Variation in the formation of the retromandibular and the external jugular veins with embryological overview: A case report.

Awareness of the formation and termination of the head & neck's superficial vein, such as jugular veins, are imperative for anatomists, surgeons, and radiologists during interventional procedures. We report an uncommon variation in the formation of the retromandibular vein and external jugular vein (EJV) in an embalmed male cadaver's right side. The joining of the facial vein and superficial temporal vein within the parotid gland formed the retromandibular vein (RMV). The anterior division joined with the submental vein forming an anomalous venous trunk. The anomalous vein united with the EJV forming a common trunk in the lower third of the neck and terminated into the subclavian vein. We compared the available literature and justified the embryological development of this rare variation.

Influence of pretesting and a near peer sharing real life experiences on CPR training outcomes in first year medical students: a non-randomized quasi-experimental study.

BACKGROUND: Existing literature on cardiopulmonary resuscitation (CPR) training focuses on the knowledge and skill components while the attitudinal component is rarely addressed. There is a need to explore how peer interaction, learning atmosphere, and communication influence learning effectiveness during CPR training. Therefore, this study's objective was to evaluate how a senior student (near peer) sharing their real-life experience of performing CPR would influence medical students' learning and readiness to perform CPR. METHODS: The present study involved 250 newly enrolled undergraduate medical students. The Solomon's four-group study design was used to evaluate the influence of both pretesting and peer interaction. Students belonging to two groups initially completed a pre-training knowledge test (pretest) and a questionnaire on readiness to perform CPR. Students from all four groups then participated in instructor-led hands-on skills training, after which the two intervention groups interacted with their senior, who shared their life experiences of performing CPR. Finally, all four groups underwent skills evaluation, immediate and delayed post-tests, and completed a questionnaire to assess readiness to perform CPR. The students also provided their feedback on the experience of interacting with a peer during the training. RESULTS: Post-test scores were significantly higher than pretest scores (Kruskal-Wallis test, p < 0.05). Scores were significantly higher in pretested intervention groups than in the non-pretested non-intervention group (p < 0.05). Delayed post-test scores were slightly but not significantly lower than the immediate post-test scores with no significant difference observed in the scores among the groups. The pretested groups showed more readiness to perform CPR and the pretested intervention group were least concerned about acquiring infection during CPR. Students in all groups were confident of performing chest compressions correctly, and found it inspiring and motivating listening to and discussing real-life experiences with a near peer. CONCLUSIONS: Hearing from peers about real-life CPR experience during CPR training sessions significantly impacted learning, enhanced student motivation to learn and may be an effective strategy to consider in routine CPR training. However, the positive effects of pretesting and peer interaction on knowledge were not sustained, highlighting a need for repeat training.

Diversity in approach to teaching and assessing ethics education for medical undergraduates: A scoping review.

There are diverse methods to teach medical ethics, and there is no single accepted approach towards its learning and assessment. The authors aim to explore the various strategies practised to teach undergraduate medical students the fundamentals of medical ethics and their evaluation. The authors reviewed the articles published from January 2014 to September 2019. The authors searched PubMed for the relevant publications and extracted the information using a data extraction sheet. Twenty-nine articles were included for the review, which fulfilled the inclusion criteria. Case-based discussions were a widely accepted strategy to learn ethics. The studies highlighted a mixed teaching approach using multiple teaching tools. A qualitative approach was preferred for the assessment through reflections, simulated patient interactions, and development of portfolios. However, there are gaps in the existing literature on the assessment strategies for ethics education. Heterogeneity still exists in the planning of the curricula, teaching, and assessment methods. These curricula suit the cultural and religious set up of that particular country. Case-based discussion is a popular teaching strategy, and there exist numerous innovative and cost-effective active teaching strategies. There is a need for studies that are more rigorous to address the evaluation of the ethics curricula. This review would help educators to choose their preferred approach based on their teaching environment.

Effect of Diabetes on the Male Reproductive System­A Histomorphological Study

Introduction Type 1 diabetes is an autoimmune disorder characterized by lack of insulin production by the ß cells of the pancreas. This lack of insulin causes a variety of systemic effects on the metabolism of the body, one of which is reproductive dysfunction. The present study investigates the effects of diabetes on the male reproductive system of streptozotocin (STZ)-induced diabetic rats. Material and Methods A total of 18 adult male Wistar rats weighing between 250 and 300 g were included in the present study. The animals were divided into normal and diabetic groups. The diabetic group was further subdivided into 2 subgroups with durations of 24 and 48 days. A single dose of STZ (40 mg/kg body weight) was administrated intraperitoneally to the animals of the diabetic group. After the planned duration, the testes and epididymides were dissected, and their gross weight was measured. The tissues were then processed for histological study. Results The gross weight of the testes and epididymides in diabetic rats at 24 and 48 days showed a decrease in comparison to the control. (p < 0.01 for testes and epididymides). Diabetic animals presented a significant decrease in the diameter of the seminiferous tubules compared with the control group (p < 0.01). The epididymides in the diabetic groups showed a considerable reduction in the tubular surface area compared with the control group (p < 0.01). There was also a reduction in the mean diameter, which was measured using the maximum and minimum diameter of the tubules (p < 0.01). Conclusion The present study is an insight into the adverse effects that diabetes can have on the tissue structure of the testes, of the epididymides, and ultimately on the process of spermatogenesis.

Development of the Gall Bladder, and Caudate and Quadrate Lobes of the Liver: A Fetal Morphometric Study.

