A Phase II randomized controlled trial of oral prednisolone in early diffuse cutaneous systemic sclerosis (PRedSS).

Objectives: Although the painful and disabling features of early diffuse cutaneous SSc (dcSSc) have an inflammatory basis and could respond to corticosteroids, corticosteroids are a risk factor for scleroderma renal crisis. Whether or not they should be prescribed is therefore highly contentious. Our aim was to examine safety and efficacy of moderate-dose prednisolone in early dcSSc.

Ruling the roost: Avian species reclaim urban habitat during India's COVID-19 lockdown.

As we retreated to our dwellings in the "anthropause" of spring 2020, were the wildlife sightings in previously crowded spaces a reclamation of habitat, or a mere increase in detection? We leverage an increase in balcony birdwatching, a million eBird entries, and difference-in-difference techniques to test if urban avian species richness rose during India's COVID-19 lockdown. Controlling for effort, birdwatchers in the 20 most populous cities observed a 16% increase in the number of species during lockdown. While human activity stopped overnight, and noise and visual pollution decreased soon after, increased species diversity was observed 1-2 weeks later; evidence that gradual population recovery, not better detection, underlay our results.

Improving global access to medical ethics education: a free self-paced online course on the Peoples-uni website.

In an attempt to increase global access to education about medical ethics, a free fully online course was developed on the Peoples-uni Open Online Courses site. Students came from 60 countries and were more likely to be medical practitioners, have come from the global North, and to have heard about the course through the web than other students enrolled in the Peoples-uni Open Online Courses site. Students scored high marks on the five quizzes.

A Clinical, Radiological, and Histopathological Correlation of Neck Nodes in Patients Undergoing Neck Dissection.

Objectives: Management of neck metastases in terms of diagnosis and treatment has always been a controversial issue in patients of head and neck malignancy. The main area of debate in case of diagnosis lies with the fact that whether we should rely on ultrasound, as a diagnostic modality for diagnosing micrometastases in the neck in head and neck malignancy patients? The second controversial issue is the management of N0 neck, whether to be radical or conservative?

Materials And Methods: This study was conducted on 70 diagnosed patients of head and neck carcinoma who were planned for resection of the primary. An appropriate neck dissection was performed in all the patients, and their clinical, ultrasonography, and postoperative histopathological neck findings were correlated.

Patterns and predictors of skin score change in early diffuse systemic sclerosis from the European Scleroderma Observational Study.

Objectives: Our aim was to use the opportunity provided by the European Scleroderma Observational Study to (1) identify and describe those patients with early diffuse cutaneous systemic sclerosis (dcSSc) with progressive skin thickness, and (2) derive prediction models for progression over 12 months, to inform future randomised controlled trials (RCTs).

Methods: The modified Rodnan skin score (mRSS) was recorded every 3 months in 326 patients. 'Progressors' were defined as those experiencing a 5-unit and 25% increase in mRSS score over 12 months (±3 months).

Disability, fatigue, pain and their associates in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study.

Objectives: Our aim was to describe the burden of early dcSSc in terms of disability, fatigue and pain in the European Scleroderma Observational Study cohort, and to explore associated clinical features.

Methods: Patients completed questionnaires at study entry, 12 and 24 months, including the HAQ disability index (HAQ-DI), the Cochin Hand Function Scale (CHFS), the Functional Assessment of Chronic Illness Therapy-fatigue and the Short Form 36 (SF36). Associates examined included the modified Rodnan skin score (mRSS), current digital ulcers and internal organ involvement.

Open Online Courses in Public Health: experience from Peoples-uni.

Open Online Courses (OOCs) are offered by Peoples-uni at http://ooc.peoples-uni.org to complement the courses run on a separate site for academic credit at http://courses.

Treatment outcome in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study (ESOS).

Objectives: The rarity of early diffuse cutaneous systemic sclerosis (dcSSc) makes randomised controlled trials very difficult. We aimed to use an observational approach to compare effectiveness of currently used treatment approaches.

Methods: This was a prospective, observational cohort study of early dcSSc (within three years of onset of skin thickening).

Using mobile technology to optimize disease surveillance and healthcare delivery at mass gatherings: a case study from India's Kumbh Mela.

Background: Planning for mass gatherings often includes temporary healthcare systems to address the needs of attendees. However, paper-based record keeping has traditionally precluded the timely application of collected clinical data for epidemic surveillance or optimization of healthcare delivery. We evaluated the feasibility of harnessing ubiquitous mobile technologies for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people.

Evaluation of Apparent Diffusion Coefficient Values in Spinal Tuberculosis by MRI.

