Audiological Evaluation of Leprosy Patients in an Endemic Area of Central India: A Case-Control Pilot Study.

There are discrepancies in the literature about the specific influence of leprosy on auditory functions. In routine clinical practice regular hearing screening of leprosy patients is not done. Due to conflicting reports of auditory system involvement in the literature, we conducted this case control study to evaluate the need of regular hearing screening in leprosy patients. A complete otological examination of thirty leprosy patients was conducted. Thirty age and sex matched healthy individual attending ear, nose and throat outpatient department were enrolled as control. Ten cases (33.3%) out of the thirty leprosy patients were found to have high frequency (4 and 8 kHZ) sensorineural hearing loss. The results of this study suggest that leprosy patients require routine monitoring for auditory functions for early identifications of sensorineural hearing loss. As our study is a case-control study with small sample size, in future large prospective studies are required to evaluate the correlation of hearing loss with leprosy and to see the progression hearing loss. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04381-1.

Role of Autoerythrocyte Sensitization Test in the Diagnosis of Recurrent Spontaneous Bruising.

Introduction: Psychogenic purpura, also known as autoerythrocyte sensitization syndrome, is a rare condition which is characterized by spontaneous development of painful purpura, or ecchymoses. Skin lesions are usually preceded by stress and emotional trauma. It is usually a diagnosis of exclusion after ruling out history of trauma, drug intake and other bleeding disorders. Autoerythrocyte sensitization test (AEST) and a psychiatric evaluation helps in the diagnosis and treatment. Objective: To demonstrate the importance of AEST in diagnosing the patient of Gardner Diamond syndrome. Materials and Methods: Five suspected cases of autoerythrocyte sensitization syndrome underwent AEST after ruling out other causes of bleeding. Results: Four out of five patients were positive for AEST while one patient was negative. Psychiatric complaints were present in three patients. One patient was lost to follow up. Rest all patients responded well to vitamin C supplementation. Conclusion: Autoerythrocyte sensitization syndrome is a rare disorder and is a diagnosis of exclusion, so a thorough workup of the patient to rule out common causes of bruising is essential. A high index of suspicion on the clinician's part and a simple OPD-based AEST may help in the diagnosis. Psychiatric consultation is important to find out the stress factor and timely management.

Various techniques for marking patch test sites.

Patch test helps in identifying the allergen causing allergic contact dermatitis. Proper identification of the site of individual patch test allergen is very important for identifying the positive allergen. In this article, various techniques for markings patch test sites are discussed.

An Analysis of Interns' Feedback after Dermatology Posting.

Background: Dermatology knowledge among fresh medical graduates is poor in India as undergraduate medical curriculum and Internship training lack adequate focus on this subject. This contributes to the inappropriate management of Dermatology patients by the medical graduates. Objective: To analyse the expectations, motivations and experience of interns during their dermatology posting. Materials and Methods: This was a retrospective record review of questionnaire-based anonymous validated feedback forms submitted by interns posted in a dermatology department of a tertiary care institute. The feedback form contained nine multiple choice questions some of which allowed multiple responses. Results: A total of 63 completed forms were analysed. The common expectations before the posting were, to learn the management of basic dermatological problems (98.4%), to take an informed decision regarding post-graduation in dermatology (53.9%) and hope that the posting will be useful for the postgraduate entrance test (50.7%). After the posting, 69.87% of them felt that their expectations were fulfilled. After the posting, 84.1% of the interns felt that they would have liked to study dermatology as a separate undergraduate subject with a summative assessment at the end. Limitations: The sample size was less and the feedback form contained limited questions. Conclusion: The majority of the interns were satisfied after dermatology posting. Increased exposure of interns to dermatology inpatients and side laboratory procedures will further enrich their clinical experience. The inclusion of dermatology as a separate subject with examination in the undergraduate curriculum was a felt need.

Azathioprine-Induced Anagen Effluvium with Myelosuppression.

Anagen effluvium and myelosuppression are rare adverse effects of azathioprine. Hair loss due to azathioprine is more frequent in transplant than in nontransplant patients. We report three patients with azathioprine-induced anagen effluvium and myelosuppression, who were prescribed azathioprine for dermatologic conditions. (SKINmed. 2022;20:192-196).

