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The clinical features of hand-arm vibration syndrome in a warm environment--a review of the literature

Su AT, Darus A, Bulgiba A, Maeda S, Miyashita K

J Occup Health, 2012;54(5):349-60.
PMID: 22863899

The internationally accepted limit values and the health effects of hand-transmitted vibration exposure have been described extensively in the literature from temperate climate countries but not from a tropical climate environment.
OBJECTIVES: We conducted a systematic review of the health effects of hand-transmitted vibration exposure in tropical countries to determine the characteristics of hand-arm vibration syndrome in a warm environment and compared the findings with the results of the systematic reviews published by the US NIOSH.
METHODS: We searched major medical databases including MEDLINE, PubMed, Embase, CINAHL, Ovid and Cochrane based on the terms "hand arm vibration syndrome," "hand transmitted vibration," "vibration white finger" and "Raynaud" up to January 2011. Only studies conducted in a tropical or subtropical environment were selected for the review. The quality of the selected papers was assessed independently by two investigators using predefined criteria. A standard set of information was abstracted from the papers for review.
RESULTS: Only six papers from tropical countries and three papers from subtropical countries were available in the literature. No vibration white finger was reported in the tropical countries. Neurological symptoms were prevalent in the vibration-exposed workers. Finger coldness seems to be an important surrogate for vascular disorder in a tropical environment. Meta-analysis could not be performed due to inadequacy of the information reported in these papers.
CONCLUSIONS: The current dose-response relationship in ISO5349-1 for hand-transmitted vibration exposure is not applicable to a tropical environment. Further studies on hand-arm vibration syndromes in tropical countries are needed.

Matched MeSH terms: Hand-Arm Vibration Syndrome/physiopathology*
Making collapsing pulse user-friendly

Puthiaparampil T

Med J Malaysia, 2020 07;75(4):406-408.
PMID: 32724004

Collapsing pulse is generally elicited by elevating the patient's arm. However, the pulse becoming stronger on arm elevation is a physiological phenomenon, which is bound to create confusion, if routine lifting of the arm in search of collapsing pulse is practiced. The name 'collapsing pulse' represents only the second component of this sign. It masks the more important first component - the slapping, bounding upstroke, characterised by its other name 'water-hammer pulse'. It is possible to elicit this sign by appreciating the slapping character on routine pulse examination. The insistence on arm lifting in medical school teaching is better avoided.

Matched MeSH terms: Arm*; Heart Rate/physiology*
Chromoblastomycosis of the arm in a Chinese in Sabah

Med J Malaya, 1965 Jun;19(4):319-20.
PMID: 4220861
Matched MeSH terms: Arm/pathology*
An atypical course of a 71-year old man with right arm weakness and ataxia: Expert commentary

Mohamed Ibrahim N

Parkinsonism Relat Disord, 2022 Dec;105:157-158.
PMID: 36274018 DOI: 10.1016/j.parkreldis.2022.10.015
Matched MeSH terms: Arm*; Cerebellar Ataxia*
Standards for subcutaneous fat and arm circumference in Malaysian school children

Chen ST

J Singapore Paediatr Soc, 1977 Jun;19(2):97-100.
PMID: 916636
Matched MeSH terms: Arm*
Alveolar soft part sarcoma: a case report

Sengupta S, Murugasu R

Med J Malaya, 1970 Sep;25(1):70-2.
PMID: 4249502
Matched MeSH terms: Arm*; Sarcoma/pathology*
Quantifying Arms and Legs Contributions during Repetitive Electrically-Assisted Sit-To-Stand Exercise in Paraplegics: A Pilot Study

