Background: Atopic dermatitis (AD) is a common and chronic, pruritic inflammatory skin condition that affects all age groups. There was a dearth of consensus document on AD for Indian practitioners. ...This article aims to provide an evidence-based consensus statement for the management of AD with a special reference to the Indian context. This guideline includes updated definition, etiological factors, classification, and management of atopic dermatitis. Methodology: The preparation of guidelines was done in multiple phases. Indian Dermatology Expert Board Members (DEBM), recommended by the Skin Allergy Society of India, prepared 26 evidence-based recommendations for AD. An extensive literature search was done in MEDLINE, Google scholar, Cochrane, and other resources. Articles published in the past 10 years were reviewed and recommendations were graded based on the quality of evidence as per GRADE. After forming the initial structure, DEBM met in Mumbai and gave their decisions on an agree and disagree scale with an Indian perspective. Finally, their suggestions were compiled for preparing the article. After DEBM finalized the draft, a treatment algorithm was formulated for the management of AD. Results: DEBM suggested a working definition for AD. The panel agreed that moisturizers should be used as mainstay of therapy and should be continued in all lines of therapy and in maintenance phase. Topical corticosteroids and topical calcineurin inhibitors should be considered as the first line of treatment. Among systemic therapies, cyclosporin should be considered first line, followed by azathioprine, methotrexate, and mycophenolate mofetil. Phototherapy can be an effecive alternative. Empirical food restriction was recommended against. Conclusion: These guidelines should form a reference for the management of patients with AD in an evidence-based manner.
Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder affecting 15-20% of children and 1-10% of adults. Staphylococcus aureus (S. aureus) infection is the most frequent ...complication of AD and is involved in the worsening of the disease. Systemic and topical antibiotics are used in the treatment for AD but there are concerns over increasing resistance. Bleach (sodium hypochlorite, NaOCl) baths are an inexpensive, widely accessible, alternative antibiotic treatment that may not worsen antibiotic resistance. Bleach baths are used as adjunctive treatment in AD patients to treat superinfections, although their mechanism of action is not well understood. Balancing safety concerns with efficacious treatment should be important especially for AD where the majority of patients are in pediatrics age groups. Studies available in PubMed databases were included in this review. Most suggested bleach bath improves clinical symptoms of AD and restores surface microbiome by eradicating bacteria, most notably S. aureus. Some studies have noted that this antimicrobial effect has reduced the need for topical corticosteroids. In addition, bleach seems to have strong anti-inflammatory and antipruritic effects. Overall, bleach baths seem to be safe on human skin, without disrupting the epidermal barrier function. The review concluded, although there are some advantages of use of bleach baths, more studies to investigate long-term efficacy and safety of bleach baths are required before fixing its role in the treatment of AD especially in the context of the Indian scenario.
The evolvement in digital media and information technology over the past decades have purveyed the internet to be an effectual medium for the exchange of data and communication. With the advent of ...technology, the data has become susceptible to mismanagement and exploitation. This led to the emergence of Internet Security frameworks like Information hiding and detection. Examples of domains of Information hiding and detection are Steganography and steganalysis respectively. This work focus on addressing possible security breaches using Internet security framework like Information hiding and techniques to identify the presence of a breach. The work involves the use of Blind steganalysis technique with the concept of Machine Learning incorporated into it. The work is done using the Joint Photographic Expert Group (JPEG) format because of its wide use for transmission over the Internet. Stego (embedded) images are created for evaluation by randomly embedding a text message into the image. The concept of calibration is used to retrieve an estimate of the cover (clean) image for analysis. The embedding is done with four different steganographic schemes in both spatial and transform domain namely LSB Matching and LSB Replacement, Pixel Value Differencing and F5. After the embedding of data with random percentages, the first order, the second order, the extended Discrete Cosine Transform (DCT) and Markov features are extracted for steganalysis.The above features are a combination of interblock and intra block dependencies. They had been considered in this paper to eliminate the drawback of each one of them, if considered separately. Dimensionality reduction is applied to the features using Principal Component Analysis (PCA). Block based technique had been used in the images for better accuracy of results. The technique of machine learning is added by using classifiers to differentiate the stego image from a cover image. A comparative study had been during with the classifier names Support Vector Machine and its evolutionary counterpart using Particle Swarm Optimization. The idea of cross validation had also been used in this work for better accuracy of results. Further parameters used in the process are the four different types of sampling namely linear, shuffled, stratified and automatic and the six different kernels used in classification specifically dot, multi-quadratic, epanechnikov, radial and ANOVA to identify what combination would yield a better result.
