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The risk of Musculoskeletal Disorders (MSDs) can occur in a variety of occupations including in traditional jewelers. The complaint is caused by an awkward position during work activities. The study aims to identify complaints of Musculoskeletal Disorders (MSDs). This study used qualitative approach through in-depth interviews on 5 key informants and 2 key expert informants and ergonomic risk determination referring to the BRIEF method. The results showed that all informants experienced complaints of the upper neck, lower neck, right shoulder, back, right elbow, right upper arm, and right forearm. Measurements through the BRIEF sheet show that complaints on the left and right elbows, left and right shoulders, neck, and back include high category ergonomic hazards while complaints on the hands and wrists of the right include moderate category ergonomic hazards. High risk of Musculoskeletal Disorders (MSDs) is found at all stages of work (smelting, grinding, posturing, jewelry formation, and gilding). Therefore, workers are recommended to perform muscle relaxation for (8-12 seconds) every half hour.

Diverse Onchocerca species are present mostly parasitizing ungulates, with the exception of Onchocerca volvulus (O. volvulus) in humans and O. lupi in canids and cats. The human cases due to the O. lupi have been more highlighted during last years. So, the present review was performed to determine the detailed characteristics of confirmed human O. lupi case reports documented worldwide. Hence, a systematic search was done using English international databases (Scopus, PubMed, Web of Science, Embase, ProQuest, and Google Scholar). Totally, 14 confirmed human cases were documented during the last decade, mostly from the USA and Turkey with 7 and 3 cases, respectively. Most cases (7 individuals) were male with the age range of 22-month-old to 54-year-old. The parasite was frequently isolated from the right eye (5 cases), followed by the left eye (4 cases), cervical spinal canal (3 cases), scalp, and right forearm (one case each). Molecular identification of the isolated agent was the preferred way of diagnosis in most cases (9 records). In conclusion, human O. lupi cases have been more highlighted in recent years, whether due to the improved diagnostics and/or host-switching phenomenon, and both veterinarians and healthcare authorities should be alerted.

Malignant melanoma and particularly metastatic melanoma represent a diagnostic challenge due to the wide variety of histologic patterns, resemblance to benign entities, and extensive range of clinical presentations. A high index of suspicion for melanoma is important for accurate diagnosis, especially when there is a previous history of malignancy. Here, we present a patient with a history of melanoma and locally metastatic melanoma, who subsequently developed a nodule on his right forearm near the site of his previous melanoma excision. Histologically, the melanoma appeared as granuloma annulare (GA) with benign cytologic features, but was identified as metastatic melanoma using SOX-10 immunohistochemical staining. Other malignancies, including lymphomas, leukemias, sarcomas, and cutaneous metastases of internal malignancies, have mimicked GA and interstitial granulomatous processes. Therefore, further immunohistochemical staining should be performed to assess for metastatic disease in the setting of a histological pattern that resembles a benign granulomatous process in a patient with a history of malignancy, including malignant melanoma.

Background Silicon is an abundant element in the human body and plays an important role in the skin, taking part in the synthesis of collagen and glycosaminoglycans. The use of nanotechnology methods, which processes materials at an atomic and molecular scale, has allowed the development of nanosilicons. Aims The study evaluates the effectiveness of a food supplement and a topical solution containing nanosilicon in improving skin hydration and elasticity. Methods A total of 30 female subjects were randomized to receive the placebo (n = 15) and the active compound (n = 15). All enrolled subjects took the food supplement twice a day for 20 days and then once a day for the next 20 days, and they also had to apply the nanosilicon solution on the right forearm four times a day. Evaluation of several parameters was performed after 20 and 40 days through the use of non-invasive instrumental methods (Corneometer® CM 825, Cutometer® MPA 580, Visioscan® VC, Tewameter® TM 200). Results Both treatment groups showed a statistically significant improvement in barrier function and in skin hydration on the right forearm after 20 days; increase in skin elasticity was observed only in the group taking the active compound. Conclusions The study showed that the administration of a food supplement and a topical solution, both containing nanosilicon, improves hydration, elasticity, and skin barrier function.

Silica granulomas have been described on the skin and are rare; however, this is the first report of a sarcoid-like granulomatous reaction because of siliceous diatom frustules in the subcutis, making this an unprecedented case. A 41-year-old female presented with a subcutaneous nodule on the right forearm clinically suggestive of cyst, foreign body, or lipoma. Excisional biopsy revealed subcutis with a sarcoid-like granulomatous reaction in a background of fibrosis, containing abundant semitransparent, exquisitely geometric particles, mildly refringent under polarized light, highlighted by phase contrast microscopy; special stains were negative for microorganisms. Definitive characterization of the peculiar fragments was accomplished by confocal laser microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy, revealing them as diatom frustules made of silicon dioxide (SiO2 ) or silica. Diatoms are unicellular algae, their skeletons (frustules) made of silica have collected on the bottom of rivers, lakes, and oceans for thousands or millions of years and form what we know as diatomite or diatomaceous earth, which is widely used in different industries and easily available in the market. The mechanism whereby diatom frustules gained access to the patient's subcutis is enigmatic.

Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old man developed pain and skin swelling over right forearm at the intravenous access site during amphotericin B administration treatment given for mucormycosis, the post-operative of sinuses. After 4 hours of affected period, amphotericin B was administration. A well revealed thrombophlebitis of the right forearm was noted. The systemic reaction was assessed based on the naranjo algorithm and was found to be probable. The safety profile of amphotericin B and its adverse effects must be monitored on long term treatment usage. Key words: Thrombophlebitis, Amphotericin B, Adverse drug reaction, Pharmacovigilance, Mucormycosis.

