jnana srotas febraury

Apl-Sept. -2011/ Oct-March - 2011-12 Jnana Srotas Vol. 7 / 8, Issue-1-2/3-4

Apl-Sept. -2011/ Oct - March - 2011-12 Jnana Srotas Vol. 7 / 8, Issue - 1-2 / 3-4


All IndIA shArIrA reseArch InstItute,(AIsrI) KArnAtAKA regIonAl brAnchEXECUTIVE BODYmEmBErs

PATrON : Poojya Dr. D. Veerendra Heggade Dharmadhikari Shri Kshetra Dharmasthala

DIrECTOr : Dr. Prasanna N Rao, Prof.& Principal S D M College of Ayurveda, Hassan.

CHAIrmAN : Dr. Giridhar M Kanthi, Prof & Head, Dept. of Basic Principles S D M College of Ayurveda, Kuthpady – Udupi

VICE CHAIrmAN : Dr.N.Muralidhara, Prof. Dept of Shareera Rachana Sri Sri Ayurveda Medical College Udayapur Bangalore Dr. U. Govindaraju Prof & Head, Dept. of Shareera Rachana S D M College of Ayurveda Kuthpady – Udupi Dr. S B Kottur, Prof Alva’s Ayurveda Medical College, Moodabidri.

sECrETArY : Dr. B.G. Kulkarni, Asst. Prof. SDM College of Ayurveda, Hassan

JOINT sECrETArIEs: Dr. Vinod kumar Alapati Asst. Prof. Dept of Shareera Rachana Rajeev Ganndhi Ayurvedic Medical College MAHE. Kerala Dr.R.V.Pakkannavar, Prof & Head Dept of Shareera Rachana KLE’s B M K Ayurvedic Medical College,Belgaum.

HONOrArY sECrATArIEs: Dr. B G Swami Prof & Head Shareera Rachana D G M Ayurvedic Medical College, Gadag

Dr. S B Govindappaavar, Prof. Dept of Shareera Rachana D G M Ayurvedic Medical College, Gadag Dr. B B Hunagund Prof & Head Shareera Rachana Ayurveda Mahavidyalaya Hubli. Dr Uma Prof. Dept. of Shareera Rachana S D M College of Ayurveda Kuthpady – Udupi

TrEAsUrEr : Dr. Hemanth D Toshikhane Prof. Dept of Shalya KLE’s B M K Ayurvedic Medical College, Belgaum.

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EDITOrIAL BOArD

managing EditorDr G. M. Kanthi, Prof. SDMCA,Udupi

Chief EditorsDr. Prasanna N. Rao, Principal, SDMCA, HassanDr. U.N. Prasad, Principal, SDMCA, Udupi.

Co - EditorsDr. K.R.Ramchandra, Prof. SDMCA Udupi Dr. N Muralidhar, Prof. Sri Sri AMC B,loreDr. Jayakrishna Nayak, Lect. SDMCA, UdupiDr. S.B. Govindappanavar, Prof. DGM AMC, Gadag Advisory BoardDr. Sridhar Holla Prof. SDMCA UdupiDr. Suresh Negalguli, Prof PNMAMC, KeralaDr. B. G. Swami, Prof. DGMAMC Gadag

membersDr. U. Govind Raju, Prof. SDMCA UdupiDr. R.V. Pakkannavar, Prof. BMKAMV Belgaum Dr. B B Hunagund, Prof. AMV Hubli Dr. Vinoda Alpathi, Asst.Prof RGAMC, Mahe KeralaDr. R.N.Gennur prof. Dr.BNMRAMC BijapurDr. Uma G. Gubbi, Prof BAMC Davangere

Published by All India Shareera Research InstituteKARNARAKA REGIoNAL BRANCHSDM College of Ayurveda & Hospital, Hassan - 573 201

Editorial

Dear colleagues,

Seasonal Greetings to all Faculty Members,

The Jnana Srotas new issue gives new information about the anatomical variations articles which will be found during the routine dissection at Udupi, Manipal and Moodabidari, Ayurveda colleges during their U G & P.G. dissection Classes. The upper limb muscular variations mainly biceps brachi and palamaris longus, superficial veins including varicose vein articles are really very informative topics. Such anatomical variations knowledge is most important in the field of surgical and medicinal point of view.

The Dept of anatomy Kasturba Medical College Manipal, was organized the one day C.M.E on Advance imaging technique on the anatomy understanding through radio-imaging technique, the benefit of this knowledge was attempted by Post Graduate Scholars of Sri Dharmasthal Manjunatheswar College of Ayurveda Udupi, and Under Graduate students of Muniyal Ayurveda college Manipal and other P.G Scholars of different medical college students. Such advanced teaching methodology was very impressive to most of the young anatomist; there was anatomy quiz to the P.G. Scholars in one session it is also very effective to the all participants. Such reorientation teaching programs are essential in the field of medical teaching profession. The same may be adopted in Ayurvedic colleges.

This year National Conference of Shareera Rachana (Anatomy) held at koppal on 15th October 2011 organized by shree Jagdguru Gavishiddeswar Ayurvedic Medical College Koppal, in association with All India Shareera Reaserch Institute karnataka S D M College of Ayurveda Hassan Karnataka Regional Branch, with blessings of Poojya Shree Ma. Ni. Pra. Swa. Jagadguru Abhinava Gavisiddheshwar


Appeal to subscribers & Advertisers Please renew your yearly

subscription.

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CONTENTs

UNILATERAL ACCESSORY HEAD OF THE BICEPS BRACHI – A CASE STUDY

PRImARY VARICOSE VEIN OF UPPER LImB – A CASE REPORT

A B S E N C E O F PA L m A R I S L O N G U S mUSCLE - A CASE REPORT

“NATIONAL CONFERENCE” -REPORT

SUPERFICIAL VENOUS VARIATION OF THE UPPER LImB – A CASE REPORT

IT IS NO FAULT OF THE STUDENT BECAUSE A YEAR HAS ONLY 365 DAYS.

REGImEN DURING WINTER SEASON

VARIATION IN FLExOR DIGITORUm SUPERFICIALIS (SUBLImIS) – A CASE STUDY

AFTER 25 YEARS IN WOmAN’S STOmACH, A PEN STILL WRITES

EmERYLOGICAL DEVELOPmENT OF TESTIS

EmBRYOLOGICAL DEVELOPmENT OF BLADDER, URETHRA, UTERUS AND UTER-INE TUBES, PROSTATE AND ExTERNAL GENITALIA

STUDY OF PADA PRAmAN WITH SPECIAL REFERENCE TO PLANTAR ARCH INDEx IN VOLUNTEERS OF VARIOUS REGIONS

KNOW ABOUT BONES

‘SKIN DONATION – A RAY OF HOPE FOR BURN PATIENTS’

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*****

Mahaswamiji Shree Gavimath Koppal,

The AISRI regional branch Hassan, wish to teachers for awarding the best teachers award 2011. Dr S A Patil retired Prof of anatomy, Ayurveda Mahavidyalaya Bijapur. Dr K B Hiremath Prof Vice Principal S J G Ayurvedic Medical College koppal were honored as “Best Shareera Teacher Award 2011”. Dr Mahantesha Ramannavar Asst Prof KLE’s BMK Ayurveda Mahavidyalaya honored as “Best Young Anatomy Teacher Award 2011”. In 17th century sir William Harvey dissected her sister’s body to find out the circulation of blood, Dr Mahantesh Ramannavar Ayurvedic anatomist contributed in the field of anatomy from India on 13-11-2010, by dissecting his own father’s body as committed teacher, and also motivating the public’s for Eye and Body donations.

Dr B S Ramannavar Memorable GOLD MEDAL bagged this year by top scorer in Rachana and Kriya subjects from RGUHS Bangalore, Kumara Nandeesha N 333 Marks highest in Shareer Rachana in the year 2009/10 Sri Raghavendra Ayurvedic Medical College, Malladihally Dist – Chitradurga; and Kumari Sushobhitha M 342 Marks highest in Shareer Rachana in the year 2010/11 Shri Dharmasthala Manjunatheshwara College of Ayurveda, Hassan are honored by Dr Sushiladevi Ramannavar president Dr B S Ramannavar Charitable Trust Bailhongal.

AISRI regional branch Hassan, will congratulates to Dr. Muralidhar N for awarding “Shareera Ratna - 2011” by International Association of Physicians.

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UNILATERAL ACCESSORY HEAD OF THE BICEPS BRACHI – A CASE STUDY

• Dr Giridhar M Kanthi ** Dr Parameswaran ** Dr Shakthi Kumar

Abstract -During our routine cadaver dissection in the Dept of Anatomy S D m College of Ayurveda Udupi, we found an accessory (third) head of the biceps brachi muscle in the left upper limb. This muscle took origin just medial to the origin of Brachialis on the middle of the shaft of the humerus and it is fused in the middle part of the biceps muscle and continued along with rest of the muscle and gets inserted into the radial tuberosity. The bicipital apponeurosis is attached to the fibrous capsule of the elbow joint. The detail study was carried out in the presentation of the paper.Introduction -The arm extends from the shoulder joint till the elbow joint. The medial and lateral inter muscular septa divides the arm into anterior and posterior compartments. The biceps brachi is one among the muscles of anterior compartment of the arm. Since this muscle has two heads (one short head & one long head)usually, it is called as Biceps Brachi.The short head of the muscle originates from the tip of coracoid process of scapula in conjunction with the coracobrachialis. The long head of biceps originates as a tendon from the supraglenoid tubercle of the scapula. The long head passes through the fibrous capsule of the gleno humeral joint superior to the head of the humerus. Then it passes through the intertubercular sulcus and enters the arm, the synovial membrane which extend to the beginning part of the long head, so the fibrous capsule is not covers the region of tendon passes. In the arm the tendon joins with its muscle belly and together with the muscle belly of the short head overlies the brachialis muscle. The long head and short head converge to form a single tendon which inserts on to the radial tuberosity. As the tendon enters the forearm, a flat sheet of connective tissue in the form of aponeurosis (bicipital aponeurosis) trans

• Dr Giridhar M Kanthi Prof & Head.** Dr Parameswaran S & Dr Shakthi Kumar 3rd year P G in Anatomy S D m College of Ayurveda Udupi

out from the medial side of tendon to blend with deep fascia covering, the anterior compartment of the forearm.Blood supply –Biceps brachi is supplied by eight vessels originating from the brachial artery in the middle third of the arm. Smaller branches from the anterior circumflex humeral artery also supply muscle the Biceps.Nerve supply -The Biceps brachi muscle is supplied by musculocutaneous nerve (c5, c6)Additional points about Biceps Brachii1) Additional head of biceps.a) When present the 3rd head of biceps, that

arises from the upper and medial part of brachialis, passes behind the brachial artery and is inserted in the medial side of the bicipital aponeurosis. At times the third head consists of two slips which pass in front and behind the brachial artery.

b) 4th head may arise from the lateral side of the humerus from intertubercular sulcus.

