Reappraisal of the anatomical diversities of the pyramidalis muscle with their potential clinical applicability: cadaveric analysis.

INTRODUCTION: The present study examined the morphology and morphometric parameters of the pyramidalis muscle (PM) in detail with their potential applicability in making midline infra-umbilical incisions and biomechanics of the linea alba. METHODS: PM was examined in 51 formalin-fixed cadavers (36 males and 15 females), and based on the mode of insertion or the level of apex, the formation or shape of the muscle was classified into nine types (Mori's classification). RESULTS: Bilateral PM was more prevalent (39.21%) than unilateral (1.96%) (p = 0.001). All the cases showed side symmetry except one. Mori's type 7 (right PM is higher apex and the left PM with elongated origin) was the most common form. The mean length of PM in males and females was 4.51 ± 0.14 and 3.33 ± 0.12 cm on the right and 4.51 ± 0.11 and 3.26 ± 0.16 cm on the left side. The mean width of right-sided PMs in males and females was 1.90 ± 0.17 and 1.58 ± 0.13 cm and left-sided 1.88 ± 0.14 and 1.55 ± 0.38 cm. The mean of pyramidalis-pubo-umbilical index (PPI) in males and females was 32.82 ± 1.65 and 27.50 ± 1.08, respectively. The mean insertion angle was 24.56 ± 3.07 on right side and 23 ± 2.03 on the left side (p = 0.03). Male predominance existed on right- and left-sided PM length (p < 0.001 and p < 0.001), width (p = 0.001) and PPI (p = 0.001). The strong positive correlation (r = 0.83) between length and width indicates a symmetrical muscle augmentation in the two dimensions. CONCLUSION: PM is an inconsistent anatomical structure with persistent morphology. The level and angle of insertion into the linea are crucial in the biomechanics of linea alba. PPI, determining the termination level would be useful to surgeons making midline infra-umbilical incisions.

A Closer Look at Anatomy Educator Safety: Identifying and Preventing Workplace Hazards: A narrative review.

Abstract: Anatomy, one of medicine's vital subjects, demands extreme visualization to understand the intricate architecture of the human body. Although various other methods of virtual dissections are in place, an increasing number of anatomists, clinicians, and surgeons are advocating for re-enhancing anatomical education through traditional cadaveric dissection. These traditional pedagogies potentially expose anatomy educators to various risks in the dissection laboratory, which endangers their health and well-being. Unfortunately, no one is counting on them or the hazards they face. It's like saying, "Fall ill at your own peril." Various studies have revealed the occupational hazards anatomists are exposed to, but the issue remains unheard of or relatively heard. Hence, this narrative review aims to highlight numerous occupational risks that anatomists face worldwide, particularly in underdeveloped or developing nations. Simultaneously, the authors strongly advocate that competent authorities review and evaluate the working conditions of anatomy laboratories and frame policies that ensure the rights and optimal health of anatomy educators.

The morphological and morphometric analysis of the variant patterns of the tricipital aponeurosis: a new anatomical classification with possible clinical implications.

BACKGROUND: Tricipital aponeurosis (TA) has gained attraction as a constant and reliable landmark to identify the location of radial nerve in the setting of fracture distal humeri. The aponeurosis itself shows variant anatomical patterns. In this study, we intend to provide a comprehensive description and functional classification of observed anatomical variations with possible clinical implications. MATERIALS AND METHODS: Sixty arms belonging to 30 adult cadavers were studied. TA was examined grossly to document variations in its shape and classified accordingly. Subsequently, length and breadth of TA were measured. The distance of the radial nerve (RN) from the point of confluence and from the lateral border of TA was also measured (tricepso-radial distance [TRD]). These distances were correlated with the different patterns of TA obtained. RESULTS: Based on the shape of the proximal apex of TA or point of confluence and frequency of their occurrence, we propose a new classification of 4 patterns for the TA anatomy. Pattern I: classically seen as the triangular proximal apex (76.67%); pattern II: tongue shaped or blunt proximal apex (18.33%); pattern III: bifurcated or dual proximal apex (3.33%); pattern IV: as the absence of TA (1.67%). The mean of length and breadth of TA was 16.58 ± 2.05 cm and 3.61 ± 0.61 cm, respectively. The mean distance of RN from point of confluence and lateral border of TA was 3.57 ± 0.19 cm and 2.04 ± 0.56 cm, respectively. The length, breadth of TA and TRD differs amongst the different patterns of TA. CONCLUSIONS: Anatomical variations in the shape and size of TA are frequently encountered. The proposed, hitherto undescribed, classification may make operating surgeon aware of these morphological variations and help prevent iatrogenic injury to RN. Such classification is simple and unique; however, its success relies upon universal acceptance.