Grade 2 disability among leprosy patients: A pilot study from an endemic area of Central India.

Background and Aim: Deformities and disabilities in leprosy lead to significant morbidity to the individual and financial burden to the family. As the prevalence of leprosy is higher in central India, this study was conducted to know the burden of deformity and disability among leprosy patients in central India and the factors associated with it. Materials and methods: This was a hospital-based, cross-sectional study, conducted on 50 new or on treatment or released from treatment leprosy patients, attending the Dermatology OPD of a tertiary care institute in Central India. Disability was graded as per the WHO criteria for disability grading of hands and feet. Results: Grade 2 disability was found among 32% of the patients with leprosy, whereas a total of 60% of our patients had either grade 1 or grade 2 disabilities. Trophic ulcer was found among 20% and claw hand among 14% of leprosy patients. We found significant associations of lepromatous leprosy with trophic ulcer (p = 0.004) and grade 2 disability (p = 0.012). All patients with claw hands and 80% of the patients with trophic ulcers presented to the healthcare facility at least 6 months after the onset of symptoms. Conclusions: We found very high rates of disability and deformity among leprosy patients indicating possible huge burden of morbidity among leprosy patients in central India. The significant association of lepromatous leprosy with trophic ulcer and grade 2 disability indicated delayed presentation and diagnosis of lepromatous leprosy patients. Our results underlined the need for large scale community-based studies on disability and deformity among leprosy patients in Central India. These results also call for better training of primary level healthcare workers for early detection and management of deformities and disabilities as well as better patient education for leprosy patients regarding hand and foot care.

Retroanalytical Study of Epidemiological Factors of Rhinosporidiosis.

Introduction Rhinosporidiosis is a granulomatous disease of humans and animals that is caused by Rhinosporidium Seeberi . This disease is endemic in certain states of India, like Chhattisgarh, Tamil Nadu, Kerala, Orissa, and eastern Madhya Pradesh. We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh. Objective To study the epidemiology of rhinosporidiosis, especially host risk factors. Methods We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh, India. A total of 55 histologically proven rhinosporidiosis patients who were surgically treated in the department over a period of 2 years from November 2014 to November 2016 were included. Results This study involved 55 histologically proven rhinosporidiosis cases. There were 87% males and 12% females. Most of the cases belonged to lower socioeconomic status (92.73%). All the cases had history of pond bathing. Of 55 cases, 27 cases (49.09%) had O+ blood group followed by A+ in 10 (18.18%), B+ in 9 (16.36) and AB+ in 9 (16.36%). Conclusion The results of the study showed that the disease was associated with the male gender, young and middle age, low socioeconomic status, rural background, pond bathing and O+ blood group.

Cryosurgery Vs Trichloroacetic Acid Chemical Cautery for the Treatment of Hypertrophied Nasal Turbinate: A Comparative Study.

INTRODUCTION: The Study Aimed To Compare The Results of Cryosurgery With Trichloroacetic Acid Chemical (TCA) Cautery For The Treatment of Hypertrophied Nasal Turbinates. MATERIALS AND METHODS: This was a prospective study of 70 patients with nasal obstruction due to hypertrophied nasal turbinates who were randomly divided in 2 groups of 35 each. In group 1, patients underwent inferior nasal turbinate reduction by cryosurgery and in group 2 patients with cautery by 50 % TCA. The patients were evaluated using SNOT-20 score pre and postoperatively on 6th month. RESULTS: Significant improvement in symptoms was seen in 28 patients (80 %) in group 1 and in 10 patients (28.57%) in group 2..Improvement in average SNOT Score after cauterization of hypertrophied nasal turbinates by cryosurgery was from 55(severe) to 16(mild) and by TCA was from 54(severe) to 32(mod) in 6 months and this was statistically significant (P<0.001). Complications like bleeding, scarring, infection and adhesion formation were more with TCA than that of cryosurgery group and among these complications scarring was statistically significant (P =0.003). CONCLUSION: The use of cryosurgical treatment for hypertrophied nasal turbinates is a safe, curative method as compared to that of TCA cautery which is less curative and with more complications.

