A Cross-Sectional Study of Clinico-etiological Profile and Associated Comorbidities in Indian Patients of Pigmented Purpuric Dermatoses.

BACKGROUND: Pigmented purpuric dermatoses (PPDs) are a group of chronic benign vascular disorders with varied clinical presentation. The etiopathogenesis of the condition largely remains unknown with a paucity of clinico-epidemiological and/or clinico-etiological studies. OBJECTIVE: To study the clinico-epidemiological pattern, etiological factors and associations of PPD and correlate them with its severity in a set of Indian patients. MATERIALS AND METHODS: In a cross-sectional study, all clinically diagnosed and histopathologically confirmed cases of PPD attending the outpatient department of dermatology from November 2015 to October 2016 were included in the study. Patients were evaluated based on a detailed history of the illness, comorbid conditions, drug usage, general physical, systemic, and cutaneous examinations, severity of disease (mild, moderate, or severe), laboratory parameters, and Doppler ultrasonography of the lower extremities. RESULTS: There were a total of 60 patients with a female-to-male ratio of 1.14:1. The mean age of patients was 47 ± 12.10 (range: 15-70) years. Majority (70%) of the patients were housewives, bankers, and businessmen. The possible etiological and/or aggravating factors included prolonged standing (28.3%), drug intake (13.3%), alcohol ingestion (10%), strenuous exercise (5%), and varicose vein (3.3%). Schamberg's disease (90%) was the most common type observed. The most common systemic comorbidity identified was hypertension (58.3%) followed by diabetes mellitus (31.6%) and dyslipidemia (28.3%). A positive correlation was found between severity of the disease and presence of comorbidities (Mantel-Haenszel method, P < 0.0001). CONCLUSION: PPD was found to be associated with a variety of disorders and comorbidities. The number of the comorbidities increased with increasing severity of the disease. Besides exposing the patient to various risk factors, this may contribute to the vessel wall damage seen in the condition. All patients with PPD should, therefore, undergo an initial screen for these comorbidities.

Dual-energy computed tomography: A reliable and established tool for In vivo differentiation of uric acid from nonuric acid renal Stones.

BACKGROUND: Dual-energy computed tomography (DECT) utilises the technique of simultaneous image acquisition of a body part at two different energy levels of the X-ray tubes. We used the DECT in this project to study its accuracy in non-invasive in vivo differentiation of uric acid (UA) calculi from non-UA calculi using the 3rd generation dual-source computed tomography (CT) scanner. MATERIALS AND METHODS: The DECT ratios of the various stones were noted and compared with the postextraction analysis of stones for composition. Sixty stones from 53 patients were included in the study, and their DECT results were compared with the post-extraction analysis (by infrared spectroscopy as the standard comparative method). RESULTS: DECT was highly sensitive and specific in the diagnosis of various types of calculi based on their dual-energy ratio. It was found to be 100% sensitive and specific for differentiating UA stones from the non-UA stones. The DE ratio for the UA stones was found to be 0.98-1.13. Most of the stones belonged to non-UA category (85%), and only 15% were UA calculi. The sensitivity and specificity in differentiating a calcium oxalate from non-calcium oxalate calculus was 97.8% and 92.3%, respectively. CONCLUSION: DECT using the 3rd generation CT scanners is highly sensitive in the determination of urinary calculi composition which will be very helpful to the treating surgeon in selecting the optimal modality of treatment as UA stones are amenable to medical therapy while most of the non-UA stones require surgical intervention.

Prenatal sonographic diagnosis of limb-body wall complex: case series of a rare congenital anomaly.

Three case reports of a rare congenital anomaly "limb-body wall complex" also known as "body stalk syndrome" are presented with prenatal ultrasonographic diagnostic features, immediate after delivery evaluation, and histopathologic analysis.