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The two Houses of Parliament, its committees, and their members are granted specific rights, immunities, and exemptions known as "parliamentary privileges." The Indian Constitution's Article 105 defines certain rights. Members of Parliament are protected by these privileges from civil liability for statements made or actions taken while performing their official duties, but not from criminal culpability. Only when a person is a member of the house can they make use of the privileges. The privileges are stated to be terminated as soon as the person ceases to be a member. The privilege matters only see the question of Parliament and Court relationship. It involves certain facets, that are who amongst the Court or the Legislature, decides whether a particular privilege claimed by a House exists or not? When a privilege is held to exist, is the House the final judge of how, in practice, that privilege is to be exercised? Can the Courts go into the privilege of validity or proprietary of committal by a House for its contempt or breach of privilege? Can the Courts interfere with the working of the Committee of Privileges? These are the areas that shall be dealt with in the following article to clarify the relation existing between the privileges provided to parliamentarians and the powers of the Courts.
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A nematode parasite, Dracunculus medinensis, causes dracunculiasis. Despite being non-fatal, this condition causes significant morbidity. Dracunculiasis is considered an eradicated disease in India since 1999. We report two cases that document the unusual linear morphea- like morphology of the calcified D. medinensis and the rare periorbital location of the worm. The cases presented here are rare and a diagnostic challenge, considering the eradicated status of dracunculiasis
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Purpose: Extraction of tear protein from Schirmer’s strip is a prerequisite for the proper identification and screening of biomarkers in dry eye disease. The study compares different methods of extraction of tear proteins from the Schirmer’s strip. Methods: Reflex tear was collected from healthy controls (HC; n = 12), Stevens–Johnson syndrome (SJS; n = 3) and dry eye disease (DED; n = 3) patients using capillary tube. This tear was used to measure the volume absorbed by Schirmer’s strip per microliter. Different buffers (6) were used to compare the protein yield from the Schirmer’s strip in four different conditions. The tear proteins extracted using the highest protein yield buffer were analyzed by mass spectrometry. Results: A linear relationship between the tear volume and wetting length was observed (r = 0.0.997, n = 6). The highest yield was observed after incubation of the Schirmer’s strip in 100 mM ammonium bicarbonate (ABC) with 0.25% Nonidet P?40(NP?40) at 4°C for an hour (P < 0.00005). The in?solution digestion of tear eluted in the above condition 100 Mm ABC + 0.25% NP?40 with one?hour incubation yielded a total of 2119 proteins in HC, SJS, and DED. The unique protein observed in SJS and DED was 0.6% and 17.9%, respectively. The significantly expressed proteins are associated with innate immune response, proteolysis, wound healing, and defense response. Conclusion: A method for extraction of protein from Schirmer’s strip was optimized for increase in protein yield from the tear sample. SJS and DED tear samples have unique protein signature. The study will aid in better design of tear protein?based experimental study.
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Purpose: To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents. Methods: A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty?three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre? and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented. Results: The mean age of patients was 14.16 ± 3.49 years (range: 10–19 years). The mean intraocular lens power was ? 12.20 diopter spherical (DS) in 23 eyes and ? 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best?corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale. Conclusion: Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.
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Human cysticercosis is caused by cysticercus cellulosae, larvae of a tapeworm, taenia solium. Cysticercois can involve any tissue in the body even it has maximum tendency towards neural tissue. The most common affected sites are central nervous system, subcutaneous tissue, eyes and muscles. An isolated case of intramuscular cysticercosis is a rare presentation. Here we present the case of a 35 year old female with a swelling on the posterolateral aspect of right arm and was diagnosed as myocysticercosis which was abuting to the extensor muscle that is triceps muscle on high resolution ultrasound and ct scan and it was managed by antihelminthic medications followed by surgical excision.
