Proximal to the 2nd part of the duodenum ( approximately at the major duodenal papilla – where the bile duct enters ) the arterial supply is from the gastroduodenal artery and its branch the superior pancreaticoduodenal artery.

Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position.

The most frequently performed surgery is the Proximal Row Carpectomy, where the lunate, scaphoid and triquetrum are extracted.

* Proximal check ligament desmotomy has been shown to return horses to work faster, but is thought by some to predispose to suspensory ligament injury.

Proximal femoral focal deficiency ( PFFD ) is a rare, non-hereditary birth defect that affects the pelvis, particularly the hip bone, and the proximal femur.

Proximal femur nail with locking and stabilisation screws for treatment of femur fractures of left thigh.

According to Lev Vygotsky's Zone of Proximal Development ( ZPD ), students typically learn vicariously through one another.

Proximal caries take an average of four years to pass through enamel in permanent teeth.

According to Vygotsky's Zone of Proximal Development a child can, through the help of an adult or more capable child, perform at a higher level than he or she can independently.

• Zone of Proximal Development: Learning through socialization where individuals are able to gain from the experience of their peers or teacher that they would not be able to on their own.

* Proximal promoter-the proximal sequence upstream of the gene that tends to contain primary regulatory elements

* Proximal spinal muscular atrophies, i. e., conditions that affect primarily proximal muscles ;

Proximal Phalanges or singular, " proximal Phalanx ", are bones found in the limbs of most vertebrates.

Proximal shunts, such as the Quackel's, are more involved and entail operative dissection in the perineum to where the corpora meet the spongiosum, making an incision in both, and suturing both openings together.

* Proximal convoluted tubule: It then may reabsorb urea in the thick descending limb.

* Proximal convoluted tubule ( lies in cortex and lined by simple cuboidal epithelium with brushed borders which help to increase the area of absorption greatly.

Proximal obstruction of the large bowel may present as small bowel obstruction.

The calcaneus has two articulations, being part of the Proximal intertarsal joint and the Talocalcaneal joint.

Proximal urea cycle defects, such as ornithine transcarbamylase deficiency and carbamoyl phosphate synthetase deficiency are not included in newborn screening panels because they are not reliably detected using current technology, and also because severely affected infants will present with clinical symptoms before newborn screening results are available.

Proximal ambulacral pairs can be partially separated, forming a buccal slit, an expansion of the mouth frame.

Proximal muscle weakness, characteristic skin rash and elevated muscle enzymes are routinely used to identify JDM.

Proximal causation: explanation of human social behaviour by considering the immediate factors, such as symbolic interaction, understanding ( Verstehen ), and individual milieu that influence that behaviour.

* Proximal phalanges are closest to the main part of the hand or foot and articulate with the metacarpals of the hand or metatarsals of the foot.

From Vygotsky come concepts such as the Zone of Proximal Development ( ZPD ) and scaffolding.

Proximal tubal occlusion has also been overcome by using hysteroscopy with tubal canalization using a catheter, not a falloposcope.

* Proximal convoluted tubule: Aminoglycoside antibiotics ( e. g. gentamicin ), amphotericin B, cisplatin, radiocontrast media, immunoglobulins, mannitol

Vygotsky ( 1978 ) referred to this as the Zone of Proximal Development and believed that fostering development within this zone leads to the most rapid development.

* Distal subungual onychomycosis is the most common form of tinea unguium, and is usually caused by Trichophyton rubrum, which invades the nail bed and the underside of the nail plate.

It is performed by a physician or surgeon to relieve the pain associated with a subungual hematoma ( blood under the nail ); a small amount of blood is expressed through the hole and the pain associated with the pressure is partially alleviated.

Acute subungual hematomas are quite painful, and are usually treated by releasing the blood by creating a small hole in the nail.

The case definition for trichinosis at the European Center for Disease Control states " at least three of the following six: fever, muscle soreness and pain, gastrointestinal symptoms, facial edema, eosinophilia, and subconjuctival, subungual, and retinal hemorrhages.

* Melanonychia ( longitudinal streaking that darkens or does not grow out ), especially on the thumb or big toe, may indicate subungual melanoma.

Solitary glomus tumors, particularly subungual lesions, are more common in females than in males.

For advanced onychomycosis, especially if more than one nail is infected, systemic medication ( pills ) is preferred.

In podiatry, the Nd: YAG laser is being used to treat onychomycosis, which is fungus infection of the toenail.

Epidermophyton is a genus of fungus causing superficial and cutaneous mycoses, including E. floccosum, a cause of tinea corporis ( ringworm ), tinea cruris ( jock itch ), tinea pedis ( athlete ’ s foot ), and onychomycosis or tinea unguium, a fungal infection of the nail bed.

Involvement of the nails is termed onychomycosis, and they may thicken, discolour, and finally crumble and fall off.

The prevalence of onychomycosis is about 6-8 % in the adult population.

* White superficial onychomycosis ( WSO ) is caused by fungal invasion of the superficial layers of the nail plate to form " white islands " on the plate.

* Candidal onychomycosis is Candida species invasion of the fingernails, usually occurring in persons who frequently immerse their hands in water.

Trichophyton rubrum is the most common dermatophyte involved in onychomycosis.

Aging is the most common risk factor for onychomycosis due to diminished blood circulation, longer exposure to fungi, and nails which grow more slowly and thicken, increasing susceptibility to infection.

Treatment of onychomycosis is challenging because the infection is embedded within the nail and is difficult to reach ; full removal of symptoms is slow and may take a year or more.

For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised.

A Pinpointe type laser is available in the USA and approved by the FDA for onychomycosis treatment.

* Australian tea tree oil has been tested, but there is insufficient information to make recommendations for its use for onychomycosis.