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Workshops or training sessions on medical writing and publishing exist worldwide. We aimed to evaluate published articles about such workshops and examine both the content and teaching strategies employed. We searched ISI Web of Science, Ovid EMBASE, ERIC, Ovid Medline, and the grey literature. We considered no language, geographical location, or time period limitations. We included randomized controlled trials, before–after studies, surveys, cohort studies, and program evaluation and development studies. We descriptively reported the results. Out of 222 articles that underwent a full-text review, 30 were deemed eligible. The educational sessions were sporadic, with researchers often developing their own content and methods. Fifteen articles reported teaching the standard structure of medical articles, ten articles reported on teaching optimal English language use for writing articles, nine articles discussed publication ethics issues, and three articles discussed publication strategies to enhance the chance of publication. Most reports lacked in-depth descriptions of the content and strategies used, and the approach to those topics was relatively superficial. Existing workshops have covered topics such as the standard structure of articles, publication ethics, techniques for improving publication rates, and how to use the English language. However, many other topics are left uncovered. The reports and practice of academic-teaching courses should be improved.

This article examines the jurisdictional status of the internet. Because of the underly ing nature of technology, nations cannot effectively monitor online transactions that originate or conclude within their borders. Governments can seek to enforce their laws within the constraints of their physical, geographical, and political domains as defined by an atlas, but a borderless cyberworld regulated by fast -expanding technology has a variety of challenges. This study sheds light on those challenges, the jurisdiction for parties to suit, the remedies accessible to them, and the territorial concerns discussed in various domestic courts. It also focuses on the pressures on stakeholders to act, as well as the economic, human rights, and techno logical infrastructure implications of jurisdictional concerns. In general, jurisdictional issues on the internet have resulted in haphazard and unrestricted jurisdictional implementations, and this article emphasizes the territorial difficulties of internet administration and its direct influence on many nations and elements.

Objective: Parent peer advocacy, mentoring, and support programs, delivered by parents with lived child protection (CP) experience to parents receiving CP intervention, are increasingly recognized internationally as inclusive practices that promote positive outcomes, but little is known about what shared characteristics exist across these types of programs and what variations may exist in service delivery or impact. This scoping review examines 25 years (1996–2021) of empirical literature on these programs to develop a systematic mapping of existing models and practices as context for program benefits and outcome achievement. Method: Studies were selected using a systematic search process. The final sample comprised 45 publications that addressed research on 24 CP-related parent peer advocacy and support programs. Data analysis explored how programs were studied and conceptualized and examined their impact on parents, professionals, and the CP system. Results: Substantial variation in program settings, target populations, aims, advocate roles, and underlying theoretical frameworks were identified. Across program settings, existing empirical evidence on impact and outcomes also varied, though positive impacts and outcomes were evident across most settings. Conclusions: Findings from this review highlight the need to account better for parent peer advocacy and support program variations in future practice development to ensure alignment with inclusive and participatory principles and goals. Future research is also needed to address current knowledge gaps and shed light on the impact of these differences on individual, case, and system outcomes.

Lysimeters are often used in research concerning nutrient leachate all over the globe. However, due to factors such as Florida's high water table (a condition when the water level stays relatively close to the soil surface) in some production areas, the assessment and collection of leachate are not feasible. Another obstacle to the use of lysimeters in field research is the fact that several types of irrigation methods are used in Florida (e.g., subirrigation with seepage or drain-tile, overhead, microsprinkler, and drip irrigation) requiring different strategies for leachate assessment. This publication focuses on the use of crop models as alternatives to estimate nitrate leaching from cropping systems at a field scale. This publication's target audience is growers, extension agents, crop consultants, representatives of the fertilizer industry, state and local agencies, students, instructors, researchers, and interested Florida citizens.

The genus, Cicer, accomodate chickpeas which offer a highly nutritious profile for human wellness. In this study, we hydrolyzed different species of Cicer seed proteins using various proteolytic enzymes to determine DH, antioxidant, ACE-I inhibitory and anti-inflammatory activity. The alcalase hydrolysis experimented for 120 minutes achieved maximum peptide content. And subsequent size fractionation of peptide by G-50 gel filtration column chromatography showed an enhancement in bioactivity. The alcalase hydrolysate demonstrated highest ACE inhibition (66.18 ± 2.65%, 64.22 ± 1.32%, and 60.19 ± 1.46%) in Cicer arietinum, Cicer reticulatum, and Cicer echinospermum, respectively. Furthermore, alcalase hydrolysate showed promising antioxidant efficacy measured by various techniques. Hyaluronidase inhibition was moderate, while lipoxygenase inhibition of alcalase hydrolysate showed an elevated response (IC50 = 32.6 ± 1.4 μg/ml for C. arietinum). Among all proteases, alcalase generated maximum degree of hydrolysis, resulting in peptides that exhibited significantly improved bioactivity.

Objective: The objective of the study is to identify the social determinants of cervical cancer screening among women aged 35-44 in Haiti. Methods: We used Haiti’s Demographic and Health Survey data to identify social determinants of cervical cancer screening in Haiti among women aged 35-64. Results: We found that higher education attainment and household wealth were significantly associated with cervical cancer screening: higher education (AOR = 4.94, CI: 2.46-9.89) and secondary education (AOR = 2.28, CI:1.44-3.61); “richest” (AOR = 8.15, CI:3.97-16.72), “richer” (AOR = 4.38, CI:2.23-8.59), and “middle” (AOR =2.90, CI:1.53-5.49). Conclusion: Cervical cancer screening efforts should prioritize disadvantaged groups to address health disparities, strengthen access to screening, and provide optimal care.

