bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatitis B vaccination coverage among health care workers in rural Kerala
Authors: Srinivas Vani , Shajan Tess , Karippankunnath Sudheesh Muthuthodiyil , Reshmi Theertha Pradeep , Victor Vidhu , P. Sreelakshmi Ravindran
Published: June 2021

Background: Hepatitis B is one of the most important blood borne infection, the health care workers may acquire while providing care to the patients. The overall aim of this study was to estimate the Hepatitis B vaccine coverage and its determinants among health care workers.Methods: This cross-sectional study was done in a rural tertiary care hospital in Palakkad district, of Kerala. We particularly looked for self-reported hepatitis B vaccination coverage and its determinants, using self-administered pretested questionnaire in 410 health workers. We calculated the proportions and looked for association between the various independent variables and dependent variables for vaccination coverage.Results: Out of 410 study participants, 119 (29%) of them were males and 291 (71%) of them were females. The mean age of the participant was 31.3 years and the range was between 19 to 70 years. 365 (89%) were vaccinated with atleast one dose of Hepatitis B Vaccine. Of these 306 (74.6%) had received all the 3 doses of vaccine, as per schedule. Gender and years of experience was not associated with the Hepatitis B vaccination status. However, variables like educational status, professional background was associated with hepatitis B vaccine coverage.Conclusions: The coverage of hepatitis B vaccine was high. Among those with incomplete vaccination few of them were waiting for completing the vaccination schedule in near future. Good hospital policies like vaccinating the new medical students and new employees were the main factors responsible for high vaccination coverage among the health care workers in our study.
Perceptions regarding childhood immunization among mothers in Kunnukara Panchayat, North Paravur, Ernakulam, Kerala
Authors: Kuruvilla Babita Susan , Cherian Vinu , Thomas Ann Mary , Rose Brilly M. , John Alexander
Published: June 2021

Background: Vaccines have been claimed to be one of the most important contributions for the relief of human misery and the spectacular increase in life expectancy. Worldwide, an estimated 1.4 million children under the age of five died in 2010 due to vaccine preventable diseases. Objective of the study was to determine the immunization perception and practice regarding immunization among mothers of children from 1-5 years in Paravur taluk, Ernakulam district.Methods: This cross-sectional study was done among the mothers of children from 1-5 years of age in Kunnukara panchayat. The panchayat has 15 wards. 3 wards were chosen by simple random sampling. All the houses having mothers of children from one to five years were surveyed. The data collected was entered in MS excel and analysed using Statistical package for social sciences (SPSS) 20 software.Results: Mean age of mothers is 29. The most common source of information regarding vaccination was obtained through health workers (80.3%). 72% mothers knew that OPV prevents polio and 53.6% mothers knew about the frequency of giving polio vaccination to their children. Ninety two percent mothers agreed that vaccines prevent the diseases. 100% mothers have given immunization to their children.Conclusions: Perception regarding vaccination was 95.2% and practice of immunization was 92.3%. There was a statistically significant association between (female gender of child v/s practice of immunization) and (perceptions regarding vaccination v/s practice of immunization).
Rising epidemic of COVID-19 in India – knowledge, attitude and practices among general population
Authors: Monya Michi , Chaudhari Yasmeen
Published: June 2021

Background: Coronavirus disease 2019 (COVID-19) is an emerging disease caused by a novel corona virus, Severe Acute respiratory syndrome coronavirus 2 (SARS CoV2). It was first detected in December 2019 in Wuhan, China. The rapid spread and the novel nature of the disease has created an environment of confusion and panic among people.Methods: A cross-sectional study was conducted using web-based questionnaire in different languages, the link of the online questionnaire shared as text message was shared/posted/reposted through author’s social media accounts and e-mails. It consisted two parts: Demographic details and KAP containing total 19 questions (K-13, A-3, P-3). Data analysis was conducted using SPSS-20 statistical software.Results: It was found that higher education level has associated significantly with higher knowledge score (β= -0.213: p=0.00). Multiple regression analysis showed that attitude of people avoiding Chinese restaurants was significantly associated with younger age group (Expβ=0.975: p=0.021). The practice of wearing mask while leaving home was found significantly associated with education (p=0.024) and occupation (p=0.000) in univariate analysis. Similarly, the practice of washing hands was significantly associated with age in both univariate (p=0.049) and multivariate analysis (Expβ=0.932: p=0.049).Conclusions: The practice of majority of Indian residents was very cautious. But correct response rate for knowledge score was only 72.54% and positive attitude about COVID-19 control in India was demonstrated by 74.18% respondents, thus reflecting inadequate information about COVID-19 and lower confidence on its control. Information, education and communication (IEC) campaigns by various sources needs to be optimized across various sociodemographic groups to address those at higher risk.
Insights of healthcare providers and patients on implementation of dietary/lifestyle intervention for reversal of obesity and type 2 diabetes: a qualitative study
Authors: Lyngdoh Tanica , Sharma Neha , Zodpey Sanjay
Published: June 2021

