Daisy Sahni

Estimation of stature from facial measurements in northwest Indians.

Estimation of stature is one of the important component in identification of human remains in forensic anthropology. The present investigation attempts to estimate stature from seven facial measurements of 300 (173 males and 127 females) healthy subjects between the ages of 18-70years from Northwest India. Height of all the subjects was measured and facial measurements were taken. Data was subjected to statistical analysis like mean, standard deviation, multiplication factors, Karl Pearsons correlation coefficient (r), linear and multiple regression analyses using statistical package for social sciences (SPSS). The average height of the subjects was in the range of 154.3-178.3cm in males and 155.1-168.4cm in females. Estimated stature calculated by regression analysis of seven facial measurements was almost similar to mean actual stature in both males and females and the difference by using multiplication factors was found to be greater. Standard error of estimation (SEE) computed both by linear and multiple regression analyses was found to be low for the two sexes. Thus we can conclude that regression equations generated from facial measurements can be a supplementary approach for the estimation of stature when extremities are not available.

Anatomic consideration of caudal epidural space: A cadaver study

The knowledge of sacral hiatus anatomy is imperative in clinical situations requiring caudal epidural block for various diagnostic and therapeutic procedures of the lumbosacral spine to avoid failure and dural injury. In this study, a detailed anatomic study of the sacral region was carried out on 49 male adult Indian cadavers. Dorsal surface of sacral region was dissected to study sacral cornua, sacral hiatus, and the dimensions of triangle formed by the right and left posterosuperior iliac spines with apex of the hiatus. Midsagittal sections were subjected for various anatomical measurements. The angle of needle insertion and the depth of caudal space were noted. Cornu was not palpable bilaterally in 7 (14.3%) and palpable unilaterally in 12 (24.5%) specimens. Mean (standard deviation) distance between apex of hiatus and coccyx tip was 57.5 (8.7) mm and length of sacrococcygeal ligament was 34.2 (7.4) mm. The dimensions of the triangle were found to be interchangeable in 25 cadavers. Once the needle is introduced into the canal after penetrating the sacrococcygeal ligament, it should not be advanced >5 mm to prevent dural puncture. The level of maximum curvature of sacrum was S3 in 34 (69.4%) of cases. The dural sac was found to terminate at S2 in 41 (83.6%). The mean (SD) angle of depression of the needle was 65.7 (5.5) (range 58–78). The measurements described for the identification of the sacral hiatus, optimal angle of depression, and depth of the needle may improve the safety and reliability of a caudal epidural block. Clin. Anat. 22:730–737, 2009.

Time of fusion of the basisphenoid with the basilar part of the occipital bone in northwest Indian subjects

To find out the time of fusion of the basisphenoid with the basilar part of the occipital bone in Northwest Indian subjects, a quadrilateral piece of bone extending from the posterior clinoid processes to the jugular tubercles was removed from 50 male and 34 female autopsy subjects between the ages of 10 and 20 years. The piece of bone was X-rayed and then macerated. In addition CT scan cuts of the basisphenoid were obtained in 46 male and 27 female living subjects between the age of 10 and 19 years. In the males, partial fusion was seen at 13 years while a complete fusion was noticed at 15 years in 25% of the subjects. The age of a boy showing complete fusion should be 15 years or above. If there is no fusion or partial fusion he should be below 19 years as complete fusion is seen in all male subjects at 19 years. In females, the earliest partial fusion was noted at 12 years and complete fusion was present at 13 years in 16.6%. All female subjects showed complete fusion at 17 years. The minimum age of a girl showing complete fusion should be 13 years; if no fusion or partial fusion is seen, her age should be below 17 years.

Anatomical study of the infraorbital foramen: A basis for successful infraorbital nerve block.

Detailed knowledge of variations of the infraorbital foramen (IOF) and the establishment of a constant reference point for needle insertion are important for safe and successful regional block and for avoiding iatrogenic injury to the nerve during surgery in the midfacial region. Infraorbital foramina from 133 sides of 67 dry intact adult skulls of undetermined gender were examined for variations in shape, number, location in relation to bony landmarks, and relationship to the maxillary teeth. The angles of needle insertion in the sagittal and Frankfurt planes were determined. The infraorbital foramina were located at an average distance of 6.33 ± 1.39 mm below the infraorbital margin, 25.69 ± 2.37 mm from the median plane, 15.19 ± 1.70 mm from the lateral margin of the piriform aperture, and 28.41 ± 2.82 mm above the maxillary alveolar border. The average angles of needle insertion through the IOF with the sagittal and Frankfurt planes were 21.14° ± 10.10° and 31.79° ± 7.68°, respectively. Multiple foramina were found in 21% of the hemi‐skulls. The foramen was less than 2 mm in size in 23.31% of the hemi‐skulls. The position of the IOF with respect to the maxillary teeth varied from the interval between the canine and first premolar to the first molar, but in half of the specimens it lay in line with the second maxillary premolar tooth. The observations made in this study should be useful for planning infraorbital nerve block or surgery around the IOF. Clin. Anat. 28:753–760, 2015.

Surgical anatomy of the basal turn of the human cochlea as pertaining to cochlear implantation.

