Mental Health

New research into approach/avoidance conflict P Vijayalakshmi Archives of Mental Health 2018 19(2):51-51

"PUT A SIGN HERE and PUT A SIGN THERE!" (obtaining informed consent is not so easy in this changed litigious world) Rama Reddy Karri Archives of Mental Health 2018 19(2):52-53

APPSYCON Kakinada - "Extending with interventions" P Srinivasa Teja Archives of Mental Health 2018 19(2):54-56

The mystery of the missing dream in psychiatry (DS Raju Memorial Oration at IPS-AP State Conference Kakinada) M S. V. K. Raju Archives of Mental Health 2018 19(2):57-63

The role of human touch in psychiatry (Manasa Oration IPS-AP State conference Kakinada) M Vijaya Gopal Archives of Mental Health 2018 19(2):64-69

A review of functional gastrointestinal disorders: A primer for mental health professionals Suhas Chandran, SN Prakrithi, Supriya Mathur, M Kishor, T S. Sathyanarayana Rao Archives of Mental Health 2018 19(2):70-81 Functional gastrointestinal disorders (FGIDs) are chronic, recurrent, frequently debilitating disorders with no identifiable underlying pathology. They occur due to a complex interplay between biological, psychological, and social factors and are some of the most common conditions encountered in general clinical practice as well as the specialist gastroenterological clinic. The top-down regulation of visceral sensations plays an important role in the pathophysiology of the disease, i.e., the central processing of emotions and stressors altering the sensory and motor components of the gut, which increases hypersensitivity and therefore symptom severity. In addition, the core personality traits of the individual play their part in the way symptoms are perceived, further providing proof for the long-prevailing belief that the gut and emotions are linked, the so-called “gut feeling.” The current diagnostic criteria for FGIDs are entirely based on subjective symptoms, challenging in itself due to the varied presentations, and further complicated by the current unavailability of objective laboratory tests which could confirm its presence in the symptomatic individual. The various treatment modalities include psychotherapies ranging from cognitive behavioral therapy to mindfulness, along with appropriate pharmacotherapy to treat physical and psychiatric comorbidities. Addressing all these underlying causes, in addition to weighing in the genetic makeup of the individual, is necessary for delineating accurate prognosis, reducing attending health-care costs, and improving overall outcome of the individual.

Therapeutic intervention for children through play: An overview Basavaraj Shrinivasa, Madina Bukhari, G Ragesh, Ameer Hamza Archives of Mental Health 2018 19(2):82-89 Play is children's innate mode of self-expression and a method through which they explore the world. It has important implication for overall (physical, psychological, and psychosocial) development of any children. Play therapy capitalizes on such therapeutic powers or changing mechanisms within play and considers its strategic use through trained professionals to promote specific therapeutic outcomes within therapeutic contexts. This review article aims to provide a brief description on the use of play as therapeutic agent for change, different processes expressed in play, therapeutic powers within the play, and major approaches to play therapy. An attempt has also been made to list out some of the research studies from the available literature to prove the efficacy of play therapy in different conditions. The article concludes with highlighting the current issues and challenges faced by play therapy practice as a therapeutic medium to be used with children and way forward has been suggested.

Impact of psychosocial paradigms on gender equality Abdul Raffie Naik, Tejaswini Padikkal Archives of Mental Health 2018 19(2):90-94 Gender is the social, behavioral, and cultural attributes, expectations, and norms associated with being a woman or a man. The aim of gender equality is the empowerment of women, thus enabling them to manage their lives. Gender equality is a fundamental issue. The lives of people are heavily influenced by the societal stereotyping of gender. While there are differences in the biological makeup of men and women, the gender roles that are played are determined both socially and culturally. Despite major changes in the attitudes of people over the years, the issue of gender is still very much alive in society today. Gender inequalities impact women over their lifetime, their health, educational attainment, and economic conditions. Gender equality will be achieved only when women and men enjoy the same opportunities, rights, and obligations in all spheres of life. The paper is a study on the existing literature on gender and equality to understand the existing social and psychological paradigms that act as a barrier to equality among the different genders. The present study aims at understanding an overall picture of the psychosocial paradigms that infringe on gender equality. Journal articles and texts on gender inequality were identified and reviewed. psychological, sociological, and psychosocial perspectives of gender inequality are presented in the paper. Gender inequality in health, education, and work is present to date.

Mental health issues in Kashmir valley: An overview Rizwan Hassan Bhat, Shah Mohd Khan Archives of Mental Health 2018 19(2):95-96 Most mental health researchers believe that there is a variety of contributing factors to the onset of mental health issues. Studies have found that there are physical, social, environmental, and psychological causes. This paper highlights some of the mental health issues that are prevailing in Kashmir. The research so far conducted in the valley has pointed social, environmental, and psychological issues prevailing in general in the Kashmir Valley. The prevailing disturbances in the valley from the past two decades of turmoil in Kashmir were cited by most researchers as the main reasons for mental health problems. Apart from this, the changing political parties, ethics to divide, and rule resulting economic dynamics of inhabitants are also responsible for this menace. Depression, posttraumatic stress disorder, obsessive-compulsive disorder, stress, and anxiety are diagnosed in general to cause mental trauma, and illness.

