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Several insect species visit the flowers of a plant to obtain floral rewards in the form of pollen and/or nectar. In return, we would anticipate that those visitors would contribute to the reproductive success of the plant. Do these visitors contribute equally towards the reproductive success of the plant? This issue has been the interest of many pollination ecologists. To find a solution to this problem, I investigated the pollination ecology of rocket (Eruca vesicaria (L.) Cav. ssp. sativa (Mill.) Thell), an important leafy vegetable used as salad. I captured the flower visitors with a hand net from the experimental field and had these identified. I also recorded the number of loose pollen grains carried on the body of the visitors of different species and deposited on the stigmas. Effects of single and multiple visits of visitors on the seed set of rocket flowers were also determined. Abundances and foraging rates of the flower visitors of this species were recorded and their values were used to calculate their respective contributions towards the reproductive success of this species. Five species of Hymenoptera, three of Diptera, one of Lepidoptera, and one of Coleoptera visited the flowers of the rocket. Apis florea was the most abundant among the flower visitors, followed by the dipterous flies, Apis mellifera, Apis dorsata, Andrena savignyi, and Andrena leaena in descending order. The number of loose pollen grains carried and deposited, foraging behaviors, foraging rates, and abundances did not provide conclusive measures to differentiate the contributions of different flower visitors towards the reproductive success of the rocket. However, the data recorded on abundances, foraging behaviors, and foraging rates together could do so. Accordingly, Andrena savignyi was the most efficient pollinator of rocket, followed by Andrena leaena, Apis dorsata, Apis mellifera, and Apis florea; dipterous flies were the least efficient pollinators of this plant species. In rocket, 28.84% of pollination was brought by Andrena savignyi, 24.69% by Andrena leaena, 20.34% by Apis dorsata, 18.37% by Apis mellifera, and 7.7% by Apis florea; dipterous flies caused only 0.06% pollination. Butterflies were very rare and Coccinella sp. was not a pollinator of this plant. Therefore, not all the pollinators of rocket contributed equally towards its reproductive success (seed production). Bees brought about 99.94% of total pollination and melittophily distinctly predominated over other pollination modes. However, among the bees, native bees together are the major pollinators in the flowers of rockets and accomplished more than 81.5% pollination. Therefore, the conservation of native bees is most important for the pollination of crops such as rockets.

Background: Cutaneous manifestations associated with celiac disease (CD), other than dermatitis herpetiformis, are poorly known. The aim of the present study was to study the spectrum of dermatological disorders in children with CD. Methodology: A total of 100 cases of biopsy-confirmed CD (both new and old) were recruited after taking written informed consent/assent from the child/guardians. The patient's demographic details, history, vitals, general physical examination, systemic examination, and cutaneous examination findings were recorded. Relevant investigations were carried out, depending on the clinical findings of the cutaneous examination. Results: A total of 100 patients comprising 62 girls and 38 boys were studied, with the average age being 8.08 ± 3.67 years. Seventy patients showed the presence of dermatological findings. Cutaneous, mucosal, nail, and hair findings were seen in 35%, 7%, 14%, and 14% of patients, respectively. A higher incidence of dermatological findings was found in females (39%) compared to males (18%). The most common cutaneous conditions seen were atopic dermatitis (17%) and xerosis (10%). The most common mucosal finding was oral aphthae (4%). The most common nail changes were leukonychia and ragged cuticles (4% each). There was no statistical correlation between the presence of dermatological findings with the duration of the disease or with the duration of a gluten-free diet. Conclusion: Mucocutaneous manifestations are present in a significant proportion of patients with CD. Further studies with a larger sample size are needed to determine whether these findings are true associations or coincidental.

