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Background: Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it. Aims/Objectives: To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it. Methods: A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India. Results: Most (84.8%) patients belonged to the age group of 16–25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education. Limitations: A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results. Conclusion: Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.
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Background: Type 2 diabetes mellitus (T2DM) is a leading cause of significant morbidity and mortality in developing countries. Evaluation of anti-diabetic drug use pattern guides the healthcare professionals to identify early signals of irrational prescribing and to plan interventions to optimize the benefits of pharmacotherapy.Methods: Observational descriptive study was conducted on 500 prescriptions of T2DM patients collected from Outpatient department of a tertiary care hospital. Prescriptions were analysed for type, number, generic/brand names, fixed dose combinations (FDCs) of anti-diabetic drugs and anti-diabetic drugs prescribed from within National List of Essential Medicines (NLEM) 2015.Results: Average number of anti-diabetic drugs per prescription was 2.5. Of these 49% were from within NLEM and only 39% were prescribed by their generic names. Among all the anti-diabetic groups of drugs used, biguanide (32.85%) was the most frequently prescribed followed by insulins (25.4%) and DPP-4 inhibitors (13.75%). Combined drug therapy was more prevalent than monotherapy (70% versus 30%). Metformin+sitagliptin and metformin+linagliptin were most commonly prescribed fixed dose combinations.Conclusions: Recent trend of anti-diabetic drug use included newer anti-diabetic drugs in combination with metformin to achieve better euglycemia and to minimize complications of T2DM.
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background and Aim: Central venous catheters can be considered as important pillars in the practice of modern-day intensivecare including oncological and onco-hematological units. However, like all medical interventions, central venous catheters tooare linked with a number of complications. The objective of the particular study had been aimed to assess the complicationslinked with peripherally inserted central catheters (PICCs) in a group of oncology patients.Materials and Methods: In this retrospective study, we included all patients carrying PICCs (n = 201) inserted at SMH cancerCentre during June 2015–May 2018 (i.e., 36 months). The major variables that were collected and analyzed have been medicalinvestigation, catheter care, placement, time span of catheterization, rationale of catheter removal, obstacles, and nursing care.Complications/obstacles were enumerated as infection, phlebitis, edema, thrombosis, ecchymosis, and/or migration.Results: The same nursing care protocol was used to treat all the patients. The rate of incidence of complications was notedto be two cases per 1000 days of catheter time span. The most pertinent complications warranting the removal of PICCs werefound to be infection and thrombosis, with an incidence of 0.17 cases per 1000 days of total catheterization duration. The averagetime period of catheterization was 170 days. In addition to common causes such as “treatment completion” (48.42%) and “death”(22.53%), the other most talked cause of catheter removal was its migration (displacement toward the exterior) of 5.90%.Conclusions: The central venous catheter (PICC) is quite a safe device that allows the administration of long-term treatment inaddition to preserving the integrity of the venous system of the patient. Adequate care of the catheter is quite crucial to preventthe occurrence of complications and improve the quality of life of the patients having oncological and hematological conditions.Thus, proper training with the latest recommendations for nursing staff as well as patients is particularly required.
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Background: Stevens–Johnson syndrome and toxic epidermal necrolysis are severe, life‑threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor‑α inhibitors. Aim: The ideal therapy of Stevens– Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments. The aim of this article is to comprehensively review the published medical literature and frame management guidelines suitable in the Indian perspective. Methods: The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these guidelines to its special interest group on cutaneous adverse drug reactions. The group performed a comprehensive English language literature search for management options in Stevens–Johnson syndrome/toxic epidermal necrolysis across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for keywords (alone and in combination) and MeSH items such as “guidelines,” “Stevens–Johnson syndrome,” “toxic epidermal necrolysis,” “corticosteroids,” “intravenous immunoglobulin,” “cyclosporine” and “management.” The available evidence was evaluated using the strength of recommendation taxonomy and graded using a three‑point scale. A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared. Results: A total of 104 articles (meta‑analyses, prospective and retrospective studies, reviews [including chapters in books], previous guidelines [including Indian guidelines of 2006] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these guidelines. Recommendations: This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1‑2 mg/kg/day or equivalent), tapered rapidly within 7‑10 days. Cyclosporine (3‑5 mg/kg/day) for 10‑14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.
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An open label randomized controlled study was conducted to compare the quality of life (QoL) and safety of newly diagnosed stage 1 hypertensive patients randomized into two groups of 30 receiving either enalapril 5 mg or losartan 50 mg per-oral once daily for three months. QoL was assessed at the baseline and at the end of study using SF-36v2 health care questionnaire. Adverse drug reactions (ADRs) were monitored. Investigations at baseline were compared with those after intervention. Pre & post-intervention QoL transformed scores within each group and change in the same between two groups were analyzed using paired and unpaired t-test respectively. Transformed scores of role limitation due to energy/fatigue, emotional well being and general health domains improved significantly in both treatment groups. Scores of bodily pain improved significantly (p=0.0008) in losartan group only. Results were not significantly different between two groups (except for bodily pain). No serious ADR was reported.
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Background: Beetle dermatitis is a common condition seen in regions with warm and tropical climate. The condition causes significant morbidity and can be misdiagnosed. Aim: The study was conducted to know the clinical profile of beetle dermatitis and to increase awareness among nondermatologist physicians about this condition. Methods: All clinically diagnosed cases of beetle dermatitis were included in the study. Detailed history was taken and a thorough clinical examination was conducted in all the cases. Clinical photographs were taken in all the cases. Results: A total of 70 cases comprising of 46 males and 24 females were studied. The age of the patients ranged from 5 to 60 years. Majority of the cases presented during the post monsoon months (September-November), indicating a distinct seasonal trend. Morphology of lesions was mainly linear, but kissing and bizarre lesions were also observed. Head, neck and upper extremities were the most commonly involved sites. Fever and malaise was observed in a few cases. Conclusion: Beetle dermatitis should be included in differential diagnosis while examining erythematous vesicular lesions of sudden onset, especially on exposed parts during rainy and post rainy season. Awareness of this condition and its clinical features among the physicians will prevent misdiagnosis. Preventive measures can be undertaken based on the behavioral pattern of this beetle.
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Bleomycin frequently causes cutaneous toxicity in the form of pigmentary disturbances. We report 2 patients with testicular tumours who developed distinctive "flagellate" pigmentation on trunk and extremities during bleomycin therapy.