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Background: Dermatoses in the elderly differ from those in the younger age group due to additional effects of intrinsic and extrinsic aging, increased prevalence of comorbidities, effects of polypharmacy, socioeconomic factors, and geographical factors. Various prevalence studies on the dermatoses in geriatric age group are available from the Indian subcontinent. Studies focusing on the agreement between their clinical and histopathological diagnosis, however, are scarce. Aims and Objectives: The study aimed at categorizing and describing the various dermatoses in the geriatric population subjected to biopsy and to determine the level of agreement between the clinical diagnosis made and the histopathological diagnosis offered in them. Materials and Methodology: Histopathological records of skin biopsies performed in patients belonging to the age group of ≥60 years in the past 5 years were analyzed. Demographic characteristics, clinical diagnosis made or the differential diagnoses considered, and histopathological diagnosis offered in each case were noted. The various dermatoses among the patients in whom a histopathological diagnosis was offered were categorized into inflammatory (infections and noninfectious dermatoses), neoplastic, and other dermatoses groups. The level of agreement between clinical and histopathological diagnosis was described as complete agreement, partial agreement, and disagreement. Statistical significance was assessed using the Chi-square test, and the strength of association was assessed using kappa statistics. Results: A total of 109 biopsies meeting the inclusion criteria were analyzed. The mean age of the study population was 67.02 ± 6.624 years, with a male-to-female ratio of 1.6:1. Majority of the dermatoses belonged to the noninfectious inflammatory group (52 [47.70%]) followed by neoplasms (28 [25.68%]). Overall, complete agreement between the clinical diagnosis made or one of the differential diagnoses considered and the histopathological diagnosis offered was seen in 91 of 109 cases (83.5%), which was statistically significant (P = 0.0001). A higher level of complete agreement was noted among the inflammatory dermatoses (67 of 79 cases [84.81%]) when compared to neoplastic dermatoses (22 of 28 cases [78.57%]). Among the inflammatory dermatoses, complete agreement was more for the noninfectious (46 [88.46%]) than the infectious (21 [77.78%]) dermatoses. All the cases (2) belonging to the other group of dermatoses showed complete agreement. Disagreement was highest among the neoplasms (6 [21.43%]), followed by the noninfectious inflammatory dermatoses (5 [9.62%]). Partial agreement with the clinical diagnosis was maximum for the infectious diseases (5 [18.51%]). Conclusion: This study noted a statistically significant high rate of concordance (Chi-square test –P = 0.0001) between the clinical and histopathological diagnosis among the dermatoses in the geriatric population when taken together as well as among individual categories. Noninfectious inflammatory dermatoses constituted the major group with the highest and statistically significant concordance between the clinical and histopathological diagnosis. Furthermore, there was almost perfect strength of association (kappa statistics –P = 0.000) noted among the individual categories of dermatoses.

Background: Nail examination plays a critical role in dermatologic conditions. Children with nail changes involve fewer physician consultations. Nail signs in early childhood can indicate the presence of a syndrome or underlying systemic disorder. Aim: The aim of the study was to investigate the frequency of nail findings in patients under 5 years of age. Subjects and Methods: The study involved 368 pediatric patients under the age of 5 years. It was an observational study conducted in dermatology, obstetrics and gynecology, and pediatric departments. A Dermlite handyscope FFH2 (×10 zoom) was used to magnify visible nail changes during a comprehensive nail examination. Results: Out of 368 cases, 213 were male and 155 were female. The average age of the patients was 22.74 months (range: 0–60). Nail findings were observed in 130 (35.3%) patients. In the study, single nail changes were observed in 123 (33.42%), whereas multiple nail changes were seen in 5 (1.35%) patients. The most common clinical nail finding was white striations in 60 (16.3%) cases, followed by punctate leukonychia in 21 (5.7%), onychoschizia in 13 (3.5%), pseudohypertrophy of the hallux in 12 (3.3%), koilonychia in 7 (1.9%), Beau’s lines in 3 (0.8%), and subungual hematoma in 3 (0.8%) cases. Median canaliform nail dystrophy, Muehrcke’s lines, onychophagia, and pitting were found in only one case each (0.3%). Conclusion: Physiological nail findings were more prevalent than pathological ones. The use of an onychoscope facilitated a more precise identification of nail changes by highlighting their features.