Background: A diet plan that includes limiting eating frequency to twice a day along with other lifestyle modification was implemented as part of a campaign for diabetes reversal. The objective of this study was to identify facilitators and barriers to practice of this self-management regime among adults with type 2 diabetes mellitus (T2DM) living in urban communities.Methods: Participants included purposively sampled 10 diabetics recruited from 12 Diabetes Reversal Centres (DRCs) located across Maharashtra, Goa, Karnataka and Gujarat in India. Additionally, healthcare providers (including 10 doctors and 10 coordinators) from these centres were interviewed. Data collection employed in-depth interviews using structured interview guides. Thematic data analysis was undertaken to identify themes.Results: Continued rapport and supervisory role of the healthcare providers in the DRCs was the key facilitator in helping patients to assume responsibility and adhere to the diet regime for self-management. Visible reduction in sugar levels and body weight were other rewarding benefits that motivated sustained compliance. Social and cultural aspects (including social functions and formalities) was a perceived barrier that interfered with adherence to diet regime and goals. A common suggestion from both the healthcare providers and patients was the need to expand this initiative through capitalizing on use of relevant technological devices.Conclusions: In conclusion, a self-management patient model where there is continued and active involvement of healthcare providers through all stages is a recipe for success. However, this initiative can be further strengthened through complementing it with individualized, context-driven solutions to address the barriers.
Pattern of use of hydroxychloroquine as prophylaxis among health care workers against COVID-19: a KAP study
Authors: Singh Madhusudan , Saurabh Sushant , Ali Obaid , Tripathi Saparya , Pathak Vineet Kumar , Krishna Ekta
Published: June 2021

Background: Hydroxychloroquine (HCQs) was one of the first chemoprophylaxis that received the recommendation for coronavirus disease 2019 (COVID-19). ICMR also time to time revised the guidelines for the use of HCQs as a prophylactic agent against COVID-19. But its mechanism of action for the same and duration of use was not much supported by available evidence. Hence, we conducted a web-based survey among Health Care Workers (HCWs) to know their Knowledge attitude practice (KAP) on HCQs use.Methods: We used a web-based questionnaire through google form which was circulated through snowball technique among health care worker working in a various hospital set up through various social media over a period of 1-month.Results: In our study total 159 HCWs responded to questionnaire. 37.1% (59/159) HCWs had taken HCQs, out of which 13.2% (21/59) participants acquired SARS-CoV-2 infection. Out of suffered HCWs, 38% (8/21) had taken full 7 weeks regime. Also, 84.7% (50/59) participants responded that they were confused whether to continue further taking HCQ after completing 7 weeks HCQ regimen or before every turn of their COVID duty.Conclusions: ICMR recommended its use in early phase of COVID-19 when there was not sufficient data available about its treatment and prophylaxis. But with the coming evidences we now know that there is limited role of HCQ in terms of prophylactic agent against SARS-CoV-2.
A departing mystery: dementia related knowledge and attitude among dental professionals in Chennai
Authors: Premnath Parvathy , Velmurugan Kutraaleeswaran , Vignaraja Kirran , Ramanathan Kalimuthu , Abdullah Zoha
Published: June 2021

Background: Improving dentist’s knowledge, perceptions and attitudes of dementia is important in the formation of dementia-friendly communities. The aim of the study was to evaluate dentist’s knowledge and attitudes of dementia. The purpose of this study was to examine dentist’s, interns, postgraduate’s knowledge and attitudes towards dementia and to provide basic data for educating about knowledge of dementia and strengthening positive attitudes towards dementia related patients.Methods: One hundred and ten dentists, dental post graduates, interns aged 22-46 years, from dental schools in Tamil Nadu were invited to complete a series of questions that assessed their dementia knowledge and attitudes.Results: A total of 110 dentists completed the questionnaire. Out of 24 questions on dementia knowledge and attitude, participants were on average able to answer less than half correctly. Responses to the attitude’s questionnaire showed that dentists had both positive and negative attitudes toward dementia.Conclusions: There is scope for dentists to improve their dementia knowledge and attitudes. Until a validated measure of dementia knowledge has been developed specifically for an dentist sample, researchers should avoid summary statistics (i.e.; total score) and instead focus on interrogating where the gaps in knowledge.
Assessment of knowledge and awareness of breast cancer among rural women in Telangana, South India
Authors: Pydipalli Mounika , Roy Pritam Kumar
Published: June 2021

Breast cancer is the most common type of cancer diagnosed in women globally contributing around 15% of mortality. In India, it is the second most common cancer with the incidence in rural areas being twice than in urban. There is lack of knowledge and awareness of breast cancer especially in rural areas. So this survey was conducted to assess the existing levels of awareness to plan comprehensive health programs, early detection and carrying out treatment campaigns. A cross-sectional survey was carried out among the attendees of patients visiting cervical cancer screening centre in Mahbubnagar, Telangana from May 2020 to June 2020. A total of 60 participants were selected by convenient sampling. Data was collected using a pretested questionnaire. Out of a total of 60 participants, nearly two-third (63.3%) women had some knowledge regarding cancers and less than half were aware of breast cancer (45%). Among those who were aware (27), more than three-fourth did not know about symptoms of breast cancer (77.8%) and had not undergone any breast cancer screening (77.7%). Also, nearly half of the participants among these were unaware of breast cancer (44.4%). It is necessary to increase community participation through social mobilization by engaging the human resources at the grass root level.
A menace to human health: rhino-orbital cerebral mucormycosis
Authors: Sharma Arvind , Bharti Aditi , Singh Tej Pratap , Sharma Richa
Published: June 2021

