Plantar Region Research Articles

A Comparative Study of Dermatoglyphic Patterns of Fingers in Normal Children and In Children with Congenital Heart Diseases

Introduction: Dermatoglyphics is the study of epidermal ridges and their configurations on the palmar and the plantar regions. Currently dermatoglyphics is being used as a tool in the field of biology, anthropology, genetics and medicine to explain, compare and to predict the occurrence of bio medical events. Finger prints are usually categorized into three basic groups namely arches (60-65%), loops (30-35%) and whorls (5%). Any prenatal insult during this critical period of embryogenesis/organ system development should have an influence on the dermatoglyphic patterns.4Congenital heart defects are a heterogeneous group of diseases in which etiology, importance of genetic as well as environmental factors have been recognized. These defects show a familial tendency but no Mendelian pattern of inheritance has been described. In the present study, finger dermatoglyphic patterns in congenital heart diseases are studied and compared with controls. Subjects and methods: Dermatoglyphics are studied in 100 children with congenital heart diseases, both males and females. The dermatoglyphic patterns of palms and fingers were studied and the information was recorded systematically and statistically analyzed. Results: Ventricular septal defects (VSD) form the majority in the both the males (50%) and females (34.8%) in the congenital heart diseases group, followed by Atrial septal defects (ASD) in both males (20.4%) and females (39.1%). In both, the cases and controls group, it is found that the majority are loops followed by whorls and then the arches. The increase in whorls in congenital heart diseases is statistically significant with p value < 0.001. Comparing the cases with controls it is found that the Whorls (p < 0.001) and the loops (p <0.001) were statistically significant, it means that the Whorls are more frequently found in congenital heart diseases than the controls. Conclusion: Congenital heart diseases are associated with abnormal dermatoglyphic patterns. Increased number of Whorls and decreased number of Arches are seen in the congenital heart disease children. The above fingerprint pattren may help as a diagnostic aid in diagnosis of congenital heart diseases in children. They may also help in distinguishing congenital heart diseases from the functional and acquired heart diseases. A larger sample study is required to ascertain the value of this dermatoglyphic parameter as a diagnostic tool in congenital heart diseases in children.

Design of wireless device to measure plantar pressure and gait analysis

Foot plantar pressure is the pressure field that acts between the plantar region of the foot and supporting ground. The pressure exerted on the variable region of the foot can be determined using discrete pressure sensors. Information obtained from these sensors is useful in the measurement of gait and posture for diagnosing various problems associated with a lower limb, footwear design, and sports biomechanics. This project is aimed to design a portable in-shoe plantar pressure and gyroscope-based gait angle measurement system. Six Force Sensitive Resistor (FSR) placed in the sole (hallux, 1st, 5th metatarsal, midfoot lateral, midfoot medial and heel respectively) detects the plantar pressure and gyroscope placed at the ankle, knee and hip help measure the orientation and angle of joint movement during various phases of gait. The study among 16 male and 16 female subjects illustrated the significant pressure variation (p&lt;0.0001, t=5.17 with α=95%). Similarly, there was a significant difference in pressure between normal and fast walking speed (p&lt;0.0001, t=5.88) with mean values of 353Kpa and 426Kpa respectively. The mean pressure value for slow walking speed was 423Kpa while there was no significant variation between slow and normal walking speeds (p=0.62, t=1.98). Plantar pressure increased linearly with an increase in the body weight of a person as well. The mean pressure for the 45-50 age group was 313.25Kpa and that for 70-75 was 449Kpa. The study among 10 diabetics and 10 non-diabetic subjects illustrated significantly higher pressure on 1st and 5th metatarsal on diabetic subjects (p=0.0207 and t=2.536). The movement of ankle, knee and hip joint is visualized using the 3D model of a lower limb through processing software. The study illustrated the range of ankle joint movement between -60(dorsiflexion) to 200(plantarflexion), for knee joint was 00 to 300 (flexion) and that for hip joint was -50(extension) to 400(flexion). There was a significant difference in angular values for all three joints while climbing up and down the staircase as compared to walk in a level surface.

