Palmar Region Research Articles

Ayurvedic Management of Palmo-Plantar Psoriasis(~Ek kushta) : A Case Report

Psoriasis is a chronic variant of Psoriasis that characterstically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic, pustular skin lesions. Palmoplantar Pustulosis is a possibly related to dermatosis characterized by small sterile pustules that may be a type of Palmoplantar Psoriasis. As such they are associated with substantial impairment in quality of life. The exact cause of Palmoplantar Psoriasis is unkown. However, it is caused by a combination of genetic and enviornmental factors. In the present case study, female of age 40yrs visit in Ayurveda OPD had complaint of severe itching, redness and pain in skin lesions, transient white, brown, or red macule, localized at bilateral sole region and palm region since 2yrs. She had associated complaint of loss of appetite, headache, dizziness, disturbed sleep and irregular bowel evacuation since 2yrs. She took allopathic treatment but does’nt get any improvement so she decided to switch on Ayurveda management for better cure and preventive care. On the basis of clinical presentation patient was diagnosed with Vicharchika, type of Kushtha Roga so the line of management is based on Kushtha Chikitsa. After 2months of drug intervention Panchtikt Ghrita 10ml, OD in morning, in combination with Mahakalyanak Ghrita in dose of 5ml HS(at bed time) and Cap.Stresscom 2tab at night, patient get significant relief in symptoms ie. dryness and peeling of skin, pain and bleeding with severe itching. Size of lesions is reduced. This is effective in reducing the progression of disease and improve quality of life of patient.

Infrared thermography for normal endothelial function screening.

Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death. To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors. Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase < 11% at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11% post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney's U-test, chi-square test, or Fisher's exact test were used. Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation [FMV]: 2.5%). The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85% sensitivity, 70% specificity, positive and negative predictive values of 78 and 77%, area under the curve of 0.796, LR+ 2.82, LR- 0.22. An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.

The value of local dexmedetomidine as an adjuvant to ultrasound-guided wide awake local anesthesia no tourniquet (WALANT) in flexor tendon repair surgeries: a randomized controlled trial

BackgroundThe Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique allows intraoperative motor assessment of tendon repair integrity of the hand compared with general anesthesia or brachial plexus block. No studies have tested the effect of adding dexmedetomidine to lidocaine on the analgesic properties of the WALANT technique, which is the aim of our study.MethodsA total of 128 patients aged more than 18 years were scheduled for surgical flexor tendon injury repair using WALANT technique. Patients were divided into two equal groups. Ultrasound-guided subcutaneous injection of lidocaine 1% with dexmedetomidine (1 µg/kg), Group D, or without dexmedetomidine, Group C, was performed at four points: proximal to the wrist joint, the distal forearm, palm region, and proximal phalanges. The primary outcome was total morphine consumption throughout the first postoperative day. Secondary outcomes included number of patients requiring rescue analgesia, time to first analgesic request, and pain score.ResultsTotal morphine consumption was significantly (P < 0.001) lower in group D (2.66 ± 0.998) than in group C (3.66 ± 1.144) mg. Number of patients requiring rescue analgesia was significantly (P < 0.001) lower in group D (54.7% (35)) than group C (100.0% (64)). The time for first request for analgesia was significantly (P < 0.001) longer in group D (11.31 ± 6.944) than in group C (5.91 ± 4.839) h. Pain score was significantly higher in group C than D at three (P < 0.001), and six (P = 0.001) hours (P = 0.001) postoperatively.ConclusionDexmedetomidine significantly improves the analgesic quality of WALANT when added to lidocaine with less opioid consumption.Trial registration(ID: PACTR202203906027106; Date: 31/07/2023).

