Search

Dermatophytoses are increasing at an alarming rate in the paediatric population. The trend is now shifting from the more familiar tinea capitis to involvement of the glabrous skin.To evaluate the various clinical manifestations, factors governing the clinical patterns, and causative species of fungus.A prospective observational study was done on all cases upto 15 years of age presenting with a clinical picture characteristic/ suspicious of dermatophytic infections. Direct microscopy was done on all cases, fungal culture in select cases.Two hundred and seventy cases were found to be suffering from dermatophytoses. Three groups of presentation were seen, 68(25.1%) cases presented with tinea incognito, 80(29.6%) cases showed some alteration while 122(45.2%) cases presented with classical features. Direct microscopy was positive in 230(85%) cases, fungal culture in 60%. Maximum number of cases were tinea corporis with 57.4%, followed by tinea faciei in 33.1% cases. Family history was positive in 200(74%) cases, younger patients came earlier for consultation. Hospital based study where cases with minimal involvement might have been excluded.Paediatric tinea is now presenting with adult patterns of presentation. They often mimic other dermatoses due to involvement of previously uninvolved sites and often evades diagnosis. Awareness, high index of suspicion and laboratory tools will result in early diagnosis and treatment.

Background Hybrid imaging became an instrumental part of medical imaging, particularly cancer imaging processes in clinical routine. To date, several radiomic and machine learning studies investigated the feasibility of in vivo tumor characterization with variable outcomes. This study aims to investigate the effect of recently proposed fuzzy radiomics and compare its predictive performance to conventional radiomics in cancer imaging cohorts. In addition, lesion vs. lesion+surrounding fuzzy and conventional radiomic analysis was conducted. Methods Previously published 11C Methionine (MET) positron emission tomography (PET) glioma, 18F-FDG PET/computed tomography (CT) lung, and 68GA-PSMA-11 PET/magneto-resonance imaging (MRI) prostate cancer retrospective cohorts were included in the analysis to predict their respective clinical endpoints. Four delineation methods including manually defined reference binary (Ref-B), its smoothed, fuzzified version (Ref-F), as well as extended binary (Ext-B) and its fuzzified version (Ext-F) were incorporated to extract imaging biomarker standardization initiative (IBSI)-conform radiomic features from each cohort. Machine learning for the four delineation approaches was performed utilizing a Monte Carlo cross-validation scheme to estimate the predictive performance of the four delineation methods. Results Reference fuzzy (Ref-F) delineation outperformed its binary delineation (Ref-B) counterpart in all cohorts within a volume range of 938–354987 mm3 with relative cross-validation area under the receiver operator characteristics curve (AUC) of +4.7–10.4. Compared to Ref-B, the highest AUC performance difference was observed by the Ref-F delineation in the glioma cohort (Ref-F: 0.74 vs. Ref-B: 0.70) and in the prostate cohort by Ref-F and Ext-F (Ref-F: 0.84, Ext-F: 0.86 vs. Ref-B: 0.80). In addition, fuzzy radiomics decreased feature redundancy by approx. 20%. Conclusions Fuzzy radiomics has the potential to increase predictive performance particularly in small lesion sizes compared to conventional binary radiomics in PET. We hypothesize that this effect is due to the ability of fuzzy radiomics to model partial volume effects and delineation uncertainties at small lesion boundaries. In addition, we consider that the lower redundancy of fuzzy radiomic features supports the identification of imaging biomarkers in future studies. Future studies shall consider systematically analyzing lesions and their surroundings with fuzzy and binary radiomics.

