bluuebunny/crossref_metadata_2025 huggingface dataset:
Atypical Mycobacterial Cutaneous Infection Caused by Mycobacterium abscessus Complex
Authors: Khandait Gaurav Harishchandra , Bagane Rajvardhan , Khatu Swapna S , Palaskar Nachiket , Patokar Abhishek S , Pophale Himanshu
Published: May 2023

Atypical mycobacterial infections are caused by mycobacteria other than those from the Mycobacterium tuberculosis complex and Mycobacterium leprae. They are ubiquitous, aerobic, nonmotile, and acid-fast bacilli seen in soil and water. Here, we report the case of a 31-year-old married female who presented with multiple painful pus-filled lesions over both the breast, abdomen, and back associated with yellow-colored discharge for 6 months. Tuberculosis-polymerase chain reaction revealed the presence of atypical mycobacteria which on further investigation with matrix-assisted laser desorption/ionization-time of flight isolated Mycobacterium abscessus species.
Herpes Zoster Ophthalmicus in an Healthy Infant with Intrauterine Infection
Authors: Megha R , Prabhu Sweta R , Naveen KN , Athanikar SB , Kulkarni Vijay
Published: May 2023

Herpes zoster (HZ) or shingles is a viral infection with segmental eruption due to reactivation of varicella zoster virus (VZV) from the dorsal root ganglion. HZ is uncommon in immunocompetent children and early adult life. Incidence increases in individuals over the age of 50 years. However, zoster can occur in childhood following intrauterine infection or exposure to VZV at an early age. We report this case, as HZ is rare in infants, especially HZ ophthalmicus due to both intrauterine infection and exposure after birth.
A Study of Sexually Transmitted Diseases and Dermatological Manifestations in Human Immunodeficiency Virus-Infected Patients
Authors: Gangavaram Dinesh Reddy , Babu Aneeha Ramesh , Prasad Anupama Manohar
Published: May 2023

Background:

The majority of human immunodeficiency virus (HIV)-infected patients develop skin lesions at some point during the course of the disease. The occurrence of sexually transmitted diseases (STDs) may increase the transmission and progression of HIV. Hence, it is essential to study the various infectious and noninfectious dermatoses.

Objectives:

(1) To study the various STDs and to familiarize with the atypical presentation of various STDs in HIV infected individuals. (2) To study clinical and epidemiological aspects of various dermatological manifestations in HIV infected individuals. (3) To identify dermatological manifestations as indicators (markers) of HIV/acquired immunodeficiency disease syndrome progression.

Materials and Methods:

A cross sectional descriptive study was conducted on known HIV-positive individuals attending the outpatient department of Dermatology in Siddhartha Medical College, Vijayawada, with symptoms suggestive of skin disease or sexually transmitted infections. A detailed clinical history and physical examination were done in all cases. Wherever necessary, relevant investigations were done to confirm the diagnosis in patients. Statistical analysis used: Results were tabulated and analyzed using simple statistical methods.

Results:

A total of 500 patients were recruited in the study among whom 363 (72.6%) had only dermatological manifestations, 127 (25.4%) had sexually transmitted infections (STIs) and 10 (2%) had overlap manifestations. The majority of them were in the age group of 28–37 years. The most common STI observed was herpes genitalis, followed by genital warts and genital molluscum contagiosum. Pruritic Papular Dermatoses were found to be the most common noninfectious dermatosis.

Conclusions:

There is a need to know the atypical manifestations of various dermatoses in HIV patients, as these conditions may pose a diagnostic dilemma to the treating dermatologist. This ensures correct diagnosis and the necessary treatment.
Toxic Epidermal Necrolysis Due to Dual Infection of Mycoplasma pneumoniae and Streptococcus Complicated by Herpes Simplex Virus
Authors: Gudi Suma D , Murthy Sambasiviah Chidambara , Nagaraja Niveditha , Devendra Vandana
Published: May 2023

Stevens–Johnson syndrome and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, characterized by blistering and epidermal sloughing. They are mainly caused by drugs and less commonly due to infections. A 9-year-old boy presented with fever, cough, atypical target lesions involving >30% of body surface area along with few erosions and positive pseudo-Nikolsky sign. Multiple mucous membranes were involved. Clinical features were consistent with TEN. Radiological and laboratory investigations showed evidence of Mycoplasma pneumonia and Group A Streptococcal infection. The course was further complicated by herpes simplex 1 infection. He responded well to systemic antibiotics, corticosteroids, cyclosporine, acyclovir, and supportive care. This report highlights the occurrence of TEN due to dual infections that further got complicated by a third infection.
Prevalence of Psychological Distress and Quality of Life among People Living with HIV/Acquired Immunodeficiency Syndrome at Tertiary Health-care Center in Coastal Karnataka, Institutional-Based Cross-sectional Study
Authors: Hariprasada A R , Shruthi H N , Phatak Akshay
Published: May 2023

Background:

With increase in cases of HIV, in addition to the direct effect of HIV, the social stigma causes psychological distress in people living with HIV/AIDS (PLWHA). With improvements in antiretroviral therapy (ART), HIV has become a chronic disease, which increases the incidence of other psychiatric comorbidities.

Objectives:

To assess the predisposing factors causing psychological distress and to assess the quality of life (QOL) in people living with HIV.