Collate and interpret data on rhino-orbital-cerebral mucormycosis (ROCM) infections admitted at the tertiary care centre and investigate the common contributing factors leading to such infections and highlighting the relationship of this upsurge seen in patients infected with COVID-19. We conducted a cross-sectional study in Central India, in the period of eleven days (from 9 May to 18 May). A total of ten patients with ROCM was investigated, admitted to the separate ward for mucormycosis in the tertiary care centre. A self-pre-designed questionnaire was used for the evaluation. Verbal consent was obtained from the patients before the start of the study and also ensured the confidentiality of their respective details. Among ten of the patients, six patients were known cases of diabetes mellitus, two of the patients were diagnosed with diabetes mellitus after the initiation of corticosteroid therapy during their treatment and two of them were non-diabetic. All the patients in this case series were on corticosteroid therapy and on oxygen supplementation. Majority of the patients showing mild to moderate disease with unilateral symptoms, although only 10% showed the severe disease with bilateral eye involvement. It is evident that the poor or impaired immune functioning is the leading cause of the upsurge in mucormycosis cases. Therefore, early diagnosis and treatment of fungal infections can substantially reduce morbidity and mortality.
Probiotic supplement and gluten withdrawal in gluten allergy Patients may lead to gluten tolerance: first case report
Authors: Kumari Moni , Bansal Renu , Singh Ranjit , Bansal Parveen , Arora Malika
Published: June 2021

Probiotic species such as lactobacillus and bifidobacteria are known to have a major role in gluten digestion and regulation of proper functioning of gastrointestinal system however these are found to be missing in gluten allergy patients. So, here in this case we aimed to find the effect of probiotic supplementation along with gluten free diet in celiac disease patient. A case of an 8-year-old female child admitted to civil hospital, Faridkot with chief complaints of vomiting, diarrhea, weight loss, retarded growth, and malnutrition was studied. When she first visited the hospital, based on her symptoms, she was advised celiac disease workup and was found to be highly tTG IgA positive (10.62). The subject was shifted to a strict gluten free diet along with probiotic supplementation. The subject was regularly followed up for the period of four and half years in order to find improvement in her symptoms. After 4 years, gluten diet was gradually reintroduced in a phased manner; the patient remained well even on full gluten diet. This may be due to probiotic supplementation to the subject along with gluten free diet. Present case report describes the spontaneous recovery of celiac disease patient after strict adherence to gluten free diet and probiotic supplementation for a specified period. It is suggested that there should be a proper monitoring and detailed evaluation of clinical and histological markers of recovery in a patient after strict adherence to gluten free diet and probiotic supplementation in order to evaluate the possible role of probiotic supplements in the management of CD.
Change model for a school-based program to promote oral hygiene practices among Indian school children
Authors: Mehra Rashmi
Published: June 2021

The present paper addresses basic evaluation and procedural concepts that are involved in the process of implementing a school-based program to promote oral hygiene practices among Indian school children using the I-change intervention mapping model. Core components for effective intervention design and implementation are presented as part of a comprehensive model composed of six stages along with in depth discussion about sustaining each step under the I-change model providing with the imminent need for such a school based program in India. This model systematically addresses the design program, the production of said program called insta-brush. Special attention has been given to the planned program implementation delineating suggested sequence of implementation followed by comprehensive measurement of the impact of the program with proposed process and summative evaluation plans. Assessment tools and evaluation strategies are recommended and illustrated based on evaluations of interventions implemented in school based oral health programs worldwide.
Is the second wave of COVID-19 socially retrogressive? Social liaison is the need of hour
Authors: Govil Gaurav , Tomar Lavindra , Dhawan Pawan
Published: June 2021

The challenges of COVID-19 pandemic have invoked changes in behavioral patterns of the society. The retrogressive behavior has been one of the most frequently exhibited changes in behavior. There has been both a physical and emotional imbalance for the society at large. There has been an utter lack of empathy for the practiced cultural values and civilization norms.
Zymbilan®-PSO cream with nano-encapsulated RetileX-A®-PRO mitigates the clinical severity and relieves the symptoms of chronic plaque psoriasis: an interventional clinical study
Authors: Wadstein Jan
Published: June 2021

Background: Skin psoriasis is a serious inflammatory disorder with increased risk of rheumatic, cardiometabolic and psychosocial complications. At present, >50% of patients are dissatisfied with their treatment; thus, novel approaches are in high clinical demand. Retinoids are a major group of anti-psoriatic compounds; nonetheless, dose-dependent topical side effects have limited their effective topical application. RetileX-A®-PRO (Pharma Medico, Aarhus, Denmark) is a novel nano-encapsulated retinol ester designed to minimise the risk of skin irritation. The proprietary nano-encapsulation technology used in this compound can protect retinoid molecules from degradation, and thereby prolong and stabilise its release profile. The safety and efficacy of RetileX-A®-PRO were evaluated in this study.

Methods: 45 patients (58% female, aged 18-80 years) with mild to moderate skin psoriasis were enrolled in a 4-week interventional study. Participants were treated once daily with Zymbilan®-PSO cream with RetileX-A®-PRO and evaluated both objectively and subjectively at baseline, after 8 hours and at endpoint.

Results: Our observations demonstrated that Zymbilan®-PSO cream possesses both short-term and long-term anti-psoriatic effects. Shortly after application, objective skin characteristics were improved, and itching reduced in >84% of subjects. At endpoint, 87% of skin lesions improved, 9% did not change and 4% progressed as assessed by a dermatologist. Patients’ self-evaluation yielded similar results: 78% judged Zymbilan®-PSO cream as a ‘good’ to ‘very good’ skin care product with suitable cosmetic parameters. No side effects recorded in 95% of participants.