Assessment of POFA-Pervious Concrete Performance with Oil Palm Shells as a Partial Aggregate Replacement

Introduction: In Malaysia today, periods of excessive rain can result in flooding poses a significant challenge. The existing drainage system struggles to manage the wastewater effectively. In addressing the persistent issue of flooding in Malaysia, this issue’s solution was recommended to introduce pervious concrete (PC). Recognizing the urgency of finding sustainable and environmentally friendly solutions, the present study focuses on the application of PC as a potential remedy that allows water to infiltrate through its porous structure. Aims: Despite the potential benefits of PC, there exists a notable gap in the understanding of its performance, especially when incorporating oil palm shells (OPS) as a partial aggregate replacement in POFA-pervious concrete (PPC). OPS is an agricultural waste material abundant in palm oil-producing regions, remarkably in Malaysia. This research aims to bridge this gap to evaluate the performance of PPC and PPC with OPS. By addressing the performance of PPC at different OPS replacement levels and curing ages, the lack of such detailed investigations in the existing body of knowledge underscores the novelty and importance of this present research. Methods: Experimental tests were conducted to evaluate the performance of PPC and PPC incorporating OPS comprising density, water absorption, void content, and compressive strength. All the tests were conducted at 7 and 28 days after the hardened concrete was cured in water. Results: The results revealed that as the OPS content increased, the compressive strength of PPC with OPS decreased but was significantly higher than recommended in the standard. Conversely, the reduction in strength was accompanied by an improvement in water absorption, making PPC encompassing OPS suitable for applications. The void content of the PPC increased with higher OPS replacement levels, indicating an increase in porosity. This increase in porosity led to a decrease in the density of the PPC incorporating OPS. Conclusion: The findings of this research suggest that the incorporation of OPS as an aggregate replacement in PPC can offer advantages in terms of water absorption. The inclusion of 10% OPS significantly and positively affects the performance of PPC.

The efficacy of different torque profiles for weight compensation of the hand.

Orthotic wrist supports will be beneficial for people with muscular weakness to keep their hand in a neutral rest position and prevent potential wrist contractures. Compensating the weight of the hands is complex since the level of support depends on both wrist and forearm orientations. To explore simplified approaches, two different weight compensation strategies (constant and linear) were compared to the theoretical ideal sinusoidal profile and no compensation in eight healthy subjects using a mechanical wrist support system. All three compensation strategies showed a significant reduction of 47-53% surface electromyography activity in the anti-gravity m. extensor carpi radialis. However, for the higher palmar flexion region, a significant increase of 44-61% in the m. flexor carpi radialis was found for all compensation strategies. No significant differences were observed between the various compensation strategies. Two conclusions can be drawn: (1) a simplified torque profile (e.g., constant or linear) for weight compensation can be considered as equally effective as the theoretically ideal sinusoidal profile and (2) even the theoretically ideal profile provides no perfect support as other factors than weight, such as passive joint impedance, most likely influence the required compensation torque for the wrist joint.

A Rare Case of Spindle Cell Hemangioma in the Palmar Region

A Rare Case of Spindle Cell Hemangioma in the Palmar Region

Differences in the microanatomy of skin of sole and palm in humans

Background: The prevalence of skin diseases has increased over the last few decades and they contribute to a significant burden on the health-care systems all across the world. In some forms of reconstructive or plastic surgery, palm skin has successfully been replaced with sole skin, removed to form a full-thickness graft that covered almost the entire palm of the hand without impairing the weight-bearing areas of the feet or encumbering the gait. In cases such as these, the skin of the palm and sole is preferred for grafts. Aims and Objectives: The study was conducted to learn the microanatomy of palm and sole. Materials and Methods: The present observational study was carried out in the Department of Anatomy, King George Medical University, Lucknow, from the period of September 2017 to August 2018. Ethical clearance was obtained from Institutional Ethics Committee (Ref. code:63/Ethics/R-Cell-18). For the present study, skin was procured from the palm and sole of six freshly embalmed human cadavers (three males and three females). The mean age of the cadavers was 67 years. Tissues were preserved in 10% of formaldehyde for 48 h, fixed, Stained in H and E, and observed under light microscope. Results: The study showed that the thickness of epidermis and ratio of epidermis to stratum corneum (Edp: sc) of the sole are greater than palm, dermoepidermal junctions were more in sole. Thickness of dermis both papillary and reticular dermis was more in sole than palm. Conclusion: The values of thickness of skin of palm and sole region provide data for plastic surgeons to plan cosmetic surgeries.