Background One in four people experience a mental health problem every year and improving mental health care is an international priority. In the course of their work, pharmacists frequently encounter people with mental health problems. The experience of mental health teaching, including Mental Health First Aid (MHFA) training, in undergraduate pharmacy (MPharm) students in the UK and Ireland is not well documented. Students’ viewpoints, contextualised with curricular overviews provided by staff, were analysed to understand their experience. Methods An anonymous, online questionnaire was distributed to MPharm students and staff in the UK and Ireland. Students were asked closed questions regarding their course and exposure to MHFA, which were analysed using descriptive statistics. Open questions were included to enable explanations and these data were used to contextualise the quantitative findings. One member of staff from each university was invited to answer a modified staff version of the questionnaire, to provide a curriculum overview and staff perspective. Results 232 students and 13 staff, from 22 universities, responded. Three-quarters of students did not agree with the statement that ‘mental health was embedded throughout the MPharm’. Most students (80.6%) stated that they were taught neuropharmacology whilst 44.8% stated that their course included communicating with people about their mental health. One-third (33.2%) of students stated that their degree ‘adequately prepared them to help people with their mental health’. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported greater preparedness than those who did not, but student numbers were small. Conclusions Mental health teaching for pharmacy undergraduates is more focussed on theoretical aspects rather than applied skills. MHFA was viewed by students as one way to enhance skill application. The association of the increased self-reported preparedness of those who completed MHFA could be confounded by a positive environmental cultural. MPharm programmes need sufficient focus on real-world skills such as communication and crisis response, to complement the fundamental science.

Introduction We aim to elucidate female student interest in Surgery and factors that are deterring students from considering a surgical career. With this information, we can evaluate if there are changes that can be made within medical education. Method A cross-sectional online survey was distributed via LimeSurvey to medical students across 33 UK medical schools. Our survey assessed student interest in a surgical career, personal experience on clinical placements, and what attracts or dissuades students from a surgical career. Results 211 student responses were collected. 57% of students indicated an interest in Surgery. 55% of female and 63% of male students expressed surgical interest. 65.7% of second-year students indicated surgical interest, compared to 54.3% of students in final year; a 17.35% decrease. When asked, 88% of students believe there is disproportionate female to male surgeons. Conclusions Although our survey revealed that there is a healthy interest in Surgery, the number of women considering Surgery continues to dwindle throughout training, leading to massive discrepancy. It is paramount that there are both male and female mentors for students to visualise that there are no limitations for women in the field of Surgery.

Purpose To assess whether a radiomics and machine learning (ML) model combining quantitative parameters and radiomics features extracted from simultaneous multiparametric 18F-FDG PET/MRI can discriminate between benign and malignant breast lesions. Methods A population of 102 patients with 120 breast lesions (101 malignant and 19 benign) detected on ultrasound and/or mammography was prospectively enrolled. All patients underwent hybrid 18F-FDG PET/MRI for diagnostic purposes. Quantitative parameters were extracted from DCE (MTT, VD, PF), DW (mean ADC of breast lesions and contralateral breast parenchyma), PET (SUVmax, SUVmean, and SUVminimum of breast lesions, as well as SUVmean of the contralateral breast parenchyma), and T2-weighted images. Radiomics features were extracted from DCE, T2-weighted, ADC, and PET images. Different diagnostic models were developed using a fine Gaussian support vector machine algorithm which explored different combinations of quantitative parameters and radiomics features to obtain the highest accuracy in discriminating between benign and malignant breast lesions using fivefold cross-validation. The performance of the best radiomics and ML model was compared with that of expert reader review using McNemar’s test. Results Eight radiomics models were developed. The integrated model combining MTT and ADC with radiomics features extracted from PET and ADC images obtained the highest accuracy for breast cancer diagnosis (AUC 0.983), although its accuracy was not significantly higher than that of expert reader review (AUC 0.868) (p = 0.508). Conclusion A radiomics and ML model combining quantitative parameters and radiomics features extracted from simultaneous multiparametric 18F-FDG PET/MRI images can accurately discriminate between benign and malignant breast lesions. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05492-z.

