Nerves supplying the hand are notoriously variable in their divisions and their course; do not follow any standard pattern. The palmar aspect of hand is supplied by median and ulnar nerve. The clinical importance of Guyon's canal is emphasized due to the various branching patterns of the ulnar nerve in this canal. The palmar aspect of hand is usually supplied by ulnar nerve and median nerve. Medial one and a half fingers are supplied by ulnar nerve and lateral three and a half fingers are supplied by the median nerve. The branches of ulnar nerve are notoriously variable morphologically and no standard pattern can be given regarding the course of these branches. Presence of trifurcation of ulnar nerve or communications of superficial branches to median nerve do not cause symptoms usually but becomes important during surgical and orthopaedic interventions. Material and Methods: The study was conducted on 40 hands (20 left and 20 right) of preserved adult human cadavers.The roof of the Guyon's canal was opened with care not to disturb the stuctures. The ulnar nerve observed for its terminal branches, the course of its superficial branches was observed. The point of division of superficial branch into digital branches was measured from bistyloid line. The point of origin of superficial communicating branch from superficial branch or digital branch of ulnar nerve to median nerve was observed from bistyloid line. Observations: In 29 hands the ulnar nerve showed bifurcation, in 10 hands it trifurcated in the Guyon's canal and in 1 right hand of a male cadaver there was higher division of the ulnar nerve and trifurcation.The superficial branch was observed for its course and division from bistyloid line. The superficial branch gave rise to 2 digital branches in 27 hands and it gave 3 branches i.e. 2 digital branches and 1 communicating branch to medialmost digital branch of median nerve in 13 hands. The typical ramus communicans from digital branch of ulnar nerve to the medial most digital branch of median nerve was observed in 27 hands.(67.5%). Conclusion: This study attempted at exploring the superficial anatomy of ulnar nerve in hand.The branching pattern of the ulnar nerve in Guyon's canal is variable as there is no exact level at which the nerve terminates.The superficial communicating branch to median nerve though present in all the hands but the typical ramus communicans was observed in 67.5% of specimens. Thus surgical procedures in hand should be planned carefully keeping in mind in advance such variations which can be encountered.

The aim of the study was to evaluate the efficacy of an orthodontic toothbrush in comparison to a normal toothbrush. Materials and methods:The patients were randomly divided into two groups. Group A received Colgate orthodontic brushes for oral hygiene maintenance whereas, and group B received normal toothbrush. Data of the patients regarding their age, sex, type of toothbrush, gingival index (GI), and plaque index (PI) were collected. Results:The average plaque index of group A using an orthodontic brush before orthodontic brackets were 1.37, and two months after bonding was 1.48. The average plaque index what patients using a conventional brush before putting brackets was 1.41, and 1.67 at the end of two months. The gingival index in group A at the baseline was 1.44 and 1.48 at the end of two months. Similarly, the gingival index of group B at baseline was 1.46 and 1.72 at the end of two months. Conclusion:There is no significant difference in the clinical efficacy of both the type of brushes in the patients who are undergoing orthodontic treatment.

Documentation is a significant mechanism to prove one’s identity. Palestinians, being robbed of this privilege to document their history, have taken upon other creative means to prove their existence. Being instruments of resistance, graphics and comics have a historical prominence in the Palestinian community. Building on this rich history of resistance through art, the paper contends that the modern graphic novel is used as a tool by the author to reclaim the Palestinian identity by drawing their rootedness in the region, thus resisting their effacement from public memory.

The outcome of children born with cyanotic congenital heart disease has markedly improved over the years. Follow up is recommended for most post-operated cases as complications may occur over long term. One of the complications is the development of ventricular dysfunction, often seen after a successful Fontan surgery (or one of its modifications) for single ventricle. The aim of this study was to determine the prevalence of myocardial perfusion abnormalities in the ventricular myocardium of asymptomatic patients, older than 8 years of age, who had earlier undergone either a univentricular palliation (modified Fontan procedure) or a biventricular repair for tetralogy of Fallot, more than a year ago. All eligible patients underwent screening electrocardiogram (to rule out rhythm disturbance) and echocardiography. Patients with ventricular ejection fraction of more than 50 % by echocardiography were included. Enrolled patients were subjected to gated stress-rest myocardial perfusion imaging using Technitium-99m tetrofosmin single photon emission-computerized tomography (SPECT). Ventricular ejection fraction was also calculated from gated rest study. For the Fontan group, we also analyzed data to see if the morphology of the systemic ventricle would make a difference as far as myocardial perfusion was concerned. Twenty-six patients were enrolled (11 had undergone Fontan surgery and 15 had complete repair of tetralogy of Fallot). Seven of 11 patients in the Fontan group had myocardial perfusion defects (63.6 %) as against none in the repaired tetralogy of Fallot group (p < 0.001). The ejection fraction was within normal range in both the groups; it was statistically higher in the post tetralogy of Fallot repair group (p < 0.04). There were two subgroups in the post Fontan group depending on the morphology of systemic ventricle-left (4 patients) and non-left (7 patients). Higher number and larger size of perfusion defects were present in the non-left ventricular systemic ventricle morphology as compared with left ventricular morphology, but this difference did not reach statistical significance. Myocardial perfusion defects are common in patients who have undergone univentricular repair more than one year ago in contrast to patients who had a biventricular repair for tetralogy of Fallot. In the Fontan group, the morphology of the systemic ventricle was not predictive of prevalence of perfusion defect.