bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Psychological Distress and Quality of Life among People Living with HIV/Acquired Immunodeficiency Syndrome at Tertiary Health-care Center in Coastal Karnataka, Institutional-Based Cross-sectional Study
Authors: Hariprasada A R , Shruthi H N , Phatak Akshay 
Published: May 2023

Background:
With increase in cases of HIV, in addition to the direct effect of HIV, the social stigma causes psychological distress in people living with HIV/AIDS (PLWHA). With improvements in antiretroviral therapy (ART), HIV has become a chronic disease, which increases the incidence of other psychiatric comorbidities.

Objectives:
To assess the predisposing factors causing psychological distress and to assess the quality of life (QOL) in people living with HIV.

Materials and Methods:
A total of 380 patients who visited ART center in a Coastal Karnataka tertiary health-care center were included in this study. They were given questionnaires, which included World Health Organization-QOL-Bref, HAM-Depression, MOS-social support survey, perceived stress scale (PSS), and substance abuse.

Result:
Out of 380, the prevalence of psychological distress in patients with HIV/acquired immunodeficiency syndrome (AIDS) was 30.5%. The mean of the total QOL scores was 78. Prevalence of poor QOL in patients with HIV/AIDS was 1.58%. About 5.8% were mild or moderately depressed. Only 0.5% were found to be with severe depression. There was no statistically significant substance abuse among PLWHA.

Conclusion:
PLWHA who were in the age group of 30–60 years, illiterate, those with history of alcohol abuse, and having lower QOL scores and high scores in PSS had increased odds of psychological distress. Thus, concerned medical fraternity should collaborate on integrating HIV/AIDS treatment services with mental health services. Future interventions are needed to improve the level of social support and psychological support to the people living with chronic illnesses like HIV/AIDS.
Profile of Dermatology Consultations for Inpatients: The Scope for Telemedicine During the COVID-19 Pandemic and Beyond
Authors: Pangti Rashi , Gupta Somesh 
Published: May 2023

Background:
Attending dermatology consultations for inpatients is an integral part of the role of dermatologists inpatient care.

Materials and Methods:
A retrospective study was conducted at a large tertiary care hospital when the country, particularly the city, was severely affected by the COVID-19 pandemic. The aim was to study the profile of dermatology referrals for inpatients at the time of the COVID-19 pandemic and assessing the need for telemedicine in these inpatients.

Results:
A total of 341 dermatology consultations for 288 patients were received. Most of the consultations were from internal medicine (15.3%) and obstetrics and gynecology (8.7%). Around 65% of consultations were for new-onset (≤30 days) skin conditions while around 35% were for chronic (>30 days) conditions. The most commonly seen conditions were superficial fungal infections (14.9%) followed by eczematous disorders (13.2%). On grading the level of urgency of the referrals, 34.4% required an immediate consultation, 41% required it within a week, 12.8% within 2–4 weeks, 8% within 1–3 months, and 3.8% after the pandemic settles. The need for urgent consultation was more in acute cases than in chronic cases (P = 0.00). 62.5% of the consultations could have been done by telemedicine.

Conclusion:
As a majority of the consultations were for common and straightforward skin conditions and could mostly be done on telemedicine, this study underlines the need for strengthening the telemedicine services for inpatients referrals during this COVID-19 pandemic and even beyond.
An Image-Based Scoring System as an Alternative to Face-to-Face Examination for Acne Vulgaris to Deliver Follow-Up Care: A Comparative Study
Authors: Shetty Samiksha Shankar , Joshi Ruta Ujjval , Kombettu Ashwini Padubidri , Gurumurthy Chethana Santhebachalli , Kanthraj Garehatty Rudrappa 
Published: May 2023

Background:
AV is a chronic disease with flares and remissions requiring regular follow-ups. Image-based lesion counting (LC) is useful when in-person consultations are not possible, like the COVID-19 pandemic.

Objective:
The aim of this study is to validate the proposed scoring system for teledermatology consultation and compare it with face to face.

Materials and Methods:
The face was divided into three zones which was further divided by drawing the imaginary lines from fixed points. AV (Grade 1 and 2) lesions were counted by co-investigator in person at baseline, first, and second follow-up visits. The images of the same were evaluated and scored by the principal investigator. Acne scores obtained were compared and statistically analyzed.

