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Pneumonia is a leading cause of economic losses in the ruminant industry throughout the world. This study aimed to determine the relevance of species-specific procalcitonin (PCT) and C-reactive protein (CRP) as clinical biomarkers in goat pneumonia. Forty-six confirmed cases of goat pneumonia and 10 apparently healthy goats were included in this investigation. Detailed clinical examination involved recording of vital parameters in diseased as well as in apparently healthy goats. The level of PCT and CRP was analyzed in serum samples collected on day 0 and day 5 from all the 46 diseased goats and on day 0 from 10 healthy goats. A significantly higher pre-treatment concentrations of PCT (229.88±38.79 pg/mL) and CRP (44.13±2.72 µg/mL) in diseased goats was observed when compared with the control group. Significant positive correlation was found between PCT and CRP. Both PCT and CRP revealed a high level of discrimination between diseased goats and healthy ones (AUC= 1.0). Significant inhibition was observed in the values of PCT and CRP 5 days post-treatment in goats treated with two different antimicrobial drugs. Moreover, the obtained data showed a high degree of accuracy for both PCT and CRP in predicting the therapeutic response of infected goats at the selected thresholds (AUC = 1.0 and 1.0, respectively). Positive correlation between PCT and CRP with body temperature and heart rate was recorded. Measurement of PCT and CRP with clinical examination might be useful in assessing severity of goat pneumonia.

Over the past 30 years surgical training, including urology training, has changed from the Halstedian apprenticeship-based model to a competency-based one. Simulation-based education (SBE) is an effective, competency-based method for acquiring both technical and non-technical surgical skills and has rapidly become an essential component of urological education. This article introduces the key learning theory underpinning surgical education and SBE, discussing the educational concepts of mastery learning, deliberate practice, feedback, fidelity and assessment. These concepts are fundamental aspects of urological education, thus requiring clinical educators to have a detailed understanding of their impact on learning to assist trainees to acquire surgical skills. The article will then address in detail the current and emerging simulation modalities used in urological education, with specific urological examples provided. These modalities are part-task trainers and 3D-printed models for open surgery, laparoscopic bench and virtual reality trainers, robotic surgery simulation, simulated patients and roleplay, scenario-based simulation, hybrid simulation, distributed simulation and digital simulation. This article will particularly focus on recent advancements in several emerging simulation modalities that are being applied in urology training such as operable 3D-printed models, robotic surgery simulation and online simulation. The implementation of simulation into training programmes and our recommendations for the future direction of urological simulation will also be discussed.

Natural fiber composites provide an environmentally favorable and sustainable alternative to traditional materials, greatly reducing environmental impact. Aging tests are required to evaluate the long-term mechanical performance and durability of these composites under varied situations, ensuring their dependability and safety over time. This study investigates the effects of ecological aging on jute-banana fiber reinforced phenol-formaldehyde (JBP-F) composites. The experiment involved fabricating JBP-F composites using jute and banana fibers with varying weight ratios (60:40, 50:50, 40:60, 30:70) and subjecting them to various aging tests like long-time water resistance, accelerated water resistance, thermal aging, hydrothermal aging, soil burial test, and accelerated weathering test. The result showed that the composite with a 50:50 jute-banana fiber to resin ratio (JBP-F50) outperformed the other compositions examined in terms of aging resistance. This balanced ratio likely optimized fiber-matrix interaction, leading to superior strength and water resistance. Higher fiber content composites (like JBP-F60) absorbed more water due to weaker bonding, while lower fiber content (JBP-F30) suffered more in high temperatures. All composites experienced strength loss during thermal and hydrothermal aging due to heat and moisture cycles. JBP-F50 again showed the least degradation, possibly due to the resin’s ability to recover. In soil burial tests, biodegradation impacted strength, with higher fiber content composites (JBP-F60) degrading more. Finally, weathering tests revealed some surface deterioration due to UV radiation. However, the resin offered protection, with JBP-F30 (higher resin content) experiencing the most weight loss.JBP-F50, with its balanced fiber-resin ratio, demonstrated the best resistance to various environmental stresses, making it a promising option for sustainable composite applications.