Background: The current trend in the declining rates of new COVID-19 case detection may be attributed to better awareness and more robust screening and testing programs all across the country. Although there have been many studies on the impact of COVID-19 in India and its management, there are no studies currently regarding the knowledge, attitudes, and practices (KAP) among the community. Objective: This study aims to study the KAP regarding COVID-19 attending the dermatology outpatient department in a tertiary care center. Materials and Methods: A cross-sectional, descriptive study was conducted on 202 patients attending the dermatology outpatient department. After taking consent, the enrolled patients were directed to complete the COVID-19 KAP questionnaire, which was adapted from a previous study, and was translated into Hindi. Results: Our study showed a good knowledge score of 8.01 ± 1.94 for males and 7.71 ± 2.4 for females. The knowledge scores were similar in both genders and across all age groups and employment groups. The knowledge scores were significantly higher in those with higher education levels. Conclusion: Male gender, with higher education and a higher COVID-19 knowledge score, was also associated with a significantly more positive attitude. Females, with higher education and a higher COVID-19 knowledge score, were also found to have better protective measures against COVID-19.

Background: Premature canities refer to the loss of hair pigment, at an earlier age than normal. Vitamins and minerals are involved in the various steps of melanogenesis. There is a paucity in the current literature on possible correlation between the serum levels of micronutrients and premature graying of hair. Materials and Methods: A case − control study was conducted on 56 patients of premature canities and 50 age- and sex-matched healthy controls between 12 and 18 years of age. After taking detailed history and physical examination, serum was analyzed for copper, zinc, iron, magnesium, Vitamin B12, folic acid, and Vitamin D levels in both cases and controls, and the results were compared. Results: Mean serum levels of zinc, magnesium, and Vitamin B12 were significantly lower in cases (P < 0.01). No significant difference between mean serum copper, iron, Vitamin D, and folic acid levels between cases and controls was found. Patients having deficiency of copper, zinc, iron, magnesium, and Vitamin B12 were significantly higher in cases compared to controls (P < 0.05). No significant association between the serum levels of micronutrients with severity of canities was found. Conclusion: On basis of our study, we conclude that patients of premature graying can have micronutrient deficiencies such as copper, zinc, iron, magnesium, and Vitamin B12. These micronutrients should be analyzed in patients of premature canities if facilities are available and if patients are found deficient, they should be supplemented for the same. However, further studies on a larger population and effect of supplementation of these micronutrients on premature graying are required.

Background: Treatment of childhood lichen planus (LP) is challenging owing to high rate of relapses. Moreover, majority of treatment options for LP have been extrapolated from studies done in adults. Topical corticosteroid remains the first line of treatment in localized classic form of LP, but till date, no consensus exists regarding standardized therapy in children. Hence, we conducted this study to evaluate the efficacy of mid-potent topical steroid fluticasone propionate 0.005% in childhood LP. Aims and Objectives: The aim of this study was to evaluate the therapeutic efficacy of fluticasone propionate ointment 0.005% in childhood LP. Materials and Methods: Thirty-one patients (6 months to 18 years of age) with clinical and histopathologically confirmed diagnosis of LP were subjected to routine baseline severity assessment, patient/parent assessment, pretreatment photographic record of the fixed anatomical site under treatment, and then received topical mid-potent steroid therapy (fluticasone propionate ointment 0.005%) twice daily and cetirizine dihydrochloride in predefined doses for 8 weeks. Follow-up was done at the end of 2 weeks, 4 weeks, 6 weeks, and 8 weeks. After 8 weeks, a proportion of patients achieving clinical improvement and side effects were assessed. Observation and Results: The difference between pre- and posttreatment induration was not statistically significant (P = 0.336). The mean number of lesions before the start of treatment was 50.29, which reduced to 14.77 (P = 0.000) after treatment, and the mean of patients' itching score before treatment was 6.74 ± 1.6, which reduced to 2.61 ± 2.3 (P = 0.000) following treatment, which was statistically significant. Clinical improvement was seen in 67.7%, whereas 32.3% showed no improvement over a period of 8 weeks. Conclusion: Mid-potency steroid fluticasone propionate ointment twice daily is an effective therapeutic agent for localized childhood LP, with minimal side effects.

