Variant anatomy of muscles and veins of the neck is of importance to plastic surgeons, radiologists and general surgeons. We report the variations of sternocleidomastoid muscle and veins of the neck in the present article. Right sternocleidomastoid muscle had three heads of origin. The third head took its origin from the clavicle just lateral to the usual clavicular head. All the three heads were about 4 inches long and united with each other at the level of thyroid cartilage. There was no external jugular vein on the right side. The retromandibular vein united with facial vein to form common facial vein. Common facial vein joined with superior thyroid and lingual veins to form a thyrolinguo-facial trunk one inch below the angle of mandible. This trunk was about 2 inches long and terminated into the internal jugular vein. Knowledge of this case could be useful while raising a sternocleidomastoid flap, administering anesthesia to brachial plexus, neck surgeries and carotid endarterectomy.
Neck Muscles

Criminal activities involving human life always puts lives at stake. Newer advances in other fields especially medicine and dentistry is essential in solving the mysteries of death. Different disciplines insert a part of the puzzle until it is complete. Fingerprints, DNA profiling, Forensic anthropology are commonly employed in personnel identification, mass disasters and others. Investigators may also rely on lip prints to identify possible suspects or to support evidence gained in specific investigations. A lip print at scene of crime can be the basis for inference as to the number of people involved, gender, habits, occupational traits, and others, based on the pathological changes present. This review deals with lip prints and their possible acquisition and usage.

BACKGROUND: Access to early knee osteoarthritis treatment in low and middle income nations is often believed to be limited. We conducted a cross-sectional study in India to assess prior access to treatment among patients presenting with knee pain to specialist orthopaedic clinics. METHODS: The multi-centre, cross-sectional study included patients presenting with knee pain at 3 hospitals in India. Patients who met the inclusion criteria and provided informed consent completed a questionnaire designed to assess patient demographics, socioeconomic status, knee pain, treatment method, and patient's knowledge on osteoarthritis (OA). Their orthopaedic surgeons also completed a questionnaire on the severity of patient's OA and their recommended treatments. The impact of demographic characteristics on the prescription of treatment options was analyzed using logistic regression. RESULTS: A total of 714 patients met the eligibility criteria and participated in this study. The majority of patients had been experiencing pain for less than 1 year (64.8%) and had previously been prescribed medications (91.6%), supplements (68.6%), and nonpharmacological (81.9%) treatments to manage their knee OA. Current treatment recommendations included oral medications (83.3%), intra-articular injections (29.8%), and surgical intervention (12.7%). Prescription of oral medications was related to younger age, lack of deformities, and lower Kellgren-Lawrence grades (p < 0.01). Patients treated in private hospital settings were more likely to have been previously treated with medications (range, 84.3% to 92.6%; p < 0.01) and physical treatments (range, 61.8% to 84.8%; p < 0.01) than patients treated at government hospitals. CONCLUSIONS: Contrary to the perception, our findings suggest a similar proportion of early knee OA treatment between India and North America.
Congenital Abnormalities ; Cross-Sectional Studies* ; Demography ; Hospitals, Private ; Humans ; India* ; Informed Consent ; Injections, Intra-Articular ; Knee* ; Logistic Models ; Methods ; North America ; Osteoarthritis* ; Osteoarthritis, Knee* ; Prescriptions ; Social Class ; Specialization ; Surgeons ; Surveys and Questionnaires