Materials and Methods:

A total of 380 patients who visited ART center in a Coastal Karnataka tertiary health-care center were included in this study. They were given questionnaires, which included World Health Organization-QOL-Bref, HAM-Depression, MOS-social support survey, perceived stress scale (PSS), and substance abuse.

Result:

Out of 380, the prevalence of psychological distress in patients with HIV/acquired immunodeficiency syndrome (AIDS) was 30.5%. The mean of the total QOL scores was 78. Prevalence of poor QOL in patients with HIV/AIDS was 1.58%. About 5.8% were mild or moderately depressed. Only 0.5% were found to be with severe depression. There was no statistically significant substance abuse among PLWHA.

Conclusion:

PLWHA who were in the age group of 30–60 years, illiterate, those with history of alcohol abuse, and having lower QOL scores and high scores in PSS had increased odds of psychological distress. Thus, concerned medical fraternity should collaborate on integrating HIV/AIDS treatment services with mental health services. Future interventions are needed to improve the level of social support and psychological support to the people living with chronic illnesses like HIV/AIDS.
Fluid and Diet Management in Acute Skin Failure
Authors: George Neethu Mary , Potlapati Amruthavalli , Shivanna Ragunatha
Published: May 2023

Acute skin failure (ASF) is due to dermatological conditions that cause total dysfunction of skin. Normal skin resists mechanical damage, protects body from external contaminants, regulates heat loss from the body, and retains body fluids and protein, all of which are lost in ASF. The treatment includes a multidisciplinary approach with aims to arrest the progression and heal the already formed lesions, wound care, fluid, electrolyte, and diet management. Along with medical management, it is extremely important to equally consider supportive therapy with correction of fluid and nutrient losses. Fluid and diet correction should neither be underdone, which can delay recovery, nor be overdone, which can lead to complications. The article covers the basis of fluid and nutritive loss and methods of correction in this dermatological emergency.
Androgenetic Alopecia
Authors: Bansod Shashank , Sharma Aseem , Mhatre Madhulika
Published: May 2023

Androgenetic alopecia, known alternatively as male pattern baldness when men are affected, and female pattern hair loss, when it affects women, is a form of alopecia characterized by miniaturization – a process wherein thick, long terminal hair are converted to short, thin, miniaturized hair due to the effect of dihydrotestosterone. Various pathogenetic mechanisms exist that support the process. Due to the unusually high disease burden and the psychosocial affliction, a lot of research in underway in the field. Clinically, this subtype of patterned hair loss presents with typical and atypical patterns presenting with thinning of hair and / or balding, or both. It is of paramount importance to recognize and grade the disease early to administer appropriate therapy. Trichoscopy also plays a major role in diagnosing, prognosticating and even monitoring patient response to therapy.
Profile of Dermatology Consultations for Inpatients: The Scope for Telemedicine During the COVID-19 Pandemic and Beyond
Authors: Pangti Rashi , Gupta Somesh
Published: May 2023

Background:

Attending dermatology consultations for inpatients is an integral part of the role of dermatologists inpatient care.

Materials and Methods:

A retrospective study was conducted at a large tertiary care hospital when the country, particularly the city, was severely affected by the COVID-19 pandemic. The aim was to study the profile of dermatology referrals for inpatients at the time of the COVID-19 pandemic and assessing the need for telemedicine in these inpatients.

Results:

A total of 341 dermatology consultations for 288 patients were received. Most of the consultations were from internal medicine (15.3%) and obstetrics and gynecology (8.7%). Around 65% of consultations were for new-onset (≤30 days) skin conditions while around 35% were for chronic (>30 days) conditions. The most commonly seen conditions were superficial fungal infections (14.9%) followed by eczematous disorders (13.2%). On grading the level of urgency of the referrals, 34.4% required an immediate consultation, 41% required it within a week, 12.8% within 2–4 weeks, 8% within 1–3 months, and 3.8% after the pandemic settles. The need for urgent consultation was more in acute cases than in chronic cases (P = 0.00). 62.5% of the consultations could have been done by telemedicine.

Conclusion:

As a majority of the consultations were for common and straightforward skin conditions and could mostly be done on telemedicine, this study underlines the need for strengthening the telemedicine services for inpatients referrals during this COVID-19 pandemic and even beyond.
Contact Dermatitis Follow-up Care in a Comorbid, Elderly Woman Using Patient-assisted Teledermatology Consultation in Covid-19 Era
Authors: Anisha Yapamakula Amarnath , Chethana Santhebachalli Gurumurthy , Ashwini Padubidri Kombettu , Kanthraj Garehatty Rudrappa
Published: May 2023

Teledermatology is a boon in the current situation considering the ongoing COVID-19 pandemic. The use of teledermatology with the available technology for follow-up care in a comorbid, geriatric and COVID-19 situation is reported. An elderly female with comorbidities presented to us with acute history of itchy red lesions over the face and scalp after application of hair dye. She was diagnosed with a case of contact dermatitis and was treated with topical corticosteroids and antihistamines after routine investigations. Considering her status of being elderly, comorbidities and no caretakers, we offered patient-assisted teledermatology consultation (PATC) through mobile messenger app for her follow-up. We were able to assess the serial images sent by the patient on days 3, 5, and 7 and observed improvement. Mobile messenger apps are convenient for the patients and reduce 75% of follow-up visits. It achieves both patient and physician satisfaction. We suggest PATC for follow-up, especially in the elderly with comorbidities. It minimizes multiple follow-up visits, save time, and cost.
An Image-Based Scoring System as an Alternative to Face-to-Face Examination for Acne Vulgaris to Deliver Follow-Up Care: A Comparative Study
Authors: Shetty Samiksha Shankar , Joshi Ruta Ujjval , Kombettu Ashwini Padubidri , Gurumurthy Chethana Santhebachalli , Kanthraj Garehatty Rudrappa
Published: May 2023

Background:

AV is a chronic disease with flares and remissions requiring regular follow-ups. Image-based lesion counting (LC) is useful when in-person consultations are not possible, like the COVID-19 pandemic.

