Rajani Singh

Study of Position, Shape, Size and Incidence of Mental Foramenand Accessory Mental Foramen in Indian Adult Human Skulls

La paralisis del nervio mentoniano es una de las principales complicaciones de la cirugia del canal mandibular y la region del foramen mentoniano. Por lo tanto, la identificacion del foramen mentoniano es de gran importancia para cirujanos dentistas en el bloqueo del nervio y los procedimientos quirurgicos como el legrado apical de premolares inferiores, obturacion de amalgamas, la cirugia periodental, etc., a fin de evitar lesiones del paquete neurovascular. Los foramenes mentonianos accesorios tienden a existir en la zona apical del primer molar y la zona posterior o inferior del foramen mentoniano. Las ramas accesorios del canal mandibular presentan caracteristicas comunes en el curso de la leve pendiente de direccion posterosuperior de la superficie bucal. Verificar la existencia de foramenes mentales accesorios evitaria la lesion del nervio accesorio durante la cirugia periapical. En el tratamiento del canal radicular, la posibilidad parestesia relacionada con dano de los foramenes mentonianos accesorios es baja a menos que el foramen mentoniano y el canal mandibular se lesionen. El conocimiento de la morfologia y la morfometria del foramen mentoniano y los foramenes mentonianos accesorios puede permitir un efectivo bloqueo anestesico mentoniano, y es fundamental previo a una cirugia. Ademas de esto, se ha encontrado que los foramenes varian en su posicion en diferentes grupos etnicos, siendo importante estudiar su morfologia y morfometria. Se realizo el estudio sobre mandibulas humanas adultas secas, de ambos sexos. El tamano y la posicion de los foramenes se determinaron utilizando calipers digitales. La incidencia y la forma del foramen mentoniano y foramenes mentales accesorios tambien fueron observados. El foramen mentoniano estaba presente en las 100 mandibulas observadas, y fueron bilaterales. Foramenes mentales accesorios estaban presente en un 8 % en el lado izquierdo, mientras que en el lado derecho, un 5%. Ninguna de las mandibulas presento formanes accesorios bilaterales. La forma era predominantemente redonda, 94% lado derecho y 87% lado izquierdo, mientras que ovalada se observo 6% lado derecho y 13% lado izquierdo. El tamano promedio de foramen mentoniano fue de 2,79mm en el lado derecho, mientras que 2,57mm en el lado izquierdo. El tamano promedio de los foramenes accesorios fue 1,00mm (rango 0,5-4,00 mm). El Foramen mental se ubico por debajo del apice del segundo premolar en un 68,8%, entre el primer y segundo premolar 17,8% y en el 11,5% se encuentro entre segundo premolar y primer molar. Los foramenes accesorios se ubicaron 0,67mm lateral al foramen mentoniano y por debajo del apice del primer molar.

Semi-solid-state fermentation of Eicchornia crassipes biomass as lignocellulosic biopolymer for cellulase and β-glucosidase production by cocultivation of Aspergillus niger RK3 and Trichoderma reesei MTCC164

An aquatic weed biomass, Eicchornia crassipes, present in abundance and leading to a threatening level of water pollution was used as substrate for cellulase and β-glucosidase production using wild-type strain Aspergillus niger RK3 that was isolated from decomposing substrate. Alkali treatment of the biomass (10%) resulted in a 60–66% increase in endoglucanase, exoglucanase, and β-glucosidase production by the A. niger RK3 strain in semi-solid-state fermentation. Similarly, the alkali-treated biomass led to a 45–54% increase in endo- and exoglucanase and a higher (98%) increase in β-glucosidase production by Trichoderma reesei MTCC164 under similar conditions. However, the cocultivation of A. niger RK3 and T. reesei MTCC164 at a ratio of 3:1 showed a 20–24% increase in endo- and exoglucanase activities and about a 13% increase in the β-glucosidase activity over the maximum enzymatic activities observed under single culture conditions. Multistep physical (ultraviolet) and chemical (N-methyl-N′-nitrosoguanidine, sodium azide, colchicine) mutagenesis of the A. niger RK3 strain resulted in a highly cellulolytic mutant, UNSC-442, having an increase of 136, 138, and 96% in endoglucanase, exoglucanase, and β-glucosidase, activity, respectively. The cocultivation of mutant UNSC-442 along with T. reesei MTCC164 (at a ratio of 3:1) showed a further 10–11% increase in endo- and exoglucanase activities and a 29% increase in β-glucosidase activity in semi-solid-state fermentation.

Is the decline of human anatomy hazardous to medical education/profession?--A review.