Efficiency Improvement is an essential objective of today's industrial world. Among the many techniques for loss minimization methods (LMM), a loss-model controller (LMC) has some advantages: high accuracy and fast response. However, the accuracy of LMM is very depended on the precision of the parameters. On the other hand, among different models of the loss, the parameters of the flux-based model are more uncertain because they need accurate magnetic analysis. This model is used for model predictive torque and flux control (MPC) more prevalently. In this research, in order to solve this drawback, a new flux optimization approach is presented for MPC. This matter has been fulfilled by dividing the consubstantial parameters. Besides, the need for the eddy current and hysteresis coefficients calculations have been removed by substitution of iron core loss resistance. By this approach, in a way, the estimation accuracy of iron core loss will increase. Simulations and experiments have used for performance verifying of the proposed method. For more accuracy, the parameters of the simulated motor are identified by analyzing an induction motor (IM) in ANSYS Maxwell.

Introduction Improving mental health care is an international priority, and one that is championed by the Royal Pharmaceutical Society. (1) In the course of their work, pharmacists frequently encounter people with mental health problems. The extent to which mental health is taught on the undergraduate pharmacy degree in the UK and Ireland, and the inclusion of Mental Health First Aid (MHFA) training, has not be described recently. Aim We aimed to determine how mental health teaching is embedded into the MPharm and students’ perception of their own preparedness to help people with their mental health. We explored if and how MHFA training is included, and students’ experience of, or desire to complete this. Methods We conducted an anonymous, online questionnaire of UK and Ireland MPharm students, distributed via networks and social media. Students were asked a series of closed questions about mental health teaching in the MPharm, and exposure to MHFA. We analysed answers using descriptive statistics. We included some open-ended questions to enable students to expand on their answers. We used this qualitative data to contextualize findings. We invited one member of staff from each university to answer a modified staff version of the questionnaire, in order to provide a curriculum overview and staff perspective on MHFA provision. Results 232 students and 13 staff responded, from 22 universities in total. Eighty percent of student participants were female and 70% were in the third or final year of study. Three-quarters of students felt that mental health was not embedded throughout the MPharm. Eighty-percent of students stated that they were taught about neuropharmacology and 44.8% stated that their course included communicating with people about their mental health. One third of students felt that their degree adequately prepared them to help people with their mental health. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported more preparedness than those who did not, but student numbers were small. Conclusion Mental health teaching remains focused on theoretical aspects, such as pharmacology, with less emphasis on practical skills, such as communication skills that might support interactions about mental health. MHFA was viewed by students as one way to enhance this. Of the small number of students who had completed MHFA, they displayed an increased self-reported preparedness. This could, however, be linked to the environmental culture of the programme rather than the training per se. MPharm programmes need sufficient focus on skills including communication and crisis response that may be required by pharmacists, alongside the fundamental scientific knowledge relating to mental health. References 1. Royal Pharmaceutical Society. No health without mental health: How can pharmacy support people with mental health problems? London: RPS; 2018.