Results:
Two hundred cases were enrolled. Mean acne scores for in-person were 945.37, 647.57, and 550.81 and for teledermatology 1044.99, 718.79, and 654.36 for baseline, 1st, and 2nd follow-up, respectively. The mean decrease from baseline, 1st and 2nd follow-up, independent sample t-test and correlation analysis was significant in both groups (P = 0.001).

Limitations:
AV grade 3 and 4 are not included.

Conclusion:
During the 1st follow-up, a decrease in acne scores was observed, along with consistency in the scores between the evaluators. Image-based lesion counting is a promising approach. The proposed scoring system can be used for both modes of consultation-face-to-face and teledermatology.
Influence of Internet Health Information on Patient Compliance in Dermatology
Authors: Nair Pragya Ashok , Tandel Jinal , Shah Pratiksha , Rutoo  , Parmar Dharmesh , Patel Brijesh 
Published: May 2023

Background:
Many patients use the Internet to self-diagnose and find treatment options, thus avoiding the need to visit a doctor in person. Objectives: This study was done with the primary objective to determine how Internet health information impacts the patient–physician relationship, compliance, and its effect on patient treatment.

Materials and Methods:
It was a cross-sectional study, done at the Department of Dermatology, Venereology, and Leprosy, over a period of 6 months from January to June 2019. All patients with any dermatological diseases above the age of 12 years, who conducted an Internet search for the disease were included in the study. Participants were provided with an information sheet, outlining the details of the study. They were asked to fill out a questionnaire in their vernacular language. The questionnaire had questions about the patient's perspective toward his health as well as the doctor's advice before and after Internet usage. Descriptive analysis was used for statistical analysis.

Results:
A total of 110 patients were included in the study with 56.36% of males and 34.54% between 21 and 40 years of age group. Wikipedia was used by 51.81% of participants, followed by 40% who used Google. After Internet use, participants strongly agree that doctors possess more information than the information on Internet in 39.09%, while 61.81% of participants believe that there is good communication between doctor and patient. After Internet use, a maximum of 48.18% agree and followed the doctor's recommended medication.

Conclusion:
Online medical information has a positive effect on patient disease status and on patients' relationships with their physicians. Doctors should be more aware of the health information available online and should be able to guide patients to accurate and reliable websites.
Psoriasis and Its Association with Metabolic Syndrome: A Case–Control Study at a Tertiary Care Center in a Semi-Urban Region of South India
Authors: Samagani Akshay , Yadalla Harikishan Kumar , Belliappa P Raju 
Published: May 2023

Background:
Metabolic syndrome (MS) has been associated with skin diseases such as psoriasis. They share a common inflammatory pathway and therefore have an impact on each other.

Objectives:
To estimate the prevalence of MS and its individual components in psoriasis patients to that of the controls and to compare the characteristics in psoriasis patients with and without the MS.

Materials and Methods:
One hundred patients with a clinical diagnosis of chronic plaque psoriasis were evaluated for the prevalence of MS and compared with the age- and sex-matched controls.

Results:
The study population belongs to the semi-urban region with a low socioeconomic status. The psoriatic cases showed male preponderance, and the majority of the subjects belonged to 31–40 years of age group. The mean psoriasis area severity index score among cases was 26.19 ± 10.8, and 92% of cases were with severe disease affecting the quality of life. MS was found to be statistically significant in cases. The cases with MS had a higher prevalence of central obesity, hypertriglyceridemia, elevated fasting blood glucose levels, and hypertension. The presence of MS in psoriasis patients was statistically independent of the severity.

Conclusions:
Psoriasis patients should be periodically evaluated for metabolic syndrome to prevent the associated mortalities and for their effective management.
Sweet's Syndrome
Authors: Bangaru H , Raghavendra K R , Shankar Sathish 
Published: May 2023

Background:
Sweet's syndrome (SS) is a classical representative of neutrophilic dermatosis characterized by the abrupt onset of fever, erythematous tender plaques and nodules on exposed parts, and histopathological reaction in response to different external and internal stimuli.

