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2.
Indian J Tuberc ; 65(1): 87-90, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29332658

RESUMO

Sweet's syndrome is a skin manifestation of various systemic infections, drugs, malignancies and autoimmune disorders. There are very few case reports describing the relationship between Sweet's syndrome and non-tubercular mycobacterium infection. Further development of Sweet's syndrome secondary to mycobacterium tuberculosis (active pulmonary tuberculosis) is extremely uncommon and this is the second well established case reported from India. Here we report a forty eight year old man who presented with multiple erythematous and tender plaques over neck, palms and sides of soles. He also had high grade fever, headache, myalgias, cough, chest pain and difficulty in breathing. With clinical possibilities of (1) Sweet's syndrome with pulmonary involvement and (2) Sweet's syndrome secondary to pulmonary infection, we send the skin biopsy for histopathological examination and also advised routine laboratory plus imaging investigations to find out the underlying cause. Clinical and lab parameters together with the biopsy report fulfilled the diagnostic criteria for Sweet's syndrome. Further chest X-ray findings, demonstration of acid fast bacilli of mycobacterium tuberculosis on sputum smear microscopy and MGIT report confirmed the diagnosis of pulmonary tuberculosis. Patient was put on colchicine and standard anti-tubercular drugs. Significant improvement was noticed in skin lesions within five days of treatment and no recurrence has been seen for the past six months.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Síndrome de Sweet/etiologia , Tuberculose Pulmonar/complicações , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Doenças Raras , Recidiva , Síndrome de Sweet/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia
3.
Int J Prev Med ; 5(6): 741-8, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25013694

RESUMO

BACKGROUND: Weaning plays a major role in determining the nutritional status of a child. Poor weaning practices during infancy and early childhood, resulting in malnutrition, contribute to impairment of cognitive and social development, poor school performance and reduced productivity in later life. The objective of this study is to know weaning practices of mothers of difficult terrain. METHODS: Cross-sectional study was conducted in all villages under Rural Health Training Center, the field practice area of Department of Community Medicine. A total of 500 mothers with children within 3 years of age were included in the study. Pre-tested pre-designed semi-structured questionnaire was used to collect information on weaning practices. RESULTS: Majority of children (51.57%) were weaned at >6 months and were observed to be more under nourished (79.34%) as compared with those between 4 months and 6 months (61.50%). Majority of boys were weaned earlier than girls irrespective of the age of the weaning. Malnutrition was found in majority of those children who were weaned inadequately in terms of both frequency and amount. CONCLUSIONS: The present study revealed suboptimal weaning practices among the mothers of hilly region. Thus, appropriate educational strategies should be directed particularly on counteracting various myths related to infant feeding Moreover, promotion of appropriate feeding should target not only on maternal caregivers, but also on other family members, particularly husbands and grandmothers, taking into account the social and cultural situation of the area.

4.
Photodermatol Photoimmunol Photomed ; 30(6): 294-301, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24828298

RESUMO

BACKGROUND: Isotretinoin has been used in combination with oral psoralen + UVA (PUVA) and narrowband UVB (NBUVB) for treating psoriasis, especially in women of child-bearing age. The efficacy of oral psoralen + sun exposure (PUVAsol) is comparable to that of PUVA. This study was planned to compare the efficacy of oral PUVAsol with that of the combination of oral isotretinoin and PUVAsol in patients with chronic plaque psoriasis. METHODS: Forty patients with psoriasis vulgaris were randomized to two groups. Group A (control group) received PUVAsol only. Group B (intervention group) received PUVAsol + isotretinoin (0.5 mg/kg/day). Psoriasis Area Severity Index (PASI) score was recorded at baseline and weeks 4, 8 and 12. Dermatology Life Quality Index was assessed at baseline and 12 weeks. The end point of the study was PASI 75 or 12 weeks, whichever came earlier. RESULTS: Thirty-five patients completed the study. There were statistically significant differences between the two study groups for the number of patients achieving the endpoint of PASI 75, PASI scores at the end of 12 weeks, mean duration to achieve PASI 75, number of PUVAsol sessions needed to achieve PASI75 and mean cumulative dosage of 8-methoxypsoralen needed to achieve PASI 75. CONCLUSION: The combination of isotretinoin with PUVAsol is more effective compared with PUVAsol alone for treating chronic plaque psoriasis.