This article explores the concept of Industrial Heritage and its relevance within the Indian context. Conservation in India has unique challenges arising out of the limited protection framework, the complexity of heritage resources and limited awareness and priority. The main issues confronting the preservation of Industrial Heritage sites in India are related to its lack of identification as a cultural resource and lack of awareness in local communities due to their perception and attitudes towards it. But the question has remained as to how to generate public opinion towards the need to preserve and promote our industrial heritage in a holistic manner, for its conservation as a cultural legacy and part of our identities in this globalizing world. This article explores the challenges in documenting, protecting, restoring, and managing Industrial Heritage sites in India, drawing upon personal experience of the last 27 years in attempting to conserve them.

Users are now able to actively interact with images and pose different questions based on images, thanks to recent developments in artificial intelligence. In turn, a response in a natural language answer is expected. The study discusses a variety of datasets that can be used to examine applications for visual question-answering (VQA), as well as their advantages and disadvantages. Four different forms of VQA models—simple joint embedding-based models, attention-based models, knowledge-incorporated models, and domain-specific VQA models—are in-depth examined in this article. We also critically assess the drawbacks and future possibilities of all current state-of-the-art (SoTa), end-to-end VQA models. Finally, we present the directions and guidelines for further development of the VQA models.

Frailty is common in end stage renal disease (ESRD) and is a marker of poor outcomes. Its prevalence increases as chronic kidney disease (CKD) progresses. There are different measurement tools available to assess frailty in ESRD. The pathogenesis of frailty in ESRD is multifactorial including uraemia and dialysis related factors. In this current review, we discuss the importance of frailty, its pathogenesis, screening methods, prognostic implications and management strategies in context of ESRD. Resumen: La fragilidad es común en la enfermedad renal en etapa terminal (ESRD) y es un marcador de malos resultados. Su la prevalencia aumenta a medida que avanza la enfermedad renal crónica (ERC). Hay diferentes herramientas de medición disponibles para evaluar la fragilidad en la ERT. La patogenia de la fragilidad en la ESRD es multifactorial que incluye uremia y factores relacionados con la diálisis. En esta revisión actual, discutimos la importancia de la fragilidad, su patogénesis, métodos de cribado, implicaciones pronósticas y estrategias de manejo en el contexto de la ESRD.

Antecedentes y Objetivos: Se realizó una encuesta transversal que incluyó 38 preguntas sobre demografía, estado clínico, cambio de hábitos de salud, tratamientos médicos a pacientes cardiometabólicos en seguimiento ambulatorio. Un total de 13 países latinoamericanos inscribieron pacientes del 15 de junio al 15 de julio de 2020. Método: Los países se dividieron en 3 regiones geográficas Región 1 (NCCR): Región Norte, Centro y Caribe; Región 2 (AR): Región Andina; Región 3 (SCR): Región Cono Sur. Las medidas de aislamiento se estimaron a partir de informes nacionales y se correlacionaron utilizando el coeficiente R de Spearman. Se analizaron 4.216 pacientes, NCCR (33.82%); AR (32.23%) SCR (33.94%). Resultados: Se encontraron diferencias significativas entre regiones. Este análisis de la medicación habitual mostró que la discontinuación de la medicación fue mayor en RA, llegando a casi el 30% (p < 0.001). El principal hallazgo de este estudio fue el impacto negativo que tienen las medidas restrictivas sobre la adherencia a la medicación y la actividad física, Rs = 0.84 (p = 0.0003) y Rs = 0.61 (p = 0.0032), respectivamente. Se encontraron diferencias significativas entre regiones. AR es la región más vulnerable. Conclusiones: Las medidas restrictivas impuestas por los diferentes países (cuarentena) mostraron una correlación positiva con la interrupción de la medicación y una correlación negativa con la cantidad de actividad física. El impacto de las consecuencias que deja esta pandemia será muy profundo en la mayoría de los países latinoamericanos.

Background: There has been a significant increase in the cases of skin cancer throughout the world in the last few decades. Sun exposure and photoprotection-related behavior and knowledge are important aspects in the prevention of skin cancer. Despite various recommendations advising individuals to reduce their sunexposure, many people still do not utilize these sunprotection strategies. Aims and Objectives: To assess the knowledge, attitude and practices about sun exposure and sunscreen usage in outpatients attending a dermatology clinic Materials and Methods: Three hundred consecutive patients attending a dermatology clinic were enrolled for this questionnaire-based cross-sectional, descriptive study. Results: A total of 300 patients, comprising of 112 (37.33%) men and 188 (62.67%) women, aged between 14 and 78 (mean 47.13) years, were included in the study. Majority of the patients, 216 (72%) were in the 20-60 year age group and 226 (75.33%) belonged to an urban background. Assessment of the sunexposure revealed that 224 (74.67) respondents reported daily sunexposure whereas 76 (25.33%) had occasional sunexposure. Assessment of the knowledge revealed that 241 (80.33%) patients were aware of the adverse effects of excessive sunexposure but only 139 (46.33%) were aware of the carcinogenic effect of sunlight. A total of 212 (70.67%) respondents were aware of the benefits of sunscreens but only 156 (73.58%) were using the sunscreens. Sixty one respondents (39.1%) reported that they used sunscreens on a daily basis while 95 (60.89%) used it occasionally. Lack of awareness was the most common reason (44.67%). Newspapers (47%) and television (39%) were the most common source of information in our respondents. Conclusions: Information, education, and communication activities are imperative to educate people regarding the risks of excessive sunexposure and significance of preventive measures like sunscreens to bridge the gaps in their knowledge. While improvement in individual economic status and education remains highly desirable, mass media can play a pivotal role in creating awareness among masses.

