Keloids and hypertrophic scars (HTS) are the result of overgrowth of fibrous tissue, following healing of a cutaneous injury, and cause morbidity. There are several treatment modalities which are ...useful for the management of keloids, though no single modality is completely effective. The most commonly used modalities are pressure, silicone gel sheet, intralesional steroids, 5-fluorouracil (5 FU), cryotherapy, surgical excision, and lasers. They may be used either singly or, as is done more commonly, in combinations. Any qualified dermatologist who has attained postgraduate qualification in dermatology can treat keloids and HTS. Some procedures, such as cryosurgery and surgical excision, may require additional training in dermatologic surgery. Most modalities for keloids, including intralesional injections and mechanical therapies such as pressure and silicone gel based products, can be given/prescribed on OPD basis. Surgical excision requires a minor operation theater with the facility to handle emergencies. It is important to counsel the patient about the nature of the problem. One should realize that keloid will only improve and not disappear completely. Patients should be informed about the high recurrence rates. Different modalities carry risk of adverse effects and complications and the treating physician needs to be aware of these and patients should be informed about them.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Microbes are the most prevalent form of life yet also the least well-understood in terms of their diversity. Due to a greater appreciation of their role in modulating host physiology, microbes have ...come to the forefront of biological investigation of human health and disease. Despite this, capturing the heterogeneity of microbes, and that of the host responses they induce, has been challenging due to the bulk methods of nucleic acid and cellular analysis. One of the greatest recent advancements in our understanding of complex organisms has happened in the field of single-cell analysis through genomics, transcriptomics, and spatial resolution. While significantly advancing our understanding of host biology, these techniques have only recently been applied to microbial systems to shed light on their diversity as well as interactions with host cells in both commensal and pathogenic contexts. In this review, we highlight emerging technologies that are poised to provide key insights into understanding how microbe heterogeneity can be studied. We then take a detailed look into how host single-cell analysis has uncovered the impact of microbes on host heterogeneity and the effect of host biology on microorganisms. Most of these insights would have been challenging, and in some cases impossible, without the advent of single-cell analysis, suggesting the importance of the single-cell paradigm for progressing the microbiology field forward through a host-microbiome perspective and applying these insights to better understand and treat human disease.
Most of the layered metal oxides are relatively “open” structures and eventually find use in applications where charge intercalation or de-intercalation is critical. One of the limitations of layered ...structures is that they have a tendency to collapse after repeated cycling. In this study, it is established that use of single-phasic marteyite-type layered (Zn3V2O7(OH)2·2H2O) can be effectively extended in the field of energy storage devices. The pyrovanadate groups act as pillars and prevent the brucite-like Zn–O layers from collapsing. To induce further enhancement in the already stable materials, it is shown that the surface characteristics of these particles, with floriated morphology, can be easily tuned by tailoring the annealing temperature. Contrary to expectation, both the surface area and capacitive behavior showed improvement when the sample was annealed post-hydrothermal treatment for longer durations. Careful analysis, using large number of techniques, establish that this observation can be attributed to atomic rearrangement in the crystal unit cell and formation of cross-linked type particle morphology. This would lead to efficient path for charge transfer, which originate at the electrode-electrolyte interface. The samples showing interlinkages in the pores could deliver specific capacitance of ∼383 F g−1, which was ∼2.5 times higher in comparison to original porous particles. The particles continued to have ∼90% capacitance retention after 2000 cycles, which shows their potential as energy storage materials.
•Supercapacitor application of layered zinc pyrovanadate with floriated microstructure.•Duration of hydrothermal treatment positively affects electrochemical performance.•Heat treatment at 300 °C transforms layered structure to highly porous.•230% increment in specific capacitance due to heat treatment.•Evolution of interlinked pores as channels: increased surface for charge storage.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
64.
Vitiligo and the psyche Sharma, V.K.; Bhatia, R.
