Left Wrist Research Articles

Brachial plexus tuberculosis: A unique neurological variant of a common clinical disease

Isolated primary tuberculous involvement of the brachial plexus has not been reported in the past. Here, we report the case of a 29-year-old male who developed neck pain and radiculopathy for 3 months. Weakness in the left shoulder-elbow (2/5 MRC grade) and wrist (4/5 MRC grade) was present with numbness to pain and temperature along the C4–C5 dermatome. Magnetic resonance imaging (MRI) revealed a T2 hyperintense heterogeneously contrast-enhancing lesion involving the upper trunk of the brachial plexus. Under suspicion of malignancy, surgical exploration was undertaken. Intraoperatively, pus was noticed with unhealthy granulation tissue extending along the left-sided C4–5 lamina and transverse process. The frozen section suggested granulomatous infection and histopathology confirmed tuberculosis (TB). After 18 months of antituberculous treatment, the patient gradually recovered complete strength in the left upper limb. Follow-up brachial plexus MRI showed near-complete resolution of the lesion. We describe a unique case of a young patient clinically suggestive of the rapid progressive lesion (mimicking malignancy) affecting brachial plexus, turning out as TB on histopathology.

The Utility of a Novel Proximal Femur Maturity Index for Staging Skeletal Growth in Patients with Idiopathic Scoliosis.

For growing patients, it is ideal to have a growth plate visible in routine radiographs for skeletal maturity assessment without additional radiation. The proximal femoral epiphyseal ossification is in proximity to the spine; however, whether it can be used for assessing a patient's growth status remains unknown. Two hundred and twenty sets of radiographs of the spine and the left hand and wrist of patients with idiopathic scoliosis were assessed for skeletal maturity and reliability testing. Risser staging, Sanders staging (SS), distal radius and ulna (DRU) classification, the proximal humeral ossification system (PHOS), and the novel proximal femur maturity index (PFMI) were used. The PFMI was newly developed on the basis of the radiographic appearances of the femoral head, greater trochanter, and triradiate cartilage. It consists of 7 grades (0 to 6) associated with increasing skeletal maturity. The PFMI was evaluated through its relationship with pubertal growth (i.e., the rate of changes of standing and sitting body height [BH] and arm span [AS]) and with established skeletal maturity indices. Longitudinal growth data and 780 corresponding spine radiographs were assessed to detect peak growth using receiver operating characteristic (ROC) curve analysis. The PFMI was found to be correlated with chronological age (τ b = 0.522), growth rates based on standing BH (τ b = -0.303), and AS (τ b = -0.266) (p < 0.001 for all). The largest growth rate occurred at PFMI grade 3, with mean standing BH growth rates (and standard deviations) of 0.79 ± 0.44 cm/month for girls and 1.06 ± 0.67 cm/mo for boys. Growth rates of 0.12 ± 0.23 cm/mo (girls) and 0 ± 0 cm/mo (boys) occurred at PFMI grade 6, indicating growth cessation. Strong correlations were found between PFMI gradings and Risser staging (τ b = 0.743 and 0.774 for girls and boys), Sanders staging (τ b = 0.722 and 0.736, respectively), and radius (τ b = 0.792 and 0.820) and ulnar gradings (τ b = 0.777 and 0.821), and moderate correlations were found with PHOS stages (τ b = 0.613 and 0.675) (p < 0.001 for all). PFMI gradings corresponded to as young as SS1, R4, U1, and PHOS stage 1. Fair to excellent interrater and intrarater reliabilities were observed. PFMI grade 3 was most prevalent and predictive for peak growth based on ROC results. The PFMI demonstrated clear pubertal growth phases with satisfactory reliability. Grade 3 indicates peak growth and grade 6 indicates growth cessation. The use of PFMI can benefit patients by avoiding additional radiation in skeletal maturity assessment and can impact current clinical protocol of patient visits. PFMI gradings had strong correlations with SS, DRU gradings, and Risser staging, and they cross-referenced to their established grades at peak growth and growth cessation. PFMI may aid in clinical decision making.

