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Camptothecin (CPT), an alkaloid isolated from the Camptotheca tree, has demonstrated significant anticancer properties in a range of malignancies. However, its therapeutic efficacy is limited by its hydrophobicity, poor bioavailability, and systemic toxicity. Derivatives, analogues, and nanoformulations of CPT have been synthesized to overcome these limitations. The aim of this review is to comprehensively analyze existing studies to evaluate the therapeutic efficacy, mechanistic aspects, and clinical potential of CPT and its modified forms, including derivatives, analogues, and nanoformulations, in cancer treatment. A comprehensive literature review was performed using PubMed/Medline, Scopus, and Web of Science databases; articles were selected based on specific inclusion criteria, and data were extracted on the pharmacological profile, clinical studies, and therapeutic efficacy of CPT and its different forms. Current evidence suggests that derivatives and analogues of CPT have improved water solubility, bioavailability, and reduced systemic toxicity compared to CPT. Nanoformulations further enhance targeted delivery and reduce off-target effects. Clinical trials indicate promising outcomes with enhanced survival rates and lower side effects. CPT and its modified forms hold significant promise as potent anticancer agents. Ongoing research and clinical trials are essential for establishing their long-term efficacy and safety; the evidence overwhelmingly supports further development and clinical testing of these compounds. [ABSTRACT FROM AUTHOR]

We present an extensive contemporaneous X-ray and radio campaign performed on the repeating fast radio burst (FRB) source FRB 20220912A for 8 weeks immediately following the source's detection by CHIME/FRB. This includes X-ray data from XMM-Newton, NICER, and Swift, and radio detections of FRB 20220912A from CHIME/Pulsar and Effelsberg. We detect no significant X-ray emission at the time of 30 radio bursts with upper limits on a 0.5–10.0 keV X-ray fluence of (1.5–14.5) × 10−10 erg cm−2 (99.7% credible interval, unabsorbed) on a timescale of 100 ms. Translated into a fluence ratio η x/r = F X-ray/ F radio, this corresponds to η x/r < 7 × 106. For persistent emission from the location of FRB 20220912A, we derive a 99.7% 0.5–10.0 keV isotropic flux limit of 8.8 × 10−15 erg cm−2 s−1 (unabsorbed) or an isotropic luminosity limit of 1.4 × 1041 erg s−1 at a distance of 362.4 Mpc. We derive a hierarchical extension to the standard Bayesian treatment of low-count and background-contaminated X-ray data, which allows the robust combination of multiple observations. This methodology allows us to place the best (lowest) 99.7% credible interval upper limit on an FRB η x/r to date, η x/r < 2 × 106, assuming that all 30 detected radio bursts are associated with X-ray bursts with the same fluence ratio. If we instead adopt an X-ray spectrum similar to the X-ray burst observed contemporaneously with FRB-like emission from the Galactic magnetar SGR 1935+2154 detected on 2020 April 28, we derive a 99.7% credible interval upper limit on η x/r of 8 × 105, which is only 3 times the observed value of η x/r for SGR 1935+2154. [ABSTRACT FROM AUTHOR]

Introduction: Although living kidney donation is generally considered a safe procedure, it is ethically critical that prospective donors are fully informed before consent. However, prospective donors lack a deep understanding of the donation experience, making the postdonation aftermath feel unanticipated. We sought to gain in‐depth qualitative descriptions of the short‐ and long‐term risks and benefits associated with kidney donation among an ethnically diverse group of donors to offer a balanced view of the positive and negative experiences that may occur postdonation. Methods: We conducted individual narrative in‐depth interviews (September 2020–March 2021) using the DIPEx (database of individual patient experiences) method with former living kidney donors primarily via Zoom. Results: Fourteen donors (10 women; 8 White, 5 Hispanic, and 1 Native American) completed interviews. Interactions with healthcare providers leading up to donation were largely positive; however, lack of clarity regarding postdonation laboratory values among primary care providers led three participants to be erroneously told they developed kidney disease. Most experienced unanticipated outcomes, including postsurgical complications (e.g., hernia), long‐term fatigue (i.e., ≥12 weeks), emotional distress (e.g., depression), hypertension, and gout. Difficulty obtaining life insurance following donation was an unexpected challenge. Despite these issues, participants were unanimously enthusiastic about living kidney donation and reported no regrets. Conclusions: Enthusiasm for living kidney donation remained high among all participants despite most experiencing negative outcomes. These findings suggest that greater transparency regarding postdonation experiences may not preclude the decision to move forward with living kidney donation. These narratives will be utilized for an online module of lived experiences of donation. [ABSTRACT FROM AUTHOR]

Background: Tinea incognito presents with atypical, widespread, and recurrent lesions. Dermoscopy can aid its rapid diagnosis. Aim and Objectives: This study aimed at assessing dermoscopic features and response to treatment in patients with tinea incognito. Materials and Methods: An evaluation of 62 patients with tinea of glabrous skin (Group A (cases)—31 steroid modified and Group B (controls)—31 treatment naïve) was done. Clinical, dermoscopic, and mycological evaluations were done for both groups at baseline, 2, and 4 weeks of terbinafine therapy. Clinical severity (Clinical Assessment Severity Score (CASS) and Visual Analogue Scale (VAS)) and frequency of various dermoscopic changes were compared at 0 and 4 weeks between cases and controls, using unpaired Student's t-test, Mann–Whitney U-test, and Wilcoxon signed-rank test. Results: Baseline dermoscopic features for both groups were significantly different with respect to frequency of broken hair, bent hair, micropustules and Morse code hair. Earliest feature to resolve with treatment was micropustules at 2 weeks. Significant reduction in frequency of morphologically altered hair was evident at 4 weeks. Telangiectasia, dotted vessels, I-hair, and broken hair persisted for a longer period of time. Terbinafine for 4 weeks was an effective treatment, producing complete cure in 73% of cases and 93% of controls. Persistent dermoscopic changes at 2 weeks were found to be associated with treatment failure at 4 weeks, highlighting the role of dermoscopy in identifying patients requiring prolonged treatment. Conclusions: Dermoscopy can be used as a diagnostic and monitoring tool for tinea of glabrous skin. [ABSTRACT FROM AUTHOR]

