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Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi commonly affecting nasal mucosa, conjunctiva, and urethra. Subcutaneous tumor nodule presentation is rare and often mimics as sarcoma. Such tumoral rhinosporidiosis has been reported rarely. This report describes a 60-year male who presented with a solitary, firm, nontender swelling in posterior aspect of right leg with an ulcer and mimicking clinically as soft tissue sarcoma. Histopathology was diagnostic. Surgical excision was found to be useful.
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The disability and progress of leprosy patients is monitored by the WHO disability grading system which has limited sensitivity in leprous neuropathy. This study aims to report the spectrum of leprosy patients at a tertiary care neurology service and compare WHO grading, modified Rankin Scale (mRS) and Leprosy Neuropathy Scale (LNS) in monitoring the treatment outcome. The patients with leprosy diagnosed as per WHO criteria were subjected to medical history and clinical examination. Their disability was graded as per WHO grading scale, modified Rankin scale (mRS) and LNS. These parameters were repeated and compared after six months of multiple drug therapy (MDT). Thirty-eight patients with leprosy, aged 40 (`5-80) years, 33 of whom were males have been evaluated. The duration of symptoms was 24 (91-120) months. Mononeuropathy was present in 14, mononeuropathy multiplex in 24, trophic ulcer in two, claw hand in 11, wrist drop in two, foot drop in four, facial palsy in one, Charcot’s joint in one and lepra reaction in seven patients. Their disability as per WHO grade 1 and 2 was in 19 patients each. After 6 months of MDT, WHO grade improved in two patients, mRS revealed improvement in seven and LNS in nine patients. LNS- a clinical scale, seems more effective and easier to use for monitoring the progress/ outcome of neuropathy in leprosy patients and may complement the WHO grading scale
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Background: Skin diseases occur in all age groups in developed and developing countries. Various types of skin diseases are found worldwide and depend on factors like environment, surrounding ecology, dietary habits, socioeconomic status, mental health, and literacy. Health-related quality of life (HRQOL) improves after treatment or cure of the diseases. Objectives: To estimate the pattern of skin disease. To find out the quality of life and association of skin disease with sociodemographic factors among patients. Methods: This observational cross-sectional study was done in skin OPD at the tertiary care center, Banda district of Uttar Pradesh, India from May 2022 to July 2022. All patients who attended to skin OPD during study period were included in the study after taking informed verbal consent. Results: Skin diseases had further divided in subcategories which were infectious conditions, pigmentary disorders, inflammatory dermatoses, miscellaneous skin conditions, benign tumor and other lesions with their percentage 44.8, 10.5, 28.6, 7.1, 2.9 and 6.2%, respectively in this study Classes of DQLI where major portion of patients (49.52%) were in ‘Small effect on patient’s life’ category. The relation of age, religion, education and member of household with history of skin disease were found to be highly statistically significant. Conclusion: Infectious skin diseases were found more common in study area. Male populations were more commonly affected. Skin diseases were more common in age group of 18–60 years. Study participants showed no predominant effect on quality of life. But small effect class had major effect on participant’s quality of life.
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Introduction: Overweight and obesity has become a worldwide epidemic and is a growing public health concern. The increase in prevalence and severity of obesity among children and adolescents has been attributed largely to behavioral factors such as changing eating habits and sedentary lifestyles. Objective: To determine prevalence of obesity and abdominal obesity among adolescents and its association with sociodemographic factors and lifestyle. Methods: Present cross-sectional study was conducted in the urban field practice area under the Community Medicine Department of LLRM Medical College, Meerut, among 872 adolescents. All localities in the field area were covered and house to house survey was done. Questions were asked about eating patterns, physical activity and sedentary lifestyle. Data was collected and analyzed using appropriate statistical tests. Results: The prevalence of overweight and obesity was 17.43, 6.88%, respectively. Obesity was significantly higher among females, those who indulged in unhealthy eating habits were physically inactive, watched television for a longer duration and ate junk while watching television. Conclusion: In the present study, we found that high junk food consumption and a sedentary lifestyle were found to be significantly associated with childhood overweight/obesity. As a result, timely interventions should be taken to improve awareness about healthy lifestyle behavior to prevent obesity and its complications among adolescents.
