Amaç: Bu çalýþma, elin baþparmak metakarpofalangeal (MKP) ekleminde sesamoid kemiklerin (Sbs) kemikleþme zamanýnýn baþlangýcýný ve ergenlik dönemi ile iliþkisini belirlemeyi amaçlamýþtýr.
Yöntemler: Bu retrospektif radyografik çalýþmaya 5-17 yaþ arasý hastalar dahil edildi. Her yaþ grubu için ayrý ayrý Sbs varlýðý araþtýrýldý. Hastalar yaþ, cinsiyet ve radyal-ulnar sesamoid varlýðýna göre kaydedildi.
Bulgular: Dokuz yüz otuz dokuz hastanýn 1.020 radyografisi incelendi. Sbs kýzlarda 8, erkeklerde 9 yaþýnda kemikleþmeye baþladý. Ayný yaþ grubundaki tüm bireylerde ulnar-radyal sesamoidlerin bulunduðu yaþ kýzlarda 13-14, erkeklerde 15 idi. Sesamoidin ayný yaþ grubundaki bireylerin %50’sinde görüldüðü yaþ radyal taraf için kýzlarda 10,4, erkeklerde 11,9 iken ulnar taraf için ise kýzlarda 9,5, erkeklerde 11,5 yaþ olarak belirlendi.
Sonuçlar: Örneklemimizde ergenlik baþlangýç zamaný ve süresi ile karþýlaþtýrýldýðýnda; 1. MKP eklemdeki sesamoidlerin görülmeye baþladýðý yaþtan tüm bireylerde görülmeye baþladýðý yaþa kadar geçen süre fizyolojik ergenlik süresi ile benzerdir. Ergenlik baþlangýç yaþý ise ayný yaþ grubundaki hem cinslerinin %50’sinde Sbs’nin görüldüðü zamana denk gelmektedir.

Objective: The current study aimed to determine the onset of sesamoid bones (Sbs) ossification at the thumb metacarpophalangeal (MCP) joint of the hand and its relationship with puberty.
Methods: This retrospective radiographic study included patients aged 5-17 years. The presence of Sbs was investigated separately for each age group. Patients were classified based on their age, gender, and the presence of radial and ulnar sesamoids.
Results: A total of 1,020 radiographs from 939 patients were analyzed. Sbs began to ossify in girls at the age of 8 years and in boys at the age of 9 years. The ulnar-radial sesamoids were present in all individuals in the same age group at the age of 13-14 years in girls and 15 years in boys. The age at which 50% of the individuals in the same age group had a sesamoid was 10.4 years in girls and 11.9 years in boys on the radial side, 9.5 years in girls, and 11.5 years in boys on the ulnar side.
Conclusions: In all individuals, the time between the onset of sesamoids of the MCP joint and development corresponds to the physiological period of puberty. However, the age at which puberty begins coincides with the time when Sbs begin to ossify in 50% of both sexes in the same age group.

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Amaç: Sigara içmek, hücre dýþý matriksin üretimi ve degradasyonu arasýndaki stabiliteyi deðiþtirebilen kardiyovasküler riske neden olur. Matriks metalloproteinaz-9, hücre dýþý matriksi bozan ve doku yenilenmesinde ve çeþitli fizyolojik süreçlerde yer alan çinko içeren bir endopeptidazdýr. Sonuç olarak, sigaranýn neden olduðu yüksek serum MMP-9 seviyeleri, özellikle genç yaþta, koroner kalp hastalýðý (KKH) riskini artýrýr. Bu nedenle, bu çalýþma genç sigara içenlerde, sigaranýn neden olduðu dolaþýmdaki MMP-9 ile kardiyovasküler hastalýk riski arasýndaki olasý iliþkiyi belirlemeyi amaçlamýþtýr.
Yöntemler: Bu kesitsel çalýþmada hastalar üç gruba ayrýldý. Her grup 120 katýlýmcý içerdi. Birinci grup, fiziksel ve ruhsal hastalýðý olmayan 120 saðlýklý bireyden, ikinci grup kalp hastalýðý olan 120 aktif sigara içicisinden ve üçüncü grup, Sri Ramaswamy Memorial Hastanesi’ne kardiyoloji kontrolü için baþvuran, kalp hastalýðý ve diyabeti olan 20-55 yaþlarýndaki 120 aktif sigara içicisinden oluþtu. Serum MMP-9, yüksek hassasiyetli C-reaktif protein (hs-CRP) ve apolipoprotein-E (APO-E) seviyeleri ELISA yöntemi kullanýlarak analiz edildi ve lipit seviyeleri AU480 otomatik analizörü (Beckman Coulter) kullanýlarak enzimatik olarak ölçüldü.
Bulgular: Sigara içmeyenlerle karþýlaþtýrýldýðýnda, çalýþma ortalama serum MMP-9, hs-CRP ve APO-E düzeylerinin sigara içenlerde anlamlý olarak daha yüksek olduðunu gösterdi (p<0,001). MMP-9 ile hs-CRP, APO-E, sigara içme yükü ve sigara içme yoðunluðu arasýnda da güçlü bir iliþki bulundu.
Sonuçlar: Sigara içmek ile MMP-9 arasýnda anlamlý bir iliþki bulundu. Dolaþýmdaki enflamasyon belirteçlerine nispi maruziyet KKH patogenezinde potansiyel rol oynamaktadýr.

