Dorsum Of Hand Research Articles

Strategies for genetic manipulation of the halotolerant black yeast Hortaea werneckii: ectopic DNA integration and marker-free CRISPR/Cas9 transformation.

Hortaea werneckii is a halotolerant black yeast commonly found in hypersaline environments. This yeast is also the causative agent of tinea nigra, a superficial mycosis of the palm of the hand and soles of the feet of humans. In addition to their remarkable halotolerance, this black yeast exhibits an unconventional cell division cycle, alternating between fission and budding cell division. Cell density and the salt concentration in their environment regulate which cell division cycle H. werneckii uses. Although H. werneckii have been extensively studied due to their unique physiology and cell biology, deciphering the underlying mechanisms behind these remarkable phenotypes has been limited due to the lack of genetic tools available. Here, we report a new ectopic integration protocol for H. werneckii using polyethylene glycol-CaCl2 mediated protoplast transformation. This approach relies on a drug (hygromycin B) resistance gene to select for successful integration of the genetic construct. The same construct was used to express cytosolic green fluorescent protein. Finally, we developed a marker-free CRISPR/Cas9 protocol for targeted gene deletion using the melanin synthesis pathway as a visual reporter of successful transformation. These transformation strategies will allow testing hypotheses related to H. werneckii cell biology and physiology.IMPORTANCEHortaea werneckii is a remarkable yeast capable of growing in high salt concentration, and its cell division cycle alternates between fission-like and budding. For these unique attributes, H. werneckii has gathered interest in research programs studying extremophile fungi and cell division. Most of our understanding of H. werneckii biology comes from genomic analyses, the usage of drugs to target a particular pathway, or the heterologous expression of its genes in S. cerevisiae. Nonetheless, H. werneckii has remained genetically intractable. Here, we report on two strategies to transform H. werneckii: ectopic integration of a plasmid and gene deletion using CRISPR/Cas9. These approaches will be fundamental to expanding the experimental techniques available to study H. werneckii, including live-cell imaging of cellular processes and reverse genetic approaches.

Teleoperation system for multiple robots with intuitive hand recognition interface

Robotic teleoperation is essential for hazardous environments where human safety is at risk. However, efficient and intuitive human–machine interaction for multi-robot systems remains challenging. This article aims to demonstrate a robotic teleoperation system, denominated AutoNav, centered around autonomous navigation and gesture commands interpreted through computer vision. The central focus is on recognizing the palm of the hand as a control interface to facilitate human–machine interaction in the context of multi-robots. The MediaPipe framework was integrated to implement gesture recognition from a USB camera. The system was developed using the Robot Operating System, employing a simulated environment that includes the Gazebo and RViz applications with multiple TurtleBot 3 robots. The main results show a reduction of approximately 50% in the execution time, coupled with an increase in free time during teleoperation, reaching up to 94% of the total execution time. Furthermore, there is a decrease in collisions. These results demonstrate the effectiveness and practicality of the robotic control algorithm, showcasing its promise in managing teleoperations across multi-robots. This study fills a knowledge gap by developing a hand gesture-based control interface for more efficient and safer multi-robot teleoperation. These findings enhance human–machine interaction in complex robotic operations. A video showing the system working is available at https://youtu.be/94S4nJ3IwUw.

Knowledge of hand hygiene and evaluation of hand washing technique among nurses at the University of Nigeria Teaching Hospital