Objective:

The aim of this study is to validate the proposed scoring system for teledermatology consultation and compare it with face to face.

Materials and Methods:

The face was divided into three zones which was further divided by drawing the imaginary lines from fixed points. AV (Grade 1 and 2) lesions were counted by co-investigator in person at baseline, first, and second follow-up visits. The images of the same were evaluated and scored by the principal investigator. Acne scores obtained were compared and statistically analyzed.

Results:

Two hundred cases were enrolled. Mean acne scores for in-person were 945.37, 647.57, and 550.81 and for teledermatology 1044.99, 718.79, and 654.36 for baseline, 1st, and 2nd follow-up, respectively. The mean decrease from baseline, 1st and 2nd follow-up, independent sample t-test and correlation analysis was significant in both groups (P = 0.001).

Limitations:

AV grade 3 and 4 are not included.

Conclusion:

During the 1st follow-up, a decrease in acne scores was observed, along with consistency in the scores between the evaluators. Image-based lesion counting is a promising approach. The proposed scoring system can be used for both modes of consultation-face-to-face and teledermatology.
Influence of Internet Health Information on Patient Compliance in Dermatology
Authors: Nair Pragya Ashok , Tandel Jinal , Shah Pratiksha , Rutoo  , Parmar Dharmesh , Patel Brijesh
Published: May 2023

Background:

Many patients use the Internet to self-diagnose and find treatment options, thus avoiding the need to visit a doctor in person. Objectives: This study was done with the primary objective to determine how Internet health information impacts the patient–physician relationship, compliance, and its effect on patient treatment.

Materials and Methods:

It was a cross-sectional study, done at the Department of Dermatology, Venereology, and Leprosy, over a period of 6 months from January to June 2019. All patients with any dermatological diseases above the age of 12 years, who conducted an Internet search for the disease were included in the study. Participants were provided with an information sheet, outlining the details of the study. They were asked to fill out a questionnaire in their vernacular language. The questionnaire had questions about the patient's perspective toward his health as well as the doctor's advice before and after Internet usage. Descriptive analysis was used for statistical analysis.

Results:

A total of 110 patients were included in the study with 56.36% of males and 34.54% between 21 and 40 years of age group. Wikipedia was used by 51.81% of participants, followed by 40% who used Google. After Internet use, participants strongly agree that doctors possess more information than the information on Internet in 39.09%, while 61.81% of participants believe that there is good communication between doctor and patient. After Internet use, a maximum of 48.18% agree and followed the doctor's recommended medication.

Conclusion:

Online medical information has a positive effect on patient disease status and on patients' relationships with their physicians. Doctors should be more aware of the health information available online and should be able to guide patients to accurate and reliable websites.
Androgenetic Alopecia – Medical Management
Authors: Kaliyadan Feroze
Published: May 2023

There are a number of options available for the medical management of androgenetic alopecia. The key questions for practitioners are what the available medications are and what is their efficacy? What are the possible side-effects of these options? Are there differences in response according to parameters like gender? Are combinations effective? What are the newer options available and what could the future hold? This narrative review attempts to answer these questions. The main focus is on the medical treatment options which have significant evidence as of now – minoxidil, 5 alfa-reductase inhibitors, low light laser therapy, and platelet-rich plasma.
Psoriasis and Its Association with Metabolic Syndrome: A Case–Control Study at a Tertiary Care Center in a Semi-Urban Region of South India
Authors: Samagani Akshay , Yadalla Harikishan Kumar , Belliappa P Raju
Published: May 2023

Background:

Metabolic syndrome (MS) has been associated with skin diseases such as psoriasis. They share a common inflammatory pathway and therefore have an impact on each other.

Objectives:

To estimate the prevalence of MS and its individual components in psoriasis patients to that of the controls and to compare the characteristics in psoriasis patients with and without the MS.

Materials and Methods:

One hundred patients with a clinical diagnosis of chronic plaque psoriasis were evaluated for the prevalence of MS and compared with the age- and sex-matched controls.

Results:

The study population belongs to the semi-urban region with a low socioeconomic status. The psoriatic cases showed male preponderance, and the majority of the subjects belonged to 31–40 years of age group. The mean psoriasis area severity index score among cases was 26.19 ± 10.8, and 92% of cases were with severe disease affecting the quality of life. MS was found to be statistically significant in cases. The cases with MS had a higher prevalence of central obesity, hypertriglyceridemia, elevated fasting blood glucose levels, and hypertension. The presence of MS in psoriasis patients was statistically independent of the severity.

Conclusions:

Psoriasis patients should be periodically evaluated for metabolic syndrome to prevent the associated mortalities and for their effective management.
Sweet's Syndrome
Authors: Bangaru H , Raghavendra K R , Shankar Sathish
Published: May 2023

Background:

Sweet's syndrome (SS) is a classical representative of neutrophilic dermatosis characterized by the abrupt onset of fever, erythematous tender plaques and nodules on exposed parts, and histopathological reaction in response to different external and internal stimuli.