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Background and Aims:Transcatheter device closure of congenital heart defects (CHD) has recently gained popularity. As limited literature exists regarding the ideal anesthetic technique for these procedures, we studied the perioperative anesthetic management and its effects on hemodynamics and complication rate in patients undergoing device closure. Methods: In this prospective observational study, all patients of 1 month to 50 years of age with acyanotic congenital heart diseases undergoing device closure were included. The anesthesia technique, i.e., general anesthesia with endotracheal tube (GETA)/supraglottic airway device (SGD) or conscious sedation with face mask (S?FM), and intravenous induction agent used was noted. Intraoperatively vital parameters, use of transesophageal echocardiography (TEE), and perioperative complications if any, were noted. Descriptive statistical analysis was done using a statistical package for the social sciences (SPSS) version 15. Results: GETA was used in the atrial septal defect (ASD) (62.8%), patent ductus arteriosus (PDA) (66.7%), ventricular septal defect (VSD) (65%) patients, SGD in ASD (6.3%), PDA (16.7%), and VSD (13.3%) patients. S?FM in ASD (31.3%), PDA (16.7%) and VSD (21.7%) patients. Etomidate was used as an induction agent in 30.61% of the patients and propofol in 69.39% of the patients. The mean arterial pressure (MAP) in the etomidate and propofol groups was statistically insignificant while decreased heart rate was noted in both groups. Complications like SGD dislodgement, supraventricular tachycardia, and device dislodgements were seen. Conclusion: In PDA device closure patients, GETA should be preferred. Patients for VSD device closure should receive general anesthesia as complications are common. In ASD device closure, patients without TEE use can be done under general anesthesia with SGD.
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Purpose: The purpose of this study was to compare and analyze the endothelial cell loss during manual small-incision cataract surgery (MSICS) using the viscoelastic-assisted nucleus removal versus basal salt solution plus technique. Methods: This was a prospective randomized trial of 204 patients who underwent MSICS using viscoelastic-assisted nucleus removal (Group 1- OVD) versus basal salt solution plus technique (Group 2- BSS) at a tertiary eye care hospital in North India from January 2018 to 2021. Of these 204 patients, 103 (50.5%) and 101 (49.5%) were allocated to Group 1 and 2, respectively. The parameters assessed were detailed history, demographics, and anterior and posterior segment details. Visual acuity, intraocular pressure (IOP), keratometry, pachymetry, and endothelial cell density were evaluated preoperatively and postoperatively on day 1 and 30. Results: The mean age of the patients was 64.5 � 8.2 years (range 48� years). There were 129 (63.2%) males and 75 (36.8%) females. The mean LogMAR visual acuity for both groups on day 1 (Group 1- 0.3 � 0.1, Group 2- 0.5 � 0.2) and day 30 (Group 1- 0.1 � 0.2, Group 2- 0.1 � 0.1) was statistically significant (P < 0.001), and the mean IOP value showed a statistically significant value (P < 0.009) on day 1 in Group 2 (15.0 � 2.4 mmHg) and on day 30 (P < 0.001) in both the groups (Group 1- 13.6 � 1.8 mmHg, Group 2- 13.5 � 2 mmHg). The horizontal and vertical k values also showed a statistically significant difference on day 1 and day 30 (P < 0.001). The mean percentage change of central corneal thickness (CCT) in Group 1 was 17.7% and in Group 2 was 17.4% on day 1, and it was 1.1% on day 30 in both the groups, which was statistically significant (P < 0.001) compared to preoperative values. The percentage change in endothelial cell density on day 1 was 9% in Group 1 and 4.6% in Group 2, which was statistically significant (P < 0.001). On day 30, it was 9.7% and 4.8%, respectively, which was statistically significant (P < 0.001). Conclusion: Our study highlights statistically significant endothelial cell loss with viscoelastic-assisted nuclear delivery compared to BSS-assisted nuclear delivery during MSICS in a short follow-up of 1 month. The CCT values showed a slight increase, and the keratometry and IOP were unaffected compared to the preoperative parameters in both the groups
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Purpose: The purpose of this study was to genotype two previously identified SNPs (rs1048661:R141L, and rs3825942:G153D) in the lysyl oxidase?like 1 (LOXL1) gene and determine their association with pseudoexfoliation glaucoma (XFG) in patients from Pune, India. Methods: All subjects underwent detailed phenotyping, and DNA extraction was performed on blood samples by using standardized techniques. Exon 1 of the LOXL1 gene containing the SNPs (rs3825942:G153D; rs1048661:R141L) were Sanger sequenced, and the results were analyzed using sequence analysis software SeqScape 2.1.1. Results: Data were analyzed from 71 patients with XFG and 81 disease?negative, age?matched controls. There was a strong association between the G allele of rs3825942 and XFG with an odds ratio of 10.2 (CI: 3.92–26.6; P < 0.001). The G allele of rs1048661 also showed an increase in risk relative to the T allele (OR = 1.49; CI: 0.88–2.51; P = 0.13), but this was not significant. Haplotype combination frequencies were estimated for rs1048661 and rs3825942; the GG haplotype was associated with a significant increase in risk (OR = 3.91; CI: 2.27–6.73; P < 0.001). Both the GA and TG haplotypes were associated with decreased XFG risk, although the latter was not significant (GA: OR = 0.08; CI: 0.03–0.21; P < 0.001; TG: OR = 0.67; CI: 0.40–1.13; P = 0.13). Conclusion: The risk G allele in rs3852942 (G153D) is strongly associated with the development of XFG in the Western Indian population. Genetic screening strategies to identify LOXL1 risk alleles in the population can assist in case definition and early diagnosis, targeting precious resources to high?risk patients.
