Analysis of the morphometry and variations in the extensor digitorum brevis muscle: an anatomic guide for muscle flap and tendon transfer surgical dissection

Srinivasa Rao Sirasanagandla,Ravindra S. Swamy,Satheesha B. Nayak,Nagabhooshana S. Somayaji,Mohandas K. G. Rao,Kumar M. R. Bhat 대한해부학회 2013 Anatomy & Cell Biology Vol.46 No.3

The extensor digitorum brevis muscle (EDB) is a practical option for use as an island flap or free flap when reconstructing soft tissue defects in the ankle as well as in the entire lower limb. It is frequently used to correct crossover toe deformity and other painful toe disorders. We evaluated the morphometry of the EDB in 44 formalin-fixed limbs. Length and width of the muscles were measured. Surface area was calculated as the product of length and width of the muscle. The length of each tendon was also measured from its origin to the point of distal attachment. Presence of any additional tendons was noted. Mean length, width, and surface area of the muscle were 7.39±0.71 cm, 4.1±0.37 cm, and 30.5±4.78 cm2 on the right side and 7.2±0.84 cm, 3.9±0.37 cm, and 28.4±5.35 cm2 on the left side, respectively. Morphometry of the tendons revealed that the tendon of the great toe had the highest mean length (9.5 cm) and the tendon of the fourth toe had the lowest mean length (6.3 cm). Four of the limbs studied (9.09%) had only three tendons. Three of the limbs studied (6.81%) had five tendons, and in one exceptional case (2.27%), six tendons were detected. These observations have significant value and are applicable to plastic and orthopedic surgery.

Unilateral duplication of vas deferens: a cadaveric case report

Srinivasa Rao Sirasanagandla,Satheesha B. Nayak,Raghu Jetti,Kumar M. R. Bhat 대한해부학회 2013 Anatomy & Cell Biology Vol.46 No.1

Duplication of vas deferens is a rare congenital anomaly. All previously reported cases of this rare anomaly were identified during procedures such as orchiepexy, inguinal hernia repair, vasectomy, varicocoelectomy, and radical prostatectomy. Here, we report a case of unilateral duplicated vas deferens noted in an adult cadaver during regular dissection for medical students. The right spermatic cord contained 2 separate and completely developed cord-like structures. Both cords communicated separately with the tail of the epididymis. When traced cranially, both traversed the inguinal canal as content of the spermatic cord and finally fused at the level of the deep inguinal ring. No other variations were found in the testis or epididymis, and no variations were seen in the left spermatic cord. In addition, no associated renal abnormalities were noted.

Prevalence of diffuse idiopathic skeletal hyperostosis among elderly subjects referred for radiological investigation in tertiary hospital at Oman

Srinivasa Rao Sirasanagandla,Humoud Al Dhuhli,Ahmed Al Abri,Ahmed Salmi,Sathish Kumar Jayapal,Crosetto Sara,Sanjay Jaju 대한해부학회 2018 Anatomy & Cell Biology Vol.51 No.3

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification of different entheseal sites including the anterior longitudinal ligament of the spine. There is no documented information about DISH in Oman. This study determined the prevalence of DISH and associated factors among elderly subjects in a national tertiary care referral hospital in Oman. This retrospective study reviewed chest X-rays of all patients aged more than 50 years, referred to the radiology department of Sultan Qaboos University Hospital in the year 2016, based on the Resnick s criteria. The prevalence was expressed as proportions across age groups and sex. Chi-square test and logistic regression analysis was done to determine the association of the age and sex with DISH. A total of 1305 chest X-rays of patients were reviewed. The overall prevalence of DISH was 10%, with male to female ratio of 1.56:1. The odds ratio for males and increasing age were 1.63 (95% confidence interval [CI], 1.12‒2.3; P<0.05) and 1.34 (95% CI, 1.14‒1.58; P<0.001) respectively. The prevalence increased with age to maximum of 13% in the age group of ≤80. The pre-stage DISH prevalence was 9.3% and more frequently observed among males. Prevalence of DISH in the national tertiary care referral center in Oman is lower than in Jewish population, almost similar to Japanese, but higher than in Koreans. DISH prevalence is positively associated with age and sex. It is necessary to take appropriate precautionary measures to target the ageing population in Oman, especially elderly males.

Radiological study of fabella in Omani subjects at a tertiary care center

Omar Darwish Al Matroushi,Srinivasa Rao Sirasanagandla,Ammar Al Shabibi,Athari Al Obaidani,Humoud Al Dhuhli,Sanjay Jaju,Mohamed Al Mushaiqri 대한해부학회 2021 Anatomy & Cell Biology Vol.54 No.3

Ethnic diversity is associated with variability in the prevalence rates of fabella. We aimed to evaluate the prevalence and the radiological features of fabella in Omani patients. This is a retrospective analysis of hospital electronic database of patients referred for radiological investigations (radiographs and magnetic resonance imaging) of the knee, at a tertiary care referral center. Descriptive statistics were performed to determine the prevalence of fabella. Chi-square test was used to determine the association between sex or age with respect to the presence of fabella. A total of 813 knee radiographs were reviewed for the presence of fabella. Fabella was found in 24.1% of total cases. A statistically significant sex difference was observed with respect to the presence of fabella in left knees in males (P<0.01). The presence of fabella was significantly associated with age groups for the right (P<0.05) and left knees (P<0.01). In magnetic resonance imaging film reviews, all the identified fabellae (20.2%) were bony structures and were located within the lateral head of the gastrocnemius muscle. There were no cartilaginous fabellae detected. The current study revealed a prevalence of 24.1% of fabella in Omani subjects which is almost similar to the results as seen in Caucasian ethnic populations.