Deep marine microorganisms survive under extreme ecological settings and harsh environmental conditions of low temperature, high salinity, and high atmospheric pressure making it significant of scientific interest. Southern Ocean (SO) is one such example of deep marine ecosystem and the microorganisms inhabiting in such hostile environment may produce different bioactive secondary metabolites. SO (Indian Sector) is relatively less documented in terms of microbial composition and community dynamics. The present study involves isolation of exopolysaccharides (EPSs) from three potent SO (Indian Sector) bacteria, optimization of the EPS production and partial characterization of them. Three different EPSs show varying structural conformation, that is from porous to strong flakes mimicking polymeric structure with C/N ratio ranging between 4 - 11. FTIR spectra have exhibited the presence of different active groups of carbohydrate moieties, water molecules and protein-associated amides. EPSs produced by marine microorganisms show high biotechnological promises such as drug carrier in pharmaceutical field, emulsifier and cryo- protectant in food-processing industry, detoxification of petrochemical oils and much more. The three bacterial isolates in this study showed potential of producing EPS biopolymer that can be further explored in terms of its proper biotechnological applications.

Sociological transactions play an important role in human behaviour and social standing. The Titanic was the perfect example as the passengers belonged to high income, middleincome, and low-income groups. It is interesting to see how social factors influenced who was going to survive. The data was collected from the website “Kaggle.com”, and machine learning algorithms were applied after carrying out an exploratory and visual analysis. The hypothesis that women and children were saved (which became famous after Steven Spielberg’s Titanic (1975)) was tested by random forest algorithm as well as the hypothesis that family density played a major role in survival. The results showed that title and sex were the most important factors influencing if the passenger was to survive. RESUMEN Las transacciones sociológicas cumplen un papel importante en el comportamiento humano y la posición social. El Titanic era la paradoja perfecta ya que los pasajeros pertenecían a grupos de altos ingresos, de ingresos medios y de bajos ingresos. Es interesante ver cómo los patrones en el sentido sociológico decidieron cómo iba a sobrevivir. Los datos fueron recolectados del sitio web “Kaggle.com” y se aplicaron algoritmos de aprendizaje automático después de un análisis visual y exploratorio. La hipótesis, las mujeres y los niños se salvaron y se hicieron famosos después de que la película Titanic de Steven Spielberg (1975) se pusiera a prueba mediante un algoritmo forestal aleatorio junto con la hipótesis de que la densidad familiar desempeñaba un papel importante en la supervivencia. El resultado enumeró ese título y el sexo fue el factor más importante que decidió la tasa de supervivencia de los pasajeros.

Background: Hair dye usage is extremely common all over the world. Hair dyes have been reported to cause a wide range of adverse effects, therefore, the consumer’s knowledge about hair dyeing and related side effects are important. Aim: To assess the knowledge, attitude and practices of general population towards the use of hair dyes. Materials and Methods: Two hundred and fifty consecutive persons using hair dyes were enrolled for this questionnaire-based cross-sectional, descriptive study. Results: These 250 patients comprised 141 men (56.4%) and 109 women (43.6%) (M: F 1.29:1), aged between 16 and 74 (mean 47.13) years. The majority, 212 patients (84.8%) were aged between 20–60 years and 66.4% (n=166) belonged to an urban background. When asked about the reason for using hair color, the principle reason was “to look younger” (59.6%, n=149). Most of the respondents were using synthetic hair dye preparations (55.2%, n=138) and when asked about the brand of hair dye being used, 25.2% (n=63) did not know about the brand they were using. When asked about their perception regarding safety of HD, 61% (n=152) respondents agreed that hair dyes are not safe and on being asked about the carcinogenic potential of HD, only 24% (n=60) respondents agreed. When enquired about the safest variety of HD, majority of respondents (52.4%, n=131) believed that plant based hair colors are the safest. When asked about the safety of HD during pregnancy and lactation, 68% (n=168) of the respondents were unaware regarding this aspect. 14.4% of the respondents reported suffering from some adverse effects due to hair dye use but only 11.11% (n=4) of those stopped using hair dyes. Conclusions: There is lack of awareness about the hair dyes and their adverse effects in the general population. There is an urgent need to increase awareness among consumers regarding the adverse effects of hair dyes and the available safer alternatives. Limitations: Small number of respondents and the use of a convenience sample, which might not be representative of the whole community.

Sir, We read with interest the case report “Endocarditis bacteriana por Kocuria kristinae en un paciente inmunocompetente. Reporte de caso” by S.M. Rojas Molina, et al1 . The authors described about the Kocuria kristinae endocarditis in an immunocompetent woman. We agree that Kocuria kristinae is a rare organism and endocarditis caused by this organism is worth mentioning. However, there are certain questionable points in the report which we would wish to highlight and which need clarification.

Background: Geriatric health care has assumed worldwide importance due to increase in the life expectancy during the last few decades. Aging skin has a marked susceptibility to dermatologic disorders due to the structural and physiologic changes that occur as a consequence of intrinsic and extrinsic aging. Aim: This study was aimed to evaluate the magnitude, pattern, contributory factors and systemic association of various dermatoses among geriatric population. Materials and Methods: Patients aged 60 years and above attending the dermatology outpatient department during a period of one year were enrolled in the study. Detailed history taking followed by general, systemic and cutaneous examination, and relevant investigations were carried out. The findings were recorded in a proforma for analysis and interpretation of data. Results: Out of total 610 patients enrolled, 68.2% were males and 31.8% females. The male to female ratio was 2.14:1. Maximum (339; 55.6%) number of patients were in the age group of 60-69 years. Wrinkling (273; 44.8%) was the commonest physiological cutaneous finding. Among the pathological changes, benign tumors (620; 39.9%), nevus (253; 16.3%), infection and infestation (244; 15.7%), dermatitis (158; 10.1%), pruritus (78; 5.0%), pigmentary disorders (67; 4.3%) and papulosquamous disorders (62; 4.0%) were common conditions. Associated systemic illness was recorded in 180 (29.5%) patients, of which hypertension (96; 15.7%) was the commonest. Conclusion: With the expected increase in the geriatric population in the coming years, the dermatological problems in geriatric population assume great importance. Our study shows that physiological changes seen with ageing such as wrinkling, senile purpura, xerosis, senile comedone, atrophy and senile lentigens are major cutaneous findings. Eczemas of various types and fungal and bacterial infections are the common dermatological morbidities. These dermatological morbidities in geriatric population can be minimized by reassurance, regular use of emollients and proper education regarding routine care of skin.

