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Residency programs that effectively utilize social media (SoMe) have the potential to distinguish themselves and improve their resident recruitment. These platforms allow programs to connect with applicants they otherwise might have limited ability to reach before the interview season. We sought to evaluate the presence of SoMe across diagnostic radiology residency programs and highlight future trends that programs should account for. A list of diagnostic radiology residency programs within the United States was obtained from the American Medical Association (AMA) FREIDA Residency Database. A search for the presence of Twitter, Facebook, and Instagram was performed for each program. Based on the analysis, the most utilized SoMe platform by diagnostic radiology residency programs was Twitter (61.73%), followed by Instagram (47.45%), and then Facebook (37.76%). Given that Twitter was the most utilized, further analysis was done to evaluate the total number of followers and the year of account creation. The results showed that the average program had 1081 ± 1438 followers and the mean year of creation was 2017 ± 2.6 years. Social media is an effective tool to disseminate information efficiently and effectively to prospective residency candidates. It is important that those involved in radiology medical education stay up to date with current and future social media trends while maintaining an active professional presence on these platforms.

Given limited exposure to radiology during the pre-clinical and clinical years, it has been challenging to recruit medical students to radiology. Now, many medical students considering radiology as a career are deterred due to misinformation surrounding how AI implementation will affect radiologists in the future. Artificial Intelligence (AI) has the potential to revolutionize the way in which medicine is practiced, especially in the field of radiology, and will ultimately support radiologists and advance the specialty. We aimed to provide a basic guide for medical students on the application of artificial intelligence in radiology, address misconceptions, highlight the role radiologists will play in AI development, and discuss the challenges faced in the future.

Introduction:This is a case study of 61 cases admitted in our hospital to study the various etiologies of vocal cord immobility (including both paralysis and paresis of vocal cord) and to study the incidence of vocal cord immobility.Vocal cord paralysis is a common symptom of the disease which can be originated from laryngeal nerve paralysis following laryngeal carcinoma, oesophageal carcinoma, bronchogenic cancers, thyroid neoplasms, surgical procedures in neck and thorax, post anaesthesia complication,or neurologic diseases. Materials and methods:The present study includes all the cases having vocal cord paralysis presenting in out-patient department of Otorhinolaryngology, examination of larynx externally,by indirect laryngoscopy and direct laryngoscopy was done.All the routine and systemic examination were done. Results:In our study, left vocal cord was the most commonly involved and was observed in 40(65.5%) patients, with neoplasm being the most common cause in 19(31.1%) patients. Right vocal cord involvement was found in 20(32.8%) patients, with neoplasm being the most common cause in 13 (21.3%) patients. The ratio of left side and right side involvement of vocal cord was 2:1 in our study. The longer course of the Left Recurrent Laryngeal Nerve might account for the difference. Conclusion:In our study the etiology which was found to be more common was neoplasms then that of idiopathic causes. The reason behind this could be advanced investigation procedures which allows us to do a thorough work upon any case, but even after that we have found some of Idiopathic causes as well.

Twitter provides students with a centralized platform to learn about numerous opportunities within radiology. The platform can be immensely beneficial to students by providing opportunities to learn, network, connect with mentors, and find events while also preparing applicants for The Match. Having a prominent Twitter presence can pay dividends in the long term throughout one's training. We aim to provide a guide for medical students on how to create a Twitter account and best utilize the platform.

TikTok provides opportunity for citizen-led debunking where users correct other users’ misinformation. In the present study (N=1,169), participants either watched and rated the credibility of (1) a misinformation video, (2) a correction video, or (3) a misinformation video followed by a correction video (“debunking”). Afterwards, participants rated both a factual and a misinformation video about the same topic and judged the accuracy of the claim furthered by the misinformation video. We found modest evidence for the effectiveness of debunking on people’s ability to subsequently discern between true and false videos, but stronger evidence on subsequent belief in the false claim itself.