Abd Aziz M, Hamzaid NA, Hasnan N

J Vis Exp, 2022 Nov 11.
PMID: 36440840 DOI: 10.3791/63149

Execution of Sit-to-Stand (SitTS) in incomplete spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support, in particular, is a significant assistive factor while executing SitTS movement in SCI population. In addition, the application of functional electrical stimulation (FES) onto quadriceps and gluteus maximus muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower extremities during SitTS has not been thoroughly investigated. Two motor incomplete SCI paraplegics performed repetitive SitTS to fatigue exercise challenge. Their performance was investigated as a mixed-method case-control study comparing SitTS with and without the assistance of FES. Three sets of SitTS tests were completed with 5-min resting period allocated in between sets, with mechanomyography (MMG) sensors attached over the rectus femoris muscles bilaterally. The exercise was separated into 2 sessions; Day 1 for voluntary SitTS and Day 2 for FES-assisted SitTS. Questionnaires were conducted after every session to gather the participants' input about their repetitive SitTS experience. The analysis confirmed that a SitTS cycle could be divided into three phases; Phase 1 (Preparation to stand), Phase 2 (Seat-off), and Phase 3 (Initiation of hip extension), which contributed to 23% ± 7%, 16% ± 4% and 61% ± 6% of the SitTS cycle, respectively. The contribution of arms and legs during SitTS movement varied in different participants based on their legs' Medical Research Council (MRC) muscle grade. In particular, the applied arm forces start to increase clearly when the leg forces start to decline during standing. This finding is supported by the significantly reduced MMG signal indicating leg muscle fatigue and their reported feeling of tiredness.

Matched MeSH terms: Arm/physiology
Fulltext Successful revascularisation of near total amputation of the upper limb after ten hours of warm ischaemia

Merican AM, Kwan MK, Cheok CY, Wong ELW, Sara TA

Med J Malaysia, 2005 Jun;60(2):218-21.
PMID: 16114164

Near total amputation of the upper limb if unsalvageable would cause severe disability. However, delayed revascularisation can be life threatening. We report two cases of revascularisation of the upper limb following near total amputation that was successful and functional after a warm ischaemic time of ten hours. The first was a traction avulsion injury of the arm leaving major nerves contused but in continuity. The second was a sharp injury through the mid-forearm attached by only a bridge of skin. Attempting revascularisation of a proximal injury beyond 6 hours, in selected cases is worthwhile.

Matched MeSH terms: Arm/blood supply*; Arm Injuries/surgery*
Fulltext An ultra-low power wireless sensor network for bicycle torque performance measurements

Gharghan SK, Nordin R, Ismail M

Sensors (Basel), 2015;15(5):11741-68.
PMID: 26007728 DOI: 10.3390/s150511741

In this paper, we propose an energy-efficient transmission technique known as the sleep/wake algorithm for a bicycle torque sensor node. This paper aims to highlight the trade-off between energy efficiency and the communication range between the cyclist and coach. Two experiments were conducted. The first experiment utilised the Zigbee protocol (XBee S2), and the second experiment used the Advanced and Adaptive Network Technology (ANT) protocol based on the Nordic nRF24L01 radio transceiver chip. The current consumption of ANT was measured, simulated and compared with a torque sensor node that uses the XBee S2 protocol. In addition, an analytical model was derived to correlate the sensor node average current consumption with a crank arm cadence. The sensor node achieved 98% power savings for ANT relative to ZigBee when they were compared alone, and the power savings amounted to 30% when all components of the sensor node are considered. The achievable communication range was 65 and 50 m for ZigBee and ANT, respectively, during measurement on an outdoor cycling track (i.e., velodrome). The conclusions indicate that the ANT protocol is more suitable for use in a torque sensor node when power consumption is a crucial demand, whereas the ZigBee protocol is more convenient in ensuring data communication between cyclist and coach.

Matched MeSH terms: Arm
Fulltext Heel effect: dose mapping and profiling for mobile c-arm fluoroscopy unit toshiba SXT-100A

Husaini Salleh, Supian Samat, Mohd Khalid Matori, Muhammad Jamal Md Isa, Mohd Ramli Arshad, Shahrul Azlan Azizan, et al.