Impact of traumatic brain injury on cognitive functions Padilla-Zambrano Huber Said, Amrita Ghosh, Ranabir Pal, Nataraja Poli, Luis Rafael Moscote-Salazar, Amit Agrawal Archives of Mental Health 2018 19(2):97-101 In this systematic review, we summarize the current understanding and controversies on cognitive sequelae after traumatic brain injury (TBI) to understand the cognitive deficits such as memory, attention, executive functions, and unawareness of their deficits in TBI patients. This review presents the cognitive sequel of patients with moderate-to-severe TBI by a comprehensive focused conglomeration of research publications by searching various resources. A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the WHO Global Health Library. This review noted that TBI is related with increase of various neurological and non-neurological disorders including problems with attention, inability to concentrate, speech and language dysfunctions, learning and memory impairment, impaired reasoning, impaired planning and problem-solving. This review found that patients&#39; cognitive deficits are common in victims of moderate to severe TBI often as the long-lasting sequalae. The present review suggests that there is a need for further research to develop unique rehabilitation methods that will help to enhance brain plasticity and process of recovery after TBI.  EDITORIAL   New research into approach/avoidance conflict  p. 51 P Vijayalakshmi DOI:10.4103/AMH.AMH_45_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta GUEST EDITORIAL "PUT A SIGN HERE and PUT A SIGN THERE!" (obtaining informed consent is not so easy in this changed litigious world)  p. 52 Rama Reddy Karri DOI:10.4103/AMH.AMH_42_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta PRESIDENTIAL ADDRESS APPSYCON Kakinada - "Extending with interventions"  p. 54 P Srinivasa Teja DOI:10.4103/AMH.AMH_37_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta ORATIONS The mystery of the missing dream in psychiatry (DS Raju Memorial Oration at IPS-AP State Conference Kakinada)  p. 57 M S. V. K. Raju DOI:10.4103/AMH.AMH_39_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta The role of human touch in psychiatry (Manasa Oration IPS-AP State conference Kakinada) p. 64 M Vijaya Gopal DOI:10.4103/AMH.AMH_44_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta REVIEW ARTICLES A review of functional gastrointestinal disorders: A primer for mental health professionals p. 70 Suhas Chandran, SN Prakrithi, Supriya Mathur, M Kishor, T S. Sathyanarayana Rao DOI:10.4103/AMH.AMH_25_18   Functional gastrointestinal disorders (FGIDs) are chronic, recurrent, frequently debilitating disorders with no identifiable underlying pathology. They occur due to a complex interplay between biological, psychological, and social factors and are some of the most common conditions encountered in general clinical practice as well as the specialist gastroenterological clinic. The top-down regulation of visceral sensations plays an important role in the pathophysiology of the disease, i.e., the central processing of emotions and stressors altering the sensory and motor components of the gut, which increases hypersensitivity and therefore symptom severity. In addition, the core personality traits of the individual play their part in the way symptoms are perceived, further providing proof for the long-prevailing belief that the gut and emotions are linked, the so-called "gut feeling." The current diagnostic criteria for FGIDs are entirely based on subjective symptoms, challenging in itself due to the varied presentations, and further complicated by the current unavailability of objective laboratory tests which could confirm its presence in the symptomatic individual. The various treatment modalities include psychotherapies ranging from cognitive behavioral therapy to mindfulness, along with appropriate pharmacotherapy to treat physical and psychiatric comorbidities. Addressing all these underlying causes, in addition to weighing in the genetic makeup of the individual, is necessary for delineating accurate prognosis, reducing attending health-care costs, and improving overall outcome of the individual. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Therapeutic intervention for children through play: An overview p. 82 Basavaraj Shrinivasa, Madina Bukhari, G Ragesh, Ameer Hamza DOI:10.4103/AMH.AMH_34_18   Play is children's innate mode of self-expression and a method through which they explore the world. It has important implication for overall (physical, psychological, and psychosocial) development of any children. Play therapy capitalizes on such therapeutic powers or changing mechanisms within play and considers its strategic use through trained professionals to promote specific therapeutic outcomes within therapeutic contexts. This review article aims to provide a brief description on the use of play as therapeutic agent for change, different processes expressed in play, therapeutic powers within the play, and major approaches to play therapy. An attempt has also been made to list out some of the research studies from the available literature to prove the efficacy of play therapy in different conditions. The article concludes with highlighting the current issues and challenges faced by play therapy practice as a therapeutic medium to be used with children and way forward has been suggested. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Impact of psychosocial paradigms on gender equality p. 90 Abdul Raffie Naik, Tejaswini Padikkal DOI:10.4103/AMH.AMH_22_18   Gender is the social, behavioral, and cultural attributes, expectations, and norms associated with being a woman or a man. The aim of gender equality is the empowerment of women, thus enabling them to manage their lives. Gender equality is a fundamental issue. The lives of people are heavily influenced by the societal stereotyping of gender. While there are differences in the biological makeup of men and women, the gender roles that are played are determined both socially and culturally. Despite major changes in the attitudes of people over the years, the issue of gender is still very much alive in society today. Gender inequalities impact women over their lifetime, their health, educational attainment, and economic conditions. Gender equality will be achieved only when women and men enjoy the same opportunities, rights, and obligations in all spheres of life. The paper is a study on the existing literature on gender and equality to understand the existing social and psychological paradigms that act as a barrier to equality among the different genders. The present study aims at understanding an overall picture of the psychosocial paradigms that infringe on gender equality. Journal articles and texts on gender inequality were identified and reviewed. psychological, sociological, and psychosocial perspectives of gender inequality are presented in the paper. Gender inequality in health, education, and work is present to date. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Mental health issues in Kashmir valley: An overview p. 95 Rizwan Hassan Bhat, Shah Mohd Khan DOI:10.4103/AMH.AMH_9_18   Most mental health researchers believe that there is a variety of contributing factors to the onset of mental health issues. Studies have found that there are physical, social, environmental, and psychological causes. This paper highlights some of the mental health issues that are prevailing in Kashmir. The research so far conducted in the valley has pointed social, environmental, and psychological issues prevailing in general in the Kashmir Valley. The prevailing disturbances in the valley from the past two decades of turmoil in Kashmir were cited by most researchers as the main reasons for mental health problems. Apart from this, the changing political parties, ethics to divide, and rule resulting economic dynamics of inhabitants are also responsible for this menace. Depression, posttraumatic stress disorder, obsessive-compulsive disorder, stress, and anxiety are diagnosed in general to cause mental trauma, and illness. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Impact of traumatic brain injury on cognitive functions p. 97 Padilla-Zambrano Huber Said, Amrita Ghosh, Ranabir Pal, Nataraja Poli, Luis Rafael Moscote-Salazar, Amit Agrawal DOI:10.4103/AMH.AMH_14_18   In this systematic review, we summarize the current understanding and controversies on cognitive sequelae after traumatic brain injury (TBI) to understand the cognitive deficits such as memory, attention, executive functions, and unawareness of their deficits in TBI patients. This review presents the cognitive sequel of patients with moderate-to-severe TBI by a comprehensive focused conglomeration of research publications by searching various resources. A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the WHO Global Health Library. This review noted that TBI is related with increase of various neurological and non-neurological disorders including problems with attention, inability to concentrate, speech and language dysfunctions, learning and memory impairment, impaired reasoning, impaired planning and problem-solving. This review found that patients' cognitive deficits are common in victims of moderate to severe TBI often as the long-lasting sequalae. The present review suggests that there is a need for further research to develop unique rehabilitation methods that will help to enhance brain plasticity and process of recovery after TBI. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Self in schizophrenia: Current issues and future directions p. 102 Chandril Chandan Ghosh, Rajeshwari Muthukumaran DOI:10.4103/AMH.AMH_12_18   Background: The objective of this review is to discuss the current advancements, and critical issues, in the area of studying disturbances of self in schizophrenia. The critical and systematic review of the self in schizophrenia is significant because it has been regarded as a prodrome and a predictor of the development of future psychosis. In addition, it has been found to be over and above clinical symptoms and is common in people with schizophrenia. Methodology: A systematic electronic literature search was done using PubMed, MEDLINE, and PMC (PubMed Central) databases were searched systematically, and relevant articles published in English peer-reviewed journals were selected. Results: The findings were discussed, and critical analysis of the studies revealed methodological and conceptual issues in the literature studying self in schizophrenia. Conclusion: The review has concluded with the discussion on future directions in terms of research and clinical applications. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta ORIGINAL ARTICLES A study to assess the knowledge of psychiatric aspects of alcohol use disorders in medical students p. 111 Goutham Tialam, Raghuram Macharapu, Pramod Kumar Reddy, Ravulapati Sateesh Babu DOI:10.4103/AMH.AMH_31_18   Aims and Objectives: The aim of this study was to assess the knowledge of psychiatric aspects of alcohol use disorders (AUDs) in medical students. Materials and Methods: A cross-sectional study conducted in Mamata Medical College, Khammam, Telangana, from June 2014 to May 2015. The study sample consisted of 180 medical students (115 final year and 65 interns), who agreed to answer the Knowledge of Psychiatric Aspects of Alcohol Questionnaire (KPAAQ) anonymously, indicating their gender, year of study and whether they had attended any lecture or workshop on alcohol. KPAAQ consists of 50 questions of 6 clinically relevant categories. Each response to 50 questions of the KPAAQ was assessed. Each correct response was awarded 2 points, thereby, yielding a possible range from 0 to 100 points. Results: The mean knowledge score in medical students was 44.53 (standard deviation = 11.23) without any significant differences (t = 1.171; P > 0.05) between final year students and interns, while the mean knowledge score was significantly more in 74 male students when compared to 106 female students (46.62 ± 10.58; 43.07 ± 11.49) (t = 2.103; P < 0.037). Conclusions:Irrespective of their year of study. Knowledge of psychiatric aspects of AUDs in medical students was inadequate. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A comparative study of caregiver burden and self-efficacy in chronic psychiatric illness and chronic medical illness: A pilot study p. 115 Supriya Mathur, Suhas Chandran, M Kishor, SN Prakrithi, T S. Sathyanarayana Rao DOI:10.4103/AMH.AMH_16_18   Background: A caregiver is an individual who provides assistance and assumes the responsibility for the physical and emotional needs of another individual who is incapable of self-care. Caregiver burden is a universal phenomenon and more than half of the caregivers experience burden in their role as caregivers. There is a paucity of studies to understand the burden and coping strategies of caregivers in chronic psychiatric illness and chronic medical illnesses, especially in the Indian scenario. Aims and Objectives: (i) To compare the caregiver burden in chronic psychiatric illness and chronic medical illness (ii) To compare the caregiver efficacy in chronic psychiatric illness and chronic medical illness. Materials and Methods: The study sample included caregivers of inpatients admitted in a tertiary care hospital in South India. A total of 120 caregivers were included in the study with 60 caregivers from psychiatric ward and medicine ward, respectively. The caregivers were then assessed using the Caregiver Burden Scale and the Revised Caregiver Self-efficacy Scale Results and Conclusion: We found that majority of the caregivers were first-degree relatives and women constituted a major part of the caregiver group. Caregiver burden was significantly higher in psychiatric illnesses compared to medical illnesses. Caregiver efficacy was similar in both study groups. Interventions to reduce caregiver burden and to improve caregiver efficacy should be implemented to ensure optimal management of both patient and caregiver. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Comparing strengths, difficulties, and loneliness between socioeconomically deprived and advantaged children p. 123 M Vijay Kumar, Raghuram Macharapu, Pramod Kumar Reddy Mallepalli, Ravulapati Sateesh Babu DOI:10.4103/AMH.AMH_28_18   Aims and Objectives: The present study is an attempt to study strengths-difficulties, and experiences of loneliness in below poverty line (BPL) and above poverty line (APL) children and compared the same between two groups. Materials and Methods: The total sample consisted of 120 participants (age range 10–13 years), 60 BPL and 60 APL children. Each group further consisted of 25 females and 35 males. The samples were drawn using convenience sampling method. Strengths and difficulties questionnaire (SDQ) and loneliness and social dissatisfaction scale were the tools used. Results: In BPL children, peer problems were found to be the highest (i.e. 25% in abnormal and 55% in borderline range). Significant difference was found between BPL and APL children on emotional symptoms (P = 0.003), peer problems (P = 0.02), and prosocial behavior (P = 0.03), on SDQ, and experiences of loneliness (P = 0.04) on loneliness and social dissatisfaction questionnaire. The significant negative correlation was found between loneliness score and emotional symptoms score (P = 0.03), loneliness score and hyperactivity score (P = 0.002), and between loneliness score and peer problems score (P= 0.001). The significant positive correlation was found between experiences of loneliness score and prosocial behavior score (P = 0.03). Conclusions: In BPL children, peer problems were found to be the highest. BPL children have more emotional symptoms, peer problems, and feeling more lonely compared to APL children. APL children have low prosocial behavior. Children with more emotional symptoms, peer problems, and hyperactivity are feeling lonely. Children with low prosocial behavior are feeling lonely. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A study of psychiatric referrals from other specialties at a tertiary care center p. 129 Sujitha Gurram, Raghuram Macharapu, M Vijay Kumar, Pramod Kumar M Reddy DOI:10.4103/AMH.AMH_30_18   Objective: The objective was to study the reasons for referral, to study diagnostic categories of psychiatric referrals, and to study the associations if any between reasons for referral and diagnostic categories of psychiatric referrals. Materials and Methods: The present study was conducted at the Department of Psychiatry, Mamata General Hospital, Khammam. The present study consists of 112 psychiatric referrals; 12 referrals were excluded from the study as they are not willing to give consent, so the study was conducted on 100 psychiatric referrals. The study protocol was approved by the Institutional Ethics Committee. Results: In the present study, based on the sources of referrals, it was found that majority of the patients were from the Department of General Medicine (38%). In the present study, the most common reason stated for referral was suicidal/self-harm act by 29% of the sample. The most common psychiatric disorder diagnosed in the present study was found to be substance use disorder which is seen in 33% of the sample. On evaluation of diagnostic categories with reference to reasons for referral, it is found that most of the referrals with a history of excessive alcohol intake were diagnosed as substance use disorders (91.6%). Majority of referrals with a history of suicidal attempts were diagnosed as intentional self-harm (58.6%). Referrals with a history of altered sensorium were diagnosed with organic mental disorders (50%), substance use disorder (37.5%), and 12.5% had no psychopathology. Conclusion: Suicidal attempts are most commonly diagnosed to have intentional self-harm. Substance use disorder came to be high in referrals which are referred for excessive alcohol intake. Regarding referrals to psychiatry department, majority of the patients were from the Department of General Medicine. The most common reason stated for referral to psychiatry was suicidal/self-harm. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Impact of occupational and psychological stress on police health in South India p. 136 Manaswitha Boyanagari, Vamsi Krishna Boyanagari, Mehul Shankar, Ravishankar Ayyanar DOI:10.4103/AMH.AMH_19_18   Background: Police personnel form an important occupational group who constantly work under stressful situations. Preventive programs in the government organizations and studies investigating the occupational stress among police officers in India, particularly in the state of Andhra Pradesh, are still limited. Materials and Methods: Demographic details such as age, educational qualification, years of service, and number of children etc of Demographic details such as age, educational qualification, years of service, and number of children etc of Male police constables (n = 123) working in the Bellampalli subdivision of Adilabad district of erstwhile Andhra Pradesh were captured. Details of height, weight, body mass index (BMI, kg/m2), blood pressure (BP), pulse, the status of addiction, and type of illness were extracted from the records. Descriptive statistics were calculated, and Chi-square test to find an association between categorical variables was performed using SPSS version 16.Results: About 72.4% of the constables were addicted to at least one habit such as alcohol consumption, smoking, and chewing smokeless tobacco and pan. Nearly 20.3% were addicted to chewing tobacco/pan followed by addition to alcohol consumption 14.6%. With the increase in age, the prevalence of hypertension also increased showing a significant association (systolic BP [SBP]: P = 0.001; diastolic BP [DBP]: P = 0.001). Similarly, higher BMI (SBP: P = 0.008; DBP: P = 0.001) and increased number of service years (SBP: P = 0.001; DBP: P = 0.001) were associated with higher prevalence of hypertension. Conclusion: Developing an adequate evaluation of the association between chronic diseases and mortality in addition to a hazard surveillance system for tracking the risks for occupational injury and illness among police officers should be considered. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta The relationship between professional quality of life and general health of postgraduates in a Tertiary Care Hospital p. 141 Pavani Narukurthi, Raghuram Macharapu, Pramod Kumar Reddy Mallepalli, Ravulapati Sateesh Babu DOI:10.4103/AMH.AMH_32_18   Introduction: Professional quality of life (ProQOL) is the measure that everyone feels in relation to their work. Both the positive and negative aspects of doing a job, influence the ProQOL. The majority of people spend more time at work than they do anywhere else, doing anything else. Aims and Objectives: The aim of this research is to study the relationship between ProQOL and general health in the postgraduates of a tertiary care hospital.Methodology: This is a cross-sectional study, which is conducted at Mamata General Hospital in Khammam, Telangana during a 6-month period (2017). The tools used are the ProQOL questionnaire and general health questionnaire. Results: Statistical analysis needs to be done, and the results will be analyzed and presented later. Conclusion: The current study is carried out to support the findings between the ProQOL and general health among postgraduates at a tertiary care hospital. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Assessment of nutritional status, psychological depression, and functional ability of elderly population in South India p. 150 Vamsi Krishna Boyanagari, Paramjot Panda, Manaswitha Boyanagari, Suchismita Panda DOI:10.4103/AMH.AMH_15_18   Background: Nutrition and depression among elderly have emerged as a major public-health problem, and depression is one of the leading causes of disease burden worldwide. The evidence shows that more than 50% of the elderly population is underweight and more than 90% has an energy intake below the recommended intake. Objective: The objective of this study is to determine the prevalence and correlates of malnutrition and the relationship with disability and psychological well-being, and to assess the pattern of morbidity, co-morbidity, among the elderly in Udupi taluk of Karnataka. Methodology: This cross-sectional study conducted during January–June 2017 included 570 participants of ≥60 years of age. The data were analyzed for percentages, mean, and standard deviation. The tests of significance such as analysis of variance and Independent t-test were used; P < 0.05 was considered statistically significant. Results: It was observed during the study that the majority belonged to the young old age group (63.2%), were financially dependent (55.8%) and most of them are from rural (61. 1%). The prevalence of malnutrition based on the malnutrition indicator score was found to be (11.22%) and (44.73%) are at risk of malnutrition. The mid-upper arm circumference and calf circumference measurements were (8.24%) and (11. 75%), respectively. The prevalence of depression in the elderly was found to be 6.6%. Conclusion: The care of the elderly should also include the nutrition and mental healthcare components for better addressal of the health needs of elderly which requires to be brought on the national health care agenda. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Sociodemographic profile and mental health orientation of self-help group members in rural Karnataka p. 155 Basavaraj Shrinivasa, Navaneetham Janardhana, Bergai Parthasarathy Nirmala DOI:10.4103/AMH.AMH_29_18   Background: Perception of the people about mental illness will have a substantial impact on the treatment outcome and quality of life of people affected since it greatly influences the identification, help-seeking behavior, and stigma attached to it. To realize the goal of community-based mental health care, community needs to be educated on mental health issues. Aims: The aim of the study is to ascertain the sociodemographic profile of the members enrolled in self-help group (SHG) and their orientation toward mental illness (OMI). Materials and Methods: A cross-sectional research design was employed to assess the orientation of SHG members toward mental illness using OMI scale. Descriptive statistics and nonparametric tests were used for the analysis of the data. Results: Overall, participants obtained score of 212.50 which was above than the cutoff score, indicating unfavorable orientation to mental illness. Conclusion: Assessing and orienting the members of SHGs on mental health issues will aid in addressing the need to include an economic empowerment and social inclusion component while scaling up of mental health services in low- and middle-income countries. Further intervention model that is acceptable to the local community needs to be developed, and the efficacy of such intervention programs needs to be tested scientifically. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Sexual dysfunctional beliefs among male and female medical students p. 162 Sridivya Reddy Kandhi, Raghuram Macharapu, Pramod Kumar Reddy, Ravulapati Sateesh Babu DOI:10.4103/AMH.AMH_35_18   Objective: The aim was to study about the sexual dysfunctional beliefs among male and female medical students and analyze the factors in which the beliefs are more obvious. Materials and Methods: The present study was conducted among male and female interns in Mamata General Hospital, Khammam. The present study consists of 156 participants, 68 students were excluded from the study as they are not willing to give consent, so the study was conducted on 88 students. The study was conducted using "sexual dysfunctional beliefs questionnaire – male and female versions." The study protocol was approved by the Institutional Ethics Committee. Results: Sexual dysfunctional beliefs among females and males showed significance of P value. In females, there is a significant positive correlation among all the variables and whereas in males, there is both significant positive correlation and negative correlation among the variables. Conclusion: Overall, findings in the current study population suggest that dysfunctional sexual beliefs are more in men than in women. In males, "Macho belief" is more evident than other factors and whereas in females, it is sexual conservatism. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Perception of stress and coping tactics among medical students at Aligarh Muslim University, Aligarh p. 166 Zeenat Fatima, Shahnawaz Mushtaq, Faisal Shaan DOI:10.4103/AMH.AMH_23_18   Introduction: Medical students face a number of stressors because of time pressure, which affects their academic performance and quality of life. Previous studies have shown that coping reduce the level of stress among medical students. Aim: The aim of this study was to assess the level of stress and coping mechanism among medical students. Methods: In this cross-sectional study, 200 first-year medical students at Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh (130 males and 70 females), were invited to fill in a self-administered questionnaire in the 2017–2018 academic year. The questionnaire comprised of 12 items on stress factors and 10 items on coping strategies. The responses were measured quantitatively on a five-point Likert scale. Result and Discussion: The response rate was high. Different stress factors and coping strategies were identified by students. The prevalence of perceived stress among medical students was high. This might affect not only their academic performance but also other aspects of their life as well. There is a wide range of strategies for coping with stress that could play an important role in helping students to cope with stress. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta CASE REPORT Solar retinopathy on sun-gazing in mania p. 169 Mrinalini Reddy, Pallavi Abhilasha, Arul Saravanan Ramachandran, M Thirunavukarasu DOI:10.4103/AMH.AMH_24_18   Solar retinopathy is a rare complication of damage to the retina due to unnatural exposure to bright light. Few cases have been reported in international literature in special groups like in children, psychiatric patients, direct gazing of solar eclipse and in certain occupations like arc welding. Of the few that are reported in mental institutions, majority had a diagnoses of schizophrenia. Along with the review of the reported cases, we report the first case of solar retinopathy in a patient who indulged in sun gazing during acute manic phase in our country. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta LETTERS TO EDITOR Impression management – How much does this serious confounder influence in interviews/examinations? p. 172 V Dinesh Kumar DOI:10.4103/AMH.AMH_43_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Selfie: How the hunt for "self" has developed from past p. 174 V Dinesh Kumar DOI:10.4103/AMH.AMH_33_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bloodpool SPECT as part of bone SPECT/CT in painful total knee arthroplasty (TKA): validation and potential biomarker of prosthesis biomechanics