Objective The Liver Imaging Reporting and Data System (LI-RADS) has been widely applied to CT and MR liver observations in patients at high-risk for hepatocellular carcinoma (HCC). We investigated the impact of CT vs MR in upgrading LI-RADS 3 to LI-RADS 5 observations using a large cohort of high-risk patients. Methods We performed a retrospective, longitudinal study of CT and MR radiographic reports (June 2013 - February 2017) with an assigned LI-RADS category. A final population of 757 individual scans and 212 high-risk patients had at least one LI-RADS 3 observation. Differences in observation time to progression between modalities were determined using uni- and multivariable analysis. Results Of the 212 patients with a LI-RADS 3 observation, 52 (25%) had progression to LI-RADS 5. Tp ranged from 64 - 818 days (median: 196 days). One hundred and three patients (49%) had MR and 109 patients (51%) had CT as their index study. Twenty-four patients with an MR index exam progressed to LI-RADS 5 during the follow-up interval, with progression rates of 22% (CI:13%-30%) at 1 year and 29% (CI:17%-40%) at 2 years. Twenty-eight patients with a CT index exam progressed to LI-RADS 5 during follow-up, with progression rates of 26% (CI:16%-35%) at 1 year and 31% (CI:19%-41%) at 2 years. Progression rates were not significantly different between patients whose LI-RADS 3 observation was initially diagnosed on MR vs CT (HR: 0.81, P = 0.44). Discussion MR and CT modalities are comparable for demonstrating progression from LI-RADS 3 to 5 for high risk patients.

Psoriasis is a common, chronic and non- infectious skin disease characterized by well defined slightly raised, dry erythamatous macules with silvery scales Modern medicine offers treatment with PUVA, Corticosteroids & Anti mitotic Drugs but therapy gives serious side effects like Bone Marrow depletion, Liver & kidney Failure. While treating Kustha, Ayurvedic Classics especially focused on Panchakarma Treatment. So Vaman, Virechana & Laghu-Manjisthadi Ghan was selected for trial. Total 30 well diagnosed patients were selected & divided in two groups. One group receiving Ayurvedic Treatment & other Allopathic Regimen (Tb.Methotraxate7.5 mg/week) for 2 months & comparative study was done. Assessment was done on improvement in clinical symptoms as well as on Laboratory parameters.

Background: Keloids are benign proliferative condition of dermal broblast. Intralesional corticosteroid improves keloid but associated with signicant adverse effects like dyspigmentation, tissue atrophy and telengectasia and contraindicated in certain conditions like hypertension and diabetes. 5-Fluorouracil (5-FU), a pyrimidine analogue with an inhibitory effect on TGF-β induced broblast proliferation is useful in treatment of keloids but is associated with ulceration and pain. A low dose of Triamcinolone if added to 5-FU injection overcomes these issues. Approach: This study was conducted in a tertiary care hospital. Sixty patients; thirty in each group were included. In group A, once weekly intralesional Triamcinolone and in group B, intralesional injection of Triamcinolone mixed with 5-Flurouracil in 1: 9 dilution were injected for 8 sessions. Parameters of Vancouver scale were noted at the baseline and at the end of treatment. Results: Out of 60 patients enrolled in this study. The combination group was better in improving height (62.11% vs 78%), pliability (44.14% vs 8.81%), and vascularity (55.78% vs 61.30%) and results were statistically signicant (P valve 0.05). Pain and pruritus improved completely (100%) in both the groups at the end of the treatment. Excellent improvement in patient and observer assessment score was seen in 96.67% vs 3.33% in combination group and TAC group respectively. The difference was statistically signicant (P valve

Radiologists have shouldered a myriad of personal and professional burdens during the ongoing pandemic, leading to high levels of stress and burnout. Herein we discuss a set of strategies known as the 8-point program to help radiologists better cope with these stressors. Although the onus should be on leadership at the workplace to implement meaningful strategies to alleviate burnout, individual strategies such as the 8-point program can be beneficial for optimizing radiologist well-being in the read room.

The duodenum can be affected by a variety of abnormalities because of its development during embryogenesis and its dual intra- and retroperitoneal location. If small bowel embryogenesis is disturbed, congenital errors occur. Although some congenital variants may be asymptomatic and inconsequential to the patient, other anomalies can result in life-threatening emergencies such as malrotation, leading to midgut volvulus. Many infectious processes affect the duodenum, including duodenal ulcers and opportunistic infection in patients with HIV/AIDS or Crohn disease. Small bowel malignancies are uncommon but important to recognize, because the duodenum can be involved in polyposis syndromes or the development of primary adenocarcinoma, neuroendocrine tumors, lymphoma, and metastasis. Although endoscopy is currently the most used diagnostic method to assess the lumen of the upper gastrointestinal tract, fluoroscopy is a valuable adjunct technique and the study of choice for many diseases, specifically those for which anatomic and functional information is required. Fluoroscopy is also commonly used postoperatively to assess for complications such as obstruction and extraluminal leaks. Compared with endoscopy, fluoroscopy is an inexpensive and noninvasive technique that provides salient anatomic information and allows delineation of the duodenal mucosa and assessment of real-time duodenal motility. The authors examine the broad spectrum of conditions that can involve the duodenum, including congenital, infectious, inflammatory, and neoplastic abnormalities, and review their typical appearances at fluoroscopy.