Background: Consultation-liaison (C-L) psychiatry is the subspecialty of psychiatry dealing with mental health disorders in nonpsychiatric settings. The ubiquity of mental health problems has increased the need for such a service to exist in general hospital psychiatric units, as many psychiatric patients report to a different specialty of medicine for the first time. This study aims to evaluate the utilization of psychiatry C-L services by nonpsychiatric inpatient units in a general hospital psychiatry unit taking into consideration the paucity of data for understanding the trends and improving service provision in the future. Materials and Methods: A retrospective chart review of all inpatient referrals received by the psychiatry department from July 2015 to February 2017 was conducted. The sociodemographic profile, source of referral, reason for referral, and psychiatric diagnosis using the International Statistical Classification of Diseases-10 were analyzed using descriptive statistical methods. Results: A total of 605 patients were referred, which comprised 0.86% of total indoor admissions. Maximum number of consultations was sought from internal medicine. “Unexplained physical symptoms” was the most common reason for referral (35%). Consequently, neurotic, stress-related, and somatoform disorder (25.5%) was the most common psychiatric diagnosis followed by mood disorder (19.8%). Conclusion: Poor and variable referral rate from various departments highlights the increasing need to sensitize all clinicians regarding psychiatric comorbidity. There is a need to explore factors that would result in increasing referral rates and making psychiatric consultation services effective and efficient.

Background: Modernization and increasing level of competition in day to day life has increased the expectations from teachers. Objective: To describe the level of stress and its associated factors among teachers using Teacher's stress inventory in a government school of urban area of South Delhi. Methods: A cross sectional study among teachers of a senior secondary school located in south Delhi. This was part of mental health literacy workshop conducted March 2017. 124 teachers attended the same and 94 participated in the study. Teachers' stress inventory scale was used as a tool to assess the level of stress along with demographic factors of the study participants. Only 82 completed questionnaires were included in analysis. Results: The mean score among discipline and motivation sub category was a significantly higher source of stress among young age teachers (P

Background: Worldwide, limited studies have been done to study the spectrum of dermatological referrals in children. Aims and Objectives: The aim of this study was to analyze the spectrum of dermatological disorders in children referred from pediatrics department. Materials and Methods: It was a hospital-based observational study. Five hundred twenty-five children of either sex or age ≤18 years, in whom, parents had given written informed consent, and referred to Dermatology from Pediatric medicine department were included in this study. The diagnosis was made based on clinical features supported by necessary investigations. Working hours were considered as routine and emergency. Nelson' severity scoring system was used to classify children as sick. Results: Most of the children were referred during routine hours (85.7%), maximally from inpatient department (46%) followed by outpatient department (37%). Most common diagnosis was viral infections (21.2%), closely followed by eczematous disorders (17.6%) and disorders due to arthropods (17.1%). Majority of patients were not sick (83.61%). Pediatricians did not suggest any diagnosis in 70.85% of referrals followed by doubtful diagnosis in 26.85% and definitive diagnosis in 2.28% of patients. Conclusion: Majority of referrals were done during routine hours in nonsick patients. As many common easily treatable dermatoses were observed in all the referrals reiterating the fact that these referrals should be sought as early as possible to prevent unnecessary delays in the diagnosis and patient management. Furthermore, a robust dermatological training should be provided to undergraduates and interns to better equip the nondermatologists to diagnose common dermatological disorders.

Introduction: Lichen planus pigmentosus (LPP) is a distinct clinical entity commonly encountered in the Indian population. Aim: To study the clinicoetiological profile of LPP at a tertiary care hospital. Methods: A total of 100 patients with clinically and histopathologically confirmed diagnosis of LPP were included. Demographic details including the age of onset, duration of disease, symptoms, and family history were obtained. History regarding any precipitating factors, cosmetics, drug intake, and associated cutaneous or systemic diseases was taken. Clinical examination of the skin, oral cavity, hair, and nails was carried out. Results: Of the total 100 patients, 56 (56%) were females and 44 (44%) males with age ranging from 18 to 54 years (mean age - 31.23 years). The duration of disease ranged from 2 to 60 months with a mean of 19.31 months. Cosmetic disfigurement (68%) was the commonest complaint, followed by itching (41%) while, 30% of the patients were asymptomatic. History of topical mustard oil and hair dye application was present in 62% and 48% of the cases each. Other topicals included perfumes (24%), aftershave lotion (36%), and cosmetics (20%). Face (54%) and neck (48%) were the commonest sites affected, followed by upper back (36%), upper limbs, and chest (each 32%). A total of 11 patients showed only flexural involvement. The commonest pattern of pigmentation was diffuse (56%) followed by reticular in 16%. The color of the pigmentation varied from slate grey to brownish-black in varying proportions. A positive association was found between hypothyroidism with diffuse LPP where the P value was