BackgroundHealthcare worker’s hands are route for cross-transmission of potentially harmful germs between patients in a healthcare facility. As hand washing is an established cost-effective measure for infection control, hand hygiene knowledge and compliance with the recommended steps are essential to control healthcare-associated infections (HCAI). We assessed the knowledge and practice of hand hygiene among nurses at the University of Nigeria Teaching Hospital (UNTH), Enugu.MethodsA cross-sectional study was carried out from 14th September to 24th December 2023 on all consenting nurses in UNTH. A modified World Health Organization (WHO) knowledge questionnaire structured to collect demographics and assess hand hygiene knowledge expressed as good(> 75%), moderately good(50–74%) and poor(< 50%) knowledge. Duration to completion of hand washing was timed while Glo germ gel with ultraviolet lamp were used to assess effectiveness of hand washing. Ineffective hand washing was graded as fair, poor, or very poor. The WHO checklist was used to assess steps in hand washing technique performed.ResultA total of 395 nurses participated in the study (mean age and standard deviation, 41.40 ± 8.82 years). Most were females (93.2%), married (80.8%), and functioned in the surgery department (38.5%). Moderately good knowledge of hand hygiene was demonstrated by 58.2% while effective hand washing occurred in 29.2% of them. Steps of hand washing technique most frequently missed were the use of towel to turn off faucet (94.3%), rubbing backs of fingers to opposing palms with fingers interlocked (89.8%), and wetting hands with water before applying soap(55.9%). Zones of hands not adequately washed were mainly the fingernails and perimeter of fingernails (38.4%), the palm (28.6%), and the dorsum of hand (22.9%). There was no significant difference in hand hygiene knowledge and effective hand washing across the different age groups, sex, nursing cadre, educational qualifications, and departments.ConclusionNurses at the UNTH had fair hand hygiene knowledge with the majority demonstrating ineffective hand washing; a finding suggesting sub-optimal infection prevention and control. Periodic hand hygiene training targeting nurses and other health personnel engaged in patient care while emphasizing frequently missed areas is paramount to improving hand hygiene knowledge and effectiveness.Clinical Trial NumberNot applicable.

Leishmaniasis Diagnosed in the United States Successfully Treated With Miltefosine

Abstract Leishmaniasis is an infectious disease caused by the parasitic protozoa species Leishmania and is most often transmitted to humans through the bite of a sandfly. The most common manifestation is a cutaneous lesion. Leishmaniasis is endemic to many countries throughout the world but rarely diagnosed in the United States. Here, we report a 64-year-old man with initially undisclosed recent travel to Sudan, an endemic country, who returned to the United States with cutaneous lesions on his forehead and dorsal hand. After failing initial therapy, a biopsy showed amastigotes (the tissue stage of the parasite), chronic inflammation with numerous plasma cells, granulomatous features, focal necrobiosis, and neutrophilic debris, consistent with leishmaniasis. The lesions did not significantly improve with fluconazole, but miltefosine (100–200 mg daily) resulted in remission over an 8-week course. The purpose of this case report is to highlight the importance of including rare infectious organisms in the differential and briefly discuss diagnostic and treatment methods.

Erythematous Plaques on the Dorsum of both Hands and Forearm: A Quiz.

Erythematous Plaques on the Dorsum of both Hands and Forearm: A Quiz.

Collagenase injection versus limited fasciectomy surgery to treat Dupuytren's contracture in adult patients in the UK: DISC, a non-inferiority RCT and economic evaluation.