Background: Membranoproliferative glomerulonephritis (MPGN type I, II and III) was reclassified in 2013 as MPGN and C3 glomerulopathy (C3G) based on the complement system activation mechanism. Objectives: To evaluate whether C4d, a component of the classical pathway, could be a diagnostic tool in differentiating between MPGN and C3G. Methods: We conducted a retrospective study of 15 MPGN type I, II and III and 13 minimal change disease (MCD) patients diagnosed between 2000 and 2012. C4d staining using the peroxidase method was employed. Results: Using the 2013 C3G consensus classification, the 15 MPGN types I, II and III biopsies were re-classified as MPGN (8) and C3G (7). Following C4d staining, of the 8 biopsies diagnosed as MPGN, 4 had classical pathway involvement [C1q (+), C3 (+), C4d (+)]; two had lectin pathway involvement [C1q (−), C3 (+), C4d (+)]; and, two were reclassified as C3G because the absence of C4d and C1q suggested the presence of the alternative pathway [C1q (−), C3 (+), C4d (−)]. Three of the seven C3G biopsies presented classical pathway involvement and were reclassified as MPGN. The alternative pathway was present in one of the other 4 biopsies considered to be C3G. Two C3G biopsies involved the lectin pathway and the one case of dense deposit disease had lectin pathway involvement. Conclusions: C4d staining may help to differentiate between MPGN and C3G. In addition, the lectin pathway could play a role in the pathogenesis of these glomerulopathies.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, reactive vaso-proliferative disease, presenting with painless, vascular nodules in the dermal and subcutaneous tissues, sually seen in the head and neck region. It is characterized clinically by single to multiple red brown dome shaped papules or subcutaneous nodules. Its etiology is unknown and the histology is characterized by hyperplastic blood vessels lined by a hypertrophic endothelium with an inflammatory infiltrate rich in eosinophils. We report three cases of ALHE presenting over the ears and scalp.

Con motivo del 20º aniversario del Informe sobre el Desarrollo Mundial 1993, una Comisión de la revista The Lancet reconsideró el argumento a favor de la inversión en salud y desarrolló un nuevo marco de inversión para lograr mejoras dramáticas en materia de salud para el año 2035. El informe de la Comisión contiene cuatro mensajes clave, cada uno acompañado de oportunidades para los gobiernos nacionales de países de ingresos bajos y medios y para la comunidad internacional. En primer lugar, invertir en salud acarrea enormes rendimientos económicos. Las impresionantes ganancias son un fuerte argumento a favor de un aumento en el financiamiento nacional de la salud y de asignar una mayor proporción de la asistencia oficial al desarrollo de la salud. En segundo lugar, en el modelo creado por la Comisión se encontró que es posible lograr para el año 2035 una “gran convergencia” en salud, consistente en la reducción de las tasas de mortalidad materna, infantil y por infecciones a niveles universalmente bajos. Tal convergencia requeriría la ampliación de las herramientas de salud existentes y un incremento agresivo de nuevas herramientas, y podría ser financiada en su mayor parte con recursos derivados del crecimiento económico esperado de los países de ingresos bajos y medios. La mejor manera en que la comunidad internacional puede apoyar la convergencia es financiando el desarrollo y suministro de nuevas tecnologías de salud, y frenando la resistencia a los antibióticos. En tercer lugar, las políticas fiscales –tales como los impuestos al tabaco y al alcohol– son una palanca poderosa y subutilizada que los gobiernos pueden emplear para detener el avance de las enfermedades no transmisibles (ENT) y las lesiones, a la vez que elevan los ingresos públicos para la salud. La acción internacional sobre las ENT y lesiones debería enfocarse en proporcionar asistencia técnica sobre políticas fiscales, en cooperación regional para el combate al tabaquismo y en financiar investigación sobre políticas e implementación para ampliar las intervenciones que enfrenten estos problemas. En cuarto lugar, la universalización progresiva –una vía hacia la cobertura universal de salud (CUS) que incluya desde el comienzo a los pobres– es una manera eficiente de lograr la protección a la salud contra riesgos financieros. Para los gobiernos nacionales, la universalización progresiva produciría elevadas ganancias en salud por cada dólar que se gaste en ésta, y los pobres serían quienes más ganarían en términos tanto de salud como de protección financiera. La mejor manera en que la comunidad internacional puede brindar apoyo a los países para implementar una CUS progresiva es financiando la investigación sobre políticas e implementación, por ejemplo, sobre la mecánica del diseño e instrumentación de la evolución del paquete de beneficios conforme crezca el presupuesto para las finanzas públicas.

Introduction: There is paucity of data on efficacy of isotretinoin versus methotrexate in psoriasis patients. Aims: We compared the efficacy and safety of once a week methotrexate and daily isotretinoin for the treatment of moderateto-severe chronic plaque psoriasis. Methods: 43 (M: F 30:13) consenting patients having moderate-to-severe chronic plaque psoriasis were divided on alternate basis in Group-A for treatment with methotrexate (15mg/week) and Group-B for isotretinoin (30mg/d) therapy. The clinical response was assessed by the percentage reduction in the baseline PASI scores during next 12 weeks. Results: 14 patients in Group-A and 11 patients in Group-B completed the study. The mean percentage reduction in the PASI score was 79.78 ± 20.68 in the methotrexate group and 51.92 ± 23.83 in the isotoin group at the end of 12 weeks. Five patients in Group-A achieved >75% reduction in the PASI score, while only 3 patients in Group-B showed similar results at the end of 12 weeks signifying faster disease clearance with methotrexate. Isotretinoin-related serious adverse effects were fewer and did not warrant treatment discontinuation. Conclusions: Isotretinoin may be an option for alternative therapy in patients who cannot afford acetretin, are intolerant to methotrexate, have achieved its cumulative dose, or in rotational therapy

