Variations of Weight of Thyroid Gland in Different Age and Sex Groups of Bangladeshi Cadavers

A cross sectional descriptive study was designed to find out the difference in weight of the thyroid gland of Bangladeshi people in relation to age and sex. The present study was performed on 70 post mortem human thyroid gland (35 of male and 35 of female) collected from the morgue in the Department of Forensic Medicine, Mymensingh Medical College, Mymensingh by purposive sampling technique. The specimens were collected from Bangladeshi cadavers of age ranging from 10 years to 85 years. All the specimens were grouped into three categories Group A (upto 20 years), Group B (21 to 50 years) and Group C (>50 years) according to age. Dissection was performed according to standard autopsy techniques. The weight of the thyroid glands were measured and recorded. The mean weight of the thyroid gland was 6.94 ± 5.20 gm in Group A, 7.91 ± 5.89 gm in Group B and 10.42 ± 6.27 gm in Group C. The mean weight of the thyroid gland in male was 7.0 ± 5.77 gm in Group A, 9.94 ± 7.63 gm in Group B and 11.89 ± 5.73 gm in Group C and in female was 6.88 ± 4.88 gm in Group A, 5.88 ± 2.15 gm in Group B and 9.10 ± 6.74 gm in Group C. Variance analysis shows that there was no significant difference in mean weight between the Age Group A & B, B & C and C & A. There was significant difference of weight of thyroid gland between sex in age Group B but in Group A and Group C were statistically insignificant. The weight of the thyroid gland was found to increases with age. In statistical analysis, differences between age groups were analyzed by using one way ANOVA test. The present study will help to increase the information pool on the weight of thyroid gland of Bangladeshi people.

Length of papillary muscles in both ventricles of different age group on Bangladeshi cadaver

Papillary muscle rupture and dysfunction can lead to complications of prolapsed atrioventricular valve and valvular regurgitation. Morphology, measurements and attachments of papillary muscles in both tricuspid and bicuspid valve gains utmost importance in cardiac surgeries and variations in the papillary muscle morphology is one of causes for myocardial infarction in recent time. Therefore, it is important to know both the normal anatomy and variations of papillary muscles. The study was carried out in the department of Anatomy, Mymensingh Medical College, Mymensingh from July 2013 to June 2014. A total 80 human hearts were collected by purposive sampling method, among them 49 were male and 31 were female. The specimens were collected from Bangladeshi cadavers of age ranging from 6 months to 60 years, from autopsy laboratory of the Department of Forensic Medicine of Mymensingh Medical College. All the specimens were grouped into three categories Group A (upto 20 years), Group B (21 to 40 years) and Group C (41 to 60 years) according to age. Dissection was performed according to standard autopsy techniques. Length of each papillary muscle was measured in both ventricles in different age groups. In present study the mean length of the anterior papillary muscles of right ventricle was higher than both the posterior and septal papillary muscles among the age groups. The mean±SD length of the anterior papillary muscle was 1.07±0.48, 1.50±0.37 and 1.60±0.25cm in Group A, B and C respectively. The mean±SD length of the posterior papillary muscle was 1.02±0.35, 1.31±0.40 and 1.37±0.34cm in Group A, B & C respectively. The mean±SD length of the septal papillary muscle in right ventricle was 0.51±0.42, 0.65±0.31 and 0.81±0.35cm in Group A, B & C respectively. It was also observed that the mean length of anterior, posterior and septal papillary muscle was increased with age. In present study the mean length of the anterior papillary muscles in left ventricle was higher than that of the posterior papillary muscle among the age groups. The mean±SD length of the anterior papillary muscle was 1.53±0.34, 2.05±0.39 and 2.01±0.25cm in Group A, B and C respectively. The mean±SD length of the posterior papillary muscle was 1.33±0.34, 1.95±0.89 and 1.81±0.76cm in Group A, B and C respectively and it was also observed that the mean length of both anterior and posterior papillary muscle was increased with age. In statistical analysis, differences between age groups were calculated by using one way ANOVA test.

