Antony Sylvan D'Souza

Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance

The lateral femoral cutaneous nerve (LFCN), a branch from the lumbar plexus, may come to the clinicians or surgeons attention. We studied this nerve to determine its location and its relationship with neighboring structures around the anterior superior iliac spine (ASIS) and the inguinal ligament (IL). Additionally, cross‐sectional microanatomy of the LFCN at the IL was studied. The LFCN was dissected in 47 lower limbs from formalin‐fixed cadavers. The distances from the ASIS to the point where the LFCN crossed the IL and the lateral border of the sartorius were measured. The distance between the ASIS and the point it pierced the deep fascia was also measured. Twelve nerve specimens at the IL were collected for histological sectioning and were stained with hematoxylin and eosin. On examination of the cross‐sectional area, the nonfascicular area was wider than the fascicular area because of an increased amount of thick collagen fibers. This study may be of help to clinicians managing meralgia paresthetica and may also assist in defining a safe area for surgical intervention on the anterolateral aspect of the thigh. Clin. Anat. 23:978–984, 2010.

Methyl Parathion Inhibits the Nuclear Maturation, Decreases the Cytoplasmic Quality in Oocytes and Alters the Developmental Potential of Embryos of Swiss Albino Mice

Methyl parathion (MP) is one of the most commonly used and extremely toxic organophosphorous group of pesticide. A large number of studies in the literature suggest that it has adverse effects on the male reproductive system. However, there is limited information about its toxicity to the female reproductive system. In the present study we report the toxic effects of methyl parathion on the female reproductive system using Swiss albino mice as the experimental model. The female mice were administered orally with 5, 10 and 20mg/kg of MP. One week later, the mice were superovulated with pregnant mare serum gonadotrophin (PMSG) and human chorionic gonadotrophin (hCG) to study the quality of the oocytes, spindle organization, developmental potential of early embryos and the DNA integrity in blastocysts. MP exposure resulted in a non-significant decrease in the number of primordial follicles and increased DNA damage in granulosa cells. Though MP did not have any effect on the ovulation it had a significant inhibitory effect on the nuclear maturity of oocytes which was associated with spindle deformity. In addition, the oocytes had higher cytoplasmic abnormalities with depleted glutathione level. Even though it did not have any effect on the fertilization and blastocyst rate at lower doses, at 20 mg/kg MP it resulted in a significant decrease in blastocyst hatching, decrease in cell number and high DNA damage. While low body weight gain was observed in F1 generation from 5mg/kg group, at higher dose, the body weight in F1 generation was marginally higher than control. Post-natal death in F1 generation was observed only in mice treated with 20mg/kg MP. In conclusion, we report that MP has adverse effects on the oocyte quality, developmental potential of the embryo and reproductive outcome.

Sperm Abnormalities Induced by pre-pubertal Exposure to Cyclophosphamide are Effectively Mitigated by Moringa Oleifera Leaf Extract

Moringa oleifera L. is a medicinal plant with potential antioxidant property. This study was aimed at investigating the chemoprotective effect of Moringa oleifera leaf extract (MOE) on cyclophosphamide (CP)‐induced testicular toxicity. Two‐week‐old male Swiss albino mice were intraperitoneally injected with phosphate‐buffered saline, 50 mg kg−1 of CP and 25 mg kg−1 of MOE. In combination treatment, mice were injected with 25 mg kg−1 of MOE 24 h prior to CP injection, 24 h prior and post‐CP injection and 24 h post‐CP injection for 5 consecutive days (10 mg kg−1). Six weeks later, mice were sacrificed to assess epididymal sperm parameters. MOE alone did not have any significant effect on sperm parameters. However, acute injection of CP resulted in significant decline in motility (P < 0.001), increase in head abnormality (P < 0.01) and DNA damage (P < 0.05). Combining MOE with CP increased the sperm density, motility and reduced head defect and DNA damage, irrespective of the schedule and dosage of MOE. Administration of MOE prior to CP significantly elevated the level of superoxide dismutase and catalase with concomitant decrease in lipid peroxidation in the testicular tissue. In conclusion, MOE may have potential benefit in reducing the loss of male gonadal function following chemotherapy.