In- silico evaluation of bioactive compounds from selected medicinal plants from Southern Nigeria against hepatitis C virus genotype 1 RNA-directed RNA polymerase

BackgroundAt the moment, there is no vaccine for the hepatitis C virus (HCV), despite it being more infectious than the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV). Existing drugs based on protease and polymerase inhibitors present adverse clinical outcomes, sparking the search for alternatives. Medicinal plants contain bioactive compounds that hold great promise. Thus, the present study was aimed at evaluating the druggability of bioactive compounds implicated in folk medicine in the management of HCV against RNA-directed RNA polymerase (RdRp). MethodsTraditional healers involved in the management of hepatitis were consulted, and they suggested the use of leaves of Vernonia amygdalina, Jatropha tanjorensis, Annona muricata, and Solanum nigrum (berries too) in the management of hepatitis. The collection of plant parts and phytochemical screening via gas chromatography-mass spectrophotometer (GC–MS) were carried out. Resulting bioactive compounds and a control HCV drug, remdesivir, were screened for ADMET properties using the pkCSM online prediction tool, while molecular docking was performed using AutoDockTool 1.5.6 and the resulting interactions visualised in 2-Dimension using Discovery Studio 2022 Client. ResultsGC–MS analysis of the medicinal plants revealed 60 bioactive compounds, of which 15 did not violate Lipinski's rule of five and 2 returned only one violation, while the control drug returned two violations. All the ligands were not inhibitors of CYP1A2, CYP2C19, CYPCC9, CYPAD6, and CYP3A4, except for 1,3-dihydrobenzo-[c]thiophen, docosahexaenoic acid, and benzonitrile N-oxide, which were inhibitors of CYP1A2. The intestinal absorption rates of the various ligands (73.56–100 %) were better than those of remdesivir, with an intestinal absorption rate of 67.15 %. Docking analysis revealed scores that ranged from -4.3 to -8.0 k/cal for the ligands, while the score for remdesivir was -9.0 k/cal. Eight ligands and remdesivir interacted with both the finger and palm regions, while one ligand interacted with the finger and thumb regions. Others interacted either with the finger (n = 5) or palm (n = 3) regions. These various interactions have the potential to alter the structural integrity and conformation of the RdRp protein and, in the process, interfere with its role in replication. ConclusionThe findings indicate that the selected medicinal plants possess bioactive compounds that hold great promise for the development of newer and safer nucleoside inhibitors against HCV. Given the high diversity of the virus, there may be a need to expand the scope of genotype-specific treatment regimens using bioactive compounds from medicinal plants. List of Abbreviations and UnitsAA, Amino Acid; HCV, Hepatitis C Virus; HBV, Hepatitis B Virus; GC–MS, Gas chromatograph-mass spectrophotometer; MD, Molecular docking; PDB, Protein Data Bank; RdRp, RNA directed RNA polymerase; RNA, Ribonucleic Acid; HIV, Human Immunodeficiency virus; NIST, National Institute of Standards and Technology; WHO, World Health Organization

Antiviral Effect of 5'-Arylchalcogeno-3-aminothymidine Derivatives in SARS-CoV-2 Infection.