Growth in the demand for higher capacity hard disk drives has pushed the requirement for head-media spacing to sub-nanometer levels. The drop in operational clearance makes a head-disk interface more susceptible to potential head-wear and contamination related issues. Such degradation processes are often accompanied by a noticeable shift in the head-disk clearance. Hence monitoring an interface for a spacing change can be helpful in early detection of its imminent failure. In this paper, we present a method to detect the change in head-disk spacing using an embedded contact sensor (ECS). This technique involves the analysis of ECS dynamic response for an interface that is subjected to heater induced spacing modulations. As the head moves closer to the disk surface, the magnitude of the ECS frequency components can be used to determine the ‘characteristic spacing’ which can be used as a metric to detect any physical change for a given interface.

Radiologists' personal productivity and efficiency are critically important for both improving patient outcomes and protecting clinician well-being. There are several solutions that individuals can implement to improve personal productivity and efficiency in the radiology workroom. Strategies include understanding the psychology behind productivity, using personal productivity methodologies to accomplish daily tasks, and learning to modulate stress to optimize performance. Institutional infrastructure requirements include a robust departmental commitment to information technology and informatics, including universal log-in systems, internal websites, and dashboards. The workstation itself can be optimized by utilizing hanging protocols, customized keyboard shortcuts, hotkeys, advanced scripts, gaming mice, and other input devices. Personal devices like smartphones can be harnessed to maximize productivity by using online storage applications and radiology-specific applications to augment knowledge. Reading room layouts must be designed to minimize interruptions and workstations must consider ergonomics to prevent fatigue and strain. High-efficiency teams also need to be created to allow radiologists to delegate non-clinical tasks to reduce administrative burdens. Lastly, continued advances in artificial intelligence including the use of smart report templates will lead to substantial gains in radiologists' productivity and efficiency.

“Big data” has changed the way businesses operate in finance, insurance, communications, manufacturing, and logistics, with companies reporting successful outcomes from the implementation of data-driven analytics. Health care has slowly started leveraging big data analysis to identify more cost-efficient and effective care for patients. Business intelligence software aims to help with this transition, converting large data sets into useful, actionable information. Radiology practices have used business intelligence toolkits in the past to increase reading room productivity, scanner efficiency, and patient throughput. Although these tactics have driven down costs and increased volumes, an essential aspect of radiology practice growth—consumer satisfaction—remains largely unexplored. The first commandment of marketing is “know thy customer,” which is the key to increasing radiology’s value to referring clinicians who use our services. Our article explores the business case behind a basic business intelligence model, giving any radiologist the instruments to access and draw business conclusions from their radiology information system data.

Aspergillosis is an uncommon fungal infection in which primary cutaneous sites are very rare. Most cases occur in immunocompromised patients and infection in immunocompetent patients, is extremely rare, but an increase in prevalence has been noted in last 20 years. A case of primary cutaneous aspergillosis (PCA) in a 40-year-old immunocompetent shopkeeper resident of Jaipur Rajasthan presenting with verrucous growth on the lower lip has been reported in this case study.

Purpose To evaluate the impact of environmental and socioeconomic factors on outpatient cancellations and “no-show visits” (NSVs) in radiology. Materials and Methods We conducted a retrospective analysis by collecting environmental factor data related to outpatient radiology visits occurring between 2000 and 2015 at our multihospital academic institution. Appointment attendance records were joined with daily weather observations from the National Oceanic and Atmospheric Administration and estimated median income from the US Census American Community Survey. A multivariate logistic regression model was built to examine relationships between NSV rate and median income, commute distance, maximum daily temperature, and daily snowfall. Results There were 270,574 (8.0%) cancellations and 87,407 (2.6%) NSVs among 3,379,947 scheduled outpatient radiology appointments and 575,206 unique patients from 2000 to 2015. Overall cancellation rates decreased from 14% to 8%, and NSV rates decreased from 6% to 1% as median income increased from $20,000 to $120,000 per year. In a multivariate model, the odds of NSV decreased 10.7% per $10,000 increase in median income (95% confidence interval [CI]: 10.3%-11.1%) and 2.0% per 10°F increase in maximum daily temperature (95% CI: 1.3%-1.6%). The odds of NSV increased 1.4% per 10-mile increase in commute distance (95% CI: 1.3%-1.6%) and 4.5% per 1-inch increase in daily snowfall (95% CI: 3.6%-5.3%). Commute distance was more strongly associated with NSV for those in the two lower tertiles of income than the highest tertile (P Conclusion Environmental factors are strongly associated with patients’ attendance at scheduled outpatient radiology examinations. Modeling of appointment failure risk based on environmental features can help increase the attendance of outpatient radiology appointments.