British journal of dermatology (1951),
September 2017, 2017-09-00, 20170901, Volume:
177, Issue:
3
Journal Article
Peer reviewed
Linked Article: Lai et al. Br J Dermatol 2017; 177:708–718.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This paper presents a fuzzy predictive‐proportional integral derivative (FP‐PID) controller approach for automatic generation controller (AGC). This new AGC approach aims to balance the total ...generating system without any power losses and load changes in keeping constant system frequency per tie‐lie power flow. But, a sudden load variation in multi‐area Interconnected power system (MIPS) creates nonlinearities (frequency deviation & tie‐line) in all control areas. Because, penetrating of renewable sources to the power system, the sluggish control action may cause inefficiency in migrating frequency and tie‐line power flow. Hence, an accurate and fast‐acting controller is required to maintain the nominal value also the quality and stability of power system, because traditional AGC is not feasible for further process. Here, we propose an FP‐PID controller in MIPS for controlling large parametric uncertainties. Modeling error is taken into account to reduce the maximum deviation and time of oscillation. The main purpose of FP‐PID based AGC is to ensure stable and reliable power system operation. A grasshopper optimization algorithm (GOA) is used to tune the parameters of FP‐PID controller with Integral of time multiplied squared error (ITSE) as the objective function. The proposed method is compared with conventional two‐area and three‐area system, the result are built‐in Simulink/MATLAB show that the proposed method has a good dynamic response, fast operation reduced magnitude error and minimized frequency transients for three power areas. The robustness of the controller is, it need not be retuned for wide variations in system parameters and random step load power.
Full text
Available for:
FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Summary
Background
Accurately diagnosing the subtype of epidermolysis bullosa (EB) is critical for management and genetic counselling. Modern laboratory techniques are largely inaccessible in ...developing countries, where the diagnosis remains clinical and often inaccurate.
Objectives
To develop a simple clinical diagnostic tool to aid in the diagnosis and subtyping of EB.
Methods
We developed a matrix indicating presence or absence of a set of distinctive clinical features (as rows) for the nine most prevalent EB subtypes (as columns). To test an individual patient, presence or absence of these features was compared with the findings expected in each of the nine subtypes to see which corresponded best. If two or more diagnoses scored equally, the diagnosis with the greatest number of specific features was selected. The matrix was tested using findings from 74 genetically characterized patients with EB aged > 6 months by an investigator blinded to molecular diagnosis. For concordance, matrix diagnoses were compared with molecular diagnoses.
Results
Overall, concordance between the matrix and molecular diagnoses for the four major types of EB was 91·9%, with a kappa coefficient of 0·88 95% confidence interval (CI) 0·81–0·95; P < 0·001. The matrix achieved a 75·7% agreement in classifying EB into its nine subtypes, with a kappa coefficient of 0·73 (95% CI 0·69–0·77; P < 0·001).
Conclusions
The matrix appears to be simple, valid and useful in predicting the type and subtype of EB. An electronic version will facilitate further testing.
What's already known about this topic?
Epidermolysis bullosa (EB) represents a highly diverse group of genodermatoses characterized by skin fragility.
Immunofluorescence antigen mapping is the first‐line diagnostic test in characterizing EB into its major types.
Genetic testing, the gold standard for confirming the diagnosis, is not readily available in resource‐poor settings.
What does this study add?
We developed a novel clinical diagnostic matrix to help classify EB into its major types and subtypes, in patients > 6 months of age.
The diagnostic matrix is useful in diagnosing EB when accurate laboratory testing is unavailable.
An electronic version is available to facilitate use of the diagnostic matrix in practice.
Respond to this article
Linked Comment: McGrath. Br J Dermatol 2017; 176:1442–1443
Plain language summary available online
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Abstract
Background
Metagenomic studies carried out in the past decade have led to an enhanced understanding of the gut microbiome in human health; however, the Indian gut microbiome has not been ...well explored. We analyzed the gut microbiome of 110 healthy individuals from two distinct locations (North-Central and Southern) in India using multi-omics approaches, including 16S rRNA gene amplicon sequencing, whole-genome shotgun metagenomic sequencing, and metabolomic profiling of fecal and serum samples.
Results
The gene catalogue established in this study emphasizes the uniqueness of the Indian gut microbiome in comparison to other populations. The gut microbiome of the cohort from North-Central India, which was primarily consuming a plant-based diet, was found to be associated with Prevotella and also showed an enrichment of branched chain amino acid (BCAA) and lipopolysaccharide biosynthesis pathways. In contrast, the gut microbiome of the cohort from Southern India, which was consuming an omnivorous diet, showed associations with Bacteroides, Ruminococcus, and Faecalibacterium and had an enrichment of short chain fatty acid biosynthesis pathway and BCAA transporters. This corroborated well with the metabolomics results, which showed higher concentration of BCAAs in the serum metabolome of the North-Central cohort and an association with Prevotella. In contrast, the concentration of BCAAs was found to be higher in the fecal metabolome of the Southern-India cohort and showed a positive correlation with the higher abundance of BCAA transporters.
