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A positive ulnar fovea sign is usually considered to be specific for foveal disruption of the distal radioulnar ligaments. A retrospective review was done of 73 patients with a positive ulnar fovea sign. Only 21 patients had a foveal tear on arthroscopic examination. Level of evidence: IV., Competing Interests: Declaration of conflicting interestsThe authors declared that there are no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Introduction: Hand tumours are frequently encountered in clinical practice. However, large-scale epidemiological data of soft tissue tumours in the hand are infrequently published. Epidemiological data provide diagnostic cues to guide the workup and management of hand tumours. Assessing significant independent demographic factors and tumour characteristics associated with hand tumours is essential in health care., Methods: A retrospective review of patients who underwent excision of hand tumours in Singapore General Hospital between 2004 and 2015 was conducted. The data collected included age, gender, ethnicity, histological diagnosis, malignancy and location of tumour. Generalised linear latent and mixed models (GLLAMM) analyses were performed., Results: A total of 4476 tumours were identified from 4226 patients with a mean age of 51.3 (range 8-101) years and male to female ratio of 1 to 1.15. Most patients were Chinese (75%), followed by Malay (9%), Indian (8%) and others (8%). The most common hand tumours excised were ganglions (43%) (majority in the wrist), followed by giant cell tumours (9%) (commonly in the digits). Most soft tissue tumours were benign (97%), with only 3% of malignant cases. The GLLAMM analyses revealed further potential factors on the status of malignancy, tumour origin and tumour location., Conclusion: Most soft tissue tumours in the hand and wrist are benign. This can guide workup and counselling of patients before the operation. While malignant tumours are uncommon, they have the potential for significant morbidity and mortality if not appropriately evaluated or treated. The application of GLLAMM analyses showed that age, ethnicity and gender were significant predictors of malignancy., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

As per Globocan 2012, every year the incidence of head and neck cancer is 683235/1000000 with a mortality of around 375665/1000000 thus being the sixth cause of cancer death throughout the world. Head and neck cancer includes cancer of the nasopharynx, oropharynx, hypopharynx, larynx, and oral cavity. Early diagnosis of head and neck cancer is very challenging, hence detecting mucosal lesions at an early stage decreases mortality thereby improving overall survival, disease-free survival, and quality of life. Out of different diagnostic modalities, narrow-band imaging (NBI) combined with endoscopic techniques can provide a promising diagnostic tool in detecting early lesions of head and neck cancer. Numerous studies have shown that Ki-67 is a good prognostic marker in oral cancers. Our study aims to evaluate the diagnostic accuracy of NBI and combine the Ki-67 index to diagnose head and neck cancer., Materials and Methods: All patients were first examined under white light and then under NBI endoscopy, and a biopsy was obtained from suspected lesions and sent for histopathological examination (HPE) and Ki-67 index., Results: Eighty patients were examined out of which, 68 patients having lesions in the oral cavity, oropharynx, larynx, and hypopharynx were examined. The rate of detecting cancerous lesion by white light and NBI were respectively 92% and 100% for oral cavity lesions, 69% and 100% for oropharyngeal lesions, 38% and 100% for hypopharyngeal lesions, and 37% and 100% for laryngeal carcinoma. However, we have found no significant difference in detecting T2-T4 tumors. Hence, we concluded that NBI mode can be a significantly better diagnostic tool than white light mode in detecting early mucosal cancer in head and neck cancer., Conclusion: We have concluded that NBI combined with Ki-67 estimation is a very promising tool that helps in the early diagnosis of mucosal lesions in head and and neck cancer., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: The development of identity formation occurs during adolescence through experiences, ideals and principle. With greater accessibility to sports, recent trends have shown increased rates of sports specialization over the past decade in youth athletes. Athletic identity measures the strength an individual is tied to the athlete role and can be formed in conjunction to adolescent identity formation. More specialized youth athletes may have stronger ties to their athletic identity during their adolescent identity formation period., Methods: Youth basketball athletes were surveyed on specialization levels and athletic identity via the Athletic Identity Measurement Scale (AIMS), including three submeasures: social identity, exclusivity, and negative affectivity., Results: Participants showed stronger identification to social identity items and the weakest identification with exclusivity items. Athletes reporting more time spent playing their primary sport presented higher scores across all measures of athletic identity, and total athletic identity was stronger in athletes reporting specialization at an earlier age. Exclusivity and negative affectivity tended to increase with specialization level which may primarily be driven by specialized athletes choosing to quit non-primary sports., Discussion: Athletic identity may be worth noting as a psychological indicator of potential risk of injury. The long-term goal of this work is to provide the research and clinical community a greater understanding of a potential psychosocial risk factor as youth athletes continue specializing and spending more time training in a singular sport., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Choudhury, Erdman, Stapleton, Gale and Ulman.)