Based on calculations by the Directorate General of Food Plants (Ditjen TP), Ministry of Agriculture. Corn production in the last 5 years has increased by an average of 12.49% per year. According to the Secretary of the Directorate General of Food Crops of the Ministry of Agriculture (Kementan) Maman Suherman in 2019 maize production is estimated to reach 33 million tonnes of dry shell (PK) in an interview with Republika on January 6, 2019. Cepiring sub-district, Kendal district, apart from being planted with rice in the rainy season, rice fields also planted with maize. After harvesting, the corn that has been plucked is separated from the cob using a corn sheller. The shelling machine is used using diesel fuel and electricity, with workers standing for long periods of time, causing fatigue in the arms, waist, thighs and back. The data processing of the nordic body map questionnaire was carried out to determine the complaints on the skeleton and muscles of the workers. From the results of the questionnaire above, most Sido Rejo farmers feel complaints on their right shoulder, left upper arm, back, right upper arm, back, waist, left elbow, right elbow, left forearm, right forearm, left wrist, wrist right, left hand, right hand, left thigh, right thigh, left calf, right calf, left leg to right leg. With anthropometric measurements, the dimensions of the body used are the height of the sitting shoulders and the data used are the average data or the 50th percentile. With this solar sheller, it can save fuel and be environmentally friendly and reduce the complaints of the frame and muscles of farmers

Sports fatigue will cause deformation of actions. In this study, badminton was analyzed, and the influence which was brought by fatigue was studied from the perspective of biomechanics. The forehand smash of professional badminton athletes under normal and fatigue states was tested. The biomechanical indexes of athletes were obtained by infrared remote shooting test system and plantar pressure test system for comparison. The results showed that the forehand smash effect of athletes was significantly worse under fatigue state, the maximum gravity center height decreased to 1.22 ± 0.14 m, and the maximum gravity center speed decreased to 2.33 ± 0.12 m/s, which showed significant decreases compared to the normal state (P< 0.05). Moreover the maximum velocity of the right upper arm, right forearm, elbow joint, wrist joint and knee joint decreased significantly (P< 0.5), the maximum angle of the right hip joint, knee joint and left ankle joint also decreased significantly. The pressure of the inner side of the forefoot and the pressure in the middle of the forefoot increased (P< 0.05). The biomechanical analysis of forehand smash under fatigue condition reveals the relationship between fatigue and movement, which provides some scientific bases for the reasonable control of sports load.

The neurobehavioral mechanisms of human motor-control and learning evolved in free behaving, real-life settings, yet this is studied mostly in reductionistic lab-based experiments. Here we take a step towards a more real-world motor neuroscience using wearables for naturalistic full-body motion-tracking and the sports of pool billiards to frame a real-world skill learning experiment. First, we asked if well-known features of motor learning in lab-based experiments generalize to a real-world task. We found similarities in many features such as multiple learning rates, and the relationship between task-related variability and motor learning. Our data-driven approach reveals the structure and complexity of movement, variability, and motor learning, enabling an in-depth understanding of the structure of motor learning in three ways: First, while expecting most of the movement learning is done by the cue-wielding arm, we find that motor learning affects the whole body, changing motor-control from head to toe. Second, during learning, all subjects decreased their movement variability and their variability in the outcome. Subjects who were initially more variable were also more variable after learning. Lastly, when screening the link across subjects between initial variability in individual joints and learning, we found that only the initial variability in the right forearm supination shows a significant correlation to the subjects’ learning rates. This is in-line with the relationship between learning and variability: while learning leads to an overall reduction in movement variability, only initial variability in specific task-relevant dimensions can facilitate faster learning.

Indelible ink is formulated by National Physical Laboratory and produced by Mysore Paints and Varnishes Limited since 1962. It is most used to prevent voter fraud in elections. The ink’s believed to be composed of silver nitrate (7%–25%), which binds to the proteins in skin and nails. The ink is said to be relatively safe at this concentration. However, frequent exposure, older ink, and higher concentrations can result in cumulative exposure and various degrees of damage. Herein, we report irritation reactions with the ink in several students labelled for home quarantine during COVD19 pandemic. Overall, 97 students (aged 15–17 years) with travel history were screened and quarantined according to COVID19 protocols. They were stamped with “HOME QUARANTINE” on the ventral aspect of the right forearm. Approximately 4-6 hours later, all students complained of localised burning and swelling to a variable extent. The severity was more in girls. They were treated with topical antibiotics, steroids and cetirizine tablets which showed symptomatic improvement. Irritation with indelible ink has rarely been reported, especially, with a large sample size. This report highlights the risk of severe irritant dermatitis with indelible ink and hence the need for its judicious use. Keywords: Indelible ink, Irritant dermatitis, COVID.

Posterior compartment of forearm and hand is among the most variable parts of the human body. During a routine dissection, we found two anatomical variants in the right forearm and hand of an 84-year-old male cadaver including the extensor indicis radialis and the extensor medii proprius associated with a fibromuscular slip. Histological analysis using hematoxylin and eosin staining revealed that this unusual fibromuscular slip associated with the extensor medii proprius was composed of dense connective tissue along with small amount of skeletal muscle fibers, and the innervation from the posterior interosseous nerve. Based on the existing literature, a fibromuscular slip associated with a hand extensor tendon on the dorsum of hand has never been reported. Further studies are needed to clarify the evolutionary origin of this structure, although it resembles to a certain extent the dorsometacarpales, a group of muscles that were once present in our mammalian ancestors.

