bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraocular metallic foreign body ultrasound and computed tomography imaging
Authors: Singh Rohan K , Phatak Suresh V , Vaidya Shirish V , Mishra Gaurav V , Patwa Prerna A
Published: May 2024

Orbital foreign bodies are still serious diagnostic problem even after the development of diagnostic imaging techniques. We present an interesting case report of a 42-year-old man who presented with a history of sudden loss of vision after sustaining injury to the left eye due to metallic piece while working. Grayscale ultrasound and computed tomography findings are discussed.
Unraveling the Significance of Immune Contexture in Oral Cancer
Authors: Sharma Deepti , Koshy George , Sharma Vishal Kumar , Malik Gauri
Published: May 2024

Numerous epidemiological and molecular biological studies have shown that inflammatory cells and cytokines in the tissues that surround tumors contribute to tumor development and progression. The immune response to tumors is complex, involves the interaction of several cell types of the adaptive and the innate immune systems, and has an important role in the progression of a variety of solid tumors. Tumor-infiltrating lymphocytes (TILs) have been studied as an indicator of tumor inflammation, and it has been reported that TIL subsets have their own roles in cancer progression. The differences in T-cell repertoire in different stages of cancer influence the prognostic and predictive response of the patient. Several studies have reported that CD3+ and CD8 + TILs are associated with good clinical prognosis in different cancer types including head-and-neck cancer, although contradictory reports are available regarding the role of CD4+ T-cells and + regulatory T-cells (Treg cells; forkhead box protein 3 [FOXP3] cells). This review is an attempt to elucidate the concept of immune infiltrate in oral squamous cell carcinoma to comprehend the role of immunoscore as an adjunct to tumor, node, metastasis staging to guide patient treatment. Immunoscore could provide an excellent setting for immunotherapeutic strategies to complement current standard chemoradiation and may benefit high-risk patients. We emphasize the need to standardize methodology, scoring criterias and also to develop validated cutoff values. Tumor aggressiveness and therapy resistance are influenced by the interplay between tumor cells and their microenvironment, only a better understanding of this will permit a rational design of new immunotherapeutic approaches.
Gastric Ultrasonography in Assessment and Quantification of Gastric Contents in Fasting Diabetic and Nondiabetic Patients
Authors: D’Cunha Delma , Balakrishna Achar Padubidri S , Gurumurthy T , Acharya Manasa
Published: May 2024

Context:

Gastric ultrasound is an emerging point-of-care diagnostic tool to examine stomach contents and determine pulmonary aspiration risk at the bedside. This is helpful in guiding airway and/or anesthetic management in the acute care setting, when nil per oral (NPO) status is doubtful or unknown or patient has conditions or comorbidities that affect gastric emptying.

Aims:

The objectives of the study were to evaluate and quantify the gastric contents and grade the fullness of the stomach in fasting patients.

Settings and Design:

This was a prospective, observational, hospital-based, analytical study conducted on surgical patients who presented for elective surgeries who were fasted for 8 hours for solids and 6 hours for clear liquids.

Materials and Methods:

Adult patients aged between 18 and 70 years of American Society of Anesthesiology physical status 1–3 were included in the study. Gastric ultrasonography was performed, and gastric volume was calculated. Data were entered in Microsoft Excel 2007 and analyzed using the SPSS software version 22.0.

Results:

Our study included a total of 80 participants. The mean age in diabetic group was 49.3 ± 16.4 years and in the nondiabetic group 49.4 ± 16.8 years. Despite fasting status, 75% of the participants were found to have Grade 1 (up to 100 ml) gastric contents on ultrasonography. The data were found to be statistically significant with P < 0.05. There was no significant correlation of age and ultrasonography findings. However, body mass index of the patient was found to have strong correlation with gastric content and its volume (P < 0.0001).

Conclusion:

In the current practice, NPO status, especially for emergency cases is elicited through history which is unreliable and in individuals at higher risk for delayed gastric emptying this may pose greater threat for aspiration. Using gastric ultrasonography as a screening tool before planning, the anesthetic induction and technique can help avoid unnecessary perioperative complications.
Recurrent and disseminated abdominal Echinococcosis in unusual locations
Authors: Gunasekaran Gautham , Paramasivam Surendran , Anand Sundeep , Sidarth Gautham Radhakrishnan
Published: May 2024

Hydatid disease is an immense health problem in developing countries. The most frequently involved organ is the liver. Hereby we present an interesting case of 47-year-old man with recurrent and disseminated abdominal Echinococcosis in unusual locations.
Superolateral Dislocation of Mandibular Condyle Associated with Parasymphysis Fracture
Authors: Faraz Amber Ali , Fatima Asmat , Faraz Samar Ali
Published: May 2024

Superolateral dislocation of intact mandibular condyle is a rare clinical condition due to trauma of the mandible. We report the case of a 31-year-old male patient presenting with superolateral dislocation of the mandibular condyle and an associated parasymphyseal fracture following traumatic insult to the mandible in a road traffic accident.
Twin Pregnancy with Intrauterine Fetal Demise
Authors: Patvekar Meenal , Suryarao Prashant , Khumujam Princy Panthoi , Laxmi Kale Dhana , Sree K Divya
Published: May 2024

