Clinicoepidemiological study of fixed drug eruption in tertiary care hospital

Background: Adverse cutaneous drug reactions pose diagnostic difficulties due to a varied clinical manifestations and broad categories of causative agents. Fixed drug eruptions (FDE) are one of them. Present study aims i) to record various clinical features of FDE, their causative agents and ii) to study the pattern of morbidity in patients with FDE in a tertiary care hospital, Rajkot, Gujarat, India.Methods: The 88 patients with FDEs attending department of dermatology, venereology and leprosy at PDU govt. medical college and hospital, Rajkot, Gujarat from September 2018 to September 2020 were included after informed consent. After taking thorough history, complete blood count and biochemical tests were done. HIV testing was done in severe reactions with generalised involvement. Appropriate treatment was given with counselling regarding the offending drug for prevention of reaction in future.Results: The male patients were more affected than female patients with M: F ratio of 1.3:1. The most common age group affected was 21-30 years (22.7%). Antimicrobials were the most common offending drugs (43.2%). None of the patients were HIV reactive in our study. No mortality was reported in our study.Conclusions: The patterns of FDE and the causative drugs are remarkably different in our study. Knowledge of patterns and the causative agents helps in prevention of same reactions in future in patients

Imaging and intervention for coronary artery disease following irradiation of malignant thymoma

Thymomas are rare malignant epithelial growths, constituting 20% of mediastinal tumours. Resection followed by irradiation may be employed in all thymomas except for stage 1 thymomas. Mediastinal irradiation is associated with coronary artery disease. The mean duration of presentation of post-irradiation coronary artery disease is 16 years (range 3-29 years). In our patient coronary artery disease was found only a year post irradiation. A 55 year old male who presented with complaints of dyspnoea, retrosternal chest pain and heaviness since one year underwent resection for malignant thymoma followed by radiotherapy. He presented with coronary artery disease a year after undergoing mediastinal irradiation. On follow-up, patient was treated successfully by coronary artery bypass graft. This case is an unusual occurrence and suggests that mediastinal irradiation may result in significant coronary artery disease as early as within one year

Benign granulomatous polyp obstructing the bronchus.

Abstract Inflammatory endobronchial polyps are rarely encountered. We report a case of a 14 years old girl with a benign granulomatous polyp originating in the bronchus. Computed tomography scan showed an intraluminal soft tissue opacity while fiberoptic bronchoscopy revealed a large soft tissue mass completely occluding the left lower lobe. Rigid bronchoscopy under general anaesthesia identified a fleshy mass in the left main stem bronchus which was excised via bronchoscopy. The histopathology showed benign polyp with non-specific inflammation. The patient\u27s symptoms improved subsequently and no recurrence was reported till two years of follow-u

Multiplication and Composition in Weighted Modulation Spaces

We study the existence of the product of two weighted modulation spaces. For this purpose we discuss two different strategies. The more simple one allows transparent proofs in various situations. However, our second method allows a closer look onto associated norm inequalities under restrictions in the Fourier image. This will give us the opportunity to treat the boundedness of composition operators.Comment: 49 page

JISC User Behaviour Observational Study: User Behaviour in Resource Discovery: Final Report

The report discusses the information-seeking behaviour of students and researchers working in the Business and Economics disciplines using subscribed and freely available Internet resource discovery systems in three UK HE institutions: Cranfield University, London School of Economics and Middlesex University. The institutions were chosen as examplars of the Russell Group, the 94 Group, and the Million+ groups of universities in the UK. The intention was to describe and gain a better understanding of: (i) how different users (undergraduates, postgraduates and researchers) currently seek information on the existing resource discovery systems, (ii) the roadmap used in a user’s information seeking journey, and (iii) their expectations and needs based on their understanding and experience of using the Internet to find information resources for academic study. In addition, we hope to inform JISC, publishers of electronic resources, and librarians working in the HE sector about user behaviours and the issues relating to resource discovery systems. The data was obtained from an observational study and in-depth interview of 34 participants. Each participant was studied on an individual basis and each session lasted up to two hours. The analysis of the data provided an insight on: resource discovery systems used by participants and what they found to be useful, users information search behaviour and strategies when seeking information, the issues that affect their searching behaviour, problems and difficulties users experienced with library resources, issues related to physical library services as well as recommendations for the publishers and librarians in order to improve the use of electronic resources

Taking ACTION to reduce pain: ACTION study rationale, design and protocol of a randomized trial of a proactive telephone-based coaching intervention for chronic musculoskeletal pain among African Americans

Abstract Background Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. Methods/Design The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain. Participants assigned to the intervention will receive a telephone counselor delivered pedometer-mediated walking intervention that incorporates action planning and motivational interviewing. The intervention will consist of 6 telephone counseling sessions over an 8–10 week period. Participants randomly assigned to Usual Care will receive an informational brochure and a pedometer. The primary outcome is chronic pain-related physical functioning, assessed at 6 months, by the revised Roland and Morris Disability Questionnaire, a measure recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). We will also examine whether the intervention improves other IMMPACT-recommended domains (pain intensity, emotional functioning, and ratings of overall improvement). Secondary objectives include examining whether the intervention reduces health care service utilization and use of opioid analgesics and whether key contributors to racial/ethnic disparities targeted by the intervention mediate improvement in chronic pain outcomes Measures will be assessed by mail and phone surveys at baseline, three months, and six months. Data analysis of primary aims will follow intent-to-treat methodology. Discussion We will tailor our intervention to address key contributors to racial pain disparities and examine the effects of the intervention on important pain treatment outcomes for African Americans with chronic musculoskeletal pain. Trial registration ClinicalTrials.gov: NCT01983228. Registered 6 November 2013

