bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemical Evaluation of C4d and C3d Markers in Bullous Pemphigoid as a Substitute for Direct Immunofluorescence Technique
Authors: Oryani Mahsa Akbari , Tayebi-Meybodi Naser , Nahidi Yalda , Sabi Mohsen Soltani , Aghaei Monavar Afzal
Published: August 2024

Background:

There are several methods for the diagnosis of autoimmune bullous disease. Direct immunofluorescent (DIF) testing is an important diagnostic method in the diagnosis of immunobullous disease but requires skilled pathologist, fresh tissue and well-equipped laboratory to perform the procedure. The immunohistochemistry analysis of C4d and C3d is easily compared with other methods. This study was conducted to assess the value of immunohistochemistry (IHC) analysis for expressions of C3d and C4d in the diagnosis of bullous pemphigoid (BP).

Aims and Objectives:

This study was conducted to assess the value of immunohistochemistry (IHC) analysis for expressions of C3d and C4d in the diagnosis of bullous pemphigoid (BP). Materials and

Method:

We applied C4d and C3d immunohistochemistry on formalin-fixed, paraffin-embedded tissue on 30 cases of bullous pemphigoid that was confirmed by direct immunofluorescence (DIF) evaluation as well as 16 cases in control group (12 cases of herpetiform dermatitis, 3 cases of linear IgA dermatosis and 3 cases of bullous lichen planus).

Results:

Mean and SD of age were 68.13 ± 14.00, female to male ratio was 1:3. In cases where both C3d and C4d staining were positive, the intensity of C3d staining was higher than C4d. Twenty-two cases showed C4d-positive staining in IHC study, such that in seven cases focal staining and in 15 cases diffuse staining were observed. Also 26 cases showed C3d-positive staining in IHC study such that in four cases focal staining and in 22 cases diffuse staining were observed. In cases with C3d-positive staining, there were 21 cases of deposition only on the bullous floor, one case on the bullous roof and four cases on the bullous roof and floor. In cases with C4d-positive staining, there were 17 cases of deposition on the bullous floor, two cases only on the bullous roof and three cases on the roof and floor. All control cases were negative for C3d and C4d staining in the dermoepidermal junction. For C3d immunohistochemical staining, sensitivity, specificity, positive predictive value and negative predictive value were 86.66%, 100%, 100% and 80%, respectively, and for C4d immunohistochemical staining, respectively, were 73.3%, 100%, 100% and 66.66%.

Conclusion:

The immunohistochemical specificity of C4d and C3d on tissue blocks is the same as that of direct immunofluorescence test on fresh tissue, but it is less sensitive, so positive results for C3d and C4d immunohistochemical staining on paraffin blocks can be used to confirm the diagnosis of bullous pemphigoid.
Disability among Leprosy Patients in the Lustrum 2016-2020
Authors: Jayapalan Sabeena , Bindu R. S. , Mathew Rony
Published: August 2024

Background:

The stigma surrounding leprosy in the community is due to grade 2 disability (G2D). The current global leprosy project aims towards a 90% reduction in G2D by 2030. This research was done to estimate the proportion of leprosy patients who had G2D at the time of diagnosis and to identify the clinical and demographic factors that predicted G2D.

Materials and Methods:

Design -Hospital-based retrospective cross-sectional study. The outcome variable was G2D and the determinants were demographic and clinical characteristics.

Results:

G2D was seen in 22.3% and G1D in 17.5%. The M:F ratio of G2D was 5:1. G2D was highest in the hands (62.1%), followed by the feet (59.4%), and the eyes (16.2%). The claw hand was the most common deformity in the hand and the plantar ulcer was the most common deformity in the feet. Age >45 (OR 2.27, 95% CI 1.1–4.8), males (OR 3.3,95% CI 1.3–8.5), multibacillary type (OR 6.95,95% CI 1.6–30.6), pure neuritic type (OR 3.6,95% CI 1.1–12.3), and thickened nerves (OR 14.3, 95% CI 1.9–108.7) were the significant determinants.

Conclusion:

Being male, being older than 45, having multibacillary leprosy, having pure neurotic leprosy, and having a thicker nerve trunk predicted G2D. Training primary care health workers in recognising the subtle early symptoms and raising community awareness are the need of the hour. Frequent leprosy case detection programmes should be held to identify undiagnosed cases.
Apremilast in Paediatric Dermatoses – A Comprehensive Review
Authors: Patro Nibedita , Panda Maitreyee , Dash Mrityunjay , Das Anupam
Published: August 2024

Apremilast has recently garnered attention in the management of multiple dermatological conditions including psoriasis. The comparable effectiveness with immunosuppressive drugs and a favorable side effect profile makes the drug, a prudent alternative for managing a gamut of dermatoses. In this article, we have reviewed the literature on apremilast use in children.
Novel Association between STAT3 Gene Variant and Vitiligo
Authors: Venkatesh Vaibhav , Mendez Deena C. , Rajashekar T S , Balakrishna Sharath
Published: August 2024

Background:

Vitiligo is an autoimmune disorder involving inflammatory damage to melanocytes. STAT3 genetic variant (rs744166 T > C) increases inflammatory signaling via JAK/STAT pathway.

Aim:

The purpose of this study was to check whether this translates into an association between vitiligo and STAT3 gene variant (rs744166 T > C).

Materials and Methods:

This is a case-control study. A total of 56 vitiligo patients and 90 healthy, age and gender-matched volunteers were recruited for the study. The STAT3 gene variant (rs744166 T > C) was genotyped using the restriction fragment length polymorphism method.

