Pitfalls in the lab assessment of hypopituitarism.

The diagnostic approach to hypopituitarism involves many disciplines. Clinical symptoms rarely are specific. Imaging techniques are helpful but cannot prove the specific functional defects. Therefore, the definitive diagnosis of pituitary insufficiency is largely based on laboratory tests. However, also laboratory methods come with inherent limitations, and it is essential for the clinician to know and recognize typical pitfalls. Most factors potentially impairing the quality of hormone measurements are introduced in the preanalytical phase, i.e. before the hormones are measured by the laboratory. For example, the timing of blood drawing with respect to circadian rhythm, stress, and medication can have an influence on hormone concentrations. During the actual analysis of the hormones, cross-reactions with molecules present in the sample presenting the same or similar epitopes than the intended analyte may affect immunoassays. Interference can also come from heterophilic or human anti-animal antibodies. Unexpected problems can also be due to popular nutritional supplements which interfere with the measurement procedures. An important example in this respect is the interference from biotin. It became only clinically visible when the use of this vitamin became popular among patients. The extreme serum concentrations reached when patients take it as a supplement can lead to incorrect measurements in immunoassays employing the biotin-streptavidin system. To some extent, hormone analyses using liquid chromatography mass spectrometry (LCMS) can overcome problems, although availability and cost-effectiveness of this method still imposes restrictions. In the post-analytical phase, appropriateness of reference intervals and cut-offs with respect to the specific analytical method used is of outmost importance. Furthermore, for interpretation, additional biological and pharmacological factors like BMI, age and concomitant diseases must be considered to avoid misinterpretation of the measured concentrations. It is important for the clinician and the laboratory to recognize when one or more laboratory values do not match the clinical picture. In an interdisciplinary approach, the search for the underlying cause should be initiated.

Meaningful cognitive change for the Minimal Assessment of Cognitive Function in Multiple Sclerosis.

BACKGROUND: There is limited information on interpretation of cognitive changes over time in multiple sclerosis (MS). OBJECTIVE: This study aimed to provide normative data for the assessment of statistically meaningful change in all tests of the Minimal Assessment of Cognitive Function in MS (MACFIMS). METHODS: We applied the reliable change methodology to a healthy Italian cohort, assessed with two alternate versions of the MACFIMS 1 year apart. We calculated confidence intervals of retest score variance using the reliable change index (RCI). Moreover, multivariable linear regression models adjusted for age, sex, education, and baseline score were built to calculate the regression-based change index (RB-CI). RESULTS: Overall, 200 healthy individuals were enrolled. Thresholds for interpreting change in each test were calculated. In the multivariable models, baseline score was associated with retest score in all tests (B from 0.439 to 0.760; p < 0.001). RB-CI can be calculated with data of the multivariable models. CONCLUSION: We provide normative data for reliable cognitive change evaluation for all the tests of the MACFIMS, which includes the Symbol Digit Modalities Test and Brief International Cognitive Assessment in MS, two widely used tools for screening and monitoring cognition in MS. Our findings can significantly improve the interpretation of cognitive changes in MS.

Development of robust normative data for the neuropsychological assessment of Greek older adults.

OBJECTIVE: Normative data for older adults may be tainted by inadvertent inclusion of undiagnosed individuals at the very early stage of a neurodegenerative process. To avoid this pitfall, we developed norms for a cohort of older adults without MCI/dementia at 3-year follow-up. METHODS: A randomly selected sample of 1041 community-dwelling individuals (age ≥ 65) received a full neurological and neuropsychological examination on two occasions [mean interval = 3.1 (SD = 0.9) years]. RESULTS: Of these, 492 participants (Group 1; 65-87 years old) were without dementia on both evaluations (CDR=0 and MMSE ≥ 26); their baseline data were used for norms development. Group 2 (n = 202) met the aforementioned criteria only at baseline, but not at follow-up. Multiple linear regressions included demographic predictors for regression-based normative formulae and raw test scores as dependent variables for each test variable separately. Standardized scaled scores and stratified discrete norms were also calculated. Group 2 performed worse than Group 1 on most tests (p-values < .001-.021). Education was associated with all test scores, age with most, and sex effects were consistent with the literature. CONCLUSIONS: We provide a model for developing sound normative data for widely used neuropsychological tests among older adults, untainted by potential early, undiagnosed cognitive impairment, reporting regression-based, scaled, and discrete norms for use in clinical settings to identify cognitive decline in older adults. Additionally, our co-norming of a variety of tests may enable intra-individual comparisons for diagnostic purposes. The present work addresses the challenge of developing robust normative data for neuropsychological tests in older adults.

Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R).

OBJECTIVE: Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores. METHOD: A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05). RESULTS: Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures. CONCLUSIONS: The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.

Norms for neuropsychological tests in cognitively healthy French oldest old adults.

OBJECTIVE: Normal aging often leads to cognitive decline, and oldest old people, over 80 years old, have a 15% risk of developing neurodegenerative diseases. Therefore, it is important to have appropriate tools to assess cognitive function in old age. The study aimed to provide new norms for neuropsychological tests used to evaluate the cognitive abilities in people aged 80 years and older in France, focusing on the impact of education and gender differences. METHOD: 107 healthy participants with an average age of 85.2 years, with no neurological history or major cognitive deficits were included. A comprehensive neuropsychological assessment was performed, covering several cognitive functions such as memory, visuospatial abilities, executive functions, attention, processing speed, and praxis. RESULTS: Individuals with lower levels of education performed poorly on some tests and took longer to complete. Gender differences were observed, with women outperforming men in verbal episodic memory, while men showed better performance in visuoconstructive tasks. The participants showed lower performance in verbal episodic memory compared to norms established in previous French studies. In relation to executive functions, participants were slower to perform complex tasks than participants in previous studies. CONCLUSION: This study provides cognitive norms specifically adapted to the oldest old population, which differ from established norms for younger aging adults. It highlights the importance of including these norms in future clinical and scientific investigations. The findings underscore the importance of education on cognitive abilities and emphasize the need to consider gender differences when assessing cognitive functions in aging populations.

Psychometric properties and normative data of the Italian version of the Cognitive Function at Work Questionnaire: a screening tool for detecting subjective cognitive complaints at work.

INTRODUCTION: Considering the extension of working life due to socioeconomic and political factors, many people may experience cognitive complaints (CC) at their workplace, with severe consequences on their quality of life. The identification of workers reporting significative SCC is crucial to eventually address them to an objective neuropsychological evaluation and implement cognitive interventions to guarantee workers' well-being. Since no Italian questionnaires for detecting CC were designed for occupational settings, the aim of the study was to validate the Italian version of the Cognitive Function at Work Questionnaire (CFWQ) and to provide its normative data. MATERIALS AND METHODS: Internal consistency, convergent and divergent validity, and factorial structure of the CFWQ were evaluated. A regression-based procedure served to compute percentiles of CFWQ and its subscales. RESULTS: Four hundred twenty-one participants without psychiatric and/or neurological disorders completed the survey. We found that the Italian CFWQ included 26 items, with a good internal consistency (Cronbach's alpha = 0.897) and a six-factor structure (memory, language, processing speed, abstract thinking/behavioral control, behavioral inertia, planning ability). CFWQ score did not correlate with empathy but correlated strongly with memory scores and moderately with anxiety and depression scores. CONCLUSIONS: The Italian CFWQ showed good psychometric properties, in analogy with the original English scale. Therefore, it can be successfully employed in organizational contexts to possibly identify workers with CC and therefore with possible co-occurrent psychological, behavioral, and cognitive consequences.

Regression-based normative data for Corsi Span and Supraspan learning and recall among Italian adults.

INTRODUCTION: The Corsi Block Tapping Test, or Corsi Span (CS), is a widely used task to measure visuospatial short-term and working memory. The same setup can be used to administer the Corsi SupraSpan Learning (CSSL) and Recall (CSSR), tests assessing visuospatial long-term memory. While the CS has relatively recent normative data, those of the CSSL are outdated For CSSR, no normative data are available. Given this critical lack, our study aimed to provide updated norms for CS, CSSL, and specifically for the recall delayed phase (CSSR). MATERIALS AND METHODS: A sample of 340 healthy participants, aged between 20 and 89, took part in the study. Norms were developed using a regression approach and defined using rank equivalent scores and percentiles. RESULTS: Age and education influenced Corsi's Span, while SupraSpan Learning and Recall were influenced by age, education, and span. The comparison with previous norms for Span and SupraSpan Learning shows a high level of agreement. CONCLUSIONS: This study provides integrated norms to evaluate visuospatial memory in all aspects of immediate recall, long-term learning and delayed recall. Its use is needed to assess specific neuropsychological deficits, dissociate visuospatial versus verbal memory deficits and allow the evaluation of memory in patients with limited verbal abilities.

