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Vitiligo is an usual acquired pigmentary disorder of the skin characterized by well-circumscribed depigmented macules and patches. Though the association between vitiligo and thyroid disorders has been suggested, only a few studies from India and overseas have paid attention to describe the association between vitiligo and thyroid abnormalities, particularly in children. Hence, this study was taken up for evaluating thyroid disease in childhood vitiligo compared to controls in a tertiary care centre.This was a hospital-based case-control study conducted at a tertiary teaching hospital over 18 months which included 50 new patients of vitiligo and 50 age and sex-matched controls. Blood samples were garnered from cases and controls to access the levels of free triiodothyronine (fT3), free thyroxine (fT4), Thyroid-stimulating hormone ( TSH), anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti –Tg).In our study, females outnumbered males in both groups. The frequencies of thyroid function and thyroid autoantibody abnormalities among vitiligo patients and control were 32% and 6%, respectively. The difference between case and controls for thyroid function abnormality was significant with a p-value of 0.001.Our study found a significant association betwixt thyroid disease and childhood vitiligo. Thus, evaluating vitiligo patients for thyroid abnormalities help to detect thyroid diseases or determine the possibility of eventual onset.

Background: Among all the available diagnostic tools, computed tomography (CT) is the preferred diagnostic tool for clinically suspected pulmonary embolism (PE) cases. Further, with the development of multi–detector row CT (MDCT) technology, previous limitations of CT have been overcome effectively. For patients with clinical suspicion of PE, MDCT pulmonary angiography has become the first line of modality for the diagnosis. Aims and Objectives: To evaluate various common observations of CT pulmonary angiography (CTPA) in suspected cases of PE that could accurately determine the choice of management. Materials and Methods: Fifty patients with clinically suspected PE referred to the department of Radiodiagnosis for CTPA from various departments were studied in the cross-sectional study. CT images were obtained with a SIEMENS 64-slice multi-detector CT scanner (somatom definition AS). Images were reconstructed into 3D, axial, coronal, sagittal maximum intensity projection sections, and volume rendering techniques. The axial as well as reformatted coronal and sagittal images were evaluated. Results: The incidence of PE was 52%. The incidence of PE was highest in patients older than 60 years (30.8%) and males (30.3%; p=0.662). The most common symptoms evoking a suspicion of pulmonary embolism were dyspnea (69.2%), followed by chest pain (15.4%), cough (11.5%), and hemoptysis (3.8%). Out of 26 patients who had PE, 61.5% had right ventricular enlargement. DVT (23.1%) was the most common past history. The majority of the patients had thrombus in the right main pulmonary artery (21.1 %), followed by the left main pulmonary artery (19.3 %). Conclusion: In clinically suspected cases of PE, MDCT pulmonary angiography was a useful diagnostic tool. CTPA is the modality of choice for its rapid, minimally invasive, and well-tolerated nature.

The use of siRNA therapeutics to treat cancer is a very promising approach. However, specific delivery of siRNAs to tumors remains a major challenge. The recent success of siRNA delivery to the liver has incentivized the development of biomaterials for siRNA delivery into tumors. Here, we report a new class of amino acid-modified lipids for siRNA delivery to cancer cells. Eight lipids were developed by headgroup modification with histidine and lysine. The lipids were screened in PC3-luciferase stable cells for gene silencing and cellular cytotoxicity study. The best lipid LHHK shows a pKa of 6.08, which is within the optimal pKa range of lipid nanoparticles (LNPs) for siRNA delivery. The LHHK LNP protects siRNA from serum degradation for up to 24 h and shows higher endosomal release and better cellular uptake compared to other lysine-modified lipids in PC3 cells. The LHHK LNP exhibits significant silencing activity of IKKα and IKBKE in prostate cancer and pancreatic cancer, respectively. Moreover, the LHHK LNP encapsulating IKBKE siRNA inhibits cell proliferation of pancreatic cancer cells and suppresses the tumor progression in a pancreatic cancer mouse model. STATEMENT OF SIGNIFICANCE: Lipid nanoparticle (LNP) is a promising platform for siRNA delivery. However, LNP is generally associated with high systemic toxicity. As a result, efficient and biodegradable lipids are highly needed for siRNA-based cancer therapy. Herein, we develop amino acid-modified biodegradable lipids. These lipids show very low cellular toxicity and high transfection efficiency. The best lipid LHHK shows a pKa of 6.08, which is within the optimal pKa range of LNPs for siRNA delivery. The LHHK LNP efficiently silences IKKα and IKBKE in prostate and pancreatic cancer, respectively. Moreover, the LHHK LNP encapsulating IKBKE siRNA inhibits cell proliferation and suppresses tumor growth of pancreatic cancer in vivo. These results suggest that amino acid-modified lipids possess a great potential for siRNA delivery in cancer therapy.