Objectives:

The aim of this study was to assess the clinical, epidemiological, histological features and therapeutic outcomes of SS.

Materials and Methods:

A retrospective study of all patients diagnosed with SS over a 4-year period (2016–2020) was conducted.

Results:

Over a period of 4 years, a total number of cases of SS were 16. Female patients were predominant around 13 (81.25%), and male patients were 3 (18.75%). The most common site affected was face in 87.5% (14), followed by upper limb in 50% (8) and lower limb in 25% (4). Among the systemic manifestations, fever was there in all cases. The associated causes were infectious conditions in 6 (37.5%) cases, among which five cases were upper respiratory tract infection, hematological malignancy in three cases, one case with solid tumors, one case was associated with acquired cutis laxa (Marshall' s syndrome), one was drug induced (diclofenac sodium), one case was pregnancy associated, and other three cases were idiopathic.

Conclusion:

SS can be diagnosed based on clinical and laboratory findings. In all atypical and recurrent SS cases, thorough evaluation for malignancy is essential. Dapsone can be considered a concomitant therapy along with steroids and also a steroid-sparing agent.
Clinical Audit of Methotrexate Therapy in Psoriasis at a Tertiary Care Teaching Hospital in Western India
Authors: Bhut Anuj , Tandel Jinal Jitendrabhai , Nair Pragya Ashok
Published: May 2023

Background:

Methotrexate (MTX) is one of the most useful drugs in the treatment of psoriasis. It is like a double-edged sword; beneficial when given under strict medical supervision and harmful when standard guidelines are not followed.

Objective:

The present study was a process audit done with the aim to improve quality of care in patients of psoriasis with MTX therapy and to minimize the errors.

Materials and Methods:

The study was a clinical audit assessing patients of psoriasis who were given MTX therapy. Patients were selected on a random basis from hospital data records from January 2018 to August 2019. To assess the patients on MTX therapy, a pro forma was filled which included demographic details, psoriasis area severity index (PASI) scores, baseline investigations carried before starting MTX and at regular intervals afterward, dosage of MTX, its tapering schedule, and cumulative dose. The data were analyzed using descriptive statistics. Ratios, proportions, and percentages were used to describe the data.

Results:

A total of 30 psoriasis patients on MTX therapy were selected randomly, of which 25 (83.3%) participants had record of proper history and clinical assessment. PASI >10 was observed in 24 (80%) and was calculated by the 1st-year residents in 15 (50%) participants. Before starting MTX therapy, baseline laboratory investigations (CBC, LFT, and RFT) were done in all 30 (100%) participants. Initial dose of MTX (2.5–5 mg/week) was given in 6 (20%) participants. Supplementary medications such as folic acid in proper dosage were given to 28 (93.3%) participants. Twenty-nine (96.6%) participants were investigated for CBC and LFT every 2 weekly in the first 3 months, while only 16 (53.3%) participants were investigated for RFT. After reduction of 75% of PASI, MTX was tapered in 21 (70%) participants.

Conclusion:

The study reveals some pitfalls in following the guidelines in patients on MTX. Educational interventions in the form of training among dermatologist and resident doctors should be carried out.
Unmasking Dermoscopic Evaluation of Melasma
Authors: Sreenath Sahana , Phulari Yoganand J , Hiremath Ravishekar N , Ghodke Sandhya , Raj Rishi
Published: May 2023

Background:

There exists a wide range of variations in skin tone around the world, with Asian and Indian subjects showing a greater susceptibility toward pigmentation disorder.

Objective:

This study was carried out with the objective to assess the clinical and dermoscopic findings among different types of melasma in a single center of Central India.

Materials and Methods:

A cross-sectional study was carried out among patients with clinical features of melasma attending the outpatient department at multispecialty hospital with a sample size of 100. A prestructured pro forma was used to collect the baseline data. Clinical and dermatological examination was done after taking a detailed history. Clinical pattern of melasma such as centrofacial, malar, and mandibular was noted. The areas of melasma were examined using a contact polarized Dermlite DL4 3rd Gen Dermoscope attached to an iPhone.

Results:

The mean age of study participants was 38.15 years with a standard deviation of 6.93. Seventeen percentage were of male gender. Thirty-one percentage of the female patients had a history of oral contraceptive pill (OCP) usage, and 22% of the female patients had a history of menstrual abnormalities. Fitzpatrick skin Type IV was the most commonly affected skin type. Centrofacial type of melasma is the most common clinical type and reticuloglobular pattern is the commonly seen pattern on dermoscopy. The color of dermoscopy was predominantly brown in malar (52.2%) and mandibular (57.1%) and mixed in Centrofacial (45.7%), which was followed by 26.1%–28.6% mixed color in malar and andibular types and 41.4% brown color in centrofacial type. The difference in the color of dermoscopy (P = 0.48), presence of telangiectasia on dermoscopy (P = 0.23), pattern of dermoscopy (P = 0.15), and mean Melasma Severity Index scores with different clinical types was not statistically significant. Similarly, the association between different clinical types of melasma with duration of sun exposure (P = 0.33) and topical photo protection (P = 0.34) was also not statistically significant.

