Poor Self-image Research Articles

Skin Disease in Children: Effects on Quality of Life, Stigmatization, Bullying, and Suicide Risk in Pediatric Acne, Atopic Dermatitis, and Psoriasis Patients.

Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with their families and peers. Physicians recognize the importance of addressing both the physical and mental symptoms of their patients but are currently not equipped with clear guidelines to manage long-term psychosocial comorbidities in pediatric dermatologic patients. A PubMed and Google Scholar search of key words was conducted to explore self-image in pediatric patients with acne, AD, and psoriasis. Chronic skin diseases put pediatric patients at risk for strained family relationships, poor self-image, psychiatric comorbidities, stigmatization, and eventual suicidal behavior. A limitation of this study is a lack of a validated measure of quality of life in the pediatric population that fulfills enough criteria to evaluate long term quality of life in children and adults. Possible management options, including connecting patients with the same diagnosis and allocating resources to parents and teachers to better understand these chronic skin conditions, may provide pediatric patients with the support they need to develop resilience in the face of these challenges.

A Smartphone App for Supporting the Self-management of Daytime Urinary Incontinence in Adolescents: Development and Formative Evaluation Study of URApp.

BackgroundDaytime urinary incontinence (UI) is common in childhood and often persists into adolescence. UI in adolescence is associated with a range of adverse outcomes, including depressive symptoms, peer victimization, poor self-image, and problems with peer relationships. The first-line conservative treatment for UI is bladder training (standard urotherapy) that aims to establish a regular fluid intake and a timed schedule for toilet visits. The success of bladder training is strongly dependent on good concordance, which can be challenging for young people.ObjectiveThis paper aims to describe the development of a smartphone app (URApp) that aims to improve concordance with bladder training in young people aged 11 to 19 years.MethodsURApp was designed by using participatory co-design methods and was guided by the person-based approach to intervention design. The core app functions were based on clinical guidance and included setting a daily drinking goal that records fluid intake and toilet visits, setting reminders to drink fluids and go to the toilet, and recording progress toward drinking goals. The development of URApp comprised the following four stages: a review of current smartphone apps for UI, participatory co-design workshops with young people with UI for gathering user requirements and developing wireframes, the development of a URApp prototype, and the user testing of the prototype through qualitative interviews with 23 young people with UI or urgency aged 10 to 19 years and 8 clinicians. The app functions and additional functionalities for supporting concordance and behavior change were iteratively optimized throughout the app development process.ResultsYoung people who tested URApp judged it to be a helpful way of supporting their concordance with a timed schedule for toilet visits and drinking. They reported high levels of acceptability and engagement. Preliminary findings indicated that some young people experienced improvements in their bladder symptoms, including a reduction in UI. Clinicians reported that URApp was clinically appropriate and aligned with the best practice guidelines for bladder training. URApp was deemed age appropriate, with all clinicians reporting that they would use it within their own clinics. Clinicians felt URApp would be of particular benefit to patients whose symptoms were not improving or those who were not engaging with their treatment plans.ConclusionsThe next stage is to evaluate URApp in a range of settings, including pediatric continence clinics, primary care, and schools. This research is needed to test whether URApp is an effective (and cost-effective) solution for improving concordance with bladder training, reducing bladder symptoms, and improving the quality of life.

Comparative Study of Efficacy and Safety of Microneedling with Topical Autologous Platelet Rich Plasma Versus Microneedling Alone in Facial Atrophic Acne Scars

Introduction: Atrophic acne scars are dermal depressions resulting from destruction of collagen after inflammatory acne which can lead to poor self-image and treating them can help improve patients’ self-esteem. Objectives: This study compared the efficacy and safety of combination of microneedling using dermaroller with topical application of autologous platelet rich plasma versus microneedling using dermaroller alone in facial atrophic acne scars. Methods: Patients with atrophic acne scars were randomized into 2 groups of 20 patients each and treated with either dermaroller alone or with a combination of dermaroller and topical application of autologous PRP at 4 weeks intervals for 16 weeks. Final response was evaluated at 4 weeks after the last sitting. Goodman and Baron’s qualitative acne scarring grading system, Goodman and Baron’s quantitative acne scar grading system, physician’s global assessment (PGA) and visual analogue scale were used to evaluate the treatment outcome in both the groups. Side effects were also noted at each visit. Results: At the end of treatment, improvement in Goodman and Baron’s qualitative acne scar grades, decrease in mean Goodman and Baron’s quantitative acne scar scores, percentage decrease in mean Goodman and Baron’s quantitative acne scar scores, physician global assessment and visual analogue scale were significantly higher in patients treated with dermaroller in combination with topical autologous PRP as compared to patients treated with dermaroller alone without much adverse effects. Conclusion: The combination approach using dermaroller and PRP was a better treatment option compared to dermaroller alone in atrophic acne scars with similar safety profile.

