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Summary The inner ear can be the target of autoimmune attacks, and sensorineural hearing loss can occur as a complication in various non‐organ‐specific autoimmune diseases. The aim of this study was to compare cochlear functions and hearing evaluation in patients with psoriasis and controls. In total, 29 patients with psoriasis and 30 healthy controls (HCs) were included in the study. Pure‐tone audiometry at 250, 500, 1000, 2000, 4000, 8000, 10 000, 12 000, 14 000 and 16 000 Hz was performed for patients as HCs, as were immittance measures including tympanometry, acoustic reflex and otoacoustic emission testing. There were statistically significant (P < 0.05) differences between patients and HCs for pure‐tone thresholds at high frequencies, and for distortion product otoacoustic emission (DPOAE) responses and signal : noise ratio at all frequencies. In our study, based on DPOAE and audiological findings, there was damage to the outer hair cells of the cochlea, resulting in high‐frequency hearing loss in patients with psoriasis.

Focused assessment with sonography for trauma (FAST) is a limited ultrasound examination, primarily aimed at the identification of the presence of free intraperitoneal or pericardial fluid. In the context of blunt trauma abdomen (BTA), free fluid is usually due to hemorrhage, bowel contents, or both; contributes towards the timely diagnosis of potentially life-threatening hemorrhage; and is a decision-making tool to help determine the need for further evaluation or operative intervention. Fifty patients with blunt trauma abdomen were evaluated prospectively with FAST. The findings of FAST were compared with contrast-enhanced computed tomography (CECT), laparotomy, and autopsy. Any free fluid in the abdomen was presumed to be hemoperitoneum. Sonographic findings of intra-abdominal free fluid were confirmed by CECT, laparotomy, or autopsy wherever indicated. In comparing with CECT scan, FAST had a sensitivity, specificity, and accuracy of 77.27, 100, and 79.16 %, respectively, in the detection of free fluid. When compared with surgical findings, it had a sensitivity, specificity, and accuracy of 94.44, 50, and 90 %, respectively. The sensitivity of FAST was 75 % in determining free fluid in patients who died when compared with autopsy findings. Overall sensitivity, specificity, and accuracy of FAST were 80.43, 75 and 80 %, respectively, for the detection of free fluid in the abdomen. From this study, we can safely conclude that FAST is a rapid, reliable, and feasible investigation in patients with BTA, and it can be performed easily, safely, and quickly in the emergency room with a reasonable sensitivity, specificity, and accuracy. It helps in the initial triage of patients for assessing the need for urgent surgery.

Introduction: The government issued a country-wide lockdown in Nepal as a measure to curb the spread of COVID-19 pandemic. This has resulted in various difficult experiences which includes financial loss, separation from loved ones, grief, uncertainty over disease status and loss of freedom. During these stressful situations, interpersonal violence is likely to be aggravated. To avoid the occurrence of adverse events such as impulsive acts, homicide, or suicide, it is important to identify high-risk individuals. Methods: This is a descriptive cross-sectional, questionnaire-based, online survey by convenience sampling. The prevalence of different types of interpersonal violence with socio-demographic factors, substance use, and overall mental wellbeing was assessed by using descriptive statistical tests. Results: Out of total 556 participants included in the analysis, 50.9% (283) were male and 48.7% (271) were female. There were 100 (18.0%) participants who reported being a victim of interpersonal violence and 101 (18.2%) participants who reported being a perpetrator during the lockdown. The victims of violence were more likely to be living with their spouse alone. The victims and perpetrators were also more likely to have increased alcohol and tobacco use. More number of victims and perpetrators had lower mental wellbeing scores on the WHO wellbeing index. Conclusions: There was prevalence of interpersonal violence during the COVID-19 lockdown. In addition to the fear regarding pandemic, victims have to face domestic violence placing them at a double injustice. Identification of vulnerable groups and proper management of survivors must be prioritized given the unanimous consensus on the rise of interpersonal violence during periods of heightened stress.

The purposes of this study were to revisit the utility of ultrasonography (USG) as a primary imaging modality in acute appendicitis (AA) and to establish the role of CT scan as a second-line/problem-solving modality. All cases of suspected AA were referred for urgent USG. USG was done with standard protocol for appendicitis. Limited computed tomographic (CT) scan [NCCT ± CECT (IV contrast only)] was done for the lower abdomen and pelvis where sonographic findings were equivocal. One hundred and twenty-one patients were referred for USG for suspected appendicitis. Eight-four patients underwent surgery for AA based on clinical as well as imaging findings, of whom 76 had appendicitis confirmed at histopathology. Three patients were misdiagnosed (3.6 %) on USG as appendicitis. Of 76 patients of appendicitis confirmed histopathologically, 63 (82.8 %) had features of appendicitis on USG and did not require any additional imaging modality. Of 121 patients, 12 (10 %) needed CT scan because of atypical features on USG. Of these 12 patients, seven had retrocecal appendicitis, and three high-up paracolic appendicitis. USG alone had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 81, 88, 92.6, 71.6, and 83 %, respectively. When combined with CT scan in select cases, the sensitivity, specificity, PPV, NPV, and accuracy of combined USG + CT scan were 96 % (P 00.0014), 89 %, 93 %, 93.5 % (P00.0001), and 93 % (P00.0484), respectively. Twentyeight (23 %) patients were given alternative diagnosis on USG. Dedicated appendiceal USG should be used as a primary imaging modality in diagnosing or excluding AA. Appendiceal CT can serve as a problem-solving modality.

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Introduction and Aims To control the spread of COVID‐19, India imposed a nationwide lockdown in phases including lockdown 1.0 (25 March–14 April) and 2.0 (15 April–3 May). Among other restrictions, it involved a complete ban of alcohol sales. We aimed to examine and interpret the changes in online search interest for keywords representing different alcohol‐related themes during the lockdown period in India. Design and Methods Data were extracted using the framework described for using Google Trends in health‐related research. The list of alcohol‐related search queries was prepared for four broad themes: types of alcoholic beverages consumed; means of accessing alcohol; problems experienced due to break in alcohol supply; and help‐seeking for alcohol use disorders. The mean relative search volumes across three time periods (pre‐lockdown; lockdown 1.0; lockdown 2.0) were compared using spss version 23.0. Results A significant increase in online search interest for keywords related to the procurement of alcohol was observed in lockdown 1.0 but not during lockdown 2.0, compared with pre‐lockdown. A significant increase in online search interest for alcohol withdrawal was observed during lockdown 1.0 compared to the pre‐lockdown period. A significant increase in online search interest for keywords representing benzodiazepines was observed in lockdown 2.0. Discussion and Conclusions Indian internet users exhibited significantly increased online interest for alcohol‐related searches during lockdown. It seems that the challenges associated with offering interventions for alcohol use‐related problems are likely to continue once the lockdown is lifted and people have the option to access alcohol and treatment services freely.