Treatment with clobetasol propionate 0.025% topical therapy in various dermatoses

Owing to their anti-inflammatory and vasoconstrictive properties. Topical corticosteroids (TCs) provide benefits in various dermatological conditions, including atopic eczema, psoriasis, chronic hand eczema, and localized vitiligo. Clobetasol propionate (CP) is the most common topical agent possessing anti-inflammatory, antimitotic, antipruritic, and immunosuppressive properties that are employed in the management of plaque psoriasis. CP 0.025% cream was approved by the United States food and drug administration for the treatment of moderate-to-severe psoriasis in adult patients. The formulation is free from known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers, and has demonstrated hypoallergenic effects. High penetration of active ingredients and a lower degree of systemic absorption make CP 0.025% an effective and safe agent. This case series discusses the clinical experience of using CP 0.025% cream in various dermatologic conditions, focusing on its efficacy and safety

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Bioinspired ZnS:Gd Nanoparticles Synthesized from an Endophytic Fungi <i>Aspergillus flavus</i> for Fluorescence-Based Metal Detection

Recently, several nonconventional sources have emerged as strong hotspots for the biosynthesis of chalcogenide quantum dots. However, studies that have ascertained the biomimetic methodologies that initiate biosynthesis are rather limited. The present investigation portrays a few perspectives of rare-earth(Gd)-doped ZnS biosynthesis using the endophytic fungi Aspergillus flavus for sensing metals based on their fluorescence. Analysis of ZnS:Gd nanoparticles was performed by elemental analysis, energy-dispersive X-ray spectroscopy (EDS), atomic force microscopy (AFM), X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), photoluminescence (PL), and transmission electron microscopy (TEM). The results of TEM demonstrated that the particles were polycrystalline in nature, with a mean size of 10&#8315;18 nm. The fluorescence amenability of the biogenic ZnS nanoparticles was further used for the development of a simple and efficient sensing array. The results showed sensitive and detectable quenching/enhancement in the fluorescence of biogenic colloidal ZnS nanoparticles, in the presence of Pb (II), Cd (II), Hg (II), Cu (II) and Ni (II), respectively. The fluorescence intensity of the biogenic ZnS:Gd nanoparticles was found to increase compared to that of the ZnS nanoparticles that capacitate these systems as a reliable fluorescence sensing platform with selective environmental applications

Comparison of the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block versus thoracic erector spinae block for postoperative analgesia in caesarean section parturients under spinal anaesthesia—A randomised study

Background and Aims: Truncal blocks play an important role in multimodal analgesia regimens to manage the postoperative pain after lower segment caesarean section (LSCS). This study was aimed to compare the analgesic efficacy of ultrasound (US)-guided transmuscular quadratus lumborum block (TQLB) and thoracic erector spinae plane block (TESPB) in parturients of LSCS done under subarachnoid block (SAB). Methods: In a randomised and double blind study, 60 parturients scheduled for LSCS under spinal anaesthesia were randomly divided into two equal groups: group E (n = 30) and group Q (n = 30). After surgery, each parturient received either US guided bilateral TQLB (group Q) or TESPB (group E) with 20 ml 0.375% ropivacaine and 4 mg dexamethasone on each side. Assessments were done at 2, 4, 6, 8, 10, 12 and 24 h. The primary objective was to compare the duration of analgesia (first request to rescue analgesia) and the secondary objectives were to compare pain scores [numerical rating score (NRS)], total amount of tramadol consumption, incidence of nausea-vomiting, parturient satisfaction and other adverse effects in 24 hours postoperatively. Results: The duration of analgesia (mean ± standard deviation) was comparable in group E (11.90 ± 2.49 h) and group Q (12.56 ± 3.38 h), P = 0.19. Pain scores (NRS) at rest and on movement were comparable at all time points of 2, 4, 6, 8, 10, 12, and 24 h (P > 0.05). The amount of tramadol used was comparable in group E and group Q (P = 0.48). Conclusion: TESPB and TQLB are equally efficacious to provide postoperative analgesia after LSCS done under SAB when used as a part of multimodal analgesia

