Fingers Of Left Hand Research Articles

Embraced: On hands and nerves

AbstractIn 2001, I experienced severe radial neuropathy, leading to permanent dysfunctions in the fingers of my left hand. In this personal account of nerve damage, medical and surgical treatment, and adaptation, I first describe the sequence of neuropathies, then turn to how through serendipity, the brace enabled other connections—nervelines—with individuals and places. The brace is a metonym of a severed nerve with its associated loss of movement and capacity; it is also both a functional orthotic and an affordance. It carries me forward, activating other nervelines and networks to make things happen. I write of literal and metaphoric nerves, evolving connectivities, and fiber lines, thought lines and collaborations. I then extend the idea of nervelines and networks to global connnections; I emphasize how the organization of labor, the distribution of goods and services, and the expectations of workers shape body histories and life outcomes.

The impact of fine motor activities like playing musical instruments on the thickness and strength of the flexor digitorum muscle

BackgroundThis study aimed to explore the impact of occupational activities involving extensive finger movement on the muscular characteristics of the forearms. In particular, the flexor digitorum (FD) muscular thickness and strength asymmetry between right and left hand were compared between musicians and non-musicians.MethodsUltrasonography was employed to measure the thickness of the FD in each hand, while a validated custom-made device was used to assess the strength of the flexor and extensor digitorum (ED). Initially, muscle differences were estimated by computing the asymmetry index between dominant and non-dominant hands. To assess potential occupational disparities, comparisons of the asymmetry index were conducted between 25 right-handed instrumental musicians and 25 right-handed non-musicians.ResultsMusicians exhibited lower asymmetry between dominant and non-dominant hands in both FD thickness and ED strength when compared to non-musicians. This effect was particularly pronounced in musicians playing instruments that extensively use the left-hand fingers (e.g., violinists).ConclusionsOccupational activities, such as playing a musical instrument, can alter forearm muscle mass and strength distribution between dominant and non-dominant hands. This underscores the importance of considering occupational parameters in clinical or experimental interventions and musculoskeletal assessments.

Enhancing Classification Accuracy with Integrated Contextual Gate Network: Deep Learning Approach for Functional Near-Infrared Spectroscopy Brain-Computer Interface Application.

Brain-computer interface (BCI) systems include signal acquisition, preprocessing, feature extraction, classification, and an application phase. In fNIRS-BCI systems, deep learning (DL) algorithms play a crucial role in enhancing accuracy. Unlike traditional machine learning (ML) classifiers, DL algorithms eliminate the need for manual feature extraction. DL neural networks automatically extract hidden patterns/features within a dataset to classify the data. In this study, a hand-gripping (closing and opening) two-class motor activity dataset from twenty healthy participants is acquired, and an integrated contextual gate network (ICGN) algorithm (proposed) is applied to that dataset to enhance the classification accuracy. The proposed algorithm extracts the features from the filtered data and generates the patterns based on the information from the previous cells within the network. Accordingly, classification is performed based on the similar generated patterns within the dataset. The accuracy of the proposed algorithm is compared with the long short-term memory (LSTM) and bidirectional long short-term memory (Bi-LSTM). The proposed ICGN algorithm yielded a classification accuracy of 91.23 ± 1.60%, which is significantly (p < 0.025) higher than the 84.89 ± 3.91 and 88.82 ± 1.96 achieved by LSTM and Bi-LSTM, respectively. An open access, three-class (right- and left-hand finger tapping and dominant foot tapping) dataset of 30 subjects is used to validate the proposed algorithm. The results show that ICGN can be efficiently used for the classification of two- and three-class problems in fNIRS-based BCI applications.

2D/4D Finger Length Ratio in the Screening of Developmental Dysplasia of the Hip.