Multiple gestations are very commonly associated with higher rates of every complication of pregnancy with the exception of postterm pregnancy and macrosomia. It, therefore, increases the risk of perinatal morbidity and mortality as compared with singleton pregnancies. Fetal loss in twin gestation involves the various factors and is an unfortunate event, which is uncommon. The incidence of single fetal death in twin gestation is 2.5%–5.0% as compared to 0.3%–0.6% in singleton pregnancy. The presence of death twin in rare occasions creates a hostile environment for the surviving twin. This may lead to most feared complication like disseminated intravascular complication, which is fatal to both the mother and the surviving twin. Hence, the early detection of fetal demise in multiple gestations is important as they carry all potential obstetric complications.
Assessment of Knowledge, Attitude, and Practices (KAP) on Menstrual Hygiene among Adolescent Girls Residing in Govt. Social Welfare Hostels
Authors: Nagoor Khadervali , Babu Surendra , Raziya Dudekula
Published: May 2024

Background:

Adolescent girls, in particular, should be encouraged toward practicing hygienic methods during menstruation like usage of sanitary pads and they should get access to clean sanitary products to safeguard their health

Objectives:

The aim of this study was to assess the level of knowledge, attitude, and practices of menstrual hygiene among the adolescent girls in social welfare hostels and their morbidity pattern during menstruation.

Materials and Methods:

A cross-sectional study was done among adolescent girls (11–19 years) residing in the government social welfare hostels, Chittoor. The study was started after obtaining the clearance from the institutation ethical committee. A predesigned, pretested, semistructured questionnaire was used and the data were expressed in proportions and frequencies, and appropriate statistical tests were done to see the association with the age category and morbidity profile.

Results:

A total of 200 were participated amongst them early adolescent age group (10–14 years) 68 and late adolescent age group (15–19 years) of 132 were involved. Majority of them (82 [41.0%]) reported menstruation as a physiological process, 57 (28.5%) as pathological process, 48 (24.0%) as curse of God, and very few did not know the reason. The source of information was the mother 73 (36.5%), sisters 72 (36.0%), and friends, respectively. More than three-fourth (155 [77.5%]) of the students were absent from the classes during menstruation and 45 (22.5%) students attended the classes regularly. Approximately 172 (86%) of the students had restrictions and the remaining 28 (14%) did not have any restrictions during menstruation. Treatment seeking during menstruation as home remedy was 48 (24.0%), consulting doctor was 64 (32.0), and 88 (44.0%) were not seeking any treatment during menstruation. The association between menstrual morbidities and age-wise distribution is found to be highly significant with χ2 = 39.04 and P < 0.001

Conclusions:

The adolescent school girls had good knowledge and good practices regarding menstrual health among those who had attained menarche. Mothers were the primary source of information and education about menstruation and restrictions should be intensified.
Megaloblastic Anemia
Authors: Khajuria Atul , Sehrawat Raju
Published: May 2024

Megaloblastic anemia is a kind of anemia, which is triggered by means of inhibition of DNA synthesis at some point of erythropoiesis. The most frequent motive of defects in red blood cell DNA synthesis is vitamin deficiency, especially vitamin B12 deficiency or folic acid deficiency. Micronutrient loss can additionally be a cause. Moderate deficiency can consist of swollen tongue and neurological problems, inclusive of peculiar sensations such as a tingling sensation, whereas severe deficiency can encompass reduced coronary heart feature and greater serious neurological issues
Clinicopathological Spectrum of Testicular and Paratesticular Lesions
Authors: Jaiswal Shruti , Jaiswal Swapnil
Published: May 2024

Background:

Both neoplastic and non neoplastic conditions affect the testis. Although non neoplastic testicular lesions are more common, still most of the published studies are done on testicular neoplasms only. Hence the present study was undertaken to study histopathological spectrum of testicular and paratesticular lesions, their age distribution and clinical presentation.

Materials and Methods:

This is a retrospective study of 77 cases of orchidectomy specimens, testicular biopsies and paratesticular lesions received in the department of Pathology.

Results:

Non neoplastic testicular lesions were more common than neoplastic (90.1% Vs 9.8%) with majority in the second and third decade. Undescended testis comprised 46.1% of the total orchidectomy specimens followed by Torsion/Infarction testis (15.3%). None of the undescended testis showed tumour deposits unlike western countries. Majority of patients presented with empty scrotum (31.16%) and testicular/scrotal swelling (18.11%). Only 5 cases of testicular neoplasm were diagnosed during the study period amounting to only 1.42 cases per year. All were germ cell tumours (4 classic seminoma and 1 yolk sac tumour).

Conclusions:

Non neoplastic testicular lesions were more common than neoplastic lesions. Complete neonatal examination for testicular descent should be mandatory to avoid late presentations and future malignancies. Germ cell tumours formed the bulk of testicular tumours.
Depression Among Tuberculosis Patients and its Socio-Demographic Correlates: A Cross-Sectional Study from Western Maharashtra
Authors: Kapoor Suraj , Faujdar Dharamjeet S , Garg Uma S , Dhawan Rakhi
Published: May 2024

Introduction:

Tuberculosis being a public health challenge has mental illness as a significant, hidden challenge. Tuberculosis-related perceived stigma and social support remain poorly understood in the developing world and the data on the assessment of perceived stigma and social support remain scarce. The present study was conducted to estimate the prevalence of depression in tuberculosis and its association with social support and perceived stigma.