Melanonychia is a brownish-black staining of the nail plate. It can affect a single or several nails on both the fingers and toes. Melanocytic activation and melanocytic hyperplasia are the two basic mechanisms involved in the development of melanonychia. Melanocytic activation occurs as enhanced melanic pigmentation of the nail matrix epithelium and nail plate without a corresponding rise in the number of melanocytes, resulting in melanonychia. The number of matrix melanocytes increases in melanocytic hyperplasia. Involvement of a pathogen has also been suggested as a mechanism for its development. A thorough clinical history should be taken, including questions regarding various triggers and causal events, as well as the use of a questionnaire. A proper detailed physical examination is of a great need to properly identify the type of melanonychia and to rule out melanoma which is of great importance in clinical practice. Onychoscopy and nail biopsy also acts as an aid in proper diagnosis of melanonychia. Treatment of melanonychia basically depends on the underlying etiology. One major aim is to rule out melanoma if present and its proper management in time.

A strong faculty development program is crucial to recruit, support, and advance early-career faculty members in order to achieve and sustain an exceptional and diverse medical community. There has been increasing appreciation for the importance of fostering intrapersonal "soft-skills" such as leadership, mentorship, resilience, adaptability, and emotional intelligence. These skills allow an individual to better interact with others and their environment, and can facilitate teamwork, time management, decision-making, and conflict resolution. The development of these skills is an ongoing process that is cumulative in nature, and generalizable to any career phase or field of medicine. A comprehensive faculty development program must emphasize these contemporary notions alongside the traditional curriculum, and this includes individual, departmental, institutional, and national level considerations.

Aim: We sought to identify predictors of progression of an indeterminate observation (LI-RADS 3) to hepatocellular carcinoma (LI-RADS 5). Methods: Imaging reports with LI-RADS (LR) assignments were identified among patients at the University of Washington, 2013-2017. Patients with an LR3 lesion and follow-up scan within 1 year of LR3 lesion date were included (n = 313). Features of interest were abstracted from chart review. Survival analyses employing interval censoring were performed, with variables potentially predictive of LR3 progression identified in univariate analyses. Backwards elimination (P < 0.05) was used to obtain the final multivariate model. Results: 20.4% of LR3 lesions progressed to LR5; 73% remained LR3, 8% LR4. The cohort was predominantly male (61%), Caucasian (54%), older than 55 (63%). 47% had a history of hepatitis C virus (HCV), 33% with alcohol abuse, not mutually exclusive. Alpha-fetoprotein (AFP) at the time of LR3 scan was low if available (39% with AFP < 5, 29% unknown). CT was the most common exam (56%). Men (HR = 2.0, P = 0.02), earlier scan year (HR = 0.47 per year, P < 0.0001), and older age (HR = 1.48, P = 0.03), appeared as predictors of LR progression in the final model. HCV and alcohol use were more common among men but did not appear to explain the difference in LR progression by sex. Conclusion: Our analysis is an early exploration of characteristics that may predict the risk of progression of an LR3 observation to hepatocellular carcinoma. Future efforts may allow for risk stratification to identify high-risk indeterminate lesions that may benefit from earlier intervention or more frequent surveillance.

We have all been guilty of making ineffective presentations at some point in our career. In this article we explore the key principles behind “Presentation Zen,” an approach intended to decrease cognitive overload, make presentations more visual, natural, and unique; as well as improve the overall impact of our presentations by allowing the listener to process the information while listening to the presenter.

To analyze the trends in international medical graduates (IMGs) matching into diagnostic radiology residency programs in the United States (US).The National Resident Match Program data was accessed for years 2005-2020 and diagnostic radiology residency-specific data was extracted for US MD, osteopathic (DO), and IMG applicants. IMGs were categorized into US-citizen IMGs and non-US citizen IMGs per the National Residency Match Program. Variables collected for each year included the number of positions, number of applicants in each group, positions filled/unfilled, and fill rate of each group. Additional data for some years included USMLE Step 1 score, United States Medical Licensing Examination (USMLE) Step 2 clinical knowledge (CK) score, number of research experiences, number of abstracts/publications, and additional degrees obtained. Trends were analyzed using simple linear regression model and p value0.05 was considered significant.The number of diagnostic radiology residency programs increased from 203 (2006) to 212 (2020). The total number of diagnostic radiology residency positions increased from 1011 (2006) to 1113 (2020), with the peak of 1145 in 2014. The overall "match rate," that is, proportion of positions filled to positions available, increased from 96.4% (2006) to 97.3% (2020), with a brief decline to 86.7% in 2015. Among the filled positions, the proportion filled by US medical school graduates significantly declined from 89.7% (2006) to 69.2% (2020) (p0.001), and the proportion of positions filled by osteopathic seniors and graduates significantly increased from 2.2% (2006) to 15.1% (2020; p0.001). The proportion of US IMGs increased from 3.2% (2006) to 5.4% (2020), while the proportion of non-US IMGs increased from 4.4% (2006) to 9.4% (2020), with overall IMG match rate increased significantly from 7.6% to 14.9% (p = 0.009). The mean Step 1 scores of US IMGs and non-US IMGs were 238 and 237.3, and the mean Step 2 CK scores were 241.67 and 241, respectively. Cumulatively over the study period, a total of 736 US IMGs and 1051 non-US IMGs have matched into diagnostic radiology residency.There is an increasing proportion of IMGs, especially the non-US citizen IMGs, matching into US radiology residency programs in the last decade. Diagnostic radiology remains a competitive specialty evidenced by average USMLE scores higher than national average and research experiences of matched candidates.