Plantar pressure changes in hindfoot relief devices of different designs

BackgroundIt is frequently observed that overloading the foot can impair bone and soft tissue healing and can lead to harmful sequelae (i.e. ulcers, stress reactions) in context of pre-existing tissue disabilities. In terms of offloading, hindfoot relief devices are commonly applied as a non-operative treatment as well as after various surgical procedures for hindfoot disorders. Despite their common use, there is a paucity of data comparing different orthotic devices with respect to changes in plantar pressure distributions. The aim of this study was to investigate plantar loadings in hindfoot relief devices of different designs.MethodsTwenty-five healthy participants (13 women, 12 men; (mean ± SD) age 37 ± 14 years; BMI 23 ± 4 kg/m2) were recruited. Plantar pressure distributions were collected using i.) a neutral shoe, ii.) a hindfoot relief shoe (HRS) and iii.) a hindfoot relief orthosis (HRO). Peak pressure values were measured via dynamic pedobarography during walking and were analysed from four different plantar regions: the hindfoot, midfoot, metatarsal I-V and forefoot. As a reference standard, the normal walk using neutral shoes served as the condition for full weight-bearing.ResultsConcerning the hindfoot, using the HRS as well as the HRO resulted in significant decreases in plantar pressures compared to baseline values that were obtained with the neutral shoe (− 52% for the HRS and − 52% for the HRO, p < 0.001). Significant increases in peak pressures were found in the midfoot region for both devices (HRS: 32%, p = 0.002; HRO: 47%, p < 0.001). For the metatarsal region, peak pressures were found to decrease significantly (HRS: − 52%, p < 0.001; HRO: -17%, p = 0.034). With respect to the forefoot, a significant reduction in peak pressures using the HRS (− 41%, p < 0.001) was detected, whereas the HRO did not lead to significant changes (− 4%, p = 0.691).ConclusionsBoth the HRO and HRS significantly reduced plantar hindfoot pressure, corresponding to a relative decrease of nearly 50% of the baseline. Nevertheless, the adjacent midfoot zone displayed a significant increase in plantar pressure values for both devices. Supported by these findings, physicians should cautiously consider a substantial increase in midfoot loading, especially in patients affected by additional midfoot injuries or accompanying impairments of tissue healing.Level of evidenceIV, Case series.

Association of quadriceps angle with plantar pressure distribution, navicular height and calcaneo-tibial angle

ObjectiveThe aim of study was to analyze the association between Quadriceps Angle (QA) and plantar pressure, navicular height (NH), and calcaneo-tibial angle (CTA). MethodsA total of 64 volunteers (mean age: 22.25 ± 2.54 (range:19–33)) participated in this cross sectional study. EMED-m (Novel GmbH, Germany) electronic pedobarograph was employed for dynamic plantar pressure measurement using two step protocol. The angle between the vertical axis of calcaneus and the long axis of Achilles tendon for CTA. The height of navicular tubercle from the ground was measured while the subject was standing on both feet for NH. QA was measured while the subject was standing in a relaxed posture where both feet bearing equal weight. ResultsThere were significant negative correlations between QA and maximum force (MxF) under the 4th. metatarsal head (MH4). The QA was also significantly correlated with MxF and force-time integral (FTI) under the bigtoe (BT). FTI under the 3rd. metatarsal head (MH3), MH4 and 5th. metatarsal head (MH5) were significantly negatively correlated with QA. Pressure-time integral (PTI) under the MH4 and MH5 were found to be significantly negatively correlated with QA. A significant correlation was also found between QA and NH (p < 0.0001), whilst there was no correlation between QA and CTA. Regression analysis showed that NH was appeared as the major contributor for the QA (β = −0.49, p < 0.001) in the dynamic condition, followed by BT-FTI (β = 0.37, p < 0.001) and MH5-MxF (β = −0.21, p < 0.037). ConclusionThese findings may imply that the NH which can at least be controlled by appropriate shoe inserts may affect QA. This way, loading pattern of both plantar region and whole lower extremity may be altered. Level of evidenceLevel III, Diagnostic Study.

