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Competing Interests: There are no conflicts of interest.

Background: The reduction in insulin sensitivity during rumen development may predispose dairy calves towards lactose intolerance, which could be the reason behind neonatal calf diarrhea (NCD). Chromium (Cr) results in a range of effects when fed to ruminants, but most studies have shown improved insulin sensitivity. The aim of this study was to determine the effect of Cr supplementation on insulin sensitivity, lactose intolerance, diarrhoea and antioxidant, and immune response in young Hariana calves., Methods: A total of 20 milk-fed Hariana calves were randomly assigned to 1 of 2 treatments, each consisted of 10 calves: (1) a control group without supplemental Cr and (2) a 0.15 mg Cr as Cr-picolinate (CrPic)/kg BW 0.75 supplemented group (Cr 0.15 )., Results: A more rapid glucose disappearance with unaltered insulin kinetics during intravenous glucose tolerance test (IVGTT) and oral lactose tolerance test (OLTT) indicates greater insulin sensitivity in Cr supplemented calves. Better insulin sensitivity in Cr supplemented calves was further confirmed by higher values of the quantitative insulin sensitivity check index (QUICKI), revised quantitative insulin sensitivity check index (RQUICKI) and insulin receptor substrate-1 (IRS-1) and lower (P < 0.05) values of homeostasis model assessment-insulin resistance (HOMA-IR) and glucose-to-insulin ratio in Cr supplemented calves during IVGTT. Cr supplementation resulted in a lower (P < 0.05) serum cortisol concentration, whereas serum non-esterified fatty acid (NEFA) concentrations during IVGTT did not differ among the groups. The rise in serum glucose concentrations within 2 h post lactose infusion during OLTT peaked at more than twice the basal glucose concentration, therefore calves were not considered as lactose intolerant. Within monthly blood samples, concentrations of serum insulin were similar among treatments, whereas the Cr supplemented group had lower (P < 0.05) serum glucose concentration and glucose-to-insulin ratio compared with the control group. No treatment differences were detected in the biomarkers of antioxidant status and immunity. Serum Cr concentrations were higher (P < 0.05) in Cr supplemented calves while concentrations of other studied minerals were remained unaltered. The incidence, duration of diarrhea, and faecal score were better (P < 0.05) in calves fed on Cr supplemented diet whereas, no treatment effect was observed on average daily gain (ADG). During the study period, no calves died, and no calves were found to have pneumonia, navel or joint disease., Conclusion: Feeding a Cr-supplemented diet improved insulin sensitivity and reduced the risk of diarrhoea in milk-fed young calves, but had no or minimal effects on lactose intolerance, antioxidant status, immune response, and growth performance., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

