The pancreas is a soft lobulated gland situated transversely across the upper part of the posterior abdominal wall. Its parts include the head, neck, body and tail. Annular pancreas is a rare condition where the head of the pancreas surrounds the second part of the duodenum like a ring.
Occurrence of vascular variations in the upper limb is not uncommon and is well described in the medical literature. However, occurrence of superficial ulnar artery associated with unusual origin of the common interosseous and ulnar recurrent arteries is seldom reported in the literature. In the present case, we report the anomalous origin of common trunk of common interosseous, anterior and posterior ulnar recurrent arteries from the radial artery, in a male cadaver. Further, ulnar artery had presented superficial course. Knowledge of anomalous arterial pattern in the cubital fossa reported here is clinically important during the angiographic procedures and plastic surgeries.
Manual ground searches and cadaver dogs are traditional methods for locating remains, but they can be time- and resource-intensive, resulting in the decomposition of bodies and delay in victim identification. Therefore, thermal imaging has been proposed as a potentially useful tool for detecting remains based on their temperature. This study investigated the potential of a novel search technique of thermal drones to detect surface remains through the detection of maggot mass temperatures. Two trials were carried out at Selangor, Malaysia, each utilizing 12 healthy male Oryctolagus cuniculus European white rabbits and DJI Matrice 300 RTK drone China, equipped with a thermal camera; Zenmuse H20T to record the thermal imaging footage of the carcasses at various heights (15, 30, 60-100 m) for 14 days for each trial. Our results demonstrated that the larval masses and corresponding heat emissions were at their largest during the active decay stage; therefore, all the carcasses were observable in thermal images on day 5 and remained until day 7. Statistical analyses showed that (1) no statistically significant differences in thermal images between clothed and unclothed subjects (p > 0.05); (2) 15 m above ground level was proven to be the optimal height, as it showed the greatest contrast between the carcass heat signature and the background (p
There is accumulating evidence that criminals wrap dead bodies in an attempt to conceal evidence. To anticipate the forensic implications of this phenomenon, we examined whether flies that are naturally associated with cadavers exhibit a delay in attendance or differ in species composition and abundance patterns because of the presence of wrapping material. Wrapped and exposed carcasses of dead monkeys placed in an oil plantation in Kedah, Malaysia, were visited over 50 d. On daily visits to each of the six carcasses, visiting adult flies were sampled using hand nets. Flies of 12 families were encountered. Calliphoridae (Chrysomya rufifacies Macquart and C. megacephala (F.) was the most prevalent family, followed by Sphaeroceridae. Some families tended to be more abundant in WRCs (i.e., Calliphoridae, Muscidae, and Phoridae), whereas others (i.e., Piophilidae, Sepsidae, and Psychodidae) were more prevalent in exposed carcasses. Wrapping delayed the arrival of all fly species encountered, with delays varying from 1 to 13 d depending on species. Wrapping did not affect species composition of flies, but prolong the occurrence of some species. The results of the current study emphasize the need to take into consideration the presence of a wrap when estimating postmortem interval.
