Sharmin Akter Sumi

The vermiform appendix is a narrow, muscular diverticulum of the cecum, exhibiting considerable variability in position, shape and size. It originates from the cecal fundus near the ileocecal valve at the convergence of the three taeniae coli, a key surgical landmark for identifying its base. This study aimed to determine the distance between the base of the vermiform appendix and the ileocecal junction in a Bangladeshi population across different age and sex groups. Specimens, including the vermiform appendix along with adjacent segments of the distal ileum, cecum and proximal ascending colon, were collected from medico-legal autopsies of individuals aged 5-75 years. The study was conducted in the Department of Anatomy, Mymensingh Medical College, Bangladesh, from October 2016 to March 2017. The samples were categorized into four age groups: Group A (Up to 20 years), Group B (21-40 years), Group C (41-60 years) and Group D (>60 years), with further subdivision by sex. The external distance was measured from the lower border of the terminal ileum at its junction with the cecum to the midpoint of the appendiceal base. The internal distance was recorded between the nearest edges of the ileocecal and appendicular orifices after opening the cecum. Measurements were taken using a point divider, which was then placed on a measuring scale graduated in centimeters. The maximum external distances recorded were 2.60 cm, 2.60 cm, 2.80 cm and 3.00 cm in Groups A-D, respectively, while the minimum values were 1.80 cm, 2.00 cm, 2.00 cm and 2.10 cm. Internal distances showed a similar increasing trend with age, with maximum values of 2.80 cm, 3.00 cm, 3.00 cm and 3.12 cm and minimum values of 2.00 cm, 2.00 cm, 2.00 cm and 2.20 cm across the groups. Although mean distances were higher in males, the differences between sexes were not statistically significant (p≥0.05). These findings provide population-specific anatomical data that may assist in preoperative planning and intraoperative orientation, potentially reducing operative time, minimizing iatrogenic injury and improving surgical outcomes in appendiceal and right iliac fossa procedures.

The mesoappendix, a fold of peritoneum that suspends the vermiform appendix from the mesentery of the terminal ileum, serves as the channel for its essential blood supply. In this study, specimens including the vermiform appendix and adjacent structures such as the distal ileum, cecum and the proximal portion of the ascending colon were collected from Bangladeshi cadavers aged between 5 and 75 years. The samples were obtained from medico-legal autopsy cases conducted in the Department of Forensic Medicine, Mymensingh Medical College (MMC), Mymensingh, Bangladesh, between October 2016 and March 2017. The collected specimens were categorized into four age groups: Group A (up to 20 years), Group B (21-40 years), Group C (41-60 years) and Group D (above 60 years). Each group was further subdivided by sex. Observations were made to determine whether the mesoappendix extended to the tip of the appendix or not. The length of the mesoappendix was measured along its attached border to the vermiform appendix using a thread, which was then placed on a measuring scale and expressed in centimeters. The breadth was measured at the midpoint of the appendix- from the attached border to the free border- using a point divider and the measurement was recorded in centimeters. In this study, the mesoappendix extended to the tip in 46 cases (65.7%) and did not reach the tip in 24 cases (34.3%). The extension up to the tip was found in 72.4% of Group A, 53.1% of Group B, 76.9% of Group C and 81.9% of Group D. Conversely, it did not extend to the tip in 28.6%, 46.9%, 23.1% and 18.1% of these respective groups. The mean lengths of the mesoappendix were 8.35±1.66?cm, 7.47±1.81?cm, 7.19±1.72?cm and 6.25±1.31?cm in Group A, B, C and D, respectively, showing a gradual decrease with advancing age. Similarly, the mean breadths were 1.67±0.47?cm, 1.58±0.36?cm, 1.52±0.38?cm and 1.41±0.43?cm, with the maximum mean breadth observed in Group A and the minimum in Group D. This study aimed to provide a comprehensive analysis of mesoappendix extension, length and breadth. By integrating anatomical, pathological and clinical perspectives, we hope to contribute valuable insights to the existing literature and provide a foundation for improved surgical decision-making and patient care.