Importance: Exact etiopathogenesis of chronic spontaneous urticaria (CSU) remains elusive. Infections, pseudoallergens, autoimmunity, and contact sensitization are various postulated factors. Few studies are available measuring cytokine levels in CSU. Objectives: The aim was to study various etiological factors of CSU and levels of IL-6 and IFN-ϒ in cases and controls, and correlation between various etiologies with the levels of the abovementioned interleukins in the cases. Design: Case-control study performed over 2 years with no follow-up of the participants. Setting: It was a referral-center-based study. Participants: Sixty patients of CSU and equal age and sex-matched healthy controls were recruited on the basis of convenience sampling. Exposures: Biochemical and hematological investigations with hepatitis serology, thyroid function tests, anti-thyroid antibodies, and levels IL-6 and IFN-ϒ were performed in all cases and controls. All cases were subjected to ASST. Cases with all above negative tests were patch-tested with Indian standard series. Urticaria activity score (UAS7) was calculated for all the cases and repeated in patients with positive etiological factor after 3 weeks (improvement after allergen or drug avoidance, treatment of infection). Outcomes: To study the various etiological factors (food, infection, autoimmunity, autoreactivity, and contact sensitization) and the levels of IL-6 and IFN- γ in patients of chronic spontaneous urticaria. Results: Etiology was ascertained in 75% of patients (autoimmunity: 50%, contact sensitization: 21.67%, food and drug allergy: 1.67% each). Mean values of the interleukins and anti-thyroid antibodies were significantly higher in cases versus controls. Levels of IFN-ϒ were significantly elevated in patients with higher UAS7 scores. Conclusion: Antithyroid antibodies, ASST, and patch testing are important tools and should be considered in patients of CSU after a thorough history and history-based workup. Elevated levels of IL-6 and IFN- ϒ in cases suggest that both Th1 and Th2 type of immune responses are implicated in pathogenesis of CSU.

Background: Lichen planus (LP) is a papulosquamous disease of unknown etiology that is relatively uncommon in children. There is a paucity of data on the clinical profile of LP in children. Available case series are few and majority being retrospective. A cross-sectional observational study to evaluate the clinical profile of childhood LP was performed. Materials and Methods: All childhood cases (

Systemic lupus erythematosus (SLE) is a connective tissue disorder with a high prevalence in certain races like Africans. It also has a female predilection. The pathogenesis of SLE is a complex interplay of genetic and environmental factors. Familial presentation of SLE has been well documented. We herein illustrate a scenario of SLE presenting in related females (mother and daughter) concurrently with similar clinical features and fulfilling the Systemic Lupus Collaborating Clinics criteria. Stress was identified as a common possible triggering factor.

Hypomelanosis of Ito (HOI) is a sporadic disorder characterized by naevoid hypomelanosis in association with neurological, musculoskeletal, and other systemic defects. Localized hypertrichosis has been reported in HOI, however, multifocal hypertrichosis along with hirsutism in HOI are rare. We report an interesting coexistence of multifocal hypertrichosis and hirsutism in a 7-year-old girl with HOI.

Introduction: Periorbital hyperpigmentation (POH) is one of the common conditions seen in outpatient department. Despite of its huge prevalence, clinical data regarding its etiology and associations are still insufficient. Materials and Methods: We conducted a clinico-investigational study in 50 patients of periorbital pigmentation. A detailed clinical history was recorded, clinical examination and laboratory investigation including complete blood count, vitamin B12 level, and thyroid profile are done. Results: The mean age of the patients presenting with periorbital hyperpigmentation was 29.5 years, out of 50 patients 42 (84%) were females and 8 (16%) were males. About 14% patients give positive family history of POH, history of atopy was positive in 30% of patients. History of various other habits like lack of adequate sleep, prolonged exposure to computers, rubbing eyes, and application of various cosmetics were also found to be positive in these patients. The other associated clinical findings were freckles (12%), telengectesia (2%), erythema (2%), and melasma (2%). In maximum (90%) number of patients, both upper and lower eyelids were involved and pigmentation involving >1 cm of eyelid margin was seen in 62% of patients. Laboratory investigations showed anemia in 10% of patients and low serum vitamin B12 in 12%; however, none of the patients has deranged thyroid profile. Conclusion: POH has a multifactorial etiology and role of correcting various faulty habits is important factor in its management. Presence of anemia and low serum vitamin B12 levels also points toward need of detailed laboratory evaluation in these patients.

