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J Clin Diagn Res ; 11(4): AD01-AD02, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28571125


Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus. The lower division of the nerve passed deep to the iliopsoas muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined just above the inguinal ligament to form the trunk of the femoral nerve. Further course and distribution of the nerve was normal. The reports have shown that compression neuropathies of femoral nerve in the limbs are caused by neoplastic masses, vascular abnormalities and also by different anomalous muscles. Such neuropathies may also result from indirect compression of femoral nerve between the fibres of psoas major muscle and lateral pelvic wall. The potential clinical importance of above mentioned variations in the division of femoral nerve would emphasize the surgeons to diagnose the neuromuscular entrapments and consequent alterations of sensation in the anterior and medial aspects of the thigh.

J Clin Diagn Res ; 8(1): 148-9, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24596750


Dorsal and ventral divisions of ventral rami of lower lumbar and sacral spinal nerve were found to pass ventral and dorsal to the piriformis muscle respectively. These divisions joined each other below the piriformis muscle to form sciatic nerve. This low formation of sciatic nerve was observed in distal part of left gluteal region of a 50-year-old male cadaver. The sciatic nerve thus formed passed caudally into back of thigh and divided into tibial and common peroneal nerves in the upper part of popliteal fossa. In addition, a communicating nerve from the sciatic nerve was found to join the common peroneal nerve in the popliteal fossa. Such variations may lead to piriformis syndrome or non-discogenic sciatica.

Bratisl Lek Listy ; 113(10): 622-3, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23233914


Normally, brachioradialis originates from the upper part of the lateral supracondylar ridge of the humerus. Variations in its origin are very rare. We observed the presence of an additional set of fleshy muscle fibers in the lateral part of the anterior compartment of the arm in addition to the other normal muscles. This unusual case was observed at the Mookambika Institute of Medical Sciences, Kulashekara, Tamil Nadu, India, during routine dissection of the upper limb. The anomalous fleshy fibers were attached proximally to the middle part of the shaft of the humerus, close to the insertion of deltoid. Some of its fibers continued further up to the acromian process of scapula. These fibers passed downwards along with deltoid and joined the fibers from the humerus before getting merged with the brachioradialis distally. These additional muscle fibers were compared with the brachioradialis accessorius and the uniqueness, functional significance and the clinical relevance werediscussed (Fig. 2, Ref. 6). Full Text in PDF

Braço/inervação , Músculo Esquelético/anormalidades , Nervo Radial/patologia , Idoso , Humanos , Masculino
Int. j. morphol ; 30(3): 783-785, Sept. 2012. ilus
Artigo em Inglês | LILACS | ID: lil-665478


The abnormal origin, presence of additional head and layered arrangement of fibers are the reported variations of sternocleidomastoid muscle in the past. In the present case we report a rare unusual origin of third head of the sternocleidomastoid muscle in a 60 year-old male cadaver. This additional head originated from the investing layer of cervical fascia in the roof of the subclavian triangle close to the clavicle and traversed obliquely upward, forward and fused with clavicular head. The insertion and nerve supply of the muscle was found to be normal...

El origen anormal, presencia de una cabeza adicional y disposición en capas de fibras son las variaciones reportadas del músculo esternocleidomastoideo. En el presente estudio, se presenta un origen poco habitual de la tercera cabeza del músculo esternocleidomastoideo en un cadáver de sexo masculino de 60 años. La cabeza supernumeraria se originaba en la lámina superficial de la fascia cervical en el techo del triángulo subclavio próximo de la clavícula y cruzaba oblicuamente hacia arriba y adelante para fusionarse con la cabeza clavicular. La inserción e inervación del músculo eran normales...

