 Good morning. I am Dr. Nadeesh Mohanjee. I am the junior resident at the Department of Pre-do Diagnosis and Imaging, Command Hospital, Central Command Lucknow. I'll be covering this paper presentation under the following headings, the title, author, aim and introduction, methods, results, discussion, and the references used. The title of the paper presentation is the ultrasound assessment of carotid intima media thickness in Soryasis patients. Soryasis is an immune-mediated chronic inflammatory and hyperproliferative skin disease, presenting with scaly erythematous plaques on body surfaces with or without arthritis. There is accumulating evidence to suggest that Soryasis is a multi-system disease with chronic systemic inflammation. Soryasis patient also has an increased risk of subclinical atherosclerosis, hypertension, diabetes, metabolic syndrome, cardiovascular diseases, and stroke. The carotid intima media thickness can be used as an indirect marker for subclinical atherosclerosis and predict the risk of cardiovascular disease in Soryasis patients. The aims and objectives of the study are to assess the carotid artery intima media thickness on ultrasonography in patients with Soryasis and correlate the same with Pasi or the Soryasis area and severity index score. The carotid intima media thickness henceforth abbreviated as CIMT was measured using the following technique. It was done by an ESOT my lab gamma ultrason machine using a 7.5 megahertz linear array transducer. The depth was set at 4 centimeter with a dynamic range of 70 decibel and a frame refresh rate of 32 watts. Patients were rested for 10 minutes prior to the examination. The CIMT measurement was taken in the distal common carotid artery on both sides one centimeter proximal to the carotid bulb. The CIMT of the anterior posterior and lateral walls of the common carotid artery was taken on both sides and average assessment was done for the carotid plug also in the same setting. A case control study was done using the technique described earlier for the measurement of CIMT using 100 age and sex matched cases and controls. For cases the inclusion criteria was Soryasis patients with or without history of Soryatic arthritis. Exclusion criteria were patients with known or suspected history of systemic inflammatory diseases except for Soryatic arthritis. Prior diagnosis of treatment of coronary or peripheral arterial diseases, acute coronary syndrome, heart failure, stroke or transient dischemic attacks, significant liver or kidney dysfunction and severe hypertension was also an exclusion criteria. For controls the inclusion criteria included individuals recruited from the same dermatology clinics who are being seen for common dermatological complaints including Saboric keratosis, Watsniwi and Actinic keratosis. Non-genetically related subjects presiding with Soryasis patients were also taken. Exclusion criteria for controls for patients with history of atopic dermatitis, contact dermatitis, acne, connective tissue disorder or autoimmune blistering diseases. As these conditions were non-systemic inflammatory diseases. The results of the study showed that the CIMT of the cases was approximately 0.494 plus minus 0.245 mm or significantly higher than the control which was approximately 0.316 plus minus 0.113 mm. In the case group a total of 18% patients showed subclinical atherosclerosis for which the CIMT was taken as more than or equal to 0.8 mm whereas in the control group none of the patients showed subclinical atherosclerosis. In statistical terms there was significant difference between the two groups where the P value was less than 0.001. This is a frequency polygon and bar diagram showing the distribution of the CIMT in the cases and the controls. There was a significant correlation between the CIMT at all sides on both sides in both in the cases that were included in the study. Other results or conclusions that were derived from the study was younger, the older patients considered more than 45 years of age, overweight and obese patients had significant higher CIMT compared to the controls. The CIMT was significantly lower in psoriasis vulgaris medians as compared to that of pustular and psoriasis and psoriasis and the psoriathic arthritis variant. More than five years of illness duration or the earlier the onset of illness and the longer the duration of the disease process was significant had significant higher CIMT. The presence of common mobility significantly increased the CIMT in the cases means AMD of those having PASI scores more than 10 was higher as compared to those having PASI scores in the range 5 to 10, but this association was not significant statistically. In this case, the BMI profile of the patient, the presence study is compared to that as reported by Girisha et al who reported it to be 24.25 kilogram per meter square and they did not find a significant difference from controls. The study is reporting high prevalence of severe psoriasis, Sabri et al found 40% of the patients with severe and remaining 60% with moderate disease with a mean PASI score of 12.3 only. Although NGAN et al did not report any significant correlation between duration of the diseases and age at onset and the PASI score. All these studies similar to the present study have also reported a significant higher means AMD in cases as compared to controls. The minimum proportional difference between the two groups as found by Talari et al was mean CIMT to be approximately 1.04 times higher than in cases as compared to control, which is much lower than the what is found in the present study which was 1.56 times. Some other workers also found mean CIMT cases to be approximately 1.08 and 1.09 times higher than the controls. However, Maharoos et al and Kotiwal et al have found it to be 1.34 and 1.61 times higher than the control group. These are a few of the references that I have used to complete this study. Thank you.