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Fulltext Dermatoglyphic pattern among Kadazandusun and Bajau ethnic groups in Sabah

M. Tanveer Hossain Parash, Zainal Arifin Mustapha, Urban John Arnold D’Souza, Sadia Choudhury Shimmi

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):81-81.
MyJurnal

Introduction:Dermatoglyphics have been used extensively to characterize populations, analyse the nature and origin of human variation and population structure and evaluate the micro-differentiation of populations. Dermato-glyphics is considered as a sensitive indicator of intrauterine anomalies and known to be one of the best available diagnostic tools in genetic disorders. KadazanDusun and Bajau are the major ethnic groups of Sabah. The aim of the study was to study the distribution of fingerprint patterns on different digits in these two ethnicities of Sabah and to find if any variation occurs in fingerprint pattern qualitatively between these ethnicities. Methods: This cross-section-al study was conducted from March’ 2016 to February’ 2018 at different villages of Kudat, Ranau, Kota Belud, Kota Kinabalu and Papar, Sabah. After obtaining informed consent 400 persons (KadazanDusun 250, Bajau 150) were included in this study by stratified random sampling. Demographic data and history of present and past illness were obtained from each subject through a valid questionnaire. Finger and palm prints were photographed using Nikon D5200 camera and later were grouped into different types manually. Results: There were 205 female and 195 male participants in the study. Among the three types of fingerprints, whorls were more abundant (>50%) in the thumbs, index, ring and little fingers whereas loops were observed more (>55%) in the middle fingers. The arches were the least (0-3%) observed pattern in all the fingers. The dermatoglyphic pattern of right and left index fingers were only significantly different (p0.05) difference in respect of left and right hands and gender. Conclusion: The study findings would serve as a baseline data for further studies to develop data base of the dermatoglyphic pattern of major ethnic groups of Sabah which would facilitate non-invasive diagnosis of congenital anomalies and various genetic disorders.

Matched MeSH terms: Thumb
Fulltext An adult with thumb sign In the lateral neck radiograph

Irfan Mohamad, Mohd Syafwan Mohd Soffian, Amran Mohamad

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):85-88.
MyJurnal

Acute epiglottitis though relatively common in pediatric patients as compared to adults, present with almost similar clinical presentations. They include voice change, difficulty or painful swallowing and sometimes with upper airway obstruction. Physical finding of swollen epiglottis is difficult to be obtained owing to the danger of introducing laryngeal mirror into the oropharynx as to avoid contact spasm. The diagnostic thumb sign appearance on lateral neck radiograph is considered pathognomonic of epiglottitis. We report a case of an adult with clinical features and radiological finding of an acute epiglottitis, which did not resolve with antibiotic treatment. Subsequent imaging confirmed the presence of an abscess in the epiglottic mucosa.

Matched MeSH terms: Thumb
Fulltext A Diabetic Elderly Man with Finger Ulcer

Mohamad N, Badrin S, Wan Abdullah WNH

Korean J Fam Med, 2018 Mar;39(2):126-129.
PMID: 29629046 DOI: 10.4082/kjfm.2018.39.2.126

Fixed cutaneous sporotrichosis is a differential diagnosis that can be considered in diabetic patients who present with a poorly healing ulcer. Although its prevalence is low, it can occur in patients with immunocompromised status. Here we report a case of a 70-year-old man with diabetes mellitus who presented with a 1-month history of an unhealed ulcer over the tip of his left middle finger. He experienced a cat bite over his left middle finger 1 month prior to the appearance of the lesion. A skin biopsy revealed the presence of Sporothrix schenckii. Oral itraconazole 200 mg twice daily was started empirically and the patient showed marked improvement in the skin lesion after 2 months of therapy.

Matched MeSH terms: Thumb
Fulltext Huge brachial plexus schwannoma, masking as a cystic neck mass

Kho JPY, Prepageran N

AME Case Rep, 2018;2:41.
PMID: 30363802 DOI: 10.21037/acr.2018.08.01

Schwannomas are solitary, benign tumors arising from the nerve sheaths. They are frequently reported in the thorax predominantly in the posterior mediastinum, but are rarely seen to arise from the brachial plexus. Schwannomas are well demarcated lesions with a slow insidious growth. Presented is a case of a large brachial plexus schwannoma, masking as a cystic lesion in the lateral neck. The patient presented with concerns of a cystic mass progressively increasing in size over a period of four years, initially symptomless, but later caused numbness and tingling sensation over his right forearm, tip of right thumb and index finger. Following histological confirmation via fine needle aspiration and magnetic resonance imaging, the patient underwent surgical excision where by the tumor was dissected from its attachment to the nerve sheath. The patient recovered well, and by the third day post operatively, his neurological symptoms resolved completely. Upon follow up in clinic 1-week post-surgery, the scar had healed well, and his numbness or tingling sensation remained in abeyance. This case illustrates that a schwannoma may present insidiously as a cystic lesion and its possible origin may arise from the brachial plexus.

Matched MeSH terms: Thumb
Variant Abductor Pollicis Longus Muscle: a Case Report

Shipra P, Srijit D

Acta Medica (Hradec Kralove), 2007;50(3):213-215.
PMID: 28795947 DOI: 10.14712/18059694.2017.85

Abductor pollicis longus (APL) muscle is known to exhibit different variations with respect to its attachments. Various studies have reported the splitting of the APL muscle. Comparative anatomical findings of split insertion of APL is commonly found in chimpanzees, gorillas and gibbons. In the present study, we describe an anomalous APL muscle, which originated from the posterior surface of the shaft of the radius and ulna and traversed a course deep to the extensor retinaculum. Interestingly, immediately after emerging form the deeper aspect of extensor retinaculum, the thin tendon of the APL muscle continued again as a muscular belly in relation to the dorsolateral part of the 1st metacarpal bone, to end as a tendon with its attachment to the base of the proximal phalanx. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest.