Conclusions
The study reveals the unique composition of the Indian gut microbiome, establishes the Indian gut microbial gene catalogue, and compares it with the gut microbiome of other populations. The functional associations revealed using metagenomic and metabolomic approaches provide novel insights on the gut-microbe-metabolic axis, which will be useful for future epidemiological and translational researches.
Summary
Because of a lack of contemporary data regarding seizures after cardiac surgery, we undertook a retrospective analysis of prospectively collected data from 11 529 patients in whom ...cardiopulmonary bypass was used from January 2004 to December 2010. A convulsive seizure was defined as a transient episode of disturbed brain function characterised by abnormal involuntary motor movements. Multivariate regression analysis was performed to identify independent predictors of postoperative seizures. A total of 100 (0.9%) patients developed postoperative convulsive seizures. Generalised and focal seizures were identified in 68 and 32 patients, respectively. The median (IQR range) time after surgery when the seizure occurred was 7 (6–12 1–216) h and 8 (6–11 4–18) h, respectively. Epileptiform findings on electroencephalography were seen in 19 patients. Independent predictors of postoperative seizures included age, female sex, redo cardiac surgery, calcification of ascending aorta, congestive heart failure, deep hypothermic circulatory arrest, duration of aortic cross‐clamp and tranexamic acid. When tested in a multivariate regression analysis, tranexamic acid was a strong independent predictor of seizures (OR 14.3, 95% CI 5.5–36.7; p < 0.001). Patients with convulsive seizures had 2.5 times higher in‐hospital mortality rates and twice the length of hospital stay compared with patients without convulsive seizures. Mean (IQR range) length of stay in the intensive care unit was 115 (49–228 32–481) h in patients with convulsive seizures compared with 26 (22–69 14–1080) h in patients without seizures (p < 0.001). Convulsive seizures are a serious postoperative complication after cardiac surgery. As tranexamic acid is the only modifiable factor, its administration, particularly in doses exceeding 80 mg.kg−1, should be weighed against the risk of postoperative seizures.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Stray animals are unowned free roaming, homeless, abandoned, street or sheltered animals, particularly dogs, cats and cattle. They could act as carrier of several zoonotic pathogens such as rabies ...virus, Mycobacterium and Brucella species. However, comprehensive information on the prevalence of zoonotic pathogens in stray animals is very limited. We conducted a systematic review as per Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines to estimate the prevalence of brucellosis in stray dogs, cats and cattle. Eligibility criteria for the study were determined using the PECOS classification (population, exposure, comparison, outcome, study design) as a tool to guide the research and adjust the search strategy. Major bibliographic databases Web of Science, Medline, Scopus, ScienceDirect, Google Scholar and PubMed were searched using predefined keywords for published epidemiological studies on brucellosis in stray animals (dogs, cats and cattle). Systematic assessments of all the studies since 1990–2022 were conducted and those reporting the prevalence of brucellosis in stray dogs, cats and cattle using appropriate diagnostic tests (culture, molecular, serological) were included. Studies reporting prevalence of brucellosis (Brucella infection or exposure) in kennel dogs, dairy herds, livestock farms, humans or marine species were excluded. The apparent individual test- wise prevalence along with 95% confidence intervals (CI) was estimated using Epitools. Out of 2689 studies, 37 met the inclusion criteria and were included in the systematic review. Of 37 studies, 28 (75.7%) were conducted in stray dogs, 7 (18.9%) in cattle and 2 (5.4%) in cats. Furthermore, only 21.62% studies (8/37) used probabilistic random sampling approaches and 13.51% studies (5/37) explained and justified the study sample size using appropriate methods for estimation of disease prevalence in the study populations. Higher sero-prevalence in stray dogs has been reported in studies conducted in Jordan (38.0% (95% CI: 24.0–54.0) and Pakistan (38.0% (95% CI: 31.0–45.0) whereas no sero-positivity was recorded in the studies conducted in Brazil, North Colombia, Cyprus, South Korea and USA. All studies on brucellosis (n = 7) in stray cattle were from India; conducted in stray cattle reared in cow-shelters. Sero-prevalence in the range of 4.3%− 64.3% was reported in stray cattle. Differences in diagnostic tests and host species, as well as limited number and non-randomized studies and high statistical heterogeneity did not allow us to determine combined meta-analysed prevalence estimates. Stray animals are likely to pose a zoonotic and disease spillover risk to human and livestock populations.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
