Comparative Analysis of P-selectin Levels in Psoriasis, Vitiligo, and Nonskin Disease in a Tertiary Care Hospital: A Case-Control Study.

INTRODUCTION: The role and function of P-selectin levels in various inflammatory and immune-mediated diseases have been established. Whether they have an association with inflammatory skin diseases such as vitiligo and psoriasis needs to be established. OBJECTIVE: The objective of this study was to assess P-selectin levels in psoriasis and vitiligo and to compare them with matched controls without skin disease. MATERIALS AND METHODS: The study included a total of 90 subjects with age- and sex-matched - 30 each in psoriasis, vitiligo and 30 controls without skin disease. Psoriasis and vitiligo severity was assessed using the Psoriasis Area and Severity Index and the Vitiligo Area Scoring Index scores. P-selectin levels were assessed and compared among the groups. P-selectin levels were also compared with the severity of psoriasis and vitiligo. Chi-square and analysis of variance tests were used to compare the data. RESULTS: The mean age of subjects was 36.28 ± 11.80 years. Majority of the subjects were males (65.6%). The three groups were matched for age, sex, and other demographics. The mean P-selectin levels were 610.43 ± 134.19, 292.52 ± 60.99, and 158.97 ± 34.76 ng/ml, respectively, in the psoriasis, vitiligo, and control groups, respectively (P < 0.001). No significant association of P-selectin levels was observed with psoriasis severity; however, with increasing vitiligo severity, there was a significant increase in P-selectin levels (P < 0.001). CONCLUSION: Patients with skin diseases have raised P-selectin levels. Within skin diseases, inflammatory diseases such as psoriasis have higher P-selectin levels as compared to autoimmune diseases such as vitiligo. A significant association of P-selectin levels was observed with vitiligo severity but not with psoriasis severity.

Résumé Introduction:Le rôle et la fonction des niveaux de P-sélectine dans diverses maladies inflammatoires et à médiation immunitaire ont été établis. Si leur association avec des maladies inflammatoires de la peau telles que le vitiligo et le psoriasis doit être établie.Objectif:L'objectif L'objectif de cette étude était d'évaluer les niveaux de P-sélectine dans le psoriasis et le vitiligo et de comparer l'anthropo avec des témoins appariés sans maladie cutanée.Matériels et méthodes:L'étude a inclus un total de 90 sujets ­ 30 dans chaque groupe, des sujets de même âge et sexe atteints de psoriasis, de vitiligo. et contrôles sans maladie de peau. La gravité du psoriasis et du vitiligo a été évaluée à l'aide du Psoriasis Area and Severity Index et du Vitiligo. Scores de l'indice de notation de zone. Les niveaux de P-sélectine ont été évalués et comparés entre les groupes. Les niveaux de P-sélectine ont également été comparés aux gravité du psoriasis et du vitiligo. Des tests du chi carré et d'analyse de variance ont été utilisés pour comparer les données.Résultats:L'âge moyen des sujets était de 36,28 ± 11,80 ans. La majorité des sujets étaient des hommes (65,6 %). Les trois groupes ont été appariés en fonction de l'âge, du sexe et d'autres données démographiques. Les taux moyens de P-sélectine étaient respectivement de 610,43 ± 134,19, 292,52 ± 60,99 et 158,97 ± 34,76 ng/ml dans les patients atteints de psoriasis, de vitiligo et de contrôle. groupes, respectivement (P <0,001). Aucune association significative entre les taux de P-sélectine et la gravité du psoriasis n'a été observée; cependant, avec l'augmentation En cas de gravité du vitiligo, il y avait une augmentation significative des taux de P-sélectine ( P < 0,001).Conclusion:les patients atteints de maladies de peau ont augmenté la sélectine P les niveaux. Parmi les maladies de la peau, les maladies inflammatoires telles que le psoriasis ont des taux de sélectine P plus élevés que les maladies auto-immunes telles que comme le vitiligo. Une association significative des taux de P-sélectine a été observée avec la gravité du vitiligo mais pas avec la gravité du psoriasis.

