Atomic Layer Deposited Ti2 O3 Thin Films.

Ti2 O3 thin films have been prepared through atomic layer deposition and subjected to electrical resistivity measurements as a function of temperature. The as-prepared films were stable for up to three weeks. In Ti2 O3 thin films, the insulator-metal transition is observed at ∼80 K, with nearly 3-4 orders of magnitude change in resistivity. The anomalous increase in electrical resistivity in the films is in accordance with the two-band model. However, the energy interval between the bands depending on the crystallographic c/a ratio leads to a change in electrical resistivity as a function of temperature.

Comparison of heart rate and oxygen saturation measurements from Masimo and Nellcor pulse oximeters in newly born term infants.

AIM: To compare heart rate (HR) measurements from Masimo and Nellcor pulse oximeters (POs) against HR measured via a three lead electrocardiograph (ECG) (HRECG ). We also compared peripheral oxygen saturation (SpO2 ) measurements between Nellcor and Masimo oximeters. METHOD: Term infants born via elective caesarean section were studied. ECG leads were placed on the infant's chest and abdomen. Masimo and Nellcor PO sensors were randomly allocated to either foot. The monitors were placed on a trolley, and data from each monitor screen captured by a video camera. HR, SpO2 measurements and signal quality were extracted. Bland-Altman analysis was used to determine agreement between HR from the ECG and each oximeter, and between SpO2 from the oximeters. RESULTS: We studied 44 infants of whom 4 were resuscitated. More than 8000 pairs of observations were used for each comparison of HR and SpO2. The mean difference (±2SD) between HRECG and HRN ellcor was -0.8 (±11) beats per minute (bpm); between HRECG and HRM asimo was 0.2 (±9) bpm. The mean (±2SD) difference between SpO2Masimo and SpO2Nellcor was -3 (±15)%. The Nellcor PO measured 20% higher than the Masimo PO at SpO2 <70%. CONCLUSION: Both oximeters accurately measure HR. There was good agreement between SpO2 measurements when SpO2 ≥70%. At lower SpO2 , agreement was poorer.

Determining the best method of Nellcor pulse oximeter sensor application in neonates.

AIM: To identify the optimal sensor application method that gave the quickest display of accurate heart rate (HR) data using the Nellcor OxiMax N-600x pulse oximeter (PO). METHODS: Stable infants who were monitored with an electrocardiograph were included. Three sensor application techniques were studied: (i) sensor connected to cable, then applied to infant; (ii) sensor connected to cable, applied to investigator's finger, and then to infant; (iii) sensor applied to infant, then connected to cable. The order of techniques tested was randomized for each infant. Time taken to apply the PO sensor, to display data and to display accurate data (HR(PO) = HR(ECG) ± 3 bpm) were recorded using a stopwatch. RESULTS: Forty infants were studied [mean (SD) birthweight, 1455 (872) g; gestational age, 31 (4) weeks; post-menstrual age, 34 (4) weeks]. Method 3 acquired any data significantly faster than methods 1 (p = 0.013; CI, -9.6 to -3.0 sec) and 2 (p = 0.004; CI, -5.9 to -1.2 sec). Method 3 acquired accurate data significantly faster than method 1 (p = 0.016; CI, -9.4 to -1.0 sec), but not method 2 (p = 0.28). CONCLUSION: Applying the sensor to the infant before connecting it to the cable yields the fastest acquisition of accurate HR data from the Nellcor PO.

Hair in psoriasis: a prospective, blinded scanning electron microscopic study.

We examined hairs from psoriatic plaques by scanning electron microscopy, and compared the morphological changes in the hairs with those from the corresponding nonlesional skin of the same patients and those from healthy subjects, in a observer-blinded prospective study. Micropits or macropits (sharply demarcated defects on the cuticle < 0.5 microm or > 0.5 microm, respectively, in diameter), dystrophy (areas showing generalized roughness and ragged appearance of the cuticle), upturned edges of cuticular cells, transverse and longitudinal fissures were seen in varying frequency in all three groups. Micropits were significantly more frequent in the lesional hair compared with hair from the nonlesional area and controls. Dystrophic changes were significantly more severe in lesional hairs compared with hair from the nonlesional area. Upturning of cuticular edges was more frequent (but not significantly so) in hair from psoriatic plaques. The presence of micropits and hair dystrophy could contribute to the thinning and loss of hair in the psoriatic plaques.

Dowling-Degos disease with dyschromatosis universalis hereditaria-like pigmentation in a family.

Dowling-Degos disease is a rare autosomal dominant inherited pigmentary disorder characterized by reticulate pigmentation of the flexures, prominent comedone like lesions and pitted scars. Dyschromatosis universalis hereditaria is characterized by the presence of hypopigmented as well as hyperpigmented macules. We report a family showing features of both these diseases.

Chronic macrocheilia: a clinico-pathological study of 28 patients.

