Association of Attention Deficit Hyperactivity Disorder with the Use of Oral Propranolol in Infantile Haemangiomas: An Ambispective Comparative Study.

Previous studies have raised concerns about the effects of oral propranolol on the central nervous system in infants, the exact measure and mechanism and the long-term follow-up of which is less well studied. This was an ambispective comparative study of children with infantile haemangioma (IH) followed by a repeat visit 4-10 years after completion of propranolol therapy. Parents were asked about psychologic functioning along with an initial screening examination. All patients were evaluated by a paediatric psychiatrist. After evaluation by the Strength and Difficulties Questionnaire, and subsequently by the paediatric psychiatrist, 2 of 12 patients (16.67%) showed features of attention deficit hyperactivity disorder in comparison to 0 of 40 subjects in the control group (0.0498; α = 0.05). These results indicate an increased risk of neuropsychiatric illnesses such as attention deficit hyperactivity disorder (ADHD) in patients given propranolol for IH, as supporting evidence to previous claims.

Nerve function impairment and quality of life in patients with leprosy: a prospective, observational study.

BACKGROUND: There is a limited number of studies assessing the alterations in nerve function impairment (NFI) in leprosy over an extended period of time. To the best of our knowledge, no published study has evaluated neurological state longitudinally during treatment utilizing a combination of clinical, functional (activity limitation), electrophysiological, and patient-reported quality of life (QOL) outcomes. METHODS: This prospective, observational study included leprosy patients of all spectra. Over 1 year of treatment, cutaneous and neurological examinations were done in addition to a nerve conduction study (NCS) and sympathetic skin response (SSR) assessment. QOL and activity limitation assessments using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Screening of Activity Limitation and Safety Awareness scale (SALSA), respectively, were also performed. RESULTS: Out of 63 leprosy patients, loss of sensation was noted in 43 (68.2%) at baseline. At the completion of treatment, proportionate change revealed no change in 18 (28.5%), restored function in 9 (14.2%), improved status in 34 (53.9%), and deteriorated NFI in only 2 (3.1%) cases. The association between NCS-SSR abnormalities was significant for a longer duration of disease at presentation (P = 0.04), in multibacillary cases [OR 9.12 (95% CI, 1.22-67.93)], in those in reaction [OR 3.56 (95% CI, 0.62-20.36)] and in those aged over 40 [OR 1.93 (95% CI, 0.28-13.41)]. There was an improvement in WHOQOL-BREF and SALSA scores at release from treatment (P = 0.005 and P = 0.01, respectively). CONCLUSION: The majority of leprosy patients on treatment show improvement in NFI at the completion of therapy. However, change is influenced by critical factors such as bacillary load, disease duration, age, and the presence of reaction(s).

A challenging case of borderline lepromatous leprosy non-responsive to WHO-MDT: exploring approaches beyond WHO-MDT.

Just as we prioritize personalized medicine for various other medical conditions, we should also include a neglected disease like leprosy, ensuring that patients receive the best care possible and improving their quality of life. Our case highlights the importance of instituting an alternate therapeutic regimen in a scenario where there is a lack of clinical response to multidrug therapy, even in the absence of documented drug resistance of the currently available molecular diagnostics. The search for the perfect regimen tailored for each individual leprosy patient should continue. Alternate anti-leprosy therapy is highly useful in cases with confirmed drug resistance or clinically non-responsive cases; however, their misuse should also be strictly avoided to prevent the development of resistance to them.

Lipidomic Analysis Reveals Systemic Alterations in Servicemen Exposed to Repeated Occupational Low-Level Blast Waves.

