Rajani Singh, Fabrice Duparc, David Gareth Jones, Kavita Gupta, Rahul Kumar

The development of science and technology and population explosion with changing life style has thrown the threats and challenges to the medical education/profession, besides, the existing complexity of human body and diseases. This clearly, alarms the existing clinical practice to equip it with consistence and intensive integrated research in medical subjects in general and anatomical research in particular to combat these threats and challenges. Therefore, this study has been aimed at analyzing the involvement of grey areas in clinical practice due to lack of known/unknown Human Anatomy and research in it to improve safe and successful clinical practice. This has been done by feedback survey and literature review. The statistical mean analysis of feedback survey reveals that anatomical standalone/collaborative research is most essential. However, percentage analysis of individual subjects reveals that total population in the range of 67%-100% advocate anatomical research to be most essential, 0%-33% plead for essential and none of the subjects expressed their viewpoints for research to be not essential. In the same continuation, the literature review too brings out the knowledge gaps/handicaps of clinical practice due to known/unknown Anatomy. Thereafter, it is elaborated as to how anatomical research can minimize the handicaps by improving safe and successful clinical practice. The inference of study by both methods, namely, statistical analysis of feedback and review of literature hold the intensive integrated standalone/synergistic anatomical research high. So that, it can generate wings to clinical practice to fly high in the sky of safety and success.

Rajani Singh, David Gareth Jones, Fabrice Duparc, Kavita Gupta

Human Anatomy is the science of all the macro/microstructures of human body. These structures are invaded by trauma/infection causing partial/full impairment of functions/activities of these structures producing signs and symptoms of diseases. The recovery from these diseases is done in clinical practice after studying the basics in medical education. Thus, neither medical education can be mastered nor clinical analysis carried out without sound knowledge of Anatomy. Consequently, Anatomy, medical education and clinical practice have an interwoven interdependent interrelationship among them. Hence, where there is clinical practice, Anatomy is associated with it. Therefore, this study has been designed to argue for Human Anatomy to be recognized as a clinical subject. The need, utility and applications of Human Anatomy/clinical Anatomy in medical education and clinical practice has been explored through literature search and argued as to why Anatomy should be a clinical subject. As there is intimate relationship among medical subjects and clinical practice, the teaching of human anatomy should be continued throughout all stages of medical education and clinical practice. Disease is caused by anatomical distortions/variations, and these, in turn, impair the functions and activities of affected structures. Impairment produces signs and symptoms of discomfort causing disease. As a result, it is argued that this makes Human Anatomy essential not only in medical education but also in clinical practice. In other words, there is a case for treating Human Anatomy as a clinical subject.

Rajani Singh

Thyroidea ima artery shows variability in origin and course with infrequent occurrence. Most frequently it originates from the brachiocephalic, followed by the aortic arch, common carotid, internal thoracic, inferior thyroid, transverse scapular, and suprascapular arteries. Clinically Thyroidea ima artery is very important for vascular surgeons. Hence the study was carried out. Aim of the study is to describe incidence, origin, course and clinical significance of this artery. Literature was explored using various databases. Only English language articles were selected for the study. Various terms related to thyroid ima artery were used for searching the literature. The detailed knowledge of origin and course of this artery is very essential to clinicians and vascular surgeons as it may be injured during surgery in the superior mediastinum or lower neck as in a low tracheostomy as during these procedures the artery may be damaged causing fatal haemorrhage. Its presence may be misinterpreted in neck angiography.

Rajani Singh

Third trochanter is defined as elongated, circular or conical tubercle at the superior part of gluteal tuberosity. It may influence the fracture break lines in pertrochanteric fractures. And may provide increased skeletal mass for the attachment of gluteus muscle, thereby improving its function. Hypotrochanteric fossa is varied expression of gluteus muscle attachment. There is scanty literature describing third trochanter and hypotrochanteric fossa. So, the study was conducted. The aim od the study is elaborate the incidence of these entities and to bring out their significance. Forty five unpaired (24 right, 21 left) femora were observed for the presence of third trochanter and hypotrochanteric fossa obtained from the osteology lab of Department of Anatomy, UP university of Medical Science. Incidences and association of hypotrochanteric fossa with gluteal ridges and third trochanter was computed. Incidences of third trochanter and hypotrochanteric fossa are 51% and 37.8% respectively. Out of total 17 femora, hypotrochanteric fossa was associated with third trochanter in 9 femora and that with gluteal ridges in 8 femora. Information about presence of third trochanter and hypotrochanteric fossa is useful for the diagnosis and management of pertrochanteric fractures and also in the study of microevolutionary trends in the anthropometric, epigenetics and comparative studies.

Rajani Singh, DG Jones, Raj Kumar, Naresh Chandra

Vanishing of cadaveric dissection, pruning of the curriculum and teaching schedule, the deployment of unqualified tutors/demonstrators and removal of experienced faculties with closing of Anatomy departments has eroded medical education. So tomorrows’ doctors accumulate deficient Anatomical knowledge impeding successful clinical practice. The objective of this study is to evolve a new model of Anatomy as a subject to deliver adequate Anatomy to improve clinical practice. The literature was reviewed regarding falling standards of the knowledge of Anatomy and growing failure cases. This resulted in a model for the development of Anatomy as a subject by standardizing the curriculum to be taught by medically qualified and experienced staff with the ability for standalone and collaborative research. The model will allow interaction of anatomists with clinicians/trainees by providing instant anatomical solutions during medical education. The well guided cadaveric dissection by experienced faculty will also improve the clinical practice. The model will also generate ready-made records containing variations corresponding to relevant clinical complications helping clinical trainees during clinical practice. This model will provide sufficient knowledge of Anatomy, reservoir of competent anatomical faculty and also revolutionize clinical skills among medical trainees. The aim is to ensure that the quality of medical education is enhanced.