The vermiform appendix is known to play a role in immune function due to its concentration of lymphoid tissue, specifically lymphoid follicles. These lymphoid follicles do not remain confined to the mucosa but push through the muscularis mucosa and invade the submucosa. By counting the number of lymphoid follicle with their location researchers can evaluate the immune status of the Bangladeshi population across different age and sex groups. This cross-sectional descriptive study was conducted at the Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh and specimen were collected from autopsy laboratory of the department of Forensic Medicine of Mymensingh Medical College, Bangladesh from October 2016 to March 2017. The collected specimen was categorized into four groups: Group A (up-to 20 years), Group B (21-40 years), Group C (41-60) years and Group D (above 60 years). For this study 10 specimens from each group (total 40) were collected. Then after several tissues processing permanent histological slides were made for microscopic examination. For estimation of the number of lymphoid follicle of the vermiform appendix in the entire stained sections were examined under microscope and the number of lymphoid follicle was counted (4x objective &10x eye piece) and their number was counted and noted. From these the mean number of lymphoid follicle per age group was calculated. After counting the total number of lymphoid follicles in a histological section, the number of lymphoid follicles was located in the lamina propria and extending into submucosa were noted. Then the percentage of lymphoid follicles extending into submucosa was calculated. The mean number of lymphoid follicle was 9.40±1.07, 9.10±0.74, 5.70±1.49 and 1.80±1.03 in Group A, B, C and D respectively. It was also observed that number of lymphoid follicle gradually decreased as age advanced. The mean difference of number of lymphoid follicle between Group A&B was statistically non significant at p = or >0.05 level and differences between Group B&C, C&D, A&C, B&D, A&D were statistically highly significant at p 0.05 level. In the present study, the correlation between number of lymphoid follicle and age of the individual were done. It was also observed that number of lymphoid follicle gradually decreases as age advances. There is negative correlation between age and the number of lymphoid follicle and this differences was statistically highly significant where, r = - 0.934, p value was 0.001. In this study the location of lymphoid follicle in the lamina propria was 84.0%, 86.8%, 91.2% and 94.4% in Group A, B, C and D respectively and lymphoid follicles were found to extend into submucosa was 16%, 13.2%, 8.8% and 5.6% in Group A, B, C and D respectively. Here we can see that in early age percentage of extension of lymphoid follicle from lamina propria to submucosa is more than in later age. It may be due to size of lymphoid follicle. Size of lymphoid follicle was more in early ages and less in later ages. Overall, the study noted a progressive decrease in the number of lymphoid follicles as age increased.

The vermiform appendix is a tubular, blind-ended secondary lymphoid organ located near the caecum, often referred to as the "tonsil of the abdomen" due to the abundance of lymphoid follicles in its histology. The presence of germinal centers, which are indicators of lymphatic tissue response to antigens and subsequent antibody production, helps assess the immune status of individuals. By counting these germinal centers, researchers can evaluate the immune status of the Bangladeshi population across different age and sex groups. This study was conducted at Mymensingh Medical College, approximately 120 km north of Dhaka, the capital of Bangladesh. Samples were randomly selected from the local population between 2016 and 2017, including 40 vermiform appendices from various age groups: Group A (up to 20 years), Group B (21-40 years), Group C (41-60 years) and Group D (over 60 years). After obtaining ethical approval, the germinal centers, identified by their lighter staining in the center of lymphoid follicles, were counted under a microscope (X4 objective, X10 eyepiece). The average number of germinal centers per age group was then calculated. The study found that the mean±SD number of germinal centers was 3.20±1.66, 2.40±0.66, 1.50±1.11 and 0.30±0.45 across the advancing age groups. The mean differences of number of germinal center between A&B, B&C were statistically non significant at p= or >0.05 level, difference between group C&D, A&C was statistically significant at p<0.05 level and differences between group B&D, A&D were statistically highly significant at p0.05 level. Overall, the study observed a gradual decline in the number of germinal centers with increasing age.

