Bimatoprost versus Clobetasol Propionate in Scalp Alopecia Areata: A Prospective Non-Randomized Open-Label Clinical Trial.

Background: Alopecia areata (AA) is one of the most common forms of alopecia presenting to the dermatology out patient department (OPD) worldwide as well as in Nepal. It is mostly diagnosed clinically. Treatment depends on the extent, location, and severity of the condition. Various treatment options available are topical, intralesional, and oral medications. Bimatoprost is a relatively newer treatment modality in AA. Aim and Objective: To compare the efficacy and safety of topical bimatoprost 0.01% solution versus clobetasol propionate 0.05% cream in scalp AA. Materials and Methods: A total of 50 patients attending the dermatology OPD of a tertiary hospital between March 2018 and February 2019 were included in this prospective non-randomized open-label clinical trial. Patients were divided into two groups i.e., Group A- topical bimatoprost solution 0.01% and Group B- topical clobetasol propionate cream 0.05%, and followed up at weeks 4, 8, and 12. The improvement was analyzed subjectively by hair regrowth and objectively by Severity of Alopecia Tool (SALT) score. Side effects, nature of terminal hair and onset of initial response were also recorded. Results: Out of 50 patients, 27 were males and 23 were females with a mean age of 28.5 ± 9.34 years and mean duration of disease of 18.67 ± 46.1 weeks. Hair regrowth rate and reduction in SALT score from baseline were seen more in clobetasol group compared to bimatoprost (p = 0.282 and P = 0.246, respectively). Side effects were seen more in the clobetasol group compared to bimatoprost group (p = 0.002). Onset of cosmetically acceptable hair regrowth was seen earlier in the bimatoprost group (p = 0.017) and also the nature of regrown hairs was more pigmented in bimatoprost group (p = 0.024). Conclusions: There is no significant difference in hair regrowth between clobetasol and bimatoprost in the treatment of AA on scalp at the end of 12 weeks, although bimatoprost has an advantage of lesser side effects, more rapid response and growth of more pigmented hairs.

Experiences of nurses and midwives in policy development in low- and middle-income countries: Qualitative systematic review.

Background: Nurses provide 90% of health care worldwide, yet little is known of the experiences of nurses and midwives in policy development in low- and middle-income countries (LMICs). Objective: To identify, appraise and synthesize the qualitative evidence on the experiences of nurses' and midwives' involvement in policy development LMICs. Design: A qualitative systematic review using modified Joanna Briggs Institute (JBI) methodology. Setting: Low and middle-income countries. Participants: Nurses' and midwives' involved in policy development, implementation, and/or evaluation. Methods: A systematic search was undertaken across nine databases to retrieve published studies in English between inception and April of 2021. Screening, critical appraisal, and data extraction was undertaken by two independent reviewers. Results: Ten articles met inclusion criteria. All studies were published between 2000 to 2021 from a variety of LMICs. The studies were medium to high quality (70-100% critical appraisal scores). Four major themes were identified related to policy development: 1) Marginal representation of nurses; 2) Determinants of nurses' involvement (including at the individual, organization, and systematic level); 3) Leadership as a pathway to involvement; 4) Promoting nurses' involvement. Conclusion: All studies demonstrated that nurses and nurse midwives continue to be minimally involved in policy development. Findings reveal reasons for nurses' limited involvement and strategies to foster sustained engagement of nurses in policy development in LMICs. To enhance their involvement in policy development in LMICs, change is needed at multiple levels. Systemic power relations need to be reconstructed to facilitate more collaborative interdisciplinary practices with nurses co-leading and co-developing health care policies.

Biochar and compost from cotton residues inconsistently affect water use efficiency, nodulation, and growth of legumes under arid conditions.

There is an urgent global need to expand crop cultivation into arid and semiarid lands to guarantee food security. Thus, limited irrigation strategies and soil amendments are promising strategies for conserving water in arid and semi-arid crop production. Soil amendments, such as compost and biochar can improve soil water relationships, nitrogen (N) fixation, soil fertility, and crop productivity. A study was designed to evaluate the effect of biochar and compost applications on soil water relationships, nutrient uptake, plant growth, and N-fixation. A greenhouse pot experiment was conducted in two soils using a complete factorial design. The main effect, i.e., water content of each soil, was maintained at either 40% or 60% water filled porosity. The sub-effect, organic amendment type, was applied as biochar or compost. The sub-sub effect was rate of application (0, 5, and 10 Mg ha-1). Plant height and root length were significantly affected by the rate of amendment applied, whereas shoot and root mass differences were explained by irrigation strategy. Whole plant N uptake was moderately affected by water content only (p = 0.0818). Phosphorus and Potassium uptake were highly affected by amendment type and rate. Biochar moderately improved plant available water (0.061 %Vol Mg-1 ha-1) over the range of 0-20 Mg ha-1 in the sandier soil. Compost did not improve plant available water in either soil. Nodulation was affected by soil type only. The benefits of biochar or compost for plant were inconsistent and depended upon irrigation strategies, soil type, application rate, and plant species.

Decay of low-density polyethylene by bacteria extracted from earthworm's guts: A potential for soil restoration.

Low-density polyethylene (LDPE) is the most abundant source of microplastic pollution worldwide. A recent study found that LDPE decay was increased and the size of the plastic was decreased after passing through the gut of the earthworm Lumbricus terrestris (Oligochaeta). Here, we investigated the involvement of earthworm gut bacteria in the microplastic decay. The bacteria isolated from the earthworm's gut were Gram-positive, belonging to phylum Actinobacteria and Firmicutes. These bacteria were used in a short-term microcosm experiment performed with gamma-sterilized soil with or without LDPE microplastics (MP). We observed that the LDPE-MP particle size was significantly reduced in the presence of bacteria. In addition, the volatile profiles of the treatments were compared and clear differences were detected. Several volatile compounds such as octadecane, eicosane, docosane and tricosane were measured only in the treatments containing both bacteria and LDPE-MP, indicating that these long-chain alkanes are byproducts of bacterial LDPE-MP decay.

Autoscopic Hallucination in Alcohol Dependence Syndrome: A Rare or Missed Phenomenon?

Autoscopic phenomenon, a psychic illusionary duplication of one's own self, has been the subject of interest in the literature and science for years. It has been reported in various diseases of the central nervous system but with an unknown mechanism. Hallucinations are a common presentation in alcohol dependence syndrome during delirium tremens and as induced disorder. However, autoscopic hallucination has been rarely reported in the cases of alcohol dependence. We present a case of a 40-year-old man who experienced autoscopic hallucination during the withdrawal state of alcohol. He was successfully treated with detoxification and an antipsychotic medication and was doing well. The case highlights the need for strong suspicion and exploration of the autoscopic hallucination and autoscopic phenomenon in general in cases of alcohol dependence syndrome.