Humanos , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/anatomia & histologia , Músculos do Pescoço/anormalidades , Cadáver
Bratisl Lek Listy ; 113(7): 431-40, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22794519


A thorough anatomical knowledge is very essential for clinical practice and any surgical procedure. Unfortunately anatomical variations can lead to hazards in medical and dental diagnosis and treatment. Such knowledge is very essential even in effective local anesthesia which is an essential part of treatment in patients with many oral disorders. Therefore a normal anatomy and its possible variations are utmost important aspects also in dentistry. One of the structures that dentists very often deal with is the mandibular nerve which therefore needs a thorough review. However, there are not many consolidated literature reviews available regarding its variations and clinical applications. Keeping this in mind, in this article, the authors have brought together available literature on various aspects of mandibular nerve. The final review will be of benefit to clinicians (Fig. 2, Ref. 63).

Nervo Mandibular/anatomia & histologia , Anestesia Dentária , Anestesia Local , Humanos
Bratisl Lek Listy ; 113(7): 451-3, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22794523


Normally, the popliteal fossa contains popliteal vessels, tibial and common peroneal nerves. An occurrence of muscle in the popliteal fossa is very rare. During routine dissection classes for medical undergraduates, an anomalous muscle in the popliteal fossa was encountered. The muscle was originating from the thick fascia around the popliteal vessels. It was getting inserted to the medial head of the gastrocnemius through a narrow tendon and was supplied by a branch of tibial nerve. The muscle was observed in the right limb and was unilateral. An awareness of the possibility that such anomalous muscles can occur in the popliteal fossa is clinically essential as these may possibly entrap and compress the popliteal vessels. The muscle reported in the present case bears clinical significance since near its origin it almost completely surrounded the popliteal vessels and could pull on these vessels on contraction (Fig. 3, Ref. 14).

Joelho , Músculo Esquelético/anormalidades , Cadáver , Humanos
Int. j. morphol ; 30(1): 45-48, mar. 2012. ilus
Artigo em Inglês | LILACS | ID: lil-638757


Histotechnology is concerned with processing and preparing of the body tissue in such a manner as to enable a satisfactory study of it. Section cutting is an integral part of histology and histopathology. It is an art by itself requiring skill and knowledge on the part of technician or the person who needs to do section cutting. In the routine method of preparing paraffin sections, it is often encountered by the presence of artefacts like fine wrinkles or folds. Attempts have been made to remove the wrinkles by floating the sections in the warm water bath. However this method has not been able to remove all the wrinkles from the sections. We have designed a simple and reliable method, in which the paraffin sections were floated over the ethyl alcohol diluted with water (1:15) before they were placed in the water bath. Through this method, we have been able to get the wrinkle free sections of superior quality. The advantage of our method is that, it is easy to prepare the dilute alcohol and is cost effective. This method can be used by the histology and pathology technicians and the researchers.

Histotecnología se refiere a la elaboración y preparación de los tejidos del cuerpo de tal forma que permitan un estudio satisfactorio de éste. El corte seccionado es una parte integral de la histología y la histopatología. Es un arte por sí mismo que requiere habilidad y conocimiento por parte del técnico o la persona que tiene que hacer el corte de la sección. En el método de rutina de la preparación de las secciones de parafina se encuentra a menudo la presencia de artefactos como arrugas finas o pliegues. Se han hecho intentos para eliminar las arrugas por flotación de las secciones en el baño de agua tibia. Sin embargo, este método no ha sido capaz de eliminar todas las arrugas de las secciones. Hemos diseñado un método sencillo y fiable, en el que las secciones de parafina fueron colocadas por flotación sobre alcohol etílico diluido con agua (1:15) antes de ser colocado en el baño de agua. A través de este método, hemos sido capaces de obtener secciones sin arrugas de calidad superior. La ventaja de nuestro método es que, es fácil de preparar el alcohol diluido y es rentable. Este método puede ser utilizado por los técnicos de histología, patología e investigadores.