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Neurological manifestations of coronavirus disease (COVID-19) have increasingly been reported since the onset of the pandemic. Herein, we report a relatively new presentation. A patient in the convalescence period following a febrile illness with lower respiratory tract infection (fever, myalgia, nonproductive cough) presented with generalized disabling myoclonus, which is phenotypically suggestive of brainstem origin, along with additional truncal cerebellar ataxia. His neurology work-ups, such as brain MRI, electroencephalography, serum autoimmune and paraneoplastic antibody testing, were normal. His CT chest scan revealed right lower lung infiltrates, and serological and other laboratory testing did not show evidence of active infection. COVID-19 titers turned out to be strongly positive, suggestive of post-COVID-19 lung sequelae. He responded partially to antimyoclonic drugs and fully to a course of steroids, suggesting a para- or postinfectious immune-mediated pathophysiology. Myoclonusataxia syndrome appears to be a neurological manifestation of COVID-19 infection, and knowledge regarding this phenomenon should be increased among clinicians for better patient care in a pandemic situation.
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Neurological manifestations of coronavirus disease (COVID-19) have increasingly been reported since the onset of the pandemic. Herein, we report a relatively new presentation. A patient in the convalescence period following a febrile illness with lower respiratory tract infection (fever, myalgia, nonproductive cough) presented with generalized disabling myoclonus, which is phenotypically suggestive of brainstem origin, along with additional truncal cerebellar ataxia. His neurology work-ups, such as brain MRI, electroencephalography, serum autoimmune and paraneoplastic antibody testing, were normal. His CT chest scan revealed right lower lung infiltrates, and serological and other laboratory testing did not show evidence of active infection. COVID-19 titers turned out to be strongly positive, suggestive of post-COVID-19 lung sequelae. He responded partially to antimyoclonic drugs and fully to a course of steroids, suggesting a para- or postinfectious immune-mediated pathophysiology. Myoclonusataxia syndrome appears to be a neurological manifestation of COVID-19 infection, and knowledge regarding this phenomenon should be increased among clinicians for better patient care in a pandemic situation.
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The shoulder can be considered as one of the largest and most flexible joints in the human body. Bursa is a liquid-filled sac that can be found between tissues (bone, skin, tendons and muscle). Bursa reduces the pressure and tension between the tissues. If the bursa isn't disturbed, joints work quickly and without discomfort. So, if it becomes bloated and inflamed, patient will experience pain during physical activity.1Subcoracoid bursa is located between the scapula's coracoid process and the shoulder joint capsule. Subcoracoid bursitis should be seen as a potential cause of painful snapping of the anterior shoulder.2 Inflammation of the sub acromial - sub deltoid bursa (SASD) has lately been indicated as a key radiological predictor indicating shoulder joint discomfort and chronic restriction in operation in both operated patients and general patients. The SASD bursa is an extra-articular synovial gap between the tendons of the rotator cuff and the under surface of the acromion, the acromioclavicular joint and the deltoid muscle, which forms the bicipital groove. Friction between the neighbouring structures or rotator cuff impingement can result in inflammation and bursitis.3 Supraspinatus tendinitis is also one factor that allows discomfort to radiate over the shoulder. Supraspinatus tendinitis progresses to tendinitis supraspinatus, specific impingement location arises in both the cycles of acromion and the bursa.4Physiotherapy modalities and manual techniques are the preferred choice of management in such musculoskeletal disorders. The shoulder can be considered as one of the largest and most flexible joints in the human body. Occurrence of shoulder discomfort in individuals is enhanced as different pathologies exist in shoulder joint systems. Shoulder bursitis is a debilitating form with shoulder joint inflammation. It is natural, treatable and found more in the young and middle-aged population. In this case, the recorded pain progression had been gradual; there was no history of fall or trauma. Pain was sharp during external rotation, abduction and flexion of the left shoulder and reported NPRS was 9 / 10 on activity. The patient was managed conservatively with PRP therapy and physiotherapy. The patient underwent 4 weeks rehabilitation and follow up for 2 weeks period in preparation for return to normal daily activities.