PurposeThe continuous decrease in teaching time, the artificially created scarcity of competent anatomical faculties and a reduced allocation of resources have brought about the decline of anatomy in medical education. As a result of this, anatomical knowledge and the standard of medical education have fallen with consequences including safety in clinical practice. The aim of the present study is to analyze this declining phase of anatomy and its impact on medical education and to consider corrective measures.MethodsThis article expresses comparative viewpoints based on a review of the literature.ResultsAnatomy enables doctors to master the language of medical science so they can communicate with patients, the public and fellow doctors and diagnose and treat diseases successfully in all medical fields. No medical specialist or expert can master their field without adequate knowledge of human anatomy. The shrinkage of anatomical schedules, inadequate faculties and declining allocation of resources is therefore unfortunate. These factors produce stress in both student and faculty creating gaps in anatomical knowledge that means insufficient skill is developed to practice medicine safely.ConclusionThis decline is hazardous not only to the medical profession but also to society. Reforms consisting of balanced rescheduling of medical curricula and optimum resource allocation have been proposed to improve the standard of education of doctors.

A historical glimpse into treating childhood hydrocephalus

Hydrocephalus was known to the ancients with Hippocrates describing it as early as the fifth century BC; some even claim that he made the first attempt to drain this excess fluid. Hundreds of years later, Galen (130–200 AD) made some of the early contributions to the then-mysterious condition [1]. In the tenth century, Abul-Qasim Al-Zahrawi, who is also known as Abulcasis, wrote a 30-volume treatise considered by many as a medical encyclopedia; he was the first to give details about the instruments used in decompression-trepanation as a treatment for hydrocephalus [2]. Some rare reports of hydrocephalus and its treatment were seen in the sixteenth century (Fig. 1 and cover figure), but it was not until the seventeenth century when Isbrand de Diemerbroeck presumed that bad nutrition and poor feeding were the main reasons for the enlargement of an 18-month-old child’s head; he described it to be Bas big as a man’s head.^ His explanation for the swelling was that an unhealthy diet caused the production of copious amounts of phlegm and thick fluids that then traveled from the intestines to the skull. He proposed a simple treatment composed of a laxative syrup and a warm head poultice while giving the child a Bdry^ diet in an attempt to decrease the amount of fluids in the body, but if these modalities failed, a small skin puncture could be made to evacuate the fluid [3]. Meanwhile, English physician Nicholas Culpeper thought the disease was fatal and very difficult to cure; however, he suggested some basic home preparations to be applied on the head to help decrease the swelling. In 1663, Robert Bayfield suggested wrapping the head with warm wool and applying an ointment [4]. Less than a hundred years later, French surgeon ClaudeNicolas Le Cat made the first documented attempt of a ventricular puncture for hydrocephalus in 1744 (Fig. 2). Le Cat thought that rapid evacuation of the fluid was the main reason surgical treatments did not work. He reported the case of a 3month-old child with massive head enlargement. Le Cat used his newly invented trocar to slowly drain the fluid outside the brain; however, his patient did not survive a second attempt [5, 6]. Still in the eighteenth century, in his letter to Dr. Hans Sloane, John Friend detailed the results of an autopsy performed on a 2-year-old patient with hydrocephalus. Friend mentioned that there was a lack of fusion of the skull due to the large amounts fluid, which occupied the space between the pia mater and dura mater [7]. Around the same time, another English physician, Michael Underwood, explained the symptoms associated with hydrocephalus which was described by him as a disease that is difficult to diagnose and even more difficult to treat. As described by Underwood, hydrocephalus could begin with vomiting, low-grade fever, photosensitivity, diplopia, and bradycardia. Later in the course of the disease, patients would have dilated pupils and tachycardia before falling into deep coma that would eventually lead to death [4]. The nineteenth century saw a giant leap in the understanding of hydrocephalus with many renowned physicians contributing to the topic (Fig. 3). Starting with Mathew Baillie in the early 1800s, his work on morbid anatomy had a very detailed description of hydrocephalus [8]. Richard Bright (1789–1858) gave a good example of hydrocephalus by pointing out the case of James Cardinal and used his wonderful hand-colored illustrations to explain the nature of the then fatal disease [9]. In the mid nineteenth century, around the time of the early Bresurrectionists,^ Robert Liston studied hydrocephalus and A. Demerdash :R. S. Tubbs (*) Pediatric Neurosurgery, Children’s of Alabama, Birmingham, AL, USA e-mail: shane.tubbs@childrensal.org