This study compares the results of Tympanoplasty in terms of graft uptake and hearing improvement in patients with Chronic Otitis Media which are divided on the basis of discharging ear and non discharging ear with perforation at the time of surgery. Total 110 patients were selected suffering from chronic otitis media. Out which 55 patients had discharging ear (wet ear) and 55 patients had non discharging ear (dry ear). Tympanoplasty was performed using temporalis fascia graft. Hearing improvement and graft uptake was seen in both wet and dry ears. No statistically difference is noted in the results between the two. Mucoid ear discharge at the time of surgery is not a contraindication for Tympanoplasty as it has no adverse effects on the outcomes of the surgery in respect to graft uptake and hearing improvement.

Radiologists serve in leadership roles throughout their career, making leadership education an integral part of their development. A maxim of leadership style is summarized by 360-Degree Leadership, which highlights the ability of a leader to lead from any position within the organization while relying on core characteristics to build confidence from within their team. The qualities of leadership discussed can be learned and applied by radiologists at any level. These traits can form a foundation for the leader when faced with unfavorable events, which themselves allow the leader an opportunity to build trust.

Purpose Computed tomography (CT) is a fast and ubiquitous tool to evaluate intra-abdominal organs and diagnose appendicitis. However, traditional CT reporting does not necessarily capture the degree of uncertainty and indeterminate findings are still common. The purpose of this study was to evaluate the reproducibility of a standardized CT reporting system for appendicitis across a large population and the system's impact on radiologists' certainty in diagnosing appendicitis. Methods Using a previously described standardized reporting system, eight radiologists retrospectively evaluated CT scans, blinded to all clinical information, in a stratified random sample of 237 patients from a larger cohort of patients imaged for possible appendicitis (2010-2014). Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to evaluate the diagnostic performance of readers for identifying appendicitis. Two-thirds of these scans were randomly selected to be independently read by a second reader, using the original CT reports to balance the number of positive, negative and indeterminate exams across all readers. Inter-reader agreement was evaluated. Results There were 113 patients with appendicitis (mean age 38, 67% male). Using the standardized report, radiologists were highly accurate at identifying appendicitis (AUC=0.968, 95%CI confidence interval: 0.95, 0.99. Inter-reader agreement was >80% for most objective findings, and certainty in diagnosing appendicitis was high and reproducible (AUC=0.955 and AUC=0.936 for the first and second readers, respectively). Conclusions Using a standardized reporting system resulted in high reproducibility of objective CT findings for appendicitis and achieved high diagnostic accuracy in an at-risk population. Predictive tools based on this reporting system may further improve communication about certainty in diagnosis and guide patient management, especially when CT findings are indeterminate.

Gynecological malignancies are a leading cause of mortality and morbidity in women and pose a significant health problem around the world. Currently used staging systems for management of gynecological malignancies have unresolved issues, the most important being recommendations on the use of imaging. Although not mandatory as per the International Federation of Gynecology and Obstetrics recommendations, preoperative cross-sectional imaging is strongly recommended for adequate and optimal management of patients with gynecological malignancies. Standardized disease-specific magnetic resonance imaging protocols help assess disease spread accurately and avoid pitfalls. Multiparametric imaging holds promise as a roadmap to personalized management in gynecological malignancies. In this review, we will highlight the role of magnetic resonance imaging in cervical, endometrial, and ovarian carcinomas.

Stephen R. Covey's landmark work in the field of effectiveness and professional development delineated first 7, then ultimately eight, habits of highly effective people with applicability to all professions.1 This article describes the eight habits in specific relation to the radiologist, and proposes a ninth habit to help one bring a positive and centered approach during the journey to effectiveness and beyond.