Recent studies have suggested that

Background Leukoplakia is a oral pathology characterized by an increased risk for malignant transformation. Histopathology of leukoplakia can disclose hyperkeratosis with dysplasia or carcinoma or hyperkeratosis or parakeratosis without dysplasia. Existence of the different treatment options not decrease the the rates of recurrence up to 35%. Methods Totally 40 patients with OL (homogenous type - 35 cases; verrucous type - 4 case; erythroleukoplakia - one case) were recruited for the study. In a period September 2017 – may 2019 all the patients were screened, and only those patients with clinically, and histologically proven OL was included under the study. All the patients had the history of using tobacco in smoking or smokeless form (Nasvay). 1470 nm diode laser ablation was done under 5- ALA induced spectroscopy. In case of detection a pathological fluorescence after the session treatment was accompanied with PDT treatment. 10% ALA emulsion (0.1 g of 99.9% ALA powder in 1 ml liquid paraffin) was used freshly just before the start of the therapy to avoid deterioration of the emulsion on contact with light. Diode lamp (Vostok -1, Uzbekistan) with power - 5 W, wavelength -630 ± 5 nm was used as the light source. Total dose delivered per session was 100 J/cm 2. The therapy was performed in a one session. All patients were recalled at 4 weeks after completion of the last session of modified therapy. Lesion response was characterized as follows: Complete response (CR), ; partial response (PR), reduction at least 20% in diameter; no response (NR). The patients were followed-up for a period of 1 year. Results One month (4 weeks) after 1470 nm diode laser ablation + ALA-PDT, the response was evaluated based on clinical examination. CR was obtained in 35 out of 40 patients; PR in 5 out of 40 patients; and NR no patient. During the follow-up, no changes in the clinical appearance of the treated lesions were recorded. There was no recurrence of the lesion noted in CR cases. During the incubation period of 3 h after ALA application, the patients did not have any adverse effect in the form of pain, redness or discomfort. Patients did not have any other side effects. Conclusions Our observations suggest that topical ALA mediated PDT with laser ablation is a promising means of treating OL. Legal entity responsible for the study Tashkent medical academy. Funding Has not received any funding. Disclosure The author has declared no conflicts of interest.

Solution processed, high K nanocomposite dielectric material was demonstrated as a low cost insulating material for printed organic electronics applications. A nanocomposite dielectric consisting of an epoxy solution with propylene glycol methyl ether acetate (PGMEA) as the solvent and barium titanate (BTO) nanoparticles was developed and utilized as a printed dielectric. The high relative permittivity (K=35), bimodal nanocomposite system utilized has two different filler particle sizes 200 and 1000nm diameter particles. Due to the nanosize of the BTO particles, they disperse well in the organic matrix, which makes it possible to use low cost solution-processable methods, such as pad printing. In this paper we present our work to develop an characterize a low cost pad printed bimodal nanocomposite dielectric with a high capacitance density of about 62pF/mm^2 with low dielectric loss (approximately 3%) and quite low current leakage.

Ceramic–polymer nanocomposite dielectric consisting of an epoxy solution with propylene glycol methyl ether acetate as the solvent and barium titanate nanoparticles with capacitance in excess of 60 pF/mm 2 was developed and utilized as the gate insulator for organic field-effect transistors (OFETs). The high relative permittivity ( κ = 35), bimodal nanocomposite utilized had two different filler particle sizes 200 nm and 1000 nm diameter particles. Bottom gate organic filed-effect transistors were demonstrated using a commercially available printing technology for material deposition. A metal coated plastic film was used as the flexible gate substrate. Solution processable, p-type arylamine-based amorphous organic semiconductor was utilized as the active layer. Fabricated OFETs with the solution processed nanocomposite dielectric had a high field-induced current and a low threshold voltage; these results suggest that the low operating voltage was due to the high capacitance gate insulator. In this paper, we review the characteristics of the nanocomposite dielectric material and discuss the processing and performance of the printed organic devices.

In a sixty-seven year old female smoker, a right lower lobe mass, intimately related to the mediastinum, was detected on computed tomography (CT) scanning. Bronchoscopy confirmed non-small cell lung cancer (NSCLC) and a subsequent integrated 18F-FDG Positron Emission Tomography (PET)/CT scan demonstrated a rim of non-FDG avid tissue between the lung tumour and the mediastinum, and no nodal or distant metastases. The patient was pre-operatively staged as cT3N0M0 and proceeded to exploratory thoracotomy. On histological examination of the resected right lower lobe, multiple deposits of bronchioalveolar cell carcinoma (BAC) were found surrounding a central adenocarcinoma, in addition to a small deposit of adenocarcinoma in a right upper lobe wedge resection sample. Neither the BAC deposits nor the upper lobe disease had been detected on integrated FDG-PET/CT scanning. The final pathological staging of this case (pT4N0M1 (stage IV)) is inconsistent with the improved survival rate of patients with multi-focal intrapulmonary NSCLC confined to the lung over other forms of T4 or M1 disease, particularly when the BAC cell type is involved. This case highlights these major limitations of the current TNM classification and discusses the increased risk of false negative results from integrated FDG-PET/CT scanning in the BAC form of NSCLC.

