Topical Steroid Damaged Face - A Dermascopic Analysis.

Background and Objectives: Dermoscopy particularly could be helpful in patients with steroid damaged face to assess and look for the damage caused by the steroid creams as also in cases where the patient provides improper history. Materials and Methods: Patients attending to dermatology OPD with suspected/diagnosed TSDF between the ages of 18 and 60 years were enrolled and assessed on the basis of age, gender, residence, duration, potency, brand of application topical steroid creams, clinical and dermoscopic features. Results: Majority abusing the topical steroid creams were females (n-14) with mean age with SD of 34 ± 11 and were from rural areas (57.8%). Red raised lesions were the most common clinical presentation (n-15) with telangiectasias as the most common dermoscopic feature (n-26). Triple combination creams containing hydroquinone 2%, tretinoin 0.025%, and 0.1% mometasone were on the top of the list (n-20). Conclusion: In this study, the importance of dermoscopy in assessing the features of topical steroid damaged face and preventing further damage is highlighted. Various factors causing topical steroid creams misuse and the easy availability of the creams is to be kept on check.

A Rare Case of Cystic Biliary Atresia

@#Biliary atresia is one of the commonest causes of prolonged jaundice in neonate, whereas cystic biliary atresia is a rare form of biliary atresia with similar presentation, but a slightly different sonographic finding. Being able to differentiate them radiologically is important as the surgical management is different for these two diagnoses. An ultrasound examination was done for a 2-month-old baby girl with prolonged jaundice with the finding of a cyst along the portal triad, which raised the suspicion for cystic biliary atresia. The diagnosis was confirmed with intraoperative cholangiography (IOC) and Kasai procedure was done. The patient was well after the surgery with resolution of jaundice.

An expedient ion chromatography based method for high-throughput analysis of phytic acid in groundnut kernels.

A study was made to expedite ion chromatography method using IonPac analytical column and self-regenerating anion suppressor for phytic acid determination in groundnut seeds and compared with a widely adopted spectrophotometric method based on enzymatic hydrolysis. The Ion Chromatography method equipped with AG11 guard and AS11 analytical columns in isocratic mode using 65 mM NaOH mobile phase at 1 mL min-1 flow rate showed a sharp peak for phytic acid with a retention time of 2.42 ± 0.2 min. The peak area was plotted v/s concentration showed linearity with an R2 value of 0.997, detection limit of 0.028 mg L-1 and recovery of 98% as against R2 value of 0.988 and detection limit of 0.065 mg L-1 in the spectrophotometric method. The study demonstrates that Ion Chromatography method was more accurate with a better detection limit than spectrophotometry. Also, this method provides robust handling with lesser reagent requirements due to combined eluent generation and self-regenerating suppression. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-022-05527-9.

Locomotor and histological changes in a cuprizone-induced animal model of multiple sclerosis: comparison between alpha-tocopherol and fingolimod.

Background and purpose: Fingolimod is a sphingosine 1-phosphate receptor modulator used to treat multiple sclerosis (MS). Alpha-tocopherol (AT) has been found to improve motor function in an animal model of MS. In the present study, the effects of AT and fingolimod on the locomotor function and histological evidence of demyelination were compared in a cuprizone-induced rat model of MS. Experimental approach: Female Sprague-Dawley rats (8 weeks) were fed with 0.2% (w/w) cuprizone diet for 5 weeks followed by intraperitoneal injections of fingolimod (3 mg/Kg; group F, n = 10) and alpha- tocopherol (100 mg/Kg; group A, n = 10). Vehicle-treated rats (group V, n = 10) were treated intraperitoneally with 1% ethanol in saline on weeks 6 and 7. Open field and beam walking tests were carried out every 10 days. The mean area of demyelination in the corpus callosum was quantified using Luxol fast blue stained histological sections of the forebrain. Findings/Results: The mean speed of movement was increased by 54% and 50% in groups F and A compared to group V. Total distance moved was increased by 61% and 52.7% in groups F and A compared to group V. Mean time to walk the beam was reduced in group A by 52% compared to group V. Mean frequency of crossing lines from the inner squares to outer squares was reduced in groups A and F compared to group V. Mean area of demyelination in corpus callosum showed 62% reduction in group A compared to group V. Conclusion and implications: Both fingolimod and AT treatments improved the locomotor function. However, AT treatment reduced the areas of demyelination in higher proportion and improved motor coordination and exploratory behavior.