2) The tendon of the long head of Biceps may be displaced from the intertubercular sulcus.

3) The tendon of insertion of biceps is twisted in such a way that its anterior part is formed by the short head and the posterior part by the long head.

Methods -During our routine cadaver dissection in the Dept of Anatomy S D m College of Ayurveda Udupi we found an accessory (third) head of biceps brachi muscles in the left upper limb of a 65 yr old male cadaver. A careful dissection was carried out to determine its structure, including its attachments and innervations.Observation

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The Accessory (third) head was situated deep to the short head of biceps on the middle of the shaft of humerus, originating just medial to the origin of brachialis muscle. This muscle along with the bellies of short and long heads was found to be overlying the brachialis muscle in the arm. Later this muscle was inserted into the radial tuberosity as forms the common tendon along with the other two heads of Biceps, to blend with the deep fascia covering the anterior compartment of the forearm. As far as bulk of muscle is concerned, this accessory head is thin and short when compare with remaining two bellies. This accessory head was having vascular supply from the branch of brachial artery and was innervated by the branch from the median nerve rather than the common musculo cutaneous nerve.DiscussionUsually the Biceps will be having only two heads,Short head and a Long head. The incidence of the third head of the biceps brachi muscle has been reported in several articles. Gray’s Anatomy reported the incidence of this variation to be as much as 10%,(1) which concurs with the observations of Bergmanet in white Europeans.(5) Asvatet al reported an incidence of 21.5% in their study group consisting of blacks.(4)It appears that the incidence varies among ethnic groups. Kopuzet al attributed the appearance of these variants to evolutionary or racial trends.(6)Santo Netoet al reported an incidence of 9% among blacks, which was significantly lower than the reported incidence for whites in his series.(7) Khaledpour contradicted Santo Netoetal’s results by comparing his series to the results from other authors. He reported that the third head of biceps brachii was rare in whites and relatively high among blacks. Asvatet al observed that the third head of biceps brachii originated from the humeral shaft either inferior to, and in common with, the insertion area for the coracobrachialis, or in common with the brachialis muscle.(4) They also observed a dual origin in which the medial fibres originated from the short head of biceps and the lateral fibres from the deltoid fascia. According to Kopuzet al, the third head of biceps brachii frequently arise

from the anterior surface of the humerus distal to the insertion of the coracobrachialis muscle.(6) Kosugi et al observed that the supernumerary head of biceps arose from the humerus between the insertion of coracobrachialis and the upper part of the origin of brachialis are from the medial inter muscular septum.(9) The same authors have also reported that in a few cases, the biceps brachii was seen to be arising from the tendon of the pectoralis major, the deltoid, the articular capsule, or the crest of the greater tubercle.(9) Abu-Hijleh reported that the supernumerary bicipital head originated from the anteromedial surface of the humerus just below the insertion of coracobrachialis.(10) Embryological observations by Testut described this variation of the third head of biceps brachii as a portion of the brachialis muscle supplied by the musculocutaneous nerve, in which its distal insertion has been translocated from the ulna to the radius.(2)Knowledge of the existence of the third head of the biceps brachii may become significant in preoperative diagnosis and during surgery of the upper limbs. Therefore, surgeons, in particular orthopaedic surgeons, should be aware of this anatomical variation when dealing with some of the clinical syndromes.In the present case study an accessory (third) head was located deep to the short head of biceps, originating from anterior medias surface of the humerus and associated with the other two bellies of biceps. It was found to be overlying the brachialis muscle. This later merges with the other two muscle bellies of biceps forming a common tendon and gets inserted into the radial tuberosity. The nerve supply is by median nerve in this case, that may effect to the functions of the third head that may or may not be associated with other two heads function. The function may defend on the basis of nerve innervations. The presence of this accessory head may result in the strong flexion at elbow joint and supination of the forearm.REFERENCES1. Williams PL, Bannister LH, Berry mm, et al,

eds. Gray’s Anatomy: The Anatomical Basis of medicine And Surgery, 38th ed. Edinburgh: ELBS Churchill Livingstone, 1995: 843.

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2. Testut L. En:Tratado de Anatomia Humana. Barcelona: Salvat, 1902.3. Sargon mF, Tuncali D, Celik HH. An unusual origin for the accessory head of biceps brachii muscle.

Clin Anat 1996; 9:160-2.4. Asvat R, Candler P, Sarmiento EE. High incidence of the third head of biceps brachii in South

African populations. J Anat 1993; 182:101-4.5. Bergman RA, Thompson SA, Afifi AK. Compendium of Human Anatomic Variation: Text, Atlas, and

World Literature. Baltimore:Urban and Schwarzenburg, 1988.6. Kopuz C, Sancak B, Ozbenli S. On the incidence of third head of biceps brachii in Turkish neonates

and adults. Kaibogaku Zasshi 1999; 74:301-5.7. Santo Neto H, Camalli JA, Andrade JC, meciano Filho J,marques mJ. On the incidence of the

biceps brachii third head in Brazilian white and blacks. Ann Anat 1998; 180:69-71.8. Khaledpour C. [Anomalies of the biceps muscle of the arm].Anat Anz 1985; 158:79-85. German.9. Kosugi K, Shibata S, Yamashita H. Supernumerary head of biceps brachii and branching pattern

of musculocutaneous nerve in Japanese. Surg Radiol Anat 1992; 14:175-85.10. Abu-Hijleh mF. Three-headed biceps brachii muscle associated with duplicated musculocutaneous

nerve. Clin Anat 2005; 18:376-9.

Fig.1 Shows accessory head of biceps brachi

Fig.2 The accessory head along with long and short heads.

Fig.3 Shows accessory muscle lies posterior to brachial artery

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PRIMARY VARICOSE VEIN OF UPPER LIMB – A CASE REPORT

* m.D (Anatomy) Lecturer, Dept of Anatomy. ** 1st year students mIAmS manipal. Udupi.*** Prof. SDmCA,Udupi

Abstract: During routine dissection in the department of anatomy, the unusual left Basilic vein varicosity was found. The left Basilic vein terminating as the Axillary vein, in its early course was found normal. The varicosity was observed in the upper part of the vein, just above the level of elbow and just before the termination as the Axillary vein. This unique case of varicosity in the Basilic vein gains tremendous importance in the context of congenital vascular anomaly viz Klippel Trenaunay syndrome and Park Weber syndrome. Keywords: Upper limb, basilic vein, varicosity.Introduction: A varicose vein may be defined as a vein that becomes elongated, dilated, tortuous & thickened due to continuous dilatation under the pressure. Primary varicose veins are common afflictions of the lower extremities where as upper limb veins are rarely affected. The literature has little reference as regards the number of cases & management of upper limb varicose veins.Case report: The left basilic vein varicosity was observed only on the left arm during the routine dissection in a female cadaver of about 50 years of age. The basilic vein in its early course was found running upwards along the medial border of the forearm, winding round the elbow, it then continuing upwards in front of the elbow & along with the medial margin of the biceps brachii muscle up to the middle of the arm, where it pierced the deep fascia and ran along the medial side of the brachial artery up to the lower border of teres major where it continued as the axillary vein. The course of the median cubital vein was as usual.

Discussion: Primary varicose veins are the ones which develop due to intrinsic valvular incompetence & have no apparent underlying cause. Secondary varicose veins due to outflow obstruction, valve destruction and secondary deep vein thrombosis are because of arterio-venous fistulae. Due to the compression and improper flow of venous blood, it results in swelling in the arm, back of the scapula, and compression of the nerves in the axillary region. Donogue & Leahy have quoted the prevalence of visible tortuous veins as 10-15% in males and 20-25% in females. The non Saphenous varies are nearly 45% in men & 50% in women.Clinical importance.Varicosity of the upper limb vein is a rare phenomenon. The vein can cause compression of the surrounding structures which include median nerve and medial cutaneous nerve of arm. References:-1. Donogue GO. Leahy A. varicose veins.

Surgery 2002; 1:8-11.2. Rose SS, Ahmed A. Some thoughts on the

etiology of varicose veins. J. Cordiovasc surg. 1986; 27:534-43.

3. Clark Dm. Warren R. Idiopathic varicose veins of upper extremity. N Engl J. med. 1954; 250:408-12.

4. Welch HJ. Villavicencio JL. Primary varicose veins of upper extremity: A report of 3-cases. J. Vas. Surg. 1994; 20: 839 – 43.

5. Duffy Dm, Garcia C, Clark RE. The role of sclerotherapy in abnormal varicose hand veins. Plast Reconstr surg. 2000; 106: 227-29.