Morphometric study of dentate nucleus of cerebellum in Bangladeshi cadaver

This cross sectional descriptive study was done by using nonprobability sampling technique and performed by examining 63 (sixty three) cerebellum. Out of them 40 postmortem human cerebellum collected from Bangladeshi cadavers of both sexes (male 25 and female 15) age ranging from 5 to 60 years and 23 cerebellums from caesarian section of intrauterine death cases of both sexes (male 14 and female 9) age ranging from 34 to 41 weeks of gestation. Specimens were collected from dead bodies autopsied on different dates from April' 2009 to September' 2009 at the autopsy laboratory of department of Forensic Medicine and prenatal cases from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The collected specimens were grouped into three age groups like Group A (28 to 42 weeks of gestation), Group B (5 to 30 years) and Group C (31 to 60 years) and, two sex groups (male and female) and two sides (right and left). A transverse section was made at the level of horizontal fissure, and length and breadth of dentate nucleus were measured by divider and scale. The mean (±SD) length and breadth of dentate nucleus was 8.619±2.995mm and 14.770±3.604mm respectively and it was observed that length and breadth of dentate nucleus increased with age upto certain level then slightly decreased in the late age Group C. In this study, differences of the mean length of dentate nucleus on both right and left sides were statistically moderately significant between age Groups A&B. The differences of mean breadth of dentate nucleus on both right and left side were statistically highly significant between age Groups A&B and moderately significant between age Groups A&C on right side and only significant on left side. The differences between male & female were statistically insignificant in length and breadth of dentate nucleus.

The site of attachment of umbilical cord and branching pattern of umbilical arteries within the placenta

Placenta is the mirror of maternal and fetal status; it reflects the changes due to complication in pregnancy of mother. Numerous common and uncommon findings of the placenta, umbilical cord and membranes are associated with abnormal fetal development and perinatal morbidity. So, the examination of the placenta can yield information that may be important in the immediate and later management of mother and newborn. This information may also be essential for protecting the attending physician in the event of an adverse maternal or fetal outcome. This cross sectional descriptive study was carried out to determine the incidence of different types of placenta depending on attachment site and branching pattern of arteries of umbilical cord in Bangladeshi Women. To achieve this aim sixty placenta with umbilical cord were collected. Placenta was from 28 weeks to 42 weeks gestational age of normal pregnancy during normal labour at gynaecology and obstetric department of Mymensingh Medical College Hospital. After preservation in 10% formol saline, study was done in the Department of Anatomy of Mymensingh Medical College. In the present study, incidence of different types of placenta depending on attachment site of umbilical cord was 50% Central, 46% Paracentral and 18% Marginal in type. In this study it was also observed that 58% placenta were Disperse in type and 42% were Magistral in type depending on the distribution of umbilical arteries. Observed findings of this study were compared with those of Western and Bangladeshi researchers.

Variations of thickness of trigonal muscle layer in different age and sex

This cross sectional descriptive study was to measure the thickness of muscular layer in trigone of the urinary bladder and to establish the difference between sexes of different age groups in Bangladeshi cadaver. A total 60 human urinary bladders were collected by purposive sampling from May 2013 to October 2013. Among them from male 43 and from female 17 were collected from Bangladeshi cadavers of age ranging from 01 to 60 years, from autopsy laboratory of the Department of Forensic Medicine of Mymensingh Medical College, Mymensingh. The thickness of muscular layer in trigone of the urinary bladder was measured and significant differences of the value between age and sex groups were observed. The mean±SD thickness of muscular layer of trigone of the urinary bladder was 318.59±93.15μm in age Group A (01 to 20 years), 633.25±79.79μm in age Group B (21 to 40 years), and 352.50±116.15μm in age Group C (41 to 60 years). The mean difference of muscular layer of the trigone of the urinary bladder between age Groups A&B, B&C was statistically highly significant, where p=0.001. In statistical analysis, differences between age groups were calculated by using one way ANOVA test. The present study revealed that the value of thickness of muscular layer in trigone of the urinary bladder was increased with the increase of age and it was declined to a low level in the late age. The mean value of muscular layer of the trigone of the urinary bladder was higher in male than that of in female of Group A, B & C.