STUDY DESIGN: Retrospective case study by clinical and radiological data analysis. PURPOSE: To analyze different types of vertebral anomalies and the incidence of associated intraspinal anomalies in the Indian population. OVERVIEW OF LITERATURE: This is the largest study of congenital scoliosis and associated intraspinal anomalies in Indian population. Incidence of intraspinal anomaly in this series is 47% which is higher than previous literature. Hemivertebra was the most common anomaly as seen in previous studies. METHODS: A total of 119 patients with congenital scoliosis who underwent surgery between December 2006 and December 2012 were studied. Data was reviewed with medical records, plain radiographs, and magnetic resonance imaging (MRI) scans. RESULTS: Thoracolumbar curve was most common, seen in 43.6% of patients. In addition to scoliotic deformity, kyphosis was seen in 26% of patients. Failure of formation, the most common vertebral anomaly, was seen in 51.2% of patients, failure of segmentation was seen in 19.3% of patients, and there were 29.4% patients having both formation and segmentation anomalies. Hemivertebra was the most common vertebral anomaly seen in 66.3% of patients and for whom 63.2% were in thoracic spine. Intraspinal anomalies were associated with 47% of patients with congenital scoliosis. Tethered cord was the most common intraspinal abnormality and was found in 48.2% patients with intraspinal anomalies. The patients with failure of segmentation and mixed deformities were found to have a significantly higher incidence of intraspinal anomalies (65% and 57%, respectively) than those with failure of formation (34%). Out of 31 patients with kyphotic deformity 29% had intraspinal anomalies, and amongst them tethered cord was the most common anomaly seen in 66% patients. Out of 12 patients with neurocutaneous markers, 83% patients had intraspinal anomaly. CONCLUSIONS: Intraspinal anomalies were seen in 47% of patients with congenital scoliosis in the Indian population. Tethered cord was the most common intraspinal anomaly, seen in 48% cases of congenital scoliosis. Hemivertebra was seen in 66% cases and was the most common vertebral defect. Hence MRI imaging of whole spine should be done in all cases of congenital scoliosis before any surgical intervention. Special attention should be given to physical examination and visualization of any neurocutaneous markers, which are associated with a higher incidence of intraspinal anomalies; absence of a neurocutaneous marker, however, does not rule out intraspinal anomaly.
Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Magnetic Resonance Imaging ; Medical Records ; Physical Examination ; Retrospective Studies ; Scoliosis* ; Spine ; Statistics as Topic

Cutaneous sins tract of dental origin are often misdiagnosed and inappropriately treated because of their uncommon occurrence and absence of symptoms in about half of the patients. A case report describing the diagnosis and treatment of an extra oral cutaneous sinus tract of odontogenic origin in relation to mandibular left first molar with surgical treatment and proper antibiotic coverage is presented.

The mucocele is a salivary gland pathology that results from rupture of salivary gland duct and spillage of mucin into the surrounding tissues. The term mucous extravacation is also used to describe this lesion. The rupture of the gland or duct may be due to local trauma. The most common site of mucocele is lower lip. The treatment of mucocele includes cryosurgery , intra-lesional corticosteroid injection, micro-marsupialization, marsupialization of the mucocele, conventional surgical removal of the lesion , and laser ablation. The advantages of laser ablation over other methods include less treatment time, avoidance of suturing, minimal complications and relapse. Here we report a case of mucocele on lower lip treated using diode laser.

Dentinogenesis imperfecta is an autosomal dominant disorder of tooth development characterized by the presence of opalescent dentine, resulting in a dusky blue to brownish discoloration of the teeth. It is the most common dental genetic disease. This condition is genetically and clinically heterogeneous, it may affect only the teeth or it may be associated with the osteogenesis imperfecta. Diagnosis is based on history, clinical examination and radiographic features. This report describes an 18 year old male patient who showed the characteristic dental features of dentinogenesis imperfecta.

Prospective case series.

Purpose: The integration of large-scale gene data and their functional analysis needs the effective application of various computational tools. Here we attempted to unravel the biological processes and cellular pathways in response to ionizing radiation using a systems biology approach. Materials and Methods: Analysis of gene ontology shows that 80, 42, 25, and 35 genes have roles in the biological process, molecular function, the cellular process, and immune system pathways, respectively. Therefore, our study emphasizes gene/protein network analysis on various differentially expressed genes (DEGs) to reveal the interactions between those proteins and their functional contribution upon radiation exposure. Results: A gene/protein interaction network was constructed, which comprises 79 interactors with 718 interactions and TP53, MAPK8, MAPK1, CASP3, MAPK14, ATM, NOTCH1, VEGFA, SIRT1, and PRKDC are the top 10 proteins in the network with high betweenness centrality values. Further, molecular complex detection was used to cluster these associated partners in the network, which produced three effective clusters based on the Molecular Complex Detection (MCODE) score. Interestingly, we found a high functional similarity from the associated genes/proteins in the network with known radiation response genes. Conclusion This network-based approach on DEGs of human lymphocytes upon response to ionizing radiation provides clues for an opportunity to improve therapeutic efficacy.