Developments in Hand Surgery: Experience from a Tertiary Hospital of Northern Bangladesh.

Hand Surgery is a specialized branch of Plastic and Reconstructive surgery. There are many conditions that require hand surgery, for example, congenital deformity, electric or flame burn, mechanical or road traffic injury, and post burn or post traumatic deformity. A retrospective observational study was conducted in the department of Burn and Plastic surgery, Mymensingh Medical College Hospital, Bangladesh during a 2 years period extending from 9th September 2021 to 8th September 2023. The objective of this study was to see the hand surgery status in a tertiary hospital of Bangladesh during the post Covid pandemic period. During this period 236 hand surgery procedures were performed in 176 patients. The age of the patients ranged from 02 to 78 years (Mean 31.14±1.52). One hundred and four (59.0%) were male and 72(41.0%) were female. Thirty-four (19.32%) patients had co-morbidities e.g., Epilepsy, Diabetes Mellitus, Chronic Kidney Diseases and HBsAg +ve. Causes of surgery included, wound due to electric burn 49(27.84%), flame burn 36(20.45%), post traumatic 24(13.64%), post infective 11(06.25%), tumor excision 02(2.24%), Dupuytren's contracture 03(1.70%), congenital anomalies 06(3.41%), post burn scar contractures 41(23.29%), nerve injury 01(00.57%) and carpal tunnel syndrome 01 (00.57%). Procedures were performed: post burn scar contracture release 41(17.37%), syndactly release 06(2.54%), release of post traumatic contracture 06(2.54%), carpal tunnel release 01(00.42%), release of Dupuytren's contracture 03(01.27%), nerve repair 01(00.42%), debridement, amputation and Fillet flap 29(12.29%), split thickness skin graft 46 (19.49%), V-Y advancement flap 06(2.54%), transposition flap 18(07.63%), cross finger flap 16 (06.78%), reverse cross finger flap 02 (00.85%), first dorsal metacarpal artery (FDMA) flap 05 (02.12%), reverse FDMA flap 01 (00.42%), metacarpal artery perforator flap 08(3.39%), radial artery perforator flap 04(01.69%), posterior interosseous artery flap 05(2.12%), abdominal flap 11(04.46%) and flap division and insetting 27(11.44%). Outcome of surgery was satisfactory in 225(95.34%) and 11(04.46%) cases had complications (p value 0.453), which was not significant. So, it can be concluded that the outcome of various types of hand surgery procedures in tertiary hospital of northern Bangladesh during the post Covid period was satisfactory overall.

Coverage of defects over Posterior aspect of Ankle Joint and Heel with Lateral Calcaneal Artery Flap- Experience in Mymensingh Medical College Hospital.

Lateral calcaneal artery flap is randomly used by many Plastic Surgeons for covering any defect on the posterior aspect of heel. A prospective observational study was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to June 2022, to see the outcome of the flap for coverage of defects over the posterior aspect of ankle joint and heel. A total number of 09 patients, selected by purposive sampling, were included in the study. The age of the patients ranged from 06 years to 70 years. The cause of the defects were post traumatic in 07 cases, electric burn in 01 case and pressure sore in 01 case. The defect sizes varied from 3×2 to 6×3cm. and flap size ranged from 4×2.5 to 7×4.5cm. The follow-up period ranged from 3 to 6 months. All the flaps survived completely without any complications; except in two cases. In one case, there was marginal epidermal necrolysis that healed secondarily without the need of any further surgical intervention. In the other case, there was gangrene of about 0.5 cm area at the flap tip, which was debrided and the resulting wound healed secondarily. The average operating time was 63 minutes. The results were satisfactory on the context of adequate coverage, and flap and donor site morbidity. So, the lateral calcaneal artery flap can be a good and safe option for the coverage of posterior ankle and heel defects.

A data-driven typology of emotion regulation profiles.

Typologies serve to organize knowledge and advance theory for many scientific disciplines, including more recently in the social and behavioral sciences. To date, however, no typology exists to categorize an individual's use of emotion regulation strategies. This is surprising given that emotion regulation skills are used daily and that deficits in this area are robustly linked with mental health symptoms. Here, we attempted to identify and validate a working typology of emotion regulation across six samples (collectively comprised of 1,492 participants from multiple populations) by using a combination of computational techniques, psychometric models, and growth curve modeling. We uncovered evidence for three types of regulators: a type that infrequently uses emotion regulation strategies (Lo), a type that uses them frequently but indiscriminately (Hi), and a third type that selectively uses some (cognitive reappraisal and situation selection), but not other (expressive suppression), emotion regulation strategies frequently (Mix). Results showed that membership in the Hi and Mix types is associated with better mental health, with the Mix type being the most adaptive of the three. These differences were stable over time and across different samples. These results carry important implications for both our basic understanding of emotion regulation behavior and for informing future interventions aimed at improving mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

You changed my mind: Immediate and enduring impacts of social emotion regulation.