Conclusions: In conclusion, Zymbilan®-PSO cream is a well-tolerated treatment that can mitigate both clinical severity and subjective symptoms of chronic skin psoriasis.
Cutaneous manifestations of chronic alcoholism in cases attending rural tertiary cases center: a descriptive cross-sectional study
Authors: Sagar P. Vidya , Reddy Vijayabhaskar , Reddy Navaneetha
Published: June 2021

Background: Alcoholism is a potentially fatal condition damages skin directly or through organ dysfunction. Studies suggested that dermatological manifestations have also been found to be a marker of alcohol misuse. The aim of the study was to assess the various cutaneous manifestations of alcohol dependence.

Methods: This study consisted of 205 cases diagnosed with alcohol dependency attending dermatology department and psychiatry wards, above 18 years of age. A detailed clinical examination and dermatological examination including hair, nails, oral and genital mucosa was performed. Alcoholic liver disease was diagnosed on clinical findings, abdominal sonogram and LFT.

Results: Among the study cases 50.25% cases had alcoholic liver disease. The severity of alcohol dependence score ranged from 1-60 with Ameena score of 24.68. It was seen that 45.23% (90) of alcoholics were mildly dependent, 41.7% (83) of alcoholics were moderately dependent, and 13.07% (26) were severely dependent on alcohol. Seborrheic dermatitis, urticaria, hyperhidrosis was among the commonly encountered dermatoses.

Conclusions: Cutaneous manifestations are a significant pointer to underlying, perhaps undetected problem of alcohol dependency and an awareness of these signs is imperative to alter a dermatologist to problems of alcohol abuse even in a busy clinic.
Predictors of insulin resistance among women with acne vulgaris and polycystic ovarian syndrome presenting to a tertiary care hospital in North India
Authors: Chandra Mini , Vats Koshinder , Garg Palak , Tibrewal Abhishek
Published: June 2021

Background: Acne vulgaris is now being increasingly associated with hyperandrogenism or metabolic syndrome. The aim of the study was to know the burden and determinants of insulin resistance among females suffering from acne and polycystic ovarian syndrome (PCOS).

Methods: This prospective observational study included non-pregnant females with acne and PCOS aged 14 to 36 years. PCOS was diagnosed using Rotterdam criteria. Insulin resistance (IR) was confirmed using HOMA-IR values. Important history was ascertained, and hormonal essays were done. SPSS version 22 was used for the analyses.

Results: The average age of the 81 subjects was 22 (IQR: 19-23) years and median duration of acne was 8 (7-9) months. Their median (IQR) insulin level was 10.5 (8.4 - 18.5), fasting blood glucose was 82 (73.2 - 90) and HOMA-IR value was 2 (1.7 - 3.9). A total of 27 (33.3%) were diagnosed with IR. Subjects having IR had significantly lower FSH (median=3.1, IQR: 2.3-6.3), LH (3.0, 1.2-3.3) and insulin level (median=26.0, 18.5-28.5) versus those without IR (p=0.04, p=0.04 and p<0.001 respectively). Subjects with IR were more likely to be having irregular menses, weight gain, and acanthosis nigricans versus those without IR.  

Conclusions: One-third of the patients with acne and PCOS also had IR according to the HOMA-IR values. All women with acne and PCOS should be considered for underlying IR and examined for other sign of impaired glucose tolerance.
Mask associated dermatosis: unmasking the challenges- a cross sectional study
Authors: . Ketki , Gupta Sonali , Paliwal Vijay , Mathur Rachita , Mathur Deepak K.
Published: June 2021

Background: The novel coronavirus, referred to as SARS-COV 2 causing COVID 19, has become a great health challenge to the mankind. After its origin from Wuhan, China, it spread all over the globe within a short period of time. World Health Organization (WHO) officially declared COVID 19 as pandemic on 11th March, 2020. Aerosoles or droplets are the commonest mode of infection through respiratory tract making it mandatory to wear masks as a preventive measure.

Methods: It is a cross-sectional study conducted over patients attending the out patients department of Dermatology. They were observed for presence of dermatosis over the face and categorized according to nature of dermatoses.

Results: We observed 385 patients, 200 (52%) patients had new dermatoses and 185 (48%) patients noticed flare of existing dermatoses. The predominant new dermatoses were dermatophytosis, indentations, sweat induced dermatitis, urticaria, pressure urticaria developing with indentations, contact dermatitis to metal and other materials in 49 (24.5%%), 42 (21%), 42 (21%) ,38(19%), 19 (9.5%) and 10 (5%) cases respectively. The flared dermatoses were acne, rosacea , plane warts and molluscum contagiosum in 120 (64.8%), 24 (12.9%), 22 (11.9%) and 17 (9.2%) cases respectively. Koebnerisation of vitiligo and lichen planus was also seen in few subjects.