Materials and Methods:

A cross-sectional analytical study was conducted at the Directly Observed Treatment Short course (DOTS) center in the government medical college of Western Maharashtra. Pretested and prevalidated questionnaires were used for data collection with face-to-face interviews carried out among study participants.

Results:

Overall, the prevalence of depression including mild mood disturbances was 26/160 (16.25%). Among various socio-demographic correlates, we found a significant association (P = 0.001) of marital status with depression in tuberculosis. it was found that there was a significant association between perceived stigma with depression (P = 0.001). The odds of depression among participants with perceived stigma was 15.24 times more (OR = 15.24) in comparison to the odds of depression in participants with no perceived stigma. Similarly, it was found that there was a significant association between poor social support with depression (P = 0.02). The odds of depression in participants with good social support were 72% lesser (OR = 0.28) than the odds of depression among participants with poor social support.

Conclusion:

In conclusion, this study highlights that depression is highly prevalent among patients with tuberculosis. Depression among tuberculosis patients was significantly associated with poor social support and perceived stigma. Thus, to improve tuberculosis treatment adherence, a patient-centric approach should be considered at the programmatic level with social support and awareness generation and other measures to mitigate stigma as its key components.
Assessment of Knowledge–Attitude–Practice Towards COVID-19 among Population Visiting the Endocrinology Department in a Tertiary Care Center in south India
Authors: Acharya Himamshu , Maddukuri Hanumantha R. , Kalra Pramila , Dharmalingam Mala
Published: May 2024

Background:

Novel corona-virus disease (COVID-19) has rapidly spread worldwide since its origin in late 2019 in the Wuhan province of China. Knowledge about the disease or lack thereof determines the success of containment of the virus. Individuals with chronic noncommunicable diseases are at a higher risk of complications of COVID-19.

Materials and Methods:

This cross-sectional survey was conducted to assess the knowledge, attitude, and practices of patients and the people accompanying the patients visiting the Endocrinology out patient department of a tertiary care hospital in south India. A questionnaire that included questions pertaining to knowledge, attitude, and practices regarding COVID-19 was administered. The COVID-19 knowledge questionnaire had 12 questions: four regarding clinical presentations, three regarding transmission routes, and five regarding the prevention and control of COVID-19.

Results:

Data of 268 individuals were analyzed. The mean knowledge score was 8.43 out of 12. Education was the significant factor that determined knowledge score. The majority agreed that COVID-19 will be controlled (69%) and were hopeful about India winning the battle against COVID-19 (70.5%), 82.1% were avoiding crowded places, and 77.6% were wearing a mask when leaving the house. Caregivers had better knowledge scores as compared with patients.

Conclusions:

The majority of the individuals attending the Endocrinology clinic had good knowledge about COVID-19. The level of education played an important role in determining the level of knowledge.
Study of fine needle aspiration cytology of salivary gland according to the Milan system
Authors: Parmar Riddhi A , Patel Jaimin M , Patel Keval A
Published: May 2024

Background:

Fine-needle aspiration cytology (FNAC) of salivary gland lesions is the initial screening test. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) classifies FNAC into six categories, which is a simple, convenient and standardized diagnostic method of reporting and also provides management guidelines. The study was encountered in our tertiary care hospital.

Aims and Objectives:

To study the cytology of salivary gland lesions by Fine Needle Aspiration Cytology and to classify lesions according to The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).

Materials and Methods:

This is a prospective study of 100 patients with clinically enlarged salivary gland presented at the G.K. General Hospital, Bhuj, during April 2019 to March 2020.

Results:

Of 100 cases, 40 cases were nonneoplastic, 52 cases were neoplastic, and 8 cases were unsatisfactory for evaluation. The category II had 40 cases, out of which chronic sialadenitis was the most common cytological diagnosis (20 cases). There were two case in each category IVb and category V. Category IV had 41 cases on cytology. Category VI had eight cases.

Conclusions:

It is of particular relevance in the head and neck area because of easy accessibility of the target site minimally invasive procedure, excellent patient compliance and thereby help to avoid surgery in nonneoplastic, inflammatory conditions.
Antrochoanal polyp among children: A review
Authors: Swain Santosh Kumar
Published: May 2024

Antrochoanal polyp (ACP) or Killian polyp originates from the inflamed and edematous mucosa of the maxillary sinus. The etiopathogenesis of the ACPs is not clear. It has two components such as antral one which is always cystic and the nasal part is solid. The expanded intramural cyst enlarges to the point that it completely occupies the maxillary sinus, emerging through the natural ostium into the nasal cavity and extending towards the choana. The common clinical presentations are nasal obstruction and nasal discharge. Diagnostic nasal endoscopy, computed tomography (CT) scan, and magnetic resonance imaging (MRI)are needed for making the diagnosis and the treatment planning. Surgery is indicated for the treatment of ACP. The endoscopic technique consists of an uncinectomy and resection of the polyp and its attachment to the maxillary sinus via a wide middle meatal antrostomy. Endoscopic sinus surgery via middle meatal antrostomy combined with trans-canine sinuscopy ensures the complete removal of the antral part of the ACP in children. The use of a microdebrider through the canine fossa is helpful to resect a broad attachment of the ACP in the maxillary sinus and it may be indicated as complementary to endoscopic sinus surgery. Simple avulsion of the ACP has a high chance of recurrence, whereas the Caldwell Luc procedure is associated with damage to the maxillary and dental growth centers. More research is needed for establishing the exact etiopathology and newer treatment options for ACPs.
Post-Viral Polyarthritis
Authors: Arulekar Rutuja , Shinde Sandeep Babasaheb
Published: May 2024

Background:

Viral infection is the infection caused by a virus in the human body. The immune response to a virus infection is attacking the body’s own cells. This causes stress and inflammation of tissues in the body and damage to the cells. Polyarthritis is one of the most common complications caused by viral infection. Post viral polyarthritis mainly affects the large joint such as the knee, but can affect several joints such as ankle, wrist. The full recovery time is still not sure, some studies have shown that it usually takes six weeks or it can even last for months or years.

