Left Palm Research Articles

Bullous Drug Eruption.

A 63-year-old woman presented at our emergency department with a disseminated dermatosis that developed after undergoing a cardiac catheterization procedure. Her past medical history included an end-stage renal disease undergoing hemodialysis. Clinical examination revealed erosions and hemorrhagic crusts located on her lips and along the arteriovenous fistula. Additionally, we observed five hyperpigmented macules on her left hand's dorsum and palm and multiple hypopigmented macules in the genital area. Upon medical record review, we discovered the occurrence of prior bullous eruptions following contrast administration. A fixed drug eruption (FDE) due to radiocontrast was diagnosed based on clinical history, clinical examination, eruption timeframe, and positive drug provocation test. Intravenous contrast media reactions can be immediate or delayed, with delayed hypersensitivity reactions (DHR) occurring one hour to seven days post-administration. DHRs often present as maculopapular rashes. FDEs are rare. Skin tests are used to identify culprit agents. Ideally, intradermal tests, with delayed readings, and patch tests are combined for optimal sensitivity. Despite lacking standardized protocols, premedication with corticosteroids may mitigate reaction severity.

A Case Report on Dyschromatosis Universalis Hereditaria with Palmar Involvement

Dyschromatosis universalis hereditaria (DUH) is a rare genetic disorder characterized by hyper- and hypopigmented macules forming a reticulate pattern on the skin. This report presents an unusual case of a 14-year-old male patient with DUH involving the palms, a relatively uncommon manifestation of the condition. The patient presented with hyperpigmented lesions on the palms, which had developed over the previous eight years. Family history revealed similar pigmentary changes, suggesting a hereditary pattern. Clinical examination revealed no history of chemical or drug exposure, photosensitivity, or photophobia. Systemic evaluation was unremarkable, except for a low cortisol level of 1.12 mcg/dl (normal range: 6.2 to 19.4 mcg/dl) on the ACTH stimulation test. Skin biopsy from the left palm revealed diffuse hypermelanosis confined to the basal cell layer and occasionally extending to the lower third of the epidermis. Additionally, increased collagenization was observed in the deep dermis. Based on these findings, a diagnosis of DUH was established. The patient was initiated on long-term hydrocortisone therapy for cortisol hormone replacement. This case highlights the rare occurrence of palmar involvement in DUH and underscores the importance of thorough clinical evaluation and histopathological examination in establishing an accurate diagnosis. DUH is an uncommon genodermatosis, and reports of palmar involvement are scarce in the literature. This case contributes to the existing knowledge about the varied clinical presentations of DUH and emphasizes the need for increased awareness among clinicians

An interactive gesture control system for collaborative manipulator based on Leap Motion Controller

Gesture control is often used for the control of robotic manipulators. However conventional methods always focus on position control of robotic manipulators and use a fixed position to place gesture detection devices, which limits the flexibility to control and interact. This paper presents an interactive gesture control system based on Leap Motion Controller that can overcome these shortcomings. A coordinate transformation is performed between the position of the left palm detected by Leap Motion Controller and the tool center point (TCP) of the collaborative manipulator to obtain gesture data first. This gesture data is used to control the posture of a six-joint collaborative manipulator-Lite6. The position of gripper is controlled by grip level of the right palm. A controller is designed to manipulate a lift table on which Leap Motion Controller is placed to achieve adaptive ascending and descending movements to meet the needs of operators of different heights and arm spans. A modified Kalman filter is used to filter noise and smooth the signal captured by Leap Motion Controller. The experiments demonstrate that the system can operate stably and accurately control the position, posture, and gripper position of a collaborative manipulator in real time using human palms’ gestures.

The role of phenotypic factors in predicting the effectiveness of chemoprophylaxis in children