Morphometric study of thyroid angle in different age and sex in Bangladeshi cadaver

This cross sectional descriptive study was to measure the thyroid angle and to establish the difference between sexes of different age groups in Bangladeshi cadaver. A total 60 human larynges were collected by purposive sampling from October 2008 to March 2009. Among them 45(male 23 and female 22) were collected from Bangladeshi cadavers (9 to 60 years) at the autopsy laboratory of Department of Forensic Medicine and 15 (male 6 and female 9) from stillborn infants of viable age (28 to 40 weeks of gestation) from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The thyroid angle was measured and significant differences of the dimensions between different age and sex groups were observed. In the present study observed findings was compared with those of other researchers. The mean±SD thyroid angle was found as 65.00±11.65 degree in age Group A (28 to 40 weeks of gestation), 73.69±6.56 degree in age Group B (9 to 16 years) and 77.76±7.76 degree in age Group C (17 to 60 years). The mean thyroid angle was higher in female (83.1667±5.78220 degree) than that in male (73.9412±7.09460 degree) and statistically moderately significant in Group C, where t = 3.853 and p = 0.001. In statistical analysis, differences between age and sex groups were calculated by using Students (unpaired) 't' test. The present study revealed that the value was significantly greater in adult female than male and the value increased with age.

Histomorphological study of germinal centre of vermiform appendix in Bangladeshi cadaver

The study was done to find out the number of germinal centre in human vermiform appendix of Bangladeshi people to magnify the knowledge regarding the diverse number of germinal centre of human vermiform appendix in our population in the department of Anatomy, Mymensingh Medical College, Bangladesh from July 2006 to June 2007. Total 40 appendices were collected for histological study of different age and sex during postmortem examination in the autopsy laboratory of department of Forensic Medicine, Mymensingh Medical College. This cross sectional study was done by convenient sampling technique. For convenience of differentiating the changes in number of germinal centre of vermiform appendix in relation to age and sex, findings were classified in four groups, Group A up to 20 years, Group B 21-35 years, Group C 36-55 years and Group D 56-70 years. In the present study the number of germinal centre was highest in Group B (52.38%) but in Group D it was nil. Here mean number of germinal centre in male (1.05) were more than in female (0.8).

Weight of uterus in bangladeshi cadaver

This cross sectional descriptive study was done to see the weight of uterus in Bangladeshi cadavers to increase the knowledge regarding variational anatomy in our country. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected by non random or purposive sampling technique from cadavers of different groups and fixed in 10% formol-saline solution. This study was carried out in the Department of Anatomy of Mymensingh Medical College, Mymensingh from July 2006 to June 2007. Gross and fine dissection was carried out to study the weight of uterus. In this study our findings were compared with those of the references. Maximum weight of the uterus was found in age group B (13 to 45 years). It is about 51.35 ± 17.95 gm.

Morphometric study of splenic volume in Bangladeshi cadaver

To determine the volume of spleen of Bangladeshi people by water displacement method, this cross sectional descriptive study was carried out over 120 cadaveric spleen of which 87 male and 33 female, in the department of Anatomy of Mymensingh Medical College from July 2007 to June 2008. The maximum volume of male spleen was 200ml in group D (46-60 years) and female spleen was 150ml in group B (16-30 years). The minimum volume was 30ml in group A (up to15 years) in both male and female. The maximum mean volume of male was 84.23 ml in group B (16-30 years) and minimum mean volume was 47.75ml in group A (upto 15 years). The mean volume of female spleen was highest, 78.33ml in C (31-45 years) age group and lowest 45.62ml in A (upto 15 years) age group. From this study it was evident that the volume of spleen increases with age during childhood and adolescence remains stable in young adult and declined in older age groups. Volume of spleen shows positive correlation with age up to 60 years of age. Mean±SE volume of male spleen was 75.27±3.78ml, ranges from 30-200ml and in female; mean±SE volume was 60.51±4.90ml, ranges from 30-150ml. Here it is observed that volume of spleen was higher in male than in female but the difference was not statistically significant.

Sputum smear microscopy at two months into continuation-phase: should it be done in all patients with sputum smear-positive tuberculosis?

Background

The Revised National Tuberculosis Control Program (RNTCP) of India recommends follow-up sputum smear examination at two months into the continuation phase of treatment. The main intent of this (mid-CP) follow-up is to detect patients not responding to treatment around two-three months earlier than at the end of the treatment. However, the utility of mid-CP follow-up under programmatic conditions has been questioned. We undertook a multi-district study to determine if mid-CP follow-up is able to detect cases of treatment failures early among all types of patients with sputum smear-positive TB.

Methodology

We reviewed existing records of patients with sputum smear-positive TB registered under the RNTCP in 43 districts across three states of India during a three month period in 2009. We estimated proportions of patients that could be detected as a case of treatment failure early, and assessed the impact of various policy options on laboratory workload and number needed to test to detect one case of treatment failure early.

