Background: Mycobacterium leprae is a noncultivable mycobacteria, and diagnosis of the disease is based on its clinical and histopathological characteristics and finding the bacteria in skin ...scrapings and in biopsies taken from the patients. The aim of this study was to shed light on the clinical classification (based on the number of skin lesions) used extensively in the field where patients classified as paucibacillary (PB) were positive on skin smears and histopathology leading to treatment failure and drug resistance. Methods: In this study, we enrolled untreated 62 leprosy patients with 1-5 skin lesions and did a detailed bacterio-histopathological analysis by slit-skin smears (SSSs) and histopathology. Results: Of 62 patients analyzed, 15 patients came out to be multibacillary (MB) and 47 were PB by SSS and histopathology. Conclusion: The findings of the present study showed that the WHO classification of leprosy based on the number of lesions seems to be inappropriate as it considers a number of MB lesions as PB only, thus misleading the treatment strategies. Hence, it is essential that a comprehensive clinicobacteriological assessment of leprosy cases should be done to ensure the appropriate bacillary status and guiding the appropriate treatment strategy.
The importance of controlling operations from a central location cannot be over emphasized. As urban transit networks become more intricate with addition of several lines and stations, the task of ...monitoring operations becomes complex. Alarms and statuses from traction power substation equipment, wayside equipment, switches, signals, building fire alarms, and trains are constantly monitored and recorded at the operator control room. An airport's central control room can become more complicated as it displays information about the various flights, terminals and buildings along with the data from the internal passenger transportation network. A large airport may have, not just one, but many such passenger transportation systems that move passengers from one location to another quickly and safely. This paper, examines a problem where the airport authority requested access to certain important alarms from a newly built passenger transportation system. The alarms had to be sourced from various sub-systems, passed over different networks and distributed onto multiple stakeholders. Finally, a working solution was put into place.
This paper focuses on creating an Android application in which the users will be able to search their required medicines, along with the required quantity, and will be able to see all the nearby ...pharmacies having the required medicines, and then they can easily navigate to the pharmacy, which solves the problem mentioned above. Apart from the customers/users, the pharmacists will also benefit from the app as they can keep a track of all the medicines and medical apparatus in their shop, along with their quantities, and can also update this data regularly on the application. This application is named “PharmaSpotter” as it will help the customers to spot the pharmacies near them quickly.
Background: The increased cases of dermatophyte infections and their poor response to oral drugs with current doses and duration of treatment is common. So, we conducted the study with a goal to ...assess the efficacies of two antifungal drugs with their increased dosages and duration. Methods: A prospective comparative study was done on 145 patients belonging to age group 18-60 years which were both clinically and microbiologically confirmed cases of tinea cruris and tinea corporis. Patients were randomized into two groups A and B. Group A patients were given capsule itraconazole 100 mg twice daily and group B were given tablet terbinafine 250 mg twice daily, both for 6 weeks. Patients were followed up at 2, 4 and 6 week and at each visit, scores for 3 parameters (erythema, scaling and pruritus) were recorded and were analysed.Results: A total 140 patients completed the study with 72 patients in group A and 73 patients in group B. In group A 72.5% patients achieved complete remission compared to 67.6% in group B. At each follow up patients were evaluated based on total symptom score (erythema, scaling and pruritus) which had shown significant improvement with negative potassium hydroxide results. None of the patients had severe side effects.Conclusions: Study showed that Itraconazole has higher clinical and mycological cure rates as compared to terbinafine. So itraconazole is superior to terbinafine in treatment of tinea corporis and cruris.
Background: Melasma is a common pigmentary disorder which presents with brown coloured macules that occurs around the sun-exposed areas of the skin, particularly on the face. Many treatment ...modalities are present but often it is resistant to treatment. The aim of our study was to compare the therapeutic efficacy and safety of tranexamic acid administered by oral and topical route in patients of melasma.
Methods: Our study was a prospective, randomised study which consisted of 40 new melasma patients. 20 patients were given Oral Tranexamic acid 250 mg twice daily, classified as Group 1, other 20 patients were given topical Tranexamic acid (3%) twice a day (fully covering the lesion), classified as Group 2 for a period of 8 weeks and both were given broad spectrum sunscreen (SPF 50). MASI was determined before starting treatment (baseline), 4 weeks and 8 weeks. Based on the reduction in the mean MASI, the therapeutic response is graded and subjective response and adverse effects were also recorded at each visit.
Results: Mean percentage reduction in MASI scores was higher in oral (52.1%) as compared to topical (31.9%) group. In oral group, headache was the only adverse effect, however, in topical group, erythema, burning, acneiform eruptions were reported. At final assessment, fair improvement was seen in both groups.
Conclusions: Both oral as well as topical tranexamic acid were efficacious for treatment of melasma, however, of the two oral tranexamic acid was safer and provided a better proportional response.
Heavy freight trains waiting to enter railyards, is a familiar sight across North America. Despite being on some of the busiest routes, majority of the railyards, lack automation, causing delays and ...accidents. This paper presents a solution to control train movements in and out of the railyards using Global Positioning System (GPS) data. The satellite detects the exact position of the train. The data from the train is sent to the PLC within railyard control house (RCH) to enable switch movements depending upon vacant storage track. Once the switches are confirmed locked in their desired positions, a confirmation is sent to the locomotive pilot to drive forward into the empty track. While exiting the railyard and entering the mainline, the locomotive communicates directly with the yard control house to enable exit switch movement. The aim of this paper is to establish a base case upon which higher degrees of automation could be built upon. Automation using GPS data, PLCs with interlocked programming and switch machines makes the railyard more operationally efficient and safer, limiting over the track manual intervention.
