Background: Muscular variations are relatively fewer when compared to vascular variations. A few muscles show extra heads of origin apart from their original heads. One such muscle which has extra heads of origin is biceps brachii (BB). Understanding of these extra heads is significant in handling injuries of the muscle and in tendon reconstruction operations. So, the aim of this study was to look for the incidence of the third head of the biceps brachii. Materials and Methods: The study was carried out on 24 cadaveric upper limbs. Dissection of the front of arm was done and the origin and insertion of the BB was looked. Any additional head if present was particularly looked for and photographed. Results: We found the three headed BB unilaterally in three male cadavers, one belonging to the left side and two to right side. The third head of BB originated near the insertion of the CB and at the origin of the brachialis in two cases and in both cases it goes and merges with the other two heads and insert into the posterior part of radial tuberosity. In one case it originates along with the long head of BB and its tendon goes and insert into the deep fascia of the arm. Conclusion : These all variations in the study should be known to the orthopedic surgeons during treatment of the bones fractures in this region because sometime the presence of third head may cause unusual bone displacement subsequent to fracture.

Background: Pre-eclampsia is a pregnancy-specific disorder recognized clinically by the onset of hypertension and proteinuria. It complicates about 2%-10% of pregnancies worldwide and contributes to maternal and foetal morbidity and mortality. However there is paucity of information on its prevalence in Calabar. Aims: To determine the prevalence of pre-eclampsia in the University of Calabar Teaching Hospital, Calabar, Nigeria over a period of 3 years for the purpose of further genetic studies. Settings and Design: A descriptive epidemiologic study that consisted of all documented cases of Pre-eclampsia in a tertiary referral center from 2009 to 2011. Materials and Methods: Data on pre-eclamptic patients were obtained from the Records Department of the hospital. Statistical Analysis: The results were anaylzed using SPSS version 17, percentages, mean and standard deviations were used to describe data. Results and Conclusions: A total of 8,524 deliveries and 104 cases of pre-eclampsia were documented giving an overall prevalence of 1.2%. The prevalence in 2009, 2010, and 2011 was 0.7%, 1.2%, and 1.5%, respectively. Fifty-nine case notes were available for analysis (56.7% retrieval). The mean age of the patients was 27 ± 4.9 and majority; 25 (42.4%) were in the age group 25-29 years. The mean parity was 1.1 ± 1.4 and 26 (44.1%) were nulliparous. 11 (18.6%) had family history of hypertension, 2 (3.4%) had personal history of hypertension, and 2 (3.4%) had a personal history of pre-eclampsia. The slight increase in the prevalence rate over the years underscores the need for close surveillance.

Objectives: To evaluate the frequency and prevalence of using herbal drugs in treatment of diabetes in Taif area, Kingdom of Saudi Arabia. Materials and Methods: Structured questionnaire was the main instrument used to collect information to evaluate the attitude of respondents towards use of herbal medicine. In all, 228 diabetic patients were subjected to this study from clinics in 3 major hospitals in Taif - KSA (King Faisal Hospital (KFH), King Abdul-Aziz Hospital (KASH), Alhada Armed Forces Hospital over a 4-month and 20-day period. Results: Out of the 228 diabetics, (24.6%) of those patients were using herbs, more than half of them 31 (55.4%) were males and half of them 28 (50%) and were aged 50 years and above. Interestingly, when exploring the commonly used herbs, a total of 20 different herbal names were reported to be used by the surveyed diabetics. The top four used herbs were fenugreek, nigella, myrrh and garlic with a frequency of 57.1, 44.6, 42.9 and 32.1%, respectively. Conclusion and recommendation: About one-fourth of diabetic patients in this study were using herbs and the most frequently used herbs were fenugreek, nigella, myrrh and garlic. Pharmacists should be referred for consultation regarding the use of herbal remedies. In addition, knowledge about herbal drugs should be updated to the pharmacists and physicians through continued scientific programs. Public awareness about herbal remedies should be considered to guide the public for the trusted and safe source of information when it is needed.