Cyathodium is a thalloid marchantialean liverwort with five species reported for the Neotropics. Three species that occur in Panama (C. bischlerianum, C. spruceanum, C. cavernarum) and one from Costa Rica (C. foetidissimum) were studied chemically. Female and male plants of the dioecious C. spruceanum were very similar in their chemical composition except for two compounds that were found only in female plants. All samples of C. spruceanum and C. bischlerianum contained, in less than three percent, the sesquiterpenes germacrene D and bicyclogermacrene. The presence of these compounds suggests a close affinity between these two species. Cyathodium bischlerianum contained mainly aromatic monoterpenes with nerolidol as the main compound. Cyathodium cavernarum also had a very distinct chemical composition with an octane derivative as its major compound. Indole compounds were found only in C. foetidissimum. The presence of these compounds in plants from Costa Rica and Tahiti suggests that they could be considered as potential chemosystematic markers for the species. Based on their chemical composition there is a clear distinction between the four species of Cyathodium studied. The chemistry of these species supports previous morphological and genetic studies. Only two compounds could be identified in Leiosporoceros dussii. There is a need for additional genetic and chemical studies on neotropical Cyathodium and Leiosporoceros. Key

Plasmoacanthoma and plasma cell cheilitis are rare disorders of obscure etiology characterized by a plasma cell infiltrate an 80-year-old woman presented with a verrucous, fleshy, skin colored plaque over lips, gingiva, and the palate and painful swallowing for over a period of 6 months. Histopathology of the lesion showed dense infiltrate of plasma cells. The lesions resolved completely after intralesional triamcinolone acetonide. Another 52-year-old male had progressively enlarging, erosive lesion over vermilion border of lower lip for 6months resembling actinic cheilitis. Histology was diagnostic of plasma cell cheilitis. Treatment with topical clobetasol propionate was effective. Plasma cell cheilitis and plasmoacanthoma perhaps represent a spectrum of oral ”plasma cell mucositis” with plasmoacanthoma being an advanced version of the former.

Down’s syndrome is a common chromosomal anomaly characterized by mental retardation and distinct physical appearance. It is associated with a large variety of dermatological disorders like anetoderma, cheilitis, cutis marmorata, elastosis perforans serpiginosa, fissured and geographic tongue, onychomycosis, palmoplantar hyperkeratosis, psoriasis, syringomas, alopecia areata and vitiligo. Syringomas are benign adnexal tumors which have been reported to occur with higher frequency among patients with Down’s syndrome. We report a case of eruptive syringomas over face and hand in an 8-year old child with Down’s syndrome.

Seborrhoeic keratoses (SKs)are common skin lesions that occur with increasing age. Usually they have a benign course but varying degrees of squamous atypia have been seen. Bowenoid transformation of benign SKs into squamous cell carcinoma in situ has been documented but the development of basal or squamous cell carcinoma in a seborrhoeic keratosis is rare. Herein, we report a case of squamous cell carcinoma arising over a long-standing seborrhoeic keratosis in 70-year old male, which was managed with a wide surgical resection.

La componente nacionalista del cine indio ha estado siempre a la orden del día y sigue estándolo en la actualidad, ya sea en el marco de películas bélicas, anticolonialistas o, simplemente, que apelan de manera enfática a la vigencia y pervivencia de la cultura, la tradición y los valores indios en un mundo crecientemente globalizado. En los últimos años, sin embargo, muchas de estas películas han pasado relativamente desapercibidas mientras que otras, que exploran de forma consistente la asociación entre nacionalismo y desarrollismo, subrayando el enorme potencial de la India contemporánea en un cambiante contexto internacional, han cosechado grandes éxitos y se han convertido incluso en una suerte de subgénero de la producción comercial de Bollywood. Este nacionalismo de nuevo cuño, de corte abiertamente desarrollista, refleja en realidad los profundos cambios que se están produciendo actualmente en la sociedad india y está en consonancia con las grandes transformaciones a que está sometido también el mercado cinematográfico indio, cada vez más estratificado y dependiente para sus rendimientos de sectores acomodados y aun diaspóricos del público.Palabras clave: Bollywood, nacionalismo, desarrollismo, orientalismo, público.AbstractThe nationalist factor has been a constant presence in Indian cinema and continues to be so to this day, be it in war films, anticolonial movies or simply in those films that stress the validity and permanence of the Indian values, culture and traditions in an increasingly globalized world. In the last few years, however, many of these movies have gone relatively unnoticed while others that explore the links between nationalism and development, underlying the enormous potential of contemporary India in an ever changing international context, have resulted in big hits and have become a sort of subgenre in the commercial production of Bollywood. This new brand of nationalism-cum-developmental undertones reflects the profound changes that are taking place in the Indian society, and runs parallel to the big transformations that the Indian film market is undergoing –a market increasingly stratified and dependent on the upper urban classes and the diaspora for box office revenues.Keywords: Bollywood, Nationalism, Development, Orientalism, Audience.

This position paper has been drafted by the members of the Working Group for Children Under 6 [of Jan Swasthya Abhiyan (People’s Health Movement India) and the Right to Food Campaign]. It was published in abridged form as a letter to the editor in Economic and Political Weekly, January 2, 2016;Vol 2, No 1 under the title Hunger and Structural Inequality