As social creatures, our relationships with other people have tremendous downstream impacts on health and well-being. However, we still know surprisingly little about how our social interactions regulate how we think and feel through life's challenges. Getting help from other people to change how one thinks about emotional events-known as "social reappraisal"-can be more effective in downregulating negative affect than reappraising on one's own, but it is unknown whether this regulatory boost from social support persists when people face the same events alone in the future. In a preregistered study of 120 young adults (N = 60 same-gender dyads, gender-split sample) involving in-lab emotion regulation tasks and a follow-up task online approximately 1 day later, we found that participants responded less negatively to aversive images that were socially regulated (i.e., reappraised with the help of a friend) both immediately and over time, as compared to images that had been solo regulated (i.e., reappraised on one's own) or not regulated (i.e., passively viewed). Interestingly, the regulatory boost from social support observed both in the lab and at follow-up was driven by women dyads. This work highlights one important mechanism explaining how support from others can facilitate emotional well-being: By changing peoples' lasting impressions of distressing events, interactions with others can help prepare them to cope with future exposure to those events on their own, underscoring how valuable others' perspectives can be when navigating ongoing emotional stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Peer facilitation of emotion regulation in adolescence.

Emotion regulation is particularly important for adolescents as they undergo normative developmental changes in affective systems and experience heightened risk for psychopathology. Despite a high need for emotion regulation during adolescence, commonly studied emotion regulation strategies like cognitive reappraisal are less beneficial for adolescents than adults because they rely on neural regions that are still developing during this period (i.e., lateral prefrontal cortex). However, adolescence is also marked by increased valuation of peer relationships and sensitivity to social information and cues. In the present review, we synthesize research examining emotion regulation and peer influence across development to suggest that sensitivity to peers during adolescence could be leveraged to improve emotion regulation for this population. We first discuss developmental trends related to emotion regulation at the level of behavior and brain in adolescents, using cognitive reappraisal as an exemplar emotion regulation strategy. Next, we discuss social influences on adolescent brain development, describing caregiver influence and increasing susceptibility to peer influence, to describe how adolescent sensitivity to social inputs represents both a window of vulnerability and opportunity. Finally, we conclude by describing the promise of social (i.e., peer-based) interventions for enhancing emotion regulation in adolescence.

One size does not fit all: Decomposing the implementation and differential benefits of social emotion regulation strategies.

Although considerable research has demonstrated the importance of social relationships for well-being, limited work has assessed how people help regulate each other's emotions, a process called social emotion regulation. The present research utilized two experiments in 2020 (N1 = 50, N2 = 268) where people shared and responded to personal experiences to examine: (a) the kinds of regulatory support people offered others; (b) how people felt receiving different types of social feedback about their experiences; and (c) whether the support they offered others shaped how they felt receiving different feedback. When providing feedback to a confederate, participants varied in whether they chose to use validation, which affirms someone's feelings, or one of three types of social reappraisals, which help others change how they think about an emotional experience (i.e., temporal distancing: emphasizing how things change over time; positive focus: focusing on the bright side; and perspective taking: considering others' perspectives). Across studies, when participants received feedback about their own experiences, validation was the most comforting and preferred feedback. In Study 2, temporal distancing emerged as the most comforting, helpful, and preferrable type of social reappraisal and was the only reappraisal perceived as no less helpful than validation. Additionally, participants who provided social reappraisal to the confederate benefited most from receiving this type of support from others. Together, these results highlight the variability in how people use social emotion regulation strategies to support others and demonstrate how such differences in implementation, as well as individual differences in those receiving support, can shape social regulatory outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Comparative Study of Collagen Sheet versus 1% Silver Sulfadiazine Dressing in Superficial Partial Thickness Burns.