Audiological Abnormalities in Vitiligo Patients: A Hospital-Based Cross-Sectional Study

Abstract Introduction There are some discrepancies in the literature about the influence of vitiligo on auditory functions. According to some authors, vitiligo influences hearing, whereas others question such influence. Therefore, we conducted a study to evaluate audiological functions in vitiligo patients. Objectives To determine the effect of vitiligo on auditory functions. Methods A hospital-based observational study was done from January 2017 to July 2017. Clinically diagnosed cases of vitiligo were enrolled for the study. A complete otological examination was conducted in all patients. Results Fifty-two patients (male: female 28:24) were included in the study. Ten patients (19.2%) had sensorineural hearing loss (SNHL). Seven patients (13.5%) had bilateral and 3 (5.7%) had unilateral SNHL. High frequency loss was seen in 17 out of 20 ears (10 affected patients), 6 ears had both low and high-frequency hearing loss. Of 12 ears with speech frequency involvement, mild hearing loss was seen in 5 and moderate to severe in 1 ear.Most cases of SNHL were detected in the age group 41 to 60 years old (63.6%), which was statistically significant (p-value 0.00). Conclusion The results of this study suggest that vitiligo patients require routine monitoring for auditory functions for early identification of SNHL. Older subjects with vitiligo might be at a higher risk for audiological abnormalities. These patients should also be informed regarding the associated risk with noise and ototoxic drug exposure.

Audiological Abnormalities in Vitiligo Patients: A Hospital-Based Cross-Sectional Study.

Introduction There are some discrepancies in the literature about the influence of vitiligo on auditory functions. According to some authors, vitiligo influences hearing, whereas others question such influence. Therefore, we conducted a study to evaluate audiological functions in vitiligo patients. Objectives To determine the effect of vitiligo on auditory functions. Methods A hospital-based observational study was done from January 2017 to July 2017. Clinically diagnosed cases of vitiligo were enrolled for the study. A complete otological examination was conducted in all patients. Results Fifty-two patients (male: female 28:24) were included in the study. Ten patients (19.2%) had sensorineural hearing loss (SNHL). Seven patients (13.5%) had bilateral and 3 (5.7%) had unilateral SNHL. High frequency loss was seen in 17 out of 20 ears (10 affected patients), 6 ears had both low and high-frequency hearing loss. Of 12 ears with speech frequency involvement, mild hearing loss was seen in 5 and moderate to severe in 1 ear. Most cases of SNHL were detected in the age group 41 to 60 years old (63.6%), which was statistically significant ( p -value 0.00). Conclusion The results of this study suggest that vitiligo patients require routine monitoring for auditory functions for early identification of SNHL. Older subjects with vitiligo might be at a higher risk for audiological abnormalities. These patients should also be informed regarding the associated risk with noise and ototoxic drug exposure.

A Rare Case Report of Dabigatran Induced Oral Ulcers.

BACKGROUND: Dabigatran is a novel oral anticoagulant molecule which is a direct thrombin (Factor IIa) inhibitor and is used for prevention of stroke and systemic embolism. It is easy to administer as compared to warfarin therapy as it does not require routine laboratory monitoring and has fewer drug interactions. OBJECTIVE: To present a rare case of oral ulcers secondary to dabigatran in a patient with deep vein thrombosis. CASE REPORT: A 68-year-old female presented with painful oral ulcers, retrosternal pain and difficulty in swallowing. She had been taking capsule Dabigatran for the prevention of systemic embolism for 2 months. She had experienced symptoms of onset taking dabigatran for 7 days. Clinical examination revealed three tender, well-defined, clean looking ulcers of various sizes present over the dorsum of the tongue. Dabigatran was withdrawn and the patient was on oral proton pump inhibitors. Patient showed remarkable improvement in oral ulcers after 2 weeks. CONCLUSION: Patient education and counseling should be done regarding this side effect of dabigatran and proper intake of this medicine.