Rishi Pokhrel

Thyroid isthmus agenesis

The thyroid gland is the largest of all endocrine glands and is placed anteriorly in the lower neck in level with fifth cervical and first thoracic vertebrae. It is H shaped with two large lateral lobes, connected by a narrow isthmus in the midline. The gland bears very important clinical significance; both physiologically and pathologically and; a wide range of variations and anomalies of the gland have been reported. We report a case of complete agenesis of thyroid isthmus found during routine cadaveric dissection for the purpose of teaching learning of medial undergraduates at our department. This anomaly is quite uncommon and bears important clinical importance in wide fields of surgical and medical specialties. The embryological basis of the anomaly is high separation of a thyroglossal duct, which can give rise to two independent thyroid lobes with no isthmus.

Redeeming dissection course for medical undergraduates by compact structured schedules and frequent in-course assessments

Introduction Trends of doing away with dissection in anatomy are increasing worldwide for a variety of reasons. We have developed a strategy to redeem dissection by making it more purposeful and edit it to highlight clinical relevance using 90 structured dissection schedules and frequent in-course assessments. Materials and methods This strategy was tested by a longitudinal interventional study in medical undergraduates in the first year of preclinical phase. Out of 268 students, 134 were in a study group and the remaining 134 in a control group. Groups were similar in terms of age and sex composition and, prior academic performance. For the control group, dissection was performed using traditional methods and for the study group by the new strategy using 90 structured dissection schedules and weekly in-course assessments. Comparison of these groups was made in terms of their performance in three examinations spanning over one academic year. Results The study group performed better than the control group in both written and oral/practical parts of the first term, preliminary examinations and university examinations, the difference being statistically significant. Conclusion The threat to wreak havoc on the very edifice of medical education is to be countered by making dissection indispensable. It has been achieved by following a planned strategy that makes the student realise the importance of dissection. Dividing dissection course in well-defined schedules and conducting frequent in-course assessments improves the participation and performance of medical undergraduates.

Unilateral high bifurcation of brachial artery

Abstract Introduction Brachial artery, the principal artery of the arm, usually divides at the level of neck of radius into two branches. This article reports a case of unilateral high bifurcation of the brachial artery. Case report We report a case of high division of the brachial artery at the level of insertion of the coracobrachialis muscle. Further course of the ulnar and radial artery after reaching the forearm was usual. Discussion This variation, though not very uncommon, occurs in the embryo due to persistence of the upper portion of the radial artery arising from the brachial artery proximal to the origin of the ulnar artery followed by failure of development of the new connection of the radial artery with the brachial artery at the level of origin of the ulnar artery. Conclusion High division of the brachial artery has a profound applied importance especially in the field of vascular surgery and radiology, and the possibility of this variation should be bore in mind before any vascular surgery in the region of the forearm or while interpreting arteriograms of the upper limb.