INTRODUCTION: The gall bladder (GB) is a storage reservoir that allows bile acids to be delivered in a high concentration. The quadrate (QL) and caudate lobes (CL) are functional parts of the liver. The knowledge of the gross and developmental anatomy of GB and CL and QL of liver is important for surgeons who operate in this region. The present study was conducted to examine the developmental sequence and morphometry of the GB, and CL and QL of liver. MATERIALS AND METHODS: In the present cross sectional study the parameters measured were length of GB from the neck to the lowest point on the fundus, and the length and width of QL and CL measured at the midpoint. The data was analyzed statistically and the various parameters were correlated using Pearson's correlation. RESULTS: There was a statistically significant correlation indicating that the growth of GB, QL and CL was proportional to the gestational age (GA). The variations in the morphology of the GB were also noted. In two specimens it was found that the GB was embedded partially in the substance of the liver and failed to reach the inferior border of the liver. CONCLUSION: The regression equations calculated in the study provide a tool to estimate the lengths of GB, QL and CL prenatally.

Histological and biochemical study of the superficial abdominal fascia and its implication in obesity.

The advancement of liposculpturing and fascial flaps in reconstructive surgery has renewed interest in the superficial fascia of abdomen. Its histological and biochemical composition may play a vital role in maintaining strength and elasticity of the fascia. Hence, study of abdominal fascia for the elastic, collagen, and hydroxyproline contents is desirable to understand asymmetrical bulges and skin folds and in improving surgical treatment of obesity. Samples of superficial fascia were collected from of upper and lower abdomen from 21 fresh cadavers (15 males and 6 females). Samples were stained using Verhoeff-Van Gieson stain. Digital images of superficial fascia were analyzed using TissueQuant software. The samples were also subjected to hydroxyproline estimation. The superficial fascia was formed by loosely packed collagen fibers mixed with abundant elastic fibers and adipose tissue. Elastic contents and collagen contents of superficial fascia were significantly more in the upper abdomen than that in the lower abdomen in males. Hydroxyproline content of superficial fascia of upper abdomen was significantly more than that of lower abdomen in both males and females. The elastic, collagen and hydroxyproline contents of superficial fascia of upper abdomen were higher compared to the lower abdomen. This may be a reason for asymmetric bulging over abdomen and more sagging fold of skin in the lower abdomen than in the upper abdomen. This study may therefore be helpful in finding new ways to manage obesity and other body contour deformities.

A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity.

INTRODUCTION: The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. AIM: The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. MATERIALS AND METHODS: The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. RESULTS: There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female. CONCLUSION: The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of subcutaneous abdominal fat towards resorption.

Morphometric Study of Anterior Clinoid Process and Optic Strut and the Ossification of Carotico-Clinoid Ligament with their Clinical Importance.

INTRODUCTION: Knowledge about the ossification of the Carotico-Clinoid Foramen (CCF), as it forms a potential site for compression of the internal carotid artery may be beneficial for neurosurgeons and radiologists. AIM: To obtain a detailed knowledge of morphometry of Anterior Clinoid Process (ACP) and Optic Strot (OS) and the type of ossification of CCF which would be necessary to increase the success of surgeries related to the cavernous sinus and internal carotid artery. MATERIALS AND METHODS: Parameters such as the length of ACP from its base to the tip, the width at its base and the distance between the tip of ACP to optic strut were measured in mm using digital calipers. SPSS version 17 was used for the statistical analysis. Paired t-test was applied to compare between right and left sides. Presence of carotico-clinoid foramen was observed and was classified as incomplete, contact form or complete. RESULTS: The average length of ACP ranged from 12 to 15mm on right side and 11 to 16mm on the left side. Paired t-test was applied to compare the means between the right and left sides. The width of ACP varied between right and left sides and this difference was statistically significant (p<0.05). Out of 12 CCF observed, the commonest type was incomplete (N=7) followed by complete (N=3) and contact form (N=2). CONCLUSION: Considering the immense anatomical surgical and radiological importance of morphology of ACP, OS and CCF, this study highlighted the detailed morphometry of these structures. The study also has explained the sexual dimorphism in their morphology.

Cytokinesis blocked micronucleus assay of peripheral lymphocytes revealing the genotoxic effect of formaldehyde exposure.

Formaldehyde (FA), which is said to be a carcinogenic agent, is commonly used in anatomy laboratories. This study used the cytokinesis blocked micronucleus assay (CBMN) to assess DNA damage due to FA exposure by measuring the frequency of micronuclei (MN) in lymphocytes. The extent of DNA damage was assessed with respect to the duration of exposure. Thirty male anatomy laboratory workers from various medical colleges involved with storing specimens and embalming were included in the study. Thirty males who were not exposed to FA were included as a comparison group. Blood samples were collected after informed consent was given. Information regarding age, duration of FA exposure and smoking habits was obtained by a questionnaire. The CBMN assay was conducted on cultured isolated lymphocytes stained with Giemsa. MN were counted in a total of 1000 binucleated lymphocytes. The effect of smoking was assessed using appropriate statistical tests. The frequency of MN in lymphocytes was significantly higher in the exposed group (P < 0.001). The duration of exposure correlated positively with the frequency of MN (r = 0.5, P = 0.02). Neither aging nor smoking correlated significantly with the formation of MN. The present study highlights significant DNA damage in people exposed to FA. The extent of damage was directly proportional to the duration of exposure.