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Introduction A prospective, interventional study was conducted to evaluate the efficacy and safety profile of long-pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in the treatment of vascular lesions in the darker skin patients of Fitzpatrick skin type IV and V. Materials and method The study was conducted at a tertiary care hospital. Institutional ethical committee permission was obtained before starting the study. Twenty-nine patients presenting with vascular lesions were enrolled in the study. The patients were called once a month for sessions for six months. Clinician Global Impression (CGI) scores were used for evaluation. We followed a "per protocol" analysis. Results Of the 29 patients we enrolled, three dropped out for various logistic reasons, and 26 patients completed their treatment. After six months of follow-up of the 26 patients who completed their treatment, 12 (46.15%) had shown complete healing (CGI = 4, 70%-100% improvement in lesions). The rest of the 14 (53.84%) patients showed good improvement (CG1 = 3, reduction of 50%-70% of lesions). No permanent side effects were noted. Conclusion Long-pulsed 1064 Nd:YAG laser proves to be an effective treatment for hemangioma and vascular malformation in darker skin patients with its major advantages of being a safe, well-tolerated, cost-effective procedure with minimal downtime and minimal side effects.

Introduction. We undertook a prospective, interventional study to evaluate the efficacy and safety profile of Intense Pulsed light (IPL) treatment of melasma in dark skin phenotypes. Material and Methods. The study was conducted in 32 patients of skin type IV and V. IPL with 640 nm and 690 nm filters was used. The patients were called once a month to undergo 6 sessions. Melasma area and severity index (MASI) and Clinician Global Impression Scores were used for evaluation. We followed “per protocol” analysis. Results. Out of 26 patients who completed the treatment, 12 patients showed improvement, MASI remained unchanged in 10 patients and 4 patients showed deterioration. MASI scores before and after treatment were 6.70 ± 3.53 and 6.32 ± 3.90 (p value=0.6891). Erythema and pain were the common side effects noted. Seventeen out of 32 patients had thyroid disorders. Conclusion. IPL should be avoided as a first line therapy in darker skin type. However, it can be used as an adjuvant therapy in some cases after careful deliberations.

Our current, mostly analog system for taking traffic fine and validating documents or certificates (e.g., RC paper, driving license, etc.) is sluggish, complex, and unpredictable. Moreover, recently proposed traffic fine ordinances give rise to bribery. To ensure traffic fine and document verification as a transaction at real-time cost and in a hassle-free way, this paper proposes the use of a permissioned model of blockchain, i.e., hyperledger fabric technology for executing smart contracts. This paper also describes a prototype for carrying out the traditional fine in an efficient, secure, and transparent manner using hyperledger composer. Digitized strategy for validation of documents before each transaction and permissioned technology could supplant the traditional traffic fine system.

Background Recent clinical studies have suggested that systemic metal ion levels are significantly elevated at midterm follow-up in patients with ceramic-on-metal (COM) bearing. However, it is not clear whether there is a correlation between patient-related factors including the lifestyle and elevated levels of serum metal ions following COM total hip arthroplasty (THA). Methods Serum metal levels were measured in 201 patients (234 hips) including 121 COM patients (140 hips) and 80 non-COM patients (94 hips). The Harris Hip Score, University of California, Los Angeles activity scale score, and Western Ontario and McMaster Universities Osteoarthritis Index score were measured and radiographs were obtained for the analysis. Results Significantly higher levels of cobalt (Co) and chromium (Cr) were detected in the serum of the COM THA group (Co: 1.86 ± 4.0 μg/L; Cr: 1.81 ± 2.87 μg/L) than those of the non-COM THA group (Co: 0.27 ± 0.14 μg/L; Cr: 0.19 ± 0.25 μg/L; P The serum metal levels of patients who achieved the squatting position and the kneeling position were significantly higher than those of patients who could not squat (Co: P = .033; Cr: P = .074) and kneel (Co: P = .049; Cr: P = .031). The metal ion levels of the COM THA group correlated with the total range of motion (Co: P = .0293; Cr: P = .0399). Conclusion Patients who underwent a 36-mm COM THA showed high serum metal levels although good clinical outcomes at the midterm follow-up. We found that COM THA patients who were capable of greater range of motion, squatting, and kneeling are at risk of metal ion–related problems.

OBJECTIVES: Local corticosteroid infiltration is a common practice of treatment for lateral epicondylitis. In recent studies no statistically significant or clinically relevant results in favour of corticosteroid injections were found. The injection of autologous blood has been reported to be effective for both intermediate and long-term outcomes. It is hypothesized that blood contains growth factors, which induce the healing cascade. METHODS: A total of 50 patients were included in this prospective randomized study. Patients were divided in 2 groups of 25 patients each. Group I received 2 ml local corticosteroid + 1 ml 2% lignocaine, Group II received 2 ml autologous blood drawn from ipsilateral upper limb vein + 1 ml 2% lignocaine, and at the lateral epicondyle. Outcome was measured using a pain score (VAS). Follow-up was continued for total of six months. RESULTS: The corticosteroid injection group showed a statistically significant decrease in pain compared with autologous blood injection group at six weeks follow up. At final six-month follow-up, autologous blood injection group showed statistically significant decrease in pain compared with corticosteroid injection group. CONCLUSIONS: Autologous blood injection is efficient compared with corticosteroid injection, with less side-effects and minimum recurrence rate in long term.

We report a case of 22 year female with toxic epidermal necrolysis while on carbamazepine. One hospital outside treated her with steroids but she didn’t show any improvement and rather worsened. The patient reported to us with fluctuating blood pressure and dyselectrolytemia. Patient also developed neutropenia (3,200/mm3) and sepsis. Patient was treated with filgrastim and dexamethasone. Filgrastim was added because of neutropenia and earlier case reports suggesting it aid in faster healing. Patient made a complete recovery.

Identification of high risk among viruses is crucial for interpreting its oncogenic mechanisms. Also it is gainful in developing ultra modern clinical tools for its diagnosis, prevention and treatment. Prediction of the structure of a particular virus helps to classify the risk type of that virus. Prediction methods based on text based classification do not provide satisfactory results as compared to sequence-based techniques. In particular, text-mining approaches only relay on the documentation procured from the studies. Hence insufficiency of the evidences for an unknown virus gives rise to classification issues. Therefore risk prediction of viruses from protein sequence and its structure is an effective alternative to text based classification. In this work, Machine learning techniques are used for risk type classification of Papillomaviruses which is having high potentials to cause cancer.