A novel model of obesity prediction: Neurobehaviors as targets for treatment.

Obesity is a worldwide epidemic that is on the rise, with approximately 30% of the world population classified as either overweight or obese. The United States has some of the highest rates of obesity, and in most countries in the world, obesity now poses more of a serious health concern than malnutrition. Obesity is a chronic, relapsing disorder that is both preventable and treatable; however, traditional interventions that target eating less and exercising more have low success rates, especially in the long term. Therefore, identifying the neurobehaviors that predict obesity is important to help identify targets to decrease BMI and improve obesity outcomes. Using the Competing Neurobehavioral Decisions System (CNDS) Theory, we hypothesized that individuals with obesity compared to individuals without obesity would display neurobehaviors marked by a hyperactive impulsive system and a hypoactive executive system. To test this hypothesis, we collected data from a battery of self-reported measures and neurocognitive assessments through Amazon Mechanical Turk from n = 178 obese (BMI ≥ 30) and n = 198 nonobese controls who were weight stable for the past 3 months. We found that compared to the nonobese control group, individuals with obesity showed heightened delay discounting (a marker of CNDS imbalance), impaired motivation, poor self-image, decreased affective state, and impaired executive function. Using a Bayesian network approach, we established a neurobehavioral model that predicts obesity with 64.4% accuracy and indicates an imbalance between impulsive and executive neural systems. Results from our study suggest that interventions targeting neurobehaviors may be integral to help improve obesity outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Association Between the Incidence of Acne Vulgaris and Lifestyle Factors Including Dietary Habits, Physical Activity, and Bathing Frequency

Background: Acne vulgaris is a multifactorial skin disease affecting many of the world’s population throughout their lives and can cause severe emotional distress and psychological disorders such as poor self-image, depression, and anxiety. Several underlying risk factors are known for acne development, and many, including different aspects of lifestyle, are yet to be studied. Objectives: In this study, we aimed to determine the role of lifestyle factors including dietary habits, physical activity, and bathing frequency in the incidence of acne vulgaris. Methods: The study population included 425 subjects, of whom 171 were acne patients (the case group), and 254 were non-acne patients (the control group). All participants filled out a questionnaire addressing their demographic information and some lifestyle habits. The data were analyzed by SPSS. Results: Fast food consumption was significantly higher in the case than in the control group (P = 0.008). Dairy intake and bathing frequency were significantly higher among non-acne patients than those with acne (P < 0.001 and P = 0.001, respectively). Vegetable consumption, water intake, and the number of episodes and minutes of physical activity per week were not significantly different between the two groups (P = 0.1, P = 0.4, P = 0.9, and P = 0.8, respectively). The mean weight of participants was significantly higher in the case than in the control group (P = 0.001). Conclusions: There was no significant difference in most of the studied factors between the two groups. Therefore, further studies are needed to assess the role of other underlying conditions such as genetic factors and hormonal changes in the development of acne vulgaris.

Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study.