Normative data and correlation parameters for vessel density measured by 6 × 6-mm optical coherence tomography angiography in a large chinese urban healthy elderly population: date from the Beichen eye study.

BACKGROUND: To establish a normative database for macular vessel density (VD) measured by optical coherence tomography angiography (OCTA) and explore the parameters related to the VD. METHODS: An observational study in epidemiology. 5840 healthy elderly participants in Beichen district, Tianjin, China underwent detailed ophthalmic and systemic examinations. OCTA was performed in all subjects using a 6 × 6-mm line scan mode centered on the macula and the built-in software was used to quantify VD and stratify the retina. RESULTS: One thousand four hundred sixty-one healthy elderly citizens (30.4% men) were included, with a median age of 60.0 years (8.0 years) and an age range of 50 to 87 years.VDs in the different plexuses: superficial capillary plexus (SCP) 43.9% (3.2%), deep capillary plexus (DCP) 44.3% (2.8%), outer capillary plexus (OCP) 21.9% (5.9%), choriocapillaris (CC) 52.1% (1.4%). 90% medical reference range of the VDs at different plexuses was reported. Age was correlated with the VDs of each capillary plexus. Sex was correlated with the VDs of DCP and OCP, and the VDs of DCP (p < 0.001) and OCP (p = 0.015) in women were higher than that in men. After age and sex adjustment, choroid average thickness was positively correlated with VDs of SCP (R = 0.067, p = 0.010) and DCP (R = 0.108, p < 0.001), ganglion cell layer (GCL) average thickness (R = 0.072, p = 0.006) was positively correlated with the VD of OCP, best-corrected visual acuity (BCVA) (R = 0.082, p = 0.002) was positively correlated with the VD of CC. CONCLUSIONS: In this study, the normative VD database of the Chinese urban healthy elderly population measured by the OCTA was established, and parameters related to the VD of each capillary plexus were analyzed, providing new ideas for the future study of the relationship between macular VD and disease. TRIAL REGISTRATION: The Beichen Eye Study had been registered on the Chinese Clinical Trial Registry website (registry number: ChiCTR2000032280) on April 25, 2020.

The Kessler Psychological Distress Scale in Australian adolescents: Analysis of the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

INTRODUCTION: The 10-item Kessler Psychological Distress Scale (K10) is used to screen adolescents for mental disorders in Australian clinical practice; however, there are no Australian adolescent normative data. METHODS: Data were drawn from a nationally representative sample (N = 2964) of Australian adolescents (11-17 years). This study had three aims: (1) to examine concurrent validity between the K10 and Strengths and Difficulties Questionnaire (SDQ) emotional symptoms subscale, (2) to establish normative Australian adolescent K10 data and (3) to determine optimal K10 cut-off scores for screening for major depressive disorder (MDD) via receiver operator characteristic curve analysis and stratum-specific likelihood ratios. RESULTS: The K10 and SDQ emotional symptoms scales were moderately correlated (rs = 0.63, p < 0.001). Older female adolescents reported higher total K10 scores compared with younger female adolescents (15-17 years: M = 20.2, standard error [SE] = 0.3; 11-14 years: M = 16.8, SE = 0.3) and male adolescents (11-14 years: M = 16.6, SE = 0.2; 15-17 years: M = 16.0, SE=0.2). K10 scores to optimally discriminate those with and without MDD varied by age and sex and had low specificities. Stratum-specific likelihood ratios indicated adolescents with a K10 score of ≥30 will have a 12.9 (95% confidence interval = [10.2, 16.2]) increased likelihood of MDD. CONCLUSION: The K10 has utility for assessing psychological distress in health care and epidemiological research in Australian adolescents. Adolescents with K10 scores in the 'very high' range are at increased risk of MDD. Further assessment of these young people is indicated to identify those with or at risk of developing MDD.

A validation and normative study of the Parents' Evaluation of Aural/Oral Performance of Children plus (PEACH+) rating scale in Malaysia.