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Background: Foot ulcers are considered as a serious complication, especially for patients with diabetes. People with diabetes and people with peripheral vascular disease are more likely to develop foot ulcers. If an infection occurs in an ulcer and is not treated in the proper way, it can develop into cellulitis, osteomyelitis, or gangrene that may require some part of the toe, foot, or lower leg to be amputated. The aim of this study was to find the socio-demographic, clinical, and diabetes status of foot ulcer patients. Material & Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, during the period from March 2012 to August 2012. In total 100 patients with foot ulcers in the different surgical units of the mentioned hospital were enrolled in this study as study subjects. Data from the study regarding age, sex, occupation, smoking habit, and socio-demographic condition were recorded in the prescribed questionnaire. The purposive sampling technique was used for this study. All data were processed, analyzed, and disseminated using MS Excel and SPSS version 23 programs as necessary. Results: In this study, the male-female ratio of the participants was 2:1. The maximum number of patients (42%) were from the age of 51-60 years and the highest number of patients were housewives (28%), followed by farmers (22%). Among the total male patients, 87.88% were smokers. Low HDL was found in 51% of patients and 68% of patients had been suffering from diabetes mellitus,18% from Buerger’s disease and 6% from atherosclerosis, and 8% from malignant foot ulcer. Most of the diabetic patients (95.59%) were hyperglycemic on admission and 55.88% had diabetes for 6-10 years. On admission, 3 patients (4.41%) had controlled blood sugar and 65 patients (95.59%) had uncontrolled blood sugar. Conclusion: The frequency of foot ulcers among the male population was higher than that in females. Concerning occupation of the patients, housewives and farmers were the most prevalent. Smokers were most affected groups among the study population. Pre-diagnosed diabetes mellitus for a long period was one of the major clinical issues in most of the patients. Uncontrolled blood sugar was also seen in majority of the patients regarding clinical background.
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Introduction: Fanconi Anaemia (FA) is a very rare genetic disease characterised by genetic alterations, which causes con- genital abnormalities in individuals. This clinical case report of Fanconi anaemia, will review classical signs of the disease in detail. The various aspects of this rare condition are examined, with an emphasis on oral manifestations and their impact on af- fected patients overall health. Since this group is more likely to acquire cancers, paediatric dentists must be aware of common oral symptoms and possibly malignant lesions in order to make an early diagnosis and provide thorough care and maintenance of oral health to those who are affected. Case Presentation: A four-year-old female patient was brought by her parents to the Department of Pediatric and Preventive Dentistry, Yenepoya Dental college, with a chief complaint of pain in the upper back tooth region. The child had already been diagnosed with FA. Conclusion: Patients with FA are more prone to get infections, so proper precautions should be taken to avoid any situation that might put them at risk of infection or bleeding. Patients should be motivated to have regular follow-ups and encourage them to maintain good periodontal health, to help prevent the incidence of caries and to monitor their overall oral wellbeing.
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Introduction: Millions of people have died as a result of the Covid-19 pandemic caused by Sars-CoV-2. To increase aware- ness and knowledge of Covid-19, numerous online resources have been made available, particularly those pertaining to the dental profession. The purpose of this study was to determine dental professionals’ knowledge, perceptions, and attitudes concerning Covid-19 in Saudi Arabia. We performed a study using a Google Docs questionnaire that was disseminated to 305 dentists practising in Saudi Arabia. Materials and Methods: The questionnaire was divided into four sections: dentists’ demographic and professional character- istics; dentists’ awareness of the incubation period, disease symptoms, mode of transmission, and infection control measures for preventing Covid-19; and dentists’ attitude toward treating patients with Covid-19. The questionnaire was completed by participants by selecting one response to each question. The descriptive statistics were used to analyze the data, which were expressed as frequencies and percentages. The chi-square test was used to examine the relationship between professional activity and knowledge, perceptions, and attitudes towards Covid-19. Results: A total of 305 dentists took part in the survey, which resulted in a cohort of 305 dentists. Dentists in Saudi Arabia were well-versed in the signs and symptoms of Covid-19 infection in dental clinics, as well as the methods of transmission, infection control measures, and preventative techniques. Dentist, on the other hand, demonstrated a reasonable understanding of the additional preventative measures that can be taken to protect dental employees and other patients from Covid-19. Conclusion: Saudi dentists have an acceptable level of knowledge and understanding of Covid-19. However, such advance- ments would benefit patient management throughout this pandemic. Due to the high risk of infection spreading and acquisition among dental workers or individuals due to the close contact with patients and the nature of dental treatment, it is critical for dentists to remain updated on current knowledge in this rapidly moving field. Dentists’ infection control expertise should be reinforced through continuous educational programs.
