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Introduction: Knee joint problems, such as Osteoarthritis (OA), primarily affect the upper weight-bearing end of the tibia. Total and unicompartmental knee arthroplasty are commonly performed as treatment options. However, existing studies on morphometric assessment of the knee joint mainly focus on the Western population, with a lack of data among the Indian population. Obtaining such data is crucial for designing tibial components of knee prostheses tailored to the Indian population. Aim: To compare the morphometric data of the upper end of the tibia between the North and East Indian populations. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy at FMHS Medical College, SGT University, Gurugram, Haryana, North India, involving 41 dry tibias, and at Medical College and Hospital Kolkata in East India, involving 43 dry tibias. Measurements of the Anteroposterior (AP) and Transverse Diameters (TD) of the Medial Tibial Condyle (MTC), Lateral Tibial Condyle (LTC), and Total Tibial Condyles (TTC) were performed using digital Vernier callipers with a least count of 0.01 mm. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) (version 21.0), and Student's t-test was applied, with p<0.05 considered significant. Results: The mean TD and AP diameters of the tibial plateau were found to be greater in the East Indian population (TD: 65.47±5.46, AP: 44.29±4.36). In both samples, the AP diameter of MTC (North Indians: 38.30±3.54, East Indians: 40.63±3.46) was greater than that of LTC (North samples: 35.30±3.51, East samples: 35.70±3.96). When comparing parameters between the North and East samples using Student's t-test, significant differences were found on the right-side for the mean AP (p-value=0.0065) and TD (p-value=0.0213) of TTC, mean AP (p-value=0.0006) and TD (p-value=0.0219) of MTC, mean TD of LTC (p-value=0.0002), mean AP (p-value=0.0005) and TD (p<0.0001) of the Intercondylar area at anterior ends, and mean AP (p<0.0001) and TD (p-value=0.0017) of the Intercondylar area at posterior ends. On the left-side, significant differences between the North and East population were found for mean TD of LTC (p-value=0.0348), AP (p<0.0001) and TD (p-value=0.0207) of the Intercondylar area posterior end. When comparing the areas between the North and East populations, significant differences were found on the right-side only for the MTC (p-value=0.0013), LTC (p-value=0.0083), and TTC (p-value=0.0055). Conclusion: There are significant regional variations in the anthropometric measurements of the North and East Indian populations, emphasising the need to develop populationspecific tibial prostheses for improved surgical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Determination of age and gender using bones of skull is central aspect of forensic odontology. Maxillary sinuses in this regard have shown high accuracy in predicting gender. Aim: To identify gender using the volumetric and linear measurements of maxillary sinuses obtained from a Cone Beam Computed Tomography (CBCT) by using Artificial Neural Network (ANN) based tool. Materials and Methods: A retrospective study was conducted on 80 volumes of CBCT (derived from n=80 patients) with equal gender distribution. The CBCT images were analysed for eight linear and two volumetric measurements namely the maxillary sinus height, maxillary sinus length, maxillary sinus width, distance between infraorbital foramen and distance between maxillary sinus. The data from these parameters were reported by two experts and subjected to discriminant analysis and McNemars test for gender determination. The same data was also fed to the ANN software and the accuracy of its gender prediction was analysed by Receiver Operating Characteristics Curve (ROC) and Area Under the Curve (AUC). Results: The ROC test and AUC (ANN-test) had shown high accuracy for prediction of gender form the data of the CBCT parameters for maxillary sinuses. McNemars test showed that the difference in proportion between the actual gender and ANN predicted gender was not significant (p-value=0.687) and the agreement between the actual gender and ANN in measuring the gender was 84.6%. The male sex was predicted correctly upto 89.7% and female sex upto 94.9%. Conclusion: This study has found ANN to have an encouraging predictive power in gender determination based on linear and volumetric measurements of maxillary sinus obtained from CBCT. [ABSTRACT FROM AUTHOR]

