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.
As it is known; the majority of the human subjects has two renal arteries arising from the abdominal aorta; each will supply one kidney but in 30% of individuals, certain variations can be found. Accessory renal arteries constitute the most common and clinically important of these variations. For our case report, we are presenting one of these different variations that can be found in the blood supply of the kidneys. During dissecting the abdomen of an approximately 65 years-old male cadaver, multiple variations were found. There were double right renal arteries with prehilar branching of the upper renal artery. We found also that the right renal vein ascended upwards obliquely before ending in the lateral aspect of the inferior vena cava. Variation in the renal vessels is relatively common, especially multiple renal arteries, and can go smoothly without any abnormalities with the function of the kidney, but in some situations like renal transplantations, vascular reconstructions, and various surgical and radiological diagnostic techniques, the study of the anatomy of these variations is of crucial importance to decrease the patient morbidity during surgical procedures.
Decomposition is degradation process of a corpse into basic respective constituents macroscopically and microscopically by action of microorganisms, arthropods and scavengers. Post mortem changes could be separated into early post mortem changes (i.e. algor mortis, rigor mortis and livor mortis) and putrefaction stages of corpse. These changes function as suitable indicators for determination of post mortem interval (PMI). In this paper, different stages of post mortem changes, possible variations such as mummification and formation of adipocere and special circumstances such as burial condition is discussed. This article also refers to several arguments in the different texture of adipocere and the influence of different types of fabric in affecting the post mortem changes and formation of adipocere. This is largely due to the property of permeability and resistance of material against degradation process. Undeniably, decomposition process involves numerous potential variables including burial condition, presence of clothing, potential formation of adipocere and mummification. Hence, studies in forensic taphonomy combined with real case scenario are crucial in understanding the nature of decomposition and estimation of PMI with higher accuracy.
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.
Dorsal plating is commonly used in proximal phalanx fractures but it bears the risk of interfering with the extensor apparatus. In this study, dorsal and lateral plating fixation methods are compared to assess biomechanical differences using conventional 1.5mm non-locking plates and novel 1.3mm lateral locking plates.
The distributions of flies are not only confined to ground level but can also be at higher altitudes. Here, we report three forensic cases involving dipterans in high-rise buildings in Kuala Lumpur, Malaysia. Case 1 involved a corpse of adult female found at the top floor of a fifteen-story apartment. Case 2 dealt with a body of a 75-year-old female discovered in a bedroom on the eleventh floor of an eighteen-story building, while Case 3 was a 52-year-old male found in his fifth floor shop house. Interestingly, entomological analysis revealed that all corpses were infested with similar Dipterans: Megaselia scalaris (Loew) (Diptera: Phoridae), Synthesiomyia nudiseta (Wulp) (Diptera: Muscidae) and sarcophagid (Diptera: Sarcophagidae). The first two species were commonly associated with corpses found indoors at ground level. We noted the additional occurrence of blowflies Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) and Chrysomya rufifacies Macquart (Diptera: Calliphoridae) larvae in Case 2 and Case 3, respectively. Findings from this study are significant as they demonstrate that certain groups of fly can locate dead bodies even in high-rise buildings. Forensic entomofauna research on corpses found at high elevation is scarce and our study has highlighted the peculiarity of the fly species involved in Malaysia.
Percutaneous placement of pedicle screws is a well-established technique, however, no studies have compared percutaneous and open placement of screws in the thoracic spine. The aim of this cadaveric study was to compare the accuracy and safety of these techniques at the thoracic spinal level. A total of 288 screws were inserted in 16 (eight cadavers, 144 screws in percutaneous and eight cadavers, 144 screws in open). Pedicle perforations and fractures were documented subsequent to wide laminectomy followed by skeletalisation of the vertebrae. The perforations were classified as grade 0: no perforation, grade 1: < 2 mm perforation, grade 2: 2 mm to 4 mm perforation and grade 3: > 4 mm perforation. In the percutaneous group, the perforation rate was 11.1% with 15 (10.4%) grade 1 and one (0.7%) grade 2 perforations. In the open group, the perforation rate was 8.3% (12 screws) and all were grade 1. This difference was not significant (p = 0.45). There were 19 (13.2%) pedicle fractures in the percutaneous group and 21 (14.6%) in the open group (p = 0.73). In summary, the safety of percutaneous fluoroscopy-guided pedicle screw placement in the thoracic spine between T4 and T12 is similar to that of the conventional open technique.