Conclusion:

Our study findings concluded that melasma is common in women in the age group of 27–56 years range. Exposure to sunlight and the hormonal changes (due to OCP usage) were those among the various factors influencing the development of melasma. Centrofacial melasma was the most common pattern seen in our study group. Epidermal melasma features on dermoscopy were reticuloglobular patterns with a brownish hue, while the features of dermal melasma were irregular patterns with a bluish hue and mixed melasma had irregular patchy brown pigmentation. Perifollicular globules and telangiectasia were also seen.
Teledermatology in the Era of COVID-19, Perspective from a Developing Country
Authors: Choudhary Paras , Mehta Rajesh Datt , Sharma Divya , Kacchawa Dilip , Ghiya Bhikam Chand , Singh Kamaldeep
Published: May 2023

Background:

With the advent of the COVID-19 pandemic, the medical fraternity across the world, including India, is facing unprecedented challenges, and to cope with this, creative solutions are required. During this COVID-19 crisis, telemedicine has emerged as a weapon to reduce disease transmission while continuing with non-COVID care.

Objectives:

The purpose of this study is to highlight the changes and challenges in dermatology practice, to explore the usefulness of tele-dermatology during the pandemic, and to understand the dermatologist's perspective.

Materials and Methods:

An online cross-sectional survey was done among Indian dermatologists to evaluate the changes in their practice, impact of telemedicine, and their experience, during COVID-19.

Results:

A total of 177 responses from qualified Indian dermatologists were analyzed. Teleconsultation was done by 20.5% of consultants before lockdown which increased up to 82% after lockdown. Most commonly preferred device was mobile phone (83%), and the most common format was chat applications (WhatsApp/Messenger) (55.7%). Discontinued consultation was due to technical issues, patient's misbehavior, and poor-quality clinical photographs. Only 13.5% of practitioners were satisfied with teledermatology.

Conclusion:

With the onset of the COVID-19, the shift of clinical care to telemedicine practice has hastened. However, continuous investment in systems and technology as well as refinement of regulations for telemedicine is needed to sustain its widespread adoption.
A Study to Compare Efficacy of Non Cultured Autologus Melanocyte Transfer Versus Punch Grafting Technique for Stable Vitiligo Patients
Authors: Badad Ambresh S , Bhatia Amrit Singh , Hogade Ashok , Badad Shruti Ambresh , Mitra Debdeep
Published: May 2023

Background:

Vitiligo is a common acquired idiopathic hypomelanosis, which is characterized by loss of melanocytes in the epidermis associated with autoimmune and hereditary causes. The various surgical modalities available are tissue grafting techniques such as punch grafts, suction blister grafts, and split-thickness grafts as well as cellular grafts such as autologous noncultured epidermal cell suspensions and cultured melanocyte suspensions.

Objective:

We aimed to study and compare the efficacy of noncultured melanocyte transfer technique and punch grafting technique in the management of stable vitiligo.

Materials and Methods:

Fifty patients of both sexes between the ages of 15 and 50 years having stable vitiligo for minimum 1 year were included in the study and divided in two groups. Group 1 was treated with autologous noncultured melanocyte-rich cell suspension and Group 2 was treated by punch grafting technique. Response to treatment was evaluated on the basis of degree of repigmentation (both subjective and objective assessment), which was carried out at monthly intervals for a period of 6 months along with clinical photographs.

Results:

The results were statistically analyzed using “Chi-square test” and “statistical significance” (p-value) methods. An excellent (>75% repigmentation) result was obtained in 77.27% of patients by NCMT (noncultured melanocyte transfer) technique whereas good (60%–75% repigmentation) result was obtained in 78.57% of patients by punch grafting technique after 6 months.

Conclusion:

Noncultured melanocyte transfer is a simple and effective technique to produce uniform pigmentation in short duration and is suitable to cover large body surface areas with a cosmetically better outcome and is better than punch grafting.
Use of Punch in the Treatment of Plantar Warts: A Study of 250 Cases
Authors: Patil Chetan C , Arora Sandeep , Bhatnagar Anuj , Sandhu Sunmeet , Mitra Debdeep , Suhag Devinder
Published: May 2023

Background:

Plantar wart is a frustrating infection for both patients and clinicians that can significantly cause embarrassment, negative gauging by others, and vexation due to persistence and/or recurrence of warts, affecting a patient’s quality of life.

Materials and Methods:

A prospective observational study from April 2020 to March 2021 was conducted in an Indian tertiary care center on 250 patients aged between 15 and 40 years. Punch excision of solitary to multiple plantar warts was carried out with a 5-mm punch.

Results:

A total of 342 plantar warts were punch excised in 250 cases with 162 males and 88 females. 214 (85%) patients had a complete cure over 10 days of treatment. Eleven (5%) patients developed local secondary bacterial infections managed with oral and topical antibiotics. Complete healing was achieved in all over 2–4 weeks without any scarring. There was no recurrence among 225 cases over the follow-up period of 3 months, while 25 (10%) were lost to follow-up.

Conclusion:

Use of punch excision for plantar warts is a simple, affordable, and quick outpatient department procedure, requiring no suturing even with an excision size of 5 mm. It needs minimum postprocedural care and heals without scarring. This methodology of management of plantar wart highlights it as a preferable procedure in primary care centers or resource-poor settings that requires less expertise.
Usage of Learning Management System to Implement Online Teaching Methodology in Undergraduate Medical Students
Authors: Kumar Shivakumar Ajay , Niveditha G , Seema P , Bengalorkar Girish M
Published: May 2023

Background:

The COVID-19 pandemic caused a temporary roadblock in learning among medical colleges in India as traditional classroom teaching was suspended temporarily. Students and faculty members had to adapt in a short period of time to transition from traditional practices of live classroom lectures to a virtual mode by using learning management system (LMS).