Background. The purpose was to study the prognostic role of some phenotypic factors in the effectiveness of tuberculosis chemoprophylaxis in children at present stage. Materials and methods. To study the role of phenotypic factors in predic­ting the effectiveness of tuberculosis chemoprophylaxis, an analysis was performed of dermatoglyphic indicators, gender, and the inactivation phenotype of isonicotinic acid hydrazide (IAH) in 76 children with tuberculin skin test conversion who underwent a 3-month course of preventive therapy with isoniazid. Dermatoglyphics of fingers and palms was determined according to the standard method [5]. The dynamics of skin sensitivity to tuberculin PPD-L according to the Mantoux test with 2 tuberculin units was used as a criterion for the effectiveness of chemoprophylaxis. According to the latter, the examinees were divided into two groups: the first one consisted of 52 children in whom the size of a wheal decreased by 4 mm or more after the end of a course (effective chemoprevention); the second one included 24 patients in whom skin sensitivity to tuberculin increased or remained at the previous level or decreased by a wheal size for 3 mm or less (ineffective chemoprevention). Results. The conducted statistical analysis revealed a significant difference in 7 indicators between the groups (p < 0.05). Determination of their prognostic informativeness made it possible to rank the prognostic significance of phenotypic signs, namely: the size of the atd angle on the left palm (J = 1.7), the number of ulnar loops on the right hand (J = 1.4), the type of IAH inactivation (J = 1.3), the number of whorls on the right hand (J = 1.2), the total number of whorls (J = 1.1), the atd angle on the right palm (J = 0.7), the number of whorls on the left hand (J = 0.5). The correlation analysis between the dermatoglyphic indicators and the type of IAH inactivation showed that there are reliable connections between them (p < 0.05), but their number differs significantly in groups. In patients with ineffective chemoprophylaxis, the number of correlations (n = 13) exceeded that of the alternative group (n = 2) by more than 6 times, which indicates significant structural phenotypic differences. Conclusions. There were significant correlations between the type of IAH inactivation and dermatoglyphic indicators, but the number of such connections was 6 times higher in children with ineffective chemoprophylaxis than in the alternative group. This indicates that a more pronounced integration of dermatoglyphic genes and the ability to neutralize IAH is a favorable moment in general, but negative in relation to the effectiveness of tuberculosis prevention.

Research on the electromyography-based pattern recognition for inter-limb coordination in human crawling motion.

Aiming to provide a feasible crawling motion analysis method for clinical application, this study introduced electromyography (EMG)-based motion intention recognition technology into the pattern recognition of inter-limb coordination during human crawling for the first time. Eight inter-limb coordination modes (ILCMs) were defined. Ten adult participants were recruited, and each participant performed hands-knees crawling at low, medium, and fast speeds in self-selected ILCMs and the eight predefined ILCMs, respectively. EMG signals for pattern recognition were collected from 30 limbs and trunk muscles, and pressure signals for crawling cycle segmentation were collected from the left palm. The pattern recognition experiments were conducted in participant-specific, multi-participant, and participant-independent ways, respectively, adopting three different classifiers, including bidirectional long short-term memory (BiLSTM) network, support vector machine (SVM), and k-nearest neighbor (KNN). The experimental results show that EMG-based pattern recognition schemes could classify the eight ILCMs with high recognition rates, thereby confirming the feasibility of providing an EMG-based crawling motion analysis method for clinical doctors. Furthermore, based on the classification results of self-selected ILCMs at different speeds and the statistical results of stance duration, swing duration, and the duty factors of stance phase, the possible reasons why humans chose various ILCMs at different crawling speeds were discussed. The research results have potential application value for evaluating crawling function, understanding abnormal crawling control mechanisms, and designing rehabilitation robots.

Haptic warnings for a motorcycle jacket and gloves

The risk of being killed on the road is much higher for riders than for car drivers. Nevertheless, the number of devices or technologies available to assist riders in avoiding risks and road accidents—or the number of Advanced Rider Assistant Systems (ARAS)—is still scarce. In this article, we present and discuss the development and application of two ARAS technologies using haptic interaction to assist riders on the road and increase their safety: an Haptic GPS Glove and a Warning Jacket. To determine the best locations for conveying haptic warnings in these wearables, we conducted a psychophysics experiment in a motorcycle simulator. We employed an up/down staircase method and measured the absolute detection thresholds in six locations in the hand/gloves (right and left palm, back and wrist) and six locations in the jacket (right and left forearms front and back, and shoulder blades). This experiment was conducted on a motorcycle simulator that mimics the vibrations produced by a motorcyclewhile it is running at different levels of intensity. Tests on all locations were run over three conditions: (1) baseline condition, with participants seated at a table with no background vibration; and two conditions with participants seated at the simulator experiencing two levels of background vibration of (2) minimum vibration intensity, and (3) maximum vibration intensity. Overall, our results show that, in the simulator conditions, subjects were better at detecting vibrations applied to locations covered by the jacket as compared to the areas covered by hands/gloves. Specifically, the forearms and shoulder blades emerged as the most effective locations for transmitting haptic warnings to motorcyclists. For the motorcycle gloves, the back of the hand proved to be the optimal location for conveying tactile warnings. We conclude by discussing the applicability of our results in designing future ARAS.