Magnetic Resonance Imaging Characterization of the Hippocampi in Temporal Lobe Epilepsy: Correlation of Volumetry and Apparent Diffusion Coefficient with Laterality and Duration of Seizures

Background and Purpose It is estimated that hippocampal damage is seen in 50 to 70% of patients with temporal lobe epilepsy (TLE). Although most magnetic resonance imaging (MRI) studies are adequate to detect gross hippocampal atrophy, subtle changes that may characterize early disease in TLE, such as visually nonappreciable volume loss, may often be missed if objective volumetric analysis is not undertaken. Materials and Methods We conducted a hospital-based prospective analytical study in which 40 patients with partial seizures of temporal lobe origin were included and their hippocampal volumes (HVs) were determined by manual volumetric analysis. The findings were recorded and correlated with the side of seizure and its duration. The quantitative assessment was allotted different grades accordingly. Also, the apparent diffusion coefficient (ADC) values of bilateral hippocampi were estimated and their correlation with the side of seizure was determined. Results Most patients in the study were in the age group of 11 to 20 years (37.5%). In total, 57.5% had seizures for a period of 1 to 5 years. While 67.5% (n = 27) had seizure on the right, 32.5% (n = 13) had on the left. The mean HV estimated on the right and left were correlated with the side of seizure and found to be statistically significant (p < 0.001 in those with right-sided seizures and p = 0.02 in those with left-sided seizures). Simultaneously the ADC values estimated were found to correlate with the laterality of seizures with a statistical difference (p < 0.01). Duration of seizures however did not show a positive correlation with the HV. Conclusion MRI with quantitative estimation of HV and ADC values can depict the presence and laterality in TLE with accuracy rates that exceed those achieved by visual inspection alone. Thus, quantitative MRI provides a useful means for translating volumetric analysis into clinical practice

Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial

Background: Mechanical neck pain is one of the common musculoskeletal disorders. Muscle energy technique (MET) may be a useful intervention for treating such disorder. Objective: The aim of this study was to compare the effect of MET with passive stretching on pain and functional disability in people with mechanical neck pain. Methods: A randomized controlled trial was undertaken. Sixty patients with mechanical neck pain were randomly allocated to either the MET group or control group. The former group received MET, and the latter group received static stretching. Both groups received conventional therapy. Treatment was given once a day for 6 days. A visual analogue scale (VAS) was used to measure the intensity of pain, and functional disability was assessed using the neck disability index (NDI) was immediately before treatment and again on the 6th day. Results: VAS and NDI scores showed a significant improvement in both MET and stretching groups on the 6th day postintervention (p < 0.05). However, both VAS and NDI scores showed better improvement in the MET group as compared to the stretching group (p < 0.025). Conclusion: Muscle energy technique was better than stretching technique in improving pain and functional disability in people with mechanical neck pain

Proceedings of the 6th International Conference on Modeling and Simulation in Civil Engineering

This conference proceedings contains articles on the various research ideas of the academic community and technical researchers presented at the 6th International Conference on Modeling and Simulation in Civil Engineering (ICMSC 2022). ICMSC 2022 was organized by the Department of Civil Engineering, TKM College of Engineering, Kollam, Kerala, India on December 1-3, 2022. The main aim of this conference is to bring together leading academicians, researchers, technocrats, practitioners, and students to exchange and share their experiences and research outputs on all aspects of Civil Engineering, especially related to the modeling and simulation in Civil Engineering.  Conference Title: 6th International Conference on Modeling and Simulation in Civil EngineeringConference Acronym:  ICMSC 2022Conference Date: 1-3 December 2022Conference Location: IndiaConference Organizer: Department of Civil Engineering, TKM College of Engineering, Kollam, Kerala, Indi

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

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