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AIM: To evaluate and compare macular thickness changes after uneventful Phacoemulsification and Manual Small Incision Cataract Surgery in correlation with visual acuity. METHOD: Study was conducted on 250 cataract patients they were equally divided into Group A and Group B. Group A patients underwent Phacoemulsification and Group B underwent MSICS. In both groups macular thickness using OCTand Best Corrected Visual Acuity (BCVA) was recorded preoperatively and postoperatively at 1 day, 1, 3, 6 weeks, 3 and 6 months. Macular thickness changes were evaluated and compared with visual acuity. RESULTS: Macular thickness continued to increase from 1 week to 6 months postoperatively which was statistically significant. No correlation found between increased macular thickness and BCVA. CONCLUSION: Increase in macular thickness remained subclinical and there was no impact of increased macular thickness on the final visual outcome.
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Background: Concerns about toxicity of mercury and disposal of excessive mercury has led to decreased usage of mercury in dental profession but still tooth colored restorative materials are not affordable by all the classes of any society. The disposal of excess mercury has always been a matter of concern. Thus, in the present study, we attempted to evaluate a simple procedure from Rasa Shastra using lime powder, garlic and rock salt for recycling of excess mercury obtained from dental operatory. Materials and methods: The excess mercury was recycled by the standard procedure explained in Ayurveda texts (Samanya shodhana) using Sudha churna (lime powder), Lashuna kalka (paste of Allium sativum L.) and Saindhava lavanaa (rock salt). The commercially available mercury and recycled mercury was analyzed by inductively coupled plasma mass spectrometry (ICP-MS) for the detection of elements in ppm level. Results: It was found that the excess impure mercury contained 5138 ppm, 2866.1 ppm and 0.371 ppm of Silver, Copper and Tin respectively. After Shodhana, the level of silver, tin and copper were markedly reduced. Purified mercury showed a level of 119.5ppm silver, 0.5324 ppm copper and 0.3233 ppm tin. Conclusion: Samanya shodhana is a simple promising procedure which can be used for mercury recycling. The procedure doesnot require sophisticated equipments and maneuver. Further, the materials used in the procedure are easily available and affordable at low cost.
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Objective: To assess the magnitude of male genital ulcer [MGU] and its clinico-demographic profile in patients attending dermatology OPD and STI clinic of a tertiary care hospital in the eastern part of India
Methods: The study was institution-based cross-sectional descriptive study conducted over a period of one year. All the male patients presenting to Dermatology OPD and STI clinic with complaints of genital lesions were screened for genital ulcer/s. Those having genital ulcer and giving consent for participating in the study were included in the study. At the end of study period, data were analyzed
Results: 110 patients with MGU among 22,528 male patients attending Dermatology OPD and STI clinic were included in study and relative prevalence rate was calculated as 4.88 per 1000. Non-sexually transmitted ulcers [non-STU] [65.5%] were leading cause of MGU. Among sexually transmitted ulcers [STU], genital herpes was the most common disease. Dermatitis-related ulcer, scabies related ulcer, and Zoon's balanitis [plasma cell balanitis] were most common non-STU. Positive history of sexual exposure was found in around 53.2%, 97.4% and 22.2% of MGU, STU and non-STU, respectively. Commercial sex workers were the major sex partner in both STU and non-STU groups
Conclusion: Non-sexually transmitted ulcers were more common than sexually transmitted ulcers. History of sexual exposure was seen in both STU, and non-STU. Hence, history of sexual exposure should not bias clinician towards making a diagnosis of STU
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Objective: to determine the relative indications and clinicopathological consistency of skin biopsy
Mehods: 371 of 28466 cases undergoing skin biopsy were reviewed and their histopathological reprts evaluated for consistency with clinical diagnosis
Results: 371 [1.3%] cases needed skin biopsy for diagnosis. Of these, 67.4% cases were consistent, 19.1% were corroborative and 13.5% were inconsistent with clinical diagnosis