Objective: The objective of the study was to evaluate the spectrum of skin diseases among older patients in a coastal city of Southern India and its association with systemic illness. Materials and Methods: In this retrospective, cross-sectional study, medical records from the dermatology outpatient clinics were assessed. Patients over 60 years old and attending the dermatology outpatient clinic between November 2021 and June 2022 were included in the study. Results: Of 1182 records, 663 were male (56%) and 519 were female (43.9%). Most of the patients were in the age group between 60 and 70 years (71.7%). Overall, the most frequent dermatologic diseases in this cohort of patients were infections (41.37%), eczematous dermatitis (30.02%), and papulosquamous disorders (9.39%). Among the physiological changes of aging skin, xerosis was the most common manifestation observed in 66 (5.5%) cases, followed by seborrheic keratosis in 24 (2%) cases. Twelve (1.01%) individuals had premalignant and malignant lesions identified. Bowen's disease (n = 5, 0.4%), basal cell carcinoma (n = 6, 0.5%), and leukoplakia (n = 1) were the most prevalent. Conclusion: Dermatoses in the older population are among the most common causes of daily consultations. In our study, infectious causes of dermatoses are more common than eczematous diseases. We discovered a higher prevalence of premalignant diseases like Bowen's disease, emphasizing the need for screening in people of skin color.

The Internet of Things has a set of smart objects with smart connectivity that assists in monitoring real world environment during emergency situations. It could monitor the various applications of emergency situations such as road accidents, criminal acts including physical assaults, kidnap cases, and other threats to people’s way of life. In this work, the proposed work is to afford real time services to users in emergency situations through Convolutional Neural Networks in terms of efficiency and reliable services. Finally, the proposed work has simulated with respect to the performance parameters of the proposed scheme like the probability of accuracy and processing time.

Aakash Ganju,1 Alessandra C Goulart,2 Amrit Ray,3 Anurita Majumdar,4 Barrett W Jeffers,3 Gloria Llamosa,5 Henry Cañizares,6 Ianne Jireh Ramos-Cañizares,6 Ibtihal Fadhil,7 Kannan Subramaniam,8 Lee-Ling Lim,9 Luna El Bizri,10 M Ramesh,11 Mathew Guilford,12 Raghib Ali,13 Ratna Duddi Devi,14,15 Rayaz A Malik,16 Shekhar Potkar,17 Yuan-Pang Wang18 1Executive Office, Saathealth, Mumbai, India; 2Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil; 3Research, Development and Medical, Upjohn – a Pfizer Division, New York, NY, USA; 4Research, Development and Medical, Emerging Markets, Upjohn – a Pfizer Division, Singapore; 5Mexican Neurology and Psychiatry Society, Mexico City, Mexico; 6Vicente Sotto Memorial Medical Center, Cebu City, Philippines; 7Eastern Mediterranean NCD Alliance, Kuwait City, Kuwait; 8Research, Development and Medical, Upjohn – a Pfizer Division, Sydney, Australia; 9Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 10School of Pharmacy, Lebanese University, Hadath, Lebanon; 11Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore; 12Executive Office, Common Health, Kuala Lumpur, Malaysia; 13Public Health Research Center, New York University, Abu Dhabi, United Arab Emirates; 14Executive Office, DakshamA Health and Education, Gurgaon, India; 15Board of Directors, International Alliance of Patient Organizations, London, England; 16Weill Cornell Medicine, Doha, Qatar; 17Research, Development and Medical, Upjohn – a Pfizer Division, Dubai, United Arab Emirates; 18Instituto de Psiquiatria (LIM-23), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilCorrespondence: Kannan SubramaniamResearch, Development and Medical, Upjohn – a Pfizer Division, Sydney, NSW 2000, AustraliaTel +61 413 569 077Email Kannan.Subramaniam@pfizer.comAbstract: Non-communicable diseases (NCDs) have been on the rise in low- and middle-income countries (LMICs) over the last few decades and represent a significant healthcare concern. Over 85% of “premature” deaths worldwide due to NCDs occur in the LMICs. NCDs are an economic burden on these countries, increasing their healthcare expenditure. However, targeting NCDs in LMICs is challenging due to evolving health systems and an emphasis on acute illness. The major issues include limitations with universal health coverage, regulations, funding, distribution and availability of the healthcare workforce, and availability of health data. Experts from across the health sector in LMICs formed a Think Tank to understand and examine the issues, and to offer potential opportunities that may address the rising burden of NCDs in these countries. This review presents the evidence and posits pragmatic solutions to combat NCDs.Keywords: low- and middle-income countries, multisectoral, non-communicable diseases, public–private partnership, universal health coverage