6. Davis RP. Lipsing LJ. Connolly mark m. Flinn WR, varicose ulcer of the upper extremity surgery. 1985;98:616-8.

* Dr. Sibgath Ulla Shariff. R. ** Kumari Aimon Sadaf, Kumar Anand Jaiswal, *** Guided by Dr. Giridhar Kanthi Kumar Arundeep.

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* Lecturer, Dept of Shareera rachana, ** 1st year students. mIAmS manipal, Udupi Karnataka. *** Prof. SDmCA,Udupi

ABSENCE OF PALMARIS LONGUS MUSC LE - A Case Report * Dr Seetharama Mithanthaya ** Anand Kumar Jaishwal, Aimon Sadaf, Arundeep, *** Guided Dr.Giridhar Kanthi

Abstract: - During our routine dissection we found absence of the Palmaris longus muscle in the left forearm. The arrangement of the other flexor muscles was found normal. As the muscle has less functional importance there may not be any functional deformity of the wrist joint. Tendon of the muscle is frequently used for the reconstructive surgeries. Introduction: -Palmaris longus is a slender fusiform vestigial muscle situated between the flexor carpi radialis and flexor carpi ulnaris and it is counted among the superficial flexor muscles of the forearm. The muscle takes origin from common flexor origin (medial epicondyle of the humerus), from adjacent intermuscular septa and antebrachial fascia. Its long flexor tendon passes anterior to the flexor retinaculum and gets inserted in to the distal 1/3rd of its anterior surface and centrally to palmar aponeurosis. The muscle is supplied by median nerve (c7-8)

1. Palmaris longus can be palpated by touching the pads of 5th and 1st fingers and flexing the wrist, the tendon, if present, will be visible. This test is known as schaeffer’s test2 (fig 3).Case report: -During the routine dissection for undergraduate students at muniyal Institute of Ayurveda medical Sciences, we found absence of Palmaris longus muscle in the left forearm in a male cadaver, about 55 years age. Arrangement of other flexor muscles and attachment of flexor retinaculum were found normal (fig 1, 2).Discussion: - Palmaris longus is a weak flexor of wrist and is considered functionally negligible. The prevalence of the agenesis of the muscle as reported in most of the anatomy text books is about 15%. A higher incidence (24%) was reported in North American population3. Ceyhan & mavt reported a much higher prevalence agenesis (63.9%), in the Gaziantep population in turkey4. The incidence was found in about, 3.4% & 4.6% respectively

in Japanese5 & Chinese population6, and it was about 1.02% in Ugandan population7. In Yoruba ethnic group of Nigeria, among 600 subjects, 40 (6.7%) individuals the Palmaris longus was found absent and among them 23 (3.8%) were males and 17 (2.8%) were female, the distribution on right and left were 2.3% & 3.4% respectively7.There is a growing interest in the existence of the Palmaris longus because its tendon is reported to be most frequently harvested for constructive plastic and hand surgery. Palmaris longus tendon is used for repair of ptosis in children. Palmaris longus is most popularly used in tendon graft of wrist due to its length and diameter and the fact that it can be used without producing structural deformities and using patient’s own tendon is advantageous. In case Palmaris longus muscle is absent for harvesting in an individual, the anatomically homologous plantaris muscle in the leg may be used8. Conclusion: -Palmaris longus is a slender muscle in the flexor compartment and is frequently found absent with incident rate of about 15%. The tendon of the muscle is commonly used for reconstructive surgeries and tendon grafts. So the surgeons should keep this information about frequent absence of Palmaris longus prior to the surgery and its presence can be easily examined by performing schaeffer’s test.

Fig 1: muscles of flexor compartment of left forearm

Flexor carpi ulnaris

Flexor digitorum

Superficialis

Flexor retinaculum

Radial artery

brachioradialis

Flexor carpi radialis

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Fig 2: Muscles of flexor compartment of left forearm Palmaris longus tendon

Fig 2: Schaeffer’s test demonstrating the presence of Palmaris longus.

Bibliography 1. Henry Grey. Editor: Williams PL, Warwick R

et al. Grey’s Anatomy. 38thed. 1995. Churchill Livingston; Newyork. P: 846, Pp2091.

2. S A Roohi et al. A study on absence of Palmaris logus in a multi-racial population. malaysian Orthopaedic Journal 2007 Vol 1 No 1.

3. Troha F Baibak GJ, Kellehr JC. Frequency of Palmaris longus tendon in North American Caucasians. Ann Plast Surg 1990; 25(6): 447-8.

4. Ceyhan O and mavt A. Distribution of agenesis of Palmaris longus muscle in 12 to 15 year age groups. Indian J Med Sci 1997; 51(5):156-60.

5. Adachi B. Beitrage zur Anatomiae der japaner. xII. Die Static der muskelvarietaten zweite mitteilung. Zeitsch F Morphol Anthropol Bd 1909; 12:261-312.

6. Sebastin SJ, Puhaindran mE, Lim AY, Lim IJ, Bee WH. The prevalence of absence of Palmaris longus – A study in a Chinese population and a review of literature. J Hand surg (Br 2005; 30 (5): 525-7.

7. Igbigbi PS, Sekitoleko HA. Incidence of agenesis of the Palmaris longus muscle in Ugandan population. West African J Anat 1998; 6:21-3.

8. Thejodhar P, Bhagat Kumar Potu, Rakesh G, Vasavi. “Unusual palmaris longus muscle”. Indian Journal of Plastic Surgery 41.1 (2008) :95-96. Pubmed. Web. 3 Dec. 2009.

Palmaris longus tendon


Flexor Carpi radialis

Flexor digitorum Superficialis

Ulnar nerveFlexor digitorum Superficialis tendon Flexor reinaculum

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“NATIONAL CONFERENCE” Annavaha shrotho shareera on 15th October 2011 Report (organized by “Shree Jagaddaguru Gavishiddeshwar Ayurvedic Medical

College P.G. Studies and Research Centre, Koppal)

National Conference of Shareera Rachana (Anatomy) held at koppal on 15th October 2011 organized by shree Jagdguru Gavishiddeswar Ayurvedic medical College P. G. Studies and Research Centre Koppal, in association with All India Shareera Reaserch Institute karnataka S D m College of Ayurveda Hassan Karnataka Regional Branch, with blessings of Poojya Shree ma. Ni. Pra. Swa. Jagadguru Abhinava Gavisiddheshwar mahaswamiji Shree Gavimath Koppal,

Dr. V V Doiphode Ex Dean Pune University, Dr. V. S. Shirol Prof & Head JNmC Belgaum, Dr. mukunda Erende Prof S S Ayurveda medical College Hadapsar Pune, Dr. Adinarayana Prof & Head A L N Rao Govt Ayurveda medical College Warangal, Dr. Giridhar m Kanthi Prof S D m College of Ayurveda udupi delivered the guest lectures on the different topics of Annavaha Srotas and its clinical anatomy.

Nearly about 300 delegates were participated the conference from Ayurvedic Colleges of Karnataka. P.G Scholars of different faculties were presented scientific papers on Annavaha srotas and its clinical applications.

Every year AISRI Karnataka regional branch Hassan will honoring the senior teachers who dedicated their service in the field of Shareer from Karnatak, this year Dr. S A Patil retired Prof of anatomy Bijapur. Dr. K B Hiremath Prof Vice Principal S J G Ayurvedic medical College koppal were honored as “Best Shareera teacher award 2011” with cash prize of five thousand rupees, Dr. mahantesha Ramannavar Asst. Prof KLE’s BmK Ayurveda Nahavidyalaya honored as “Best Young Anatomy Teacher award 2011” with cash prize of rupees five thousand, and citation with certificate and memento for creating the history in the field of medical science after sir William Harvey. He is the first person to receive this

prestigious award in the field of Ayurveda. In the same occasion for giving moral support to son his mother Dr. Sushiladevi Ramannavar felicitated by His Holiness, m.N.P.S Shree Jagadguru Gavisiddheshwar mahaswamiji, Koppal, Shree S R Navali Hiremath Chairman SJGAmC&H Koppal with Governing Council members of AISRI Karnataka regional branch Hassan. 17th century sir William Harvey dissected her sister body but Dr. mahantesh Ramannavar contributed to field of anatomy from India on 13-11-2010,by dissecting his own father body as committed teacher, also motivating public for Eye and Body donation,

Every year AISRI Karnataka regional branch Hassan honoring the students who secured highest marks in the Shareer Rachana and kriya subjects, first three rank students, in the annual examination of RGUHS Bangalore, Dr. Sushiladevi Ramannavar president Dr Ramannavar Charitable Trust Bailhongal has given Dr. B. S. Ramannavar memorable GOLD mEDAL to the students of 2009/10 and 2010/11 batch who secured highest marks in Shareera Rachana (Anatomy) subject from Rajiva Gandhi University of Health Sciences Bangalore.

Dr. B. S. Ramannavar memorable GOLD mEDAL bagged by to the following students, and honored by Dr. Sushiladevi Ramannavar president Dr B S Ramannavar Charitable Trust Bailhongal

1. 08A7429 Kumara Nandeesha N 333 marks highest in Shareer Rachana year 2009/10 Sri Raghavendra Ayurvedic medical College, malladihally Dist – Chitradurga

2. 09A0170 Kumari Sushobhitha m 342 marks highest in Shareer Rachana year 2010/11 Shri Dharmasthala manjunatheshwara College of Ayurveda, Hassan.

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sUPErFICIAL VENOUs VArIATION OF THE UPPEr LImB –A CAsE rEPOrT

**Dr. Giridhar m. Kanthi. *Dr. Vidhyaprabha r.

and by 2 dorsal digital veins of the thumb on its lateral side. On the medial side it receives a dorsal digital vein from the ulnar side of the thumb. The dorsal digital venous plexus is then drained by the cephalic and basilic veins on the radial and ulnar sides’ respectively2.