Context: Recently, there has been an increase in the number of chronic, recurrent, and recalcitrant dermatophytosis. Many factors implicated are barrier defects, aberrant host immune response, application of steroids or other irrational combination creams, transmission within family, occlusive clothing, poor hygienic conditions, poor compliance, drug resistance and virulence of the infecting strain. Transepidermal water loss (TEWL) is an important index in accessing the barrier function of skin. Aim: To ascertain the role of TEWL from the lesional skin and its effect on the cure rate and relapse in patients of tinea cruris. Materials and Method: A hospital based prospective comparative study was conducted for 1 year. A total of 200 patients of tinea cruris diagnosed clinically and by KOH examination, were included in the study. TEWL was calculated using Tewameter TM300 open chamber probe of Courage and Khazaka, Cologne, Germany. Patients were classified according to the TEWL values into Group A (patients with abnormal TEWL) and Group B (normal TEWL). Both groups were given oral itraconazole and antihistamines for 4 weeks. The cure rates and recurrence rates of both the groups were analyzed and compared. Results: In the Group A, i.e., patients of tinea cruris with abnormal TEWL, only 28% of the patients showed clinical improvement at the end of 1 month. Out of those cured, 78.57% of the cases showed recurrence after 2 months of completion of therapy. In Group B, i.e., patients of tinea cruris with normal TEWL, 69% (n = 69) of the patients showed clinical improvement at the end of 1 month. Out of those cured, only 21.74% of the cases (n = 15) showed recurrence. Conclusion: The cases of tinea cruris with abnormal TEWL show significant decrease in cure rates and significant relapse rates among those initially cured.

Introduction: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous units and has been associated with hyperandrogenism, which, in women, is most commonly caused by polycystic ovary syndrome (PCOS). Metformin treatment can correct ovarian and functional adrenal hyperandrogenism in adolescents with PCOS. Objective: We evaluated the efficacy of metformin therapy in women with acne and PCOS in terms of acne load. Methods: This was a hospital-based, interventional, longitudinal study that included 40 female patients with acne and PCOS diagnosed using the Rotterdam criteria. Hormonal assay, including serum levels of testosterone, dehydroepiandrosterone sulphate, luteinizing hormone, follicle-stimulating hormone, prolactin, and blood sugar, was conducted on the third or fourth day of the menstrual cycle in a fasted state. An abdominal ultrasound was performed on the ninth day of menstrual cycle to diagnose PCOS. Baseline acne severity was assessed as per the Definition Severity Index. Metformin 500mg was given to all selected patients three times a day for eight weeks. Patient follow-up and acne severity reassessment was conducted at Weeks 3 and 6. At Week 8, all work-ups were repeated. Intention-to-treat analysis was done. Wilcoxin signed-rank sum test was used to identify significance in acne severity. Results: Metformin treatment significantly reduced acne severity in patients with PCOS (p

Growth in the demand for higher capacity hard disk drives (HDD) has pushed the requirement for head-media spacing (HMS) to sub-nanometer levels. The drop in operational clearance makes a head-disk interface (HDI) more susceptible to potential head-wear and contamination related issues. Such degradation processes are often accompanied by a noticeable shift in the head-disk clearance. Hence monitoring an interface for a spacing change can be helpful in early detection of its imminent failure. In this paper, we present a method to detect the change in head-disk spacing using an embedded contact sensor (ECS). This technique involves the analysis of ECS dynamic response for an interface that is subjected to heater induced spacing modulations. As the head moves closer to the disk surface, the magnitude of the ECS frequency components can be used to determine the ‘characteristic spacing’ which can be used as a metric to detect any physical change for a given interface.

In the beginning of the COVID-19 pandemic when we were still getting used to the rising cases every day and limited resources to deal them with, the focus was to get a hold of the situation as quickly as possible. Seven months into the pandemic, the cases are still on the rise but we have gathered some knowledge through the researches getting published every day, most of which are focused on the involvement of respiratory system, cardiovascular system, central nervous system, and gastrointestinal system. Dermatological manifestations have not been given their due importance. Lately, many patients have started presenting with dermatological manifestation sometimes preceding or sometimes during COVID-19 infection with or without involvement of other systems. This may be beneficial to clinicians all over the world, to determine potential dermatological signs in COVID-19 and also help in earlier suspection of the COVID-19 infection. Many cutaneous adverse drug reactions (ADR) to drugs advocated in COVID-19 treatment are also being reported every day, which are discussed in this review.Here we attempt to review dermatological manifestations of COVID-19 infections and drug reactions by the drugs advocated for its treatment and an understanding in its path mechanisms reported thus far. This will help clinicians to get an insight into what to expect and when to expect in terms of dermatological manifestation of COVID-19 and its drugs.