In this work, the design of a robotic hand with 7 degrees of freedom is presented that allows greater flexibility, achieving the usual actions performed by a normal hand. The work consists of a prototype designed with linear actuators and myoelectric sensor, following the mechanism of the University of Toronto for the management of functional phalanges. The design, construction description, components and recommendations for the elaboration of a flexible and useful robotic hand for amputee patients with a residual limb for the socket are presented. Keywords: Robotic hand, Degree of freedom, Toronto´s Mechanism, lineal actuator. References [1]W. Diane, J. Braza and M. Yacub, Essentials of Physical Medicine and Rehabilitation, 4th ed. Philadelphia: Walter R. Frontera and Julie K. Silver and Thomas D. Rizzo, 2020, pp. 651 - 657. [2]A. Heerschop, C. Van Der Sluis, E. Otten, & R.M. Bongers, Looking beyond proportional control: The relevance of mode switching in learning to operate multi-articulating myoelectric upper-limb prostheses, . Biomedical Signal Processing and Control, 2020, doi:10.1016/j.bspc.2019.101647. [3]L. Heisnam, B. Suthar, 20 DOF robotic hand for tele-operation: — Design, simulation, control and accuracy test with leap motion. 2016 International Conference on Robotics and Automation for Humanitarian Applications (RAHA), 2016, doi:10.1109/raha.2016.7931886. [4]Y. Mishima, R. Ozawa, Design of a robotic finger using series gear chain mechanisms. 2014 IEEE/RSJ International Conference on Intelligent Robots and Systems, 2014, doi:10.1109/iros.2014.6942961. [5]N. Dechev, W. Cleghorn, S. Naumann, Multi-segmented finger design of an experimental prosthetic hand,Proceedings of the Sixth National Applied Mechanisms & Robotics Conference, december 1999. [6]O. Flor, “Building a mobile robot,” Education for the future. Accessed on: December 29, 2019. [Online] Available: https://omarflor2014.wixsite.com/misitio. [7]Vargas, O., Flor,O., Suarez, F., Design of a robotic prototype of the hand and right forearm for prostheses, Universidad, Ciencia y Tecnología, 2019. [8]O. Vargas, O. Flor, F. Suarez, C. Chimbo, Construction and functional tests of a robotic prototype for human prostheses, Revista espirales, 2020. [9]P. PonPriya, E. Priya, Design and control of prosthetic hand using myoelectric signal. International Conference on Computing and Communications Technologies (ICCCT), 2017, doi:10.1109/iccct2.2017.7972314. [10]N. Bajaj, A. Spiers, A. Dollar, State of the Art in Artificial Wrists: A Review of Prosthetic and Robotic Wrist Design. IEEE Transactions on Robotics, 2019, doi:10.1109/tro.2018.2865890.

Coexistence of bullous pemphigoid (BP) and vitiligo vulgaris (VV) is very rare. We present a unique case of BP associated with VV in a 76-year-old Japanese man, in which BP eruption developed exclusively on preexisting VV regions. The patient was referred to us with a 3-month history of blistering eruption with severe pruritis on the right forearm and left lower limb. In addition, he had been suffering from a widespread depigmented eruption on the trunk and extremities for at least 20 years. Curiously, the blistering eruption developed exclusively on preexisting depigmented eruption. Histopathological and laboratory examinations identified the blistering eruption as BP. The depigmented eruption was diagnosed as VV. BP eruption responded quickly to oral prednisolone therapy, improving within 1 week, and the prednisolone dose was gradually tapered. Within 1 month, BP lesions almost completely resolved. In the present case, BP not only coexisted with VV, but also developed exclusively on preexisting vitiliginous regions. The present case strongly suggests that BP and VV are partly caused by common pathological mechanisms.

Objetivos: Analizar la relación de la fuerza de prensión manual FPM con el Flujo espiratorio Máximo FEM y verificar como estos parámetros en conjunto pueden contribuir sobre la salud ósea en niños y adolescentes. Metodología: Se efectuó un estudio descriptivo (correlacional). Se estudió de forma probabilística a 253 niños y adolescentes (134 hombres y 119 mujeres). El rango de edad fue de 6,0 hasta 15,0 años. Se evaluó el peso, la estatura de pie, estatura sentada, longitud del antebrazo derecho, el diámetro del fémur derecho, la fuerza de prensión manual FPM derecha e izquierda y el flujo espiratorio máximo FEM. Se calculó la densidad mineral ósea DMO y el contenido mineral óseo CMO por medio de ecuaciones de regresión antropométrica. Resultados: Se observó correlaciones positivas entre FPM con el FEM en ambos sexos (R2adjust = 30 a 37%). La FPM de forma individual explica la DMO y el CMO entre 58 a 69%, mientras que el FEM entre 35 a 42%. Ambas variables en conjunto (FPM derecha e izquierda + FEM) explican la DMO y el CMO entre 67 a 68%. Conclusión: Se observó correlaciones positivas entre la FPM y FEM en escolares de ambos sexos. Ambos variables son determinantes para predecir la salud ósea de niños y adolescentes. Estos resultados sugieren que ambos parámetros pueden servir como indicadores de aptitud funcional para identificar la fragilidad ósea entre niños y adolescentes. Abstract. Objectives: To analyze the relationship between manual grasping force (FPM) and Maximum expiratory flow (FEM), and to verify how these parameters together can contribute to bone health in children and adolescents. Methodology: A descriptive (correlational) study was carried out. A total of 253 children and adolescents (134 boys and 119 girls) were selected probabilistically. The age range is 6.0 to 15.0 years old. Weight, standing height, sitting height, right forearm length, right biepicondylar femur diameter, right and left FPM, and peak FEM were evaluated. Bone mineral density (BMD) and bone mineral content (CMD) were calculated by means of anthropometric regression equations. Results: Positive correlations were observed between FPM and FEM in both sexes (R2adjust = 30 to 37%). FPM individually explains BMD and CMD by 58% to 69%, while FEM by 35% to 42%. Both variables together (right and left FPM + FEM) explain BMD and CMD by 67% to 68%. Conclusion: Positive correlations were observed between FPM and FEM in schoolchildren of both sexes. Both variables are determinant to predict children's and adolescents' bone health. These results suggest that both parameters can serve as indicators of functional aptitude to identify bone fragility among children and adolescents.