Cephalic Vein: Cephalic vein usually forms over the anatomical snuff box from the radial end of the dorsal venous arch. It curves around the radial side of distal part of the forearm to reach the ventral aspect and ascends. Just below the elbow it often gives a branch, the median cubital vein, to the basilic vein. It further ascends between brachioradialis and biceps brachii muscles and reaches the deltopectoral groove. It pierces the clavipectoral fascia, crosses the axillary artery and joins the axillary vein2.

Basilic Vein: It begins from the medial end of the dorsal venous plexus. It runs upwards and winds round to the ventral surface of forearm near the elbow and continues upwards along the medial margin of biceps brachii, pierces the deep fascia and continues as the axillary vein from the lower border of teres major muscle2.

Median Cubital Vein: It is a large communicating vein in the cubital fossa. It begins from the cephalic vein 2.5 cm below the bend of the elbow, runs obliquely upwards and medialy and ends in the basilic vein 2.5 cm above the medial epicondyle. It may receive branches tributaries from the median vein of the forearm and is connected to the deep veins through a perforator vein which fixes the median cubital vein making it ideal for intravenous injection2.

INTRODUCTIONThe superficial veins of the upper limb are clinically important as they are most commonly used for veini puncture, transfusion and cardiac catheterization. Mostly the superficial veins are considered for these purposes, the following four veins are includes1

1. Cephalic vein2. Basilic vein3. median cubital vein4. Dorsal digital network (Dorsal venous arch)

The increasing use of parenteral route for various emergency and critical therapies has made it essential that every physician has correct anatomical knowledge of superficial veins of the upper limb is necessity in the field of medical science.

many authors have reported variations in the course of superficial venous drainage of the upper limb, mostly mentioned are the variations of cephalic vein and dorsal venous arch. We observed a variation of the superficial veins of the upper limb during routine dissection. The dorsal venous arch had a variation in its site and the cephalic vein and accessory cephalic veins had a variant.

REVIEW OF ANATOMY –

Dorsal Venous Arch: The superficial venous drainage of the digits is by the dorsal digital veins which pass along the sides of fingers. They unite to form the dorsal digital metacarpal veins which plays a key role in the formation of the dorsal venous arch (dorsal venous network) in the region of the head of metacarpal bone. This is joined by the dorsal digital vein from the radial side of index finger

** Prof,SDMC Udupi *Anatomy 3rd year P G Scholar Alva’s Ayurveda Medical College, Moodabidri

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1

2

3

4

5

6

Accessory Cephalic Vein:

It is an accessory vein which is sometimes present. It drains the blood from the dorsal part of the forearm. Usually it ends by joining the cephalic vein near the elbow2.

OBSERVATION:During a routine dissection done on an Indian male cadaver of an estimated age of 50 years, a variation of the anatomical presentation of veins was noted on the left upper limb, especially the cubital region and dorsal surface of the forearm and hands. The anatomy of the veins on the right side was as usual.

POSTERIOR VIEW: 1- Dorsal digital vein, 2- Dorsal metacarpal vein, 3- Dorsal venous arch, 4- Basilic vein, 5- Accessory cephalic vein, 6- Branch of accessory cephalic vein

2 1 3 4

1

5

41

ANTERIOR VIEW: 1- Cephalic vein, 2- Branch of accessory cephalic vein, Type, 3- median cubital vein, 4- Basilic vein, 5- median vein of the forearm.

Dorsal Venous Arch: In this case the digital veins unite to form dorsal metacarpal veins, but they do not form a network in the usual anatomical site of head of the metacarpus. The dorsal metacarpal veins run forward straight beyond the wrist till the dorsal surface of distal part of forearm and form a venous network at this site. The dorsal venous arch extends over the dorsal surface of the forearm as well as to the ventral part of the forearm on the lateral side. The cephalic vein and basilic vein begins from the lateral and medial ends of the above mentioned venous network.

Basilic Vein: It begins after the distal 1/3rd of the forearm. It courses up and passes on to the ventral surface in the middle of the forearm.

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Cephalic Vein: It begins at the lateral end of the dorsal venous arch on the ventral surface of the forearm where the dorsal venous arch receives the 2 digital veins from the thumb. It passes up and just below the cubital fossa it receives the median vein of the forearm and gives away a branch the median cubital vein which joins the basilic vein. Further it courses up as a thinner blood vessel. In the region of the cubital fossa it receives a branch of the accessory cephalic vein and moves up in the normal anatomic course.

Accessory Cephalic Vein: This vein is seen as an extension from the middle of the dorsal venous arch. It courses up and below the elbow gives off a branch which joins the cephalic vein. Further it moves upwards and ends by joining the cephalic vein below the delto pectoral groove.

DISCUSSION:A variation of the superficial veins of the forearm usually comes across during routine dissection. Some such reported variations are discussed below.

Cephalic vein sometimes joins with external jugular vein to form a common trunk which ends in the axillary vein3. median vein of the forearm begins from the palmar venous network and ends in any one of the veins in front of the elbow, the basilic, cephalic, or median cubital vein. Sometimes it divides into median cephalic and median basilic veins which join the cephalic and basilic veins respectively; this pattern replaces the median cubital vein2. It has been reported that digital veins of the fingers drains in to the metacarpal veins which has variable size and location with free anastomosis1. The accessory cephalic veins originate either from a venous plexus on the dorsum of the forearm or from the medial aspects of the dorsal venous arches4.

The cephalic and basilic veins are connected by the median cubital vein in 70% of subjects. The whole cephalic vein drains into the basilic vein in 20% of cases. The cephalic and basilic veins remain separate in 10% of subjects2.

CONCLUSION:

The most commonly used veins for intravenous infusions are the superficial veins of the cubital fossa. In this region the brachial artery lies deeper to the median cubital vein separated from it only by the bicipital apponeurosis. Inadvertent passage of needle in this region may allow it to pierce the apponeurosis and the brachial artery. Some drugs may cause unwanted reactions when given intra arterially or peri arterially. Taking in to consideration such complications which may even occur in accidental puncture, some physicians prefer superficial veins of the dorsal digital plexus. In this location arterial abnormality will be of a lesser degree of concern as opposed to the anti cubital fossa1. In recent time, the clinicians prefer the superficial veins of the forearm for intravenous infusions. An attempt to access these veins in a state of such variations could result in difficulty to access, movement in the wrong direction and also may cause puncture wrong of area or structures in the related region. Therefore, the knowledge of the anatomical variations would help to reduce the occurrence of the iatrogenic complications.

REFERENCE1. Gaither B. Everett, Gerald D. Allen. Intravenous

therapy – A review of site selection and technique, Anesthesia Progress, November 1969

2. B. D. Chaurasia. Human Anatomy 4th Edition Vol I. Published by Satish Kumar Jain for CBS Publishers & Distributors. New Delhi. 2004. p. 70,71

3. Deog Im Kim. Venous variations in neck region: cephalic vein. Variant veins in the neck. September 2010

4. Robert J. Amitrano, Gerard J. Tortora. Laboratory Exercises in Anatomy and Physiology with Cat Dissections 8th Edition, Published by Thomson Brookes/Cole, 2007, P.450

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IT IS NO FAULT OF THE STUDENT BECAUSE A YEAR HAS ONLY 365 DAYS.Days in a year = 365 days

Sundays = 52 days (Sundays are meant for rest) Days left = 313 days

Summer Vacations = 60 days (Weather is very hot, so it is difficult to study) Days left = 253 days

Eight hours of daily sleep = 122 days (Necessary) Days left = 131 days

One hour daily for play = 15 days (It’s good for health) Days left = 116 days

Two hours for daily food = 30 days (Chew the food properly, don’t care for time) Days left = 86 days

Examination days in a year = 30 days (Giving exams is necessary) Days left = 56 days

Winter vacations = 25 days (Weather is cold, it’s difficult to study) Days left = 31 days

Other holidays = 20 days (These holidays are to enjoy) Days left = 11 days

Illness at least once a year = 8 days (Because of illness, study is difficult) Days left = 3 days

Result days = 3 days (Going and taking result is necessary) Days left = 0 days

So, tell me where is time for study?!

Body donarPrincipal and Department of Anatomy S D M College of Ayurveda Udupi

will be appreciated to Smt. Mainavathi Koppar for her Body Donation after the death

Name : Smt. Mainavathi W/o. Krishna Acharya Koppara

Age : 77 Years

Add : At post - Kallapur, Taluk - Hanagal Dist. - Haveri

Congratulations and Best Wishes from AISRI Regional Branch Hassan

Awarding the 4th rank in shareera Kriya 1st year BAMSof RGUHS Bangalore

Kum. Chaitra n 2nd year BAMS, SDMA, Udupi

D/o. A. Nagaraj

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Introduction:-

In Ayurveda, six seasons has been described as summer season, rainy season, Autumn season, winter season, spring season & decoy season. Long nights, short days, sparkling snow flakes and people dressed in warm clothes are the images evoked for the word winter. The winter season is marked as Hemanta ritu in ayurveda. Hemanta ritu starts from mid November and ends in mid January. This falls in southern solastice which is called as Visarga kala or dakshinayana in ayurveda.

Winter causes health problems when adequate precautions and safety measures are not taken. But winters can be enjoyed to full extent when we alter our diet and lifestyles a little as nature desires (Ritu satmaya).All seasons are responsible for sanchaya, prakopa & shaman of doshas- Vata, Pitta & Kapha.

Characteristics.