The stages of decomposition and the faunal succession on rabbit carcasses in three different habitats, namely jungle, rural, and highland areas, were studied. Three New Zealand White rabbit (Oryctolagus cuniculus) carcasses weighing ∼2 kg were sampled daily until the decomposition process was completed. Representative specimens of adult flies, larvae, pupa, and mites were collected from the carcasses and processed in the laboratory. There were differences in decomposition rate and faunal succession between the carcasses. The fastest rate of decomposition was recorded in rural area, and the slowest rate of decomposition was recorded in highland area. The carcasses exhibited the same pattern of colonization by adult flies, but the dominant species of larvae and adult flies on each carcass in specific habitats were different. The primary species of flies recorded in jungle were Chrysomya megacephala F., Chrysomya rufifacies (Macquart), Chrysomya chani Kurahashi, Chrysomya villenuevi Patton, Chrysomya nigripes Aubertin, Chrysomya pinguis (Walker), Hemipyrellia ligurriens (Wiedemann), Hemipyrellia tagaliana (Bigot), Hypopyiopsis fumipennis (Walker), Hypopygiopsis violacea (Macquart), and Hydrotaea spinigera Stein represented by both adults and larvae. Musca domestica L., Atherigona sp., Lioproctia pattoni (Senior-White), Lioproctia saprianovae Pape & Bänziger, and Seniorwhitea princeps (Wiedemann) were represented by adults only. The biodiversity of flies in the rural area were C. megacephala, C. rufifacies, H. ligurriens, Fannia canicularis L., Hydrotaea chalcogaster (Wiedemann), and Hyd. spinigera represented by both adults and larvae, meanwhile M. domestica, Atherigona sp., Boettcherisca peregrina (Robineau-Desvoidy), Parasarcophaga taenionota Wiedemann, Parasarcophaga scopariiformis Senior-White, and S. princeps were represented by adults only. The species of flies collected in the highland area were Lucilia porphyrina (Walker), C. megacephala, C. rufifacies, C. villenuevi, C. pinguis, H. ligurriens, Hyd. spinigera, Hyd. chalcogaster, F. canicularis, and Boettcherisca highlandica Kurahashi & Tan represented by both adults and larvae, whereas C. nigripes, Chrysomya thanomthini Kurahashi & Tumrasvin, M. domestica, Atherigona sp., Parasarcophaga albiceps Meigen, P. taenionota, Sepsidae, Phoridae, and Millichidae were represented by adults only. Faunal succession followed the sequence of dominant flies, i.e., Calliphoridae, Sarcophagidae, Muscidae, Sepsidae, and lastly Stratiomyidae for jungle, or Sepsidae for rural and highland studies. Mites, from suborders Mesostigmata, Prostigmata, Astigmatina, and Oribatida, were also recovered throughout decomposition, which could be used for future implementation in forensic investigations. The data obtained from this study could provide more accurate indicators for local forensic scientists in solving criminal cases especially on the determination of time and primary location of death.
This study investigated the effect of loading the iliotibial band (ITB) on the stability of the patellofemoral joint. We measured the restraining force required to displace the patella 10 mm medially and laterally (defined as medial and lateral stability, respectively) in 14 fresh-frozen knees from 0 to 90 degrees knee flexion. The testing rig allowed the patella to rotate and translate freely during this displacement. The quadriceps was separated into five components and loaded with 175 N total tension. Testing was performed at 0 to 90 N ITB tension. With no ITB tension, the lateral restraining force ranged from 82 to 101 N across 0 to 90 degrees flexion. Increasing ITB tension caused progressive reduction of the lateral restraining force. The maximum reduction was 25% at 60 degrees flexion and 90 N ITB tension. Medial restraining force increased progressively with increasing knee flexion and increasing ITB loads; it ranged from 74 N at 0 degrees knee flexion and 0 N ITB tension to 211 N at 90 degrees knee flexion and 90 N ITB tension. The maximum effect was an increase of medial restraining force of 50% at 90 degrees flexion and 90 N ITB tension.
Radial tunnel syndrome refers to pain on the lateral aspect of the forearm as a result of compression of the posterior interosseous nerve within a tunnel with specific anatomical boundaries. Diagnosis of the condition is difficult because of its close association with lateral epicondylitis, which warrants different methods of treatment. Based on a cadaveric study, a new clinical test, the Rule-of-Nine test, is proposed to improve the diagnostic accuracy in radial tunnel syndrome. The test involves constructing 9 equal squares on the anterior aspect of the forearm and noting those squares where tenderness can be elicited.
Phorid flies play an important role in forensic cases and can cause myiasis in humans. Studies on phorid flies species diversity are still limited in Malaysia. This research was carried out to collect information about species and frequency distribution of phorid flies as to provide more information on their roles in forensic and medical entomology. Bait trap was used with 100 g beef liver as baits. The species of the flies were identified using identification keys from Disney as well as Brown and Oliver. There were 449 phorid flies found in Kepong, Kuala Lumpur including Megaselia scalaris, Megaselia spiracularis, Megaselia sp. and phorid flies of genus X. Female phorid flies (98.89%) were found more prone to be trapped compared to male phorid flies (1.11%). Most phorid flies trapped in Kepong, Kuala Lumpur were from genus Megaselia and consisted of female flies. A total of five species of phorid flies probably new to science were also discovered. This study showed that Megaselia flies were found indoors rather than in open spaces. This was corresponding to their discoveries among the decomposing corpse found inside premises.