Burn injury causes a lot of suffering. The goal of burn management is to achieve rapid wound healing, pain relief, rehabilitation with minimum scars and optimal functional ability. Objective of this study was to compare the efficacy of collagen sheets and 1% silver sulfadiazine dressing (SSD) for superficial partial thickness burns. This prospective observational study was conducted among the patients of Department of Plastic surgery, Dhaka Medical College Hospital, and Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, from 1st April 2020 to 31st March 2021. Total 60 patients with superficial partial thickness burns by purposive sampling 30 patients of them were treated with collagen sheet dressing (Group A) and 30 patients with 1.0% silver sulfadiazine dressing (Group B). First case was selected by tossing a coin. Then every alternate patient was provided the same kind of dressing material (either collagen sheet or 1.0% silver sulfadiazine). Data were collected by semi structured data collection sheets. Pearson's chi-square test and student's 't' test were used for data analysis (p value was significant at <0.05). It was observed that a total of 18(60.0%) patients belonged to age <10 years in Group A and 17(56.7%) patients in Group B. The mean age was 14.9±14.2 years in Group A and 11.6±10.2 years in Group B. Good quality of healing was significantly higher in the collagen group compared to the SSD group (<0.05). The mean complete healing time in the collagen group was 10.47±2.21 days and in the 1.0% SSD group were 13.07±2.33 days. The mean healing time was significantly lower in the collagen group compared to the 1.0% SSD group (p<0.001). There was no significant difference in infection rate between the two groups (p>0.05). Considering the overall outcome, Collagen sheet dressing decreases pain, reduces the need for analgesics, aids in early healing as compared to the patients treated with 1% silver sulfadiazine.

Having more virtual interaction partners during COVID-19 physical distancing measures may benefit mental health.

Social interactions play an extremely important role in maintaining health and well-being. The COVID-19 pandemic and associated physical distancing measures, however, restricted the number of people one could physically interact with on a regular basis. A large percentage of social interactions moved online, resulting in reports of "Zoom fatigue," or exhaustion from virtual interactions. These reports focused on how online communication differs from in-person communication, but it is possible that when in-person interactions are restricted, virtual interactions may benefit mental health overall. In a survey conducted near the beginning of the COVID-19 pandemic (N2020 = 230), we found that having a greater number of virtual interaction partners was associated with better mental health. This relationship was statistically mediated by decreased loneliness and increased perceptions of social support. We replicated these findings during the pandemic 1 year later (N2021 = 256) and found that these effects held even after controlling for the amount of time people spent interacting online. Convergent with previous literature on social interactions, these findings suggest that virtual interactions may benefit overall mental health, particularly during physical distancing and other circumstances where opportunities to interact in-person with different people are limited.Open Science Framework repository: https://osf.io/6jsr2/ .

The comfort in touch: Immediate and lasting effects of handholding on emotional pain.

Consoling touch is a powerful form of social support that has been repeatedly demonstrated to reduce the experience of physical pain. However, it remains unknown whether touch reduces emotional pain in the same way that it reduces physical pain. The present research sought to understand how handholding with a romantic partner shapes experiences of emotional pain and comfort during emotional recollection, as well as how it shapes lasting emotional pain associated with emotional experiences. Participants recalled emotionally painful memories or neutral memories with their partners, while holding their partner's hand or holding a squeeze-ball. They additionally completed a follow-up survey to report how much emotional pain they associated with the emotional experiences after recalling them in the lab with their partners. Although consoling touch did not reduce emotional pain during the task, consoling touch increased feelings of comfort. Moreover, participants later recalled emotional memories that were paired with touch as being less emotionally painful than those that were not paired with touch. These findings suggest that touch does not decrease the immediate experience of emotional pain and may instead support adaptive processing of emotional experiences over time.

With a little help from my friends: Selective social potentiation of emotion regulation.

Decades of research has pointed to emotion regulation (ER) as a critical ingredient for health, well-being, and social functioning. However, the vast majority of this research has examined ER in a social vacuum, despite the fact that in everyday life individuals frequently regulate their emotions with help from other people. The present collection of preregistered studies examined whether social help increases the efficacy of reappraisal, a widely studied ER strategy that involves changing how one thinks about emotional stimuli. In Study 1 (N = 40 friend pairs), we compared the efficacy of reinterpreting the content of negative stimuli alone (solo ER) to listening to a friend reinterpret the stimuli (social ER). We found that social ER was more effective than solo ER, and that the efficacy of these strategies was correlated within individuals. In Studies 2 and 3, we replicated effects from Study 1, and additionally tested alternate explanations for our findings. In Study 2 (N = 40 individuals), we failed to find evidence that social ER was more effective than solo ER due to a difference in the quality of reinterpretations, and in Study 3 (N = 40 friend pairs), we found that social help did not significantly attenuate negative affect in the absence of reappraisal. In sum, we found that social help selectively potentiates the efficacy of reappraisal, and that this effect was not merely the outcome of social buffering. Together, these results provide insight into how social relationships can directly lend a hand in implementing ER strategies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Crane Principle in Plastic Surgery- Experience in Mymensingh Medical College Hospital.

