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1.
J Assoc Physicians India ; 49: 240-6, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11225138

RESUMO

BACKGROUND: COPCORD (Community oriented program from control of rheumatic diseases) is a global initiative of the WHO/International League of Associations from Rheumatology (ILAR). The prevalence data from the first Indian COPCORD survey (Stage 1), carried out in village Bhigwan (Dist. Pune), in 1996, is presented. AIM: To study the rural prevalence of rheumatic-musculoskeletal symptoms/diseases (RMSD). METHODS: A cross-sectional survey of the village (non-randomised selection) was completed in five weeks, using validated questionnaires, served by 21 trained volunteers. 746 patients (18.2%, 95% CI: 17-1-19-4) were identified (Phase 1) from 4092 adults (response 89%), and systematically evaluated (Phase 2 and 3) by a medical team, including a rheumatologist; limited investigations were carried out and diagnosis confirmed during a planned 12 week initial follow-up. Standard clinical criteria were used for the diagnosis; point prevalence estimates (prev)/confidence interval (CI) are shown in parenthesis. RESULTS: There was a dominant distribution of 'pain at all sites' (articular/soft tissues) in the females; painful neck (9.5%), back (17.3%), and calf (8.5%) appeared significant when compared to the Bhigwan males and the Indonesian and the Chinese rural COPCORD results. 55% RMSD were due to soft tissue rheumatism (5.5%) and an ill-defined/unclassifiable symptom-related-diagnosis (7.1%). Osteoarthritis (5.8%) and inflammatory arthritis (IA) were seen in 29% and 10% patients respectively. 240 patients (5.9%) with chronic knee pains did not show any clinical evidence of OA. The prev of rheumatoid arthritis (0.5%, 95% CI: 0.3-0.7), as classified by the American College of Rheumatology, was the highest ever reported from an Asian rural COPCORD study. Though unclassifiable IA (0.9%, 95% CI: 0.6-1.1) was seen, well defined reactive arthritis, TB, leprosy and connective tissue disorders were not observed. Gout was diagnosed in five patients (0.12%). CONCLUSIONS AND DISCUSSION: The Bhigwan COPCORD survey demonstrates a significant rural spectrum of RMSD. It provides a reasonable speculation about the Indian rheumatological burden. Further, an eight year prospective study is in progress to identify new cases and risk factors, and educate people (Stages 2 and 3).


Assuntos
Doenças Reumáticas/epidemiologia , Saúde da População Rural/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Coleta de Dados , Escolaridade , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Doenças Reumáticas/diagnóstico , Fatores de Risco , Distribuição por Sexo
2.
Artigo em Inglês | MEDLINE | ID: mdl-17664767

RESUMO

A case of pyoderma gangrenosum is reported in a 52-year-old man who had skin lesions without any association. On investigation urinary tract infection was detected. Treatment of UTI led to spontaneous healing of the lesions in short period thus avoiding the need of oral corticosteroids.

3.
Artigo em Inglês | MEDLINE | ID: mdl-20877038

RESUMO

A 38-year-old woman presented with multiple, well-defined, erythematous, scaly, slightly pain-ful nodules progressing to plaques on the palms, dorsa of fingers of both hands since 6 years. Healed lesions had well-defined hyperpigmented margins with slight central atrophy. Clinical diagnosis of dis-coid lupus erythematosus was made, but histopatholgoy confirmed the diagnosis of keratoacanthomas.

4.
Artigo em Inglês | MEDLINE | ID: mdl-20877044

RESUMO

Antiepileptics are known to produce different types of side effects including nail changes. A 20-year-old epileptic man had yellowish discolouration followed by dystrophy and onycholysis of his 15 nails after taking carbamazepine for 3 months which cleared within six months after discontinuation of the drug. This type of change has not been reported earlier with carbamazepine.

5.
Artigo em Inglês | MEDLINE | ID: mdl-20877043

RESUMO

Adiposis dolorosa, a rare condition characterised by painful subcutaneous plaques of fat associated with obesity and emotional disturbances in menopausal females, is being reported.

6.
Artigo em Inglês | MEDLINE | ID: mdl-20877094

RESUMO

Two patients with oral submucous fibrosis, a disease exclusively found in India, are being reported.

8.
Artigo em Inglês | MEDLINE | ID: mdl-20885048

RESUMO

Seventy five patients with Lichen Planus (LP) were enrolled from out-patient department for screening the therapeutic effect of dapsone. Patients were divided into two groups of 50 and 25. In regimen - 1 (RI) 25 patients were given local corticosteroids and oral chlorpheniramine maleate. In regimen - 2 (R2) 50 patients were given oral dapsone and chlorpheniramine maleate and topical coconut oil. It was found that total efficacy of R2 was 18% higher than R1.