Statistical Approximation of Plantar Temperature Distribution on Diabetic Subjects Based on Beta Mixture Model

A change in plantar temperature distribution can be an indicator of tissue damage, inflammation, or peripheral vascular abnormalities associated with diabetic foot. Despite the efforts to detect these abnormalities through infrared thermography, there are still several problems to be addressed, especially to detect abnormalities on each foot separately. In this paper, a characterization of the plantar temperature distribution based on a probabilistic approach is proposed. The objective is to detect temperature variations on each foot eluding contralateral comparison. A beta mixture model with four components approximates the plantar temperature distributions of diabetic and non-diabetic subjects. Each component represents an area of the plantar region: toes; metatarsal heads; arch; and heel. The approximation was applied to 60 temperature distributions of non-diabetic subjects and 220 of diabetic subjects. The results suggest that it is possible to characterize distribution in terms of the mean of its beta components.

Pre-Clinical Evaluation of Manilkara hexandra (Roxb.) Dubard Extract for Anti-Arthritic Activity

The instigation of the prevailing study was to explore the in-vivo anti-arthritic activity of hydro alcoholic extract of Manilkara hexandra against formaldehyde and Complete Freund's adjuvant induced arthritis. Formaldehyde induced arthritis, an acute model and Complete Freund's adjuvant induced arthritis, a chronic model were induced by administering 0.1ml of formaldehyde and Complete Freund's adjuvant into the sub plantar regions of hind paw respectively. Hydro alcoholic leaf extract of Manilkara hexandra was administered in varying doses for its evaluation of anti-arthritic activity. The parameters employed for evaluation are paw volume; paw diameter, body weight, arthritic index and hematological parameters. Hydro alcoholic extract of Manilkara hexandra at a concentration of 250mg/kg elicited potent rebate in the measured parameters associated with both the models. The percentage inhibition of paw diameter (80.4%) and paw volume (84.5%) were more potent as compared to standard aspirin (80%) in Formaldehyde induced arthritic model. In Complete Freund's adjuvant induced arthritis, significant declinement in paw diameter, arthritic index and enhancement in the body weight, hemoglobin content and WBC count were noticed. The culmination proffers dominant protective effect of hydro alcoholic extract of Manilkara hexandra against arthritis at a dose of 250mg/kg.

Plantar forefoot pain due to vascular leiomyoma

The diagnosis of plantar forefoot pain is very extensive. Plantar pain in the forefoot usually occurs due to mechanical aetiologies such as metatarsalgia, stress fractures and nerve damage. Tumours are a rare cause of plantar pain in the forefoot. We report the case of a patient with chronic pain in the plantar region of the forefoot due to a vascular leiomyoma. Level of Evidence V; Diagnostic Studies; Expert Opinion.

Free medialis pedis venous flap transfer for reconstruction of volar finger defects: Clinical application and esthetic evaluation

There have been many reports about venous flaps, which are often used for the reconstruction of soft tissue defects after finger injury because such flaps are simple to elevate. Recently, high viability rates and nearly normal histological findings were reported for venous flaps, although the mechanism of flap survival remains unclear. This study investigated the esthetic outcomes after the reconstruction of volar finger defects with free medialis pedis venous flaps, which are venous flaps that elevated between the submalleolar and medial plantar regions. Reconstruction of volar finger defects was performed in 6 patients. All flaps were arterialized flow-through flaps with the venous anastomosis as the outflow. All 6 patients were men, with a mean age of 32.0 years. The defect involved the finger shaft in 4 patients and the finger pulp in 2 patients, and the mean size of the venous flap was 16.7 mm (width) × 34.2 mm (length). Five plastic surgeons specializing in maxillofacial surgery evaluated the color match of the flaps at 6 months postoperatively by assigning a score (maximum: 5 points). The flap showed complete viability with little postoperative atrophy in all 6 patients. The mean color match score for the flaps was 3.7, and it decreased as the flaps were raised further from the medial plantar region. Free medialis pedis venous flaps can be used for the reconstruction of volar soft tissue defects of the finger. Acceptable esthetic results can be obtained if flaps are harvested from an appropriate location in the medialis pedis region by a suitable method.

