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Petroleum ether fraction of Cissus quadrangularis (PECQ) impact on the development of osteopenia in type 1 diabetic rat model has been evaluated. Diabetic rats were treated orally with two doses of PECQ. Another group of diabetic rats were treated with subcutaneous injection of synthetic human insulin. The cortical and trabecular bone thickness and bone strength were significantly decreased in diabetic rats. Treatment with two doses of PECQsignificantly prevented these changes in diabetic rats. However, PECQ treatment (two doses) did not alter the glycemic levels in these diabetic rats. Increased levels of serum alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP), and hydroxyproline were noted in diabetic rats when compared to normal control rats. The two doses of PECQ treatment further improved the serum ALP levels and significantly decreased the serum levels of TRAP and hydroxyproline. The effects of PECQ treatment on histological, biomechanical, and biochemical parameters are comparable to those of insulin. Since PECQ improves the bone health in hyperglycemic conditions by enhancing the cortical and trabecular bone growth and altering the circulating bone markers, it could be used as an effective therapy against diabetes-associated bone disorders. [ABSTRACT FROM AUTHOR]

The mylohyoid nerve is the branch of the inferior alveolar nerve (IAN) which arises above the mandibular foramen. An abnormal communication between the mylohyoid nerve and lingual nerve (LN) was noted during the routine dissection of a male cadaver. Communicating branches between IAN and LN have been identified as a possible explanation for the inefficiency of mandibular anesthesia. The communication between mylohyoid and lingual nerve was found in this case after the LN passes in close relation to third molar tooth, which makes it more susceptible to injury during third molar extractions. [ABSTRACT FROM AUTHOR]

A letter to the editor concerning the importance of palmaris longus (PL) anomalies for hand surgeons is presented.

During routine dissection of head and neck, an unusual drainage in pattern of the veins on the left side of the face was observed in an adult male cadaver. In the present case, he superficial temporal vein united with maxillary vein to form retromandibular vein within the substance of the left parotid gland. The anterior division of retromandibular vein joined with facial vein to form common facial vein that drained into left subclavian vein directly. Knowledge of such variations is important for surgeons performing head and neck surgeries. Facial veins are often grafted into carotid endarterectomy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "A Point Regarding Case Reports," by Mukund Thatte in the 2007 issue.

Background: Delayed fetal skeletal ossification is one of the known complications of maternal diabetes., Objective: The present study was designed to evaluate the protective role of petroleum ether extract of Cissus quadrangularis (PECQ) on diabetes-induced delayed fetal skeletal ossification., Materials and Methods: Female Wistar rats were rendered diabetic with streptozotocin (STZ, 40 mg/kg, intraperitonial) before mating. After confirmation of pregnancy, the pregnant rats were divided into three groups: normal control group, diabetic control group, and diabetic + CQ group. The diabetic + CQ group pregnant rats were treated with PECQ (500 mg/kg body weight) throughout their gestation period. Immediately after delivery, pups were collected from all three groups and processed for alizarin red S-alcian blue staining in order to examine the pattern of skeletal ossification., Results: Fewer ossification centers and decreased extent of ossification of forelimb and hindlimb bones were observed in the neonatal pups of diabetic control group as compared to those in the normal control group. PECQ pretreatment significantly restored the ossification centers and improved the extent of ossification of forelimb and hindlimb bones in the neonatal pups of diabetic + CQ group as compared to those in the diabetic control group., Conclusions: The results suggested that PECQ treatment is effective against diabetes-induced delayed fetal skeletal ossification. However, further studies on the isolation and characterization of active constituents of PECQ, which can cross the placental barrier and are responsible for the bone anabolic activity are warranted.