Results:

The frequency of the minor allele ‘C’ was higher in vitiligo patients (72.3%) than in healthy volunteers (57.8%). The difference between the two groups was statistically significant (P = 0.006; OR = 1.9 with 95% CI). The genotypic variant showed the highest association with vitiligo in the dominant model (P = 0.001).

Conclusion:

This study shows that the STAT3 gene variant (rs744166 T > C) is associated with vitiligo. This observation underlines the importance of the JAK/STAT signaling pathway in vitiligo pathogenesis.
An Observational Study Comparing the Number, the Localization and the Dermoscopic Patterns of Melanocytic Nevi in Cutaneous Melanoma and Basal Cell Carcinoma Patients
Authors: Demircan Caner , Elcin Gonca
Published: August 2024

Context:

Number of nevi is a risk factor for melanoma and basal cell carcinoma. Studies suggest that the dermoscopic pattern of nevi of melanoma patients may differ from healthy individuals. Similar data in patients with basal cell carcinoma is missing.

Aims:

The purpose of the study was to determine the number, anatomic distribution and dermoscopic pattern of nevi in melanoma and basal cell carcinoma patients.

Settings and Design:

An observational prospective study was conducted.

Materials and Methods:

Total body mole maps of 26 melanoma and 33 basal cell carcinoma patients were analysed.

Statistical Analysis Used:

Statistical analysis was done using the “IBM SPSS for Windows Version 22.0” package programme.

Results:

Number of nevi both on head and forearm were found significantly higher in the melanoma group (P = 0.015 and P = 0.031). Most frequent dermoscopic pattern was the complex pattern which was observed in 50.67% of melanoma and in 53.41% of basal cell carcinoma groups. Percentage of nevi with homogenous pattern located on the trunk and percentage of nevi with complex pattern located on the forearm was significantly higher in the melanoma group (P = 0.030 and P = 0.042).

Conclusions:

Higher number of nevi on the head and forearms; and more nevi showing homogenous pattern on the trunk and complex pattern on the forearms were the hallmarks of nevi in melanoma patients in comparison to basal cell carcinoma patients.
Role of Cutaneous Microbiome in Dermatology
Authors: Mustari Akash P. , Agarwal Ishan , Das Anupam , Vinay Keshavamurthy
Published: August 2024

The cutaneous microflora consists of various microorganisms which interact with host epithelial cells and innate and acquired immunity. This microbial milieu and its interaction with host cells prevent the growth of pathogenic organisms and educate host immunity to fight against harmful microorganisms. The microbial composition depends on various intrinsic and extrinsic factors and an imbalance in the cutaneous microflora predisposes the individual to both infectious and non-infectious diseases. Even though probiotics have been extensively studied in various diseases, their efficacy and safety profile are still unclear. A better understanding of the cutaneous microflora is required to develop newer therapeutic targets. In this review, we describe the commensal microbiome and its variation, the current role of the cutaneous microbiome in the pathogenesis of various dermatological diseases, and their therapeutic implications.
Update on dermatophytosis in Mashhad, Northeastern Iran, emergence of infection with Trichophyton persicum
Authors: Afsharzadeh Fatemeh , Zarrinfar Hossein , Fata Abdolmajid , Najafzadeh Mohammad Javad
Published: August 2024

Background:

Dermatophytosis is a common global superficial mycosis caused by a group of keratinophilic moulds known as dermatophytes that invade the skin and keratinized tissues such as hair and nails of humans and animals. This study takes identification of a collection of clinical dermatophyte isolates by using partial sequencing of translation elongation factor-1α (Tef-1α) gene aiming both to update the epidemiological status of dermatophytosis in Mashhad, Northeastern Iran and to corroborate the efficacy of Tef-1α for species-level identification of dermatophytes.

Method:

The demographic data related to 87 culture-positive dermatophytes isolated from patients clinically suspected to have dermatophytosis were collected. The dermatophyte isolates were subjected to a partial polymerase chain reaction (PCR)-sequencing of Tef-1α gene by using specific pan-dermatophyte primers. The data were analysed by SeqMan software, the sequences were compared and aligned with the GenBank database and the isolates were identified.

Results:

Identification based on Tef-1α partial sequence was successful for all isolates. The identified dermatophyte isolates in decreasing order were as Trichophyton interdigitale 19 (22%), T. tonsurans 19 (22%), T. mentagrophytes 13 (15%), T. persicum 10 (11.5%), Epidermophyton floccosum 9 (10.3%), Microsporum canis 7 (8%), T. rubrum 5 (5.7%), T. violaceum 2 (2.2%), Nannizzia fulva 2 (2.2%) and N. persicolor 1 (1.1%). The isolates have been associated with clinical forms of tinea corporis (n = 38; 43.7%), tinea faciei (n = 13; 15%), tinea cruris (n = 12; 13.9%), tinea manuum (n = 7; 8%), tinea unguium (n = 7; 8%), tinea capitis (n = 7; 8%) and tinea pedis (n = 3; 3.4%).