Results

Of 10055 cases, mid-CP follow-up was done in 6944 (69%) cases. Mid-CP follow-up could benefit 117/8015 (1.5%) new and 206/2040 (10%) previously-treated sputum smear-positive cases by detecting their treatment failure early. Under the current policy, 31 patients had to be tested to detect one case of treatment failure early. All cases of treatment failure would still be detected early if mid-CP follow-up were discontinued for new sputum smear-positive cases who become sputum smear-negative after the intensive-phase of treatment. This would reduce the related laboratory workload by 69% and only 10 patients would need to be tested to detect one case of treatment failure early.

Conclusion

Discontinuation of mid-CP follow-up among new sputum smear-positive cases who become sputum smear-negative after completing the intensive-phase of treatment will reduce the laboratory workload without impacting overall early detection of cases of treatment failure.

Morphometry of seminiferous tubules of human testes in different age groups in Bangladeshi cadavers

This cross sectional descriptive study was done to observe the mean diameter of seminiferous tubules and to determine its differences between different age groups in Bangladeshi male. Thirty human testes of different age groups were collected by purposive sampling technique. Among them 22 specimens were collected from cadavers during routine postmortem examination and 8 specimens were from dead fetuses from Gynaecology & Obstetrics Department. The specimens were grouped into three categories Group A (28 to 42 weeks of gestational age), Group B (Up to 14 years) and Group C (15 to 70 years). The mean diameter of seminiferous tubules was measured and significant differences of the dimensions between different age groups were determined. The mean±SD diameter was 85.37±15.51 μm in Group A, 144.04±63.34 μm in Group B and 227.92±22.47 μm in Group C. Statistically, differences between age groups were calculated by using Unpaired Students 't' test. The present study revealed that the diameter increased with age and mean differences were statistically significant between Groups A&C, B&C and A&B.

Morphometry of isthmus of thyroid gland in Bangladeshi cadaver

This cross sectional descriptive study was carried out to determine the length, breadth & thickness of isthmus of thyroid gland of Bangladeshi people. To fulfill this aim sixty postmortem tissue blocks containing thyroid gland and its neighbouring structures were collected by convenience sampling technique from 48 male and 12 female cadavers of different age groups, age ranging from 11 to 70 years and fixed and preserved in 10% formol-saline solution. Specimens were collected from dead bodies autopsied on different dates from October'2004 to February'2005 at the autopsy laboratory of Forensic Medicine Department of Mymensingh Medical College, Mymensingh, Bangladesh. Gross and fine dissection was carried out to study the length, breadth and thickness of isthmus of thyroid gland. In the present study, observed findings were compared with those of Western and Bangladeshi researchers. It was seen that the mean±SD lengths of isthmus were 10.42±7.49 mm, 10.17±5.70 mm and 9.33±6.64) mm in Group A(upto 18 years), B(19 to 45 years) and C(>45 years) respectively. Highest length (30mm) was observed in Group A and lowest length (2mm) was observed in Group C. Variance analysis showed that there was no significant difference in mean length between the age groups (F=0.086, p=0.918). The mean±SD values of breadth were 13.66±5.06 mm, 14±5.41 mm and 12.27±3.97 mm in Group A, B and C respectively. In the ranges, there was much overlapping among the groups. In Group B breadth of the isthmus was greater than other age groups. But these differences were statistically not significant, where F=0.430 & p=0.654. It was interesting to note that in this study the mean breadth of isthmus was significantly greater than the mean length (where, t=-2.727 and p=0.01). In the present study the mean±SD thickness of the isthmus of thyroid glands were 4.91±1.78 mm, 4.72±2.68 mm and 4.45±1.36 mm in three age groups respectively & the thickness of isthmus of thyroid gland was also greater in Group B than other two groups. But the variance analysis reveals that, there was insignificant difference in the thickness (F=0.133, p=0.876) of isthmus of thyroid gland among different age groups.