Introduction: Rituximab is a chimeric monoclonal antibody targeted against CD20 T-cells. It acts by the destruction of autoreactive B-cells. It is a common biologic agent widely used for the treatment of B-cell lymphoma, lymphoproliferative disorders, and inflammatory conditions that are refractory to conventional treatment, such as rheumatoid arthritis. However, various recent studies have shown an increasing number of serious adverse events associated with the use of rituximab, such as serious, often fatal, infusion reactions, infections, rigors, fever, peripheral edema, hypertension, myelosuppression, elevated transaminases, and cardiac failure. Only a few such studies have been performed in Indian patients, where Rituximab is still a new molecule. Aims: The aim of this study is to assess the efficacy and adverse events profile in patients with pemphigus group of diseases treated with rituximab. Materials and Methods: In this retrospective study, we analyzed records of 20 cases of pemphigus who received a modified rheumatoid arthritis (RA) protocol from January 2016 to June 2018, for the efficacy of rituximab as well as for the immediate and late adverse effects encountered with the use of rituximab. Results: It was found that 50% of cases achieved complete remission for the entire duration of follow up. The mean duration of remission was 8.55 months. More than 75% of patients relapsed only after 6 months. Twelve patients (60%) had various infusion reactions such as fever, chills, giddiness, breathlessness, bradycardia, and cyanosis. About 30% of the patients developed late side effects such as onychomycosis and sepsis. One of the patients died due to sepsis. Conclusions: Hence, we conclude that rituximab is still very effective at half the dose in the conventional RA protocol, and although it is a highly efficacious drug, it must be used with great caution, keeping in mind, these catastrophic side effects.

Erythema nodosum leprosum (ENL) is a manifestation of type II lepra reaction, seen in lepromatous or borderline lepromatous leprosy. Although it is a common reaction encountered in clinical practice, there are an increasingly large number of newer updates in the pathophysiology and management of this condition.The treatment options have expanded far beyond just thalidomide and steroids and now extends to TNF-α inhibitors, thalidomide analogs, tenidap, cyclosporine A, plasma exchange, and even IVIG amongst others. These updates and the current knowledge of ENL are summarized in this review.

Background and Aims: Dermatophytosis has always been a common superficial mycosis in India. However, the past 6-7 years have seen an unprecedented increase in the number of patients affected by recurrent, chronic, recalcitrant and steroid modified dermatophytosis involving the glabrous skin (tinea corporis, tinea cruris and tinea faciei). Importantly, there has been a notable decrease in clinical responsiveness to commonly used antifungals given in conventional doses and durations resulting in difficult-to-treat infections. Considering that scientific data on the management of the current epidemic of dermatophytosis in India are inadequate, the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) Task force Against Recalcitrant Tinea (ITART) has formulated a consensus statement on the management of dermatophytosis in India. Methods: Seventeen dermatologists with a focussed interest in dermatophytosis participated in a Delphi consensus method, conducted in three rounds. They responded as either “agree” or “disagree” to 132 statements prepared by the lead experts and gave their comments. Consensus was defined as an agreement of 80% or higher concurrence. Statements on which there was no consensus were modified based on the comments and were then recirculated. The results were finally analysed in a face-to-face meeting and the responses were further evaluated. A draft of the consensus was circulated among the participants and modified based on their inputs. Results: Consensus was achieved on 90 of the 132 statements. Direct microscopy using potassium hydroxide mount was recommended in case of diagnostic difficulty on clinical examination. Counselling of patients about strict adherence to general measures and compliance to treatment was strongly recommended as the key to successful management of dermatophytosis. A combination of systemic and topical antifungal drugs was recommended for the treatment of glabrous tinea in the current scenario. Topical corticosteroid use, whether used alone or in combination with other components, was strongly discouraged by all the experts. It was suggested that topical antifungals may be continued for 2 weeks beyond clinical resolution. Itraconazole and terbinafine were recommended to be used as the first line options in systemic therapy, whereas griseofulvin and fluconazole are alternatives. Terbinafine was agreed to be used as a first line systemic agent in treatment naïve and terbinafine naïve patients with glabrous tinea. Regular follow-up of patients to ensure compliance and monitoring of clinical response was recommended by the experts, both during treatment and for at least 4 weeks after apparent clinical cure. Longer duration of treatment was recommended for patients with chronic, recurrent and steroid modified dermatophytosis. Conclusion: Consensus in the management of dermatophytosis is necessary in the face of conventional regimens proving ineffective and dearth of clinical trials re-evaluating the role of available antifungals in the wake of evolving epidemiology of the infection in the country. It needs to be backed by more research to provide the required level of evidence. It is hoped that this consensus statement improves the quality of care for patients with dermatophytosis, which has emerged as a huge public health problem, imposing considerable financial burden on the country.