Background: Various studies have examined occlusive dressings in fingertip amputations and reported good outcomes. Occlusive dressing preserves appropriate pH, cell accumulation and moisture for healing, thereby limiting scar formation and deformity. To our knowledge, no study was performed in tropical Asia. This study aims to demonstrate the viability of healing fingertip amputations through secondary intention using an effective dressing technique, even in warm tropical climates. Methods: All patients who presented to our institution with fingertip amputations from 1 July 2020 to 31 July 2022 were analysed retrospectively. Seventeen patients (15 male, 2 female) of mean age 37.2 ± 9.4 years old with 18 injured digits were retrospectively analysed. Twelve (66.7%) were Allen Type III injuries, and one patient required distal phalangeal K-wire fixation. During the patient's final review, static 2-point discrimination, pulp sensation, fingertip contour and nail deformities alongside the last measured range of motion (ROM) of the injured finger was recorded. Treatment duration and days of leave taken were also summed and assessed. Results: Patients were dressed with semi-occlusive dressing for an average of 20.1 ± 6.83 days. The average total duration of dressing is 36.78 ± 18.88 days over an average of 7.18 ± 4.03 dressing visits. Mean duration of follow-up was 108 ± 63.46 days. Good outcome measures in sensation, pulp contour, nail deformity and ROM similar to existing literature were reported. Conclusions: Occlusive dressing remains a viable and feasible treatment option for fingertip amputation even in a tropical climate. While this simple treatment method may require more effort from patient, wound healing was attained after 36.8 ± 18.9 days of dressing. Level of Evidence: Level IV (Therapeutic).

Traumatic foveal tears of the triangular fibrocartilage complex lead to ulnar-sided wrist pain and instability, resulting in painful motion and loss of grip strength with a severe impact on the overall function of the upper limb. Surgical repair is nothing new and has traversed through the realm of open repair to arthroscopic assisted to all arthroscopic repair techniques over the many decades, with arthroscopic repairs showing better visualization, lesser trauma, and equally favorable patient outcomes. Techniques had varied from using trans osseous tunnels to bone anchors, with or without the usage of special jigs. Here, we describe a simple and fast 3 portal arthroscopic technique of repairing the torn foveal insertion of the triangular fibrocartilage complex using a bone anchor inserted under arthroscopic and fluoroscopic guidance into the fovea. Both the dorsal and volar limbs of the triangular fibrocartilage complex are repaired arthroscopically, resulting in a strong anatomic repair resulting in a stable and pain-free wrist., Competing Interests: Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Substance tears of the triangular fibrocartilage complex (TFCC) can occur secondary to trauma of the wrist. On the dorsal periphery, they are considered Palmer 1B tears or Atzei class 1 tears. If along the radial side, they can manifest as a tear of the central disc, classified as a Palmar class 1A tear. If it involves the ligaments, it is stated as a pre-1D tear as per the new classification system by Luchetti and colleagues. Multiple excellent repair techniques exist in the current literature for dorsal peripheral tears and even for those in the substance of the TFCC, whereas there are successful evolving techniques of repair of avulsed tears and those involving the substance of the ligaments on the radial side adjacent to the sigmoid notch. Here, we describe our technique of repairing substance tears of the TFCC arthroscopically without the need for any specialized equipment apart from the basic arthroscopy set. The technique was conducted in a patient with a transverse substance tear on the radial side of the triangular fibrocartilage involving the central disc with complete resolution of symptoms. It is a simple technique, which can be used to repair class 1B peripheral tears and pre-1D tears in the substance of the TFCC., Competing Interests: Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