This study was conducted to evaluate the effect of nano copper (nano Cu) and nano zinc (nano Zn) supplementation on the biomarkers of immunity and antioxidant and health status attributes in young dairy calves. Twenty-four young cattle calves were randomly assigned into four groups (6 calves per group) on a body weight and age basis for a period of 120 days. The feeding regimen was the same in all the groups except that these were supplemented with 0.0 mg nano Cu and nano Zn (control), 10 mg nano Cu ( nano Cu 10 ), 32 mg nano Zn (nanoZn 32 ), and a combination of nano Cu and nano Zn ( nano Cu 10  +  nano Zn 32 ) per kg dry matter (DM) basis in four respective groups. Supplementation of nano Cu along with nano Zn improves immune response which was evidenced from higher immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), total immunoglobulin (TIg), and Zn sulphate turbidity (ZST) units and lower plasma concentrations of tumour necrosis factor-α (TNF-α) and cortisol in the nanoCu10 + nanoZn32 group. There was no effect of treatment on the plasma concentrations of immunoglobulin E (IgE) and interferon-gamma (IFN-γ). Antioxidant status was also better in the nanoCu10 + nanoZn32 group as evidenced by lower concentrations of malondialdehyde (MDA) and higher activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), ceruloplasmin (Cp), and total antioxidant status (TAS). However, treatment did not exert any effect on catalase (CAT) activity. Although the nano Cu or nano Zn supplementation, either alone or in combination, did not exert any effect on growth performance or body condition score (BCS), the frequency of diarrhoea and incidence of diarrhoea were lower, while faecal consistency score (FCS) and attitude score were better in the nano Cu 10  +  nano Zn 32 groups. In the control group, one calf was found affected with joint illness and two calves were found affected with navel illness. During the experimental period, none of the calves in all four groups were found to be affected by pneumonia. The findings of this study revealed that dietary supplementation of nano Cu in combination with nano Zn improved the health status of young dairy calves by improving immunity and antioxidant status., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The decrease in insulin sensitivity during the transition of preruminant calves into ruminant animals is the common denominator. Meanwhile, this adaptation predisposes dairy calves towards various health issues and metabolic disorders that occur in later life. Chromium (Cr) has been shown to potentiate insulin functioning and is thereby helpful in reducing the risk of these metabolic disorders. The aim of this study was to assess the effect of Cr supplementation on the insulin sensitivity and health status in Hariana calves during their transition period. A total of 24 preruminant Hariana calves were randomly allocated into four groups (6 calves per group) for a period of 90 days. Calves either received a basal diet devoid of supplemental Cr (control; Cr 0.0 group) or were supplemented with 0.05 mg (Cr 0.05 group), 0.10 mg (Cr 0.10 group), and 0.15 mg (Cr 0.15 group) of Cr per kg BW 0.75 as Cr-picolinate (Cr-Pic). To determine the effect of Cr supplementation on the insulin response, glucose-insulin-non-esterified fatty acids (NEFAs) kinetics was studied during the intravenous glucose tolerance test (IVGTT) and oral glucose tolerance test (OGTT). A rapid glucose disappearance (p < 0.05) with unaltered insulin kinetics during IVGTT and OLTT indicates greater insulin sensitivity in calves supplemented with 0.10 and 0.15 mg of Cr per kg BW 0.75 . Improved insulin sensitivity in the Cr 0.10 and Cr 0.15 groups was further confirmed by higher (p < 0.05) values of the insulin sensitivity check index (QUICKI), revised quantitative insulin sensitivity check index (RQUICKI), and lower (p < 0.05) values of the homeostasis model assessment-insulin resistance (HOMA-IR) during IVGTT. Mean serum non-esterified fatty acids (NEFA m ), and insulin receptor substrate-1 (IRS-1) levels were the highest (p < 0.05) and cortisol concentrations were the lowest (p < 0.05) in the Cr 0.15 groups. Unlike IVGTT, there was no effect of treatment, period, and treatment × period interaction on mean serum glucose and insulin levels during OGTT. However, Cr-supplemented calves had a higher (p < 0.05) glucose clearance rate ( g CR). Serum IRS-1 concentrations during OGTT were also higher (p < 0.05) in the Cr 0.10 and Cr 0.15 groups than in the other groups. Serum Cr levels increased dose dependently and were the highest (p < 0.05) in calves fed a diet supplemented with 0.15 mg Cr per kg BW 0.75 . There was no effect of treatment on average daily gain (ADG) and body condition score (BCS) while frequency and duration of diarrhea were lower and fecal score was better in Cr-supplemented calves. The current findings show that Cr supplementation improved glucose utilization and health status in calves during their transition period by improving insulin sensitivity., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction Bloodstream infection (BSI) and subsequent sepsis are life-threatening medical conditions. The onset of antimicrobial resistance and subsequent multi-drug resistant organisms (MDRO) significantly increase healthcare-associated expenditure with adverse clinical outcomes. The present study was undertaken to identify the trends of BSI in community settings in secondary care hospitals (smaller private hospitals and district hospitals) in the state of Madhya Pradesh in Central India with the support of the Indian Council of Medical Research (ICMR) and National Health Mission, Madhya Pradesh. Methodology The present study was a prospective, longitudinal observational chart review type of study. The study was carried out at 10 secondary care hospitals (eight smaller private hospitals and two government district hospitals) nominated by the State Government as part of the ICMR Antimicrobial Resistance Surveillance and Research Network (AMRSN). The hospitals were nominated depending on the availability of a microbiology laboratory and a full-time microbiologist. Result A total of 6202 blood samples were received from patients with suspected BSI, out of which 693 samples were positive for aerobic culture. Among these, 621 (89.6%) showed bacterial growth and 72 (10.3%) grew Candida species (spp). Out of the 621 bacterial growth samples, Gram-negative bacteria were 406 (65.3%) and Gram-positive bacteria were 215 (34.6%). Among the Gram-negative isolates (406), the predominant isolate was Escherichia coli (115; 28.3%) followed by Klebsiella pneumoniae  (109; 26.8%), Pseudomonas aeruginosa  (61; 15%), Salmonella spp. (52; 12.8%), Acinetobacter spp. (47; 11.6%) and the other Enterobacter spp. (22; 5.4%). Among the Gram-positive isolates (215), the predominant isolate was Staphylococcus aureus  (178; 82.8%) followed by Enterococcus spp. (37; 17.2%). Among the Escherichia coli , third-generation cephalosporin resistance was identified in 77.6%, piperacillin-tazobactam resistance in 45.2%, carbapenem resistance in 23.5% and colistin resistance in 16.5% of cases. Among the Klebsiella pneumoniae , third-generation cephalosporin resistance was identified in 80.7%, piperacillin-tazobactam resistance in 72.8%, carbapenem resistance in 63.3% and colistin resistance in 14% of cases. Among the Pseudomonas aeruginosa , ceftazidime resistance was identified in 61.2%, piperacillin-tazobactam resistance in 55%, carbapenem resistance in 32.8%, and colistin resistance in 38.3% of cases. Among the Acinetobacter spp., piperacillin-tazobactam resistance was identified in 72.7%, carbapenem resistance in 72.3%, and colistin resistance in 9.3% cases. While analyzing the antibiogram for Staphylococcus aureus isolates, methicillin resistance (MRSA) was seen in 70.3% of cases, followed by vancomycin resistance (VRSA) in 8% of cases and linezolid resistance in 8.1%. Among the Enterococcus spp. isolates, linezolid resistance was found in 13.5%, vancomycin resistance (VRE) in 21.6%, and teicoplanin resistance in 29.7% of cases. Conclusion In conclusion, the first-ever study to identify the risk of high-end antibiotics causing significant drug resistance in secondary and tertiary care settings has highlighted the urgent need for more randomized control studies and proactive measures from healthcare authorities and serves as a beacon for future research efforts and underscores the importance of implementing antibiograms to combat the growing threat of antibiotic resistance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Karuna et al.)

