Studies show that the number of dyslexic students is increasing, as it does the need of the appropriate learning techniques and methodologies increases as well. For the students with learning disability, generally and the dyslexic stu-dents specifically there aren’t enough technologies that helps them in the learning process. Not only the students with learning disability face this prob-lem but parents and teachers are involved as well. The challenge that students with dyslexia face is that they find difficulties in processing and re-membering information, so they need extra effort and time to learn especial-ly when learning the basics like alphabets. In order to help students’ teachers and parents in the learning process, we developed methodology that mixes education with entertainment and produces an effective way of teaching. The proposed application teaches the students the alphabet by tracing the Ar-abic letters in the three forms initial, middle and final form, and pronounce the letters as well. It uses a friendly virtual reality environment. Virtual reality VR is one of the latest techniques in both education and entertainment which proved its effectiveness. It motivates the students to learn, interact and make the learning processes more productive. The aim of this research is to help the dyslexic students, teachers and parents to learn and enhance the learning process. The evaluation of the system revealed that the proposed application successfully supported students learning in general and students with dyslexia specifically.
Oral isotretinoin is a highly effective drug for severe acne but with ongoing serious safety concerns, and we are cautiously reminded by the Medicines and Healthcare products Regulatory Authority (MHRA) to prescribe this drug within licence. We review the National Institute for Health and Care Excellence (NICE) recommendations for considering referral of acne to specialist care and propose some improvements. This may help manage patient expectations of treatment, ensure only appropriate cases are seen in secondary care, and help prescribers remain within the isotretinoin product licence.
We propose hidradenitis suppurativa (HS) is added to the list of weight-related comorbidities in the new National Institute for Health and Care Excellence guideline on obesity. Effective obesity management in patients with HS could help reduce disease severity, pain and cardiovascular risk, and improve quality of life and the efficacy of biologic therapy. In addition, it could reduce the costs of HS-associated care (GP visits, hospital outpatient attendances, biologic drugs, inpatient admissions, elective and emergency surgery).
The Elective Recovery Plan, published by NHS England (2022), has advocated that teledermatology (TD) should be available in every service receiving urgent suspected skin cancer referrals. However, evidence supporting the effectiveness of TD for the accurate diagnosis and triage of skin lesions remains limited. A 2018 Cochrane review found variable agreement between TD and face-to-face (FTF) assessment of lesions considered to be of low concern when seen FTF, with remote assessment more likely to recommend intervention (including excision) for low-risk lesions. The number needed to biopsy (NNB) ratio, calculated by dividing the total number of biopsies by the number of biopsied skin cancers, is increasingly used as a metric for the diagnostic accuracy for melanoma detection, with a low ratio suggesting high specificity and vice versa. We undertook a study to compare the NNB ratio for melanoma detection between TD and FTF models for assessing new 2-week-wait (2WW) skin cancer referrals within our service. Over 2019–2020, the service switched over from FTF to a full TD consultant-run model for 2WW referrals. Retrospective analysis of the FTF 2WW model between August and November 2018 identified 53 cases suspicious for melanoma referred for biopsy [30 women and 23 men; median age 44 years (range 27–90)]. Of these, six patients received a histopathological diagnosis of melanoma (NNB 8.8). Retrospective analysis of the TD model between August and November 2022 identified 62 cases suspicious for melanoma triaged directly to a biopsy appointment [37 women and 25 men; median age 49.5 years (range 18–90)]. Of these, three patients received a histopathological diagnosis of melanoma (NNB 20.7). NNB in the TD model was 2.3 times higher than in the FTF model. The NNB of 8.8 in our FTF 2WW model is comparable to a review of 46 studies, which generated an NNB of 7.5 for dermatologists worldwide. The higher NNB of 20.7 for TD indicates poorer diagnostic accuracy for melanoma in this model. The higher NNB in TD is consistent with previous findings that remote assessment is more likely to lead to the excision of low-risk lesions. Further large-scale studies are needed to compare NNB in teledermatology vs. FTF models of skin cancer assessment. TD brings considerable advantages of convenience and increased clinic capacity but may come at a cost of lower specificity for melanoma diagnosis and an increase in the number of biopsies of benign lesions.
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