Introduction: Reference intervals are important for interpretation of clinical laboratory tests. The platelet parameters are recently reported newer haematological parameters and serve as clinically valuable biomarkers. It provides further information on platelet morphology and proliferation kinetics. The lack of information from manufacturers about the geographical reference ranges for the Complete Blood Count (CBC) parameters highlights the need for laboratories to establish reference intervals. Aim: To determine the reference interval for platelet parameters using Sysmex XN-1000 haematology analyser in South Indian population. Materials and Methods: The present retrospective record-based study was carried out during July 2021 to September 2021 and the data was retrieved from a continuous 12-month period (November 2018-October 2019) in the haematology laboratory at a tertiary care dental hospital, Chennai, Tamil Nadu, India. The data of CBC parameters were retrieved from the Sysmex XN-1000 analyser and a total of 1,883 reports labelled as negative/unflagged were included in the study. The reference intervals for platelet parameters which include Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Ratio (P-LCR) and Plateletcrit (PCT) for male and female subjects were compared using the Mann-Whitney U-test. Kruskal-Wallis test was used to compare between the different age groups using Statistical Package for the Social Sciences (SPSS) version 24.0 software. Results: The data for the platelet parameters are shown as median, with statistically significant difference in the reference interval for all the parameters (p<0.001). There was no significant difference in age divided reference intervals, except for PCT (p=0.04) PDW was found to be 9-16.4 fL for males and 9.1-16.6 fL for females (p<0.001). Similarly, MPV was 9-12.3 fL for males and 9-12.6 fL for females (p<0.001); P-LCR was 16-42.1% for males and 16.6-43% for females (p<0.001); and PCT was 0.15- 0.36% for males and 0.14-0.41% for females (p<0.001). Conclusion: The study has determined the reference interval for platelet parameters with respect to age and gender in area specific population and these results can be utilised for other laboratories using the same analyser system for south Indian population. [ABSTRACT FROM AUTHOR]

Introduction: There is a significant degree of anatomical variation at the level of the sphenoid sinus and sella turcica and a wide range of these values have been reported in literature and ethnic variation has also been found to contribute to this. Thus preoperative imaging of the central skull base with a knowledge of the normal anatomy and measurements in a specific population is imperative to identify these variations and prevent avoidable intraoperative complications. Aim: To assess the normal intracranial measurements of the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance in healthy subjects of the South Indian population aged between 10 to 80 years and to establish normal reference ranges across the various age groups. Materials and Methods: This retrospective study was conducted in the Radiology Department at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, from July 2021 to December 2021. The study included normal Magnetic Resonance Imaging (MRI) brains of 700 healthy subjects (378 males and 322 females) in the age range of 10 to 80 years. Subjects were divided into seven groups of 100 subjects for each decade. The variables that were measured included the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance. RStudio version 1.2.1093 was used for statistical analysis and p-value<0.05 was considered statistically significant. Association between age and outcome variables were assessed by Pearson’s correlation coefficient at 95% confidence interval. Results: The overall mean age was 45.4 years. The overall mean intercarotid distance was 16.2±3.7 mm, optic chiasm width was 13.1±1.6 mm, optic chiasm height was 2.18±2.7 mm, pituitary width was 12.1±2.3 mm, pituitary to optic chiasm distance was 5.7±1.84 mm. The overall pituitary fossa width and pituitary to optic chiasm distance was found to be higher in males (p-value <0.001; p-value=0.03, respectively) than females while there was no significant difference between genders in the rest of the parameters. A low and positive correlation was found between age and the pituitary width, age (r-value=0.175, p-value<0.001) and the pituitary to optic chiasm distance (r-value=0.342, p-value<0.001) and pituitary width and optic chiasm width (r-value=0.236, p-value <0.001). A strong and positive correlation was found between the pituitary width and the intercarotid distance (r-value=0.736, p-value<0.001). Conclusion: Establishment of normal reference values across various age groups of the South Indian population may prove useful for future reference and improving diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Introduction: Pregnant women with chronic hypertension and who developed superimposed Preeclampsia (PE) had a higher rate of adverse maternal and perinatal outcomes. Prospective data on the outcome of pregnancies with chronic hypertension are sparse. Aim: To evaluate the maternal and perinatal outcomes in pregnancies complicated by chronic hypertension with and without superimposed PE in South Indian population. Materials and Methods: A two group, parallel, prospective observational study was carried out in 270 women with singleton pregnancy and chronic hypertension with and without superimposed PE and who received