Conclusion: Providing proper history and clinical findings, provisional and differential diagnosis to pathologist increases the diagnostic yield of skin biopsy
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Background. We aimed to determine the prevalence of coeliac disease among children with short stature at a tertiary care centre and to define the predictors for coeliac disease, if any, in them. Methods. In this retrospective study, we reviewed the case records of children and adolescents with growth retardation attending the Paediatric Endocrinology Clinic from January 2008 to June 2011. All patients underwent the multi-tier stratified diagnostic protocol for complete evaluation of short stature. Coeliac disease was screened using IgA-anti-tissue transglutaminase antibody. The diagnosis of coeliac disease was made on the basis of the modified European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. Results. Of 432 patients (238 boys) who presented with short stature, 72 (16.7%) had physiological, while 360 (83.3%) had pathological causes. Endocrine causes were growth hormone deficiency (86 patients, 19.9%), hypopituitarism (31, 7.2%), hypothyroidism (22, 5.1%) and others (7, 1.6%). The systemic causes were: coeliac disease (47, 10.9%), haematological diseases (14, 3.2%), renal diseases (11, 2.5%) and others (24, 5.6%). Chronic diarrhoea (OR 15.7, 95% CI 7.8–31.5) and anaemia (OR 4.9, 95% CI 1.9–12.7]) were significant predictors for coeliac disease in patients with short stature. There was a definite response to gluten-free diet in them and the mean (SD) growth velocity measured over at least 6 months of gluten-free diet was 8.1 (3.0) cm/year. Conclusion. Nearly 11% of patients presenting with short stature have coeliac disease. In these patients chronic diarrhoea and anaemia were significant predictors of coeliac disease.
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Objective To find the relative prevalence of lepra reactions among leprosy patients attending Dermatology out-patient department, the pattern of reactions in different types of leprosy and histopathological features of reaction.
Methods The study was an institution-based, longitudinal study. A total 316 leprosy cases attended the Dermatology out-patient department [OPD] of a tertiary care hospital in Eastern India.
Results Out of 316 leprosy patients, 58 [18.4%] were diagnosed to have lepra reactions and relative prevalence of type 1 and type 2 reaction was 10.4% and 7.9%, respectively. Among 58 patients, 50 fulfilled the inclusion criteria and were considered for final evaluation. Lepra reactions were common in patients over 30 years of age. There was a high male preponderance and the male to female ratio was 4.5:1. More than 60% of the patients belonged to the below poverty line. Farmers and laborers were more affected. Almost 62% of the patients were literates but most of them had primary education only. Type 1 reaction was more common in BT patients [50%], whereas type 2 reaction were more commonly seen in LL patients [32%]. Erythema and swelling of the skin lesions, neuritis and edema of hands and feet were common features of type 1 reaction. Fresh crops of tender evanescent nodules, joint pain, neuritis and fever were common in type 2 reaction. Classical histopathological features were present in all the 50 slides examined. In type 1 reaction patients, lymphocytic infiltration [96%], dermal edema [93%], epithelioid cells [78%] and Langhans type giant cells [15%] were the common histological findings. Edema and foamy macrophages were seen in all cases of type 2 reaction patients. However, polymorphonuclear leucocytes and vasculitis were seen in 21 [95%] and 16 [73%] patients, respectively.
Conclusion Lepra reactions, both type 1 and 2, occur in about 20% of leprosy patients. Early detection is warranted to avoid complications.
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Angiokeratoma corporis diffusum [ACD] is a rare clinical type of angiokeratoma and has been reported, mostly, in association with various life threatening conditions, of which Fabry disease is the most known. Rarely, it has been reported as an isolated finding without any systemic features. A 23-year-old male presented with numerous red papules of various sizes with a history of intermittent bleeding. Histopathology findings were consistent with angiokeratoma and our case was diagnosed as ACD. We herein present a case of cutaneous variant of ACD without any associated systemic associations. Also, the conditions associated with ACD have been briefly discussed.
