Acquisition of cadavers for anatomy education and research in Malawi

BACKGROUND

The use of human cadaveric dissection forms an essential part of teaching anatomy to health sciences students in Malawi. Despite worldwide struggles in acquiring sufficient human cadavers for anatomy education, the current recommendations on the best anatomy practices require the use of cadavers exclusively from the body donation programs. The current study aims to describe the sources of cadaveric bodies used for anatomy education in the Malawian context and reflect on the feasibility of using cadavers from the body donation program only.

METHODS

A retrospective audit of the cadaveric records for the 2006-2022 academic years at the Kamuzu University of Health Sciences was done. The perceived challenges when sourcing the cadavers were identified and described based on the authors experiences in Malawi.

RESULTS

The majority (97.3%) of the cadavers used between 2006 and 2022 were unclaimed bodies. The mean age of the cadavers was 45 years. Most (95.6%) of the unclaimed bodies were males. All the unclaimed bodies were sourced from hospitals. The body donation program in Malawi was patronized by populations of European descent only. Strongly held sociocultural and religious beliefs as well as economic reasons were perceived as significant barriers to acquiring cadavers of the indigenous Malawians through the body donation program.

CONCLUSION

Cadavers for anatomy education in Malawi are mainly from unclaimed bodies, similar to other African countries. The authors support the transition from using "mostly unclaimed bodies (and, less often, body donation)" to using "mostly body donation (and, less often, unclaimed bodies)" through awareness campaigns that are targeted to address the prevailing challenges.

Morphometric study of the suprascapular notch and scapular dimensions in adult malawian cadavers and implications of completely ossified superior transverse scapular ligament

Introduction

the anatomy of the suprascapular notch and its relationship to scapular dimensions are critical in the management of suprascapular neuropathies. Individuals show considerable differences in the dimensions of the suprascapular notch across populations. The purpose of this study was to determine the morphology and morphometric dimensions of the suprascapular notch in adult Malawian cadavers and to suggest clinical implications associated with complete ossification of the suprascapular ligament.

Methods

adult dry scapulae from undetermined sex specimens (n=125) obtained from the skeletal collection at Kamuzu University of Health Sciences were classified according to the Rengachary categorization method to assess the suprascapular notch superior transverse distance, mid transverse distance, depth, scapula length and width using a standard Vernier caliper.

Results

the most prevalent suprascapular notch class was type I, which was found in 46 (36.8%) of all scapulae. Type VI was the least common, found in only 1 (0.8%) of the scapulae. The mean notch superior transverse distance was 1.3 ± 0.6 cm, while the mean maximum depth was 0.6 ± 0.3 cm. Only the differences in depth, however, were statistically significant (p=0.001).

Conclusion

the current study has described the morphology and morphometry of the suprascapular notch in relation to the risk of suprascapular nerve entrapment associated with complete ossification of the suprascapular ligament. Our sample population generally showed smaller suprascapular notch and scapular dimensions than other populations. This should be considered during the management of suprascapular neuropathy and preoperative planning of surgical operations of the shoulder region.

Distribution of variations in anatomy of the circle of Willis: results of a cadaveric study of the Malawian population and review of literature

Introduction

the circle of Willis is an anatomical structure of clinical importance particularly in the evaluation of neurovascular diseases. Individuals show considerable variations in the anatomical configuration of the circle of Willis. A cross-sectional study was conducted to determine the distribution of morphological variations of the circle of Willis in Malawians and compare with other ethnic groups.

Methods

brains were collected from twenty-four recently deceased black Malawians during autopsy at Queen Elizabeth Central Hospital, a referral teaching hospital in Blantyre, Malawi and fixed in 10% buffered formalin. Digital images of the interpeduncular region (exposing the circle of Willis) were taken with an 18.4 megapixels camera from the base of the brain. Whole-circle and segmental parameters of the circle of Willis were assessed using the Osiris computer programme and classified based on a 22-type classification scheme.

Results

the following morphological variations were observed: hypoplasia, aplasia, asymmetry and accessory vessels. Typical circle of Willis was seen in 26% of the cases. Only six of the original twenty-two types were observed. Consistent with most previous studies, types 1, 3, 4, 6, 8 and 9 were common while types 10-22 were rare. Three variants not previously described in the original scheme (unilateral PcoA aplasia, AcoA duplication, and PcoA aplasia with contralateral PcoA hypoplasia) were observed in this study.