Primary, Nonmidline, Extragonadal, Immature Teratoma of the Palm with Axillary Nodal Metastasis: A Rare Case Report and Review of Literature

AbstractPrimary, nonmidline, extragonadal germ cell tumors are rare. Numerous hypotheses have been proposed regarding their origin. There is lack of consensus regarding their appropriate management. We report a case of an immature teratoma arising of the left palm. A 36-year-old lady presented with a recurrent left palm swelling. Histopathological features with immunohistochemical evaluation were characteristic of an immature teratoma. Alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) were elevated. She received preoperative chemotherapy with bleomycin, etoposide, cisplatin (BEP) followed by wide excision of the palm lesion and reconstruction with free latissimus dorsi flap. Postoperatively, two more cycles of BEP were given. Eight months later, she presented with large left axillary mass which showed metastatic deposits of immature teratoma on trucut biopsy. AFP and LDH were mildly elevated. On staging fluorodeoxyglucose-positron emission tomography (FDG-PET), there were no distant metastases. She received two cycles of vinblastine, ifosfamide, and cisplatin (VeIP). Postchemotherapy FDG-PET showed good metabolic response; however, the mass remained morphologically stable. Complete resection of the axillary mass was achieved with resection of a segment of axillary vein and end-to-end reanastomosis. At 12 months of follow-up the patient is disease free. This is the first report of axillary metastases in immature teratoma of the upper extremity. Axilla is a possible site of lymph node metastases in extremity teratoma. Primary extragonadal germ cell tumor should be managed with complete surgical resection and chemotherapy.

Speech-derived haptic stimulation enhances speech recognition in a multi-talker background

Speech understanding, while effortless in quiet conditions, is challenging in noisy environments. Previous studies have revealed that a feasible approach to supplement speech-in-noise (SiN) perception consists in presenting speech-derived signals as haptic input. In the current study, we investigated whether the presentation of a vibrotactile signal derived from the speech temporal envelope can improve SiN intelligibility in a multi-talker background for untrained, normal-hearing listeners. We also determined if vibrotactile sensitivity, evaluated using vibrotactile detection thresholds, modulates the extent of audio-tactile SiN improvement. In practice, we measured participants’ speech recognition in a multi-talker noise without (audio-only) and with (audio-tactile) concurrent vibrotactile stimulation delivered in three schemes: to the left or right palm, or to both. Averaged across the three stimulation delivery schemes, the vibrotactile stimulation led to a significant improvement of 0.41 dB in SiN recognition when compared to the audio-only condition. Notably, there were no significant differences observed between the improvements in these delivery schemes. In addition, audio-tactile SiN benefit was significantly predicted by participants’ vibrotactile threshold levels and unimodal (audio-only) SiN performance. The extent of the improvement afforded by speech-envelope-derived vibrotactile stimulation was in line with previously uncovered vibrotactile enhancements of SiN perception in untrained listeners with no known hearing impairment. Overall, these results highlight the potential of concurrent vibrotactile stimulation to improve SiN recognition, especially in individuals with poor SiN perception abilities, and tentatively more so with increasing tactile sensitivity. Moreover, they lend support to the multimodal accounts of speech perception and research on tactile speech aid devices.

Unilateral clustered papules on the palm

abstractA 34‐year‐old Chinese man had been experiencing asymptomatic, pinpoint‐sized, skin‐colored, umbilicated papules distributed throughout his left palm for more than 10 years. Physical examination showed multiple, discrete, flesh‐colored, flat‐topped shiny papules, some of which were umbilicated like molluscum, dispersed across the left palm (Figure 1A), measuring about 1‐2 mm in diameter (Figure 1B). The patient's family history was unremarkable, and he had no remarkable medical antecedents. A skin biopsy was done (Figures 2A and B)This article is protected by copyright. All rights reserved.

Real-Time Hand Gesture Recognition Using YOLO and (Darknet-19) Convolution Neural Networks

There are at least three hundred and fifty million people in the world that cannot hear or speak. These are what are called deaf and dumb. Often this segment of society is partially isolated from the rest of society due to the difficulty of dealing, communicating and understanding between this segment and the rest of the healthy society. As a result of this problem, a number of solutions have been proposed that attempt to bridge this gap between this segment and the rest of society. The main reason for this is to simplify the understanding of sign language. The basic idea is building program to recognize the hand movement of the interlocutor and convert it from images to symbols or letters found in the dictionary of the deaf and dumb. This process itself follows mainly the applications of artificial intelligence, where it is important to distinguish, identify, and extract the palm of the hand from the regular images received by the camera device, and then convert this image of the movement of the paws or hands into understandable symbols. In this paper, the method of image processing and artificial intelligence, represented by the use of artificial neural networks after synthesizing the problem under research was used. Scanning the image to determine the areas of the right and left palm. Non-traditional methods that use artificial intelligence like Convolutional Neural Networks are used to fulfill this part. YOLO V-2 specifically was used in the current research with excellent results. Part Two: Building a pictorial dictionary of the letters used in teaching the deaf and dumb, after generating the image database for the dictionary, neural network Dark NET-19 were used to identify (classification) the images of characters extracted from the first part of the program. The results obtained from the research show that the use of neural networks, especially convolution neural networks, is very suitable in terms of accuracy, speed of performance, and generality in processing the previously unused input data. Many of the limitations associated with using such a program without specifying specific shapes (general shape) and templates, hand shape, hand speed, hand color and other physical expressions and without using any other physical aids were overcome through the optimal use of artificial convolution neural networks.