Objective: Smoking causes cardiovascular risk, which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and is involved in tissue remodelling and several physiological processes. As a result, smoking-induced elevated serum MMP-9 levels, particularly at a younger age, raise the risk of coronary heart disease (CHD). Thus, this study aimed to determine the possible relationship between smoking-induced circulating MMP-9 and the risk of cardiovascular disease in young smokers.
Methods: In this cross-sectional study, the patients were divided into three groups. Each group contains 120 study participants. Group one consisted of 120 healthy individuals with no physical and mental illness, group two consisted of 120 active smokers with a heart disease, and group three consisted of 120 active smokers with a heart disease and diabetes, who attended Sri Ramaswamy Memorial Hospital for cardiology checkup at the age of 20-55 years. The serum MMP-9, high-sensitivity C-reactive protein (hs-CRP), and apolipoprotein-E (APO-E) levels were analyzed using the ELISA method, and the lipid levels were measured enzymatically using AU480 automatic analyzer (Beckman Coulter).
Results: Compared with non-smokers, the study shows that the mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in smokers (p<0.001). A strong relationship was also found between MMP-9 and hs-CRP, APO-E, smoking load, and smoking intensity.
Conclusions: A significant association was found between cigarette smoking with MMP-9, and relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

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Amaç: Biparametrik prostat manyetik rezonans görüntüleme (bpMRG) ile multiparametrik prostat manyetik rezonans görüntülemenin (mpMRG) Prostat Görüntüleme Raporlama ve Veri Sistemi (PIRADS) skoru 3-4 olan hastalarda retropubik radikal prostatektomi (RRP) patolojik evresi ve biyokimyasal nüksü (BKN) öngörmedeki etkisini kýyaslamaktýr.
Yöntemler: Preoperatif mpMRG çekildikten sonra RRP uygulanan ve düzenli takipleri yapýlan toplam 107 hasta deðerlendirildi. Grup 1 hem bpMRG hem de mpMRG’de PIRADS 3 olarak deðerlendirilen 31 hastadan, grup 2 bpMRG’de PIRADS 3 ve mpMRG’de PIRADS 4 olarak deðerlendirilen 31 hastadan oluþturuldu. Grup 3 ise kontrastsýz çekimde PIRADS 4 skoru alan 45 hastadan oluþuyordu. Grup 1 ve 2 ile grup 2 ve 3 arasýnda karþýlaþtýrmalar yapýldý.
Bulgular: Demografik veriler, preoperatif/postoperatif radyoloji ve patoloji bulgularý açýsýndan gruplar arasýnda anlamlý fark yoktu. Anlamlý olmasa da ekstraprostatik yayýlým (EPY) pozitifliði ve BKN grup 2’de grup 1’e göre daha sýktý. BKN, patoloji raporunda seminal vezikül invazyonu pozitifliði ve yüksek patolojik evreyi öngören risk faktörlerini belirlemek için çok deðiþkenli regresyon analizi yapýldý. Grup 2 ve 3 karþýlaþtýrýldýðýnda, prostat spesifik antijen (PSA) ve PSA dansitesi anlamlý olmasa da grup 3’te daha yüksekti.
Sonuçlar: Çalýþmamýzda mpMRG yöntemi bpMRG yöntemiyle karþýlaþtýrýldýðýnda, RRP sonrasý BKN’yi öngörmede ek bir katký saðlamadý.