According to the National Family Health Survey of 2021, about 57% of women aged 15-49 in India currently suffer from anemia, marking a significant increase from the 53% recorded in 2016. Similarly, a study conducted in southern India reported a 32.60% prevalence of preeclampsia. Several community-based initiatives have been launched in India to address these public health challenges. However, these interventions have yet to achieve the desired results. Could the challenges faced by traditional healthcare interventions be overcome through a technological leap? This study assesses pregnant mothers' perceptions regarding mobile health interventions for managing anemia and preeclampsia. Additionally, the study captures their health awareness and knowledge. We conducted a survey with 131 pregnant mothers in three underserved villages in Jharkhand, India. Statistical analysis was conducted using the SEMinR package in R (Version 2023.06.0), utilizing the non-parametric partial least squares-structural equation modeling. We found that every household had at least one smartphone, with the respondents being the primary users. The main uses of smartphones were for calling, messaging, and social media. A total of 61% of respondents showed interest in a nutrition and pregnancy app, while 23.66% were uncertain. Regarding nutritional knowledge during pregnancy, 68.7% reported having some knowledge, but only 11.45% claimed comprehensive knowledge. There was a considerable knowledge gap regarding the critical nutrients needed during pregnancy and the foods recommended for a healthy pregnancy diet. Awareness of pregnancy-related conditions such as anemia and preeclampsia was low, with most respondents unsure of these conditions' primary causes, impacts, and symptoms. This study serves as a critical step towards leveraging technology to enhance public health outcomes in low-resource settings. With the accessibility of mobile devices and an apparent willingness to utilize mHealth apps, compounded by the pressing need for improved maternal health, the impetus for action is indisputable. It is incumbent upon us to seize this opportunity, ensuring that the potential of technology is fully realized and not squandered, thus circumventing the risk of a burgeoning digital divide.

Aim: The aim of the present study was to compare the treatment outcome in oral cancer cases treated with neoadjuvant chemotherapy (NACT) and upfront surgery in localized advance disease., Materials and Methods: A randomized, prospective study was conducted in 20 cases. Patients were divided into two groups. Group A was taken up for upfront surgery and group B was taken up for surgery after two to three cycles of NACT based on patients' response, performance, and compliance., Results: Neither group showed statistically significant differences in clinical characteristics. In the present study, satisfactory outcomes were seen in nine patients belonging to NACT group and eight patients of non-NACT group had satisfactory outcomes after surgery, which were found to be statistically significant ( P = 0.001)., Conclusion: NACT may be considered as a treatment option for oral squamous cell carcinoma patients, particularly those with locally advanced tumors. Further prospective studies are needed to validate these findings in patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Pharmacy and Bioallied Sciences.)

Background  Ulnar-sided wrist pain is a common problem encountered by hand surgeons. Symptomatic recurrent subluxation of the extensor carpi ulnaris (ECU) tendon has become increasingly recognized as one of the pathological conditions leading to ulnar-sided wrist pain. Surgical reconstruction of the subsheath is usually needed. ECU tendon subsheath reconstruction with the periosteal flap was first described by Schlesinger in 1907. Since then, various other techniques have been widely used. We describe a technique of ECU subsheath reconstruction using the dorsal capsule of the distal radioulnar joint (DRUJ). Description of Technique  Two hand surgeons performed the surgeries with the same steps taken each time. A detailed description of our surgical technique, with the dorsal capsule of the DRUJ used to reconstruct the ECU tendon subsheath, is illustrated. Patient and Methods  Patients who presented with symptomatic ECU instability despite conservative treatment or who have failed primary subsheath repair were offered this surgical option. Patients were followed up postoperatively for an average duration of 6.7 months in our outpatient clinics for assessment of wrist function. The surgical outcomes were reviewed and graded with the Modified Mayo Wrist Score (MMWS). Results  All but one of the seven patients had an overall improvement in their range of movement of the wrist, grip strength, and pain scores. Four patients had excellent outcomes on the MMWS, one of whom had an asymptomatic recurrence seen on dynamic ultrasound. Two patients required subsequent surgeries: one had an excellent outcome and the other had a poor outcome on the MMWS. Conclusion  We present our first seven cases of ECU subsheath reconstruction with the dorsal capsule of the DRUJ. Our results in the short term have been satisfactory. The technique does not disrupt the integrity of the extensor retinaculum, which is essential for optimal extensor tendon function, and can also be considered as an option to salvage failed procedures., Competing Interests: Conflict of interest None declared., (Thieme. All rights reserved.)