Objetivo: Las mediciones orbitofaciales y orbitales del feto pueden ser útiles para el diagnóstico precoz prenatal de malformaciones craneofaciales. La mayoría de los estudios anteriores se basan en la ecografía y sólo hay unos cuantos estudios basados en autopsias fetales. El Análisis detallado de los distintos parámetros puede proporcionar una base de datos útil para una rápida referencia. Métodos: En cincuenta fetos normales de edades gestacionales diferentes, se midieron los siguientes parámetros: las distancias cantales externa e interna, la longitud de la hendidura palpebral, la longitud oropalpebral, la profundidad y la anchura de la órbita y la distancia interorbital. Resultados: El análisis estadístico reveló una correlación positiva significativa de todos estos parámetros con la edad gestacional y con el diámetro biparietal. Los patrones de crecimiento de los pará-metros orbitales y orbitofacial también demostraron una correlación significativa entre sí. Conclusión: Nuestros resultados muestran que el aumento de las partes laterales de la cara y de la longitud facial vertical se produce a un ritmo más rápido en comparación con la parte media de la cara. Las desviaciones de los datos normativos generados para los parámetros orbitales y orbitofacial ayudarán en la detección precoz de síndromes genéticos específicos. Objective: Fetal orbitofacial and orbital measurements may be helpful in early prenatal diagnosis of craniofacial malformation. Most of the earlier studies are ultrasound based and there are only a few studies based on fetal autopsies. Comprehensive analysis of various parameters can provide useful database for easy reference. Methods: In fifty normal fetuses of different gestational ages, the following parameters were measured: outer and inner canthal distances, palpebral fissure length, oropalpebral length, depth and width of orbit and inter orbital distance. Results: Statistical analysis revealed significant positive correlation of all these parameters with gestational age and biparietal diameter. The growth patterns of the orbitofacial and orbital measurements also demonstrated significant correlation between these parameters. Conclusion: Our results demonstrate that the lateral parts of the face and the vertical facial length grow at a faster rate than the median part of the face. Deviations from the normative data generated for the orbitofacial and orbital parameters will help in early detection of specific genetic syndromes.

In 1553, the corpse of Jesuit missionary Francisco Xavier was declared miraculously preserved and shipped to Goa. How did the idea of his material incorruptness (through signifiers of blood, smell, and skin) get sustained over the long durée of the Estado da Índia? This paper examines a series of medical examinations (1554, 1614, 1782, 1859, 1952) that were issued to sanction this saint’s public displays or Exposições as colonial officials eventually called them. That these autopsy reports discursively lie between Catholic hagiography and Western medicine makes them compelling for understanding the changing anatomy of church and state relations in Portuguese India.

Pseudoainhum is the term applied to constricting bands around the digits or the limb which are either congenital or secondary to another disease. Progression of the constriction bands can lead to irreversible damage and autoamputation of the affected digit. Congenital pseudoainhum usually results due to amniotic bands or adhesions in utero while acquired pseudoainhum is usually secondary to trauma, neuropathy, systemic sclerosis or infections like leprosy. Psoriasis is a rare cause of acquired pseudoainhum with only five cases reported till date. We report a case of pseudoainhum secondary to psoriasis vulgaris in a 45 year old male which was successfully treated with topical corticosteroids and systemic methotrexate therapy.

Beer is a popular alcoholic beverage consumed all over the world. Type I hypersensitivity reactions like urticaria and anaphylaxis due to beer have been reported very infrequently in the literature. We report a case of a 29 year old male who presented with episodes of acute urticaria and angioedema after intake of beer while tolerating other alcoholic beverages. A positive prick test to beer was observed which confirmed the diagnosis of beer induced angioedema. On cessation of beer consumption, no recurrence was observed over a follow-up period of six months.

The International Union of Pure and Applied Chemistry (IUPAC) decidió en 2006 impulsar el estudio en América Latina de los nutracéuticos como una oportunidad científica y de interés comercial para toda la comunidad. La inciativa, impulsada por el Subcommittee on Medicinal Chemistry and Drug Development de la IUPAC, presidido por C.R. Ganellin, ha permitido unir esfuerzos de investigadores de América Latina. El proyecto se ha realizado con una presentación general del tema, que se corresponde con este trabajo, al que seguirá inmediatamente una publicación acerca de la situación concreta en diferentes países de la región. El trabajo se presenta de forma simultánea en distintas revistas de manera que se facilite el acceso a él y su siguiente discusión por parte de los interesados, en un intento de crear un clima de interés por el tema sobre la base de la investigación de conocimientos tradicionales y experiencias científicas que permitan la innovación en beneficio de todos, muy especialmente, de las sociedades productoras, así como de las personas que precisen de los compuestos

This article explores the way that “received ideas” about space and place have shaped, and continue to shape, the common sense of the anthropological task. Specifcally, we want to inquire how the renewed interest in postmodern and feminist theory about space theorization (revealed in notions such as vigilance, panopticism, simulacrum, deterritorialization, postmodern hyperspace, frontiers and marginality), has forced us to revaluate key anthropological analytical concepts such as “culture” and “cultural difference”.

Background: for advance grades of symptomatic hemorrhoids (grade III and IV) the author has innovated a procedure called radiofrequency ablation and fixation of hemorrhoids. The procedure is performed as a day care surgery. Patients and methods: the surgical technique and clinical follow-up of patients operated by this technique are presented. An Ellman dual frequency radiofrequency generator was used for ablation, which was followed by suture fixation of the hemorrhoids. Patient satisfaction score was assessed using a visual analogue scale. The results of this procedure are presented and are compared with the results of published data of stapled hemorrhoidopexy and Doppler guided hemorrhoidal artery ligation procedures. Results: between 1998 and 2005, 2,376 patients were operated with this technique. Patient's mean age was 34 years and 1,438 patients were males. The postoperative complication rate was 3.5%, which included secondary bleeding, retention of urine and perianal thrombosis. The recurrence rate was less than 1.5%. The satisfaction score was 9.2 on VAS. Conclusions: radiofrequency ablation and fixation of hemorrhoids is a technique that results in less postoperative pain, shorter hospital stay, and early return to normal activity. It seems to be a better alternative to stapled hemorrhoidopexy or Doppler guided hemorrhoidal artery ligation with regard to effectiveness and symptomatic relief on long term.