Abstract

Purpose

To compare bloodpool SPECT with planar imaging in bone SPECT/CT of painful total knee arthroplasty (TKA) with respect to inter-rater agreement, confidence, prosthesis outcome, and biomechanical functioning.

Methods

Retrospective study of bloodpool SPECT and planar control images. Four raters used the validated Bruderholz scheme and a 5-point scale to grade uptake. Inter-rater agreement and overall confidence scores were calculated. Variable cluster analysis was performed to identify patterns of uptake, and associations between patterns and prosthesis outcome and biomechanical functioning were examined.

Results

In all, 55 knees in 43 patients were analyzed (median follow-up 17 months; revision rate 21.8%). SPECT significantly improved inter-rater agreement in 24% of regions (all P < 0.05) and overall confidence by 20% (P < 0.001). Regional uptake cluster analysis showed improved antero-posterior separation with SPECT, and distinct patterns associated with prosthesis survival in lateral femoral (P = 0.041) and medial tibial (P < 0.001) regions. The prognostic value of SPECT outperformed planar imaging for tibial (P < 0.001), patellar (P = 0.009), and synovial (P = 0.040) assessment. Internal femoral malrotation resulted in increased uptake in posteromedial (P = 0.042) and anterolateral (P = 0.016) femoral, and lateral patellar (P = 0.011) regions. Internal tibial malrotation increased uptake in posterolateral (P = 0.026) and posteromedial tibial (P = 0.005), and medial patellar regions (P = 0.004). Bloodpool SPECT improved the prognostic value of late-phase SPECT/CT for the assessment of the medial tibial region.

Conclusions

Bloodpool SPECT outperforms planar assessment of painful TKAs and the identification of distinct uptake patterns make it a potentially clinically relevant biomarker of prosthesis survival and biomechanical functioning.

http://bit.ly/2ApmBzg

Fabrication and photocatalytic performance evaluation of hydrodynamic erosion–resistant nano-TiO 2 –silicone resin composite films

Abstract

Herein, we present the preparation of nano-TiO₂–silicone resin composite films by double liquid phase spray deposition. The films exhibit better adhesion stability and photocatalytic activity under a hydrodynamic erosion condition than conventional nano-TiO₂ composite films. The TiO₂ layer morphology and effective TiO₂ coverage ratio (CR) were affected by the initial curing time (ICT) of the silicone resin, e.g., the increase in an ICT from 10 to 40 min resulted in a CR change from 79.1 to 98.7%. The surface morphology evolution of composite films was studied under a hydrodynamic erosion period of 4 weeks. Obtained results allowed the 4-week evolution to be divided into four stages (pitting, crack pregnant, banded stripping, and surface stripping periods), additionally revealed that the CR of all samples was remained above 65%. The photocatalytic activity of composite films before and after 4-week hydrodynamic erosion was evaluated by rhodamine B degradation experiments. The 4-week erosion only led to the decrease of the photodegradation efficiencies by less than 40% in all cases. Thus, the fabricated TiO₂–silicone composite films demonstrated excellent durability and photocatalytic activity under the conditions of long-term hydrodynamic erosion, allowing one to conclude that this work paves the way to the fabrication of next-generation photocatalytic materials for industrial applications.

http://bit.ly/2F2LILT

Exogenous application of Ca 2+ mitigates simulated acid rain stress on soybean productivity and quality by maintaining nutrient absorption

Abstract

Acid rain is a global environmental problem that threatens agricultural production. Calcium (Ca), as a signal substance for physiological activities, has been known to regulate plant growth under abiotic stresses. To clarify whether calcium could be one of possible ways to alleviate the reduction caused by acid rain in agricultural production and investigate its regulating mechanism on adaptation of plants under acid rain stress, we studied the effect of exogenous Ca²⁺ (5 mM CaCl₂) on growth of soybean at different growth stages (seedling, flowering-podding, and filling stages) as well as yield and grain quality of soybean under simulated acid rain (pH 4.5 or pH 3.0) stress. We found that the application of Ca²⁺ could regulate the activity of plasma membrane H⁺-ATPase, for mitigating the increase of ammonium and the decrease of nitrate and phosphorus in soybean roots, which mitigated the inhibition on growth and improved the yield and grain quality of soybean under simulated acid rain stress. In addition, the alleviating effect of exogenous Ca²⁺ on soybean was the most significant at seedling stage. The results indicate that the exogenous Ca²⁺ could enhance the adaptation of soybean and facilitate the recovery of soybean productivity and grain quality under simulated acid rain stress by maintaining the uptake of nitrate, ammonium, and phosphorus.

http://bit.ly/2F2Tm8c

In Situ Hybridization Analysis of Long Non-coding RNAs MALAT1 and HOTAIR in Gastroenteropancreatic Neuroendocrine Neoplasms

Abstract

Recent studies suggest onco-regulatory roles for two long non-coding RNAs (lncRNAs), MALAT1 and HOTAIR, in various malignancies; however, these lncRNAs have not been previously examined in neuroendocrine neoplasms (NENs) of gastroenteropancreatic origins (GEP-NENs). In this study, we evaluated the expressions and prognostic significance of MALAT1 and HOTAIR in 83 cases of GEP-NENs (60 grade 1, 17 grade 2, and 6 grade 3 tumors) diagnosed during the years 2005–2017. Expression levels of MALAT1 and HOTAIR were digitally quantitated in assembled tissue microarray slides labeled by chromogenic in situ hybridization (ISH) using InForm 1.4.0 software. We found diffuse nuclear expression of both HOTAIR and MALAT1 in all primary tumors of GEP-NENs with variable intensities. By multivariate model which adjusted for age and histologic grade, high expression of HOTAIR was associated with lower presenting T and M stages and subsequent development of metastases (P < 0.05). MALAT1 expression was associated with presenting T stage and development of metastases (P < 0.05). In summary, MALAT1 and HOTAIR are commonly expressed in GEP-NENs. High expression of either lncRNA showed grade-independent associations with clinically less aggressive disease.

http://bit.ly/2Sx5ZfN

Highly adsorptive chitosan/saponin-bentonite composite film for removal of methyl orange and Cr(VI)

Abstract

Robust and simple composite films for the removal of methyl orange (MO) and Cr(VI) have been prepared by combining chitosan, saponin, and bentonite at a specific ratio. There are several composite films (chitosan-saponin-bentonite (CSB)) prepared; among them, the composite films CSB_2:3 and CSB_1:1 have the highest removal efficiency toward MO and Cr(VI) where the maximum removal is 70.4% (pH 4.80) and 92.3% (pH 5.30), respectively. It was found that different types of adsorbate have different thermodynamic properties of the adsorption process; the adsorption of MO onto CSB_2:3, chitosan, and acid-activated bentonite (AAB) proceeded endothermically, while the adsorption of Cr(VI) onto CSB_1:1, chitosan, and AAB proceeded exothermically. The parameters of the adsorption were modeled by using isotherm and kinetic equations. The models of Langmuir, Freundlich, Redlich-Peterson, Sips, and Toth were used for fitting the adsorption isotherm data at a temperature of 30, 45, and 60 °C; all of the isotherm models could represent the data well. The result indicates that CSB_2:3 has the highest adsorption capacity toward MO with q_m of 360.90 mg g⁻¹ at 60 °C; meanwhile, CSB_1:1 has the highest adsorption capacity toward Cr(VI) with q_m 641.99 mg g⁻¹ at 30 °C. The pseudo-second-order model could represent the adsorption kinetics data better than the pseudo-first-order equation. The adsorption mechanism was proposed, and the thermodynamic properties of the adsorption were also studied.

http://bit.ly/2Vh8WCW

Venoprotective drugs in pigmented purpuric dermatoses: A case report

Summary

Pigmented purpuric dermatoses (PPD) or capillaritis represent a benign condition, presenting with extravasation of erythrocytes in the skin and prominent hemosiderin deposition. The eruption runs a chronic relapsing course and is resistant to therapy. Capillary fragility, cellular immunity, and microvascular inflammation play important roles in the pathogenesis of PPD. Bioflavonoids, currently used as venoprotective agents for the management of chronic venous insufficiency, have been shown to reduce capillary fragility and permeability by inhibiting endothelial cell activation and modulating the leukocyte‐endothelium interaction. We report a case of PPD with dramatic improvement consequent to a therapy with a fixed dose combination containing flavonoids like diosmin, hesperidin, and Euphorbia prostata extract along with calcium dobesilate.

http://bit.ly/2F2Ex6p

Comparative study of testosterone and vitamin D analogue, elocalcitol, on insulin-controlled signal transduction pathway regulation in human skeletal muscle cells

Abstract

Purpose

Skeletal muscle (Skm) plays a key role in regulating energetic metabolism through glucose homeostasis. Several hormones such as Testosterone (T) and Vitamin D (VD) have been shown to affect energy-dependent cell trafficking by determining Insulin (I)-like effects.