Morphometry of purkinje cell body of cerebellum in bangladeshi cadaver

This cross sectional descriptive study was performed by examining 30 (thirty) relatively fresh cerebellum. Out of them 20 postmortem human cerebellum collected from Bangladeshi cadavers of both sexes (male 10 and female 10) age ranging from 5 to 60 years and 10 cerebellums from caesarian section of dead fetuses of both sexes (male 6 and female 4) age ranging from 34 weeks to 41 weeks. Specimen containing cerebellum was collected from dead bodies autopsied on different dates from April'2009 to September'2009 at the autopsy laboratory of department of Forensic Medicine and Gynaecology and Obstetrics of Mymensingh Medical College, Mymensingh. Samples were collected by using nonprobability sampling technique. The collected sample was grouped in to three age groups like Group A (34 to 41 weeks of gestation), Group B (5 to 30 years) and Group C (31 to 60 years) and two sex groups (male and female). Ten cerebellums were studied from each age group for this histological study. Sections were processed following standard histological procedure and were stained with Hematoxylin and Eosin stain. Slides were examined under 15X40 magnifications and measurement of vertical and transverse diameter of the cell body were taken with the help of ocular micrometer. In this study, the mean difference of mean vertical and transverse diameter of Purkinje cell body between Groups A & B and Groups A & C was statistically highly significant (p<0.001) but differences between Groups B & C was statistically significant only in case of transverse diameter.

Morphological study of extrauterine length of the fallopian tube at different age group in Bangladeshi people

This cross sectional descriptive study was done to see the length of the right & left fallopian tube in Bangladeshi female and to increase the knowledge regarding variational anatomy in our country. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected by non random or purposive sampling technique from cadavers of different age groups and fixed in 10% formol saline solution. This study was carried out in the department of Anatomy of Mymensingh Medical College, Mymensingh from July 2006 to June 2007. Gross and fine dissection was carried out to study the length of fallopian tube (right & left). In this study our findings were compared with those of the standard text books. Maximum length of fallopian tube was found in middle age group (B = 13 to 45 years). It is about 9.19 cm in right side and 8.82 cm in left side. It is also important to note that more kinking was observed in middle age group.

Study of prenatal and postnatal development of spleen of Gallus Domesticus (deshi chicken)

Spleen is one of the secondary or peripheral lymphoid organs along with cecal tonsils in birds. The growth of the spleen of Gallus Domesticus (deshi chicken) from prenatal embryonic day fifteen (ED15) to postnatal day ninety (D90) were studied. In macroscopic study it was found that the shape of the spleen was rounded with slightly flattened from side to side at its middle part at prenatal period (ED15, ED18) and becomes rounded at postnatal stages of the deshi chicken (D90). Regarding position it lies close to the right side of the junction between proventriculus and gizzard and was similar in prenatal and postnatal stages. The result of the present study revealed that the mean diameter and weight of the spleen in deshi chicken gradually increases with increase of age, which were 2.00+/-0.136mm and 0.007+/-0.00gm respectively at ED15 stage and it reaches upto 10.40+/-0.331mm and .303+/-0.004gm respectively at day 90 (D90). It was observed that the differences of diameter & weight of the spleen between different ages were statistically significant (p<0.01). Histologically the spleen was surrounded by thin capsule in prenatal life, which gradually becomes thicker in postnatal life. The splenic pulps were not differentiated into white and red pulp on 15th day of embryonic life (ED15) but they were gradually differentiated into white and red pulp in the late prenatal (ED18) and postnatal period. The growth and development of spleen at each stage of the study period were found to be significantly high. Present study indicates that chicken splenic cell population, structure and function were similar to human spleen histologically. It was also found that the chicken embryo allows easy experimental access to all the stages of the splenic development, so the present study will be helpful for experimentation on lymphoid organs and to understand pathophysiology of immunological diseases of human.

Measurement of different external dimensions of the heart in adult Bangladeshi cadaver

The cross sectional descriptive study was carried out to determine the gross morphological parameters regarding heart to establish a racial characteristic of Bangladeshi adult population. To fulfill this aim, different external dimensions of the heart in Bangladeshi adult people of both sexes were measured and compared with the findings of other researchers of Bangladesh and western countries. A total fifty normal human hearts from both sexes were collected during routine postmortem examination in autopsy laboratory of Forensic medicine department of Mymensingh Medical College, Mymensingh on different dates from August 2003 to April 2004. The age at death of cadavers was ranged from 20 to 60 years. The mean weight, length, breadth and antero-posterior diameter were measured and the following values were found. In male the mean (+/-SD) weight was 247.92(+/-40.26) gm, mean (+/-SD) length was 10.5(+/-0.62) cm, mean (+/-SD) breadth was 8.51(+/-0.61) cm and mean (+/-SD) antero-posterior diameter was 5.86(+/-0.63) cm. In female the mean (+/-SD) weight was 164.29(+/-33.56) gm, mean (+/-SD) length was 9.2(+/-0.89) cm, mean (+/-SD) breadth was 7.67(+/-0.61) cm and mean (+/-SD) antero-posterior diameter was 5.47(+/-0.55) cm. In statistical analysis, difference between male and female values was calculated by using students 't' test. The present study revealed that the values were always greater in male than in female group, though statistically there was no significant difference (p>0.05) between them.

