Ring Syndrome Research Articles

Phantom vibration and ringing syndromes among Indian medical students

Mobile phones are now crucial to our everyday routines, transforming how we interact, granting immediate access to information, fostering social bonds, facilitating shopping, advancing healthcare, enriching education, increasing productivity, and broadening entertainment choices. However, excessive phone usage can result in a higher prevalence of physical or psychological disorders. Phantom sensations, such as Phantom Vibration Syndrome (PVS) and Phantom Ringing Syndrome (PRS), describe the experience of feeling vibrations or hearing ringing from a phone when it is not actually vibrating or ringing. The objectives of the present study are a) to develop a self-administered smartphone addiction scale (SAS) among medical students at a tertiary care facility and b) to find out the aggravating factors for PVS and PRS among medical students in a tertiary care hospital. Our study was a cross-sectional observational survey conducted among 473 medical undergraduate students, using stratified random sampling to select the participants. The self-administered questionnaire was developed based on the Smartphone Addiction Scale (SAS), which is validated and efficient for evaluating smartphone addiction. Among the participants, 46% were males and 54% were females. Our study reported that 60% of the students experienced phantom vibration/ringing syndrome, 53% had poor sleep patterns due to excessive use of mobile phones, 58% felt their lives would be empty without phones, 57% thought about mobile phones even when they were not in their hands, and 56% felt the urge to use their smartphones again right after they stopped using them. About 58% of the students preferred talking with smartphone buddies to hanging out with real-life friends or other family members, reflecting poor socialization among young adults. We recommend a qualitative analysis of behavioural and psychological components to explore the root cause of this issue. Literature on the causes of phantom sensations/vibrations has been limited, with existing theories lacking a comprehensive perspective.

Interrelations of phantom ringing related anxiety and personal self-esteem in undergraduate university students

IntroductionManifestations of phantom ringing syndrome are widely seen in healthy population. Are there any interrelations between this phenomenon and personal psychological characteristics that are connected with the level of their mental health?ObjectivesTo determine the specificity of interrelations of phantom ringing syndrome related anxiety and personal self-esteem in university studentsMethodsThe anonymous survey covered 546 undergraduate university students. The questions were centered on the students’ patterns of their personal smartphone use.Results The research showed that manifestations of phantom ringing syndrome is available in 189 students, or in every third student (34.6%), who use mobile phones. It is equally represented in males (49.7%) and females (50.2). Clinically, it is characterized by a higher level of anxiety, which reliably correlates (p<0.01) with the level of stress (r=.17), level of nervousness caused by absence of a mobile phone (r=.18), the frequency of headache (r=.15), the frequency of medication consumption related to chronic somatic disease (r=.15). We also established valid negative interrelations between the level of phantom ringing syndrome related anxiety and the personal self-esteem based on the parameters of religious belief (r=-.15), personal attractiveness (r=-.16), mind (r=-.17), happiness (r=-.24), liveliness (r=-.25) and well-being (r=-.15). We have not found any proof of valid interrelations with self-assessment of health.ConclusionsThe received results prove that phantom ringing syndrome related anxiety is connected with the personal self-esteem, the level of the perceived stress and some other clinical manifestationsDisclosure of InterestNone Declared

Live-born autosomal ring chromosomes at the Johns Hopkins Hospital Cytogenomics Laboratory: Case series-Spanning 52 years of experience in a single center.

Ring chromosomes (RCs) are a structural aberration that can be tolerated better in acrocentric or gonosomal chromosomes. Complete RCs arise from telomere-telomere fusions. Alternatively, genomic imbalances corresponding to the ends of the chromosomal arms can be seen with RC formation. RCs are unstable in mitosis, result in mosaicism, and are associated with a "ring syndrome," which presents with growth and development phenotypes and differs from those features more frequently observed with pure terminal copy number changes. Due to variability in mosaicism, size, and genomic content, clear genotype-phenotype correlations may not always be possible. Given the rarity of RCs, this historical data is invaluable. We performed a retrospective review of individuals bearing RCs to investigate the incidence in our laboratory. This work details the methods and features seen in association with twenty-three autosomal RCs. In decreasing order, the most frequently seen autosomal RCs were 18, 22, 4, 13, 17, and 9. The additional cases detail clinical and cytogenomic events similar to those reported in RCs. As methodologies advance, insights may be gleaned from following up on these cases to improve genotype-phenotype correlations and understand the cryptic differences or other predisposing factors that lead to ring formation and development.

