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Introduction: Vitiligo is a cosmetically disfiguring,psychologically devastating disease and is resistant to therapy.Vitiligo in childhood can be associated with significantemotional trauma that may have long‑lasting effects on thepsychosocial development of these children and self esteem.Childhood vitiligo has different epidemiological, clinical,therapeutic, and prognostic profile. This study was carried outto assess the clinical and epidemiological characteristics ofvitiligo in pediatric patients.Material and methods: It was a prospective, observationalstudy carried out over a period of 1 year. All patients youngerthan 18 years of age with vitiligo attending the Dermatologyop of Osmania General hospital, hyderabad between April2017 and March 2018 were included in the study.Results: The most common pattern of vitiligo wasvulgaris (48%) followed by focal (34%), mucosal (8%)acro‑facial(6%), segmental (4%). Lower limb was the mostcommon site for vitiligo seen in 56 patients (56%), followedby face (21%), upper limbs (10%), mucosal (8%) and scalp(5%). No patients had universal presentation. 27 patients(27%) had Leukotrichia whereas Koebner’s phenomenon waspositive in 24 patients (24%).Conclusion: Childhood vitiligo is common depigmentingdisorder encountered frequently in females probably dueto higher concern about the disfiguring nature of disease infemales, with a mean age of onset being around 6.3 years.Vitiligo vulgaris was the most common pattern of presentation,followed by the focal type of vitiligo while the universalpattern was rare in childhood. Lower limbs were the mostcommon site of involvement followed by face. Patients withfamily history tend to present at an early age
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Background: Study of risk factors of stroke is very important in different settings to confirm their existence and to take necessary steps to prevent them especially in elderly so that incidence of stroke can be brought down. The objective of the present study is to perform the risk factor analysis among patients with stroke.Methods: A hospital based cross sectional study was carried out at a tertiary care hospital from June 2015 to March 2016. A total of 40 patients diagnosed with stroke were included in the present study. Detailed information and all necessary investigations were carried out. Risk factor analysis was done, and categorization was done for certain risk factors.Results: The predominant age group was 6-60 years. The age ranged from 1 month to 67 years. The Male: Female ratio was 14:9. The common etiologies were congenital, post infective and intracranial bleed in 26.1% (n=6) each. Favourable outcome was seen in 82.6% of cases. The failure rate was 17.4%. Most no of cases with favourable outcome was seen in 6-60 years age group, whereas >60 years age group had the most no of cases with poor outcome. The overall mortality rate was 21.6% (n=5). Wound related complication was seen in 1 patient (4.3%). Two (8.7%) patients required VP shunt post ETV. The cause of mortality was aspiration pneumonitis in 3 cases, CSF metastasis and wound infection in 1 cases each.Conclusions: The leading cause as well as risk factor for stroke was found to be hypertension followed by alcohol and smoking.
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Background: Intra-cerebral hemorrhages account for approximately 10-15 percent of all stroke cases and are associated with the highest mortality rate (30-40%). Study of predictors can modify the mortality rates. The objective of the present study the predictors of mortality in patients with intra cranial hemorrhage.Methods: Hospital based cross sectional study was carried out. Forty patients with CT scan evidence of intra cranial hemorrhage admitted to our hospital were randomly selected. All investigations were done. Patient characteristics were noted down.Results: In the present study among 40 patients, 16 patients died. The mortality was 40%. As the age increased, the mortality rate increased. But there was no difference between the mortality among males and females. Mortality was more than twice among those with SBP more than 180 mmHg i.e. 58.8% compared to only 26.1% among those with SBP less than 180 mmHg. Similar findings were noted for DBP and MAP. As the severity of motor weakness increased, the mortality increased. Patients with presence of bilateral plantar extensor response were found to be more at risk of death with a death rate of 66.7% compared to only 18.2% among those without presence of bilateral plantar extensor response. As the Glasgow coma scale increased, the mortality decreased from 100% in patients with a score of 3-4 to only 31.2% in patients with a score of 9-13. Intra-ventricular extension of haemorrhage, presence of hydrocephalus, volume of hematoma >30 ml, decreased consciousness level was important predictors.Conclusions: Bad prognosis i.e. death can be expected if the patient is older, low GCS, hematoma size > 30 ml, gaze palsy, severe motor neuron weakness, abnormal pupils, ataxic respiration etc. hence intensive care should be given to such patients to bring down the mortality.