The testis is an important organ upon which the survival of the human species depends. Any compression of testicular artery may lead to loss of gametogenesis and hormone production. We found a left testicular artery entrapped between two divisions of a left renal vein in an approximately 50 year old cadaver. The left renal vein was formed by union of two veins coming from the kidney, left suprarenal vein, left testicular vein and an abnormally enlarged lumbar vein. This case may be of particular importance to surgeons who transplant kidneys, radiologists and orthopaedic surgeons dealing with the spine repairs.
The musculocutaneous and median nerves frequently show variations from their normal course. The purpose of this paper is to report a rare variation, in which the right musculocutaneous nerve was absent. Consequently, the median nerve supplied motor innervation to the flexor compartment of the arm and sensory innervation to the lateral aspect of the forearm. The primary targets of this paper are orthopedic surgeons, anesthesiologists and radiologists. In cases of injuries to the upper limb, knowledge of these variations can assist them in avoiding misdiagnoses.
Background Gallstone disease (GSD) is one among the most prevalent diseases that affects approximately 10-15% of the population. It is associated with many other diseases like gallbladder cancer, renal stones, atherosclerosis, coronary heart disease and stroke. Objective Objective of this study is to document the prevalence of gallstones among south Indian cadavers. Method One hundred and twenty three South Indian cadaveric livers/gallbladders were observed for the presence of gallstones. The age range was 40 to 70 years. The gallbladders were palpated to know the presence of stones. They were then dissected and the stones were classified based on appearance. Gall bladder walls were also observed to know the associated fibrosis. Result Among the cadavers studied, 0.81% possessed cholesterol stones and 4.06% had pigment stones. Among the stones, 83.33% were pigment stones and 16.66% were cholesterol stones. Conclusion Compared to the western countries and north Indian studies, the prevalence of gallstone diseaseis low in the south Indian population (4.87%). The low prevalence was probably due to the low socioeconomic status and the diet and lifestyle.
Celiac trunk is the first ventral branch of the abdominal aorta. It usually terminates by giving three branches; the common hepatic artery, the left gastric artery and the splenic artery. We report a rare variation of the branching pattern of the celiac trunk. The Celiac trunk divided into two branches; left gastric artery and splenicogastroduodenal trunk. The splenico-gastroduodenal trunk divided into splenic and gastroduodenal arteries. The superior mesenteric artery and hepatic artery took origin from a common hepato-mesenteric trunk. The hepatic artery had a winding course around the portal vein and hepatic duct. The knowledge of these variations is important while doing radiological investigations and liver transplant and pancreatic surgeries.
During extensive osteological study of 150 dry skulls in the Department of Anatomy, Vardhman Mahavir Medical college, an unusual Paramedian Occipital (POC) condyle was detected in the occipital bone of a cadaveric skull. The anatomical details of this unusual occipital condyle were carefully studied and its morphometric measurements taken. A coronal multiplanner reformatted image and a volume rendered image were taken to study radiological details and establish significant clinical correlation. Precise understanding of anatomy of craniovertebral junction and its anomalies have become immensely important for the present day surgeon during orthopaedic and neurosurgical procedures of this region . Technical advancements in imaging modalities such as CT and MRI scans further signify the importance of these anatomical variations ,which are often missed in routine examination. Osteological study combined with radiological details of the paramedian occipital condyle in the present case aims to emphasize the importance of bony anomalies in the craniovertebral region and their role in diagnosis and appropriate treatment of neurovascular compression syndromes of craniovertebral junction. The present study highlights anatomical details, clinical relevance and embryological basis of such a rare unusual paramedian occipital condyle.
Anomalous structures of the liver are incidentally detected during autopsies or during routine cadaveric dissection. The present study aimed to observe the abnormal shapes of quadrate lobe, accessory sulci and ligamentum teres of the liver.
