A rare finding of the superficial palmar arch-developmental and clinical significance.

The ulnar artery provides a major blood supply to the hand in the form of the superficial palmar arch, with the assistance of the radial artery. A rare pattern of the superficial palmar arch was observed in a formalin fixed, male cadaveric left hand. The ulnar artery was only involved in the formation of this arch, which provided three common palmar digital arteries which ran into the second, third and the fourth spaces between the corresponding digits and one proper palmar digital artery which ran along the ulnar side of the little finger. The main trunk of the ulnar artery bifurcated to supply the thumb and the index finger. The superficial branch of the radial artery did not participate in the arch formation. The arch was completed by the radial artery proper on the dorsolateral surface of the hand, after joining the point of bifuracation of the ulnar artery.

Efficacy of carcinogenic embryonic antigen in differential diagnosis of diseases of pancreas and liver--a comparative study in a tertiary care hospital of Western Nepal.

OBJECTIVE: The objective of our present study was to assess the efficacy of carcinoembryonic antigen (CEA) for differentiating and diagnosis of pancreatic and liver diseases in Pokhara valley. MATERIALS AND METHODS: A hospital based retrospective study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2011 and 31st October, 2011. Estimation of CEA was performed by ELISA reader for all cases. Approval for the study was obtained from the institutional research ethical committee. RESULTS: Of the 771 subjects, 208 (27%), 60(7.8%), 240(31.1%), 54(7.0%) , 75(9.7%), 59(7.7%), 75(9.7%) cases were of active chronic hepatitis , cryptogenic cirrhosis, alcoholic cirrhosis, primary biliary cirrhosis, hepatoma, acute or chronic pancreatitis, carcinoma of pancreas respectively. The majority of cases (104) of active chronic hepatitis had CEA levels <5 ng/ml(50%). CEA levels were found to be increased in cases of alcoholic cirrhosis with maximum number of cases (106) in range of 10 to 20 ng/ml (44%). There were no cases having more than 20 ng/ml of CEA in primary biliary cirrhosis and acute or chronic pancreatitis. In cases of pancreatic cancer, maximum number of cases (35) were having CEA >20 ng/ml(47%). CONCLUSION: High levels of CEA are associated with advanced stage of disease. CEA can thus provide an important improvement in the diagnosis by differentiating pancreatic cancer especially from chronic pancreatitis when there is a high suspicion of malignancy. Increased CEA levels may also signify progression from benign to malignant transformation in the liver.