Background: Each vertebra is formed by combining the distal portion of one somite and the cranial half of its proximate part. HOX genes regulate the patterning of the shapes of the non-identical spinal column. In the sacral area, anatomical dissimilarity is on account of the distinct shape of the sacral hiatus and the outright non-subsistence of the posticous embankment of the sacral neural tube, which is a consequence of the non-fulfillment of bonding of lamina of all sacral vertebrae. After that, the meninges and the spinal nerve are unprotected and undiagnosable without an X-ray examination. Therefore, it is difficult to detect the reasons for caudal block failure, low back pain, etc. The current research aimed to improve the proficiency of anatomical and developmental errors of the dorsal wall of the sacrum. Methods: This study was conducted on 60 dried adult sacra of unknown sexes from the stock wing of Anatomy, Sylhet MAG Osmani Medical College, Bangladesh, from 2017 to 2018. The undefined gender of the sacrum was identified. Results: Out of 60 sacra, 30 (50.0%) were found to be that of males and 30 (50.0%) of females. Among the study samples, only three (5%) samples presented a complete absence of the sacrum's dorsal wall and and incidence among males was higher than females. Conclusion: This type of sacral aberration has paramount clinical importance. Thereby avoiding caudal epidural block-connected sufferings and backbone operative procedures. The expertise regarding the anatomical variation of sacral hiatus is necessary to reduce the failure rate during caudal epidural anesthesia, helps orthopedic surgeons diagnose the cause of low back pain or in surgical situations, and helps pediatricians deal with congenital anomalies such as meningocele and myelomeningocele.

Axial length (AL) and corneal curvature (CC) are one of the furthest critical parameters for optometry and oculoplastic surgery. These two variables are crucial in biometry for accurately measuring the power of the intraocular lens in cataract surgery. This research aimed to determine the association linking axial length and corneal curvature with demographic characteristics in emmetropic eyes of Bangladeshi people. This descriptive cross-sectional research was carried out among 200 emmetropic eyes of Bangladeshi people attending the Department of Ophthalmology at Rajshahi Medical College, Bangladesh, with different eye conditions, between July 2017 and June 2018. Data was gathered by conducting person-to-person interviews, checking visual activity using the Snellen chart, and measuring corneal curvature using an auto-keratometer and axial eyeball length using A-scan ultrasonography. A total of 200 attendances were studied, 90 males and 110 females. All were emmetropic. The age range was 21-52 years, and the highest contributors were in the 21-30-year age group. The association between right axial length and right corneal curvature shows a negative relation among both sexes. It was -0.61 (β-coefficient (β-coff)), and highly significant in females at -0.89 (β-coff). Additionally, the association between left axial length and left corneal curvature shows a negative relation of -0.65 (β-coff), which was again highly significant in females at -0.87 (β-coff). Both were not significant in males. There was no significant association linking axial length and eye axis in both sexes. The multivariate regression model was used to assess the p-value, and the regression model was adjusted by age. Optical parametric measurement is a noninvasive diagnostic and assessment tool that might help in the actual measurement of intraocular lens implantation in cataract surgery and may also provide supplementary information to the researcher domain.

Background: In the sacrococcygeal region, anatomical variation is due to the sacralization of the coccygeal vertebra, which is the due union of/fusion of the fifth sacral with the first coccygeal vertebra of five couples of sacral foramina under-detected or asymptomatic beyond radiological assessment. That is why it is challenging to know the cause of coccydynia, caudal block failure, the difficult second stage of labor, and perineal tears. The present study aims to improve knowledge about the anatomical variation of sacralization of the coccygeal vertebra. Additionally, to find the prevalence of sacralization of coccygeal vertebra in Sylhet, Bangladesh. Methods: This study was performed on 60 parched, totally calcified, typical sacra of mature-age individuals of undetermined sexes, fulfilling the inclusion criteria from the bone bank of the osteology museum of the Department of Anatomy, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh, from July 2017 to June 2018. Sex determination of the collected unknown sacra was conducted using discriminant function analysis. It was found that 50% (30) were male and 50% (30%) were female. The unpaired t-tests and chi-square were utilized to determine the statistical significance. Results: Out of 60 sacra, eight (13.33%) samples presented with sacralization. This study found that males had significantly higher straight (p=0.05) and curved (p=0.05) lengths of sacrococcygeal vertebrae. The sacrococcygeal curvature index (SCI) showed statistically significant (p=0.05) differences between the sexes. Conclusion: Sacralization may exert an impact on the caudal block. It could extend the second stage of the labor process with perineal tears. Therefore, knowledge about the anatomical variation of the coccygeal vertebra is essential.