1. Earth moves away from sun closer to moon during this period(dakshinayan kala)

2. Environment is therefore cold and unctuous during this season and cold breeze flows.

3. Cold and refreshing climate helps in increase of digestive fire. .

4. Cooling effect of climate as also increased overall nourishment due to increased appetite leads to increased strength and vitality of body.

5. Nights are long and day short during this period.

Regimen during Winter Season *Dr. Vinay Bhardwaj ** Dr. Hem Raj Meena

6. Cold and unctuous environment lead to building up of excess phlegm in body.

7. Usually in India, it is observed during months of November-December.

8. Less humid & more cool air blows in winter.

9. All directions are covered by fog & aerosols.

10. Pounds are covered by snow.

11. Water evaporates from water surfaces.hot vapors come out from hand pump water.

Physiological changes

1. Sanchaya of kapha & Shaman of vata occurs in hemant ritu(winter season).

2. In winter the Jatharagni ( agni or body fire) increases with the support of vata . which can digest dravya guru(heavy) & matra guru(more quantity) food easily.

3. Hence there will be a marked increase in appetite. The frequency of food consumption increases. In absence of sufficient diet increased digestive fire may cause variety of health problems and reduce strength and vitality of body

4. Skin is bound to become dry and irritated. Dry skin tends to crack and bleed. Cracked skin looses its ability to protect the body and increases the risk of infection.

5. weight gain (Bala vriddhi), mild depression, irritability and short temper.

This condition is well marked in persons who live in places which experience long severe winter.

* P.G. Scholar, Sharir-Kriya Deptt., National Institute of Ayurveda** Asst. Prof., Sharir-Kriya Deptt., National Institute of Ayuveda.

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11. Use of sweet, sour fruits like apple, custard apple, hog plum, banana, dry fruits etc is beneficial.

12. Heavy breakfast during morning is advisable as digestive power is high.

Diet to be avoided

1. Use of food dry in nature and light to digest (laghu) like biscuits, bread or cereals like and grains like barley, gram, spiked dolichos etc should be avoided during winter.

2. Use of diet in very low quantity or reduced frequency of diet is not at all advisable.

3. Food which is not fresh and cold in nature like frozen food, overnight food should be strictly avoided.

4. Use of cold refrigerated water, soft drinks, cold fruit juices, milkshakes etc is also not advisable (vata vitiated food).

5. Avoid consumption of junk foods,

6. Too much of sweets and oil food as these lead to obesity (sthaulya)

7. Sattu (mixture of oat, wheat & chana) prepared with water.

Non dietary measures

1. Exposing our body to sunlight

2. Exercising (vyayam) for 30 minutes and using bright light when you are indoors

3. The best ways to keep the skin soft, healthy and moisturized are

I. Avoid long hot showers and bath.

II. Quick three minutes bath is advisable.

III. Use moisturizing body wash.

IV. Apply petroleum jelly on tough areas like knees, elbows and heels.

4. Apply lip balm to prevent cracking

5. Twenty to 30 minutes of aerobic exercise three times a week can give your skin a healthy glow.

6. Ayurveda stresses on massaging body with oil (tail malish)

4. mix few drops of coconut oil in little water. Rub this all over body at the end of bath or shower.

5. Always wear warm clothes.

6. Regular use of full body oil massage is very much helpful to keep away cold. Oil should be hot in nature or prepared from medicines that are hot in nature like sesame oil, mustard oil etc. Also more pressure and friction should be applied during massage.

7. Herbal powders of pine tree. Acorus calamus etc could be applied over body after massage as these are hot in nature.(ubtan)

8. Also use of sudation therapy(jentak swed therapy) like herbal steam bath etc is very much useful to reduce impact of cold.

9. Use of hot water is must for bath.

10. Environment at home and work should be warm and cozy with use of room heaters, chimney fire etc.

11. Use of warm bed sheets during sleeping is useful. Cotton plug in ears could be used to reduce Impact of cold.

12. Use of proper footwear including use of sleepers, socks etc even at home to avoid contact of feet with cold.

13. Exercise for longer durations could be carried out especially jogging and warm-up exercise. Use of ‘Praanaayaama-Yoga’ is beneficial to keep body warm and guard against cold and should be carried under expert guidance. Also sporting events like

16


wrestling is useful.

14. Due to cold and refreshing climate, frequency of sexual intercourse can be the maximum during this season.

15. Avoid sleeping during afternoon.

Susceptibility for diseases

1. Hypothermia -drop in body temperature to 95 deg. Fahrenhite or less. Person affected by hypothermia will be having symptoms like shivering, drowsiness, slurred speech, week pulse, slow heart beat, slow and shallow breathing. If the body temperature falls down below 86 F he may slip into coma.

2. Frostbite - The exposed areas of body like face, feet, wrists and hands are affected by frost bite. The skin on the affected part becomes white, stiff and feels numb.

3. obesity- due to excessive eating & wt. gain

4. Heart diseases-Increases in heart disease are also noted at very cold temperatures as well.

Precautions-

1. Protect your Tiny tots from cold.

Children are usually thrilled to go o utside irrespective of weather conditions. To ensure that these tiny tots have a safe and fun winter, take some simple measures to keep them warm and unharmed both inside and outside. Ensure that they stay warm while waiting for school bus in low temperature conditions. Keep them as dry as possible in cold weather and make them to wear properly fitting warm clothes. Cover their head, face and neck as much as possible. Inadequate head protection lead to loss of almost half of body heat. Don’t allow them to overexert and sweat. Sweating cools the body which is hazardous in winter and it becomes difficult to warm up again. Keep them well hydrated as they may not drink sufficient

water in winter due to less thirst.

2. Avoid long hot showers and bath. Use luke warm water instead of hot water to wash face. Apply moisturizer lotion if you feel dryness on skin. Apply sun screen lotion to exposed parts of body and face when you go out in sun

3. In ayurveda it is advised to drink hot water, wear warm clothes and to stay near fire place at indoors in winter to prevent hypothermia.

4. Preventing cold and cough in winter. Consume well balanced good nutritious food, exercise thrice in a week and sleep well to keep up natural resistance. Avoid direct contact with those who have colds and wash your hands frequently.

5. most of your body heat is lost through your head so wear a hat, preferably one that covers your ears.

6. Wear waterproof, insulated boots to help avoid hypothermia or frostbite by keeping your feet warm and dry and to maintain your footing in ice and snow.

7. Recognize the symptoms of hypothermia that can be a serious medical condition: confusion, dizziness, exhaustion and severe shivering. Seek medical attention immediately if you have these symptoms.

8. Recognize frostbite warning signs: gray, white or yellow skin discoloration, numbness, waxy feeling skin. Seek medical attention immediately if you have these symptoms.

Warm the affected parts gradually. Wrap the area with warm clothes or keep the affected hands under arm pits and seek the medical attention immediately. Do not rub the affected areas as it may damage the underlying tissues.


VARIATION IN FLExOR DIGITORUM SUPERFICIALIS (SUBLIMIS) – A CASE STUDY* Dr. Sharath.S.G, Dr. Maya Mukundan Dr. Vidhyaprabha. R Dr. Anjana. V Dr. Poojarani. *** Dr. Shubada. V. I. Guided by **Dr. Giridhar. M. Kanthi.

AbstractFlexor digitorum superficialis is the largest among the five superficial muscles of flexor compartment of forearm. It arises by two heads (humero-ulnar & radial). The variations in this muscle are not uncommon. Around twenty-four different variations are identified by now. These variations will have no role in altering the normal action of the muscle (Flexor digitorum superficialis is a potential flexor of proximal interphalangeal, metacarpo-pahalangeal and wrist joints). The variations which we found during our dissection are completely new. Surprisingly there are two different kinds of variations in both sides (Right & Left). There is an additional slip on both sides, but in right side, there is a digastric appearance of radial head of Flexor digitorum superficialis.Key words : Flexor digitorum superficial is additional slip, digastrics,

Introduction:The forearm comprises of two sets of musculature, anterior or flexor group and posterior or extensor group of muscles. Each of these groups is divided into superficial and deep sets again. The flexor group has five superficial and three deep muscles. These flexor muscles flex the forearm at elbow and wrist; some of them even flex the fingers (metacarpo-phalangeal and interphalangeal joints).

The flexor compartment of forearmSuperficial Deep 1.Pronator tere 1.Flexor digitorum

profundu2.Flexor carpi radialis 2.Flexor pollicis longus3.Flexor digitorum 3.Pronator quadratus

superficialis 4.Palmaris longus

5.Flexor carpi ulnaris

The variations of Flexor digitorum superficialis are found out during our routine cadaver dissection. There are two different kinds of variations found. many authors have reported variations in its origin, appearance, additional slip, accessory muscle, absence of one head, absence of tendon to the little finger, etc.

Review of Anatomy:Muscles of the superficial flexor compartment arise from the medial epicondyle of the humerus by a common tendon. As above mentioned, there are five superficial flexor muscles in forearm region.

Flexor digitorum superficialis (sublimis):Even though it is a muscle of superficial flexor group of forearm, it lies deeper to the preceding muscles. It is the largest of the superficial flexors,

Origin: arises by two heads, the Humero-Ulnar head arises from the medial epicondyle of humerus via a common tendon; the anterior band of the ulnar collateral ligament; adjacent intermuscular septa, and from the medial side of the coronoid process proximal to the ulnar origin of pronator teres. The Radial head is a thin sheet of muscle which arises from the anterior radial border extending from the radial tuberosity to the insertion of pronator teres. The median nerve and ulnar artery descend between the heads. The muscle usually separates into two strata, directed to digits 2-5. The superficial stratum, joined laterally by the radial head, divides into two tendons for the middle and ring finger. The deep stratum gives off a muscular slip to join the superficial fibres directed to the ring finger, and then ends in two tendons for the index and little finger. As the tendons pass behind the flexor retinaculum they

* PG scholars, Dept.of Shareera Rachana, Alva’s Ayurveda medical College, moodbidri, Karnataka, India.** Professor & H.O.D , SDm college of Ayurveda, Kuthpady, Udupi, Karnataka, India.*** Asst.Professor , Department of Shareera Rachana, Alva’s AmC, moodbidri, Karnataka, India

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are arranged in pairs: the superficial pair pass to the middle and ring fingers, the deep to the index and little finger. Distal to the carpal tunnel the four tendons diverge. Each passes towards a finger superficial to the corresponding flexor digitorum profundus tendon. The two tendons for each finger enter the digital flexor sheath (which starts over the metacarpophalangeal joint) in this relationship. The superficialis tendon then splits into two bundles which pass around the profundus to lie posteriorly. They subsequently reunite and insert into the anterior surface of the middle phalanx. Some fibres interchange from one bundle to another.