BackgroundChildren with adolescent idiopathic scoliosis (AIS) have reduced quality of life related to poor self-image, perhaps because of cosmetic concerns. However, there has not been a large-database epidemiologic study on the association between psychiatric disorders and scoliosis.Questions/purposesUsing the Korean National Health Insurance database, we asked: (1) How common are psychiatric disorders among children with AIS? (2) After controlling for gender, age, insurance type, and residential district, are psychiatric disorders more common among children with AIS than among age-matched controls?MethodsA retrospective analysis was conducted using sample datasets from the Health Insurance Review and Assessment Service from 2012 to 2016, which is a 10% randomly extracted sample of total inpatients and outpatients each year. The mean number of total patients in each dataset was 1,047,603 ± 34,534. The mean number of children with AIS was 7409 ± 158 for each year. The age criteria was 10 to 19 years for the matching. Mood disorders, anxiety disorders, and behavioral disorders were selected as disorders possibly associated with AIS. We identified children with AIS who had any of the disorders above, and we obtained the prevalence of these disorders based on diagnostic codes. As an exploratory analysis, clinically meaningful variables were selected among the available codes in the dataset, and a univariable logistic regression test was performed for each variable. A multivariable logistic regression test with advanced variables was performed to identify the adjusted odds ratios of psychiatric disorders in children with AIS.ResultsThe median (range) prevalence of psychiatric disorders in children with AIS from 2012 to 2016 was 7% (6% to 7%). Compared with children who did not have AIS, and after controlling for gender, age, insurance type, and residential district, children with AIS were more likely to have psychiatric disorders in all 5 years. The adjusted ORs of psychiatric disorders in children with AIS compared with children who did not have AIS ranged from 1.47 to 1.74 (2012: OR 1.60 [95% CI 1.46 to 1.75]; p < 0.001; 2013: OR 1.73 [95% CI 1.58 to 1.89]; p < 0.001; 2014: OR 1.74 [95% CI 1.59 to 1.91]; p < 0.001; 2015: OR 1.71 [95% CI 1.56 to 1.88]; p < 0.001; 2016: OR 1.47 [95% CI 1.33 to 1.62]; p < 0.001).ConclusionConsidering the higher prevalence of psychiatric disorders in children with AIS compared with children who did not have AIS, children with AIS and their parents should be counseled about the increased risk of deteriorating mental health of the patients, and surgeons should provide early referral to pediatric psychiatrists. Further studies should investigate the effect of the factors related to AIS, such as curve type, Cobb angle, and treatment modality.Level of EvidenceLevel III, prognostic study.

ANOREXIA NERVOSA: FACTORS AND LONG-TERM HEALTH CONSEQUENCES

Anorexia nervosa is a psychological disorder regarding eating habits that affects females far more often than males and is most commonly observed in adolescent females. The exact cause of anorexia has not been definitively established, but thoughts about self-image, family dynamics, and community pressures to some extent genetic factors can be accountable for the disorder. According to a report it affects about one percent of adolescent girls in America. Under the condition, people be likely to illustrate neurotic behaviors and may become infatuated with food that led to extreme dieting and weight loss and to the stage of malnutrition. Actually, characterized by anxiety, especially is experienced during eating and poor self-image in the mirror. The present study is aimed to quantify the percentage of population suffering from the disorder and to correlate the age and gender with the issue. The current study was conducted among teen aged, undergraduate and adults. Male and female read a ten-point vignette describing the conditions that were further quantify to understand the relationship between food anxiety, eating disorders, and related correlates as like co- morbid disorders and personality. One in each twelve participants was observed for experiencing food anxiety at high. They spent meal time with full concentration on their imaginary obesity, mistakes and mishaps consequently stress lowers their appetite. The findings showed that how psychological and personality disorders of perfectionism correlates to anxiety during meals and emotional strain of being obese.

Sexual Dysfunction in Women With Kidney Disease.

Sexual health is inversely associated with estimated glomerular filtration rate and is associated with adverse cardiovascular outcomes, depression, poor self-image, and impaired quality of life. Many women with chronic kidney disease (CKD) and ESKD experience symptoms of sexual dysfunction which is underrecognized secondary to a variety of factors including physicians' discomfort in discussing sexual health, patients' reluctance to bring up sexual health, difficulty in the assessment of sexual health in comparison to men, and the overall lack of well-conducted clinical studies in women. The pathophysiology is not fully understood but likely involves changes in sex hormones throughout the hypothalamic-pituitary-ovarian axis. Proper evaluation of this axis is necessary as treatment is tailored to these findings and can improve outcomes. A comprehensive assessment of sexual dysfunction inclusive of women with varying gender identification and sexual orientation, partnered with recognition and treatment of contributing factors as well as identifying the underlying cause, is paramount. With the lack of studies, particularly in women with CKD, treatment options, in some cases, can be considered unchartered territory. In this article, we will review available evidence on the pathophysiology, clinical manifestations, and treatment for sexual dysfunction in women with CKD and ESKD.