Introduction Nested graft is a surgical technique that allows to manage difficult-to-treat medical conditions such as chronic cutaneous ulcers, thanks to the high efficacy it has in reverting the fibroblasts senescence. Because of its peculiar regenerative property, nested graft is a surgical technique suitable also for the treatment of cutaneous ulcers developing on fibrotic scar tissue. Case report We reported the case of a 45-year-old man, drug-addict, with a large ulcer on the back of the right forearm in the context of scar fibrotic tissue. This lesion resulted from a previous heroin extravasation treated with a dermo-epidermal skin graft, that was accidentally scratched away by mechanical trauma. After several therapeutic failures with topical medications, we decided to treat the ulcer performing a skin graft using the nested graft technique. No adverse events were reported by the patient during or after the surgery. At the clinical evaluation performed three years later the wound was completely healed. Conclusions Nested graft represents a safe and easy-to-use technique that can be successfully used to treat ulcers on scar tissue, ensuring the achievement and the long-term maintenance of optimal resistance and aesthetic results.

Introduction Air bag deployment after high velocity trauma has been associated with burn injuries. So, we aimed to present a clinical case report associated with air bag deployment experienced by the author himself. Case presentation The author was driving a hatchback car which collided head on with the high speeding vehicle from opposite direction. He sustained a burn injury around 4 × 3 cm in size in the flexor aspect of right forearm involving epidermis and some part of dermis which was superficial partial thickness in nature when the air bag deployment was observed at both the sides. Burn injury was healed with topical antibiotics and regular dressings with no any complications. Discussion Air bag deployment has always been a safety measures for the road traffic injuries but the safety comes with a cost. It has been associated with burn injuries, especially chemical induced, thermal and frictional burns. Timely diagnosis of type of burn and intervention is required in order to minimize complications associated with burns. Conclusion Though burn injuries associated with air bag deployment cause less harm or complications, the companies making such commodities should explore the further options in order to develop burn injury free vehicle safety., Highlights • Air bag introduction has been one of the milestones for road traffic safety. • Air bag deployment is associated with thermal, chemical and frictional burn injury. • Identification of type of burn is required for proper management.

The rapid progress in the industrial sector has an important role in growing the economy. Without the industrial sector, growth in developing countries will be slower than in previous years. UD. Berkah Alam is one of the informal industrial sectors that focuses on coconut management. The types of jobs available at UD. The blessings of Nature are the pacak part, the scrap part, the daily part and the copra part. This type of work has a risk of musculoskeletal disorders. The study was conducted with the aim of knowing the prevalence of complaints of Musculoskeletal Disorders (MSDs) in each work section. The method used is a survey using a nordic body map using a questionnaire. The results showed that 59% of all workers experienced complaints of pain or pain, especially in the musculoskeletal system. Workers who experience complaints on the musculoskeletal system are highest in the copra (100%). Complaints of disorders experienced by workers of the right shoulder, left shoulder, buttocks, buttocks, right forearm and left forearm.

This study tested the hypotheses that compared to drinking water, consumption of a caffeinated soft drink sweetened with high‐fructose corn syrup (HFCS) attenuates the cutaneous vasodilatory response to local skin heating without (Protocol 1) and following ischemia‐reperfusion injury (Protocol 2). In a randomized, counterbalanced crossover design, 14 healthy adults (25 ± 3 year, 6 women) consumed 500 ml of water (water) or a caffeinated soft drink sweetened with HFCS (Mtn. Dew, DEW). Thirty minutes following beverage consumption local skin heating commenced on the right forearm (Protocol 1), while on the left forearm ischemia‐reperfusion commenced with 20 min of ischemia followed by 20 min of reperfusion and then local skin heating (Protocol 2). Local skin heating involved 40 min of heating to 39℃ followed by 20 min of heating to 44℃. Skin blood flow (SkBf, laser Doppler) data were normalized to mean arterial pressure and are presented as a cutaneous vascular conductance (CVC) and as percentage of the CVC response during heating to 44℃ (%CVCmax). Protocol 1: During local heating at 39℃, no differences were observed in CVC (water: 2.0 ± 0.6 PU/mmHg; DEW: 2.0 ± 0.8 PU/mmHg, p = 0.83) or %CVCmax (water: 59 ± 14%; DEW 60 ± 15%, p = 0.84) between trials. Protocol 2: During local skin heating at 39℃, no differences were observed in CVC (water: 1.7 ± 0.5 PU/mmHg; DEW: 1.5 ± 0.5 PU/mmHg, p = 0.33) or %CVCmax (water: 64 ± 15%; DEW 61 ± 15% p = 0.62) between trials. The cutaneous microvascular vasodilator response to local heating with or without prior ischemia‐reperfusion injury is not affected by acute consumption of a caffeinated soft drink sweetened with HFCS., We examined the effect of consumption of a caffeinated soft drink sweetened with high‐fructose corn syrup on the cutaneous vasodilatory response to local skin heating without and following ischemia‐reperfusion injury. We identified that the cutaneous microvascular vasodilator response to local heating with or without prior ischemia‐reperfusion injury is not affected by acute consumption of a caffeinated soft drink sweetened with high‐fructose corn syrup.