Psoriasis is an immune-arbitrated cutaneous disorder in which both genetic and habitational factors play a decisive role. Certain endocrinological disturbances like thyroid dysfunction can exacerbate the disease. This research aspires in knowing the prevalence of thyroid disease in psoriatic patients and the severity of psoriasis in those with thyroid disease with age and gender-evened controls. This was a case-referent study encompassing 100 adult psoriasis patients and 100 age and gender-evened healthy controls. The statistical differences between proportions were determined by chi-square analysis. A P-value of In the current study, thyroid dysfunction was present in 20 % of cases and 8% of controls and serum TSH levels were significant among cases, with a p-value of 0.046. There was a clear association betwixt the psoriasis area severity index (PASI) and presence of thyroid dysfunction with a significant P-value of < 0.001. There was also a positive correlation between familial incidence of psoriasis and the presence of thyroid dysfunction in conjunction with span of psoriasis and the presence of thyroid dysfunction providing significant P-values of Observations from our study provide compelling evidence that psoriasis is associated with thyroid dysfunction, which may affect the quality of life, as we documented higher PASI scores in psoriatics with thyroid dysfunction than those with normal thyroid function. It also highlights the importance of adopting a multidimensional approach for the management of psoriasis.

Introduction: McCoy laryngoscope and video laryngoscopes are being increasingly used as they offer advantages over the conventional laryngoscopes in airway management. The aim of this study is to compare and evaluate the efficacy of McCoy laryngoscope and TAScope in providing good glottic view and ease of intubation and observing the hemodynamic stress response. Materials and Methods: It is a randomised study including 60 patients aged 18-60 years with ASA grade I and II, divided equally in Group M and Group T, posted for elective surgery. Ease of intubation was evaluated by intubation difficulty score(IDS). Hemodynamic parameters, intubation time and airway trauma were compared in both the groups. Results: IDS TOTAL was higher in group M and was statistically significant (p

Background: Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. Aims and Objectives: Delphi exercise to define and categorise acquired dermal pigmentary diseases. Methods: Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. Results: Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term ‘acquired dermal macular hyperpigmentation’. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis, lichen planus pigmentosus and pigmented contact dermatitis. Limitations: A wider consensus involving representatives from East Asian, European and Latin American countries is required. Conclusion: Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation.

The main design principles in computer architecture have recently shifted from a monolithic scaling-driven approach to the development of heterogeneous architectures that tightly co-integrate multiple specialized processor and memory chiplets. In such data-hungry multi-chip architectures, current Networks-in-Package (NiPs) may not be enough to cater to their heterogeneous and fast-changing communication demands. This position paper makes the case for wireless in-package nanonetworking as the enabler of efficient and versatile wired-wireless interconnect fabrics for massive heterogeneous processors. To that end, the use of graphene-based antennas and transceivers with unique frequency-beam reconfigurability in the terahertz band is proposed. The feasibility of such a nanonetworking vision and the main research challenges towards its realization are analyzed from the technological, communications, and computer architecture perspectives., Comment: 8 pages, 4 figures, 1 table - Accepted at IEEE Wireless Communications Magazine