A Rapid Inflation and Deflation Technique in Digital Subtraction Angiography for Improved Visualization of Expansion of a Balloon Catheter

An 85-year-old woman with resting pain in her right foot was referred to our hospital. The index of skin perfusion pressure in the dorsal and plantar regions was 29 and 28 mm Hg, respectively, and duplex echocardiography revealed a chronic total occlusion of both anterior and posterior tibial

Transient receptor potential ankyrin 1 (TRPA1) plays a critical role in a mouse model of cancer pain.

There is a major, unmet need for the treatment of cancer pain, and new targets and medicines are required. The transient receptor potential ankyrin 1 (TRPA1), a cation channel expressed by nociceptors, is activated by oxidizing substances to mediate pain‐like responses in models of inflammatory and neuropathic pain. As cancer is known to increase oxidative stress, the role of TRPA1 was evaluated in a mouse model of cancer pain. Fourteen days after injection of B16‐F10 murine melanoma cells into the plantar region of the right hind paw, C57BL/6 mice exhibited mechanical and thermal allodynia and thigmotaxis behavior. While heat allodynia was partially reduced in TRP vanilloid 1 (TRPV1)‐deficient mice, thigmotaxis behavior and mechanical and cold allodynia were absent in TRPA1‐deficient mice. Deletion of TRPA1 or TRPV1 did not affect cancer growth. Intrathecal TRPA1 antisense oligonucleotides and two different TRPA1 antagonists (HC‐030031 or A967079) transiently attenuated thigmotaxis behavior and mechanical and cold allodynia. A TRPV1 antagonist (capsazepine) attenuated solely heat allodynia. NADPH oxidase activity and hydrogen peroxide levels were increased in hind paw skin 14 days after cancer cell inoculation. The antioxidant, α‐lipoic acid, attenuated mechanical and cold allodynia and thigmotaxis behavior, but not heat allodynia. Whereas TRPV1, via an oxidative stress‐independent pathway, contributes partially to heat hypersensitivity, oxidative stress‐dependent activation of TRPA1 plays a key role in mediating thigmotaxis behavior and mechanical and cold allodynia in a cancer pain model. TRPA1 antagonists might be beneficial in the treatment of cancer pain.

Arglabin as a potential drug in the treatment of Freund’s complete adjuvant-induced arthritis in rats

Purpose: To investigate the anti-arthritic activity of arglabin in Freund’s complete adjuvant- induced arthritis in rats, and the likely underlying mechanism.Methods: A total of 40 male albino Wistar rats weighing between 120 and 150 g were used for this study. The rats were divided into four groups of ten rats each: control group, arthritis group, arglabintreated group, and standard (STD) group. Chronic arthritis was induced by injecting Freund's complete adjuvant in the plantar region of the rats. Rats in the arglabin-treated group received 5 ng/g arglabin intraperitoneally (i.p.), while those in the STD group received 1.5 mg/kg indomethacin, p.o. for 4 weeks. The development of arthritis was assessed at 0, 7, 14, 21 and 28th day of protocol by measuring thermal hyperalgesia, mechanical nociceptive threshold, arthritic score and paw volume. Activities of liver alkaline phosphatase (ALP), alanine amino-transaminase (ALT) and aspartate amino-transaminase (AST), and the levels of inflammatory cytokines -tumor necrosis factor-α (TNF-α), interferon gamma (IFN-γ), interleukin (IL)-6 and interleukin (IL)-1β were measured in the synovial fluid, while those of inflammatory mediators - thromboxane B2 (TXB2), prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were determined in serum. The expressions of mRNAs of nuclear factor kappa-light-chain-enhancer of activated B cells (NFkB), cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) were also determined in rat synovial tissues.Results: Arglabin significantly decreased the paw swelling and arthritic scores, but significantly increased the paw withdrawal latency, when compared to the arthritis group (p &lt; 0.05). It also attenuated the altered levels of inflammatory cytokines in arthritic rats, and significantly reduced the levels of inflammatory mediators, when compared to the arthritis group (p &lt; 0.05). The expressions of mRNAs of NFkB, COX-2 and iNOS also significantly decreased in arglabin-treated group, relative to the arthritis group (p &lt; 0.05).Conclusion: The anti-arthritic activity of arglabin is due to its effect on inflammatory pathway via decreases in the levels of inflammatory mediators and cytokines, and decrease in the expressions of NFkB, COX-2 and iNOS in the synovial tissues of arthritic rats.Keywords: Arglabin, Arthritis, Freund’s complete adjuvant, Inflammatory cytokines