Objectives:

The present study aims to describe the perceptions of students and faculty members about their experience using the LMS to attend online classes. It also aims to assess the possibility of using the same for postgraduate medical education, particularly in specialties requiring visual aid for learning such as radiology, dermatology, and pathology.

Materials and Methods:

A cross-sectional survey-based observational study was conducted on 123 MBBS students and 36 faculty members after 6 months of the online teaching using LMS. Responses were collected on their experience with the LMS and assessed using a three-point Likert scale.

Results:

About 62.6% of the students who participated in the study felt that it was easy to log into the LMS platform. About 58.6% of the students felt that the audio and video quality of the classes on the platform was good. The majority of students (93.5%) felt that the user interface of the LMS was easy to use. Poor Internet connectivity issues accounted for the main cause of interruptions during online classes for 48% of the students. About 88.9% of the faculty members felt that it was easy to log into the LMS to conduct online classes. Around 86.1% of them felt that the audio and video quality was good on the platform. Browsing through the platform during online lectures was easy according to 75% of them.

Conclusion:

The majority of students and faculty members felt that the user interface and quality of the audiovisual feed of the LMS were very good. The LMS platform made the scheduling of classes, marking attendance, and usage of additional annotation tools convenient. Usage of LMS can supplement the traditional face-to-face lecture classes to enhance learning in medical undergraduate and postgraduate education.
Role of Dietary Factors in Acne Vulgaris among Young Adults: A Case–Control Study
Authors: Fernandes Michelle Serene , Pereira Pradeep
Published: May 2023

Background:

Previous studies on the potential role of diet in acne vulgaris have shown conflicting results. However, there are very few studies from India.

Objective:

This study aims to evaluate the role of dietary factors in the causation of acne vulgaris among young adults.

Materials and Methods:

This case–control study studied the dietary factors of people aged 18–25 years. A total of 224 patients with moderate-to-severe acne were evaluated. The control group comprised 260 individuals with no or mild acne. Both groups were asked to fill up a questionnaire on sociodemographic characteristics, family history of acne among first-degree relatives, and relevant medical history. The information on selected food items such as milk and dairy products, rice, fruits, vegetables, fish, meat, chocolates, and cakes was recorded on a food frequency questionnaire. Frequency of intake was categorized as: More than 3 days/week, from 1 to 3 days/week, <1 day/week and never. Acne severity was determined as per a global score. Body mass index and other anthropometric measures were obtained.

Results:

There was a positive association of family history of acne with the occurrence of acne. Milk was highly significantly association with occurrence of acne (P = 0.000). The protective effect of fish consumption on acne was also noted.

Conclusion:

Clinicians need to counsel their patients regarding the effect of diet, especially dairy products on their acne lesions.
Muehrcke’s Lines in a Known Case of Lung Carcinoma on Chemotherapy
Authors: Patel Dhruv Ramanbhai , Tandel Jinal Jitendrabhai , Nair Pragya Ashok
Published: May 2023

Muehrcke’s nails are changes in the fingernail that may be a sign of an underlying medical condition. These lines have been linked to low levels of albumin, indicating decreased protein synthesis as a result of liver disease, nephrotic syndrome, glomerulonephritis, malnutrition, or dietary protein deficiency. It can also occur during periods of metabolic stress such as systemic infection, trauma, Acquired immunodeficiency syndrome, chemotherapy drugs, Hodgkin’s disease, pellagra, and sickle cell anemia. Muehrcke’s nails are characterized by double white transverse line, across the nail, parallel to the lunula on the fingernails, and thumb involvement is rare. Treatment is the correction of albumin deficiency or any other underlying conditions. Examination of the nails should be an integral part of a complete dermatological examination. Here, we report a case of 47-year-old male diagnosed with Muerhcke’s lines, secondary to intake of cytotoxic chemotherapeutic drugs.
Multisystem inflammatory syndrome in neonate with skin lesions—A rare case report
Authors: Arunakumar Sanmithra P. K. , Rao Raghunadan B. G. Krishnamurthy , Rajagopaliah Lakshmipathy S. , Ramabhatta Sujatha
Published: May 2023

Multisystem inflammatory syndrome in children is a serious condition that occurs due to postinfectious immune-mediated hyperinflammatory reaction seen in children, which develops after 4–6 weeks of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection; it is rare in neonates. We present here a case of a term newborn with fever, respiratory distress, and necrotic skin lesion that gradually progressed to multisystem dysfunction. Reverse transcription polymerase chain reaction for SARS-CoV-2 was negative for both mother and the baby. SARS-CoV-2 IgG titer was negative in the mother but was found to be positive in the newborn. The diagnosis of multisystem inflammatory syndrome in neonate was made and was successfully treated with intravenous immunoglobulin and corticosteroids.
Etiological profile of seizure in children of age group 1 month to 18 years with special reference to neuroimaging in a tertiary care hospital
Authors: Mondal Bikram , Sarkar Oendrila , Halder Pankaj K. , Deb Sukanya , Guha Debasree , Mandal Amita S.
Published: May 2023

Background:

Seizure is a common cause of childhood hospitalization. Neuroimaging studies help in identifying etiologies, including the rare ones, and planning management.