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Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of this disease. It is an autoimmune disease which also leads to the involvement of skeletal, cardiac, nervous tissues, and other systemic organs. Aim and Objectives: This study was conducted to assess the correlation between the Bath AS Disease Activity Index (BASDAI) score/visual analog scale (VAS) and various age groups in the patients suffering with AS using standard questionnaire. Materials and Methods: Forty-eight AS patients having BASDAI scores of ?4 were included in this study. The height and weight were taken and responses to the standard questionnaire were recorded. BASDAI Score, body mass index (BMI), and VAS were computed. The patients with history of chronic diseases such as hyper/hypothyroidism, diabetes mellitus, and hypertension or the use of any medication such as ?/? blockers, calcium channel blockers, and antiepileptics were excluded from the study. Results: The patients were divided into six different age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years. The mean ± SEM values of the BASDAI score in various age groups were 6.8 ± 0.34, 6.3 ± 0.33, 6.2 ± 0.26, 7.1 ± 0.41, 6.5 ± 0.30, and 5.8 ± 0.48, respectively. The mean ± SEM values of VAS are shown in relation to the various age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years and the values were 6.88 ± 0.312, 6.58 ± 0.22, 6.55 ± 0.66, 6.00 ± 0.23, 6.72 ± 0.25, and 6.0 ± 0.50, respectively. Conclusion: This study indicates that in the young age group, patients BASDAI score is higher and BMI is lower, and in the older age group, patients BASDAI score is lower and BMI is higher than each other indicating higher disease activity in the younger patients than older patients. An inverse correlation between VAS and age further substantiates our previous finding.
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Background: Body cavity fluids are evaluated by cell block (CB) technique. In conventional cytological smears (CS), appropriate identification of the cells as either reactive mesothelial cells or malignant cells is a diagnostic problem. In CB method, there is increase in cellularity, so it gives more morphological details of cells and improving the sensitivity of diagnosis. Sections obtained by CB method are also can be stored for future study like immunohistochemistry (IHC). Aims and Objectives: The aim of the study was to determine the diagnostic efficacy of CB technique over conventional CS and to study of IHC in CB of malignant pleural effusion. Materials and Methods: This will be institution-based, cross-sectional, and observational study. The pleural fluid (except blood and pus) obtained by thoracocentesis from both male and female patient (>18 years of age) 100 cases was included in the study. Pleural fluid mixed with blood/pus, fluid from cystic lesion, and inadequate sample (<15 ml vol.) were excluded in the study. Results: Association between architectural pattern in CB versus architectural pattern in cytology smear showed statistically significant value Chi-square: 201.7417, P < 0.0001. Conclusion: We may conclude that CB technique is better than conventional cytology smear technique especially in case of malignant pleural effusion. It increases true positive cases and decreases false negative cases. It also increases cellularity, maintain architectural pattern, and cellular morphology.
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Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India’s NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
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Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.
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Background: Obesity is a positive risk factor in development of hypertension, diabetes, gallbladder diseases, coronary heart diseases, and few types of cancers. Body mass index (BMI) is an inexpensive and easy screening method for weight category: Underweight, healthy weight, overweight, and obesity. Only a few studies have been conducted until now which focuses on finding any relationship between BMI and blood group of school going children. Aims and Objectives: The aims of this were as follows: (a) To find out BMI in school children of study center and (b) to find out correlation of BMI with blood groups and other variables of participants. Materials and Methods: It was a cross-sectional study conducted among 101 children of school going age group 10–15 years at one of the private schools of Ahmedabad, Gujarat. A questionnaire was prepared which included sections of demographic details, blood group, diet history, and family history. Results: About 50% of participants were from of either age 13 or 14. There was almost same proportion of participants of both sexes. About 70% of participants were found to be underweight, while about 15% were overweight. Overweight category of BMI is most commonly seen in children having blood group “A” while no child of “O” blood group was found to be overweight. This association was statistically significant. Conclusion: Almost 70% of participants were underweight, while about 15% were overweight. Overweight was most commonly seen in children having blood group “A.” No child of “O” blood group was found to have overweight.