Dupuytren's contracture is caused by nodules and cords which pull the fingers towards the palm of the hand. Treatments include limited fasciectomy surgery, collagenase injection and needle fasciotomy. There is limited evidence comparing limited fasciectomy with collagenase injection. To compare whether collagenase injection is not inferior to limited fasciectomy when treating Dupuytren's contracture. Pragmatic, two-arm, unblinded, randomised controlled non-inferiority trial with a cost-effectiveness evaluation and nested qualitative and photographic substudies. Thirty-one National Health Service hospitals in England and Scotland. Patients with Dupuytren's contracture of ≥ 30 degrees who had not received previous treatment in the same digit. Collagenase injection with manipulation 1-7 days later was compared with limited fasciectomy. The primary outcome was the Patient Evaluation Measure score, with 1 year after treatment serving as the primary end point. A difference of 6 points in the primary end point was used as the non-inferiority margin. Secondary outcomes included: Unité Rhumatologique des Affections de la Main scale; Michigan Hand Outcomes Questionnaire; recurrence; extension deficit and total active movement; further care/re-intervention; complications; quality-adjusted life-year; resource use; and time to function recovery. Online central randomisation, stratified by the most affected joint, and with variable block sizes allocates participants 1 : 1 to collagenase or limited fasciectomy. Participants and clinicians were not blind to treatment allocation. Between 31 July 2017 and 28 September 2021, 672 participants were recruited (n = 336 per group), of which 599 participants contributed to the primary outcome analysis (n = 285 limited fasciectomy; n = 314 collagenase). At 1 year (primary end point) there was little evidence to support rejection of the hypothesis that collagenase is inferior to limited fasciectomy. The difference in Patient Evaluation Measure score at 1 year was 5.95 (95% confidence interval 3.12 to 8.77; p = 0.49), increasing to 7.18 (95% confidence interval 4.18 to 10.88) at 2 years. The collagenase group had more complications (n = 267, 0.82 per participant) than the limited fasciectomy group (n = 177, 0.60 per participant), but limited fasciectomy participants had a greater proportion of 'moderate'/'severe' complications (5% vs. 2%). At least 54 participants (15.7%) had contracture recurrence and there was weak evidence suggesting that collagenase participants recurred more often than limited fasciectomy participants (odds ratio 1.39, 95% confidence interval 0.74 to 2.63). At 1 year, collagenase had an insignificantly worse quality-adjusted life-year gain (-0.003, 95% confidence interval -0.006 to 0.0004) and a significant cost saving (-£1090, 95% confidence interval -£1139 to -£1042) than limited fasciectomy with the probability of collagenase being cost-effective exceeding 99% at willingness to pay thresholds of £20,000-£30,000 per quality-adjusted life-year. At 2 years, collagenase was both significantly less effective (-0.048, 95% confidence interval -0.055 to -0.040) and less costly (-£1212, 95% confidence interval -£1276 to -£1147). The probability of collagenase being cost-effective was 72% at the £20,000 threshold but limited fasciectomy became the optimal treatment at thresholds over £25,488. The Markov model found the probability of collagenase being cost-effective at the lifetime horizon dropped below 22% at thresholds over £20,000. Semistructured qualitative interviews found that those treated with collagenase considered the outcome to be acceptable, though not perfect. The photography substudy found poor agreement between goniometry and both participant and clinician taken photographs, even after accounting for systematic differences from each method. Impacts of the COVID-19 pandemic resulted in longer waits for Dupuytren's contracture treatment, meaning some participants could not be followed up for 2 years. This resulted in potential underestimation of Dupuytren's contracture recurrence and/or re-intervention rates, which may particularly have impacted the clinical effectiveness and long-term Markov model findings. Among adults with Dupuytren's contracture, collagenase delivered in an outpatient setting is less effective but more cost-saving than limited fasciectomy. Further research is required to establish the longer-term implications of both treatments. Recurrence and re-intervention usually occur after 1 year, and therefore follow-up to 5 years or more could resolve whether the differences observed in the Dupuytren's interventions surgery versus collagenase trial to 2 years worsen. Current Controlled Trials ISRCTN18254597. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/102/04) and is published in full in Health Technology Assessment; Vol. 28, No. 78. See the NIHR Funding and Awards website for further award information.

Case reports on hand prejuvenation: clinical outcomes in middle-aged women with hyaluronic acid filler plus lidocaine.

Hand rejuvenation with hyaluronic acid filler injections is gaining more attention for its ability to correct volume loss and improve skin quality. The hand dorsum is prone to loss of dermal elasticity and subcutaneous atrophy as individuals age, and administering hyaluronic acid fillers has become an option to restore the smoothness and youthful contour of the hand. The aim of this study is to demonstrate that injections with Definisse Touch Filler Plus Lidocaine are effective and safe for hand rejuvenation. Ten subjects underwent filler placement of 0.5 to 1.0 mL in the dorsal superficial lamina, which is devoid of sensory nerves and major skin vessels, using a blunt cannula via the fanning technique. Measurements were done before, immediately after, and 1 month after the treatment using validated aesthetic scales. There was a significant correction of volume loss immediately after the first treatment and an improvement in skin texture and topography 1 month after the procedure. No lasting or severe adverse effects were observed. To show significant and conclusive results, it is recommended to conduct further prospective, comparative, blinded studies in more subjects followed for longer periods (ie, 12 months or more). Objective analysis of volumetric changes using automated three-dimensional surface techniques is likewise beneficial. Injecting a low G-prime hyaluronic acid along the dorsal superficial lamina via cannula provides an effective and tolerable option for improving the appearance of aged hands.