Variations in the urogenital vascular anomalies in the abdomen are very common. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. During routine dissection of abdomen in a male cadaver, unique urogenital vascular anomalies were observed. On the right side, the right renal artery was found to be originated from the abdominal aorta at the level of L2 and divided into five branches; the right testicular artery and inferior suprarenal artery originated from the lower branch. We also observed, accessory renal artery arising from abdominal aorta at the level of L3 and double renal veins on right side. On the left side, we found left renal artery originating from the abdominal aorta at the level of L2 and divided into two branches. Double testicular (medial and lateral) arteries were also observed. In addition to these vascular variations, bilateral kinking of ureter at the pelviureteric junction was also observed. Although the variations in the origin of urogenital vessels in the abdomen are common, deeper understanding of the urogenital vascular variations and their relations to adjacent structures is significant during surgical and radiological procedures.
Variations of the sciatic nerve have been extensively studied in the past including its relationship with the piriformis muscle and associated clinical conditions like piriformis syndrome and sciatica. In the present study we noticed some interesting variations of the sciatic nerve, which were slightly different from the cases described earlier. In the previous studies most of the authors described the higher division of sciatic nerve and none of them discussed its formation. In this study we tried to look its formation from the sacral plexus and its divisions in the thigh. We noticed that in one cadaver the two components of the sciatic nerve originated directly from the sacral plexus and coursed down without merging in the thigh. Should this be called a higher division or non formation of the sciatic nerve? On the other hand in two other cadavers, the two divisions after emerging separately from the sacral plexus, united in the gluteal region and in the thigh respectively. Should we call this as higher division or low formation of the sciatic nerve? In two other cadavers the sciatic nerve emerged from the greater sciatic foramen below the piriformis and divided in the gluteal region itself. Ideally this should be called as higher division of sciatic nerve.
Mortality rate due to heart diseases increases dramatically with age. Captopril is an angiotensin converting enzyme inhibitor (ACE) used effectively for the management of hypertension. Due to short elimination half-life of captopril the oral dose is very high. Captopril is prone to oxidation and it has been reported that the oxidation rate of captopril in skin tissues is considerably low when compared to intestinal tissues. All these factors make captopril an ideal drug candidate for transdermal delivery. In this research work an effort was made to formulate transdermal films of captopril by utilizing polyvinylpyrrolidone (PVP) and polyvinyl alcohol (PVA) as film formers and polyethylene glycol 400 (PEG400) as a plasticizer. Dimethyl sulfoxide (DMSO) and dimethylformamide (DMF) were used as permeation enhancers. Physicochemical parameters of the films such as appearance, thickness, weight variation and drug content were evaluated. The invitro permeation studies were carried out through excised human cadaver skin using Franz diffusion cells. The in-vitro permeation studies demonstrated that the film (P4) having the polymer ratio (PVP:PVA = 80:20) with DMSO (10%) resulted a promising drug release of 79.58% at 24 hours with a flux of 70.0 µg/cm(2)/hr. No signs of erythema or oedema were observed on the rabbit skin as a result of skin irritation study by Draize test. Based on the stability report it was confirmed that the films were physically and chemically stable, hence the prepared films are very well suited for transdermal application.
Human pluripotent stem cells (hPSCs) derived from either blastocyst stage embryos (hESCs) or reprogrammed somatic cells (iPSCs) can provide an abundant source of human neuronal lineages that were previously sourced from human cadavers, abortuses, and discarded surgical waste. In addition to the well-known potential therapeutic application of these cells in regenerative medicine, these are also various promising nontherapeutic applications in toxicological and pharmacological screening of neuroactive compounds, as well as for in vitro modeling of neurodegenerative and neurodevelopmental disorders. Compared to alternative research models based on laboratory animals and immortalized cancer-derived human neural cell lines, neuronal cells differentiated from hPSCs possess the advantages of species specificity together with genetic and physiological normality, which could more closely recapitulate in vivo conditions within the human central nervous system. This review critically examines the various potential nontherapeutic applications of hPSC-derived neuronal lineages and gives a brief overview of differentiation protocols utilized to generate these cells from hESCs and iPSCs.
The brachial plexus at the infraclavicular level runs deeper compared to its course proximally, giving rise to impaired needle visualisation due to the steep angle of needle insertion with the current ultrasound-guided approach. A new posterior parasagittal in-plane ultrasound-guided infraclavicular approach was introduced to improve needle visibility. However no further follow up study was done.
Variations in the arterial pattern of upper limb are of colossal importance to the surgeons as they are liable to iatrogenic injuries. During routine dissection for undergraduate medical students, an anomaly of brachial artery was discovered. The brachial artery terminated at higher level into ulnar and radial artery. The common interosseus artery took origin arising from radial artery. The ulnar artery did not give any branches in the forearm. Both radial and ulnar artery displayed a superficial course in the forearm. The anatomical knowledge of these variations may be of great help for the clinicians in planning and conducting flap harvesting during reconstructive surgeries and in arteriography.
