UNMASKING THE SILENT EPIDEMIC: EVALUATING BIOTHESIOMETRY FOR EARLY DETECTION OF DIABETIC NEUROPATHY IN INDIA

Due to the alarmingly high prevalence of type 2 diabetes mellitus (T2DM), India is experiencing a growing healthcare crisis. Diabetic peripheral neuropathy (DPN), one of the range of T2DM consequences, is particularly concerning, with prevalence rates in India ranging from 8% to 59%. DPN greatly increases the chance of serious side effects such gangrene, amputations, foot infections, and deformities. Factors like poor foot cleanliness, wearing the wrong shoes, and going barefoot all add to the intricacy of this problem. Methods: This single-centre, hospital-based cross-sectional study spanned 18 months, involving 87 participants with confirmed T2DM. Data collection included anthropometric measurements, blood tests for glucose control and lipid profiles, urine sugar levels, and assessments for peripheral neuropathy using biothesiometry and nerve conduction velocity. Statistical analysis included mean values, percentages, chi-square tests, and t-tests. Results: The study involved mostly male participants (64.4%) with an average age of 59.6 years and an average T2DM duration of 8.1 years. Notable findings included elevated fasting blood sugar (160.9 mg/dL), postprandial blood sugar (251 mg/dL), and HbA1c levels (7.1%). Approximately 49% of participants had high urine sugar levels, with 35.6% showing 4+ urine sugar. Nerve conduction velocity tests indicated peripheral neuropathy in 90.8% of cases. Biothesiometer assessments of the right foot revealed peripheral neuropathy in 78.2% of individuals, with varying severity. In contrast, left foot assessments indicated that 21.8% had no neuropathy. An association was found between HbA1c levels and neuropathy, and a significant difference existed between biothesiometer and nerve conduction velocity results (p=0.021). When assessing neuropathy based on disease duration, nerve conduction velocity tended to identify more cases than the biothesiometer. Conclusion: This study underscores the significance of early detection of peripheral neuropathy in T2DM patients. The biothesiometer proves to be a practical, non-invasive, and cost-effective tool for this purpose. Routine biothesiometer use is recommended for early detection of peripheral neuropathy in T2DM patients, providing a valuable contribution to managing this significant healthcare challenge in Indi

Motivating a Terminological Clarification in the Account of Representation Between Computational and Dynamical Paradigms

Debate in philosophy of cognition between computatationalists and dynamists often are found to be taking past one another. This is largely due to inconsistency within the dynamic camp regarding whether or not there are representations; and for those that do affirm them, clarifying how a representation is to be conceived and used under a dynamical system paradigm. Having been equipped with an understanding of a dynamic conception of representation may prove resourceful for giving a dynamic account for cognitive tasks in a ‘representation-hungry’ problem domain, largely thought only to be explained through a computational cognitive model

A Study in Worship: Blending the African American Style of Preaching with Epic Preaching

The stories in Scripture are rich in meaning, mood and mystery with messages often concealed from those who would just glide over them with a glancing eye. The art of preaching exhibited in the African American pulpit is complete with theology, struggle, issues, passion, and excitement. This style of sermon presentation is uniquely tied to the many cultures of the West African diaspora into the Americas. This unique style was used in the storytelling of the ancestors and through the struggles of the African in America evolving into the art of black preaching. The purpose of this dissertation is to look at the craft of African American Preaching and pair it with the EPIC preaching model of Dr. Len Sweet. Chapter One begins with the rich history of the African the voyage on the “middle passage,” and the stories told from the shores of West Africa to the shores of North America. Chapter Two provides history into the evolution of African American preaching and the emphasis on story. Chapter Three centers on the building of worship in the African American Church. Chapter Four gives the history of Image in the African American pulpit and where Image is found today. Chapter Five focuses on the components black preaching and how preachers have used the elements of EPIC worship in sermonic presentations and this student’s reflections of the preaching styles of contemporary scholars who are master preachers in the art of African American preaching. Chapter Six includes an overview of the new EPIC preaching model as presented by Dr. Len Sweet. Chapter Seven focuses on the idea of combining the elements of the new EPIC worship style of preaching with the traditions of the African American style of worship further discovering the implication that the two styles may ix have on modern congregants. Concluding, the idea of blending the two worship styles, Chapter 8 includes expression of this student and members of Calvary Christian Church as we reflect on the EPIC worship Services attended during this dissertation program

Assessment of bismuth oxide-based electrolytes for composite gas separation membranes