Objective: This study aimed to evaluate the difference in predicting the pathological stage of retropubic radical prostatectomy (RRP) and biochemical recurrence (BCR) in patients with Prostate Imaging Reporting and Data System (PIRADS) scores of 3 and 4 on biparametric prostate magnetic resonance imaging (bpMRI) compared to patients who upgraded from PIRADS 3 to PIRADS 4 based on the contrast-enhanced PIRADS version 2.1.
Methods: This study evaluated 107 patients who underwent RRP and had preoperative multiparametric prostate magnetic resonance imaging (mpMRI) and were followed regularly. Group 1 included 31 patients evaluated as PIRADS 3 in both bpMRI and mpMRI, group 2 included 31 patients evaluated as PIRADS 3 in bpMRI and PIRADS 4 in mpMRI, and group 3 included 45 patients evaluated as PIRADS 4 without contrast. Comparisons were made between groups 1 and 2 and between groups 2 and 3.
Results: No significant difference was found between the groups in terms of demographic data, preoperative or postoperative radiology, and pathology findings. Extraprostatic extension positivity and BCR were more common in group 2 compared to group 1 although not significant. Multivariate regression analysis was performed to determine the risk factors in predicting BCR, which revealed the positivity of seminal vesicle invasion and high pathological stage in the pathology report as significant factors. Prostate-specific antigen (PSA) and PSA density were higher in group 3 than in group 2, but without significance.
Conclusions: This study revealed that mpMRI did not contribute in predicting BCR after RRP compared to bpMRI.

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Amaç: Travmatik beyin hasarý (TBH) önemli bir saðlýk sorunudur ve artmýþ mortalite ile iliþkilidir. Ciddi TBH’de prognozun öngörülmesi esastýr. Optik sinir kýlýfý çapýnýn (ONSD) geniþlemesi kafa içi basýncýnýn artmasýný gösterir ve kötü prognoz ile iliþkilidir. Bu çalýþmada, ciddi TBH’li hastalarda ONSD’nin prognostik önemini deðerlendirmeyi amaçladýk.
Yöntemler: Bu çalýþmaya ciddi TBH’li toplam 44 hasta geriye dönük olarak dahil edildi. Hastalar iki gruba ayrýldý: sað kalanlar (n=17) ve ölenler (n=27). Tüm hastalar için temel karakteristik ve klinik veriler, baþvuru sýrasýnda Glasgow koma skalasý (GKS) skoru, beyin bilgisayarlý tomografi (BT) tarama sonuçlarý, yaralanma þiddet skoru (ISS) ve Marshall skoru kaydedildi. ONSD göz küresinin 3 mm gerisinden, skleranýn hemen altýndan ölçüldü.
Bulgular: Ýlk BT’deki ONSD, ölenlerde hayatta kalanlara kýyasla anlamlý derecede daha yüksekti (6,83±1,40’a karþý 6,40±1,36, p<0,05). Ek olarak, ISS ve Marshall skoru ölenlerde anlamlý derecede daha yüksek iken, GKS ise anlamlý olarak daha düþüktü. ONSD, Marshall skoru ile pozitif korelasyon gösterdi (r=0,332, p<0,05). Alýcý iþletim karakteristik analizinde, ONSD’nin ≥6,61 olmasý mortaliteyi öngörmede %70,4 duyarlýlýða ve %64,7 özgüllüðe sahip olduðu görüldü. ONSD’nin ≥6,61 olmasýnýn hastane içi mortalite için 4,3 kat artmýþ riske sahip olduðu gösterildi (risk oraný: 4,35, %95 güven aralýðý: 1,195-15,865, p<0,05).
Sonuçlar: Ýlk BT’de ONSD geniþlemesi, þiddetli TBH’li hastalarda artmýþ mortalite ile iliþkili bulundu.