Background: Footwear dermatitis represents a common but often undiagnosed or misdiagnosed condition. Patch testing aids in its confirmation and identification of the offending allergen. Aims: This study aimed to find the frequency of positive patch test reactions in cases with suspected allergic contact dermatitis (ACD) to footwear, as well as the common responsible allergens. Materials and Methods: This is a retrospective record based study of 37 patients, with suspected ACD to footwear, who underwent patch testing with Indian standard series and Indian footwear series from July 2012 to July 2015. Results: The majority of patients (45.94%) belonged to the age group of 20–40 years. Dorsal aspects of feet (81.08%) and soles (18.92%) were the common sites involved. Patch test was positive in 18.92% patients. The most common causative allergens were hydroquinone monobenzylether (8.11%) and 4-aminoazobenzene (5.41%). Conclusion: Common chemicals implicated in ACD were rubber, rubber additives, and dyes. The principal culprit allergens were hydroquinone monobenzylether and 4-aminoazobenzene.

Adams Oliver syndrome (AOS) is a rare autosomal dominant congenital disorder characterized by absence of skin and or underlying structure over scalp along with transverse limb defect. It was first described by Adam and Oliver in 1945. We report a rare case of adams oliver syndrome with limited expression involving scalp, transverse limb defects along with unreported truncal involvement.

Knowledge of efficiency of pollinators is valuable in the derivation of (i) the degree of mutualism specialization of a flower visitor in the natural plant communities, (ii) the optimum number of pollinators needed for the maximum pollination in a plant population, and (iii) the pollinator risk assessment in the sustainable agriculture. Earlier researchers used many direct and indirect methods for measuring the pollination efficiency (PE) of flower visitors. However, a great ambiguity exists in the usage of this terminology that necessitated its fresh scrutiny. I tested the available three standard methods afresh to find the efficiency of pollinators. These included comparing the (i) number of pollen grains removed and deposited by the visitors; (ii) seed set resulting from a single and the multiple visits of the visitors; and (iii) “pollen transfer efficiency (PTE)” derived from the foraging behavior and abundances of the visitors. Observations were recorded on the visitors of four plant species in an agroecosystem of Northwest India. These plants represented a wide variety of the floral types across the angiosperms. The first two methods, namely, the “number of pollen grains removed and deposited” and the “seed set resulting from a single and the multiple visits,” were appropriate in finding differences between the efficiency ranks of the pollinators of those flowers where the number of deposited pollen grains was less than the number of ovules in the ovary. However, these two methods completely failed in situations where exactly reverse condition of pollen grains and ovules existed. Thus, these two methods of measuring the PE of visitors had limited approach and lacked a universal application over the entire angiosperm taxa. On the other hand, use of “pollen transfer efficiency”, derived from the foraging behavior and abundance of the visitors, seemed to have an edge over the other two methods as this was helpful in finding differences between the efficiency ranks of the pollinators of plants in all the three situations tested in this study. However, validation of all the three methods through the plant reproductive potential seemed to be an integral confirmatory step for drawing inferences about the efficiency of pollinators.