Immunology researchers are beginning to explore the possibilities of reproducibility, reuse and secondary analyses of immunology data. Open-access datasets are being applied in the validation of the ...methods used in the original studies, leveraging studies for meta-analysis, or generating new hypotheses. To promote these goals, the ImmPort data repository was created for the broader research community to explore the wide spectrum of clinical and basic research data and associated findings. The ImmPort ecosystem consists of four components-Private Data, Shared Data, Data Analysis, and Resources-for data archiving, dissemination, analyses, and reuse. To date, more than 300 studies have been made freely available through the Shared Data portal (www.immport.org/immport-open), which allows research data to be repurposed to accelerate the translation of new insights into discoveries.
We simulate the East India Coastal Current (EICC) using two numerical models (resolution
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an oceanic general circulation model (OGCM) called Modular Ocean Model and a simpler, ...linear, continuously stratified (LCS) model, and compare the simulated current with observations from moorings equipped with acoustic Doppler current profilers deployed on the continental slope in the western Bay of Bengal (BoB). We also carry out numerical experiments to analyse the processes. Both models simulate well the annual cycle of the EICC, but the performance degrades for the intra-annual and intraseasonal components. In a model-resolution experiment, both models (run at a coarser resolution of
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) simulate well the currents in the equatorial Indian Ocean (EIO), but the performance of the high-resolution LCS model as well as the coarse-resolution OGCM, which is good in the EICC regime, degrades in the eastern and northern BoB. An experiment on forcing mechanisms shows that the annual EICC is largely forced by the local alongshore winds in the western BoB and remote forcing due to Ekman pumping over the BoB, but forcing from the EIO has a strong impact on the intra-annual EICC. At intraseasonal periods, local (equatorial) forcing dominates in the south (north) because the Kelvin wave propagates equatorward in the western BoB. A stratification experiment with the LCS model shows that changing the background stratification from EIO to BoB leads to a stronger surface EICC owing to strong coupling of higher order vertical modes with wind forcing for the BoB profiles. These high-order modes, which lead to energy propagating down into the ocean in the form of beams, are important only for the current and do not contribute significantly to the sea level.
Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia ...represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil.
Though the deep mixed layers (MLs) that form in the northeastern Arabian Sea (NEAS) during the winter monsoon (November–February) have been attributed to convective mixing driven by dry, cool ...northeasterly winds from the Indian subcontinent, data show that the deepest MLs occur in the northern NEAS and the maxima of latent-heat and net heat fluxes in the southern NEAS. We use an oceanic general circulation model to show that the deep MLs in the NEAS extend up to ~20°N till the end of December, but are restricted poleward of ~22°N (~23°N) in January (February). This progressive restriction of the deep mixed layers within the NEAS is due to poleward advection of water of lower salinity by the West India Coastal Current (WICC). The deep MLs are sustained till February in the northern NEAS because convective mixing deepens the ML before the waters of lower salinity reach this region and the wind stirring and convective overturning generate sufficient turbulent energy for the ML to maintain the depth attained in January. Though the atmospheric fluxes tend to cool the ML in the southern NEAS, this cooling is countered by the warming due to horizontal advection. Likewise, the cooling due to entrainment, which continues in the southern NEAS even as the ML shallows during January–February, is almost cancelled by the warming caused by a downwelling vertical velocity field. Therefore, the SST changes very little during December–February even as the ML shallows dramatically in the southern NEAS. These deep MLs of the NEAS also preclude a strong intraseasonal response to the intraseasonal variability in the fluxes. This role of horizontal advection implies that the ML depth in the NEAS is determined by an interplay of physical processes that are forced differently. The convective mixing depends on processes that are local to the region, but the advection is due to the WICC, whose seasonal cycle is primarily forced by remote winds. By inhibiting the formation of deep MLs in the southern NEAS, the WICC limits the region of formation of the high-salinity water masses of this region. Since the deep MLs in the NEAS have been linked to the high chlorophyll concentration there, our results imply that the conventional approach of averaging over boxes for studying the impact of physics on biogeochemistry can mask important details that are due to advection because it is the advective component of any budget that is most affected by the averaging process.
Abstract
A new series of highly soluble perylene
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‐bis(4,5‐dialkoxybenzimidazole)s bearing branched flexible chains stabilizing room temperature columnar hexagonal phase and with balanced ...ambipolar charge carrier mobility is reported for the first time. Only the
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isomer was successfully separated and characterized. These compounds have a high extinction coefficient, small optical band gap and wide absorption range, thus making them a promising class of ambipolar organic semiconductors capable of self‐organizing.