Caries preventive practices and dental caries among boys aged 6-15 in Saudi Arabia.

AIM: The aim of the present study was to assess caries preventive practices and dental caries among boys aged 6-15 in Saudi Arabia. MATERIALS AND METHODS: The present cross-sectional study included a sampling frame of all male school students aged 6-15 years in a subpopulation of Saudi Arabia. A questionnaire was developed to collect information from mothers on the use of recommended caries preventive practices (RCPP) by the child. Children were examined clinically for dental caries status using DMFT index. RESULTS: A total of 722 children and respective mothers participated in the study. The mean DMFT scores were significantly greater in children with no RCPP than those who used at least a single RCPP and a combination of RCPP (p<0.05). Regression analysis revealed that all RCPP were significantly associated with dental caries (p<0.05). Children not using any RCPP tool had higher risk of developing dental caries (OR 8.69; 95% CI 6.38-11.83). CONCLUSION: Brushing teeth at least twice a day, use of fluoridated toothpaste and consumption of sugary snacks less than once a day have significant influence in occurrence of dental caries. Using all RCPP tools were more effective in caries prevention than used individually.

Thermoreversible gel for intrapocket delivery of green tea catechin as a local drug delivery system: An original research.

The periodontal therapies along with systemic antibiotic therapy aim at eliminating the subgingival microbiota to arrest the progression of periodontal diseases. The complete elimination is often difficult, and thus the probability of repopulation after periodontal therapy is also high. The objectives of the study are to develop in situ thermoreversible gelling system of green tea catechins suitable for periodontal pocket administration, which would act as an adjunct to mechanical periodontal therapy. Gel is prepared on a weight basis using a cold process. In vitro drug release pattern is observed through spectrophotometer analysis at 277 nm. The gel is subjected to serial dilution analysis to determine the minimum inhibitory concentration (MIC) and disc diffusion analysis to determine the in vitro antibacterial effectiveness. Release pattern studies showed a complete release of drug from gel occurred by 36 h. A volume of 1.25 mg/ml was determined as MIC required against the periodontal pathogens. Disc diffusion analysis showed a 14 mm zone of inhibition is present around the 75 µl well for all the four species and 12 mm zone of inhibition around the 50 µl well. The advantage of F-127 is its thermoreversible nature that used for in situ gel formulation. Pluronic gel proved to be a promising carrier for prolong and effective release of green tea catechin.

Assessment and Correlation of Urea and Creatinine Levels in Saliva and Serum of Patients with Chronic Kidney Disease, Diabetes and Hypertension- A Research Study.

INTRODUCTION: Serum urea and creatinine are most widely accepted parameters to assess Chronic Kidney Disease (CKD)status as well as to assess renal status in susceptible diabetic and hypertensive subjects. AIM: To assess and correlate the serum and salivary urea and creatinine levels of CKD, diabetes mellitus and hypertensive subjects. MATERIALS AND METHODS: This cross-sectional study was done on 120 subjects involving 30 CKD, 30 diabetic, 30 hypertensive subjects and 30 healthy controls. After collection of saliva and blood samples, urea was analyzed by enzymatic calorimetric method and creatinine by Jaffe's method. Kruskal Wallis test and Mann Whitney U test were used for comparison between different groups and correlations between serum and salivary parameters were evaluated by applying Spearman's correlation test. The p-value <0.05 was considered statistically significant. RESULTS: The median serum and salivary urea and creatinine levels were highest in CKD group followed by diabetic, hypertensive groups and controls. The correlation coefficient for serum urea and salivary urea was 0.977 and for serum creatinine and salivary creatinine was 0.976, with p-value <0.001. CONCLUSION: This study showed that there is a significant positive relationship between salivary and serum urea and creatinine. Thus, salivary urea and creatinine levels can be used non-invasively to detect serum urea and creatinine levels respectively in renal disease and diabetic and hypertensive nephropathic cases.

Morphometric Analysis of Axis and Its Clinical Significance -An Anatomical Study of Indian Human Axis Vertebrae.

