Cutaneous leishmaniasis is endemic in the Baluchistan province of Pakistan and poses a great risk to non-immune visitors to the area. The wide spectrum of clinical variants of this common disease is at times a diagnostic challenge. A total of 1709 patients with cutaneous leishmaniasis were recorded over a 1-year period. In 37 (2%) patients the lesions were very unusual, and therefore worth reporting. These included acute paronychial, chancriform, annular, palmoplantar, zosteriform and erysipeloid forms. The zosteriform and erysipeloid forms have rarely been reported previously, but to the best of our knowledge, acute paronychial, chancriform, annular and palmoplantar lesions are being reported for the first time. The morphologically unusual lesions may be attributed to an altered host response or involvement of an atypical strain of parasite in these lesions.
Background. The use of topical steroids on the skin of the face should be carefully evaluated by the dermatologist; however, its misuse still occurs producing dermatological problem resembling rosacea. Objectives. To report the different clinical manifestations of steroid dermatitis resembling rosacea and to discover causes behind abusing topical steroids on the face. Methods. In this prospective observational study, 75 patients with steroid dermatitis resembling rosacea who had history of topical steroid use on their faces for at least 1–3 months were evaluated at the Department of Dermatology, Baghdad Teaching Hospital, between August 2010 and December 2012. Results. The majority of patients were young women who used a combinations of potent and very potent topical steroid for average period of 0.25–10 years. Facial redness and hotness, telangiectasia, and rebound phenomenon with papulopustular eruption were the main clinical presentations. The most common causes of using topical steroid on the face were pigmentary problems and acne through recommendations from nonmedical personnel. Conclusion. Topical steroid should not be used on the face unless it is under strict dermatological supervision.
In this paper, the design of projection-based Adaptive Sliding Mode Controller (ASMC) is presented for position control of Permanent Magnet Linear Synchronous Motor (PMLSM) with unknown mover mass. The PMLSM model was first established and a vector control based on field orientation is used to decouple the cross-coupling in motor model. ASMC has been adopted to deal with the unknown mover mass and to give robust operation against external load thrust. Based on the Lyapunov method, the stability of adaptive sliding mode-controlled PMLSM has been proven and the adaptive law has been developed. Additionally, a continuous projection operator is applied to adaptive law such as to enforce the estimated mover mass within a pre-specified bound. The performance of ASMC based on continuous projection operator is investigated via simulation results within MATLAB environment. Also, a comparison study in ASMC performance is made due to the inclusion continuous and discontinuous projection operators. The simulated results showed that ASMC based on continuous projection gives better performance than that based on discontinuous one.
We aim to explore the practice of who makes the PCNL tract in the U.K. and Northern Ireland as well as presenting our data for two different approaches to PCNL tracts in Northern Ireland. A national questionnaire survey was carried out across the National Health Services hospitals in U.K. In addition, a retrospective analysis of 134 PCNL cases was carried out. Group I included 103 (77%) cases with urologist-made tracts, while group II included 31 (23%) cases with radiologists-made tracts. The survey suggested that 45% (42) of the hospitals adopted a radiologist-made tract, 44% (41) use urologist-made tract, while the remaining 11% (11) use both. Most of the radiologists' performed tracts in our series were for complex cases. Failed access occurred in 6 (5.8%) in group I and none in Group II. The overall stone-free rate was 92 and 50% for group I and II, respectively. There is a better stone clearance rate in Group I (p = 0.0016). This however is likely to be attributed to the complexity of the cases in group II. However, urologist made percutaneous tract is safe and efficacious but a team approach with radiology is needed for more complex cases.
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