OBJECTIVE: The purpose of the present study was to (1) translate and validate the PEACH + Rating Scale in Malay and (2) establish normative curves as a function of age and examine test-retest reliability for the Malay and English versions of PEACH+. DESIGN: This is a cross-sectional study that used a convenient sampling technique. STUDY SAMPLE: One hundred and fifty-seven parents of typically developing children aged between 4 months and 7 years participated in the study. Forty-nine completed the Malay PEACH + in a pen-to-paper format (Aim 1). One hundred and eight parents completed PEACH + online (69 completed the Malay version and 39 the English version), and 20 of them completed the questionnaire twice (Aim 2). RESULTS: The PEACH + in Malay showed high internal consistency and item-total correlation. The normative data revealed that scores for frequency of auditory behaviour increased rapidly with age until about 20 months and reached an asymptote of around 90% by about 40 months of age. A similar trend was observed for ease of listening scores, which asymptoted around 85%. CONCLUSIONS: The validated Malay PEACH + Rating Scale can be used as a guide to monitor auditory functional performance and listening efforts of Malaysian children in real-world environments.

Alouette-R normative data for French-speaking school-aged children living in Quebec.

BACKGROUND: The Alouette-R (2005) by Lefavrais is one of the most widely used tools to assess reading skills in French. However, this instrument does not have normative data specific to the French-speaking population of Quebec, Canada. AIMS: The validity of an assessment being strongly compromised when using inappropriate norms, the first objective of this study was to establish local norms for the Alouette-R. The second objective was to provide sensitivity and specificity data for each Alouette-R measure in the French-speaking Quebec population. The third objective was to compare Quebec and French normative data and their sensitivity to better understand the applicability and effectiveness of the Alouette-R test at the regional level. METHODS & PROCEDURES: A total of 347 fluent readers and 48 children with dyslexia from 3rd to 6th grades were recruited from different regions in Quebec. Participants had to read aloud the 265-word text of the Alouette-R in a maximum of 3 min. OUTCOMES & RESULTS: Norms (means, standard deviations and percentiles) by school grades were created for each test measure: reading time, number of words read, number of errors, number of words correctly read, reading accuracy index and reading fluency index. The sensitivity (i.e., the ability to correctly identify children with dyslexia) and specificity (i.e., the ability to correctly identify children without dyslexia) of these measurements were also documented. The norms and their sensitivity were then compared with those of the original French study by Lefavrais in 2005. CONCLUSIONS & IMPLICATIONS: The presence of differences between European and Quebec norms supports the importance of using local norms when assessing language skills. The reading accuracy and fluency indexes are the measurements that best discriminated children with dyslexia from those without a reading disorder in our study. This study will allow clinicians working in Quebec to have a better interpretation of the Alouette-R measurements and ultimately avoid erroneous conclusions resulting from the use of foreign normative data. WHAT THIS PAPER ADDS: What is already known on this subject The Alouette-R is a reading test validated and standardized in France to screen for dyslexia in children. The validity of existing norms with the Quebec population in Canada is questionable due to socio-linguistic differences with the population of France. What this study adds to existing knowledge This study provides for the first time normative and sensitivity/specificity data of the Alouette-R for French-speaking school-aged children living in Quebec. Differences were noted with the normative data from France, which supports the importance of using local normative data when administering reading tests in Quebec. What are the potential or actual clinical implications of this work? When administering the Alouette-R, clinicians in Quebec will now be able to use normative data adapted to the local population, which will limit erroneous conclusions resulting from the use of foreign normative data. In addition, the sensitivity and specificity values reported in the article will allow these clinicians to better interpret their results when screening for a developmental reading disorder.

Thermal threshold for knee osteoarthritis people evaluated with infrared thermography: A scoping review.