Self-perception of sexual harassment: A comparison between female medical and nursing students during clinical practice.

BACKGROUND: Sexual harassment (SH) may occur anywhere in the world, including the hospital setting. Medical and nursing students are not excluded from being sexually harassed during their clinical practice. This study examined the experiences and compared the perception of SH between female medical and nursing students during their clinical practice in Perak, Malaysia. METHODS: A comparative cross-sectional study design was done among female medical and nursing students during their clinical practice. RESULTS: Total respondents were 481 female medical and nursing students (response rate of 96.2%). About 17.8% of medical and 18.8% of nursing students had been sexually harassed. The most common harasser for medical and nursing students were males (51.2% and 48.8%, respectively), patients (39.7% and 60.3%, respectively), age 30s (41.0% and 59.0%, respectively) and 40s (65.5% and 34.5%, respectively), occurred in medical wards for both groups (50% each). From the SH checklist, 76.9% of medical and 73.5% of nursing students had experienced at least one item of the total 18 items. The abnormal sexual desire of an individual was chosen as the reason for SH by 44.9% of medical and 33.8% of nursing students. The majority of respondents said the issue of SH in clinical practice was very serious. Around 32% of medical students choose the fear of being disadvantaged during clinical practice as the reason why the victims kept quiet while 41.5% of nursing students chose because of not having evidence. Both groups of students suggested establishing rules and laws relating to SH (30.8% and 35.5%, respectively) as effective methods to prevent it. About 75.3% of medical and 81.6% of nursing students agreed that it was very necessary for implementing a SH prevention program. DISCUSSION: Although SH is not a new issue, there is insufficient exposure about SH among medical and nursing students. This can be corrected by increasing their knowledge and awareness about SH.

Knowledge and attitude of nurses towards diabetic foot care in a secondary health care centre in Malaysia

@#Introduction: Nurses play a vital role in the care and prevention of ulcers in patients with diabetic foot. Patient education, prevention of ulcers and rehabilitation are some of the vital aspects that nurses provide on a daily basis. Thus, good knowledge and attitude of nurses towards diabetic foot ulcers and its care will ensure better patient care. Objectives: The aim is to study the level of knowledge and attitude of nurses towards diabetic foot ulcers and its care in Hospital Segamat, Malaysia. Methods: A validated questionnaire was used between February 2019 to May 2019 covering area such as demography, predisposing factors of ulcer formation, characteristics of ulcers, complications of ulcers, and attitude towards diabetic foot care. Results: A total of 101 nurses took part and 57% of the participants scored poorly in the knowledge section of the questionnaire. In all 72% had scored poorly when asked regarding complications of diabetic foot ulcers; 49.5% of the nurses had positive attitude towards diabetic foot care; and 79.3% thought that care for diabetic foot ulcer is timeconsuming. Majority of them think that their colleagues are the main source of information. All demographic variables were deemed to be confounders with the knowledge and attitude of nurses towards diabetic foot ulcers and its care. Conclusions: Nurses in this centre had poor knowledge towards diabetic foot ulcers and its care. None of the variable studied were correlated with the level know knowledge. Good or poor knowledge of nurses does not correspond equally to good or poor attitude towards diabetic foot ulcers care. More frequent formal training of diabetic foot care would be needed to ensure better knowledge.

Safety and Efficacy of Different Systemic Treatment Modalities for Acute Pain of Herpes Zoster: A Pilot Study.

