Vesicular herpes zoster eruption following chronic obstructive pulmonary disease treatment in the emergency department: lessons learnt from immunosuppression.

Background: Herpes zoster (HZ) is a reactivation of the varicella-zoster virus (VZV) that can occur in people with weakened immune systems. Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that can also impair the immune system.6-8. Case presentation: The authors present the case of a 65-year-old male with COPD who developed HZ. The patient was initially admitted to the hospital for an acute exacerbation of COPD. After his condition stabilized, he developed vesicular rashes on the medial aspect of his left leg. A skin biopsy confirmed the diagnosis of HZ. Clinical discussion: This case report provides further evidence that HZ can be induced in patients who are undergoing treatment for COPD. The authors recommend that COPD patients be vaccinated against HZ to prevent this complication. Conclusion: HZ can develop in COPD patients, mainly using inhaled steroids. Compliance to medication should be monitored, on the other hand zoster vaccination should be provided to prevent it and its foremost complication which includes secondary bacterial infection, post-herpetic neuralgia, scarring, nerve palsy and encephalitis in case with disseminated zoster.

Role of cancer literacy in cancer screening behaviour among adults of Kaski district, Nepal.

Cancer Screening is a key approach to detect cancer at an early stage and help reduce cancer mortality globally. Inadequate Cancer Literacy may pose a barrier to patient engagement in getting screened for cancer. This study assessed Cancer Screening behavior and its association with Cancer Literacy and other factors among adults of Kaski district, Nepal. A cross-sectional study was carried out among 180 adults from March to August 2019, selected using a multi-stage random sampling method. Data on demographics, history of cancer, use of naturopathy, fatalism, family support, cancer literacy and cancer screening behaviour were collected using a semi-structured questionnaire, with the aid of face-to-face interviews. Cancer Literacy was measured using a cancer health literacy tool (CHLT-6), and Cancer Screening behaviour was assessed on the basis of the self reported information about having gone through any type of cancer screening in the past. Odds ratio (OR) with 95% Confidence Interval (CI) was calculated to determine the strength of association using Multivariate Logistic Regression analysis. Only 43.4% of the respondents had Cancer Literacy scores more than the median and only 11.7% had ever gone through any Cancer Screening test in the past. In this study, Cancer Screening behaviour was significantly associated with Cancer Literacy [OR = 1.43, 95% CI (1.01-2.02)]. Similarly, significant association was found between Cancer Screening behaviour and other exposure variables such as age [OR = 1.06, 95% CI (1.02-1.11)] and gender [OR = 0.06, 95% CI (0.01-0.35)]. This study showed low cancer screening and cancer literacy scores amongst the respondents. This suggests that to tackle the ever increasing burden of cancer and hence, to increase cancer screening, we need to focus on improving knowledge and awareness about cancer, as well as, on targeting efforts towards people's understanding of basic health and cancer terminologies.

Association of Prevalence of Dental Caries in Mandibular Second Molar with Impacted Third Molar.

BACKGROUND: An impacted tooth is a tooth which does not reach the occlusal plane even after two-thirds root formation. Conditions associated with impacted teeth include trismus, cystic lesions, and cervical caries of second molars. The objective of this study was to evaluate the occurrence of carious lesions in the distal aspect of the mandibular second molar and its association with the presence of mandibular third molars. METHODS: A cross-sectional study was conducted from September 2018 to September 2020. Approval was taken from the Institutional Review Committee with reference number 90/77/78. Orthopantomograms of patients aged 18 years or older were studied. Information on age, gender, mandibular second and third molars were recorded. Convenient sampling was done. Statistical analysis was done using Statistical Package for Social Sciences version 21. RESULTS: A total of 626 radiographs were studied of which mesioangular impaction (35.3%) was the most prominent type and followed by horizontal impaction, causing distal caries in second molars. The age group between 20-40 years and female gender had the higher prevalence of distal caries in second molar teeth. There was a significant correlation between gender and cavity existence (p=0.00), between impaction and existence of decay (p=0.00), and depth of impaction with cavity formation (p=0.004). CONCLUSIONS: A total of 31.8% of the patients with impacted mandibular third molars had distal cervical caries in second molars. Mesioangular type, female gender, type A were the prominent factors associated with distal caries in second molar teeth due to impacted third molars.