Purpose:

The aim of this study is to determine the etiology of seizures in pediatric patients and the utility of neuroimaging in the same.

Materials and Methods:

A prospective study was carried out on 100 children who were admitted with seizures (including recurrent episodes) in our tertiary care institute. The sociodemographic profile, clinical features, neuroimaging findings, and findings of other investigations were documented and analyzed, to classify the type and etiology of seizures.

Results:

The male–female ratio among patients was 1.94: 1. Seizures of generalized onset were most common (95%), affecting mostly the age group of 1–5 years (50.53%), followed by the 5–18 years (29.47%) and the 1 month to 1 year (20%) groups. The etiologies were simple febrile seizure (51%), seizure disorder (8%), cerebral palsy (8%), acute viral meningoencephalitis (7%), pyogenic meningitis (6%), and complex febrile seizure (5%). Neuroimaging was carried out in 30 children, in which 14 showed abnormal reports, and abnormal electroencephalogram (EEG) report was found in 6 out of 10 patients. The analysis of the distribution of the types of seizures concerning age, gender, family history of seizure, history of seizure, socioeconomic status, and developmental milestones did not reveal any statistically significant relationships (P> 0.05).

Conclusion:

Seizure of generalized onset was the most common type, and the most common etiology was a simple febrile seizure. Abnormal neuroimaging/EEG findings were more pronounced in patients with focal seizures.
Evaluation of chemotherapeutic regimen and associated adverse drug reactions of colorectal cancer in a tertiary care hospital
Authors: Mol Linda S. , Jose Akash , Mohan Arathy , Madhu C. S. , Lakshmi R.
Published: May 2023

Background:

Colorectal cancer (CRC) is the fourth most common cause of death diagnosed in both men and women. Though there are modifiable and non-modifiable risk factors for CRC. cancer patients encounter chemotherapy-associated drug interactions and adverse drug reactions hence the need for such a study will help the professionals to improve the patient’s quality of life.

Materials and Methods:

A six-month retrospective study of 130 patients who satisfied the inclusion and exclusion criteria was conducted by collecting data from November 2020 to May 2021. Data was collected from the Mediware system of the hospital using specially designed data collection forms.

Results:

Out of 130 patients, 61.51% were male and most of the patients were more than 60 years old. In this study, 11 patients had a history of smoking and alcoholism and 4% had a family history of CRC. Comorbidities associated with CRC were HTN and DM. In the study, stage 4 cancer patients were found to be more. 77.69% of patients had received chemotherapy along with surgery, and the most commonly prescribed regimen was Capcetabine and OxaliplatinThe length of hospital stay was increased for the FOLFOX (Oxaliplatin, 5-Fluorouracil, and Leucovorin) regimen. The common ADR analyzed was constipation, followed by vomiting and neutropenia, and most ADRs were associated with the CAPOX regimen (diarrhea) and treated accordingly.10 patients had febrile neutropenia, 5 patients had grade 4 neutropenia and all were treated with antibiotics and filgrastim. Febrile neutropenia was seen in patients with metastasis.

Conclusion:

Timely and appropriate treatment for ADRs and early screening can improve the quality of life of individuals. Further studies on this topic will help to improve the treatment quality provided by professionals
Comparison of onset of action of Intrathecal Clonidine vs Intrathecal Fentanyl as an adjuvant with hyperbaric Bupivacaine and Bupivacaine alone under spinal anesthesia for lower limb orthopedic surgeries
Authors: Devi Aradhana , Santosh Amrita , Har Archana , Vennel Jessy , Gadkari Vikrant
Published: May 2023

Background:

Adjuvants are added to a local anesthetic solution to prolong the duration of analgesia. There is a paucity of studies comparing the onset of action of adjuvants like Clonidine and Fentanyl. In this study, the time of onset of action of intrathecal clonidine and intrathecal fentanyl as adjuvants to bupivacaine and bupivacaine alone were compared in the subarachnoid block for lower limb orthopedic surgeries.

Materials and Methods:

90 adult patients posted for orthopedic surgery of the lower limb were divided into three equal groups of 30 each. Group A being the control group was given hyperbaric Bupivacaine(3ml) +0.5ml of Normal saline, Group B was given Intrathecal hyperbaric Bupivacaine (3 ml) +30 μg Clonidine and Group C was given Intrathecal hyperbaric Bupivacaine (3 ml) + Fentanyl 25 μg. The primary objective was to compare the time of onset of block and duration of analgesia. The secondary outcomes were the duration of sensory and motor block, duration of analgesia, hemodynamic parameters, and side effects.

Results:

The time of onset of the sensory blockade was 4.83 ± 0.64, 1.72 ± 1.47, and 3.4 ± 1.43 mins in groups A, B, and C respectively. The time of onset of the motor blockade as estimated by the time to reach level 2 on the Bromage scale, was 6.07 ± 0.55, 2.38 ± 1.32, and 5.06 ± 1.28 mins in groups A, B, and C respectively. The duration of postoperative analgesia was prolonged in the Clonidine group compared to the Fentanyl group.