Context: Amyloidosis is group of rare diseases that are characterized by extracellular deposition of abnormal amyloid proteins either involving multiple organ systems (systemic amyloidosis) or restricted to a single-tissue site, such as skin (localized amyloidosis). In primary cutaneous amyloidosis, there is deposition of amyloid in apparently normal skin. The hyperpigmentation in all the lesions of primary cutaneous macular amyloidosis gives us an insight of a possibility of a connection between amyloid fibrils and melanogenesis. Aims: To compare the melanin content from the lesional skin of upper back and surrounding non-lesional skin of macular amyloidosis. Settings and Design: A hospital based, cross-sectional study conducted over a period of 6 months. Methods and Materials: Forty-two patients (30 females and 12 males) clinically and histopathologically diagnosed as macular amyloidosis were enrolled in the study. A Mexameter MX18 was used to measure the melanin index of the lesions of Macular amyloidosis over upper back and non-affected similar areas (control). Results: The melanin index of the lesional skin of female patients ranged from 552 to 823 (mean = 705.1). The melanin index of the lesional skin of male patients ranged from 621 to 792 (mean = 697.41). In the non-affected surrounding skin of females, the mean melanin index was 357.66, whereas in males, the melanin index of the surrounding normal skin was 296.75. The P value came out to be significant, that is

Objective: Comparative analysis of expression of lupus erythematosus (LE) in geriatrics versus adults. Materials and Methods: We analyzed and compare the patient's records attending our department between June 2017 and June 2019, diagnosed clinically and immunologically as LE between the two groups. Results: Sixty patients, 30 in each group, met ACRA criteria, were enrolled with mean age of presentation for early-onset was 28 ± 9.8 years and late-onset, 59 ± 4.8 years. Most of the patients were females with decrease in sex ratio with age. The most common presentations were malar rash, photosensitivity, and oral ulcers. Joint complaints, lung and cardiac involvement, and nonscarring alopecia were more common in the elderly. Direct Coombs test positive hemolytic anemia, renal involvement in forms of proteinuria and lupus nephritis, and neurological involvement were seen more commonly in adults. In immunological parameters, antinuclear antibody, anti-double standard DNA antibody (AntiDsDNA), and anti-smith antibody testing were done. AntiDsDNA positivity was more in adults correlate with disease severity. We calculate the systemic LE disease activity index 2000 score was higher in the adult population. Conclusion: Our study illustrated that disease activity and damage are more in adults in comparison to geriatrics. However, geriatrics had more organ damage that may be attributable to associated comorbidities. Although the connective tissue diseases in the elderly needs less aggressive management, it requires more attention for possible organ damage due to associated comorbidities.

It is an important task for leadership to identify the motivating factors for employees and motivate them to fulfill their individual and organizational goals. Although there are several motivational factors (extrinsic and intrinsic), intrinsic motivational factors such as autonomy, mastery, and purpose are more important for deeper lasting job satisfaction and higher performance. In this article, the authors discuss how an understanding of these factors that influence motivation has the potential to transform an organization.

Hepatocellular carcinoma is a common malignancy for which prevention, screening, diagnosis, treatment, and surveillance demand a multidisciplinary approach. Knowledge of the underlying pathophysiology as well as advances in clinical management should be employed by radiologists to effectively communicate with hepatologists, surgeons, and oncologists. In this review article, we present recent developments in the clinical management of hepatocellular carcinoma.

Radiology is no exception to the ubiquitous presence of change in every aspect of our life. Managing change is a challenge, with a high probability of failure if not properly implemented. While change management is not part of the radiology curriculum, it is a highly specialized discipline in the business world. It has been extensively researched and has emerged as a vital skillset in the management of major projects. In this article, the authors discuss how these change management strategies of the business world can be put to use in the radiologists's practice.