To investigate whether there is a relationship between the 2nd finger and 4th finger length measurement ratios and developmental dysplasia of the Hip (DDH). Cross-sectional observational study. Place and Duration of the Study:Department of Orthopaedics and Traumatology, Meram Faculty of Medicine Hospital, Konya, Turkiye, from January 2020 to May 2023. Infants were screened for DDH with Graff method for the ultrasounds of both hips. Lengths of the 2nd and 4th fingers of both hands were measured and recorded. Patients with additional risk factors for developmental dysplasia of the hip (breech birth, family history, oligohydramnios, swaddling) were excluded. Two hundred and fifty-six babies were screened including 55.1% (n = 141) girls and 44.9% (n = 115) boys. Their mean age was 2.51 ± 0.80 months. The average lengths were 31.73 ± 3.05 mm, for the left 2nd finger and 34.26 ± 3.48 mm for the left 4th finger. In the hip USG measurements, the mean alpha angles were 62.91 ± 3.12° for the right hip and, 63.20 ± 3.55° for the left hip. Eighteen (7%) of babies who underwent hip ultrasound (USG) had unilateral or bilateral DDH. Among these cases, 2.7% (n = 7) had right, 2.3% (n = 6) had left, and 2% (n = 5) had bilateral DDH. There was no statistically significant correlation between the ratios of right 2/4 finger lengths and the right alpha angle (rs = 0.051; p = 0.421). There was a statistically positive and statistically significant correlation between the ratios of left 2/4 finger lengths and the left alpha angle (rs = 0.154; p = 0.013). Only the left-hand finger ratio among the parameters in the model had a statistically significant effect on DDH. Therefore, the left hand 2D/4D finger length may be of value in screening for DDH. Developmental dysplasia of the hip, Second to fourth finger digit ratio, Ring finger, Digit ratios.

P-57 A case of pituitary carcinoma treated with osilodrostat for severe Cushing's syndrome

Abstract Introduction Pituitary carcinoma is a rare disorder accounting for 0.1–0.2% of pituitary tumors. We present a case of a male subject with ACTH-secreting pituitary carcinoma with metastasis to the spine, achieving eucortisolism on osilodrostat treatment. Clinical Case A 31-year-old male presented with complaints of pain in the rear-left thigh, numbness in the left-hand fingers and shoulder. MRI revealed an invasive pituitary tumor which had spread to the left frontal and temporal lobes with infiltration of the dura mater and compression of the left part of the optic chiasm, multiple formations in the large hemispheres, hemispheres of the cerebellum, in the right internal auditory meatus and at the level of the C1 vertebra compatible with metastasis. Spinal MRI showed a mass at Th6, L1-S2 level compatible with metastasis (Fig.1). The patient was diagnosed with Cushing's disease (CD) at 23 (late-night serum cortisol 1450 nmol/L (64–327), late-night salivary cortisol (LNSC) 66.4 nmol/L (0.5–9.65), 24hUFC 608 nmol/L (100–379), ACTH 107.3 pg/mL (7.2–63.3)) and underwent transsphenoidal pituitary surgery for pituitary macroadenoma 26×18×29 mm with biochemical remission. Two years later his symptoms of CD relapsed and he had a second transsphenoidal surgery. Histological examination showed an atypical corticotroph tumor with Ki67 – 11.6%. Two months after surgery, Kiber knife surgery was performed. However, 2 years later he had gradual deterioration of vision due to loss of lateral margins. A third transcranial adenomectomy was performed with following panhypopituitarism and diabetes insipidus. The tumor was positively stained for ACTH and also contained some atypical features including nuclear pleomorphism. Postoperative chemotherapy adjuvant treatment with Temozolomide and Carboplatin was prescribed. After 6 cycles, proton radiotherapy was done. In order to control hypercortisolism the patient received ketoconazole 800 mg per day, cabergoline 1 mg twice weekly and pasireotide 1.8 mg per day. However, it was not possible to achieve remission of hypercortisolism. As an adverse event of pasireotide, diabetes mellitus developed, which required insulin therapy and finally lead to pasireotide cessation. Ketoconazole and cabergoline were discontinued and osilodrostat treatment was initiated with a final dose of 5 mg daily over 2 years. He also received another course of radiation therapy at the age of 31 years. Over the past 2 years of observation, his ACTH level ranged from 37 pg/mL to 325.1 pg/ml. In spite of tumor progression and raised ACTH, the patient remains in eucortisolism (late-night serum cortisol 163.3 nmol/L, LNSC 5.21 nmol/L, 24hUFC 70.14 nmol/L) on osilodrostat 10 mg daily. Conclusion In this case osilodrostat was effective at controlling hypercortisolism, but its effects on the tumor are unknown. As this patient is the first described case of corticotroph carcinoma tumor treated with Osilodrostat, the results should be taken with caution.Figure 1.Pituitary and spinal MRI of the patientT1-weighted MRI demonstrating (A) chiasmal-sellar region formation, (B) formation in the rigt internal auditory meatus, (C) a highly invasive sacral L1–S2 metastasis