Antibiotic-resistant acne vulgaris treated with oral isotretinoin in a patient with thalassemia minor

Acne vulgaris is very common among adolescents and young adults. Permanent scarring, poor self-image, depression, and anxiety can result from it. The acne treatment options include topical therapies, systemic agents, physical modalities, lasers, photodynamic therapy or combinations. Oral isotretinoin is widely recognised as a very effective treatment for severe acne. However, it may cause adverse effects. We report a case of an 18-year-old man affected by thalassemia minor treated with oral isotretinoin because of a severe form of acne unresponsive to conventional oral antibiotic therapy. During the treatment clinical and biochemical evaluations were closely monitored each month in order to discover potential adverse effects of isotretinoin and the impact over thalassemia. After 9 months of oral isotretinoin application we can tell that the drug was well tolerated by the patient, the acne totally cleared, and the thalassemia did not deteriorate. In conclusion, although a highly effective drug, isotretinoin use is limited by its side effects. However, patients may accept these procedures to improve the psychosocial effects of acne, because it can target all aspects of acne pathology. Something else, it is the choice of treatment in antibiotic-resistant forms of acne. It has been seen that the oral isotretinoin could be successfully used in patients with severe acne suffering from thalassemia minor in which the antibiotic treatment failed with the explicit requirement for strict clinical and biochemical follow-up.

The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport

Identification, evaluation and management of disordered eating (DE) is complex. DE exists along the spectrum from optimised nutrition through to clinical eating disorders (EDs). Individual athletes can move back and...

Lived experiences of adults with borderline personality disorder: a qualitative systematic review protocol.

The objectives of this review are: to explore the lived experiences of individuals with a diagnosis of borderline personality disorder (BPD) and to present recommendations for policy, practice, education and research. Borderline personality disorder is a mental disorder characterized by poor capacity to engage in effective relationships, intense and sudden mood changes, poor self-image and emotion regulation, significant impulsivity and severe functional impairment. Studies estimate the prevalence of BPD at 15% to 22% and identify a predominantly negative attitude among health professionals towards individuals with BPD. This review will examine the lived experiences of people with a diagnosis of BPD in order to better understand this condition. This review will include peer-reviewed qualitative studies on adults with a diagnosis of BPD in all settings and from any geographical location. A three-step search strategy will be used. A search strategy has been developed for MEDLINE. A second search using all identified keywords and index terms will be conducted across MEDLINE, CINAHL, PsycINFO and Embase. Studies will be screened by title and abstract by two independent reviewers against the review inclusion criteria. The full text of selected citations will be assessed against the inclusion criteria and for methodological quality. Qualitative data will be extracted from included papers using a standardized data extraction tool. Qualitative research findings will be pooled using the meta-aggregation approach. The final synthesized findings will be graded according to the ConQual approach and presented in a Summary of Findings. PROSPERO CRD42019141098.

Biaxial Stress Relaxation of Vaginal Tissue in Pubertal Gilts.

Pelvic organ prolapse (POP) is a condition characterized by displacement of the vagina from its normal anatomical position leading to symptoms such as incontinence, physical discomfort, and poor self-image. Conservative treatment has shown limited success and surgical procedures, including the use of mesh, often lead to severe complications. To improve the current treatment methods for prolapse, the viscoelastic properties of vaginal tissue need to be characterized. We determined the biaxial stress relaxation response of vaginal tissue isolated from healthy pubertal gilts. Square specimens (n = 20) with sides aligned along the longitudinal directions (LD) and circumferential direction (CD) of the vagina were biaxially displaced up to 5 N. The specimens were then kept at the displacements corresponding to 5 N for 20 min in both the LD and CD, and the corresponding strains were measured using digital image correlation (DIC). The stresses in the LD and CD were found to decrease by 49.91 ± 5.81% and 46.22 ± 5.54% after 20 min, respectively. The strain in the LD and CD increased slightly from 0.080 ± 0.054 to 0.091 ± 0.064 and 0.050 ± 0.039 to 0.058 ± 0.047, respectively, but these changes were not significant (p > 0.01). By using the Peleg model, the initial decay rate and the asymptotic stress during stress relaxation were found to be significantly higher in the LD than in the CD (p≪0.001), suggesting higher stress relaxation in the LD. These findings may have implications for improving current surgical mesh, mechanical devices, and physical therapy used for prolapse treatment.