How can ethnographic methods track implicit & explicit forms of structural casteism in Indian public health policy and praxis? How can a critical attention to ordinary stories and subjectivities of casted lives reveal the underlying Brahmanical moralities, assumptions and imaginations of public health but equally also unravel anti-caste counter-framings/counter-theorizations of symptoms, afflictions, injuries and chronic wounds wrought by caste? How, in other words, can the horizons of anti-colonial theory-making be expanded to capaciously conceptualize casteism as a core determinant of community health outcomes and life-chances in India? By mobilizing 'counter-storytelling' as a concept and method for critical medical anthropology from the Global South, and case studies from longitudinal ethnography in northern India, this paper provides a dual critique of: 1. Public health praxis in relation to questions of caste, addiction, respiratory debilitation, air pollution and TB. And, 2. Epistemologies of health policy making pertaining to wellness for 'the poor' and the gendered and casted labour of community care workers like ASHAs and non-institutionalized health actors. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is a lack of well-controlled US studies of intramuscular (IM) interferon beta (IFNβ)-1a use in pregnant women with multiple sclerosis; however, in the European Medicines Agency region, IFNβ formulations may be considered during pregnancy if clinically needed based on data from European Union cohort registries. The AVONEX Pregnancy Exposure Registry was established to prospectively study the effects of IM IFNβ-1a on the risk of birth defects and spontaneous pregnancy loss in a US population. Methods: Pregnant women with multiple sclerosis exposed to IM IFNβ-1a within ~ 1 week of conception or during the first trimester were included. Participants were followed until there was a pregnancy outcome, live-born infants were followed until age 8–12 weeks. Data were collected on IM IFNβ-1a exposure, demographics, patient characteristics, medical history, and pregnancy outcomes, including live births (with or without birth defect), spontaneous abortions/miscarriages and fetal death/stillbirth, elective abortions (with and without birth defect), and ectopic pregnancies. A population-based birth defect surveillance program, the Metropolitan Atlanta Congenital Defects Program (MACDP), served as the primary external control group for evaluating the risk of birth defects. Results: Three-hundred and two patients with a median (range) age of 31.0 (16–48) years and a median (range) gestational age at the time of enrollment of 10.1 (4–39) weeks were evaluable. Most patients (n = 278/302; 92%) reported IM IFNβ-1a exposure in the week before conception and most (n = 293/302; 97%) discontinued treatment before the end of the first trimester. Of 306 pregnancy outcomes, there were 272 live births, 28 spontaneous abortions of 266 pregnancies enrolled before 22 weeks' gestation (rate 10.5%; 95% confidence interval 7.2–15.0), five elective abortions, and one stillbirth. There were 17 adjudicator-confirmed major birth defects of 272 live births (rate 6.3%; 95% confidence interval 3.8–10.0); the pattern of birth defects observed was not suggestive of a relationship to prenatal IM IFNβ-1a exposure. Conclusions: This large US registry study suggests IM IFNβ-1a exposure during early pregnancy was not clinically associated with adverse pregnancy outcomes in women with multiple sclerosis. These findings help inform clinicians and patients in weighing the risks and benefits of IM IFNβ-1a use during pregnancy. Clinical Trial Registration: ClinicalTrials.gov: NCT00168714, 15 September, 2005. [ABSTRACT FROM AUTHOR]

Plant growth-promoting bacteria are valuable microbes that enhance the plant growth, development, and yield. Several seed priming methods are able to improvise seed germination, seedling potency, to overwhelmed abiotic stress and biotic stress management which gets prime attention. Generally, plant-growth promoting bacteria are utilized for biopriming technique that is able to survive under stress environmental conditions. The aims of the present investigation were to screening of KC9 bacterial isolate as PGPB in groundnut and chickpea and study the effects of KC9 bacterial isolation seed, seedling germination and growth during the development of both seeds. In this study KC9 has been isolated from the soil sample of chickpea crop field at Saurashtra region. Preliminary screening was conducted based on their identification via morphological, biochemical i.e., catalase, starch hydrolysis, sugar utilization, motility, IMViC test, gram's nature and by 16S rRNA gene nucleotide sequences and identified as Bacillus sp. that has been submitted to the NCBI for Accession number. Further examine the production of indole acetic acid (IAA), Ammonia (NH3), HCN, Siderophore and Phosphate solubilization. KC9 (Bacillus sp.) was recognized as most efficient plant-growth promoting bacteria. For the pot experiment seed biopriming method is employing to coat the seeds of chickpea and groundnut with Bacillus inoculant consider as treated and seeds sown with double distilled water as control. Bacillus coated seed biopriming also minimize the seed germination time period that takes only 3-4 days to proper seed radicle development. By the statistical approach of paired t-test of pot experiment on chickpea and groundnut seeds and seedlings were treated with Bacillus strain exhibited significantly higher levels at of seed germination, seedling growth via root length, shoot length and number of leaves in compared to non-treated control plants. In this present investigation, impact of seedling germination on the inoculated condition with KC9 of groundnut and chickpea, determining remarkable changes in total chlorophyll content (11.81 µg/g and 10.40 µg/g), relative water content(RWC) obtained 86% and 83%., total free amino acids (92.14±0.03µg/ml whereas 37.5±0.02µg/ml), total phenolic acid content (76.28±0.03mg GAE/100g and chickpea is 52.83±0.08 mg GAE/100g) and total flavonoid content increases with the treatment of KC9 (Bacillus sp.) 626±0.05QE/100g is recorded in groundnut seedlings and chickpea is 0.085±0.01QE/100g respectively. [ABSTRACT FROM AUTHOR]

Studies of dense core morphologies and their orientations with respect to gas flows and the local magnetic field have been limited to only a small sample of cores with spectroscopic data. Leveraging the Green Bank Ammonia Survey alongside existing sub-millimeter continuum observations and Planck dust polarization, we produce a cross-matched catalogue of 399 dense cores with estimates of core morphology, size, mass, specific angular momentum, and magnetic field orientation. Of the 399 cores, 329 exhibit 2D vLSR maps that are well fit with a linear gradient, consistent with rotation projected on the sky. We find a best-fit specific angular momentum and core size relationship of J / M  ∝  R 1.82 ± 0.10, suggesting that core velocity gradients originate from a combination of solid body rotation and turbulent motions. Most cores have no preferred orientation between the axis of core elongation, velocity gradient direction, and the ambient magnetic field orientation, favouring a triaxial and weakly magnetized origin. We find, however, strong evidence for a preferred anti-alignment between the core elongation axis and magnetic field for protostellar cores, revealing a change in orientation from starless and prestellar populations that may result from gravitational contraction in a magnetically-regulated (but not dominant) environment. We also find marginal evidence for anti-alignment between the core velocity gradient and magnetic field orientation in the L1228 and L1251 regions of Cepheus, suggesting a preferred orientation with respect to magnetic fields may be more prevalent in regions with locally ordered fields. [ABSTRACT FROM AUTHOR]