Correlations between body postures and musculoskeletal pain in guitar players.

BackgroundThe guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players’ report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported.Purpose(a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing.MethodsTwenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing.ResultsWe found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist.ConclusionOur results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders.

NIRS Measurement on Visual Reaction Tasks for Analysis of Esports

Cerebrum activation during a hand movement task and a visual stimulus task were investigated with a NIRS to address esport player’s skill. In this paper, results focused on prefrontal cortex are reported. In the hand movement task, a participant was asked to move one’s right and left wrists. Four experimental conditions were set: only right wrist, only left wrist, both wrists simultaneously with a mirror arrangement, and both wrists simultaneously with a parallel arrangement. In the visual stimulus task, a participant was asked to watch moving visual stimuli and imagine response to the stimuli without actual response motions. As the results, activation and deactivation concerning prefrontal cortex were inferred at some channels of a NIRS.

Sonnet # 3, and: Sonnet # 5, and: Sonnet # 7, and: Flight to Portland

Sonnet # 3, and: Sonnet # 5, and: Sonnet # 7, and: Flight to Portland Jalen Eutsey (bio) Sonnet # 3 In the dream of the life you did or didnot live, disease spins eddies in the bloodof your kin and bullets do what they willin the dark. Yet the repast still smellsof fried catfish and ham hocks—someone mustmake a run for more hot sauce. In the dreamthat is memoir, you died before a kingtide swept through the city and reshaped coast-line and inland escape without bias,before anyone could solve the brutalmystery of blue—you never gave MaggieNelson the time of day. What about gray—the brain’s subtle decay, another coastleft lifeless, left longing in rank silence. [End Page 42] Sonnet # 5 The story always starts with slaves,a sucked-up swamp, some ill-placed railway,and generations worth of loot overstuffedinto bags & bull-knotted aroundthe ankles of the not yet dead. Later,the capital starts to play its bloodymelody. Song of Solomon, your choicebook in the good word. There was a poetdeep inside you when you said, you got tobring yours to get mine, when you curved orangeand road, and planned a grandchild’s whooping.Like the perfect bend of a switch, the turntakes time to master. In the dream of life,this sonnet is the sole box you’ll sleep in. [End Page 43] Sonnet # 7 For Biker Boy Will How could America ever love you?She misunderstands your fresh pressed white T,the gaudy ticking gold on your left wrist,the swim trunks and fitted, the retro Jsgracing the grimy pink-red outside courts.She don’t know what to do with all your swaggerand braggadocious bluster, the gum-flappingwolf—pronounced woof—tickets. You said,the losing team’s son aint gon eat tonight.You said the game was for five racks.You could lie your ass off.You said, this shit is really really hard.But of course, there is a mother’s protection—my old girl kept me in the house and I thank her for that. [End Page 44] Flight to Portland We all have weak, uncontrollablebladders, brutally boxed inon this Boeing Airbus. The head flight attendantis a whip of a man,tall and southern, his briskwalk only bested bythe tempo of his tongue. His quick wit I suspectis both weapon and shield,from what I wonder? The flitter in his voicewhen he says down,makes an older gentlemanchuckle and reminisceon a past lover. All of us on this full flighthave named him I’m sure—Boy Wonder, Rude Boy,Waylon, maybe. I’m a flight attendant,I’ve had it all, he says.Any other questions? [End Page 45] Jalen Eutsey jalen eutsey is a poet, librarian, and sportswriter from Miami, Florida. He received an mfa in Poetry from the Writing Seminars at Johns Hopkins University. His work has been published in or is forthcoming from South Florida Poetry Journal, Nashville Review, storySouth, Harpur Palate, and others. Copyright © 2022 Jalen Eutsey

Commercial smartwatch with pulse oximeter detects short-time hypoxemia as well as standard medical-grade device: Validation study.