Subject(s)
Humans , Male , Skin/pathology , Angiokeratoma , Dilatation, Pathologic , Aspartylglucosaminuria , FucosidosisABSTRACT
Objective: To review the disease course in patients with steroid sensitive nephrotic syndrome (SSNS) and the factors that determine outcome Design: Retrospective, analytical Setting: Pediatric Nephrology Clinic at referral center in North India Participants/patients: All patients with SSNS evaluated between 1990 and 2005 Intervention: None Main outcome measures: Disease course, in patients with at least 1-yr follow up, was categorized as none or infrequent relapses (IFR), frequent relapses or steroid dependence (FR), and late resistance. Details on complications and therapy with alternative agents were recorded. Results: Records of 2603 patients (74.8% boys) were reviewed. The mean age at onset of illness and at evaluation was 49.7±34.6 R E S E A R C H P A P E R INDIAN PEDIATRICS 881 VOLUME 49__NOVEMBER 16, 2012 and 67.5±37.9 months respectively. The disease course at 1-yr (n=1071) was categorized as IFR in 37.4%, FR in 56.8% and late resistance in 5.9%. During follow up, 224 patients had 249 episodes of serious infections. Alternative medications for frequent relapses (n=501; 46.8%) were chiefly cyclophosphamide and levamisole. Compared to IFR, patients with FR were younger (54.9±36.0 vs. 43.3±31.4 months), fewer had received adequate (≥8 weeks) initial treatment (86.8% vs. 81.7%) and had shorter initial remission (7.5±8.6 vs. 3.1±4.8 months) (all P<0.001). At follow up of 56.0±42.6 months, 77.3% patients were in remission or had IFR, and 17.3% had FR. Conclusions: A high proportion of patients with SSNS show frequent relapses, risk factors for which were an early age at onset, inadequate initial therapy and an early relapse.
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Alopecia areata [AA] is a chronic inflammatory condition that affects the hair follicles and sometimes, the nails. It is believed that AA is caused by T cell-mediated autoimmune response and increased frequency of other autoimmune diseases in persons suffering from AA supports this hypothesis. A 12-year-old boy presented with extensive alopecia areata with pitting in all nails for 6 years. He had developed lesions of vitiligo and lichen planus on trunk in a segmental manner. While the association of alopecia areata and vitiligo as well as lichen planus is well known, segmental nature of both vitiligo and lichen planus is quite rare
Subject(s)
Humans , Male , Vitiligo/diagnosis , Lichen Planus/diagnosis , NailsABSTRACT
A 17-year-old girl presented with multiple perifollicular hemorrhagic lesions on legs for 2 weeks. There was history of intermittent gum bleeding for last 2 months. Clinical examination revealed follicular keratosis and broken twisted hair [corkscrew hair], in addition to hemorrhagic lesions. Perifollicular hemorrhagic lesions and corkscrew hair are virtually pathognomonic for scurvy. When specifically asked, mother revealed that the girl was on self-imposed diet with almost no citrus fruits. Based on history and clinical findings, diagnosis of scurvy was made. The response to vitamin C supplementation was very good and all the lesions disappeared within one month. Scurvy has been reported in increasing numbers in recent literature; hence, recognition of scurvy is essential to avoid many serious complications including internal bleeding and even, death
Subject(s)
Humans , Female , Scurvy/diagnosis , Ascorbic Acid Deficiency/complications , Hair , Hemorrhage , Leg , KeratosisABSTRACT
Inverse [flexural] psoriasis is characterized by shiny, pink to red, sharply-demarcated thin plaques. Frequency of isolated involvement of these areas is very rare and the morphology is frequently altered by maceration and friction. All this leads to diagnostic confusion. We describe two cases of inverse psoriasis with isolated involvement of axillae. One patient presented with dry mildly scaly plaque, while the other presented with macerated plaque. Histopathology was consistent with the diagnosis of inverse psoriasis. Although there are previous reports, but localization of lesions only to axillae in a case of inverse psoriasis is unique