Anxiety, depression and harmful use of alcohol in severe chronic plaque psoriasis: A cross-sectional study.

Background: Psoriasis is a common, chronic T cell-mediated disease characterised by erythematous, scaly plaques. Psoriasis is associated with depression, anxiety, poor quality of life, harmful use of alcohol and suicidal ideation. We performed this study to find out prevalence of psychological morbidity in our patients with severe psoriasis and to know clinical variables associated with higher risk of psychological morbidity. Method: This study is a cross-sectional, observational study conducted in a dermatology outpatient department (OPD) of a tertiary care centre. Study population included patients with severe psoriasis area severity index (PASI>10). Clinical and epidemiological data, Patient health questionnaire-9, Generalised anxiety disorder-7, Dermatology life quality index (DLQI) and Alcohol Use Disorders Identification Test questionnaires were recorded. Data were analysed using SPSS, version 24. Chi-square test and Spearman's rank correlation test (ρ) were performed, and p value of <0.05 was considered statistically significant. Result: A total of 140 patients were included in the study and consisted of 67 men and 73 women. The median age was 44 years, median duration of disease was 10 years and median PASI was 13.6. Scoring revealed moderate-to-severe depression in 69 (49.3%) patients, moderate-to-severe anxiety in 40 (28.6%), severe impairment in quality of life in 98 (70%), harmful use of alcohol in 23 (16.4%) and suicidal ideation in 11 (7.8%) patients. Young age, recent onset, higher PASI and facial involvement show significant association with depression, anxiety and poor quality of life. Conclusion: Screening for psychological morbidity should be performed in patients with severe psoriasis especially younger patients with recent onset disease. Higher DLQI points to concomitant psychological morbidity and it should be performed in all the patients.

Buffer gas cooled ice chemistry. I. Buffer gas cell and mm-wave spectrometer.

A new instrument is described that will employ buffer gas cooling with mm-wave rotational spectroscopy (60-90 GHz) to probe molecules desorbed from astrochemical ices prepared in an ultrahigh vacuum environment. Here the design and performance of the buffer gas cell, mm-wave spectrometer and data acquisition system are reported, while application to molecules desorbed from ice surfaces will be described in a future publication. The effective temperature of the neon-cooled buffer gas cell is determined by monitoring a range of rotational lines of propyl cyanide introduced into the cell. Its number density is estimated from comparison to room temperature measurements and the effective collision cross section with neon is estimated by monitoring the free induction decay (FID) lifetimes. The spectrometer and data acquisition system described are capable of acquiring and time-domain averaging the FIDs at 10 Gs/s, 10 bit vertical resolution and 98% duty cycle.

An observational study on the effects of aviation turbine fuel and lubricants on the skin of Indian Air Force ground crew in flying stations.

BACKGROUND: Ground crew of the Air Force routinely handle aviation turbine fuel (ATF) and lubricants and a need was felt to study the adverse effects of these substances on their skin so that remedial measures could be taken to prevent these adverse effects. METHODS: A multi-centric, cross-sectional, observational study was performed at three Air Force flying stations. 109 ground crew members of the Indian Air Force (IAF) who were in direct contact with ATF and lubricants were screened for dermatological manifestations on exposed areas. History of atopy was elicited, systemic and dermatological examination done and occlusive patch testing carried out where indicated. Fungal infections were excluded by a potassium hydroxide mount. RESULTS: 20 out of the 109 personnel (18.34%) were symptomatic in the form of mild irritant contact dermatitis. There was no case of allergic contact dermatitis. Only two cases showed an irritant reaction on patch testing. 65% of the symptomatic personnel were atopic. There was no predisposing trade or age group for adverse effects to ATF. CONCLUSION: This study revealed that contact with ATF is associated with only mild irritant contact dermatitis in exposed ground crew members of the IAF and atopy was a predisposing factor for susceptibility to the dermatitis.

Electrochemical Sensor Based on Fe Doped Hydroxyapatite-Carbon Nanotubes Composite for L-Dopa Detection in the Presence of Uric Acid.

A novel amperometric sensor based on iron doped hydroxyapatite (Fe-HA) and multiwalled carbon nanotubes (CNT) composite immobilized on a glassy carbon electrode (GCE) has been fabricated. The hybrid composite made of Fe-HA nanoparticles and CNT promotes electron transfer kinetics between the analyte levodopa (L-dopa) and the modified GC electrode. Under optimum conditions, the fabricated sensor gave a linear response range of 1.0 x 10(-7)-1.1 x 10(-6) M with the detection limit as low as 62 nM. The Fe-HA/CNT modified electrode showed good selectivity towards the determination of L-dopa in the presence of ascorbic acid (AA), uric acid (UA) and other common interferents. The sensor displays a high sensitivity, good reproducibility and long-term stability and it was successfully applied for the detection of L-dopa in pharmaceutical and medicinal plant samples.