Relationship of uterine artery with ureter

The study was done to see the relationship of right and left uterine artery with corresponding ureter. Their distance from lateral border of uterus and site of crossing in relation to internal os in Bangladeshi female were observed. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected from cadavers of different age groups and fixed in 10% formol saline solution. Gross and fine dissections were carried out to study the relationship and distance of uterine artery where it crosses the corresponding ureter and the site of crossing in relation to internal os. In the present study our findings were compared with those of the standard text books. In this study, there were no variations regarding relations of right and left uterine artery with corresponding ureter. In all cases of all age groups, ureters were found to cross the uterine artery anteriorly on both sides. Site of crossing of uterine artery of both sides with ureter at the level of internal os was 50% in 2-12 years (Group A) 20.45% in 13-45 years (Group B) and 12.50% in 46-80 years (Group C) age group. Below the level of the os was found in remaining cases except one which crosses above the level of the os in group B. In this study mean distance of uterine artery where it crosses the ureter from lateral border of uterus was more on right side in all age groups, which was 1.67 cm, 2.30 cm and 2.11 cm in age Group A, B & C respectively.

An anatomical study on pyramidal lobe of thyroid gland in Bangladeshi people

The study was done to see the incidence of pyramidal lobe of thyroid gland including its position, attachment, length and incidence of its association with levator glandulae thyroidae in Bangladeshi population. Sixty postmortem tissue blocks containing thyroid gland and its related neighbouring structures were collected from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Gross and fine dissection was carried out to study the incidence of presence of pyramidal lobe, its attachments, length, breadth and association with levator gladulae thyroidae. In the present study, findings were compared with those of Western and Bangladeshi researchers. It was evident that, fifty percent of the thyroids possesses pyramidal lobe. Incidence was more in male (52.1%) than in female (41.7%). It also appeared from the observations that, this lobe was commonly situated on the left side. In the majority of cases (56.66%), base of the pyramidal lobes were attached to the upper border of the isthmus with or without encroachment on the adjacent part of the left lobe. The range of length and breadth of the pyramidal lobe was from 1.8 to 35mm and 1.3 to 19mm respectively. In 73.33% cases, pyramidal lobe was associated with levator glandulae thyroideae and in only 26.66% cases pyramidal lobe was found independently.

An anatomical study on interventricular septum of postmortem hearts of adult Bangladeshi people

To study the thickness of interventricular septum (both muscular and membranous parts) of adult Bangladeshi people, fifty postmortem hearts were collected, fixed in 10% formol saline and examined. The thickness of both muscular and membranous parts of the septum was measured. Among fifty hearts, thirty-six were collected from male and fourteen from female cadavers. All hearts were collected from medicolegal cases. The findings were compared between male and female cadavers of our country as well as with the findings of the western countries. The findings suggest that in female, the thickness of both muscular and membranous parts of the septum was less than that of male though there was no significant difference statistically (P>0.05). The findings were compared with the findings of other workers and not so much variation was found. There was no available data regarding the thickness of the membranous part of the septum to compare.

Interventions for latent autoimmune diabetes (LADA) in adults

BACKGROUND

Latent autoimmune diabetes in Adults (LADA) is a slowly developing type 1 diabetes which presents as non-insulin dependent diabetes and progresses to insulin dependence. However, the best treatment strategy for LADA is unclear.

OBJECTIVES

To compare interventions used for LADA.

SEARCH STRATEGY

Studies were obtained from searches of electronic databases (including MEDLINE, EMBASE), supplemented by hand searches, conference proceedings and consultation with experts.

SELECTION CRITERIA

Selection was in duplicate by two independent reviewers. RCT and controlled clinical trials evaluating interventions for LADA or type 2 diabetes with antibodies were included.

DATA COLLECTION AND ANALYSIS

Two reviewers independently extracted data and assessed study quality. Studies were summarised in a descriptive manner.