The understanding that zidovudine (ZDV or azidothymidine, AZT) inhibits the RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 and that chalcogen atoms can increase the bioactivity and reduce the toxicity of AZT has directed our search for the discovery of novel potential anti-coronavirus compounds. Here, the antiviral activity of selenium and tellurium containing AZT derivatives in human type II pneumocytes cell model (Calu-3) and monkey kidney cells (Vero E6) infected with SARS-CoV-2, and their toxic effects on these cells, was evaluated. Cell viability analysis revealed that organoselenium (R3a-R3e) showed lower cytotoxicity than organotellurium (R3f, R3n-R3q), with CC50 ≥ 100 µM. The R3b and R3e were particularly noteworthy for inhibiting viral replication in both cell models and showed better selectivity index. In Vero E6, the EC50 values for R3b and R3e were 2.97 ± 0.62 µM and 1.99 ± 0.42 µM, respectively, while in Calu-3, concentrations of 3.82 ± 1.42 µM and 1.92 ± 0.43 µM (24 h treatment) and 1.33 ± 0.35 µM and 2.31 ± 0.54 µM (48 h) were observed, respectively. The molecular docking calculations were carried out to main protease (Mpro), papain-like protease (PLpro), and RdRp following non-competitive, competitive, and allosteric inhibitory approaches. The in silico results suggested that the organoselenium is a potential non-competitive inhibitor of RdRp, interacting in the allosteric cavity located in the palm region. Overall, the cell-based results indicated that the chalcogen-zidovudine derivatives were more potent than AZT in inhibiting SARS-CoV-2 replication and that the compounds R3b and R3e play an important inhibitory role, expanding the knowledge about the promising therapeutic capacity of organoselenium against COVID-19.

Function and phylogeny support the independent evolution of an ASIC-like Deg/ENaC channel in the Placozoa

ASIC channels are bilaterian proton-gated sodium channels belonging to the large and functionally-diverse Deg/ENaC family that also includes peptide- and mechanically-gated channels. Here, we report that the non-bilaterian invertebrate Trichoplax adhaerens possesses a proton-activated Deg/ENaC channel, TadNaC2, with a unique combination of biophysical features including tachyphylaxis like ASIC1a, reduced proton sensitivity like ASIC2a, biphasic macroscopic currents like ASIC3, as well as low sensitivity to the Deg/ENaC channel blocker amiloride and Ca2+ ions. Structural modeling and mutation analyses reveal that TadNaC2 proton gating is different from ASIC channels, lacking key molecular determinants, and involving unique residues within the palm and finger regions. Phylogenetic analysis reveals that a monophyletic clade of T. adhaerens Deg/ENaC channels, which includes TadNaC2, is phylogenetically distinct from ASIC channels, instead forming a clade with BASIC channels. Altogether, this work suggests that ASIC-like channels evolved independently in T. adhaerens and its phylum Placozoa. Our phylogenetic analysis also identifies several clades of uncharacterized metazoan Deg/ENaC channels, and provides phylogenetic evidence for the existence of Deg/ENaC channels outside of Metazoa, present in the gene data of select unicellular heterokont and filasterea-related species.

T3-T5 Thoracoscopic sympathectomy versus sympathicotomy in the treatment of palmar–axillary–plantar hyperhidrosis

Background Compensatory hyperhidrosis is a common complication after thoracoscopic interruption of the sympathetic chain in hyperhidrosis patients. Nonetheless, no interruption technique has been defined to decrease the incidence of that dreadful complication. Herein, we compared T3-5 sympathectomy with sympathicotomy at the same levels with regard to postoperative outcomes. Methods Eighty patients diagnosed with primary palmar–axillary–plantar hyperhidrosis were randomized into two equal groups: the sympathectomy and sympathicotomy groups. They were followed up for 6 months after the procedure. The incidence and criteria of compensatory hyperhidrosis were compared between the two approaches. Results The sympathectomy group showed a significant prolongation of the operative time. However, postoperative pain, hospital stay, and the incidence of complications were statistically comparable between the two approaches. Both procedures were associated with a significant decline in the severity of sweating in the three regions, which was more prominent in the palmar and axillary regions compared with the foot. The incidence of compensatory hyperhidrosis was 65% in sympathectomy patients and 77.5% in sympathicotomy patients, with no significant difference between them (P=0.217). About two-thirds of these cases were temporary, and the majority of them had mild to moderate symptoms. Patient satisfaction did not differ between the two approaches, with poor satisfaction in patients with permanent compensatory hyperhidrosis. Conclusion Both sympathectomy and sympathicotomy had comparable outcomes in patients with palmar–axillary–plantar hyperhidrosis, manifested in comparable decreased sweating severity, incidence of compensatory hyperhidrosis, quality of life, and patient satisfaction.