Matched MeSH terms: Thumb
Handedness in man: The energy availability hypothesis

Chan YK, Loh PS

Med Hypotheses, 2016 Sep;94:108-11.
PMID: 27515214 DOI: 10.1016/j.mehy.2016.06.018

More than 90% of the human species are right handed. Although outwardly our body appears symmetrical, a 50/50% lateralization in handedness never occurs. Neither have we seen more than 50% left handedness in any subset of the human population. By 12-15weeks of intrauterine life, as many as 6 times more fetuses are noted by ultrasound studies to be sucking on their right thumbs. Distinct difference in oxygenation leading to dissimilar energy availability between right and left subclavian arteries in place by week 9 of life may hold the clue to the lateralization of hand function and eventually, the same in the brain. We know there is a higher incidence of left handedness in males, twins, premature babies and those born to mothers who smoke. They may represent a subset with less distinct difference in oxygenation between the 2 subclavian arteries during the fetal stage. This hypothesis if correct not only closes the gap in understanding human handedness and lateralization but also opens a vista for new research to focus on in utero tissue energy availability and its impact on outcome in life.

Matched MeSH terms: Thumb
Fulltext Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy

Abdullah S, Ahmad AA, Lalonde D

Plast Reconstr Surg Glob Open, 2020 Aug;8(8):e3023.
PMID: 32983779 DOI: 10.1097/GOX.0000000000003023

Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.

Matched MeSH terms: Thumb
High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis

Low TH, Hales PF

J Hand Surg Eur Vol, 2014 Oct;39(8):838-44.
PMID: 24051478 DOI: 10.1177/1753193413506150

We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

Study a collaboration between Malaysia and Australia

Matched MeSH terms: Thumb/surgery
Chronic nonhealing ulcer of the right thumb with multiple subcutaneous nodules

Manohar A, Nizlan MN

Orthopedics, 2008 Jul;31(7):710.
PMID: 19292371

A 60-year-old man presented with a 3-month history of nonhealing ulcer over the tip of his right thumb. The ulcer started as a blister over the tip of the thumb that later ruptured and spread proximally to cover the whole pulp area of the thumb. There was no history of trauma, fever, weight loss, or loss of appetite. He is a pensioner and an avid gardener. He has a few cats as pets. The patient initially presented to a private orthopedic surgeon with a nonhealing ulcer of the right thumb. Multiple debridements were unsuccessful in ameliorating the ulcer. Three months after the onset of the initial lesion, multiple painless erythematous nodules had developed on his right arm, and one on the right thigh. All routine blood investigations were nondiagnostic. Swab culture from the ulcer failed to grow any organism and a course of antibiotics did not resolve the problem. Cultures of the biopsy specimen using Sabouraud's dextrose agar and potato carrot medium grew dark brown plaques that microscopically appeared to be branching hyphae. A diagnosis of sporotrichosis of the right upper limb was made and the patient was started on antifungal treatment immediately (T. Itraconazole [Sporanox] 200 mg BD). One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months all the lesions including the one on the right thigh had healed.

Matched MeSH terms: Thumb/pathology*
Fingerprint verification prediction model in hand dermatitis

Lee CK, Chang CC, Johor A, Othman P, Baba R

Int J Dermatol, 2015 Jul;54(7):765-70.
PMID: 25427962 DOI: 10.1111/ijd.12451

Hand dermatitis associated fingerprint changes is a significant problem and affects fingerprint verification processes. This study was done to develop a clinically useful prediction model for fingerprint verification in patients with hand dermatitis.

Matched MeSH terms: Thumb
Fulltext Bowling: Occupational Hazards of the Wrist and Hand in Elite Tenpin Bowlers

Lee YJ, Harmony T, Jamal-Azmi IS, Gunasagaran J, Ahmad TS

Malays Orthop J, 2021 Mar;15(1):113-118.
PMID: 33880157 DOI: 10.5704/MOJ.2103.017

Introduction: Bowling is an immensely popular, but scarcely researched sport associated with overuse injuries in its participants. The purpose of this study was to investigate and report on the incidence of common upper extremity complaints in elite bowling athletes.
Materials and methods: All Malaysian national level bowlers (n=39) were evaluated via questionnaire on their upper limb symptoms. A focused, relevant clinical examination was performed on each subject to exclude de Quervain's tenosynovitis, tennis and golfer's elbow, carpal tunnel syndrome and trigger finger. The athletes were then allowed to resume bowling for two hours before completing another symptom-related questionnaire.
Results: Pain was the predominantly observed symptom, with a predilection for the wrist, ring and middle fingers, and thumb. De Quervain's tenosynovitis was found in 53.8% (n=21) of the subjects, with 52.4% and 42.9% of them experiencing pain during and after training, respectively. Other repetitive injury-related disorders were also considerably more common than in their non-playing limb and the general population.
Conclusion: The incidence of de Quervain's tenosynovitis was exceptionally high in this population. Further studies on sports kinematics are needed to prevent long term morbidities in these athletes.

Matched MeSH terms: Thumb