•Impact of physics on fisheries in the eastern Arabian Sea.•Longer growing season, small phytoplankton imply carnivorous fishery in the north.•Shorter growing season, large phytoplankton imply ...planktivorous fishery in the south.•Weaker upwelling in the centre implies weaker fishery compared to south.•Physical forcing linked to decline in sardine catch from south to centre.
We use available data and model simulations to make a case for physical forcing of the spatial variation in the nature of fisheries off the west coast of India in the eastern Arabian Sea (EAS). The approach is heuristic, but builds the case on the basis of model simulations and well-established implications of specific physical processes for the marine ecosystem. We address three questions.
First, we show that it is differences in the physical forcing lead to a carnivore-dominated fishery in the northeastern Arabian Sea (NEAS) and a planktivore-dominated fishery in the southeastern Arabian Sea (SEAS). In the NEAS, the growing season for phytoplankton is longer because the upwelling during the summer monsoon (June–September) is followed by convective mixing during the winter (November–February) monsoon. Detrainment, again leading to a phytoplankton bloom, follows the convective-mixing season. The long duration of the growing season permits the existence of a longer food chain, leading to a carnivore-dominated fishery. In the NEAS, the phytoplankton also tend to be small owing to weaker upwelling during the summer monsoon and limitations imposed by silicates, turbulence, and light during the winter monsoon. In the SEAS, the stronger upwelling implies larger phytoplankton that can be directly fed on by fish like the oil sardine. The growing season in the SEAS is also limited to the summer monsoon, predisposing the ecosystem towards a shorter food chain.
Second, we show that it is the differences in physical forcing that lead to the weaker fishery in the central-eastern Arabian Sea (CEAS) compared to the SEAS. Though the growing season in both SEAS and CEAS is comparable, the upwelling is weaker in the CEAS, implying a limitation of nitrate and a dominance of small phytoplankton in contrast to the SEAS, where large phytoplankton dominate. Hence, the phytoplankton biomass is less in the CEAS compared to the SEAS and the region cannot support a fishery comparable to the SEAS.
Third, we show that it is the difference in physical forcing that leads to a sharp decline in the catch of oil sardines from the SEAS to the CEAS even as the catch of mackerel does not change much. Not only does the stronger upwelling in the SEAS compared to the CEAS imply a larger size of the phytoplankton in the former, but the phytoplankton biomass is also higher in the SEAS. The zooplankton standing stock, as estimated using the backscatter measured by the acoustic Doppler current profilers (ADCPs) deployed on moorings, is determined more by the vertical movement of the depth of the 20 °C isotherm (D20). Hence, the standing stock of zooplankton tends to be lowest when upwelling peaks, i.e., during the summer monsoon. This is also the time when the phytoplankton biomass peaks. The phytoplankton surplus is greater in the SEAS compared to the CEAS because of the stronger upwelling, which implies higher primary productivity and a shallower D20, in the SEAS. This phytoplankton surplus can be fed on by the oil sardine, which prefers diatoms. In contrast, the higher zooplankton standing stock in the CEAS competes with the oil sardine off Karnataka and Goa, where the mackerel, which feed on zooplankton, is the dominant fishery. The weaker upwelling implies lower primary productivity and a deeper D20 (higher zooplankton standing stock) in the CEAS.
This limitation of the mature habitat by the physical forcing and the seasonal reversal of the currents limits the spawning regimes of these fish because the carnivorous (planktivorous) fish like the Bombay Duck (oil sardine) can spawn only in those regions from where they can make it to their mature habitat in the NEAS (SEAS).
Aim
To evaluate the effectiveness of a modified maxillo-mandibular nerve block technique that includes anesthetizing the maxillary and mandibular nerve with single injection.
Materials and Methods
A ...prospective, clinical cohort study was carried out including patients who presented for surgical removal of maxillary and mandibular third molars. All patients were administered maxilla-mandibular nerve block through a single injection on one side. Three clinical neurosensory tests were used for mapping the area of anesthesia and to assess and grade objectively the effect of the block. Light touch (LT), two-point discrimination (TPD), pin prick (PP) and Electric pulp testing (EPT) were used for all branches of maxillary and mandibular nerve. An extra oral mapping chart for depth of anesthesia was maintained for each patient to categorize the grades as nil, intermediate and highly anesthetized areas.
Results
62 patients were assessed in the study. EPT showed greater depth of pulpal anesthesia in posterior teeth than the anterior in both maxilla and mandible. PP and TPD tests also showed that the anesthetic effect varied between posterior divisions demonstrating extreme anesthesia compared to the anterior divisions.
Conclusion
This technique was found to be successful for surgical extractions involving the maxillary and mandibular regions.
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