Stress, Anxiety and Depression as an Accelerating Factor for Phantom Vibration and Ringing Syndrome in Medical Students

Stress, Anxiety and Depression as an Accelerating Factor for Phantom Vibration and Ringing Syndrome in Medical Students

Outcomes of Linear Circumferential Skin Closure for Congenital Constriction Ring Syndrome.

Background: Congenital constriction ring syndrome (CCRS) is a rare condition diagnosed at birth characterised by deformation due to a constriction ring. The usual treatment for CCRS involves excision of the constriction ring and suture of the skin incorporating a Z-plasty to prevent scar contracture. A Z-plasty often results in an unsightly scar. In order to avoid this, we performed linear circumferential skin closure (LCSC). The aim of this paper is to report the outcomes of LCSC for CCRS. Methods: We retrospectively investigated all patients with CCRS who underwent LCSC between 2002 and 2020. Two linear incisions were placed proximal and distal to the constriction ring in parallel, and the constriction ring was excised carefully so as not to damage nerves or vessels. The deep subcutaneous and dermis layers were sutured. The skin was closed using adhesive tape. Two-stage surgery was performed in two patients with severe CCRS of the lower leg to avoid problems with distal circulation. Patients were followed up for at least 1 year and assessed for complications and quality of scar. Results: We performed LCSC for 31 sites in 19 patients, including one forearm, 14 fingers, 10 lower legs and six toes. The median age at the operation was 16 months (range: 4-175). The median follow-up period after surgery was 5.8 years (range: 1.9-16.0). The linear surgical scar had healed well in all patients and there were no complications. There was no recurrence of the constriction ring and no scar hypertrophy, though we did not perform fat mobilisation in all cases. None of the patients required additional surgery and the aesthetic outcome of the linear circumferential surgical scar was maintained at the final observation. Conclusions: Treatment for CCRS using LCSC resulted in no complications, no recurrence of constriction and an excellent aesthetic outcome. Level of Evidence: Level IV (Therapeutic).

A CROSS SECTIONAL STUDY ON PHANTOM VIBRATION SYNDROME AND ITS IMPACT ON PSYCHOLOGICAL MORBIDITY AMONG MEDICAL STUDENTS.

Background - Phantom vibration syndrome (PVS) is the sensation of false belief that mobile phone is vibrating when actually it is not. It is an emerging psychological disorder due to overuse of mobile phones owing to its charismatic features such as portability, accessibility, etc. Mobile phones have become an essential part of day-to-day life. As a society increasingly dependent on mobile phones, PVS easily becomes a phenomenon of worry. Frequent use of Mobile phones on prolonged vibration mode lead towards PVS. Studies suggest that PVS can cause psychological stress, anxiety, depression and if left unmanaged, primary symptoms progress to advanced stages. Aims and Objectives - To estimate the proportion of Phantom Vibration Syndrome among medical students and to assess the Impact of Phantom Vibration Syndrome on Stress, Anxiety and Depression. Materials and Methods - Across sectional online questionnaire-based study was conducted among 280 medical students of Indira Gandhi Government Medical College, Nagpur from January 2022 to February 2022. Data was collected using pre-tested questionnaire which included questionnaire regarding Mobile phone usage and Psychological well- being. Stress, Anxiety and Depression were assessed using Perceived stress scale, Hamilton Anxiety rating scale and Beck's Depression Inventory Scale respectively. Results – Out Of 280 respondents, 135 (48.2%) are Male and 145 (51.8%) are Female. 74% (208) reported having experienced Phantom Vibration Syndrome (PVS) from mobile phones. Whereas only, 18.57% of Study Participants experienced Phantom Ringing Syndrome. Conclusions – Excessive problematic usage of mobile phone has resulted in various disorders like phantom vibration syndrome, Phubbing, Ringxiety and Nomophobia that deals with psychological or socio behavioral changes. By limiting mobile phone use in a productive way, these health-related problems can be avoided.