Conclusion

anatomical variations of the circle of Willis in Malawians seem to be distributed in similar frequencies and patterns as in other more-diverse populations. Circle of Willis variants with potential predilection for atherogenesis and aneurysm formation exist in the Malawian population. These should be considered in clinical practice.

Effect of Herbal Aphrodisiac, Dioscorea Bulbifera on Sperm Parameters, Serum Hormonal Levels and Testicular Histology of Wistar Rats

Aim:

The present study was aimed at screening phytochemicals of Dioscorea bulbifera extracts and evaluating its effects on male rat reproductive system.

Background:

Since ancient times, man has found a lot of health benefits from medicinal plants. According to the World Health Organisation (WHO), about 80% of the world population depends on traditional medicine, which is 90% plant-based, for their health needs. In respect of this, men in Africa use herbal medicines in the management of erectile dysfunction and infertility. Amongst thousands of herbs, folklore has implicated Dioscorea bulbifera bulbils in the treatment of piles, dysentery, syphilis, ulcers, cough, leprosy, diabetes, asthma, cancer and infertility. Despite such great health benefits from D. bulbifera, in vitro studies and clinical data in support of its efficacy as an aphrodisiac are scanty.

Objective:

The objective of the study was to investigate the effects of Dioscorea bulbifera extracts on Wistar rat sperm parameters, hormonal levels and histology of the testis.

Methods:

Thirty healthy adult male Wistar rats were divided into 5 groups of 6 rats each and were given different treatments of Dioscorea bulbifera extracts by oral gavage at 200 and 400 mg kg-1 body weight. After 8 weeks, body and reproductive organ weights, sperm concentration, hormonal levels and histological structure of the testis were evaluated. A calorimetric method was used to assess the quantity of phytochemical constituents.

Results:

Testosterone, luteinizing hormone, estradiol and follicle-stimulating hormone levels were significantly (p<0.05) enhanced whereas prolactin levels were significantly (p<0.05) down-regulated in the treated groups. Total sperm motility, sperm concentration and the percentage of progressively motile cells increased compared to the control. All the treated animals showed an increase in body weight, seminiferous tubule diameter and germinal epithelial height with the testes showing all the stages of spermatogenesis. Phytochemical screening of the methanol extracts revealed the presence of alkaloids, steroids, flavonoids, phenols and saponins.

Conclusion:

Dioscorea bulbifera has secondary metabolites that seem to stimulate androgenic and anabolic effects. These secondary metabolites appear to be responsible for the positive changes in testicular architecture, serum hormonal levels, caudal sperm concentration and motility parameters. This study supports the ethno-aphrodisiac claims that have been made against it.

The in Vivo Effects of Cassia Abbreviata Oliv., on Sperm Parameters And Testicular Histology of The Male Wistar Rat

Introduction:

A lot of unsubstantiated claims have been made regarding the ability of Cassia abbreviata Oliv. to promote male reproductive function. The study was aimed at evaluating the effects of aqueous and 50% (v/v) methanol stem bark extracts of Cassia abbreviata Oliv. on hormonal levels, sperm parameters, testicular histo-architecture, mean body and right testis weights of the male Wistar rat.

Methodology:

Thirty healthy adult male Wistar rats were divided into five groups. Group A, control rats received pure tap water; group B received aqueous extracts at 200 mg/kg body weight; group C received aqueous extracts at 400 mg/kg body weight; group D received 50% (v/v) methanol extracts at 200 mg/kg body weight and group E received 50% (v/v) methanol extract at 400 mg/kg body weight. After 8 weeks, reproductive organ weights, sperm parameters, hormonal levels and histological structure of the right testis were evaluated.

Results:

Testosterone, luteinizing hormone, estradiol, follicle-stimulating hormone levels were significantly increased (p<0.05) whereas prolactin levels were significantly decreased (p<0.05) in the treated groups compared to the control. Total sperm motility, sperm concentration and the percentage of progressively motile cells increased significantly (p<0.05) compared to the control. All the treated animals showed an increase in seminiferous tubule diameter and germinal epithelial height with the testes showing all the stages of spermatogenesis. Phytochemical screening of both extracts showed the presence of of flavonoids, phenols, tannins, saponins and alkaloids.