Introduction Diabetes mellitus (DM) is associated with significant morbidity and mortality due to vascular complications. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. Videocapillaroscope has been the predominant tool for nailfold capillary analysis. We aimed at using the commonly available handheld dermatoscope and observe changes in the nailfold capillaries as a part of evaluating diabetic microvascular involvement. Materials and methods A cross-sectional observational study involving 262 patients of diabetes mellitus and 150 controls was conducted for nailfold capillaroscopic changes using a hand-held dermatoscope over a period of 1 year. Results All the capillaroscopic variables like tortuosity, increased capillary density, neoangiogenesis, microhaemorrhages, avascular areas, crossing and meandering capillaries and receding capillaries were significantly more among diabetic than healthy controls. Patients with diabetic retinopathy had significant nailfold capillaroscopic features as compared to patients without DR (P value < 0.001). Neoangiogenesis, receding capillaries and avascular area were significantly higher in proliferative DR as against nonproliferative DR (P < 0.001). A positive association was found between the duration of DM and HbA1c values and NFC features. A decrease in the visualisation of NFC features was noted with increasing skin tone. The difference was significantly more between Fitzpatrick skin phototypes 4 and 5. Limitations The study was limited by its qualitative nature of accessing parameters as precise quantitative assessment of various findings cannot be done by a hand-held dermatoscope. Conclusion Nailfold capillaroscopy is a quick, cost-effective screening tool for identifying patients at high risk of DR in patients with skin of colour. NFC findings may mirror DR changes. The qualitative findings of NFC using a hand-held dermatoscope were comparable to other modes of nailfold capillaroscopy.