Case Description:

A 15-year-old male complains of fever with dry cough for 2 days followed by Multiple joint pain and soft tissue pain since 2 months. Swelling was also noticed in both wrist and knee for a week. For assessment outcome measures like VAS, MMT, ROM were taken prior to the treatment. Patient underwent a 4 weeks physiotherapy rehab program and showed marked improvement in the pain, range of motion, muscle strength and functional activities.

Result:

When the post-assessment was done, patient showed significant improvement in the pain relief, showed improvement in range of motion of the joints, increase in the muscle strength and noticeable improvement in functional capacity.

Conclusion:

This concluded that starting physiotherapy management in the sub-acute stage of the condition is effective in reducing pain increasing mobility and increasing the strength and endurance.
To evaluate the hematological markers in patients having nutritional anemia attending National Institute of Medical Sciences Hospital of Jaipur, Rajasthan
Authors: Khajuria Atul , Rajput Vipul Kumar , Sehrawat Raju
Published: May 2024

Background:

Nutritional anemia is the most common preventable cause of anemia. Anemia of nutritional origin is an acquired problem caused by consumption of diets that lack sufficient quantity of vitamin B12 levels and serum iron and other components. As per World Health Organization guidelines, hemoglobin (Hb) of <10 g/dL concentration treated as anemia. Nutritional anemia is identified by determining Hb concentrations, evaluating red cell indices and examining peripheral blood picture accompanying serum iron parameters and serum vitamin B12 level.

Objectives:

To study complete blood count indices with different serum vitamin B12 levels and serum iron profile among nutritional anemia patients attending NIMS Hospital, Jaipur.

Materials and Methods:

An observation study was conducted among 274 patients having nutritional anemia from General medicine out patients between 15 and 60 years. Two blood samples were collected from each participant to estimate the complete blood counts and red blood cells (RBCs) morphology and to analyze the iron profile and vitamin B12.

Results:

This presence study shows nutritional anemia in 55% of women than men. 15.6% of patients were from age group 15–20 years. 56.57% patients had moderate anemia, 29.92% patients had severe anemia, and 13.56% patients had mild anemia. Study shows 55% population were nonvegetarians and 45% had vegetarian diet. Microcytic hypochromic blood picture was found in 59.49% patients.

Conclusions:

Nutritional deficiency anemia was the most prevalent anemia. Peripheral smear is in concordance with serum iron parameters and serum vitamin B12 level. Our study suggests RBC morphology along with red cell indices in diagnosis and management of nutritional anemia which can be cured by dietary adjustment and fortification of food with iron and other micronutrients.
Prevalence of megaloblastic anemia in patients at NIMS Hospital, Jaipur, Rajasthan
Authors: Khajuria Atul , Das Rakesh , Sehrawat Raju , Verma Mahendra K
Published: May 2024

Background:

Anemia is defined operationally as a reduction in the hemoglobin content of blood that can be caused by a decrease in red blood corpuscles, hemoglobin, and hematocrit below the reference interval for healthy individuals of similar age, sex, and race under similar environmental conditions. Megaloblastic anemia is a condition, in which the bone marrow produces unusually large, structurally abnormal, and immature red blood cell. World Health Organization identifies anemia as the most common nutritional deficiency disorder in the world and a serious health concern among pregnant women. The 2011 estimates suggest that anemia affects around 800 million children and women all over the world, including 273 million children, 496 million non-pregnant women, and 32 million pregnant women.

Objective:

To determine the prevalence of megaloblastic anemia in patients at NIMS Hospital, Jaipur, Rajasthan, India.

Materials and Methods:

Blood was collected and investigations are done on Elite 580.

Results:

Male patients were more likely than female individuals to have megaloblastic anemia. Only 62 patients were female, with 210 patients being men. Male patients made up 77.21% of the prevalence, while female patients made up 22.79%. Megaloblastic anemia is more common in people between the ages of 41 and 50, both in male and female patients. Between the ages of 41 and 50, there were 144 male patients and 35 female patients overall. According to their ages, the prevalence of mean ± standard deviation was 43.5 ± 15.6 years for male patients and 41.32 ± 6.53 years for female patients. Male patients with megaloblastic anemia had an average hemoglobin concentration of 9.990.94 g/dL, whereas female patients had one of 9.970.87 g/dL.