ObjectiveWe investigated how a commercially available smartwatch that measures peripheral blood oxygen saturation (SpO2) can detect hypoxemia compared to a medical-grade pulse oximeter.MethodsWe recruited 24 healthy participants. Each participant wore a smartwatch (Apple Watch Series 6) on the left wrist and a pulse oximeter sensor (Masimo Radical-7) on the left middle finger. The participants breathed via a breathing circuit with a three-way non-rebreathing valve in three phases. First, in the 2-minute initial stabilization phase, the participants inhaled the ambient air. Then in the 5-minute desaturation phase, the participants breathed the oxygen-reduced gas mixture (12% O2), which temporarily reduced their blood oxygen saturation. In the final stabilization phase, the participants inhaled the ambient air again until SpO2 returned to normal values. Measurements of SpO2 were taken from the smartwatch and the pulse oximeter simultaneously in 30-s intervals.ResultsThere were 642 individual pairs of SpO2 measurements. The bias in SpO2 between the smartwatch and the oximeter was 0.0% for all the data points. The bias for SpO2 less than 90% was 1.2%. The differences in individual measurements between the smartwatch and oximeter within 6% SpO2 can be expected for SpO2 readings 90%–100% and up to 8% for SpO2 readings less than 90%.ConclusionsApple Watch Series 6 can reliably detect states of reduced blood oxygen saturation with SpO2 below 90% when compared to a medical-grade pulse oximeter. The technology used in this smartwatch is sufficiently advanced for the indicative measurement of SpO2 outside the clinic.Trial RegistrationClinicalTrials.gov NCT04780724

Can Wearable Devices and Machine Learning Techniques Be Used for Recognizing and Segmenting Modified Physical Performance Test Items?

Assessment of physical performance is essential to predict the frailty level of older adults. The modified Physical Performance Test (mPPT) clinically assesses the performance of nine activities: standing balance, chair rising up & down, lifting a book, putting on and taking off a jacket, picking up a coin, turning 360°, walking, going upstairs, and going downstairs. The activity performing duration is the primary evaluation standard. In this study, wearable devices are leveraged to recognize and predict mPPT items' duration automatically. This potentially allows frequent follow up of physical performance, and facilitates more appropriate interventions. Five devices, including accelerometers and gyroscopes, were attached to the waist, wrists and ankles of eight younger adults. The system was experimented within three aspects: machine learning models, sensor placement, and sampling frequencies, to which the non-causal six-stages temporal convolutional network using 6.25 Hz signals from the left wrist and right ankle obtained the optimal performance. The duration prediction error ranged from 0.63±0.29 s (turning 360°) to 8.21±16.41 s (walking). The results suggest the potential for the proposed system in the automatic recognition and segmentation of mPPT items. Future work includes improving the recognition performance of lifting a book and implementing the frailty score prediction.

Comparison of the effective intensity of transcutaneous electrical nerve stimulation contralateral to a pain site for analgesia.

[Purpose] This study aimed to compare the effectiveness of transcutaneous electrical nerve stimulation contralateral to the pain site for analgesia to identify the effective stimulation intensity. [Participants and Methods] Ten healthy adult females were recruited for the study. The same heat stimulation was applied to the left wrist joint of each participant to induce pain, serving as the control. Transcutaneous electrical nerve stimulation was then randomly administered to the right wrist, corresponding to the same dermatome contralateral to the painful site, at the intensities of comfortable stimulation, pain threshold, and maximum pain. The effect of transcutaneous electrical nerve stimulation was assessed using a Visual Analogue Scale and by analysis of heart rate variability. [Results] The Visual Analogue Scale score was significantly lower after stimulation with the maximum pain intensity than that for control, and there were no significant differences among the intensities of comfortable stimulation, pain threshold, and maximum pain. No significant differences were found among the groups in terms of high and low-to-high frequency components. [Conclusion] Transcutaneous electrical nerve stimulation at the maximum pain intensity to the dermatome area contralateral to that of the dorsal pain site of the left wrist was considered effective.