INTRODUCTION: Knee degenerative processes, such as osteoarthritis, are disabling. An early intervention is generally more effective making important a timely diagnosis. A pre-diagnosis tool could be the thermal camera that allows the detection of joint inflammation. Consequently, the objective of the present study was to evaluate the literature and propose a thermal attention threshold for infrared thermography data in people with knee osteoarthritis. METHODS: four electronic databases were searched with specific keywords until the 25th of March 2024. Only original articles about joint inflammation due to osteoarthritis evaluated through digital infrared thermal images were included. A quality assessment analysis was performed. The attention threshold was extracted through the median of the extracted data. The findings were narratively discussed. RESULTS: A total of 9 studies have been included after the eligibility criteria selection. The studies presented some differences in terms of acquisition protocol, thermal imaging camera, data extrapolation, and analysis. Despite these differences, the studies presented similar thermal data. CONCLUSION: A knee thermography of or above 31.3 °C could indicate osteoarthritis, highlighting the necessity of further, more specific, and accurate analysis.

Four hundred Greek idiomatic expressions: Ratings for subjective frequency, ambiguity, and decomposability.

Idioms differ from other forms of figurative language because of their dimensions of subjective frequency, ambiguity (possibility of having a literal interpretation), and decomposability (possibility of the idiom's words to assist in its figurative interpretation). This study focuses on the Greek language and aims at providing the first corpus of 400 Greek idioms rated for their dimensions by 113 native Greek students, aged 19 to 39 years. The study aimed at (1) rating all idioms for their degree of subjective frequency, ambiguity, and decomposability, and (2) investigating the relationships between these dimensions. Three different assessments were conducted, during which the participants were asked to evaluate the degree of idioms' subjective frequency, ambiguity, and decomposability. The idioms were selected from a dictionary of Greek idioms titled "Dictionary of Idioms in Modern Greek" (Vlaxopoulos, 2007). This study resulted in the first database of Greek idioms assessed for their dimensions. The intraclass correlation coefficient (ICC) (two-way mixed, absolute agreement) demonstrated high internal consistency in the ratings given for each dimension, for the same idiom, by the different individual raters. Correlational analyses showed that subjective frequency was positively moderately correlated with decomposability, and positively weakly correlated with ambiguity, while decomposability was positively moderately correlated with ambiguity.

Validation of a computerized version of the MNREAD chart for children.

PURPOSE: We aimed the develop and validate a computerized version of the MNREAD for the assessment of reading speed for children. METHODS: A computerized version of the MNREAD was built in Psykinematix software using the same parameters as the physical chart. We measured the reading velocity of 104 children (n = 44 of the 3rd grade; n = 60 of the 5th grade). Bland-Altaman analysis was used to quantify agreement between two chart measurements. RESULTS: Comparison between the 3rd and 5th-grade children for physical and computerized MNREAD versions showed statistical differences in Maximum Reading Speed (F = 2669.6; p < 0.001), Critical Print Size (F = 17.49; p < 0.001), and Reading Acuity (F = 14.19; p = 0.002) with huge effect size (η2 = 0.930). No differences were found between the versions within grades. Bland-Altman analysis showed 95% of the data points within ± 2 s of the mean difference, suggesting a similarity between versions of the MNREAD parameters. CONCLUSION: Our reading speed values for children in the 5th grade were higher than previous studies, suggesting a better quality of the assessment in the computerized version. Tolerance Limits were calculated as normality references for clinical purposes.

Indian Hand Anthropometry: First Web Space Angle Measurement in A Population of 800 Subjects.

Background The first web space of the hand plays a crucial role in determining the hand's span. Our study aims to examine and quantify the first web space angle in both hands of adult individuals within the Indian population with no upper limb pathologies. The primary objective of this study is to establish normative data. These data will be useful in surgical correction for the first web release, recommending corrective splints, and calculating the percentage of disability in hand function. Materials and Methods Data from 800 individuals from various regions across India, ranging in age from 20 to 50 years who had no pathology in both upper limbs were collected. A goniometer was used to measure the first web space angle of both hands by keeping the forearm pronated, elbow flexed, and arms adducted. The subjects from different states were divided into various zones. Results In 800 subjects, the average measurement in the right hand was 97.28 degrees, and in the left hand, 99.76 degrees. In males, the average measurement in the right hand was 97.54 degrees, and in the left hand, it was 99.61 degrees. In females, in the right hand, it was 96.93 degrees, and in the left hand 100 degrees. The result was recorded in subjects from each zone in the country. Conclusion The large sample size from various parts of the country makes the study more reliable. The technique of measuring the angles was easily reproducible. Our findings provide crucial normative data for clinicians and therapists.

Normative Data of Ulnar Length in Pediatric Indian Population.