Álcoois/química , Diluição , Microtomia/métodos , Técnicas de Laboratório Clínico/métodos , Técnicas Histológicas/métodos
Biotech Histochem ; 87(4): 303-11, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22250760


Adult adipose-derived mesenchymal stem cells (AD-MSC) are very interesting to our research group because they are easy to harvest, they are abundant in humans, and they have potential clinical applications in autologous cell therapy for disc degeneration. We examined these cells through sequential serial passages to assess osteogenic and chondrogenic capabilities, mean doubling time and cell senescence. Osteogenic and chondrogenic potencies were maintained through 13 passages. Mean passage doubling time increased significantly with increasing passage number. When donor age was evaluated, passages 1-4 from older donors had significantly longer doubling times compared to cells from younger donors. Passages 5-11 showed similar findings when analyzed by donor age. The mean percent senescence increased significantly with cell passaging, rising from 0% at passage 1 to 3.4% at passage 13. These novel data suggest that caution should be exercised when using AD-MSC with long passage times.

Tecido Adiposo/citologia , Células-Tronco Mesenquimais/citologia , Tecido Adiposo/química , Adulto , Idoso , Diferenciação Celular , Senescência Celular , Condrogênese , Feminino , Humanos , Pessoa de Meia-Idade , Osteogênese
J Chin Med Assoc ; 74(12): 567-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22196473


Occurrence of abnormal muscles in the pelvic wall is very rare. During a routine dissection of the pelvic wall, an abnormal muscle referred to as sacrococcygeus ventralis was noted in a 65-year-old South Indian cadaver. The fleshy fibers of the muscle were arising from the lateral part of the ventral surface of the sacrum at the level of S3 segment. The muscle passed downwards in front of the S4 and S5 sacral segments, halfway through its course it became tendinous and finally became inserted in the ventral surface of the coccyx. Sacrococcygeus ventralis is a muscle which is well developed in animals where it acts on their tail. In human beings, sacrococcygeus ventralis is seen only during fetal life. A rare case of its persistence in an adult pelvic wall is reported and discussed here.

Músculo Esquelético/anormalidades , Pelve/patologia , Idoso , Cadáver , Dissecação , Feminino , Humanos , Região Sacrococcígea
Int. j. morphol ; 29(3): 675-677, Sept. 2011. ilus
Artigo em Inglês | LILACS | ID: lil-608640


The spleen is the largest lymphoid organ. It is wedge shaped and measures about 1 inch thick, 3 inches broad and 5 inches long. It presents characteristic notches on its superior margin and has a hilum on the visceral surface. The aim was to study the anomalies related to size, shape and external features of the spleen and discuss their clinical importance. As there are not many reports on variations in size shape and features of spleen in the South Indian population, we decided to do this study on cadaveric specimens. We observed 50 spleens fixed with 10 percent formalin. Among the 50 spleens observed, 25 spleens (50 percent) were normal and had all the features explained in the textbooks. 25 spleens (50 percent) did not have any notches on the superior margin, 2 spleens (4 percent) did not have a hilum and 4 spleens (8 percent) were small sized i.e. about 3 inches long. One of the spleens (2 percent) was "liver shaped" with 2 lobes. The knowledge of external features and dimensions of spleen are important for radiologists and surgeons as it may lead to confusions in interpreting radiographs and in the procedures of ultrasound examinations.

El bazo es el mayor órgano linfoide. Tiene forma de cuña y mide alrededor de 2,5 cm de espesor, 7,5 cm de ancho y 12,5 cm de largo. Presenta incisuras características en su margen superior y tiene un hilio en la superficie visceral. Debido a que no existen muchos informes sobre las variaciones del bazo en la población del sur de la India, el objetivo de esta investigación fue estudiar dichas variaciones y discutir su importancia clínica. Se observaron 50 bazos fijados con formalina al 10 por ciento. 25 bazos (50 por ciento) fueron normales y tenían las características que se explican en los libros anatómicos. 25 bazos (50 por ciento) no tenían ninguna incisura en el margen superior, 2 bazos (4 por ciento) no tenían hilio y 4 bazos (8 por ciento) eran de tamaño pequeño, con alrededor de 7,2 cm de largo. Uno de los bazos (2 por ciento) tenía "forma de hígado" con dos lóbulos. El conocimiento de las características externas y las dimensiones del bazo son importantes para los radiólogos y cirujanos, ya que pueden dar lugar a confusiones en la interpretación de radiografías y en los procedimientos de examen ultrasonográfico.