Background and Aims Through this clinical case we aim to raise awareness of the existence of highly effective peripheral nerve blocks that allow to minimize the volume of local anesthetic, thus reducing the associated complications. Methods A 20 year-old ASA I man was admitted for urgent reconstructive plastic surgery after left hand flexor tendon injury and right forearm extensor digitorium injury. To offer anesthesia of the whole hand, we decided to perform a left axillary block. The right-limb wound was expected to be superficial and thus manageable under subcutaneous anesthetic infiltration. When initiating the intervention on the right wound it was obvious that subcutaneous anesthesia was insufficient as the injury was deeper than predicted. Faced with the fact that we had almost reached the toxic dose and that we were avoiding approaching the airway, we decided to perform an ultrasound guided distal-arm radial block, as the involved structures depended on radial sensory innervation. Results A total amount of 3 ml of local anesthetic was used. The patient experienced complete anesthesia of the radial nerve territory, and surgery was successfully achieved. No complications were reported Conclusions This approach reminds us that that, similar to the distal-arm radial block, there are numerous distal blocks that can be performed. While allowing a volume sparing technique, these blocks are both easy and safe to perform, offering high quality anesthesia and analgesia.

Aplasia cutis congenita (ACC) refers to congenital absence of skin occurring alone or in association with other anomalies. Congenital epidermal naevi are benign naevi of epidermal component present at birth or appearing in the first few years of life in characteristic developmental pattern. We are reporting the case of a 9-month-old female baby born of a non-consanguineous marriage reported to the department of dermatology for loss of skin over the right side of the scalp and lesions over the right upper limb since birth. Systemic examination did not reveal any abnormalities. The mother's antenatal history was uneventful. On examination erythematous, thin parchment-like hairless scar with crusting is present over the right frontoparietal region of the scalp. Hyperpigmented verrucous papules with surrounding erythematous skin present over right axilla, dorsum of right ring finger and hypopigmented macules present over extensor aspect of right forearm in blaschkoid distribution. According to modified Frieden's classification, aplasia cutis has been categorised into nine types. Around 86% of cases are seen over the vertex of the scalp. In the third type, ACC is associated with epidermal naevi. This is an unusual association, hence being reported here.

Currently, the challenge of replantation of the upper limb after amputation has become an achievable and meticulously perfected reality in recent decades and is in constant evolution. The surgical option for replantation should take into account not only a comprehensive analysis of the viability of the replantation but fundamentally its potential for long-term functional recovery. We present the clinical case of a 40-year-old man, victim of a work accident, with cut trauma, which resulted in distal amputation of his right forearm. The warm ischemia time was 5 h, having been submitted to joint replantation surgery. Following the surgery, physical medicine and rehabilitation (PMR) was referred early, carrying out a sequential functional rehabilitation program. This work aims to emphasize the importance of the role of PMR in an early, careful, and extensive rehabilitation program, a fundamental factor in the functional recovery and long-term prognosis of these injuries and prevention of complications.

Introduction Diffuse cellulitis is a serious and potentially fatal condition. The etiology is most often dental. The aim of this work is to highlight the morbidity of diffuse cellulitis and the associated therapeutic difficulties, by reporting a serious, unusual case of diffuse cervico-thoracofacial cellulitis of dental origin. Observation A 37-year-old patient with no particular pathological history presented with 48 odontalgia evolving for two weeks. The patient self-medicated of unspecified nature. He developed a secondary infection of the cellulosic fatty tissues of the lodges which spread to the cervical region and then to the thorax and the right forearm. Large areas of skin necrosis appeared, associated with an alteration of the general condition and motivated the consultation. The diagnosis of diffuse cervico-thoracofacial cellulitis was retained. Biological tests showed hyperleukocytosis with a predominance of neutrophils. Treatment consisted of resuscitation, synergistic tri-antibiotic therapy, and iterative removal of dead tissue under general anesthesia. Avulsion of the causal tooth was performed. The evolution was favorable after one month of hospitalization. Conclusion Diffuse cellulitis is serious and is prognostic for the patient. The management is urgent and multidisciplinary.

We report a case of a 13-year-old boy with extensive lymphomatoid papulosis (LyP) involving his elbows, forearms, proximal thighs, and right hip, with treatment-resistant nodules on his right forearm. He was treated with full-body narrowband ultraviolet B and targeted photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA). After two months, there was complete resolution of the right forearm nodules. Due to its minimal toxicity, PDT offers unique advantages and may be considered for pediatric LyP patients with symptomatic, localized disease resistant to conventional treatments.

Objective To report the outcome of a patient who developed aneurysm after a Deinagkistrodon acutus snakebite. Case report. A 65-year-old man, bitten by Deinagkistrodon acutus in his right forearm, came to our hospital 10 h after the bite. A pulsatile bulge was found on the right wrist at the third night, and spontaneous ruptured and hemorrhaged suddenly, an emergency surgery was arranged. A ruptured aneurysm of the radial artery was identified and the aneurysm was removed during the surgery. The patient underwent a total of six surgeries, regretfully, he was eventually discharged from the hospital with the right forearm amputated. Conclusion: A bite by the Deinagkistrodon acutus snake may be accompanied by aneurysm and spontaneous rupture, and vessel assessment is necessary in snakebite patients.

Papillary digital adenocarcinoma (PDA) is a rare eccrine tumor that is most often found on the digits. Few case reports have described PDAs located on atypical sites. It is now accepted that PDAs cannot be distinguished from benign adenomas based on histological features, and it is recommended to excise all of these lesions. Even with excision, recurrence and metastasis rates are high. Only limited genomic analyses have been performed to date, and no driver mutations have been identified. We report a case of a 63-year-old woman with a PDA on the right forearm. Biopsy showed moderate cytologic atypia and mitotic figures. Next-generation DNA sequencing of the tumor showed a BRAFV600E mutation and high tumor mutational burden (5.51 mutations/Mb). This mutation is known for its response to small molecular inhibitors of BRAF and Mitogen-activated protein kinase kinase. Such therapy may be a consideration should our patient develop recurrent unresectable disease.

