Advancement in imaging techniques and interventional cardiology procedures have generated renewed interest in anatomy of tricuspid valve complex. The purpose of the present study was to characterize the morphology of tricuspid valve leaflets using objective criteria. Thirty-six embalmed cadaveric hearts were utilized for the present study. Leaflet morphology was studied using newly defined criteria. Commissural zones were identified and leaflets were delineated. Presence of scallops was also recorded. Single leaflet was observed in six cases, double in 26 cases, and triple in four cases. The anterior leaflet is large with multiple scallops and frequently accrues portion of inferior leaflet. The septal leaflet is in the form of a plateau and also frequently accrues parts of inferior leaflet. The inferior leaflet rarely occurs as independent leaflet. A wide un-indented basal zone exists across the valve leaflets. The study found that the tricuspid valve is rarely tricuspid. It also generated the hypotheses that the tricuspid valve does not open completely due to presence of a wide basal zone and the valve does not close completely owing to incongruence and lack of coaptation of leaflets. The findings provide clear understanding of leaflet morphology of tricuspid valve. This will help imaging specialists for interpretation of images and cardiologists for interventional procedures. The findings also enhance our understanding of pathophysiology of conditions like functional tricuspid regurgitation.
SUMMARY:The atrioventricular valve is the most commonly repaired valve of the heart. Interventional procedures like annuloplasties, valvotomy/valvuloplasty, repair/replacement of the valve for regurgitation or prolapse are increasing by the day. This necessitates a clear understanding of the mitral valve anatomy. The present study is an attempt to revisit the anatomy of mitral valve. The present study was conducted on 34 adult embalmed heart specimens. Based on the newly defined criteria, observations were made on: 1) Number of commissures and their positions, 2) Number and position of leaflets, 3) Number and position of minor commissures, 4) Annular circumference (AC), 5) Length of annular attachment of each leaflet (LAA), 6) Maximum width of coapted/ folded margin (FM) of the anterior and posterior leaflet, 7) The surface area of each leaflet (SA). The observations were analyzed statistically. The findings of the present study and the subsequent statistical analysis offer a dynamic concept of the anatomy of mitral valve leaflets. It suggests that the valvular anatomy depends upon a complex interplay of various valve components. The extra leaflets tend to occur when annular circumference increases and is not appropriately compensated by various valvular elements. The different methodology adopted in the present study and the interpretations deduced hereupon, shall dispel the existing ambiguities in the description of the leaflets and improve our understanding of the structure and function of the mitral valve complex.
In wake of changing lifestyle and increasing surgical expertise, knee replacement surgeries have become common. Attempts at improving the postoperative range of motion have prompted high-flexion knee arthroplasties. Consequently, there is a need to study the anatomy of knee joint in high flexion. This study focused on a holistic description of terminal condylar articular facet (TCAF; part of the femoral articular area in contact with the tibia in high flexion) of medial and lateral condyles and their quantification. In total, 104 dry femora and 16 dissected cadaveric knee joints (10 adult and 6 fetal) were studied. In most cases, the medial TCAF showed a tongue- or wedge-shaped extension in its lateral half, which has been referred to as extended condylar facet (ECF). The surface area of the ECF was approximately 0.5 cm. In adult cadaveric dissections, the fibrous capsule showed the lax attachment beyond the ECF, thus creating a cave in the medial tibiofemoral compartment. These features were absent in fetal dissection. The presence of an ECF has not been documented in dry bones and has not been quantified. The variability of the size of this extension supports the hypothesis of this being an acquired trait. This study is expected to provide factual data for implant design improvement and a new anthropological data on Indian femora.
Introduction: Sufficient sleep is essential in children as it directly impacts mental and physical development. However, chronic sleep loss continues to increase in our country. In this context the present study aimed to shed light on the sleep schedule and pre-sleep behavior, of school going children. Material and Methods: A cross sectional interview study was conducted on 380 school children of 4 th-10 th standard from 4 Government schools of Chennai within 10 km of Madha Medical College. The schools were selected by simple random sampling method. Childrens Sleep Habit Questionnaire was administered to them from August 2014 to January 2015. Results: This study included 380 school children, 8-17 years with a mean age of 13.5±2.02. More than half 234 of the children were girls (61.6%). Total sleep time on weekdays was 8.4 hours that increased to 9.8 hours on weekends. Watching Television before going to bed was found in 92.6% of the children. Room sharing with family members was seen in 95.2% of the children. Co-sleeping was observed in 98.4% of the children. Day time sleepiness was observed in 63.2% of the children. Conclusion: It has been observed from our study that there is a chronic sleep loss in the children which has to be addressed by creating awareness among the parents and the children regarding the importance of sleep. Regular sleep studies could be conducted in the schools to implement effective interventions for the harmful sleep habits like watching Television before going to bed.
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