Prevalence of Phantom Vibrations and Ringing Syndrome, and its Association with Smartphone Addiction among Medical Students of Teaching Hospital, South India

Introduction Phantom vibration syndrome (PVS) and phantom ringing syndrome (PRS) is a false sensation of phone vibration and ringing when it is not. This study aimed to estimate the prevalence of PVS/PRS among medical students and to determine factors including level of smartphone usage associated with the development of phantom sensations. Methods Using cross-sectional analytical design, sociodemographic details, information on phantom sensations and phone usage among medical students in our institution in Puducherry, India, was obtained. Stratified random sampling strategy was incorporated to achieve a sample size of 369. Also, overuse of phone was assessed using Smartphone Addiction scale – short version (SAS-SV). Prevalence of PVS and PRS was summarized as a proportion with a 95% confidence interval (CI). Prevalence ratio for the factors associated with the phantom syndrome (PVS/PRS) was estimated using log-binomial regression. Results Using data from 383 students, the prevalence of phantom syndrome (PVS/PRS) was 44.9% (39.9–50.0%). PVS was more prevalent than PRS (27.9% vs 21.2%). There was a significant difference in SAS-SV scores between those with the phantom syndrome and those without. Students who stay in hostel (aPR = 1.88; 95% CI: 1.46 to 2.43), self-reported overuse of phone (aPR = 1.96; 95% CI: 1.56 to 2.45) and higher smartphone addiction score (aPR = 1.26; 95% CI: 1.04 to 1.53) were found to be significant determinants to have PVS/PRS. Conclusion Overall, one in two medical students had either PVS or PRS in our institution, Puducherry. Higher smartphone usage was a significant predictor of the presence of PVS/PRS.

Constriction ring syndrome: Severe cuts.

Constriction ring syndrome: Severe cuts.

The past, present, and future for constitutional ring chromosomes: A report of the international consortium for human ring chromosomes.

SummaryHuman ring chromosomes (RCs) are rare diseases with an estimated newborn incidence of 1/50,000 and an annual occurrence of 2,800 patients globally. Over the past 60 years, banding cytogenetics, fluorescence in situ hybridization (FISH), chromosome microarray analysis (CMA), and whole-genome sequencing (WGS) has been used to detect an RC and further characterize its genomic alterations. Ring syndrome featuring sever growth retardation and variable intellectual disability has been considered as general clinical presentations for all RCs due to the cellular losses from the dynamic mosaicism of RC instability through mitosis. Cytogenomic heterogeneity ranging from simple complete RCs to complex rearranged RCs and variable RC intolerance with different relative frequencies have been observed. Clinical heterogeneity, including chromosome-specific deletion and duplication syndromes, gene-related organ and tissue defects, cancer predisposition to different types of tumors, and reproductive failure, has been reported in the literature. However, the patients with RCs reported in the literature accounted for less than 1% of its occurrence. Current diagnostic practice lacks laboratory standards for analyzing cellular behavior and genomic imbalances of RCs to evaluate the compound effects on patients. Under-representation of clinical cases and lack of comprehensive diagnostic analysis make it a challenge for evidence-based interpretation of clinico-cytogenomic correlations and recommendation of follow-up clinical management. Given recent advancements in genomic technologies and organized efforts by international collaborations and patient advocacy organizations, the prospective of standardized cytogenomic diagnosis and evidence-based clinical management for all patients with RCs could be achieved at an unprecedented global scale.