Introduction: Spinal tuberculosis presents a radiological challenge in many cases when it presents with atypical pattern of involvement and has to be distinguished from various differentials, which include metastases. In such cases Diffusion Weighted Imaging (DWI) with Apparent Diffusion Co-efficient (ADC) value may play a role in reaching towards a conclusion, thereby preventing unnecessary biopsy in such patients.

Aim: Measurement of mean ADC values in tubercular vertebrae and associated collection.

Contemporaneous Evaluation of Intraoperative Ulnar and Median Nerve Somatosensory Evoked Potentials for Patient Positioning: A Review of Four Cases.

Somatosensory evoked potentials (SSEPs) are a valuable tool for assessing changes in peripheral nerve pathways caused by patient positioning during spinal surgeries. These changes, when left undiagnosed, may lead to postoperative neurological sequelae. Why an upper extremity SSEP attenuates due to positioning is not necessarily clear and can be multifactorial, affecting the peripheral nerves or elements of the brachial plexus.

Treatment outcome with guiding flange prosthesis in hemimandibulectomy patients: Case series of three patients.

There are various indications that may necessitate partial or complete resection of the mandible, from trauma to congenital deformities. However, the most prevalent indication that requires surgical resection of the mandible along with the involved adjacent oral structures is the presence of a locally aggressive neoplastic growth. The resultant continuity defect leads to an alteration in the range and direction of mandibular movement, impedes clear articulation of syllables and cosmetic disfigurement.

Comparison of the Effect of Addition of Cyanoacrylate, Epoxy Resin, and Gum Arabic on Surface Hardness of Die Stone.

Purpose: To observe the effects of incorporating cyanoacrylate, epoxy resins, and gum arabic on the abrasion resistance of type IV gypsum die materials.

Materials And Methods: Forty specimens were prepared and divided into four groups (10 specimens in each group), namely group A (control), group B (die stone mixed with cyanoacrylate), group C (die stone mixed with epoxy resin), group D (die stone mixed with gum arabic). All the specimens were subjected to abrasion testing, wear volume analysis, Fourier transform infrared spectroscopy (FT-IR), and scanning electron microscope (SEM) analysis.

Systemic lupus erythematosus: lupus nephritis.

Introduction: Systemic lupus erythematosus (SLE) occurs predominantly in young women, but also in children. The prevalence of SLE varies worldwide, ranging from about 1 in 3500 women (regardless of race) in the UK, to 1 in 1000 women in China, to 1 in 250 African-American women in the US.

Methods And Outcomes: We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of immunosuppressants in people with proliferative lupus nephritis? What are the effects of different immunosuppressants compared with each other in people with proliferative lupus nephritis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).

Motor evoked potentials for femoral nerve protection in transpsoas lateral access surgery of the spine.

Detecting potential intraoperative injuries to the femoral nerve should be the main goal of neuromonitoring of lateral lumber interbody fusion (LLIF) procedures. We propose a theory and technique to utilize motor evoked potentials (MEPs) to protect the femoral nerve (a peripheral nerve), which is at risk in LLIF procedures. MEPs have been advocated and widely used for monitoring spinal cord function during surgical correction of spinal deformity and surgery of the cervical and thoracic spine, but have had limited acceptance for use in lumbar procedures.

Technical nuances of the minimally invasive extreme lateral approach to treat thoracolumbar burst fractures.

Purpose: Contemporary minimally invasive techniques have evolved to enable direct access to the anterior spinal column via the extreme lateral approach. We have employed this access approach to treat selected burst fractures. We report our technique.

Promoting patient safety in India: situational analysis and the way forward.

Unsafe healthcare is a well-recognized issue internationally and is attracting attention in India as well. Drawing upon the various efforts that have been made to address this issue in India and abroad, we explore how we can accelerate developments and build a culture of patient safety in the Indian health sector. Using five international case studies, we describe experiences of promoting patient safety in various ways to inform future developments in India.

Evaluation of bowel wall thickening by computed tomography to differentiate benign from malignant lesions.

Purpose: Computed tomography(CT) is an excellent non-invasive modality to evaluate bowel wall thickening.The aim of our study was to evaluate CT appearance of bowel wall thickening due to various benign and malignant conditions taking into consideration pattern of attenuation, bowel wall thickness, extent of lesion, symmetry of lesion and other associated CT findings.

Materials And Methods: The prospective study was carried out on 50 patients who underwent computed tomographic evaluation of abdomen for suspicion of bowel pathology based on ultrasonography, barium studies and/or clinical grounds.