Objective  Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals. Materials and Methods  It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages. Results  Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category. Conclusion  Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later., Competing Interests: Conflict of Interest None declared., (The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Introduction: Platelet-rich plasma is an autologous blood preparation which is used in various medical specialties because of its regenerative properties. There is a wide variation in platelet-rich plasma preparation protocols and attaining the ideal platelet yield (>1 million platelets/μL) in a clinic setting can be challenging. We aimed at analyzing the centrifuge spin rates at which to attain an ideal platelet-rich plasma yield and also to study the effect of inclusion of the buffy coat after the first spin on the final platelet concentration in platelet-rich plasma., Methods: Seventy-five whole blood samples were obtained and divided into two groups - (1) leukocyte-rich platelet-rich plasma group and (2) leukocyte-poor platelet-rich plasma group. Samples in both groups were centrifuged using the dual spin method, at one of three centrifugation speed combinations (initial "soft" spin and second "hard" spin speeds, respectively): (1) 100 g/400 g, (2) 350 g/1350 g and (3) 900 g/1800 g. Platelet, red blood cell (RBC) and white blood cell (WBC) counts in both groups were compared., Results: The 100 g/400 g spin gave a high platelet yield (increase of 395.4 ± 111.1%) in the leukocyte-poor-platelet-rich plasma group, while in the leukocyte-rich platelet-rich plasma group both 100 g/400 g and 350 g/1350 g spins resulted in significantly higher yields with an increase of 691.5 ± 316.3% and 738.6 ± 193.3%, respectively., Limitations: The study was limited by a smaller sample size in the pure platelet-rich plasma (leukocyte-poor platelet-rich plasma) group., Conclusion: Ideal platelet yields can be achieved with both the 100 g/400 g as well as the 350 g/1350 g spins using the buffy coat inclusion method while the 100 g/400 g spin for "pure" platelet-rich plasma accomplishes a near-ideal platelet count with significantly reduced contamination with other cells.

Cutis verticis gyrata is a rare disorder characterized by redundant skin forming deep furrows and convolutions. It has been associated with several systemic and cutaneous disorders. We report a case of primary non-essential cutis verticis gyrata in association with acne keloidalis nuchae in a schizophrenic patient.

Background: Acitretin is a widely used systemic retinoid in the treatment of psoriasis. Dosage of acitretin in not weight adjusted due to certain interindividual variations., Objective: To evaluate the clinical efficacy and effects on biochemical parameters of fixed tapering dosage of acitretin in patients with psoriasis administered over a period of 4 weeks., Materials and Methods: This was an observational study. The study included patients of psoriasis vulgaris in the age group of 18 and 65 years with a psoriasis area severity index (PASI) score of >10 which was not responsive to topical therapy and phototherapy. Patients were given oral acitretin daily at a dose of 25 mg BD for 2 weeks, which was later tapered to 25 mg OD for another 2 weeks. The clinical efficacy and biochemical parameters were assessed., Results: Out of the 18 patients, PASI 75 was achieved in 66% of the patients by the end of the third week. Significant elevations were noted in serum lipids during 4 weeks, which returned to normal limits or near baseline levels at the end of 4 weeks., Conclusion: Fixed tapering dose of acitretin is effective in psoriasis with minimal clinical and biochemical adverse events., Competing Interests: There are no conflicts of interest.

Background and Aim: In the recent past,few studies have been carried out in chicken to assess the effect of Azolla meal and raw Azolla feeding on the performance of chicken. If turkeys effectively use unconventional feedstuffs like Azolla without reducing the performance, it will increase the profitability of turkey business. Hence, a study was carried out to evaluate the effect of dried Azolla pinnata vis-a-vis raw Azolla as choice feeding on the growth, feed conversion ratio (FCR), blood biochemical attributes, and immune competence traits of growing turkeys under intensive system., Materials and Methods: A total of 72, 8-week-old grower turkey poults of black variety were randomly distributed into three dietary treatments having three replicates each with eight birds. The birds of the control group (T1) were fed a basal diet (CP - 19.71% and ME - 2789.79 Kcal/kg), while the other group (T2) and choice-feeding group (T3) were fed 5% of basal diet replaced by dry Azolla powder on DM basis and ad libitumAzolla along with basal diet, respectively., Results: There was no significant difference among the different groups in the average weekly weight gain during the entire experiment. FCR was significantly better (p<0.05) in the choice-feeding group compared to the other two experimental groups during 8-16 weeks of age. There was no significant difference among the treatment groups in any of the blood biochemical indices except plasma uric acid, which was significantly decreased (p<0.01) in T2 compared to T1 at 16 weeks of age. HA and IgM response to 1% sheep red blood cells (log2 titer) were numerically better in T2 and T3 compared to the T1., Conclusion: Thus, it may be inferred that choice feeding with Azolla , and basal diet may improve FCR without any adverse effect on blood biochemical attributes and immune competence traits.