Usefulness of computed tomography performed after forensic autopsy in the diagnosis of the battered child syndrome: a case report

Diagnostic imaging methods routinely used in clinical practice (mainly multi-slice computed tomography, CT) are increasingly entering forensic practice, also in Poland. Typically these exams are performed prior to an appropriate external examination and autopsy. The aim of the study is to present a case in which computed tomography examination performed only after forensic medical autopsy turned out to be useful in the diagnosis of an abused child syndrome. The CT examination showed, inter alia, nighstick injury/fracture of the ulna in its distal part, and deformation of the base of the phalanx of the distal finger of the fourth left hand, corresponding to a fracture/crush. Post-mortem imaging may be useful in the case of a suspected abused child syndrome.

Dynamic Suzuki frame for the interphalangeal joint fracture: A case report

Proximal interphalangeal (PIP) joint injuries are one of the common injuries of hand. Most common in motor vehicle accidents and sports injury. Various treatment modalities are available to treat such fractures like buddy strapping with or without extension block splint, CRPP, ORIF with interfragmentary screws, Schenck dynamic traction, Hynes and Giddings device and many other modalities. This is one of the challenging fractures as there is high incidence of stiffness, loss of function and deformity leading to disability following the treatment. The pins and rubber traction frame (Suzuki frame) system is one of the novel technique to reduce the disability.Case: 66 years old male with history of motor vehicle accident, presented with comminuted intra-articular fracture of base of middle phalanx (PIP joint) extending distally to DIP joint of the fourth finger of left hand. We used Suzuki frame for the treatment of the fracture.Suzuki frame technique is a simple, minimally invasive, soft tissue sparing, cost effective, dynamic external fixation technique, can be done at minimal resource setting, which allows early ROM at PIP and DIP joint, enabling good bone and joint remodeling and good function of the finger, leading to disability free hand with minimal complication rate.

ASSESSMENT OF THE PATTERN OF AGRICULTURAL ACCIDENTS IN A TRIBAL DISTRICT, RATLAM, CENTRAL INDIA

Objectives: The objectives of this study were as follows: (1) Study the various type of agricultural accident in selected district. (2) Study the various factors associated with agricultural accidents. Methods: An observational cross-sectional study conducted after getting ethical approval from ethical committee in villages of Ratlam District selected by stratified random sampling method for the duration of 1 year. Data collected using predesigned structured pro forma through selected villages using key informant approach. Study financially supported by Indian Council of Social Science Research (ICSSR). Discussion: Total 865 were victims of agricultural accidents in our study which include 22.20% (192) females and 77.80% (673) males. Most of the victims (46.24%) who met agricultural accident were from age of 30–45 years and about 6.47% (37 – males and 19 – females) victims were below age of 15 years. Mean age of victims was 32.98 and SD 12.415. Conclusion: Mean ages of victims were 32.98 and SD 12.415. Young workers recorded the highest rate of agricultural injury with 52 accidents per 1000 workers. Incidence of agricultural accidents found to be ≈ 26.11 per 1000 workers per year. Total 865 agricultural injuries were reported, of which 457 (52.83%) by hand tool (Sickle/Pick-axe/hand hoes). The overall accident’s incidence rate calculated was 3.66/1000/year. Sickle accidents were highest which constituted 400(46.24%). The right hand fingers (101) are most affected part followed by the left hand fingers (95).

No Differences Between Instrument-Independent Manual Dexterity and Finger Dexterity of Musicians and Nonmusicians