The dead body of a 13-year-old boy was transferred from the Department of Forensic Medicine in Al-Qadisiya Health Directorate, Al-Qadisiya province to the main medico-legal directorate in Baghdad. Bruises were scattered all over his body with bite marks on his left shoulder and superficial wounds in different regions, in addition to a bruise similar to a ligature around the neck. There was also an electrocution burn on the right forearm. The body was transferred because of the unavailability of forensic pathologists in that region and the difficulty of performing the autopsy by other doctors in order to give a proper autopsy report to the court and whether it was a case of battered child syndrome, electrocution, or homicide through injuries the perpetrator tried to conceal. It was revealed that the boy was lectrocuted, and electrocution was recorded as the cause of death.

Introduction: Echocardiography is essential in the evaluation of patients with cardiovascular disease. Repetitive movements, however, expose ultrasound operators to a high risk of musculoskeletal strain injuries. Aim: We investigated to what extent a probe stabilizer could reduce repetitive movements. Materials and methods: The study population consisted of 31 male patients referred for routine transthoracic echocardiography. A good apical acoustic window was prerequisite for inclusion. Standard apical views and measurements were first recorded without using the probe stabilizer. Afterwards, the same apical views and measurements were acquired with utilization of the probe stabilizer. During the entire procedure, shoulder abduction and muscle activity of right forearm flexor and extensor muscles were recorded. To this purpose, an EMG-sensor was attached to the right lower arm and a gyroscope to the right shoulder blade. Results: Extreme right arm abduction (>30˚) occurred in 58% of the time with use of the stabilizer and in 98% of the time without (p

Purpose. This study aimed to investigate the effects of using hand grip or resisted wrist extension as the reference contraction, and two electrode positions, on field recordings of forearm extensor muscle activity. Materials and methods. Right forearm extensor muscle activity was recorded using two electrode pairs (over the most prominent part (position 2) and proximal to that (position 1)) during one working day in 13 female hotel housekeepers. Each subject performed the two maximal voluntary contractions (MVCs), and the electrical activity obtained during these (maximal voluntary electrical activity (MVE)) was used for normalization. Each set of recordings was analysed twice, once using hand grip as the MVC and once using resisted wrist extension. Results. Resisted wrist extension showed a higher group mean MVE than hand grip. Position 2 had higher correlation between MVE and force during the MVCs. The workload during cleaning was lower when using resisted wrist extension as reference than when using hand grip (24%MVE vs 46%MVE; p = 0.002 at position 2) for the 90th percentile. The workload (99th percentile) was overestimated in two subjects when using hand grip as reference. Conclusions. Problems associated with poorly activated forearm extensors can be overcome by using resisted wrist extension as reference.

Stature is an important parameter of personal identification of an individual there are many studies conducted along with others parameters such as age, sex, race, etc. The present study is an attempt to examine the relationship between the stature and right forearm length of 100 males and 100 females of north Karnataka, population in age ranging from 21 to 35 years. Linear and multiple regression equations formula for stature estimation were calculated. The co-relation co-efficient between stature and both right and left forearm length were found to be positive and statistically significant (P Keywords: Human anatomy, Anthropology, Stature, North Karnataka.

Acute plastic deformation of long bones is more common in young children. We report a case of an acute plastic deformation of a pediatric radius via magnetic resonance imaging (MRI) evaluation. A 15-year-old boy fell on landing after a jump while practicing soccer, which injured his right forearm. He was diagnosed with a radial neck fracture and a medial epicondylar fracture of the humerus on the basis of plain radiograms. MRI was additionally performed and showed abnormal shadows indicating intramedullary bleeding at multiple bamboo-joint-like deformity sites of the radius. Surgery was performed and injury completely healed. Acute plastic deformation of long bones was often diagnosed by simple radiographic imaging. To our knowledge, there has been no previous reports of plastic deformation evaluated by MRI. If bone plastic deformation is missed, functional impairments such as limited range of motion remain; thus, an early diagnosis of acute bone plastic deformation by performing MRI is recommended.

We present a case of a female neonate with a cluster of six skin colored to yellowish pseudovesicular papules on her right forearm present since birth, initially thought to be a herpes simplex virus infection. Punch biopsy with immunostaining revealed a diagnosis of S100-negative, CD163-positive congenital cutaneous non-neural granular cell tumor. Only four other reports are presented in the literature of this entity, three of which also presented on the arm with somewhat similar clinical findings. We briefly reviewed the subtypes of classic and S100-negative non-neural granular cell tumors.

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a type of connective tissue cancer, which may also have genetic backgrounds. More than half of patients have neurofibromatosis. The treatment of this tumor is a combination of surgery, radiotherapy, and chemotherapy. As usual, the tumor may be present anywhere with several manifestations. Case Presentation: A 4-year old boy presented with sweating and pain in the right forearm that was diagnosed with MPNST developed in the paravertebral region after laboratory and radiographic evaluation. Conclusions: The patient was treated successfully and followed up for one year without any complications.