In various applications like bearings, gear pairs, and brake pads, understanding how polymer composites interact with harder counterparts during sliding motions is crucial. A challenge arises from the heat generated during sliding friction, which has the potential to raise the contact temperature. This temperature increase, if it exceeds the material's glass transition temperature, can compromise the thermal stability of the composites, leading to rapid material wear. In the present investigation, dry sliding wear test was performed on 25 wt. % of short carbon fiber (SCF) reinforced polyethersulfone (PES) composites filled with 2.5 and 5.0 wt. % of potassium titanate whisker (PTW) using pin-on-disc tribometer. Wear test was planned and executed according to the experiment design formulations obtained by central composite design method. Contact temperature at the interface between composite pin and steel disc was monitored with an infrared thermal camera. Wear resistance was found to increase with the addition of fibers and fillers. PTW filled composites exhibited minimum wear with maximum coefficient of friction. Morphology studies were carried out on worn surfaces of the composites using scanning electron microscope to identify and describe the mechanism of wear involved. This investigation sheds light on the intricate behavior of polymer composites during sliding interactions.

BackgroundDermatology is an ideal specialty for artificial intelligence (AI)–driven image recognition to improve diagnostic accuracy and patient care. Lack of dermatologists in many parts of the world and the high frequency of cutaneous disorders and malignancies highlight the increasing need for AI-aided diagnosis. Although AI-based applications for the identification of dermatological conditions are widely available, research assessing their reliability and accuracy is lacking. ObjectiveThe aim of this study was to analyze the efficacy of the Aysa AI app as a preliminary diagnostic tool for various dermatological conditions in a semiurban town in India. MethodsThis observational cross-sectional study included patients over the age of 2 years who visited the dermatology clinic. Images of lesions from individuals with various skin disorders were uploaded to the app after obtaining informed consent. The app was used to make a patient profile, identify lesion morphology, plot the location on a human model, and answer questions regarding duration and symptoms. The app presented eight differential diagnoses, which were compared with the clinical diagnosis. The model’s performance was evaluated using sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F1-score. Comparison of categorical variables was performed with the χ2 test and statistical significance was considered at P

The use of Artificial Intelligence (AI) in developing new teaching-learning solutions is gaining momentum towards transforming the education system in India. Schools are beginning to shift from conventional methods of teaching to smart education to enhance students' learning experiences. Reviewing the literature on machine learning, personalized learning, and Bloom's taxonomy, we set out to examine the following: How are the educational technology firms in India using AI to change the ways teachers teach and students learn? What are the untapped AI-technologies that have the potential to transform the Indian education system? We conducted in-depth interviews with four subject matter experts working on AI-related technologies and four senior managers from leading Indian educational technology firms that have developed AI-based applications for schools. Deploying grounded theory, we found that personalized learning, recommendation systems, and adaptive assessments are helping students and supporting teachers. In an emerging country context, we demonstrate the educational technology firms' view of AI and the experts' view of AI. The gaps between these views indicate the immense potential of AI which can be tapped by educational technology firms in their future applications. The study has practical implications for the transformation of the education system in emerging countries.

Acute methotrexate (MTX) toxicity is most commonly due to overdose of the drug, which may be due to the patient's noncompliance to doctor's orders or physician's prescription error. Other causes include acute renal failure, concomitant use of other drugs, and genetic susceptibility. MTX toxicity presents with pancytopenia, mucositis, hepatotoxicity, pulmonary toxicity, and acute renal failure. Treatment involves a polypragmatic approach which includes vigorous hydration, urinary alkalinization, administration of leucovorin, and glucarpidase. Administration of granulocyte colony-stimulating factor should be considered in cases of severe neutropenia. Here, we present two cases of acute MTX toxicity in chronic plaque psoriasis presenting with ulceration of psoriatic lesions and mucosal ulceration successfully treated with leucovorin and pegylated granulocyte colony-stimulating factor (G-CSF). This case report demonstrates that G-CSF might be lifesaving by contributing to rapid reconstitution of leukopoiesis.

Hematological indices have long been used in a variety of conditions as indicators of systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inexpensive tools in predicting severity and disease activity in acute coronary syndrome, malignancy, coronavirus disease 2019 (COVID-19) illness, and other autoimmune conditions. Evidence suggests that such hematological indices can be used in various dermatoses as predictors of systemic inflammation, to assess the severity of the disease, prognosis, and treatment response.