Conclusion:

Government of Rajasthan as well as Health Ministry of India should take appropriate action to control the megaloblastic anemia in patient. Megaloblastic anemia is a common anemia found in the rural parts of Jaipur. The present study helps physicians to take necessary steps to control it. Not only for physicians, it will also be helpful for the government authorities to take appropriate steps to prevent and control the megaloblastic anemia. Iron and vitamin B12 supplements should be given to the patients on right time to control megaloblastic anemia. A balanced diet should be taken to prevent it. Government should take steps to educate the peoples of Rajasthan by displaying posters, conducting educational dramas, etc., both in rural and in the urban parts of this state.
Microscope in Periodontics
Authors: Mukherjee Suman , Dasgupta Sharmistha
Published: May 2024

The microscope has been one of the oldest yet most exquisite inventions in human history. The lenses changed the future of medical science and its abstraction forever. Previously, humans never know much about the source of disease, but today, we know that the universe of microbes is vaster and more limitless than it ever was. However, the microscope is not just limited to laboratory in vitro research and study, it has remodeled dentistry more today than ever. This article describes the various types of microscope used in periodontics, endodontics, and oral pathology in dentistry.
Relationship between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peripheral blood and prognosis after castration therapy for prostate cancer
Authors: Wu Hao , Gong Mancheng , Yuan Runqiang
Published: May 2024

Background:

The relationship between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peripheral blood and prognosis after castration therapy for prostate cancer remains unclear.

Methods:

A total of 186 patients with prostate cancer treated between January 2018 and March 2021 were selected as the study subjects. All patients underwent castration therapy. Patient follow-up records for 2 years were examined to assess progression-free survival. NLR, PLR, and PSA levels were measured in the participants’ blood. Logistic regression analysis was used to identify factors affecting the occurrence of castration-resistant prostate cancer. Kaplan-Meier survival curves were plotted to analyze progression-free survival, and ROC curves were plotted to assess the predictive value of NLR and PLR for progression-free survival.

Results:

In the stable group, NLR, PLR, PSA levels, bone metastasis ratio, and Gleason score ≥8 were significantly lower than in the progression group. T3 stage, N0 stage, and M0 stage were significantly higher in the progression group, with statistical significance (P < 0.05). NLR, PLR, and PSA levels were all significantly linearly correlated (P < 0.05). High NLR, high PLR, high PSA, high bone metastasis, Gleason score <8, T3 stage, and N0 stage were independent risk factors for poor prognosis after castration therapy for prostate cancer, with statistical significance (P < 0.05). Patients with low NLR had significantly better progression-free survival than the high NLR group, and patients with low PLR had significantly better progression-free survival than the high PLR group, with statistical significance (P < 0.05). The area under the curve for NLR and PLR in predicting progression-free survival after castration therapy for prostate cancer was both greater than 0.90, indicating high clinical utility.

Conclusion:

Peripheral blood NLR and PLR after castration therapy for prostate cancer are highly correlated with patient prognosis quality and can serve as important potential indicators for predicting patient prognosis quality.
Cross-sectional Study Shows an Association between Paediatric Lichen Planus and Dyslipidemia
Authors: Mahajan Rahul , Raj Dinesh , De Dipankar , Handa Sanjeev
Published: May 2024

Background:

Few studies have shown an association between adult lichen planus and dyslipidemia, but none has shown an association with the pediatric population. We planned to study the association between pediatric lichen planus and metabolic syndrome (MS).

Methodology:

This is a single-centre, cross-sectional, case-control study from July 2018 to December 2019 at a tertiary care institute. Twenty children in the age group of 6–16 years, diagnosed as cases of childhood/adolescent lichen planus, and 40 age- and sex-matched controls were included in this study and evaluated for metabolic syndrome.

Patients' anthropometry including weight, height, waist circumference, and body mass index (BMI) was recorded. Blood samples were sent for the measurement of fasting plasma glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, and triglyceride levels.

Results:

The mean HDL was found to be significantly lower in children with lichen planus compared to children without lichen planus (p = 0.012), although there was no statistically significant difference in the frequency of patients having deranged HDL levels between the groups (p = 0.326). Children with lichen planus had a higher prevalence of central obesity, but the difference was not statistically significant (p = 0.101). There was no significant difference between mean BMI, hypertension, triglyceride, LDL, and fasting blood sugar values between the groups. Using the logistic regression analysis model, it was found that the strongest independent variable that impacts the occurrence of lichen planus was an HDL value less than 40 mg/dl (p = 0.017; OR 1.02 to 1.29).

Conclusions and Relevance:

This study shows an association between paediatric lichen planus and dyslipidemia.
A Cross-Sectional Study to Assess Sub-clinical Atherosclerosis in Patients of Psoriasis Independent of Metabolic Syndrome
Authors: Deoghare Shreya , Talanikar Hemant , Deora Mahendra S. , Kothari Rohit , Sharma Yugal K. , Dalve Kalyan , Kapoor Asmita , Patil Aishwarya
Published: May 2024

Background:

A sustained inflammatory state of psoriasis causes comorbidities such as psoriatic arthritis, metabolic syndrome (MetS), and cardiovascular disease.

Aims:

To note the duration and severity of psoriasis, assess prevalence of MetS, and correlate these with indicators of sub-clinical atherosclerosis.

Methodology:

Thirty-two patients of chronic plaque psoriasis were enrolled in the study. Their demographic particulars, clinical details, results of investigations to assess MetS, and indicators of sub-clinical atherosclerosis, namely, carotid intimal media thickness (CIMT) measured using B-mode USG and epicardial fat thickness (EFT) using 2-D ECHO, were recorded.