MAIN RESULTS

Searches identified 8067 citations. Eight publications (seven studies) were included, involving 735 participants. All studies had high risk of bias. There were no data on use of metformin or glitazones alone. Rosiglitazone or sulphonylurea (SU) with insulin did not improve metabolic control significantly more than insulin alone. SU alone gave either poorer (one study, mean difference in HbA1c 2.8% (95% confidence interval (CI) 0.9 to 4.7) or equivalent metabolic control compared to insulin alone (two studies). There was evidence that SU caused earlier insulin dependence (insulin treated at two years: 60% (SU) and 5% (conventional care) (P < 0.001); classified insulin dependent: 64% (SU) and 12.5% (insulin group) (P = 0.007)). No interventions influenced fasting C-peptide, but insulin maintained stimulated C-peptide better than SU (one study, mean difference 7.7 ng/ml (95% CI 2.9 to 12.5) and insulin with rosiglitazone was superior to insulin alone (one study) at maintaining stimulated C-peptide. A pilot study showed better metabolic control at six months with subcutaneously administered glutamic acid decarboxylase (GAD) GAD65, a major autoantigen in autoimmune diabetes, compared to placebo. There was no information regarding quality of life, mortality, complications or costs in any of the publications. Time from diagnosis varied between recruitment at diagnosis to recruitment at nine years of disease duration and there was a great deal of variation in the selection criteria for LADA patients, making it difficult to generalise findings from these studies.

AUTHORS' CONCLUSIONS

There are few studies on this topic and existing studies have a high risk of bias. However, there does seem to be an indication that SU should not be a first line treatment for antibody positive type 2 diabetes. There is no significant evidence for or against other lines of treatment of LADA.

Morphological study of parathyroid in relation to thyroid gland of Bangladeshi people

The morphological study was done to see the number and location of parathyroid glands in relation to thyroid gland of Bangladeshi people to increase the knowledge regarding variational anatomy in our population. Sixty post mortem tissue block containing thyroid and parathyroids along with surrounding structures were collected from 48 male and 12 female cadavers of different age groups and fixed in 10% formol saline solution. Gross and fine dissections were carried out to study the topographic relationship and number of parathyroid glands in relation to thyroid gland. In the present study, findings were compared with the findings of Western and Bangladeshi researchers. In the present study, the so-called typical number of parathyroid glands that is 2 pairs per person (in relation to thyroid gland) was externally visible only in fifty percent (50%) of cases. According to this study, middle third of posterior border of thyroid gland lodged most of the glands (60-65%).

Vascular change in the placenta of diabetic mothers and hypertensive diabetic mothers

Pregnancy complicated by diabetes and/or hypertension is a significant medical problem not only affecting maternal health, but also jeopardizing fetal normalcy. The placenta being the bridge between maternal fetal activity, this structure is considered as a window through which understanding of maternal dysfunctions as well as of their impacts on fetal wellbeing can be obtained. And as it is an almost all-vessel organ, its functional status depends primarily on the structural status of its vessels. To observe vascular changes in the placenta, a study was carried out on 44 placentas.19 from overt diabetic mothers having no hypertension and 5 from hypertensive diabetic mothers, and 20 from control group having no hypertension or diabetes. These were collected just after delivery though caesarian section. Macroscopic findings of the study was that there was a trend of increase weight, volume and number of cotyledons in overt diabetes group, where as the in the hypertensive diabetes group was the opposite. But none of these levels has reached a significant level. For all these variables, the hypertensive diabetes group had smaller values than the overt diabetes group, significantly so for the number of cotyledons. The placental diameter was non-significantly larger in the overt diabetes group than in the control group, but a smaller than control value was found in the hypertensive diabetes group. Although neonatal weight did not show any significant change in either group, but in overt diabetes group, it showed a significant positive correlation with placental weight.

Morphological study of recurrent laryngeal nerve in relation to thyroid gland

The study was done to see the relationship of recurrent laryngeal nerves with corresponding inferior thyroid artery with the aim to increase the knowledge regarding variational anatomy in our population. Sixty samples were collected as block dissection of thyroid gland along with the surrounding structures containing the supplying vessels and adjacent nerves from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Fine dissections were carried out to study the toporgaphic relationship of recurrent laryngeal nerves with corresponding inferior thyroid artery. The findings were compared between different age groups and also with the findings of western researchers. In this study, in majority of the cases the recurrent laryngeal nerves were found in their usual location that is posterior to the terminal branches of inferior thyroid artery on the left side and anterior to that artery on the right side. It was important to note that, on both sides recurrent laryngeal nerves were also frequently found to pass in between the terminal branches of inferior thyroid artery.