Objective: Traumatic brain injury (TBI) is a serious health problem that is related to an increased mortality. In cases of severe TBI, the prediction of prognosis is essential. The enlargement of the optic nerve sheath diameter (ONSD) shows an increased intracranial pressure and is associated with poor outcomes. In this study, we aimed to evaluate the prognostic value of ONSD in patients with severe TBI.
Methods: Forty-four patients with severe TBI were retrospectively enrolled in the study. The patients were divided into two groups: survivors (n=17) and non-survivors (n=27). Baseline characteristics, clinical data, Glasgow coma scale (GCS) on hospital admission, brain computed tomography (CT) results, injury severity score (ISS), and Marshall score were recorded for all patients. ONSD was calculated at 3 mm distance from the globe, immediately below the sclera.
Results: The ONSD on the initial CT was significantly higher in non-survivors compared with survivors (6.83±1.40 vs. 6.40±1.36, p<0.05). In addition, ISS and Marshall score were significantly higher, whereas GCS was significantly lower in non-survivors. ONSD was positively correlated with Marshall score (r=0.332, p<0.05). Receiver operating characteristics analysis demonstrated that ONSD ≥6.61 had a sensitivity of 70.4% and specificity of 64.7% for predicting mortality. It was shown that ONSD ≥6.61 had a 4.3-fold increased risk for in-hospital mortality (odds ratio: 4.35; 95% confidence interval: 1.195-15.865; p<0.05).
Conclusions: The enlargement of ONSD on initial CT was detected to be associated with increased in-hospital mortality in patients with severe TBI.

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Amaç: Diyabetik retinopati, diabetes mellitusun yaygýn bir mikrovasküler komplikasyonudur. Hastalýðýn teþhisi ve sýnýflandýrýlmasý, klinik fundus muayenesindeki gözle görülür deðiþikliklere dayanmaktadýr. Ancak proliferatif diyabetik ve diyabetik olmayan retinopatili hastalarýn olasý vitreus biyobelirteçlerin keþfedilmesi hem retinopatinin ayrýmý hem de derecesi hakkýnda yol gösterici olabilir. Ayrýca kabul görecek biyomarkerler birer tedavi hedefi de olabilir. Amfiregülinin (AREG), epidermal büyüme faktörü reseptörlerini baðlayarak ve aktive ederek çoðu hücre tipinin çoðalmasýný, yenilenmesini ve onarýmýný uyardýðý bilinmektedir. Progranülin (PGRN), birçok fizyolojik ve patolojik süreçte karmaþýk fonksiyonlara sahiptir. Bu çalýþmada, proliferatif diyabetik retinopatili hastalarda vitreus AREG ve PGRN düzeylerinin raporlanmasý ve sonuçlarýn diyabetik olmayan kiþilerle karþýlaþtýrýlmasý amaçlandý.
Yöntemler: Bu çalýþmaya 33 proliferatif diyabetik retinopatili hastanýn 33 gözü ve 31 diyabetik olmayan bireyin 31 gözü dahil edildi. Pars plana vitrektomi ameliyatý sýrasýnda cerrahi iþlemden hemen önce tüm hastalardan vitreus örnekleri toplandý. Vitreus AREG ve PGRN seviyeleri ELISA yöntemi ile ölçüldü.
Bulgular: Ortalama AREG ve PGRN seviyeleri gruplarda benzerdi (sýrasýyla p=0,427, p=0,459).
Sonuçlar: Vitreus AREG ve PGRN düzeylerinin proliferatif diyabetik retinopati ile anlamlý bir iliþkisinin olmadýðý gösterildi.

Objective: Diabetic retinopathy is a common diabetic microvascular problem. Its diagnosis and classification are based on visible changes in clinical fundus examination. However, the discovery of possible vitreous biomarkers in patients with proliferative and nonproliferative diabetic retinopathy may guide both the differentiation and degree of retinopathy. Biomarkers that will be accepted can be also a treatment target. Amphiregulin (AREG) promotes proliferative and regenerative activity and repairs most cell types by binding and activating epidermal growth factor receptors. Progranulin (PGRN) has complex functions in many physiological and pathological processes. Thus, this study aimed to report vitreous AREG and PGRN levels in patients with diabetes and proliferative retinopathy and compare the results with those without diabetes.
Methods: Thirty-three eyes of 33 patients with proliferative diabetic retinopathy and 31 eyes of 31 patients without diabetes were included in this study. Vitreous humor samples were collected from all patients at the time of pars plana vitrectomy surgery immediately before the surgical procedure. Vitreous AREG and PGRN values were determined by the ELISA method.
Results: The mean AREG and PGRN values were similar in the groups (p=0.427, p=0.459, respectively).
Conclusions: The results demonstrated that vitreous AREG and PGRN levels have no significant relationship with proliferative diabetic retinopathy.