Diferentes métodos de processamento de imagens termográficas para avaliação da temperatura do carpo em bezerros saudáveis

Abstract The aim of this study was to compare three methods of processing thermographic images for the evaluation of carpal temperature in healthy calves. Additionally, we sought to evaluate the thermal symmetry between the contralateral carpi of these calves. Thermographic images were obtained from both carpi of eight healthy calves aged between 20 and 45 days with a mean weight of 38.65 ± 2.27 kg. Using GRAYESS® IRT Analyzer 7 software, the total temperature (Ttot), region-of-interest temperature (Troi), and maximum mean temperature (Tmax) were determined. There was no difference between the temperatures obtained by the Ttot and Troi methods. Tmax showed higher temperatures (p &lt; 0.01) than the other methods. The three image processing methods showed high and significant positive correlations for the temperature of the right and left carpi of healthy calves. Tmax presented a higher correlation coefficient (r = 0.99) than the two other methods, which suggests a greater sensitivity for identifying thermal variations among the contralateral carpi. The 99% confidence interval for the difference between the temperatures of the right and left carpi (∆r-l) was between 0.03 and 0.26°C; thus, a temperature variation within that range does not refer to pathologic processes.

Machine Learning Distinguishes Familiar from Unfamiliar Pairs of Subjects Performing an Eye Contact Task: A Systemic Physiology Augmented Functional Near-Infrared Spectroscopy Hyperscanning Study.

Eye contact is an important aspect of human communication and social interactions. Changes in brain and systemic physiological activity associated with interactions between humans can be measured with systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) hyperscanning, enabling inter-brain and inter-body synchronisation to be determined. In a previous study, we found that pairs of subjects that are socially connected show higher brain and body synchrony. To enable a deeper understanding, our aim was to build and automatically detect the best set of features to distinguish between two different groups (familiar and unfamiliar pairs). We defined several features based on the Spearman correlation and wavelet transform coherence (WTC) of biosignals measured on 23 pairs of subjects (13 familiar and 10 unfamiliar pairs) during eye contact for 10 min. Additional custom features that identify the maximum brain-to-body coupling instants between pairs were generated. After testing on combinations of different feature extraction methods, four subsets of features with the strongest discrimination power were taken into account to train a decision tree (DT) machine learning (ML) algorithm. We have obtained 95.65% classification accuracy using a leave-one-out cross-validation. The coupling features which represent the two maximum mean values resulting from the sum of 7 time-dependent WTC signals (oxyhaemoglobin concentration of the right prefrontal region, total haemoglobin concentration of the left and right prefrontal region, heart rate, electrodermal activity on the left and right wrist, and skin temperature on the right wrist) played an essential role in the classification accuracy. Training the DT-ML algorithm with combined brain and systemic physiology data provided higher accuracy than training it only with brain or systemic data alone. The results demonstrate the power of the SPA-fNIRS hyperscanning approach and the potential in applying ML to investigate the strength of social bonds in a wide range of social interaction contexts.

Reducing the Calibration Time in Somatosensory BCI by Using Tactile ERD.

We propose a tactile-induced-oscillation approach to reduce the calibration time in somatosensory brain-computer interfaces (BCI). Based on the similarity between tactile induced event-related desynchronization (ERD) and imagined sensation induced ERD activation, we extensively evaluated BCI performance when using a conventional and a novel calibration strategy. In the conventional calibration, the tactile imagined data was used, while in the sensory calibration model sensory stimulation data was used. Subjects were required to sense the tactile stimulus when real tactile was applied to the left or right wrist and were required to perform imagined sensation tasks in the somatosensory BCI paradigm. The sensory calibration led to a significantly better performance than the conventional calibration when tested on the same imagined sensation dataset ( [Formula: see text]=10.89, P=0.0038), with an average 5.1% improvement in accuracy. Moreover, the sensory calibration was 39.3% faster in reaching a performance level of above 70% accuracy. The proposed approach of using tactile ERD from the sensory cortex provides an effective way of reducing the calibration time in a somatosensory BCI system. The tactile stimulation would be specifically useful before BCI usage, avoiding excessive fatigue when the mental task is difficult to perform. The tactile ERD approach may find BCI applications for patients or users with preserved afferent pathways.