Ethanolic extract of Moringa oleifera Lam. leaves protect the pre-pubertal spermatogonial cells from cyclophosphamide-induced damage

ETHNOPHARMACOLOGICAL RELEVANCE Moringa oleifera Lam. is widely cultivated in Asian and African countries for its medicinal and dietary significance. The leaves are highly nutritious and are known to possess various biological activities. MATERIALS AND METHODS Pre-pubertal Swiss albino male mice were injected with single dose of cyclophosphamide (CP, 200mg/kg body weight) or ethanolic extract of Moringa oleifera leaves (MOE, 100mg/kg body weight) intraperitoneally. In combination group, MOE was administered 24h prior to CP injection. RESULTS CP induced a significant decrease in testicular weight (p<0.01) and depletion of germ cells (p<0.001) and higher level of DNA damage (p<0.001) compared to control. The expression of P53, Bax, Cytochrome C (Cyt C) was increased while there was a decrease in the expression of Bcl2, c-Kit and Oct4. Administration of MOE 24h prior to CP treatment ameliorated the depletion (p<0.001), DNA damage (p<0.001) and apoptosis (p<0.01) of germ cells induced by CP. The mitigating effect of MOE appears to be mediated by up-regulating the expression of c-Kit and Oct4 transcripts in P53-independent manner. CONCLUSION MOE protects the spermatogonial cells from CP-induced damage by modulating the apoptotic response elicited by CP and therefore can be considered as an efficient method of male fertility preservation.

A morphological and morphometric study of placenta with its clinical implications

Objective: In the idiopathic intrauterine growth restriction where there are no clear maternal or fetal causes, the placenta may hold the key to its etiology. So, this study was undertaken to look for any placental and umbilical cord abnormality and to establish the relationship of fetal birth weight with placental measurements. Materials and Methods: In this study, 100 freshly delivered placentae were collected. The placenta and the umbilical cord were examined to look for any abnormalities in the shape, cord insertion, and vessels in the cord; placenta weight, its circumference, diameter, volume, and thickness at the level of cord insertion were also noted. Baby′s weight at birth and age in weeks, maternal history about diabetes and hypertension were also noted down. IBM SPSS Statistics for Windows version 20.0, USA was used to do statistical analysis of the measurements. Results: In the present study, placenta weight, volume, diameter, and circumference show a strong correlation with fetal weight. We found placenta of round and abnormal shapes in 89% and 11% of cases, respectively. In 76% of cases, we got normal cord insertion and in 24% of cases, abnormal cord insertion. Statistical analysis of all the parameters of the placenta was done. Conclusion: In our study, placenta weight, volume, diameter, and circumference showed a strong correlation with fetal weight. The knowledge of these measurements on the placenta and umbilical cord will be helpful to the pediatrician and obstetrician in clinical practice.

Anatomic study of the occipital condyle and its surgical implications in transcondylar approach

Background: Craniovertebral surgeries require the anatomical knowledge of craniovertebral junction. The human occipital condyle (OC) is unique bony structure connecting the cranium and the vertebral column. A lateral approach like transcondylar approach (TA) requires understanding of the relationships between the OC, jugular tubercle, and hypoglossal canal. Hence, the aim of the present study was to analyze the morphological variations in OCs of dry adult human skull. Materials and Methods: The study was carried out on 142 OC of 71 adult human dry skulls (55 males and 16 females). Morphometric parameters such as length, width, thickness, intercondylar distances, and the distances from the OC to the foramen magnum, hypoglossal canal and jugular foramen were measured. In addition, the different locations of the hypoglossal canal orifices in relation to the OC and different shapes of the OC were also noted. Results: The average length, width and height of the OC were found to be 2.2, 1.1 and 0.9 cm. The anterior and posterior intercondylar distances were 2.1 and 3.9 cm, respectively. Maximum and minimum bicondylar distances were 4.5 and 2.6 cm, respectively. The intra-cranial orifice of the hypoglossal canal was found to be present in middle 1/3rd in all skulls (100%), and extra-cranial orifice of the hypoglossal canal was found to be in anterior 1/3rd (98%) in relation to OC. The oval shaped OC (22.5%) was the most predominant type of OC observed in these skulls. Conclusion: Occipital condyle is likely to have variations with respect to shape, length, width and its orientation. Therefore, knowledge of the variations in OC along with careful radiological analysis may help in safe TAs during skull base surgery.

