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.

Effect of Obesity on Sympathovagal Activities in Hypertensive Indian Population.

Decreased physical activity, increased psychosocial stress and work stress have contributed to the increased prevalence of obesity and Hypertension (HTN). Irrespective of the aetiology, sympathetic over activity has been recognized as the main pathophysiologic mechanism in the genesis of obesity and HTN. Sympathovagal imbalance or dysregulation of autonomic functions owing to sympathetic over activity and vagal withdrawal is reported to be the basis of many clinical disorders. Obesity, hypertension and diabetes mellitus are known to be associated with dysregulation of autonomic functions independently. Heart Rate Variability (HRV) has emerged as a practical, non-invasive tool to quantitatively investigate cardiac autonomic dysregulation. The present study was undertaken to ascertain whether obesity has any effect on further disruption of autonomic functions particularly in hypertensive patients. A total of 96 male and female adults aged between 40-50 years visiting the Primary Health Centre, Yelwala, Mysuru district, India were recruited for this study. They were grouped in to 3 (n=32) as Groups I (Obese hypertensive), II (non-obese hypertensive) and II (non-obese normotensive, control), HRV was determined using the One minute during deep breathing method. Data were presented as Mean ± SD, inferential statistics was by One Way ANOVA and Tukey's Post Hoc test p value <0.005 at α0.05 HRV was significantly decreased in obese hypertensive patients compared to the non-obese hypertensive patients. Our present study supports that obesity and hypertension probably has additive effect in causing autonomic dysregulation.

Changes in Ocular Perfusion Pressure in Response to Short Term Isometric Exercise in Young Adults.

Ocular Perfusion Pressure (OPP) is the pressure difference between the Mean Arterial Pressure (MAP) and theIntra Ocular Pressure (IOP). Decreased OPP could be a major risk factor for glaucoma. The aim is to study the effect ofIsometric exercise on OPP in apparently healthy young adults. Forty apparently healthy young adult volunteers comprising20 males and 20 females in the age group of 18-21 years were selected among MBBS Phase I students of JSS Medicalcollege, JSSU, Mysore. IOP and BP were recorded. Mean arterial pressure (MAP) and OPP were calculated. There was astatistically significant difference (p<0.05) in the mean OPP before and after performing Isometric exercise and betweenmales (50.58±0.72 to 56.85±1.15 mm Hg) and females (49.35 ± 1.66 to 56.71 ± 1.61 mm Hg). Physical activity in the formof Isometric exercise improves ocular blood flow - OPP. Hence regular exercise of prescribed intensity may prove useful forglaucomatous patients which enhance their OPP.

Somatostatin receptors in non-endocrine tumours.

The presence of cellular somatostatin receptors, particularly of subtype 2, has been reported in a large number of human primary non-neuroendocrine tumours, such as breast and colon cancer. Our aim was to evaluate whether subtype 2 expression may represent a prognostic factor in these tumours, and if the exact determination of its expression might help to identify patients eligible for a new treatment modality based on somatostatin analogues. Large groups of neuroblastomas as well as breast and colon cancers were studied for subtype 2 expression. In the two latter groups the expression of subtype 2 was evaluated both in tumour and in the corresponding normal tissue from the same patient, to correctly evaluate any modification of subtype 2 mRNA expression in cancer. Subtype 2 mRNA expression was measured with accurate quantitative retro transcription-polymerase chain reaction procedures (first, by competitive polymerase chain reaction and then, by real-time assays). When possible, results of mRNA measurement were compared with in vitro (in situ hybridisation and immunohistochemistry) and in vivo (octreoscan) demonstration of subtype 2 expression in the same patients. Our results seem to suggest the hypothesis that subtype 2 may represent a marker of cell differentiation in certain tumours, such as neuroblastoma, and another instance may be represented by breast and colon cancer. Beside this, the question whether subtype 2 may have an active role in inhibiting cancer cell proliferation, stays open.