Amniotic band disease: a case report

Amniotic band disease or constriction ring syndrome (CRS) is a variety of birth defects. It is a rare pathology caused by strands of the amniotic sac that separate and entangle the limbs, digits or other parts of the body. Unlike genetic malformations, CRS-related abnormalities are often asymmetrical, polymorphic and do not adhere to any embryological systematization. The complications from the amniotic band disease can range from mild such as amputations of the digits or the limbs, syndactyly and deformities to severe when the band becomes wrapped around the neck, the umbilical cord and the neurological system resulting in fetal death and neural-tube like defects. The strands are often hard to see by ultrasound, and typically the condition is detected indirectly by the constrictions and swellings they cause. Therefore, CRS poses diagnostic difficulties and therapeutic challenges for practitioners. We report two cases of CRS, one of postnatal discovery and one of prenatal discovery. The usefulness is to highlight the diagnostic difficulties of this rare pathology.

Amniotic Band Sequence Syndrome – A Rare Disorder

Amniotic bands sequence is a inherited diseases distinguished by craniofacial, body wall, and limb oddities that may be in relation with foetal-placental fibrous bands. Its pervasiveness has been delineated to range from 0.19 to 8.1 per 10 000 births [1]. It is a customary state prospectively alike with a variety of different confinements’ disability. The deformities arise in the wake of the pompous bodily part have formed usually in early evolution. The required cause of amniotic disruption complex is undisclosed .The three most usual decorative design are constriction ring syndrome signalized by one or more limbs being high-flown; the limb-body- wall complex; and amniotic band syndrome characterized by abnormalities of the head and face (craniofacial abnormalities), inadequacies of the brain and genuine deformation of the appendages [2].
 The condition in few cases might be considered prior to nativity (antepartum), unlikely to change upon the sequels of explicit detailed imaging practices, like fetal USG, which may give away the feature inadequacies [3].
 Here we present a case of pregnant woman admitted in our Obstetrics and gynecological department with her ultrasonography report indicative of amniotic band and further discussed about antenatal diagnosis, diagnostic and therapeutic approach, prognosis and genetic counselling of amniotic disruption complex.

Clinical and molecular characterization of an almost complete ring chromosome 4 in two sisters, with recurrence due to gonadal mosaicism.

Autosomal ring chromosomes are rare cytogenetic findings that arise from breakage and fusion of the chromosome ends. Rings are mitotically unstable, usually sporadic and associated with a 'ring syndrome', characterized by a variable phenotype: growth retardation, no significant dysmorphisms and normal to moderately disabled intelligence. We describe the clinical features and molecular characterization of two sisters with ring chromosome 4. Karyotype analysis was performed on both sisters and parents. Chromosome microarray was performed on both sisters to delineate the breakpoint imbalance. Both sisters had a large ring 4 chromosome in the majority of cells analyzed on karyotype. Microarray results were identical in the sisters, showing a 55.8 kb duplication on the terminal 4p arm and a 1.5 Mb deletion on the terminal 4q arm. No genes of interest were identified in these regions. Parental karyotypes on lymphocytes and fibroblasts were normal, with no finding of mosaicism for the ring 4 chromosome. Polymorphic marker analysis revealed the maternal origin of the ring. To our knowledge, this is the first reported instance of a ring 4 chromosome recurring in siblings after extensive parental testing, which suggests this was due to maternal gonadal mosaicism.

Hypospadias in ring X syndrome

Ring X is a chromosomal anomaly mainly seen in females with turner syndrome and usually present in mosaic form with 45,X cells (45,X/46,X,r(X)) because of their mitotic instability. In males it is an extremely rare finding because large nullisomy for X chromosome material is likely not compatible with survival. Only two cases of male with ring chromosome X were previously reported. We report here a four-year-old male with ring chromosome X characterized using Karyotype, FISH and array CGH and presenting short stature, microcephaly and hypospadias. Molecular investigations showed 923 Kb terminal deletion on the pseudoautosomal region 1 (PAR1) including SHOX gene followed by a duplication of 2.4 Mb. The absence of functional nullisomy because of a second copy of deleted genes was present in chromosome Y PAR1 region may explain the compatibility with survival in our case of male with ring X. Short stature common with the two previously reported cases is likely related to SHOX gene deletion but also to the effect of “ring syndrome”. However, hypospadias was not reported in the previous cases and can be due to the associated duplication outside PAR1 region including in particular PRKX gene coding for a protein involved in urogenital system morphogenesis.