Aim

To elucidate possible hormone-related differences on muscular metabolic control, we analyzed and compared the effects of T and elocalcitol (elo), a VD analogue, on the activation of energy-dependent cell trafficking, metabolism-related-signal transduction pathways and transcription of gene downstream targets.

Methods

Human fetal skeletal muscle cells (Hfsmc) treated with T or elo were analyzed for GLUT4 localization, phosphorylation/activation status of AKT, ERK1/2, IRS-1 signaling and c-MYC protein expression.

Results

T, similar to elo, induced GLUT4 protein translocation likely in lipid raft microdomains. While both T and elo induced a rapid IRS-1 phosphorylation, the following dynamic in phosphorylation/activation of AKT and ERK1/2 signaling was different. Moreover, T but not elo increased c-MYC protein expression.

Conclusions

All together, our evidence indicates that whether both T and elo are able to affect upstream I-like pathway, they differently determine downstream effects in I-dependent cascade, suggesting diverse physiological roles in mediating I-like response in human skeletal muscle.

http://bit.ly/2GMCNjl

Parathyroid scintigraphy in primary hyperparathyroidism: comparison between double-phase and subtraction techniques and possible affecting factors

Abstract

Purpose

Parathyroid scintigraphy is superior to other imaging techniques in detecting hyperfunctioning parathyroid glands. It is mainly performed using double-phase or dual-tracer subtraction methods. Neither of the techniques is perfect and different protocols are being used. We aimed to evaluate the accuracy of double-phase and subtraction methods in detecting abnormal gland as well as the potential effects of coexisting thyroid disease and clinical-laboratory data.

Methods

We considered patients with primary hyperparathyroidism who underwent parathyroid surgery, after a parathyroid scintigraphy between April 2015 and February 2017. Sixty-eight patients were included; in 45 cases (66.2%), a thyroid disease was coexistent. Diagnostic performances of the two techniques were compared. The effect of thyroid disease and clinical-pathological data on examination interpretation was considered.

Results

Double-phase scintigraphy showed higher sensitivity and accuracy in detecting the exact abnormal gland compared to the digital subtraction (90% and 75% vs. 76% and 66%, respectively). For double-phase technique, sensitivity and accuracy were higher in cases with no thyroid disease when compared to those with thyroid disease (92% and 86% vs. 88% and 69%, respectively). Similarly, for digital subtraction, sensitivity and accuracy were higher in the absence of thyroid disease compared to their presence (84% and 79% vs. 70% and 58%, respectively). There was no significant variation in the performance of both techniques, considering clinical-laboratory data.

Conclusions

Double-phase scintigraphy has been more accurate than digital subtraction. The presence of thyroid disease could be a possible limit, affecting the subtraction more than the double-phase technique. Clinical data did not influence the scintigraphic outcome.

http://bit.ly/2GOkFWv

هفت باور نادرست درباره سرقت علمی - نیتیو پیپر

هفت باور نادرست درباره سرقت علمی

۱۳۹۷/۰۷/۱۰|آموزش ها|بدون ديدگاه

مانند سایر موضوعات، بدفهمی‌ها و باورهای نادرست زیادی درباره سرقت علمی وجود دارد. با نادیده گرفتن قانون حق تألیف که به‌روشنی مجازات‌های سرقت علمی را تبیین کرده است، بسیاری از پژوهش‌گران خود را به‌طور جدی دچار دردسر می‌کنند. علی‌رغم آگاهی از نادرست بودن باورهای زیر، بسیاری از افراد آن‌ها را توجیهی برای سرقت‌های علمی می‌دانند. سرقت علمی از جمله پدیده‌هایی است که مردم دوست ندارند در کلاس درس یا محل کار درباره‌اش صحبت کنند. در اینجا، هفت باور نادرست درباره سرقت علمی مرور می‌شوند، پس با نیتیو پیپر همراه باشید.

هفت باور نادرست درباره سرقت علمی

۱- تنها محتوایی که مالکیت خصوصی دارد را نمی‌توان سرقت کرد

سرقت علمی و کپی‌رایت در این زمینه وجه اشتراک دارند. برخی فکر می‌کنند اگر اثری تحت مالکیت عمومی بوده یا مدت زمان مشخصی از انتشارش گذشته باشد، نیازی نیست به نام صاحب اثر اشاره کنند. هرچند در این حالت حق تألیف را نقض نکرده‌اید، با این حال، حتی اگر نویسنده اثر سال‌ها پیش فوت کرده باشد یا اثر تحت مالکیت عمومی باشد، باز هم باید به نام وی اشاره کنید؛ در غیر این صورت، مرتکب سرقت علمی شده‌اید.

۲- تنها باید نقل قول‌های مستقیم را ارجاع‌دهی کرد

بسیاری از دانشجویان تنبل که از ارجاع دادن بیزارند همیشه در اینجا قربانی می‌شوند. آن‌ها فکر می‌کنند تنها باید نقل قول مستقیم را ارجاع‌دهی کنند. بنابراین، با پارافریز کردن کل اثر از نقل قول مستقیم فرار می‌کنند. اما واقعیت این است که کلمات ابزارهای انتقال دادن، قرض گرفتن و اشتراک‌گذاری ایده‌ها و افکارند. ارجاع دادن کمک می‌کند سایر افراد محل دقیق منبع شما را پیدا کنند. بنابراین، حتی اگر کار را پارافریز کنید و به منبع‌تان ارجاع ندهید، مرتکب سرقت علمی شده‌اید.

۳- سرقت علمی تصادفی اهمیتی ندارد

حتی پس از پارافریز کردن، شباهت‌هایی که با متن اصلی وجود دارد قابل ردگیری‌اند. حتی اگر برای پارافریز کردن تلاش زیادی انجام دهید، باز هم سرقت علمی صورت گرفته است. برخی اوقات، مشابهت یاب‌های آنلاین مواردی از شباهت را ردیابی می‌کنند که باعث شگفتی شما می‌شود. ممکن است به علت ثبت نکردن منابع پژوهشی از ابتدای نوشتن مقاله، آن‌ها را گم کرده باشید. اینجا جایی است که ادعای بی‌گناهی می‌کنید. ممکن است از سرقت علمی اجتناب کرده باشید، اما واقعیت این است مرتکب خلاف شده‌اید و ممکن است جریمه‌ای سنگین در انتظارتان باشد. سرقت علمی تصادفی یا غیرتصادفی مهم نیست؛ مقاله همچنان سرقتی است.

۴- اینترنت یعنی دانش مشترک

بسیاری از دانشجویان گمان می‌کنند که چون اینترنت رایگان و دسترسی به آن برای همه آزاد است جزئی از دانش عمومی به حساب می‌آید و نیازی نیست اطلاعات استخراج‌ شده از آن را ارجاع‌دهی کنند. دانش مشترک تعریف خاص خود را دارد. دانش مشترک یعنی اطلاعات و حقایقی که برای همه آشناست و در تمام کتاب‌های مرجع در دسترس عموم است و به‌راحتی می‌توان آن را بازیابی کرد. بنابراین، باید تمام منابع اطلاعاتی اینترنتی را ارجاع‌دهی کرد.

۵- سرقت علمی از خود مهم نیست

بسیاری از دانشجویان عادت کرده‌اند که مقاله خود را بازنویسی و در ژورنال‌های متعدد سابمیت کنند. این کار نوعی سرقت علمی آکادمیک است. بسیاری از افراد این ادعا را که چیزی از دیگران سرقت نشده است قبول ندارند. کپی‌برداری از کارهای خودتان و بازنویسی کردن‌شان ممکن است دردسرساز شود. بیشتر نویسندگان از فرصت سوء استفاده می‌کنند و از کارهای‌شان مجدداً استفاده می‌کنند. به همین دلیل، بسیاری از نشریات قانون‌هایی دارند که مانع از استفاده مجدد از آثار پیشین می‌شوند، مگر آنکه به روشنی به آن‌ها ارجاع‌دهی شده باشد.

+بیشتر بخوانید: سرقت علمی از خود یا self-plagiarism چیست و چرا باید از آن اجتناب کرد؟

۶- هم می‌توانم از ارجاع‌دهی درون‌متنی استفاده کنم و هم از کتاب‌شناسی

بسیاری از دانشجویان فکر می‌کنند می‌توانند یکی از این دو شیوه را به کار ببرند. واقعیت این است که ژورنال‌ها هم ارجاع درون‌متنی و هم کتاب‌شناسی را الزامی می‌دانند. ارجاعات درون‌متنی نشان می‌دهند که محتوای قرض‌ گرفته‌ شده کجا آغاز می‌شود و کجا پایان می‌یابد. کتاب‌شناسی به مخاطب نشان می‌دهد که چگونه می‌توانند به منابع استفاده‌ شده دسترسی پیدا کنند.

۷- سرقت علمی تنها در کشورهای غیرانگلیسی‌زبان رایج است

موانع زبانی تا حدی در این مسئله نقش داشته است. این باور تا حدی درست است. پژوهش‌گرانی که کارهای‌شان را به انگلیسی آماده می‌کنند با مسائل متعددی مواجه می‌شوند که آن‌ها را در معرض سرقت علمی قرار می‌دهد. ممکن است به دلیل کمبود اعتماد به نفس مرتکب این عمل شوند. با این حال، واقعیت این است که سرقت علمی مسئله‌ای جهانی است، و هم در کشورهای انگلیسی‌ زبان اتفاق می‌افتد و هم در کشورهای غیرانگلیسی‌ زبان.