Babinski's hand sign: many have tried….

Recognizing the semiologic importance of the second, and most famous, sign described by Joseph Babinski - the extension of the hallux after stimulation of the plantar region in order to differentiate organic from pithiatic paralysis- several authors have tried to find a comparable signal in the hand. After 122 years, no one has succeeded.

Effect of different flooring types on pressure distribution under the bovine claw \u2013 an ex vivo study

BackgroundMechanical interactions between hard floorings and the sole of bovine claws can be reasonable to cause traumatic claw lesions. In this ex vivo study, the direct kinetic impact of concrete and three types of rubber mats on the sole of dairy cattle claws was analyzed. In order to apply uniform loads, isolated distal hind limbs of adult Holstein Friesian dairy cows were functionally trimmed according to the Dutch method and attached to a load applicator. Kinetic data were recorded using a thin, foil-based pressure measurement system (Hoof™ System, Tekscan®).ResultsOn concrete, the load distribution between the lateral and medial claw was less balanced than on the rubber floorings. The loaded area was significantly smaller on concrete (32.2 cm2) compared to all rubber mats (48.3–58.0 cm2). Average pressures (Pav) and maximum pressures (Pmax) were significantly higher on concrete (Pav 44.7 N/cm2; Pmax 130.3 N/cm2) compared to the rubber floorings (Pav 24.9–29.7 N/cm2; Pmax 71.9–87.2 N/cm2). Pressure peaks occurred mainly in plantar and abaxial parts of the lateral claw and in apical and plantar regions of the medial claw. Load distribution displayed a widely unloaded slope region, but considering the pressure distribution under the claw, none of the zones showed a generally lower pressure exposure.ConclusionsAltogether, rubber floorings lead to a significant mechanical relief of the sole compared to concrete. Furthermore, relevant differences between the tested rubber mats could be determined. Therefore the used system may be applied to compare further flooring types.

Medial plantar nerve

Objective: To measure and evaluate the distance from the medial plantar nerve (MPN) to six predetermined anatomical landmarks, identifying 12 distances, and establish a correlation with the trajectory of the flexor hallucis longus (FHL) tendon, especially the knot of Henry, and the location of the bifurcation of the posterior tibial nerve (PTN) relative to the tarsal tunnel. Methods: A descriptive and quantitative study was conducted in which 15 adult feet (six right and nine left) from cadavers were dissected, and the anatomical relationship between the MPN and predetermined structures was evaluated. The distance from the medial border of the medial malleolus to the inferior calcaneal tuberosity [defined as a fixed reference (FR)] was measured to compensate for variability in foot size. Results: The results indicated that the bifurcation of the PTN was proximal to the tarsal tunnel in 11 feet (73.3%), within the tunnel in three feet (20%), and distal to the tunnel in one foot (6.66%). A statistically significant (p=0.035) association was found between the FR and the distance from the superior calcaneal tuberosity to the MPN, a strong correlation (p=0.004) was found between the FR and the distance from the inferior calcaneal tuberosity to the MPN, and a significant association (p=0.013) was found between the FR and the distance from the medial calcaneal tuberosity to the knot of Henry. Conclusion: Some anatomical structures, especially the knot of Henry, have a strong correlation with the MPN and should be considered by surgeons who intend to approach the FHL in the plantar region. Bifurcation of the PTN proximal to the tarsal tunnel was the most common presentation.Level of Evidence V; Expert opinion.

