RESUMO
Background: Rural population constitutes a significant population of our country. According to the regions, the sexual behavior and pattern of sexually transmitted infections (STIs) changes because of variation in health facilities, education, and sociocultural belief. Objective: To study the sociodemographic profile, sexual behavior, and pattern of STIs based on the syndromic approach in the rural population attending STIs clinic from the east-central zone of India. Materials and Methods: Between January 2020 and July 2022, a retrospective study was carried out in a STIs clinic at a tertiary care facility in India's east-central region. Data included demographics, clinical profiles (syndromic approach), and sexual behavior from all the rural population suffering from STIs. The data were corroborated using the proper statistical tools. Results: Seven hundred and twenty-two (63.6%) of the 1135 STI cases were from the rural population. The gender ratio was 17:1, with 333 (46.1%) patients between the ages of 20 and 30 years. Four hundred and ninety-four (68.4%) of the rural population had education qualifications below the 10th class. The predominant occupation was a homemaker (582; 80.6%). Drug abuse was noted in 13 (1.8%) cases. Lower abdominal pain was the most clinical manifestation seen in 441 (61%) cases, followed by vaginal discharge in 89 (12.3%) cases. The majority of the patients presented with the first episode of symptoms and had a single regular partner with no symptoms in a partner. In 22.9% of cases, the partner had a history of frequent travel. In 94.1% of cases, protective measures were not used. Conclusions: Young married adults, female partners, lower education, and low-income classes were among those who had STIs, with frequent unprotected sexual activity. Lower abdominal pain is the most common symptom in this area.
RESUMO
Background and Aim: Geriatric populations are susceptible to leprosy infection with masked clinical signs due to lower immunity in them. Our aim was to analyze the clinicoepidemiologic profile of patients with geriatric leprosy and find out the reasons for delayed diagnosis and treatment. Materials and Methods: A retrospective, record-based study was conducted in a tertiary care center from May 2019 to May 2022. The clinicodemographic data of biopsy-confirmed leprosy cases aged ≥60 years were obtained from the leprosy clinic record. Various reasons for the delay in treatment were also recorded. Simple statistics was used for analysis. Results: Out of 605 leprosy cases, 50 (7.4%) cases belonged to the geriatric population. Males outnumbered females (M/F = 37/13). The mean age of the patients was 66.28 + 6.5 years. Maximum patients belonged to 60-69 years of age. The mean duration of illness was 35.22 months (range 1-240 months). Most of the patients were illiterate (33.6%), and 56% were farmers by occupation. The ulnar nerve was the most common nerve to be thickened in 90% (45/50) cases, followed by the common peroneal nerve in 54% (27/50) cases, radical cutaneous nerve in 52% (26/50) cases, and posterior tibial nerve in 24% (12/50) cases. Borderline tuberculoid was the most common type in 44% cases, followed by lepromatous leprosy in 22%, borderline lepromatous leprosy in 18% (9/50), and pure neuritic leprosy in 14%. Type 1 and type 2 lepra reactions were found in 18% and 14% cases, respectively. Also, 38% had grade 2 disability. Common reasons for the delay in treatment were financial constraints, lack of family support, and personal superstitious beliefs. The study was limited by its retrospective nature. Conclusion: Geriatric leprosy needs special attention as the elderly are more prone for deformities; also, because of low immunity, there is a high chance of developing multibacillary leprosy, and therefore, they are potential sources of infection to the community.
RESUMO
Background: Narrow-band ultraviolet B (NB-UVB) is the standard therapy for vitiligo. Objective: The objective of this study is to compare the safety and clinical efficacy of a handheld NB-UVB comb device with the standard whole-body NB-UVB therapy in localized stable vitiligo. Materials and Methods: Thirty-one vitiligo patients were allocated to either daily therapy with a home-based handheld comb device (group A, n = 17) or thrice-weekly hospital-based whole-body NB-UVB therapy (group B, n = 14) for 4 months, based on their preference. The primary and secondary outcomes were assessed at each follow-up, and appropriate statistical tools were used for analysis. Results: Of the 31 patients enrolled, 26 patients (study groups A/B: 15/11) completed the study. Primary outcome: Median percentage repigmentation of the representative patch in groups A and B were 51.35% and 63.85%, respectively (P = 0.64). The median size reduction of the representative patch in both groups was statistically significant (P < 0.05). The mean difference between "per protocol analysis" and "intention to treat" showed noninferiority. Secondary outcomes: Both groups were comparable on Lund and Browder score, patient global assessment and investigator global assessment scores, adverse events, color match, and change in the quality of life. The comparison group had a significantly greater number of missed sessions (P = 0.02). The majority of patients had a "good" response in both groups. Conclusion: Handheld NB-UVB comb device daily with a fixed dose of fluence was found to be noninferior with better compliance to standard whole-body NB-UVB therapy.