Facial vein is the main vein of the face. Though its origin is constant, it frequently shows variations in its termination. We report a rare type of variation of facial vein. The right facial vein coursed transversely across the masseter, superficial to the parotid duct and entered into the substance of the parotid gland, at its anterior border. Deep dissection of the gland revealed the abnormal termination of facial vein into the superficial temporal vein. The transverse facial vein drained into the facial vein. The superficial temporal vein after receiving the facial vein continued as retromandibular vein. Knowledge of this anomalous course and termination of facial vein may be important for the surgeons doing parotid, maxillofacial and plastic surgeries.

PURPOSE: In this study, the effect of calcium sodium phosphosilicate (NovaMin) desensitizing agent, which is a powder-based system, and hydroxyethyl methacrylate and glutaraldehyde (Gluma desensitizer), which is liquid-based system, on dentinal tubule occlusion was analyzed by scanning electron microscope. The effects of the above two along with one control group were compared to determine the more effective method of sealing the dentinal tubules after initial application. METHODS: Twenty specimens were allocated to each of 3 groups: Control, Gluma desensitizer, and NovaMin. Two additional samples were also prepared and treated with Gluma and NovaMin; these samples were longitudinally fractured. The specimens were prepared from extracted sound human premolars and were stored in 10% formalin at room temperature. The teeth were cleaned of gross debris and then sectioned to provide one to two dentin specimens. The dentin specimens were etched with 6% citric acid for 2 minutes and rinsed in distilled water. Control discs were dried, and the test discs were treated with the desensitizing agents as per the manufacturer's instructions. The discs as well as longitudinal sections were later analyzed under the scanning electron microscope. The proportions of completely occluded, partially occluded, and open tubules within each group were calculated. The ratios of completely and partially occluded tubules to the total tubules for all the groups was determined, and the data was statistically analyzed using nonparametric tests and statistical significance was calculated. RESULTS: NovaMin showed more completely occluded tubules (0.545+/-0.051) while Gluma desensitizer showed more partially occluded tubules (0.532+/-0.075). The differences among all the groups were statistically significant (P< or = 0.05). CONCLUSION: Both materials were effective in occluding dentinal tubules but NovaMin appeared more promising in occluding tubules completely after initial application.
Bicuspid ; Calcium ; Citric Acid ; Dentin Sensitivity ; Dentin* ; Formaldehyde ; Glutaral ; Humans ; Methods ; Microscopy, Electron, Scanning ; Sodium ; Tooth ; Water

Though ulnar arterial variations are rare, superficial ulnar artery (SUA) is one of its commonest variations. During routine dissection in our department, we observed a unilateral case of SUA in a 70-year-old male human cadaver. It originated from the left brachial artery in the middle of the arm, 13cm above the medial epicondyle of humerus (15cm below the outer margin of first rib). From its origin, it passed downwards in the medial part of arm and forearm in a superficial plane compared to normal ulnar artery. In the hand, the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. The superficial palmar arch gave additional branches to the thumb and index finger. Brachial artery divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. The existence of a SUA is undeniably of interest to the clinicians as well as to the anatomists. We hereby present a case of unilateral SUA along with a brief review of the literature and analysis of its clinical significance.

Though congenital anomalies of the spleen are quite common, the peritoneal anomalies of the spleen are very rare. In the present case, we observed two unusual phrenico-splenic ligaments connecting the spleen to the diaphragm. Apart from this, the left lobe of the liver was elongated and was related to the diaphragmatic surface of the spleen. The splenic artery had a straight course to the spleen, indicating the possible restricted movements of the spleen. Knowledge of such unusual relation of spleen is essentially important for the surgeons as the elongated left lobe of the liver might get ruptured in addition to the spleen in the fractures of the left 9th, 10th and 11th ribs. Awareness of the straight course of the splenic artery is also of importance to Radiologists performing arterial splenoportography.

Facial vein, being the largest vein of the face forms the common facial vein after joining with the anterior division of retromandibular vein below the angle of the mandible. Usually, it drains into the internal jugular vein. During routine dissection of head and neck region of a male cadaver, aged approximately 50 years, an unusual pattern in the termination of veins on the left side of the neck was observed. The formation, course and termination of external jugular vein were normal. The anterior division of retromandibular vein joined with external jugular vein about 5 cm above the clavicle and the facial vein opened into the external jugular vein about 2.5 cm above the clavicle. In addition, there was a thin venous communication between anterior division of retromandibular vein and external jugular vein. The superficial veins of the neck are often used for cannulation; either for intravenous infusion or for central venous pressure monitoring. Furthermore, these venous segments are used as a patch for carotid endarterectomies. Hence, a thorough knowledge of the normal anatomy and their variations may be useful for performing these procedures.

Intestinal malrotations are associated with various anatomical anomalies. We report a unique case wherein the caecum was located in the right lumbar region instead of the right iliac fossa. The ileo-caecal junction was also placed higher up. The appendix was ‘uncinate’ shaped, highly coiled and retroperitoneal with the absence of mesoappendix. Both, the caecum and appendix were supplied by ascending branch of the ileocolic artery instead of the descending branch. Further, we also observed that the ascending colon was very short and sub-hepatic in position. Such type of variations is of clinical and surgical importance in diagnosis and treatment of appendicitis.