Background: Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue in India has dramatically expanded over the last few decades, with rapidly changing epidemiology. Dengue is emerging as major public health concern in northeast India and spreading with increased morbidity.Objective:This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam during the period 2013-2016.Methods: A retrospective study was done from the year 2013 to 2016. A total of 340 serum samples received in the department of microbiology FAAMCH, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests were performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity.Results: Out of 340 samples tested, 68 were positive either by NS1 antigen or for IgM antibody ELISA tests. These comprised all age groups of both sexes with higher incidence of cases in young males aged 26– 60 years.Conclusion: From this study, it is apparent that dengue surveillance and control should be enhanced by wider use of laboratory testing to confirm dengue as a cause of fever of unknown origin, especially during the local dengue transmission season.

Single photon emission computed tomography (SPECT) is a nuclear medicine tomographic imaging technique using gamma rays with dual camera planar acquisition providing a 3D image. SPECT-CT is a hybrid system which coregisters functional data from SPECT with anatomical data from computerised tomography (CT). It provides single session characterisation of abnormalities noted on planar scintigraphy, increasing specificity. Malignant spinal cord compression (MSCC) is a common oncological emergency and early detection and treatment relieves pain and preserves neurological function improving quality of life [Bucholtz JD. Metastatic epidural spinal cord compression. Semin Oncol Nurs 1999;15(3):150–9] . Previous work by the Clinical Resource and Audit Group (CRAG) showed that diagnosis was frequently delayed often leading to paraplegia [Levack P, Graham J, Collie D, et al. A prospective audit of the diagnosis, management and outcome of malignant spinal cord compression Clinical Resource and Audit Group (CRAG) 97/08, 2001] . We present a case where bone scintigraphy followed by SPECT-CT aided in the rapid diagnosis and treatment of MSCC resulting in relief of pain and preservation of neurological function.

Nitric oxide (NO) regulates a wide range of plant processes from development to environmental adaptation. In this study, we investigated the production and/or function of NO in Arabidopsis thaliana leaf discs and plants elicited by oligogalacturonides (OGs) and challenged with Botrytis cinerea. We provided evidence that OGs triggered a fast and long lasting NO production which was Ca(2+) dependent and involved nitrate reductase (NR). Accordingly, OGs triggered an increase of both NR activity and transcript accumulation. NO production was also sensitive to the mammalian NO synthase inhibitor L-NAME. Intriguingly, we showed that L-NAME affected NO production by interfering with NR activity, thus questioning the mechanisms of how this compound impairs NO synthesis in plants. We further demonstrated that NO modulates RBOHD-mediated reactive oxygen species (ROS) production and participates in the regulation of OG-responsive genes such as anionic peroxidase (PER4) and a β-1,3-glucanase. Mutant plants impaired in PER4 and β-1,3-glucanase, as well as Col-0 plants treated with the NO scavenger cPTIO, were more susceptible to B. cinerea. Taken together, our investigation deciphers part of the mechanisms linking NO production, NO-induced effects and basal resistance to B. cinerea.