Aim: In the recent past, few studies have been carried out about sea buckthorn (SBT) and giloe in chicken as a part of the quest for suitable alternatives to antibiotics. However, studies in turkeys are lacking. Hence, the present study was conducted to evaluate the effects of SBT and giloe leaf meal by dietary feed supplementation in turkey poults., Materials and Methods: A total of 1-day-old turkey poults (n=84) of small white variety were distributed into four dietary treatments having three replicates each with seven birds. The study was conducted in turkey poults during 0-8 weeks of age. During the experiment, the poults were fed basal ration (28% crude protein [CP], 2800 Kcal/kg ME) T1, T2-basal ration was supplemented with SBT leaf meal powder at 0.5%, T3-basal ration was supplemented with giloe leaf meal powder at 0.5%, and T4-basal ration was fed along with supplementation of both SBT at 0.5% and giloe leaf meal powder at 0.5%., Results: T2 turkey poults had a significantly higher (p<0.01) body weight gain than T3 and T4 at 7 th week of age. Weekly body weight gain was significantly higher (p<0.05) in T2 than T3 during 5 th -8 th week and 0-8 th week of the growth phase. Feed conversion ratio (FCR) was significantly better (p<0.01) in T2 than other treatment groups during 4 th -8 th week phase of growth (2.09 vs. 2.36, 2.29 and 2.31). Further, FCR was significantly better (p<0.01) in T2 group as compared to other treatment groups during 0-8 th week of growth phase (1.95 vs. 2.21, 2.21 and 2.12). Plasma uric acid was found significantly increased (p<0.05) in T1 than T3 and T4, and alkaline phosphatase value was significantly higher (p<0.05) in T1 and T3 than T2. Zinc content of breast (pectoralis major) muscles was significantly higher (p<0.05) in T2 and T4 as compared to T1, while ether extract (EE) in thigh (ilio tibialis) muscles was significantly higher (p<0.05) in T2 as compared to the other treatment groups., Conclusion: It may be concluded that supplementation of SBT leaf meal at 0.5% may improve production performance of turkey poults. Supplementation of 0.5% SBT leaf meal may result in higher levels of zinc and EE in the breast and thigh cuts of turkey poults.

Background: Chronic alcohol intake impacts skin directly, through organ dysfunction or by modifying preexisting dermatoses. However, dermatoses afflicting chronic alcoholics figure in a few studies only., Aim: This study aims to correlate the spectrum of dermatoses in chronic alcoholics with the quantum/duration of alcohol intake and raised liver transaminases., Materials and Methods: Adult males, totaling 196, ascertained to fulfill the Royal College of Psychiatry criteria for chronic alcoholism by the de-addiction center and referred for dermatological consult were enrolled as cases, and similar number of age-/sex-matched teetotallers, as controls. Data emanating from detailed history, clinical examination, and routine liver functions tests were summarized and subsequently analyzed, including statistically using the Chi-square, independent " t " and Spearman's rank correlation tests, and compared with data from previous studies., Results: Majority (104) drank 41-50 units of alcohol/week since 3-40 (mean: 20.01 ± 9.322) years. Generalized pruritus (odds ratio [OR]: 31.15, P < 0.001), xerosis (OR: 3.62, P = 0.008), and seborrheic dermatitis (OR: 12.26, P < 0.001) were significantly more common in cases than controls. Infections (73; 37.2%), eczemas (45; 22.9%), and generalized hyperpigmentation (28; 14.2%) were the major presenting complaints. Spider nevi, gynecomastia, and pellagroid dermatitis were present in 34 (17.3%), 19 (9.7%), and 8 (4.1%) respectively exclusively in cases only. Commonly seen systemic abnormalities were an alcoholic liver disease (45; 22.9%), diabetes mellitus (23; 11.7%), and peripheral neuropathy (19; 9.7%)., Conclusion: Knowledge of cutaneous manifestations of chronic alcoholism could prompt in-depth history taking of alcohol intake, lead to specialist referral and thereby enable timely de-addiction, hopefully before serious adversities in the chronic alcoholics., Competing Interests: There are no conflicts of interest. What is new? Generalized pruritus, xerosis, and seborrheic dermatitis were significantly more common in cases than controlsGeneralized hyperpigmentation and xerosis correlated significantly with the duration as well as the quantum of alcohol intakeSpider nevi, gynecomastia, and pellagroid dermatitis were seen exclusively in alcoholics.