Background: Impact of COVID-19 pandemic has been immense. An innocent casualty of this disaster is medical education and training. Dermatology, which primarily deals with out-patient services, medical and surgical interventions, and in-patient services, was one of the worst hit. The National Medical Commission of India has implemented competency-based medical education (CBME) in Dermatology, Venereology, and Leprosy since 2019. The new curriculum relies on acquiring practical and procedural skills, training skills in research methodology, professionalism, attitude, and communication. Objectives: The study was undertaken to understand the implications of the COVID-19 pandemic on postgraduate dermatology CBME training in India. Materials and Methods: A questionnaire-based survey was carried out on postgraduate dermatology teachers and residents in India after obtaining ethics committee approval. An online semi-structured English questionnaire was administered by Google Forms. The calculated sample size was 366 dermatology faculty and 341 postgraduate students. Validity (Content validity ratio (CVR) ≥0.56) and reliability (Cronbach's alpha coefficient 0.7249) of the questionnaire were determined. Results: Among the 764 responses received, 51.4% reported that their institutes were converted to exclusive COVID hospitals. Domains of dermatology education affected were procedural training (n = 655), bedside clinical teaching (n = 613), outpatient department-based clinical teaching (n = 487), bedside laboratory procedures (n = 463), research activities (n = 453), histopathology (n = 412), and theory classes (n = 302). To keep up with the teaching-learning process, online platforms were mostly utilized: Zoom Meeting (n = 379), Google Meet (n = 287), and WhatsApp Interaction (n = 224). Teaching during ward rounds was significantly more affected in exclusively COVID institutes than non-exclusive COVID institutes (P < 0.001). Psychomotor skill development suffered a major jolt with 26.7% of respondents reporting a standstill (P < 0.001). Communication skills among students suffered due to social distancing, mask, and poor attendance of patients. According to 23.84% of respondents, formative assessment was discontinued. Conclusion: Online seminars, journal clubs, and assessments have been incorporated during the pandemic. Online modalities should be used as a supplementary method as psychomotor skills, communication skills, research work, and bedside clinics may not be replaced by the e-learning. [ABSTRACT FROM AUTHOR]

The CHIME/FRB project has detected hundreds of fast radio bursts (FRBs), providing an unparalleled population to statistically probe the foreground media that they illuminate. One such foreground medium is the ionized halo of the Milky Way (MW). We estimate the total Galactic electron column density from FRB dispersion measures (DMs) as a function of Galactic latitude using four different estimators, including ones that assume spherical symmetry of the ionized MW halo and ones that imply more latitudinal variation in density. Our observation-based constraints of the total Galactic DM contribution for ∣ b ∣ ≥ 30°, depending on the Galactic latitude and selected model, span 87.8–141 pc cm−3. This constraint implies upper limits on the MW halo DM contribution that range over 52–111 pc cm−3. We discuss the viability of various gas density profiles for the MW halo that have been used to estimate the halo's contribution to DMs of extragalactic sources. Several models overestimate the DM contribution, especially when assuming higher halo gas masses (∼3.5 × 1012 M ⊙). Some halo models predict a higher MW halo DM contribution than can be supported by our observations unless the effect of feedback is increased within them, highlighting the impact of feedback processes in galaxy formation. [ABSTRACT FROM AUTHOR]

Capillary leak syndrome (CLS) is a well-known phenomenon that has been reported commonly in association with septic shock, polytrauma, and pancreatitis in intensive care settings. In the hematologic literature, it has been reported following granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor, tumor necrosis factor, interleukin 2, and interleukin 4 infusions; and autologous and allogenic bone marrow transplantations in both pediatric as well as adult populations. Only a few cases of CLS have been reported in the pediatric population following G-CSF. We report here a case of a 9-yearold female who developed CLS within 60 minutes of receiving the first dose of G-CSF that was successfully treated with immediate symptomatic management. [ABSTRACT FROM AUTHOR]

Green nanotechnology has emerged as a sustainable fabrication technology that has offered tremendous frontiers in the field of food science. This review intends to provide a succinct overview of various green nanofabrication technologies including green creation of nanoparticles using biological sources explicitly from plants as natural reducing agents. In addition, the review explores various biocompatible nano delivery systems for nanoencapsulation of food ingredients for enhancing the sensorial and functional properties food products. Promising applications based on these approaches employing active and smart packaging systems, nanosensors along with functional foods for ensuring food quality and safety have been briefly outlined. Abbreviations: AgNPs: Silver nanoparticles; EOs: Essential Oils; Nm: Nanometer; NPs: Nanoparticles; NLC: Nanostructured lipid carrier; (O/W): Oil-in-water; NLC: Nanostructured lipid carrier; PHB: Poly (3-hydroxybutyrate); PVA: Polyvinyl alcohol; RFID: Radiofrequency identification; SARS: Severe Acute Respiratory Syndrome; SLN: Solid lipid nanoparticles; UV-Visible: Ultraviolet–visible; (W/O): Water-in-oil [ABSTRACT FROM AUTHOR]

Demand for rice labeled as organic is growing globally. Consumers state that foods labeled as organic are nutritionally superior and safer than their conventionally produced equivalent. The research question for this systematic review is as follows: is there a difference between the effects of sustainable agriculture and conventional farming methods on rice grain end-use quality, healthfulness, and safety? The studies (n = 23) examined for this review suggest that organic production practices don't influence most end-use quality (e.g., chalk, milling yield, pasting properties) and healthfulness (e.g., gamma-oryzanol fraction and tocols) traits studied, or if it does, it will be to a small degree. If differences in end-use quality traits are found, they will be associated with grain protein content, which varies along with the dose of nitrogen applied during rice growth. We conclude that the studies evaluated in this review found that organically produced rice grain was less likely to contain residues of the pesticides (e.g., organochlorine) examined in the study than the rice is grown using conventional methods. There was some evidence that organically grown rice is more likely to be contaminated with mycotoxin-producing fungi and some mycotoxins. Common shortcomings of the studies were that they were poorly designed, with limited to no details of the cultural management practices used to grow the rice studied, the length of time fields was under organic management not stated, cultivars were not named, and the data wasn't analyzed statistically. [ABSTRACT FROM AUTHOR]