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Objective: The objectives of this study include performing pharmaceutical care-related research and documenting regarding drug-related problems in the surgery department. Further, these types of studies may bring consciousness to both physicians and patients regarding drug use in surgery. Methods: A Prospective interventional study was conducted in a general surgery hospital. The prescriptions were analyzed for the use of inappropriateness of drugs using the classification for drug-related problems. Results: Out of 100 cases, 62 patients were observed with drug-related problems. The number of antibiotics prescribed was 0, 1, 2, 3, 4, 5, 6 in 8, 11, 12, 32, 18, 18, 1 cases respectively. A significant increase in the outcome of antibiotic rationality and cases adhered to guidelines was seen in November compared to October and somewhat decreased in December due to some limitations. The overall study states that prescribing has a more important cause of Drug-related problems compared to dispensing and the use of the drug. Conclusion: Drug-related problems have to be acknowledged as a very important contributing treatment factor for the best health care outcome. Our study shows the importance of clinical pharmacists in every hospital for identifying and resolving drug-related problems and medication errors.
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Background: Dengue fever caused by dengue virus is a self-limiting acute febrile illness transmitted by Aedes aegypti, a daytime biting mosquito. Dengue virus belongs to family of Flaviviridae and there are 4 serotypes. A fifth serotype DENV-5 was isolated in 2013 which was said to cause mild form of the disease. In 2019 total numbers of dengue cases are 10,524 in Karnataka which is 138% increase over 2018 (4,427 cases).Methods: A retrospective conducted in Yenepoya Medical College hospital from January 2017 to July 2019 for a period of 2' years. Medical records of children who were diagnosed with dengue fever were retrieved and analyzed. Clinical and laboratory findings were noted down. Clinical course and outcome were noted down from the case sheet and cases were classified as per WHO 2011 classification.Results: 97 children diagnosed with dengue fever were included in the study. Common age group was 5-15 years. 49.5% had dengue fever, 40.2% had dengue haemorrhagic fever (DHF) and 10.3% had expanded dengue syndrome. Fever was the main complaint. Children with dengue fever presented with vomiting, abdominal pain, myalgia, arthralgia in descending order of frequency. Children with DHF, petechiae were seen in 38% patients. Among bleeding manifestations, epistaxis was more common. Children with expanded dengue syndrome had atypical manifestations.Conclusions: Dengue fever like any other viral illness, presents with prodromal symptoms which should be picked up at the earliest with high index of suspicion in children coming from endemic area. Identification of atypical manifestations and co-infections at the earliest and prompt treatment avoids serious life-threatening complications.
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Background: Osteoporosis is a metabolic bone disorder characterised by a low bone mass and microarchitectural deterioration of bone tissue followed by enhanced bone fragility and a consequent rise in fracture risk. Aim of the study is to correlate the biomarkers and bone mineral density in postmenopausal osteoporosis.Methods: This is a prospective study done in the department of obstetrics and gynaecology, Narayana medical College and Hospital, Nellore for a period of 2 years (October 2016-October 2018). This study was designed to assess the correlation between bone mineral density (BMD) and various biochemical markers.Results: The mean age of the present study is 60.51±9.35 years. There is a significant correlation found between age, serum phosphorus, urinary OHPr and bone mineral density. The mean BMI of the present study is 24.75±4.25 kg/m2. There is a significant correlation observed between BMI, serum ionized calcium, urinary OHPr and bone mineral density. There exists a significant correlation between BMD and urinary OHPr. It is found that in menopausal women spine and hip are the major sites affected by osteoporosis. The early changes are found in lumbar spine compared to hip. In the present study with increase in BMI there is increase in BMD signifying obesity is a protective factor for osteoporosis leaving aside all it’s ill effects. Urinary hydroxyproline a marker of resorption is found to have a negative correlation with BMD.Conclusions: BMD measurements using DEXA are not readily available in India. Biochemical markers of bone remodelling are useful tools in assessment of osteoporosis and are safe, inexpensive, easily performed. In the present study an attempt is made to correlate biochemical markers and BMD so as to detect osteoporosis even before the changes being evident on imaging studies.
