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Background: Psoriasis is an inflammatory systemic disease with a chronic relapsing course. Methotrexate, a dihydrofolate reductase inhibitor, and Apremilast, an oral phosphodiesterase type 4 inhibitor, are currently the mainstay drugs in the treatment of psoriasis. Aims and Objectives: To compare the efficacy of Methotrexate with a combination of Methotrexate and Apremilast in treating chronic plaque psoriasis. Materials and Methods: The present study was a prospective comparative study conducted among 40 patients, aged above 18 years, with clinically diagnosed psoriasis attending Dermatology OPD of a tertiary care hospital in North India. The study utilised a pre-structured proforma to record a detailed demographic profile and clinical examination related to chronic plaque psoriasis. The patients were divided into two groups of 20 each. Group A was treated with oral Methotrexate, while Group B was treated with oral Apremilast and Methotrexate, and they were evaluated every 4 weeks for 12 weeks. Necessary investigations were done wherever indicated. Results: The male-to-female ratio was 1.35, and the majority (55.0%) of patients belonged to the age group of 31-50 years. 27.5% of patients had comorbidities like diabetes, hypertension, etc., The mean PASI score of group A at the first, second and third follow-ups was higher than that of group B. The reduction in mean PASI score was statistically significant in group B at successive follow-ups, with a percentage improvement of 89.4% at the end of 12 weeks. Conclusions: When comparing monotherapy with methotrexate and multidrug therapy with Methotrexate and Apremilast, multidrug therapy had better efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Kidney transplantation is the treatment of choice for patients suffering from end‑stage renal disease and health‑related quality of life (HRQoL) is routinely used for measuring the outcome. Although the generic HRQoL questionnaire provides useful information on multiple dimensions, they fail to capture emotional and behavioral components of well‑being, which is supplemented by the Transplant Effects Questionnaire (TxEQ). The present research studies the impact of these two questionnaires on various parameters affecting the health of kidney transplant recipients. Methodology: This cross‑sectional study included 500 postrenal transplant patients within 5 years of transplant (18–70 years) evaluating HRQoL using a Short Form Survey‑36 Questionnaire and emotional/behavioral outcomes using a TxEQ. Results: Mean age of participants was 44.92 ± 5.86 years and males constituted the majority (>75%). The mean physical component score (PCS) was 41.3 ± 9.2 and the mental component score (MCS) was 48.1 ± 8.4. The highest score was observed for bodily pain, followed by role limitations attributable to emotional problems (RE). The PCS was significantly higher among younger participants, among males, among participants who have got a transplant >24 months ago, and among participants who had serum creatinine levels <2 mg/dl (*P < 0.05). However, the mental component score did not differ significantly in any of the matched variables. In TxEQ, medication adherence had the highest mean score, followed by perceived responsibility toward others. Conclusion: In our study, we concluded that reduced physical functioning among female gender, illiterate patients, with increasing age, in employed section, and with associated comorbidities such as hypertension and with a history of rehospitalization. [ABSTRACT FROM AUTHOR]

Context: Pollution-related health hazards are very common among people living and/or working in industrial areas, particularly near industries and metro cities. These air pollutants contribute to allergens, increase inflammation, and affect lung function. Aim: The present study aimed to examine the effect of yoga training on lung functions and inflammation in terms of soluble interleukin-2 receptor (sIL-2R) in people working and living in a polluted area. Settings and Design: This is a randomized controlled interventional pilot study. Methods and Materials: Forty-eight male volunteers from the industrial area, aged 20--50 years, were randomly assigned to the experimental group and the control group. Each group comprises 24 study participants. Lung function and sIL-2R were studied at the baseline and post-yoga intervention period of 16 weeks. Statistical Analysis Used: Study data were analyzed using descriptive methods, a one-tailed t-test, a paired t-test, and an independent t-test. Result: Study results showed directional and significant improvements in forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow rate compared to the control group participants. The results pertaining to sIL-2R showed a directional and significant decrease in the experimental group compared to the control group. Conclusion: The present study showed that yoga helps to promote better health, improve lung function and reduce inflammation among people residing in polluted environments. [ABSTRACT FROM AUTHOR]