With the rapid increase of fast radio burst (FRB) detections within the past few years, there is now a catalogue being developed for all-sky extragalactic dispersion measure (DM) observations in addition to the existing collection of all-sky extragalactic Faraday rotation measurements (RMs) of radio galaxies. We present a method of reconstructing all-sky information of the Galactic magnetic field component parallel to the line of sight, B ∥, using simulated observations of the RM and DM along lines of sight to radio galaxies and FRB populations, respectively. This technique is capable of distinguishing between different input Galactic magnetic fields and thermal electron density models. Significant extragalactic contributions to the DM are the predominant impediment in accurately reconstructing the Galactic DM and 〈 B ∥〉 skies. We look at ways to improve the reconstruction by applying a filtering algorithm on the simulated DM lines of sight and we derive generalized corrections for DM observations at | b | > 10° that help to disentangle Galactic and extragalactic DM contributions. Overall, we are able to reconstruct both large-scale Galactic structure and local features in the Milky Way's magnetic field from the assumed models. We discuss the application of this technique to future FRB observations and address possible differences between our simulated model and observed data, namely: adjusting the priors of the inference model, an unevenly distributed population of FRBs on the sky, and localized extragalactic DM structures. [ABSTRACT FROM AUTHOR]

Cereals and cereal-based products are primary sources of nutrition across the world. However, contamination of these foods with aflatoxins (AFs), secondary metabolites produced by several fungal species, has raised serious concerns. AF generation in innate substrates is influenced by several parameters, including the substrate type, fungus species, moisture content, minerals, humidity, temperature, and physical injury to the kernels. Consumption of AF-contaminated cereals and cereal-based products can lead to both acute and chronic health issues related to physical and mental maturity, reproduction, and the nervous system. Therefore, the precise detection methods, detoxification, and management strategies of AFs in cereal and cereal-based products are crucial for food safety as well as consumer health. Hence, this review provides a brief overview of the occurrence, chemical characteristics, biosynthetic processes, health hazards, and detection techniques of AFs, along with a focus on detoxification and management strategies that could be implemented for food safety and security. [ABSTRACT FROM AUTHOR]

Background: The etiological pattern of hemoptysis has evolved, with pulmonary tuberculosis (PTB) becoming less prevalent as a cause. There is a paucity of literature regarding the spectrum of diseases that present as hemoptysis and the data related to detailed clinical profile are lacking. Hence, this study is taken up to determine the clinical profile of hemoptysis and its correlation with radiological and microbiological findings. Methods: This was a 3-year observational prospective study of a total of 50 patients who presented with active hemoptysis. Data were recorded from these patients for assessing the clinical characteristics, radiological, and microbiological correlation. Results: The most common etiologies of hemoptysis identified in this study were PTB in 60% of the patients, aspergilloma in 14%, followed by bronchiectasis in 8%, pneumonia in 8%, carcinoma lung in 4%, and lung abscess in 1 (2%). Mild hemoptysis was present in 8% of patients, whereas 42% had moderate hemoptysis, 18% of patients had severe, and 32% had massive hemoptysis. Sixty percent of patients had recurrent hemoptysis, and the majority of the patients, i.e., 68% tested negative on sputum smear examination for acid-fast bacillus. In 60% of patients, no growth was obtained in the sputum cultures. The most common organisms isolated from sputum cultures of the rest of the patients were Pseudomonas in 14%, Klebsiella in 10%, Escherichia coli in 4%, Staphylococci in 4%, and Streptococcus pneumoniae in 4% of the cases. The majority of the patients were having consolidation and cavitary disease. A highly significant correlation was noted between the radiological findings of consolidation, mycetoma, cystic shadows, lung mass, and lung abscess and the etiology of hemoptysis (P = 0.000). Conclusion: Hemoptysis of any volume implies a life-threatening process, which mandates immediate evaluation and treatment. It is evident that the etiological spectrum of hemoptysis is continuously changing, and more sophisticated investigations, better imaging techniques, bronchoscopic tools, availability of newer techniques in the developing world, and changing patterns of diseases, all contribute to these changes. Identification of the etiology, and localization of the bleeding site, is essential for the efficient management of hemoptysis. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) has been one of the most challenging infectious diseases globally. Cutaneous tuberculosis (CTB) accounts for 0.5–2% of extrapulmonary TB and is often missed owing to its varying morphology and paucibacillary nature. Methods: In this retrospective analytical study, we share our 22‐year experience to describe the clinicoepidemiological features and treatment response of CTB in 1458 Indian patients. In each patient, detailed history was followed by clinical examination, hematological and biochemical investigations, Mantoux testing, chest x‐ray, and other specialized investigations to detect coexisting systemic foci. Clinical diagnosis of CTB was confirmed on histopathology/cytology and response to standard antitubercular treatment (ATT). All details were recorded on a predesigned proforma. Results: Of 1458 eligible patients, 803 were children. The mean disease duration was 15.3 months. Lupus vulgaris (40.4%) was the most common clinical variant, followed by scrofuloderma (32.7%) and lichen scrofulosorum (15.2%). Other variants included tuberculosis verrucosa cutis, gumma, tuberculids, and inoculation TB. Multiple clinical variants were observed in 3.6% of patients. A total of 41.4% of patients had coexistent systemic foci; in lymph nodes (50.4%), lungs (35.6%), bone (10.3%), and abdomen (5.8%). TB foci were also observed at uncommon locations like the eye, central nervous system, and genital organs. Treatment response to ATT was favorable in 99.2%. Interpretation: The burden of CTB still persists in developing countries. The diagnosis is often missed due to the wide spectrum of clinical and histological presentations. Awareness among clinicians of varying aspects of CTB is of paramount importance for early diagnosis and management and will significantly prevent morbidity and disease complications. [ABSTRACT FROM AUTHOR]

