Vitiligo is more than skin deep: a survey of members of the Vitiligo Society.

BACKGROUND: Vitiligo is a common, largely acquired skin disease of unknown aetiology, which causes a variable amount of skin and hair depigmentation in affected people. It affects over half a million people in the UK alone, and a massive 50 million people worldwide. AIM: To quantify the psychosocial burden of vitiligo in the UK, by estimating its effect on daily life. METHODS: All members (n = 1790) of the Vitiligo Society, a UK national patient support group, were sent a questionnaire. Survey questions included demographics, disease-related characteristics, effect of vitiligo on daily life, and psychosocial support measures for patients with vitiligo. Results. In total, 520 (29% of members) responded, of which 354 (68%) were women. Vitiligo affected the hands in 414 (80%) and the face in 394 (76%) of the respondents. Over half (56.6%) of respondents indicated that vitiligo moderately or severely affects their quality of life (QOL). Finding a cure or effective lasting treatment was the main priority for most affected respondents. Most respondents obtain information about their disease from nonmedical sources: 431 (83%) from the Vitiligo Society and 129 (25%) from the internet, compared with 61 (12.5%) from dermatologists. CONCLUSION: Vitiligo is a skin condition that moderately or severely affects the QOL of most patients. Although most patients look for a cure or long-lasting treatment, only 12.5% of respondents to our survey had obtained information from a dermatologist. Vitiligo is a common condition that affects more than the skin, and has profound psychosocial implications for affected patients.

Evaluation of antenatal risk scoring in a preterm birth prevention and perinatal loss.

PIP: The study aim was to determine risk factors associated with preterm delivery, perinatal mortality, and neonatal morbidity among 687 indigent, pregnant women in their first term registered with the New Civil Hospital, Ahmedabad, India, between September, 1989, and March, 1991. Women were scored according to their level of risk: no risk, mild risk, moderate risk, and severe risk, from scores based on sociodemographic and obstetric data: pallor, maternal weight, 2 or more prior abortions, first pregnancy or 5 pregnancies, adolescent pregnancy, prior preterm birth, prior prenatal mortality or stillbirths. Out of 696 deliveries, there were 71 (10.2%) preterm births, of which 3 (2.38%) were among women within the no risk groups. There were 47 (11.10%) from the mild risk group and 20 (14.08%) from the moderate risk group. There were 20% from the severe risk group. Perinatal mortality was 84.77/1000 births, and 7.94 among the no risk group. The perinatal mortality rate rose with level of risk, with 92.20 per thousand births for the mild risks to 200 for the severe risks, which was statistically significant. Neonatal morbidity also increased with the increased level of risk. Preterm birth was found not to be associated with pallor and prior history of stillbirth. Perinatal mortality was not associated with pallor and first pregnancy. Factors significantly associated with preterm births and perinatal mortality were maternal malnutrition, higher pregnancy order, older maternal age at delivery, and prior preterm births and fetal loss. Pregnant women with risk factors had greater relative risk of preterm birth and perinatal mortality by 5.01 and 13.09 times. With maternal risk factors, the risk increased by 80.05% and 92.35%. The risk factors were highly sensitive for preterm births (95.77%), but had low specificity (19.69%), and low positive predictive value (11.93%). Perinatal mortality sensitivity, specificity, and positive predictive values were 98.31%, 19.90%, and 10.34%n respectively. The findings differed from previously reported studies; scoring system used has a higher sensitivity to predicting preterm birth and perinatal mortality among high risk women, and poor sensitivity among low risk women. Moderate and mild could be identified with this system and referred for follow-up.^ieng

Scoring of high risk pregnant women and related outcome.

PIP: During September 1989-December 1990 in India, clinicians included every fifth pregnant woman attending the prenatal clinic of New Civil Hospital in Ahmedabad with amenorrhea no greater than 12 weeks in a longitudinal study of scoring of high-risk pregnant women and their pregnancy outcomes. They used the ICMR risk scoring system to score the 900 women during their first and second visits, during their second and third trimesters, and when admitted for delivery. The clinicians were able to follow up on only 687 women. 81.66% had high risk factors. The higher the risk score, the less likely the women had a normal delivery (0 score = 96.03%, 1-3 = 79.14%, 4-6 = 61.87%, =or 7 = 40%; p 0.0001). 40% of women in the most severe risk group had an instrumental delivery compared to only 3.17% for those with no risks (p 0.0001). The incidence of premature birth was significantly higher among women with a risk score greater than zero than among those with no risk factors (95.77% vs. 2.38%; p 0.001). Women with no risk factors had no stillbirths, while 20% of those in the highest risk group did. 16.3% of mothers had at least one postnatal complication. Postnatal complications increased with the risk level (6.35% for 0; 15.59% for 1-3, 26.62% for 4-6, and 40% for =or 7). The only maternal death occurred in a woman with a risk score of 4-6. The maternal mortality rate was 1.46/1000 live births. These findings indicate a need for proper and timely prenatal care, improving general hygiene in labor rooms, washing hands before and after dressing women who undergo obstetrical surgery, and perineal support during delivery.^ieng

Comparison of autofocus methods for automated microscopy.

Traditional autofocus methods were designed for microscopes driven by single processor computers. As computers are developed that exploit massive parallelism when acquiring and analyzing images, parallel cellular logic techniques became available to focus automatically. This paper introduces the reader to both cellular logic techniques for autofocus and a new spectral moment autofocus measure. It then compares these methods with more traditional autofocus methods. It is shown that traditional methods based on measurements of image power-give the best results when tested on one set of real images and two sets of synthetic images. The next best methods are the cellular logic and spectral moment techniques, while the worst are those based on the image probability density function or histogram.

A study of twin births in rural communities of Gujarat.

The incidence and the factors that influence twinning were studied in six villages of Dholka Taluka, a rural field training centre. The twinning rate was 10.10 per 1000 maternities. The monozygotic and dizygotic twinning rates were 4.53 and 5.56, respectively by applying Weinberg's differential formula. In three fourths of the twin births, both twins were of same sex while in one fourth, they were of opposite sex. The twinning rates increased significantly with increase in parental age and pregnancy order of mother.