Psychosocial and Financial Impact of Disease among Patients of Dermatophytosis, a Questionnaire-Based Observational Study.

INTRODUCTION: In the present epidemic of chronic, recalcitrant, and widespread dermatophytosis, impact of disease on quality of life (QoL) can be severe. Similarly, financial impact due to treatment cost and loss of wages needs consideration too. AIMS AND OBJECTIVES: Our primary aim was to evaluate the impact of dermatophytosis on QoL and the financial burden on individual and family. MATERIALS AND METHODS: Adult patients having dermatophytosis were included in the study. Standard Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate the psychosocial impact, and financial burden was evaluated by nine binary questions. RESULTS: A total of completed 299 DLQI surveys and 275 financial burden surveys were taken for final analysis. Mean DLQI was 12.25 (SD = 5.56, n = 299). Significant association between total body surface area (BSA) and DLQI score was observed (r s = 0.251, P < 0.001, n = 299). Presence of tinea corporis was found to be significantly affecting the choice of clothing (P = 0.018, χ2 = 5.127, CI 95%). More numbers of male respondents reported loss of work or study hours due to their illness (P = 0.015, χ2 = 5.196, CI 95%), which was significantly associated with the BSA involved (P < 0.05, t = 5.529, CI 95%). Some difficulties in sexual activity were reported by 35.6% patients, which has significant association with tinea cruris (P = 0.001, χ2 = 10.810, CI 95%). Median household income was 10,000 INR and interquartile range (IQR) being 8,000-19,000. Mean financial burden calculated at 3.458 (SD = 1.696, n = 275), whereas mean financial worry reported by patient stood at 3.661 (SD = 1.216, n = 275). Financial burden showed significant correlation with "previous treatment approximate cost," financial worry, and DLQI (P < 0.05, CI 95%). Financial worry (P = 0.016, r s = 0.145, CI 95%) and financial burden (P = 0.002, r s - = 0.145, CI 95%) both showed positive correlation with duration of disease. CONCLUSION: In present scenario of Dermatophytosis in India, the disease and its treatment causing impact on QOL as well as on personal financial burden and worry need consideration.

Scar size and effectiveness of Bacillus Calmette Guerin (BCG) vaccination in the prevention of tuberculosis and leprosy: a case-control study.

BACKGROUND: The study was undertaken to estimate the effectiveness of BCG vaccination in relation to scar size in the prevention of tuberculosis and leprosy. METHODS: The present study was designed as hospital-based pair-matched case-control study and was carried out at Government Medical College Hospital, Nagpur, Maharashtra, India. It included 877 cases of tuberculosis and 292 cases of leprosy (diagnosed by WHO criteria), born onwards 1962. Each case was pair-matched with one control for age, sex and socio-economic status. BCG vaccination status was assessed by examination for the presence of BCG scar, immunisation records if available and information from subjects/parents of children. Subjects uncertain about BCG vaccination were not included. The diameter of the BCG scar was measured both across and along the arm in millimeters using a plastic ruler. The average was then calculated. RESULTS: A significant protective association between BCG vaccination and tuberculosis (OR=0.38, 95% CI 0.31-0.47) and leprosy (OR = 0.38, 95% CI 0.26-0.55) was observed. The overall vaccine effectiveness (VE) was 62% (95% CI 53-69) against tuberculosis and 62% (95% CI 45- against leprosy. Vaccine effectiveness against tuberculosis and leprosy was non-significantly greater in the group who had BCG scar size < or =5 mm as compared to subjects who had BCG scar size > 5 mm. Thus there was no clear association between BCG scar size and its effectiveness. CONCLUSION: The current study did not identify any significant association between BCG scar size and its effectiveness against tuberculosis or leprosy.

Fluorimetric quantification of brimonidine tartrate in eye drops.

A simple and sensitive spectrofluorimetric method has been developed for the estimation of brimonidine tartrate in pure and eye drops. Linearity was obeyed in the range of 0.2-3.0 ΅g/ml in dimethyl formamide as solvent at an emission wavelength (λem) of 530 nm after excitation wavelength (λex) of 389 nm with good correlation coefficient of 0.998. The limit of detection and limit of quantification for this method were 22.0 and 72.0 ng/ml, respectively. The developed method was statistically validated as per International Conference on Harmonisation guidelines. The percentage relative standard deviation values were found to be less than 2 for accuracy and precision studies. The results obtained were in good agreement with the labelled amounts of the marketed formulations. The proposed method was effectively applied to routine quality control analysis of brimonidine tartrate in their eye drops.

Effectiveness of Bacillus Calmette-Guerin (BCG) vaccination in the prevention of leprosy; a case-finding control study in Nagpur, India

A hospital-based, pair-matched, casecontrol study was carried out at Government Medical College Hospital in Nagpur in central India to estimate the effectiveness of BCG vaccination in the prevention of leprosy. The study included 314 incidence cases of leprosy [diagnosed by World Health Organization (WHO) criteria] below the age of 32 years. Each case was pair matched with one control for age, sex and socioeconomic status. Controls were selected from subjects attending this hospital for conditions other than tuberculosis and leprosy. A significant protective association between BCG and leprosy was observed (OR 0.29, 95% CI 0.21-0.41). The vaccine effectiveness (VE) was estimated to be 71% (95% CI 59-79). The BCG effectiveness against multibacillary and paucibacillary leprosy was 79% (95% CI 60-89) and 67% (95% CI 45-78), respectively. It was more effective during the first decade of life (VE 74%; 95% CI 38-90), among females (VE 82%; 95% CI 64-90), and in the lower socioeconomic strata (VE 75%; 95% CI 32-92). The prevented fraction was calculated to be 51% (95% CI 38-62). In conclusion, this study has identified a beneficial role of BCG vaccination in the prevention of leprosy in central India.