Jurnal Sains Nuklear Malaysia, 2014;26(2):9-13.
MyJurnal

Heel Effect is the well known phenomena in x-ray production. It contributes the effect to image
formation and as well as scattered radiation. But there is paucity in the study related to heel effect.
This study is for mapping and profiling the dose on the surface of water phantom by using mobile
C-arm unit Toshiba SXT-1000A. Based on the result the dose profile is increasing up to at least
about 57% from anode to cathode bound of the irradiated area. This result and information can be
used as a guide to manipulate this phenomenon for better image quality and radiation safety for
this specific and dedicated fluoroscopy unit.

Matched MeSH terms: Arm
Fulltext Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity and Speed Variations of Triceps Push-Down Exercise

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

Front Physiol, 2020;11:112.
PMID: 32153422 DOI: 10.3389/fphys.2020.00112

The objective of this study was to investigate the effects of changes in exercise intensity and speed on the three heads of the triceps brachii (TB) during triceps push-down exercise until task failure. Twenty-five subjects performed triceps push-down exercise at three different intensities (30, 45, and 60% 1RM) and speeds (slow, medium, and fast) until failure, and surface electromyography (sEMG) signals were recorded from the lateral, long and medial heads of the TB. The endurance time (ET), number of repetitions (NR) and rate of fatigue (ROF) were analyzed. Subsequently, the root-mean-square (RMS), mean power frequency (MPF) and median frequency (MDF) under no-fatigue (NF) and fatigue (Fa) conditions were statistically compared. The findings reveal that ROF increases with increase in the intensity and speed, and the opposite were obtained for the ET. The ROF in the three heads were comparable for all intensities and speeds. The ROF showed a significant difference (P < 0.05) among the three intensities and speeds for all heads. The three heads showed significantly different (P < 0.05) MPF and MDF values for all the performed exercises under both conditions, whereas the RMS values were significantly different only under Fa conditions. The current observations suggest that exercise intensity and speed affect the ROF while changes in intensity do not affect the MPF and MDF under Fa conditions. The behavior of the spectral parameters indicate that the three heads do not work in unison under any of the conditions. Changes in the speed of triceps push-down exercise affects the lateral and long heads, but changes in the exercise intensity affected the attributes of all heads to a greater extent.

Matched MeSH terms: Arm
Fulltext Low-Profile Slotted Metamaterial Antenna Based on Bi Slot Microstrip Patch for 5G Application

Hoque A, Islam MT, Almutairi AF

Sensors (Basel), 2020 Jun 11;20(11).
PMID: 32545228 DOI: 10.3390/s20113323

A low-profile high-directivity, and double-negative (DNG) metamaterial-loaded antenna with a slotted patch is proposed for the 5G application. The radiated slotted arm as a V shape has been extended to provide a low-profile feature with a two-isometric view square patch structure, which accelerates the electromagnetic (EM) resonance. Besides, the tapered patch with two vertically split parabolic horns and the unit cell metamaterial expedite achieve more directive radiation. Two adjacent splits with meta units enhance the surface current to modify the actual electric current, which is induced by a substrate-isolated EM field. As a result, the slotted antenna shows a 7.14 dBi realized gain with 80% radiation efficiency, which is quite significant. The operation bandwidth is 4.27-4.40 GHz, and characteristic impedance approximately remains the same (50 Ω) to give a VSWR (voltage Standing wave ratio) of less than 2, which is ideal for the expected application field. The overall size of the antenna is 60 × 40 × 1.52 mm. Hence, it has potential for future 5G applications, like Internet of Things (IoT), healthcare systems, smart homes, etc.

Matched MeSH terms: Arm
Epithelioid sarcoma and concurrent Volkman ischaemic contracture: a case report

Suria-Hayati MP, Siti-Aishah MA, Eshagroni A, Jamari S, Abdolvahab F, Yazmin Y, et al.