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Aim: To compare the efficacy of dish wash solution, diluted lemon water, coconut oil and xylene as deparaffinizingagents for hematoxylin and eosin staining procedure.Objective: The objective is to find eco-friendly deparaffinizing agents like dish wash solution, diluted lemonwater and coconut oil as substitute to xylene and comparing the staining characteristics of each individualdeparaffinizing agent with Xylene.Materials and Methods: The study comprised of paraffin embedded 45 blocks of various tissues. Each block offour sections of 5 microns thickness was prepared. They were considered in four different groups like A, B, C andD. Tissue sections in Group A were stained with H & E method where xylene was used as deparaffinizing agent. Theother three sections were stained with H & E where dish wash solution, diluted lemon water and coconut oil wereused as deparaffinising agent’s alternative to Xylene. Staining characteristics were compared with xylene andscoring was given. The total score of 3–5 was regarded as satisfactory for diagnosis and less than that isinsufficient for diagnosis.Statitistical Analysis: Chi square test was used.Results: Adequacy of staining characteristics such as nuclear, cytoplasm, uniformity, clarity and crispiness ofstaining for diagnosis was greater with dish wash solution followed by diluted lemon water, coconut oil andxylene.Conclusion: The Eco-Friendly deparaffinizing agents such as dish wash solution, diluted lemon water, and coconutoil can be used as alternatives to xylene
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Context: Gender identification is one of the most important aspects in the forensic science. It is based onscientific principles involving dental records, fingerprints and DNA comparisons. Sometimes, it becomes necessaryto apply easy techniques like cheiloscopy. The wrinkles and grooves on the labial mucosa form a characteristicpattern called lip prints, the study of which is referred to as cheiloscopy.Aim: The present study was done to evaluate the accuracy of various methods of lip prints in gender determinationand its stability over a period of time.Subjects and Methods: It consists of 80 healthy individuals (40 males and 40 females) in the age group of 18 to25 years. Lip prints were taken by lipstick, latent and digital photography methods. Data was collected by twoobservers at 0 month and 6months to assess their stability in gender determination.Statistical Analysis Used: Chi-square test was used.Results: The results obtained showed an accuracy of 0% and 57.5% by observer I, 30% and 67.5% by observer IIat 0 and 6th month in gender determination. The measurement of agreement in stability of lip prints was found tobe 27.8% by observer II.It was found that digital photography being the accurate method followed by lipstick andlatent methods.Conclusion: This study revealed that lip prints can be used for determining the gender of an individual.
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Background: Sex chromatin is a chromatin mass of 1 micron size usually seen at the periphery of nucleus infemales. The term sex chromatin comprises of two superficially dissimilar structures known as Barr body inepithelial cells, other tissue cells and as Drumstick appearance in polymorphonuclear leucocytes. Aim of thestudy is gender determination by drumstick appearance of neutrophils using Leishman’s stain and Field stain.Materials and Methods: The present study included 60 individuals ranging from 20-50 age group of both thesexes to observe the morphology of sex chromatin in neutrophil by using Leishman’s and Field stain for thegender determination and comparison between the 2 staining procedure, using research microscope.Results: Presence of drumsticks, sessile nodule and non specific appendages like racket, tag, hook, minor lobe,small club, were found in neutrophils. In males 37% of drumstick, 7% of sessile nodule, 20% of racket structure,3% small club, 13% minor lobe, 7% hook, 3% tag, was seen and in females 10% of drumstick, 60% of sessilenodule, 17% of racket structure, 7% small club, 1% minor lobe, 0% hook, 3% tag, was seen and field’s stainshowed better results in appreciating the morphology of neutrophil.Conclusion: Observation on morphology and comparison between 2 different stain presented a moderate agreementin gender determination.
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Myocarditis is a common occurrence among patients infected with human immunodeficiency virus (HIV). However, it is rare to find HIV-associated myocarditis presenting as ST-segment elevation myocardial infarction with cardiogenic shock. A case of HIV-related myocarditis presenting as an acute inferolateral wall myocardial infarction in a 32-year-old male is described.