Studi Kasus Tatalaksana Skabies Melalui Pendekatan Kedokteran Keluarga Pada Pasien Anak Laki-Laki Usia 10 Tahun

Scabies is a parasitic infectious disease (Sarcoptes scabiei var. hominis) which is still a public health problem in the world, including Indonesia. Scabies can be transmitted through direct and indirect contact with the greatest prevalence in children, densely populated populations, poor sanitation and hygiene. Symptoms and signs of scabies include papules, vesicles, pustules or nodules accompanied by itching at night with a predilection for a thin epidermal layer. This study is a case report that aims to examine the accuracy in diagnosing and providing pharmacological and non-pharmacological (communication, information and education) treatment of scabies patients. Primary data were obtained through anamnesis (by autoanamnesis and alloanamnesis with the patient's family members) and physical examination by conducting home visits, filling out the family folder, and filling out patient files. The assessment was carried out based on the initial holistic diagnosis, process and end of the visit both quantitatively and qualitatively. In the study, a 10-year-old boy patient was found at the Pediatric Polyclinic at the Dewantara Health Center with complaints of itching all over the body, especially between the fingers, since the last 8 months. Complaints of itching worsen at night so that it disturbs the patient's sleep. The patient has two siblings who live in Dayah with the same complaint and occasionally stay at home with the patient. The patient's mother also had the same complaint. On physical examination, HR: 88x/I, RR: 18x/I, temperature: 36.5°C and nodules were found in the left palmar region of the manus, and canaliculi in the form of white straight lines with papular tips. Management in the form of communication, information and education on environmental sanitation and hygiene as well as pharmacological treatment.

Palm Print Database Collection System

Contactless biometric palm print recognition technology has attracted increased attention due to the covid-19 pandemic. Many dual camera based sensors have been proposed to capture palm vein and palm print image synchronously. However, translations between captured palm print images differ depending on the distance between the hand and the sensor. A biometric palm image Alignment method is proposed based on the imaging and ranging model. A palm print refers to an image acquired of the palm region of the hand. Palm print image enhancement is required for better feature extraction. To extract fine features enhancement is required. Fine features increase the accuracy of palm print recognition system. The main purpose of this review paper is to study and compare various palm print recognition techniques in terms of performance, accuracy, overheads and Peak Signal to Noise Ratio (PSNR)

Regional Development, Rural Transformation, and Land Use/Cover Changes in a Fast-Growing Oil Palm Region: The Case of Jambi Province, Indonesia

The development policies implemented in Jambi Province, Indonesia, since the New Order era, have encouraged transformations in demography, regional paradigms, growth base sectors, and growth actors. This study aims to understand how the central government’s demographic policies and plantation development program have impacted regional land cover change, rural development transformation, and economic development in Sumatra Island’s biodiversity-rich rainforest region (Jambi Province). This study explores the shifts in village typology that have occurred. Descriptive analysis and cluster analysis were applied to collect data at the provincial level that included population, poverty rate, levels of education, HDI, GRDP, Gini index, and land cover. Village Potential Data at the village level was then used to build an infrastructure index and a diversity of activities index. The results of this study indicated that macro development indicators are in a positive trend: HDI, educational levels, GRDP per capita, and the proportion of the tertiary sector in GRDP have all increased. The growth of the tertiary sector was largely driven by the trade and motorized-vehicle repair sectors. The provincial landscape has changed significantly due to the expansion of oil palm plantations. At the village level, the infrastructure index and diversity index show an increase in the number of facilities and variations in economic activity in most villages. Some shifts in rural typology are highlighted: the increase in urban villages and in villages that specialize in oil palm plantation or other industrial plantation crops.

