communicating vein between obturator vein and external iliac vein and inferior epigastric artery arising from the obturator artery. The anomalous obturator vessels and inferior epigastric artery in the present case may be in a dangerous situation in pelvic surgeries that require dissection or suturing along the pelvic rim. Developmental reasons and clinical significances of the variations are discussed.

A artéria obturatória é muitas vezes um ramo da divisão anterior da artéria ilíaca interna. Ela tem chamado atenção de cirurgiões pélvicos, anatomistas e radiologistas devido à alta freqüência de variações em seu trajeto e origem. A veia obturatória é geralmente descrita como uma tributária de veia ilíaca interna. Durante aulas de dissecação para estudantes de medicina, observamos a artéria obturatória surgindo a partir da artéria ilíaca externa, veia obturatória drenando para a veia ilíaca externa, veia comunicante entre a veia obturatória e a veia ilíaca externa e artéria epigástrica inferior surgindo a partir da artéria obturatória. Os vasos obturatórios anômalos e a artéria epigástrica inferior no presente caso podem se encontrar em situação perigosa em cirurgias pélvicas que exigem dissecação ou suturas ao longo da borda pélvica. Discutem-se as causas de desenvolvimento e a significância clínica das variações.

Additional muscle slip of flexor carpi ulnaris associated with anomalous ulnar nerve and ulnar artery in the distal forearm / Fascículo adicional del músculo flexor ulnar del carpo asociado con una variación del nervio ulnar y arteria ulnar en la parte distal del antebrazo

During routine dissection classes to under graduate medical students, we observed an anomalous flexor carpi ulnaris muscle associated with abnormal ulnar nerve and ulnar artery in the distal part of forearm. There was an additional belly arising from the lower part of the flexor carpi ulnaris muscle and crossed ulnar nerve and vessels, median nerve and ended in a broad aponeurosis which crossed the tendons of flexor digitorum superficialis and merged with the deep fascia and flexor retinaculum. The ulnar nerve and ulnar artery divided into their terminal branches in the lower part of the forearm. However, the distribution of the terminal branches of both ulnar nerve and artery were normal. An understanding of these unusual findings may be clinically relevant in describing the anterior compartment of the forearm.

Durante una disección de rutina en clases para estudiantes de Medicina, se observó una anomalía del músculo flexor ulnar del carpo asociado con una variación del nervio y arteria ulnar, en la parte distal del antebrazo. Un vientre adicional derivado de la parte inferior del músculo flexor ulnar del carpo cruzaba el nervio ulnar y vasos ulnares, nervio mediano y terminaba en una amplia aponeurosis la cual cruzaba los tendones del músculo flexor superficial de los dedos y se fusionaba con la fascia profunda y el retináculo flexor. El nervio ulnar y la arteria ulnar se dividían en sus ramas terminales, en la parte inferior del antebrazo. Sin embargo, la distribución de las ramas terminales tanto del nervio ulnar como de la arteria ulnar eran normales. La comprensión de estos inusuales hallazgos pueden ser clínicamente relevantes para describir el compartimiento anterior del antebrazo.

Multiple variations in the paired arteries of the abdominal aorta.

Variations in the origin of arteries in the abdomen are very common. The arteries that show frequent variations include the celiac trunk, renal arteries, and gonadal arteries. We observed multiple variations in a 45-year-old male cadaver. The variations found on the left side were: one accessory renal artery, two testicular arteries, and middle suprarenal and inferior phrenic arteries that branched from the celiac trunk. On the right side, the inferior phrenic and middle suprarenal arteries arose from the right renal artery.