Self inflicted injury in a case of delusional parasitosis

Delusional parasitosis also known as Ekbom抯 syndrome, is a fixed, firm, false belief about a parasitic infestation of skin despite absence of evidence. Non-suicidal self injury (NSSI) is the deliberate and direct change leading to destruction of healthy body tissues e.g. skin cutting, scratching, burning, hitting of oneself and even enucleation of eye and amputation of body parts. We present a case of a 35-year-old male patient with delusional parasitosis for the past 3 months, referred from dermatology, who resorted to cutting himself on his arm and abdomen. He was treated successfully with anti-psychotics and had no further intention of self-harm.

A study to assess perceived stress, life events and prevalence of dissociative experiences in patients with anxiety disorders

Background: Anxiety disorders are characterized by a central theme of intense subjective distress and apprehension of impending danger. Dissociation has been frequently associated in such patients, where it acts as a defense mechanism that allows temporary relief. Previous studies have also shown that more number of life events and higher perceived stress are seen in patients of anxiety disorder, which may even act as predictors of developing the disease. Addressing these factors may contribute to improved understanding of underlying psychopathology and better treatment outcomes. Methods: This was a cross-sectional, 1 year time bound study. As per calculation from prevalence, 161 participants were selected as sample population with specific inclusion and exclusion criteria. Socio-demographic data was collected, appropriate scales were administered to assess the required parameters and statistical analysis was carried out thereafter. Results: We found that 21.74% patients had dissociative experience, 40.37% patients had perceived stress during last month, 53.4% had less/moderate stress and 39.1% patients had severe stress. Most frequently occurring life event was financial loss or problem. Statistically significant association was found between total life events score and socio-demographic variables. Mean dissociative experience scale score was positively correlated with total perceived stress scale score and total life event score. Total perceived stress scale score was also positively correlated with total life event score. Conclusions: Anxiety disorder patients had high levels of dissociation, perceived stress and life events, and these three parameters were also correlated with each other.

Habit nail tic disorder: onychotillomania involving thumbs and toes responding to fluoxetine

Habit nail tic disorder is a type of nail dystrophy caused by repetitive trauma to the nail matrix. It is a body-focused repetitive behavior that is commonly reported among adults and may or may not be associated with obsessive-compulsive behavior. In this report, we present a case of a 12-year-old adolescent girl who had a central furrow with longitudinal ridges running parallel from the proximal to the distal end of both her thumbnails and toenails, giving them a "washboard" appearance and diagnosed as habit nail tic disorder, and treatment involved fluoxetine 20 mg and the application of permeable adhesive tape to protect the nails from external trauma. There was a positive response observed two months after the beginning of the treatment and the nail matrix resolved spontaneously.

Study of extra-nodal lymphoma with special reference to histomorphology, immunohistochemistry, and topographical distribution

Background: Primary extra-nodal lymphomas (ENLs) are rare neoplasm but can affect many organ systems of body. Proper and timely diagnosis and justified treatment of primary ENL are often affected due to variety of lymphoma types and the relative rarity of many of these tumor types. They are mainly of Non-Hodgkin lymphoma which further consists of many subtypes having variation of epidemiology and clinical presentation along with geographic distribution. Aim and Objectives: Aim and objectives of the study were to find out topographical distribution and histological patterns of ENL along with their immunohistochemical character in a tertiary care hospital of Eastern India. Materials and Methods: All the cases from April 2015 to March 2018 diagnosed as ENL by histopathological examination were included in this descriptive cross-sectional study for further immunohistochemical analysis for CD45 Life-cycle assessment (LCA), CD3 and CD 20 to identify the cell of origin (B cell vs. T cell). Results: Out of total 31 cases, 67.74% were male and the most common age group was 51–60 years. Gastrointestinal tract was the most common organ system (61.29% of cases) affected and stomach (29.03%) followed by Ileum (9.67%) were the most common sites affected by ENL. Histomorphologically diffuse large cell lymphoma was the most common pattern while immunohistochemistry study revealed all the cases were B cell type with LCA and CD 20 positive and CD3 negative. Conclusion: This study revealed the topographical pattern along with predominant histomorphological and immunohistochemical character of ENL in study population. However, further studies with meta- analysis can enlighten these characters more comprehensively.

Prevalence of anti HCV, HBsAg and HIV antibodies in high risk recipients of blood and blood products.

Along with hepatitis B virus (HBV) and human immunodeficiency virus (HIV), Hepatitis C virus (HCV) is emerging as a major transfusion hazard. 22 cases of haemophilia (A 19, B 3) and 20 cases of thalassaemia (2 16, E(2) 4) constituted the study group. Patients tested for anti HCV (using third generation ELISA), HBsAg and antibodies to HIV I and II. Prevalence of anti HCV was 54.5% in haemophilics and 5% in thalassaemics. HBsAg was detected in 9.09% haemophilics and 5% thalassaemics. No anti HIV was detected in this cohort. Anti HCV seropositivity in haemophilics has increased compare to previous studies.