An intermediate tendon is always found in the central branching area of the muscle belly and is an important landmark in deep dissection: it can initially be confused with the median nerve. The radial head of flexor digitorum superficialis may be absent and the muscular slip from the deep stratum may provide most or all of the fibres acting on the index finger. The fibers associated with the little finger may be absent, when they are replaced by a separate slip from the ulna, flexor retinaculum or palmar fascia. Variations occur in the arrangement of the tendons.

Relations: The median nerve and ulnar artery descend between the heads of flexor digitorum superficialis.

Vascular supply: The humeral head of flexor digitorum superficialis is supplied by the anterior ulnar recurrent artery. The main part of the muscle is supplied on its anterior surface by three or four branches from both the ulnar and radial arteries. The posterior surface is supplied by the ulnar artery and median artery, and the lateral surface by additional branches from the radial artery.

Innervation: Flexor digitorum superficialis is innervated by the median nerve, C8 and T1.

Action: Flexor digitorum superficialis is potentially a flexor of all the joints over which it passes, i.e. proximal interphalangeal, metacarpophalangeal and wrist joints. Its precise action depends on which other muscles are acting. It has

independent muscle slips to all four fingers, unlike flexor digitorum profundus, which has a muscle group common to the middle, ring and little fingers. It is therefore able to flex the proximal interphalangeal joints individually.

Fig 01 – The superficial flexor muscles of forearm

Observation :

As a part of the routine dissection done on an Indian male cadaver aged about 50 years, it was observed to have some discrepancy in the flexor compartment muscles of forearm. An additional slip of muscle was found to connect Flexor digitorum superficialis with Flexor pollicis longus, bilaterally. A digastric appearance of a portion of Flexor digitorum superficialis was also observed on the right forearm.

Bilateral Additional slip :

The occurrence of additional slip of muscle was found bilaterally, but there was difference in the attachments of the slip on both sides.

Brachial arteryMedian Nerve Common Fascia

Radial NerveBicipital aponeurosisUlnar artery Posterior Interosseous NerveSupinator Arcade of froshePronator teresBrachioradialisRadial arteryFlexor carpi radialisPalmaris longus


Flexor digitorum superficiali(radial head)

Flexor digitorum superficiali

Abducto pollicis longus

Radial artery

Median nerve

Ulnar arteryUlnar nerveFlexor retinaculum Abductor pollicis brevis

Guyo’ns canal Flexor pollicis brevis

Palmaris brevis

Adductor pollicis

Palmar aponeurosis

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In the right forearm, the slip is attached proximally to the lateral part of Flexor digitorum superficialis and Ulnar head of Pronator teres close to its proximal attachment and distally to the Tendon of Flexor pollicis longus in the upper half of forearm. In the left forearm, the slip has its proximal attachment on lateral part of Flexor digitorum superficialis 5 cm from its origin and distal attachment on the tendon of Flexor pollicis longus in the middle of the forearm.

Digastric appearance of a portion of Flexor digitorum superficialis :

Humero-ulnar head of the muscle had two separate portions, of which the lateral portion was found to have a digastric appearance. The intermediate tendinous portion was proximal to the middle third of the forearm.

Nerve supply:

The additional slip did not show to have any separate nerve supply.

Relations:The additional slip crossed the Ulnar artery superficially. Median nerve and humeral head of Pronator teres were superficial to the additional slip.The relations on right forearm:Anteriorly- Humeral head of pronator teres, median nervePosteriorly- Ulnar artery in the upper part, Flexor digitorum profundusMedially- Flexor digitorum superficialis, Ulnar artery in the lower partLaterally- Ulnar head of Pronator teresRelations on left forearm:Anteriorly- Humeral head of pronator teres, median nervePosteriorly- Ulnar artery in the upper part, Flexor digitorum profundusMedially- Flexor digitorum superficialis, Ulnar artery in the lower partLaterally - Humeral head of Pronator teres, Flexor pollicis longus in the lower part.

Relations of the additional slip

Right forearm Left forearm

Anterior Humeral head of pronator teres, Anterior Humeral head of pronator teres, median nerve median nerve

Posterior Ulnar artery in the upper part, Posterior Ulnar artery in the upper part, Flexor digitorum profundus Flexor digitorum profundus

Medial Flexor digitorum superficialis, Medial Flexor digitorum superficialis, Ulnar artery in the lower part Ulnar artery in the lower part

Lateral Ulnar head of Pronator teres Lateral Humeral head of Pronator teres, Flexor pollicis longus in the lower part

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Fig 03- Additional slip of muscle in left forearm flexor compartment.

Fig 04 – Additional slip and Digastric appearance of Flexor digitorum superficialis in

right forearm flexor compartment.

Discussion and Conclusion:

The flexor compartment of forearm has five superficial and three deep muscles. An intermediate tendon is always found in the central branching area of the muscle belly and is an important landmark in deep dissection and it can initially be confused with the median nerve. The radial head of flexor digitorum superficialis may be absent. Variations occur in the arrangement of the tendons.

The additional slip noted in the present dissection was a connection from the superficial Flexor digitorum superficialis to the deep Flexor pollicis longus. The additional slip didn’t have any separate nerve supply, which confirms that it is a part of the Flexor digitorum superficialis. So action of the muscle is also not different.

The presence of digastric mode of arrangement of the portion of Flexor digitorum superficialis is also a rare finding encountered.

References:

1. Chaurasia . B.D. Human Anatomy Vol.1: Bangalore: CBS publishers and distributors; 4th edition. 2004.

2. Henry Gray. Gray’s Anatomy: Edited by Susan Standring. UK: Churchill

Livingstone, Elsevier; 40th edition. 2008.

3. Romanes. G.J. Cunningham’s manual of Practical Anatomy Vol.1; Oxford: Oxford University Press; 15th edition. 2008.

4. Anatomy Atlases. A digital library of anatomy information. Flexor Digitorum Superficialis (Sublimis) [internet] 2011. [cited – 2011 December 4th ]. Available from: http://www.anatomyatlases.org/

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after 25 years in Woman’s stomach, a Pen still Writesby SCOTT HENSLEY and MELISSA FORSYTH

CT scan proves woman was right. She did swallow a pen 25 years ago.

You might have heard about the case on Wednesday’s morning Edition.

Twenty-five years ago, a British woman who saw a spot on a tonsil tried to get a better look using a pen and a mirror. She slipped and the pen went down her throat.

Neither the woman’s husband nor her doctor believed her. x-rays at the time didn’t detect the pen. Now, “they are eating their words,” as NPR’s Linda Wertheimer put it.

A CT scan shows she was right. And the woman, 76, had the felt-tip pen removed. Even after all these years without trouble, doctors figured there was a risk the pen could tear a hole in her stom-ach. Remarkably, the pen still worked.

Take a look for yourself at the scan showing the pen in her stomach. And the acid test, so to speak, “Hello,” written with the retrieved pen afterward.

The images come courtesy of BmJ Case Reports, a peer-reviewed clearinghouse for quirky and significant cases, that has become one of our favorite reads. The journal kindly gave us permission to reproduce the images.

For more, see the case report: “An incidental finding of a gastric foreign body 25 years after inges-tion.”

Beyond being a bit bizarre, the case does have a few lessons for clinicians, the reporting doctors write: “plain abdominal x-rays may not identify ingested plastic objects and occasionally it may be worth believing the patient’s account however unlikely it may be.”

Courtesy by Internet medical news and BJm

EnlargeCourtesy of BmJ Case Reports EnlargeCourtesy of BmJ Case ReportsA pen removed from a woman’s stomach after 25 years still works.

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emerylogiCal develoPment of testis

• Testis Develops from Coelomic epithelium• Genital ridges form first.• Sex cords are formed by the cells of germinal epithelium. • Sex cords reach deep into the gonad to from Medullary cords• Canalization occurs and Seminiferous tubules are formed. • Interstitial cells of testis are derived from sex cords and are not canalized. • Tunica albuginea is formed from mesenchymal cells surrounding testis. • Ends of seminiferous tubules anastomose to form Rete testis. • Rete testis along with mesonephric tubules forms Vasa efferentia. • Cranial part of mesonephric duct form Epididymis. • Caudal part forms Ductus deferens . • Seminal vesicles arise as a diverticulum from lower end of mesonephric duct. • Part of mesonephric duct which lies in between the prostratic urethra and diverticulum forms

Ejaculatory duct

development of ovary • Coelomic epithelium of mesonephros form genital ridges. • Sex cords proliferate from germinal epithelium. • Primordial germ cells migrate to the region of developing ovary to form Oocytes. • Sex cords are broken up into masses and surround primordial germ cells to from Testis reaches

Primordial follicle,

descent testis • Testis reaches iliac fossa in the 3rd month • They lie at the site of deep inguinal ring up to 7th month. • In 7th Month they pass through inguinal canal. • They reach scrotum by end of 8th month.

descent of ovary • Ovary Descends from lumbar region. • Gubernaculum is formed which extends from ovary to labium majus. The part of gubernacu-

lum persisting in between ovary and uterus becomes Round ligament of ovary. • The part of gubernaculum which lie in between uterus and labium majus becomes Round liga-

ment of uterus. dr. Parameswar s. final yr. P.g. scholar dept. of rachana shareera.