Summary: The recent COVID pandemic required medical staff to be deployed at short notice to makeshift COVID hospital. A questionnairebased study for nding the satisfaction levels of the medical staff working in an emergency makeshift COVID hospital was conducted to ensure the right kind of working environment for the staff. A questionnaire was developed by the authors Method: and validated by experts in the eld and then circulated amongst the medical staff in the facility. The responses were marked on a Likert's scale with ve options. The data on demographic variable was collected. The data on various aspects of difculties such as administrative, structural, process and personal fronts was collected. Results: Most individuals were satised with the administrative provisions, however, 51% of the participants were concerned about taking the infection back home to their families, 41% of individuals had qualms about the patient-to-staff ratio, and 40% of the staff were unhappy with the under performance of the housekeeping staff. The deployment of medical staff needs t Conclusion: o align with the number of patients in need of care. Also, the ancillary staff needs to be made accountable for their actions through proper contract management. Organizational background makes a considerable difference in maintaining the morale of its employees.

Background Home blood pressure measurements have equal or even greater predictive value than clinic blood pressure measurements regarding cardiovascular outcomes. With advances in home blood pressure monitors, we face an imminent flood of home measurements, but current electronic health record systems lack the functionality to allow us to use this data to its fullest. We designed a data visualization display for blood pressure measurements to be used for shared decision making around hypertension. Methods We used an iterative, rapid-prototyping, user-centred design approach to determine the most appropriate designs for this data display. We relied on visual cognition and human factors principles when designing our display. Feedback was provided by expert members of our multidisciplinary research team and through a series of end-user focus groups, comprised of either hypertensive patients or their healthcare providers required from eight academic, community-based practices in the Midwest of the United States. Results A total of 40 participants were recruited to participate in patient (N = 16) and provider (N = 24) focus groups. We describe the conceptualization and development of data display for shared decision making around hypertension. We designed and received feedback from both patients and healthcare providers on a number of design elements that were reported to be helpful in understanding blood pressure measurements. Conclusions We developed a data display for substantial amounts of blood pressure measurements that is both simple to understand for patients, but powerful enough to inform clinical decision making. The display used a line graph format for ease of understanding, a LOWESS function for smoothing data to reduce the weight users placed on outlier measurements, colored goal range bands to allow users to quickly determine if measurements were in range, a medication timeline to help link recorded blood pressure measurements with the medications a patient was taking. A data display such as this, specifically designed to encourage shared decision making between hypertensive patients and their healthcare providers, could help us overcome the clinical inertia that often results in a lack of treatment intensification, leading to better care for the 35 million Americans with uncontrolled hypertension.

With the introduction of spectrum sharing and het-erogeneous services in next-generation networks, the base stations need to sense the wideband spectrum and identify the spectrum resources to meet the quality-of-service, bandwidth, and latency constraints. Sub-Nyquist sampling (SNS) enables digitization for sparse wideband spectrum without needing Nyquist speed analog-to-digital converters. However, SNS demands additional signal processing algorithms for spectrum reconstruction, such as the well-known orthogonal matching pursuit (OMP) algorithm. OMP is also widely used in other compressed sensing applications. The first contribution of this work is efficiently mapping the OMP algorithm on the Zynq system-on-chip (ZSoC) consisting of an ARM processor and FPGA. Experimental analysis shows a significant degradation in OMP performance for sparse spectrum. Also, OMP needs prior knowledge of spectrum sparsity. We address these challenges via deep-learning-based architectures and efficiently map them on the ZSoC platform as second contribution. Via hardware-software co-design, different versions of the proposed architecture obtained by partitioning between software (ARM processor) and hardware (FPGA) are considered. The resource, power, and execution time comparisons for given memory constraints and a wide range of word lengths are presented for these architectures.