سرقت علمی مجازات دارد. مهم نیست در کجا اتفاق افتاده است. بنابراین، پیشنهاد می‌شود از استادان دانشگاه کمک گرفته شود. مطمئن شوید که باورهای درست و نادرست درباره سرقت علمی و مجازات‌های آن را مطابق با قانون حق تالیف درک کرده‌اید. ویراستاران باید پژوهش‌گران را توجیه کنند که سرقت علمی چه تاثیر نامطلوبی بر صاحبان اصلی آثار دارد.

http://www.nativepaper.ir/%d9%87%d9%81%d8%aa-%d8%a8%d8%a7%d9%88%d8%b1-%d9%86%d8%a7%d8%af%d8%b1%d8%b3%d8%aa-%d8%af%d8%b1%d8%a8%d8%a7%d8%b1%d9%87-%d8%b3%d8%b1%d9%82%d8%aa-%d8%b9%d9%84%d9%85%db%8c/

Health literacy – a new piece of the puzzle in psoriasis care?

Summary

Background

Health literacy (HL), the ability to seek, understand and utilize health information, is important for good health. Suboptimal HL has been associated with poorer health outcomes in other chronic conditions, although this has not previously been studied in patients with psoriasis.

Objectives

The aim of this study was to investigate the HL strengths and weaknesses of a cohort of patients with moderate to severe psoriasis. Another aim was to examine possible associations between patients' quality of life, their demographic, clinical and self‐management characteristics and dimensions of HL.

Methods

A cross‐sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had participated in climate helio therapy from 2011‐2016 (N= 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self‐management variables was analysed using bivariate correlation and a four‐step linear multiple regression model.

Results

The scores on all HLQ dimensions indicate lower health literacy compared to other populations. The linear regression models showed a significant association between HL, quality of life and self‐management variables, with higher HL predicting higher quality of life, self‐efficacy, and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy.

Conclusions

Improving HL may be a useful strategy for reducing disparities in self‐management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self‐ efficacy and quality of life may positively increase HL.

This article is protected by copyright. All rights reserved.

http://bit.ly/2GMEtta

Depressive Symptom Profiles and Survival in Older Patients with Cancer: Latent Class Analysis of the ELCAPA Cohort Study

AbstractBackground.The expression of depressive symptoms in older people with cancer is heterogeneous because of specific features of age or cancer comorbidity. We aimed to identify depressive symptom profiles in this population and describe the associated features including survival.Materials and Methods.Patients ≥70 years who were referred to geriatric oncology clinics were prospectively included in the ELCAPA study. In this subanalysis, depressive symptoms were used as indicators in a latent class analysis. Multinomial multivariable logistic regression and Cox models examined the association of each class with baseline characteristics and mortality.Results.For the 847 complete‐case patients included (median age, 79 years; interquartile range, 76–84; women, 47.9%), we identified five depressive symptom classes: "no depression/somatic only" (38.8%), "no depression/pauci‐symptomatic" (26.4%), "severe depression" (20%), "mild depression" (11.8%), and "demoralization" (3%). Compared with the no depression/pauci‐symptomatic class, the no depression/somatic only and severe depression classes were characterized by more frequent comorbidities with poorer functional status and higher levels of inflammation. "Severe" and "mild" depression classes also featured poorer nutritional status, more medications, and more frequent falls. Severe depression was associated with poor social support, inpatient status, and increased risk of mortality at 1 year (adjusted hazard ratio, 1.62, 95% confidence interval, 1.06–2.48) and 3 years (adjusted hazard ratio, 1.49; 95% confidence interval, 1.06–2.10).Conclusion.A data‐driven approach based on depressive symptoms identified five different depressive symptom profiles, including demoralization, in older patients with cancer. Severe depression was independently and substantially associated with poor survival.Implications for Practice.Older patients with cancer present with distinct profiles of depressive symptomatology, including different severity levels of depression and the demoralization syndrome. Clinicians should use a systematic assessment of depressive symptoms to adequately highlight these distinct profiles. Geriatric and oncological features are differently associated with these profiles. For instance, severe depression was associated with more frequent comorbidities with poorer functional, poor nutritional status, polypharmacy, frequent falls, inpatient status and poor social support. Also, severe depression was independently and substantially associated with poor survival so that the identification and management of depression should be considered a high priority in this population.

http://bit.ly/2SuRpWe

An Open‐Label, Multicenter, Phase I, Dose Escalation Study with Phase II Expansion Cohort to Determine the Safety, Pharmacokinetics, and Preliminary Antitumor Activity of Intravenous TKM‐080301 in Subjects with Advanced Hepatocellular Carcinoma

AbstractLessons Learned. TKM‐080301 showed a favorable toxicity profile at the studied dose.TKM‐080301 targeting PLK1 through small interfering RNA mechanism did not demonstrate improved overall survival in patients with advanced hepatocellular carcinoma compared with historical control. Preliminary antitumor activity as shown in this early‐phase study does not support further evaluation as a single agent.Background.Polo‐like kinase 1 (PLK1) is overexpressed in hepatocellular carcinoma (HCC). Knockdown of PLK1 expression by PLK1 small interfering RNA (siRNA) in an HCC cell line showed reduced expression in RNA‐induced silencing complex and a reduction in cell proliferation.Methods.A 3 + 3 dose escalation plus expansion cohort at the maximum tolerated dose (MTD) was implemented. Patients with HCC, Eastern Cooperative Oncology Group (ECOG) performance status ≤2, and Child‐Pugh score A received TKM‐080301 as an intravenous infusion once every week for 3 consecutive weeks, repeated every 28 days.Results.The study enrolled 43 patients. The starting dose of TKM‐080301 was 0.3 mg/kg, and MTD was declared at 0.75 mg/kg. Following the development of grade 4 thrombocytopenia in two subjects on the expansion cohort, the MTD was redefined at 0.6 mg/kg. Four patients did not have any evaluable postbaseline scan. Of the other 39 subjects who had received at least 0.3 mg/kg, 18 subjects (46.2%) had stable disease (SD) by independent RECIST 1.1 criteria. By Choi criteria, eight subjects (23.1%) had a partial response (PR). For 37 assessable subjects, with 2 subjects censored, median progression‐free survival (PFS) was 2.04 months. Median survival for the whole study population was 7.5 months.Conclusion.TKM‐080301 was generally well tolerated. In this early‐phase study, antitumor effect for TKM 080301 was limited. Further evaluation as a single agent in large randomized trials is not warranted.

http://bit.ly/2AolGyZ

Adverse Event Management in Patients with BRAF V600E‐Mutant Non‐Small Cell Lung Cancer Treated with Dabrafenib plus Trametinib

AbstractTherapies for advanced non‐small cell lung cancer (NSCLC) continue to become more sophisticated. Chemotherapeutics are giving way to newer approaches such as immune checkpoint inhibitors and targeted therapies for greater efficacy and improved outcomes. Dabrafenib plus trametinib combination therapy was first approved for the treatment of metastatic melanoma harboring the BRAF V600‐mutation in 2014. In 2017, the U.S. Food and Drug Administration approved the combination for patients with NSCLC with the same mutation based on an ≈ 65% response rate and median progression‐free survival of 10–11 months. BRAF mutations are a high‐frequency event in melanoma (≈ 50%), whereas the overall incidence in lung cancer is ≈ 2%, but similar in number, because of the high incidence of the disease. As a new approach in NSCLC treatment, dabrafenib plus trametinib has a unique toxicity profile that is likely unfamiliar to care providers in thoracic and general oncology who have not used the combination to treat patients with melanoma. Common adverse events such as pyrexia, fatigue, and nausea, as well as a range of less frequent cutaneous, ocular, and hemorrhagic events, can be observed during treatment with dabrafenib plus trametinib. Previous experience in metastatic melanoma revealed that these events can be effectively managed to improve patient quality of life and reduce unnecessary drug discontinuation. The aim of this review is to summarize treatment guidelines, along with key insights obtained from previous clinical‐trial and real‐world experience in patients with metastatic melanoma, to properly manage toxicities associated with dabrafenib plus trametinib for NSCLC.Implications for Practice.The combination of dabrafenib plus trametinib has demonstrated substantial clinical activity in patients with BRAF V600E‐mutant non‐small cell lung cancer, leading to U.S. Food and Drug Administration approval. Although the combination has a manageable safety profile, many toxicities associated with the regimen may not be familiar to thoracic specialists or general oncologists. Extensive clinical experience with the combination in patients with metastatic melanoma has provided a wealth of strategies to identify and manage adverse events associated with dabrafenib plus trametinib. These can be used by medical oncologists to enhance early recognition of toxicities and facilitate effective management, thereby improving quality of treatment for patients.

http://bit.ly/2SxkP60

Retrospective Analysis of Taxane‐Based Therapy in Small Bowel Adenocarcinoma

AbstractCurrently, treatment of small bowel adenocarcinoma (SBA) mirrors that of colorectal cancer (CRC). Recent genomic data have demonstrated SBA to be a genetically unique entity, suggesting that therapies not traditionally utilized in CRC should be explored. In order to further characterize the activity of taxanes in this rare cancer, we completed a single‐center retrospective study. Twenty patients were found to have been treated with taxane‐based regimens (monotherapy in 3, combination therapy in 17). Median time to progression was 3.8 months (95% confidence interval [CI] 2.9–4.6), and median overall survival was 10.7 months (95% CI: 3.1–18.3). The results of this study demonstrate clinical activity from taxane‐based therapy in advanced SBA and support further clinical trial investigation.