Three-dimensional heat and moisture transfer analysis for thermal protection of firefighters’ gloves with phase change materials

Transient three-dimensional (3D) heat and moisture transfer simulations were conducted to analyze the thermal performances of the entire phase change material (PCM) integrated into firefighters’ gloves. PCM was broken down into several segments to cover the back and palm of the hand but to avoid finger joints to keep hand functions. Parametric studies were performed to explore the effects of PCM melting temperatures, PCM locations in the glove and PCM layer thicknesses on the overall thermal performance improvement of firefighters’ gloves. The study found that PCM segments could extend the time for hand skin surfaces (areas covered or not covered by PCM) to reach second-degree burn injury (60 °C) by 1.5–2 times compared to conventional firefighters’ gloves without PCM. Moreover, PCM segments could help mitigate the temperature increase on hand skin and glove surface after fire exposure.

Dual-Stream Enhanced Deep Network for Transmission Near-Infrared Dorsal Hand Vein Age Estimation with Attention Mechanisms

Dorsal hand vein recognition, with unique stable and reliable advantages, has attracted considerable attention from numerous researchers. In this case, the dorsal hand vein images captured by the means of transmission infrared imaging are clearer than those collected by other infrared methods, enabling it to be more suitable for the biometric applications. However, less attention is paid to individual age estimation based on dorsal hand veins. To this end, this paper proposes an efficient dorsal hand vein age estimation model using a deep neural network with attention mechanisms. Specifically, a convolutional neural network (CNN) is developed to extract the expressive features for age estimation. Simultaneously, another deep residual network is leveraged to strengthen the representation ability on subtle dorsal vein textures. Moreover, variable activation functions and pooling layers are integrated into the respective streams to enhance the nonlinearity modeling of the dual-stream model. Finally, a dynamic attention mechanism module is embedded into the dual-stream network to achieve multi-modal collaborative enhancement, guiding the model to concentrate on salient age-specific features. To evaluate the performance of dorsal hand vein age estimation, this work collects dorsal hand vein images using the transmission near-infrared spectrum from 300 individuals across various age groups. The experimental results show that the dual-stream enhanced network with the attention mechanism significantly improves the accuracy of dorsal hand vein age estimation in comparison with other deep learning approaches, indicating the potential of using near-infrared dorsal hand vein imaging and deep learning technology for efficient human age estimation.

Speech motor cortex enables BCI cursor control and click.

Decoding neural activity from ventral (speech) motor cortex is known to enable high-performance speech brain-computer interface (BCI) control. It was previously unknown whether this brain area could also enable computer control via neural cursor and click, as is typically associated with dorsal (arm and hand) motor cortex. We recruited a clinical trial participant with ALS and implanted intracortical microelectrode arrays in ventral precentral gyrus (vPCG), which the participant used to operate a speech BCI in a prior study. We developed a cursor BCI driven by the participant's vPCG neural activity, and evaluated performance on a series of target selection tasks. The reported vPCG cursor BCI enabled rapidly-calibrating (40 seconds), accurate (2.90 bits per second) cursor control and click. The participant also used the BCI to control his own personal computer independently. These results suggest that placing electrodes in vPCG to optimize for speech decoding may also be a viable strategy for building a multi-modal BCI which enables both speech-based communication and computer control via cursor and click.

Multiple Abscesses and Plaques in an Immunocompetent Patient.

A 40-year-old immunocompetent man experiencing housing insecurity presented with a two-week history of fluctuant abscesses on the left forehead and supraorbital area that became crusted, scaly plaques, a pink plaque on the right dorsal hand, and a necrotic ulcer on the right great toe, resistant to two weeks of doxycycline. Shave biopsy of a new plaque on the right cheek revealed large, broad-based fungal yeast forms and concomitant right middle lobe consolidating pneumonia suggestive of a rare case of disseminated blastomycosis with fluctuant abscesses. Fungal cultures confirmed infection with blastomycosis, and patient was started on a six-month course of itraconazole.