The aims of this study were to explore muscle activity levels during different violin repertoires, quantify the general levels bilaterally in upper extremity muscles, and evaluate associations between muscle activity and anthropometrics characteristics. In 18 skilled violin players surface EMG was recorded bilaterally from trapezius (UT), flexor digitorum superficialis (FDS), extensor carpi ulnaris (ECU), extensor digitorum cummunis (EDC), and extensor carpi radialis (ECR) during A and E major scales played in three octaves and Mozart’s Violin Concerto no. 5. To compare side differences the static, median and peak levels of muscle activity were calculated from an amplitude probability distribution function (APDF). This study demonstrated that scales played as standardized tasks can be used to estimate the average muscle activity during violin playing. Comparing results from scales and the music piece revealed a similar muscle activity across all muscles in the music piece and E major scales. The static, median and peak EMG levels were higher in left than in right forearm muscles with left ECU presenting the highest peak load of 30 %MVE. Females demonstrated a higher muscle activity than males, but this was in accordance with differences in anthropometric measures.

This paper details the development of an e-textile gesture controller using screen-printed electrodes to measure Electromyography (EMG); the electrical signals produced in a muscle during its use. The final e-textile consists of 7 fabric electrodes able to take measurements from three muscular groups in the right forearm. When accompanied with processing circuitry, also produced in this study, a total of five gestures are uniquely identified with an average accuracy of ~93% when operating with a switching delay of 150 ms or greater.

In this report, we discuss the case of a two-month-old boy with an isolated radius shaft fracture in the right forearm. The history and nature of the injury may be inconclusive in such injuries. A radiograph confirmed that the child had a fracture. We treated the boy conservatively, and the fracture united well in four weeks. Surgeons should be aware of this rare presentation in infants of this age. Inquiry into possible child abuse as well as clinical and metabolic workup is essential in these cases.

A student with a physical disability successfully completes the first 2 years of a baccalaureate in nursing degree program and is preparing to enter the clinical phase of his education. The student was born without a right forearm but has learned to compensate for the disability. The faculty are concerned that he will not be able to perform all required nursing skills or cannot practice safely in the clinical setting. The student is also concerned about how he will be viewed by both students and faculty.

Background and objectives Energy-based devices have been widely applied for skin ablation. A novel ablation technique based on thermomechanical principles (Tixel© ) has been recently developed. The aim of this study was to examine the wound-healing process and clinical aspects after thermomechanical skin ablation. Study design/materials and methods Six female participants were treated with Tixel© on healthy skin of the dorsal side of the right forearm in a single session with a 600 µm protrusion and 12 milliseconds pulse. The treated area was examined with confocal laser scanning microscopy on day 1, 2, 7, and 14 after treatment. Clinical symptoms were evaluated at the same time-points. Results All patients developed erythema and mild edema on the treated areas, which completely disappeared within 14 days. No post-inflammatory hyperpigmentation or scarring was observed. Thermomechanical skin ablation resulted in the formation of homogeneous micro-ablation zones. Two weeks after ablation, the honeycomb patterns of the epidermis in all examined layers was thoroughly restored. Thus, wound-healing was completed. Conclusions Wound healing after thermomechanical skin ablation is much faster compared with other fractionated ablation methods. Treatment intervals of 2-4 weeks could be recommended. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

Introduction Psoriasis is an immune-mediated disease affecting the skin and joints with a prevalence of 0.44 to 2.8% in India. This manifests most often as plaque psoriasis (PP); it is a chronic, relapsing, inflammatory skin disorder with a strong genetic basis. PP is rarely life threatening but it is often intractable to treatment. Here, a 31-year-old male diagnosed with PP presented with a history of multiple reddish moist lesions with thickness and scaling of skin from right forearm, chest, abdomen and back for 3 years. Patient was taking allopathic medications for the same but there was only temporary relief of the complaints. So, patient approached for homeopathic intervention for permanent cure. On the basis of the totality of symptoms and analysis by repertorisation, homoeopathic medicine Lycopodium was prescribed and repetition was done according to the response of medicine and as per the condition of patient, following the principles of homoeopathy. It showed improvement in all complaints, but there was relapse of eruptions after sometime which called for increase in the potency of the Lycopodium (200C & 1M) as per homoeopathic principles. The assessment of patient was done on the basis of Psoriasis Area and Severity Index (PASI) score and photographic evidence. The PASI score of the patient at baseline was 23.4 and it was reduced to 1 after the continuous follow-up of patient for 1 year. Photographs during follow-up visits have provided a documentary evidence about the effectiveness of homoeopathic medicine Lycopodium in plaque psoriasis. Thus, it can be concluded that homoeopathy plays an effective role in managing the cases of PP symptomatically along with complete recovery of the patient.

Aim: We examined the effect of modulating the shear stress (SS) profile using forearm warming and cooling on subsequent endothelial function in the brachial artery (BA) during exercise. Methods: Twelve healthy young subjects immersed their right forearm in water (15°C or 42°C) during a leg cycling exercise at 120–130 bpm for 60 min. The same exercise without water immersion served as a control. The BA diameter and blood velocity were simultaneously recorded using Doppler ultrasonography to evaluate the antegrade, retrograde, and mean shear rates (SRs, an estimate of SS) before, during, and after exercise. The endothelial function in the right BA was evaluated using flow-mediated dilation (FMD) (%) using two-dimensional high-resolution ultrasonography before (baseline) and 15 and 60 min after exercise. Results: During exercise, compared with the control trial, higher antegrade and mean SRs and lower retrograde SRs were observed in the warm trial; conversely, lower antegrade and mean SRs and higher retrograde SRs were observed in the cool trial. At 15 min postexercise, no significant change was observed in the FMD from baseline in the warm (Δ%FMD: +1.6%, tendency to increase; p = 0.08) and control trials (Δ %FMD: +1.1%). However, in the cool trial, the postexercise FMD at 60 min decreased from baseline (Δ%FMD: −2.7%) and was lower than that of the warm (Δ%FMD: +1.5%) and control (Δ%FMD: +1.2%) trials. Accumulated changes in each SR during and after exercise were significantly correlated with postexercise FMD changes. Conclusion: Modulation of shear profiles in the BA during exercise appears to be associated with subsequent endothelial function.

