COVID-19: A Curious Abettor in the Occurrence of Stevens-Johnson Syndrome.

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are immune-mediated life-threatening skin diseases. The condition is known to be caused by various infections, drugs (mainly antibiotics), or can be idiopathic. Amidst the novel coronavirus 2019 (COVID-19) pandemic, there is an increasing number of SJS/TEN cases being reported. Viral infections are known to have decreased the threshold of drug reactions by inducing a pro-inflammatory state in the body. We report a case of TEN secondary to tamsulosin use in the setting of COVID-19 infection. There is only one documented case of tamsulosin-induced SJS, and no documented case of TEN secondary to tamsulosin use. Our patient was a 26-year-old male who presented to the hospital after a recent history of COVID-19 infection with a diffuse maculo-vesicular rash with bullae, involving the mucosa. The patient had recent use of tamsulosin on the day of presentation and there were bullae and erythematous rashes present in the oral mucosa as well as significant conjunctival erythema with pain on ocular movement on physical examination. His rash progressively worsened, involving greater than 30% of his body. A biopsy was done that showed full-thickness necrosis indicative of toxic epidermal necrolysis (TEN). We hypothesize that in our patient COVID-19 infections lowered the threshold for the development of SJS/TEN.

Dangerous dog licks! - A rare case of epidural abscess secondary to Capnocytophaga.

We present a rare case of a 71-year-old female. She has a history of irritable bowel syndrome that is diet controlled. However she presented to the emergency department (ED) with a history of diarrhea, weakness, chills and right lower back pain for two days. She was found to have epidural abscesses secondary to Capnocytophaga bacteremia. To date, there has been only one case report of a sacral abscess secondary to Capnocytophaga sp. Capnocytophaga is a genus of facultative anaerobic gram-negative bacilli that are frequent commensals in the oral cavity of cats and dogs. It can be transmitted by bites, scratches or contact of saliva with exposed mucosa or skin. It is a rare but potentially fatal infection, that is known to cause severe septicemia and shock, especially in patients with splenectomy. Our case is a unique presentation of sepsis and epidural abscesses in an immunocompetent host due to Capnocytophaga. Given the slow growing and fastidious nature of the organism, it requires a high suspicion in a patient presenting with slow growing gram-negative rod bacteremia and diligent following of cultures and sensitivities to ensure correct antibiotic coverage.

Clinico-Epidemiological Profile of Children Orphaned due to AIDS Residing in Care Giving Institutions in Coastal South India.

BACKGROUND: HIV/AIDS has a greater impact on children. Besides being orphaned by the untimely demise of one or both parents due to the disease, these children are more prone for discrimination by the society. METHODS: In this cross-sectional study 86 children orphaned by AIDS residing in care giving institutions for HIV positive children in Mangalore were assessed for their clinico-epidemiological profile and nutritional status. Institutional Ethics Committee clearance was obtained before the commencement of the study. The collected data were analyzed using SPSS (Statistical Package for Social Sciences) version 11.5 and the results expressed in mean (standard deviation) and proportions. BMI was calculated and nutritional status assessed using WHO Z scores (BMI for Age) for children between 5 and 19 years separately for boys and girls. RESULTS: The mean age of the children was 13.2 ± 3 years. Majority (n = 56, 65.1%) of the children were double orphans. Most of the children orphaned by AIDS (n = 78, 90.7%) had a history of both the parents being HIV positive. The median CD4 count of participants at the time of our study was 853.5 (IQR 552-1092) cells/microliter. A higher percentage of orphans were malnourished compared to nonorphans. (41.1% vs. 36.7%). All the educational institutions, wherein the children orphaned by AIDS were enrolled, were aware about their HIV status. Five of the participants felt discriminated in their schools. Only two of the participants felt discriminated by their friends because of their HIV status. CONCLUSION: From our study we draw conclusion that even though the children orphaned due to AIDS are rehabilitated in terms of having shelter and provision of education and health care, much needs to be done in terms of improving the nutritional status of these children and alleviating the discriminatory attitude of the society towards them.

Profile of cervical cancer patients attending Tertiary Care Hospitals of Mangalore, Karnataka: A 4 year retrospective study.

OBJECTIVES: To describe the sociodemographic characteristics and clinical profile of women presenting with cervical carcinoma and to identify factors associated with the timing of presentation and prognosis. MATERIALS AND METHODS: A record-based descriptive study was carried out from 1st February to 31st March 2014 at Tertiary Care Hospitals of Mangalore. The study population included women who were diagnosed with cervical carcinoma from January 1, 2010 to December 31, 2013. A pretested data extraction sheet aimed at collecting information from the inpatient records was used as the study instrument. The collected data were entered and analyzed using SPSS version 16.0. RESULTS: A total of 227 patients were included in the study. Mean (Standard Deviation) age of diagnosis of cervical cancer was found to be 55 ± 11 years. Majority of the women were Hindus (88.5%) and 51.0% of the women had occupational activities out of which manual labor was the most common. Forty-eight percent of the patients presented in the late stages. Squamous cell carcinoma was found to be the most common histological type. It was also observed that a slightly higher proportion of women with an age >49 years presented in late stages of the disease (n = 70, 48.6%) compared to women <49 years of age (n = 28, 46.7%); however, the difference was not statistically significant (P = 0.800). CONCLUSIONS: Our study found out a higher proportion of late presentation by the patients. It emphasizes the need for the development and implementation of an efficient screening cum prevention program for cervical cancer and to continue active research in the domains of identifying all possible risk factors and steps to mitigate them.