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   Table of Contents - Current issue
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July-September 2020
Volume 69 | Issue 3
Page Nos. 125-184

Online since Wednesday, September 30, 2020

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EDITORIAL  

Acceptance of donor bodies and their embalming during COVID-19 period: A challenge to anatomists Highly accessed article p. 125
Vishram Singh, Rohini Pakhiddey
DOI:10.4103/JASI.JASI_173_20  
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ORIGINAL ARTICLES Top

Morphometric variations of nasal parameters in gujarati population: An anatomical study p. 127
MM Rohith, Jyotirmoy Roy, Abraham Johnson
DOI:10.4103/JASI.JASI_139_19  
Introduction: Nasal morphology is an important factor in forensic investigations and facial reconstructive procedures. Found to be strongly related to ethnicity and environmental factors, and known to be sexually dimorphic, the study of nasal parameters is useful in forensic facial reconstruction. The aim of the study is to evaluate the nasal morphological characteristics of the Gujarati population as an indicator for personal identification and to assess the prevalent nasal morphology of the study population determined. Material and Methods: The study involved randomly selected 180 healthy subjects (90 males and 90 females) between three age groups. Nasal width and nasal height were measured using a digital vernier caliper, and nasal index was calculated along with other parameters. The data were statistically analyzed. Results: The mean nasal width for male and female was 38.23 mm and 34.94 mm while the mean nasal height was 47.59 mm and 44.35 mm, respectively. The mean nasal index for male subjects (81.08) was also higher than for female subjects (77.30). The morphological classification showed the mesorrhine nose type as the most prevalent among both the males (58.88%) and females (66.66%). Discussion and Conclusion: The population under the study exhibits mesorrhine type of the nose and shows sexual dimorphism in the values of nasal measurements. Thus, the current study is valuable not only in forensic facial reconstruction but also as an added method for determining the gender and ethnicity of an unidentified individual.
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Morphometry of sphenoid air sinus and its ostium for surgical relevance: A cadaveric study p. 133
B Senthil Kumar, G Panneer Selvi
DOI:10.4103/JASI.JASI_110_19  
Introduction: The sphenoid air sinuses and their ostia are highly variable structures. The ostia are located on either side of the midline. The exact location of the sphenoid ostium is very much essential in endoscopic sinus surgeries as well as for the transsphenoidal hypophyseal approach. The present study was done to determine the anatomical location of the sphenoid sinus ostium in relation to the surrounding landmarks. It is a descriptive study. Material and Methods: The study was carried out in the Department of Anatomy, VMKV Medical College and Hospital, Salem, on forty sagittal head and neck sections of adult formalin-fixed cadavers. The length and width of the sinus were measured. The shape and type of the sphenoid sinus ostia were also noted. The distance of the sinus ostium from various landmarks was measured using Vernier calipers. The morphometric parameters were compared by Student's t-test on both sides. Results: Most of the specimens showed sellar variety than presellar variety on both right and left sides. The shape of the sphenoid sinus ostia was predominantly round shape, followed by oval and slit shape. The length and width of the sinus on the right side were less when compared to the left side. The distance between the sphenoidal ostia and several landmarks showed no significant difference except the distance from ostium to superior concha. Discussion and Conclusion: During the endoscopic approach of the sphenoid sinus ostium, it is not always easy to locate the ostium. The present morphometric study will serve as a guideline for the endoscopic surgical approach of the sphenoid sinus ostium using the various anatomical landmarks.
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Anomalous subaortic left brachiocephalic vein: Prevalence and associated anomalies p. 137
CS Ramesh Babu, Arjun Kumar, Om Prakash Gupta
DOI:10.4103/JASI.JASI_111_20  
Introduction: Thoracic venous anomalies are very rare with an estimated prevalence of 0.7% in the general population. One of the rarest such anomaly is a subaortic course of the left brachiocephalic vein (LBV) commonly associated with congenital cardiac or aortic arch anomalies. Material and Methods: We retrospectively analyzed chest computed tomography scans of 710 participants and found incidentally two cases of anomalous subaortic course of the LBV in two females. Results: The observed prevalence of subaortic LBV is 0.28% (2/710 cases). Isolated subaortic LBV without any associated cardiac or aortic arch anomaly was observed in a female patient. Rare bilateral ectopic origin of bronchial arteries from corresponding subclavian arteries was also noted in this patient. In another female patient, right aortic arch anomaly was associated with subaortic LBV. The right-sided aortic arch had an aberrant retroesophageal left subclavian artery arising from a Kommerell's diverticulum as the last branch. Discussion and Conclusion: Extensive literature search has yielded only 15 cases of isolated anomalous subaortic LBV in subjects without any cardiac and aortic arch anomaly. Although this condition is asymptomatic, its presence, when detected, should alert the clinician to the possible presence of associated congenital cardiac and aortic arch anomalies. Accurate knowledge of these rare anomalies will enhance the diagnostic accuracy and proper interpretation of radiological images. Such thorough knowledge will avoid interpreting the anomalous vein as an enlarged lymph node, enlarged left superior intercostal vein, and reduce the chances of surgical complications.
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The measurement indexes and the relationships with adjacent structures of vidian canal and foramen rotundum using computed tomography p. 144
Gozde Serindere, Kaan Gunduz, Hakan Avsever
DOI:10.4103/JASI.JASI_56_20  
Introduction: The aim of this study was to evaluate vidian canal (VC) and foramen rotundum (FR) and their anatomical relationships with adjacent structures using computed tomography (CT) in a Turkish subpopulation. Material and Methods: CT images of 150 patients were retrospectively evaluated. Various morphometric measurements (distance from FRs to midline, distance from FR to VC, position and angle of FR, and types of FR and VC) were performed from both left and right sides on CT scans. Results: One hundred and fifty patients with a mean age of 41.06 ± 17.812 years were included in this study. The mean distance from midline to right FR was 17.89 ± 1.94 and 18 ± 1.83 in females and males, respectively. The mean distance from midline to left FR was 18.33 ± 1.94 and 19 ± 2.18 in females and males, respectively. Twenty-three cases had Type 1 VC and 40 and 112 cases had Type 2 and 3 VCs, respectively. Three patients had Type I FR, 25 and 57 patients had Type IIa and IIb, respectively, and 93 patients had Type III FR. The position of FRs regarding the base of lateral pterygoid plate was online in 77 patients, medially placed in 92 patients, and laterally placed in 12 patients. Discussion and Conclusion: It is important to know sphenoid sinus and neighboring anatomical structures for planning of endoscopic skull base surgery because it is located close to some important anatomical structures such as internal carotid arteries, optic nerve, and cranial nerves. Surgeons should be careful in preoperative treatment planning and also during the operation.