A clinico-epidemiological study of herpes zoster.

BACKGROUND: Herpes zoster is a common viral infection of skin caused by reactivation of varicella zoster virus infection from the spinal ganglia. The clinico-epidemiological patterns of this disease in an Indian setting required to be studied. METHODS: A cross sectional study was conducted on all consecutive cases of herpes zoster reporting to the Dermatology Outpatient Department at a Tertiary Care Hospital in Bangalore during a period of one year from 01 Jun 2013 to 31 May 2014. Detailed history, examination, HIV screening and Tzanck smear were carried out in all cases. RESULTS: 84 cases of herpes zoster were seen with a mean age of 30 years. Majority (39%) of cases were seen in the 21-30 year age group. Thoracic segments were involved in 65.4%, cervical in 11.9%, cranial in 11.5%, lumbar in 8.3% and sacral segments in 3.5%. 63% of cases had zoster associated pain. One case had motor involvement.3.57% of the patients were HIV positive. CONCLUSION: This study shows a lower age incidence of herpes zoster HIV positivity and zoster associated pain as compared to other studies. The pattern of segmental involvement in herpes zoster seen in this study was similar to other studies.

Recurrent stuck mitral valve: eosinophilia an unusual pathology.

Eosinophilia is a very unusual and rare cause of thrombosis of prosthetic mitral valve. We report a 10-year-old male child of recurrent stuck prosthetic mitral valve. The child underwent mitral valve replacement for severe mitral regurgitation secondary to Rheumatic heart disease. He had recurrent prosthetic mitral valve thrombosis, despite desired INR levels. There was associated eosinophilia. The child was treated on the lines of tropical eosinophilia with oral prednisolone and diethylcarbamazine, the eosinophil count dropped significantly with no subsequent episode of stuck mitral valve. We discuss the management of recurrent stuck mitral valve and also eosinophilia as a causative factor for the same.

Embedded tooth fragment masquerading as keloid for 11 months.

A foreign body retained in the skin can originate from numerous sources and most of the time these foreign bodies are removed without any sequelae. The present article reports a case of persistent swelling in the lower lip misdiagnosed as keloid, which later turned out to be an embedded tooth fragment identified post spontaneous extrusion after 11 months.

Fabrication of folic acid sensor based on the Cu doped SnO2 nanoparticles modified glassy carbon electrode.

A novel folic acid biosensor has been fabricated using Cu doped SnO2 nanoparticles (NPs) synthesized by a simple microwave irradiation method. Powder XRD and TEM studies confirmed that both the pure and Cu doped SnO2 (Cu: 0, 10, 20wt%) crystallized in tetragonal rutile-type structure with spherical morphology. The average crystallite size of pure SnO2 was estimated to be around 16 nm. Upon doping, the crystallite sizes decreased to 9 nm and 5 nm for 10 and 20wt% Cu doped SnO2 respectively. XPS studies confirmed the electronic state of Sn and Cu to be 4+ and 2+ respectively. Cu (20wt%) doped SnO2 NPs are proved to be a good sensing element for the determination of folic acid (FA). Cu-SnO2 NPs (20wt%) modified glassy carbon electrode (GCE) exhibited the lowest detection limit of 0.024 nM over a wide folic acid concentration range of 1.0 × 10(-10) to 6.7 × 10(-5) M at physiological pH of 7.0. The fabricated sensor is highly selective towards the determination of FA even in the presence of a 100 fold excess of common interferent ascorbic acid. The sensor proved to be useful for the estimation of FA content in pharmaceutical sample with satisfactory recovery.

Pediatric hyperlipidemia.

The leading cause of mortality worldwide is atherosclerotic cardiovascular disease. Atherosclerotic plaques are well known to originate early in the childhood. Identifying hyperlipidemia in early childhood creates an opportunity to prevent major cardiovascular events in adults. Children with identified risk factors are at an increased risk of developing cardiovascular incidents in later life. This article emphasizes the diagnosis and management of pediatric hyperlipidemia with reference to the recent guidelines. In terms of etiology pediatric hyperlipidemia are divided into primary and secondary causes. The mainstay of management includes high-risk target screening, early risk factor identification and lifestyle modifications in vulnerable population. Drug therapy is recommended in primary hyperlipidemia and in children with no response to lifestyle changes.