The present study was undertaken to partly understand the molecular mechanism of defence response during pigeonpea-Fusarium udum interaction. To study the response of defence related gene expression using reverse transcription quantitative real time PCR (RT-qPCR), roots of resistant and susceptible pigeonpea cultivars were infected with F. udum pathogen and samples were collected at 2, 24, 48, and 72 h after inoculation (HAI). PR2, PR10, PAL2, CHS8, IFS1, F3H, LOX, ADC, SPDS, and SPMS were amongst the ten defence response genes studied. The major changes observed in gene expression for all the ten genes are as follows: (i) Out of the ten genes, the expression of three genes, PR2, PR10, and CHS8, peaked at 48 HAI in resistant cultivars compared to susceptible cultivars (ii) the expression of two genes, IFS1 and F3H, was highly induced at all stages in resistant cultivars, while some genotypic differences were observed in susceptible cultivars (iii) the expression of the LOX gene increased only during the early stages at 2 HAI but decreased at later stages in resistant cultivars (iv) In resistant cultivars, the expression of three genes involved in polyamine synthesis, namely ADC, SPDS, and SPMS, peaked at 24 HAI compared to susceptible cultivars. Overall, increased gene expression was found mostly at earlier stages of infection, indicating that these genes are important in providing early resistance to F. udum infection in pigeon pea cultivars. The LOX gene, which codes for the lipooxygenase enzyme, appears to play a role in conferring susceptibility to pigeonea cultivars against F. udum infection, though more research is needed. Further validation studies of all ten genes using overexpression or RNAi technology will provide more information about their roles in the pigeonpea-F.udum interaction.

A novel dissimilar Laser Beam Weld of MDN 250 and 15CDV6 steels with adequate joint strength was successfully achieved using CO2 laser source. Electron probe microanalysis of the weld, weld microstructure, micro-hardness measurement across the weldment and transverse tensile properties of the weldment were evaluated. The fusion zone of the dissimilar welds exhibits an epitaxial grain growth. In dissimilar metal welds, HAZ (Heat Affected Zone) width is more on 15CDV6 steel side compared to MDN 250 steel side. An asymmetrical hardness profile across the dissimilar weld joint was observed, and HAZ region on 15CDV6 steel exhibited a high hardness. The tensile strength values of the welded specimens were close to that obtained for sheet specimens.

Context: Psoriasis is a common papulosquamous disorder characterized by increased epidermal turnover resulting in excessive skin shedding and a compromised barrier function of the skin. Transepidermal water loss (TEWL) is an effective and non-invasive way to measure the barrier function in this condition. Aims: To measure the physiological changes in the skin barrier function in psoriasis by measuring the extent of TEWL. To study the differences in TEWL in pathologically involved and uninvolved skin in psoriasis. To compare the TEWL in skin lesions in psoriatic patients and site matched controls. Subjects and Methods: To determine the barrier quality of the stratum corneum, we performed TEWL measurements using the closed chamber evaporation method (VapoMeter Delfin Technologies, Kuopio, Finland). The ambient temperature ranged between 21°C and 24°C, with a mean relative humidity range of 39%–50%. In total, four sites were measured for all the 50 cases, two involved plaques on the body were selected for the study of lesional psoriatic skin, and the standard sites of ankle and elbow were measured irrespective of being involved or uninvolved with psoriatic skin. TEWL measurements in controls were site matched. Statistical testing was done using SPSS ver. 17. The interval scale data were tested for normality using Shapiro-Wilk test, and between groups testing was done using Mann-Whitney test. Results: The TEWL was higher among the cases in all the four measured areas compared to the controls, thus showing overall impaired skin barrier function in psoriatic skin. In addition, among the cases, the involved sites show higher TEWL in comparison to the uninvolved skin. This is highly suggestive that plaques of psoriasis have reduced water holding capacity. Conclusions: Psoriasis is a dermatosis with overall compromise of the skin barrier function exhibiting exponential TEWL in lesional skin, with increased TEWL over non-lesional skin as well. Thus, it may be concluded that TEWL is an effective, non-invasive and objective method in assessment of skin barrier function.