Salvage Reconstruction of a Congenital Hypoplastic Thumb Due to Constriction Ring Syndrome Using a Third Toe Transfer, When the Usual Donor Sites of Index Finger, Great and Second Toes Are Not Available.

Isolated third toe-to-thumb transfers have been rarely reported and none in the pediatric population. We describe a third toe-to-thumb transfer for reconstruction of a congenital hypoplastic thumb with excellent functional results and no morbidity in the donor foot.

Total thumb reconstruction by an original groin pocket flap-graft design

Background: The thumb plays a key role in hand function for precise dexterity. The surgical treatment of full avulsions of the digital skin sheath by tearing (ring syndrome) is complex and the management of these lesions is challenging for the reconstructive surgeon. When replantation is not possible, other alternatives are available if the covering tissue is thin and flexible. Case presentation: A 30-year-old male, tobacco addict, had a thumbsequelae similar to a stage III ring finger. Revascularization attempt failed and the skin envelope necrosed secondarily. A groin pocket flapgraft allowed a conservation of his thumb with a satisfactory aesthetic and functional result. Conclusions: We described a thumb coverage by a groin flapgraft using an original pocket design. This simple and safe procedure, in the carefully selected patient can successfully address functional and aesthetic concerns simultaneously, with minimal sequelae at the donor site. This technique can be used to treat a cutaneous tearing of the other fingers.

Взаимосвязь состояния лимфоидно-глоточного кольца и синдрома ксеростомии

Xerostomia is a condition that develops with a decrease in saliva secretion (hyposialia) or cessation of saliva secretion (asialia) and is characterized by dryness in the oral cavity. Xerostomia is widespread in different age groups, but is most common in older age groups. In a number of diseases, for example, in Sjogren's disease, xerostomia is the leading symptom complex and determines the severity of the clinical picture. Chronic inflammatory diseases of the pharynx, such as chronic tonsillitis and chronic pharyngitis, may be accompanied by a pronounced decrease in saliva secretion. Timely conservative treatment of inflammatory diseases of the pharynx has a positive effect on the dynamics of the course of xerostomia. To diagnose this condition, patients are advised to undergo sialometry. Xerostomia can be observed in the long term after bilateral tonsillectomy and, which forces patients to seek medical help. To eliminate dryness in the oral cavity after otorhinolaryngological interventions, in particular after bilateral tonsillectomy, saliva substitutes are widely used in practical otorhinolaryngology. Data on the relationship between the state of the lymphoid-pharyngeal ring and xerostomia syndrome are presented in the modern literature by single publications, and therefore, studies of the relationship between inflammatory diseases of the pharynx and the level of saliva secretion are certainly of significant scientific and practical interest. Treatment of patients suffering from both subjective and objective xerostomia requires an interdisciplinary approach with the participation of a dentist, otorhinolaryngologist and doctors of other specialties (gerantologist, endocrinologist, rheumatologist, psychotherapist). Modern methods of surgical treatment of patients with chronic tonsillitis and xerostomia using radio wave methods, highenergy laser radiation, coblator should be considered as an alternative to classical bilateral tonsillectomy.

When Marriage Hurts: A Literature Review of Embedded Jewellery Ring Injuries.

A ring is traditionally worn as a symbol of love and affection or as decorative ornamental jewellery. However, rings are not without risk. The spectrum of danger can range from debilitating avulsion injuries to simple contact dermatitis. Unknown to many, an unusual rarity exists; previous authors have termed this entity ‘embedded ring syndrome’. We sought to review the literature and collate evidence on the common features of this syndrome.A literature review was performed on cases reported from 1947 to 2017 accessed through the healthcare database advanced search (HDAS). A total of 28 cases were analysed for demographics, symptomatology and operative techniques. Overall, 64.3% were females, and 50% had a psychiatric comorbidity. There was a causative event preceding the injury in 35.7% of cases; 71.4% had a reduced range of movement or reported a stiff finger and 32.1% had reduced sensation. The majority of patients underwent ring removal and primary closure, without documentation as to whether neurovascular bundles and tendons were visualised. Embedded ring injuries are rare. Consequently, information is sparsely available regarding its natural history and management. The hand surgeon’s approach requires an understanding that the chronicity of these injuries can have a significant traumatic impact on the structures of the finger.