Clin Ter, 2012;163(3):215-7.
PMID: 22964694

Epithelioid sarcoma is a very infrequent soft tissue sarcoma involving predominantly distal extremities of adolescent and young adult. We hereby report a case of epithelioid sarcoma in a 34-year-old young adult who presented with 1-year history of a painful left upper limb associated subsequently with warm left forearm swelling and a Volkman contracture. He was treated as an inflamed soft tissue condition of the left upper limb. A computed tomography study showed presence of multiple hypodense lesions mainly in the flexor compartment of the left arm as well at the subcutaneous tissue, which measured 1 to 1.7 cm in diameter. Histological examination of the left upper limb mass showed nodular proliferation of epithelioid tumour cells and some with rhabdoid features surrounding a central zone of necrosis and was diagnosed as epithelioid sarcoma. Concurrent presence of epithelioid sarcoma and Volkman ischaemic contracture are rarely seen in clinical practice. The present case highlights the importance of the histology which can be confused with other types of sarcoma or chronic granuloma and even missed at times thereby causing diagnostic problems.

Matched MeSH terms: Arm*; Sarcoma/complications*
Fulltext Deep penetrating nevus: a distinct variant of melanocytic nevus

Gupta A, Srilatha PS, Suvarna N, Rao L

Indian J Pathol Microbiol, 2011 Jan-Mar;54(1):156-7.
PMID: 21393904 DOI: 10.4103/0377-4929.77384

Deep penetrating nevus (DPN) is a variant of melanocytic nevus which goes unrecognized due to its relative rarity and may be misinterpreted as malignant melanoma. It commonly presents in young adults as a dark pigmented lesion on the face, neck, or shoulder. A 60-year-old lady presented with a mole over the left arm of 8 years duration. A biopsy of the lesion was performed under the clinical impression of a compound nevus with suspicion of malignancy. Based on the histologic features, a diagnosis of DPN was put forward.

Matched MeSH terms: Arm/pathology
Fulltext The efficacy of side arm traction in the reduction of supracondylar fracture humerus in children

Harwant S, Borhan TA

Med J Malaysia, 2000 Sep;55(3):311-7.
PMID: 11200710

156 consecutive children with supracondylar fracture humerus were reviewed. Of these, 56 children with severely displaced fractures were treated with side arm traction. A retrospective review revealed that a mean post-reduction Baumann angle of 74.2 degrees for boys and 75.9 degrees for girls; and mean post-reduction humero-ulna angle of 11.6 degrees for boys and 12.7 degrees for girls was achieved. A linear correlation was noted between the duration of traction and the age of the patient, older patients requiring longer traction. The region below the line in the graph, plotting the duration of traction (y-axis) versus the age of the patient (x-axis) shows when the fracture is unstable; and the region above the line shows when the fracture is stable and can only be reduced by surgery. 10 children presented late; 6 presented within the unstable period and were successfully reduced with traction; while 4 presented stable and required open reduction. We conclude that traction is an acceptable and safe method for reduction of this fracture, and can be used to reduce late presentations while their fractures are still unstable.

Matched MeSH terms: Arm*
An anomalous muscle in the distal half of the arm

Dharap AS

Surg Radiol Anat, 1994;16(1):97-9.
PMID: 8047976

During dissection an anomalous muscle was found on the medial aspect in the distal half of one left upper extremity. This muscle arose from the humerus between the m. coracobrachialis and the m. brachialis, passed obliquely across the front of the brachial artery and median nerve and blended with the common origin of the forearm flexor muscles. It does not appear to be an additional head of the biceps brachii or the brachialis muscles. The existence of this anomalous muscle should be kept in mind in a patient presenting with a high median nerve palsy together with symptoms of brachial artery compression.

Matched MeSH terms: Arm*; Brachial Artery/pathology
Fulltext The Evaluation of Physical Stillness with Wearable Chest and Arm Accelerometer during Chan Ding Practice

Chang KM, Chun YT, Chen SH, Lu L, Su HT, Liang HM, et al.

