Seasonal variation of allergy profile of patients visiting a tertiary care hospital in hilly areas of Himachal Pradesh

Background: Allergic diseases are very common and are caused by allergen whose role varies according to climate changes. Not many studies are available regarding the same in our region. Skin prick test is a diagnostic procedure for allergy testing. The aim of the present study was to find out the seasonal variation of different allergies in our region.Methods: A total of 686 patients with allergic complaints were assessed for age and sex distribution, seasonal variation of number of allergy patients and seasonal variation of patient symptoms. 608 patients who gave consent and were found fit for skin prick tests underwent the tests and were analysed for allergy profile of the patients in different seasons.Results: The majority of patients were females and of younger age group. The majority of the patients had nasal symptoms and these symptoms were more in summer and rainy season during which pine mix and grass pollen were common allergens. Pulmonary symptoms were maximum in winters with dust mite and moulds being the common allergens. Dust mite was overall the most common allergen involved. Sensitization to allergens was less in winter months.Conclusions: This study focussed on seasonal variation of allergies and found pine mix and grass pollens to be major cause of nasal allergy and dust mite and mould mix to mainly cause pulmonary symptoms.

Isolated tear in left atrial appendage due to blunt trauma chest: a rare case report

Blunt traumatic cardiac rupture is associated with a high mortality rate. Motor vehicle accidents account for most cardiac ruptures, but crush injury is relatively rare. We describe a case of a 72-year-old man who had the left atrial appendage ruptured through blunt trauma due to a fall from scooter. Simple suture repair of the atrial appendage was achieved after clamping the base of the left atrium to control the bleeding. He recovered without complication. Traumatic injury to left atrial appendage is rarely seen and reported

Comparative Clinical Trial of Paracetamol alone and Vitamin C and E as an Add on Therapy in Patients Suffering From Primary Knee Osteoarthritis.

A randomized observational blind comparative clinical study was conducted to compare the antioxidant effect of vitamin C and E with paracetamol in patients of primary knee osteoarthritis.Subjects presenting with sign, symptoms of primary knee osteoarthritis were given paracetamol 1 gm (n=50) twice daily for 8 weeks and combinations of paracetamol 1gm bid with vitamin C (500 mg ) and E (200 IU) (n=50) twice daily for 8 weeks. Subjects completed an over all evaluation of symptoms relief on 2nd, 4th and 8th weeks of completed treatment were evaluated by clinical, routine laboratory and radiographic investigations for improvement of disease conditions, also for adverse drug reaction. On completion of 8 weeks of treatment it was observed that both the treatment group patients showed significant efficacy with better results with patients receiving antioxidant therapy in primary knee osteoarthritis patients (p<0.001) and adverse drug reaction were minor and none of patients complain of any severe adverse drug reaction. Present study indicate that antioxidant therapy can be used as an effective add on therapy in primary knee osteoarthritis.

Retinitis pigmentosa and congenital toxoplasmosis: a rare coexistence.

We describe a previously unreported co-existence of retinitis pigmentosa and congenital toxoplasmosis. An eight year old male presented to our center with complaints of decreased night vision. Fundus evaluations in both the eyes demonstrated features typical of retinitis pigmentosa. There were well-defined punched out healed chorio-retinal scars suggestive of congenital toxoplasmosis. On the basis of history, clinical findings and reduction of a and b wave amplitudes on scotopic and photopic electroretinograph, a diagnosis of retinitis pigmentosa with congenital toxoplasmosis was made. Retinitis pigmentosa may co-exist with congenital toxoplasmosis that may affect the patient's overall ocular morbidity and visual acuity.

Recurrent Salzmann's nodular degeneration: report of two cases and review of literature.

Recurrence of Salzmann's nodular degeneration following corneal transplantation is uncommon. The earlier reports of recurrence of Salzmann's degeneration were based on clinical evidence. We report two histopathologically proven cases of recurrence of Salzmann's nodular degeneration following keratoplasty; one recurring after lamellar keratoplasty and the other following penetrating keratoplasty. Two male patients (40 yrs and 24 yrs) presented to us with a clinical picture of Salzmann's nodular degeneration. One patient had undergone lamellar keratoplasty in both eyes for Salzmann's degeneration, 22 years ago. A repeat lamellar keratoplasty was performed in the right eye (7.5 mm/8 mm). In the other patient, penetrating keratoplasty was performed in the left eye, 6 years ago for the same. Lamellar keratoplasty was performed in the left eye (8 mm/8 mm). The histopathologic evaluation of the host button in both the cases, showed features very much suggestive of a recurrence of Salzmann's nodular degeneration.

Genetic basis of HIV-1 resistance and susceptibility: an approach to understand correlation between human genes and HIV-1 infection.

HIV infection is the serious medical and public health issue of present generation. By 2005, it has already infected a cumulative total of more than sixty million people worldwide and the number of HIV positive cases are rising day by day. India is currently estimated to have about 5.1 million infected persons with HIV-1 or AIDS (second only to South Africa) and this number could increase to 24 million in the next ten years. This pandemic situation of the AIDS stimulated a plethora of longitudinal cohort studies which are designed to document medical heterogeneity as well as to mitigate the factors that regulate the HIV-1 infection, disease progression and the immune defenses. In recent years these genetic studies have led to the discovery of various MHC and non MHC encoded genes, which directly or indirectly influence the susceptibility and resistance to HIV infection and AIDS. These genes and their mutated forms and their products which play a major role in determining the susceptibility or resistance to HIV-1 infection and AIDS. These genes have been categorized into MHC or non MHC encoded genes. The MHC encoded genes which determine HIV resistance or susceptibility are HLA-B57, HLA-B58, HLA-B27, HLA-Bw4 and HLA-A11 in Southeast Asians. On the other hand, non MHC encoded genes are CCR5, CCR2, RANTES, CXCL12, CXCR6, CCL3L1, Interleukin-10 (IL-10), and interferon gamma. The site specific mutations in these genes determine the susceptibility or resistance to HIV-1 infection and AIDS. In future the study of host genes in relation to HIV-1 infection may provide the researchers to develop newer chemotherapeutic approaches to prevent or cure HIV-1 infection effectively.