Determination of bone age and evaluating the applicability of Greulich-Pyle standards among the Turkish children

Background/Aim: Bone age (BA) is important in the diagnosis and follow-up of pediatric growth disorders. Skeletal maturation can vary according to the geographical region and climate. The goal of this study is to investigate whether Greulich-Pyle (GP) method is suitable for detecting BA for Turkish children for all age groups and both genders. Methods: In our retrospective cohort study, the roentgenograms of all pediatric patients who visited the pediatrics or pediatric endocrinology outpatient clinics and underwent left hand and wrist radiographs for suspicious trauma or BA determination were examined with reference to the GP atlas. Patients without evidence of chronic disease or growth disorders with body size and weight values between the 25th-75th percentile were included. Poor quality roentgenograms were excluded. Results: Radiographs of 665 patients were analyzed and 310 (161 boys and 149 girls, age range 13-203 months) patients were included. The rate of concordant BA with CA was significantly higher in the children above 120 months of age and low BA was significantly higher among the children aged 120 months or below (P

Synovial tuberculosis in wrist diagnosed based on metagenomic next-generation sequencing: A case report

Synovial tuberculosis in the wrist is a rare disease that is usually misdiagnosed at the early stage. In this case, we presented a 67-year-old male with wrist joint tuberculosis who presented repeated left wrist joint edema for more than 2 years. The patient received surgery twice. During the second surgery, the combination of metagenomic next-generation sequencing (mNGS) and pathological analysis contributed to the detection of Mycobacterium tuberculosis in lesion tissues. Conventional anti-tubercular therapy confirmed the diagnosis of synovial tuberculosis in the wrist joint. In conclusion, mNGS contributed to the rapid and accurate detection of tubercle bacillus.

COMPARATIVE RADIOLOGICAL DIAGNOSTICS OF ACUTE TRIANGULAR FIBROCARTILAGE COMPLEX INJURIES.

The aim was to analyze patients with clinical diagnosis of triangular fibrocartilage complex (TFCC) lesion using standard x-ray, ultrasound, conventional magnetic resonance imaging (MRI) and MR arthrography (MRA); to evaluate the accuracy of MRA compared with MRI in the diagnosis of this lesion; and to evaluate ultrasound as a method of diagnosing TFCC lesion. We analyzed 72 patients (46 female and 26 male; age range, 22-61 years; mean age 37 years; 50 right and 22 left wrists) with suspected TFCC lesion with clinical examination, standard x-rays, and ultrasound. We confirmed patients with traumatic TFCC injury on MRI and MRA. Ultrasound found 13 lesions in 72 patients with suspected TFCC lesions. Conventional MRI found 66 and MRA 68 TFCC lesions. Ultrasound is useful for visualizing intra-articular effusion, soft tissue, bone surface, and for early detection of occult fractures. MRI is a better diagnostic modality, fully able to visualize the TFCC cartilage and ligaments. MRA is consistently and accurately able to visualize structural abnormalities of TFCC.