Chronic macrocheilia has a multifactorial aetiology and is often a diagnostic and therapeutic challenge. Epidemiological information on this condition is scarce, most of the data reported relating only to granulomatous cheilitis. We have performed a detailed clinico-pathological analysis of all patients with chronic macrocheilia presenting to us during the last 6.5 years. Of the 28 patients identified, 13 (46.4%) had granulomatous cheilitis (GC), six (21.4%) had tuberculosis of the lip, three (10.7%) had leprous macrocheilia, two (7.1%) had multiple endocrine neoplasia type IIb, and one each had Ascher's syndrome and non-Hodgkin's lymphoma. Two patients were diagnosed as 'nonspecific cheilitis'. Histopathological differentiation between tuberculosis and GC was often not possible; but PCR for Mycobacterium tuberculosis was positive in all patients with tuberculosis and negative in four patients with GC in whom M. tuberculosis was sought. In spite of detailed clinical examination and investigations, a therapeutic trial was required to confirm the diagnosis in five (17.9%) patients. We have reviewed the available literature on this subject, and to our knowledge this study is the first of its kind. More such studies from other centres will help physicians to make an accurate aetiological diagnosis and treat this uncommon but disfiguring condition with confidence.

Fabric-staining properties and washability of a novel liposomal dithranol formulation.

AIM: To test the staining potential of a novel liposomal dithranol gel on different types of fabrics and compare it with the only commercially available dithranol preparation in India, Derobin. METHODS: Pure cotton, pure polyester and four blends of the two fabrics were tested for staining and washability. RESULTS: Both products showed the least staining and spreading on pure cotton with progressively worse stains as the proportion of polyester in the fabric increased. When compared with each other the liposomal dithranol gel showed markedly lighter staining than Derobin on all fabrics. It also washed off completely with water whereas the Derobin stains could not be washed off, even with detergent. CONCLUSION: The liposomal gel due to its superior staining properties may potentially increase the acceptability of dithranol amongst psoriasis patients.

Mucocutaneous adverse effects of hydroxyurea: a prospective study of 30 psoriasis patients.

Hydroxyurea is an anti-tumour agent most commonly used to treat chronic myeloproliferative disorders in doses up to 4 g per day. Dermatological adverse effects reported so far have been observed predominantly in these patients. As we are treating selected psoriasis patients with low dose hydroxyurea we attempted to define the spectrum and chronology of dermatological adverse effects in this group of patients prospectively. Of the 29 evaluable patients, 19 (65.5%) developed a mucocutaneous adverse reaction after a mean duration of 6.4 weeks of treatment. Pigmentation of nails, skin or mucosa was the most common observation and was seen in 17 (58.6%) patients. Other less common findings were xerosis, diffuse alopecia, oedema of the legs, oral ulcers and actinic psoriasis. Adverse effects subsided in 11 (57.9%) patients during a mean follow up of 18 weeks. Three hitherto unreported side-effects - scleral pigmentation, acquired ichthyosis and pigmentation of lunula of the nails - were noted. This first study of dermatological adverse effects of hydroxyurea therapy on Asian psoriatic patients reveals several new findings. Pigmentation of skin, nails and mucosa appears to be very common and occurs early. Serious dermatological side-effects probably do not occur with low dose (up to 1.5 g per day) hydroxyurea in patients with psoriasis.

Rediscovering hydroxyurea: its role in recalcitrant psoriasis.

BACKGROUND: There is an acute paucity of second-line systemic agents for the treatment of extensive chronic plaque psoriasis (CPP). Recent studies using hydroxyurea in patients with HIV infection and sickle cell anemia have rekindled interest in this old drug and have provided more data regarding safety and dosage. OBJECTIVE: We wanted to test the efficacy and tolerability of hydroxyurea in patients with extensive CPP who had to discontinue first-line oral agents for any reason. METHODS: The study was a prospective nonrandomized series. Thirty-one patients, including 26 with prior history of systemic antipsoriatic therapy were given hydroxyurea 1-1.5 g per day for a median duration of 36 weeks. They were followed up for a mean period of 36.1 +/- 13.8 weeks. RESULTS: Almost 75% of the patients showed an adequate response (35% reduction in Psoriasis Area and Severity Index at or before 8 weeks) with over half showing more than 70% reduction in PASI score. All adverse effects were mild and reversible and none of the patients required cessation of therapy. CONCLUSION: Hydroxyurea is an effective, very safe but relatively slower acting alternative for patients with extensive CPP over the short-to-medium term.

Comparison of calcipotriol and coal tar in conjunction with sun exposure in chronic plaque psoriasis: a pilot study.

This study was a left-right comparison of the efficacy of 0.005% calcipotriol ointment and 5% coal tar ointment in conjunction with sun exposure in 10 patients with stable plaque psoriasis. After four weeks of therapy, the calcipotriol treated site showed a significantly faster fall in PASI compared to the coal tar treated site. At eight weeks, this difference was not significant with both sides showing comparable improvement in lesions, as shown by PASI values. There were no significant side effects from either therapy. We conclude that both calcipotriol and coal tar ointments have comparable efficacy in treating stable plaque psoriasis when used simultaneously with sun exposure, although the initial response to calcipotriol is faster.