PKLNet: Keypoint Localization Neural Network for Touchless Palmprint Recognition Based on Edge-Aware Regression

The usage of touchless palmprint recognition (PPR) increases due to its acceptant interaction mode. However, the region of interest (ROI) localization at a distance is quite challenging for touchless PPR in real-world scenarios with complex backgrounds and hand poses. To address this issue, we proposed a palm keypoint localization neural network (PKLNet) that combines information on the hand region, palm boundary, and finger valley edges to achieve accurate and robust keypoint localization. First, a two-stage neural network was proposed. It effectively adopted the transformer framework to capture global relations of the palm boundary points to perform palm region segmentation and ROI keypoint coordinate regression. Second, an image synthesis-based training strategy was developed based on conventional palmprint ROI localization methods. The obtained ROI localizer (namely PalmKit) can automatically generate palm region masks and keypoint coordinates, which can significantly simplify the data annotation process and hence liberate the heavy manual labor. Finally, extensive experiments were performed on various touchless palmprint datasets. The proposed PKLNet obtained an 82.1% success rate and a 7.7 pixels median localization error in the cross-dataset test. The results demonstrate that the proposed PKLNet is robust to palm rotation, translation, and inference from complex backgrounds, ensuring the usability of the touchless PPR technique in real-world application scenarios.

DRIS I: elaboración de los índices DRIS en el cultivo de palma de aceite

Nutritional diagnosis based on foliar tissue analysis is an efficient tool for detecting nutritional imbalances and aiding in the fertilizer recommendation process. Therefore, the objective of this study was to use this information to implement the Diagnosis and Recommendation Integrated System (DRIS), a method that uses the relationships between nutrients and their respective coefficients of variation in a high-productivity population, establishing the norms. In this study, DRIS norms and indices were developed for the oil palm crop, specifically the IRHO hybrid, in the central palm region of Colombia. A total of 113 samples were taken, of which 28 were considered representative of the population with high yields in fresh palm fruit production, exceeding 32.9 tons per hectare. The selection of DRIS norms was based on the criteria of the highest variance ratio and the "R" value criterion. The decreasing order of deficiency constraints for foliar tissue concentrations is Fe&gt;Zn&gt;S&gt;P&gt;Cl&gt;Mg&gt;B&gt;Na&gt;K&gt;Ca&gt;Cu=Mn&gt;N, with Iron and Zinc being the limiting elements due to deficiency, and Nitrogen due to excess. Small changes in sulfur concentrations have a significant impact on yield.

Revealing the Meissner Corpuscles in Human Glabrous Skin Using In Vivo Non-Invasive Imaging Techniques.

The presence of mechanoreceptors in glabrous skin allows humans to discriminate textures by touch. The amount and distribution of these receptors defines our tactile sensitivity and can be affected by diseases such as diabetes, HIV-related pathologies, and hereditary neuropathies. The quantification of mechanoreceptors as clinical markers by biopsy is an invasive method of diagnosis. We report the localization and quantification of Meissner corpuscles in glabrous skin using in vivo, non-invasive optical microscopy techniques. Our approach is supported by the discovery of epidermal protrusions which are co-localized with Meissner corpuscles. Index fingers, small fingers, and tenar palm regions of ten participants were imaged by optical coherence tomography (OCT) and laser scan microscopy (LSM) to determine the thickness of the stratum corneum and epidermis and to count the Meissner corpuscles. We discovered that regions containing Meissner corpuscles could be easily identified by LSM with an enhanced optical reflectance above the corpuscles, caused by a protrusion of the strongly reflecting epidermis into the stratum corneum with its weak reflectance. We suggest that this local morphology above Meissner corpuscles has a function in tactile perception.

What happens under the flexor tendons of the fingers in dactylitis?

