Psoriasis is an inflammatory skin condition that affects approximately 2 % of people worldwide. Topical treatments, systemic treatments, biologic agents, and phototherapy are all treatment options for psoriasis. Ultraviolet (UV) B phototherapy is most appropriate for patients with >10 % affected body surface area who have not responded to topical treatments. This review outlines the use, dosage, safety, and efficacy of narrowband UVB (NB-UVB) and targeted phototherapy. NB-UVB and excimer laser are effective treatment options for psoriasis; they are administered two to three times weekly until clearance followed by maintenance treatment before discontinuation. Long-term data on NB-UVB indicate that it has a good safety profile. NB-UVB is commonly used with adjunctive topical treatments such as emollients, calcipotriene, cortico-steroids, retinoids, and tar. NB-UVB can be used in selected patients with traditional systemic agents such as methotrexate, mycophenolate mofetil, and cyclosporine, although the duration of the combined treatment should be kept to a minimum and patients need to be closely monitored. Acitretin can be safely used with phototherapy, but robust data on the combination use of biologic agents or phosphodiesterase inhibitors with phototherapy are lacking.

The prevalence of infection with SG and NSG was almost identical. The cost to use SG was 3.5 times as great as for NSG. The use of NSG for MMS and reconstruction is safe and cost effective.

Purpose – The purpose of this paper is to develop a statistically reliable and valid model of lean manufacturing (LM) implementation drivers for the Indian ceramic industry through an empirical study. Design/methodology/approach – The research methodology is based on the empirical study of the Indian ceramic industry through a questionnaire specifically developed for the study through literature review and discussions held with practitioners. Exploratory factor analysis, confirmatory factor analysis and structural equation modeling techniques have been used to propose and validate the model. SPSS and AMOS statistical tools have been used for the statistical analysis of the data. Findings – The study identified 12 drivers for the LM implementation in Indian ceramic industry. Further, these 12 drivers have been categorized into internal, policy and external drivers (ED). Structural model affirms that ED are positively related to policy drivers (PD) and PD are positively related to internal drivers. Research limitations/implications – This study provides casual relationships among the various drivers, which can be leveraged by the managers for the easy and effective implementation of LM in their organizations. It is expected that the model will help the decision makers during LM implementation in taking informed decisions in prioritizing and sequencing the implementation strategy. The results of the research may apply to other industries as well, but this needs to be validated by collecting data and analysing its results. Practical implications – The results provide insights into motivating factors that should be focused on while taking lean decisions. The correlation results among drivers will enable the policy makers in government and industry to strategically leverage the resources for the successful implementation of LM in the industry. Originality/value – This research empirically develops a model of drivers for LM implementation. The novelty of the study is the causal relationship among the drivers which can be used for decision making to implement lean easily and effectively. Moreover, the categorization of the drivers into internal, external and policy categories and driving/driven relationship among these categories provides the top management an incisive insight into broad improvement areas.

Scalp reconstructions using a single layer of pulley sutures result in time and cost reduction and similar scar appearance compared to bilayered closures.

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