The crane principle is a Plastic surgical technique whereby, a pedicled flap can be used as an engineering crane to lift and transport subcutaneous tissue from one area and deposit it in another. The flap can be returned later to its original bed. It takes only one week for the conveyance. Here we present a case of 25 year old female patient with degloving injury of scalp with exposed skull bone was initially managed with transposition flap for coverage of the scalp defect in Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh on 07 December 2017. After 8 months the scalp flap was returned to its original site following the crane principle and the new wound was covered by split-thickness skin graft. The flap survived completely and patient was satisfied.

Posterior Tibial Artery Perforator Based Propeller Flap for Lower Leg and Ankle Defect Coverage: A Prospective Observational Study.

Reconstruction of lower leg and ankle defect with exposed bone or tendon is a challenging task for a Plastic Surgeon. There are various options, among them perforator based propeller flap is a very good option though this is a microsurgical procedure but no need of microvascular anastomosis. This study was designed to see the clinical results of Posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage. The study was a prospective observational study. It was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2017 to June 2018. Sample size was 9. Sampling was carried out purposively. Postoperative follow up period was up to 6 weeks. Among the 9 cases, 8 flaps completely survived, 1 case developed marginal necrosis which was secondarily healed. There were total 2 complications among 9 cases i.e. transient venous congestion and superficial epidermonecrolysis which were resolved spontaneously. Regarding the cause of the defect, maximum cases were post traumatic wound (66.7%), others were post infective, post malignancy excision and post electric burn wound. Defect size was 2cm×2cm to 7cm×5cm. Maximum dimension of the flap was 19cm×6cm and minimum size was 7cm×3cm. Posterior tibial artery perforator location was 4cm to 9cm from lowest level of medial malleolous (mean 6.2±1.6cm). Rotation of the flap was 145°-180° (mean 163°±1.39°). In all cases donor site was covered with split thickness skin graft. Operation time was 120 minutes to 180 minutes; mean operative time was 143.3±2.38 minutes. After operation hospital stay was 10 days to 21 days, mean 11.44±3.64 days. So, posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage is a very good option.

Understanding invasion history and predicting invasive niches using genetic sequencing technology in Australia: case studies from Cucurbitaceae and Boraginaceae.

Part of the challenge in dealing with invasive plant species is that they seldom represent a uniform, static entity. Often, an accurate understanding of the history of plant introduction and knowledge of the real levels of genetic diversity present in species and populations of importance is lacking. Currently, the role of genetic diversity in promoting the successful establishment of invasive plants is not well defined. Genetic profiling of invasive plants should enhance our understanding of the dynamics of colonization in the invaded range. Recent advances in DNA sequencing technology have greatly facilitated the rapid and complete assessment of plant population genetics. Here, we apply our current understanding of the genetics and ecophysiology of plant invasions to recent work on Australian plant invaders from the Cucurbitaceae and Boraginaceae. The Cucurbitaceae study showed that both prickly paddy melon (Cucumis myriocarpus) and camel melon (Citrullus lanatus) were represented by only a single genotype in Australia, implying that each was probably introduced as a single introduction event. In contrast, a third invasive melon, Citrullus colocynthis, possessed a moderate level of genetic diversity in Australia and was potentially introduced to the continent at least twice. The Boraginaceae study demonstrated the value of comparing two similar congeneric species; one, Echium plantagineum, is highly invasive and genetically diverse, whereas the other, Echium vulgare, exhibits less genetic diversity and occupies a more limited ecological niche. Sequence analysis provided precise identification of invasive plant species, as well as information on genetic diversity and phylogeographic history. Improved sequencing technologies will continue to allow greater resolution of genetic relationships among invasive plant populations, thereby potentially improving our ability to predict the impact of these relationships upon future spread and better manage invaders possessing potentially diverse biotypes and exhibiting diverse breeding systems, life histories and invasion histories.

Fibronectin: functional character and role in alcoholic liver disease.