Chromosome 14 deletions, rings, and epilepsy genes: A riddle wrapped in a mystery inside an enigma.

The ring 14 syndrome is a rare condition caused by the rearrangement of one chromosome 14 into a ring-like structure. The formation of the ring requires two breakpoints and loss of material from the short and long arms of the chromosome. Like many other chromosome syndromes, it is characterized by multiple congenital anomalies and developmental delays. Typical of the condition are retinal anomalies and drug-resistant epilepsy. These latter manifestations are not found in individuals who are carriers of comparable 14q deletions without formation of a ring (linear deletions). To find an explanation for this apparent discrepancy and gain insight into the mechanisms leading to seizures, we reviewed and compared literature cases of both ring and linear deletion syndrome with respect to both their clinical manifestations and the role and function of potentially epileptogenic genes. Knowledge of the epilepsy-related genes in chromosome 14 is an important premise for the search of new and effective drugs to combat seizures. Current clinical and molecular evidence is not sufficient to explain the known discrepancies between ring and linear deletions.

Investigation of the Role of Anxiety and Depression on the Formation of Phantom Vibration and Ringing Syndrome Caused by Working Stress during Medical Internship.

Phantom vibration syndrome (PVS) and phantom ringing syndrome (PRS) are prevalent hallucinations during medical internship. Depression and anxiety are probably understudied risk factors of PVS and PRS. The aim was to evaluate the role of anxiety and depression on the relationship between working stress during medical internship and PVS and PRS. A prospective longitudinal study, consisted of 74 medical interns, was carried out. The severity of phantom vibrations and ringing, as well as anxiety and depression as measured before, at the third, sixth, and 12th month during internship, and two weeks after internship. We conducted a causal mediation analysis to quantify the role of depression and in the mechanism of working stress during medical internship inducing PVS and PRS. The results showed that depression explained 21.9% and 8.4% for stress-induced PRS and PVS, respectively. In addition, anxiety explained 15.0% and 7.8% for stress-induced PRS and PVS, respectively. Our findings showed both depression and anxiety can explain a portion of stress-induced PVS and PRS during medical internship and might be more important in clinical practice and benefit to prevention of work-related burnout.

The phantom syndrome: a descriptive study on prevalence and association with smartphone addiction and perceived stress among medical students in central Kerala

Background: Technology in Communication has developed drastically in recent years and the introduction of smartphone is a crucial milestone in history. The constant involvement of people with their smartphone has led to the surfacing of a new kind of psychological disorder called as the phantom syndrome, comprising of phantom vibration syndrome (PVS) and phantom ringing syndrome (PRS), characterized by a recurrent false sensation of vibration and ringing from their smartphones.Methods: A cross sectional study was conducted among Four hundred eighty seven medical students in Thiruvalla Taluk of Pathanamthitta District, Kerala to estimate prevalence of such sensations among medical students and their association with perceived stress levels and smartphone addiction. Data was collected using a semi structured questionnaire for details about the phantom vibration/phantom ringing sensations over the last 1-month, perceived stress scale (PSS), smartphone addiction scale short version (SAS SV). Chi-square test and odds ratio with 95% confidence interval were used to evaluate statistical significance of association.Results: 59.1% have a sensation of phantom vibration and 61% experienced phantom ringing syndrome. 73.5% students perceived stress and 67.6% had smartphone addiction. Phantom vibration and phantom ringing were significantly associated to perceived stress and smartphone addiction.Conclusions: This study throws light on the stress levels and excessive smartphone use among medical students, and the association of smartphone phantom sensations with smartphone addiction and stress level.