Classification and Analysis of Fifth Pair of Sacral Foramina in Indian Dry Sacra

Un sacro con cinco pares de foramenes es una variante anatomica que resulta de la sacralizacion de la vertebra lumbar al extremo craneal o sacralizacion de la vertebra coxis al extremo caudal. Esta variacion inusual es de interes para los anatomistas como tambien motivo de preocupacion para los medicos al asemejar una patologia. Un sacro con un quinto par anomalo de foramenes fue observado, por lo que se examinaron otros sacros del laboratorio de osteologia del Departamento de Anatomia Medica de la Universidad de Lucknow, India. De un total de 66 sacros estudiados, en 11 casos (16,6%) se observaron cinco pares de foramenes sacros, debido a la sacralizacion de la vertebra lumbar; mientras que en 9 casos (13,6%), se observo la sacralizacion de la vertebra caudal. Estos fueron clasificados en cinco categorias para sistematizar el estudio anatomico, sus causas y complicaciones clinicas. La sacralizacion de la vertebra lumbar puede comprimir el quinto nervio, causando ciatica sacra y dolor de espalda. Tambien puede causar una hernia discal superior a la sacralizacion. La sacralizacion de la vertebra caudal, puede influir en la anestesia de bloqueo caudal en procedimientos quirurgicos y tambien dar lugar a una prolongada etapa del trabajo de parto y desgarros perineales.

Estimation of Stature and Age from Head Dimensions in Indian Population

Los segmentos corporales presentan proporciones de acuerdo a estatura, edad, sexo y raza. Asi, la prediccion de medidas de los restos craneales es vital para determinar la identidad de un individuo en desastres naturales, como tambien, en la investigacion arqueologica en los casos cuando no se encuentra disponible el esqueleto completo. Existe escasa informacion acerca de las dimensiones craneales en la poblacion de la India. El presente estudio se llevo a cabo para predecir la estatura, edad y sexo con el proposito de asistir en la resolucion de problemas medico-legales, las complejidades antropologicas y las investigaciones arqueologicas. Como sujetos de estudio fueron seleccionados, debido a su facil contribucion, estudiantes universitarios entre 17 a 26 anos de edad de la CSM Medical University, UP, India. Las dimensiones craneales de los sujetos se midieron mediante caliper digital deslizante y llave de Todd. Las alturas de los sujetos fueron tomadas por medicion en posicion anatomica de pie y en el tiempo fijado para evitar la variacion diurna. Los analisis de correlacion y regresion ademas de los analisis estadisticos realizados son importantes para antropologos y expertos en las ciencias forenses con el proposito de facilitar y resolver complejos problemas medico-legales.

Incidence of Sutural Bones at Asterion in Adults Indians Skulls

El asterion es el punto de confluencia sutural observado en norma lateral del craneo, donde se reunen los huesos parietal, occipital y temporal. El presente estudio se llevo a cabo en el Departamento de Anatomia de la CSM Medical University, Lucknow, utilizando 55 craneos humanos secos para analizar la incidencia de los huesos suturales en el asterion y su variacion. En el asterion, la morfologia sutural se clasifica en dos tipos: Tipo I, cuando un hueso sutural estaba presente y Tipo II estaba ausente. Entre 27 craneos femeninos, el porcentaje de asterion Tipo I fue 14,81% y Tipo II 85,19%. En los craneos masculinos, 17,86% de los asterion fueron clasificados como Tipo I y 82,14% como tipo II. En el total de la muestra (sin distincion de sexo), el Tipo I fue 16,36% y 83,64% Tipo II. La morfologia sutural del asterion es esencial para determinar las vias de abordaje hacia la fosa craneal posterior. La presencia de huesos suturales en asterion puede complicar la orientacion quirurgica. Por lo tanto, el estudio se ha llevado a cabo para alertar a los neurocirujanos. Este trabajo tambien puede ser util para los antropologos y expertos en ciencia forense como examen preliminar para diferencias un craneo masculino o femenino.

Vascular Anomalies of Posterior Fossa and Their Implications

Abstract Posterior fossa houses very vital and sensitive structures namely midbrain, pons, medulla, and cerebellum. These structures are irrigated by vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. Parts of brain located in posterior fossa control important parts of body so any variation pertaining to stenosis, atresia, hypoplasia, fenestration, agenesis, and duplication in the arteries supplying these parts alter the irrigation pattern culminating into various morbid and mortal neurologic disorders. Therefore, a sound understanding and thorough knowledge of posterior circulation vascular variant anatomy builds the foundation for the accurate diagnosis and appropriate management of neurovascular ischemic and hemorrhagic diseases of posterior fossa. To aid in addressing these complex neurologic disorders and neurosurgical treatment to be carried out successfully, updating and consolidating the knowledge of all the variations/insults of these arteries becomes essential. Therefore, review study has been carried out. Literature search was carried out using databases, including Scielo, Scopmed, Medline, PubMed, and Wiley online library. Papers containing original data were selected and secondary references retrieved from bibliographies. Search terms used were posterior fossa, anomalies of vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. The study will be of paramount importance to angiographers in interpreting angiographs, neurologists in diagnosis and treatment of neurologic disorders, and neurosurgeons in performing surgery in posterior fossa and craniovertebral region particularly dealing with tumors and vascular malformations.