<p class="abstract"><strong>Background:</strong> Aplasia or agenesis of frontal sinuses is not uncommon in the literature. Previous studies have shown unilateral aplasia varying from 1-10% and bilateral agenesis of frontal sinus in 3-10% of patients. It is critical for the operating surgeon to be well aware of the normal anatomy and the variations while doing procedures like endoscopic sinus surgeries, cranialisation of frontal sinuses, frontal sinus trephination, and during anterior skull base procedures. The aim of this study is to demonstrate the incidence of anatomic variations of frontal sinus among Indian populations<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> We did a cross sectional study on computed tomography (CT) scan of head, nose and paranasal sinuses in 730 patients above the age of 10 years. We excluded pregnant ladies, patients with prior sinus surgeries, sinonasal tumors, nasal polyposis, craniofacial trauma<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">We observed an incidence of 6.2% of unilateral aplasia of frontal sinus (2.2% in males and 4.0% in females, 3.7% right side and 2.5% left side) and 2.5% of bilateral frontal sinus aplasia (0.95% in males and 1.5% in females). </span></p><p class="abstract"><strong>Conclusions:</strong> Frequent occurrence of frontal sinus aplasia highlights the need to gain a thorough knowledge of the normal anatomy and its variations in order to navigate safely through the nose during basic endoscopic sinus or anterior skull base surgeries to avoid complications<span lang="EN-IN">.</span></p>

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Background: The nerve of Kuntz is an inconstant intra thoracic ramus arises from the 2 nd thoracic nerve and it carries the sympathetic fibres joined with either 1 st thoracic or 1 st intercostal nerve or stellate ganglion to contribute the sympathetic innervations to the upper limb. The intra thoracic nerve of Kuntz is one of the causes for surgical failures and recurrence of symptoms after sympathectomy. Knowledge of anatomy of the sympathetic innervation to the upper limb is of great importance for neurosurgeons during surgical sympathectomy procedures. Materials and Methods: The study was conducted in 12 formalin fixed cadavers (24 sides) in the Department of Anatomy, Chettinad Hospital and Research Institute. After reflection of the anterior wall and eviscerated of the thorax, the intrathoracic organs were removed to expose the posterior mediastinum. The incidence of any connection between the 2 nd to 1 st thoracic or 1 st intercostal nerve or stellate ganglion were noted and photographed. The variations observed were classified as per Zaidi and Ashraf (2010) classification of intra thoracic nerve of Kuntz. Observations: In the present study, Out of 12 cadavers (24 sides) dissected, the nerve of Kuntz was present in 9 Specimens (37.6%). As per Zaidi and Ashraf (2010) classification, Type A was seen in 12.5%, Type B in 4.3%, Type C in 8.3% and of Type D in 12.5% Conclusion: The data regarding the study on variations of intra thoracic nerve of Kuntz is helpful to the surgeons to successfully perform upper limb sympathectomy.

This study aims to reveal the incidence of origin, insertion, and nerve supply of Gantzer's muscle and to provide necessary information to surgeons in concern to compartment syndrome.Material and Methods: 50 embalmed disarticulated upper limbs (23 right & 27 left sides) were dissected and analyzed to find the incidence of Gantzer's muscle along with their sources of origin, the sites of insertion and nerve supply were observed and documented.Results:The incidence of an accessory head of flexor pollicis longus (Gantzer's muscle) was 24 % (12 out of 50 upper limbs). All the incidences of Gantzer's muscles were unilateral, among which, in 5, it was seen on the right side and in 7 on the left side and bilateral occurrence was not found. All the Gantzer's muscles originated from two different sources, one from the medial epicondyle and other from the coronoid process of ulna and the majority of the cases were inserted to the middle third of the tendon of FPL. In the present study, Gantzer's muscle was innerved by the anterior interosseous nerve in all specimens except in one, which was supplied by the median nerve. Conclusions:The knowledge of which, has to be borne in minds of the operating surgeons for anterior interosseous nerve syndrome and median nerve compression for an effective outcome.