Melanomas on the dorsum of the hand are extremely rare: A series of seven cases with clinical and dermatoscopic images.

Melanomas on the dorsum of the hand are exceedingly rare, with limited documentation in medical literature. This report presents seven cases of dorsal hand and finger melanomas, encompassing patients from Australia, New Zealand and Turkey, predominantly women with a mean age of 53 years. The majority were invasive, with a mean Breslow thickness of 1.1 mm and none were of lentigo maligna subtype. The rarity of dorsal hand melanomas prompts speculation into potential protective factors unique to this site, challenging existing knowledge on melanoma aetiology and sun exposure.

Palmoplantar Psoriasis Treatment with Topical Roflumilast 0.3%

Palmoplantar psoriasis is a manifestation of psoriasis that includes pustules, scales, and erythematous hyperkeratotic plaques on the palms of the hands and the soles of the feet. Despite being limited to these regions, palmoplantar psoriasis is difficult to treat and imposes a greater level of quality-of-life burden compared to plaque psoriasis. We describe a case of palmoplantar psoriasis refractory topical corticosteroid and dupilumab that was successfully treated with topical roflumilast 0.3% once daily.

Variations of the ulnar nerve within the ulnar tunnel and palm in a select South African population

BackgroundUlnar tunnel syndrome (UTS) is a rare peripheral neuropathy associated with the entrapment of the distal portion of the ulnar nerve (UN) in its course through the fibro-osseous ulnar tunnel (eponymously known as Guyon's canal) at the wrist. The UN within the ulnar tunnel is prone to injury or compression resulting in an UTS. Therefore, it is of clinical importance to know the anatomical variations in the branching pattern of the UN within the ulnar tunnel. UTS is characterised by sensory deficits and muscular weakness, impaired sensation of the volar fingertips, and weakness in grasping with intrinsic hand muscles. This study aimed to examine the anatomical variations of the UN in the palm of the hand within a select South African cadaveric population. MethodsThe variations in the branching patterns of the UN were examined in 81 cadavers (n = 162) and described according to the classification system of Murata et al. (2004) [10]. Communicating branches were classified according to their description in previous literature. The length of the ulnar tunnel was measured from the level of the pisiform bone to the level of the hook of hamate. ResultsThe branching pattern was found as Type 1 (52.9 %), Type 2 (34 %), Type 3 (2.7), Type 4 (6.5 %), Type 5 (3.9 %). Berrettini, Riche-Cannieu and Kaplan anastomoses were found in 51.6 %, 2 % and 3.3 % of specimens, respectively. ConclusionIt is important for surgeons to be aware of these anatomical variations as they may lead to misdiagnosis and complications during surgical procedures during the treatment of UTS.

Tingkat Nyeri Desminore pada Remaja dengan Massage Efflurage di SMAN 1 Cihaurbeuti

Efflurage massage is a method of massaging using the palms of the hands to apply gentle pressure to the surface of the body in a repeated direction of circulation. This technique aims to increase blood circulation, apply pressure and warm the abdominal muscles and increase physical and mental relaxation. Dysmenorrhea is pain or cramps that women feel in the lower abdomen area which occurs before or after experiencing the first day of menstruation (menarche) until the second day. The aim of this study was to determine the effect of massage efflurage on reducing desminorrhea pain. The method in this research is Quasi-Experimental research using the One Group Pretest-Posttest Design research method. The results of this study were that those who experienced desminore pain levels before efflurage massage were 14 respondents (47%) with severe desminore pain levels, 9 people (30%) with moderate pain levels and 18 (60%) respondents after efflurage massage. mild pain level. The conclusion from this study is that there is an effect of efflurage massage on reducing the level of desminore pain. Advice for teenagers is that when experiencing desminorrhea, they should try not to consume drugs and herbal medicines, and should do efflurage massage.