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Prevalence and pattern of molar incisor hypomineralization in Delhi Region p. 150
Rashi Singh, Binita Srivastava, Nidhi Gupta
DOI:10.4103/JASI.JASI_101_20  
Introduction: Molar incisor hypomineralisation (MIH) is currently the most prevalent of developmental defects of enamel among children. Molar incisal hypomineralisation presents itself as a serious clinical dilemma for pediatric dentists and clinical practitioners. It is a global endemic. However, its prevalence in India remains uncertain to find prevalence and pattern of MIH in Delhi Region. Material and Methods: A total of 649 children aged between 7 and 10 years were randomly selected from various schools in Delhi National Capital Region (NCR). The teeth were examined moist under natural light. The developmental defects of enamel were graded using the modified European Academy of Pediatric Dentistry judgment Criteria given by Ghanim et al. 2015. Results: A total of 97 subjects presented with MIH of 649 subjects examined. MIH presented with a prevalence of 15%. Creamy white opacities were the most common of defects present, followed by yellowish-brown opacities. Discussion and Conclusion: The prevalence of MIH in the Delhi NCR region is 15%.
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Global research output of the cerebellum: Yesterday, today, and tomorrow p. 155
Murat Golpinar, Emre Demir
DOI:10.4103/JASI.JASI_114_20  
Introduction: The cerebellum has been regarded as a valuable research topic over the years because of its numerous roles in motor and nonmotor functions. The aim of the current study was to provide a comprehensive and holistic evaluation of publications concerning the cerebellum over the last 40 years which can be a potential guide for future research related to the cerebellum. Material and Methods: The Web of Science database was used to identify the publications relating to the cerebellum between 1980 and 2019. The identified publications were analyzed using the bibliometric approaches. The number of the publications concerning the cerebellum to be published between 2020 and 2028 was predicted using the linear regression analysis. Results: The literature review revealed a total of 33,186 publications. The top three active countries were found to be the USA (7362), Japan (2987), and the UK (1994). A positive and significant correlation was found between the number of cerebellum articles produced by the countries and the development indexes of the countries (r = 0.743, P < 0.001; r = 0.676, P < 0.001, r = 0.656, P < 0.001). The top three productive journals were found to be the Journal of Neuroscience, Brain Research, and Cerebellum. The total number of cerebellum publications is expected to continue in an increasing trend and reach a total of 891 publications at the end of 2028. Discussion and Conclusion: Recent studies on the cerebellum have mostly focused on the cerebellar degeneration, functional connections of the cerebellum, and its relationship with various diseases such as ataxia, schizophrenia, Parkinson's disease, autism, and aneurysms.
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A study of microscopic changes in the placenta in gestational diabetes mellitus p. 166
Vishram Singh, Kumud Ranjan, SL Tewarson
DOI:10.4103/JASI.JASI_133_20  
Introduction: Gestational diabetes mellitus is a complication connected with pregnancy defined as any degree of glucose intolerance that appears during pregnancy with normal values before and usually after the pregnancy. We investigated histological changes of the gestational diabetic placenta and non-diabetic placenta. Research work accomplished in the department of Anatomy, government medical college and superfacility hospital Azamgarh. Placenta collected from the labour room/operation theatre of the department of Obstetrics and Gynecology, government medical college and superficiality hospital, Azamgarh. Material and Methods: Sixty-two freshly delivered placentas were collected – 31 placentas from diabetic mother and 31 placentas from non-diabetic mother (control group). All parturient were aged between 20 to 44 years. This placenta measured on a weighing machine graduated in grams. An approximately 5mm piece of the diabetic placenta was taken and processed for histological examination. Results: Microscopic examination explained dilated blood vessels, subtrophoblastic basement membrane thickness and chorangiosis present in all gestational diabetic placenta. Vessels thrombosis present in 83.87 per cent of the gestational diabetic placenta. Nucleated RBCs. were present in 93.54 per cent of the gestational diabetic placenta. Discussion and Conclusion: Gestational diabetes mellitus induces significant changes in the placenta, both gross and histologic. Effective glycemic regulation is better options for reducing anomalies that cause gestational diabetes. We find dilated blood vessels and necrosis in 100 percent of gestational diabetic placenta and 9.60 percent of nondiabetic placenta. The thickness of the subtrophoblastic basement membrane was present in 100% of the gestational diabetic placenta and 16.12% of the non-diabetic placenta. Vessel thrombosis occurs in 83.87% of gestational diabetic placenta, and 12.90% of non-diabetic placenta. In 93.54 percent of gestational diabetic placenta and 32.25 percent of non-diabetic placenta, nucleated RBC occurs.
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Evaluation of vascular and neural anatomy of the hand in adult cadavers p. 171
Yadigar Kastamoni, Afitap Anil, Tuncay Peker, Feza Anil
DOI:10.4103/JASI.JASI_216_19  
Introduction: We aimed to investigate the vascular and neural anatomy of the hand in adult cadavers and to determine the normal anatomical structure and variations of these structures. Material and Methods: Twenty hands of adult cadavers were examined by the dissection method. After the superficial palmar arch (SPA), the ulnar nerve (UN), median nerve (MN), and deep palmar arch (DPA) were identified, their anatomical structures and variations were evaluated. Then, they were classified according to the number of branches they give off and the course of these branches. Results: When the number of the common palmar digital arteries emerging from the SPA was examined, four branches were observed to emerge from the arch in 80%, and five branches in 20%. When the innervation of the MN and UN was evaluated, 3.5 + 1.5 fingers innervation was observed in 90%, 3 + 1.5 fingers innervation and 3 + 2 fingers innervation were observed in 5% of the samples. When the DPA samples were examined, four metacarpal palmar arteries were observed to emerge from the arch in all of the samples. According to the number of branches they gave off and the course of these branches, the SPA was gathered under seven groups, the nerves were gathered under four groups, and the DPA was gathered under three groups. Discussion and Conclusion: We believe that the data obtained in our study will be used, especially in anatomy education and will guide neurologists, surgeons, orthopedists, radiologists, and anatomists in their studies, diagnosis, and treatments.
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CASE REPORTS Top

