Axillary artery variation: The rule not the exception
Cameron M Thiele, Danielle A Thornburg, Sonya E Van Nuland, Natalie R Langley DOI:10.4103/NJCA.NJCA_32_20
Introduction: Anatomic morphology commonly depicted in atlases or textbooks is often emphasized in gross anatomy classrooms; however, considerable variation may be observed in cadavers during dissection, particularly in the vascular system. This study statistically assesses the frequency of the classic versus variant axillary artery branching pattern and compares these observations to the incidence of variation described in the literature. Material and Methods: Axillary artery branching pattern was studied in 62 cadaver limbs. A Chi square goodness of fit test with post hoc analyses on the adjusted standardized residuals was used to evaluate branching patterns. Results: A statistically significant difference existed between the observed and expected frequencies of the classic presentation (P < 0.001). The axillary artery branching pattern exhibited the classic presentation in 17.7% of this sample; 82.3% of the limbs displayed a variant in at least one major axillary artery branch. The lateral thoracic and posterior circumflex humeral arteries were significantly variable branches observed in their textbook locations in 40.3% and 61.3% of cases, respectively. The superior thoracic, thoracoacromial, and subscapular arteries were significantly conserved branches documented in their textbook locations in 97%, 98.3%, and 98.3% of cases, respectively. Discussion and Conclusion: While anatomy educators and students understand that anatomic structure has an inherent range of variability, the classic axillary artery branching pattern students expect to find in cadavers and patients rarely occurs. Educators must present a realistic picture of anatomic complexity and emphasize the clinical and surgical implications of anatomical variation.
Study of effect of smoking on cytomorphometry of buccal mucosal cells among smokers in South Gujarat Region
Nisha D Parmar, Neeraj Master, Deepa S Gupta DOI:10.4103/NJCA.NJCA_33_20
Background: Tobacco consumption is the major cause of oral cancer. Early detection of cytomorphometrical changes in the buccal mucosa of smoker by the use of exfoliative cytology could help in picking early premalignant changes and thereby reduce morbidity in oral cancer patients. Aim: To assess and compare the cytomorphometrical changes in the buccal mucosa cells among smoker and nonsmoker group and assess these findings in smokers with a duration of exposure to smoking by dividing them as per pack year groups. Materials and Methods: This study was carried out on 51 male cases (Cigarette or Bidi smoking) and 51 controls as per the inclusion and exclusion criteria. For finding the effect of smoking exposure severity, smokers were divided into three groups based on pack year like Group 1 with pack year <5, Group 2 with pack year 5–10, and Group 3 with pack year >10. Sample was taken from the buccal mucosa and stained with Papnicoalaou stain. Images were analyzed by Image J software and nuclear area (NA), cytoplasmic area, and nuclear/cellular ratio (N/C ratio) data collected and analyzed. Results: There was a significant difference for the mean values of NA and N/C ratio in the buccal mucosa of smokers. Significantly increased NA and N/C ratio were found with increased pack year. Conclusion: Cytomorphometrical findings such as NA and N/C ratio are observed in increased severity in premalignant conditions such as leukoplakia. Hence, it is possible to pick up these findings earlier by noninvasive method such as exfoliative cytology, and it can be used as an adjunct tool for mass screening.
The effectiveness of early clinical exposure in teaching anatomy: A study among 1st year medical students
Anita R Gune, Vasudha R Nikam, Vaishali V Gaikwad, Dhanaji T Wagh DOI:10.4103/NJCA.NJCA_31_20
Background and Objective: The new study model of the Medical Council of India 2015, suggested the introduction of a module of early clinical exposure (ECE) to 1st year medical students to improve their understanding of the subjects taught. Thus, the main objective of the study was to assess; how students respond to the modified curriculum of ECE in the 1st year. Methodology: Cross-sectional study was conducted among 1st year medical students (n = 140) and were brought to the hospital; followed by the demonstration of a visual relay of an appendectomy procedure, which in turn was followed by an interactive session with the facilitators. Following this, the students filled a questionnaire (designed as per the Likert scale) about their opinion of the module. In addition, a test was conducted before and after the module to assess the comprehension of the subject by the students. Statistical analysis was performed using descriptive statistics (for qualitative variables) and t-test, for determining the significance between pre- and post-test scores. Results: Ninety-five percent of the students responded extremely well to ECE and was appreciated by the students. This was clear through the positive feedback received on improvement in understanding and interest in the subject. The pre- and post-test evaluation also resulted in a significant increase in test scores, (P = 2.20e−16). Conclusion: ECE module significantly helped 1st year medical students to comprehend the topic better. It made learning interesting and helped those correlate basic sciences with their clinical applications and relevance in practical medicine.
Background: Medial longitudinal arch (MLA) is important as per the anatomical aspect of individual's foot. Its elastic properties reduce the risk of musculoskeletal wear and impairment. Various methods of its estimation have been presented by researchers. With this basis the aim of the study is to find the value of MLA by the devised mid-footprint planter angle method and compare it with the standard navicular height method. Methodology: Purposive analytical and comparative study done on 1st year health professional students of Sumandeep Vidyapeeth University (2015–2016 batch). MLA was estimated by the navicular height method and mid-footprint planter angle method on footprint after collecting their demographic and anthropometric data. The calculated values of MLA for both feet were compared by correlation coefficient by two different methods and Kruskal–Wallis test for the comparison as per body mass index (BMI) of participants. Results: Statistical significance was observed for right (−3.57 ± 0.85; P < 0.0001) and left (−6.4 ± 0.91; P < 0.0001) foot for MLA values by two methods, with higher level of Kappa agreement for right (0.755) and left (0.794) foot. Higher to middle level of correlation was observed for both the feet as per the two methods. Statistical significance as per gender was observed for left foot by navicular height method. While, no statistical significance was observed for MLA values as per BMI for both feet as per two methods. Conclusion: MLA values estimated by mid-footprint planter angle and compared by the standard navicular height method concludes that this method can be used in place of the gold standard in day-to-day basis, but extensive work needs to be done before considering it as a replacement, specifically in terms of sample size.