Oral valganciclovir in human immunodeficiency virus-positive patients suffering from cytomegalovirus retinitis at a tertiary care hospital in North India

Purpose: To study clinical efficacy of valganciclovir in cytomegalovirus retinitis (CMVR) in human immunodeficiency virus (HIV)?positive?positive patients in a tertiary care clinic in a developing nation. Methods: In a retrospective study, systemic and ocular records of HIV patients suffering from CMVR and treated with valganciclovir, were analyzed. Primary outcome measures were involvement of the other eye, incidence of retinal detachment, systemic involvement, and mortality encountered. Secondary outcome measures included change in BCVA. Results: Out of nine patients who were included, two patients developed CMVR in the other eye and only one patient (11.11%) developed retinal detachment during the course of the study. No patient developed any systemic manifestations or had mortality during the course of the study. The change in BCVA was not statistically significant. Conclusion: Use of oral valganciclovir showed good outcome and was found to be a better alternative compared to the use of intravitreal ganciclovir in the literature. Introduction of valganciclovir at an affordable price in developing nations can decrease disease burden

Prevalence of hypertension in patients attending dermatology outpatient department: a cross-sectional study of 1023 patients and discussion of the implications

Background: Hypertension is a very big global burden of disease with high incidence of morbidity and mortality (cardiovascular, stroke, renal and retinopathy) making it a leading cause of death all over the world. It is multifactorial in etiology and is difficult to manage at later stages once systemic organ damage has set in. But early detection can prevent this disease and intervention, if needed, can prevent morbidity and mortality in large number of patients. This study was done to find out the prevalence of hypertension in our area, in North India.Methods: A cross-sectional study was conducted in 1023 patients (including their attendants and staff) attending dermatology outpatient department of Maharaja Agrasen Medical College (MAMC), Agroha, Haryana, representing population from North India. Both urban and rural population was included with age 20 years and above.Results: The prevalence of hypertension in age group above 20 years was 31.1% (37.7% males and 22.6% females). The prevalence in age group above 30 years was 46% (54.4% males and 35% females), which showed a rising trend with age.Conclusion: High prevalence of hypertension was found in this study which increased with increasing age. We infer that more epidemiological studies should be done in India to detect hypertension at early stage which can help in preventing or early intervention in the treatment of hypertension and help in policy formulation at national level.

Psoriasis in autoimmune polyendocrine syndrome type I: A possible complication or a non-endocrine minor component.

Introduction: Autoimmune polyendocrine syndrome type I (APS I) is an autosomal recessive systemic autoimmune disorder, affecting primarily endocrine glands, in which chronic mucocutaneous candidiasis is an early and prominent manifestation. We describe the rare occurrence of unstable psoriasis (with onset of pustular lesions) in a case of APS I without mucocutaneous candidiasis. A patient presenting with unstable psoriasis (with onset of pustular lesions) was detected to have persistent hypocalcemia which led to the diagnosis of hypoparathyroidism. Subsequently he was found to have hypergonadotrophic hypogonadism, primary adrenal insuffi ciency (compensated), and coeliac disease, thus confi rming the diagnosis of APS I. Psoriasis is very rarely reported in APS I, possibly due to the protective effect of antibodies to Th17 cytokines, which are responsible for the occurrence of candidiasis in this syndrome. However, psoriasis could occur in APS I patients without mucocutaneous candidiasis, who lack these antibodies. In our patient, possible factors aggravating psoriasis include hypocalcemia due to hypoparathyroidism as well as coeliac disease via anti-tissue transglutaminase antibodies. However, defi ning psoriasis as a possible minor component of APS I would require further studies of the autoimmune regulator (AIRE) gene functions.

Low Intensity Laser Therapy in Disc Derangement Disorders of Temporomandibular Joint: A Review Article / Terapia con Láser de Baja Intensidad en Trastornos de Alteración Discal de la Articulación Temporomandibular: Un Artículo de Revisión

Temporomandibular disorders embrace a number of clinical conditions that involves the masticatory musculature, temporomandibular joint (TMJ) and associated structures. The most frequent cause of TMJ disorders are disc derangement disorders which involve progressive slipping or displacement of articular disc. Various conservative treatment strategies for disc derangement disorders includes pharmacologic therapy, psychological counselling, treatment of parafunctional habits, use of occlusal splints and acupuncture which gives short term relief only. Recently, a non traumatic introduction to dentistry can be represented by low level laser therapy or soft laser therapy. It has proved to be an effective treatment modality in management of disc derangement disorders through its analgesic and anti- inflammatory effect. Therefore, the goal of this review article is to explore the use of low level laser therapy as an emerging trend in the management of disc derangement disorders of TMJ.

Los trastornos temporomandibulares abarcan una serie de condiciones clínicas que involucran la musculatura masticatoria, la articulación temporomandibular (ATM) y estructuras asociadas. La causa más frecuente de trastornos de la ATM es la alteración discal que implica el deslizamiento o desplazamiento progresivo del disco articular. Diversas estrategias de tratamiento conservador para los trastornos de alteración discal incluyen el tratamiento farmacológico, la terapia psicológica, el tratamiento de los hábitos parafuncionales, uso de férulas oclusales y acupuntura, que solamente dan un alivio a corto plazo. Recientemente, una introducción no traumática para la odontología puede ser representada por la terapia con láser de baja frecuencia o terapia de láser blando. Esta ha demostrado ser una modalidad de tratamiento eficaz en el manejo de los trastornos de alteración discal a través de su efecto analgésico y antiinflamatorio. El objetivo de este artículo es explorar el uso de la terapia con láser de baja frecuencia como una tendencia emergente en el tratamiento de los trastornos de alteración del disco de la ATM.