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Introduction: Psychiatric disorders are most prevalent (adjustment disorder- 13-42%, depression- 41-47% and generalized anxiety disorders upto 15%) in cancer patients. Some of initial responses like shock and denial, fear of disease and anxiousness about familial responsibilities are also common. Study aimed to investigate psychiatric morbidity in cancer patients. Material and Methods: The study was conducted at the cancer research centre of a large tertiary care hospital. Hamilton Rating Scale for Depression and Beck Anxiety Inventory were administered to the 200 cancer patients and 200 normal healthy relatives of patients. It was followed by a formal psychiatric interview based on the International Classification of Diseases-10 (ICD-10). The patients were studied before commencement of treatment to know the effect of cancer on psychological status of cancer patients. Results: The study revealed that a significant number of cancer patients (74%) suffered from psychiatric diagnostic entity (Adjustment disorder in 32%, Depression in 32% and Anxiety disorder in (10%) and other morbidities (suicidal ideations in 32%, Fear of disease and anxious about their familial responsibilities in 12% and Denial defense mechanism in 6%). Gastro-intestinal cancer patients suffered more from depression and other psychiatric disorders. Evaluation by Hamilton Rating Scale for Depression and Beck Anxiety Inventory also revealed more and statistically significant (P value= 0.000 and 0.011, respectively) psychiatric disorders and morbidities among cancer patients. Conclusions: The patients who were old, male, married, less educated and from lower socioeconomic status (SES) suffered more. However, female patients suffered more from adjustment disorder and more middle aged men had fear of disease and were anxious
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Introduction: Soft palate (velar) plays an important function in head and neck region. Its diverse morphology is implicated invarious diseases.Aims and Objectives: The aim of this study was to evaluate the morphological variants of soft palate in each group of normal,oral submucous fibrosis, and obstructive sleep apnea (OSA) patients. The objective of this study was to evaluate the morphologicvariations of velar using digital lateral cephalogram.Materials and Methods: This study was conducted in the department of oral medicine and radiology and department of publichealth dentistry. Three groups were made, each of 50 patients. The soft palate morphology was evaluated according to theclassification given by You et al.Statistical Analysis: The collected data were subsequently processed and analyzed using the SPSS statistical packageversion 17.Results: We found that most common soft palate morphology in Group I was rat-tail, whereas in Group II and Group III, themost common morphology was leaf shape.Conclusion: Soft palate has different morphology. It may help in successful functional and structural repair in cleft palate casesand shed some light toward the cause of OSA and related disorders.
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Introduction: Mandibular canal or inferior alveolar canal isan important anatomical landmark in mandible which containsneurovascular bundles. Mandibular canal is considered asreference anatomical landmark in maxillofacial surgeries.The aim of this study was to evaluate the course and visibilityof the mandibular canal in Darbhanga (Bihar) populationon digital panoramic radiographs, and the objective was toassess the normal variation of mandibular canal on panoramicradiographsMaterial and Methods: A total of 500 panoramic radiographswere selected from the archives of our department as softcopies. The course of mandibular canal was evaluated onpanoramic radiographs. The collected data were subsequentlyprocessed and analyzed using SPSS statistical package version17.Results: We found that elliptic curve is most common curve.Visibility of mandibular canal is more in the third molarregion compared to first molar region. Conclusion: In thepresent study, most common curve was elliptic curve (64.8%)followed by linear curve (22.2%). Visibility of mandibularcanal in third molar region was 98.1%. In both gender, ellipticcurve was most common curve.
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Introduction: Knowledge of alveolar loop of inferior alveolarcanal is important to prevent any post operative complicationsafter mandibular surgery or any prosthesis placement inmandible parasymphysis region. The aim of this study wasto visualize anterior loop in Darbhanga (Bihar) populationon digital orthopantomogram radiographs and the objectivewas to evaluate the frequency of anterior loop in different agegroups on digital orthopantomogram radiographs.Material and Methods: The study was done in the Departmentof Oral Medicine and Radiology and Department of PublicHealth Dentistry. A total of 303 panoramic radiographs wereexamined by a single radiologist. Anterior loop was examinedin all 303 radiographs. The collected data were subsequentlyprocessed and analyzed using SPSS statistical package version17.Results: We found that anterior loop was visible in 39.6%of population. Anterior loop was most commonly seen inyounger age group. As the age advanced visibility of anteriorloop was reduced.Conclusion: In the present study, a total of 606 sites wereexamined on radiographs. Out of 156 male subjects, anteriorloop was visible in 68 subjects and out of 147 female subjects,anterior loop was visible in 52 subjects only. Visibility ofanterior loop in subjects aged 50 or more than 50 years wasseen in only 9 subjects.
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Dermoepidermal junction is the most complex structural and functional microscopic zone of the skin that enables both epidermal and dermal units to interact in many complex ways in order to perform various functions. Elimination of exogenous foreign substances or altered dermal constituents from dermis to the skin surface via epidermal channel is one of the functions of this zone which has been the mainstay in the pathogenesis of various perforating dermatoses.
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Paternally transmitted damage to offspring is recognized as a complex issue. Each parent contributes 23 chromosomes to a child; hence, it is necessary to know the effects of both maternal and paternal pre-and peri-conceptional exposure to drugs on pregnancy outcome. While there are many studies on the effects of maternal drug exposure on pregnancy outcome, literature on paternal exposure is scarce. Of late however, paternal exposure has been receiving increasing attention. We present a brief review on the safety of commonly used drugs in dermatology, focused on retinoids, immune suppressants, anti androgens and thalidomide.
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A 35-year-old man presented with a solitary, large, 15 cm × 25 cm, oval annular plaque with a characteristic peripheral keratotic ridge with a central groove on his back [Figure 1]. Besides, there were two round ulcerated overgrowths with a verrucous surface present along the inferior margin of the plaque. Further, there were multiple hyperkeratotic elongated horny eruptions distributed on the primary lesion. Biopsy from the margin of the primary plaque showed cornoid lamella (column of parakeratotic cells overlying a zone of hypogranulosis) confirming porokeratosis while a biopsy from the ulcerated lesion showed keratin pearls, atypical keratinocytes with hyperchromatic nucleus and numerous mitotic figures suggestive of squamous cell carcinoma.
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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.