Fall Injuries in Nepal: A Countrywide Population-based Survey.

BACKGROUND: An estimated 424,000 fatal falls occur globally each year, making falls the second leading cause of unintentional injury-related deaths after road traffic injuries. More than 80% of fall-related fatalities occur in low- and middle-income countries. Data from low-income South Asian countries like Nepal are lacking, particularly at the population level. The aim of this study was to provide an estimate of fall-injury prevalence and the number of fall injury-related deaths countrywide in Nepal and to describe the epidemiology of fall injuries in Nepal at the community level. METHODS: A countrywide cross-sectional study was performed in 15 of the 75 districts in Nepal using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool. The SOSAS survey gathers data in 2 sections: demographic data, including the household's access to health care and recent deaths in the household, and assessment of a representative spectrum of surgical conditions, including injuries. Data was collected regarding an individuals' experience of injury including road traffic injuries, falls, penetrating trauma, and burns. Data included anatomic location, timing of injury, and whether health care was sought. If health care was not sought, the reason for barrier to care was included. Descriptive statistics were used to analyze the data. RESULTS: Of 2695 individuals from 1350 households interviewed, 141 reported injuries secondary to falls (5.2%; 95% confidence interval [CI], 4.4%-6.1%), with a mean age of 30.7 years; 58% were male. Falls represented 37.2% of total injuries (n = 379) reported (95% CI, 32.3%-42.3%). Twelve individuals who suffered from a fall injury were unable to access surgical care (8.5%; 95% CI, 4.5%-14.4%). Reasons for barrier to care included no money for health care (n = 3), facility/personnel not available (n = 7), and fear/no trust (n = 2). Of the 80 recent deaths reported, 7 were due to fall injury (8.8%; 95% CI, 3.6%-17.2%), and patients had a mean age of 46 years (SD 22.8). Surgical care was not delivered to those who died for the following reasons: no time (n = 4), facility/personnel not available (n = 1), fear/no trust (n = 1), and no need (n = 1). CONCLUSION: The Nepal SOSAS study provides countrywide, population-based data on fall-injury prevalence in Nepal and has identified falls as a crucial public health concern. These data highlight persistent barriers to access to care for the injured and the need to improve trauma care systems in developing countries such as Nepal.

Undescended testis: how extensive should the work up be?

AIM: The aim of this study was to highlight various anomalies associated with undescended testis and to determine how much work up is necessary for this condition. MATERIAL AND METHODS: The study was conducted in the department of Pediatric Surgery SKIMS Srinagar, Kashmir. All patients between 0-14 years of age who attended out patient department (OPD) from January 2002 to December 2003 with maldescent of testes were included in the study. Detailed relevant history and physical examination findings were recorded in all the cases. Baseline investigations were performed along with ultrasonography of the abdomen. In relevant cases other investigations like intravenous urography, micturating cystourethrography, CT scan and laparoscopy were performed as and when indicated. RESULTS: A total of 250 cases of undescended testis were registered during this period. Maximum number of cases were in the age group of 5-10 years. In 130 (52%) cases the right testis was undescended while 75 (30%) had left sided undescended testis and 45 (18%) had bilateral undescended testis. Maldescended testis comprised 11% of the admissions. The majority of cases were having gestational age of 37 weeks or more. The associated anomalies picked up on investigations included duplication of upper urinary tract (3.2%), hydronephrosis and polycystic kidney (0.8% each), horseshoe kidney, ectopic kidney, crossed renal ectopia (0.4% each) Posterior urethral valves, Prune belly syndrome (0.4%) and spina bifida (0.4%). On detailed clinical examination of genitalia several abnormalities were picked which included hydrocele, hypospadias, hernia, chordee, micropenis and ambiguous genitalia. CONCLUSION: We recommend ultrasonography to be done in all cases of undescended testis in addition to a thorough history and physical examination. Intravenous pyelography, micturating cystourethrogram, CT scan and other investigations should be performed selectively based on history, physical examination or ultrasound findings.