antenatal care and delivered in the Department of Obstetrics and Gynaecology at Fernandez hospital, Hyderabad, Telangana, India from March 2019 to February 2020. A total of 180 women had chronic hypertension without superimposed PE and 90 had superimposed PE (group A, 180 cases; group B, 90 cases). The medical records were reviewed with specific reference to the treatment, development of Foetal Growth Restriction (FGR), maternal and perinatal outcomes. FGR was considered as the primary outcome variable. Secondary variables were stillbirth rate, low birth weight, Neonatal Intensive Care Unit admissions, Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) at 5 minutes, gestational age at delivery, caesarean section rate and maternal complications. Categorical variables were assessed by Pearson’s Chi-square test. Continuous variables were assessed by unpaired student t-test. Results: The mean maternal age in group A was 32±5 years and in group B was 30±4 years. Adverse maternal outcomes like abruption, Haemolysis, Elevated liver enzymes, and Low platelets (HELLP) syndrome, and pulmonary oedema were all low in women without superimposed PE than those with superimposed PE (1.6% vs 12%, p≤0.001). There were no maternal deaths in either group. Compared to group A, group B showed higher FGR rate (15.5%vs 51.1%, p<0.001), preterm deliveries (<37 weeks) (50.5% vs 80% p<0.001), stillbirths (0 vs 13.3%), low APGAR at 5 minutes (1.1% vs 16.6%%, p<0.001), low birth weight (21.2% vs 71.1%, p<0.001), NICU admissions (14.4% vs 43.3%, p<0.001). There was no significant difference in the caeserean section rate between the groups (69.4% vs 74.4%, p=0.39). Conclusion: Maternal and perinatal morbidity was higher in women having chronic hypertension with superimposed PE. They need vigilant maternal and foetal surveillance and should be counseled about all the possible adverse outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic Ovary Syndrome (PCOS) is a complex reproductive disorder characterised by hyperandrogenism, ovulatory dysfunction and polycystic/enlarged ovary. Although clinical and/or biochemical hyperandrogenism is one of the major features of PCOS, biochemical hyperandrogenism in the form of high testosterone and/or Free Androgen Index (FAI) is rarely observed in the Asian Indians. Aim: To assess various androgens to determine best available biomarker of androgens in PCOS from North India. Materials and Methods: This case-control study was conducted in the Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India, between January 2016 to December 2019. During this period 137 female with PCOS and 49 female as control were included. Serum total testosterone (T), FAI, Dehydroepiandrosterone Sulphate (DHEAS), androstenedione and Dihydrotestosterone (DHT) were measured besides assessment of hirsutism using the Ferriman-Gallwey (FG) scale. Statistical differences were derived using Mann-Whitney U test, Receiver Operating Characteristic (ROC) curve analysis and Spearman's correlation test. Results: There were 87 PCOS cases with phenotype A, 25 PCOS cases with phenotype B, 10 PCOS cases with phenotype C and 15 PCOS cases with phenotype D. The mean age was 23.7 years in the PCOS group and 26.2 years in the control group. The mean Body Mass Index (BMI) in the PCOS group was 25.23 kg/m2 and in the control was 22.6 kg/m2. FG score of ≥9 was observed in 75.9% PCOS cases. High (mean+2SD) levels of T (≥0.51 ng/mL), FAI (≥2.55), DHEAS (≥309 ug/dL), androstenedione (≥2.2 ng/mL) and DHT (≥462 pg/mL) were observed in 35.29%, 56.25%, 14.18%, 18.62% and 61.38% cases, respectively. Mean DHT value was 584.27 pg/mL in study group whereas in control was 257.15 pg/mL (p-value <0.00001) and area under ROC curve was 0.895. Similarly, area under ROC curve was 0.86, 0.817, 0.721 and 0.63 for FAI, testosterone, DHEAS and androstenedione, respectively. Spearman's correlation test of androgens with BMI, age and FG Score did not find any associations with DHT. Conclusion: Dihydrotestosterone (DHT) is best available biomarker and can be considered as diagnostic biomarker of hyperandrogenemia in PCOS women from North India. [ABSTRACT FROM AUTHOR]

Introduction: Assessing Nuchal Translucency (NT) accurately is necessary in detection of various anomalies as described in the literature. Studies deriving reference range for NT in Indian population is not widely available. Aim: To derive a normal reference range value of NT with respect to Crown Rump Length (CRL) by using ultrasound in South Indian population. Materials and Methods: A cross-sectional study was conducted on 470 pregnant women from December 2018 to March 2020. Measurement of NT thickness and CRL was performed by ultrasound at 11-14 weeks of gestation. Association between quantitative explanatory and outcome variables was assessed by calculating Pearson correlation coefficient and the data was represented in a scatter diagram. The relationship between NT thickness, CRL and gestational age was studied by using linear regression