In this case report, we report the absence of the fourth tendon of flexor digitorium superficialis (FDS) to the little finger with a concurrent anomalous muscular belly of flexor digitorum profundus (FDP) in the palm. The FDS originated from the medial epicondyle, divided into three tendons for the index, middle and ring fingers with the little finger devoid of any attachment. The FDP exhibited a muscular belly which passed deep to the flexor retinaculum (FR) and continued for another 4 cm thereby dividing into four slips for the index, middle, ring and little fingers. The presence of the muscular belly of the FDP lead us to think whether it was an adhesion between the tendons of the FDP, so we proceeded to histological analysis. The tissue was processed and stained with Hematoxylin and Eosin. Abundant longitudinal muscle fibers with peripherally situated nuclei confirmed it to be a skeletal muscle. Absence of the tendon of FDS to little finger may influence the flexion movement in the middle and proximal interphalangeal joints. Presence of anomalous muscle belly of FDP in the palm may mimic any soft tissue tumour, compress neurovascular structures or even pose difficulty while performing tendon transplant surgeries.
The flexor compartment muscles of the arm comprising of biceps brachii, brachialis and the coracobrachialis are innervated by the musculocutaneous nerve arising from the lateral cord of the brachial plexus. In the present study, we report a case of anomalous innervation of the corachobrachialis muscle on the left side of a 45-year-old male cadaver. The musculocutaneous nerve originated from the lateral cord, as usual and pierced the corachobrachialis muscle. The median nerve was formed by a contribution from both lateral and medial roots, both of which took origin from the lateral and medial cords, respectively. In addition to the usual musculocutaneous nerve which pierced the corachobrachialis muscle and innervated it, two more anomalous branches from the median nerve were observed to innervate the corachobrachialis. The anatomical knowledge of the variations of the innervations of the corachobrachialis muscle may be important not only for surgeons performing coracoid transfer but also for clinicians diagnosing nerve lesions.
The sternalis is an anomalous muscle located in the anterior wall of thorax and several past reports have described its presence with clinical implications. The sternalis muscle may be incidentally detected during routine cadaveric dissections and autopsies. We observed the presence of anomalous sternalis muscle on both sides of the anterior chest wall in 25 cadavers (n = 50), over a span of three years. Out of a 50 cases, we observed a single case of sternalis on the right side of the 55-year-old male cadaver (2%). The sternalis was found to be absent in the rest 49 cases (98%). The sternalis muscle displayed an oblique course in the anterior wall of the thorax. The muscle originated near the seventh costal cartilage extending obliquely upwards to insert into the second costal cartilage close to the sternum. The originating portion of the muscle was located at a distance of 3.5 cm lateral to the mid-sternal plane. The vertical length and the maximum width of the anomalous sternalis muscle measured 9 cm and 1.9 cm, respectively. The fibers of the muscle vertically ascended upwards. No other associated anomalies were observed in the same cadaver. The presence of sternalis muscle is considered to be a rare variation with no earlier studies being performed in the Malaysian population. The anomalous sternalis muscle may be important for reconstructive surgeons performing mastectomy and radiologists interpreting mammograms. Thus, the sternalis muscle may be academically, anthropologically and surgically important.
The sphenoid bone is known to have several foramina and the foramen ovale is one amongst them. The foramen ovale transmits the mandibular nerve, accessory meningeal artery, lesser petrosal nerve and the emissary veins. There have been past reports on the variations of the different foramina present in the skull but there are no reports on the variations of the skull foramina from any of the South-East Asian countries. The present study aims to highlight the presence of an accessory foramen ovale in the skull in Malaysian population. Both sides of fifteen adult skulls (n = 30) were taken for observation of any variations in the foramen ovale. We observed the presence of accessory foramen ovale on the left side of a single skull (3.33%). The minute accessory foramen ovale was located 0.1 cm medial to the normal foramen ovale. The anomalous accessory foramen ovale was circular in shape and measured 0.1 cm in diameter. Anatomical knowledge of the foramen ovale is important for all neurosurgical procedures involving the trigeminal nerve and administration of anaesthesia in the mandibular nerve. Interestingly, the percutaneous biopsy of the cavernous sinus is also performed through the foramen ovale. Prior knowledge of the presence of an accessory foramen ovale may be important for academic, anthropological, forensic and clinical purpose and the present study aims to highlight such.
Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications.
Femoral nerve (FN) is the largest branch of lumbar plexus. It lies lateral to femoral artery (FA) and it is located outside the femoral sheath. Profunda femoris artery (PFA) is a branch of the FA. The present study aimed to observe the topographical anatomy and relationship of the PFA and the FN.