Feminino , Anatomia/métodos , Baço/anormalidades , Índia , Pesos e Medidas Corporais/métodos
Int. j. morphol ; 29(2): 409-411, June 2011. ilus
Artigo em Inglês | LILACS-Express | ID: lil-597466


Occurrence of variant muscular slips from pectoralis major muscle is rare. In this report, we present a rare case of aberrant muscular slip associated with the pectoralis major muscle which we call costodorsalis. This muscular slip originated from the 6th rib near the costochondral junction and ran along the lower border of pectoralis major muscle. It crossed the axilla from medial to lateral side and merged with the latissimus dorsi muscle. This type of origin and insertion is unique and has not been reported earlier. The knowledge of this muscle variation may be of special importance to the anesthesiologists, physiotherapists and plastic surgeons.

Es poco frecuente la aparición de variaciones de un fascículo muscular desde el músculo pectoral mayor . En este trabajo, presentamos el caso de un fascículo muscular aberrante asociado con el músculo pectoral mayor que denominamos costodorsal. Este fascículo muscular se originó en la 6 costilla cerca de la unión costocondral y corrió a lo largo del margen inferior del músculo pectoral mayor. Cruzó la axila de medial a lateral y se fusionó con el músculo latísimo del dorso. Este tipo de origen y la inserción es único y no se ha informado anteriormente. El conocimiento de esta variación muscular puede ser de especial importancia para los anestesistas, fisioterapeutas y cirujanos plásticos.

Int. j. morphol ; 29(2): 555-558, June 2011. ilus
Artigo em Inglês | LILACS-Express | ID: lil-597491


Brachial plexus shows several variations in its formation and branching pattern. Variations in the formation of the trunks are very rare. We studied 44 dissected specimens specifically for variations in the formation of the trunks of the brachial plexus. 5 cadavers (11.3 percent) showed variations in the formation of the trunks. All the variations were unilateral. In one cadaver (2.27 percent), the middle trunk was formed by union of C7 and C8 roots and lower trunk was formed by T1 root. Upper and middle trunks were fused with each other in one specimen (2.27 percent). In 3 specimen (6.81 percent), the C5 root pierced scalenus anterior before joining C6 to form the upper trunk. Knowledge of its variations is of importance to orthopedic surgeons, neurologists and anesthesiologists.

EL plexo braquial muestra algunas variaciones en su formación y patrón de ramificación. Las variaciones en la formación de los troncos son muy raras. Se disecaron 44 especímenes para observar las eventuales variaciones en la formación de los troncos del plexo braquial. Cinco cadáveres (11,3 por ciento) mostraron variaciones en la formación de los troncos. Todas las variaciones fueron unilaterales. En un cadáver (2,27 por ciento), el tronco medio se formó por la unión de las raíces C7 y C8 y, parte inferior del tronco, estaba formado por la raíz de T1. En un caso (2,27 por ciento) los troncos superior y medio se fusionaron entre sí. En 3 muestras (6,81 por ciento), la raíz de C5 cruzó el músculo escaleno anterior antes de unirse a C6 para formar la parte superior del tronco. El conocimiento de estas variaciones es importante para los cirujanos ortopédicos, los neurólogos y anestesiólogos.

Indian J Exp Biol ; 49(1): 56-9, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21365997


To evaluate the effect of phenytoin on burn wounds and to compare the effect of the combination of topical phenytoin preparation in dexamethasone treated burn wounds in rats, partial thickness thermal burn wounds were inflicted upon five groups of six rats each. Group I was assigned as control, Group II received the standard silver sulphadiazine, Group III was given topical phenytoin and Group IV received injection dexamethasone, Group V received the combination of the phenytoin and the dexamethasone. The parameters observed were epithelialization period, percentage of wound contraction and histopathological analysis as indicative of the process of healing. Phenytoin group showed significant improvement in burn wound contraction in comparison to standard silver sulphadiazine group, the combination group of topical phenytoin and dexamethasone also showed significant contraction compared to dexamethasone group. The period of epithelialization also decreased significantly in groups II, III and V. In conclusion, phenytoin promotes burn wound healing as evidenced by decrease in period of epithelialization and faster wound contraction.