Primary cytomegalovirus infection is the most common infection during pregnancy that may have long-term neurodevelopmental sequelae in children born to these mothers. It is also associated with many obstetric complications. So the aim of this study was to determine the seroprevalence of cytomegalovirus infection in local antenatal population with bad obstetric history and to see the effects, if any, of age, socio-economic status, presenting features and different gestational periods. Seventy-five pregnant women with bad obstetric history were screened for the presence of cytomegalovirus specific IgM and IgG antibodies by doing enzyme-linked immunosorbent assay, out of which 17(22.66%) had evidence of recurrent cytomegalovirus infection as demonstrated by the presence of cytomegalovirus specific IgM antibodies. All were found to be positive for cytomegalovirus specific IgG antibodies. This indicates that the presence of cytomegalovirus specific IgM antibodies in this population is an evidence of reactivation of a latent infection or re-infection with a different strain of cytomegalovirus. Increased IgM seropositivity was found to be associated with advancing age, poor, socio-economic status, third trimester of pregnancy and bad obstetric history like premature delivery, stillbirth, recurrent spontaneous abortions, intra-uterine growth retardation. Out of 25 randomly selected non-pregnant women of childbearing age, all showed presence of cytomegalovirus specific IgG antibodies and none was found to be positive for primary or recurrent cytomegalovirus infection.

A case of a 45 years male patient with irregular warty growths over the right leg of 35 years duration is reported. The diagnosis was confirmed mycologically and histopathologically. Isolate was identified as Fonsecaea pedrosoi.

High capacitance, solution processed nanocomposite dielectric material was demonstrated as a gate insulator for printed electronics applications. A nanocomposite consisting of cross-linked propylene glycol methyl ether acetate and barium titanate (BTO) nanoparticles was developed and utilized as the gate insulator. The high relative permittivity (K=35), bimodal nanocomposite utilized had two different filler particle sizes 200 nm and 1000 nm diameter particles. Bottom contact organic field effect transistors (OFETs) were demonstrated using a combination of printing and spray coating technologies. A metal coated plastic film was used as the flexible gate substrate. An amorphous organic semiconductor was utilized as the active layer. OFETs with the solution processed nanocomposite dielectric had a high field-induced current and a low threshold voltage and thus a low operating voltage due to the high capacitance gate insulator. In this paper, we review the characteristics of the nanocomposite material and discuss the processing and performance of the printed organic devices.

To evaluate outcome of allogeneic BMT in beta-Thalassaemia at the Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan from August 2001 to November 2003.Nineteen patients with beta-Thalassaemia underwent allogeneic BMT/PBSC transplantation from HLA identical sibling donors. Patients were classified in three groups according to Pesaro (Italy) risk classification. Class-I (n = 9) and Class-II (n = 7) patients received conditioning with busulphan/cyclophosphamide, whereas Class-III (n = 3) patient received conditioning with hydroxyurea, azathioprine, fludarabine, along with Bu14 / Cy 200. Cyclosporine, prednisolone and methotrexate were given for GvHD prophylaxis. Stem cells dose infused was4.0 x 10(8)/kg body weight of the patient.Engraftment was achieved in all Class-I patients, whereas in Class-II and Class-III , graft rejection was observed in one patient from each class. Median time to achieve absolute neutrophil recovery (0.5 x 10(9)/l) was 13 days, platelet count (20 x 10(9)/1) was 15 days and reticulocyte count (0.5%) was 15 days. Acute GvHD was observed in 15 patients. One patient developed grade IV GvHD (liver and skin) and died within 30 days post BMT. Post transplant infectious complications were pseudomonas septicemia, disseminated fungal infection, CMV pneumonia and tuberculosis. Three patients died of these complications during post transplant period (31-90 days). Median stay in hospital was 25 days.Allogeneic BMT is the only curative therapy for beta-Thalassaemia patients, however the success rate can be increased if the patients are selected carefully and transplanted at an early age.

The sections in this article are 1 PWB Technology 2 Printed Wiring Board System Types 3 Graphically Produced Boards 4 Materials for Printed Wiring Boards

Sera of 2000 pregnant women attending the antenatal clinic of the Aga Khan University Hospital were tested for rubella antibodies. Of these 1684 (84.2%) were immune and 316 (15.8%) were susceptible to rubella. Majority (99.8%) of the women were Asian in origin. Susceptibility decreased with increasing age and parity. We conclude that apart from vaccination of all young children greater attention should be paid to immunization of women of child-bearing age.