A study of morphometric evaluation of the maxillary sinuses in normal subjects using computer tomography images

Objectives: The paranasal sinuses are complex anatomical structures with a significant inter-individual variation. The dimensions of maxillary sinuses are particularly significant when considering endoscopic sinus surgery . The aims of this study were to estimate different dimensions of the maxillary sinuses measured on head CT, and their relations to sex of the individuals. Materials and Methods: Cranial computerized tomographic images (CT) of 200 normal subjects between the age groups of 18 and 80 years were observed in this study. The height, width, and depth of the maxillary sinuses were measured with a Philips Brilliance 64 CT. The statistical analysis for sex and age comparison for all the parameters was done. Results: The mean width, height, and depth of maxillary sinus in male on both right and left side were 27.8, 28.2, 39.9, 39.6, and 40.0, 39.7 mm but in females were 26.6, 26.7, 36.8, 37.1, and 36.6, 37.4 mm. The discriminative analysis showed that the accuracy of maxillary sinus measurements i.e. the ability of the maxillary sinus size to identify gender was 55% in females and 69.5% in males. Conclusion: This study on CT dimensions of maxillary sinuses may be beneficial for the ENT surgeons when planning for endoscopic sinus surgery and to support gender determination.

A morphological and morphometric study of proximal and distal ends of dry radii with its clinical implications.

Background: Knowledge of the size and shape of radial head is essential for construction of radial head prosthesis. Further, the measurements of bicipital tuberosity and its angular relationship to radial head are significant in surgical techniques, like in the reconstruction of biceps tendon. Even the morphometry of the distal radius is significant in numerous clinical orthopedic situations such as reduction of distal radius fractures and in the design of distal radius prosthesis. So, the aim of the study was to determine the morphometric parameters of proximal and distal radius in dry adult Indian radius. Methods: Fifty intact adult Indian radius (right = 23, left = 27) were chosen, and the various parameters of proximal and distal ends of radius were studied. Student′s t-test was done to correlate all these parameters on the right and left sides. Results: The mean length of radius, height of head at medial and lateral ends, head anteroposterior and transverse diameter, head thickness at ventral, dorsal, and lateral ends were 23.5, 0.90, 0.75, 1.91, 1.85, 0.42, 0.32, and 0.30 cm, respectively. The mean depth of articular facet, length of neck, proximal and distal neck diameter, width and length of bicipital tuberosity, and radial circumference at bicipital tuberosity were 0.19, 1.19, 1.36, 1.31, 1.23, 1.97, and 4.54 cm, respectively. The mean length of styloid process, oblique and transverse width of lower end, anteroposterior diameter of lower end, and angle of radial inclination were 0.98cm, 2. 81cm, 2.59cm, 1.86cm, and 25.05°, respectively. Conclusion: This study will be useful for orthopedic surgeons in making prosthesis for the proximal and distal ends of radius.

A morphological and morphometric study of jugular foramen in dry skulls with its clinical implications

Objective: Jugular foramen of human skull is one of the most interesting foramina. It is a complex bony canal, numerous vital structures, including nerves and vessels are transmitted through it. Most of the intracranial and extra cranial lesions of posterior cranial fossa might affect the structures in jugular foramen in addition to intrinsic abnormalities. As the neurosurgeons have become courageous in approaching this area, so there is a need to become familiar with this area. Hence, the present study was done to examine the anatomy of jugular foramen, including its morphological features and dimensions. Materials and Methods: The study was carried out on 50 dried skulls. 100 jugular foramina were studied on both right and left side of skulls. The length, width of jugular foramen and width and depth of jugular fossa were measured using vernier calipers. Presence of dome, complete and incomplete septation was also looked for. Results: The mean right and left anteroposterior diameter, latero-medial diameter, area, jugular fossa width, depth in our study was 11.22, 16.52, 187.34, 6.83, 11.58 mm and 9.52, 16.02, 153.2, 5.69, 11.13 mm. Dome was present in jugular foramen in 74% on the right side and 58% on the left side. Complete septation in jugular foramen is seen in 44% on the right side and 42% on the left side. Conclusion: This study will help the neurosurgeons while doing surgery in this region.

Variations in the innervations to the gluteus maximus muscle: A case report

Gluteus Maximus is the largest and superficial muscle in the gluteal region. Rhomboidal in outline, possesses coarse muscle fasciculi. Supplied by inferior gluteal nerve, a branch from the sacral plexus. During routine dissection for undergraduate medical students, we observed, a branch from sciatic nerve, which supplied the gluteus maximus muscle. It’s rare variation. Knowledge of such variations may be useful for surgeons.