Hypothesis To study the morphometry of the human cochlea with special emphasis on its basal and turn and their implications for cochlear implantation. Background Cochlear implantation is an established mode of treatment for patients with bilateral, profound sensorineural hearing loss. The intricate knowledge of the anatomy of the cochlea and its variations like unusual constriction of the cochlear lumen or dysmorphic cochlea is important for the success of cochlear implantation. Design Forty nonpathologic formalin-preserved human temporal bones were microdissected to expose the medial wall of the tympanic cavity. After exposure of the cochlea, its widest transverse and vertical diameters were measured. The internal diameter of the basal turn of the cochlea was measured on 13 sites at every 30-degree interval. The outer wall length of the basal turn was also measured. Results The mean ± standard deviation transverse and vertical diameters of cochleae were 8.06 ± 0.80 and 5.85 ± 0.72 mm, respectively. The mean diameter of the basal turn gradually tapered from 1.98 ± 0.34 mm at 0 degrees to 1.21 ± 0.32 mm at 360 degrees. Unusual constrictions were observed in the basal turn of the cochlea in 3 cases (7.5%). A wide range was found in the outer wall length of the basal turn of the cochlea (range 15.6–24.6 mm). Conclusions The cochleae differed significantly in their dimensions. Unusual constrictions found in the basal turn of the cochlea in 7.5% cases may explain the difficulties experienced by surgeons to reach full insertion in such cases. An extensive range (15.6–24.6 mm) of the length of the basal turn denotes significant variations of insertion degrees at constant surgical depths. The refined morphometric information of the cochlea may help in designing and selecting the electrode array for cochlear implantation.

Anatomical variation in formation of brachial plexus and its branching

Variant brachial plexus formation with two trunks and two cords is uncommon and has clinical implications as it may result in failure of regional brachial or axillary block. During routine anatomical dissection, unilateral variation in the formation of brachial plexus accompanied by unusual positional relationship with axillary artery was discovered in the left upper extremity of a 52-year-old Indian male cadaver. Brachial plexus showed two trunks formed by ventral rami of C5, C6 and C7, C8, T1 spinal nerves, respectively, which first split and then reunited in an unusual manner to form two cords: posterior and lateral instead of three. Medial cord was absent. The branching pattern of the brachial plexus also showed important variations. Second part of axillary artery was found lying inferomedial to brachial plexus instead of passing between medial and lateral cords. Transverse cervical artery was found to be coursing between two trunks instead of passing superficial to brachial plexus. Median nerve was observed to be formed from a single root, instead of usual two roots. Embryologically, this rare variation may be due to the development of axillary artery from ninth segmental artery instead of usual seventh cervical intersegmental artery. Such rare variation is clinically important as this knowledge may help the anesthesiologists and the surgeons to avoid any inadvertent damage to nerves and axillary artery during blocks and surgical interventions.

Time of fusion of epiphyses at the elbow and wrist joints in girls of Northwest India

A radiological examination of both elbows and wrists of 149 Northwest Indian schoolgirls between the ages of 11 and 19 years, of middle socio-economic status, was undertaken to determine the time of fusion of the epiphyses with the metaphyses of the medial epicondyle of the humerus, the proximal end of the radius and the distal ends of both radius and ulna. The data were subjected to discriminant function tests as well as sensitivity and specificity tests. If the epiphysis of the medial epicondyle of the humerus or that of the head of the radius has not fused with metaphysis completely, the age of the girl would be < 16 years. However, the age of the girl should be > 16 years if the distal epiphyses of the radius and the ulna show complete fusion with their respective metaphyses. Discriminant function tests show that 91.95% of girls can be correctly classified as being above or below the age of 16 years.

Variance in coronary venous anatomy: a critical determinant in optimal candidate selection for cardiac resynchronization therapy.

Knowledge of coronary sinus (CS) anatomy and its variations is one of the important factors determining the final position of left ventricle pacing lead during cardiac resynchronization therapy.

Bilateral multiple complex variations in the formation and branching pattern of brachial plexus

Bilateral variations in the formation and branching of brachial plexus are extremely rare. Multiple bilateral variations in brachial plexus right from divisions to branching pattern were observed during the dissection in an adult male cadaver. Lateral and medial cord formation showed deviation from the usual pattern. Anterior division of upper trunk continued as lateral cord. Medial cord was formed by the union of anterior division of lower trunk and anterior division of middle trunk, thus receiving fibers from both the trunks. Anterior division of middle trunk bifurcated into upper and lower branches. We encountered two lateral roots bilaterally and two medial roots of median nerve on the left side with anomalous origin. There were three upper subscapular nerves on the left and two on the right side with variations in their origin. Anomalous origin of many other branches on both sides was encountered. It is extremely uncommon to find so many variations in one body and bilateral variations are still too rare. Understanding of such variations is clinically important for diagnosing unexplained clinical signs and symptoms as well as during nerve blocks and certain surgical procedures around the neck and proximal arm.

An Indian mummy: a case report

A case of mummification occurring in northwest India (Chandigarh) is described. A middle-aged man developed an abscess on his back and was treated by a mystical man who did not allow him any food or water. After a few days the patient died. On the advice of the mystical man the body was kept in a room which was made hot and dry. The police discovered the body after 2 years. A postmortem examination was conducted and findings are reported.