Sensors (Basel), 2016 Jul 20;16(7).
PMID: 27447641 DOI: 10.3390/s16071126

Chan Ding training is beneficial to health and emotional wellbeing. More and more people have taken up this practice over the past few years. A major training method of Chan Ding is to focus on the ten Mailuns, i.e., energy points, and to maintain physical stillness. In this article, wireless wearable accelerometers were used to detect physical stillness, and the created physical stillness index (PSI) was also shown. Ninety college students participated in this study. Primarily, accelerometers used on the arms and chest were examined. The results showed that the PSI values on the arms were higher than that of the chest, when participants moved their bodies in three different ways, left-right, anterior-posterior, and hand, movements with natural breathing. Then, they were divided into three groups to practice Chan Ding for approximately thirty minutes. Participants without any Chan Ding experience were in Group I. Participants with one year of Chan Ding experience were in Group II, and participants with over three year of experience were in Group III. The Chinese Happiness Inventory (CHI) was also conducted. Results showed that the PSI of the three groups measured during 20-30 min were 0.123 ± 0.155, 0.012 ± 0.013, and 0.001 ± 0.0003, respectively (p < 0.001 ***). The averaged CHI scores of the three groups were 10.13, 17.17, and 25.53, respectively (p < 0.001 ***). Correlation coefficients between PSI and CHI of the three groups were -0.440, -0.369, and -0.537, respectively (p < 0.01 **). PSI value and the wearable accelerometer that are presently available on the market could be used to evaluate the quality of the physical stillness of the participants during Chan Ding practice.

Matched MeSH terms: Arm*
Impact of virtual reality games on psychological well-being and upper limb performance in adults with physical disabilities: A pilot study

Singh DKA, Rahman NNA, Seffiyah R, Chang SY, Zainura AK, Aida SR, et al.

Med J Malaysia, 2017 04;72(2):119-121.
PMID: 28473675 MyJurnal

INTRODUCTION: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities.
METHODS: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test.
RESULTS: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention.
CONCLUSION: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

Matched MeSH terms: Arm/physiology*
Patterns of the superficial veins of the cubital fossa: A meta-analysis

Yammine K, Erić M

Phlebology, 2017 Jul;32(6):403-414.
PMID: 27343223 DOI: 10.1177/0268355516655670

Background The aim of this systematic review is to quantitatively synthesize evidence on the prevalence of superficial vein patterns in the cubital region. Method A systematic literature search was conducted through a number of electronic databases. We identified 27 studies, including 9924 arms, which met the inclusion criteria. Results Meta-analysis showed that "N" shaped arrangement type was the commonest pattern (≈44-60%) followed by "M" shaped arrangement (≈20-25%). The prevalence of "M" type and "M"-like type was significantly higher in males, whereas females showed a significant predominance of "I" or "O" type. No significant differences in various pattern types were found for laterality. The frequency of "M" type is significantly lesser in Indian and Japanese populations, but they have significantly higher frequency of "N" type. In Malay population, "I" or "O" type was significantly higher, while the brachial CV was poorly developed or missing significantly in Indian population. Conclusion This evidence-based clinical anatomy review contributes to our anatomical knowledge regarding the true prevalence of pattern types of the superficial veins in cubital region in humans and, subsequently, might help in performing safer venous access and more direct approaches to these veins, especially under emergency conditions.

Matched MeSH terms: Arm/blood supply*; Forearm/blood supply*
Variant origin of an arterial trunk from axillary artery continuing as profunda brachii artery--a unique arterial variation in the axilla and its clinical implications

Naveen K, Jyothsna P, Nayak SB, Mohandas RK, Swamy RS, Deepthinath R, et al.

Ethiop J Health Sci, 2014 Jan;24(1):93-6.
PMID: 24591805

BACKGROUND: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique.
CASE DETAILS: We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal.
CONCLUSION: Since the axillary artery is next choice of artery for arterial cannulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors.

Matched MeSH terms: Arm/blood supply*

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