Conclusions: The prolonged use of face mask may cause various infective and non infective facial dermatoses. In the current scenario, it is mandatory to wear face mask as a preventive measure hence it is important to wear the mask properly. However, care of the mask as well as breaks from the mask are important factors to avoid the development of mask associated dermatosis.
Recurrent pyogenic granuloma within a port wine stain
Authors: Haneefa Muhammed , Alshahrani Mohammed , Shah Sayed Agha A. , Alshahrani Abdulmajeed
Published: June 2021

Pyogenic granuloma (PG) is a common vascular growth usually seen on the face and extremities following trauma, drugs like retinoids, antineoplastic agents or pregnancy. PG and port-wine stain (PWS) represent different types of vascular lesions that may rarely occur in association. PG arising in a PWS is usually reported following trauma, pregnancy or laser treatment of PWS. Any growth in a long-standing vascular lesion creates panic in the patient and a challenge to the physician, especially in the head and neck area. We report a case of recurrent PG emerging de novo in three different locations within the same PWS in a 24 year old male. A review of literature about the coexistence of both conditions is presented here, together with dermoscopic features.
Multifocal cutaneous epithelioid hemangiodothelioma on the same lower limb
Authors: Khallaayoune Mehdi , Azzahra Elgaitibi Fatima , Mariame Meziane , Karima Senouci
Published: June 2021

Epithelioid hemangioendothelioma (EHE) is a rare low-grade vascular tumour mainly affecting bones, deep soft tissues and exceptionally the skin. Multifocal cutaneous involvement is uncommon and should raise suspicion for metastasizing extracutaneous epithelioid hemangiodothelioma. Hereby we report the case of a young patient with multifocal cutaneous EHE involving the same lower limb. We emphasize the necessity for dermatologists to evoke the diagnosis of EHE in patients presenting with nonspecific tumours of the extremities. Prompt management and diagnosis are essential in this potential aggressive tumour.
Clinicopathological and dermoscopic correlation of pigmented basal cell carcinoma
Authors: Reddy Duttala Indira , Sangaiah Sivaramakrishnan , N. R. Vignesh , G. Sukanya
Published: June 2021

Basal cell carcinoma (BCC), also known as basal cell epithelioma is the most common cutaneous malignancy affecting fair skinned individuals arising from sun exposed skin especially head and neck area. It is a slow growing tumor which rarely metastasizes. UV radiation is the most important predisposing factor. It includes mainly four variants: (a) nodular, (b) pigmented, (c) superficial BCC, (d) sclerosing or morphea form of which most common is nodular variant. Dermoscopy of pigmented BCC shows well focussed arborizing vessels which is the hallmark. The best modality of treatment is surgical excison of tumour, electrodesiccation and curettage, cryosurgery, and Mohs micrographic surgery.
Eosinophil rich infiltrate in secondary syphilis a rare histopathological variant
Authors: Kharkar Vidya D. , Rajendran Harish B.
Published: June 2021

Secondary syphilis is a sexually transmitted infection, which is referred to as “the great imitator” and has a wide spectrum of clinical manifestations. Syphilis is classically associated with plasma cells and the presence of eosinophils usually argues against a diagnosis of syphilis. The differential diagnosis for eosinophil-rich skin lesions often includes a drug reaction, arthropod-bite reaction, allergic contact dermatitis, and a response to a helminth infestation. However, many unrelated entities, such as infections, neoplasms, and inflammatory dermatoses can have prominent eosinophilic infiltrate. We report a case of secondary syphilis which on histopathology showing psoriasiform hyperplasia with superficial perivascular infiltrate and on higher magnification these infiltrate were predominantly lymphohistiocytic along with the moderate amount of eosinophils with a paucity of plasma cells. This case report is presented to highlight the need for including secondary syphilis as one of the differential diagnoses in the presence of eosinophil-rich infiltrate when it is suspected clinically.
An immunologic intrigue: psoriasis vulgaris developing on pemphigus foliaceous
Authors: Tarate Deepali C. , Misri Rachita , Khuranna Vinod K.
Published: June 2021

Pemphigus foliaceous is an autoimmune blistering disease characterized by superficial flaccid blisters, erosions, scales and crusts on the seborrheic areas of the face and trunk. Mucosal involvement is seldom seen. The first report by Bloom in 1929, stated the coexistence of pemphigus foliaceous and psoriasis vulgaris. Since then, very few cases of psoriasis coexistent with autoimmune bullous diseases have been reported in which psoriasis had preceded or simultaneously presented with pemphigus foliaceous. We reported a rare case where psoriasis vulgaris developed in case of pemphigus foliaceous after 20 years.
A Comparative Study of Diagnostic Methods of Malaria - Microscopy Versus Rapid Diagnostic Test Kits in a Tertiary Care Hospital, Rajasthan
Authors: Singh Saumya , Chauhan Neelam , Tomar Jyoti , Singh Aditya Pratap
Published: June 2021