Background: Those whose lives are most directly impacted by health care—patients, caregivers, and frontline staff—are ideally situated to improve patient health care services and care quality. Despite a proliferation of literature on both Patient and Public Involvement (PPI) and clinical quality improvement (QI), concrete strategies regarding how to involve patients remain elusive. Aim: Research suggests catalyst films, comprised of rigorously-analyzed interview data from diverse patients about their experiences with health and health care ("catalyst films") are a promising way to bring actionable patient feedback to QI. To date, such films have been crafted primarily by researchers. This project aimed to inform the science of engagement through analyzing how deliberate PPI informed the process of creating catalyst films. Methods: PPI methods included: research team norming activities through a project charter and role delineation process; key informant interviews; participant-ambassador videotaped interviews; clinician and research focus groups; and inclusion of advisors on the research team. Content studied for the analysis presented here included team meeting notes, interview and focus group transcripts, and documentation from a facilitated discussion about team processes. These data were analyzed to determine the impact of our PPI process. Member checking verified themes and lessons learned. Results: PPI shaped team deliberations and final products in substantial ways, including: what material to include in catalyst films and the tone they should convey; multiple issues regarding representation; and our collective understanding of how catalyst films could be used in the United States. Specific discussions addressed: how to include the optimal mix of interview segments that describe experiences with those that more directly point towards care improvement strategies; and how to balance positive and negative feedback from patients about experiences with care. Team process issues included ensuring equity in involvement despite team members having differing and sometimes multiple roles that complicated power dynamics and processes. Conclusions: Multiple forms and degrees of PPI resulted in significant influence on catalyst films and companion materials. Our project thus provides proof of concept for PPI in creation of video products for QI which have traditionally been crafted by researchers. The model we developed, and document in this paper, can be adapted by others creating research-derived video products. Our findings can also inform future research on how co-designing catalyst films enhances their value for QI and the application of co-designed catalyst film use in QI. Lastly, it can guide those engaged in QI and medical education in their selection of film products focused on patient experiences. Plain English Summary: Involving patients in care improvement efforts is valuable for improving the quality and safety of health care services because patients offer unique insights and are directly impacted by the system. Involving patients in these efforts can also inform better patient and family experiences. Studies have shown that using video interviews highlighting good and bad patient experiences in healthcare is one of the promising way to include a wider range of patient narratives and feedback in care improvement. Videos used in these situations are now called catalyst films, formerly known as trigger films. This paper describes how catalyst films are similar to and distinct from other film products used in research and improvement projects. It examines a process for equitably engaging a team of many different stakeholders—patients, providers, and researchers—to select video excerpts from existing research-based patient experience interviews to create catalyst films. It describes methods used to ensure robust input from all team members, so that all perspectives influence the catalyst films. The study concluded that patient and public involvement had significant impact on both the research process and the final products created. Our findings can equip those making or selecting films for use in improving health and social care to ensure films are patient informed. The paper concludes by offering limitations and recommendations for future research to advance the fields of patient and public involvement and quality improvement. [ABSTRACT FROM AUTHOR]

Mycotoxins are fungi-produced secondary metabolites that can contaminate many foods eaten by humans and animals. Deoxynivalenol (DON), which is formed by Fusarium, is one of the most common occurring predominantly in cereal grains and thus poses a significant health risk. When DON is ingested, it can cause both acute and chronic toxicity. Acute signs include abdominal pain, anorexia, diarrhea, increased salivation, vomiting, and malaise. The most common effects of chronic DON exposure include changes in dietary efficacy, weight loss, and anorexia. This review provides a succinct overview of various sources, biosynthetic mechanisms, and genes governing DON production, along with its consequences on human and animal health. It also covers the effect of environmental factors on its production with potential detection, management, and control strategies. [ABSTRACT FROM AUTHOR]

The seventh edition of the Illustrated Synopsis of Dermatology and Sexually Transmitted Diseases, edited by Dr. Neena Khanna, has been released in 2024. The book is popular among undergraduates in India for its simple presentation of dermatological diseases and high-quality illustrations. The new edition focuses on the revised undergraduate competency-based curriculum by the National Medical Commission of India. It covers each dermatological competency, provides visual cues with 830 images and 140 diagrams, and includes sections on sexually transmitted infections and dermatology diagnostics. The book is a comprehensive and handy reference for undergraduates and practitioners alike. [Extracted from the article]

We present a 400–800 MHz polarimetric analysis of 128 nonrepeating fast radio bursts (FRBs) from the first CHIME/FRB baseband catalog, increasing the total number of FRB sources with polarization properties by a factor of ∼3. A total of 89 FRBs have >6 σ linearly polarized detections, 29 FRBs fall below this significance threshold and are deemed linearly unpolarized, and for 10 FRBs, the polarization data are contaminated by instrumental polarization. For the 89 polarized FRBs, we find Faraday rotation measure (RM) amplitudes, after subtracting approximate Milky Way contributions, in the range 0.5–1160 rad m−2 with a median of 53.8 rad m−2. Most nonrepeating FRBs in our sample have RMs consistent with Milky Way–like host galaxies, and their linear polarization fractions range from ≤10% to 100% with a median of 63%. We see marginal evidence that nonrepeating FRBs have more constraining lower limits than repeating FRBs for the host electron-density-weighted line of sight magnetic field strength. We classify the nonrepeating FRB polarization position angle (PA) profiles into four archetypes: (i) single component with constant PA (57% of the sample), (ii) single component with variable PA (10%), (iii) multiple components with a single-constant PA (22%), and (iv) multiple components with different or variable PAs (11%). We see no evidence for population-wide frequency-dependent depolarization, and, therefore, the spread in the distribution of fractional linear polarization is likely intrinsic to the FRB emission mechanism. Finally, we present a novel method to derive redshift lower limits for polarized FRBs without host galaxy identification and test this method on 20 FRBs with independently measured redshifts. [ABSTRACT FROM AUTHOR]

Background: Various nail manifestations have been reported with COVID‑19; mostly in the form of isolated reports. Objective: This cross‑sectional study was carried out to assess nail changes in hospitalized patients with moderate to severe COVID‑19. Methods: Nail findings in 43 adults being treated for COVID‑19, were evaluated after obtaining informed written consent. Nail changes involving fingernails and toenails were documented as new‑onset or pre‑existing changes. Disease status, hematological and biochemical tests, inflammatory markers, treatment administered and outcomes were also recorded. The frequency of changes in fingernails and toenails were statistically compared. Results: The red half‑moon sign (32.5%) and nail bed erythema (34.8%) were the commonest changes seen in fingernails; while apparent leukonychia (46.5%) and distal brown discoloration (51.1%) were commonest changes in toenails. The difference in frequency of changes seen between fingernails and toenails was statistically significant (p < 0.05). Nail changes correlated with systemic involvement in these patients. Limitations: Single‑center evaluation in a limited number of patients, without using augmented examination techniques like onychoscopy, nail fold capillaroscopy, or fluoroscence. Those with less severe disease or with rapid fatality could not be studied. Conclusion: Nail changes in COVID‑19 are common and reflect the systemic nature of illness, being a harbinger of underlying complications. [ABSTRACT FROM AUTHOR]

