ABSTRACT
Introduction:Vitiligo is a common form of localized depigmentation and an important public health problem which affects around one percent of the global population and about two percent of the population in India. The present study aimed to document the results and side effects of non-cultured melanocyte transplant in patients with stable vitiligo without post-procedure use of NB UVB. Methods:The present study was a prospective interventional study conducted among patients with stable vitiligo who were attending the outpatient department (OPD) of dermatology of a tertiary center of Delhi. Patients with stable vitiligo aged >10 years who gave their consent for non-cultured epidermal suspension (NCES) were included in the study. Autologous skin graft of size 0.2 mm was taken from the donor site and a melanocyte cell suspension was prepared using standardized procedure, which was later transplanted to the recipient area. All patients were asked to come for follow-up at the OPD after seven days, 15 days, one month, followed by every month till six months post-transplantation, and repigmentation was assessed visually by both graph paper and photography. Data was analyzed using SPSS vs. 21. Results:In our study, the majority of patients had vitiligo vulgaris (27 subjects with 47 patches). A total number of 59 patches were transplanted, of which 38 (64.4%) achieved excellent repigmentation, 28.8% good repigmentation, 3.4% fair repigmentation and 3.39% poor repigmentation. A total of 1302.5 cm² of the depigmented area was operated by NCES and the repigmentation of 874.5 cm2 (67.14%) was achieved by six months. Conclusion:The present study found that the majority of patients (93%) with vitiligo achieved excellent or good repigmentation after NCES and the rate of complication was very low.
ABSTRACT
Every energy system which we consider is an entity by itself, defined by parameters which are interrelated according to some physical laws. In recent year tremendous importance is given in research on site selection in an imprecise environment. In this context, decision making for the suitable location of power plant installation site is an issue of relevance. Environmental impact assessment is often used as a legislative requirement in site selection for decades. The purpose of this current work is to develop a model for decision makers to rank or classify various power plant projects according to multiple criteria attributes such as air quality, water quality, cost of energy delivery, ecological impact, natural hazard, and project duration. The case study in the paper relates to the application of multilayer perceptron trained by genetic algorithm for ranking various power plant locations in India.
Subject(s)
Environment , Models, Theoretical , Neural Networks, Computer , Power Plants , Algorithms , Humans , IndiaABSTRACT
Background Acute upper gastrointestinal bleeding is a serious medical problem in cirrhotic patients. Patients with cirrhosis may develop upper gastrointestinal bleeding from a variety of lesions, including those due to portal hypertension, namely gastroesophageal varices and portal hypertensive gastropathy and other lesions as seen in the general population. Objective To investigate the etiology of upper gastrointestinal bleeding in liver cirrhotic patients. Method A retrospective review of 72 patients with liver cirrhosis and upper gastrointestinal bleeding from January 2013 to March 2016 was carried out at Dhulikhel Hospital. Child Pugh score was used to assess severity. Endoscopic diagnosis was documented. Result Out of 72 patients, 56 (77.8 %) were male and 16 (22.2%) were female. The most common age group was 30-42 years age. Fifty four cases of cirrhosis were associated with alcohol consumption. The Child-Pugh score was A in 20 patients (27.8%), B in 15 patients (20.8%) and C in 37 patients (51.4%). A combination of alcohol consumption and HCV infection was significantly associated with a higher Child-Pugh score (p=0.031). Twenty six (36.11%) patients had esophageal varices as cause of bleeding on endoscopic examination while 29(40.28%) had varices and other lesions identified at endoscopy. Of these 29 patients, 18 were found to have bled from esophageal varices, and 11 were found to have bled from coexisting lesion. Conclusion We found that variceal bleeding was the commonest cause of bleeding in cirrhotic patients, with 55 (78.5%) having varices and 44 (61%) actually bleeding from varices.