Association between obesity and anxiety among an adolescent population of Rajkot district, Gujarat, India: a cross sectional and descriptive study

Background: Proper good nutrition are essential for mental development, physical growth, health and wellbeing and survival of adolescents. School based data of India shows a prevalence of obesity is 5.6% to 24.0% among children and adolescents. Psychosocial complications associated with obesity include poor self-image, depression, and difficulties in both social environment and home. This study was carried out with an objective to find out prevalence of malnutrition and associated factors.Methods: A cross sectional study conducted among 1026 school going adolescents from 4 schools of Rajkot, Gujarat, India. Depression and anxiety were measured using Beck Depression Inventory and Beck Anxiety Inventory. Chi-square test was applied as test of significance.Results: Majority of the students (58.1%) were belonged to early adolescent age group. About 67.1% were males. About 16.6% were underweight and 1.2% were obese. Overweight was more prevalent in girls (5.6%) as compared to boys (1.2%). Prevalence of anxiety and depression was 9.9% and 18.5% respectively. Anxiety was frequently found in overweight and obese adolescents (82.0%) as compared to only underweight and normal adolescents (7.1%, p&lt;0.0001).Conclusions: The prevalence rate of overweight and obesity were 9.7% and 4.3%. Girls are more affected with overweight. Significant number of adolescents was suffering from anxiety (9.9%) and depression (18.5%). Anxiety was frequently found in overweight and obese adolescents. There is need of immediate action to prevent adolescent obesity. Assessment of anxiety and depression among students with proper counselling should be carried out at least once a year.

Cognitive failure susceptibility and personality: Self-directedness predicts everyday cognitive failure

Susceptibility to everyday cognitive failure is often assessed in clinical and vocational settings to estimate the effectiveness of interventions or to predict performance and performance decline in stressful situations. Comparatively little is known about the relationship between cognitive failure susceptibility as quantified by the Cognitive Failure Questionnaire (CFQ) and personality factors. We examined the relationships between the CFQ and the seven personality dimensions as assessed by the Temperament and Character Inventory (TCI). Through regression analyses with out-of-sample prediction in two samples, we explained around 18% of the variance in cognitive failure from personality scores. We established the character trait self-directedness as the main inversely related predictor of everyday cognitive failure. High cognitive failure thus seems to reflect low levels of self-confidence, self-acceptance, and responsibility for one's own actions which are the key aspects of self-directedness. This result provides evidence for the previously stated ‘complaint’ hypothesis that cognitive failure results from a poor self-image rather than a vulnerability to stress.

The experience of cancer-related fatigue, exercise and exercise adherence among women breast cancer survivors: Insights from focus group interviews.

To identify the experience of breast cancer survivors regarding cancer-related fatigue, exercise and exercise adherence. Cancer-related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer-related fatigue, relatively few research studies on the experience of cancer-related fatigue and exercise adherence have been conducted. This was a qualitative study to identify breast cancer survivors' experience of cancer-related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer-related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer-related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. Participants' experience of moderate or greater cancer-related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self-image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. The insights shared by breast cancer survivors experiencing cancer-related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care.

Håp og livsmot i sykdomsfortellinger etter hjerneslag

Hope and life courage in illness narratives after stroke&#x0D; This essay illuminates the meaning of hope and life courage in the narratives of Tomas and Maria, a couple who had experienced the life changing consequences of Maria’s stroke. Hope is supported by the couple’s strong and loving relationship and by empathy and caring in their relationships with professional caregivers. In this way, the relational component of hope is revealed as the most important prerequisite for maintaining hope. The analysis demonstrates that life courage and hope are strongly needed for trust in the future and rehabilitation efforts. However, careless and unprofessional attitudes and practices of clinicians may lead to loss of control, poorer self-image and hopelessness. To support the hope of patients and relatives, clinicians must show caring attitudes and use both medical and humanistic knowledge. They should not devalue the phenomenon of hope as unrealistic.

The Impact of Massive Weight Loss on Psychological Comorbidities: A Large, Retrospective Database Review.