Dexterity is one of the abilities required for different types of work and is divided into manual and finger dexterity. The aim of this study was to examine whether there was a difference in manual and finger dexterity between musicians and nonmusicians, and between musicians divided by instrument groups and nonmusicians. The study included 128 participants (96 musicians, 32 nonmusicians). Musicians were divided into three groups as wind, string, and keyboard instrument players. The Minnesota Manual Dexterity Test (MMDT) for manual dexterity and Purdue Pegboard Test (PPT) for finger dexterity were used. Independent samples t-test and Mann-Whitney U test were used for MMDT, and the Mann-Whitney U test was used for PPT between musicians and nonmusicians. The Kruskal-Wallis H test and one-way ANOVA were used for comparisons of the MMDT and PPT between nonmusicians and musicians divided by instrument groups. There were no differences between musicians and nonmusicians in terms of MMDT and PPT (p>0.05). When musicians were divided by instrument groups, there was a statistically significant difference in only the left-hand subtest of PPT (p=0.038). In pairwise comparisons, significant differences were found between wind and string instrument players (p=0.036), keyboard and string players (p=0.012), and nonmusicians and string players (p=0.015). Wind and keyboard players and nonmusicians were more successful than string players in terms of left-hand finger dexterity. Future studies can be designed that investigate the effects of bilateral asymmetrical-symmetrical training on finger dexterity of the left hand and evaluate the performances of musicians in areas other than music.

The association between fingerprint patterns and blood groups in the Omani population

PurposeFingerprints and blood samples are important for the identification of individuals and criminals. The present study aims to identify the predominant fingerprint patterns and the association between the fingerprint patterns and ABO–Rh blood groups in Omani population.Design/methodology/approachA cross-sectional study was conducted on 200 Omani individuals aged 18 years (104 males and 96 females). The imprints of all right and left-hand fingers were taken, and the types of the fingerprints were determined using a standard protocol. The blood group of all the subjects was recorded. Chi-square test was performed to identify the association between the fingerprint patterns and the ABO and Rh blood groups.FindingsThe loop fingerprint pattern was the most common in Omani subjects (49.4%), followed by whorl (44.9%) and arch (5.7%) pattern. A significant association (p &lt; 0.001) was found between gender and fingerprint pattern. The loop was the highest occurring pattern in the females (54.6%), while the whorl was more in males (50.0%). The whorl pattern was the most common in the AB+ and O− groups. The loop was a predominant pattern in the A+, A−, B+, B− and O+ groups. The Chi-square test also revealed a significant correlation between different fingerprint patterns and blood groups of the subjects (p &lt; 0.001).Originality/valueThe present study is an outcome of undergraduate student's research project thesis for the Doctor of Medicine (MD) program. The results of the present study may help in creating a data bank for biometrics, which can be useful for diagnosing associated diseases and also help in identification of individuals.

Structural and functional state of various parts of skin microcirculation at an early stage of hypertension in working-age men.

To conduct a cross-sectional study on the structural and functional characteristics of various parts of skin microcirculation in working-age men with newly diagnosed hypertension (HTN). The study included 118 male participants (ages 30 to 60) who were not regularly taking any medicine, had no medical complaints, and subjectively considered themselves healthy at the time of study. All participants underwent a cross-sectional comprehensive medical examination. The following tests were performed: complete blood count, biochemical blood tests, video capillaroscopy (VCS), laser Doppler flowmetry (LDF) and photoplethysmography (PPG) on the left hand fingers, determination of flow-mediated vasodilation of the brachial artery, echocardiography, ultrasound of extracranial and femoral arteries, 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM data, the participants were divided into two equal groups called a control group(CG) and a hypertension group(HG). There were 59 participants with normal BP in CG, and 59 participants with newly diagnosed HTN in HG. Nailfold VCS of the ring finger revealed no significant differences between the groups at the level of exchange microvessels. According to LDF data, there was no decrease in tissue perfusion and signs of an increase in the activity of endothelial, neurogenic, and myogenic regulation of the tone of precapillary arterioles in the HTN group. According to PPG of the index finger, in contrast to CG, HTN participants had significantly higher values of the following parameters: normalized augmentation index (Alp75) - 3.8% and-5.25% (p<0.005), stiffness index (SI) - 7.6m/s and 7.35m/s (p<0.05), reflection index (RI) - 36.5% and 28.4% (p<0.005), respectively. Working-age men in the early stage of HTN have neither capillary rarefaction nor an increase in the tone of skin precapillary arterioles. The largest contribution to peripheral vascular resistance in the onset of HTN is most likely made by large muscular arterioles, in which the neurogenic regulation of vascular tone predominates.

1244: CAN ADMINISTRATION OF HIGH-DOSE HYDROXOCOBALAMIN IMPROVE OUTCOMES IN REFRACTORY SEPTIC SHOCK?