Background: The plant Cissus quadrangularis (CQ) is used as an osteoprotective agent in Ayurveda, the Indian system of alternative medicine. The present study was done to validate the anti-osteoporotic role of the petroleum ether extract of CQ on ovariectomy-induced osteoporosis in rats., Methods: Female wistar rats were divided into five groups of six rats each; (1) The Normal control (NC) group (n=6) received no surgery and no treatment, (2). The Sham control (SHAM) group (n=6) received sham surgery but no treatment, (3) the Ovariectomized (OVX) group (n=6) received an ovariectomy and normal saline treatment for 90 days, (4) the Ovariectomized+raloxifene (OVX+RAL) group (n=6) received an ovariectomy and treatment with raloxifene, a known anti-osteoporotic agent for 90 days commencing from 22nd post ovariectomy day and (5) the Ovariectomy+Cissus quadrangularis (OVX+CQ) group (n=6) received an ovariectomy, and treatmentwith the petroleum ether extract of CQ 500 mg/kg body weight daily for 90 days commencing from 22nd post ovariectomy day. At the end of the treatment period, rats in all groups were sacrificed and the right femur was used for biomechanical analysis, and the left femur for histomorphometrical analysis., Results: CQ significantly increased the force required to break the femur (p<0.001) and significantly increased the thickness of both cortical (p<0.001) and trabecular bone (p<0.001). This action of CQ was comparable to the action of raloxifene., Conclusions: The petroleum ether extract of CQ stem seems to possess anti-osteoporotic activity in rats.

During routine dissection classes to undergraduate medical students, we have observed some important anatomic variations in the right upper limb of a 45-year-old cadaver. The anomalies were superficial ulnar artery, persistent median artery, variant superficial palmar arch, third head for biceps brachii, accessory head for flexor pollicis longus, variant insertion of pectoralis major, absence of musculocutaneous nerve, coracobrachialis muscle supplied by lateral root of median nerve and anomalous branching of median nerve in arm and forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature consulted. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.

It is well known that variations in the branching pattern of the mandibular nerve frequently account for the failure to obtain adequate local anesthesia in routine oral and dental procedures, and also for the unexpected injury to branches of the nerves during surgery. During our routine dissection, we found the presence of a communicating branch between the mylohyoid and lingual nerves in a middle aged male cadaver. We also discussed its clinical and surgical implications in this report.

Objective: The study was designed to identify any association between the sacral hiatus of the dry sacral bones with that of patients with low back pain (LBP). The knowledge of the sacral hiatus is important in caudal epidural block (CEB)., Methods: Three hundred forty three (183 male and 160 female) complete and undamaged adult South Indian dry sacral bones and fifty two (30 male and 22 female) radiographs were included in the present study. The above radiographs were of patients with history of LBP. The osteological observation and the radiographic study were compared to find any associations of LBP with the location of the apex of the sacral hiatus., Results: In dry male sacrum, in 39.3% cases the sacral hiatus was inverted U shape and in 50.6% cases the female sacrum was inverted V shape. Deficient dorsal wall of the sacrum was observed in 2.7% and 12.5% in male and female sacra, respectively. The apex of the sacral hiatus was observed the most at S4 level (81.4% in male and 61.2% in female). Deficient dorsal wall was found in 40% of male and 27.2% female patients presented with LBP. The apex of the sacral hiatus in the LBP patients observed at the S4 level was 46.6% in male and 54.5% in female respectively., Conclusion: The patients with LBP had a higher percentage of deficient dorsal walls in comparison to the osteological findings (Fig. 12, Tab. 7, Ref. 12). Full Text (Free, PDF) www.bmj.sk.

During routine anatomy dissection classes for undergraduate medical students, an unilateral case of superficial ulnar artery (SUA) in a 75-year-old male human cadaver arosing from the third part of the right axillary artery at the junction of the two median nerve roots was observed. In the hand, the SUA coursed over the flexor retinaculum and anastomosed with the superficial palmar branch of the radial artery to form the superficial palmar arch. After the origin of the SUA, the axillary artery continued as the brachial artery, which was divided into radial and common interosseous arteries at the neck of the radius. The normal ulnar artery was absent. In the same cadaver, a thin walled dilatation was seen on its palmar aspect at the base of the 1st metacarpal bone (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

Axillary artery divides into 3 parts by pectoralis minor muscle and classically each part has its own branches. There are many reports to show different variations in the branching pattern of the axillary artery. However, here we have shown an unreported unique branching pattern of axillary artery, where most of the branches of the axillary artery are arising from one common trunk from its 2nd part. Further, with relevant literature review we have also discussed their developmental and clinical importance (Fig. 1, Ref. 16). Full Text (Free, PDF) www.bmj.sk.