A 67-year-old female with acute myelogenous leukemia, presented with a two-week history of enlarging ecchymosis-like plaques with hemorrhagic bullae on the right forearm and anterior legs, associated with fever, pain, and swelling. Tissue cultures were persistently negative. Lesions progressed despite broad-spectrum antibiotic coverage. Histopathology showed neutrophilic dermatitis, consistent with pyoderma gangrenosum. The patient was diagnosed with the bullous type. This type is rare with only two reported cases in the Philippines since 2011. Systemic glucocorticoids were given with note of dramatic improvement of the lesions.

International audience; Systemic use of voriconazole (VCZ) might be restricted by adverse events, such as hepatotoxicity and neurotoxicity, or drug-drug interactions. Topical VCZ application to skin may help to treat local infection more effectively and limit unwanted whole-body exposure. Topical VCZ cream was stable for 90 days when refrigerated. A patient with cutaneous Fusarium solani infection on his right forearm was successfully treated with topical 1% VCZ cream after failure of oral VCZ treatment.

The price tag on goat at the farm gate or market is usually by visual appraisal as the use of weighing scale for body weight determination is cumbersome and technical. This study was carried out to determine the reliability of using the girth tape as a non-conventional method of live weight, carcass characteristics and dressing percentage estimation for economic gain of goats. Female goats (n=75) were purchased from Akinyele goat market to comprise of WAD (n=25), Sahel (n=25) and Maradi (n=25) with the age range of 22-24 months. The weights were measured using a conventional weighing scale. Also, a calibrated girth tape was used to measure the heart girth of the circumference of the chest. The goats were humanely slaughtered and properly processed for the determination of dressing percentage. The carcasses were carefully sectioned into five parts namely: neck, right forearm, left forearm, right thigh and left thigh and the weights were determined. The values for scale and girth tape measurements were 15.90±4.15kg and 16.28±4.17kg, 20.81±5.80kg and 19.97±5.56kg, and 25.47±3.70kg and 25.20±3.48kg, respectively. There were not significant (p>0.05) differences between scale and girth tape measurements for the goats. The dressing percentages were 51.29±3.87%, 49.26±3.51% and 43.11±4.17% for WAD, Maradi and Sahel goats, respectively. There were apparent (p

Epidermal biophysical properties can be affected by many factors, including body site, age, gender, ethnicity, disease, temperature, humidity, and ultraviolet (UV) radiation. Information about variation of epidermal biophysical properties with seasons is still limited. In the present study, we determined seasonal variation of epidermal biophysical properties of women in Kunming, China.A total of 72 women, aged 22.96 ± 2.11 years, were enrolled in this study. Transepidermal water loss rates (TEWL), stratum corneum (SC) hydration, sebum content, melanin index (MI), erythema index (EI), and L*a* values were measured on the right cheek and the right forearm, using a non-invasive skin physiological instrument in the spring, summer, autumn, and winter in Kunming, China.On the cheek, TEWL, SC hydration, sebum, MI, and L*a* values varied greatly with seasons (P .05). SC hydration, sebum, MI, and a*value peaked in the summer, but went lowest in winter. In contrast, TEWL and L*value went lowest in summer but peaked in winter. Similarly, SC hydration, MI, and L*value also varied with seasons on the forearm (P .05). In addition, SC hydration, sebum, MI, EI, and a*value of the cheek were higher than that of the forearm (P .001), but L*values of the cheek were lower than that of the forearm (P .001). There were no correlations among TEWL and MI, EI, and L*a*values in any season (P .05).Both epidermal permeability barrier function, sebum, and skin pigment in healthy women vary seasons in Kunming, China.

A 20-year-old female presented for evaluation of a rash on her right arm. It began one week prior to her visit after she went hiking at a local park. Since then, the patient reported that it was spreading outwards. She recently went to the emergency room, where they prescribed her a course of oral prednisone and antibiotics, which did not improve her symptoms.

A 78-year-old patient was referred for a regular dermoscopic examination. The patient had a previous history of superficial spreading melanoma, Breslow thickness 2.1 mm, located on the back, 4 years earlier. During the regular examination, a small, clinically unremarkable, partially pigmented lesion, 4 mm in diameter, located on the right forearm was noticed and dermoscopically evaluated. The whitish structureless area in the central part of the lesion, with leaf-like structures located on the upper edge of the lesion, while on the lower edge of the lesion, concentric structures described by central brown point with fine and delicate radial projections were seen. These described dermoscopic features supported the diagnosis of a small partially pigmented superficial basal cell carcinoma, which was confirmed by a pathohistologist.

In this case, Dr. Hallock performs a right forearm squamous cell carcinoma excision followed by a split-thickness skin graft from the thigh. It was filmed in Honduras on a surgical mission with the World Surgical Foundation.

Background Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition. Methods Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject reported 6/10 pain. Other testing included body composition (lunar iDXA), activity monitoring (Actigraph), and Pain Catastrophizing Scale (PCS). Results Women reported greater TS than men (p = 0.019), and TS was correlated with right arm lean mass (r = − 0.36, p = 0.01) and magnification subscale of PCS (r = − 0.32, p = 0.03). Mediation analysis showed a complete mediation for the relation between sex and TS by right arm lean mass (indirect effect = 2.33, 95% BCa CI [0.42, 4.58]) after controlling for the temperature, the magnification subscale of PCS, and the average time spent in moderate to vigorous physical activity. Conclusion The results of this study suggest that lean mass is a contributing factor to the sex differences in TS. Future studies should investigate whether interventions that increase lean mass have a positive effect on TS.