Background. Duodenum is the second most common site of diverticula after the colon. Diagnosis of duodenal diverticula is incidental and found during other therapeutic procedures. In 90% of cases, they are asymptomatic, and less than 10% develop clinical symptoms. The difficulty to ascertain the true incidence of duodenal diverticula demanded for the present study to elucidate the prevalence of the duodenal diverticulum in South Indians. Materials and Methods. One hundred and twenty specimens of duodenum were utilized for the study. The prevalence, anatomical location, and dimension of duodenal diverticulum were studied. Results. Among the 120 specimens of duodenum, five specimens had solitary, extraluminal, and globular-shaped diverticula in the medial wall of the duodenum. In three (60%) cases, it was found in the second part of duodenum and in two (40%) cases in the third part. The mean size of the diverticula was 1.4 cm. Conclusion. In the present study in South Indian people, the prevalence (4.2%) of duodenal diverticula is low comparable to other studies in the literature. Even though most of the duodenal diverticula are asymptomatic, the knowledge about its frequency and location is of great importance to prevent complications like diverticulitis, hemorrhage, obstructive jaundice, and perforation.

Background: Rapidly growing Mycobacteria are increasingly recognized, nowadays as an important pathogen that can cause wide range of clinical syndromes in humans. We herein describe unrelated cases of surgical site infection caused by Rapidly growing Mycobacteria (RGM), seen during a period of 12 months. Materials and Methods: Nineteen patients underwent operationsby different surgical teams located in diverse sections of Tamil Nadu, Pondicherry, Karnataka, India. All patients presented with painful, draining subcutaneous nodules at the infection sites. Purulent material specimens were sent to the microbiology laboratory. Gram stain and Ziehl-Neelsen staining methods were used for direct examination. Culture media included blood agar, chocolate agar, MacConkey agar, Sabourauds agar and Lowenstein-Jensen medium for Mycobacteria. Isolated microorganisms were identified and further tested for antimicrobial susceptibility by standard microbiologic procedures.

We report a rare combination of variations in the upper limb of a human cadaver. Accessory flexor carpi ulnaris with absent palmaris longus was observed in the left forearm during routine dissection of a male cadaver. Variant vascular pattern was observed bilaterally. Brachial artery bifurcated at a higher level. Ulnar artery gave rise to persistent median artery (PMA) which pierced the median nerve and accompanied it deep into flexor retinaculum to terminate as two common palmar digital arteries. Superficial palmar arch was not formed as the PMA did not anastomose with either the radial or ulnar artery. Radial artery was small and deep palmar arch was mainly contributed by the deep branch of ulnar artery. Awareness of these coexistent variations in the forearm and hand is anatomically as well as clinically important in reconstructive hand surgeries.

Introduction:To determine the incidence and gross morphology of additional head of biceps brachii in the Indian population, and to note concurrent musculocutaneous nerve variations. Subjects and Methods: One hundred and twenty upper limbs (males-100, females-20) from 60 formalin-embalmed cadavers were utilized for the study. Results: The additional heads were found in 11 cadavers. Third head was present in 16.6% and fourth head in 1.7%. The variation was unilateral in 72.7% and bilateral in 27.3% cadavers. Out of 120 limbs, 14 had additional head, and 71.4% of these were left-sided. In 73.3%, additional head joined with tendon and with the belly of BB in 26.7%. Three types of origin: anterolateral, posteromedial and high humeral were observed in 60%, 26.7% and 13.3%, respectively. The additional muscle was 11.7 ± 3.9 cm in length. The mean length on the right and left sides was 9.8 ± 3.3 cm and 12.4 ± 3.9 cm, respectively. Incidence of concurrent additional head and musculocutaneous variations was 42.8%. The nerve variations were unilateral with 80% on the left, and ipsilateral to additional muscle. Conclusion: The incidence of additional head in biceps brachii is 18.3% in the Indian population. Most common presentation is of a left-sided third head, and musculocutaneous variants occur on the same side as additional muscle. Presence of extra head should be considered during the analysis of the diagnostic scans, and awareness of the associated musculocutaneous nerve variations would be helpful in avoiding complications during surgical interventions.