Multiple nodules with a linear distribution on the palm and wrist.

A 33-year-old woman presented with a 15-year history of multiple asymptomatic subcutaneous nodules on the left palm and wrist, which had slowly enlarged and increased in number. Physical examination showed scattered, nontender, smooth flesh-coloured nodules on the left palm and wrist in a linear distribution.

Effect of reflexology at pancreatic area of palms on blood glucose levels in patients with type 2 diabetes mellitus: A randomized controlled study

IntroductionDiabetes mellitus is one of the most prevalent metabolic diseases. Reflexology is a form of treatment which involves giving massage or pressure to the particular points of the feet and hands. This study was performed to find the effect of reflexology at pancreatic area of palms (RPP) on random blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Materials and methodsThis study was done at Government Yoga and Naturopathy Medical College, Chennai, India. A total of 100 participants with T2DM were randomly allocated to reflexology group (RG) (n = 50) and control group (CG) (n = 50). RG underwent only one session of RPP for the duration of 20-min (10-min to right palm followed by 10-min to left palm), while the CG was on rest in sitting posture for the duration of 20-min. Random blood glucose levels (RBG) were assessed before and after the intervention. ResultsInter group analysis showed a significant reduction in RBG levels in the RG (z = 4.606; p < 0.001; Effect size: d = 0.243), unlike CG (t = 0.668; p = 0.507; Effect size: d = 0.023). However, between-groups analyses did not show a significant difference in RBG levels between the groups (z = 1.406, p = 0.160; Effect size: d = 0.307). None of the participants reported any adverse events during or after the study. ConclusionRG reduces RBG levels with a small effect size compared to CG. Thus, twenty minutes of RPP might have some effect in reducing blood glucose levels in patients with T2DM. However, further studies are required to warrant the results of this study.

66 Central Palmar Necrosis Following Steroid Injections for the Treatment of Carpal Tunnel Syndrome - a Case Report

Abstract Aim Steroid injections are commonly used as a diagnostic tool or an alternative to surgical management of carpal tunnel syndrome (CTS) and are generally safe. Ischaemia is a rare complication with very few cases reported in the literature. Method We report a case of a 50-year-old female that presented with a necrotic wound to her left palm one month after a steroid injection into the carpal tunnel. She had a 2-year history of CTS in her left hand that was treated with six previous steroid injections in primary care during this period. The wound evolved from a blister to a necrotic ulcer which led to a painful, hollow defect in the centre of her palm. She did not report any history of trauma, nor did she have any co-morbidities. Clinical photographs were taken. Results On examination she had a 0.5cmx1cm defect in the palm of her left hand down to aponeurosis. There was purulent discharge in the wound with surrounding erythema but no spreading cellulitis. She had full function of her fingers but was very tender on movements and at rest. She was admitted for intravenous antibiotics and underwent a debridement, washout and carpal tunnel release the next day. The defect was packed to heal by secondary intention and has now fully healed one-month following her operation. Conclusions This is an extremely rare complication of steroid injections to the carpal tunnel and may have been avoided by earlier referral for surgery rather than treatment using multiple steroid injections.

Schwannoma of the hand

A 67-year-old lady presented with a slowly enlarging soft tissue mass on her left palm, at 4th metacarpal bone level (Figure 1).

Moonlight Rests On My Left Palm, written by Yu Xiuhua

Moonlight Rests On My Left Palm, written by Yu Xiuhua

Stature Estimation among Iraqis based on Anthropometrics of the Hands using Multivariable Regression