Results:

The study participants were predominantly male (2.5:1); their mean age was 40.45 ± 12.42 years, the median disease duration (DD) was 2 years, and the mean psoriatic area severity index (PASI) score was 8.62 ± 7.49. Mild disease (PASI <5) was present in 12 participants (37.5%), and shorter DD (<5 years) was present in 16 (50%) participants. MetS, detected in 11 (37.5%) study participants, was not significantly associated with CIMT, EFT, DD, and PASI. CIMT and EFT too did not correlate significantly with DD, PASI, or measures of MetS. Neither did there exist any significant correlation between CIMT and EFT.

Conclusion:

Sub-clinical atherosclerosis in our study participants was not significantly associated with either measures of MetS or duration/severity of psoriasis.
Curcuma Longa in the Treatment of Symptomatic oral lichen planus
Authors: Khaitan Tanya , Vishal  , Kabiraj Arpita , Sinha Dharmendra Kumar , Ranjan Rajeev , Singh Rakhi
Published: May 2024

Introduction:

Oxidative stress has been suggested as pathogenesis of oral lichen planus (OLP), implicating the vital role of antioxidants in its treatment. Curcumin, naturally found in turmeric has potent antioxidant and inflammatory properties and can be useful in reducing spread and subsiding burning and pain sensation in patients with OLP. The present study was done to evaluate the role of curcumin in the treatment of symptomatic OLP compared with the control group.

Materials and Method:

A total of 40 patients with symptomatic OLP were divided into 2 groups of 20 subjects each. Group A was treated with curcumin oral gel and a multivitamin capsule containing zinc, whereas Group B was given multivitamin containing zinc only. Patients were followed-up twice, that is, after 1 month and 3 months. A modified REU (reticulation/keratosis, erythema and ulceration) score for spread and Visual analogue scale for pain/burning sensation was used and the difference of score was calculated by t test.

Results:

During F1 period, 0.61 (Group A) and 0.19 (Group B) points improvement and in F2 period, the REU score further increased significantly to 1.36 (Group A) and 0.43 (Group B), respectively. The mean score reduction in Visual analogue scale during F1 period was 1.71 and 0.71, which further increased significantly to 2.88 and 1.24 during F2 period in Groups A and B, respectively.

Conclusion:

Curcumin, an active ingredient of turmeric is commercially available in gel form to treat different oral lesions and significantly effective in reducing spread and providing symptomatic relief in OLP without any adverse effects.
Mohs Micrographic Surgery for Melanoma
Authors: Clements Stephanie , Khachemoune Amor
Published: May 2024

Mohs micrographic surgery (MMS) is the gold standard for treating keratinocyte carcinomas in specific locations or due to other tumor-specific factors, given its comprehensive margin assessment, tissue sparing, and high cure rate. The use of MMS for treating invasive melanoma with intraoperative immunostains is still a subject of debate. Herein, a literature review supports the following recommendations. In cosmetically or functionally demanding sites such as head, neck, hands, feet, and pretibial leg, we recommend MMS for MMIS and all thin melanomas measuring <0.8 mm Breslow depth. Additionally, on the head and neck, all superficial spreading and lentigo maligna melanoma (LMM) histologic subtypes <0.8 mm Breslow depth should be treated with MMS. We recommend using melanoma antigen recognized by T cells 1 (MART-1) immunostain intraoperatively given its high sensitivity. However, microphthalmia transcription factor (MITF) and Sry-related HMG-Box gene 10 (SOX10) are useful adjuncts for difficult cases.
A Review on Cosmetics Causing Conatct Urticaria
Authors: Shaji Merin , Merin K. A , Kameswaran R.
Published: May 2024

Physical appearance is more strongly pursued than ever in today's world and is considered to provide confidence, success and self-esteem. Cosmetics are the important product in beauty market and their growth is unstoppable. It is estimated that about 95% of women and 75% of men were daily using cosmetics. Despite the considerable use of cosmetics, most people are unaware of its adverse reactions. Urticaria is severe as well as the most common adverse reaction caused by cosmetics. Major cosmetics that cause urticaria include fragrance, preservatives, hair care products, lip plumbers, plant- and animal-derived products, bindi or kumkum, nail cosmetics, glycol peel, permanent makeup and tattoos, etc. This review provides a brief explanation of the cosmetic components that cause urticaria.
Porokeratosis Ptychotropica
Authors: Zhang Shan
Published: May 2024

We report a case of porokeratosis ptychotropica with a rare manifestation. Dermoscopy showed dotted vessels, cerebriform pattern, white scales, and brown and greyish white tracks in the periphery over a red-brown background. A skin biopsy confirmed the diagnosis from the presence of cornoid lamellae.
A Clinico Epidemiological Study of Adverse Cutaneous Manifestations on Using Personal Protective Equipment Among Health Care Workers During Covid Pandemic in a Tertiary Care Centre
Authors: Malathy Priyavathani A. , Daniel Samuel J. , Venkatesan S , Priya B Yuva
Published: May 2024

Background:

COVID-19 (Coronavirus Disease 2019) pandemic was caused by a novel coronavirus. The frontline health care workers (HCW), wearing personal protective equipment (PPE) for a longer duration can result in a spectrum of adverse skin reactions. Recognizing occupationally induced adverse skin manifestations from PPE is necessary to avoid skin damage and risk of infections and to maintain compliance.