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Fundamentos: la hipertensión arterial es el cuarto principal factor de riesgo de muerte e incapacidad, así como el responsable de más de 1.6 millones de fallecimientos en la India. Los informes de casos clínicos, los estudios observacionales y los ECA evidencian los efectos de los medicamentos homeopáticos en la hipertensión. Objetivos: los resultados de este estudio se añaden a la evidencia de la eficacia del uso de los medicamentos homeopáticos individualizados en la hipertensión de estadio I. Materiales y métodos: Se ha realizado un ensayo aleatorizado, simple ciego y controlado por placebo entre octubre de 2013 y marzo de 2018. El parámetro primario fue evaluar los cambios en la presión sistólica (PS) y la presión diastólica (PD) mensualmente durante tres meses. 217 pacientes de los 2,127 pacientes examinados cumplieron los criterios de selección y fueron aleatorizados para recibir un medicamento en potencias Q (o potencias LM) más indicaciones para la modificación del estilo de vida (MEV) (116 pacientes) o bien placebo + MEV (101 pacientes). La modificación del estilo de vida incluyó actividad física y dieta como parte de la pauta terapéutica. El análisis fue de intención de tratamiento. Resultados: Las mediciones ANOVA repetidas entre los grupos mostraron una diferencia estadística significativa (Lambda de Wilks 0.85, F=12.12, dF=213, P=0.0001) tanto en la PS como en la PD a favor de la Homeopatía individualizada. La prueba t independiente post hoc mostró una reducción media significativa de la PS [diferencia media 7.12 mmHg, IC del 95%; CI 4.72 a 9.53, P=0.0001] y un descenso medio de la PD [diferencia media 5.76 mmHg, IC del 95%: 4.18 a 7.23, P=0.0001] a favor del grupo con Homeopatía más MEV. Los medicamentos más utilizados fueron: Sulphur (n=24), Natrium muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) y Phosphorus (n=10). Conclusiones: Se ha constatado que la Homeopatía individualizada junto con la MEV fue más eficaz que el placebo junto con la MEV en los pacientes que sufren hipertensión en estadio I. Se precisan más ensayos en un marco estricto. (AU)
Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebocontrolled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2,127 patients screened, 217 patients who fitted the inclusion criteria were randomised to receive either homoeopathic Q potencies (or LM potencies) plus lifestyle modification (LSM)=116 or placebo + LSM=101. LSM included physical activity and diet as part of the treatment regimen. Analysis was by intention to treat. Results: Repeated-measure ANOVA between the groups showed statistically significant difference (Wilk lambda 0.85, F=12.12, df=213, P=0.0001), in both SBP and DBP favouring Individualised Homoeopathy (IH) along with LSM. Post hoc independent t-test showed a significant mean reduction in SBP (mean difference 7.12 mmHg, 95% confidence interval [CI] 4.72-9.53, P=0.0001) and DBP (mean difference 5.76 mmHg, 95% CI: 4.18-7.23, P=0.0001) favouring Homoeopathy plus LSM group. Sulphur (n=24), Natrum muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) and Phosphorus (n=10) were the most useful medicines. Conclusion: IH in LM potency along with LSM was found effective over placebo along with LSM in the patients suffering from Stage I HTN. Further trials in rigorous setting are warranted. (AU)
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Humans , Male , Female , Adult , Middle Aged , Homeopathic Therapeutics , Homeopathy , Hypertension/therapy , Life StyleABSTRACT
Squamous papilloma is a benign proliferation of the stratified squamous epithelium, resulting in a papillary mass, which appears as sessile or pedunculated growth with cauliflower-like projection. The most common sites are palate, uvula followed by tongue and lip. Most of the time it usually presents as a solitary, exophytic growth with an average size of less than 1 cm.Here, we report the case of a 28-years-old male patient presented with a solitary sessile, white growth with multiple papillary projections on the right buccal mucosa measuring approximately 4 x 3 cm. An incisional biopsy followed by surgical excision of the lesion was performed confirming the diagnosis of squamous papilloma. This paper highlights a case of unusually large-sized papilloma in an uncommon site.