BACKGROUND: The atlas and axis vertebra have unique shape and complex relationship with vertebral artery. Fracture of dens of axis accounts for 7-27% of all cervical spine fractures, but surgeries in these regions are highly risky because of the reported incidences of vertebral artery injury. AIM AND OBJECTIVES: The study was designed to measure morphometric data of human axis vertebra, of Indian origin. The different anatomical parameters on dry specimen of human axis vertebrae were established and the results were compared with other studies. MATERIALS AND METHODS: Thirty intact human axis vertebrae were measured with digital vernier caliper and mini-inclinometer. Various linear and angular parameters of axis were observed. RESULTS: The mean distance from the midline of body to the tip of transverse process of axis was 29.32 mm on right side and 29.06mm on left side. The mean distance from the midline of body to the lateral most edge of superior articulating facet was 22.8 mm on right side and 22.6 mm on left side. The mean value of anterior and posterior height of axis was 34.33±2.69mm and 30.56±2.78mm respectively. The anterior and posterior height of body of axis was 19.67 mm and 16.67mm respectively. Mean A-P and transverse diameter of inferior surface of axis was 15.42mm and 17.7mm respectively. Mean transverse diameter and mean A-P diameter of odontoid process was 9.32 mm and 10.1 mm respectively. Mean anterior and posterior height of the odontoid process was 14.66 mm and 13.89mm respectively. Mean of dens axis sagittal angle (angle between an axis that was imagined to pass longitudinally through the dens axis and the vertical line on a sagittal plane) was 13.23 degree. The shape of superior articulating facets of C2 varies from oval to circular. In the present study, 84% of SAF were oval and 16% were circular. Inferior articulating facets were circular in shape in 90% cases, and oval in 10% vertebra. Mean pedicle width was 10.07mm on right side and 10.52mm on left side. Mean transverse diameter of vertebral canal was 22.37±1.73mm. Mean of A-P diameter of vertebral canal at inlet was 18.31±2.05mm and mean of A-P diameter of vertebral canal at outlet was 14.84±1.63mm. CONCLUSION: These results obtained from this study may be helpful for the surgeons in avoiding and minimizing complications such as vertebral artery injury, cranial nerve damage and injury to other vital structures while doing surgery around cranio-vertebral region.

Effect of remineralizing agents on surface microhardness of primary and permanent teeth after erosion.

PURPOSE: The purposes of this study were to compare the susceptibility of human primary and permanent enamel to dental erosion caused by soft drinks and to compare in vitro the remineralization potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, 1.23 percent acidulated phosphate fluoride (APF) gel, and iron supplement. METHODS: Fifteen extracted primary and permanent teeth were used for sample preparation. Samples were randomly divided into three treatment groups: CPP-ACP paste, APF gel and iron supplement. The samples were subjected to a series of demineralization and remineralization cycles and were evaluated through surface microhardness. Statistical analysis was performed using one way ANOVA and unpaired t -tests. RESULTS: After remineralization, all samples showed an increase in surface hardness, which was significantly higher with CPP-ACP paste. CONCLUSION: CPP-ACP paste was more effective at preventing dental erosion than the other products.

Bacterial penetration along different root canal fillings in the presence or absence of smear layer in primary teeth.

AIMS: To study the effect of the smear layer on the penetration of bacteria along different root canal fillings and to compare the sealing ability of new endodontic material Apexit plus as compared to Zinc Oxide Eugenol (ZOE) in primary teeth. STUDY DESIGN: A total of 60 human root segments were instrumented for endodontic treatment. Half of the sample size was irrigated with normal saline and in other half 3% NaOCl, 3% H2O2 and 17% EDTA was used alternatively as irrigant during instrumentation. The roots were rinsed thoroughly with distilled water and sterilized by autoclaving for 20 min at 121 +/- 2 degrees C. Roots with and without smear layer were obturated with Apexit plus, Zinc oxide eugenol. Following storage in humid conditions at 37 degrees C for 2 days, the specimens were mounted into a bacterial leakage test model for 180 days. RESULTS: At 180 days, there is statistically significant difference with a P value of < 0.05 among all groups except ZOE-smear and -nonsmear. In the presence of smear layer Apexit plus demonstrated more leakage. No leakage was observed in ZOE groups. ZOE demonstrated better sealing ability than Apexit plus. CONCLUSIONS: Removal of smear layer helps in better resistance to bacterial penetration along Apexit plus root canal fillings but no effect is seen along ZOE root canal fillings.

Atomic force microscopic comparison of remineralization with casein-phosphopeptide amorphous calcium phosphate paste, acidulated phosphate fluoride gel and iron supplement in primary and permanent teeth: An in-vitro study.

