A 10-year-old female patient was admitted in the hospital with a history of trochanteric fracture of femur after road traffic accident. On examination patient was observed to have mental retardation and had Ventricular Septal Defect in the heart. The patient was born with flabby muscles, had delayed mile stones, stunted growth for the age, slanting of eyes, flat face and nasal bridge, ineligible speech, and had difficulty in carrying out her day-to-day activities [Table/ Fig-1 patient was the fourth living child of the consanguineous parents. Other three siblings of the case were normal and were pursuing their studies normally [Table/ Fig-2]. Parents of the case were third degree consanguineous. No other family members had any history of mental retardation. The history of the pregnancy during the present case was normal. The results of all biochemical tests were found to be normal.After obtaining signed informed consent, 3 ml of whole blood was collected in heparinised tube from both parents for lymphocyte culture and karyotype was prepared. The blood was cultured in RPMI 1640 with PHA medium (Peripheral Blood Karyotyping Medium, with Phytohemagglutinin (PHA-M), CAT No # 01-201-1B, Biological industries,) and harvested after 67 and half hours. Slides were prepared for GTG banding. The slides were stained by Giemsa stain (CAT No # S011-100ML, Himedia) and 20 spreads for each of the blood sample were examined for chromosomal abnormality by cytovision workstation (Leica DM6000B, Leica Microsystems).

BACKGROUND Sacrum is a large triangular bone formed by the fusion of 5 sacral vertebrae. It lies obliquely at the posterior part of pelvic cavity between the two hip bones. It encloses a canal called the sacral canal. The lower opening of the sacral canal is called the sacral hiatus. It transmits the 5 th pair of sacral nerves, coccygeal nerves & filum terminale externa. AIMS & OBJECTIVES The aim of the present study is to find out the variations of sacral hiatus in this part of Northeast India. MATERIALS & METHODS The study was carried out in 104 dry human sacra to know the anatomical variations of sacral hiatus. The measurements were carried out with the help of a Vernier calliper, scale & a divider. RESULT & OBSERVATIONS Various shapes of sacral hiatus were observed as follows: Inverted U shaped (53.8%), inverted V shaped (29.8 %), irregular shaped (9.6 %), dumb-bell shaped (5.7 %), bifid (0.9%). The length of the sacral hiatus was found to be between 20-30 mm in 46.1% cases. The apex of the sacral hiatus was at the level of S4 vertebra in 46.1% specimens. The anteroposterior diameter of the sacral canal at the apex of the sacral hiatus ranged from 2-12 mm. CONCLUSIONS Variations of sacral hiatus is very common. The knowledge of such variations will definitely help the anaesthesiologists to take proper step while administering caudal epidural anaesthesia to increase the success rate of caudal epidural block.

Introduction: The vermiform appendix is a wormlike tube situated in the right iliac fossa. It arises from the posteromedial cecal wall, 2 cm or less below the end of the ileum and suspended by a peritoneal fold known as meso appendix. Position of the appendix influences its mobility. Most common position of appendix has been reported to be retrocecal followed by pelvic position. But there are other variable positions also reported by many. Aim: To study the anatomical variations of the positions of vermiform appendix in human cadavers. Materials and Methods: This was a descriptive cross-sectional study which was carried out in the Department of Anatomy, Assam Medical College, Dibrugarh, Assam, India, from June 2020 to May 2021. Total 14 adult cadavers and 66 new born cadavers were included in the study. All the cadavers were dissected and abdominal cavity was explored. The position of the appendix was then noted in all specimens. Results: In most of the cases the position of vermiform appendix was found in retrocecal position followed by pelvic, pre-ileal and paracolic. In adults, retrocecal positions were more in males (88.9%) than females (40%) in contrast to newborns where retrocaecal positions were more in females (76.7%). As a whole, retrocecal position (66.25%) of appendix was the commonest finding in all cadavers. This was followed by pelvic (30%) position. Paracolic (2.5%) and pre-ilial (1.25%) positions were also noted in newborn cadaver. Conclusion: Knowing the variations in the position of appendix will guide the surgeons during intraoperative procedures. Since the positions of appendix vary considerably signs and symptoms also vary depending upon the different positions. Hence, the knowledge of its diverse anatomical positions is of utmost importance which helps the surgeons in proper management of appendicular pathology.

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Introduction: Coronavirus Disease 2019 (COVID-19), the new contagious novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), pandemic in 2020-21 has had a devastating impact on human race. The most common cause of death among hospitalised patient was COVID-19 pneumonia or lung injury. Various studies have shown diurnal variation in human mortality due to all causes with or without intervention. Aim: To identify existence of diurnal variations for mortality among the hospitalised patients with COVID-19 pneumonia. Materials and Methods: This hospital-record based, retrospective study was conducted in a tertiary referral centre of north east India (Assam Medical College, Dibrugarh, Assam, India) which was a dedicated COVID-19 hospital during the pandemic. The study was conducted from September 2021 to December 2021 and the data was collected and recorded from the Cadaver slips issued to families of patient dying of COVID-19 pneumonia during the period January 2021 to August 2021. The data were generated by plotting the number of deaths of COVID-19 cases for each two hour interval as a percent of the mean number of deaths per twohour interval and as a percentage of cumulative deaths per twohour interval on a 24 hour scale. The deaths were sub grouped according to gender, age, and reported co-morbid causes of death along with pneumonia. Comparisons of data i.e., mean deaths/2 hour interval (mean±SD) were performed by one-way Analysis of Variance (ANOVA), followed by Bartlett's test for equal variances. The p-value <0.05 was considered as statistically significant. Results: Total 743 deaths, with 537 males and 206 females were included in the study. Mean age of the deaths was 56.39 years. There was rise of deaths during 4 PM to 6 PM (16:00 to 18:00) interval for all deaths due to COVID-19 pneumonia. The increase in deaths during this period was mainly due to deaths among males equal or above 65 years and females below age 65 years. However, the deaths of females equal or above the age of 65 years did not show significant diurnal variation. Only 26.51% (n=197) of pneumonia deaths were without co-morbidity. Conclusion: There exists a diurnal variation in mortality among COVID-19 pneumonia patients with evening rise of deaths. Diurnal variation is significantly more among males rather than females above 65 years.