Fibronectins are adhesive glycoproteins that can be found in tissue matrices and circulating in various fluids of the body. The variable composition of fibronectin molecules facilitates a diversity of interactions with cell surface receptors that suggest a role for these proteins beyond the structural considerations of the extracellular matrix. These interactions implicate fibronectin in the regulation of mechanisms that also determine cell behavior and activity. The two major forms, plasma fibronectin (pFn) and cellular fibronectin (cFn), exist as balanced amounts under normal physiological conditions. However, during injury and/or disease, tissue and circulating levels of cFn become disproportionately elevated. The accumulating cFn, in addition to being a consequence of prolonged tissue damage, may in fact stimulate cellular events that promote further damage. In this review, we summarize what is known regarding such interactions between fibronectin and cells that may influence the biological response to injury. We elaborate on the effects of cFn in the liver, specifically under a condition of chronic alcohol-induced injury. Studies have revealed that chronic alcohol consumption stimulates excess production of cFn by sinusoidal endothelial cells and hepatic stellate cells while impairing its clearance by other cell types resulting in the build up of this glycoprotein throughout the liver and its consequent increased availability to influence cellular activity that could promote the development of alcoholic liver disease. We describe recent findings by our laboratory that support a plausible role for cFn in the promotion of liver injury under a condition of chronic alcohol abuse and the implications of cFn stimulation on the pathogenesis of alcoholic liver disease. These findings suggest an effect of cFn in regulating cell behavior in the alcohol-injured liver that is worth further characterizing not only to gain a more comprehensive understanding of the role this reactive glycoprotein plays in the progression of injury but also for the insight further studies could provide towards the development of novel therapies for alcoholic liver disease.

Cellular fibronectin stimulates hepatocytes to produce factors that promote alcohol-induced liver injury.

AIM: To examine the consequences of cellular fibronectin (cFn) accumulation during alcohol-induced injury, and investigate whether increased cFn could have an effect on hepatocytes (HCs) by producing factors that could contribute to alcohol-induced liver injury. METHODS: HCs were isolated from rats fed a control or ethanol liquid diet for four to six weeks. Exogenous cFn (up to 7.5 µg/mL) was added to cells cultured for 20 h, and viability (lactate dehydrogenase,LDH), apoptosis (caspase activity) and secretion of proinflammatory cytokines (tumor necrosis factor alpha, TNF-α and interleukin 6 IL-6), matrix metalloproteinases (MMPs) and their inhibitors (tissue inhibitors of metalloproteinases, TIMPs) was determined. Degradation of iodinated cFn was determined over a 3 h time period in the preparations. RESULTS: cFn degradation is impaired in HCs isolated from ethanol-fed animals, leading to its accumulation in the matrix. Addition of exogenous cFn did not affect viability of HCs from control or ethanol-fed animals, and apoptosis was affected only at the higher concentration. Secretion of MMPs, TIMPs, TNF-α and IL-6, however, was increased by exogenously added cFn, with HCs from ethanol-fed animals showing increased susceptibility compared to the controls. CONCLUSION: These results suggest that the elevated amounts of cFn observed in alcoholic liver injury can stimulate hepatocytes to produce factors which promote further tissue damage.

Ethanol feeding potentiates the pro-inflammatory response of Kupffer cells to cellular fibronectin.

BACKGROUND: Excessive alcohol consumption leads to the increased extracellular matrix deposition of cellular fibronectin (cFn) in the liver, which is also implicated as an initiating event in the fibrogenic process. We propose that cFn directly stimulates Kupffer cells (KCs), which are involved in the early response to tissue damage, to produce factors that enhance the progression of alcohol-induced liver injury toward inflammation and fibrosis. METHOD: KCs were isolated from rats fed a control or ethanol liquid diet for 4 to 6 weeks. The effect of exogenous cFn on KC viability and the secretion of the cytokines, TNF-α and IL-6, as well as of matrix remodeling factors, MMP-2 and TIMP-2, was determined after 20 hours of cell culture. RESULTS: For KCs from both control- and ethanol-fed rats, viability remained unaffected by treatment with cFn. TNF-α and IL-6 production were increased in KCs exposed to cFn, with cells treated with 1, 2.5, and 5 µg/ml cFn secreting significantly higher levels of both cytokines compared with untreated cells (p < 0.05). Chronic ethanol administration resulted in a significantly enhanced secretion of IL-6 by KCs regardless of treatment with cFn. When MMP-2 protein and activity levels were measured by western blot analysis and gelatin zymography, respectively, we found that cFn stimulated a dramatic increase in both cells from ethanol- and control-fed rats, with the KCs from ethanol animals being more responsive to cFn at higher concentrations (p < 0.05). Significantly higher levels of TIMP-2, which inhibits both the activation and activity of MMP-2, were secreted by KCs treated with 5 µg/ml cFn. Correspondingly, more pro-MMP-2 than active-MMP-2 was detected. CONCLUSION: Altogether, these results show that cFn stimulates KCs to produce factors that may enhance the promotion of tissue damage and that ethanol administration increases these responses.