Carcinoma occurring in the cutaneous lesions of Lichen Planus though rarely mentioned in literature does occur and should be kept in mind while treating such lesions. We report a 16 year female who developed a squamous cell carcinoma in a long standing verrucous lichen planus in the lower leg. This case is being presented to indicate the possibility of malignant transformation of cutaneous lichen planus to carcinoma, especially in the hypertrophic forms and the need to have an early diagnosis so that it can be treated in the initial stages. A high degree of suspicion should be present whenever we come across a non healing lesion in a patient with lichen planus. A few markers, which may give us a clue for increased chances of malignant transformation in these cases is presented.

Globally, nearly 20 million children under five suffer from Severe Acute Malnutrition (SAM), a condition which contributes to one million child deaths annually. In India 48% of children under five years of age are stunted and 43 percent are underweight; almost 8 million suffer from SAM. Malnutrition is not a new problem in India, nor is SAM. Several hospitals and non-government organizations are engaged in community-based management of malnutrition using locally produced/procured and locally processed foods along with intensive nutrition education. These programs enable parents to meet the nutritional requirements of their children with foods that are available at low cost. The Supreme Court of India has also directed the government to universalize the Integrated Child Development Scheme and provide one hot cooked meal to children under six years of age to supplement their nutrition.

Abstract Background: Efficacy of preoxygenation depends upon inspired oxygen concentration, its flow rate, breathing system configuration and patient characteristics. We hypothesized that in actual clinical scenario, where breathing circuit is not primed with 100% oxygen, patients may need more time to achieve EtO2 ≥ 90%, and this duration may be different among various breathing systems. We thus studied the efficacy of preoxygenation using unprimed Mapleson A, Bain's and Circle system with tidal volume breathing at oxygen flow rates of 5 L.min−1 and 10 L.min−1. Methods: Patients were randomly allocated into one of the six groups, wherein they were preoxygenated using either Mapleson A, Bain's or Circle system at O2 flow rate of either 5 L.min−1 or 10 L.min−1. The primary outcome measure of our study was the time taken to achieve EtO2 ≥ 90% at 5 and 10 L.min−1 flow rates. Results: At oxygen flow rate of 5 L.min−1, time to reach EtO2 ≥ 90% was significantly longer with Bain's system (3.7 ± 0.67 min) than Mapleson A and Circle system (2.9 ± 0.6, 3.3 ± 0.97 min, respectively). However at oxygen flow rate of 10 L.min−1 this time was significantly shorter and comparable among all the three breathing systems (2.33 ± 0.38 min with Mapleson, 2.59 ± 0.50 min with Bain's and 2.60 ± 0.47 min with Circle system). Conclusions: With spontaneous normal tidal volume breathing at oxygen flow rate of 5 L.min−1, Mapleson A can optimally preoxygenate patients within 3 min while Bain's and Circle system require more time. However at O2 flow rate of 10 L.min−1 all the three breathing systems are capable of optimally preoxygenating the patients in less than 3 min.

The diabetic status of the local Jhansi patients (120 cases) was established before and after antileprosy treatment. Control studies were performed in normal healthy subjects (50 persons) without family history of diabetes mellitus. Random normals showed an incidence of diabetes only 2%, while leprosy patients (94 males and 26 females) had incidence of diabetic status of 14.2%. The highest incidence (19.3 %) of diabetes was in lepromatous leprosy and lowest incidence (6.4%) in tuberculoid leprosy patients. Repeated studies in leprosy after treatment showed not only clinical improvement for leprosy but also disappearance of the chemical and latent diabetes mellitus and lowering of blood sugar levels in manifest diabetes mellitus. Incidently it was noted that `diabetic status' was worse among males (82.3%) and with advancing age. Association and improvement of diabetic status with specific treatment would tentatively suggest that Mycobacterium leprae lesions are not confined to skin alone but somehow also related to carbohydrate metabolism. A careful management of the chemical and latent diabetes may help in clinical management of leprosy too.

A middle aged man (48 years) with short duration of illness (7 days) was admitted in the state of acute renal failure with erythema nodosum leprosum. He had repeated episodes of erythema nodosum leprosum in the past. His blood pressure was normal (150/80 mm Hg). During his hospital stay he was in the state of progressive anaemia (Hb = 8.8 g/dl to 7.2 g/dl), oliguria (urine out-put = 250-350 ml/day), azotaemia (blood urea = 198 mg/d1 to 218 mg/dl) and impaired renal function tests with fatal outcome. Kidneys were smooth, congested and weighing 150 g each with histological features of rapidly progressive (crescentric) glomerulonephritis, a result of immune complex deposition from recurrent erythema nodosum leprosum episodes.

Sixty male patients of leprosy (mean age = 27.2+5.04 years) selected at random, were studied for gonadal involvement and therapeutic efficacy of two indigenous drugs. Of these 34 were married, with the mean duration of illness 4.17+3.27 years. Only those with lepromatous and dimorphous leprosy developed testicular and epididymal changes. Testicular pain and/or swelling (lepromatous =62.5%, dimorphous 30%) was the commonest presenting feature. Altered sexual function was observed in 34 (56.6%) cases, while 11 patients revealed altered sexual hair pattern and nine gynaeco-mastia. Reduced testicular size associated with soft feel was present in 25% of cases with no testicular sensation in 8 (13.3%) and impaired testicular sensation in 9 (15%) patients. Spermogram revealed azoospermia in 19 (35%) and oligospermia in 16 (26.6%) patients. Histopathological findings of testicle biopsy revealed evidence of leprous pathology irrespective of testicular size, semen picture and clinical manifestations. Histopatho-logical changes had shown marked variation and so did not enable categorising them into vascular, interstitial and obliterative phases. These changes were believed to be due to the altered gonadal state in leprosy. The therapeutic efficacy of the indigenous preparations, Speman and Tentex forte (Himalaya) was evaluated subjectively as well as objectively in 34 patients. 823% of cases showed subjective improvement while objective improvement in spermogram was noted in 87.5% cases with oligospermia. The drugs have no side effect and were well tolerated.