BACKGROUND Malaria is one of the most prevalent parasitic diseases in the world including India. Majority of malarial cases are found in countries where cost-effectiveness, diagnostic test performance ease, and trained personnel, are the most important considerations. We wanted to compare the two methods of rapid diagnostic tests (RDTs) and microscopy in the diagnosis of malaria parasite infection. METHODS We studied 2,723 blood samples of patients who presented with signs and symptoms of malaria from out patient department (OPD) and various wards of Pacific Institute of Medical Science, Udaipur, Rajasthan, from Oct 2018 to Oct 2019. All samples obtained were first tested by RDTs and then the same samples were used to make peripheral blood film (PBF) for microscopy. RESULTS During the 1-year period, rapid card test method showed 178 positives for malarial parasite. Of these, 64 cases were positive for P. vivax and 108 cases for P. falciparum. Peripheral blood smear method showed 160 cases positive for malarial parasite. Of these, 55 cases were positive for P. vivax and 99 cases for P. falciparum and 6 cases of co-infection. PBF failed to detect 9 cases of P. vivax and 9 cases of P. falciparum which were positive by rapid card test. So, 18 cases reported PBF negative. Among these patients, there were 83 females and 95 males. Most affected age group was 16 – 30 years followed by 31 – 45 years. Maximum samples were from the month of October 19 with a positivity rate 35.4 %. CONCLUSIONS RDTs based on malaria antigen (whole blood) method is as specific and more sensitive than microscopy (which is being considered as the gold standard method). Peripheral blood smear method still remains superior for accurate species differentiation, quantitation of parasite and maintaining a permanent record. KEYWORDS Microscopy, Malaria, Rapid Diagnostic Tests
Solid Pseudopapillary Neoplasm of Pancreas – A Case Series from Bangalore, India
Authors: Obalanarasimhaiah Sathish , Swamygowda Nagesh Nayakarahalli , Setty Balakrishna Nanjundappa , Subramani Kasturi Thirumangalam
Published: June 2021

BACKGROUND Solid pseudopapillary neoplasm (SPN) of pancreas is a rare epithelial tumour of low malignant potential. SPN accounts for less than 1 to 2 % of exocrine pancreatic tumours. It mainly affects women between the second and third decade of life, and its management is not well defined. The aim of this study was to report clinicopathological characteristics of SPN and its outcome. METHODS A retrospective study was conducted in a tertiary care centre from January 2015 to December 2019. All patients who were diagnosed and treated as SPN of pancreas in our institute were retrospectively reviewed. A data of the characteristics of these patients was developed, including age, gender, size, location of tumour, treatment, histopathological and immunohistochemical features. RESULTS Six patients were diagnosed as having SPN of pancreas, during the 5-year period. All 6 patients were female. Youngest age of occurrence was 15 years. Maximum age was 41 years. Average age was 25 years. All patients were symptomatic and the most common symptom was dull aching upper abdominal pain. Contrast enhanced computed tomography (CECT) was done for all patients. 3 patients had typical features of SPN. Endoscopic ultrasound (EUS) was done for 4 patients and EUS fine needle aspiration cytology (FNAC) was done for 3 patients. Patients were provided with procedure details and informed consent was taken. All patients were subjected to surgical treatment. Out of six patients, two underwent laparoscopic spleen preserving distal pancreatectomy, two patients underwent classical Whipple’s procedure and two patients had undergone median pancreatectomy. CONCLUSIONS SPN are rare neoplasms, typically affecting young females without clear histogenesis and with a malignant potential. Appearance from imaging studies can be adequate to guide surgical resection without pre-operative pathological assessment. But in unclear cases, EUS-FNAC with immunohistochemistry helps in establishing a pre-operative diagnosis. Surgical resection should be offered when feasible. Prognosis of SPN of the pancreas is good due to its favourable biological features, even in the presence of distal metastasis. KEYWORDS Solid Pseudopapillary Neoplasm (SPN)
Morbidity Profile of School Children in Rural and Urban Areas of Visakhapatnam – A Comparative Study
Authors: Dowrula Errayya , Vithanala Venkata Durga Prasad , Sreegiri Sunita , Kajana Phani Madhavi , Bhimarasetty Devi Madhavi
Published: June 2021

BACKGROUND Children from rural areas and urban slums suffer from poor quality of life. In spite of several health programmes in existence, conditions such as infections, malnutrition etc. continue to be major threats leading to morbidities among school children. This study was conducted to evaluate the various morbid conditions prevailing among school going children and compare the urban and rural scenarios in Visakhapatnam district. METHODS A cross sectional study was conducted between November 2018 and October 2019 (1 year) among secondary school children studying in classes 6 th to 10th (age between 11 and 15 years) of three randomly selected government schools in urban and rural areas. A total of 800 school going children was considered (400 from three rural and 400 from three urban schools) for the study. Prior approval from the Institutional Ethics Committee was taken for the study. Data was collected by using a pre-tested questionnaire. Clinical examination was conducted to detect any morbidity. RESULTS The most common morbid condition was found to be anaemia. The prevalence of anaemia was 47.12 %, followed by nose, throat, and eye conditions (33.87 %, 22.5 % and 30.75 % respectively) and morbidity of oral cavity (30.62 %). The prevalence of skin infections such as pediculosis and tinea and other fungal infections was 24.87 %. CONCLUSIONS Children in urban schools were found to be suffering more from skin, nose and throat abnormalities and anaemia as compared to children from rural schools who had ocular problems especially signs of Vitamin A deficiency along with anaemia. KEYWORDS Morbidity, School Children, Rural and Urban Areas
Opioid Use and Incidence of Surgical Site Infection after Repair of Ventral and Incisional Hernia - A Prospective Clinical Study in a Tertiary Care Hospital in Tirupati
Authors: Challapalli Srikanth Reddy , Gandikota Venkata Prakash , Peddavenkatagiri Theja , Gerigi Harsha Vardhan Reddy
Published: June 2021