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Amaç: Koronavirüs hastalýðý-2019’da (COVÝD-19) gastrointestinal semptomlarýn prevalansý geniþ bir deðiþkenlik içinde bildirilmiþtir. Bu çalýþmada, pediatrik COVÝD-19’da gastrointestinal sistem (GÝS) tutulumunun prevalansý ve hastalýðýn prognozuna etkisinin araþtýrýlmasý amaçlanmýþtýr.
Yöntemler: Akut COVÝD-19 olan 0-18 yaþ arasý çocuklar çalýþmaya dahil edildi. Hastalar sistem tutulumlarýna göre gruplandýrýldý; izole solunum sistemi (SS), izole GÝS ve her ikisinin kombinasyonu (SS+GÝS). Bu gruplar demografik veriler, klinik özellikler, laboratuvar ve görüntüleme bulgularý ve hastaneye yatýþ açýsýndan karþýlaþtýrýldý.
Bulgular: Toplam 223 çocuk hasta çalýþmaya dahil edildi. On dokuzu asemptomatik, 12’si çocuklarda multisistem enflamatuvar sendrom tanýsý aldý, 21’inde hastalýk þiddetini etkileyebilecek kronik hastalýklar vardý ve 27’sinde SS veya GÝS dýþý semptomlar mevcuttu. Geriye kalan 144 hasta sistem tutulumuna göre sýnýflandýrýldý: 79’unda (%35,4) izole SS tutulumu, 14’ünde (%6,3) izole GÝS tutulumu, 51’inde (%22,9) ise SS+GÝS tutulumu birlikteydi. GÝS grubunda olan hastalarýn SS grubundakilere göre daha genç olduðu görüldü (sýrasýyla ortanca 30 ay ve 150 ay, p=0,006). Tamamý SS grubunda olan 3 hasta yoðun bakým ünitesinde takip edildi. SS grubundaki hastalarýn %21,5’inde ciddi kritik solunum semptomlarý varken SS+GÝS grubunun %7,8’inde ciddi kritik solunum semptomlarý vardý (p=0,039).
Sonuçlar: COVÝD-19 enfeksiyonu geçiren çocuklarda yaþ azaldýkça GÝS tutulumunun arttýðý görüldü. GÝS tutulumunun olmasý solunum semptomlarýnýn þiddetini ve yoðun bakýma yatýþýný azalttýðý tespit edildi. Yaþtan baðýmsýz olarak da GÝS tutulumunun daha hafif seyirli bir hastalýk ile iliþkili olduðu görüldü.

Objective: The prevalence of gastrointestinal symptoms in coronavirus disease-2019 (COVID-19) has been reported widely. In this study, the prevalence of gastrointestinal system (GIS) involvement in pediatric COVID-19 and its effect on prognosis were investigated.
Methods: Children (aged 0-18 years) with acute COVID-19 were included in the study. The patients were grouped according to system involvement: isolated respiratory system (RS), isolated GIS, and combination of both (RS+GIS). These groups were compared in terms of demographic data, clinical characteristics, laboratory and imaging findings, and hospitalization.
Results: A total of 223 pediatric patients were included in the study. Of these patients, 19 were asymptomatic, 12 were diagnosed with a multisystem inflammatory syndrome in children, 21 had chronic disorders that may affect disease severity, and 27 had symptoms not related to RS or GIS. The remaining 144 patients were classified according to system involvement: 79 (35.4%), 14 (6.3%), and 51 (22.9%) had isolated RS, isolated GIS, and RS+GIS involvement, respectively. The GIS group was much younger than the RS group (median, 30 and 150 months, respectively, p=0.006). Three patients from the RS group were followed in the intensive care unit (ICU). Moreover, 17 (21.5%) and 4 (7.8%) patients from the RS group had severe-critical respiratory symptoms, in the RS+GIS group had severe-critical respiratory symptoms (p=0.039).
Conclusions: Our study showed that GIS involvement in children with COVID-19 is more prevalent than RS involvement in the younger age group. Respiratory symptom severity and ICU admission also decreased with accompanying GIS involvement. GIS involvement