INTRODUCTION: Occupational exposure to blast is a prevalent risk experienced by military personnel. While low-level exposure may not manifest immediate signs of illness, prolonged and repetitive exposure may result in neurophysiological dysfunction. Such repeated exposure to occupational blasts has been linked to structural and functional modifications in the brain, adversely affecting the performance of servicemen in the field. These neurological changes can give rise to symptoms resembling concussion and contribute to the development of post-traumatic stress disorder. MATERIALS AND METHODS: To understand long-term effects of blast exposure, the study was conducted to assess memory function, serum circulatory protein and lipid biomarkers, and associated concussive symptomology in servicemen. Concussion-like symptoms were assessed using the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ) along with memory function using PGI memory scale. The serum protein biomarkers were quantified using a sandwich ELISA assay, and the serum lipid profile was measured using liquid chromatography-mass spectrometer. RESULTS: The findings revealed that repeated low-level blast exposure resulted in impaired memory function, accompanied by elevated levels of serum neurofilament light chain (neuroaxonal injury) and C-reactive protein. Furthermore, alterations in the lipid profile were observed, with an increase in lipid species associated with immune activation. These changes collectively point to systemic inflammation, neuronal injury, and memory dysfunction as pathological characteristics of repeated low-level blast exposure. CONCLUSION: The results of our preliminary investigation offer valuable insights for further large-scale study and provide a guiding principle that necessitates a suitable mitigation approach to safeguard the health of personnel against blast overpressure.

Dermatoscopic evaluation of leprosy: A multi-centre cross-sectional study.

Background Leprosy is known to be a great mimicker. Its dermatoscopic evaluation may be of value in establishing diagnosis. Objective To study the dermatoscopic findings encountered across the leprosy spectrum. Methods This was a multi-centre cross-sectional study of leprosy patients, where after a thorough cutaneous and neurological evaluation, representative skin lesions from the study patients were photographed in standard settings, and the most representative skin lesions were chosen for dermatoscopic evaluation. Data was entered in a structured proforma and a descriptive analysis of dermatoscopic patterns was carried out. Results A total of 53 cases of ages between 14 and 80 years, ranging from tuberculoid to the lepromatous spectrum of disease, with active skin lesions in the form of patches and plaques were included. The spectrum of leprosy as per Ridley-Jopling classification at diagnosis was indeterminate in 1 (1.9%), tuberculoid in 1 (1.9%), borderline tuberculoid in 25 (21.5%), borderline lepromatous in 9 (17%), lepromatous in 14 (26.4%) and histoid in 3 (5.7%). Dermatoscopic features included distorted pigment network in 48 (90.6%), focal white areas in 40 (75.5%), reduced eccrine and follicular openings in 43 (81.1%), widened skin lines in 28 (52.8%), circle hairs in 15 (28.3%) and white shiny streaks in 17 (32.1%). Conclusion Dermatoscopy is a practical, non-invasive device to assess skin lesions of leprosy and provide cues to its diagnosis, spectral classification and differentiating it from other granulomatous disorders. However, dermatoscopy alone cannot reliably differentiate between the various types of leprosy and future large-scale studies are required. Limitations of the study The numbers for each subtype were variable and few in some spectrum of leprosy patients. A dermatoscopic-histologic correlation was not done.

ENVINet5 deep learning change detection framework for the estimation of agriculture variations during 2012-2023 with Landsat series data.

Remote sensing is one of the most important methods for analysing the multitemporal changes over a certain period. As a cost-effective way, remote sensing allows the long-term analysis of agricultural land by collecting satellite imagery from different satellite missions. Landsat is one of the longest-running world missions which offers a moderate-resolution earth observation dataset. Land surface mapping and monitoring are generally performed by incorporating classification and change detection models. In this work, a deep learning-based change detection (DCD) algorithm has been proposed to detect long-term agricultural changes using the Landsat series datasets (i.e., Landsat-7, Landsat-8, and Landsat-9) during the period 2012 to 2023. The proposed algorithm extracts the features from satellite data according to their spectral and geographic characteristics and identifies seasonal variability. The DCD integrates the deep learning-based (Environment for visualizing images) ENVI Net-5 classification model and posterior probability-based post-classification comparison-based change detection model (PCD). The DCD is capable of providing seasonal variations accurately with distinct Landsat series dataset and promises to use higher resolution dataset with accurate results. The experimental result concludes that vegetation has decreased from 2012 to 2023, while build-up land has increased up to 88.22% (2012-2023) for Landsat-7 and Landsat-8 datasets. On the other side, degraded area includes water (3.20-0.05%) and fallow land (1-0.59%). This study allows the identification of crop growth, crop yield prediction, precision farming, and crop mapping.