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Background: Warts, the most common manifestation caused by human papillomaviruses. Treatment is needed because of risk of transmission, cosmetic point of view, multiple, painful, and disfigurement caused by warts. Aims and Objectives: In this study, two techniques of autologous therapy are compared in terms of safety and efficacy. Falknor’s needling and autoimplantation, both are minimally invasive procedures with the aim of treating one wart and inducing immunity against the viral infected cells. Materials and Methods: Forty patients of clinically diagnosed cutaneous warts were randomly divided into two groups. In Group A, Falknor’s needling was performed on a single lesion in each patient. In Group B, autoimplantation was done by harvesting a single lesion and then implanting the tissue in subcutaneous tissue of the patient at other body site. Results: Data were analyzed using SPSS software v. 23 (IBM Statistics, Chicago, USA) and Microsoft Office 2007. Both the modalities showed excellent response (P = 0.504) in the treatment of warts with Grade 4 improvement in 85% (17 patients each) in both the modalities, with 5% of the patients showing Grade 2 and Grade 3 improvement each in needling group. Conclusion: Both the modalities of autologous therapy are simple, easy to perform, safe, and cheap modalities with excellent results in the treatment of cutaneous warts.
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Background: Taenia solium infections in humans include the infection by the adult tapeworm, these infections are of public health concern and are among the most important afflictions of humans who live in areas of poverty in the developing world and least developed countries. T. solium, a zoonotic disease, transmitted between pigs and humans and among humans, is common in developing countries. Aims and Objectives: The aim of the study was to estimate the detection rate of T. solium taeniasis among patients and random community screening with an indication of intestinal parasitic infection by routine stool examination. Materials and Methods: Stool samples were collected from the community and patients. Those who were willing, samples were screened for the cysts/ova/egg by direct microscopic examination by saline, iodine, concentration technique, and modified acid fast staining, were performed to differentiate species of T. solium and Taenia saginata. Results: Overall samples were 2030, out of which 870 stool samples were from community field screening 585 (28.81%) were positive. 1160 from tertiary care center, 668 (32.90%) were positive gave a total prevalence of intestinal parasitic infection of 61.72%. The prevalence of T. solium taeniasis was 194 (9.55%) out of which 92 (4.53%) were from community and 102 (5.02%) were from tertiary care center. Conclusion: The high prevalence of intestinal parasitic infestation might be due to the poor sanitary, contaminated water, and lack of education that is prevalent in the studied region as in other pockets in rural India. Our study showed the usefulness of the Ziehl-Neelsen modified acid-fast stain for identification of Taenia species.
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Introduction: The prevalence of hyperuricemia (HU) and hypouricemia (Hypo-U) is highly variable in different parts of India and there is a lack of data from the Eastern part of Uttar Pradesh. We designed this study in order to know the exact prevalence of HU and Hypo-U. Materials and methods: This is a cross-sectional study conducted in Varanasi. Data were collected from newly onset diabetic patients over a period of 1 year. Results: Among the 312 diabetic patients, 12.5 and 19.23% were found to have HU and Hypo-U, respectively. Hypouricemic diabetic patients are phenotypically different. They are characterized by the female sex, higher glycated hemoglobin A1c (GlyHbA1c), higher estimated glomerular filtration rate (eGFR), lower body mass index (BMI), and less insulin resistance. Conclusion: The prevalence of HU and Hypo-U is high in newly-onset diabetic patients. Hypouricemic diabetic patients are phenotypically different. Hence routine screening of uric acid is essential for proper diagnosis and appropriate treatment of hypouricemic diabetic patients.