Conclusion:

Cassia abbreviata Oliv. increased sperm parameters, reproductive hormones and mean body weight of the male Wistar rat. This study supports the folklore claims that Cassia. abbreviata Oliv.modulates male reproductive function.

Anatomical variations and morphometric properties of the circulus arteriosus cerebri in a cadaveric Malawian population

BACKGROUND

Knowledge of the anatomy of the circulus arteriosus cerebri (CAC) is important in understanding its role as an arterial anastomotic structure involved in collateral perfusion and equalisation of pressure, and may explain observed variations in neurovascular disease prevalences across populations. This study was aimed at understanding the anatomical configuration and morphometric properties of the CAC in Malawian population.

MATERIALS AND METHODS

Brains were collected from 24 recently-deceased black Malawian human cadavers during medico-legal autopsies. Photographs of the CACs were taken using a camera placed at a 30 cm height from the base of the brain. Whole-circle properties and segmental vessel parameters were analysed using the OSIRIS computer programme, paying attention to completeness, typicality, symmetry, and segmental vessel diameters and lengths.

RESULTS

The complete-circle configuration was found in 69.57% of the CACs. Of these, 37.5% were typical, representing an overall typicality prevalence of 26.09%. Vessel asymmetry was observed in 30.43% of cases. There were 7 cases of vessel aplasia and 12 cases of vessel hypoplasia. The posterior communicating artery (PcoA) was the most variable (with 12 variations), widest (7.67 mm) and longest (27.7 mm) vessel while the anterior communicating artery (AcoA) was the shortest (0.78 mm). Both the AcoA and the PcoA were the narrowest vessels (0.67 mm) in this study. CAC variations in Malawian populations appeared to be similar to those observed in diverse populations.

CONCLUSIONS

Anatomical variations of the CAC exist in Malawian population and should be taken into consideration in clinical practice.

An anatomical and osteometric study of the femoral sulcus angle in adult Malawians

BACKGROUND

Femoral sulcus angle is particularly important in clinical evaluation of patellofemoral joint. Individuals show considerable differences in asymmetrical dimensions of the femur.

OBJECTIVES

To determine the size of femoral sulcus angles in adult black Malawians using the skeletal collection in the department of Anatomy, College of Medicine and assess their gender differences; to compare femoral sulcus angles of Malawians with other ethnic groups.

METHODS

A cross sectional study was done in which femoral sulcus angles of dry bones were measured using a goniometer.

RESULTS

There is no significant difference in the mean sulcus angles between right and left femora in males (p=0.8100) and females (p=0.0742); between all males combined and females combined (p=0.8845). There is a significant difference in the mean between all left femora combined and all right femora combined (p=0.0260).

CONCLUSION

This study has provided the mean size of the femoral sulcus angle of adult Malawians. These findings suggest that the size of the sulcus angle cannot determine gender among adult black Malawians suggesting the interpretation that femora asymmetric dimensions are population specific, which should be considered in the patellofemoral joint evaluation.

Anastrozole is a dose-specific superovulator and favors implantation in rats: a prospective study

An alternative superovulator to replace clomiphene citrate (CC) is needed as it is unsuitable for women with polycystic ovarian syndrome and is associated with low pregnancy rates. Anastrozole is an effective superovulator, but has not been well researched. The aim of this study was to determine the optimal dose of anastrozole as a superovulator and ascertain its effects on implantation and uterine ultrastructure during early pregnancy in Wistar rats using scanning electron microscopy. The uterine morphological characteristics which were studied in day 1 and 6 pregnant rats include microvilli density, length, surface "beads", surface glycocalyx, cell borders and apices, uterine surface fording and large surface protrusions. A significant increase in implantation sites is seen in the 15 mg/kg anastrozole group, compared to control. Day 1 and 6 anastrozole groups have similar morphology to the control and different to the CC group. At day 6, large surface protrusions are mostly noted but not limited to anastrozole-treated rats; anastrozole also appears to retain glycocalyx to some extent. The increased number of implantation sites in the 15 mg/kg anastrozole group suggests that this dose superovulates and favors implantation. Anastrozole is probably dose-/species-specific and additionally the surface uterine morphology suggests that anastrozole is implantation friendly.