Objective The aim of this study is to create clinical normative data for ulnar length in the pediatric population and to demonstrate the usefulness of such data. Materials and Methods A nationally representative sample of healthy children aged 1 day to 18 years from five centers across India was collected. The percutaneous length of the ulna was measured by using a certified calibrated measuring tape across all centers. Other variables such as geographical domicile, dominance of the hand, age, body mass index (BMI), and sex of the child were also recorded. Results In total, 1,300 children (883 males and 417 females) with age ranging from 1 day to 18 years were included in the study. Gradual lengthening of the ulna was seen in both male and female children with increasing age without a significant difference; however, at 8, 9, and 14 years, there was significant lengthening of the ulna in males compared with females although the difference was statistically insignificant at 17 years. Apropos BMI at 16 years of age, a longer ulna was observed in obese children. Later on, at 18 years, the difference in ulnar length was insignificant. South Indian children had a significantly longer ulna up to the age of 11 years, but after the age of 11 years there was no difference in ulnar length in all zones. The length of the ulna was not affected by hand dominance. There was good inter-observer agreement and reliability between different centres. Age, zone, and gender, had statistically significant effect on the length of ulna but BMI and hand dominance was not significant. Conclusion This multicentric study provides normative data on the percutaneous length of the ulna in the Indian pediatric population. Gradual lengthening of the ulna was seen in all children with increasing age. The length of the ulna was significantly more in male, obese, and in South Indian children. However, except for age, other factors become insignificant at maturity.

Normative Values for Thumb Length in Central Indian Adult Population.

Introduction This article aims to establish the relative thumb length in comparison to the index finger in central Indian adults. Materials and Methods Five hundred normal adult hands (1,000 thumbs), 316 men and 184 women, mean age 30 years, were included in the study. The relative length of the thumb was measured using the length of the proximal phalanx of the index finger (thumb-proximal phalanx index) and the distance between the proximal digital crease and proximal interphalangeal crease of the index finger (thumb-digital crease index). Results The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. The tip of a normal adducted thumb extends to 68% for male and 69% for female of the length of the proximal phalanx of the index finger. For the dominant hand the tip of a normal adducted thumb extends to 68%, while for nondominant hand it reaches 71% of the length of the proximal phalanx of the index finger. The difference between the laterality, gender, and hand dominance was not statistically significant. Conclusion The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. Relative normal thumb length is independent of gender, laterality, or hand dominance.

Prevalence of the Absence of the Palmaris Longus and Functional Flexor Digitorum Superficialis of the Little Finger in the Indian Population.

Background The absence of the palmaris longus (PL) varies with race. The presence of a functional flexor digitorum superficialis (FDS) of the little finger also varies widely. The aim of this study is to determine the prevalence of the absence of the PL and functional FDS of the little finger in the Indian population. Materials and Methods This is a prospective observational study conducted as a part of the Indian normative data project of the Indian Society for Surgery of the Hand. The presence of the PL was assessed by Schaeffer's test. The function of the FDS was assessed by the standard test and modified test and its function designated as absent, present independently, or present combinedly with the ring finger FDS. Results A total of 200 volunteers including 84 males and 116 females in the 21- to 60-year age group were examined. Of the 400 hands examined, the PL was absent in 26 upper limbs (6.5%). The PL was absent unilaterally in 12 individuals (6%) and bilaterally in 7 individuals (3.5%). Of the 400 little fingers examined, FDS function was absent in 72 fingers (18%), while 67 fingers (16.75%) had a common function and 261 fingers (65.25%) had an independent function. Only 2% had a bilateral absence of both the PL and functional FDS tendons and 5% had a unilateral absence of both tendons. Conclusion The PL and FDS of the little finger were more absent in the right side than in the left side, but the difference was not statistically significant. There was no significant association between the absence of the PL and the absence of the functional FDS of the little finger.

Indian Hand Anthropometry: Computer Tomography-Based Morphometric Analysis of Metacarpal.