Background: Global health care is moving toward function, quality of life, and occupation. Occupational therapy (OT) has been the only profession using "occupation" as core intervention since inception. With advancements in intervention techniques, occupational therapists (OTs) need to ensure the continued use of "occupation" as core intervention type. Previous surveys were conducted to analyze the use of specific intervention types: occupation-based interventions (OBIs), creative activities, acute-hospital-based rehabilitation, and different interventions used in pediatric OT practice. However, information on OT practices and types of interventions used by Indian OTs versus global OTs is unavailable. Objectives: The objective of this study was to analyze differences, if any, in the OT practices and types of interventions frequently used in daily practice by Indian versus global OTs. Study Design: This was an online, survey-based, cross-sectional study. Methods: The Google Forms questionnaire link was sent to OTs on E-mail with electronic written informed consent from May 2020 to March 2021 using convenient sampling. The questionnaire included participant's demographics, 17 clinical practice areas, and 9 intervention types and factors influencing OT practice. Total 201 (84 Indian OTs and 117 global OTs) fulfilled the selection criteria: OTs with at least bachelor's degree and minimum 3 years of work experience. Results: Indian OT workforce showed significantly more male OTs than global OTs (31 [36.9%] vs. 11 [9.4%]; 95% confidence interval [CI]: [0.0236-0.2964]; P = 0.0001) and OTs with master's degree (56 [66.7%] vs. 41 [35.04%]; 95% CI: [0.1852-0.4480]; P = 0.0001). Global OTs have more OTs with additional qualifications in non-OT fields (58 [49.57%] vs. 27 [32.10%]; 95% CI: [-0.3088--0.0406]; P = 0.013) and more OTDs (13 [11.11%] vs. 1 [1.23%]; 95% CI: [-0.1641--0.0335]; P = 0.006) than Indian OTs. Indian OTs practiced significantly more in the private sector: clinic and hospital (52 [61.90%] vs. 40 [35.80%]; 95% CI: [0.1273-0.3947]; P = 0.0001), whereas global OTs practiced significantly more in the government sector (46 [39.31%] vs. 19 [22.61%]; 95% CI: [-0.2930--0.0410); P = 0.0124). Among the organizational roles, Indian OTs work significantly more as consultants (50 [50.95%] vs. 35 [29.91%]; 95% CI: [0.0751-0.3457]; P = 0.0001) while global OTs work significantly more as managers (36 [30.76%] vs. 12 [14.28%]; 95% CI: [-0.2770--0.0526]; P = 0.0069). Among patient population treated, Indian OTs majorly (54.76%) treat children (up to 15 years) but significantly more in "all age groups" (35 [41.67%] vs. 18 [15.38%]; 95% CI: [0.1388-0.3870]; P = 0.0001) while global OTs treat significantly more adults (21-65 years) (61 [52.13%] vs. 25 [29.76%]; 95% CI: [-0.3569--0.0905]; P = 0.0015) and geriatric (>65 years) (50 [42.73%] vs. 17 [20.23%]; 95% CI: [-0.3492-0.1008]; P = 0.0008). Indian OTs practice significantly more in developmental disability rehabilitation (78 [92.85%] vs. 68 [58.11%]; 95% CI: [0.2424-0.4524]; P = 0.0001), ante- and postnatal women's care (15 [17.85%] vs. 3 [2.56%]; 95% CI: [0.0662-0.2396]; P = 0.00018), and hemophiliac rehabilitation (14 [16.67%] vs. 2 [1.70%]; 95% CI: [0.0666-0.2328]; P = 0.00012) areas of practice than global OTs. Indian OTs practice significantly more in clinic outpatient department (OPD) (62 [73.80%] vs. 55 [47%]; 95% CI: [0.1375-03985]; P = 0.0001), hospital OPD (40 [47.61%] vs. 27 [23.07%]; 95% CI: [0.1141-0.3767]; P = 0.0002), and inpatient (37 [44.04%] vs. 30 [25.64%]; 95% CI: [0.0516-0.3164]; P = 0.0006) while global OTs practice significantly more in natural environment settings (53 [45.29%] vs. 24 [28.57%]; 95% CI: [-0.2994--0.0350]; P = 0.016). Most preferred types of interventions among both groups are relatively the same: client education, counseling, and consultation and interview; therapeutic relationships; and therapeutic use of self. Besides these, Indian OTs prefer performance skills training and adaptive interventions, while global OTs prefer activities as therapeutic media and OBIs over other types. Preventive interventions and advocacy were the least preferred types of intervention among each group. Despite these relative preferences, significant differences were found between groups with regard to number of OTs practicing these 5 types of interventions: client education, counseling, and consultation (46 [54.76%] vs. 47 [40.17%]; 95% CI: [0.0073-0.2845]; P = 0.04]; performance skills training (41 [48.80%] vs. 34 [29.05%]; 95% CI: [0.0626-0.3324]; P = 0.004); preventive intervention and health promotion (29 [34.5%] vs. 24 [20.51%]; 95% CI: [0.0148-0.308]; P = 0.026]; adaptive interventions (39 [46.42%] vs. 23 [19.65%]; 95% CI: [0.1390-0.3964]; P = 0.001]; and preparatory interventions: (35 [41.67%] vs. 28 [23.93%]; 95% CI: [0.0467-0.3081]; P = 0.0075). Conclusion: The study provides the current stand for preferences and practices of therapeutic interventions by OTs in India versus globally, thus aiding in repositioning of OT practice, focusing on core OT domains as well as providing a baseline for monitoring practice trends over time. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate in a prospective, randomized study, the efficacy and safety profile of photoselective vaporization of prostate (PVP) using a 80W potassium titanyl phosphate (KTP) laser when compared to standard transurethral resection of prostate (TURP) in patients with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE). Materials and Methods: Between February 2009 and August 2009, 117 patients satisfying the eligibility criteria underwent surgery [60 PVP{Group A}; 57 TURP{Group B}]. The groups were compared for functional outcome (both subjective and objective parameters), perioperative parameters and complications, with a follow up of one year. P value<0.05 was considered statistically significant. Results: The baseline characteristics of the two groups were comparable. Mean age was 66.68 years and 65.74 years, mean IPSS score was 19.98 and 20.88, mean prostate volume was 44.77 cc and 49.02 cc in Group A and B, respectively. Improvements in IPSS, QOL, prostate volume, Q max and PVRU at 12 months were similar in both groups. PVP patients had longer operating time, lesser perioperative blood loss, shorter catheterization time and a higher dysuria rate when compared to TURP patients. The overall complication rate was similar in the two groups. Conclusions: In patients with LUTS due to BPE, KTP-PVP is an equally efficacious alternative to TURP with durable results at one year follow up with additional benefits of lesser perioperative blood loss, lesser transfusion requirements and a shorter catheterization time. Long term comparative data is awaited to clearly define the role of KTP-PVP in such patients. [ABSTRACT FROM AUTHOR]