Various studies have shown that the prevalence of CAD among diabetic patients is higher than non-diabetic patients. 3 It is also seen in literature that the prevalence of CAD among the urban is higher compared to rural patients. 2 CAD in diabetic patient is mainly owing to dyslipidemia (raised triglycerides, raised cholesterol and low HDL). Both persistent hyperglycaemia and dyslipidemia, especially raised LDL and low HDL eventually causes ABSTRACT Background: The patients with type 2 diabetes have an increased prevalence of lipid abnormalities (Dyslipidemia). Early diagnosis of diabetic patients with silent CAD and dyslipidemia can reduce the morbidity and mortality for cardiovascular death. The objective of the present study is to assess the prevalence of silent coronary disease among south Indian type-2 diabetic patients without cardiovascular symptoms and association between lipid profile and silent coronary disease among them. Methods: 100 Type 2 diabetes mellitus patients (65 males and 35 females) of age 40-80 years attending the OPD of Sri Siddhartha Medical College, Tumakuru, Karnataka, India were enrolled in this study. The Serum samples were analysed for fasting blood glucose (FBS), post prandial blood glucose (PPBS), HbA1c, and lipid profile. The patients were classified into CAD and Non CAD groups based on ECG changes and stress test. Results were analysed SPSS 16.0 software. Results: The study revealed that 46% of our study population had silent CAD. The prevalence of dyslipidemia was found higher in males than females in both study groups. CAD group patients had significantly higher levels of serum total cholesterol, triglycerides, LDL-cholesterol and low HDL-cholesterol compared to Non CAD group. Conclusions: Dyslipidemia is indicating the strong association with silent CAD in type 2 diabetes mellitus. It is also advisable to have a screening ECG for silent CAD at the time of diagnosis or during the follow-up period in type 2 diabetes.

Introduction: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been implicated in a variety of vulnerable bacterial and fungal diseases. Mucormycosis is a life-threatening infection caused by fungi belonging to the class Zygomycetes and the order Mucorales. The aim of the present study is to evaluate the level of serum ferritin level in mucormycosis patients and to prognosticate them based on those values. Materials and methods: This prospective observational study was conducted in the Department of General Medicine, Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli, in 50 diagnosed mucormycosis patients. Results: During the study period, 44 had prior COVID-19 illness (post-COVID). Six patients had mucormycosis with no prior COVID-19 illness. Rhino-orbital involvement was found in 44 of the 50 cases, with three of them having cerebral extension. Forty-one cases recovered and were discharged, six cases remained sick and were hospitalized, and three died. The post-COVID patients (554.13 ± 371.60) have greater serum ferritin levels than non-COVID patients (259.95 ± 110.15), which are statistically significant. Conclusion: Mucormycosis patients tend to have higher serum ferritin values, especially among non-survivors and sick patients than survivors. For a better chance of recovery and survival, early identification, surgical debridement, and antifungal medications are essential.

Variations in the pectoralis major (PM) muscles have been reported by various authors in the literature. We report a case of accessory slip of PM with variation in insertion which has not been reported in the literature to the best of our knowledge. This accessory slip was partially muscular getting inserted into medial lip of intertubercular sulcus (ITS) and partially aponeurotic getting inserted into lateral lip ITS, thus forming "H"-shaped pattern. Knowledge of such anatomical variation will create awareness among surgeons performing surgical reconstruction using PM muscle.

Introduction: The lumbrical muscles are unique in their functions in being only intrinsic muscles which bridges between the palmar and dorsal surface. This unique property endows them in performing fast, alternating movements and fine tuning digit motion. The aim of this study was to evaluate the anatomical variations in the morphology and architecture of lumbricals and to discuss its clinical implications. Subjects and Methods: This study was conducted on 74 disarticulated upper limbs during routine dissection of cadavers in the Department of Anatomy of MVJMC & RH. The dissection was carried out based on the steps as per the Cunningham’s manual. Results: Variations in lumbricals were observed in 12 specimens (8 in right side & 4 in left side). The variation encountered were the proximal origin of lumbricals in 4 specimens (5.41%), Split insertion in one specimen (1.35%), bipennate second lumbrical in two specimens (2.70%), accessory belly of first lumbrical in 4 specimens (5.41%) and hypertrophied lumbrical in one specimen (1.35%). Conclusion: Variations of the lumbrical can present with wide range of clinical presentations like compression of neurovascular structures as in hypertrophy, carpal tunnel syndrome as in proximal origin and accessory belly of lumbrical.