Aim: Analytical HPTLC technique was developed for the simultaneous estimation of candesertan celexitil (CAN) and hydrochlorothiazide (HYD) in 2 totally different strengths of pharmaceutical dosage form. Materials and Methods: Chromatography was performed on 60F 254 TLC pre-coated aluminum plates with mobile phase of toluene: ethyl acetate: formic acid (85%) in the ratio of 6:4:1 v/v. The mean Rf values with standard deviation were found to be 0.39 ± 0.01 and 0.73 ± 0.01 for CAN and HYD, respectively. Results: The linear regression data has shown a good linear relationship over a concentration range of 200-1200 ng/spot for each drug with a correlation coefficient of 0.9999. Limit of quantification and the limit of detection establish the sensitivity of the developed technique. The stability study indicates that drugs were stable up to 72 hours. The technique was precise and relative standard deviations were found to be less than 0.05%. System suitability tests are used to verify that the resolution and repeatability of the system is adequate for the analysis. The technique was specific and selective since there is no additional peak beside with main peak. The Robustness study, recovery study and percentage of assay of the formulation were within the limit as per ICH guidelines. Conclusion: A simple, rapid, cost-effective, eco-friendly, specific, precise, sensitive and efficient analytical HPTLC technique was developed for the simultaneous estimation of candesertan celexitil (CAN) and hydrochlorothiazide (HYD) completely in 2 totally different strength of pharmaceutical marketed formulations.

Context : Though the co-morbidity of cannabis use disorder is common in patients of bipolar disorder, there is a paucity of Indian studies evaluating the effects of cannabis on symptoms of bipolar disorder. Aim : To study pattern of resolution of symptoms of acute psychotic mania with and without co-morbid cannabis dependence. Materials and Methods : Thirty inpatients of acute psychotic mania with co-morbid cannabis dependence (Group-I) and 30 without co-morbid cannabis dependence (Group-II) were assessed on day-0, day-7, day-14, day-21, day-28, and day-42 for manic and psychotic symptoms with the help of Young Mania Rating Scale (YMRS) and the Brief Psychiatric Rating Scale (BPRS). Results : Acute phase treatment response was noticed around day 21-28 of admission in majority of the patients of both groups. Both the groups were comparable on manic and psychotic symptoms prior to day-28 assessment. Patients of Group-I obtained significantly higher mean score of the item 'irritability' of YMRS and 'psychological discomfort' subscale of BPRS on day 28 and day 42. Group-I patients required significantly higher doses of mood stabilizers and antipsychotics compared to Group-II patients. Conclusion : Patients of mania with co-morbid cannabis dependence showed delayed resolution of manic and psychotic symptoms, specifically irritability and psychological discomfort, and needed higher doses of medication for control of symptoms in comparison to mania patients without co-morbid cannabis dependence. Comprehensive evaluation of patients with bipolar disorder should include a detailed assessment for cannabis use disorder.

Context: The study of medicine is extensive, time-consuming, and highly stressful, especially during preclinical study period. Aim: To assess perceived stress in medical students studying in a medical college in Saudi Arabian Eastern Province and observe any gender-related variations in stress. Study and Design: Cross-sectional comparative study. Materials and Methods: The present study was carried out in College of Medicine, University of Dammam using Arabic version of Perceived stress scale-10 questionnaire. Eighty students (40 males and 40 females) studying in 2 ^nd year were included in the study. Statistical Analysis: Data were analyzed by using Microsoft Excel and SPSS version 19. Descriptive analyses were conducted to determine the frequency distributions of the study variables. Independent sample t-test was used to compare stress scores among male and female students. Stress level was analyzed by quartiles of perceived stress. Results: The overall prevalence of stress found in this study was 71.7%. Mean perceived stress score of all the students was 17.31 ± 5.31. There was no significant difference in the mean stress scores of males and females students. The percentage of students with no, mild, moderate, and severe stress was found to be 28.3%, 21.7%, 31.7%, and 18.30%, respectively. Conclusions: The present study indicates of high prevalence of stress in these medical students in the preclinical years. Hence, there is a need to take measures by the authorities to reduce stress among students.