In a forensic acarology study, conducted in a secondary forest of Forensic Science Simulation Site, Universiti Kebangsaan
Malaysia (UKM) in Bangi, Selangor, six carcasses consisted of three monkeys and three rabbits were placed individually
in steel enclosures and observed for 35 days. The carcasses, the soil beneath them and pitfall traps were checked daily
for insects and mites. A species of mesostigmatid mite, Macrocheles scutatiformis was discovered and this is a first time
reported in Malaysia. There are about 94.0% of Macrocheles present inside the cages of the monkey and rabbit carcasses.
Most mites in this study were collected from soil beneath the carcasses, on a dung beetle and a Chrysomya rufifacies
larva. Our findings showed that M. scutatiformis have a potential role in forensic investigation involving dead animals
perhaps corpses especially during the dry stage of decomposition.
Multiple anomalies in the celiac arterial system presents as rare vascular malformations, depicting deviations of the normal vascular developmental pattern. We found a common left gastro-phrenic trunk and a hepato-spleno-mesenteric trunk arising separately from the abdominal aorta in one cadaver. We also found a common hepatic artery and a gastro-splenic trunk arising individually from the abdominal aorta in another cadaver. Even though many variations in the celiac trunk have been described earlier, the complex variations described here are not mentioned and classified by earlier literature. Knowledge of such variations has significance in the surgical and invasive arterial radiological procedures in the upper abdomen.
Considering that crimes against animals such as illegal killing and cruelty have been alarmingly increasing and since burning is one of the common ways for disposing cadavers, ability to estimate minimum postmortem interval (PMI) using entomological data merits consideration. Chrysomya megacephala and Chrysomya rufifacies are common necrophagous species recovered from cadavers in many countries including Malaysia. Specific studies focusing on the oviposition and developmental patterns of both species on cadavers manifesting different levels of burn as described by the Crow-Glassman Scale (CGS) remain scarce. In four replicates, rabbit carcasses were burned to CGS levels #1, #2 and #3 by varying the amount of petrol used and duration of burning. Oviposition by C. megacephala and C. rufifacies was delayed by one day in the case of carcasses burned to the CGS level #3 (p<0.05) when compared with that of controls. Such delay in oviposition was not observed in the CGS level #1 and #2 carcasses. No significant differences (p>0.05) in the duration of development were found between control and burned carcasses. These findings deserve consideration while estimating minimum PMI since burning as a mean for disposing animal and human cadavers is gaining popularity.
Organ donation rates have continued to fall seriously short of needs worldwide, with the lowest rates recorded among developing economies. This study seeks to analyze evidence from a developing economy to explore the usefulness of social psychological theory to solve the problem. The study deployed a large survey (n = 10 412) using a convenience sampling procedure targeted at increasing the number of Malaysians registered with the Ministry of Health, Malaysia who are willing to donate organs upon death. Structural equation modeling was deployed to estimate simultaneously the relative influence of cognitive and noncognitive variables on willingness to donate deceased organs. The cognitive factors of donation perception, socioeconomic status and financial incentives, and the noncognitive factors of demography and fear showed a high statistically significant (1%) relationship with willingness to donate organs after death. While financial incentives were significant, cash rewards showed the least impact. Donation perception showed the highest impact, which shows that the development of effective pedagogic programs with simultaneous improvements to the quality of services provided by medical personnel engaged in retrieving and transplanting deceased donor organs can help raise organ donation rates.
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.
Formation, distribution and possible communication of the median nerve are essential to know in treatment and surgeries of various conditions of injuries e.g. repair or reconstruction of the median nerve post traumatic accident. In the present study, 44 upper limbs were dissected. Root forming the median nerve, the median nerve in relation with the axillary artery and communication of the median nerve with other nerves were noted.
Due to cost containment considerations, it is common to have medical schools being
located in buildings or campuses built for some other purposes. These buildings are converted into
medical schools which often compromising the functional architectural aspects. Objectives: The
paper examines, explores and proposes an architectural concept of a purpose-built medical school. The
architectural design proposed is sensitive to the values and norms of many schools around the globe.
Methods: An Internet search and personal communication were conducted, focusing on the concepts
of the functionality of medical school. It emphasises on general design of the main building, keeping
in mind the various kinds of teaching, learning and assessment activities. We examined lecture hall,
pre-clinical laboratory, skill laboratory, general facilities of Objective Structured Practical Examination
(OSPE) and Objective Structured Clinical Examination (OSCE). Results: We present hypothetical
structural designs based on built-functions concepts. For example, for the better vision of students
around a demonstration table, an inclined floor surface is proposed. The concept is as illustrated by
anatomy dissection area built inclined upward from the cadaver table. It inevitably provides a better
visual access to the students around the table. Other teaching and learning areas are also illustrated
wherever appropriate in the text. Conclusion: The paper is hypothetical and explores innovative
structural designs of modern medical schools. While most are built to meet the demands of current
technology, it cannot however completely replace face-to-face teaching and learning processes.
Research in architectural designs of education buildings and facilities may be further developed into a
new research niche of medical education.