Light emitting diode (LED) therapy reduces local pathological changes induced by Bothrops asper snake venom

The therapeutic effect of the Light Emitting Diode (LED) treatment in two wavelengths (635 or 945 nm) was evaluated in the local pathological alterations induced by Bothrops asper snake venom. Mice received irradiation of infrared LED (120 mW, 945 nm) or red LED (110 mW, 635 nm) applied immediately, 1 and 2 h after venom injection. LED treatment reduced edema formation in the plantar region and gastrocnemius muscle and significantly reduced neutrophil migration and hyperalgesia after the venom injection. Also, both infrared LED and red LED treatment significantly reduced myonecrosis, as revealed by muscle CK and plasma CK levels. Histological analysis corroborated the reduction in the extent of venom-induced myonecrosis. In conclusion, our data demonstrates that PBM with LED light in both red and infrared wavelengths, when applied after envenomation in mice, reduces the extent of myotoxicity, edema, inflammatory infiltrate and hyperalgesia, suggesting that photobiomodulation is a potential therapeutic approach that should be further investigated for the treatment of local effects of Bothrops snakebite.

Upper extremity sympathectomy

Hyperhidrosis is a condition in which there is excessive production of sweat that is disproportional to thermoregulation needs and that profoundly hampers the quality of life (QOL) of the population that is affected by it. The disorder is typically limited to the palms, the plantar and craniofacial regions, armpits, and manifests itself in a symmetrical fashion in addition to being associated to family history. At present, sympathectomy is considered the golden standard treatment and there are a number of approaches a surgeon may elect to adopt in its care. The clinical treatment with oxybutynin also improves screening of the group of patients that will benefit the most with this indication. However, the efficacy of the surgical method, what most counts for a successful outcome is the occurrence or not of compensatory hyperhidrosis whose intensity may impact the results. All patients are and must be thoroughly informed of this possibility prior to surgery. For the others indications, is also one of the final approaches necessary for a fruitful treatment.

Plantar pressure distribution during running in early childhood

IntroductionPlantar loads represent a reliable estimation of the mechanical efficiency of movement. The aim of this study was to describe and compare plantar pressure measures during running in children 4–6 years of age. MethodsTwenty-eight children were divided into three groups (4, 5 6 year-olds). Plantar pressure during running at self-selected speed was recorded using an Emed-AT platform (Novel). Contact area, peak pressure, relative maximum force, and relative contact time were analyzed under five different plantar regions. Foot length and dynamic plantar arch index were calculated. The MANOVA and Bonferroni post-hoc were used to compare groups. Level of significance was set at p < 0.05. ResultsBMI and arch index did not differ between the age groups. When compared to the younger groups, 6-year-old children produced higher loads of peak pressure (p < 0.01) and maximum force (p < 0.01), larger contact area (p < 0.01) and longer contact time (p < 0.05) under most foot regions, except for maximum force under the midfoot (p < 0.05). ConclusionsFoot structure and plantar loads during running seem to be still developing in 6-year-olds. These children present different values of peak pressure, maximum force, contact time, and contact area than 4 and 5-year-olds, with higher values in the forefoot and lower values in the midfoot.