Conclusion:

Dermatophytosis has yet remained a public health problem in Northeastern Iran, and infection with new and less frequent species, e.g., T. persicum, N. fulva and N. persicolor have emerged. The Tef-1α gene partial sequencing reconfirmed the resolution power of this locus for the determination of species boundaries in dermatophytes.
Proliferating Pilar Tumor of the Cheek Misdiagnosed as Squamous Cell Carcinoma
Authors: Lee Se Il , Choi Joo Heon , Sung Kun Yong , Min Joonhong , Joo Hong Sil
Published: August 2024

Proliferating pilar tumours, also known as trichilemmal tumours, are rare tumours that arise from the external root sheath of hair follicles. These lesions usually have a firm-to-soft texture and form small nodules, but may grow gradually, causing pressure ulceration or hyperkeratinisation. Because of this feature, care should be taken to differentiate proliferating pilar tumours from squamous cell carcinoma. An 89-year-old woman presented with a protruding horn-shaped mass on her left malar area, which was first misdiagnosed as squamous cell carcinoma and then revealed to be a low-grade malignant proliferating pilar tumour. We report this case due to its rarity and clinically atypical characteristics.
Efficacy and Safety of Erbium-YAG Laser Ablation Therapy in Superficial Dermatoses
Authors: Arora Aakanksha , Mehta Rajesh D. , Ghiya Bhikam C. , Soni Prasoon , Mohta Alpana , Khokhar Rajesh , Jangir Vishnu K. , Yadav Manoj K. , Pareek Sumiti
Published: August 2024

Background:

Erbium-YAG laser has been the working horse in dermatology for years. Surprisingly, data on the efficacy and adverse effects of this novel resurfacing and ablative technique of erbium-YAG laser for superficial dermatoses in Indian skin is limited.

Aim and Objective:

To evaluate the efficacy and safety profile of erbium-YAG laser ablation in superficial cutaneous lesions.

Materials and Methods:

Two hundred and fifty patients of various superficial dermatoses, treatable by erbium-YAG laser, were recruited in the study. All the patients were subjected to erbium-YAG laser sessions. The number of laser sessions, fluence, frequency and other parameters were individualized as per the respective dermatosis. The clinical response was evaluated as grade 4 (100% lesion clearance), grade 3 (75–99%), grade 2 (50–75%) or grade 1 (<50%).

Results:

The overall mean age of our study group was 37.70 years. In our study, 52.38% cases of verruca plana, 36.84% cases of seborrheic keratosis, 56.4% cases of xanthelasma palpebrarum, 22% cases of acquired melanocytic nevus, 23.8% cases of plantar wart and 40% cases of sebaceous hyperplasia showed complete clearance. The most common adverse effect was post-laser erythema in 50.4% of cases, followed by pain in 36.8%. Besides this, scarring and dyspigmentation were observed in 11.6% and 12% of cases, respectively. The rate of recurrence on 3 months follow-up was 9 (23.07%) cases in xanthelasma palpebrarum, 11 (28.9%) cases in seborrheic keratosis, 10 (23.8%) cases in verruca plana and 9 (42.8%) cases in plantar warts.

Conclusion:

This study suggested that erbium-YAG ablation achieved good results for superficial lesions like verruca plana, seborrheic keratosis, xanthelasma palpebrarum, plantar wart, sebaceous hyperplasia and acquired melanocytic nevus. Thus, Er: YAG laser can offer a one-step procedure with better cosmetic results and a lesser rate of recurrence.
Cardiac Dysautonomia, Decreased Baroreflex Sensitivity and Increased Myocardial Workload in Patients with Chronic Spontaneous Urticaria
Authors: Ferdous Suraiya , Rajasegaran Rajalakshmi , Munisamy Malathi , Basu Sharbari , Harichandrakumar KT
Published: August 2024

Background:

Chronic stress, a potential risk factor for cardiac autonomic dysfunction and cardiovascular (CV) risk, is known to induce the onset and exacerbation of chronic spontaneous urticaria (CSU), a psychodermatological disorder. However, data regarding CV risks due to the stress associated with CSU are very limited.

Aims and Objectives:

This study aimed at comparing the cardiac sympathovagal balance (SVB), inflammatory markers, perceived stress and quality of sleep in patients with CSU (test group) and normal subjects (control group). In addition, it also aimed at assessing the correlation between the SVB and other study parameters in individuals with CSU.

Materials and Methods:

Thirty-four patients with CSU and twenty-eight age- and gender-matched healthy controls were recruited for the study. Heart rate variability (HRV), baroreflex sensitivity (BRS) and biochemical markers of stress and inflammation (s-cortisol, interleukin (IL)-6, IL-18 and high sensitivity C-reactive protein (hs-CRP)) were assessed following standard procedures. Perceived stress and sleep quality were assessed using pre-validated questionnaires. Study parameters were compared between the test and control groups using the independent-samples Student's t-test or Mann–Whitney U-test. The correlation between SVB and other study parameters was assessed using Spearman's rank correlation coefficient test. P < 0.05 was considered statistically significant.

Results:

Levels of perceived stress, inflammatory markers, mean arterial pressure (MAP), myocardial workload (rate pressure product (RPP)), and HRV indices indicative of cardiac sympathetic activity were significantly high in individuals with CSU. In contrast, BRS and HRV indices indicative of parasympathetic activity and sleep quality were significantly low in these individuals. There was no significant correlation between SVB and other study parameters.