Tenosynovitis is one of the most frequently described inflammatory lesions in psoriatic dactylitis. The aim of the study was to assess by ultrasound the distribution of content within the synovial sheath of the finger flexor tendons in a cadaveric experimental model of tenosynovitis and to describe anatomically the elements of the space between the flexor tendons and the palmar aspect of the proximal phalanx of the fingers. Silicone was injected under ultrasound guidance into the digital flexor sheath of the index finger of a hand specimen. Ultrasound images of the distribution of the filling of the flexor synovial space with the injected material were obtained. These images were compared with images from patients with psoriatic dactylitis. The palmar regions of the hand and fingers were dissected to check the distribution of the injected silicone in the synovial cavity. Additionally, we dissected the 2nd to 5th fingers of five cadaveric hands, including the one used for the experiment. During the injection of the substance, we observed an increasing homogeneous hypoechoic band around the flexor tendons that differed from the images of patients. Dissection of the specimen showed the injected silicone distributed throughout the digital flexor sheath to the distal interphalangeal joint. In addition, we provided an illustrated anatomical description of the elements located between the flexor tendons and the palmar aspect of the proximal phalanx, the inflammation of which could simulate flexor tenosynovitis. The observations of this study may contribute to a better understanding of the anatomical structures involved in PsA dactylitis.

Pharmacotherapeutic Potential of Natural Products to Target the SARS-CoV-2 PLpro Using Molecular Screening and Simulation Approaches.

Because of the essential role of PLpro in the regulation of replication and dysregulation of the host immune sensing, it is considered a therapeutic target for novel drug development. To reduce the risk of immune evasion and vaccine effectiveness, small molecular therapeutics are the best complementary approach. Hence, we used a structure-based drug-designing approach to identify potential small molecular inhibitors for PLpro of SARS-CoV-2. Initial scoring and re-scoring of the best hits revealed that three compounds NPC320891 (2,2-Dihydroxyindene-1,3-Dione), NPC474594 (Isonarciclasine), and NPC474595 (7-Deoxyisonarciclasine) exhibit higher docking scores than the control GRL0617. Investigation of the binding modes revealed that alongside the essential contacts, i.e., Asp164, Glu167, Tyr264, and Gln269, these molecules also target Lys157 and Tyr268 residues in the active site. Moreover, molecular simulation demonstrated that the reported top hits also possess stable dynamics and structural packing. Furthermore, the residues' flexibility revealed that all the complexes demonstrated higher flexibility in the regions 120-140, 160-180, and 205-215. The 120-140 and 160-180 lie in the finger region of PLpro, which may open/close during the simulation to cover the active site and push the ligand inside. In addition, the total binding free energy was reported to be - 32.65 ± 0.17kcal/mol for the GRL0617-PLpro, for the NPC320891-PLpro complex, the TBE was - 35.58 ± 0.14kcal/mol, for the NPC474594-PLpro, the TBE was - 43.72 ± 0.22kcal/mol, while for NPC474595-PLpro complex, the TBE was calculated to be - 41.61 ± 0.20kcal/mol, respectively. Clustering of the protein's motion and FEL further revealed that in NPC474594 and NPC474595 complexes, the drug was seen to have moved inside the binding cavity along with the loop in the palm region harboring the catalytic triad, thus justifying the higher binding of these two molecules particularly. In conclusion, the overall results reflect favorable binding of the identified hits strongly than the control drug, thus demanding in vitro and in vivo validation for clinical purposes.

Ultrasonographic anatomy of the palmar region of the carpus of the dog.

The palmar region of the canine carpus may be injured by traumatic, inflammatory, infectious, neoplastic, and degenerative disorders. The normal ultrasonographic anatomic features of the dorsal region of the canine carpus have been published, however information regarding the palmar region is currently lacking. The aims of this prospective, descriptive, anatomic study were (1) to describe the normal ultrasonographic characteristics of the palmar carpal structures in medium to large-breed dogs, and (2) to establish a standardized ultrasonographic protocol for evaluating them. As in the previously published study, the current study consisted of two phases: (1) identification phase, in which the palmar structures of the carpus were identified ultrasonographically in fifty-four cadaveric specimens and an ultrasonographic protocol to examine them was developed; and (2) descriptive phase, in which the ultrasonographic characteristics of the main palmar structures in twenty-five carpi of thirteen living healthy adult dogs were documented. The tendons of the flexor muscles of the carpus and digits, the superficial and deep parts of the retinaculum flexorum, the carpal canal and the median and ulnar neurovascular structures were ultrasonographically identified and described. Findings from the current study can serve as a reference for evaluating dogs with suspected injury involving the palmar carpal region using ultrasonography.