Introduction: Multiple high dose vasopressors are often required to sustain life in critically ill patients but are unfortunately associated with high mortality (>50%) and morbidity. This case discusses the potential benefit in adding high dose IV hydroxocobalamin (B12) therapy (5g) to potentially reduce the use of additional vasopressors and their impact on morbidity and mortality. Description: A 72-year-old immunocompromised man with history of multiple myeloma, refractory to multiple lines of therapy, prior CAR-T treatment with now stable disease was found down, covered in feces. He was admitted to the medical ICU for severe septic shock secondary to pseudomonas bacteremia. The patient progressed to Multiorgan failure requiring mechanical ventilation, broad spectrum antibiotics, and multiple vasopressors at maximum doses. Echocardiogram (echo) showed biventricular heart failure with ejection fraction (EF) reduced from 64% 4 months prior to 25%. The bronchoalveolar lavage sample grew Pseudomonas aeruginosa, and antibiotics were adjusted. He was requiring norepinephrine (NE) at 0.3 mcg/kg/min, vasopressin (vaso) at 0.04 units/min, epinephrine (epi) to 0.3 mcg/kg/min, angiotensin II (ATII) between 10-40 ng/kg/min, and dobutamine (dobut) as high as 12.5 mcg/kg/min for 47 hours before B12 administration. The patient remained hypotensive (MAP < 65 mmHg) with maximal vasopressors. The left hand become cold and discolored, his legs and abdomen became severely mottled. Due to lack of response to therapy a trial of 5g B12 was given. There was improvement in the patient’s blood pressure. NE and ATII were stopped within 24 hours, Epi and vaso stopped within 96 hours, and dobut was weaned gradually. He was extubated on day 12. EF improved to 60% with normal right ventricular function on day 14. The skin gradually returned to normal. The left-hand fingers appeared better perfused with only the tip remaining discolored. Discussion: Bacterial endotoxins released in sepsis induce nitric oxide synthase, activating cGMP, which causes subsequent smooth muscle inhibition and vasodilation. B12 scavenges nitric oxide decreasing vasodilation. Use of B12 as an adjuvant to traditional vasopressor therapy could help reduce morbidity and mortality in septic shock by reducing overall dose/duration of vasopressors.

Variasi Bowing Etudes Ou Caprices No. 2 Rodolphe Kreutzer Sebagai Strategi Pembentukan Teknik Tangan Kanan Pada Pemain Violin

Violin players are required to have balanced technical skills not only with the left hand (finger operation on the strings), but also the role of the right hand (playing the bow). Qualifications that emphasize exercises that focus on right-hand skills are in fact often under-appreciated. This research proposal presents a study-based violin learning strategy that emphasizes right hand skills through bowing variation treatment, which is applied to Rodolphe Kreutzer's Etudes Ou Caprices No. 2. The focus of this research is the music education study program, ISI Yogyakarta. This study uses a qualitative method with a musicological approach. The stages that were passed in this research were through the process of literature study, observation, interviews, and analysis. The results of this study are: the emergence of eight variations of bowing which was applied to Etudes Ou Caprices no.2 Rodolphe Kreutzer; the treatment applied is useful in improving the right hand technique and the differentiating specifications between each bowing technique; through continuous practice of bowing variation techniques can make students responsive in reading notation symbols, especially on the diversity of right-handed techniques; treatment of variations of bowing detache, staccato, spiccato, legato, and their variations can be easily applied to the repertoire/songs being studied to support interpretation.

Potential Maneuvers for Providing Optimal Tidal Volume Using the One-Handed EC Technique.

Bag-valve-mask is a device that manually provides positive oxygen pressure. The grip technique of the character E and C shape is recommended to carry out this effectively. However, when applying this method, the hand in which the direction of the EC technique should be performed and the degree of adhesion pressure while performing the technique are unknown. This study aims to identify the factors influencing tidal volume and to determine the ideal sealing method between mask and face in the one-handed EC technique to optimize the Vt. A simulation study was conducted using a mechanical lung model in a scenario that resembled respiratory arrest. Multiple regression analyses identified high peak pressure, high left spot adhesion strength of the mask, and low right spot and bottom spot adhesion strength of the mask as significant factors. To provide an optimal Vt, it may be necessary to apply more strength to the left area of the mask when forming the “C” shape with the thumb and index finger of left hand using the one-handed EC technique.