Fabrication of Cr doped SnO2 nanoparticles based biosensor for the selective determination of riboflavin in pharmaceuticals.

We report the fabrication and testing of a riboflavin (RF) biosensor based on the use of Cr doped SnO2 nanoparticles. The Cr-SnO2 nanoparticles with chromium concentration from 0 to 5 wt% were synthesised by a microwave irradiation method. Magnetic studies revealed that only 3 wt% Cr doped nano-SnO2 has ferromagnetic behaviour at room temperature. This Cr-SnO2 nanoparticles modified electrode responded to RF linearly over a concentration range of 0.2 × 10(-6) to 1.0 × 10(-4) M with a detection limit of 107 nM. The fabricated sensor showed an excellent anti-interference ability against electroactive species and metal ions and proved to be useful for the estimation of the RF content in pharmaceutical samples with satisfactory recovery.

Lutembacher syndrome with unroofed left superior vena cava: a diagnostic dilemma.

Lutembacher syndrome involving the association of congenital atrial septal defect (ASD), usually of the ostium secundum variety, and mitral valve disease is a well-known entity. Its association with a coronary sinus, ASD, and a persistent left superior vena cava (LSVC) draining into the left atrium (LA) (Raghib syndrome) is rarely described in the literature. This association in a 15-year-old boy erroneously deemed to be inoperable before referral to the authors' hospital due to cyanosis in the presence of atrial septal defect (ASD) and mitral stenosis is described in this report. Evaluation by echocardiography followed by cine angiography confirmed the cause of cyanosis to be drainage of the LSVC into the LA together with an ASD and rheumatic mitral stenosis, a combination of Raghib and Lutembacher syndromes. The boy underwent successful surgical correction. The authors believe this is the second such case to be reported in the English literature and the first of its kind to be managed by surgical intervention.

Three dimensional transesophageal echocardiography guided transcatheter closure of mitral paraprosthesis regurgitation - a case report.

The last two decades have witnessed vast advances in the field of cardiac intervention, particularly with regard to nonsurgical closure of structural heart diseases including para prosthetic valvular leaks. The use of imaging techniques to guide even well-established procedures enhances the efficiency and safety of these procedures. The present case report aims to highlight the role of three dimensional transesophageal echocardiography in pre, intra and post operative management of patients with mitral para prosthetic valvular regurgitation.

Comparison of transvaginal 3D sonohysterography with outpatient hysteroscopy in the evaluation of abnormal uterine bleeding.

OBJECTIVE: To compare transvaginal three-dimensional sonohysterography (3D SHSG) and outpatient hysteroscopy with regards to diagnostic accuracy, procedure time, and patient discomfort with a prospective randomized controlled cohort study in a teaching hospital in London. The study included a population group of 49 women with abnormal uterine bleeding from varied ethnic backgrounds, of which 44 completed the study. Subjects with pregnancies, pelvic infections, large uteruses, suspicious or diagnosed pelvic malignancies, and who did not meet the criteria for day surgery, were excluded. MATERIALS AND METHODS: Patients were randomized into two groups: group 1 had hysteroscopy followed by SHSG while group 2 had SHSG followed by hysteroscopy. Diagnostic accuracy, procedure time, and patient discomfort of SHSG in comparison to hysteroscopy were studied. RESULTS: A total of 44 patients completed the study. The average age of the study population was 44.8 years and the mean parity was 1.8. Nulliparas represented 34.03% of the study population and the average duration of symptoms was 14.8 months. CONCLUSION: In the investigation of women with abnormal bleeding in an outpatient setting, both hysteroscopy and SHSG are comparable in the diagnosis of intracavity lesions, pain rating, and procedure time. However patient acceptability of SHSG was significantly more when compared to outpatient hysteroscopy.

Enhancing the reliability in the noninvasive measurement of the his bundle magnetic field using a novel signal averaging methodology.

BACKGROUND: Extraction of the weak electrical activity of the "His Bundle" (HB) by noninvasive methods has not been very successful in the past. The study reassesses the use of signal averaged magnetocardiography (SAMCG), overcoming some of the limitations in earlier studies including in the signal averaging methodology. METHODS: SAMCG on healthy subjects (14 male and 1 female) were performed using R-peak as the fiducial point in all cases and also using QRS-onset as the fiducial point in select cases. RESULTS: A conspicuous feature (H) with a magnitude up to 200 femto Tesla (fT) attributed to the HB activity was observed in the PR segment at several spatial positions on the thorax, with onset at 35-50 ms before the QRS-onset (V) in 15 out of 18 trials constituting 83% of cases studied. The QRS-onset as the fiducial point resolved the feature better compared to the conventionally used R-peak, especially in trials exhibiting spread in heart rate (HR). This is attributed to the fluctuations in Q(on) RD (the time interval between QRS-onset and R-peak) compared to the temporal stability of the H-V duration. conclusions: SAMCG reveals a well-resolved H feature. The double hump morphology of the feature extended at least up to a frequency of 150 Hz. The importance of the choice of QRS-onset as the fiducial point is unequivocally demonstrated, illustrated by measurements on subjects exhibiting considerable heart rate variability. The latter has a general validity and should be applicable to SAECG as well.