Anticonvulsivantes/farmacologia , Anticonvulsivantes/uso terapêutico , Queimaduras/tratamento farmacológico , Fenitoína/farmacologia , Fenitoína/uso terapêutico , Cicatrização/efeitos dos fármacos , Administração Tópica , Animais , Queimaduras/patologia , Fenitoína/administração & dosagem , Ratos , Ratos Wistar
Oman Med J ; 26(6): e027, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28861181


Variation in the origin of long flexor tendons in the anterior compartment of forearm is common. During routine cadaveric dissection at Melaka Manipal Medical College (Manipal Campus), we observed a separate muscle belly and tendon of flexor digitorum superficialis (FDS) to the fifth digit in the right upper limb of a 60 year-old male cadaver. The anomalous muscle belly originated from the common flexor tendon from the medial epicondyle of the humerus and continued as a thin tendon at the middle of the forearm to get inserted into the middle phalanx of the fifth digit. This can be considered as a case of split flexor digitorum superficialis. Such muscle variations and knowledge of their frequency, appearance, and location can be helpful for surgeons.

Singapore Med J ; 51(11): e182-3, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21140104


The aortic arch gives rise to three classical branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. We report a rare variation of the left common carotid artery and the right vertebral arteries originating from the brachiocephalic trunk, and the left vertebral artery that was arising from the arch of the aorta, proximal to the origin of the left subclavian artery. Variations in the branching pattern of the arch of aorta can alter the cerebral haemodynamics that leads to cerebral abnormalities. Knowledge of the variations in the classical branches of the arch of aorta is important in the diagnosis of intracranial aneurysm after subarachnoid haemorrhage.

Aorta Torácica/anormalidades , Tronco Braquiocefálico/anormalidades , Artéria Carótida Primitiva/anormalidades , Artéria Subclávia/anormalidades , Artéria Vertebral/anormalidades , Aorta Torácica/patologia , Tronco Braquiocefálico/anatomia & histologia , Cadáver , Artéria Carótida Primitiva/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Subclávia/anatomia & histologia , Artéria Vertebral/anatomia & histologia
Int J Low Extrem Wounds ; 5(3): 137-43, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16928669


Centella asiatica is a reputed medicinal plant used in the treatment of various skin diseases in the Indian system of medicine. The objective of the study presented in this article was to evaluate the wound-healing potential of the ethanolic extract of the plant in both normal and dexamethasone-suppressed wound healing. The study was done on Wistar albino rats using incision, excision, and dead space wounds models. The extract of C asiatica significantly increased the wound breaking strength in incision wound model compared to controls (P < .001). The extract-treated wounds were found to epithelize faster, and the rate of wound contraction was significantly increased as compared to control wounds (P < .001). Wet and dry granulation tissue weights, granulation tissue breaking strength, and hydroxyproline content in a dead space wound model also increased at statistically significant levels as shown. The extract of the leaves had the effect of attenuating the known effects of dexamethasone healing in all wound models (P < .001, P < .05). The results indicated that the leaf extract promotes wound healing significantly and is able to overcome the wound-healing suppressing action of dexamethasone in a rat model. These observations were supported by histology findings.