Conclusions:

Patients with CSU have cardiac dysautonomia characterised by increased sympathetic activity and decreased parasympathetic activity. Also, the reduced BRS and increased RPP point towards an increased risk of CV morbidity in these individuals.
Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) Induced Severe Atypical Rash in a Patient of Non-Hodgkin's Lymphoma
Authors: Singh Gautam Kumar , Bhatnagar Anuj , Mitra Debdeep , Sharma Pooja , Singh Abhay , Mitra Barnali
Published: August 2024

Granulocyte-macrophage colony-stimulating factor (GM-CSF) infusion has been reported with the development of transient maculopapular rash with spontaneous resolution. A 54-year-old Indian female developed intense erythematous generalised rash involving the face, trunk, extremities, palms and soles following GM-CSF infusion. Focal exudation and purpura were seen. Infusion was stopped and she was managed with a short course of systemic steroids. As yet, the development of such an atypical, severe rash following this cytokine infusion has not been reported in the literature.
Uncommon Presentation of Leprosy
Authors: Supekar Bhagyashree B. , Soni Rajesh , Bhushan Ravi , Mukhi Jayesh I. , Singh Rajesh P. , Bhat Dharitri
Published: August 2024

Lazarine leprosy is an unusual expression of usually borderline tuberculoid (BT) form characterized by spontaneous ulceration of skin lesions. This is presumably the result of an exaggerated type 1 reaction. It commonly occurs in the BT, borderline lepromatous forms and rarely in the lepromatous forms of leprosy. We report two cases of lazarine leprosy in the BT and BT downgrading to borderline lepromatous spectrum in healthy and immunocompetent males.
Doors Syndrome
Authors: Cebeci Dua , Rıfkı Didem
Published: August 2024

DOORS syndrome is an autosomal recessive genetic neurometabolic disorder. It occurs equally in men and women. Major causes include TBC1D 24 mutations and genetic factors. Here, we discuss a 23-year-old male patient who applied to our clinic with anonychia of the toes and was diagnosed with DOORS syndrome with other accompanying clinical symptoms.
A Proposal for the Etiopathogenesis of Acquired Cold Urticaria
Authors: Çaytemel Ceyda , Türkoğlu Zafer , Ağırgöl Şenay , Ustaoğlu Eda , Demir Filiz T. , Uzuner Esen G.
Published: August 2024

Background:

The etiopathogenesis and cold stimulation mechanism are not fully understood in cold urticaria (CU). Substance P (SP) is released from skin neurons as a result of cold stimulation. It causes mast cell degranulation and therefore causes mast cell chymase (MCC) release. Angiotensin-converting enzyme (ACE) plays a role in removing SP from the environment. ACE also catalyses the conversion of angiotensin I (AT1) to angiotensin II (AT2), like MCC. This study aims to investigate the role of SP, ACE and MCC in the pathogenesis of CU.

Methods:

Patients with acquired CU were included in the study. Two punch biopsies were taken from the urticaria plaque resulting from the stimulation and the intact skin without lesions. The samples were evaluated histopathologically. All samples were stained immunohistochemically with SP, ACE and MCC antibodies.

Results:

The number of patients included in the study was 21. In the plaque lesion, the presence of dermal neutrophil and eosinophil, neutrophil in the vascular lumen were found to be statistically significantly higher than intact tissue (p = 0.046, P = 0.014, P = 0.014). Strong positive staining was detected in the full thickness of the epidermis, vascular endothelial cells, eccrine and sebaceous glands with ACE. MCC was statistically significantly higher in lesional skin than lesion-free skin samples (p < 0.001).

Conclusions:

Mast cell maintains its central role in CU pathogenesis. SP, which causes neurogenic inflammation, may not be detected due to its rapid destruction in the tissue. Strong staining of ACE, which takes part in the local renin-angiotensin-aldosterone (RAS) system in the skin, should be documented quantitatively.
Secondary Cutaneous Mucormycosis Post-COVID-19
Authors: Abhirami B , Kumar Prabhat , Mishra Dharmendra Kumar , Yadav Satyendra Prasad
Published: August 2024

Background:

Mucormycosis is an angioinvasive mucorales fungal infection. Cutaneous type formed 10.5% of cases in India in precovid-19 era. Glucocorticoid-induced immunosuppression and hyperglycemia, reusable oxygen humidifiers in COVID-19 therapy, and preexisting uncontrolled diabetes mellitus contribute to post-COVID-19 mucormycosis. However, for post-COVID-19 cutaneous mucormycosis, sufficient data is not available.

Aim:

To study factors related to post-COVID-19 cutaneous mucormycosis.

Methodology:

Clinical and investigation details of six patients admitted in tertiary center with post-COVID-19 cutaneous mucormycosis.

Results:

Among six patients, three were males and three females; all in 45–60 years age group from districts under tertiary center. Site of eschar was face (four) and lips (two). All six were positive for COVID-19 10–12 days prior to admission for mucormycosis. All had intravenous steroids and supportive humidified oxygen therapy for minimum 1 week under COVID-19 treatment. They presented to emergency with ophthalmic/ENT complaints; subsequently, they developed cutaneous manifestations within 2–3 days. All six had diabetes mellitus, with above 400 mg/dL sugar levels at admission.

Conclusion:

This study's findings correlated with various studies across the country and elsewhere. Preexisting diabetes mellitus and steroid therapy for COVID-19 increase the risk of mucormycosis. Caution for early diagnosis, maintaining blood glucose levels, and judicious use of steroids for treatment of COVID-19 are indicated.
Detection of the Safe Zone for Upper Eyelid Hyaluronic Acid Injections
Authors: Can Bilgen , BetülGözel
Published: August 2024

Background:

Hyaluronic acid (HA) injections for upper eyelid volumisation are safe procedures with short downtime and low complication rates. Nevertheless, the upper eyelid is a high-risk area for vascular complications because of its rich vascular network. After injection, bruising, an indicator of vascular penetration, develops very often and prolongs the short downtime.

Aims:

To describe a pain-controlled withdrawal technique for minimizing vascular complications and to examine the effects of topical anaesthesia administered prior to injection on complications related to vascular penetration.