BACKGROUND: Herpes zoster is a viral infection of skin caused by Varicella Zoster virus. The most important symptom for which the patient seeks medical advice is pain, which is perceived before the development of rash and lasts even after its resolution. The pain during the first 30 days after onset of herpes zoster is known as acute herpetic neuralgia. The aim of this study was to compare the efficacy and side-effects of different systemic treatment modalities for acute herpes zoster neuralgia. MATERIALS AND METHODS: This was a randomized, single-blind, parallel control study. Forty-five patients of herpes zoster within 72 hours of onset were enrolled after considering various inclusion and exclusion criteria over a duration of 1 year. Pain severity was assessed after sequential distribution and allotment of patients in three groups using verbal rating scale (VRS). Patients in Group A (control group), were treated with Tab.valacyclovir (1 g tds × 7 days), Group B-Tab.valacyclovir (1 g tds × 7 days) + Cap. Pregabalin (75 mg bd × 1 month), and Group C -Tab.valacyclovir (1 g tds × 7 days) +Cap. Pregabalin (75 mg bd × 1 month) + Tab.methylprednisolone (0.64 mg/kg body weight in two divided doses × 7 days). Patients were followed up at 1, 4, 6 weeks. Complete resolution of acute pain and side-effects were noted. RESULTS: At the end of 4 weeks, reduction in acute pain was statistically significant (P < 0.05) in all the three groups individually compared to the baseline value. At the end of 6 weeks, percentage of patients with persistence of pain was more in Group A and B compared to Group C, which was statistically significant (P = 0.0001). In group A, postherpetic neuralgia was observed in more patients compared to group B and C. No significant side-effects were observed in any group except vomiting, somnolence, and dizziness. LIMITATIONS: Sample size of this study was limited. Further studies with large sample size are required to further validate the findings of the present study. CONCLUSIONS: Combination therapy with valacyclovir, methylprednisolone, and pregabalin has better efficacy compared to valacyclovir and pregabalin and valacyclovir alone in the management of acute herpes zoster neuralgia. No significant side-effects were observed.

Late onset Warfarin induced skin necrosis in human immunodeficiency virus infected patient with pulmonary tuberculosis.

The incidence of Warfarin-induced skin necrosis (WISN) is very low 0.01-0.10%. The majority of the WISN cases appear between day 3 and 6 of onset of Warfarin therapy. The cases of late onset WISN are rarely seen. We report a case of late onset WISN in a young human immunodeficiency virus positive female patient with thrombotic pulmonary embolism and reactivation of pulmonary tuberculosis.

Parental depression and offspring psychopathology: a children of twins study.

BACKGROUND: Associations between parental depression and offspring affective and disruptive disorders are well documented. Few genetically informed studies have explored the processes underlying intergenerational associations. METHOD: A semi-structured interview assessing DSM-III-R psychiatric disorders was administered to twins (n=1296) from the Australian Twin Register (ATR), their spouses (n=1046) and offspring (n=2555). We used the Children of Twins (CoT) design to delineate the extent to which intergenerational associations were consistent with a causal influence or due to genetic confounds. RESULTS: In between-family analyses, parental depression was associated significantly with offspring depression [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.20-1.93] and conduct disorder (CD; HR 2.27, CI 1.31-3.93). Survival analysis indicated that the intergenerational transmission of depression is consistent with a causal (environmental) inference, with a significant intergenerational association in offspring of discordant monozygotic (MZ) twin pairs (HR 1.39, CI 1.00-1.94). Logistic regression analysis suggested that the parental depression-offspring CD association was due to shared genetic liability in the parents and offspring. No intergenerational association was found when comparing the offspring of discordant MZ twins [odds ratio (OR) 1.41, CI 0.63-3.14], but offspring of discordant dizygotic (DZ) twins differed in their rates of CD (OR 2.53, CI 0.95-6.76). All findings remained after controlling for several measured covariates, including history of depression and CD in the twins' spouses. CONCLUSIONS: The mechanisms underlying associations between parental depression and offspring psychopathology seem to differ depending on the outcome. The results are consistent with a causal environmental role of parental depression in offspring depression whereas common genetic factors account for the association of parental depression and offspring CD.

Comparison of Ni-sensitive and Ni-resistant strains of Nostoc muscorum.

A wild-type Ni-sensitive (Ni(s)) strain of Nostoc muscorum ISU spontaneously yielded mutants resistant to inhibition by 40 µM Ni with a frequency of about 10(-7). A Ni-resistant (Ni(r)) mutant was deficient in the activities of urease and uptake hydrogenase. Cellular Ni uptake in the Ni(s) strain was dependent on concentration (40 to 120 µM) and time (0 to 30 min) (Vmax=0.51 nmol/µg protein.min; Km=92 µM). The Ni bioconcentration factor for such cells ranged between 0.95×10(3) and 1.89×10(3). Ni uptake in spheroplast preparations from Ni(s) cells followed almost the same trend as intact cells except that the bioconcentration factor was slightly less [(0.82 to 1.39)×10(3)]. In contrast, Ni uptake in the Ni(r) intact cells was not concentration dependent and also the uptake was saturated, even at 40 µM, within 10 min. Spheroplasts from the Ni(r) strain showed a Ni bioconcentration factor of 1.19×10(3) compared with 4.41×10(3) for intact cells. The invariably lower Ni uptake by spheroplasts was attributed to altered membrane transport properties.