Centella , Dexametasona/administração & dosagem , Glucocorticoides/administração & dosagem , Fitoterapia/métodos , Extratos Vegetais/administração & dosagem , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Administração Tópica , Animais , Dexametasona/uso terapêutico , Modelos Animais de Doenças , Feminino , Glucocorticoides/uso terapêutico , Masculino , Extratos Vegetais/uso terapêutico , Ratos , Ratos Wistar , Resultado do Tratamento , Ferimentos e Lesões/patologia
Spinal Cord ; 44(12): 729-33, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16446753


STUDY DESIGN: Retrospective review. OBJECTIVE: This retrospective review observes the evolution of bladder management by time and reports adult urological outcomes and complications in paediatric onset spinal cord injury (SCI). SETTING: Spinal Injuries Unit RNOH Stanmore. METHOD: In total, 10 traumatic SCI patients with mean age at injury of 13.6 years underwent treatment, for a mean period of 13.1 years. Characteristics of injury were noted. Two diagnostic subgroups, neurogenic detrusor overactivity (NDO), and acontractile detrusor were made. Complications, treatment changes, operative procedures with follow-up were noted. RESULTS: In group 1 (6/10 patients) with NDO, five had DSD. Initial bladder management was reflex/urge voiding (n=4), suprapubic catheterisation (SPC), (n=1) and self-intermittent catheterisation (SIC), (n=1). Two patients had multiple upper tract complications with decreased renal function, two recurrent symptomatic urinary infections and one; bladder calculus. In total, 12 operative procedures were performed to treat complications and change bladder management to, SIC+oxybutynin (n=3), ileal conduit (n=1), sacral anterior root stimulator implant (SARSI), (n=1), voiding on urge (n=1). In group 2 (4/10 patients) with a-contractile detrusor two had low compliance. Initial bladder management was SIC (n=3) and voiding on urge/straining (n=1). Two patients converted from SIC to permanent catheter drainage and reported complications. Incidental kidney stone was diagnosed in one. A total of four interventions were carried out with final management of SIC (n=2), voiding on urge/straining (n=1) and Mitrofanoff+ileocystoplasty (n=1). CONCLUSION: Bladder management in paediatric SCI is dependent on neurological level and type of injury; it changes with growth and is affected by changes in bladder management.

Traumatismos da Medula Espinal/complicações , Bexiga Urinaria Neurogênica/terapia , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Retrospectivos , Traumatismos da Medula Espinal/fisiopatologia , Resultado do Tratamento , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/fisiopatologia , Cateterismo Urinário , Urodinâmica
Indian J Exp Biol ; 44(1): 49-54, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16430091


Ethanolic extract of leaves of O. sanctum was investigated for normal wound healing and dexamethasone depressed healing using incision, excision and dead space wound models in albino rats. The extract of O. sanctum significantly increased the wound breaking strength in incision wound model. The extract treated wounds were found to epithelialize faster and the rate of wound contraction was significantly increased as compared to control wounds. Significant increase in wet and dry granulation tissue weight, granulation tissue breaking strength and hydroxyproline content in dead space wound model was observed. The extract significantly decreased the antihealing activities of dexamethasone in all the wound models. The results indicated that the leaf extract promotes wound healing significantly and able to overcome the wound healing suppressing action of dexamethasone. Histological examination of granulation tissue to determine the pattern of lay-down for collagen confirmed the results.

Ocimum , Cicatrização/efeitos dos fármacos , Animais , Dexametasona/toxicidade , Feminino , Masculino , Fitoterapia , Extratos Vegetais/farmacologia , Ratos , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/patologia
Anat Rec B New Anat ; 285(1): 16-8, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16032756


Confusion still exists about the anatomy to be taught to the medical undergraduate. We did an interview-based survey at the Melaka Manipal Medical College in Manipal, India, to try to evaluate the quantum of anatomy that should be taught to the medical undergraduate. The results suggest that excluding trivia and making anatomy more clinically oriented would be advantageous. A hybrid approach to anatomy including both problem-based learning and discipline-based curricula would be a better option than the regional or systemic approaches.

Anatomia/educação , Educação de Graduação em Medicina/normas , Aprendizagem Baseada em Problemas/normas , Faculdades de Medicina , Currículo/normas , Coleta de Dados , Humanos , Índia , Entrevistas como Assunto