Methods:

HA was injected into the upper eyelids of 25 patients using the pain-controlled withdrawal technique without topical anaesthesia. The patients’ median age, complication rates, average amount of HA administered, and follow-up periods were evaluated. In addition, the patients were asked to evaluate their pain during injection using a numerical pain rating scale.

Results:

The patients’ mean age was 40.4 ± 7.3 years. Minimal eyelid edema developed in all patients but did not prevent any of the patients’ social activities. No bruising was detected in any of the patients, and no major vascular complications, such as blindness or cerebrovascular events, developed. The average amount of HA administered was 1.43 ± 0.45 cc. All patients evaluated their pain during injection as mild.

Conclusions:

With the pain-controlled withdrawal technique, none of the patients had minor or major complications due to vascular penetration. The procedure was well tolerated by the patients. The detection of the safe injection zone allowed the administration of more than the standard/accepted 01 cc HA (up to 0.3 cc) from one point.
Newer Therapies in Dermatophytosis
Authors: Poddar Shreya , Das Anupam , Hay Roderick James , Wollina Uwe
Published: August 2024

With the advent of newer drugs and formulations, the armamentarium to combat dermatophytosis is ever-expanding. However, we must be rational and scientific when choosing the drugs. This review is an attempt to summarise the recently approved and upcoming therapeutic options for dermatophytosis.
Red Flaging Unscientific Prescriptions in Dermatophytosis
Authors: Das Anupam , Praveen Pranjal , Khurana Ananta , Sardana Kabir
Published: August 2024

Dermatophytosis has acquired an epidemic-like proportion, fuelling a wide gamut of irrational, unethical and unscientific prescriptions. The menace can be attributed to poorly regulated legislative laws controlling the approval of molecules, unscientific marketing gimmicks by the pharmaceutical industry, over-the-counter availability of drugs and lack of awareness and knowledge among the prescribing physicians. In this review, we have attempted to enlist the irrational and unethical prescription patterns for dermatophytosis.
Therapeutic Updates on the Management of Tinea Corporis or Cruris in the Era of Trichophyton Indotineae
Authors: Khurana Ananta , Sharath Savitha , Sardana Kabir , Chowdhary Anuradha , Panesar Sanjeet
Published: August 2024

The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chronic and recurrent and requires prolonged treatment. Rising resistance to terbinafine, with documented squalene epoxidase (SQLE) gene mutations, and slow clinical response to itraconazole leave clinicians with limited treatment choices. However, in these testing times, it is essential that the tenets of antifungal stewardship be followed in making therapeutic decisions, and that the existing armamentarium of antifungals be used in rationale ways to counter this extremely common cutaneous infection, while keeping the growing drug resistance among dermatophytes in check. This review provides updated evidence on the use of various systemic antifungals for dermatophytic infection of the glabrous skin, especially with respect to the emerging T. indotineae species, which is gradually becoming a worldwide concern.
A Case of Primary Cutaneous CD4+ Small/Medium T-Cell Lymphoproliferative Disorder
Authors: Hong Qingyu , Li Jiashuai , Li Fangfang , Lu Lixia , Su Juan , Chen Mingliang
Published: August 2024

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is indolent clinical behaviour and uncertain malignant potential. Histologically, these lesions show a predominance of small to medium-size CD4+ pleomorphic T-cell expressing follicular helper T-cell markers. We report the case of a 59-year-old female who presented with nodules on the left chest for 3 years. Dermatological examination showed four red nodules localized on the left chest with angiotelectasis without tenderness. The histopathological manifestation was consistent with the diagnosis of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. We focus on the clinical appearance, histopathological features, diagnosis, and differential diagnosis of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder.
Spectrum of Mucocutaneous Reactions to COVID-19 Vaccination
Authors: Sil Abheek , Jakhar Deepak , Das Anupam , Jagadeesan Soumya , Aradhya Sujala Sacchidanand
Published: August 2024

Background:

With the COVID-19 vaccination taking stride all across the globe, there are multiple reports of vaccine-induced adverse reactions (cutaneous and systemic).

Objectives:

To study the frequency and characteristics of mucocutaneous reactions to COVID-19 vaccines.

Methods:

An online questionnaire-based study was performed among the recipients of COVID-19 vaccines

Results:

Majority (73.6%) of the responders had received the Covishield vaccine (AstraZeneca-Oxford), while 26.4% had been vaccinated with Covaxin (Bharat Biotech-ICMR). One or more post-vaccination mucocutaneous effects were experienced in 87 (19.6%) participants. Vaccine-associated mucocutaneous changes were observed in 19.7% and 22.2% of individuals who received Covishield and Covaxin, respectively. Local injection site reaction was the predominant mucocutaneous finding, followed by urticarial rash, exacerbation of preexisting dermatoses, morbilliform rash, apthous ulcers, pityriasis rosea like eruption, telogen effluvium, herpes zoster, purpuric rash, erythema multiforme and others. Anaphylaxis was reported in three individuals. However, fatality was not reported in any of the vaccine recipients. Intergroup assessment of parameters with respect to type of vaccine was found to be insignificant.