Objectives:
The aim of this study was to assess the clinical, epidemiological, histological features and therapeutic outcomes of SS.

Materials and Methods:
A retrospective study of all patients diagnosed with SS over a 4-year period (2016–2020) was conducted.

Results:
Over a period of 4 years, a total number of cases of SS were 16. Female patients were predominant around 13 (81.25%), and male patients were 3 (18.75%). The most common site affected was face in 87.5% (14), followed by upper limb in 50% (8) and lower limb in 25% (4). Among the systemic manifestations, fever was there in all cases. The associated causes were infectious conditions in 6 (37.5%) cases, among which five cases were upper respiratory tract infection, hematological malignancy in three cases, one case with solid tumors, one case was associated with acquired cutis laxa (Marshall' s syndrome), one was drug induced (diclofenac sodium), one case was pregnancy associated, and other three cases were idiopathic.

Conclusion:
SS can be diagnosed based on clinical and laboratory findings. In all atypical and recurrent SS cases, thorough evaluation for malignancy is essential. Dapsone can be considered a concomitant therapy along with steroids and also a steroid-sparing agent.
Clinical Audit of Methotrexate Therapy in Psoriasis at a Tertiary Care Teaching Hospital in Western India
Authors: Bhut Anuj , Tandel Jinal Jitendrabhai , Nair Pragya Ashok 
Published: May 2023

Background:
Methotrexate (MTX) is one of the most useful drugs in the treatment of psoriasis. It is like a double-edged sword; beneficial when given under strict medical supervision and harmful when standard guidelines are not followed.

Objective:
The present study was a process audit done with the aim to improve quality of care in patients of psoriasis with MTX therapy and to minimize the errors.

Materials and Methods:
The study was a clinical audit assessing patients of psoriasis who were given MTX therapy. Patients were selected on a random basis from hospital data records from January 2018 to August 2019. To assess the patients on MTX therapy, a pro forma was filled which included demographic details, psoriasis area severity index (PASI) scores, baseline investigations carried before starting MTX and at regular intervals afterward, dosage of MTX, its tapering schedule, and cumulative dose. The data were analyzed using descriptive statistics. Ratios, proportions, and percentages were used to describe the data.

Results:
A total of 30 psoriasis patients on MTX therapy were selected randomly, of which 25 (83.3%) participants had record of proper history and clinical assessment. PASI >10 was observed in 24 (80%) and was calculated by the 1st-year residents in 15 (50%) participants. Before starting MTX therapy, baseline laboratory investigations (CBC, LFT, and RFT) were done in all 30 (100%) participants. Initial dose of MTX (2.5–5 mg/week) was given in 6 (20%) participants. Supplementary medications such as folic acid in proper dosage were given to 28 (93.3%) participants. Twenty-nine (96.6%) participants were investigated for CBC and LFT every 2 weekly in the first 3 months, while only 16 (53.3%) participants were investigated for RFT. After reduction of 75% of PASI, MTX was tapered in 21 (70%) participants.

Conclusion:
The study reveals some pitfalls in following the guidelines in patients on MTX. Educational interventions in the form of training among dermatologist and resident doctors should be carried out.
Unmasking Dermoscopic Evaluation of Melasma
Authors: Sreenath Sahana , Phulari Yoganand J , Hiremath Ravishekar N , Ghodke Sandhya , Raj Rishi 
Published: May 2023

Background:
There exists a wide range of variations in skin tone around the world, with Asian and Indian subjects showing a greater susceptibility toward pigmentation disorder.

Objective:
This study was carried out with the objective to assess the clinical and dermoscopic findings among different types of melasma in a single center of Central India.

Materials and Methods:
A cross-sectional study was carried out among patients with clinical features of melasma attending the outpatient department at multispecialty hospital with a sample size of 100. A prestructured pro forma was used to collect the baseline data. Clinical and dermatological examination was done after taking a detailed history. Clinical pattern of melasma such as centrofacial, malar, and mandibular was noted. The areas of melasma were examined using a contact polarized Dermlite DL4 3rd Gen Dermoscope attached to an iPhone.