"ЭТО БЫЛ (НЕ)ПРАВИЛЬНЫЙ ОБЫЧАЙ": РИТУАЛ ПОДНЯТИЯ ЛЕВОЙ РУКИ В ТАНАТОЛОГИЧЕСКОМ ДИСКУРСЕ ЧЕРКЕСОВ ДИАСПОРЫ

The custom of raising the left hand has been preserved until recently in the thanatological practices of one of the Circassian diaspora communities in Turkey (Uzunyayla – Kayseri). According to the stereotypical narrative descriptions of the ritual, one of the groups arriving at the funeral slowly steps forward, taking three steps from the left foot, and slowly raises the left wrist to the level of the chin, temple, or crown. By raising his hand, the condolent publicly expresses the recognition of the social status of the deceased. According to informants, in the late 1980s, the custom was eradicated under the pressure from the Islamic clergy. Those who opposed its cessation understood this custom as a sacred one ‘brought from the ancestral homeland’ and bequeathed by Zhabagi Kazanoko (the folkloric and historical hero, philosopher, humanist and reformer of the 18th century). The idea of “reviving” the ritual was initiated during the pandemic, when mass gatherings and physical contacts (handshakes and embraces, which are common in ordinary funeral practices) were prohibited. In particular, in relation to the Day of Remembrance of the Victims of the Caucasian War (celebrated by the Circassian community annually on May 21), it was proposed to hold an online campaign for posting photos with a raised left hand. The explicit and hidden strategies of actualizing the ritual of raising the left hand as “our own”, “the primordial” and ‘undeservedly forgotten one’ are analyzed in this work on the material of the texts of classical folklore (heroic legends) and memoranda recorded by the author during fieldwork, as well as posts on the social media. The main aim of the research is to show how the bearers of the tradition reproduce (verbally and visually) the stable and changeable structures of a narrative / a ritual under the influence of certain ideological dominants.

Antropometry Analysisi Of Stove Cooking Tofu Production On the Employee’s Safety And Convenience

Ergonomics approach to vehicle design is emphasized on researching the limited capabilities of humans, both physically and mentally psychologically and their interactions in an integral human-machine system. Then systematically the ergonomics approach will then utilize this information for design purposes, so as to create a product system or work environment that is more suitable for humans. Objectives of the Research; Knowing the anthropometry of workers and the furnace knows the process of boiling tofu; determine the suitability of the anthropometry of workers with the tofu boiling process furnace; knowing the level of complaints felt by workers during the tofu boiling process. This study uses quantitative methods, with a descriptive analysis approach to the dimensions of the tofu boiling stove on the anthropometry of the workers' bodies. The instruments used in this research are literature study, observation and interviews. The variable used is the anthropometric data of workers in the manufacture of tofu. The dimensions measured include; hand width, the distance from the fingertips to the left to the right, the height of the hand grip from a vertical hand position up from standing upright, the distance from the hand grip to the back, the length of the hand, and the width of the palm. The body dimensions measured in the study are as follows: body height in standing position, shoulder height, elbow height, shoulder height in sitting position, elbow height in sitting position, shoulder width, hip width, body height in sitting position. The results of this study indicate that the measurement of the dimensions of the body of the community in the city of Mataram obtained varying results. The results of the measurement of body height when standing ranged from 131 to 153 cm and for the average body height of all people measured was 151 cm. Interviews on average workers complained of pain in the left elbow and right elbow and pain in the upper arm. left, right upper arm, right wrist and left wrist. By using the NBM questionnaire which is described in 27 points, the method of collecting data directly to workers by means of direct interviews on the spot is used

Are Reports of Pain, Disability, Quality of Life, Psychological Factors, and Central Sensitization Related to Outcomes of Quantitative Sensory Testing in Patients Suffering From Chronic Whiplash Associated Disorders?

