Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center

Background: Sexually transmitted infections (STIs) constitute a major health problem in the developing countries and prevalence of STIs varies from region to region in our country. Aim: To study the pattern and prevalence of sexually transmitted infections and HIV seropositivity among patients presenting in a tertiary care center. Materials and methods: A retrospective data was collected in the department of Dermatology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIHMS), Shri Mahant Indiresh Hospital (SMIH), a tertiary care center in Dehradun, Uttarakhand, India, from January 2011 to December 2018. A total of 525 patients were analyzed in this study. Results: A total of 525 patients were enrolled in our study. STIs were more common in men, with male (365): female (160) ratio of 2.2:1. Maximum numbers of patients were in the age group of 25 to 34 years. Unskilled workers (22.28%) and housewives (20.00%) constituted major proportion. Majority of the cases presented with warts (38.09%) followed by molluscum contagiosum (20.95%) and herpes genitalis (19.61%). But herpes genitalis (27.39%) was found to be the most common STD seen among males and warts (68.75%) among the females. HIV seropositivity was seen among 20 (3.80%) patients and was most commonly associated with herpes genitalis infection (60.00%). Gunjan Gupta, Jitendra Singh Bist, Rahul Sudan, Kewal Krishan, Neeti Kumari. Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center. IAIM, 2019; 6(2): 7-12. Page 8 Conclusion: Increased prevalence of viral STDs like herpes genitalis, genital warts and mollascum contagiosum was seen in our study. Widespread use of antibacterial lead to falling trend of bacterial STDs.

Quality of medical education: Is our health in safe hands?

The medical profession, once considered a “noble profession” has been under the scanner for deterioration in services. This decline is generally attributed to commercialisation of services, waning human values, and a lack of empathy and communication skills. At a time when discussions are focused on devising approaches to test medical students for attributes such as empathy, communication skills and concern for the less privileged, developing nations like India are suffering from the “problem of too many”. On the one hand, a skewed doctor-patient ratio in India (less than 1 doctor per 1000 people that is lower than that prescribed by the World Health Organisation) has left medical practitioners so overburdened, they have little time to empathise with their patients. Students inadvertently follow their teachers and the vicious cycle continues. On the other hand, there has been a mushrooming of commercially–run medical institutions to overcome this shortage of doctors. Medical education has become unaffordable to many and, very obviously, merit has taken a back seat.

Study of cutaneous manifestations in HIV infection

Background: HIV infection is associated with numerous cutaneous changes even before the onset of immunologic dysfunction and AIDS. We all know that as search for reliable clinical indicators for management of human immunodeficiency syndrome in resource poor settings continues, cutaneous disorder can be a good clinical marker of HIV infection, underlying immune status and the disease progression. Aim and objectives: To study occurrence of various cutaneous manifestations in a patients infected with HIV. Materials and methods: 120 HIV positive patients above 14 year old with definite cutaneous manifestations attending dermatology OPD in Department of Skin, STD and Leprosy, in a tertiary care centre Dehradun were studied from December 2013 to January 2016. Results: Among 120 HIV positive patients in our cross-sectional study highest number of patients belonged to 31-40 years age group. Male to female ratio was 1.9: 1 and heterosexual route was the most common route of transmission. Among all cutaneous manifestations pruritic papular eruption, cutaneous drug reactions, molluscum contagiosum, seborrheic dermatitis were common. 14.17% had more than one cutaneous disorder and they had advanced stage of the disease. Conclusion: Early recognition of the cutaneous manifestation can help in better management of HIV infection in resource poor setting as it can indicate progression of the disease and underlying immune status

Thyroid abnormality in hilly children with vitiligo: A case control study

Background: Vitiligo is a common disorder causing depigmentation of the skin affecting patient’s quality of life. Various autoimmune disorders accompany vitiligo; this study was done to determine the prevalence of thyroid abnormality in children with vitiligo and compared with controls in this part of India. Materials and methods: Forty five children, suffering from non-segmental vitiligo, less than 16 years old and 60 healthy children were enrolled as cases and controls, respectively. Serum levels of Thyroid stimulating hormone (TSH), Free triodothyronine (fT3), Free thyroxine (fT4) and Anti-TPO antibody were accessed and compared with controls. Results: In both the groups, females outnumbered males. Thyroid function tests and thyroid autoantibodies abnormality were found in 15 (33.3%) cases. In controls, 8 (13.33%) children had increased TSH. The difference in both groups for thyroid function abnormality was significant (P= 0.0142). Conclusion: There is significant incidence of thyroid disease in children with vitiligo and hence they should be screened for thyroid function tests.

Physical growth and nutritional status of Garhwali girls.

OBJECTIVE: The present study was conducted to evaluate physical growth and nutritional status of 214 school-going girls ranging in age from 5 to 12 years of rural area in Pauri Garhwal district of Uttaranchal. METHODS: Physical growth was evaluated using eleven standard anthropometric measurements viz., height, body weight, sitting height, biepicondylar humerus, bicondylar femur, head circumference, chest circumference, upper arm circumference, biceps skinfold, triceps skinfold and subscapular skinfold. To assess the nutritional status, weight deficit for age, height deficit for age, upper arm circumference deficit for age and triceps skinfold deficit for age have been calculated using NCHS standards. RESULTS: It has been observed that the well nourished Indian girls and American girls show better performance in physical growth parameters as compared to the Garhwali girls at all ages. The Garhwali girls were found to be comparable with rural Indian girls in their growth status. Grade-I and Grade-II malnutrition was prevalent among the Garhwali girls, however, Grade-III malnutrition was found to be present in only a few girls. CONCLUSION: This average to poor nutritional status of the present Garhwali girls may be attributed to low dietary intake, low-middle socio-economic background, uneducated or partially educated parents, large family size, gender discrimination etc.

Intra-individual difference between recumbent length and stature among growing children.

OBJECTIVE: Difference between recumbent length and stature in an individual has been observed by many researchers in the past in European and American populations. The present study explores the intra-individual differences between recumbent length and stature (R.L.-Stature). METHODS: A sample of 920 school-going children was considered in Chandigarh city. RESULT: These differences are found to be statistically significant and have definite relationship with age and weight of the children. The mean difference between recumbent length and stature is found to be greater in males than in females between 5 through 10 years and between 15 through 18 years of age. However, between 10 through 15 years, it was greater in females than in males. CONCLUSION: This was largely due to the fact that adolescent spurt in stature preceded by two to three years in girls than that of boys. This difference was also found to be significantly correlated with age, weight and stature in both the sexes. Two regression equations are derived separately for the two sexes, from which, one can convert recumbent length into stature and vice-versa.