Summary: Mycotoxin‐producing fungi are a significant source of crop and food contamination, posing a significant threat to global food safety and security. Essential oils, plant extracts and phytochemicals have emerged as green preservatives to extend the shelf‐life of foods due to their unique antimicrobial properties. Unlike conventional synthetic preservatives, they are a sustainable and safe way to preserve food with no or little harmful effects on the environment. Use of nanoformulations containing essential oils and phytochemicals offer enormous potential as a mitigation strategy to lower mycotoxin contamination incidences in food and crop with enhanced release behaviour to efficiently transport them to the target location for a rapid reaction without much impact from environmental variables. Hence, this review overviews various essential oils and phytochemicals utilized through nanoformulations to control the mycotoxigenic fungi, probable mechanism of actions involved as well as emerging mycotoxins and associated safety concerns to ensure food sustainability. [ABSTRACT FROM AUTHOR]

Sir, Ecchymosis is defined as purpura with a size of more than 1 cm and occurs due to extravasation of blood into the subcutaneous tissue, leading to discoloration of the skin.[[1]] It is classified as one of the subtypes of purpuric lesions alongside petechiae, macular purpura, palpable purpura, noninflammatory, and inflammatory retiform purpura.[[2]] Ecchymosis may occur due to blunt trauma or be physiological as in obese individuals. The occurrence of ecchymosis without trauma or any known predisposition in adults should be investigated as it may be a subtle clue to an underlying malignancy. [Extracted from the article]

Objective: To evaluate individual and group long-term efficacy and safety of erenumab in individuals with episodic migraine (EM) for whom 2-4 prior preventatives had failed.Methods: Participants completing the 12-week double-blind treatment phase (DBTP) of the LIBERTY study could continue into an open-label extension phase (OLEP) receiving erenumab 140 mg monthly for up to 3 years. Main outcomes assessed at week 112 were: ≥50%, ≥75% and 100% reduction in monthly migraine days (MMD) as group responder rate and individual responder rates, MMD change from baseline, safety and tolerability.Results: Overall 240/246 (97.6%) entered the OLEP (118 continuing erenumab, 122 switching from placebo). In total 181/240 (75.4%) reached 112 weeks, 24.6% discontinued, mainly due to lack of efficacy (44.0%), participant decision (37.0%) and adverse events (AEs; 12.0%). The ≥50% responder rate was 57.2% (99/173) at 112 weeks. Of ≥50% responders at the end of the DBTP, 36/52 (69.2%) remained responders at ≥50% and 22/52 (42.3%) at >80% of visits. Of the non-responders at the end of the DBTP, 60/185 (32.4%) converted to ≥50% responders in at least half the visits and 24/185 (13.0%) converted to ≥50% responders in >80% of visits. Change from baseline at 112 weeks in mean (SD) MMD was -4.2 (5.0) days. Common AEs (≥10%) were nasopharyngitis, influenza and back pain.Conclusions: Efficacy was sustained over 112 weeks in individuals with difficult-to-treat EM for whom 2-4 prior migraine preventives had failed. Erenumab treatment was safe and well tolerated, in-line with previous studies.Trial Registration Number: NCT03096834. [ABSTRACT FROM AUTHOR]

Background: Akin to cervical squamous intra-epithelial neoplasia (CIN), anal squamous intra-epithelial lesion (a-SIL) is attributed to persistent infection with high-risk human papilloma virus infection. Amplification of human telomerase reverse transcriptase (hTERT) gene and aneuploidy are known to correlate with CIN evolution. It is plausible that the underlying genetic events in a-SIL are similar. We conducted this cross-sectional analytical study with the objective of determining expression of hTERT gene expression and chromosome 7, as marker of cell ploidy in a-SIL. Methods: Conventional anal cytology was performed in 86 adult consenting subjects with history of receptive anal intercourse (RAI) and 4 controls without history of RAI. Cases with a-SIL and controls were subjected to fluorescent in-situ hybridization (FISH) to evaluate hTERT gene and chromosome 7 expression, as marker of cell ploidy. Results were expressed as number of abnormal nuclei (≥3 respective signals), maximum degree of amplification, mean signals/nucleus and proportion of cases showing abnormal nuclei. Results: Twenty cases showed a-SIL; with 15 atypical squamous cells of undetermined significance (ASCUS), 3 low grade squamous intra-epithelial lesion (LSIL) and 2 cases of high-risk cytology. Expression of both hTERT gene and chromosome 7 increased from controls to ASCUS to LSIL with concomitant increase in proportion of cases having abnormal hTERT gene and chromosome 7 expression. Conclusions: Positive association of hTERT gene with a-SIL suggests its possible role in evolution of anal squamous abnormalities. Increase in chromosome 7 also correlated positively with a-SIL. These findings corroborate the similarities between squamous carcinogenesis in CIN and a-SIL. [ABSTRACT FROM AUTHOR]

A wide variety of wires are available for use in interventional radiology, with wires demonstrating differences in construction, diameter, length, coating, shape, and taper. It is crucial to understand the difference in characteristics between these wires to select the most effective and safe wire for the intended purpose when undertaking a procedure. This article reviews the qualities and functions of different types of wires to aid in this decision-making process. [ABSTRACT FROM AUTHOR]

Background: In India, sexuality not confirming to hetero‑conjugal and peno‑vaginal norm is abhorred and discriminated against. Individuals engaging in Receptive Anal Intercourse (RAI) are marginalized. Reappraisal of their sexual health conditions is likely to promote inclusive health care. Methods: Eighty‑five consenting adults with RAI history were recruited from a tertiary care hospital in Delhi. Clinico‑demographic data was noted and anal cytology samples were reported by Bethesda 2014 terminology. Results: There were 29 transgenders (TGs), 51 males (31 bisexual) and five females. Fifty‑four subjects were Human Immunodeficiency Virus (HIV) infected (22 TGs, 31 males (17 bisexual) and one female) and 52 were receiving anti‑retroviral treatment (ART). Thirty‑one subjects had anal warts (6 TGs, 20 males, five females). Anal cytology revealed squamous intra‑epithelial lesions (SIL) in 20 (5 TGs, 13 males, two females). TGs had significantly risker sexual practices than homosexual males, bisexual males and females, with consistently earlier age of first RAI exposure and frequent childhood (≤16 years) RAI experience compared to homosexual males, bisexual males and females, even after stratification by HIV status, warts and SIL. Conclusions: TGs had the highest sexual health risk profile including higher frequency of HIV infection compared to other subjects with RAI history. Bisexuality was common; their risk profile was variably lower than homosexual males. Mindfulness of above is likely to help overcome barriers to health care access and promote compassionate approach at all levels including primary care physicians. [ABSTRACT FROM AUTHOR]