analysis. The Statistical Package for Social Sciences (SPSS) software version 22.0 was used for statistical analysis. The p-value less than 0.05 was considered statistically significant. Results: Total sample of 470 pregnant females (mean age 25.626±3.82 years, 357 multipara, mean gestational age 12.60±1.36 weeks) was analysed. The mean CRL was 59.84±10.17 mm and mean NT thickness was 1.3±0.26 mm, respectively. The median gestational age was 12.4 weeks. The regression equation which showed relation between median NT thickness and CRL was described as follows: Expected NT thickness=-1.652+(0.050)×CRL mm (R2 linear=0.995, p<0.0001). Conclusion: The study provides normative data of NT thickness in normal foetus. This data can be used as reference to screen various chromosomal abnormalities between 11-14 weeks of gestation. [ABSTRACT FROM AUTHOR]

Introduction: The anterior interosseus nerve syndrome, is a compression neuropathy affecting the anterior interosseus nerve, resulting in motor weakness of the long tendons to the index finger and thumb. Of the many conditions leading to this syndrome, one of the more common yet most overlooked aetiologies is the presence of accessory head of the flexor pollicis longus muscle, also called the Gantzer's muscle. Even though numerous studies have been done in both Indian and international populations regarding the frequency of the Gantzer's muscle, there are hardly any studies involving the South Indian population. Aim: To analyse the frequency and morphology of the Gantzer's muscle in the sub-population of Malabar region, Kerala. Materials And Methods: This descriptive observational study was performed in Department of Anatomy at Malabar Medical College, Atholi, Kerala, India, from July 2021 to August 2021. Study included 60 upper limbs from the cadavers provided for undergraduate medical education. In the limbs where the muscle was identified, parameters such as proximal and distal attachments, shape and length of muscle and tendon, relation to adjacent median and anterior interosseus nerves were studied. Frequencies of each of these parameters were analysed using Statistical Package for the Social Sciences (SPSS) software version version 21.0. Percentages obtained were compared with existing studies. Results: The Gantzer's muscle was found in 28 of the 60 limbs dissected. It was more common on the right side (17 limbs), and the most common origin was the medial epicondyle (53.6%). All the cases identified were inserted onto the ulnar aspect of the Flexor Pollicis Longus tendon, mostly in the upper third. In all cases, the Median Nerve was superficial and the Anterior Interosseus Nerve was deep to the accessory head. In majority of the cases the Anterior Interosseus Nerve was related to the posterior aspect of the belly of the Gantzer's muscle (82.1%). Conclusion: Clinicians and surgeons should be conscious of the possibility of the Gantzer's muscle being the aetiology, in cases of isolated Anterior Interosseus nerve palsies. [ABSTRACT FROM AUTHOR]

Introduction: The middle hepatic artery is an artery which supplies blood to the fourth segment of the liver. Most commonly, it originates from the right hepatic artery. Injury to the middle hepatic artery during liver transplant surgeries may lead to ischaemia and also may lead to life threatening conditions like hepatic artery thrombosis in donor as well as recipient. The variations in the origin of the middle hepatic artery in the living donors were focused in the present study as it has surgical importance in the liver transplantations. Aim: To find out the incidence of the variations in the origin of the middle hepatic artery in living liver donors using Computed Tomography (CT) angiography. Materials and Methods: This was a retrospective observational study conducted from August 2018 to October 2021 in the Department of Anatomy, Deccan College of Medical Sciences, Hyderabad, Telangana, India. The images of CT angiographies of 100 living liver donors were collected from the Department of Radiology, Global Hospital, Hyderabad, Telangana, India. All the CT angiographs of the living liver donors were observed for any variations in the origin of the middle hepatic artery and recorded and the percentage of each variation was calculated. Results: Out of 100 CT angiographs studied, the incidence of the origin of middle hepatic artery was reported as 55% from right hepatic artery, 34% from the left hepatic artery, 5% from replaced left hepatic artery, 2% from the hepatic artery proper, 1% from the common hepatic artery, 1% from left gastric artery. Double middle hepatic arteries were observed in 1% of cases. Accessory middle hepatic artery was observed in 1% cases. Conclusion: To increase the success rate of liver transplantations, the clear knowledge on the possible variations of the middle hepatic artery is needed. The variations of the middle hepatic artery reported in this study are rare and will be useful for the liver transplant surgeons. [ABSTRACT FROM AUTHOR]