Aluminium Metal Matrix Composites (AMMCs) are popular materials for aviation and automotive sectors due to their enhanced strength to weight ratio, increased resistance to corrosion and better tribological properties. In this work, the AA7075 alloy was reinforced with Titanium Boride (TiB2) particles (0, 4, 8, 12 wt. %) via stir casting process. In this process, the preheated TiB2 powder is dispersed into molten AA7075 at 850 to improve wettability and distribution. The tensile strength, hardness, wear resistance, and microstructural studies were conducted for the proposed composites. Pinon-Disc set up was used to study the wear behaviour of the proposed composites. The results revealed that the addition of TiB2 particulates to AL7075 matrix improved all the properties when compared to AL7075 matrix. Worn surface of the abraded surface was analysed using Scanning Electron Microscope.

A 42-year-old woman presented with asymptomatic discrete hyperpigmented plaques over the body and face since childhood. Over time, these lesions amalgamated to form diffuse plaques over the entire forearm and lower legs, with a recent onset of pinkish firm growths over the preexisting lesions of the elbows and knees. Histopathology was suggestive of Human papillomavirus (HPV) infection. The patient's history, physical examination, and HPE were conclusive of epidermodysplasia verruciformis, which is a rare genetic disorder with defective cell-mediated immunity towards HPV. It is characterized by a persistent eruption of pityriasis versicolor-like macules, verruca-like papules, and seborrheic keratosis-like plaques with an increased tendency of cutaneous malignancies. We present this case for its atypical nature, i.e., the absence of typical pityriasis versicolor-like lesions and absence of malignant transformation.

Raoultella planticola (R. planticola) is a Gram-negative, aerobic, rod bacteria found in water and soil that has been on rare occasions associated with clinical infections. However, in recent years, there has been both an increase in the frequency and severity of R. planticola infections. We present the first case of Meckel’s diverticulum perforation and peritonitis in a child associated with R. planticola infection and a systematic review of the paediatric literature. At present, in the paediatric population, R. planticola presents good susceptibility to a variety of antibiotics with the exception of ampicillin. Keywords: Meckel’s diverticulum, Raoultella planticola, Infection, Perforation, Peritonitis

Human uses communication language either by written, spoken or typed to describe visual the world around them. So, the study of text description for any video goes increasing. This paper represents a framework that gives output as a description for any video having a maximum size of 50 seconds by using natural language processing. The framework is divided into two sections called training and testing. The training section is used to train the video with its description like activities of objects present in that video. The trained data is stored into the database with its features of scenario of video. Another section is testing section. The testing section is used to test the video and retrieve the output as description of video. By using Natural language processing sentences are generated from objects and their activities present in the video.

Background: Lichen planus pigmentosus (LPP), a rare variant of lichen planus, is reported in various ethnic groups, more often from the Indian subcontinent and the Middle East. Aims: Although the condition is encountered quite often by dermatologists of this region, the data on the clinical, pathological, and immunohistochemical (IHC) aspects of LPP are limited. This prospective study is aimed towards filling this lacuna. Materials and Methods: Data were collected from thirty clinically diagnosed cases of LPP who presented to the dermatology outpatient department. Skin biopsy and blood investigations were conducted and the specimens were further analyzed for their histopathological features and IHC staining for CD4+, CD8+ T-lymphocyte subsets along with CD45RO (UCHL-1), and CD68. The results were statistically analyzed. Results: The study showed a female preponderance (56.7%). Photo aggravation as a precipitating cause was seen in 40% of the individuals. The lesions with duration

Title: Secukinumab efficacy and safety in Indian patients with moderate-to-severe plaque psoriasis: sub-analysis from FIXTURE (Full Year Investigative Examination of Secukinumab vs. Etanercept Using Two Dosing Regimens to Determine Efficacy in Psoriasis), a randomized, placebo-controlled, phase 3 study. Background: Evidence has suggested Interleukin (IL)-17A to be an important effector cytokine in the pathogenesis of psoriasis. Here, we report results for an Indian sub-population from a multinational study FIXTURE, designed to assess the safety, tolerability, and long-term efficacy of fully human anti–IL-17A monoclonal antibody secukinumab in patients with moderate-to-severe plaque psoriasis. Materials and Methods: In this double-dummy, placebo controlled, 52-weeks phase 3 study FIXTURE, 149 Indian patients were randomized 1:1:1:1 to receive secukinumab at a dose of 300 mg or 150 mg, etanercept, or placebo. The study objective was to show the superiority of secukinumab over placebo at week 12, vis-à-vis proportion of patients achieving a reduction of 75% or more from the baseline in the psoriasis area-and-severity index score (PASI 75) and a score of 0 (clear) or 1 (almost clear) on a 5-point modified investigator's global assessment (IGA mod 2011) (co-primary end points). Results: At week 12, 61.0% and 55.9% patients in secukinumab 300 mg and 150 mg groups, respectively, achieved PASI 75 response compared to 20.0% in the etanercept and 7.1% in the placebo groups. Similarly, IGA mod 2011 0 or 1 response was achieved by 43.9% and 20.6% in patients in the secukinumab 300 mg and 150 mg group, respectively, vs. 13.3% in the etanercept and 2.4% in the placebo groups at week 12. Likewise, higher proportions of patients in secukinumab 300 mg (41.5%) and 150 mg (20.6%) group were PASI 90 responders at week 12 than those in the etanercept (10.0%) or placebo (0.0%) groups. The incidences of adverse events (AEs), during the induction period were similar in all the treatment groups. Overall secukinumab was well-tolerated at both doses in the Indian sub-population. Conclusion: The results from the Indian sub-population suggest that secukinumab is an efficacious and safe drug for use in moderate-to-severe chronic plaque psoriasis