Assuntos
Furocumarinas/uso terapêutico , Isotretinoína/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Fototerapia , Psoríase/terapia , Luz Solar , Adulto , Idoso , Terapia Combinada , Feminino , Furocumarinas/administração & dosagem , Furocumarinas/efeitos adversos , Hospitais , Humanos , Isotretinoína/administração & dosagem , Isotretinoína/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/efeitos adversos , Fototerapia/efeitos adversos , Psoríase/tratamento farmacológico , Psoríase/radioterapia , Adulto Jovem
5.
ISRN Dermatol ; 2014: 271230, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24701356

RESUMO

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

6.
Artigo em Inglês | MEDLINE | ID: mdl-24685846

RESUMO

BACKGROUND: Though drug promotion regulations exist worldwide, low quality of journal drug advertising is a global issue. Medical journals are regarded as a leading source of information for new drugs. They may also modulate prescribing behavior of physicians without their knowledge. A comparative analysis of advertisements from different countries may provide insights regarding strengths and weaknesses of different regulating systems. AIMS: Prescription drug advertisements from the Indian Journal of Dermatology, Venereology, and Leprology (IJDVL) and Journal of American Academy of Dermatology (JAAD) were compared to check their compliance with criteria of World Health Organization (WHO) and International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). METHODS: All the prescription drug advertisements of at least one page length appearing in all the issues of IJDVL and JAAD from January 2012 till December 2012 were included in this study. The contents of both advertisements were compared for compliance regarding different criteria of ethical codes for drug advertising of WHO and IFPMA. Statistical analysis was done using Fisher's exact test. RESULTS: Compared to IJDVL, more advertisements in JAAD complied with WHO and IFPMA codes. On the whole, advertisements in IJDVL had significantly less information regarding the approved usage, dosage, abbreviated prescribing information (API), summary of scientific information, safety information regarding the drug, and references to the scientific literature to support various claims. However, JAAD had more advertisements with multiple claims than IJDVL, and many advertisements interspersed between scientific articles while IJDVL had none. CONCLUSION: The complex issue of ethical drug advertising in dermatology journals requires constant review and discussion. Dermatologists should be cautious in assessing any advertisement or claim even if it seems evidence-based. The results from our study highlight the need for a global, proactive and effective regulatory system to ensure ethical medicinal drug advertising in medical journals.


Assuntos
Publicidade/ética , Dermatologia , Indústria Farmacêutica/ética , Publicações Periódicas como Assunto/ética , Humanos , Índia , Medicamentos sob Prescrição , Estados Unidos
7.
ISRN Dermatol ; 2014: 743027, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24600520

RESUMO

Introduction. Topical application of local anesthetics is currently considered to be the easiest, most effective, and convenient way for treatment of patients who may be undergoing superficial dermatosurgical procedures. Materials and Methods. This study compares the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lignocaine and 7% tetracaine combination cream for radio ablative dermatosurgery when applied, under occlusion, for 30 minutes. 40 subjects of achrocordons were enrolled in this split-side randomized trial. Result. The pain severity experienced by subjects in terms of visual analogue scale score was significantly lesser for lignocaine/tetracaine combination cream as compared to lidocaine/prilocaine combination. Conclusion. This small study proves the efficacy of lidocaine/tetracaine combination as a topical anesthetic cream when applied for a short time interval of 30 minutes. This will help a dermatosurgeon to perform various dermatological procedures in a better and efficient manner with a shorter waiting period for analgesia to set in.

9.
Indian J Dermatol ; 58(5): 407, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24082204

RESUMO

Vitamin K deficiency bleeding (VKDB) disorder is an uncommon entity, which occurs due to inadequate activity of vitamin K-dependant coagulation factors. An 8-months-old exclusively breast-fed male infant presented with multiple, purpuric and nodular non-collapsible swellings on trunk of 4 days duration. Investigations revealed raised activated partial thromboplastin time and prothrombintime. Fibrinogen level and platelet counts were normal. Late VKDB usually presents as intra-cranial or mucosal hemorrhages.([1]) Though skin and mucosal bleeding may occur in 1/3(rd) of infants with VKDB, 'nodular purpura' is not the common presenting feature. Earlier recognition of VKDB and immediate investigation/treatment helps prevent the potentially fatal outcome of the disease. Very little is mentioned about this entity in dermatology literature.