Radial-sided tears of the triangular fibrocartilage, though uncommon, can still be a reason for ulnar-sided wrist pain, and, at times, instability of the distal radioulnar joint. Historically, it has been believed that because of the paucity of vascularity along the radial edge of the triangular fibrocartilage complex (TFCC), any form of repair will not lead to healing, thus stating it to be an exercise in futility. Current literature deftly argues against this previously prevailing concept and supports the need of repair in case of symptomatic radial-sided TFCC tears. In our study, we describe an all-arthroscopic technique of repairing radial-sided tears using a bone anchor which can be a fast and simple procedure in the hands of an orthopaedic or hand surgeon trained in arthroscopy. This technique also circumvents the risk of injuring the superficial radial nerve and other radial-sided structures which are stated complications of the current arthroscopic repairs., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Background In symptomatic chronic injury of ulnar-sided tear of the triangular fibrocartilage complex, reconstruction techniques involving foveal reconstruction with palmaris longus tendon graft using the method described by Bain have been described with good outcomes. Description of Technique With increasing popularity of wrist arthroscopy to address various wrist pathologies, we present our technique of arthroscopic foveal reconstruction. We also include a step-by-step description of the procedure with illustrations, with aims to aid surgeons in executing it Conclusion Unlike other arthroscopic techniques described, this involves single osseous ulnar tunnel and performed completely arthroscopically, allowing an end result similar to Bain's open technique., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Septic arthritis of the wrist though decidedly rare can lead to severe consequences with loss of form and function of the hand. The approach to diagnosis and treatment remains challenging and may need multiple surgeries, prolonged hospital stays along with intravenous antibiotics for restitution of a pain and disease-free functioning wrist. Arthroscopic washout of the wrist joint, has paved the way for a less invasive and more effective approach to the management of the condition reducing the number of operations needed and the need for open wrist washout. In our paper, we describe in addition to arthroscopic washout of an infected wrist joint the insertion of irrigation catheters followed by continuous irrigation with normal saline through the catheters using an infusion pump for 5 days leading to resolution of symptoms without further surgical interventions., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Mobile health (mHealth) applications have the potential to improve health awareness. This study reports a quasi-controlled intervention to augment maternal health awareness among tribal pregnant mothers through the mHealth application. Households from 2 independent villages with similar socio-demographics in tribal regions of India were selected as intervention (Village A) and control group (Village B). The control group received government mandated programs through traditional means (orally), whereas the intervention group received the same education through mHealth utilization. Postintervention, awareness about tetanus injections and consumption of iron tablets was significantly (P < .001) improved in the intervention group by 55% and 58%, respectively. Awareness about hygiene significantly (P < .001) increased by 57.1%. In addition, mothers in the intervention group who recognized vaginal bleeding, severe abdominal pain, severe blurring of vision, or convulsions as danger signs during pregnancy significantly (P < .001) increased by 18.30%, 23.2%, 20.0%, and 4.90%, respectively. Our study indicates that despite the low literacy of users, mHealth intervention can improve maternal health awareness among tribal communities., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Driven by the clinical need for a strong tissue adhesive with elastomeric material properties, a departure from legacy crosslinking chemistries was sought as a multipurpose platform for tissue mending. A fresh approach to bonding wet substrates has yielded a synthetic biomaterial that overcomes the drawbacks of free-radical and nature-inspired bioadhesives. A food-grade liquid polycaprolactone grafted with carbene precursors yields CaproGlu. The first-of-its-kind low-viscosity prepolymer is VOC-free and requires no photoinitiators. Grafted diazirine end-groups form carbene diradicals upon low energy UVA (365 nm) activation that immediately crosslink tissue surfaces; no pre-heating or animal-derived components are required. The hydrophobic polymeric environment enables metastable functional groups not possible in formulations requiring solvents or water. Activated diazirine within CaproGlu is uniquely capable of crosslinking all amino acids, even on wet tissue substrates. CaproGlu undergoes rapid liquid-to-biorubber transition within seconds of UVA exposure-features not found in any other bioadhesive. The exceptional shelf stability of CaproGlu allows gamma sterilization with no change in material properties. CaproGlu wet adhesiveness is challenged against current unmet clinical needs: anastomosis of spliced blood vessels, anesthetic muscle patches, and human platelet-mediating coatings. The versatility of CaproGlu enables both organic and inorganic composites for future bioadhesive platforms., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

We assessed the efficacy of ketorolac trometamol injections compared with triamcinolone acetonide injections in trigger digits. Patients with trigger digits were randomized to receive either ketorolac or triamcinolone. They were followed up at 3, 6, 12 and 24 weeks, and monitored for resolution of triggering, pain and total active motion. One hundred and twenty-one patients with single trigger digits were recruited (59 ketorolac, 62 triamcinolone). At 6 weeks, 54% of patients in the triamcinolone group had complete resolution of trigger, whereas no patients in the ketorolac group had resolution. At 12 weeks, 58% of patients in the triamcinolone group had complete resolution of trigger compared with 6.7% in the ketorolac group. At 24 weeks, both groups had comparable rates of resolution at 26% and 25%, respectively. Patients in the triamcinolone group had significantly better resolution of pain at 3, 6 and 12 weeks. But at 24 weeks, there was no significant difference in pain between both groups. Significantly less flexion deformity was reported at 3 weeks and 6 weeks in the triamcinolone group. In the short term, ketorolac was less effective in relieving symptoms of trigger digit than triamcinolone. Level of evidence: I.