Oxide + salt composites can be used in CO2 and NOx separation membranes, where high oxide-ion conductivity is crucial to improve performance. Pursuing this goal, the stability of three different bismuth oxide-based electrolytes (Cu + V, Y and Yb-doped) against molten alkali carbonates (Li, Na, K) or nitrates (Na, K) was tested firing them in the 450–550 °C temperature range, and with endurance tests up to 100 h. A well-known ceria-based composite was used as reference (CGO - Ce0.9Gd0.1O1.95). Oxides and composites were studied by X-ray diffraction, scanning electron microscopy and impedance spectroscopy (in air, 140–650 °C temperature range). Bi2Cu0.10V0.90O5.35 easily reacts with molten salts. Bi0.75Y0.25O1.5 and Bi0.75Yb0.25O1.5 have higher stability against molten carbonates and complete stability against molten nitrates. The Y-doped oxide stability against the molten carbonates was enhanced changing the molten salt composition (Y2O3 additions) and using lower firing temperatures. Above all, composites based on Y or Yb-doped Bi2O3 with molten alkali nitrates showed impressive 6× or 3× higher electrical conductivity at 290 °C, in air (4.88 × 10−2 and 2.41 × 10−2 S cm−1, respectively) than CGO-based composites (7.72 × 10−3 S cm−1), qualifying as promising materials for NOx separation membranes.publishe

A COMPREHENSIVE COMPARISON OF APREMILAST AND METHOTREXATE IN TREATING INTERFACE DERMATITIS: A RIGOROUS RANDOMIZED CONTROLLED STUDY

Interface dermatitis, a complex skin condition affecting the delicate dermoepidermal junction, presents significant therapeutic complexities. This study meticulously compared the efficacy and tolerability of oral Apremilast and Methotrexate, two promising treatments for interface dermatitis. Materials and Methods: This 12-week prospective randomized controlled study enrolled 36 patients specifically diagnosed with lichen planus, a form of interface dermatitis. Participants were divided into two groups: Group I received oral Apremilast (30mg twice daily), and Group II received oral Methotrexate (15mg weekly). Both groups were supplemented with emollients. Clinical responses were assessed using various scoring systems including Physician's Global Assessment (PGA), Visual Analog Scale (VAS), Lichen Planus Severity Index (LPSI), and mucosal scoring. Adverse effects and serious events were meticulously documented, and statistical analyses were conducted using appropriate methods. Results: Both Apremilast and Methotrexate demonstrated significant reductions in key metrics throughout the study. Apremilast exhibited a 34.3% reduction in PGA, an 83.6% reduction in VAS, a 34% reduction in LPSI, and a 64.5% reduction in mucosal score. Methotrexate displayed a 46.8% reduction in PGA, an 85.4% reduction in VAS, a 29.5% reduction in LPSI, and a 65.4% reduction in mucosal score. Methotrexate showcased a slightly faster onset of relief, and fewer adverse events were observed in the Methotrexate group. Conclusion: Both oral Apremilast and Methotrexate exhibit notable efficacy in treating interface dermatitis, with Methotrexate showing a marginally faster onset of relief and better tolerability. Apremilast, while generally well-tolerated, requires a careful titration strategy to manage gastrointestinal symptoms effectively. This study emphasizes the significance of personalized treatment approaches that balance therapeutic effectiveness and patient comfort when dealing with interface dermatiti

Synthesis of active electrocatalysts using glycine–nitrate chemistry

Due to sluggish oxygen reduction reactions, development in the solid oxide fuel cell (SOFC) field is stagnant. Two solutions, increasing the active surface or use of precious materials, can stimulate the oxygen reduction kinetics on electrodes. Thus, to gain both these benefits, the present article addressed the synthesis of high surface-area mixed oxide ionic–electronic conductor La0.6Sr0.4Co0.8Fe0.2O3-δ (LSCF) using chemistry of the propellant glycine–nitrate reaction. In this study, different fuel to oxidant ratios (ψ), 2.0, 2.6, and 3.0 were used to control the exothermicity of reaction and powder properties. The maximum reaction temperature of 1337 K at ψ = 3.0 resulted in coarsened powder. In contrast, comparatively less exothermicity of reaction at ψ = 2.0 resulted in powder with substantial Brunauer–Emmett–Teller surface area of 10.97 m2 g−1, with maximum powder compaction achieved at sintering of 1273 K. With optimal direct current in-plane electrical conductivity of 341 S cm−1, H2-temperature-programmed reduction showed excellent catalytic activity for the sample obtained at ψ = 2.0. The electrochemical performance comparisons of electrodes in two different cell geometries – with and without a gold catalytic current collecting layer (Au–CCCL) – revealed the least polarization and cell resistance in the cell with Au–CCCL. The electrode area specific resistance and cell conductivity using Au–CCCL were 0.097 Ω cm−2 and 0.15 S cm−1, respectively.publishe

VESICOBULLOUS DISORDERS WITH THE HELP OF DERMOSCOPIC FINDINGS

DS is a noninvasive diagnostic technique that enables the visualization of morphological features that are not discernible to the unaided eye. As a result, it serves as a bridge between macroscopic clinical DS and microscopic dermatopathology. Thus, the aim of the study was to evaluate and assess the dermoscopic findings associated with vesicobullous disorders(VBD). A comprehensive history and dermatological exam were performed. Examation of the disease's was performed. The demographic photos were taken and saved using a dermlite 4 DS at 10 X magnification and an iPhone camera. We used ultrasound gel as an interface material for polarized and non-polarized modes. On the "target" lesions, if needed, Tzanck smear and skin biopsy procedures were performed to validate the diagnosis. In our study we found that, DS of five cases of erythema multiforme showed red, blue, and black dots at the center, a yellowish translucent area surrounding it, and red and blue dots at the periphery with homogenous erythema. We concluded that, DS differentiation points may not even be necessary because DS results can help with the diagnosis on their ow