Influence of cell fabrication procedure on the performance of the dye sensitized solar cell.

The recent technological advancements of the Dye Sensitized Solar Cells (DSSCs) fabrication technology is gaining momentum as a low cost and simple fabrication technology to convert solar energy into electric energy. A systematic study of the DSSC fabrication procedure and its influence on the cell efficiency are presented in this paper. Preparation of the titanium dioxide (TiO2) layer on the working electrode was the most significant process improvement made to enhance cell efficiency. The Coatema tool was used to develop an automated TiO2 coating process, which yielded layer thicknesses with minimum micro cracks and repeatable TiO2 weight loading in the range of 8-13 microm. Secondary process improvements implemented were: vacuum drying step for the TiO2 layer, dilution ratio of the sensitized dye and sealant thickness. These optimized cell fabrication steps enhanced cell efficiencies over 200% and reduced total process time. The work in progress demonstrated higher cell efficiency slightly greater than 9% by reducing the cell size using the optimized fabrication process described in this paper. We are confident that higher efficiency cells can be fabricated with this optimized fabrication process illustrated in this paper.

Pattern of use of biologics in psoriasis among Indian dermatologists - A cross sectional survey.

Background and Aims Biologics are a relatively new class of highly effective drugs in the management of psoriasis. They act on specific immune processes, achieve rapid and sustained clearance and do not cause target organ damage unlike conventional systemic therapy. It appears that their use in our country is not as widespread as in developed nations despite these benefits ; their prohibitive cost may be a major factor for the limited usage. This survey aimed to find out the extent of use and factors hindering usage of biologics for the management of psoriasis by Indian dermatologists. Methods It was a cross-sectional questionnaire based study. The questionnaire was designed after a focussed group discussion, followed by validation. The survey was sent in the form of a link to Indian dermatologists. The responses were recorded in excel-sheet and the data was analyzed by SPSS ver 25. Results Of the 310 participants who took part, 287 completed the survey. Two hundred (70%) were users of biologics, while 87 (30%) had never used them. Cost was the major factor which prevented biologic use. Majority of the respondents used biologics in less than 2 cases per month. Secukinumab was the most common biologic used followed by etanercept. The factors which determined choice of biologics were convenience, cost, previous experience, co-morbid conditions and recommendations by an expert. Limitations A small sample size was the limitation of the study. Dermatologists who do not use biologics may be under-represented in the study. Conclusions Biologics are not used optimally by Indian dermatologists for management of psoriasis. The cost, fear of adverse effects, lack of awareness and inadequate felt need are major factors which prevent their regular use.

Trichoscopy of Pressure-Induced Alopecia and Alopecia Areata: A Comparative Study.

Background: Pressure-induced alopecia is an uncommon type of alopecia. It can occur in both scarring as well as non-scarring form and occurs due to ischemia resulting from prolonged head immobilisation during surgery or hospitalisation. The patchy hair loss generally involves convexities of scalp specially vertex and occiput. The hair loss is usually noticed 3 -28 days after the inciting event and regrowth of hair occurs between 1 - 4 months. Objective: To describe trichoscopic features of pressure alopecia and compare it with the closest differential, alopecia areata. Methodology: It is a retrospective observational study. Trichoscopic features of six cases of pressure alopecia seen during the study period were compared with alopecia areata and analyzed using appropriate statistical methods. Results: The study had 30 cases, six cases of pressure alopecia and 24 cases of alopecia areata. The mean age of patients with pressure alopecia and alopecia areata was 45.16 and 29.08 years respectively. Comedone- like black dots, black dots and area of scarring were statistically significant for pressure alopecia while exclamation mark hairs were significant for alopecia areata. Conclusion: Trichoscopy is a non-invasive test for diagnosis of alopecia and "Comedone-like black dots" are unique trichoscopic feature of pressure alopecia.

Variation in biochemical, physiological and ecophysiological traits among the teak (Tectona grandis Linn. f) seed sources of India.