10.
J Clin Neonatol ; 2(1): 20-4, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24027740

RESUMO

CONTEXT: Apgar score (AS) is routinely used for assessment of newborns immediately after birth. Within acceptable limits, low saturations at birth are normal in vigorous newborn babies. Various studies have questioned the reliability of AS. AIMS: To detect whether AS is an accurate indicator of hypoxemia and to study the correlation of different components of AS with the arterial oxygenation saturation (SpO2) levels of normal newborns in the delivery room. SETTINGS AND DESIGN: A prospective cross-sectional observational study on normal healthy neonates delivered vaginally in a tertiary level referral medical college. MATERIALS AND METHODS: SpO2 levels were monitored continuously in the newborns with a pulse oximeter and serial recording of SpO2 levels was done at 5 min intervals starting at 1 min of life until 30 min after birth. Simultaneously, AS was recorded in these newborns at 1 and 5 min of life. STATISTICAL ANALYSIS: Data was analyzed using the Mann-Whitney-U test. RESULTS: AS at 1 and 5 min of life didn't correlate with the changes in SpO2 of newborns. In AS; though respiratory efforts and muscle tone were significantly correlated with SpO2 of the newborns, body color did not have significant correlation with simultaneously recorded SpO2. CONCLUSIONS: A revised AS in which evaluation of color is replaced by pulse oximetry monitoring would prove to be a better tool for neonatal evaluation in the immediate postnatal period.

11.
Indian J Pediatr ; 80(4): 276-80, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22688652

RESUMO

OBJECTIVES: To ascertain the status of Tuberculin Skin Test (TST) in the children aged 0-5 y who are household contacts of adults having sputum smear positive pulmonary tuberculosis and also to study the relationship of TST and Chest X-Ray (CXR) and their relevance in contact screening under RNTCP setup. METHODS: This prospective hospital based clinical study was conducted at a tertiary level referral medical college in Northern India. Study subjects were 200 children ≤5 y of age who were household contacts of adults with sputum smear positive pulmonary tuberculosis. All these adult index cases were registered and taking regular treatment at RNTCP centre attached to a medical college. Demographic data collection, detailed clinical history along with clinical examination, growth assessment, TST and chest radiography (CXR) was done for every child. RESULTS: TST was positive in 39 % children and out of these 68 % of child contacts had CXR findings suggestive of tuberculosis. This correlation was found to be highly significant (p < 0.001), especially in children less than 1 y of age. A high percentage of clinically asymptomatic children also had positive TST and CXR consistent with definition of TB disease. CONCLUSIONS: Contact screening must be prioritized in RNTCP. Unlike presently, TST and CXR should be actively employed in RNTCP for contact screening.


Assuntos
Busca de Comunicante , Programas de Rastreamento/métodos , Tomografia Computadorizada por Raios X , Teste Tuberculínico , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/imunologia , Adulto , Pré-Escolar , Busca de Comunicante/estatística & dados numéricos , Feminino , Hospitais de Ensino , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Desnutrição/complicações , Programas Nacionais de Saúde/estatística & dados numéricos , Estudos Prospectivos , Fatores de Risco , Teste Tuberculínico/métodos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle
13.
Indian Dermatol Online J ; 3(1): 31-3, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23130258

RESUMO

Varicella zoster virus causes both chicken pox and herpes zoster. The phenomenon of herpes zoster occurring concurrently in two non-contiguous dermatomes involving different halves of the body is termed herpes zoster duplex bilateralis (HZDB). Few cases, reported in the literature, were seen in either an immunosuppressed host or in the older age group. Here we present a case of HZDB in an immunocompetent host, probably the first in India.

14.
Case Rep Oncol Med ; 2012: 342030, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23119201

RESUMO

Bowens' disease (BD) is a precancerous condition of skin and/or mucosa with a predilection towards sun-exposed areas. Extensive literature research failed to reveal any case of multiple pigmented BD in type V Fitzpatrick skin. Multiple BD is a therapeutic challenge with a tendency to recur. Here we present an otherwise healthy Indian male having multiple pigmented lesions of BD on sun-protected sites of the body mimicking malignant melanoma. These lesions were refractory to treatment with different modalities. This paper is an attempt to review the available literature regarding the pigmented variant of multiple BD. Rationale for a therapeutic trial of UVB therapy for multiple arsenic induced BD is also discussed.

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