Peptides are known to have diverse biological roles, most prominently as signaling/regulatory molecules in a broad variety of physiological processes including defense, immunity, stress, growth, homeostasis and reproduction. These aspects have been used in the field of dermatology and cosmetology to produce short, stable and synthetic peptides for extracellular matrix synthesis, pigmentation, innate immunity and inflammation. The evolution of peptides over the century, which started with the discovery of penicillin, has now extended to their usage as cosmeceuticals in recent years. Cosmeceutical peptides may act as signal modulators of the extracellular matrix component, as structural peptides, carrier peptides and neurotransmitter function modulators. Transdermal delivery of peptides can be made more effective by penetration enhancers, chemical modification or encapsulation of peptides. The advantages of using peptides as cosmeceuticals include their involvement in many physiological functions of the skin, their selectivity, their lack of immunogenicity and absence of premarket regulatory requirements for their use. However, there are disadvantages: clinical evidence for efficacy is often weak, absorption may be poor due to low lipophilicity, high molecular weight and binding to other ingredients, and prices can be quite high.

N-aralkylpyroglutamides of substituted bispidine were prepared and evaluated for their ability to inhibit collagen induced platelet aggregation, both in vivo and in vitro. Some compounds showed high anti-platelet efficacy (in vitro) of which six inhibited both collagen as well as U46619 induced platelet aggregation with concentration dependent anti-platelet efficacy through dual mechanism. In particular, the compound 4j offered significant protection against collagen epinephrine induced pulmonary thromboembolism as well as ferric chloride induced arterial thrombosis, without affecting bleeding tendency in mice. Therefore, the present study suggests that the compound 4j displays a remarkable antithrombotic efficacy much better than aspirin and clopidogrel., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Eosinophilic pustular folliculitis (EPF) was originally described by Ofuji in Japanese patients without any systemic disease. Later it was widely associated with HIV. Lately a large number of hematological malignancies have been associated with EPF. We hereby report an association of non-Hogkins lymphoma with EPF, probably the first in Indian context.

An atom-economical regioselective synthesis of N-substituted prolinamides or N-substituted piperidine-2-carboxamides via a metal-free decarboxylative multicomponent coupling between l-proline or pipecolic acid, aldehydes, and isonitriles is described. The cascade event involves sequential imine formation, decarboxylation, isonitrile insertion, and hydrolysis to afford the product in one-pot. Two of the prolinamides were found to display appreciable antithrombotic activity via inhibition of platelet aggregation.

Eruptive collagenomas are non familial connective tissue nevi of unknown etiology presented with an abrupt onset. While most cases are reported in young adults, there is a paucity of literature in children. We report a case of a 4-year-old girl, who presented with multiple asymptomatic, papules, plaques and nodules on the face, trunk and upper extremities with no systemic involvement. Histopathologically, the lesion showed thickened homogenized collagen fibres highlighted by Masson's trichrome stain and paucity in elastic fibres by Verhoeff-van Gieson stain, confirming the diagnosis of eruptive collagenoma.

Bullous pemphigoid (BP) is an autoimmune sub-epidermal blistering disorder of the skin. The association of BP with internal malignancy has always been a matter of debate with no consensus reached despite many published case reports and clinical trials. However, we report a hitherto unreported association of BP with squamous cell carcinoma of the tongue, wherein the patient had a recalcitrant downhill course despite adequate treatment measures with control of skin lesions being achieved only following excision of the tumor, and relapse coinciding with detection of metastasis. Hence, given the clinical behavior, it is reasonable to speculate that the association of malignancy was more than co-incidental.

Antioxidants neutralize free radicals produced by various environmental insults such as ultraviolet radiation, cigarette smoke and air pollutants, thereby preventing cellular damage. The role of oxidative stress and antioxidants is known in diseases like obesity, atherosclerosis, and Alzheimer's disease. Herein we discuss the effects of oxidative stress on the skin and role of antioxidants in dermatology.

