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This document is a concise, current, and practical guide for dermatologists and other health care providers managing adult patients with moderate-to-severe atopic dermatitis (AD). The recommendations made here are based on a consensus of specialists with extensive experience managing patients with AD. Topics reviewed in this publication include AD pathophysiology, assessment, comorbidities, and treatment options.

The objectives of therapy for atopic dermatitis (AD) are to reduce skin inflammation and pruritus, restore skin barrier function, and improve quality of life (QoL). Treatments can be classified as moisturizing and basic care, topical therapy, phototherapy, and systemic therapy. In this review, we summarize the treatments for AD and recommendations for their use.

Background: Cleanliness and hygiene in hospitals are critical to preventing infections and also provide patients and visitors with a positive experience and encourages molding behavior related to clean environment. Comprehensive sanitation and proper biomedical waste management is a critical factor in preventing iatrogenic causation of disease in addition to promoting health and cure. Hospitals of all levels of healthcare are assessed under the kayakalp programme every year.Methods: Observational cross sectional study was done in the Indira Gandhi Medical College Shimla in the month of April 2018 using kayakalp assessment checklist for tertiary care hospital.Results: Scores under various thematic areas was less than the required scores for qualifying for further peer and external assessment.Conclusions: The results compiled were appraised to the authorities of the IGMC Shimla for necessary improvements in different thematic areas of Kayakalp.

Cannabis ( Cannabis sativa/indica), also known as marijuana, has been used for medicinal and recreational purposes for millennia. There has been a recent trend to legalize the use of cannabis, as illustrated by the recent legalization votes in numerous states in the United States and legislation in Canada to allow recreational cannabis use. With this increasing consumption of cannabis, dermatologists will see increased pressure to prescribe cannabis and will see the side effects of cannabis use with greater frequency. There are several approved medical indications for cannabis use, including psoriasis, lupus, nail-patella syndrome, and severe pain. In addition, very preliminary studies have suggested cannabis and its derivatives might have use in acne, dermatitis, pruritus, wound healing, and skin cancer. Further well-controlled studies are required to explore these potential uses. Conversely, the side effects of cannabis use are relatively well documented, and dermatologists should be aware of these presentations. Side effects of cannabis use include cannabis allergy manifesting as urticaria and pruritus, cannabis arteritis presenting with necrosis and ulcers, and oral cancers from cannabis smoke. In this review, we summarize some of the studies and reports regarding the medicinal uses of cannabis in the dermatology clinic and some of the side effects that might present more often to dermatologists as the use of cannabis increases.

BACKGROUND According to UNDCP World Drug Report, the problem of substance abuse in adolescence is fast assuming alarming proportions in both developed and developing nations. Kullu District of Himachal Pradesh has regularly been in media headlines for extensive cannabis cultivation and abuse of other substances. The study was conducted to provide an essential source of information about substance abuse and its correlates in this Himalayan region. MATERIALS AND METHODS This was a descriptive school-based cross-sectional study conducted among students (13-19 years) studying in classes 7th to 12th. Multi-stage cluster random design and PPS sampling methodology was adopted. A sample of 3000 students both from rural and urban areas studying in 20 government and private senior secondary schools was selected. An anonymous, pretested, self-administered questionnaire adapted from WHO and ESPAD questionnaires was used to collect relevant information. Statistical analysis was done by entering the data in SPSS. RESULTS The ultimate response rate was 98.5%. Out of the total of 2864 participants, 785 (27.4%; 95%, CI 25.8% to 29.1%) had indulged in substance abuse at least once in their lifetime. Prevalence of current and regular users was 13.8% (95%, CI 12.5% to 15.1%) and 4.1% (95%, CI 3.4% to 4.9%), respectively. Alcohol was the most commonly abused substance among ever users at 18.1% followed by tobacco (17.6%) and cannabis (6.2%). Around 85% of the students perceived indulgence in substance abuse to be harmful for health. The logistic regression model revealed that substance abuse among friends (AOR 5.32), family members (AOR 2.04), inability to spend quality time with parents (AOR 2.44), gender (AOR 1.68) and older age group of 16-19 years (AOR 1.51) were the factors found to be positively associated with substance abuse. CONCLUSION The study has brought out a high prevalence of substance abuse among the students. The participants’ high knowledge about deleterious effects of substance abuse did not translate into any beneficial behavioural change. Hence, scaling up of IEC activities and life skill education focussed on school going adolescents is imperative. Further, the negative influence of family abuse practices and inability to spend quality time with their wards highlights the necessity to include parents in any awareness campaign being planned.

It is evident in the undergraduate dental curriculum that competent dental students are expected to have a broad knowledge of the intricacies of the human body and its relationship with the oral cavity, but the same cannot be guaranteed for medical students. This case report of a medical undergraduate student who presented with multiple carious lesions and a poor knowledge of the impact of her habits on her oral heath illustrates the importance of using a well-formulated and holistic treatment plan with a focus on oral health promotion and education. The review appointment proved promising with an improved plaque score and dietary analysis. This article provides a brief introduction to the topics and discusses potential future developments that aim to reduce the subjectivity in the analysis process and simplify presentation of evidence to non-dental parties. CPD/Clinical Relevance: This case re-iterates the need to encompass education and prevention to stabilize and prevent dental caries and teach other future healthcare professionals so that they can utilize and consider this knowledge in the management of their own patients. Moreover, it demonstrates that there may be scope for raising dental awareness and education within the medical profession.