Conclusion:

Majority reported mild and self-limiting reactions. This outcome should not discourage the common man in getting vaccinated.
A Retrospective Study of Demographic Profile and Management Appraisal Non-Gonococcal Urethritis in Male Patients Attending a Tertiary Care Hospital in Odisha
Authors: Dwari Binayak Chandra , Patro Nibedita , Bhatt Mamata , Tripathy Nalini
Published: August 2024

Background:

Male urethritis is primarily sexually transmitted in India and has also shown a high rate. Urethritis or inflammation of the urethra is a multifactorial condition. It is called gonococcal urethritis (GU) when Neisseria gonorrhoeae is detected in a urethral smear of the patient and non-gonococcal urethritis (NGU) when this organism cannot be visualized.

Aims and Objectives:

To study the demographic profile and management pattern of NGU retrospectively in male patients.

Materials and Methods:

Urethritis cases were identified from the dermatology outpatient record. A retrospective study of data of patients diagnosed with NGU was done for 5 years from August 2015 to July 2020. We included only male patients more than 10 years of age.

Results:

Chlamydia trachomatis (CT, 48%) was the most common causative organism found. The diagnosis was confirmed by demonstrating ≥5 polymorphonuclear lymphocytes (PMNLs) from the anterior urethra using a Gram-stained urethral smear followed by the polymerase chain reaction (PCR.) of urine. The most common age group affected was 21

–

30, (30, 46%) years with a mean ± standard deviation (SD) of 30.32 ± 10.80. Most patients were from low socioeconomic status, labourers (36, 55%). A history of heterosexual behaviour, (57, 88%) was the most common and it had been seen that sexual exposure was more common in unmarried patients (38, 59%). Associated features were seen in 18 patients. Among recommended initial therapies for NGU, doxycycline and azithromycin might be improved by the addition of antimicrobial coverage for Trichomonas vaginalis (T. vaginalis). Further, it was seen that response to doxycycline therapy was better than azithromycin.

Conclusions:

Though there is an increased incidence of Herpes infections, we found Chlamydia infection to be the most common cause of NGU. Doxycycline showed better results in NGU due to Chlamydia infection.
Serum Leptin and Adiponectin
Authors: Yan Haoxiang , Yu Bei , Tian Jinlan , Xia Dengmei , Xu Yang , Li Changqiang
Published: August 2024

Background:

To explore the role and clinical significance of serum adiponectin and leptin levels in patients with psoriasis accompanied by atherosclerosis.

Methods:

Eighty patients diagnosed with psoriasis in our dermatology department and 40 healthy people in our physical examination centre were included as the study group and control group, respectively. All the included patients underwent fasting blood and serum tests. Levels of adiponectin, leptin, and the blood lipid content; colour Doppler ultrasonography of both common carotid arteries, internal carotid and external carotid arteries; and intimal-medial thickness (IMT) and carotid plaque were evaluated.

Results:

In the study group, the leptin level increased, and the serum adiponectin level decreased; these levels were statistically significantly different compared with those in the control group (t = 6.774, P < 0.001 and t = –3.511, P < 0.05, respectively). IMT was negatively correlated with adiponectin levels (r = –0.378, P < 0.001) and positively correlated with leptin levels (r = 0.581, P < 0.001).

Conclusions:

The imbalanced expression of serum and adiponectin levels will aggravate psoriasis and promote the occurrence of atherosclerosis. Serum levels can be used to assess the disease severity, detect vascular lesions early, and prevent the development of psoriasis to cardiovascular disease.
Anal Canal Condyloma Acuminatum Treated with Anti-HPV Biological Dressing
Authors: Hu Yanyan , Li Meihua , Liu Jing , Huang Qian , Chen Jinbo , Chen Liuqing , Li Dongsheng
Published: August 2024

Background:

Anal canal condyloma acuminatum (CA) is a refractory disease with a high recurrence rate caused by human papillomavirus (HPV). Multiple clinical trials demonstrate that anti-HPV biological dressing is safe and effective in treating HPV infection, which has been used in treating high-risk HPV-positive and cervical intraepithelial neoplasia I (CIN I) patients. Yet, there is still a lack of clinical data for the treatment of anal canal CA.

Aims and Objectives:

To evaluate the clinical efficacy and application value of anti-HPV biological dressing in anal canal CA.

Materials and Methods:

Taken currently recommended treatment 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) as a positive control, 128 patients were included with 64 in each group, and a prospective, randomized, positive controlled, non-inferiority clinical trial was conducted. After removing visible skin lesions with conventional microwave, the treatment group was given anti-HPV biological dressing, while the control group received the conventional ALA-PDT treatment. Patients were followed up on the 1st, 12th and 24th weeks after the treatment. The cure rate, recurrence rate, HPV-negative conversion rate, and adverse events were recorded.

Results:

In the 1st, 12th and 24th weeks after treatment, the cure rate, recurrence rate and HPV-negative conversion rate of the treatment group and the control group showed no statistically significant difference. In the treatment group, 56 patients developed transient mild itching and all were relieved spontaneously, while in the control group, most of the patients experienced obvious pain and some patients needed symptomatic treatment. No severe systemic adverse events were observed.

Conclusion:

Compared with ALA-PDT, topical application of anti-HPV biological dressing has comparable promising outcomes in the treatment of anal canal CA, with fewer side effects and simpler operation making it suitable for clinical applications.
Analysis of Serum Immunoglobulin G (IgG) Levels against Toxoplasma Gondii, Herpes Simplex Virus Types 1 and 2, Cytomegalovirus and Hepatitis C Virus in Vitiligo
Authors: Ribeiro Rachel de Paula , Lacerda Kenia A. P. , Guillo Lídia A.
Published: August 2024

Background:

Pathogen infections have been associated with autoimmunity, which in turn has been implicated in the pathogenesis of vitiligo. However, the association between pathogen infections and vitiligo remains elusive.