COMPARATIVE STUDY OF ORAL MINOXIDIL AND FINASTERIDE IN THE TREATMENT OF ANDROGENETIC ALOPECIA: A SIX-MONTH DOUBLE-BLINDED STUDY

Androgenetic alopecia (AGA), or male pattern baldness, has a negative impact on people's quality of life. Although considerable study on the efficacy and safety of oral finasteride and oral minoxidil in treating androgenetic alopecia has not been conducted, they are both effective treatments. Materials and methodology: In a double-blind comparison trial, 28 participants received daily oral doses of minoxidil (2.5 mg) and finasteride (1 mg) for six months. Numerous factors, including the Norwood Hamilton scale, photographic assessments, trichoscopy measurements of hair count and shaft thickness, Patient Global Assessment (PGA), and Visual Analog Scale (VAS), were considered to determine effectiveness. To monitor safety, lab investigations and the documentation of negative events were used. Results: Both minoxidil and finasteride significantly increased hair growth and thickness. At the frontal and vertex sites, the minoxidil group showed an increase in the average hair count and improved hair shaft thickness. In comparison to minoxidil, the finasteride group demonstrated superior hair growth and greater hair counts. Finasteride had little negative side effects and no reported sexual adverse effects. Conclusion: Over a six-month period, oral finasteride (1 mg) and oral minoxidil (2.5 mg) both showed equivalent efficacy and tolerability in the treatment of AGA. Finasteride produced superior outcomes in terms of hair growth and thickness, whereas minoxidil was well tolerated and had few side effects. People can securely select either course of treatment, guaranteeing a notable improvement in AGA patients' hair growth

PRURITIC DERMATOSES AMONG THE ELDERLY: IMPACT ON QUALITY OF LIFE AND IMPLICATIONS FOR GERIATRIC DERMATOLOGY

Itching, or pruritus, is a frequent problem in the elderly that has a big impact on their everyday lives. The frequency, trends, and effects of pruritic illnesses on the quality of life in older people are examined in this study, highlighting the many difficulties this population faces. Materials and Methods: 200 individuals 60 years of age and older who complained of pruritus participated in the study, which was conducted between February 2021 and July 2022 at Krishna Hospital in Karad. Clinical evaluations that were in-depth were carried out, including histories, skin checks, and medical histories. The effect of pruritus on quality of life was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. Results: 10.10% of the 1980 senior citizens who visited the outpatient department had pruritus. 55% of individuals reported having chronic pruritus. The quality of life was considerably damaged by dermatological problems (IFSI category 1), with 57% reporting a moderate impact. In 13 individuals, chronic pruritus was associated with significant impairment, highlighting the serious consequences. Conclusion: The study shows that elderly people had a 10.10% prevalence of pruritic dermatoses. The most prevalent conditions, which adversely impacted patients in IFSI category 1, were fungus infections and scabies. Chronic itch significantly reduced quality of life. The importance of treating pruritic illnesses for improving elderly people's quality of life highlights the demand for specialized geriatric clinics and gerontodermatology as a specialty

Evaluation of drug treatment awareness among caregivers and patients of chronic kidney disease: unexplored determinant in patient care

Background: Chronic kidney disease (CKD) patients are prescribed multiple drugs to slow disease progression and prevent complications mandating adherence to therapy. Lack of awareness about drug treatment is one of the contributors to nonadherence. Hence the study was conducted to explore the awareness of patients and caregivers towards CKD treatment. Methods: The study was a cross sectional questionnaire-based study conducted among 300 CKD patients (150 dialysis/150 non-dialysis) and 100 caregivers (50 of dialysis / 50 of non-dialysis patients) attending nephrology OPD at a tertiary care hospital.Patient /caregiver awareness about drug treatment was assessed usinga prevalidated drug awareness questionnaire (8 items). The items were scored as correct response=2, no response=0 and incomplete response = -1, accounting the total awareness score as +20 to - 6 Results: The mean awareness score of patients / caregivers was 8.16±3.41 and 8.3±1.6 respectively. Majority (>70%) patients/ caregivers gave accurate responses for the items -specifying number of medicines, medication frequency and regular intake of drugs but awareness regarding action plan for skipped (27% patients, 11% caregivers) or missed doses (22% patients, 15% caregivers) and adverse effects (17% patients, 5% caregivers) was poor. Patients/ caregivers belonging to dialysis group had statistically better awareness then non-dialysis group. Conclusions: Patient /caregiver awareness regarding drug treatment is less than 50% with strikingly low awareness about dose regimen, adverse effects, action plan for missed doses and co morbidities. Patient education programs to reinforce and retain this knowledge need to be implemented in CKD patients