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Sinonazal lobüler kapiller hemanjiyomlar (LCH), genellikle nazal septumdan kaynaklanan, nadir görülen iyi huylu vasküler lezyonlardýr. Nazofaringeal, nazal orta konka ve anterior nazal sürüntü, koronairüs hastalýðý-2019 (COVÝD-19) için tercih edilen tarama yöntemidir. Burada, anterior nazal sürüntü ile COVÝD-19 için sürekli kendi kendini test eden bir çocukta sinonazal LCH olgusunu sunuyoruz. Çocuk, nazal septumun ön kýsmýnda endoskopik olarak çýkarýlan, iyi tanýmlanmýþ kýrmýzý bir kitle ile baþvurdu. Histopatoloji sonucu LCH olarak raporlandý. Bu çalýþma, anterior nazal swabýn kullanýmýyla epistaksi dýþýndaki bir komplikasyona iliþkin ilk rapordur. Literatür taramasý sonucunda, COVÝD-19 taramasýnýn komplikasyonlarýný bildiren 32 çalýþma belirlendi. Beyin omurilik sývýsý sýzýntýlarý ve yabancý cisim retansiyonu bunlardan en yaygýn olanlarýdýr. Uygun bir örnek toplama tekniði ve risk faktörlerini vurgulayarak hýzlý bir hasta öyküsü, COVÝD-19 taramasýndan kaynaklanan komplikasyonlarý önlemek için en iyi uygulamalardýr.

Sinonasal lobular capillary hemangiomas (LCH) are rare benign vascular lesions commonly arising from the nasal septum. Nasopharyngeal, nasal mid-turbinate, and anterior nasal swabbing is the preferred method of screening for coronavirus disease-2019 (COVID-19). Herein, we present a case of a sinonasal LCH in a child after continuous self-tests for COVID-19, with an anterior nasal swab. The child presented with a well-defined red mass in the anterior part of the nasal septum, which was removed endoscopically. Histopathology revealed a LCH. This is the first report of a complication other than epistaxis with the use of an anterior nasal swab. Our literature review identified 32 studies reporting complications of COVID-19 screening. Cerebrospinal fluid leaks and foreign body retention are the most common ones. A proper specimen collection technique and a quick patient history with an emphasis on risk factors are the best practices to prevent complications from COVID-19 screening.

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Yüzeysel palmar ark (SPA), esas olarak ulnar arterin yüzeyel dalý ile radial arterin yüzeysel dallarýndan birinin oluþturduðu önemli bir anastomoz aðýdýr. Kadavra örneklerinde 20 elden üçünde SPA varyasyonlarý gözlendi. Ýki tek taraflý inkomplet SPA olgusu ve üçüncü bir tek taraflý ulnardan medyana komplet SPA olgusu bulundu. Ýnkomplet SPA fleksör digitorum tendonlarýnýn yüzeyelinde ve palmar aponevrozun derininde yerleþmiþ bulundu. On yedi elin geri kalanýndaki SPA anatomik olarak normaldi ve büyük katký ulnar arterin yüzeysel palmar dalýndan ve küçük katký radial arterin yüzeysel palmar dalýndan geliyordu. Bu varyasyonlar, arteriyel kan örneklemesi, kardiyak kateterizasyon ve hemodiyaliz gibi prosedürler sýrasýnda klinik olarak önemlidir. Bu bölgedeki anatomik deðiþkenlikler iþlem öncesi tespit edilmezse damar týkanýklýðý ile komplikasyonlara neden olabilir.

The superficial palmar arch (SPA) is an important anastomotic network primarily formed by the superficial branch of the ulnar artery with one of the superficial branches of the radial artery. SPA variations were observed in three out of 20 cadaveric hand specimens. Two cases of unilateral incomplete SPA and the third case of a unilateral ulnar-to-median complete SPA were recorded. The incomplete SPA was located superficial to the flexor digitorum tendons and deep to the palmar aponeurosis. SPA in the remaining 17 hands was anatomically normal, with major contributions from the superficial palmar branch of the ulnar artery and minor contributions from the superficial palmar branch of the radial artery. These variations are clinically important, especially during procedures like arterial blood sampling, cardiac catheterization, and hemodialysis. Thus, anatomical variabilities in this region may cause complications with vascular occlusion if not ascertained before the procedure.

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