Taking ACTION to reduce pain: ACTION study rationale, design and protocol of a randomized trial of a proactive telephone-based coaching intervention for chronic musculoskeletal pain among African Americans

Abstract Background Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. Methods/Design The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain. Participants assigned to the intervention will receive a telephone counselor delivered pedometer-mediated walking intervention that incorporates action planning and motivational interviewing. The intervention will consist of 6 telephone counseling sessions over an 8–10 week period. Participants randomly assigned to Usual Care will receive an informational brochure and a pedometer. The primary outcome is chronic pain-related physical functioning, assessed at 6 months, by the revised Roland and Morris Disability Questionnaire, a measure recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). We will also examine whether the intervention improves other IMMPACT-recommended domains (pain intensity, emotional functioning, and ratings of overall improvement). Secondary objectives include examining whether the intervention reduces health care service utilization and use of opioid analgesics and whether key contributors to racial/ethnic disparities targeted by the intervention mediate improvement in chronic pain outcomes Measures will be assessed by mail and phone surveys at baseline, three months, and six months. Data analysis of primary aims will follow intent-to-treat methodology. Discussion We will tailor our intervention to address key contributors to racial pain disparities and examine the effects of the intervention on important pain treatment outcomes for African Americans with chronic musculoskeletal pain. Trial registration ClinicalTrials.gov: NCT01983228. Registered 6 November 2013

Immersive horizons: navigating ethical terrain and practical boundaries in the use of virtual reality for cancer symptom management – a comprehensive narrative review

Cancer is a significant healthcare problem. However, advancements in diagnostic procedures and therapeutic modalities have led to a decline in cancer mortality rates by 1% annually in most countries. Cancer patients often experience symptoms such as pain, cancer-related fatigue, anxiety, and lymphedema. To counter these side effects, there have been tremendous efforts. One such effort is the use of virtual reality (VR) technology, which is an interactive technology. VR has played a significant role in managing disorders such as phobias and anxiety disorders, and support for patients with cognitive and physical rehabilitation, acute and chronic pain management, and emotional support in different settings such as during hospitalizations. Our team conducted an extensive search for electronic literature on virtual reality in various databases, such as Medline, PubMed, Google Scholar, and Psych INFO, up to July 2023. We used keywords like "virtual reality," "cancer care," "depression," "cognition," "pain," "telemedicine," "rehabilitation care," "physical therapy," "radiotherapy," "telerehabilitation," "avatar," "video games," and "visual aid" as our search criteria. VR interventions for cancer patients include exposure therapy, psycho-education, and relaxation techniques, which have been shown to reduce symptoms significantly. VR distraction can also mitigate pain during medical procedures. Studies suggest that VR holds promise in rehabilitation and oncologic treatment, as it can improve function metrics, range of motion, and motivation for treatment. The review scrutinizes the use of digital information and virtual reality technology to alleviate cancer-related distress by providing remote care.

Accounting students and communication apprehension: a study of Spanish and UK students

Accounting is about measuring and communicating. Accounting bodies and employers have expressed opinions, which have been supported by research results, advocating that greater emphasis is placed on the development of communication skills throughout the education and training of accountants. Consequently, an increasing number of accounting programmes now include communication skills as educational objectives or learning outcomes, and have integrated activities into the curriculum specifically to develop these skills. It is important to recognise that certain factors can severely restrict the development of communication skills; a major factor is communication apprehension. Research suggests that the existence of high levels of communication apprehension will make efforts to improve communication skills ineffective. Previous research findings indicate that accounting students have high levels of communication apprehension. This paper compares and contrasts the levels and profiles of communication apprehension exhibited by accounting students at the (UK University) and those at the (ESP University). The levels of communication apprehension are also compared with those of students from other disciplines at the same institutions. The results confirm the high levels of communication apprehension in European accounting students. There are notable differences between the two countries however in certain underlying factors.</p

Exotic Dark Matter Search with the Majorana Demonstrator

With excellent energy resolution and ultralow-level radiogenic backgrounds, the high-purity germanium detectors in the Majorana Demonstrator enable searches for several classes of exotic dark matter (DM) models. In this work, we report new experimental limits on keV-scale sterile neutrino DM via the transition magnetic moment from conversion to active neutrinos ν_{s}→ν_{a}. We report new limits on fermionic dark matter absorption (χ+A→ν+A) and sub-GeV DM-nucleus 3→2 scattering (χ+χ+A→ϕ+A), and new exclusion limits for bosonic dark matter (axionlike particles and dark photons). These searches utilize the (1-100)-keV low-energy region of a 37.5-kg y exposure collected by the Demonstrator between May 2016 and November 2019 using a set of ^{76}Ge-enriched detectors whose surface exposure time was carefully controlled, resulting in extremely low levels of cosmogenic activation