An accessory muscle was observed in left upper limb of a 50-yearold male cadaver during routine undergraduate dissection class. This muscle was seen in arm, proximal to the humeral head of pronator teres and eventually fusing with it distally. It was subsequently identified as the accessory humeral head of pronator teres.

External jugular vein is the superficial vein of the neck and is prone to variations. Multiple internal jugular veins are incidental findings that present as a duplication or fenestration. We encountered a unilateral fenestrated internal jugular vein and a bilateral variation in the course of external jugular vein, during a cadaveric dissection. The external jugular vein, after its formation, crossed the sternocleidomastoid muscle and pierced the investing cervical fascia of the posterior triangle. It traversed deep to the inferior belly of omohyoid muscle to enter the subclavian triangle and terminated by draining into the subclavian vein on the left side, and at the angle between the internal jugular vein and the subclavian vein on the right side. The fenestrated internal jugular vein on the left side divided into a small medial and large lateral division which reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein. Only the medial division of the internal jugular vein received tributaries in the neck. Awareness of the multiple variations of the jugular veins would be valuable during surgical approaches to the neck. Present report aims to be useful for vascular surgeons, radiologists, and intensivists as well.

Introduction: Introduction The testicular arteries are liable to get injured during interventions around the renal pedicle. The present study aimed to record the anatomical variations in testicular arteries to assist surgeons and radiologists in avoiding unforeseen complications. Materials and Methods: a total of 25 formalin-embalmed adult cadavers were dissected, and the number, origin, relationships with the inferior vena cava and renal veins of the testicular arteries were recorded. The distance between the origins of the renal and testicular arteries from the abdominal aorta was measured, and the results were statistically analyzed. Results: out of 50 cadaveric sides, variations were observed in 14%. The most commonly observed variation was an arched testicular artery (10%). Double testicular arteries were observed in 4% of the sample, and testicular arteries with renal origin were observed in 6%. Most variations were right-sided (71.4%). The testicular artery originated at the second lumbar vertebral level in 94.2% of the sample. The mean distance between the origins of the testicular and renal arteries was 3.60 0.36 cm on the right, and 2.28 ± 0.92 cm on the left, and the difference between the two sides was statistically significant. Conclusion: the left testicular artery is closer to the renal pedicle, and is more likely to be at risk during surgeries in the hilar area. Cases with renal origin and arching of the testicular artery are also at a high risk. Compression of the testicular artery due to arching or retrocaval course could be a causative factor for the development of varicocele. The presence of such variations should be meticulously assessed using radiological imaging prior to interventions.

Introduction: The medial end of clavicle is connected to the upper surface of anterior end of first rib and its costal cartilage by rhomboid ligament which assist the movements of pectoral girdle as well as resist the pull of medial end of clavicle by pectoralis major and sternocleidomastiod muscles. Consequently, the attachment of it on the clavicle produces various patterns like tubercles, grooves, etc. called as the rhomboid impression. This normal variant of rhomboid impression may be interpreted sometimes as pathological lesions like necrosis, osteomyelitis, and tumour. Also, the morphology of rhomboid impression varies in different population. Such study in South Indian population is very much sparse and so this study is planned for. The objective is to it is aimed to estimate the prevalence of various morphology of rhomboid impression, to measure the anthropometry of impression and the distance from the medial end of impression to medial end of clavicle. Subjects and Methods: This descriptive study was carried in 200 adult human dry clavicles of both sides and various patterns of rhomboid impression, anteroposterior and transverse diameter of impression and distance between the medial end of impression and medial end of clavicle was measured with digital vernier caliper. Statistical analysis was done and p-value of < 0.05 is considered to be significant. Results: The most common pattern observed was depression and rough (29%) followed by elevated and rough (28.5%). The resection length of the medial end of clavicle was 11 mm from the medial end of impression to medial end of clavicle. Conclusion: The findings of the present study on the morphology and anthropometry of rhomboid impression of adult human clavicles and the resection length of medial end of rhomboid impression from the medial end of clavicle will provide guidance for the anthropologists, orthopedicians, radiologists, vascular surgeons and in forensic investigations.