Results:
The mean age of study participants was 38.15 years with a standard deviation of 6.93. Seventeen percentage were of male gender. Thirty-one percentage of the female patients had a history of oral contraceptive pill (OCP) usage, and 22% of the female patients had a history of menstrual abnormalities. Fitzpatrick skin Type IV was the most commonly affected skin type. Centrofacial type of melasma is the most common clinical type and reticuloglobular pattern is the commonly seen pattern on dermoscopy. The color of dermoscopy was predominantly brown in malar (52.2%) and mandibular (57.1%) and mixed in Centrofacial (45.7%), which was followed by 26.1%–28.6% mixed color in malar and andibular types and 41.4% brown color in centrofacial type. The difference in the color of dermoscopy (P = 0.48), presence of telangiectasia on dermoscopy (P = 0.23), pattern of dermoscopy (P = 0.15), and mean Melasma Severity Index scores with different clinical types was not statistically significant. Similarly, the association between different clinical types of melasma with duration of sun exposure (P = 0.33) and topical photo protection (P = 0.34) was also not statistically significant.

Conclusion:
Our study findings concluded that melasma is common in women in the age group of 27–56 years range. Exposure to sunlight and the hormonal changes (due to OCP usage) were those among the various factors influencing the development of melasma. Centrofacial melasma was the most common pattern seen in our study group. Epidermal melasma features on dermoscopy were reticuloglobular patterns with a brownish hue, while the features of dermal melasma were irregular patterns with a bluish hue and mixed melasma had irregular patchy brown pigmentation. Perifollicular globules and telangiectasia were also seen.
Teledermatology in the Era of COVID-19, Perspective from a Developing Country
Authors: Choudhary Paras , Mehta Rajesh Datt , Sharma Divya , Kacchawa Dilip , Ghiya Bhikam Chand , Singh Kamaldeep 
Published: May 2023

Background:
With the advent of the COVID-19 pandemic, the medical fraternity across the world, including India, is facing unprecedented challenges, and to cope with this, creative solutions are required. During this COVID-19 crisis, telemedicine has emerged as a weapon to reduce disease transmission while continuing with non-COVID care.

Objectives:
The purpose of this study is to highlight the changes and challenges in dermatology practice, to explore the usefulness of tele-dermatology during the pandemic, and to understand the dermatologist's perspective.

Materials and Methods:
An online cross-sectional survey was done among Indian dermatologists to evaluate the changes in their practice, impact of telemedicine, and their experience, during COVID-19.

Results:
A total of 177 responses from qualified Indian dermatologists were analyzed. Teleconsultation was done by 20.5% of consultants before lockdown which increased up to 82% after lockdown. Most commonly preferred device was mobile phone (83%), and the most common format was chat applications (WhatsApp/Messenger) (55.7%). Discontinued consultation was due to technical issues, patient's misbehavior, and poor-quality clinical photographs. Only 13.5% of practitioners were satisfied with teledermatology.

Conclusion:
With the onset of the COVID-19, the shift of clinical care to telemedicine practice has hastened. However, continuous investment in systems and technology as well as refinement of regulations for telemedicine is needed to sustain its widespread adoption.
A Study to Compare Efficacy of Non Cultured Autologus Melanocyte Transfer Versus Punch Grafting Technique for Stable Vitiligo Patients
Authors: Badad Ambresh S , Bhatia Amrit Singh , Hogade Ashok , Badad Shruti Ambresh , Mitra Debdeep 
Published: May 2023

Background:
Vitiligo is a common acquired idiopathic hypomelanosis, which is characterized by loss of melanocytes in the epidermis associated with autoimmune and hereditary causes. The various surgical modalities available are tissue grafting techniques such as punch grafts, suction blister grafts, and split-thickness grafts as well as cellular grafts such as autologous noncultured epidermal cell suspensions and cultured melanocyte suspensions.

Objective:
We aimed to study and compare the efficacy of noncultured melanocyte transfer technique and punch grafting technique in the management of stable vitiligo.