DDF is the most significant measure among different bunch execution procedures to assess the immaculateness of any group component. Ordinarily, best groups are assessing by processing the quantity of information focuses inside a bunch. At the point when this tally is comparable to the quantity of required information focuses then this group is viewed as great. The greatness of the bunch system is fundamental not exclusively to discover the information check inside a group yet in addition to inspect it by totalling the information focuses these are (I) present inside a group where it ought not be and the other way around and (ii) not grouped for example anomalies (OL). The principle usefulness of DDF is that all bunch focuses can be gathered in comparative groups without exceptions, the current paper features on how contrasted with DDF more effective Clusters can be shaped through the Modern DDF. Further, we assess the exhibition of some grouping calculations, K-Means. As of late we, fostered the Modified K-Means Algorithm and Hierarchical Algorithm by utilizing the Data Discrepancy Factor (DDF).

CT guided Stereotactic biopsy (CTSB) is a minimally invasive procedure that uses three dimensional (3D) coordinated system for precisely locating a target within a space to obtain tissue sample for diagnostic and therapeutic purposes. The main aim of this study is to analyze the role of CTSB in deep seated lesions, multi-focal lesions, lesions in eloquent areas as well as in frail patients at high risk for major cranial surgeries and small intra-cranial lesions which are otherwise hard to access. The study was conducted in National Institute of Neurological and Allied Sciences, Nepal with retrospective data using non probability purposive sampling. The study was done from January 2007 to December 2012. Analysis of frame based stereotactic biopsy over that period was done. Descriptive statistics for patient demographics and distribution of lesions was used. Paired t-test was used to compare pre-operative and post-operative GCS to define the safety. Difference in post procedure diagnosis in terms of histology was analysed. Of the 40 cases evaluated, 55% were males and 45% females. Lesions had lobar distribution in 62.5% and were deep seated in 37.5% cases. Three (7.5%) patients had multifocal lesions. Net diagnostic yield was 97.5% and diagnosis could not be established in one case. In fi ve (12.5%) cases the preoperative diagnosis was revised by the procedure and in 13 (32.5%) a new diagnosis was established. Complications were observed in 10%, 7.5% cases having seizure and 2.5% having postoperative brain swelling. Procedure related mortality was seen in one (2.5%) moribund patient. There was no statistical difference in GCS at 48 hours post procedure as compared to preoperative state implying the safety of the procedure. CTSB of cerebral lesion appears to be safe procedure of diagnostic advantage. It can significantly change the final diagnosis making it imperative when indicated.

Favourite N Cele, Muthusamy Ramesh, Mahmoud ES Soliman Molecular Modelling and Drug Design Research Group, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Abstract: A novel virtual screening approach is implemented herein, which is a further improvement of our previously published “target-bound pharmacophore modeling approach”. The generated pharmacophore library is based only on highly contributing amino acid residues, instead of arbitrary pharmacophores, which are most commonly used in the conventional approaches in literature. Highly contributing amino acid residues were distinguished based on free binding energy contributions obtained from calculation from molecular dynamic (MD) simulations. To the best of our knowledge; this is the first attempt in the literature using such an approach; previous approaches have relied on the docking score to generate energy-based pharmacophore models. However, docking scores are reportedly unreliable. Thus, we present a model for a per-residue energy decomposition, constructed from MD simulation ensembles generating a more trustworthy pharmacophore model, which can be applied in drug discovery workflow. This work is aimed at introducing a more rational approach to the field of drug design, rather than comparing the validity of this approach against those previously reported. We recommend additional computational and experimental work to further validate this approach. This approach was used to screen for potential reverse transcriptase inhibitors using the pharmacophoric features of compound GSK952. The complex was subjected to docking, thereafter, MD simulation confirmed the stability of the system. Experimentally determined inhibitors with known HIV-reverse transcriptase inhibitory activity were used to validate the protocol. Two potential hits (ZINC46849657 and ZINC54359621) showed a significant potential with regard to free binding energy. Reported results obtained from this work confirm that this new approach is favorable in the future of the drug design industry. Keywords: HIV-1, reverse transcriptase, GSK952, molecular dynamic simulations, pharmacophore model, molecular docking

