Amol Sharad Dharap

Frequency of palmaris longus absence and its association with other anatomical variations in the Egyptian population.

The palmaris longus (PL) is one of the most variable muscles in the human body. Racial differences in its variation have been documented. Several studies have attempted to correlate PL absence with other anatomical variations. This study was conducted to determine the prevalence of absence of PL, correlate it with gender and body side and to determine its association with other anatomical variations in the Egyptian population. The presence of PL was clinically determined in 386 Egyptians using the standard technique. All subjects were examined for the presence of the flexor digitorum superficialis (FDS) to the fifth finger. Allens test was done to assess the completeness of the superficial palmar arch (SPA). The overall prevalence of absence of the PL in Egyptian subjects was 50.8%. There was no significant difference in PL absence with regard to the body side but a significant difference was seen as regards gender and when bilateral absence of PL was compared to its unilateral absence. Absence of FDS tendon to the fifth finger was seen in 1.3% subjects. There was no association between the absence of the FDS tendon to the fifth finger and either presence or absence of PL and also between the absence of PL and the incompleteness of SPA in both genders. In conclusion, the prevalence of absence of PL in the Egyptian population represents one of the highest rates of absence to be reported for this muscle, which is significantly different from that in other ethnic groups. Clin. Anat. 26:572–577, 2013.

The prevalence of absence of the palmaris longus muscle in the Bahraini population

Absence of the palmaris longus muscle has been well documented in several populations at a prevalence rate ranging between 2.2 and 63.9% which varies according to race, sex, and side of the body. There is little documentation of the prevalence of absence of this muscle from populations in the Arabian Gulf region. We examined 1,043 subjects, 3–85 years old, from the Kingdom of Bahrain for the presence or absence of the palmaris longus muscle using the conventional test for the presence of this muscle. Statistical analyses investigated the association of muscle absence with sex, hand dominance, and laterality. The palmaris longus muscle was absent in 36.8% of subjects. Bilateral absence (19%) was more common than unilateral absence (17.9%) with preponderance in female subjects. The muscle was absent more often on the left side than the right (P = 0.003). In the right upper limbs the muscle was absent in female subjects more than male subjects (P = 0.031). This study reaffirms that there is population variation in the frequency of absence of the palmaris longus muscle. The tendon of the palmaris longus bifurcated at the wrist in 7.1% of subjects, with male subjects showing this feature more frequently than female subjects in the right hand (P = 0.037) and the left hand (P = 0.030). This has not been reported before. The clinical significance of our findings is discussed. Clin. Anat. 23:956–961, 2010.

Facial Anthropometry in an Arab Population

Result: The mean inter-alar width of the nose was 35.06 mm (37.14 mm in males and 33.21 mm in females). The mean maxillary inter-canine distance was 37.96 mm (39.66 mm in males and 36.38 mm in females). The mean mouth width was 50.66 mm (52.85 mm in males and 48.63 mm in females). The maxillary inter-canine distance was 75% of mouth width; therefore, the mouth width is a reliable predictor of the maxillary intercanine distance and vice versa in the Arab population. Comparison between nationals from different GCC countries showed that Bahraini males had significantly wider mouths than Saudi Arabian males (P=0.034).

The place of anatomy in medical education: Guide supplement 41.2—Practical application

Adequate knowledge of anatomy with strong emphasis on understanding rather than knowing and the acquisition of essential anatomical skills, such as the power of observation, identification and interpretational abilities are considered crucial for effective and safe clinical practice (Abu-Hijleh et al. 1995; Boon et al. 2002; Heylings 2002). The recent review paper by Louw et al. (2009) addressed these important features in teaching anatomy through the principles governing modern medical education. We present here one example of how such principles could be practically applied. The College of Medicine and Medical Sciences (CMMS) at the Arabian Gulf University (AGU) has followed a problembased, student-centred and community-oriented curriculum since its inception in 1982. The 6-year curriculum is organised into three phases: pre-medical (1 year), pre-clerkship (3 years) and clerkship (2 years). While the subject of anatomy is covered sequentially during all the three phases of the curriculum, the bulk of it is taught in the pre-clerkship as an integrated component of problem-based, organ–system units involving basic medical and clinical sciences (Abu-Hijleh et al. 2004). Until 2002, the Department of Anatomy at AGU carried out its teaching–learning activities mostly through needs-based interactive sessions, where students scheduled appointments in small groups or individually with two designated faculty members, enabling them to focus on difficulties encountered in learning. An appointment lasted for 30–45 min and students could decide the topic or demonstration needed to discuss or see in relation to the learning objectives that emerged during small-group problem-based learning (PBL) tutorials. The visual nature of anatomy instruction created a continuous demand on faculty for demonstrations in gross anatomy and histology. While these activities took place during each unit, the manner in which they were presented was somewhat random and often lacked order or standardisation. This fact, compounded by a steady increase in the number of medical students admitted over the years, led to the realisation that a different strategy of supporting anatomy learning was necessary. A standardised learning activity called Structured ProblemRelated Anatomy Demonstrations (SPRAD) was proposed and implemented for the first time in 2002, to replace the previous system of individualised teaching activities (Abu-Hijleh et al. 2005).

Response to the "Letter to the Editor" by S. Dyankova and G. Marinov

We thank the authors for their interest. We agree with their views that the incidence of Type II lunate is higher in dissection studies than with radiographic studies. But in the muslim Arab world it is not an accepted practice to conduct dissections. Thus we would be unable to conWrm our results in dissections of cadavers from the Arab population. We recognize the Wgures quoted in the literature regarding the speciWcity of plain radiographs. However, plain radiographs of our target population were available and we were able to draw conclusions from them [1]. Thanking you. Yours sincerely, Dr Amol Sharad Dharap Reference