Aim:

This study aimed to determine the prevalence, clinical characteristics of adverse cutaneous manifestations due to PPE, and also the contributing epidemiological factors among HCW in a tertiary care institute.

Materials and Methods:

This cross-sectional study was conducted for a period of one month. Four hundred fifteen health care workers who used PPE continuously for >4 hours voluntarily participated in this study. By using a self-administered online questionnaire, the information and clinical photographs were collected.

Results:

The prevalence of adverse skin manifestations was 62.1% (258). The prevalence was more common in females. Mask-related facial skin problems were most commonly reported. Of 74 participants with pre-existing acne lesions, 35 (8.4%) reported acne flare-ups after using PPE. Increased sweating (22.6%) and itching (11%) were the most commonly noted symptoms.

Conclusion:

This study provides an insight into the prevalence of adverse skin reactions due to prolonged PPE usages, such as N95 masks and latex gloves in particular. Hence dermatological screening of HCW at regular intervals is inevitable to facilitate early management and prevent inadvertent protocol breaches. Further, it proposes the importance of raising proper safety measures to effectively reduce the COVID positivity rate among HCW by minimizing and preventing occupationally induced dermatosis.
Familial Hypercholesterolemia Presenting as Cerebral Ischemia and Xanthoma
Authors: Jingjing Yang , Zhanhua Liang , Huajun Jiang
Published: May 2024

Familial hypercholesterolemia (FH) is one of the inherited metabolic diseases, demonstrating the low-density lipoprotein receptor (LDLR) abnormality and serum cholesterol level marked elevation. FH has become an extremely high incident cause of occlusive coronary heart disease. However, even though hemorheological disorder caused by hyperlipidemia is a risk factor of ischemic cerebrovascular disease, cerebral infarction caused by FH has not been given much attention. We present a 41-year-old man with a family history of hypercholesterolemia was admitted to our hospital with dizziness, vertigo, slurred speech, and weakness in his left limbs. Head CT scan showed multiple acute cerebral infarction in the right frontal and parietal lobes. He had arcus corneae and less obvious signs of cutaneous xanthomas in the hands and knees. Molecular analysis of the LDLR gene identified heterozygous and missense mutation in exon 12 of the LDLR gene. The final diagnosis was cerebral infarction caused by FH. It is worth noting that cerebral infarction may also occur in patients with FH. Even if the most patients do not have any sign or history of cerebral ischemia, they need more attention to precise examination of the brain.
Biologics Beyond Boundaries
Authors: De Abhishek , Chowdhury Barnali , Khemka Monika , Sarda Aarti , Das Sudip
Published: May 2024

Several biologic agents have been approved for use in dermatology and other disciplines of medicine. However, based on the mechanism of action and a track record of the response, these agents are being increasingly used for off-label purposes to garner control of more remote and difficult disease processes. Herein, we present three difficult to treat patients where innovative uses of biologics beyond their approved indications have yielded good responses. Our first patient was a case of bullous pemphigoid, who showed excellent response to omalizumab. The second case was a patient of lepromatous leprosy with tenosynovitis and erythema nodosum leprosum, who was treated effectively with infliximab. Our third case was a treatment-resistant pyoderma gangrenosum, where infliximab showed a very good response. In the present study, we report the cases to highlight the usefulness of biologics that can expand much beyond the routine FDA approved indications.
Applying the Student Response System in the Online Dermatologic Video Curriculum on Medical Students' Interaction and Learning Outcomes during the COVID-19 Pandemic
Authors: Hung Chih-Tsung , Fang Shao-An , Liu Feng-Cheng , Hsu Chih-Hsiung , Yu Ting-Yu , Wang Wei-Ming
Published: May 2024

Background:

The coronavirus disease 2019 (COVID-19) pandemic impacted medical education worldwide. Online lecture is increasingly prevalent in higher education, but students' completion rate is quite low.

Aims:

This study aimed to determine the effectiveness of the student response system (SRS) in the online dermatologic video curriculum on medical students.

Methods:

A prospective study was conducted on 176 undergraduate fourth-year medical students. The online video lecture was integrated with SRS.

Results:

A total of 173 students completed the pre-test, and the attendance rate (pre-test/total) was 98.3%. A total of 142 students completed the post-test, and the completion rate (post-test/pre-test) was 82.8%. The post-test score (83.69 ± 4.34) was found to be significantly higher than that of the pre-test (62.69 ± 6.08, P =0.0002). A total of 138 students completed the questionnaire, and 92% of students opined that SRS was easy to operate. 86% of students agreed with the fact that the use of SRS could increase their learning performance by interacting with teachers. In the open-ended question, students stated that SRS offered opportunities for student–faculty interaction, allowed them to get immediate feedback, and promote active participation.

