Higher Termination of Brachial Artery in Cadavers in the Department of Anatomy of a Medical College: A Descriptive Cross-sectional Study

Introduction: The main blood supply for arm is provided by the brachial artery. It shows variation in branching and termination patterns in some individuals. Variation in brachial artery may cause difficulties during various clinical and surgical procedures. The present study aims to find out the prevalence of higher termination of brachial artery in cadavers in the department of anatomy of a medical college. Methods: A descriptive cross-sectional study was carried out from 10th January 2020 to 20th April 2021 after the ethical approval was taken from the Institutional Review Committee of Nobel Medical College (reference number: IRC-NMCTH 280/2020). The study was done in 58 upper limbs of 29 properly embalmed cadavers. Convenient sampling was done. They were carefully dissected. The level of termination of brachial artery was noted. The length of the brachial artery and the distance between its termination and the intercondylar line of humerus was recorded. Results: Higher termination of brachial artery was observed in 3 (5.17%) extremities; one (1.72%) at middle third of arm and two (3.45%) at lower third of arm. In 52 (89.66%) extremities, the site of termination was at the level of neck of radius. The brachial artery terminated a few centimeters below its usual site at the level of upper part of shaft of the radius in 3 (5.17%) extremities. Conclusions: The prevalence of higher termination of brachial artery in cadavers is slightly lower than the studies performed in similar settings. It is not an uncommon finding. It may have impact on clinical and surgical procedures.

Castleman’s disease: an entity forgotten in ENT

<p class="abstract">Castleman’s disease (CD) usually presents as localized or systemic lymphadenopathy or as an extra nodal mass. The usual site of presentation are mediastinum, retroperitoneum, axilla and mesentery. Only 3 cases of CD have been reported in retro pharyngeal space. We report a case of 20 year old male patient with retropharyngeal mass. He presented with difficulty in swallowing, change in voice and respiratory distress. The mass was removed in-toto transorally after performing elective tracheostomy. The histopathological findings were consistent with hyaline vascular type of CD. He was decannulated after two day and postoperative period was uneventful. Postoperative CT imaging confirmed the complete excision of tumor and patient is on follow up, with no signs of recurrence. The presentation of tumour in the retropharyngeal space which is a rare site of occurrence add to the uniqueness of this case. Unicentric CD has an excellent prognosis and surgery is the management of choice. Its clinical features, histological subtypes, treatment modalities and prognosis are discussed.</p>

Splenic cystic lymphangioma in adult: a case observed in the Visceral Surgery Department II of Mohamed V Military Hospital

Cyctic lymphangioma is a primary benign tumor due to congenital malformations of the lymphatic vessels. It is more often seen in pediatric patients and the usual site for lymphangioma is the cervical and axillary region. However, it is exceptionally seen in adults and involving rarely the spleen. The discovery of the splenic lymphangioma is generally accidental during imaging performed for another pathology. Indeed, being most often asymptomatic, the clinical presentation of cystic lymphangioma is polymorphic and it is related generally to mass effects. In this paper, we report the case of a 43 years old patient in whom the discovery was fortuitous during imaging for a non-specific symptomatology. The physical examination was normal and magnetic resonance imaging strongly evoked the diagnosis of cystic lymphangioma. A total splenectomy was performed and the histological examination has confirmed the positive diagnosis of splenic lymphangioma. Finally, this case confirmes that the diagnostic of splenic lymphangioma should be evoked in front of splenic cystic lesions and the confirmation and the differential diagnosis are made by histopathology and immunohistochemistry studies.

Colorectal Cancer and Bone Tissue: Fantastic Relations and Where to Find Them

Colorectal cancer (CRC) is the third most common cancer worldwide. There is a need for the early diagnosis of CRC for a better prognostic outcome. It is, therefore, crucial to understand the CRC pathogenesis in all its aspects. In many cases, one of the main causes of cancer-related deaths is the presence of metastases. In this context, an often overlooked aspect is the metastatic tropism, since CRC, like other cancers, is more prone to metastasize some organs rather than others. Beyond the liver and lung, and differently from other types of cancers, a not usual site of CRC metastases is the bone. However, it may assume a crucial role in the development and the outcome of the disease. Therefore, this review aims to discuss the complex relations between bone markers and CRC pathogenesis, suggesting the use of these molecules as potential targets for therapeutic purposes. Different osteogenic molecules, some of whom are growth factors and are implicated in the different osteogenic pathways, have been proved to also be involved in CRC progression. Some of them are oncogenes, while others oncosuppressors, and in a future perspective, some of them may represent new potential CRC biomarkers.

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Cerebral vein thrombosis (CVT) and splanchnic vein thrombosis (SVT) are two manifestations of venous thromboembolism (VTE) at unusual sites. They have an incidence at least 25–50 times lower than usual site VTE, but represent true clinical challenges. Recent evidence on the epidemiology, risk factors, prognosis, and treatment of CVT and SVT has been published in the last two decades, thus contributing to a better understanding of these diseases. The improvement in imaging techniques and a higher degree of clinical suspicion may have led to the observed increased frequency, whereas a better knowledge of provoking mechanisms could have contributed to reducing the proportion of events classified as unprovoked or idiopathic (13–21% of CVT, 15–27% of SVT). Few small randomized clinical trials and a number of observational studies, although hampered by heterogeneous therapeutic approaches, shed light on the safety and effectiveness of anticoagulant therapy in these populations. However, there are still some grey areas that warrant future research. In this narrative review, we discuss recent advances and therapeutic challenges in CVT and SVT.

Endomeriosis of Cesarean Section Why on Leet side?

Background: Endometriosis is defined as the presence or growth of ectopic endometrial tissue outside their usual site ( the uterus). It is a common condition in women. It may occur in the ovaries, fallopian tubes, vagina and rarely, endometriosis may occur in the abdomen and lungs. Endometriosis is common among women of reproductive age. It is either primary or secondary. The triad of diagnosis is a pain with menstruation, cesarean scar and a mass in the scar. Methods: A report a series of 65 patients in the period from 1st Jan 2013 to 31st Dec 2017. The study was performed in Al-Kindi Teaching Hospital and a private hospital. The mean age was 35 years (range 20-45).All patients were treated surgically i.e. excision of the tumor and old surgical scar in the lower abdomen. Result: mean age was 35 years (range 20-45). Thirty patients (46.15%) were housewives while 35(53.84%) were officers. The interesting finding is that 52 patients had the mass in the left side, 10 in the middle and only 3 in the right side of the scar respectively. Conclusion: Our study demonstrated a lateral asymmetry in the location of scar endometriosis i.e. mostly on the left side. The prevalence on left side of scar can be added to the triad of diagnosis mentioned above I.e. cyclical pain, cesarean scar and mass mostly in left side of the scar.

House and Home

Households in Renaissance Italy varied greatly in size and composition. This chapter introduces the idea of home as a social unit and considers this in relation to its physical characteristics, size, and the layout of rooms. Private chapels were rare except in elite families, but in every home, however modest, it was possible to designate a special corner or small table (altarino) for family prayers. The life of the Holy Family, as narrated in popular texts, provided a model for the pious home. The camera or bedroom, which was also a living room, seems to have been the usual site of domestic worship, and household inventories of the period suggest that devotional objects were often located around the bed. Practices varied between town and country.