Significant proportion of patients with dermatological disorders are on immunosuppressive or immunomodulatory therapy predisposing them to risk of acquisition of COVID-19 infection. However, the efficacy of COVID-19 vaccination among these patients is a matter of concern due to lack of adequate evidence for their protective effect owing to the drug induced immunosuppressed state. Hence, we from the IADVL academy have framed the recommendations to be followed for COVID-19 vaccination among dermatological patients on immunosuppressive therapy based on available related literature. [ABSTRACT FROM AUTHOR]

Marijuana, or Cannabis sativa L., is a common psychoactive plant used for both recreational and medicinal purposes. In many countries, cannabis‐based medicines have been legalized under certain conditions because of their immense prospects in medicinal applications. With a comprehensive insight into the prospects and challenges associated with the pharmacological use and global trade of C. sativa, this mini‐review focuses on the medicinal importance of the plant and its legal status worldwide; the pharmacological compounds and its therapeutic potential along with the underlying public health concerns and future perspective are herein discussed. The existence of major compounds including Δ9‐tetrahydrocannabinol (Δ9‐THC), cannabidiol, cannabinol, and cannabichromene contributes to the medicinal effects of the cannabis plant. These compounds are also involved in the treatment of various types of cancer, epilepsy, and Parkinson's disease displaying several mechanisms of action. Cannabis sativa is a plant with significant pharmacological potential. However, several aspects of the plant need an in‐depth understanding of the drug mechanism and its interaction with other drugs. Only after addressing these health concerns, legalization of cannabis could be utilized to its full potential as a future medicine. [ABSTRACT FROM AUTHOR]

Background: Lichen scrofulosorum (LS) represents immunologic reaction to the Mycobacterium tuberculosis antigen and presents with subtle, asymptomatic, grouped follicular papules over the trunk and shows good therapeutic response to antitubercular drugs. Objective: To study the clinical and epidemiological characteristics of patients diagnosed with LS. Materials and Methods: A single‐center retrospective review of patients diagnosed with LS from 1997 to 2018 was conducted. The data pertained to clinico‐epidemiological profile, BCG vaccination, Mantoux positivity, laboratory investigations, coexistent focus of tuberculosis, and response to antitubercular treatment (ATT). Results: LS cases constituted 15.2% (221/1458) of all the patients diagnosed with cutaneous tuberculosis (CTB). Of these, 156 (70.5%) were pediatric patients. All patients presented with multiple follicular and perifollicular grouped papules. The trunk was the most common site involved (98.6%), followed by lower limb (25.33%), upper limb (15.83%), face (5%), and external genitalia (3.6%). Evidence of BCG vaccination and Mantoux test positivity was observed in 52.03 and 83.2%, respectively. Coexistent TB focus was detected in 134 (60.6%) patients in lymph nodes, lungs, abdomen, and unusual sites such as intracranial, endometrium, and eye. Twenty‐eight patients (12.66%) had coexistent other clinical forms of CTB. Clinical diagnosis of LS was confirmed on histology that revealed chiefly periappendageal epithelioid cell granuloma. Response to ATT was good with complete resolution of lesion in 8–12 weeks. Conclusion: LS appears to be an underdiagnosed entity. Subtle and asymptomatic lesions of LS are often missed, thereby necessitating a high index of suspicion and appropriate evaluation of the underlying TB focus. [ABSTRACT FROM AUTHOR]

The article focuses on a study which evaluated the effect of hand hygiene practices followed by healthcare workers on the development of hand eczema during the COVID-19 pandemic. The cross-sectional survey was conducted using Google forms questionnaire related to the demographic profile of the participants, specialty, posting, hand hygiene followed, changes observed in the skin of hands and use of moisturizers. Majority of the participants exhibited signs and symptoms of eczema.

Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture the gold standard diagnostic method takes several weeks and has poor yields. Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. Our main objective is to document the evolution of trichoscopic features with treatment and their correlation with clinical parameters in patients of TC. Forty‐six and 52 children with clinically diagnosed TC that was confirmed by potassium hydroxide microscopy, received griseofulvin and terbinafine, respectively. Recruited children were subjected to clinical and trichoscopic assessment by calculation of CASS (clinical assessment severity score) and counting of TAHC (Total Altered hair count; negative and positive), respectively, at baseline and follow‐up at 2, 4, and 6 weeks. McNemar, Wilcoxon singed ranked test and Spearman‐rho correlation of various parameters was evaluated. Follow‐up trichoscopy revealed significant (p < 0.009) disappearance of negative TAHC like black dot (second week onward), corkscrew, horseshoe and zigzag hair at 4 weeks and short broken hair, erythema telangiectasia hemorrhage (ETH) resolved at 6 weeks. Positive TAHC (regrowing hair) shows significant increase at 6 weeks (p < 0.001). CASS and negative TAHC showed significant difference at 4 weeks (p < 0.001) by analyzing boxplot graph. Therefore, trichoscopic resolution occurred before the clinical cure. Terbinafine subjects showed a higher clinical cure rate at 4 weeks (p = 0.02) as compared to griseofulvin. To conclude, trichoscopy is a good monitoring tool that could document the disappearance of almost all dystrophic hair at 4 to 6 weeks and is a more sensitive tool than microscopic examination. Regrowing hair and perifollicular scaling are markers of recovery. [ABSTRACT FROM AUTHOR]