Conclusions:

These results highlight that the integration of SRS in the online video curriculum increases students' completion rates and learning outcomes. Moreover, the SRS is easy to operate for the students and enhances student–faculty interaction. The SRS may be adopted in online learning during this challenging time.
Clinical Characteristics of 9 Adult Patients with Granulomatous Periorificial Dermatitis and Comparison with Childhood Granulomatous Periorificial Dermatitis
Authors: Cho Soyun , Kim Bo Ri , Lee Ji Su , Na Jung Im , Youn Sang Woong
Published: May 2024

To our knowledge, there have been no previous reports of granulomatous periorificial dermatitis (GPD) in adult patients in contrast to childhood GPD (CGPD). We report cases of 9 adult patients with GPD with regards to the clinical and histopathological characteristics and their management. GPD in adults may be an entity that is actually underdiagnosed, especially in middle-aged females. It is a benign disorder, albeit requiring a relatively long-term treatment. Unlike CGPD, GPD in adults is frequently accompanied by pruritus with predilection for the eyelid and should be treated initially with oral medication.
Identification of Two Novel Frameshift Mutations of the ADAR1 Gene in Two Chinese Families With Dyschromatosis Symmetrica Hereditaria
Authors: Ning Xiaoying , Xiao Shengxiang , Zhang Yanfei
Published: May 2024

Background:

Dyschromatosis symmetrica hereditaria (DSH) is a rare autosomal dominant skin disease. The mutation of the ADAR1 gene is the pathogenesis of this disorder.

Aims:

This study aimed to identify the mutations of the ADAR1 gene in two Chinese families with DSH.

Methods and Materials:

Eight patients from two Chinese families were diagnosed with DSH clinically. Blood samples were collected from the patients and unaffected individuals. Sanger sequencing for all polymerase chain reaction products of the whole coding regions of the ADAR1 gene was performed to identify the mutations. Mutation Taster software was used to predict the impact of the variant on the resultant protein.

Results:

The c.3358-3359insT (p.L1053fs-1092X) mutation in exon 12 was found in affected members of the pedigree1. In pedigree2, the c.3820-3821insG (p.G1207fs-1213X) mutation in exon 15 was found. These two mutations were not found in 100 unrelated healthy people. In this study, both mutations were damaged by the Mutation Taster software.

Conclusions:

We identified two novel frameshift mutations in the ADAR1 gene. Our study expands the database of ADAR1 gene mutations in DSH.
Patterns and Trends of Tribal Leprosy
Authors: Sarkar Somenath , Sarkar Tanusree , Patra Aparesh C. , Ghosh Arghyaprasun , Gorai Hirak , Mondal Soumyadeep
Published: May 2024

Background:

Leprosy is a chronic granulomatous disease mainly affecting the peripheral nerves and skin. Any communities including the tribals are susceptible to leprosy. Very few studies on clinico-epidemiological patterns of leprosy have been reported in the tribal population, especially in the Choto Nagpur plateau.

Aims:

To observe clinical types of newly diagnosed leprosy cases among the tribal population and demonstrate bacteriological index, frequency of deformity, and lepra reaction at presentation.

Methods:

An institution-based cross-sectional study was conducted with consecutive newly diagnosed tribal leprosy patients attending the leprosy clinic of a tribal-based tertiary care center of Choto Nagpur plateau of eastern India, from January 2015 to December 2019. Thorough history taking and clinical examination were done. A slit skin smear for AFB was performed to demonstrate the bacteriological index.

Results:

There was a steady rise in total leprosy cases from 2015 to 2019. Borderline tuberculoid (BT) was the commonest form of leprosy (64.83%). Pure neuritic leprosy was not uncommon (16.26%). Multibacillary leprosy was noted in 74.72% of cases and childhood leprosy was observed in 6.70% of cases. The commonest nerve involved was the ulnar nerve. Garde II deformity was noted in around 20% of cases. AFB positivity was observed in 13.73% of cases. A high bacteriological index (BI ≥3) was noted in 10.65% of cases. Lepra reaction was observed in 25.38% of cases.

Conclusion:

BT leprosy, pure neuritic leprosy, childhood leprosy, grade II deformity, and higher AFB positivity were prevalent in this study. The tribal population required special attention and care for the prevention of leprosy amongst them.
Coexistence of Superficial Thrombophlebitis and Cutaneous Venulitis in Behçet's Disease
Authors: Sato Mayu , Chen Ko-Ron , Yamamoto Toshiyuki
Published: May 2024

Previous studies have shown that erythema nodosum-like lesions in patients with Behçet's disease show cutaneous vasculitis of either phlebitis or dermal venulitis. To analyse the clinicopathological characteristics of superficial thrombophlebitis as well as cutaneous venulitis in Behçet's disease. We re-evaluated the histopathological features of superficial thrombophlebitis in patients with Behçet's disease. Five patients, one man and four women, developed superficial thrombophlebitis on the lower extremities. Two of the patients had vascular Behçet's disease, both also developed deep vein thrombosis. One patient had intestinal Behçet's disease. In all cases, venulitis in the overlying lower dermis or adjacent subcutis spreading from the main affected subcutaneous thrombophlebitis lesions was observed. Both neutrophilic venulitis (n = 2) and lymphocytic venulitis (n = 3) were observed at the same depth level or upper/lower location of the thrombophlebitis in the same specimens. In addition, concurrent venulitis with fibrin thrombus and fibrinoid necrosis was observed in one case, suggesting that fibrin thrombus affected both venules and muscular veins. By contrast, arteritis or arteriolitis at the same depth level was not observed. Our results showed histopathological features of coexistent thrombophlebitis and venulitis without involvement of either arteries or arterioles in the biopsied specimens of superficial thrombophlebitis. Further studies are necessary to support that those unique histopathological findings are the characteristic features and significant diagnostic indicators of Behçet's disease.