A Cross-Sectional Study on the Agreement of Perfusion Indexes Measured on Different Fingers by a Portable Pulse Oximeter in Healthy Adults.

BackgroundPulse oximeters measure oxygen saturation, heart rate, and perfusion index (PI) by analyzing photoplethysmographic signals. PI is an indirect measure of peripheral perfusion expressed as a percentage of pulsatile signals to non-pulsatile signals. PI measured from different sites may show variation. PI may vary when measured on different fingers. In this study, we aimed to observe the variation of PI among different fingers of both hands.MethodologyThis cross-sectional, observational study was conducted using a convenience sample recruited from a tertiary care hospital in eastern India. PI was measured in apparently healthy adults in a sitting posture after a five-minute rest. The pulse oximeter probe was attached to each finger and readings were taken after one minute. The analysis of variance and intraclass correlation coefficient (ICC) were calculated to compare and find agreement among PI.ResultsData from a total of 391 (229 [58.57%] male and 162 [41.43%] female) adult research participants with a mean age of 34.88 ± 10.65 years were analyzed. The PI was the highest on the middle finger in both hands. There was a significant difference among the PI measured on different fingers, F (9, 3900) = 15.49, p <0.0001. The ICC was 0.474, 0.368, and 0.635 for overall, right-hand, and left-hand fingers, respectively, which indicate poor (ICC < 0.5) to moderate (ICC = 0.5-0.75) levels of reliability.ConclusionsThe PI measured using consumer-grade pulse oximeters on different fingers may provide different readings. The highest PI reading is found on the middle finger. Clinicians and primary care physicians should consider the differences in measured PI among different fingers and should use the readings with caution for any diagnostic purposes.

Trigger wrist in adult. A case report.

Background: One of common disorders in hand is trigger finger, but trigger wrist is an uncommon condition. Eibel in 1961 reported the trigger wrist. This condition gets obvious with finger or wrist flexion and extension and painful clicking or triggering of finger around carpal tunnel and can be associated with neuropathy and space occupying lesion or any other underlying condition the Objective of treatment is to achieve complete cure with surgical treatment in terms of functional and aesthetic improvement. Case: A 35 years old right handed housewife, presented to us in OPD with 1 year history of triggering at left wrist level. She had history of pain; with off and on clicking during flexion/extension of index finger of left hand. Pain had been increasing over the last 6 months. She underwent standard trigger finger surgery and release of left index finger A1 pulley four month ago but symptom was still present. Pre-operative ultrasonography showed irregular hypo echo mass at wrist that caused adhesion and inflammation at this area. After detail discussion, written informed consent was obtained and she underwent surgical treatment with zigzag incision under axillary block. Median never and all flexor tendons were identified. We found mass over FDP of left index finger that was stuck in carpal tunnel and caused snapping and clicking of left index finger. The other tendons were normal. After resection of occupying lesion of left index finger FDP and carpal tunnel release, there was free gliding of tendons at wrist level. Histopathological evaluation of the lesion turned out as fibroma of tendon sheath without evidence of inflammation and malignancy. After the discharge, physiotherapy was advised and patient was followed-up on weekly basis for 1st month then 2 weekly for 6 months. After the surgical treatment, there was free gliding of tendons at wrist level, under carpal tunnel, with complete functional and aesthetic improvement. Conclusion: Trigger wrist is an uncommon condition caused by space occupying lesion or any other associated pathology. Surgery is the mainstay of treatment that provides complete resolution of symptoms with functional and aesthetic improvement.

Functional Instability of the Second to Fifth Metacarpophalangeal Joints.

Clinically, functional instability (FI) of metacarpophalangeal joints (MCPJ) is not considered to represent a pathology. This excessive mobility can be detected by the application of external forces to a MCPJ at different angles. Our study aimed to measure the FI of 2nd to 5th MCPJ. A group of 36 healthy right-handed individuals were enrolled. The value of FI was measured in millimeters and verified by a CT scan. Statistical calculations was made in Statistica v.10.0. The largest values of the right and left-hand finger posterior displacement (FI) in the second to fifth MCPJ were obtained in the neutral position 0° (p&lt;0.05). Measurements of volar displacement of the proximal phalanx second to fifth MCPJs in both hands revealed higher values at position 0° (p&lt;0.05). 1. FI of the second to fifth MCPJs is determined by anatomical configuration and dynamic stabilizers. 2. Instability measurements show that posterior displacement of the proximal phalanges is greater by at least 1 mm in the 0° neutral position.