Introduction: Hepatitis B Virus (HBV) causes diverse clinical manifestations ranging from acute fulminant Hepatitis, Chronic Hepatitis (CHB) to liver cirrhosis and Haepatocellular Carcinoma (HCC). The HBV X gene (HBV-X) is a 154 amino acid multifunctional protein, mutates frequently and has a role in HBV related HCC. Aim: The current study was to explore the genetic variability and identify mutations of HBV-X in CHB patients from Central Kerala, India. Materials and Methods: The HBV-X sequences (n=39) from CHB (n=90) patients were analysed for nucleotide and amino acid diversity. Phylogenetic analyses were done using MEGA version 7.0.21 software to determine different genotypes. Results: Basal Core Promoter (BCP) mutations: A1762T/ G1764A (n=5) were found in HBeAg negative subjects (n=3, 60%). Bioinformatic analysis showed that the substitutions and mutations were HBV genotype/subgenotype specific. The predominant genotype detected was A1 (n=52, 57.77%) followed by genotype D (n=27, 30.00%). Nucleotide and amino acid diversities were more in genotype A1 than in D, which is responsible for transactivation (p

Background: Although Molluscum contagiosum (MC) is a self-limiting condition, active therapy could prevent further spread and improve cosmesis. Most of the available treatment modalities traumatize the lesions and have to be undertaken in the hospital, therefore evoking panic in children. In the quest for an alternative therapy, this study comparing 10% potassium hydroxide (KOH) solution and 5% imiquimod cream was taken up. Aims and Objectives: To compare the efficacy and tolerability of 10% KOH and 5% imiquimod in the treatment of MC. Materials and Methods: This comparative study was conducted over a period of 18 months from October 2011 to March 2013, 40 patients between the age group of 1-18 years with clinically diagnosed MC were divided into two groups (lottery method), 20 patients were treated with 5% imiquimod cream (Group A) and the other 20 were treated with 10% KOH solution (Group B). Patients were followed up on the 4 th , 8 th and 12 th week of treatment. Results: At the end of 12 weeks, out of 20 patients who received 10% KOH, 17 patients showed complete disappearance, whereas out of 20 patients who received 5% imiquimod, only 10 patients showed total clearance of the lesions. Adverse events were more frequent with 10% KOH, pigmentary disturbances being the most common. Conclusion: With only minor adverse effects, 10% KOH is an inexpensive and efficient modality for the treatment of MC in the pediatric age group. Although 5% imiquimod was effective in clearing the lesions with minimal adverse effects, the longer duration required for its efficacy may deter its wider use.

Context: The uncontrolled use of antibiotics has resulted in a relentless spread of multiresistant strains of Staphylococcus aureus. There are studies conducted in medical colleges in Chandigarh, Chennai, Mumbai and Vellore comparing pyodermas in the community and hospital setting based on clinical and bacteriological parameters. Aims: This study, conducted over 1½ years from March 2009 to August 2010, aimed at analyzing the clinical spectrum and antibiotic sensitivity pattern of community and hospital-associated (HA) staphylococcal pyoderma. It also assessed the prevalence of methicillin-resistant S. aureus (MRSA) in the community and hospital cohort settings. Subjects and Methods: The study comprised of 200 cases of staphylococcal pyodermas, derived from the community (150 cases) and hospital (50 cases). Patients were evaluated based on their clinical presentation; antibiotic susceptibility was tested using the Kirby-Bauer disk diffusion method. Statistical Analysis Used: Statistical significance between individual attributes between the community and HA staphylococcal pyoderma groups was analyzed using Chi-square test and mean differences using student′s t-test. Results: Factors associated with community-associated (CA) pyodermas were young age (P = 0.0021), primary pyodermas, and involvement of extremities, while those with HA pyodermas were middle age, secondary pyodermas, and significantly increased body surface involvement (P = 0.041). Incidence of CA-MRSA was 11.3%, while that of HA-MRSA was 18%. Conclusions: A high level of resistance to first-line drugs such as penicillin, ciprofloxacin and cotrimoxazole was observed, more so in the hospital strain than in the community strain. S. aureus demonstrated good susceptibility to cephalosporins. Though the two strains of MRSA differed clinically, they showed 100% sensitivity to vancomycin and linezolid.