This report describes the status of childhood cancer control initiatives in Latin America and the Caribbean (LAC). Progress between 2017 and 2023 is measured using the outcome indicators from the Pan American Health Organization (PAHO) childhood cancer logic model aligned with the World Health Organization Global Initiative for Childhood Cancer (GICC). This report also describes the advances, barriers, and facilitators for the implementation of the GICC at the Regional level. Methods used in this report encompassed a comprehensive approach, incorporating a literature review, interviews, surveys, and a Delphi study developed by the technical team of the PAHO Non-Communicable Diseases and Mental Health Department and by the GICC LAC working group. Since 2017, there has been a substantial increase in the number of countries that have included childhood cancer in their national regulations. Currently, 21 LAC countries are involved in the GICC implementation, activities, and dialogues. However, the objectives for 2030 will only be achieved if Member States overcome the barriers to accelerating the pace of initiative implementation. There is an urgent need to increase the efforts in childhood cancer control in LAC, especially regarding the prioritization of timely detection, essential diagnostics, access to cancer treatment, palliative care, and close follow-up of children and adolescents with cancer.

Electrical discharge machining (EDM) is mainly utilized for the die manufacturing and also used to machine the hard materials. Pure Copper, Copper based alloys, brass, graphite, steel are the conventional electrode materials for EDM process. While machining with the conventional electrode materials, tool wear becomes the main bottleneck which led to increased machining cost. In the present work, the composite tool tip comprises 80% Copper and 20% silicon carbide was used for the machining of hardened D2 steel. The powder metallurgy route was used to fabricate the composite tool tip. Electrode wear rate and surface roughness were assessed with respect to the different process parameters like input current, gap voltage, pulse on time, pulse off time and dielectric flushing pressure. During the analysis it was found that Input current (I p ), Pulse on time (T on ) and Pulse off time (T off ) were the significant parameters which were affecting the tool wear rate (TWR) while the I p , T on and flushing pressure affected more the surface roughness (SR). SEM micrograph reveals that increase in I p leads to increase in the wear rate of the tool. The data obtained from experiments were used to develop machine learning based surrogate models. Three machine learning (ML) models are random forest, polynomial regression and gradient boosted tree. The predictive capability of ML based surrogate models was assessed by contrasting the R 2 and mean square error (MSE) of prediction of responses. The best surrogate model was used to develop a complex objective function for use in firefly algorithm-based optimization of input machining parameters for minimization of the output responses.

Malassezia folliculitis is an under-recognizedentity commonly affecting the face and upper trunk. Clinical picture mimics acne vulgaris and diagnosis is challenging at times. 10% potassium hydroxide examination is usually performed to confirm the diagnosis. This study sought to describe the dermoscopic features in Malassezia folliculitis. Patients diagnosed clinically with Malassezia folliculitis and confirmed by 10% potassium hydroxide preparation were included in the study. Dermoscopy was performed with a videodermatoscope [Dinolite AM413ZT; Polarising] from the most representative lesion. A total of 45 patients (M:F = 1:0.8 ) were recruited. All patients had monomorphic papulo-pustular lesions. Itching was present in 64.4% patients. Dermoscopy reveled folliculocentricity (100%), perilesional background erythema (100%), dotted/linear/tortous vessels (88.9%), dirty white scaling (77.8%), hypo pigmentation of hair follicle (64.4%), coiled/looped hairs (57.8%) and broken hairs (13.3%).In conclusion, dermoscopy shows typical features in Malassezia folliculitis and can serve as a office based tool for identification of this entity. Resumen: La foliculitis por Malassezia es una entidad que no está debidamente reconocida y que afecta normalmente a la cara y tronco superior. El cuadro clínico remeda el acné vulgar, siendo a veces difícil su diagnóstico. Normalmente se realiza un examen con hidróxido de potasio al 10% para confirmar el mismo. El objetivo de este estudio fue describir las características dermatoscópicas de la foliculitis por Malassezia, incluyéndose en el mismo a los pacientes diagnosticados clínicamente y confirmados mediante aplicación de hidróxido de potasio al 10%. La dermatoscopia fue realizada con un videodermatoscopio [Dinolite AM413ZT; Polarising] en la lesión más representativa. Se incluyó a un total de 45 pacientes (V:M = 1:0.8). Todos los pacientes tenían lesiones monomórficas papulopustulosas. El 64% de los pacientes presentó prurito. La dermatoscopia reveló foliculocentricidad (100%), eritema circundante perilesional (100%), vasos punteados/lineales/tortuosos (88,9%), escamas de color gris parduzco (77,8%), hipopigmentación del folículo piloso (64,4%), pelos en espiral/enrollados (57,8%) y rotura del pelo (13,3%).En conclusión, la dermatoscopia muestra las características típicas de la foliculitis por Malassezia, pudiendo servir de ayuda en consulta como herramienta para la identificación de esta entidad.

In-patient hypertension is a common problem seen in the hospital setting. Current evidence-based guidelines define and address management of hypertension in ambulatory care and hypertensive emergencies in the hospital setting. However, they lack guidance for the management of acute asymptomatic/non-emergent hypertension in the hospitalised patient. The risk-benefit of treating inpatient asymptomatic hypertension is largely unknown. In this narrative review, we discuss current evidence-based perspectives to address this clinical entity. Resumen: La hipertensión de los pacientes ingresados es un problema frecuente en el ámbito hospitalario. Las directrices actuales basadas en la evidencia definen y abordan la gestión de la hipertensión en la atención ambulatoria y las urgencias hipertensivas en el ámbito hospitalario. Sin embargo, no hay orientaciones sobre la gestión de la hipertensión aguda asintomática/no urgente en el paciente hospitalizado. Se desconoce en gran medida la relación riesgo-beneficio del tratamiento de la hipertensión asintomática en los pacientes hospitalizados. En esta revisión narrativa analizamos las perspectivas actuales basadas en la evidencia para abordar esta entidad clínica.