http://bit.ly/2AkX224

Dermatoses with “collarette of skin”

Keshavmurthy A Adya, Arun C Inamadar, Aparna Palit

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):116-124



http://bit.ly/2VnzAdh

Unilateral distribution of cutaneous metastasis in a case of colon carcinoma

Carlos Duran Vian, Iosune Vilanova-Urdániz, Gema Pérez Paredes, M Carmen González-Vela, Marcos A González-López

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):93-96



http://bit.ly/2QeJFWq

Methods to overcome poor responses and challenges of laser hair removal in dark skin

Shehnaz Zulfikar Arsiwala, Imran M Majid

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):3-9

Conventional and advance technologies are available for laser hair removal. Complete and permanent hair reduction is not yet possible by treatment with lasers. Ideal patient for any conventional laser hair removal treatment is one who has thick, dark terminal hair, light skin and normal hormonal status. Factors that contribute to variable outcomes in laser hair removal can be broadly divided into patient related ones and the technology related ones. Skin type, hair color, thickness and density, degree of tan, hormonal dysfunction etc., constitute the patient related factors. The wavelength, fluence, spot size and pulse duration of the laser system are the technology related factors. There are some patients who respond variably, unpredictably or poorly to laser hair removal despite ensuring that indication for treatment is appropriate with adequate parameters of the laser system. This article reviews various patient related and technology related factors which lead to variable-to-poor outcomes in laser hair removal; and various challenges and limitations of laser hair removal technology in patients with dark skin types.

http://bit.ly/2Vku8rQ

Cosmetic dermatology: An integral part of current dermatology curriculum

Jasleen Kaur Sandhu

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):1-2



http://bit.ly/2QeMgPT

Optimizing Q-switched lasers for melasma and acquired dermal melanoses

Sanjeev Jayanth Aurangabadkar

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):10-17

The Q-switched Nd:YAG laser is an established modality of treatment for epidermal and dermal pigmented lesions. The dual wavelengths of 1064nm and 532nm are suited for the darker skin tones encountered in India. Though this laser has become the one of choice for conditions such as nevus of Ota, Hori's nevus and tattoos, its role in the management of melasma and other acquired dermal melanoses is not clear. Despite several studies having been done on the Q-switched Nd:YAG laser in melasma, there is no consensus on the protocol or number of sessions required. Acquired dermal melanoses are heterogenous entities with the common features of pigment incontinence and dermal melanophages resulting in greyish macular hyperpigmentation. This article reviews the current literature on laser toning in melasma and the role of the Q-switched Nd:YAG laser in stubborn pigmentary disorders such as lichen planus pigmentosus. As the pathology is primarily dermal or mixed epidermal-dermal in these conditions, the longer wavelength of 1064nm is preferred due to its deeper penetration. Generally multiple sessions are needed for successful outcomes. Low fluence Q-switched Nd:YAG laser at 1064nm utilizing the multi-pass technique with a large spot size has been suggested as a modality to treat melasma. Varying degrees of success have been reported but recurrences are common on discontinuing laser therapy. Adverse effects such as mottled hypopigmentation have been reported following laser toning; these can be minimized by using larger spot sizes of 8 to 10mm with longer intervals (2 weeks) between sessions.

http://bit.ly/2Vku5wa

Successful treatment of red ear syndrome with botulinum toxin type A

Maria Castellanos-Gonzalez, Fernando De Manueles, María García Martos, Maria Agustina Segurado Rodríguez

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):107-108



http://bit.ly/2Qdqcp6

Isotretinoin and dermatosurgical procedures

Venkataram Mysore, HM Omprakash, Gayatri Nagindas Khatri

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):18-23

Several early reports suggested that performance of dermatosurgical procedures in patients on oral isotretinoin is associated with abnormal skin healing, keloid or hypertrophic scar formation. However, this association has been recently questioned in some studies. This review examines this issue, analyzes the studies published and concludes that the recommendation made earlier about the need to avoid dermatosurgical procedures in patients on isotretinoin is based on inadequate and insufficient evidence and hence needs revision. The review also suggests that recent studies on the subject establish that performing such procedures is safe.

http://bit.ly/2Vl1zKG

An unusual early onset of lentigo maligna in the fourth decade of life

Eftychia Platsidaki, Nikolaos Kostopoulos, Kanellos Gesakis, Dorothea Polydorou, Efthymia Agiasofitou

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):129-129



http://bit.ly/2QfZJaf

Complications of laser and light-based devices therapy in patients with skin of color

BS Chandrashekar, Chaithra Shenoy, C Madura

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):24-31

Lasers and light-based devices are indispensable to an aesthetic dermatology practice. The growing popularity of lasers has been matched by a sharp increase in the incidence of complications. The Indian skin with its high melanin content is more prone to injury and careful setting of laser parameters, early detection of complications and immediate therapy are vital to avoiding permanent sequelae. We review the various complications that occur during laser procedures and their management.

http://bit.ly/2Vpt062

Authors' reply

Vishal Gupta, Vinod K Sharma

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):87-88



http://bit.ly/2QeJDOi

Autologous noncultured melanocyte-keratinocyte transplantation in stable vitiligo: A randomized comparative study of recipient site preparation by two techniques

Sumit Gupta, Vineet Relhan, Vijay Kumar Garg, Bijaylaxmi Sahoo

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):32-38

Background: Accurate preparation of recipient area is a critical step in melanocyte-keratinocyte transplantation procedure for vitiligo. It is an important potential step for adaptation in the quest to achieve better results and ablative lasers potentially offer excellent precision over margin and depth control in achieving that. Objective: To compare between the two techniques used for recipient site preparation: Er:YAG laser ablation and mechanical dermabrasion for melanocyte-keratinocyte transplantation procedure in terms of re-pigmentation achieved and adverse effects seen. Methods: A randomized comparative trial was performed among 32 patients of stable vitiligo undergoing melanocyte-keratinocyte transplantation procedure. In Group A (n = 15), recipient site preparation was done with Er:YAG laser, and in Group B (n = 17), it was done with a motorized dermabrader. Patients of both groups were objectively assessed for re-pigmentation at 1, 3 and 6 months. Results: A total of 253.696 cm2 of depigmented surface was operated upon and re-pigmentation of 125.359 cm2 (49.4%) was achieved. On comparison between two groups, no statistical difference was found with respect to total re-pigmentation achieved (Group A: 54.67% vs Group B: 48.841%, P = 0.663) and grades of re-pigmentation achieved (P = 0.796). Occurrence of adverse events was also statistically similar in both the groups. Conclusion: This study did not reveal any statistically different outcome (in terms of re-pigmentation and adverse effects) between the two methods of recipient site preparation – motorized dermabrasion and Er:YAG ablation. Limitations: This study is small and larger studies are needed to ascertain the benefit of Er:YAG for recipient site preparation. Future studies may also ascertain variables such as time taken to prepare the recipient area, nature of bleeding, postoperative healing, difficulties in specific area, cost of the procedure, patient comfort and ease of the surgeon, rather than comparing the re-pigmentation alone.

http://bit.ly/2Vmxv1p

Stevens–Johnson syndrome-like reaction without mucosal lesions associated with cyclophosphamide

Yang Lo, Chun-An Yao

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):101-103



http://bit.ly/2QbCxtX

A randomized, open-label, comparative study of oral tranexamic acid and tranexamic acid microinjections in patients with melasma

Vinod K Khurana, Rachita R Misri, Swati Agarwal, Akhilesh V Thole, Sachin Kumar, Tanu Anand

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):39-43

Background: Melasma poses a great challenge as its treatment modalities are unsatisfactory. Treatment using tranexamic acid is a novel concept. Aim: This study aimed to compare the therapeutic efficacy and safety of oral tranexamic acid and tranexamic acid microinjections in patients with melasma. Methods: This is a prospective, randomized, open-label study with a sample size of 64, 32 in each treatment arm. Thirty-two patients were administered localized microinjections (4 mg/ml) of tranexamic acid monthly in 1 arm, while in the other arm, 32 were given oral tranexamic acid 250 mg twice a day. Patients were followed up for 3 consecutive months. Clinical photographs were taken at each visit, and a modified melasma area and severity index scoring was performed at the beginning and end of treatment. Results: Improvement in melasma area and severity index score in the oral group was 57.5% as compared to 43.5% in the intralesional group. All 32 patients in the oral group (100%) showed >50% improvement, out of which 8 showed >75% improvement. In the intralesional group, 17 (53%) patients had >50% improvement, of which 3 had >75% improvement. The remaining 15 patients in this group had <50% improvement. Thus, the oral group showed a more significant response as compared to the intralesional group. No major adverse effects were observed in both the groups. At 6-month follow-up, two patients (6.2%) in the oral group had recurrence as compared to three patients (9.4%) in the intralesional group. Limitations: A small sample size was one of the limitations in this study. The dose of tranexamic acid in microinjections and the frequency of injections could have been increased. Conclusion: Tranexamic acid provides rapid and sustained improvement in the treatment of melasma. It is easily available and affordable. Oral route is undoubtedly efficacious, but the results of microinjections, while encouraging, can probably be enhanced by either increasing the frequency of injections or increasing the concentration of the preparation.