Aims:

This study aimed to assess the proportion of individuals who tested positive for specific IgG antibodies against selected pathogens in patients with vitiligo and control subjects.

Materials and Methods:

Plasma from 51 patients with vitiligo and 51 age- and gender-matched controls were tested for anti-Toxoplasma gondii (T. gondii) IgG, anti-herpes simplex types 1 and 2 (HSV-1/2) IgG, anti-cytomegalovirus (CMV) IgG and anti-hepatitis C virus IgG.

Results:

Among all participants (n = 102), 63%, 84% and 87% tested positive for anti-T. gondii, anti-HSV-1/2 and anti-CMV IgG antibodies, respectively. Anti-hepatitis C virus IgG was negative in all samples tested. Positive anti-T. gondii IgG was detected in plasma samples of 39 (78%) patients with vitiligo and 25 (49%) controls (odds ratio [OR] 3.68, 95% confidence interval [CI] 1.55–8.76, P = 0.0036). Anti-HSV-1/2 IgG was detected in samples of 47 (92%) patients with vitiligo and 38 (76%) controls (OR 3.71, 95% CI 1.11–12.44, P = 0.031). Differences in frequencies of positive results for anti-T. gondii IgG and anti-HSV-1/2 IgG were only significant in samples from female patients with vitiligo when compared with controls (P = 0.036 and 0.024, respectively). Anti-CMV IgG was detected in samples from 46 patients with vitiligo (90%) and 41 (84%) controls (P = 0.384).

Conclusions:

T. gondii IgG and HSV-1/2 IgG were significantly more frequent in patients with vitiligo, especially in women, when compared with age- and gender-matched controls. Since T. gondii and HSV-1/2 infections can trigger autoimmune events, past exposure to these pathogens may be a risk factor for the development of vitiligo.
Dietary Factors Associated with Multiple Sclerosis Risk in Kuwait
Authors: Al-Temaimi Rabeah Abbas , Alroughani Raed
Published: August 2024

Context:

Multiple sclerosis (MS) is a complex disorder of the central nervous system in which gene–environment interactions result in autoimmune targeting of neuronal myelin. In Kuwait, the rapid increase in MS prevalence is in tandem with evident changes in diet and lifestyle habits.

Aim:

To assess dietary and lifestyle habits of 128 MS patient during their preadult years in comparison to 211 Kuwaiti healthy controls.

Methods:

A questionnaire inclusive of demographics, lifestyle, and dietary habits in preadult years was administered to MS patients and healthy controls.

Results:

We found an increased risk of MS in the Kuwaiti adult life is associated with a positive family history and poor preadult dietary habits inclusive of low fresh fruit and vegetable consumption and increased processed food intake. Whereas, passive smoking, preadult weekly physical activity, adolescence milk and fish consumption, and childhood prepacked snacks consumption did not differ between MS and healthy controls.

Conclusion:

Sudden shifts in dietary habits of the Kuwaiti population in the past two decades have contributed to the increased prevalence of MS in Kuwait. Current management recommendations of MS disease should consider the inclusion of a plant-based, minimally processed dietary regimen in conjunction with MS disease modifying treatments.
Association Between Nutritional Status and Neutrophil Lymphocyte Ratio in Patients with Lung Cancer at Persahabatan Hospital, Indonesia
Authors: Anissa Lidya , Wulandari Yohannessa , Nurwidya Fariz
Published: August 2024

Context:

Systemic inflammation in patients with lung cancer can be seen by the increase of neutrophil lymphocyte ratio (NLR) where these examinations are common in hospitals. Systemic inflammation can cause anorexia resulting in decreased nutrition intake of patients with lung cancer and affecting their nutritional status. One of the diagnostics of nutritional status for patients with lung cancer is using the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria that consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be diagnosed if there are two of the six criteria.

Aims:

The study aims to determine the relationship between nutritional status and NLR in patients with lung cancer at Persahabatan Hospital in East Jakarta, Indonesia.

Settings and Design:

This cross-sectional study included 52 patients with lung cancer in oncology outpatient clinic of Persahabatan Hospital.

Methods and Material:

Data of characteristics subject were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology outpatient clinic of Persahabatan Hospital. Statistical analysis used chi-square or Fisher exact test to assess relationship between nutritional status and NLR (P < 0.05).

Results:

Based on nutrient intake, more than 50% of the subjects had low energy and protein intake. Based on patient generated subjective global assessment, 38.5% of subjects were at risk of malnutrition or moderate malnutrition, while 67.3% of them were malnutrition based on ASPEN. There was no statistically significant association between nutritional status and NLR (P = 0.35).

Conclusions:

There was no association between nutritional status and NLR, and so further research with larger samples is needed.
Insight on Synsepalum dulcificum
Authors: Doddawad Vidya G , Shivananda S , Vidya C S , Madhu B , Gurupadayya B M
Published: August 2024

The miracle fruit plant or miracle berry plant (Synsepalum dulcificum or Richadelladulcifica) is a unique medicinal plant with characteristics of taste-modifying function due to the presence of the glycoprotein miraculin. It also has high antioxidant effect. Alkaloids, vitamins, vegetable oil, phenolic acids, flavonoids, and amino acids are among the biologically active components found in the fruit. This fruit is not much known in all places of the world, so it will be used to treat a variety of medical conditions. Pharmacological medicine has proven that not only the fruit but also the other parts of the plant are helpful, based on their phytochemical properties. This fruit can be used in the baking food items, drinks, cosmetics, medicines, and coloring agents. In this article, we (authors) intend to describe on cultivation, phytochemistry, mechanism of action, extraction, purification, and preservation of fruit, as well as its nutritional and pharmacological benefits, applications in numerous fields, limitations, and future prospects. It is hard to believe that this berry is still unexplored for its use in medical area.
A Correlational Study on Depression and Quality of Life Among Older Persons
Authors: Vijayalakshmi R. , Thirunavukarasu M.
Published: August 2024

Background:

Globally, the population of older persons is increasing rapidly. Research evidences suggest that depression is a major mental health problem among older persons. Healthy ageing practices reduce the undesirable effects of ageing. It promotes good quality of life (QOL) among older persons and reduces the risk of depression among them.