Background: Estimating stature is of exceptional value in personal identification and the forensic sciences. At the same time, the literature lacks standardized methods for height estimation. Objectives: To estimate the stature of Iraqi individuals based on the morphometric parameters of both hands. Methods: 101 students recruited from Al-Rafidain University College collected data concerning ethnicity, gender, weight, and height and measured fourteen morphometric parameters for each hand, including the hand length (RHL; LHL), palm length (RPL; LPL), hand breadth (RHB; LHB), maximum handbreadth (RHB; LHB), and the length of each finger (RD1,2,3,4,5; LD1,2,3,4,5). A multivariable linear regression is used to predict stature based on the former variables. Results: The sample included males (48.5%) and females (51.5%) aged 18–23 years of Arabic (95%) and Kurdish (5%) ethnicity. The average weight (65.68±1.32) and height (169.52±1.13) were calculated. Regression analysis (accuracy=74.8%, p&lt;0.001) and the male cohort (65%, p&lt;0.001) possessed higher statistical accuracy than females (47.2%, p&lt;0.001). Stature estimation within the total sample and males assumed similarities concerning parameters allocated to both hands that principally included the length of the right hand, right middle finger, left palm, and left little finger. In contrast, females' stature estimation corresponded to morphometric parameters strictly related to the left hand, including the length of the hand, palm, ring finger, and little finger. The results also aligned with the neural network analyses and qualitative data from ChatGPT version 3.5. Conclusion: Multivariable predictive models that are crucial in personal identification for forensic purposes were predicted, such as catastrophic scenarios due to disfiguring accidents, organized crime, and mass graves that frequently occurred in Iraq during the past two decades. Our results could also interest reconstructive hand surgery experts.

Pseudoaneurysm of Ulnar Artery – A Case Report

Digital artery pseudoaneurysms are rare lesions that usually result from a blunt or penetrating injury. The thrombus that can develop within the pseudoaneurysm can be a potential source for embolisation, putting the distal tissue at risk for ischemia/necrosis. So it is important to identify these lesions at the earliest and repair surgically. Here we present a case of 39 year old male, who presented to our hospital with a pulsatile, painful swelling on left palm. There was no history of any trauma in this case, but the ulnar vessel was in close proximity to the hook of hamate bone (carpal bone), which was found to be the precipitating factor. It was diagnosed as a case of pseudoaneurysm of distal ulnar artery and segmental resection was done with end to end anastomosis of ulnar artery. Post anastomotic vascularity of the digits was reassured.

Ayurvedic Treatment of Vipadika (Kshudra Kushtha) - A Case Study

Vipadika or Vaipadika is explained as one among Eleven Kshudra Kushtas (Minor skin ailments) which has the features of Paani-paada sputana (Cracking of palms and soles) associated with Teevravedana (Intense pain) as explained by Acharya Charaka. Based on the features the major dosha (Bio-forces of human body) involved is Vata along with Pitta and Kapha. Acharya Sushruta also explains it under Kshudra Kushta (Minor skin ailments) but with a different name called Padadaari. Though Vipadika sounds like a milder disease still it can be physically and emotionally stressful to the sufferer as in this present case. This is a case report of a 34 yrs female suffering with severe pain, itching and blackish discoloration of skin at both soles and left palm from the past 10 years. Due to various medications and chronic pain, patient was mentally sick too. The case was treated with Shodana (Bio purification) followed by shamana (Pacification) line of treatment along with significant lifestyle modifications. The uniqueness of the study lies in the selection of Shodhana (Bio purification) where instead of Basti, Virechana is opted. Though it is a chronic case, the patient was able to get relieved within a month which created a promising faith towards Ayurvedic treatment.

“Wood-Bark Sign” in Dermoscopy of Aquagenic Syringeal Acrokeratoderma

“Wood-Bark Sign” in Dermoscopy of Aquagenic Syringeal Acrokeratoderma

Analysis of Inheritance patterns, gender dimorphism and their correlation in lip and palm prints - A cross-sectional study.

Forensic sciences deal with key areas to be included in judicial makeup that has been approved by both the court and the scientific community, which distinguishes truth from counterfeit. Lip and palmprints are one of a kind and do not change during the lifetime of a person unless any pathologies. To evaluate the heritability, and gender dimorphism of lip and palm prints among parents and their offspring. A total of 280 participants were included in the study. Lip and palm prints were collected from participants using a digital camera. The photographic data obtained is subjected to Adobe Photoshop and analysed for inheritance. Gender dimorphism is evaluated by the predominant lip pattern and palm ridge count in four designated areas. A positive resemblance of 28.4% was found between parents and offspring in lips, and for the right palm, it was 60.2% and 55.12% for the left palm (principal lines) which are statistically insignificant. In all six quadrants, the most predominant lip pattern found in males is type 5, and in females, type 11. The mean palm ridge density was significantly higher among females than males in all designated areas. The digital method of analysing lip and palm print images with Adobe Photoshop 7 software is a convenient method that allows for better visualisation and easier lip and palm print recording and identification. Considerable inheritance patterns and gender dimorphism were observed that aid in personal identification.