A woman with mycosis fungoides, vitiligo, and a new hand nodule.

A 70-year-old African American female with a history of stage IV mycosis fungoides in remission presented with a gradually enlarging, red, ulcerated nodule on her right dorsal hand. The lesion was biopsied, and it showed intraepidermal proliferation with cytologic atypia and increased vasculature in the papillary dermis. Immunohistochemical staining indicated a yes-associated protein 1 (YAP1) rearrangement, confirmed by RNA sequencing, revealing a YAP1::MAML2 (mastermind-like transcriptional coactivator 2) fusion. The lesion was diagnosed as an eccrine porocarcinoma (EPC). The occurrence of EPCs following radiotherapy or trauma has been documented. This case highlights the importance of considering EPCs in patients with extensive skin treatments and immunosuppression history.

Effect of pre-session discrimination training on performance in a judgement bias test in dogs

Spatial judgement bias tests (JBTs) can involve teaching animals that a bowl provides a reward in one location but does not in another. The animal is then presented with the bowl placed between the rewarded and the unrewarded locations (i.e., ambiguous locations) and their latency to approach reflects expectation of reward or ‘optimism’. Some suggest that greater ‘optimism’ indicates better welfare. Performance in JBTs, however, may also indicate a learning history independently from welfare determinants. We hypothesized that dogs’ ‘optimism’ in a follow-up JBT may be impacted by a learning treatment involving additional trials of a different discrimination task. Once enrolled, companion dogs (n = 16) were required to complete three study phases: (1) a pre-treatment JBT, (2) a learning treatment, and (3) a post-treatment JBT. During the JBTs, dogs were presented with five locations: one rewarded, one unrewarded, and three ambiguous (all unrewarded). Dogs were randomly assigned to a trial-based learning task—a nose-touch to the palm of the hand. In the Experimental discrimination treatment phase (n = 8), dogs were presented with two hands in each trial and only rewarded for touching one specific hand. In the Control treatment phase (n = 8), dogs were presented with one hand per trial in alternating sequence and were yoked to dogs in the Experimental group to receive the same number of rewarded and unrewarded trials (to control for possible frustration). Using a repeated measures mixed model with JBT repeated within dog, we found no difference in the change in approach latency to the ambiguous locations between the dogs across treatments. ‘Optimism’ as measured in this JBT was not altered by the additional discrimination trials used in our study.

Conventional versus daylight photodynamic therapy for recalcitrant hand warts: Efficacy, safety and recurrence

BackgroundAcral warts appear as skin-colored, verrucous, hyperkeratotic papules most located on the dorsal hands, distal fingers, subungual skin, and feet. Conventional photodynamic therapy (C-PDT) has shown a good efficacy and safety profile in patients with viral warts, in both adults and children, with a good cure rate and excellent cosmetic results in front of few and light side effects. The efficacy of daylight photodynamic therapy (DL-PDT) has not yet been evaluated. Objectivesto investigate and assess the short- and long-term efficacy of PDT using 10 % aminolevulinic acid (ALA) in the treatment of multiple verrucae vulgaris of the hands. The second endpoint was to compare the efficacy and safety of C-PDT versus DL-PDT. Materials and methods68 patients (38 males and 30 females) aged between 6 and 80 years, affected by hand warts, were divided into two arms: group A was treated with C-PDT, and group B was treated with DL-PDT. Patients underwent treatments three times at 1-month intervals. The response was assessed 3 months after the last session (W24) and 1 year after the last session (W52) and scored as excellent (75–100 % reduction of total wart count), partial (74−25 % reduction), and none (< 25 % reduction or no response). Any adverse events occurring during or after ALA application or irradiation as well as pain intensity were recorded at each visit. Results48 patients (70.6 %) achieved excellent response at W24, while 6 patients (8.8 %) had a partial response and 14 (20.6 %) were resistant to treatment. Patients treated with DL-PDT were less likely to have an excellent response (66.7 %) than patients treated with C-PDT (73.7 %), although not statistically significant. Among patients with excellent or partial response (n=54), 37 % (n=20) had warts relapse at W52. Both treatment modalities were well tolerated, with transient pain as the main side effects. ConclusionPDT is effective in the treatment of verrucae vulgaris of the hands. An overall response rate of 70.6 % of excellent response was achieved. While C-PDT showed a trend towards better outcomes, DL-PDT offered a more patient-friendly approach, particularly in terms of comfort and compliance.