The obese population has a higher incidence of mood disorders compared to individuals with normal body mass index (BMI). A better understanding of the unique psychosocial challenges faced by this patient population will allow physicians to better optimize patient psychosocial support systems perioperatively, as well as help the patient to maintain appropriate expectations. A large, retrospective database of 1135 patients with greater than 50 pounds of weight loss was reviewed. Data were analyzed using a multinomial regression model to determine the influence of psychosocial factors on the incidence of depression and anxiety. Prior to massive weight loss, patients reported an overall incidence of depression and anxiety of 42.5% and 26.3%, respectively. Following massive weight loss, the incidence of depression decreased to 32.3% and the incidence of anxiety decreased to 22.0%. Patients with spousal support and with positive self-image were more likely to experience resolution of depression. Patients with positive self-image were likely to experience resolution of anxiety. Resolution of medical comorbidities correlated with a decrease in the rate of depression. Depression and anxiety are prevalent in the massive weight loss patient population undergoing body contouring surgery. Support systems are a vital resource for patients with psychological comorbidities undergoing massive weight loss. Patients who have a positive self-image of themselves are more likely to experience resolution of psychological comorbidities. Physicians should consider recommending support groups and/or counseling in patients who have poor support and negative self-image. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Health-related Quality of Life and Postural Changes of Spinal Alignment in Female Adolescents Associated With Back Pain in Adolescent Idiopathic Scoliosis: A Prospective Cross-sectional Study.

A prospective cross-sectional study. To identify risk factors for chronic back pain and back pain at rest in adolescent idiopathic scoliosis (AIS) patients, particularly focusing on the psychological backgrounds of the patients and on postural changes of radiographical parameters for spinal alignment. Back pain has been recognized as a relatively common condition in AIS. However, the effect of patients' psychological backgrounds and dynamic changes of spinal alignment on back pain are unclear. One hundred two consecutive female AIS patients (mean age, 14.1 yrs [range, 10-18]) who first visited our outpatient clinic between July 2013 and December 2017 were included. Using SRS-22r questionnaire, the presence of chronic back pain and back pain at rest and the scores of self-image and mental health were evaluated. Using full-length standing and supine posteroanterior radiographs, parameters related to curve profiles and coronal global balance were measured, and postural changes of these parameters were calculated. From full-length standing lateral radiographs, sagittal spinal and spino-pelvic alignment parameters were also measured. Multivariate logistic regression analysis was performed to identify risk factors for back pain. The prevalence of chronic back pain was 22.5% and that of back pain at rest was 25.5%. Poor self-image and mental health scores in SRS-22r were identified as risk factors for chronic back pain. Higher Risser grade, poor self-image score, large postural changes of apical vertebral translation at the main thoracic curve, and hyperlordosis in the lumbar spine were identified as risk factors for back pain at rest. Psychological distress and large postural changes of spinal alignment played an important role in the occurrence of back pain. Physicians should pay more attention to mental healthcare of AIS patients as well as to radiographical assessments of curve severity for better health-related quality of life. 4.

Comparison of Complications that Arise after DT and FCLT in the Treatment of Post-Acne Scars

Background: Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Acne can present - non-inflammatory lesions (open and closed comedones), inflammatory lesions (papules, pustules, and nodules), and varying degrees of scarring or a mixture of both, affecting mostly the face but also the back and chest. Acne leads to significant morbidity that is associated with residual scarring and psychological disturbances such as poor self-image, depression, and anxiety, which leads to a negative impact on quality of life. Subjects and Methods: Total 200 patients divided into two groups of 100 each. One group was treated with dermaroller every four weeks for a period of 24 weeks and the other group was treated with fractional CO2 laser again every four weeks for a period of 24 weeks. Results: Six patients in dermaroller and nine patients in fractional CO2 laser group developed hyperpigmentation post procedure. Conclusion: Itching is not seen as a complication in the treatment with derma-roller, but in case of fractional CO2 laser group, a very small percentage of patients experienced itching a few days after the treatment due to peeling off of the scab that was formed after treatment.

Repetitive Transcranial Magnetic Stimulation in the Treatment of a Difficult to Treat Condition, Borderline Personality Disorder.

Borderline personality disorder (BPD) is a serious mental disorder characterized by a pervasive pattern of instability in affect regulation and interpersonal relationships, poor self-image and behavioral control, self-injurious behavior, suicidality, and other high-risk behaviors. It is also characterized by a high mortality rate by suicide. The published literature on repetitive transcranial magnetic stimulation (TMS), theta-burst stimulation (TBS), and deep TMS in the treatment of BPD were reviewed. Four clinical studies (2 randomized trials and 2 case studies) with limited sample sizes found that TMS and TBS were safe and potentially effective in the reduction of symptoms of BPD. Given the limited clinical evidence for efficacy on the basis of the results of these studies, future controlled studies involving larger samples and optimal stimulus parameters should be designed to confirm the short-term and long-term safety and efficacy of repetitive TMS and TBS in the treatment of BPD.