Ancient schwannoma (AS) is a rare benign, encapsulated tumor with a slow growth rate. The symptoms are very few and non specific during early stage of disease, because of that, the diagnosis of AS is always a challenge. There is a tendency to confuse AS with malignant tumors on imaging and histology. Here we are reporting a case of AS of the dorsal spinal region at T8-T9 level in a 62 year male patient initially present with non specific right upper abdominal pain. Complete excision of tumour was done successfully, without intra-operative neurophysiological monitoring and microscope with a good postoperative neurological recovery.

Psoriasis is an immune mediated genetically determined dermatological disorder affecting skin, nails, joints along with systemic associations. It is associated with high impact on the health-related quality of life and considerable cost. This disease is characterized by multiple remissions and relapses. Among various types of psoriasis, pustular psoriasis is rare. There are many triggering factors for pustular psoriasis including pregnancy also termed as impetigo herpetiformis. Here we report a female with triggering of pustular psoriasis during her postpartum period who recovered after the combination therapy of Narrow Band UltraViolet B (NB-UVB) phototherapy and Azathioprine

One child aged 16 months was admitted to hospital with history of bleeding per rectum and unremarkable physical examination findings. Technetium-99 m scintigraphy scan was positive for bleeding Meckel's diverticulum. Intra-operatively, diverticulum was detected on the mesenteric border of the ileum; the antimesenteric border of ileum being normal. Since the diverticulum was located at the base of the mesentery, resection and anastomosis was preferred instead of wedge resection. Histology revealed presence of antral type gastric mucosa showing chronic peptic ulceration apart from intestinal mucosa. Patient is doing well in follow-up.

Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome is a Müllerian abnormality, characterized by the absence of the vagina, associated with abnormal or absent uterus and the presence of apparently normal tubes and ovaries. Physical growth development and secondary sexual characters as well as the external genitalia are also normal. These patients usually present with primary amenorrhea. Here we report a case of 20-year-old woman with primary amenorrhea due to Müllerian agenesis presented with rectovaginal fistula following coital injury. To the best of our knowledge, this is the first case reported in the literature with this rare presentation.

Salivary gland agenesis is a rare disorder, which can appear singly or in combination with other genetic disorders. Bilateral parotid and submandibular salivary gland aplasia is an extremely rare condition found to be associated with mutation of gene encoding fibroblast growth factor (FGF) 10. Here, we present a rare case of non-syndromic non-familial bilateral parotid and submandibular salivary gland aplasia with lacrimal duct atresia in a 7-year-old male patient.

Malignant struma ovarii is a very rare neoplasm and constitute 0.1-0.3% of all ovarian teratoma. Herein, we report a case of follicular variant of papillary carcinoma in a struma ovarii (SO) of left side in a young female of 21 years, presented with a tubo-ovarian (T-O) mass of diameter of 8 cm. Ultrasonography revealed, slightly bulky uterus and a large cystic T-O mass in left side. Total abdominal hysterectomy with left sided salpingo-oophorectomy was done. Histopathological examination revealed multiple thyroid follicles lined by cells having optically clear, overlapping nuclei with inconspicuous nucleoli. Some nuclei showed nuclear grooves also. No papillary structures were seen. Immunohistochemically, the tumor was positive for thyroid transcription factor (TTF). Both functionally and architecturally, thyroid gland was absolutely normal. Neither postoperative radiotherapy nor adjuvant chemotherapy was given, and the patient has remained disease free 6 months postoperatively.

Movement disorders occur uncommonly after stroke and include both hyperkinetic and parkinsonian conditions. They can occur at the time of stroke or appear as later manifestations. Post-stroke hemiballism is an uncommon involuntary hyperkinetic disorder involving unilateral body parts. The incidence and precise lesion location of post-stroke hemiballism remain unclear. Cerebrovascular disease, particularly hemorrhage, due to the involvement of middle or posterior cerebral artery or vessels supplying the basal ganglia are commonly implicated in the causation of movement disorders. Deep vascular lesions are more frequent in patients with movement disorders. Chorea or hemiballism is a rare presentation of putaminal hemorrhage and is the most common movement disorder to appear in older patients. Involuntary movements tend to persist despite good functional recovery of the motor deficit. Presented here is a case of hemiballism in a 74-year-old man, who had a hemorrhagic stroke.