The diagnostic value and clinical relevance of high frequency ultrasound and shear wave elastography in systemic sclerosis: an observational monocentric study

To unravel the features of skin involvement in patients with systemic sclerosis (SSc) by high frequency ultrasound (HFU) and shear wave elastography (SWE). To assess the ultrasound capabilities to distinguish SSc patients from healthy controls (HCs). We recruited a cohort of SSc patients in this cross-sectional study. HFU and SWE were used to quantify skin thickness and skin stiffness. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic capabilities of ultrasound in SSc. The correlation analysis was used to evaluate the clinical relevance of ultrasound measurements in SSc. 20 consecutive SSc patients and 20 age-, gender- and body mass index-matched HCs were included. The skin thickness and stiffness were significantly greater in SSc patients compared with HCs. Patients with high disease activity had higher skin thickness and stiffness compared with patients with low disease activity. The area under the ROC curve (AUC) of the dorsum of middle fingers assessed by HFU was 0.847 (95% CI, 0.761–0.933). The AUC of the forearms and dorsum of hands assessed by SWE were 0.909 (95% CI, 0.829–0.989) and 0.879 (95% CI, 0.807–0.951). Further, the combined HFU and SWE tests displayed the best diagnostic performance with an AUC of 0.980 (95% CI, 0.939–1.000). A significant positive correlation between the ultrasound measurements and the modified Rodnan skin score (mRSS) was observed. The application of ultrasound can assist with disease diagnosis, it is necessary to develop a standard operating protocol to help with future implementation of ultrasound in SSc.Key Points• The application of HFU and SWE can assist with SSc diagnosis.• The skin thickness and stiffness measured by HFU and SWE positively correlate with mRSS.• HFU and SWE enable quantitative measurement of skin thickness and stiffness of different skin sites.

A Comparative Study between Honey and Alcohol as Topical Skin Disinfectant

Abstract Background Skin antisepsis is essential in every healthcare environment. Alcohol/ chlorhexidine use might disrupt skin microbiota and lead to antibiotic resistance. Objective To evaluate the efficacy of honey on reduction of skin microbes, on apparently healthy skin, and to compare the results with those of topical application of 70% isopropyl alcohol. Subjects and Methods This study was carried out on 70 children aged 2 to 12 years. Males represented 54.2% of the sample. Patients were recruited from the pediatric outpatient clinic, Children’s Hospital, Ain Shams University, Egypt, during the period from July 2022 to February 2023. A swab was taken from the skin of the dorsum of both hands for culture of skin microbes. Types and number of organisms were documented. Separately, honey and alcohol were applied alternatively on the dorsum of right and left hands. A skin swab was taken for microbiological examination before and 20 seconds after application of honey and alcohol. Results mean age of enrolled children is 7.34 (in years). Both honey and alcohol made significant reduction in the number of organisms on the dorsum of the hand (p = &amp;lt;0.001), and this effect was comparable between honey and alcohol with no statistically significant difference (p = 0.874). Before honey application, the median number of organisms is 65 colony forming unit (CFU), while 10 (CFU) is the median number of orgamisms after honey application. Before alcohol application, the median number of organisms is 80 (CFU), while 10 (CFU) is the median number of organisms after alcohol application. Percentage of reduction of organisms on dorsum of the hand after honey application is 62.5%, while 65% after alcohol application (p = 0.370). Staph coagulase negative, staph aureus, E-coli are most three common organisms were detected by swab. Conclusion Honey showed to be as effective as alcohol in reduction of skin microbes. We recommend further studies involving following up the rate of infection after minor surgical procedures to confirm the findings of our study.