BACKGROUND Preoperative opioid use is one of the predisposing factors for complications after most of the surgical procedures. This study intends to evaluate the effect of preoperative opiates on the outcomes following repair of ventral hernia. METHODS We conducted a prospective study of patients who underwent consecutive ventral hernia repair for over one year with institutional review board approval. Data were obtained regarding the usage of opioids during the preoperative period, intraoperative period, and postoperative period. Follow-up of the cases was done during the postoperative period. Data were obtained regarding the postoperative complications, duration of hospital stay, and the analyzed results. RESULTS A striking thirty percent of the total sixty patients have satisfied the criteria for the usage of opioids preoperatively. Preoperative history and operative details were found to be almost similar between the two categories of patients (no preoperative opioid use versus preoperative opioid use). The median hospital stay duration trended towards increased patients with opioid usage versus non-opioid users (P = 0.06). The bowel function's return to the normal was delayed in opioid users compared with non-opioid users (P = 0.018). The risk of superficial surgical site infection was increased among patients who used opioids preoperatively than the patients without preoperative opioid usage (55.5 % vs. 9.5 %; P < 0.001) and remained the same after multivariable logistic regression. CONCLUSIONS Among patients who underwent repair of ventral hernia, those with preoperative opioid usage experienced an increased risk of superficial surgical site infection than patients without preoperative opioid usage. KEYWORDS Opioid, Ventral Hernia Repair, Surgical Site Infection
Proportion of Rifampicin Resistance in Sputum Smear Positive Pulmonary Tuberculosis with Diabetes Mellitus in Urban Bengaluru - A Cross-Sectional Study
Authors: Venkataramanappa Srinivasa Kaligonahalli , Basavaraj Jeevan
Published: June 2021

BACKGROUND Pulmonary tuberculosis (PTB) still remains a global public health problem. Diabetes along with poor glycaemic control leads to an immune compromised state. Type 2 diabetes (DM) is a strong risk factor for tuberculosis (TB) and is associated with a slower response to TB treatment and a higher mortality rate. Objective of the study was to determine the prevalence of rifampicin resistance in pulmonary tuberculosis in patients with DM. METHODS The study was conducted in General Medicine Department, Dr. B.R. Ambedkar Medical College, Bengaluru, Karnataka, from July 2018 to December 2019. Sputum was collected from a total of 100 patients who were sputum smear positive for acid fast bacilli (AFB). Sample was collected and was subjected to GeneXpert testing for the evaluation of resistance against rifampicin. RESULTS In our study the incidence of rifampicin resistance was 45.16 % in diabetes and 5.79 % in non-diabetes which was statistically significant ( 2 -1.1; p-0.01) between rifampicin resistance and diabetic patients’ status with active TB in South Karnataka, India. This result supports previous research showing a higher multidrug-resistant tuberculosis risk in tuberculosis & diabetes patients relative to those with no diabetes. Additionally, correlation of other findings between type 2 diabetes & multidrug-resistant tuberculosis as well as delayed time to sputum smear conversion were confirmed. CONCLUSIONS The results showed correlation between diabetes & rifampicin resistance and probably suggest the necessity of integrated diabetes and tuberculosis surveillance programs in South Karnataka, India. KEYWORDS Rifampicin, Tuberculosis, Diabetes Mellitus
CT in the Assessment of Paediatric Calvarial Masses - A Prospective Observational Study, Hyderabad, Telangana
Authors: Thatipamula Madhavi , Tirumani Sudha Bindu , Thaluri Sunitha , Mudunoor Vijaya Kumari
Published: June 2021

BACKGROUND Paediatric calvarial mass lesions are common and can have prognostic and therapeutic implications based on the type of lesions. The spectrum of lesions can extend from benign lesions like cephalhaematoma, which is a common postnatal swelling in the paediatric scalp to severe lesions like neuroblastoma metastases. Therefore, proper diagnosis of these lesions is of prime importance in day to day practice which can help in accurate management of these lesions. This study was conducted to evaluate the role of computed tomography (CT) in the assessment of paediatric calvarial masses. METHODS In our prospective observational study, during a period of 1 year (October 2019 to October 2020) 26 children with visible swelling on the calvarium were subjected to CT examination. The imaging features of various paediatric calvarial lesions on CT were noted. RESULTS Out of 26 paediatric patients, which included infants from 1 day of life to children of 7 years age, the most common age of presentation was less than one-year age group. The most common type of calvarial mass lesion was cephalhaematoma and the next most common mass lesion was dermoid cyst. CT could diagnose all the lesions based on the image morphology with clear delineation of their extent. 16 cases had isolated soft tissue involvement (cephal haematoma, sub galeal haematoma, lipoma, dermoid cyst) whereas ten lesions like encephalocele, osteomyelitis, Langerhans cell histiocytosis (LCH), fibrous dysplasia, neuroblastoma metastases, lymphoma deposits had both soft tissue and bone involvement. CONCLUSIONS Accurate detection, characterisation and delineation of the lesions are important in management of the various paediatric calvarial masses. CT is a useful imaging tool in confirming the diagnosis and also for anatomical delineation in certain cases requiring surgical management. It also helps in detecting associated intracranial extension of the lesions. KEYWORDS Calvarial Masses, Paediatric, Computed Tomography
Descriptive Study of Pregnancy Dermatoses in Central Region of Gujarat
Authors: Kariya Meghana Manharlal , Patel Maheshkumar Chaturbhai
Published: June 2021