Systems Engineering is a transdisciplinary and integrative approach to enable the successful realization, use, and retirement of engineered systems, using systems principles and concepts, and ...scientific, technological, and management methods 1. Transit and rail agencies are gradually moving towards standardization around safety requirements for railway applications, and hence, complying with the CENELEC 2, 14, 16 standards are necessary. It has been observed that not enough information exists about systems architecture of DC Traction Power System. This becomes more complicated as the voltage and power collection technologies vary. This paper addresses these lacunae. Through this paper, an overview of DC Traction Power Systems from a systems engineering perspective is presented. This will help systems engineers, consultants, project managers and transit agency personnel to better understand the elements of a DC traction power system and their functional requirements (Section V). The paper describes various interfaces of DC traction power system (Section VI), with examples from past projects, enabling effective management (Section VII). The material presented in this paper, will enable audience to obtain sufficient knowledge towards meeting CENELEC standards and foster better understanding of DC traction power systems principles, functional requirements, interfaces, and their test examples.
OBJECTIVES: Psoriasis is a chronic inflammatory disease showing co-existence with metabolic syndrome (MS), as has been confirmed by numerous epidemiologic studies in recent times. In this study, the ...aim was to ascertain the beneficial effects of pioglitazone in psoriasis, simultaneously targeting the improvement of MS parameters.
MATERIALS
AND METHODS: We conducted a prospective randomized open-labeled parallel-group interventional study in patients of moderate-to-severe chronic plaque psoriasis. A total of 90 patients were inducted in study and divided into three groups of standard treatment (methotrexate 7.5 mg/week for 12 weeks), active treatment (pioglitazone 15 mg tablets once daily for 12 weeks), and their combination. Primary outcome was taken as percentage Psoriasis Area and Severity Index (PASI) improvement from baseline; secondary outcomes were PASI-75, safety profile, and MS parameters.
RESULTS: Intergroup evaluation of PASI score showed that standard treatment methotrexate and active treatment pioglitazone were comparable. Combination of methotrexate and pioglitazone proved superior in efficacy from both standard and active treatment in 8 and 12 weeks. Adverse drug reactions were mild and treated symptomatically. Pioglitazone and combination group also demonstrated beneficial efficacy in parameter of MS hence establishing it as a potential therapy in psoriasis with MS.
CONCLUSIONS: Pioglitazone alone or in combination with standard treatment may be a safe alternative drug for psoriasis coexisting with MS proving beneficial for both.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Psoriasis relatively common, chronic, inflammatory and hyper-proliferative skin disease that affects 1.4% to 2.0 % of the population. Pateints with psoriasis have to face severe problems ...with stigmatization, discrimination and negative attitudes in general among the public, and often bear the brunt of public rejection.
Methods: A cross-sectional observational study was carried out on psoriasis patients attending dermatology outpatient department of Era’s Lucknow medical college and hospital between November 2018 and November 2020. Patients with pustular psoriasis, mycosis fungoides, pityriasis rubra pilaris, and other severe medical conditions like heart failure, liver cirrhosis were excluded from the study.
Results: Present study included 170 (aged 16 to 76 years; mean age 37.74±13.70 years; 62.4% males) clinically diagnosed patients of Psoriasis. P-score was observed with increase in Body Surface area, maximum for cases with BSA ≥25%. There was a strong positive significant linear correlation between stigmatization scores and disability scores (r=0.746; p<0.001), thus indicating that with increase in p scores there was a significant increase in PDI scores and vice versa.
Conclusions: Present study showed that feeling of stigmatization and disability was highly prevalent in psoriasis patients. It was seen that stigmatization and disability showed a strong correlation. The findings of study showed that there is need to create awareness regarding psoriasis as a non-communicable disease in order to increase the acceptance of psoriasis patients in society and to reduce their stigmatization.
Background: Steroids are a wide range of chemical molecules that have varying physiological effects. Corticosteroids own anti-inflammatory and immunosuppressive effects. They also have ...anti-proliferative effects on keratinocytes. The present study was undertaken to study the clinical aspects of the use of topical corticosteroids leading to adverse effects and to know the source of information leading to its abuse.
Methods: A cross-sectional observational study was carried out on cutaneous adverse effects of TC attending the dermatology outpatient department of Era’s Lucknow medical college and hospital between December 2018 and November 2020. The patients who applied TC for more than 1 month were taken into account. Patients who had cutaneous adverse effects suggestive of TC without details of agents were excluded.
Results: Present study explored the patterns of use of topical corticosteroid, and its associated adverse effects in a total of 380 patients (aged 3 to 71 years; mean age 27.33±11.78 years; 52.9% males). Itching (72.4%), burning skin (64.5%) and skin color change (62.4%) were the three most common presenting complaints. Dermatophytoses (66.6%), acne (17.4%) and skin lightening (6.3%) were the three most common indications for use of topical corticosteroids.
Conclusions: The present study showed that the practice of using non-dermatologist prescribed topical corticosteroid use is highly prevalent and is associated with a high burden of adverse effects. To prevent this there is a need to spread awareness regarding harms associated with abuse of non-dermatologist prescribed topical corticosteroid use.
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