Objective. Bronchiolitis is one of the commonest causes of hospitalization of infants and young children in Bangladesh. About 21% of under 5 children attending different hospitals of Bangladesh have bronchiolitis. Fifty percent (50%) men and three percent (3%) women of Bangladesh are smokers. Parental smoking is an important risk factor for both susceptibility and severity of bronchiolitis. The aim of this study was to find out the role of parental smoking in severe bronchiolitis. Design. Case-control study. Place and Duration of Study . The study was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Bangladesh, from July 2013 to December 2015. Patients and Methods . Sixty-four patients admitted into the ward with severe bronchiolitis were enrolled as cases and sixty-four suitably matched apparently healthy children attending EPI centre and outpatient department presenting with nonrespiratory illness were enrolled as controls. Sample size was calculated using Guilford and Frucher formula. The technique was systematic random sampling. Every second case satisfying the inclusion and exclusion criteria was enrolled in the study. Results. The mean age of the patients was 7.53 (SD ± 4.75) months. Forty (62.5%) patients were male and twenty four (37.5%) patients were female. Male-to-female ratio was 1.7 : 1. Most of the cases (60.95%) came from low socioeconomic background. More than half of the cases (53.13%) were not exclusively breastfed babies. Mean length of hospital stay was 6.41 (SD ± 2.82) days. Thirty eight (59%) cases and twenty six (34%) controls were exposed to parental smoking. Result was highly significant ( p = 0.005). Odds ratio was 2.8 (95% CI from 1.36 to 5.72). Conclusion. Exposure to parental smoking causes a statistically significant ( p = 0.005, odds ratio = 2.8) increase in the risk of developing severe bronchiolitis in the first year of life., Competing Interests: The authors declare that they have no competing interests.

Trigger finger is one of the very common conditions encountered in hand surgery. Currently, the treatment modes we offer in our clinics are combination therapy of topical NSAIDS, occupational therapy and splinting or invasive modes involving corticosteroid injections and trigger finger release. This is a prospective review looking at the outcomes of the various initial treatment modules currently used for treating trigger fingers and the rate of surgery following non-surgical treatment. From our study we have noted that 26% of the digits which were subjected to combination therapy eventually underwent surgery whereas 60% of digits which received corticosteroid injections underwent surgery. Even though our results comparing operation rates are not statistically significant, they appear to show that combination therapy was more effective in avoiding surgery than corticosteroid injection in lower grades of trigger.

Surgical treatment for trigger finger involves division of the A1 pulley. Some surgeons perform an additional step of traction tenolysis by sequentially bringing the flexor digitorum superficialis and flexor digitorum profundus tendons out of the wound gently with a Ragnell retractor. There is currently no study which states whether flexor tendon traction tenolysis should be routinely performed or not. The objective of this study is to compare the outcome in patients who have traction tenolysis performed (A group) versus those who did not have traction tenolysis (B group) performed. It was noted that even though the mean total active motion (TAM) for the B group in our study was lower preoperatively, it was consistently higher than the A group in all the 3 post-operative visits demonstrating a better outcome in the B group. Even though it was not statistically significant, our data also showed that patients with traction tenolysis appeared to have more postoperative pain compared to those without.

To find out if there is any association of serum zinc level with different prostatic lesions like - benign prostatic hyperplasia (BPH), prostatic intraepithelial lesion (PIN) and frank prostatic carcinoma. Serum zinc level was measured by colorimetric method using RA50 semi autoanalyser from 49 patients having different prostatic pathology (BPH 13, PIN 31, carcinoma 5) and 30 age matched control who had no prostatic complaints. Statisticaly significant (p<0.01) gradual increased zinc level were found in patients having prostatic lesions. In BPH the serum (mean ± SD) zinc level was 101 ± 26.15, in low grade PIN 116 ± 21.34, high grade PIN 117 ± 20.95 and in frank prostatic carcinoma it was 139 ± 11.09 μgm/dl. Our results show statistical significant gradual increase of serum Zinc in BPH, PIN and frank prostatic carcinoma patients. Serum zinc level estimation can be routinely used as adjuvant for evaluation of prostatic lesion.