Chronic whiplash associated disorders (CWAD) are characterized by long-lasting symptoms of neck pain occurring after an acceleration-deceleration injury. Central sensitization (CS) has been suggested as the possible underlying mechanism for these symptoms, and is characterized by changes in the central nervous system. Besides CS, psychological factors are believed to play an important role in the experience of (chronic) pain. Investigatingthe relationships between self-reported pain, disability, quality of life, psychological factors, and symptoms of CS; and electrical-based quantitative sensory testing (QST) outcomesin CWAD patients. Secondly, to investigate the differences in QST between CWAD patients and pain-free controls. Seventy-two individuals with CWAD and 55 pain-free controls underwent electrical stimuli-based QST. Detection and pain thresholds (EPT), temporal summation (TS), and conditioned pain modulation were examined. Spearman correlation and linear mixed models analyses were performed to assess, respectively, the hypothesized associations and group differences in QST. The Pain Catastrophizing magnification subscale correlated with the left wrist EPT (r=-0.332; P=0.004), and the Pain Anxiety Symptom Scale-20 with the left wrist (r=-0.325; P=0.005) and ankle (r=-0.330; P=0.005) EPT. TS at the ankle correlated with the CS inventory (r=0.303; P=0.010), Short Form 36 pain subscale (r=-0.325; P=0.005), and Illness Perception Questionnaire revised consequences subscale (r=0.325; P=0.005). EPTs left (P=0.011) and right wrist (P=0.023) were lower in the CWAD group, but conditioned pain modulation and TS did not differ between groups. QST outcomes relate to psychological constructs, rather than to self-reported pain intensity and distribution. Local hyperalgesia was found in individuals with CWAD, but no differences in endogenous pain facilitation nor inhibition.

Wrist pain and swelling

A 51-year-old man presented to the Family Medicine Skin Care Clinic to follow up on his actinic keratoses. The patient had a history of degenerative joint disease and bilateral carpal tunnel surgery. During evaluation, swelling was observed over the dorsum of his left wrist and proximal half of his metacarpals. The patient mentioned that he’d had wrist and hand pain over the past year, which he’d attributed to his carpal tunnel syndrome. Imaging and laboratory work-up were ordered.What’s your diagnosis?

Wrist rash

A 28-year-old man with a history of chronic cystic acne presented to the Family Medicine Skin Clinic for an acne follow-up visit. In addition, he mentioned a new rash on the volar surface of his left wrist. The rash developed gradually over 2 weeks with no pain or pruritis. He reported no past similar difficulties. Exam revealed a small, nonblanching, erythematous, scaly plaque in the affected area.What’s your diagnosis?

Designing of Facility Layout Ecobrick Material Using Ergonomic Intervention Reduce Muscoloskeletal Disorder

Kamulyan waste bank is a place to collect the waste from the household around Lowanu Village, Brontokusuman, Mergangsan, Yogyakarta. This waste is distributed to garbage collectors and sorted. Plastic waste that cannot be recycled is used as material for making ecobricks. Ecobricks are materials made from used plastic bottles filled with plastic sachets, plastic bags, and similar materials that are compressed. In making ecobricks, workers perform activities in a sitting position on the floor with both legs folded in and a slightly bent posture. This work attitude causes muscle complaints in the upper and lower neck, upper arm, right elbow, left wrist, and left hand. The purpose of the study was to improve work attitudes to reduce muscle complaints in body parts by designing ergonomic work facilities. This research was conducted with ergonomics intervention on the design of ecobrick plastic compaction work facilities with the Nordic Body Map-VAS Modified Questionnaire. The muscle complaints of the workers' body parts were determined using the Nordic Body Map questionnaire. The results of the study provide a design for compaction of ecobrick plastic materials with dimensions of table length 134.44 cm, table width 66.39 cm, table height 71.63 cm, length of seat mat 41.41 cm, width of seat mat 43.49 cm, height seat 44.51 cm, backrest height 55.5 cm, and backrest width 45.88 cm. Based on the NBM-VAS questionnaire, it shows that the initial condition of pain or pain in the upper neck and lower neck with a moderate pain value is aimed at a scale of 6.5 cm and 7.3 cm to mild pain with a scale of 4.2 cm and 4.3 cm. . Moderate pain in the left wrist and left hand with a scale of 6.1 cm, respectively, to no pain on a scale of 3.1 cm and 3 cm.