CONTEXT: Demineralization of tooth by erosion is caused by frequent contact between the tooth surface and acids present in soft drinks. AIM: The present study objective was to evaluate the remineralization potential of casein-phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, 1.23% acidulated phosphate fluoride (APF) gel and iron supplement on dental erosion by soft drinks in human primary and permanent enamel using atomic force microscopy (AFM). MATERIALS AND METHODS: Specimens were made from extracted 15 primary and 15 permanent teeth which were randomly divided into three treatment groups: CPP-ACP paste, APF gel and iron supplement. AFM was used for baseline readings followed by demineralization and remineralization cycle. RESULTS AND STATISTICS: Almost all group of samples showed remineralization that is a reduction in surface roughness which was higher with CPP-ACP paste. Statistical analysis was performed using by one-way ANOVA and Mann-Whitney U-test with P < 0.05. CONCLUSIONS: It can be concluded that the application of CPP-ACP paste is effective on preventing dental erosion from soft drinks.

Delayed replantation of an avulsed maxillary premolar with open apex: a 24 months follow-up case report.

Avulsion of permanent teeth is most serious of all dental injuries and accounts for 1-16% of all traumatic injuries, of which maxillary incisors are most commonly involved. However, in this report a rare case of isolated avulsed immature premolar has been described. The patient had reported more than 3 hours after the trauma with a tooth stored in dry condition and soil contamination. The prognosis depends on measures taken at the place of accident or the time immediately after avulsion. Replantation is the treatment of choice, but cannot always be performed immediately. An appropriate emergency management and treatment plan is important for good prognosis. In this report stepwise management of an avulsed immature maxillary premolar with extended period of dry storage has been described followed up for a period of 2 yrs.

Clinico-embryological submission of an unilateral anomalous presentation of axillary artery.

OBJECTIVES: Descriptions of the variant arterial pattern of upper limb are not exceptional and are therefore frequently reported in anatomy archives. BACKGROUND: A noteworthy deviation from the usual branching pattern was observed unilaterally in a single cadaver. This unique division of axillary artery (AA) was present on the right side in an adult human cadaver of Indian origin. RESULTS: The first part of axillary artery gave off the superior thoracic and thoraco-acromial arteries. Just proximal to the upper border of pectoralis minor the AA was observed to divide into two trunks a medial and a lateral. The lateral trunk continued into the brachium as the usual axillary artery where as the medial trunk displayed the other branches deep and distal to the pectoralis minor muscle. The remarkable feature was the wide caliber of the axillary artery where it bifurcated into two branches. An attempt has been made to dwell upon the embryological basis of the present anomaly. CONCLUSIONS: The relevance of anomalous arterial pattern of upper limb (U.L.) is realized while performing percutaneous arterial venous catheter insertion into subclavian vein via the infraclavicular route. We advocate a meticulous familiarization of the anatomy of axillary artery and its topographical relationship to other neurovascular structures for the operating plastic surgeon, anesthetist and radiologist (Fig. 1, Ref. 12).

Apexification with MTA using internal matrix: report of 2 cases.

Calcium hydroxide (CH) has been reported to have several drawbacks when used for apexification. Mineral Trioxide Aggregate (MTA) has generated considerable interest as an alternative. Two different cases are reported using MTA for apexification. In the first case an incomplete CH barrier was used as a matrix against which MTA could be condensed. In the second case internal matrix was formed using absorbable collagen sponge and a comparable result could be achieved. Further studies are needed to develop it into a standardized method, akin to that of matrices used in class II restoration.

Biological and molecular characterization of Capsicum chlorosis virus infecting chilli and tomato in India.

Two isolates of Capsicum chlorosis virus (CaCV, genus Tospovirus) from tomato (CaCV-To-Ind) and chilli (CaCV-Ch-Pan), collected from Haryana and Uttar Pradesh states of northern India respectively, were compared. A comparison of the amino acid sequences of their N genes revealed more than 96% identity, confirming that the virus isolates in India have a high degree of sequence conservation and are closely related to Australian isolates. Analysis of the host range of CaCV revealed no biological difference between the isolates, but they differed from CaCV-Australia. The nucleotide sequences of S, M and L RNA of CaCV-Ch-Pan were determined. The S RNA contains 3,105 nucleotides (nt), with NSs and N genes of 1,320 and 828 nt, respectively. The M RNA consists of 4,821 nt, with an NSm gene of 927 nt and a Gn/Gc gene of 3,366 nt. The intergenic regions of S and M RNA contain 824 and 425 nt, respectively. The L RNA consists of 8,912 nt, with an RNA-dependent RNA polymerase gene of 8,634 nt.