Background: ViziLite Plus with TBlue system (Zila Pharmaceuticals; now Zila, a division of Tolmar, Fort Collins, Colo.) and VELscope (LED Dental, White Rock, British Columbia, Canada) are oral cancer screening aids that have been developed to assist dentists in identifying precancerous and cancerous oral lesions., Methods: The authors screened patients with an overhead examination light and then with VELscope or ViziLite. Patients with a clinically innocuous lesion underwent a biopsy, and the authors compared the results of tissue pathological analysis with findings from the screening aid tests to determine the sensitivity and specificity of each device. The authors tested these devices to determine their ability to aid in the decision-making process regarding whether further evaluation of a clinically innocuous lesion was required., Results: The authors examined 102 lesions with ViziLite and then biopsied them [corrected]. They found three dysplasias and one malignancy, none of which were detected with the ViziLite (sensitivity = 0 percent, confidence interval [CI] = 0-60.2 percent; specificity = 75.5 percent, CI = 66.7-82.8 percent). The authors examined another 156 lesions with VELscope and then biopsied them [corrected].They found 11 dysplasias and one malignancy, six of which were detected with VELscope (sensitivity = 50 percent, CI = 21.1-78.9 percent; specificity = 38.9 percent, CI = 30.8-46.9 percent)., Conclusions: The study results indicate that use of ViziLite or VELscope along with a conventional screening examination for lesions deemed clinically innocuous was not beneficial in identifying dysplasia or cancer. Additional clinical studies are needed before these devices can be recommended., Clinical Implications: Clinicians and patients could have a false sense of security after obtaining a negative ViziLite or VELscope examination result because potentially large numbers of precancerous and cancerous lesions will be missed by both devices.

Background: The purpose of this study was to determine the prevalence of oral soft tissue lesions in patients and to assess their clinicopathological attributes. 3030 subjects belonging to a semi-urban district of Vidisha in Central India were screened. Patients were examined with an overhead examination light and those who were identified with a questionable lesion underwent further investigations. Statistical analysis was done using the SPSS software., Findings: 8.4 percent of the population studied had one or more oral lesions, associated with prosthetic use, trauma and tobacco consumption. With reference to the habit of tobacco use, 635(21%) were smokers, 1272(42%) tobacco chewers, 341(11%) smokers and chewers, while 1464(48%) neither smoked nor chewed. 256 patients were found to have significant mucosal lesions. Of these, 216 cases agreed to undergo scalpel biopsy confirmation. 88 had leukoplakia, 21 had oral submucous fibrosis, 9 showed smoker's melanosis, 6 patients had lichen planus, 17 had dysplasia, 2 patients had squamous cell carcinoma while there was 1 patient each with lichenoid reaction, angina bullosa hemorrhagica, allergic stomatitis and nutritional stomatitis., Conclusions: The findings in this population reveal a high prevalence of oral soft tissue lesions and a rampant misuse of variety of addictive substances in the community. Close follow up and systematic evaluation is required in this population. There is an urgent need for awareness programs involving the community health workers, dentists and allied medical professionals.

We describe two cases of intracoronary vascular brachytherapy where bivalirudin (Angiomax), employed as an anticoagulant, led to abrupt vessel closure or threatened abrupt closure. Use of bivalirudin (Angiomax) during intracoronary brachytherapy may predispose to the formation of intracoronary thrombus, related to the reversible binding kinetics of the bivalirudin to thrombin, and resulting in recovery of thrombin functional activity during periods of prolonged stasis that occur during intracoronary brachytherapy. Intracoronary abciximab administration may be a useful strategy in resolving the acute closure, since abciximab administered early during the formation of thrombus has been shown to facilitate clot lysis.

A case of a 65-year-old woman presenting with delayed profound thrombocytopenia 7 days after the use of abciximab (ReoPro) in the setting of percutaneous coronary intervention is described. The patient had normal platelet counts for the first 24 hours after the use of abciximab (ReoPro). She presented with petechiae and profound thrombocytopenia 1 week later. The patient was treated successfully with a platelet transfusion and recovered uneventfully. Profound thrombocytopenia occurs acutely within the first few hours after abciximab (ReoPro) use, so this case was unique in that the profound thrombocytopenia presented 1 week after use of abciximab (ReoPro).