Abstract:During routine dissection of an adult male cadaver in the Department of Anatomy It was found that the right median nerve was formed by three roots, two coming from lateral cord and one from medial cord of brachial plexus.The uppermost or highest root was noted to be at the level of origin of coracobrachialis muscle. The second root was found to be immediately below the first one.These two roots were found to be passing obliquely in front of second and third part of axillary artery and joining individually with the medial root of median nerve and forming median nerve trunk, in front of third part of axillary artery. (Figure No.-1) Further distribution of the anomalous median nerve in the arm, forearm and palm was normal. The arterial pattern in arm was also normal. The left median nerve was also normal. Discussion:The median nerve is normally formed by the union of two roots: lateral root of median nerve coming from the lateral cord (C5, C6, C7) of brachial plexus and medial root of median nerve coming from the medial cord (C8, T1) of brachial plexus. The two roots embrace the third part of the axillary artery, uniting anterior or lateral to it. Some fibres from C7 often leave the lateral root in the lower part of the axilla passing

The coracobrachialis muscle in the arm is morphologically the sole representative of adductor group muscle in the arm, but such function during the process of evolution became insignificant in man. It is more important morphologically than functionally. Variant insertion of the coracobrachialis muscle was found during routine dissection of an adult male cadaver in the Department of Anatomy, College of Medical Sciences, and Bharatpur, Nepal.Normally the coracobrachialis muscle is inserted into the middle of the medial border of the humerus. In the present case an additional slender tendon passed inferiorly, crossing anterior to the median nerve and brachial artery, before attaching to the medial epicondyle of the humerus. Most of the proximal part of the tendon gave rise to an aponeurotic expansion that inserted into the distal medial border of the humerus. The tendinous insertion and aponeurotic expansion may represent a variant of the coracobrachialis longus (Wood's) muscle and the internal brachial ligament or the ligament of Struthers. The ulnar nerve was found to be traversing below the aponeurotic expansion. This type of anomalous insertion of coracobrachialis muscle may lead to compression of median nerve, brachial artery and ulnar nerve.

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Objective: To study the effect of quercetin on methotrexate induced toxicity and to observe the histopathological changes. Materials and Methods: Thirty male rats were divided into 5 different groups with each group consisting of six rats. The Group I was a control and they were treated with 10 ml/kg of carboxymethyl cellulose. The Group II, III, IV and V animals were treated with methotrexate 0.125 mg/kg; methotrexate 0.25 mg/kg; methotrexate (0.125 mg/kg) + quercetin (500 mg/kg); and methotrexate (0.25 mg/kg) + quercetin (500 mg/kg), respectively. All drugs were administered orally through oral gavage once daily for 14 days. At the end of the study, blood samples were collected from all the animals in each group. The animals were then sacrificed and organs were collected for histopathological analysis. Results: Methotrexate 0.125 and 0.25 mg/kg significantly increased the levels of liver enzymes such as AST, ALT, ALP and total protein and renal markers such as urea and creatinine. The animals treated with quercetin along with methotrexate showed significant improvement on methotrexate induced liver and renal toxicities. Methotrexate significantly reduced the levels of haemoglobin and blood sugar and which was partially reversed by quercetin. The notable histopathological changes in lungs, liver and kidneys were observed with methotrexate treated animals and this was protected by quercetin. Conclusion: Methotrexate produced significant pathological changes at 0.250 mg/kg and possible ameliorative effect of quercetin observed in lung, liver and kidney. Quercetin 500 mg/kg significantly inhibited the methotrexate induced toxicity in liver and kidneys.

Palpable masses in head and neck are a common clinical finding, affecting all age groups. These lumps may be extremely worrying for both physician and patient, as a wide variety of pathological conditions. Accurate cytological analysis has played a major role in evaluation and planning for surgery. We attempted to evaluate the role of Fine Needle Aspiration Cytology (FNAC) in diagnosing lesions of the head and neck region and to review the diversity of lesions in the patients attending the hospital. The study was conducted retrospectively in the department of pathology at College of Medical Sciences- Teaching Hospital, Bharatpur, Nepal a tertiary health care centre. The target population comprised patients presenting with palpable masses at head and neck region during the period of February 2007 to December 2009. The accuracy of FNAC was verified by histological examination in this final study group of (n=125) patients. In these (n=125) patients, twenty five were males and hundred were females. Thyroid gland (60%) was the commonest site aspirated, followed by lymph node (20%), salivary gland (16%) and soft tissue lesions (4%). In our study the sensitivity was 87.5%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 98.26% and false negatives were 12.5%. We concluded that FNAC is a safe, cost-effective, sensitive and specific technique in the initial evaluation of head and neck masses. A correct cytological diagnosis can be achieved in a majority of cases, avoiding the need for surgical interventions. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 19-25 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6721

The variations in origin of renal arteries are very common. During routine dissection of a male cadaver we found left accessory renal artery. The origin of accessory renal artery is immediately below main renal artery. The left inferior accessory renal arteries run towards inferior pole of left kidney, in the area where the left renal vein was leaving the left kidney. The vascular variations are very important for vascular surgeons, urologists, nephrologists, radiologists.

Anemia is a common medical disorder affecting a lot of women in pregnancy in the developing countries. Daily oral iron supplementation during pregnancy reduces the prevalence of anemia. In the present study we have compared the hematological responses to oral iron therapy using the formulation of iron poly maltose complex in anemic and normal pregnant women. The haemoglobin (Hb) level and other blood parameters were studied in anemic and non-anemic pregnant women both before and after oral iron therapy. Hemoglobin, iron indicators improved significantly with oral iron therapy and appear to have good compliance and efficacy. This helps us to assess the varied comparative responses in both the categories. The study will be indicative about the rational use of iron in iron deficiency anemia. Key words: Anemia; blood; hemoglobin; deficiency. DOI: 10.3126/jcmsn.v6i3.4067Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.1-7

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727