Purpose: To investigate if clinical non-contrast chest CT studies obtained with PCD CT using much lower radiation exposure can achieve the same image quality as with the currently established EID protocol. Materials/methods: A total of seventy-one patients were identified who had a non-contrast chest computed tomography (CT) done on PCD CT and EID CT scanners within a 4-month interval. Five fellowship trained chest radiologists, blinded to the scanner details were asked to review the cases side-by-side and record their preference for images from either the photon-counting-detector (PCD) CT or the energy-integrating detector (EID) CT scanner. Results: The median CTDIvol for PCD-CT system was 4.710 mGy and EID system was 7.80 mGy (p

Background: Preoperative planning is important for successful total hip arthroplasty (THA) and has been historically performed using acetate templates. Digital software templating has been adopted for evaluating implant size, position, and alignment. Commercial software can be expensive, but free programs exist. Detroit Bone Setter (detroitbonesetter.com, Detroit, MI) is a freely available templating program, but hasn’t been validated. Our study reports this program’s accuracy for templating THA. Methods: Sixty-five patients undergoing THA between 2017 and 2022 at 2 hospitals were included. All cases were templated by the senior author or orthopaedic trauma fellow prospectively or retrospectively in a blinded fashion. Direct anterior or posterior approaches were used based on attending surgeon’s preference. A student's t-test was used to compare means of templated vs actual implant sizes of femoral and acetabular components. Results: There was no significant difference between implanted (mean [M] = 6.4, standard deviation [SD] = 2.0) and templated femoral component sizes (M = 5.7, SD = 2.1). There was a significant difference between implanted (M = 57.0, SD = 3.9) and templated acetabular component sizes (M = 53.4, SD = 3.0). Bland-Altman testing demonstrated femoral components with positive measurement bias of 0.62, indicating slight overestimation of implant size. Acetabular component size was overestimated with positive measurement bias of 3.6 mm. Conclusions: Detroit Bone Setter is advantageous as it is freely available and supports most major company implants. It accurately templated femoral component size but consistently overestimated acetabular component size by 3.6 mm. Further studies are needed prior to recommending its routine use for templating THA when other validated methods exist. It could be used with caution when no other methods are available.

Background: Alopecia areata (AA) is an autoimmune disease affecting the scalp and body, resulting in hair loss. The fundamental goal of management is to keep the pathology under control. Intralesional corticosteroids suppress T-cell-mediated attacks on hair follicles. Platelet-rich plasma (PRP) contains growth factors that stimulate hair follicle stem cells and have anti-inflammatory properties with fewer side effects. Trichoscopy shows exclamation hair and black dots in the acute stage, yellow dots in long-standing cases, and short vellus hair in regrowing patches. Objective: The aim of this study was to evaluate and compare the efficacy of intralesional triamcinolone acetonide with autologous PRP in the treatment of two different scalp AA patches in the same individual. Materials and Methods: This was a hospital-based prospective follow-up study. Patients with two different patches of alopecia were selected. One was treated with intralesional triamcinolone acetonide (10 mg/ml) and the other with PRP given at 3-week intervals for four treatment sessions. Comparison of results was based on MacDonald Hull and Norris grading system and trichoscopy. Results: Out of 32 patients, 8 (25%) in triamcinolone-treated patches and 3 (9.4%) in PRP-treated patches showed complete hair regrowth at 12 weeks. Furthermore, a faster response was seen with triamcinolone. On trichoscopy, both patches showed an increase in short vellus and terminal hair and a reduction in yellow dots and exclamation hair. No changes in black dots were seen. Conclusion: Intralesional triamcinolone acetonide is more effective than PRP in the treatment of AA of the scalp and is safe. Trichoscopic findings indicate response to treatment and reduction of disease activity.

Background: Dermoscopy is a non-invasive diagnostic technique that provides an added advantage to the routine clinical diagnostic exercise. Role of dermoscopy in cutaneous small vessel vasculitis has not been explored well. Objective: This study was intended to delineate the dermoscopic features of cutaneous small vessel vasculitis and to correlate them with histopathological findings of the disease. Materials and Methods: This was a cross-sectional study involving 30 patients with cutaneous small vessel vasculitis confirmed by histopathology and direct immunofluorescence. In each patient, dermoscopic features of early/evolving and established lesions were recorded. Dermoscopic-histopathological correlation was assessed for established lesions. Results: On dermoscopy, the early/evolving lesions showed a dull red background in all the 30 (100%) patients, red globules in 8 (26.7%), and red dots in 4 (13.30%) patients. The established lesions showed red background in 28 (93.3%) patients, white and yellow structureless areas in 19 (63.33%) patients each, red globules in 18 (60%), and red dots in 16 (53.3%) patients. A statistically significant association between red globules and red blood cell extravasation was noted (P-0.01). White and yellow structureless areas also showed a statistically significant association between sparse (P-0.023) and dense (P-0.007) perivascular infiltrates, respectively. Conclusion: Dermoscopy of cutaneous small vessel vasculitis exhibits fairly reliable and reproducible features correlating well with histopathological aspects of the disease. Hence, inclusion of dermoscopy in the clinical diagnostic protocol for cutaneous small vessel vasculitis is beneficial in complementing the clinical diagnosis and in differentiating from other inflammatory purpuras.