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Background: Hematolymphoid malignancies (HLM) are primary cancers of blood, bone marrow and lymphoid organs associated with high mortality. Clinically undetected cases, diagnosed primarily at autopsy, are common.Methods: Cases of HLMs at autopsy performed in our hospital from 1st January 2009 to 30th June 2017 were analysed. Gross and microscopic findings at autopsy along with clinical parameters were studied. Special stains and immunohistochemistry (IHC) were performed wherever possible.Results: There were 49 cases of HLMs (0.98 %) among 4971 autopsies conducted during the study period, occurring predominantly in males (70 %). Fifteen (30.61 %) were primarily diagnosed at autopsy. There were 26 lymphomas and 19 leukemias; three patients had multiple myeloma and one patient had Langherhan cell histiocytosis. Non-Hodgkin’s lymphoma was the commonest (24 patients). Nine were diffuse large B-cell lymphoma; rare sub-types included angiotrophic lymphoma, post-renal lymphoproliferative disorder and hepatosplenic gamma-delta T-cell lymphoma. Among the 19 leukemias, majority were acute (13 cases) with seven cases of myeloid and six of lymphoid types. IHC was performed in 21 cases which aided the diagnosis. The commonest symptoms were fever (43%) and dyspnoea (37%). Splenomegaly (67%), hepatomegaly (61.2%) and lymphadenopathy (57.1%) were the most common autopsy findings. Infiltrations were seen in various organs; an acute myeloid leukemia (M6) had infiltration of the atrio-ventricular node.Conclusions: One-third cases in the present study were diagnosed at autopsy without any prior clinical suspicion thereby emphasizing on the relevance of autopsy in the current practice of pathology and further studies to improve accuracy of ante-mortem diagnosis.
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Linear and whorled nevoid hypermelanosis (LWNH), also known as ‘zebra-like pigmentation’ is characterized by linear and swirling streaks of hyperpigmentation along the Blaschko’slines without preceding inflammation and atrophy. It is mainly located on trunk and limbs. The hyperpigmentation may be present at birth or may develop by early childhood. Very rarely, familial cases have been described. Here, we are reporting one such rare case of familial LWNH in a 19-year-old female
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Context: Diabetes mellitus (DM) contributes to a major chunk of morbidity, mortality, and healthcare cost on a global level. The prevalence of DM is rising alarmingly, worldwide and India. Comprehensive Diabetes Care (CDC) is a combination of Panchakarma and diet management. Aims: This study was conducted to evaluate the effect of CDC on Glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight, abdominal girth and dependency on conventional therapy in DM Patients. Setting and Design: This observational study was conducted in July 2017, wherein the data of obese Type II DM patients (HbA1c >6.5%) who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified. Materials and Methods: Data of patients who were administered CDC (60-75 minutes) with minimum 6 sittings over 90 days (± 15 days) were considered. Variables were compared between day 1 and day 90 of CDC. Results: Out of 27 patients, 22 were included for analysis, out of which 10 were males while 12 females. CDC showed significant improvement in HbA1c 1.1% (from 8.80 ± 0.93 to 6.98 ± 1.73; p<0.001), BMI by 2.66 (from 33.79 ± 3.80 to 31.13 ± 3.91, p< 0.001), weight by 6.56 kg (from 83.67 ± 11.28 to 77.11 ± 12.27, p<0.001). Abdominal girth (from 104.34 ± 9.74 to 96.97 ± 11.93; p<0.001), also showed significant reduction. Dependency on concomitant medicines was reduced, with the number of patients on no concomitant medicines increasing from 27% to 41%. Conclusion: Comprehensive Diabetes Care Management Program found to be efficacious; by reducing HbA1c, as well as reducing dependency on allopathic medications.
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Pemphigus is a chronic potentially fatal autoimmune disorder that causes blisters and erosions of the skin and oral mucous membrane. most of the cases present oral manifestations as the first clinical sign along with dermal lesions. only 0.5 to 3.2 of cases are reported each year per 1,000,000 population with oral manifestations without dermal participation, and is at times difficult to diagnose. we report a case of oral pemphigus vulgaris in a 20 year old female patient without dermal manifestations treated with oral mini pulse therapy. pénfigo oral tratado con terapia minipulse. resumen: el pénfigo es un trastorno autoinmune crónico potencialmente fatal que causa ampollas y erosiones de la piel y la membrana mucosa oral. la mayoría de los casos presentan manifestaciones orales como el primer signo clínico junto con lesiones dérmicas. solo se reportan de 0.5 a 3.2 casos cada año por cada 1,000,000 de personas con manifestaciones orales sin afectación de la piel, y algunas veces es difícil de diagnosticar. presentamos un caso de pénfigo vulgar oral en un paciente de 20 años, sin manifestaciones cutáneas tratadas con mini terapia del pulso oral.