Solitary osteochondroma in the body of the pubic bone:

Satheesha B. Nayak,Naveen Kumar,Srinivasa Rao Sirasanagandla,Srilatha Parampalli Srinivas,Narendra Pamidi,Surekha D. Shetty 대한해부학회 2018 Anatomy & Cell Biology Vol.51 No.2

Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.

Radiologic evaluation of congenital anomalies of anterior and posterior arch of atlas in Omani subjects

Ghaliya Al Hinai,Mai Al Shandoodi,Srinivasa Rao Sirasanagandla,Salwa Al Sarhani,Humoud Al Dhuhli,Sanjay Jaju,Mohamed Al Mushaiqri 대한해부학회 2021 Anatomy & Cell Biology Vol.54 No.4

The atlas (C1) is known to present congenital anomalies in its anterior and posterior arches. The reported incidence of C1 anomalies is varied among the ethnic groups. We sought to determine the prevalence and various existing variations of C1 arch congenital anomalies in Omani subjects. This study was carried out by reviewing the cervical spine computed tomography scans of all the patients who had been referred to the Radiology Department, Sultan Qaboos University Hospital. Descriptive statistics and chi-square test were employed to analyse the data. A total of 663 subjects aged ≥18 years were included in the present study. Overall prevalence of C1 arch anomalies was 4.37% with 4.07% of isolated posterior arch anomalies, 0.3% of combined anterior and posterior arch anomalies. Among isolated posterior arch anomalies, type A and type B posterior arch defects were found in 3.77% and 0.3% of cases, respectively. Atlanto-occipital assimilation was noted in one case of total study subjects. The prevalence rate of C1 arch anomalies is relatively high in Omani subjects. The baseline data of C1 arch anomalies reported in the present study has a great impact on clinical practice, due to the fact that studying and evaluating the types of congenital anomalies helps in their accurate diagnosis and early intervention.

Eight prehilar branches of the right renal artery

Satheesha B Nayak,Surekha D Shetty,Swamy Ravindra,Srinivasa Rao Sirasanagandla,Ashwini P Aithal,Jyothsna Patil,Naveen Kumar 대한해부학회 2014 Anatomy & Cell Biology Vol.47 No.3

Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vessels at the hilum of the kidney. During routine dissections, a variation in the branching pattern of the right renal artery was noted in an adult male cadaver. The right renal artery divided into upper and lower divisions 6cm away from the hilum of the kidney. The upper division gave 4 branches, and the lower division gave two branches. These two branches further bifurcated and gave 2 branches each. Thus, there were 8 prehilar branches of renal artery. The multiple prehilar branches led to a congested atmosphere at the hilum of the kidney. This arterial congestion might result in hindering the blood flow at the renal hilum. Apart from this, it might cause difficulties in diagnostic and therapeutic invasive procedures. Knowledge of this variation is of importance to radiologists and urologists in particular.

Double gallbladder completely enclosed in a cystogastric fold of peritoneum

Satheesha B Nayak,Surekha Devadasa Shetty,Sudarshan Surendran,Raghu Jetti,Naveen Kumar,Srinivasa Rao Sirasanagandla 대한해부학회 2014 Anatomy & Cell Biology Vol.47 No.2

Double gallbladder is one of the rare congenital anomalies of the gallbladder. Failure to detect an accessory gallbladder hampers diagnosis and treatment of cholecystitis, which might result in recurrent attacks of cholecystitis. In addition, presence of peritoneal folds extending from the stomach and duodenum to the gallbladder is very rare. Here we report the presence of a double gallbladder enclosed in a cystogastric fold of the peritoneum. During cadaveric dissection, we observed a cystogastric peritoneal fold that extended from the lesser curvature of the stomach and the first part of the duodenum to the gallbladder. The left end of the peritoneal fold merged with the lesser omentum. It enclosed two gallbladders: the main gallbladder and a small accessory gallbladder. The accessory gallbladder was a small pouch with its fundus attached to the main gallbladder by fibrous tissue, and its duct opened into the main cystic duct.

Surgical and radiological importance of a rare cysto-duodeno-colic peritoneal fold

Satheesha B,Nayak,Bincy M,George,Snigdha Mishra,Surekha D,Shetty,Srinivasa Rao Sirasanagandla,Abhinitha Padavinangadi 대한해부학회 2017 Anatomy & Cell Biology Vol.50 No.2

It is quite common to see abnormal peritoneal folds in the abdominal cavity. Some of them might compress or strangulate the viscera and others might determine the direction of the flow of peritoneal fluid, pus or blood. Many unusual clinically important peritoneal folds such as Ladd’s band, cysto-gastro-colic fold, omento-cystic fold, and cysto-colic fold have been reported earlier. Knowledge of these folds is important for radiologists, gastroenterologists, and surgeons. We report an unusual cysto-duodeno-colic fold observed during our dissection classes. The fold was seen to compress the duodenum and colon. The fold extended from the descending part of the duodenum and the transverse colon to the gallbladder. It enclosed the entire gallbladder. A case similar to this has not been reported yet. It is important for the gastroenterologists and laparoscopic surgeons to be aware of this fold to avoid misdiagnosis and iatrogenic injuries.