22

“shareera ratna 2011” Award to Dr. Muralidhar N.

prof. Sri Sri Ayurveda Medical College, Bangalore

by International Association of Ayurveda Physicians


emBryologiCal develoPment of Bladder, urethra, uterus and uterine tuBes, Prostate and external genitalia

A . Development of blader � The primitive Uro- genital sinus divides

into i Vesico - urethral canal ii Definitive UGS

� Urinary bladder is derived from the cranial part of Vestibulo-urethral canal (endoderm)

� Internal feature - * Region of trigone is formed

by absorbed mesonephric ducts (mesoderm)

* Muscular Serous walls are de-rived from Splanchnopleuric mesoderm.

� Initially, the bladder is continuous with allantois cranially.

� Later, allantois atrophies and forms a fi-brous cord called Urachus.

� Urachus forms the median umbilical ligament connecting the apex of blad-der to umbilicus.

B. Development of Urethra � The primitive Uro- genital sins divides

into - i Vesico - Urethral canal ii Definitive UGS

� The Mesonephric ducts and Ureters open separately at the Junction of these two parts.

� Caodally, the Vesico - Urethra canal forms the primitive urethra, and defini-tive UGS divides into to Pelvic & Pjallic parts.

i In females : Urethra is formed from - * Primitive Urethra. * Part of pelvic part of UGS * Rest of the pelvic part forms vestibule. ii In males : Urethra is formed - * Prostatic urethra: Same as that in females. * Membranous urethra : From pelic part of UGS. * Penile urethra : From phallic part of UGS. * Terminal part of Penile urethra (in Glans) - Ectoderm.

C. Development of Prostate � Secretory epithelium - Develops from

the large number of buds arising from Prosthetic urethra

� Inner glandular zone - From the buds arising from rest of the prosthetic ure-thra (endoderm).

� The Mensonephric ducts, while being absorbed moves closer to enter the prosthetic urethra which develops into ejaculatory ducts.

� In females, the buds give rise to Ure-thral & Para Urethral glands.

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D. Development of Uterus & Uterine tubes � The Para - Mesonephric ducts, formed

by the invagination of coelomic epithe-lium are continuous caudally (in mid line) forming the Utero- Vaginal canal.

* Caudla end of this is in close contact with the dorsal wall of definitive UGS. This part gives rise to vestibule in female.

� Epithelium of Uterus -From fused part of Para Mesonephric ducts.

� Myometrium - From the surrounding mesoderm.

� Fundus of Uterus - As the thickness of the myometrium increases, unfused horizontal parts of para Mesonephric ducts gets partially embedded to form the fundus of uterus.

� Uterine tubes - Develop from unfused part of Para- Mensonephric duct.

E. Development of Vagina � The lower end of the Utero-Vaginal Ca-

nal, which comes in contact with UGS is separated by the formation of solid plate called Vaginal plate.

� Vagina is formed by development of lu-men within the plate.

F. Development of External genitalia I In Female: a. Clitoris - Genital tubercel be-

comes cylindrical to form Clito-ris.

b. Labia majora- Genital swellings enlarge to form Labia majora. Fused posterior commissure.

c. Urogenital membrane breaks down to establish continuity with UGS and exterior.

d. Labia minora - Primitive Ure-thral folds form labia minora

II In Male a. Phallus - Genital tubercle be-

comes cylindrical to form phal-lus. This enlarges greatly to form Penis and as it grows, coronary sulcus develops & thus Glans becomes distinguishable.

b. Prepuce - Form by reduplication of ectoderm covering Phallus.

c. Linear groove lined by ectoderm extends onto undersurface, and is called Primitive urethral groove.

d. Endodermal cells in the phallic part proliferate and grow in to phallus forming a solid plate called the Urethral plate. These are in contact with the ectoder-mal cells lining the primitive urethral groove.

f. Margins of the definitive urethral groove form definite urethral folds.

g. The folds fuse from UGS poste-riorly to phallus to form Penile urethra.

h. Genitalswellings fuse in midline to form Scrotal sac.

Dr. Remitha K.K.3rd Yr. MD

Dept. of Rachana Shareera.

24


study of Pada Praman With sPeCial referenCe to Plantar arCh index in volunteers of various regions

* Dr. Pratik S.Dhakad ** Dr.Girish T. Kulkarni

introduction : Ancient Ayurvedic scholars had defined the health status of the person. They stressed on the need of Aatura Parikshana in their re-spective texts. They mentioned signs of the person, indicating him as Swastha (healthy) or as Aatura (diseased or not healthy). xÉqÉqÉÉÇxÉmÉëqÉÉhÉxiÉÑ xÉqÉxÉÇWûlÉlÉÉå lÉU: | SØRåûÎlSìrÉ ÌuÉMüÉUÉhÉÉÇ lÉ oÉsÉålÉ AÍpÉpÉÑrÉiÉå || cha.su.21/18 A person having equilibrium (i.e. equal dis-tribution of muscle mass in his body) and also strong Indriyas (capable, strong, nor-mal sense organs); is able to sustained any kind of disease attack than a person without above characteristics feature. Taking consideration of above fact, Pramaan, Anupaat of single body constitu-ent though can not be concluded as final Samhanan of whole body, but can be con-sidered as a marker. E¨ÉUÉå¨ÉU xÉÑ¤Éå§É CÌiÉ E¨ÉUÉå¨ÉU ´Éå¸ÉcNíåû¸Ç vÉÉåpÉlÉ vÉËUU | iÉ§É mÉÉSaÉÑsTüÉå mÉëjÉqÉ ´Éå§É | Su.su35/4 dalhan Dalhana considered Pada(foot) and Gulpha(ankle) as the first important region of body to be observed. This throws light on importance of foot region, as a weight bear-ing organ of the body. The meaning of quote in charak Vimaan 8/93 narrates that while investigating health status of the person, examination of his Desha i.e. regions should be done. As Desha (Region) changes their Aahar (type of diet), Vihar (type and extent of exertion and exer-

cise), Aachar (type of behavior including gait), Bala (strength), Satva, Saatmya (adaptation to the certain habits including environmental), Dosha, Bhakti, Hita and Ahita (favorable and unfavorable)factors are liable to change due to the adaptation process. aims and objectives- - To compare Pada Pramana with Staheli’s plantar arch index. - To study the relationship between Pada Pramana of subjects of different regions with special references to Staheli’s plantar arch index. -To compare the Pada Pramana of both legs of subjects of various regions Inclusion criteria :- 1) Age – 21 to 40 years. 2) Both genders 3) Normal individuals Exclusion criteria:- 1) Individuals below 21 years and above 40 years 2) Individuals with congenital deformities 3) Individuals with various diseases of foot 4) Too obese or too thin person Plan of the Study : • 50 healthy volunteers selected from four

different regions of India i.e. northeast, Punjab,Maharashtra and Kerala region.

• Case record form was designed to as-sess volunteers after taking formal in-formed consent of the volunteer.

• Study had been conducted in different

* M.D.(Scholar) Rachana Sharir Dept. M.D.(Rachana Sharir),Associate Professor. S. S. Ayurvd Mahavidyalaya, Hadapsar - Pune 411028.

25


parts of the Pune region. The person re-siding that particular region of an India from birth up to at least 21 years of his age has been selected. Also the person must not be residing in other region (including Pune) more than 2 months, is only included.

• Pada Praman measurements (aayam and Vistar)was taken.

• The data thus generated was neatly ar-ranged and assessed.

• Pedigraphy is the instrument specially designed for measuring foot consist-ency. The instrument acts on the prin-ciple of pressure, consists of platform of metal surface. The rubber layer remains above the platform. When the person keeps the foot above rubber layer im-pression of it gets impregnated on the paper kept between rubber and plat-form. As ink was applied to the inner layer of rubber, it is possible.

• The source for the discussion was lim-ited to results of physical proportion measured on body parts (foot) and the literature available in Samhita, related with it.

observations and results :- The Plantar Arch Index is the ratio show-ing relationship between Pada Madhya Vistar (plantar arch breadth) and Parshni Vistar (heel breadth) of a person’s foot. Two methods which were used for calculating this Plantar Arch Index (Pada Anguli Pra-man) were Pedigraphy method and Vernier caliper method statistically for results and represented. 1) Punjabi volunteer having higher plantar arch index i.e. higher breadth of Pada Mad-hya (arch of foot) than its Parshni (heel) re-

gion. Northeast people having higher plan-tar arch index than Maharashtra and Kerala people. Maharashtra and Kerala nearly having same range (i.e. strong correlation, and Z test in-significance) which have lower plantar arch index than other two regions. From the literature available it can be stated that, as individuals are lived and grown up in 4 different habitats, this change in the foot measurements can because of effect of the environment on them. 2) After taking into account literature from the Samhita and the above observations, we can state affirmatively that, greater plantar arch index of the Punjabi population can be correlated with their superior health status followed by north eastern region (Arunachal Pradesh) and then subsequently Maharash-tra and Kerala region. In other words, we can state that, Pun-jab fares better qualitatively health wise followed by the other three states (N.E.>Maharashtra>Kerala) as mentioned above. 3) The value observes no significance dif-ference between two methods. Pedigraphy method to assess plantar arch index is equal-ly useful as (Swanguli) vernier caliper meth-od, as the readings from the ways do not vary significantly. 4) Observed values states that there is strong correlation between the Plantar Arch Index of left and right foot of an individual of any of four region obtained by pedigraphy meth-od as well as vernier caliper in this study. 5)Desha (region) plays a role in structur-al and physiological development of body structures of the individual. So Desha is the only factor which has been taken in to an ac-count for the study.