http://bit.ly/2VtOFdE

A solitary nodule on the posterior pinna

Ki Min Sohn, Young Jun Woo, Jung Eun Kim, Hoon Kang

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):111-113



http://bit.ly/2QbCvlP

Safety and efficacy of autologous noncultured dermal cell suspension transplantation in the treatment of localized facial volume loss: A pilot study

Alok Kumar Sahoo, Savita Yadav, Vinod K Sharma, Anita Singh Parihar, Surabhi Vyas, Somesh Gupta

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):44-50

Background: Available options for correction of facial volume loss, such as synthetic fillers, autologous fat and cultured fibroblasts, have limitations viz. temporary effect and high cost. Aim: To assess the use of a novel technique, autologous non-cultured dermal cell suspension transplantation, for correction of localized facial volume loss due to inflammatory pathologies. Methods: It was a pilot study conducted in the Dermatology Outpatient Department, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Autologous non-cultured dermal cell suspension was transplanted in a total of 10 patients, out of which 5 had predominantly dermal loss and the rest had predominantly lipoatrophy. The donor tissue from the gluteal region was digested into a single cell suspension using collagenase-1 and injected into the recipient area. The outcome was assessed subjectively by patients and investigators and objectively using ultrasonography. Cell count, viability testing and measurement of mesenchymal stem cells were also done. Results: On assessment of patients, the median improvement in the predominantly dermal atrophy group at 3 and 6 months was 70% (range: 10–90%) and 80% (range: 0–90%), respectively, and in the predominantly lipoatrophy group, 0% (range: 0–40) and 0% (range: 0–50), respectively. Mean thickness of dermis + subcutis at the baseline was 1.835 mm (range: 0.89–6.04 mm), which increased to 2.912 mm (range: 0.88–7.07 mm, P = 0.03) at 6 months. Limitations: Our pilot study has some limitations such as small sample size and heterogeneity of the recruited patients. Conclusions: Autologous non-cultured dermal cell suspension transplantation appears to be safe and effective in localized facial dermal defects because of inflammatory pathologies, but not effective in deeper defects.

http://bit.ly/2ViKUYt

Falknor's needling method as a potential immunotherapy in palmo-plantar warts

Pramila Kumari, Devendra Yadav, Anita Vijay, Suresh Kumar Jain, Mukesh Kumar, Ramesh Kumar, Asha Nyati

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):129-129

Background and Aim: Treatment of palmoplantar warts is a challenge for dermatologists. We aimed to study the efficacy and safety of Falknor's needling method in palmoplantar warts. Methods: In an open, nonrandomized study, the index wart of eligible patients was punctured several times with a 26-gauge needle to produce a "beefy" red wound. Patients were followed up to 6 months. Results: Out of 82 patients, complete resolution occurred in 58 (70.7%) and partial response in 5 (6.1%) patients. Nine (10.9%) patients developed secondary infection. Limitations: Small sample size, No comparison group. Conclusion: Falknor's needling method provides a high rate of complete resolution after a single treatment session. It is easy to perform and is cost effective.

http://bit.ly/2QbCoqp

Toenail concentrations of zinc, selenium and nickel in patients with chronic recurrent warts: A pilot two-group comparative study

Mohamed El-Komy, Vanessa Hafez, Rania Abdel Hay, Dina Mehaney, Iman Hafez

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):51-55

Background: Normal immune functioning requires sufficient levels of trace elements including zinc and selenium, while elements such as nickel can be immunotoxic. Aim: To assess long-term abnormalities in zinc, selenium and nickel levels in patients with chronic recurrent warts. Methods: Toenail samples were taken from 28 patients with chronic recurrent warts and 30 apparently healthy matching controls were analysed. Toenail concentrations of zinc, selenium and nickel were measured using inductively-coupled plasma-optical emission spectroscopy. Results: Selenium levels were significantly higher in patients than in controls (P = 0.03). Levels of trace elements did not correlate with the number or duration of warts. Toenail nickel levels in all subjects were higher than globally reported values. Limitations: A small sample size and the absence of regional reference ranges for concentrations of trace elements in toenails. Conclusion: Zinc does not seem to be involved in the chronicity of warts, and it is unclear if selenium has a protective role against warts. Our finding of high concentrations of nickel in both patients and controls raises concerns about environmental exposure.

http://bit.ly/2VguwHT

Bloom syndrome sans characteristic facial features in a Mestizo patient- a diagnostic challenge

Sonia Chavez-Alvarez, Alejandra Villarreal-Martinez, Ma Del Roble Velasco-Campos, Isabel Moreno-Vega, Laura Elia Martinez-de-Villarreal, Maira Herz-Ruelas, Jorge Ocampo-Candiani, Luis Daniel Campos-Acevedo

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):130-130



http://bit.ly/2QbChLv

Successful treatment of metastatic extramammary Paget's disease with pemetrexed monotherapy systemically and 5-fluorouracil topically

Kexu Chen, Hanlin Liang, Jiewen Peng, Yanfang Zheng

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):56-59

Advanced extramammary Paget's disease does not have a standardized treatment guideline as its incidence is low and has been rarely reported in literature. Here we describe a case of metastatic extramammary Paget's disease successfully treated with topical 5-fluorouracil (5-FU) and systemic pemetrexed. The therapy was safe without any appreciable adverse effects like diarrhea, rash, neutropenia or fatigue; maintaining remission for more than 6 months. Thus, we propose 5-FU and pemetrexed as the first-line therapy for advanced extramammary Paget's disease, especially for aged patients with unresectable skin lesions.

http://bit.ly/2VlYZUV

Everything is in the name: Macular hyperpigmentation of uncertain etiology or acquired dermal macular hyperpigmentation of varied etiologies?

Anuradha Bishnoi, Keshavamurthy Vinay, Sendhil Muthu Kumaran, Davinder Parsad

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(1):85-87



http://bit.ly/2QbCdvf

Sex‐specific Contribution of DHEA‐Cortisol Ratio to Prefrontal‐Hippocampal Structural Development, Cognitive Abilities and Personality Traits

Abstract

While dehydroepiandrosterone (DHEA) may exert neuroprotective effects in the developing brain, prolonged or excessive elevations in cortisol may exert neurotoxic effects. The ratio between DHEA and cortisol (DC ratio) has been linked to internalizing and externalizing disorders as well as cognitive performance, supporting the clinical relevance of this hormonal ratio during development. However, the brain mechanisms through which these effects may be mediated have not been identified as of yet. Further, while there is evidence that the CNS effects of cortisol may be sexually dimorphic in humans, the opposite is true of DHEA, with human studies showing no sex‐specific associations in cortical thickness, cortico‐amygdalar or cortico‐hippocampal structural covariance. Therefore, it remains unclear whether sex moderates the developmental associations between DC ratio, brain structure, cognition and behavior. Here we examined associations between DC ratio, structural covariance of the hippocampus with whole‐brain cortical thickness, and measures of personality, behavior and cognition in a longitudinal sample of typically developing children, adolescents and young adults 6‐22 years (N=225 participants (F=128); 355 scans (F=208)), using mixed effects models that accounted for both within‐ and between‐subject variances. We found sex‐specific interactions between DC ratio and anterior cingulate cortex‐hippocampal structural covariance, with higher DC ratios associated with a more negative covariance between these structures in girls, and a more positive covariance in boys. Further, the negative prefrontal‐hippocampal structural covariance found in girls was associated with higher verbal memory and mathematical ability, while the positive covariance found in boys was associated with lower cooperativeness and reward dependence personality traits. These findings support the notion that the ratio between DHEA and cortisol levels may contribute, at least in part, to the development of sex differences in cognitive abilities as well as risk for internalizing/externalizing disorders, through an alteration in prefrontal‐hippocampal structure during the transition from childhood to adulthood.

This article is protected by copyright. All rights reserved.

http://bit.ly/2VeSrr0

Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases

Abstract

Purpose

Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively.

Methods

A total of 914 RIT patients were included. Exclusion criteria were anti-thyroid drugs, pre- and/or intra-therapeutic effective half-lives (EHL) beyond 8.04 days and externally performed RIUT or 24 h RIUT. All patients received RIUT 1 week before RIT. Thyroid volume was estimated via ultrasound. Tracer radiation dose to the thyroid was calculated retrospectively. The dependence of changes in the pre-therapeutic to the therapeutic extrapolated-maximum-¹³¹I-uptake (EMU) from the dose in RIUT was evaluated statistically.

Results

EMU in RIUT ranged from 0.10 to 0.82 (median: 0.35) and EMU in RIT ranged from 0.10 to 0.74 (median: 0.33). Averaged over the whole cohort the therapeutic EMU decreased significantly (2.3% per Gray intra-thyroidal tracer radiation dose). A disease-specific evaluation showed dose-dependent thyroid stunning from 1.2% per Gray in solitary toxic nodules (n = 327) to 21% per Gray in goiters (n = 135) which was significant for the subgroups of disseminated autonomies (n = 114), multifocal autonomies (n = 178) and goiters (p < 0.05) but not for Graves' diseases (n = 160) and solitary toxic nodules (p > 0.05).

Conclusions

The presented data indicate for the first time a significant dependence of pre-therapeutic radiation dose on thyroid stunning in goiter and disseminated and multifocal autonomy. To achieve the desired intra-thyroidal radiation dose, RIT activity should be adapted depending on the dose in RIUT.

http://bit.ly/2GNJiCP

Happy New Year 2019

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com