What are the impacts of oral complications from cancer therapy on the quality of life of children? A protocol to update a scoping review.

INTRODUCTION: Cancer treatments can damage healthy tissues and organs, and leave harmful impacts on cancer survivors, especially on children and adolescents. The oral effects of cancer treatment can occur during or soon after treatment, or months-even years-later. Cancer treatments can also affect the child, psychologically and socially by hindering their speech, eating, sleeping, and social interactions. These effects can have profound impacts on children's quality of life. Building on a previous review published in 2012, this scoping review aims to identify and map the current evidence base underpinning the oral health-related impacts of cancer treatment on the quality of life of children with cancer. METHODOLOGY AND METHODS: Our methodology is guided by Arksey and O'Malley's methodological framework for scoping reviews, Levac's additions to the framework, and follows the Joanna Briggs Institute Reviewer's Manual. Five electronic databases and grey literature will be systematically searched using a predefined search strategy. Two reviewers will independently screen the retrieved articles using Rayyan software and chart data from included articles. One of the team's senior research members will act as a third reviewer and make the final decision on disputed documents. We will include literature with a focus on oral health-related quality of life of children undergoing cancer treatments. Following the selection of studies, data will be extracted, synthesized, and reported thematically and the relevant stakeholder's insight will be added to our results.

Comparative Evaluation of Microleakage With Total-Etch, Universal (Self-Etch Mode), and Nano Adhesive Systems in Class V Composite Restorations: An In-Vitro Study.

OBJECTIVES: The adhesion of bonding agents and their longevity are of interest to dentistry. Microleakage remains the major cause of composite restoration failures, which in turn depends on bonding between the restorative material and tooth substrate. The objective of this study is to evaluate and compare the microleakage with total-etch, universal, and nano adhesive systems in Class V composite restorations, utilizing a dye penetration method. METHODS: Forty-five extracted premolars were included in the present study, and a Class V cavity on the facial surface of each tooth was prepared. The samples were divided into three groups of 15 teeth each depending on the bonding agents used, following which composite restoration was done. Specimens were thermocycled, and nail varnish was applied except around the restorations. Specimens were then immersed in 2% methylene blue for 24 hours and rinsed; sectioning was done and viewed under a stereomicroscope with 10X magnification. RESULTS: The mean microleakage score was reported to be significantly higher in the universal adhesive system in the self-etch mode (3.60 ± 0.55) when compared with the total-etch adhesive system (2.40 ± 0.55) and least in the nano adhesive system (1.20+.45) (p value <.05). CONCLUSION: The study findings revealed that nano adhesives showed lesser microleakage as compared to total-etch and universal adhesive systems. CLINICAL SIGNIFICANCE: The study strengthens the findings that the nano adhesives have reduced microleakage, resulting in better marginal integrity and increased longevity of restoration. This study signifies that an eighth-generation bonding agent is reported to be better than the other bonding agents used in this study.

Immunohistochemical evaluation of superficial and invasive front of oral squamous cell carcinoma using epithelial membrane antigen as a marker.