26


KNOW ABOUT BONESSynonyms of Bones1) Collar bone - Clavicle2) Shoulder blade - Scapula3) Pisiformis / Lentiform bone - Pisiform4) Pyramidal bone - Triquetrum5) Greater multangular bone - Trapezium6) Lesser multangular bone - Trapezoid7) Unciform bone / Uncinate bone - Hamate8) Funny bone - Medial epicondyle of Humerus9) Innominate bone - Hip bone10) Thigh bone - Femur11) Knee cap / Knee pan - Patella12) Calf bone - Fibula13) Shin bone / Shank bone - Tibia14) Heel bone - Calcaneus15) Ankle bone / Astragalus - Talus16) Moustache bone - Maxilla17) Jaw bone - Mandible18) Malar bone / Jugal bone / Cheekbone - Zygomatic bone19) Inferior turbinate bone - Inferior nasal concha20) Stirrup bone - Stapes 21) Epistropheus - Axis vertebrae22) Tail bone - Coccyx

Specialty of Bones 1) Only long bone situated horizontally - Clavicle2) 1stbonetostartossification -Clavicle3) Lastbonetocompleteossification -Clavicle4) Largest carpal bone - Capitate5) Smallest carpal bonev Pisiform6) Longest metacarpal bone - 2nd Metacarpal bone7) Shortest metacarpal bone - 1st Metacarpal bone8) Modifiedphalanx -1stMetacarpalbone9) Longest & strongest bone - Femur10) Heaviest bone - Femur11) Largest sesamoid bone - Patella12) Largest tarsal bone - Calcaneus13) Smallest tarsal bone - Intermediate cuneiform14) Longest metatarsal bone - 2nd Metatarsal bone15) Shortest metatarsal bone - 1st Metatarsal bone16) Smallest bone - Stapes17) Lightest bone - Stapes18) Smallest cranial bone - Ethmoid 19) Largest & strongest facial bone - Mandible20) Smallest facial bone - Lacrimal bone21) Only bone which not articulates - Hyoid bone with any other bones 22) Digital formula of Fingers - 3>4>2>5>1 Collected by – Dr. Nithin Kumar Lecturer, SDM College of Ayurveda, Pitrody, Udupi

27


‘SKIN DONATION – A RAY OF HOPE FOR BURN PATIENTS’ * PG Scholar :- Dr. Harshad S. Kulkarni. ** Guidance:- Dr. Mukund P. Erande.

It may be a mythological story in Mahab-harata, that Mahatma Karna donated his Kavacha (i. e. Skin) to Indra (King of Gods); although we are not Karna, but still we can donate our Skin post-humously to the needy patients of certain condition like burns. Burn has become endemic health hazard in a developing country like India. It is estimated that India, with a population of 1.2 billion, has over 7,00,000 to 8,00,000 burn admis-sions annually with an estimated mortality of 1, 68,000 per year. Young women are more sustained to burn injuries than young men (women: men = 3: 1). A couple of decades have sensitised people for eye, blood, kidney and even body donations. But presently skin donation is among the least known donations in India. Burn wound is probably the most devastat-ing of all the wounds – physically, psycho-logically, socially and economically. For partial thickness burn wound (that in-volves destruction of epidermis and vari-able extent of dermis) the natural process of wound healing can be aided and / or expe-dited with appropriate use of several biologi-cal wound covers (e.g. collagen, amnion, ba-nana leaf dressing, etc.) or interactive wound dressings (e.g. Acticoat) and topical agents (e.g. antimicrobial creams, E G F containing preparations, etc.).But, for full thickness burn wound, split thickness skin grafting is the only way of ob-taining wound closure. Patients with burn size upto 40-50% Total Body Surface Area

(TBSA) can usually be provided permanent closure of such wounds with skin Autografts obtained from the unburnt areas of the pa-tient. But, with larger burn size, several fac-tors preclude Autograft procurement -• Poorgeneralconditionofpatient.• PaucityofAutograftdonorsites.• Durationneeded (usually 3weeks) for

reharvesting skin graft from same donor sites.

In these situations, the only way of sal-vaging such patients is using substitutes for skin Autografts such as.

• Xenografts(fromotherspeciese.g.pig-skin)

• Allografts(fromanotherhumanbeing)• Biosynthetic skin substitutes (Artificial

Skin)Xenografts are not commercially availablein our country. Biosynthetic skin substitutes are extremely expensive and unaffordable for most of the burnt patients in our country. The availability is also

* Dept of Rachana Sharir,S. S. Ayurved Mahavidyalaya, Pune.

Prof & Head, Rachana Sharir Dept.S. S. Ayu. Mahavidyalaya, Pune.

28


uncertain. Then the only alternative avail-able is Skin Allografts obtained from a hu-man donor. The efficacy of skin allografts in the management of burn wound was real-ized in 1881.(Skin harvesting being performed from back of leg)Skin Allograft Donors can be1. Living 2. Cadaver

Living Donor: - For procurement of Skin grafts, the living donor needs to undergo a battery of investigations for preoperative evaluation followed by a surgical procedure under suitable anaesthesia, hospitalization for at least 2-3 days, donor site healing time of about 10 days and postoperative wound site pain. Maximum body surface area that can be safety utilized for harvesting of skin grafts is 15 to 20% at a time. In the present age of nuclear families availability of such a relative is obviously very rare and inconven-ient too. It is even more difficult to come across a willing donor for a young female patient. In reality, majority of our patients are young females from poor socioeconom-ic strata with compromised nutritional sta-tus and have large burn size (average extent more than 50% TBSA) with most of the area

bearing full thickness burn wound. The other alternative is to procure split thickness skin grafts from a cadaver donor and preserve them for use in future.Cadaver Donor: - The concept of skin dona-tion after death is not new and the first skin bank was established in USA around 1950. The chief benefits of use of Allografts on ex-cised full thickness burn wounds are -• Effective control of protein and fluid

loss from wounds.• Reversal of hypermetabolic state with

improvement in nutritional status.• Augmentation of immunological re-

sponse.• Control of wound infection and im-

provement in the wound bed making it ready for acceptance of precious skin Autografts.

• Immediatepainreliefandgeneralfeel-ing of well being.

• Excellent biological wound cover tillthe autograft donor sites become ready for reharvesting.

The skin allograft transplant differs from organ transplantation as the skin grafts are used to provide temporary long term pro-tection and are not expected to survive in the recipient permanently as transplanted organ. This means that neither ABO blood group nor HLA matching is required for al-lograft skin transplantation. So, literally any human being can be a donor for anyone else.Skin can be donated within in 6 hours from the time of death. Skin is harvested by an instrument called DEMATOME from both the legs, both the thighs and the back. Only 1/8th layer i.e. the uppermost layer of the skin is only harvested. Skin is preserved in 85% glycerol solution, it is stored between 4-5 degree Celsius and it can be stored for a

29


period of 2-3 years.Any one’s skin can be transplanted on any one, there is no blood matching, no colour matching, no age matching required. Once all the blood reports for Hep B, A, HIV, sep-ticaemia, etc. are negative, the donor skin can be transplanted freely. Thus skin donation can be a ray of hope for the burn patients on social, psy-chological and personal grounds; for which AWARENESS is the only need of time. Additional advantages of skin dona-tion apart from its use in Burns patients is that, the body of the cadaveric donor can be dissected by the students of First year of

the medical course. Thus it serves dual pur-pose and adds to social contribution by the person who has made body bequeath. But if anybody wants to donate his/her skin only post-humously, one can make a such will also. The skin can be stored in a skin bank for longer duration and can be use to any-body in its need.References – 1) BMJ, Burns in the developing world,

Published 19-08-2004.2) The Times of India, Pune, 27-2-2012.3) Dehadaan –Shanka Samadhaana, Pub-

lisher Dadhichi Dehadaan Mandal, ed 5th, yr 2011, Dombivali, Thane (M.S.).

national Conference on shareera rachana on 15th october 2011 at g s ayu. medical College, Koppal

30Inauguration of Seminar on Kaya chikitsha at SDMCA Udupi


Dr. Ramannavar & Dr. Susheela Devi Honoured by Poojya Shree Ma. Ni. Pra. Swa. Jagadaguru Abhinava Gavisiddheshwar Mahaswamiji Shree Gavimath Koppal,

Students Award Highest marks in Shareera Rachana & Kriya of RGUHS Examination Honoured by Dr. Susheela Devi & Dr. Ramannavar

Lighting the lamp by Sri S R Navali Hiremath Chairman SJGAMC&H Koppal & Dr. Erande Prof. Hadapsar Pune.

national Conference on shareera rachana on 15th october 2011 at g s ayu. medical College, Koppal

Dr.K. B. Hirematha & Dr. S. A. Patil Honoured by Poojya Shree Ma. Ni. Pra. Swa. Jagadguru Abhinava Gavisiddheshwar Mahaswamiji Shree Gavimath Koppal,

31


students Council inauguration at sdm college of ayurveda, uduPi

Lighting the lamp by Dr. U N Prasad Principal SDMCA Udupi Lighting the lamp by Sri Raghupati Bhat MLA Udupi

Inaugural Speech by Sri Raghupati Bhat MLA Udupi Dignitaries on Dais of Students council inauguration

Welcome Speech by Sri Subrahmanya Bhat Lecturer SDMCA Udupi Inaugural Speech by Dr. Y N Shetty Medical Superintendent SDMCH Udupi

Chief Guest Speech by Dr.B S Prasad Principal BMK Ayurveda College Belagum

President Speech by Dr. U N Prasad Principal SDMCA Udupi

32


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