The hand is a prehensile organ, it is endowed with grasping and precision movements for skilled work and it acts as a chief tactile apparatus. Thus human hand is a revolution in evolution. Indeed the lumbricals of the hand by producing flexion at the metacarpophalangeal joints and extension at the interphalangeal joints helps in writing, stitching and any other forms of precision work. A study was conducted in the department of Anatomy, Kasturba Medical College, Manipal with 30 cadavers of both sexes. The study was carried out to check for the variations in the origin, insertion, innervations and the extension of lumbrical muscle.93.3% of case showed the normal morphology of lumbricals and remaining showed the variations like bifid first lumbrical, bipennate 2 nd lumbrical, absence of 3 rd lumbrical, hypertrophied 1 st lumbrical. Anomalous and additional lumbrical muscle can cause carpal tunnel syndrome by compressing the median nerve. Hypertrophy of the lumbricals could compress the radial and ulnar arteries of the fingers, causing chronic sub ischemia. Hence present work is under taken to know the variations in the lumbricals.

BACKGROUND Head injury causes hospitalisation of 200-300 persons per 10000 population per year. Ocular manifestations are known to occur in patients with head injury, because of the proximity of the eye to head and its neural connections with brain. Clinical correlation of the ophthalmic findings is important in early localisation, ongoing assessment, better management, prognosis of the patient with head injury. METHODS A total of 180 patients with closed head injury were examined in the casualty of KIMS Hospital, Hubli. Glasgow coma scale of all the patients was noted. Ophthalmological examination was conducted. This included, orbital margins, periorbital region, eyelids, conjunctiva, cornea, anterior chamber, iris, pupil examination and lens details. Bedside vision up to 3 meters was evaluated. Digital tension, extra ocular movements and direct ophthalmoscope examination were done. Patient was managed accordingly. The results obtained were analysed. RESULTS In this study, 153 cases (85%) were male and 27 cases (15%) were females. Age of the patients ranged from 18 to 75 years. Road traffic accident was the most common cause of head injury in 108 cases (60%), followed by assault 44 cases (24.44%). 28 cases (15.55%) had other causes like falls etc. Types of ocular injury in this included-lacerations in 16 patients(8.89%), black eye in 12 patients (6.66%), palsies in 6 patients (3.33%), sub conjunctival haemorrhage in 5 patients (2.77%), optic neuropathy, globe rupture, vitreous haemorrhage with lens dislocation in 4 patients each (2.22% each) and most frequently combined injuries occurred in 124 patients (68.89%). Cranial nerve palsies occurred in a total of 8 patients. In our study most of the patients had good vision of counting finger >3 mt. (73.33%). 3.89% had CF <3 mt and 1.67% had no perception of light. 21.11% vision was not assessable. Most of the patients with ocular findings had mild GCS. Neurological manifestations were more common with reduced GCS. Ocular manifestations are quite common in patients with head injury. CONCLUSIONS Ophthalmological examination is quite often neglected in situations of busy casualties. Ophthalmic assessment in patients with head injury might help in diagnosing visual conditions earlier. This assessment might help in early treatment as well thus preventing the patient to live a morbid life even after surviving head injury. This highlights the importance of integrated ophthalmological assessment while evaluating a case of head trauma.

Background: Human heart is supplied by coronary arteries -Right and Left coronary artery. The coronary arteries arise from the aortic sinuses and the left coronary artery from the left posterior aortic sinus. The left coronary artery has two branches, the anterior interventricular and circumflex arteries. The anterior interventricular branch is the continuation of left coronary artery, gives off septal branches, right and left ventricular branches. The left ventricular branches are called diagonal arteries. The left circumflex artery gives off left atrial and left ventricular branches. One of these atrial branches supply the sinoatrial node in 35% of subjects and AV node in 10-20% of the subjects. Materials and Methods:The study was carried out in the department of anatomy, Kasturba Medical College, Manipal, India. The study was performed on 50 formalin fixed human hearts of unknown sex and age. The left coronary artery and their branches were carefully dissected. The origin, branches & branching pattern of left coronary artery was observed, noted and photographed.Results: In present study, 49 samples (98%) showed the origin of left coronary artery from left posterior aortic sinus while 01 sample (02%) had no trunk of left coronary artery. Sino-atrial nodal artery was originating form circumflex artery in 13 samples (26%) and atrio-ventricular nodal artery from the circumflex artery in 05 samples (10%). The trunk of left coronary artery was bifurcating in 37 samples (74%) and trifurcating in 12 samples (24%) with one sample (02%) showing absent trunk of left coronary artery. The median artery was present in 12 samples (24%) and posterior interventricular artery was originating from circumflex artery in 05 samples (10%). Conclusion:Left coronary artery commonly originated from left posterior aortic sinus with very few variations. Sino-atrial nodal artery and atrioventricular nodal artery commonly originates from right coronary artery. Bifurcation of left coronary artery is commoner than trifurcation. The present study is useful in better understanding of the normal and variant anatomy of left coronary artery.

No abstract