Background: Keloids are cosmetically disfiguring benign fibrous outgrowths, which present as a major therapeutic dilemma due to their frequent recurrence. Despite a wide therapeutic armamentarium available for these scars, none has been found to be completely effective and satisfactory. Cryosurgery has offered some promise in the treatment of keloids.We conducted this study to evaluate the effect of cryotherapy in treatment of keloids and to relate the treatment outcome with the clinico-etiological factors. Materials and Methods: A hospital-based interventional study was conducted in 30 patients of keloids. Patients received two freeze thaw cycles of 15 seconds each at four weekly intervals for six sessions or flattening greater than 75%; whichever occurred earlier. Patients were assessed after three treatment sessions and at treatment completion regarding thickness and firmness of lesions. Patient satisfaction scale was used to evaluate the treatment outcome at completion of six treatment sessions. Paired Students t-test and Analysis of variance (ANOVA) were used for statistical analysis. Results: Average flattening noted after 3 and 6 sessions of cryotherapy was 30.76% and 58.13%, respectively. The duration of lesions and thickness of keloids correlated significantly with the result of treatment. The site and aetiology did not influence the outcome of cryosurgical treatment. Conclusion: Cryotherapy seems to be an effective treatment modality for keloids of recent onset, particularly smaller lesions. Duration and thickness of the keloids were found to be the most important factors in determining treatment outcome with cryotherapy in our study. Larger studies are, however, required to confirm the efficacy of this treatment modality and to validate our findings of the factors affecting treatment outcome.

An 18-year old girl with segmental vitiligo involving the left side of the trunk and left upper limb with segmental morphea involving the right side of trunk and right upper limb without any deeper involvement is illustrated. There was no history of preceding drug intake, vaccination, trauma, radiation therapy, infection, or hormonal therapy. Family history of stable vitiligo in her brother and a history of type II diabetes mellitus in the father were elicited. Screening for autoimmune diseases and antithyroid antibody was negative. An autoimmune link explaining the co-occurrence has been proposed. Cutaneous mosiacism could explain the presence of both the pathologies in a segmental distribution.

Cutaneous sporotrichosis, also known as “Rose Gardener's disease,” caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

A case of nevus comedonicus syndrome with atypical cutaneous presentation (widespread involvement without any particular pattern, midline lesions involving lower abdomen and involvement of bilateral pinna), and some unusual skeletal (adduction deformity involving bilateral metatarsal along with medial deviation at the level of tarsometatarsal joint), central nervous system (agenesis of corpus callosum with a interhemispheric cyst), visceral (pancreatic cyst) and neurological manifestations have been illustrated.

Nonhuman primates (NHPs) are threatened globally, with infectious diseases ranking among the major threat factors. NHPs may also harbor zoonotic pathogens that may spillover to humans, making the surveillance of infectious diseases and parasite infestations in NHPs of conservation and public health important. Here, we assessed the gastrointestinal helminths of sympatric green monkeys and olive baboons at the Shai Hill Resource Reserve (SHRR) in Accra, Ghana. Examination of 60 fecal samples from the two NHPs using direct wet mount preparations, formol‐ether sedimentation, and zinc‐sulfate centrifugal flotation techniques yielded 12 gastrointestinal helminth species comprising nine nematodes, two cestodes, and one trematode. Nine of the helminth species (6 nematodes, 2 cestodes, and 1 trematode) were common to the baboons and green monkeys, giving a high (86%) similarity of helminth composition between the two NHPs. The overall prevalence of gastrointestinal helminth infestations was significantly higher (p = 0.0002) in olive baboons (100%) than in green monkeys (86.7%). The prevalence of Enterobius sp. (χ2 = 30.03, p ≤ 0.00001) and Strongyloides sp. (χ2 = 19.53, p ≤ 0.0001) was significantly higher in green monkeys, while Oesophagostomum sp. (χ2 = 36.33, p ≤ 0.0001) was more prevalent in olive baboons. The occurrence of Taenia sp., Dipylidium sp., and Chabertia sp. in the NHPs suggests potential cross‐transmission of helminths between the NHPs, and both livestock and domestic animals within the fringe communities of SHRR. Ascaris sp., Enterobius sp., Oesophagostomum sp., Strongyloides sp., and Trichuris sp. in the NHPs are of public health interest because of their zoonotic nature. Our findings provide valuable baseline data for long‐term monitoring of the health of NHPs and their habitat and can inform conservation measures that safeguard wildlife, veterinary, and public health. [ABSTRACT FROM AUTHOR]