Teak being an iconic timber species the studies on its physiological and biochemical traits are very limited in India and worldwide. As a result, the current study aimed to assess biochemical parameters such as chlorophyll a, chlorophyll b, total chlorophyll, carotenoids, chlorophyll ab ratio, proline content, and peroxidase activity, along with physiological parameters such as Chlorophyll stability index, relative water content, and leaf area, as well as ecophysiological traits such as net photosynthetic rate (Pn), stomatal conductance (Gs), intercellular CO2 concentration (Ci), transpiration rate (Tr), Leaf temperature, intrinsic water-use efficiency (iWUE), instantaneous water use efficiency and intrinsic carboxylation efficiency of thirty teak seed sources collected from different states of India. FCRITK 19, FCRITK 21, FCRITK 25, FCRITK 29, and FCRITK 05 were reported to have a greater photosynthetic rate (> 17 µmol m-2 s-1) coupled with a relative water content of more than 50% and a chlorophyll stability index of more than 60%, which could be used in a future genetic improvement programme. Correlation analysis indicated that water use efficiency was found to be strongly but negatively correlated with transpiration rate (-0.601) and stomatal conductance (-0.910). The proline content had a substantial positive correlation with the chlorophyll stability index (0.890), signifying that they are associated with abiotic stress conditions. Cluster analysis was attempted to discriminate the sources based on biochemical, physiological and ecophysiological traits. Eleven sources (FCRITK 25, FCRITK 27, FCRITK 29, FCRITK 14, FCRITK 30, FCRITK 16, FCRITK 05, FCRITK 13, FCRITK 02, FCRITK 17 and FCRITK 15) exhibited superior performance compared to rest of the sources.

Palmoplantar Plaque Psoriasis is Associated with Diabetes, Hypertension, Obesity, and Metabolic Syndrome-A Case-Control Study.

Background: Palmoplantar plaque psoriasis is a regional variant of psoriasis, characterized by erythematous, indurated plaques with fissuring over palms and soles. Chronic plaque psoriasis is associated with various comorbidities such as obesity, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and cardiovascular disease. Body surface area involvement is an indicator of psoriasis severity, and most comorbidities are more strongly correlated with severe disease. Objectives: To estimate the prevalence of metabolic comorbidities in palmoplantar plaque psoriasis. Methods: It is a case-control study involving treatment naïve palmoplantar plaque psoriasis patients and age- and gender-matched healthy controls. Results: The study included 100 cases and 100 controls. The mean age among cases and controls was 45.4 ± 11.1 and 43.9 ± 10.3 years, respectively (P: 0.31). The gender ratio among cases and controls was 1.56 (61M: 39F) and 1.94 (66M: 34F), respectively. Comorbidities including metabolic syndrome (P: 0.001), obesity (P: 0.001), diabetes mellitus (P: 0.001), and hypertension (P: 0.001) were more common among cases as compared to controls. The odds of diabetes, metabolic syndrome, hypertension, and obesity in patients with palmoplantar psoriasis were 4.8 (95% CI 2.5-9.3), 3.7 (95% CI 2-6.9), 3.1 (95% CI 1.6-6), and 3.5 (95% CI 1.9-6.4), respectively. Conclusion: In this study, we found that palmoplantar plaque psoriasis is associated with metabolic comorbidities. Primary care physicians should screen patients with palmoplantar psoriasis for these comorbidities.

Long-term variability of trace gases over the Indian Western Himalayan Region.

The four-year continuous measurements of CO, NOx, NH3, SO2, and O3 were carried at a high altitude site (32.12°N, 76.56°E at 1347 m AMSL) of the Indian Western Himalayan area to study the mixing ratios of these gases for understanding the changing trends of these trace gases over the region. Each of these trace gases showed significant daily and monthly variabilities. The highest variability was recorded in the monthly mean values of O3 as it varied from 10 to 63 ppb during the study period. All the trace gases except CO showed maximum variability in the pre-monsoon seasons due to the strong advection and vertical circulation of air masses at the site. The seasonal mean maxima of CO were recorded during the monsoon season, while the mean maxima of NH3 were recorded during the post-monsoon seasons. The meteorological parameters have been found to influence the mixing ratios of trace gases. The least variability in the mean seasonal mixing ratios of SO2 during the study period indicated the constant point source of SO2 near the site. The trajectories analysis revealed that the area receives maximum air masses from the southeast to the west directions where a number of the coal-based thermal power plants, industries, cement plants, and agricultural fields are also located. The influence of valley-to-mountain circulations was also observed at the site, resulting in the transport of pollutant-rich air masses from local and distant sources to the site. A comparison of the mixing ratios of different trace gases obtained in the present study is also made with the values reported for other high altitude stations in the world.