EVALUATION OF ANTIDIABETIC DRUG ALOGLIPTIN FOR THE TREATMENT OF INFLAMMATION IN RATS

Objective: The present study was planned to evaluate the Alogliptin (Anti diabetic drug) for the treatment of inflammation in experimental models in rats. Methods: Total of 5 groups of wister rats of either sex weighing 180- 220 g, selected for the study of 2 animal model were kept at ambient temperature of 28±2°C and relative humidity of 45 to 55% with a 12:12 h light/dark cycle. The animals were fasted for 12 h before commencing the experiment with water ad libitum. Fasting was continued till completion of the experiment. Group A was served as normal toxicant control treated with toxicant Carrageenan (model 1) and Histamine (model 2), group B with Ibuprofen (40 mg/Kg p.o.) served as standard, groups C, D and E administered with Alogliptin (low, medium and high doses p.o) respectively in each model. The Groups B, C, D and E were administered with 0.1 ml of 1% w/v of carrageenan in model 1,Histamine in model 2 into sub plantar region of right hind paw of rats 1 h after the administration of Ibuprofen/ Alogliptin. Immediately thereafter the oedema volumes of the injected paws were measured plethysmographically at prefixed time intervals. Results: The Alogliptin with three selected doses i.e. 1, 2 and 3 mg/kg/day have exhibited a significant reduction in paw oedema volume at 4th h in carrageenan 36.92%, 51.49%, 65.46% and histamine 27.41%, 48.24%, 69.07% respectively. Ibuprofen (40 mg/kg) was used as standard reference thus standard drug has exhibited time dependent reduction in oedema volume. Conclusion: The results of recent studies suggest that dipeptidyl-peptidase-4 inhibitors (Alogliptin) have anti inflammatory effect on experimental models in rats. Peer Review History: Received 7 June 2018; Revised 21 June; Accepted 10 July, Available online 15 July 2018 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 9.5/10 Reviewer(s) detail: Prof. Dr. Syamsudin Abdillah, Pancasila University, Indonesia, syamsudin.abdillah@gmail.com Omnia Momtaz Al-Fakharany, Tanta, University, Eygpt, amina.elfakharany@pharm.tanta.edu.eg Similar Articles: EVALUATION OF METHANOLIC EXTRACT OF EUPHORBIA NERIIFOLIA STEM BARK ON BLOOD SUGAR LEVELS, SERUM AND TISSUE LIPIDS IN A PRECLINICAL MODEL PLASMA FERRITIN AND HEPCIDIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Analyses of Baropodometry Protocols Through Bibliometric Research.

The posture of the foot is an important and complex aspect of the human body that implies a constant and coherent adaptation, and keeps the body segments in alignment. Baropodometry is a quantitative exam that evaluates the distribution of pressures at different points in the plantar region and the foot contact area. The objective of the study was to know evaluation protocols that used Barapodometry and to verify which variables were observed after the examination. It was analyzed 43 publications, between 2014 and November 2017, indexed in the Web of Science database and / or IEEE. It was verified that the year with the most publications was 2016 and the language with the highest incidence was English. Italy was the country with the highest number of articles published. In relation to the profile of the participants the most studied were those affected by Parkinson's Disease; the most used positioning protocol was bipodal barefoot support with separated feet with open eyes and then closed and arms along the body, the analyzes performed after the examination were on the stabilization area and anteroposterior and lateral velocity of balance. It was concluded that the examination can be effective in the diagnosis of disorders of static and dynamic equilibrium in the different disorders.

POROCARCINOMA: Um relato de caso

Introdução: O porocarcinoma écrino é uma rara neoplasia maligna de pele, originária das glândulas sudoríparas écrinas, que acomete principalmente idosos. A apresentação clínica é variada e os sítios mais comuns de ocorrência são cabeça e pescoço, seguido das extremidades inferiores.&#x0D; Relato de caso: Paciente sexo masculino, com lesão nodular de 7 cm na região plantar direita, de longa evolução e que na investigação inicial apresentava metástase para linfonodos. Foi realizada radioterapia do sítio primário e da região linfonodal acometida. A cirurgia com intenção curativa não foi realizada, devido às metástases já presentes ao diagnóstico.&#x0D; Discussão: O tumor não tem a etiologia bem definida, mas pode surgir como neoplasia primária ou como transformação maligna do poroma écrino. A biópsia é o principal método diagnóstico e os exames para estadiamento se impõem necessários, visto que até um terço desses tumores são met­astáticos. A cirurgia com amplas margens é o tratamento de eleição e terapias adjuvantes são reservadas para casos recorrentes e com metástases.&#x0D; Conclusão: O diagnóstico precoce do tumor é necessário para evitar que a terapêutica ocorra em fases tardias e sem propostas curativas.