Rajani Singh, SPS Gill

Very common disease, backpain is often debilitating/disturbing day to day activities of patients. One of the causes of backpain is sacralisation. Sacralisation is caused by congenital factors besides, others as various degrees of Sacralisation and other associated anomalies, like supernumerary digits, cleft palate, absence of teeth, disorders of thymus and parathyroid, are caused by mutation of HOX 11 and deficiency of Pax1/Pax9 paralogous genes in mice. HOX 11 and Pax1/Pax9 are also present in human beings so natural mutation can also occur in them. Therefore, as per hypothesis, the varied degree of sacralisation associated with aforementioned anomalies may be present in human being also. So, if backpain associated with sacralisation is detected during diagnosis of backpain by clinicians, other anomalies can be verified to establish the hypothesis. Therefore, a project has been designed to carry out this study. Aim of the study was to establish this hypothesis. For this, 400 cases of backpain in the age group of 25-50 were observed. Out of 400 cases, complete sacralisation was observed in 4 patients and these were not found associated with other congenital anomalies as observed in mice. This may be due to process of redundancy of genes. But definite conclusion can only be derived after adding the results of genetic studies.

Rajani Singh

Spinal cord is part of central nervous system enshrined in upper 2/3rd of vertebral canal. It contains various ascending tracts which carry sensory information to the brain and descending tracts brings motor commands from brain so that proper action is executed. Aim of the this review is to consolidate morbid anatomy and compare with the normal anatomy of spinal cord which will provide ready reference to neurosurgeons while carrying out various neurosurgical interventions. The literature was explored using the terms related to normal and morbid anatomy of spinal cord using the databases; Sceilo. Pubmed, Medline, research gate etc. Only English language article were taken into account. Some standard text books of Anatomy like Gray’s Anatomy, Cunningham’s manual, Snell’s neuroanatomy etc. were also consulted. Literature survey brought out various syndromes like anterior cord syndrome, posterior cord syndrome, central cord syndrome, conus medullaris syndrome. These syndromes cause various neurological signs and symptoms due to distorted anatomy. The knowledge and information enshrined in this work will of be of utmost use to neurosurgeons in carrying out diagnosis and neurosurgical procedures successfully, with least failure rate.

Rajani Singh

Hard palate is formed by union of maxillary process of palatine bone and horizontal plate of palatine bone during development of foetus in 12th week. Three types of foramina, greater palatine allowing greater palatine nerves and vessels, lesser palatine and incisive foramina allowing passage of lesser palatine and nasopalatine nerves respectively are normally present in hard palate. The purpose of study is to report two novel foramina in hard palate and to bring out associated clinical significance. The author observed two new foramina one on either side of intermaxillary sulcus at the junction of anterior 2/3rd and posterior 1/3rd of hard palate during scanning of base of skulls for any abnormality in the Department of Anatomy of my native institute. The diameters of the right sided foramen was 6 mm while that of on left sided was 5 mm. The distance of foramen from midline on the right side was 3 mm while that of on left side was 2 mm. The distance of foramen on the right side from the centre of inferior border of hard palate was 13 mm while that of left side was 10 mm. The hard palate separates nasal cavity and oral cavity and essential for speech, feeding and respiration. The anomalous foramina observed may create problems during speech, feeding and respiration. These foramina are of paramount importance to speech therapists, maxillofacial surgeons, physicians and academicians for new entity not described in literature.

Sylvia A. Opiyo

Insect pests cause significant loss of maize production in Africa. Among pests of maize, beetles are the most important, with the maize weevil (Sitophilus zeamais Motsch.) and the larger grain borer (Prostephanus truncatus Horn.) being the major pests. The extensive tunneling in maize grain by S. zeamais and P. trancatus adults allows them to convert grain into flour within a very short time. Synthetic pesticides are available in the market. However, such pesticides have adverse effects on non-targeted organisms and also persist in the environment and accumulate in the food chain. Plant have been reported to contain secondary metabolites some of which are toxic to pests as well as pathogenic microorganism The use of botanical in pests and disease control is preferred because they are safe and non-toxic to humans. This study investigated the efficacy of Ocimum suave Willd in management of maize weevil. The essential oil, hexane, ethyl acetate and methanol extracts as well as powdered leaves from the plant exhibited repellence, mortality and growth inhibition activities against the insects. From the isolated compounds, β-sitosterol (1), β-amyrin (3), lupeol (4) and betulinic acid (5) were the most promising in weevil control. Findings from this study revealed that extracts of O. suave are effective against S. zeamais which destroy maize and other cereal grains both in the field and in storage.

Rajani Singh

Trigeminal Neuralgia is a syndrome consisting of excruciating and lancinating facial pain. It is dreaded diseases and cripples a person so much that it is given a name “suicide disease.” This condition may lead to anxiety and depression in patients due to apprehension. Literature search has been carried out between September-December 2019 using various data bases and terms related to trigeminal neuralgia in the Department of Anatomy UPUMS Saifai Etawah India. It is said that focal demyelination at the trigeminal root entry zone is the underlying cause of this condition. According to many authors vascular compression of the nerve root causes this demyelination in most patients. To alleviate severe pain associated with this disorder, non-steroidal anti-inflammatory agents, narcotics or oral steroids may be administered. In refractory cases surgical manipulations like microvascular decompression of the trigeminal nerve or Gamma knife therapy may ameliorate symptoms. Considering severity of the condition and its immense clinical implications, review has been carried out to consolidate and update the existing knowledge and to elucidate common pitfalls in management of this disorder.