Conclusion:

The study reveals that the time of onset of action of sensory and motor block was faster and the duration of analgesia was prolonged with adjuvants like Clonidine when compared to Fentanyl when added to Bupivacaine.
An unusual case of methemoglobinemia resulting from self-administration of nitrobenzene in a psychiatric patient
Authors: Sathyan Chanjal Koonampadan , Chidambaram, Harihara Sudhan , Dominic Melvin , Sirajudeen Syed Abthahir , Jinka Venkata Durga Prasad
Published: May 2023

Nitrobenzene, when consumed in large enough doses, can cause methemoglobinemia. By reducing oxygen unloading and oxygen binding, methemoglobinemia reduces oxygen delivery. This is a case of 55-year-old man who is a known case of psychiatric disorder was brought to the emergency room with an alleged history of deliberate consumption of nitrobenzene liquid approximately 10 mL in the morning of the day at his residence. He also instilled 2 drops in the right ear and was taken to a private hospital where the initial management with gastric lavage, multidose activated charcoal and methylene blue was given. He was then referred to the government tertiary care setting for further management. Prompt intravenous methylene blue treatment increases PaO2 in patients with methemoglobinemia.
Odontogenic tumors
Authors: Shinde Sumedha P. , Vatkar Arvind J.
Published: May 2023

Introduction:

Odontogenic tumors (OTs) are rare and account for around 1% of jaw lesions including tumor and tumor-like lesions. OTs are a diverse category of lesions, displaying different inductive interactions. Although some are hamartomas, others are benign and malignant neoplasms with varying degrees of aggressiveness.

Materials and Methods:

We plan to review the histopathological aspects of OTs because of their diverse properties. At a tertiary medical and dental institute in Pune, India, we studied 28 cases of OTs over 2 years, from 2013 to 2015.

Results:

The most common forms of OTs were ameloblastoma (42.86%) and odontogenic keratocyst (21.15%). The highest number of OTs was found in the 21–30-year-old age group, with an even gender distribution.

Conclusion:

Ameloblastoma is the most common OT, accounting for roughly one-quarter of all jaw tumors. The majority of OTs occurs in young people aged 20–40 years. Fortunately, malignant OTs are extremely rare.
Copper-based fabric for healthcare professionals to prevent healthcare-associated infections
Authors: Sharma Megha , Pareek Shatrughan
Published: May 2023

Healthcare-associated infections (HAIs) have a major impact on public health worldwide. Till now, we are relying on hand washing and environmental disinfection, but the compliance rate of hand washing and adequate supply of materials is always a catch. Alongside patients, surfaces and supplies act as reservoirs of microorganisms in healthcare settings. The reduction in organisms may prove to be an effective strategy to decline HAIs. The use of gold and silver in commercial textiles is prohibited because of the high cost rather than having excellent antibacterial and antimicrobial properties, so copper has become the best choice for researchers as it possesses similar properties to gold and silver and has other characteristics such as its durability, corrosion resistance, prestigious appearance, and ability to form complex shapes. It has been found that copper brings down the microbial burden of high-touch surfaces in healthcare settings. The fundamental properties of copper offer a theoretical advantage to regular cleaning, as the effect is continuous rather than episodic. So the use of copper-impregnated textiles in hospital areas whether in form of bed linen or uniforms for health professionals, as well as patients, can be a viable alternative to decline the levels of infection in healthcare settings, and with the discovery of copper-encapsulated hospital beds and fabrics, dividends will likely be paid in improved patient outcomes, lives saved, and healthcare cost saved. The application of copper in fabrics for healthcare professionals will be a sound initiative to prevent HAIs. The fabric may help decline the infection rate and mortality among hospitalized patients.
A prospective comparative study of concurrent chemoradiation in advanced carcinoma cervix patients with weekly cisplatin vs. weekly cisplatin and paclitaxel
Authors: Mukherjee Amit K. , Biswas Linkon , Bose Soumyo , Sharma Shyam , Mandal Srikrishna
Published: May 2023

Background:

Cisplatin-based concurrent chemoradiation is the standard treatment for carcinoma cervix. However, there is a need to explore alternative chemotherapeutic agents to further improve the treatment outcome. In this study, weekly paclitaxel and cisplatin-based chemoradiation was compared with weekly cisplatin-based chemoradiation in terms of disease control and toxicity profile.

Materials and Methods:

Sixty-four patients with FIGO stage IB2-IIIB squamous cell carcinoma of the uterine cervix were divided (by simple random sampling) into two groups: control arm patients who received radiotherapy (50 Gy in 25 fractions over 5 weeks) with concurrent weekly cisplatin (40 mg/m2) and study arm patients received same radiation dose with weekly cisplatin (30 mg/m2) and paclitaxel (40 mg/m2). After that, all patients received brachytherapy 21 Gy/three fractions, one fraction/week. All patients were followed up weekly during treatment, then 4–6 weeks after treatment completion, and thereafter monthly for at least 6 months.

Results:

The overall treatment response (complete+ partial response) was numerically higher in the cisplatin-containing control arm, but not significant (93% vs. 80%, P-value = 0.406). High-grade early rectal (60% vs. 25%, P-value = 0.014) and acute gastrointestinal toxicity (66% vs. 6%, P-value <0.001) were significantly higher in the cisplatin and paclitaxel-containing arm. Hematological, renal, late rectal, and bladder toxicities were also numerically higher in the study arm, but not statistically significant.

Conclusion:

There was no significant benefit of weekly paclitaxel and cisplatin as an alternative to weekly cisplatin-based chemoradiation in the treatment of carcinoma cervix.