Acquired bilateral nevus of Ota-like macules (ABNOM) or Hori′s nevus, a rare form of acquired dermal melanocytoses, presents as bilateral facial blue-gray macules without ocular or mucosal involvement. This condition is mostly found in women of Asian descent and usually appears in the fourth or fifth decade of life. Pathogenesis is unknown, though few theories have been proposed. Effective treatment has been found to be achieved with pigment-specific lasers. Herein, we report a case of Hori′s nevus with mucosal involvement. A 42-year-old male patient, presented to us with blue-gray discoloration on either side of his face, both eyes, and in the mouth since the age of one year. Histopathological examination showed clusters and singly dispersed pigmented melanocytes within the upper and mid-dermis regions. Special staining of melanocytes using Masson-Fontana stain was positive. Diagnosis of Hori′s nevus was made by correlating clinical and histopathological findings. Patient was informed of his treatment options, but refused treatment. A similar case of Hori′s nevus with mucosal involvement has not been reported so far.

Background: Dermatophytoses refer to superficial fungal infection of keratinized tissues caused by keratinophilic dermatophytes. According to observations worldwide, dermatophytoses are the most common of the superficial fungal infections. It is common in tropics and may present in epidemic proportions in areas with high rates of humidity. Although common, the precise size of the problem defies measurement. Aims: The present study was undertaken to assess the clinical profile of dermatophytic infection and to identify the species of fungi that are prevalent in this region. Materials and Methods: A total of 100 patients clinically suspected for dermatophytoses were selected for the study. Direct microscopy in 10% potassium hydroxide (KOH) and culture was done in each case. Results: Out of 100 patients, the maximum were seen in the age groups of 16-30 years. Tinea corporis was the most common clinical type (44.3%) followed by tinea cruris (38.2%). Overall positivity by culture was 39% and by direct microscopy 96%. Conclusion: Trichophyton rubrum was the predominant species isolated (67.5%) in all clinical types followed by Trichophyton mentagrophytes. Culturing the fungus may identify the species, but it is not essential for the diagnosis as it is not a sensitive test.

Background: Over the years, acyclovir has been the oral antiviral agent approved for the treatment of patients with acute herpes zoster,Its effectiveness in lessening the acute signs and symptoms of herpes zoster has been established but the effects on post herpetic neuralgia are less clear cut. Famciclovir is a new member of guanine nucleoside family of drugs. It is a well absorbed oral form of penciclovir with longer half life. This was a open comparative randomized study carried out to compare the safety and efficacy of famciclovir administered at 250mg thrice daily with acyclovir 800mg five times daily for the treatment of acute uncomplicated herpes zoster in immunocompetent individuals aged above 40 years. AIM: To assess the clinical profile of Herpes zoster, compare the efficacy and safety of acyclovir and famciclovir in the treatment of herpes zoster and to describe the effectiveness of acyclovir and famciclovir preventing post herpetic neuralgia. Methods: A total of 100 newly zoster were randomized in 1:1 ratio into acyclovir and famciclovir groups after inclusion criteria were satisfied.Treatment was initiated within 72 hrs of onset of symptoms and was continued for 7 days and evaluated at the end of each week up to six weeks period for full crusting of the lesions, complete healing of the lesion and loss of acute pain. Results: It was observed that famciclovir was as effective as acyclovir with no significant difference in time taken for full crusting, complete healing of lesions or loss of acute pain. Famciclovir was well tolerated with a better safety profile comparable to that of acyclovir. Constipation, headache, nausea and vomiting were the most commonly reported adverse effects, but constipation was considered to have a possible relationship to treatment. Conclusion: In conclusion, oral famciclovir administered three times daily for 7 days during acute zoster infection is as effective as acyclovir, administered 800mg five times daily.In addition it offers significant benefit by providing a well tolerated, cost effective, convenient dosage regime and accelerated rate of lesion resolution and a reduced duration of PHN.