Introduction Metacarpal fractures are common and have various treatment options, but understanding their morphometry is crucial for optimizing fixation techniques and reducing complications. Accurate assessment of metacarpal anatomy is challenging in conventional radiographs but feasible with computed tomography (CT) scans, which offer precise views. This study aimed to provide accurate anatomical data on metacarpals within an Indian population using CT scans and to compare the results with existing literature. The findings have implications for surgical procedures, including plating, pinning, and intramedullary screw fixation. Materials and Methods This retrospective analysis utilized CT scans of 100 hands, including 50 males and 50 females, from two hospitals in India. Inclusion criteria included complete metacarpal visualization with a slice thickness of 0.6 mm, while exclusion criteria involved trauma, deformity, or underlying pathologies. Various parameters of all metacarpals were measured using RadiAnt DICOM Viewer 2021.1, providing accurate anteroposterior and lateral views. Results Male and female cohorts had mean ages of 38.58 ± 12.02 and 43.60 ± 13.61 years, respectively. The study showed good to excellent reliability in measurements. The 2nd metacarpal was consistently the longest, and the general length pattern was 3rd > 4th > 5th > 1st metacarpal in both genders. Men generally had larger metacarpal dimensions than women, except for intramedullary diameter, which showed minimal sex-related differences. Notably, the medullary cavity's narrowest part was at the 4th metacarpal, and the thumb had the widest intramedullary diameter. Conclusion This study provides valuable anatomical reference data for metacarpals in an Indian population, aiding in optimizing surgical techniques for metacarpal fractures. The 2nd metacarpal consistently stood out as the longest, and men generally had larger metacarpal dimensions than women. These insights into anatomical variations can inform clinical decisions and stimulate further research in this field. However, a larger and more diverse sample would enhance the study's representativeness.

The Normal Active Range of Motion of the Index, Middle, Ring, and Little Fingers in a Sample of Indian Population.

Background The normative data for finger range of motion (ROM) are not available for the Indian population. The aim of our study was to measure the active ROM of finger joints in normal healthy volunteers in a sample of Indian population. Materials and Methods This is a prospective observational study conducted as a part of the Indian normative data project of the Indian Society for Surgery of the Hand (ISSH). The study included one participating center from four geographical regions of the country. Certified goniometers were used to measure the ROM of fingers in all centers. A standardized methodology was devised. A pilot study was done to assess the interobserver and intraobserver reliability, following which data were collected by one measurement. Results This pilot study was performed in 20 hands that showed good interobserver and intraobserver reliability correlation. A total of 390 hands were measured in four participating centers. Active flexion of metacarpophalangeal (MCP) joint was the highest in the middle finger (86.6 ± 10.4 degrees) followed by the index finger (86.0 ± 9.2 degrees), little finger (85.0 ± 8.4 degrees), and ring finger (84.2 ± 8.6 degrees). The index finger (97.2 ± 16.9 degrees) showed maximum proximal interphalangeal (PIP) joint flexion followed by the middle finger (96.2 ± 15.8 degrees), ring finger (96.0 ± 15.9 degrees), and little finger (91.8 ± 12.7 degrees). Distal interphalangeal (DIP) joint flexion increased from the index finger (81.6 ± 13.9 degrees) to the little finger (84.6 ± 12.9 degrees). The little finger MCP joint (26.3 ± 6.2 degrees) showed maximum extension followed by the index finger (25.7 ± 6.8 degrees), middle finger (24.7 ± 6.7 degrees) and ring finger (22.3 ± 7.1 degrees). The middle finger (15.6 ± 8.1 degrees) and ring finger (16.2 ± 8 degrees) had more PIP joint extension when compared to the index (13.7 ± 7.8 degrees) and little finger (13.2 ± 8.4 degrees). The ring finger (8.1 ± 6.8 degrees) and the middle finger (8.4 ± 6.9 degrees) had more DIP joint extension when compared with the index finger (6.0 ± 6.0 degrees) and the little finger (6.8 ± 6.7 degrees). Total active motion (TAM) of the middle finger (315.9 ± 31.0 degrees) was the maximum followed by the index finger (310.2 ± 27.3 degrees), ring finger (308.8 ± 29.1 degrees), and little finger (307.8 ± 25.2 degrees). Gender, body mass index (BMI), mother tongue, geographical location, and occupation were factors that had significant correlation, while no significant differences based on side, hand dominance, and age were noted. Conclusion We have reported normative data of finger ROM and TAM for the index, middle, ring, and little fingers in the Indian population. Finger ROM in the Indian population is highly variable. The observed TAM in the Indian population is higher than what is reported earlier.