Dual Origin of Left Vertebral Artery- A Case Report of an Uncommon Vascular Variant

Vertebral artery duplication is relatively an uncommon vascular variant. It is a developmental anomaly with a dual origin and has different levels of fusion in the neck. It is usually an incidental finding found during workup of other clinical conditions. Due to its anatomical similarity with arterial dissection it is often misinterpreted on vascular imaging so a thorough understanding of this vascular variant is necessary to avoid diagnostic and therapeutic complications during endovascular interventions. A 43-year-old male presented with complaints of pain and discolouration of fingers of left hand since 2 days. Computed Tomography (CT) angiography of upper limb was done which revealed short segment near complete to complete occlusion/thrombosis of proximal left subclavian artery which was seen 8 mm from its origin with distal reformation by the collaterals. There was an evidence of hypoplastic V1 segment of native left vertebral artery, a small artery was seen arising from the aortic arch in the middle of common carotid and left subclavian artery origins, which was found to be duplicated vertebral artery with dual origin from both the subclavian artery and aorta with fusion of both the limbs at C4-C5 levels.

Effect of MRgFUS treatment on cortical activity in Parkinson's disease: a fNIRS study

n this paper, a new combined approach, based on Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) technique and functional Near Infrared Spectroscopy (fNIRS), was applied for treatment and monitoring of patients affected by bilateral Parkinson’s disease (PD). On one side, MRgFUS enables non-invasive thalamotomy by combining FUS for tissue ablation and MR for targeting and monitoring. On the other side, fNIRS allows to monitor, non-invasively and without strict motion restriction even in a daily life environment, cortical neural activity related dynamics of both oxygenated and deoxygenated haemoglobin (HbO and HbR, respectively). In particular, the changes of cortical activation pattern in PD patients, with respect to age matched healthy control subjects, were analysed, while performing left and right hand finger tapping (LFT and RFT, respectively), before MRgFUS treatment, and at two different time intervals after the treatment. By comparison with the pre-treatment session, significant activations were predominantly observed one week after the treatment, with patterns recalling those of control group, and partially lost one month later, likely because of the neurodegenerative nature of PD. In addition, activations were more marked for LFT task, being the treatment performed on the right hemisphere. These results appear promising in view of the application of fNIRS for neurorehabilitation, especially in those clinical settings where traditional neuroimaging techniques cannot be applied.

Validation of Spectral Indices of Electrodermal Activity with a Wearable Device.

Electrodermal activity (EDA) has been found to be a highly sensitive, accurate and non-invasive measure of the sympathetic nervous system's activity and has been used to extract biomarkers of various pathophysiological conditions including stress, fatigue, epilepsy, and chronic pain. Recently, various robust signal processing techniques have been developed to obtain more reliable and accurate indices that capture the meaningful characteristics of the EDA using data collected from laboratory-scale devices. However, EDA also has the potential to monitor such physiological conditions in active ambulatory settings, for which the developed tools must be deployed in wearable devices. In this paper, we studied the feasibility of obtaining the highly-sensitive spectral indices of EDA using a wearable device. EDA signals were collected from left hand fingers using a wearable device and a laboratory-scale reference device, while N=18 subjects underwent the Head up Tilt test and the Stroop test to stimulate orthostatic and cognitive stress, respectively. We computed two time-domain indices, the skin conductance level (SCL) and nonspecific skin conductance responses (NS.SCRs), and two spectral indices, the normalized sympathetic components of the EDA (EDASympn), and the time-varying EDA index of sympathetic control (TVSymp). The results showed similar performances for EDASympn and TVSymp indices across both devices. While spectral indices obtained from both devices performed similarly in response to orthostatic and cognitive stress, time-domain exhibited large variation when obtained by the wearable device. Further research is required to develop and refine such devices, as well as the indices used to analyze EDA results.Clinical Relevance- This study proves the feasibility of obtaining spectral indices of EDA using a wearable device, which can be used to develop wearable tools to detect pain, stress, fatigue, between others.