BACKGROUND The present study was conducted to evaluate the incidence, clinical presentation, course and prognosis of physiological changes of pregnancy i.e. to study the incidence of different dermatoses during pregnancy, cutaneous manifestations associated with pregnancy according to trimester and parity of pregnancy, specific dermatoses of pregnancy, the presence of same or other diseases in the past pregnancy, and observe the relative effect of pregnancy on already existing dermatoses or which are basically not related to pregnancy. METHODS A random hospital based descriptive study of 80 patients with pregnancy, who attended skin outpatient department (OPD) in GMERS Medical College, Himmatnagar, Gujarat, India, was done. Detailed history was taken, and each patient was examined thoroughly. General- and systemic-examination were done and whenever necessary, relevant investigations were done. RESULTS A total of 80 patients were included in the study. Of them 39 (48.7 %) were primipara and 41 (51.3 %) were multipara. Skin changes were grouped into physiological changes (all cases), specific dermatoses (17 cases) and other dermatoses (52 cases). Most common physiological changes were related to pigmentation followed by striae gravidarum. Physiological changes were observed in almost all the patients. CONCLUSIONS Pregnant women are prone to suffer from a wide range of dermatological problems apart from the specific dermatoses of pregnancy. Detailed history and awareness of clinical presentation facilitates the confirmation of diagnosis and will direct the most appropriate laboratory evaluation in an effort to minimize maternal and foetal morbidity. KEYWORDS Pregnancy Dermatoses, Specific Dermatoses, Physiological Changes
A Cross-Sectional Study of Thyroid Dysfunction in Patients Suffering from Liver Cirrhosis in a Tertiary Care Hospital in Bengaluru, India
Authors: Kalmani Vishal M. , H.S Madhuvan , S.N. Ravishankar , S.R Thimmareddy , M Kavana
Published: June 2021

BACKGROUND Thyroid abnormalities are seen in most of the patients suffering from liver cirrhosis. Cirrhosis of the liver is the major cause of morbidity and mortality worldwide. Cirrhosis plays a vital role in the thyroid hormone metabolism and thyroid hormone circulation by producing thyroid binding globulin. Hence, it is seen that the thyroid dysfunction is associated with the severity of liver disease. We wanted to study the changes in the levels of thyroid hormones in patients suffering from alcoholic liver cirrhosis. METHODS In this cross-sectional study, 50 patients who were admitted to the IP department and ICU of General Medicine Department of Akash Hospital, Devanahalli, for symptoms of cirrhosis of liver were evaluated for their thyroid profile along with other relevant investigations. RESULTS Among the 50 patients studied, 43 were male and 7 were female. 17 patients had an increase in their thyroid stimulating hormone (TSH). These patients also had a significant association with various LFT parameters such as indirect bilirubin, AST, ALT, APS, and GGT. These 17 patients who had increase in TSH also had associated hepatic complications such as - jaundice (41 %), hepatic encephalopathy (35.29 %), bleeding varices (29.4 %), and portal hypertension (82.35 %). CONCLUSIONS Thyroid abnormalities are not uncommon in patients with cirrhosis. Hypothyroidism is the most common abnormality that was detected. Rate of complications is also high in patients with elevated levels of TSH. A fair amount of suspicion is required for detecting thyroid abnormalities in patients suffering from cirrhosis. KEYWORDS Cirrhosis, Thyroid Hormone, Hypothyroidism, Hyperthyroidism, Thyroiditis
Utility of Colonoscopic Biopsies in Histomorphological Spectrum of Colorectal Lesions - A Study in a Tertiary Care Centre in Aurangabad Region of Maharashtra
Authors: Pingle Suparna Sharad
Published: June 2021

BACKGROUND Colonoscopy is considered as a diagnostic procedure of choice for patients presenting with chronic diarrhoea / bloody diarrhoea. Colonoscopic mucosal biopsies have shown to be accurate indicators of extent of the involvement of colon in inflammatory bowel disease. Also, colonoscopy is still considered as the gold standard in cancer surveillance. The present study was undertaken to find out the utility of colonoscopic biopsies in histomorphological spectrum of colorectal lesions. METHODS This was a three-year retrospective study carried out in the Department of Pathology, at MGM Medical College, Aurangabad. Patient’s clinical details, colonoscopic findings and apparent pathology were noted in 206 cases along with final histopathological diagnosis. Biopsies which showed significant findings were included in the study. RESULTS In the study, the male to female ratio was 2.4 : 1. Out of 206 colorectal biopsies, 146 (70.8 %) were non-neoplastic and 60 (29.2 %) were neoplastic lesions. Amongst non-neoplastic lesions, maximum cases were of chronic colitis with 4 cases of granulomatous colitis and 30 cases of inflammatory bowel disease. Adenocarcinoma was the most common histologic type in neoplastic lesions (66.6 %), with rectum being the most common site followed by colonic polyps (25 %). As far as age group was concerned, the 2nd decade was dominated by chronic colitis, 3rd decade by adenomatous polyps and 5th decade by adenocarcinoma. CONCLUSIONS Histomorphological profile of colorectal biopsies has a wide spectrum ranging from infectious diseases, inflammatory bowel disorders to colorectal malignancies. Histopathology with correlation of clinical and endoscopic findings plays a major role in accurate diagnosis of colorectal lesions. KEYWORDS Colonoscopy, Biopsies, Neoplastic, Non-Neoplastic, Colitis, Adenocarcinoma