Background: Epithelial membrane antigen (EMA) has been used as a marker for the expression of tumour margins in various glandular neoplastic lesions. Histopathologically, oral squamous cell carcinoma (OSCC) may exhibit several features within the same tumour cells, portraying that these cells at the invasive margins commonly display certain features that differ from those of the superficial part of the tumour. Aim: To identify and study the invasive tumour front and also to recognise any micrometastases in an OSCC lesion. Materials and Method: A retrospective study of 30 OSCC cases with superficial and most invasive parts were sectioned at 4 µm. Routine H&E staining and immunohistochemical staining with mouse antihuman EMA were done. The OSCC cases were graded into well differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC) and poorly differentiated squamous cell carcinoma (PDSCC). The EMA-stained slides were observed and analysed under higher magnification to identify the individual EMA-stained cells. Results: Analysis of Variance (ANOVA) analysis revealed that when comparing the superficial and invasive fronts of OSCC, it was evident that the P values were significant across the groups. In WDSCC, positive predictive value was 70.6% and sensitivity was 100% when the same slide was analysed for large and small islands to individual cells in an EMA-stained section, while MDSCC and PDSCC showed both sensitivity and positive predictive value to be 100%. Conclusion: EMA could be considered a useful prognostic marker for describing the nature of the neoplastic epithelium as well as recognising the typical anaplastic cells in cases of OSCC.

Metabolomics and transcriptomics based multi-omics integration reveals radiation-induced altered pathway networking and underlying mechanism.

Recent advancement in integrated multi-omics has significantly contributed to many areas of the biomedical field. Radiation research has also grasped uprising omics technologies in biomarker identification to aid in triage management. Herein, we have used a combinatorial multi-omics approach based on transcriptomics together with metabolomics and lipidomics of blood from murine exposed to 1 Gy (LD) and 7.5 Gy (HD) of total-body irradiation (TBI) for a comprehensive understanding of biological processes through integrated pathways and networking. Both omics displayed demarcation of HD group from controls using multivariate analysis. Dysregulated amino acids, various PC, PE and carnitine were observed along with many dysregulated genes (Nos2, Hmgcs2, Oxct2a, etc.). Joint-Pathway Analysis and STITCH interaction showed radiation exposure resulted in changes in amino acid, carbohydrate, lipid, nucleotide, and fatty acid metabolism. Elicited immune response was also observed by Gene Ontology. BioPAN has predicted Elovl5, Elovl6 and Fads2 for fatty acid pathways, only in HD group. Collectively, the combined omics approach facilitated a better understanding of processes uncovering metabolic pathways. Presumably, this is the first in radiation metabolomics that utilized an integrated omics approach following TBI in mice. Our work showed that omics integration could be a valuable tool for better comprehending the mechanism as well as molecular interactions.

Covid-19 Vaccination and Chronic Urticaria: A Paradigm Study.

Background: Multiple vaccines were introduced during 2020-2021 to combat Covid-19 pandemic, being one of the successful vaccine programmes in the present era. Very few studies are available on status of chronic urticaria (CU) post Covid-19 vaccination. Aim: The aim of this study was to study effect of Covid-19 vaccination on our urticaria cohort. Materials and Methods: In this retrospective study, case records of CU patients registered in urticaria clinic, who had received any type of Covid-19 vaccine during the interval of March 2021-2022 were retrieved. Patients were classified as 'vaccine induced urticaria' (VIU) when CU developed for first time post-vaccination and 'vaccine exacerbated urticaria' (VEU) when administration of vaccine exacerbated disease activity in previously diagnosed CU. Results: Overall, 353 CU patients registered with us during this period, 265 had received atleast one dose of a Covid-19 vaccine, of which 12 reported VEU (ten of whom had received adenovirus vector vaccine), and three patients were diagnosed with VIU (all had received inactivated virus vaccine). Mean vitamin D3 levels were significantly higher in patients who had VEU as compared to those CU patients without exacerbation (p = 0.003). Significant correlation was observed between level of concern regarding adverse effects of vaccination, pre-vaccination, and post-vaccination urticaria activity score (UAS-7), (Pearson correlation coefficient = 0.66, P = 0.007) in both VEU and VIU. Urticaria symptoms were controlled in 75% and 66.6% patients, respectively, of VEU and VIU, after one month of initiating standard antihistamine treatment. Conclusion: Hence, we conclude that though Covid-19 vaccines can trigger CU, standard treatment protocols control disease activity in most patients.