Objectives:

To assess depression and QOL among older persons; and to correlate depression and QOL among older persons.

Materials and Methods:

A cross-sectional study design was used to assess the prevalence of depression and QOL among older persons aged ≥60 years. This study was conducted in NH 1, NH 2, and NH 3 villages covered under Community Medicine Department, SRM MCH at Chengalpattu district, Tamil Nadu. Yesavage Geriatric Depression Scale was used to assess depression and WHO Quality of Life-BREF scale was used to assess QOL among older persons. A structured face-to-face interview was carried out to collect the data after getting the consent from 600 older persons.

Results:

This study findings convey that 64.6% of the older persons are having various levels of depression ranging from mild and moderate to severe. Highly significant negative correlation (R = −0.424) between depression and QOL of respondents is observed in this study. This implies that the older persons with good QOL have low levels of depression and older persons with poor QOL have higher levels of depression.

Conclusion:

The prevalence of depression among older persons is considerably higher and the QOL is a major contributing factor. Creating public awareness on measures to overcome depression and improve QOL is a vital area to be strengthened by the health team members.
Formulation and Standardization of Siddha Pediatric Tablet dosage
Authors: Ramulu Shree Devi Munusamy Sampangi , Sathiyarajeswaran Parameswaran , Narayanan Kirubakaran , Vinayak Soman , Ganesan Kiruthiga , Kanakavalli Kadarkarai
Published: August 2024

Herbal remedies have grown at an exponential rate since ancient times. Traditional medicines require newer standardization, manufacturing, quality control, and scientifically rigorous research to meet standardization. Bala Sanjeevi Mathirai (BSM) is a Siddha pediatric tablet formulation used for the treatment of cough, fever, vomiting, biliousness, and diarrhoea occurring in children due to dyspepsia. This work was purposed to formulate and standardize BSM as per the guidelines set forth by the regulatory authorities (PLIM). Three validation batches of the formulation were prepared. Tablets were standardized by different physiochemical parameters and evaluated by various studies such as precompression and post compression parameters. All parameters were passed with reference to the standard limits. The set parameters were sufficient to evaluate the tablet and further this could be used as reference standards for the quality control/quality assurance laboratory of the pharmaceutical house.
Nutritional Composition and Sensory Evaluation of Phytoestrogen-Rich Supplement for Women with PCOS
Authors: Gayathri K. , Supriya V. , Palaniappan N.
Published: August 2024

Background:

Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive-aged women affecting up to 15% of the population and exhibiting ovulatory dysfunction, hyperandrogenism, obesity, and insulin resistance. Phytochemical like phytoestrogen helps alleviate the symptoms of PCOS without any adverse effects such as improvement in ovulation and regulation of blood glucose. Therefore, this study has developed a supplement enriched with phytoestrogen.

Aim:

The study was aimed at developing a phytoestrogen-rich supplement.

Methods:

The supplement was prepared under proper hygienic conditions. Organoleptic evaluation was done by a group of panel members. Microbial activity and nutrient composition were analyzed by standard methods such as mass spectrometry and high-performance liquid chromatography. Statistical analysis was done by Statistical Package for the Social Sciences (SPSS) software version 21.

Result:

The formulated supplement was statistically significant (P < 0.05). The microbial analysis showed that it was microbe free at the end of 30 days. The nutrient analysis concluded that phytoestrogens such as polyphenols and flavonoids, omega-3 fatty acid, irons, and fiber were present in adequate amounts.

Conclusion:

The present study revealed that the developed supplement is found to be rich in phytoestrogens and it can be effective for the treatment of PCOS.
Pattern and Correlates of Physical Activity Among Nurses from Tertiary Care Hospital
Authors: Da Silva Danica , Patil Supriya S , Durgawale Prakash M , Patil Satish R
Published: August 2024

Background:

Physical inactivity is considered as one of the important modifiable risk factor for noncommunicable diseases. Nurses play an important role in the healthcare system. Long working hours could be stressful physically and psychologically demanding patient care. Considering these, the purpose of this study is to evaluate the pattern and correlates of physical activity among nurses.

Methods:

A cross-sectional study was conducted among 125 nurses working in Krishna Hospital and Medical Research Center, Karad. Practice of physical activity was collected using Global Physical Activity Questionnaire (GPAQ) which measured the physical activity in metabolic equivalent hours per week. Statistical analysis was carried out using SPSS version 20.

Results:

Total 125 nurses participated in the study out of which 119 (95.2%) were females and six (4.8%) were males. Moderate level of physical activity was seen in 77.6% of participants, 16.0% showed low level of physical activity, and vigorous levels of physical activity were seen in 6.4% of participants. A statistically significant association was observed between physical activity and age.

Conclusion:

Majority of nurses were involved in moderate-intensity physical activity. Age appeared to be a determining factor for participation in physical activity.