Analysis of Reporting Pattern in Children Aged 7 to 14 Years with Traumatic Injuries to Permanent Teeth.

AIM: To analyze the pattern of traumatic injuries to permanent anterior teeth reporting to the dental department with regards to age, gender, cause, proportion of different types of injury and time of reporting. MATERIALS AND METHODS: Children aged 7 to 14 years with trauma or related sequelae were included. The data was collected retrospectively on the basis of case history, clinical findings, radiographs and vitality tests. Ellis' classification was used to record injuries to anterior teeth. RESULTS: Boys had more injuries with the highest injuries at 12 years. Various causes of trauma included Falls, RTA, hits by object/person and bicycle related. The most common injury reported were cases of Ellis' class IV (50.7%) and the maxillary central incisors being the teeth most frequently involved (75%). The time lapsed after injury was more than 1 year in 42.8% cases and 62% cases reported with complications. CONCLUSION: Our findings suggest that a large number of cases reported in the age group 10 to 13 years with Class IV Ellis' fracture largely when symptoms appear. Reporting was delayed by more than a year in several cases, the barriers for which need to be analyzed, to develop strategies regarding prevention of traumatic injuries and their consequences.

A review of tobacco cessation services for youth in the dental clinic.

Tobacco use is one of the leading preventable causes of illness and death. The most powerful predictor of adult smoking is smoking during adolescence. While general and pediatric dentists have a positive attitude regarding tobacco cessation counseling, the same is not extrapolated into practice. Several barriers to counseling in the dental clinic have been identified and research into some of these has been conducted. Evidence-based cessation programs are still in the nascent stage, but this should not hinder dental professionals from rendering these services to the child and adolescent populations. Brief interventions, self-help materials, and nicotine replacement therapy for established nicotine dependence form the mainstay of therapy. The purpose of this paper is to identify the several barriers encountered in providing cessation and discuss the current status of its implementation in the dental clinic.

First Report of Tobacco streak virus Infecting Guizotia abyssinica from India.

Guizotia abyssinica (L.f.) Cass. (niger), an important oil seed crop grown in India, is used in foods, paints, soaps, and as an illuminant. During a survey conducted in 2004 to monitor Tobacco streak virus (TSV) in Helianthus annuus L. (sunflower) and Arachis hypogaea L. (groundnut), typical symptoms of leaf and petiole necrosis were observed in niger plants from Karnataka State, India. The field-collected samples reacted with TSV-specific polyclonal antiserum in direct antigen coated (DAC)-ELISA. Indicator host species were mechanically inoculated with extracts from symptomatic leaves and grown under greenhouse conditions. The inoculations resulted in local necrotic lesions on Vigna unguiculata cv. C-152 (cowpea), Gomphrena globosa, and Nicotiana tabacum cv. Xanthi (tobacco) at 3 to 4 days postinoculation (dpi) and systemic mosaic mottling on sunflower and G. globosa at 7 to 9 dpi. To identify the virus at the molecular level, total RNA was isolated (RNeasy kit, Qiagen Inc., Chatsworth, CA) from the virus-inoculated cowpea leaf and used for reverse transcription-PCR using TSV CP (coat protein) specific primers (2). The resulting ~720-bp amplicon corresponding to the CP gene of TSV was cloned into pGem-T vector (Promega, Madison, WI) and sequenced. The resulting sequence of the TSV-niger isolate (TSV-NG) comprised 717 nucleotides encoding 238 amino acid residues of the viral coat protein (GenBank Accession No. DQ864458). Comparison of the sequence with those of other TSV CP gene indicated 98.5 to 99.3% nucleotide and 97.9 to 99.6% amino acid sequence identity with TSV isolates from India (1,2; GenBank Accession Nos. AF505073, AY061930, AY061929, AF515823, AF515824, and AF515825). The sequence of TSV-NG had 89.5 and 80.0% amino acid identity with TSV-WC, type strain from the United States (GenBank Accession No. X00435) and TSV-BR, isolate from Brazil (GenBank Accession No. AY354406), respectively. On the basis of symptoms, transmission, and serological and molecular data, the causal agent of necrosis in niger was identified as a strain of TSV widely prevalent in other oil seed and vegetable crops in India. The new report of Tobacco streak virus infecting niger from India, indicated the expansion of host range among oil seed crops. References: (1) A. I. Bhat et al. Indian J Biotechnol. 1:350, 2002. (2) K. S. Ravi et al. Plant Pathol. 50:800, 2001.