Methaemoglobinaemia is an extremely rare condition with multiple causes, both genetic and acquired. We present a severe case of methaemoglobinaemia occurring in a Brazilian hairdresser working in the UK. She presented after several days of preparing popular ‘Brazilian blowdry’ treatments for customers at a hair salon. She had been exposed to multiple volatile chemicals, including formaldehyde, without any respiratory protection, and we postulate that this may have caused her illness. If so, this would be the first published case of methaemoglobinaemia caused by exposure to the volatile components of beauty products.

This one-day conference, titled Canadian South Asian Youth: Gender, Identity, Sexuality, and Activism, was held at Simon Fraser University (SFU) Harbour Centre in downtown Vancouver on April 6th, 2019.

Purpose Preventing or delaying the onset of presbyopia and cataract formation remains a challenge. The goal of this study was to establish the utility of the Vision Index Pen (VIP), designed to measure in vivo dynamic light scattering (DLS) from the crystalline lens, in the detection of early cataract or loss of accommodation and to show reproducibility through trials at two independent sites. The gradual loss of transparency of the lens was characterized by the lens crystallin aggregation index (LCX) derived from measured DLS data. Methods Volunteers in different age groups participated in two independently operated observational clinical studies. All subjects underwent a detailed eye exam and VIP measurement of the intensity correlation of the backscattered light from the lens. Results LCX values extracted from DLS data show strong correlation with the aging lens, ranging from 20 at the age of 20 years to over 150 at 60 years. Quantitatively significant changes in the LCX value occur from 35 years to 55 years. LCX values were found to correlate with the loss of accommodation (correlation of -0.563 with P < 0.001) and with published data regarding the change in relative lens resistance with age. Conclusions Results from two independent observational clinical trials have confirmed the repeatability and reproducibility of the VIP diagnostic device as a viable clinical tool for tracking localized macromolecular changes taking place in the aging lens. Detection of early changes in the crystalline lens can be useful in developing patient-specific prediction models, which can be used to screen patients who may benefit from early therapeutic interventions for delaying the onset of presbyopia and cataract growth. Translational Relevance The VIP diagnostic device provides in vivo access to the human lens, enabling characterization of the unfolding and decomposition of long-lived macromolecules.

Today's collaborations across fields of health and wellness are insufficient to meet societies' challenges in combating disease and maintaining the ecosystem and public health. In this article, we present a One Health curriculum model designed to encourage undergraduate students of varying disciplines to value the connectedness of animals, humans, and the environment and to think innovatively about solutions to priority global health issues.We present the design and implementation of a course that brought together multiple faculty from different fields of study, including the dental, medical, nutrition, and veterinary schools, in a curriculum designed for undergraduates primarily from Arts & Sciences fields. The curriculum was collaboratively designed around four key One Health categories: 1) Infectious zoonotic diseases and global health, 2) Naturally occurring shared disease in companion animals that can serve as models for human disease, 3) Human-animal interactions, and 4) Impact of environmental health on human and animal health.We show this course successfully deepened students' understandings of One Health, its role in addressing high priority health issues and the overall benefits of a One Health approach to tackling societal problems. We also report a positive experience by the faculty working in collaboration to implement the curriculum model and the overall enthusiasm of students for the course, all of whom would recommend it to their peers.We conclude by proposing the potential of the curriculum model underlying this course to fill the need for One Health Curricula in programs preparing future health professionals. Keywords: One health, Animal, Environmental, Human, Interprofessional education

Background and aim Hypercholesterolemia (HC) is a major risk factor for cardiovascular (CV) diseases, that are the major cause of mortality worldwide. Free radicals mediated oxidative stress is a critical player in HC-associated pathophysiological insults including atherosclerosis. Unwanted side effects associated with statins, COX-2 inhibitors, and other synthetic drugs limit their use. Thus, modulation of oxidative stress during HC using green pharmaceuticals seems an appropriate approach against deleterious CV consequences without noticeable side-effect. In this regard, owing to an abundance of proteins, fiber and optimal ratios of omega 6 PUFA: omega-3 PUFA in Hempseed (HS), we aim to exploit its anti-inflammatory and antioxidant properties to ameliorate HC- associated CV effects. Methods and results Comparing the antioxidant capacity of protein and lipid fractions of HS using ABTS and DPPH assays, HS was supplemented to high-fat diets (HFD) induced hypercholesterolemic wistar rats. After treatment schedules, lipid profiles, histological and ultrastructural investigations, gene and protein expressions of inflammatory markers, markers of oxidative stress were studied and correlated with biophysical parameters such as ECG and impedance/conductance across the aorta. HS demonstrating in vitro free radical scavenging activity, ameliorated the signs of HC as seen with improved lipid profiles, aortic tissue damage and ECG patterns compared to HFD groups. HS administration also relieved the COX-2 mediated inflammation, which correlated well with the improved redox status in the tissue. Conclusions Current study evidently demonstrates that the anti-hypercholesterolemic effects of HS are mediated through redox-sensitive modulation of inflammatory pathways.