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Background: As of 2019, the highest prevalence of human immunodeficiency virus (HIV) in India is seen in the Northeastern states. Endocrine and metabolic disturbances can occur in HIV infection. Thyroid dysfunction is one of the common endocrinopathies. In HIV infection, thyroid function abnormalities are seen in about 4–35% of adult patients. Thyroid function abnormalities range from overt hypothyroidism, subclinical hypothyroidism, and sick euthyroid syndrome to overt hyperthyroidism. Among them, subclinical hypothyroidism is the commonest abnormality. To our knowledge, there have been no studies from Northeastern India done in this regard. Aims and objectives: To study the thyroid function in newly diagnosed cases of HIV infection attending anti-retroviral therapy (ART) center, Assam Medical College. To estimate the prevalence and types of thyroid dysfunction in newly diagnosed HIV-infected individuals. To study thyroid dysfunctions with respect to age, sex, and cluster of differentiation (CD) 4 count. Materials and methods: Hospital-based observational study was done at a tertiary care centre of upper Assam on newly diagnosed HIV-positive patients who were not started on antiretroviral therapy and who attended the ART centre, Assam Medical College during the period of our study. History, examinations and laboratory investigations, including thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and CD4 count, are done in all such patients, and only those who fulfilled the inclusion and exclusion criteria of our study are taken as study participants, and their findings tabulated. Results and observations: A total of 95 newly diagnosed HIV-positive patients fulfilling the inclusion and exclusion criteria of our study were taken. In our study, a total of 36.84% of the patients had thyroid dysfunction. We got subclinical hypothyroidism, overt hypothyroidism, sick euthyroid syndrome, and overt hyperthyroidism as the types of thyroid dysfunction. Among all the types of thyroid dysfunction, subclinical hypothyroidism was the commonest abnormality in our study. Under sick euthyroid syndrome, we got only low FT3 as the biochemical abnormality. Thyroid dysfunctions were more common in females (42.3%) than males (35.8%) and were more common in the age group of 30–39 years. In the present study, among patients with thyroid dysfunction, it was seen that 51.43% of the patients had a CD4 cell count in the range 101–200 cells/mm3, whereas only 11.43% of patients had a CD4 cell count in the range <50 cells/mm3 and no patient had a CD4 cell count >500 cells/mm3 . Conclusion: In our study, we found that thyroid dysfunctions were common in newly diagnosed HIV-positive patients, the prevalence of which was much higher in the general population. Thyroid dysfunction was present in all the stages of the HIV disease.
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Background: Chronic kidney disease (CKD) is an irreversible deterioration of renal function and cardiovascular disease is the leading cause of mortality in CKD patients. Aims and Objectives: The aim of this study was to assess the pattern of lipid profile among cases of CKD. Materials and Methods: A cross-sectional study was conducted for 1 year covering total 200 cases (males and females) of newly diagnosed or known cases of CKD. Parameters recorded were as follows: Fasting blood sugar, Serum urea (S. Urea), Serum Creatinine (S. Creatinine), and lipid profile. Estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault formula. Results: Mean age was 51.04 years in conservative management patients and 53.20 years in hemodialysis patients. Overall, male-to-female ratio was 1.82:1. S. Creatinine, S. Urea, and eGFR were deranged more in patients on hemodialysis (Group 2). Mean values of low-density lipoprotein (LDL)-cholesterol, very low-density lipoproteins (VLDL), and serum triglycerides (TG) were significantly higher in patients on hemodialysis compared to those on conservative management, while mean high-density lipoprotein cholesterol was significantly lower. Dyslipidemia was more common in female CKD patients (P = 0.02). Conclusion: Dyslipidemia in CKD worsened as patients progressed to severe stages with significant increase in TG, LDL, and VLDL levels in hemodialysis cases in comparison to conservatively managed, confirming presence of atherogenic lipid profile needing early intervention to prevent cardiovascular complications.
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Background: Telengiectasias are defined as persistent dilatation of small capillaries in the superficial dermis Case: A 26-year-old woman presented with red lesions, epistaxis, joint pains, color changes of the hands, and breathlessness. On clinical examination and investigations, a final diagnosis of mixed connective tissue disease (MCTD), with interstitial lung disease (ILD), with telangiectasias, and epistaxis was made. Telangiectasias and epistaxis are rare presentations of MCTD.
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Pulmonary hydatid is not a rare disease. But raising a suspicion for its diagnosis is limited. There are limited approaches for the diagnosis and treatment of the same. We present here four cases of pulmonary hydatid, without liver involvement, with emphasis on how it was misdiagnosed and received multiple treatment and landed into complications. Most of our cases presented with cough, sputum and hemoptysis. For these nonspecific signs and symptoms, patient is generally treated on a different line of diagnosis. Two of the cases were already treated for abscess and fungal infection. One of the patients was on antitubercular treatment. One of our cases was secondarily infected with aspergilloma. One of the cases was referred to oncologist to start chemotherapy. Interestingly, to raise a suspicion, none of our cases had liver involvement. A detailed history revealed expectoration of white salty material in sputum, living with sheep and dog and expectorating grape-like vesicles in sputum. History helped us to put hydatid as one of our differentials. Echinococcal serology was positive in three cases. Only three cases had on-table appearance of hydatid cyst. All four cases underwent surgical management for complete cure. There is need for strong suspicion and a detailed history and proper set of investigations help in timely diagnosis and management of pulmonary hydatid disease.