9.
Artigo em Inglês | MEDLINE | ID: mdl-20885053

RESUMO

A 53 year old woman presented with extensive pruritic hyperpigmented macules in interscapular area and extremities of four years duration.She was an established case of hypothyroidism on treatment for last four years.

10.
Artigo em Inglês | MEDLINE | ID: mdl-20921669

RESUMO

Chronic tobacco chewing and smoking have been implicated as precipitating factors for the development of oral lichen planus (OLP). We here report a case of chronic cigarette smoker who developed OLP plaque, without any other clinical pattern of OLP and skin involvement, which did not respond to conventional corticosteroid treatment and dapsone, but responded when vitamin A was added.

11.
Artigo em Inglês | MEDLINE | ID: mdl-20921675
12.
Artigo em Inglês | MEDLINE | ID: mdl-20944274
13.
Artigo em Inglês | MEDLINE | ID: mdl-20944280

RESUMO

Clinically it is sometimes difficult to differentiate the various hyperkeratosis of palms and soles like psoriasis of palms and soles, pustulosis palmaris et plantaris, hyperkeratotic tinea and hyperkeratotic eczema. To differentiate amongst these conditions we have to take the help of histopathology. Here we are presenting the data of 292 cases of hyperkeratosis of palms & soles examined histologically by doing Haematoxylin and Eosin staining for the typical changes of the above mentioned conditions and PAS for the demonstration of the fungus in stratum corneum in cases of hyperkeratotic tinea.

14.
Artigo em Inglês | MEDLINE | ID: mdl-20944281

RESUMO

Typical lesions of hyperkeratosis of palms and soles do not create any problem but when slight variation is there it becomes difficult to diagnose and that changes the line of treatment. For that we have studied 300 fresh cases of hyperkeratosis of palms and soles which included 110 cases of hyperkeratotic eczema. 42 cases of hyperkeratotic tinea, 64 cases of psoriasis of palms and soles and 84 cases of pustulosis palmaris et plantaris (PPP). To reach the final diagnosis alongwith the detailed history, general physical examination and routine investigations, help was taken of special investigations like pus for culture and sensitivity, KOH smear examination of skin scrapings and nail cutting and culture on Sabouraud's dextrose agar medium.

15.
Artigo em Inglês | MEDLINE | ID: mdl-20944369

RESUMO

A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.

16.
Artigo em Inglês | MEDLINE | ID: mdl-20947959

RESUMO

One hundred patients with vitiligo were enrolled from out patient department from the year 1990-91 for screening the therapeutic effect of injection placental extract (Placentrex). Patients were divided into two groups of 50 each, age and sex matched and were given two different regimens of treatment. In Regimen- I, patients were given oral psoralens followed by sun exposure after 2 hours and then application of topical betamethasone-17 valerate. In Regimen-ll patients were given treatment as in regimen-l along with injection of placental extract. It was found that initial response rate of Regimen-ll therapy was 36% higher than Regimen-l whereas total efficacy of R-ll was 20% higher than R-l.

17.
Artigo em Inglês | MEDLINE | ID: mdl-20947979
18.
Artigo em Inglês | MEDLINE | ID: mdl-20947989

RESUMO

HBsAg was studied in 50 patients of STD's and promiscuous persons. In 10.52% cases it was positive. Vaccination against Hepatitis-B was recommended in promiscuous individuals.

19.
Artigo em Inglês | MEDLINE | ID: mdl-20947996

RESUMO

A 45-year-old woman with livid plaques showing central atrophy and erythematous vesicular borders over both dorsa of feet and buttocks, and follicular and papular lesions over buttocks and lumbar area, was difficult to diagnose as either lichen planus (LP) or lupus erythematosus (LE). The histological studies from two places showed features of both LE and LP. Laboratory findings were within normal limits first, but follow up studies for two years showed persistent albuminurea, leucopenia, arthritis and erythema over the exposed areas with same histology suggesting that eruption may be an unusual variant of LE.

20.
Artigo em Inglês | MEDLINE | ID: mdl-20948019

RESUMO

Sixty cases of cutaneous vasculitis were selected from department of Skin and STD, Government Medical College/Rajendra Hospital, Patiala. Detailed history, general physical examination, systemic examination and dermatological examination were conducted in each and every case. Routine investigations were done. Clinical diagnosis was confirmed by biopsy. Histopathologic study was conducted by using H & E stain under 100X and 400X by light microscopy.

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