481 Background: We sought to identify predictors of progression of LR3 lesions (i.e. indeterminate for HCC) to LR5 lesions (i.e. definitely HCC) on follow-up imaging among cirrhotic pts. Methods: Imaging reports with LR assignments were identified among pts seen at the University of Washington, 2013-2017. Cirrhotic pts with a LR3 lesion and follow-up scan within 1 year (yr) of LR3 lesion date were included (n = 313). Clinical features were abstracted from chart review. Survival analyses employing interval censoring were performed. Variables as potentially predictive of LR3 progression were identified in univariate analyses, with backwards elimination done (p < 0.05) to obtain the final multivariate model. Results: 20.4% of LR3 lesions progressed to LR5 within 1 yr; 73% were still LR3, 8% progressed to LR4. The population was predominantly male (61%), Caucasian (71%), older than 55 (63%). The most common cirrhotic etiologies were HCV (46.7%), alcohol (32.6%), and NASH (12.8%), not mutually exclusive. AFP at the time of LR3 scan was low if available (39% with AFP 2cm. Men (HR 2.0, p = 0.02), earlier scan yr (HR 0.47 per yr, p < 0.0001), older age (HR 1.42 per 15 yr, p = 0.047), lesion size (HR 1.21 for 2cm+, global p = 0.02) appeared as independent predictors of LR3 to LR5 progression based on the final model. Of 16 variables examined, men were more likely to have chronic HCV, history of alcohol use and less likely to have autoimmune hepatitis. No other differences were seen. In an a priori analysis, risk of male sex (HR 1.99, p = 0.03) persisted despite control for HCV, alcohol, age, race, scan yr, lesion size, and number of lesions. Conclusions: Identification of clinical factors associated with LR3 progression may allow for risk modeling tools that may assist in determining imaging frequency and timing of intervention. The increased risk among men vs women is not explained by clinical or radiographic features listed above.

Purpose To investigate performance in detectability of small (≤1 cm) low-contrast hypoattenuating focal lesions by using filtered back projection (FBP) and iterative reconstruction (IR) algorithms from two major CT vendors across a range of 11 radiation exposures. Materials and Methods A low-contrast detectability phantom consisting of 21 low-contrast hypoattenuating focal objects (seven sizes between 2.4 and 10.0 mm, three contrast levels) embedded into a liver-equivalent background was scanned at 11 radiation exposures (volume CT dose index range, 0.5-18.0 mGy; size-specific dose estimate [SSDE] range, 0.8-30.6 mGy) with four high-end CT platforms. Data sets were reconstructed by using FBP and varied strengths of image-based, model-based, and hybrid IRs. Sixteen observers evaluated all data sets for lesion detectability by using a two-alternative-forced-choice (2AFC) paradigm. Diagnostic performances were evaluated by calculating area under the receiver operating characteristic curve (AUC) and by performing noninferiority analyses. Results At benchmark exposure, FBP yielded a mean AUC of 0.79 ± 0.09 (standard deviation) across all platforms which, on average, was approximately 2% lower than that observed with the different IR algorithms, which showed an average AUC of 0.81 ± 0.09 (P = .12). Radiation decreases of 30%, 50%, and 80% resulted in similar declines of observer detectability with FBP (mean AUC decrease, -0.02 ± 0.05, -0.03 ± 0.05, and -0.05 ± 0.05, respectively) and all IR methods investigated (mean AUC decrease, -0.00 ± 0.05, -0.04 ± 0.05, and -0.04 ± 0.05, respectively). For each radiation level and CT platform, variance in performance across observers was greater than that across reconstruction algorithms (P = .03). Conclusion Iterative reconstruction algorithms have limited radiation optimization potential in detectability of small low-contrast hypoattenuating focal lesions. This task may be further complicated by a high degree of variation in radiologists' performances, seemingly exceeding real performance differences among reconstruction algorithms. © RSNA, 2018 Online supplemental material is available for this article.

The purpose of this article is to assess the performance of a contrast reaction management checklist for optimal management of a contrast reaction scenario created using a high-fidelity hands-on simulation.A safety checklist was designed that presented the five adverse events that most commonly occur after administration of IV contrast medium as well as their step-by-step management. Forty-three radiology residents were randomized into two groups, a checklist group (n = 22) and a control group (n = 21), as stratified by postgraduate year. Participants took written tests involving multiple-choice questions 2 months before and immediately after participating in the high-fidelity simulation scenario, which was videotaped and independently evaluated by three graders.Both groups had similar scores on the multiple-choice question tests taken before and after participation in the simulation (p = 0.35 and p = 0.62, respectively). In the simulation, the checklist group scored significantly higher than the control group with regard to their overall management of a severe contrast reaction (85.1% vs 64.8%; p = 0.001), including individual scores for first-line treatment of bronchospasm (97.0% vs 91.3%; p = 0.035) and use of the correct route of administration and dose of epinephrine (77.3% vs 45.2%; p = 0.021).A standardized contrast reaction management checklist can reduce the number of treatment errors that occur during a simulated severe contrast reaction, particularly with regard to proper administration of epinephrine and treatment of bronchospasm. Such a checklist could be used by radiologists, technologists, and nurses to improve patient safety as a result of improved contrast reaction management and teamwork skills.