Purpose: To study the ocular manifestations, its severity and sequelae in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Methods: Prospective study of 44 consecutive patients (30 SJS and 14 TEN) presenting in the acute phase of the disease. Patients were evaluated by dermatologist as well as physician for systemic status, skin lesions and mucosal involvement. Detailed history taking, visual acuity, ophthalmic evaluation (lid margin, corneal, conjunctival changes, tear film and ocular surface). Ocular severity score (OSS) was assessed at baseline (acute) and at 6 months (chronic / OSS6), graded as mild, moderate and severe. Results: Mean age was 28.15 ± 15.78 years. Sixty-five eyes of 33 patients were included for final analysis. Thirty-eight patients (86.4%) had ocular manifestations. Drugs were the most common causative factor (95.4%). At base line mild, moderate, and severe OSS was seen in 43.1%, 44.6%, and 12.3% eyes. At 6 months mild, moderate, and severe OSS was seen in 44.6%, 7.7%, and 6.2% of eyes. There was a significant correlation between age of the patient and OSS at 6 months (p = 0.02). Younger age had higher chronic OSS. Patients with TEN had higher acute (p = 0.001) and chronic (p = 0.001) OSS than SJS. Three mucosal surface involvement associated with higher acute and chronic OSS (p = 0.001). No long-term ocular complications observed in 27 / 65 (41.5%) eyes. Acute OSS correlated significantly with chronic OSS, at 1 and 6 months (p = 0.001). Conclusions Greater severity of the disease, more number of mucosal surfaces involved and shorter symptom lag correlated with more severe acute and chronic ocular manifestations. The severity of lid margin involvement and corneal involvement in acute stage were good predictors of severity of chronic ocular findings. Initial severity of ocular involvement correlated with severity of ocular sequelae.

Purpose: To study the ocular manifestations, its severity and sequelae in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Methods: Prospective study of 44 consecutive patients (30 SJS and 14 TEN) presenting in the acute phase of the disease. Patients were evaluated by dermatologist as well as physician for systemic status, skin lesions and mucosal involvement. Detailed history taking, visual acuity, ophthalmic evaluation (lid margin, corneal, conjunctival changes, tear film and ocular surface). Ocular severity score (OSS) was assessed at baseline (acute) and at 6 months (chronic / OSS6), graded as mild, moderate and severe. Results: Mean age was 28.15 ± 15.78 years. Sixty-five eyes of 33 patients were included for final analysis. Thirty-eight patients (86.4%) had ocular manifestations. Drugs were the most common causative factor (95.4%). At base line mild, moderate, and severe OSS was seen in 43.1%, 44.6%, and 12.3% eyes. At 6 months mild, moderate, and severe OSS was seen in 44.6%, 7.7%, and 6.2% of eyes. There was a significant correlation between age of the patient and OSS at 6 months (p = 0.02). Younger age had higher chronic OSS. Patients with TEN had higher acute (p = 0.001) and chronic (p = 0.001) OSS than SJS. Three mucosal surface involvement associated with higher acute and chronic OSS (p = 0.001). No long-term ocular complications observed in 27 / 65 (41.5%) eyes. Acute OSS correlated significantly with chronic OSS, at 1 and 6 months (p = 0.001). Conclusions Greater severity of the disease, more number of mucosal surfaces involved and shorter symptom lag correlated with more severe acute and chronic ocular manifestations. The severity of lid margin involvement and corneal involvement in acute stage were good predictors of severity of chronic ocular findings. Initial severity of ocular involvement correlated with severity of ocular sequelae.

Pulp chamber is considered as a very important and integral part of the tooth. Pulp chamber undergoes different types of morphological and pathological alterations. Calcified canals are one amongst other pathological alterations. Calcified root canals have been a challenge to the diagnostician and the dental physician before diagnosis and after diagnosis respectively. It is considered that the impact of an irritant to the tooth, like trauma, caries, infection and age changes can precipitate calcification. Calcification makes a dentist to negotiate with his treatment planning and at times it can be a surprise element.

With aging, abnormal benign growth of the prostate results in benign prostate hyperplasia (BPH) with concomitant lower urinary tract symptoms (LUTS). Because the prostate is an androgen target tissue, and transforms testosterone into 5alpha-dihydrotestosterone (5alpha-DHT), a potent androgen, via 5alpha-reductase (5alpha-R) activity, inhibiting this key metabolic reaction was identified as a target for drug development to treat symptoms of BPH. Two drugs, namely finasteride and dutasteride were developed as specific 5alpha-reductase inhibitors (5alpha-RIs) and were approved by the U.S. Food and Drug Administration for the treatment of BPH symptoms. These agents have proven useful in the reducing urinary retention and minimizing surgical intervention in patients with BPH symptoms and considerable literature exists describing the benefits of these agents. In this review we highlight the adverse side effects of 5alpha-RIs on sexual function, high grade prostate cancer incidence, central nervous system function and on depression. 5alpha-Rs isoforms (types 1-3) are widely distributed in many tissues including the central nervous system and inhibition of these enzymes results in blockade of synthesis of several key hormones and neuro-active steroids leading to a host of adverse effects, including loss of or reduced libido, erectile dysfunction, orgasmic dysfunction, increased high Gleason grade prostate cancer, observed heart failure and cardiovascular events in clinical trials, and depression. Considerable evidence exists from preclinical and clinical studies, which point to significant and serious adverse effects of 5alpha-RIs, finasteride and dutasteride, on sexual health, vascular health, psychological health and the overall quality of life. Physicians need to be aware of such potential adverse effects and communicate such information to their patients prior to commencing 5alpha-RIs therapy.
Aging ; Central Nervous System ; Depression* ; Erectile Dysfunction ; Finasteride ; Heart Failure ; Humans ; Hyperplasia ; Incidence ; Libido ; Lower Urinary Tract Symptoms ; Male ; Orgasm ; Prostate ; Prostatic Neoplasms* ; Protein Isoforms ; Quality of Life ; Reproductive Health ; Sexual Dysfunction, Physiological ; Steroids ; Testosterone ; United States Food and Drug Administration ; Urinary Retention