Subject(s)
Gastrointestinal Hemorrhage/etiology , Liver Cirrhosis/complications , Adult , Aged , Child , Endoscopy , Esophageal and Gastric Varices , Female , Gastrointestinal Hemorrhage/diagnosis , Hospitals , Humans , Hypertension, Portal , Male , Middle Aged , Retrospective StudiesABSTRACT
OBJECTIVES: Obesity and stress are independently associated with decrements in neuromuscular functions. The present study examined the interplay of obesity and stress on neuromuscular fatigue and associated heart rate variability (HRV). METHODS: Forty-eight non-obese (18.5
Subject(s)
Hand Strength , Muscle Fatigue , Muscle Strength , Obesity/physiopathology , Physical Endurance , Adaptation, Physiological , Adult , Blood Pressure , Energy Metabolism , Female , Heart Rate , Humans , Male , Obesity/complications , Risk FactorsABSTRACT
Electrocardiographic (ECG) changes were analysed in one hundred patients of craniocerebral injuries irrespective of age and sex. Males comprised 82% of patients and most vulnerable age group was 15-40 years (66%). Although the overall mortality was 17%, the maximum mortality (44.44%) was observed in the age group of 41-60 years. Computed tomographic scan proved lesions in intracerebral haemorrhage, subdural haematoma, mixed lesions and extradural haematoma were associated with mortality rates in 66.66, 33.33, 20 and 11.11 per cent respectively. ECG changes of some or the other type were present in almost all patients (99%) but ST-segment shift, sinus tachycardia/bradycardia, T-wave changes and prolonged QTc-interval (> 440 msec) carried high mortality rates of 60, 34.6/27.3, 19.6 and 17.3 per cent respectively, especially if these changes persisted for long duration. Occurrence of supraventricular tachycardia and nodal arrhythmia, although associated with high (50%) mortality rates, were probably terminal events rather than the cause of increased mortality. There was, however, no direct correlation between the type of craniocerebral injury and specific ECG changes.
Subject(s)
Craniocerebral Trauma/diagnosis , Craniocerebral Trauma/mortality , Death, Sudden, Cardiac , Electrocardiography , Heart Diseases/diagnosis , Heart Diseases/mortality , Adolescent , Adult , Cohort Studies , Craniocerebral Trauma/complications , Female , Heart Diseases/complications , Humans , Male , Prognosis , Prospective Studies , Risk Assessment , Sensitivity and Specificity , Survival Analysis , Tomography, X-Ray ComputedABSTRACT
We describe two patients with palmar filiform hyperkeratosis, characterized by multiple thin spiny keratotic projections on the palms. The condition has been associated with an underlying malignancy in some cases. One patient has myelofibrosis, an association not previously described. In addition we describe a further patient with filiform hyperkeratoses of both palms and soles with no associated underlying disorder. In view of the relatively high risk of underlying malignancy occurring in patients with filiform hyperkeratosis, these patients should always be investigated fully.
Subject(s)
Keratoderma, Palmoplantar/complications , Primary Myelofibrosis/complications , Aged , Female , Humans , Keratoderma, Palmoplantar/pathology , MaleSubject(s)
Strongyloidiasis/complications , Urticaria/parasitology , Chronic Disease , Eosinophilia/parasitology , Female , Humans , Middle Aged , TravelABSTRACT
We report elastosis perforans serpiginosa (EPS) arising in three patients with Ehlers-Danlos syndrome, osteogenesis imperfecta and Down's syndrome. These cases illustrate some of the rare but well-recognized disease associations with EPS. The other causes of EPS are reviewed.
Subject(s)
Down Syndrome/complications , Ehlers-Danlos Syndrome/complications , Osteogenesis Imperfecta/complications , Adolescent , Adult , Collagen/analysis , Dermis/pathology , Down Syndrome/pathology , Ehlers-Danlos Syndrome/pathology , Facial Dermatoses/complications , Facial Dermatoses/pathology , Female , Humans , Male , Microscopy, Electron , Osteogenesis Imperfecta/pathologyABSTRACT
We describe a 60-year-old patient with verrucous carcinoma of the vulva, which recurred 6 years after simple vulvectomy and radiotherapy. Treatment with acitretin led to significant improvement and ongoing disease control has been achieved with low-dose maintenance therapy of 10 mg acitretin daily.
Subject(s)
Acitretin/therapeutic use , Carcinoma, Verrucous/drug therapy , Keratolytic Agents/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Vulvar Neoplasms/drug therapy , Carcinoma, Verrucous/pathology , Female , Follow-Up Studies , Humans , Middle Aged , Vulvar Neoplasms/pathologyABSTRACT
The present report compares Thiopentone sodium and Althesin as intravenous anaesthetic agents in modified electro-convulsive therapy. The induction time with althesin and thiopentone was more or less similar. There was significantly shorter recovery period with althesin as compared to thiopentone. Early and uneventful recovery with althesin was distinct advantage over thiopentone sodium.
ABSTRACT
The study was undertaken to assess the value of etomidate in modifed E.C.T. and compare the results with thiopentone sodium. Fifty patients of schizophrenia, depressive illness and manic depressive psychosis requiring E.C.T. were studied with thiopentone and etomidate in two subsequent sittings. The results indicate that induction time is approximately same with both the drugs. The shorter recovery time with etomidate in comparison to thiopentone proved to be of definite advantage specially to psychiatric out patients who rapidly have to regain consciousness and soon become alert enough to go back to their homes alter treatment.