Background: Muscle wasting and unintentional weight loss (cachexia) have been associated with worse outcomes in heart failure (HF), but timely identification of these adverse phenomena is difficult. Spot urinary creatinine may be an easily accessible marker to assess muscle loss and cachexia. This study investigated the association of urinary creatinine with body composition changes and outcomes in patients with new‐onset or worsening HF (WHF). Methods: In BIOSTAT‐CHF, baseline spot urinary creatinine measurements were available in 2315 patients with new‐onset or WHF in an international cohort (index cohort) and a validation cohort of 1431 similar patients from Scotland. Results: Median spot urinary creatinine concentrations were 5.2 [2.7–9.6] mmol/L in the index cohort. Median age was 69 ± 12 years and 73% were men. Lower spot urinary creatinine was associated with older age, lower height and weight, worse renal function, more severe HF, and a higher risk of >5% weight loss from baseline to 9 months (odds ratio = 1.23, 95% CI = 1.09–1.39 per log decrease; P = 0.001). Spot urinary creatinine was associated with Evans criteria of cachexia (OR = 1.26 per log decrease, 95% CI = 1.04–1.49; P = 0.016) and clustered with markers of heart failure severity in hierarchical cluster analyses. Lower urinary creatinine was associated with poorer exercise capacity and quality of life (both P < 0.001) and predicted a higher rate for all‐cause mortality [hazard ratio (HR) = 1.27, 95% CI = 1.17–1.38 per log decrease; P < 0.001] and the combined endpoints HF hospitalization or all‐cause mortality (HR = 1.23, 95% CI = 1.15–1.31 per log decrease; P < 0.001). Significance was lost after addition of the BIOSTAT risk model. Analyses of the validation cohort yielded similar findings. Conclusions: Lower spot urinary creatinine is associated with smaller body dimensions, renal dysfunction, and more severe HF in patients with new‐onset/WHF. Additionally, lower spot urinary creatinine is associated with an increased risk of weight loss and a poorer exercise capacity/quality of life. Urinary creatinine could therefore be a novel, easily obtainable marker to assess (risk of) muscle wasting in HF patients. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease (COVID-19) pandemic has affected stroke care globally. In this study, we aim to evaluate the impact of the current pandemic on racial disparities among stroke patients receiving mechanical thrombectomy (MT). Methods We used the prospectively collected data in the Stroke Thrombectomy and Aneurysm Registry from 12 thrombectomy-capable stroke centers in the US and Europe. We included acute stroke patients who underwent MT between January 2017 and May 2020. We compared baseline features, vascular risk factors, location of occlusion, procedural metrics, complications, and discharge outcomes between patients presenting before (before February 2020) and those who presented during the pandemic (February to May 2020). Results We identified 2083 stroke patients: of those 235 (1 1.3%) underwent MT during the COVID-19 pandemic. Compared with pre-pandemic, stroke patients who received MT during the pandemic had longer procedure duration (44 vs 38 min, P=0.006), longer length of hospitalization (6 vs 4 days, P<0.001), and higher in-hospital mortality (18.7% vs 11%, P<0.001). Importantly, there was a lower number of African American patients undergoing MT during the COVID-19 pandemic (609 (32.9%) vs 56 (23.8%); P=0.004). Conclusion The COVID-19 pandemic has affected the care process for stroke patients receiving MT globally. There is a significant decline in the number of African American patients receiving MT, which mandates further investigation. [ABSTRACT FROM AUTHOR]

In the United States, Medicare's flagship Accountable Care Organization (ACO) program, the Medicare Shared Savings Program (MSSP), is under close scrutiny to improve healthcare quality and decrease costs. First-year measures, released in November 2014, reveal a wide range of financial and quality performance across MSSP participants. In this observational study, we used 2013 results for 220 participating ACOs to assess key characteristics associated with generating savings. ACOs with higher baseline expenditures were significantly more likely to generate savings than lower cost ACOs. Average quality scores for ACOs that successfully reported on quality were not different between organizations that did and did not generate savings. These findings suggest ACOs that had lower utilization prior to program enrollment are less likely to be rewarded in the current program. This has important policy implications for the MSSP's ability to attract and retain efficient ACOs and incent efforts to reduce waste and improve quality. [ABSTRACT FROM AUTHOR]

Background In response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied. Methods A prospective international study was launched at the initiation of the COVID-19 pandemic. All included centers participated in the Stroke Thrombectomy and Aneurysm Registry (STAR) and Endovascular Neurosurgery Research Group (ENRG). Data was collected during the peak months of the COVID-19 surge at each site. Collected data included patient and disease characteristics. A generalized linear model with logit link function was used to estimate the effect of general anesthesia (GA) on in- hospital mortality and discharge outcome controlling for confounders. Results 458 patients and 28 centers were included from North America, South America, and Europe. Five centers were in high- COVID burden counties (HCC) in which 9/104 (8.7%) of patients were positive for COVID-19 compared with 4/354 (1.1%) in low-COVID burden counties (LCC) (P<0.001). 241 patients underwent pre- procedure GA. Compared with patients treated awake, GA patients had longer door to reperfusion time (138 vs 100 min, P=<0.001). On multivariate analysis, GA was associated with higher probability of in- hospital mortality (RR 1.871, P=0.029) and lower probability of functional independence at discharge (RR 0.53, P=0.015). Conclusion We observed a low rate of COVID-19 infection among stroke patients undergoing MT in LCC. Overall, more than half of the patients underwent intubation prior to MT, leading to prolonged door to reperfusion time, higher in-hospital mortality, and lower likelihood of functional independence at discharge. [ABSTRACT FROM AUTHOR]

Background: The high incidence, chronicity, frequent recurrences and severity of hand eczema leads to a massive impact on the quality of life. Despite great medical and socioeconomic importance, there is a paucity of data that addresses the cost of illness and economic factors associated with hand eczema. Most of the studies have originated from Europe and none have been reported from India.Aim: To analyze the clinical subtype, the pattern of contact sensitization and the impact of severity of disease on the quality of life and cost of illness in patients of hand eczema.Methods: Hundred patients of hand eczema were recruited and evaluated for morphological patterns of the condition, hand eczema severity index and quality of life (Dermatology Life Quality Index questionnaire). All patients were subjected to patch tests with Indian standard series, cosmetic series and personal or work-related products. The economic burden of hand eczema was measured by both its direct and indirect costs.Results: Morphologically, chronic dry fissured eczema 36 (36%) was the most common pattern followed by mixed type 19 (19%), hyperkeratotic palmar eczema 15 (15%), vesicular eczema with recurrent eruption 9 (9%), nummular eczema 7 (7%) and wear and tear dermatitis 7 (7%). Seventy nine patients gave positive patch test results. Etiological profile of the most common allergens, as established with a patch test, include potassium dichromate 18 (18%) followed by cetrimonium bromide 17 (17%), nickel 16 (16%), gallate 14 (14%), garlic 9 (9%) and patient's own product 8 (8%). Allergic contact dermatitis was the most common clinical pattern of hand eczema seen in 45 (45%) patients, followed by an irritant 14 (14%) and a combination of both 13 (13%). The average total cost of illness was INR 13,783.41 (0-93,000) per individual per year with an average direct cost of INR 2,746.25 ± 1,900 and indirect cost of INR 4911.73 ± 13237.72, along with a positive correlation with the Dermatology Life Quality Index (P = 0.00). The hand eczema severity index was marginally correlated with direct costs (P = 0.07) and highly correlated with indirect costs (P = 0.024).Conclusion: Hand eczema has a huge impact on the quality of life and economic consequences.Limitations: In our study, parameters like Dermatology Life Quality Index and hand eczema severity index could have been affected by the chronicity of disease as being a tertiary referral centre, most of the recruited patients had severe and persistent hand eczema at the time of visit. Also, cost of illness was based on retrospective calculations on recall basis. [ABSTRACT FROM AUTHOR]