Materials and Methods:
Fifty patients of both sexes between the ages of 15 and 50 years having stable vitiligo for minimum 1 year were included in the study and divided in two groups. Group 1 was treated with autologous noncultured melanocyte-rich cell suspension and Group 2 was treated by punch grafting technique. Response to treatment was evaluated on the basis of degree of repigmentation (both subjective and objective assessment), which was carried out at monthly intervals for a period of 6 months along with clinical photographs.

Results:
The results were statistically analyzed using “Chi-square test” and “statistical significance” (p-value) methods. An excellent (>75% repigmentation) result was obtained in 77.27% of patients by NCMT (noncultured melanocyte transfer) technique whereas good (60%–75% repigmentation) result was obtained in 78.57% of patients by punch grafting technique after 6 months.

Conclusion:
Noncultured melanocyte transfer is a simple and effective technique to produce uniform pigmentation in short duration and is suitable to cover large body surface areas with a cosmetically better outcome and is better than punch grafting.
Use of Punch in the Treatment of Plantar Warts: A Study of 250 Cases
Authors: Patil Chetan C , Arora Sandeep , Bhatnagar Anuj , Sandhu Sunmeet , Mitra Debdeep , Suhag Devinder 
Published: May 2023

Background:
Plantar wart is a frustrating infection for both patients and clinicians that can significantly cause embarrassment, negative gauging by others, and vexation due to persistence and/or recurrence of warts, affecting a patient’s quality of life.

Materials and Methods:
A prospective observational study from April 2020 to March 2021 was conducted in an Indian tertiary care center on 250 patients aged between 15 and 40 years. Punch excision of solitary to multiple plantar warts was carried out with a 5-mm punch.

Results:
A total of 342 plantar warts were punch excised in 250 cases with 162 males and 88 females. 214 (85%) patients had a complete cure over 10 days of treatment. Eleven (5%) patients developed local secondary bacterial infections managed with oral and topical antibiotics. Complete healing was achieved in all over 2–4 weeks without any scarring. There was no recurrence among 225 cases over the follow-up period of 3 months, while 25 (10%) were lost to follow-up.

Conclusion:
Use of punch excision for plantar warts is a simple, affordable, and quick outpatient department procedure, requiring no suturing even with an excision size of 5 mm. It needs minimum postprocedural care and heals without scarring. This methodology of management of plantar wart highlights it as a preferable procedure in primary care centers or resource-poor settings that requires less expertise.
Usage of Learning Management System to Implement Online Teaching Methodology in Undergraduate Medical Students
Authors: Kumar Shivakumar Ajay , Niveditha G , Seema P , Bengalorkar Girish M 
Published: May 2023

Background:
The COVID-19 pandemic caused a temporary roadblock in learning among medical colleges in India as traditional classroom teaching was suspended temporarily. Students and faculty members had to adapt in a short period of time to transition from traditional practices of live classroom lectures to a virtual mode by using learning management system (LMS).

Objectives:
The present study aims to describe the perceptions of students and faculty members about their experience using the LMS to attend online classes. It also aims to assess the possibility of using the same for postgraduate medical education, particularly in specialties requiring visual aid for learning such as radiology, dermatology, and pathology.

Materials and Methods:
A cross-sectional survey-based observational study was conducted on 123 MBBS students and 36 faculty members after 6 months of the online teaching using LMS. Responses were collected on their experience with the LMS and assessed using a three-point Likert scale.

Results:
About 62.6% of the students who participated in the study felt that it was easy to log into the LMS platform. About 58.6% of the students felt that the audio and video quality of the classes on the platform was good. The majority of students (93.5%) felt that the user interface of the LMS was easy to use. Poor Internet connectivity issues accounted for the main cause of interruptions during online classes for 48% of the students. About 88.9% of the faculty members felt that it was easy to log into the LMS to conduct online classes. Around 86.1% of them felt that the audio and video quality was good on the platform. Browsing through the platform during online lectures was easy according to 75% of them.

Conclusion:
The majority of students and faculty members felt that the user interface and quality of the audiovisual feed of the LMS were very good. The LMS platform made the scheduling of classes, marking attendance, and usage of additional annotation tools convenient. Usage of LMS can supplement the traditional face-to-face lecture classes to enhance learning in medical undergraduate and postgraduate education.