Multiple renal vasculature p. 178
V Vijaynath, Vishnu Ravi, Maya Mukundan, TS Tintu
DOI:10.4103/JASI.JASI_232_19  
Variations in the renal vasculature are often encountered in routine cadaveric dissection. In this case, variations were found in the right renal vein (RRV), right renal artery (RRA) and left renal artery (LRA) of a formalin-fixed cadaver. The RRV had two tributaries and the RRA had three branches. The LRA had two branches and was anterior to the left renal vein. Such vascular anomalies are significant clinically.
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Moyamoya disease in a 29-year-old female of Indian Origin p. 182
Suyashi Sharma, Shilpi Gupta Dixit, Pushpinder S Khera, Pawan K Garg, Ashish K Nayyar, Surajit Ghatak
DOI:10.4103/JASI.JASI_111_19  
The case presented here is a 29-year-old female patient with complaints of weakness over the left upper and lower limbs for 2 weeks. Digital subtraction angiography of the brain was suggestive of cerebral arteries, showing proliferation of cortical as well as collateral arteries arising from the internal carotid arteries (ICAs). Moyamoya is a progressive steno-occlusive disease at the terminal portions of the bilateral ICAs, with the development of “moyamoya vessels” giving a “Puff of Smoke” appearance on catheter angiography. Cerebral angiography is gold standard for diagnosis and helpful for detecting aneurysm and for surgical planning. There is no standardized surgical strategy for the treatment of this disease. Innumerable revascularization procedures have been employed with the aim of decelerating the progression of disease. Recognition of various symptoms of moyamoya would enable early diagnosis so that it could be treated surgically, as soon as possible, leading to a better neurological outcome.
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