Epidemiological profile of patients presenting to dermatology department of a tertiary care hospital during nationwide lockdown due to COVID-19: a retrospective study from north India

Background: The COVID-19 pandemic has seen an unprecedented lockdown with restrictions on human movement and interaction, imposed throughout the world to contain the spread of the disease. This gave us the unique opportunity to study the pattern of patients presenting to the dermatology out-patient department during this period.Methods: The study was a retrospective observational study involving the assessment of patient records from 25th March 2020 to 7th June 2020. This period corresponds to the duration of strictly imposed nationwide lockdown which was relaxed with phased resumption from 8th June 2020, termed as unlock 1.Results: A decrease in the absolute as well as proportional number of patients was seen in majority of the cases with a statistically significant proportional decline being seen in cases of allergic contact dermatitis (p-value =0.007), acne (p value <0.001), male pattern hair loss (p value <0.001) and female pattern hair loss (p value <0.001), verrucae (p value=0.01), seborrheic dermatitis (p value <0.001), ephelids (p value <0.001), melasma (p value<0.001), post-inflammatory hyperpigmentation (p value=0.006). However, there were certain disorders whose proportionate representation increased significantly during the lockdown period contrary to prevalent belief. These disorders included urticaria (p value <0.001), herpes zoster (p value <0.001), scabies (p value =0.01), generalized pruritus (p value <0.001) and prurigo (p value <0.001).Conclusions: Disorders like acne, male pattern hair loss, female pattern hair loss, verrucae, seborrheic dermatitis, ephelids, melasma and post-inflammatory hyperpigmentation which do not cause significant morbidity showed a significant decrease in proportional representation. The proportionate representation of disorders like urticaria, herpes zoster, scabies, generalized pruritus and prurigo increased significantly during the lockdown period.

Download Full-text

A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20194565 ◽

2019 ◽

Vol 5 (4) ◽

pp. 668

Author(s):

Nachiket Madhukarrao Palaskar ◽

Nitin Dinkar Chaudhari ◽

Garima Laxminarayan Balpande ◽

Swapna Subhash Khatu

Keyword(s):

Combination Therapy ◽

Hair Loss ◽

Tertiary Care ◽

Randomised Trial ◽

Life Questionnaire ◽

Care Hospital ◽

Female Pattern Hair Loss ◽

Group I ◽

Topical Minoxidil ◽

Group Ii

Background: Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.Methods: This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.Results: There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p<0.001). Minoxidil and spironolactone were tolerated well by the patients.Conclusions: Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.

Download Full-text

Study on Corticosteroids use Pattern in Dermatological Practice and Investigating Adverse Effect of Corticosteroids Including its Associated Factors

Kathmandu University Medical Journal ◽

10.3126/kumj.v13i3.16819 ◽

2017 ◽

Vol 13 (3) ◽

pp. 261-267

Author(s):

S. Shakya Shrestha ◽

M. Bhandari ◽

R. Shrestha ◽

S.R. Thapa ◽

A. Karki ◽

...

Keyword(s):

Adverse Effect ◽

Adverse Effects ◽

Tertiary Care ◽

Common Adverse Effect ◽

Cross Sectional Study ◽

P Value ◽

Care Hospital ◽

Cross Sectional ◽

Dermatology Department ◽

Use Pattern

Background Corticosteroids are highly effective drugs with anti-inflammatory and immunosuppressive properties. Due to this, they have become a mainstay of pharmacotherapy in dermatology. However, improper and long term uses are associated with a number of serious adverse effects.Objective To investigate the corticosteroids use pattern, adverse effects and various factors associated with adverse effects in dermatological practice.Method A cross-sectional study was conducted in a dermatology department of tertiary care hospital. All patients using at least one corticosteroids, either topically or systemically or the combination were included in this study. Informed consent was taken from the patients and interviewed using structured questionnaire. Statistical analysis was performed by using SPSS 20. p-value < 0.05 was considered as statistically significant.Result Among the 60 participants under this study, 81.67% of them were females. The mean (±SD) age of the patients was 31.03 years (±15.0). A majority (58.30%) of the patients was prescribed with topical corticosteroids with low potency (25%). Most of them had used corticosteroids for urticaria. Adverse effects were reported by 33.30% of the patients. The most common adverse effect reported was the shedding of skin. Adverse effects was significantly associated with gender; use of systemic corticosteroids; regular use of corticosteroids; discontinuation of dose abruptly; and missed dose. However, there was no significant association between adverse effects and the duration of use of corticosteroids.Conclusion In conclusion, the present study suggested that the proper counselling and clear instruction regarding the use of corticosteroid should be provided to the patients for avoiding the abrupt discontinuation of the prescribed medication leading to treatment failure.

Download Full-text

A pharmacoepidemiology study of local fungal infections in skin and venereal diseases outpatient department of a rural tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201187 ◽

2020 ◽

Vol 9 (4) ◽

pp. 616

Author(s):

Preety Bansal ◽

Seema Baishnab

Keyword(s):

Fungal Infection ◽

Fungal Infections ◽

Tertiary Care ◽

Antifungal Drugs ◽

Care Hospital ◽

Dermatology Department ◽

Number Of Patients ◽

Common Skin ◽

Cutaneous Fungal Infection ◽

Number Of Males

Background: Fungal infections of the skin were the 4th most common skin disease in 2010 affecting 984 million people. An estimated 20-25% of the world’s population has some form of fungal infection. Dermatophytes are fungi that cause superficial infections of the skin, commonly referred to as tinea infections.Methods: This was a prospective and an observational study conducted from February 2018 to January 2019 in Dermatology Department. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sex who attended dermatology OPD. Factors considered were sociodemographic parameters, the disease encountered and number of patients in each group and number of patients who received antifungal therapy (oral and topical) etc.Results: 1000 prescriptions were analysed of patients between 18 to 65 years of age with cutaneous fungal infections. There were a greater number of males (57.4%) than females (42.6%). The average number of antifungal drugs prescribed per prescription was 2.33. Majority of the patients were prescribed itraconazole (82.30%) followed by terbinafine (9.70%) and fluconazole (8.0%).Conclusions: The most common oral antifungal drug used was itraconazole. Ketoconazole and Terbinafine were the most commonly used topical agents respectively.

Download Full-text

Epidemiological study of herpes zoster in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174594 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4550

Author(s):

Nekram Baghel ◽

Sankalp Awasthi ◽

Sweta S. Kumar

Keyword(s):

Herpes Zoster ◽

Tertiary Care ◽

Uttar Pradesh ◽

Clinical Problem ◽

Care Hospital ◽

Post Herpetic Neuralgia ◽

Medical Sciences ◽

Dermatology Department ◽

Varicella Zoster ◽

Increased Risk

Background: Herpes Zoster, which presents as a localized, painful cutaneous eruption is a common clinical problem, caused by reactivation of latent Varicella Zoster Virus (VZV) and is usually self- limiting in healthy adults. In this era of HIV infection, HIV seropositive patients are at increased risk of severe or disseminated cutaneous or visceral involvement. Aim was to analyse the clinical pattern and epidemiological factors of Herpes Zoster and to know the HIV prevalence among patients with Herpes Zoster.Methods: A total of 110 patients with Herpes Zoster attending dermatology department at Uttar Pradesh university of medical sciences (UPUMS), Saifai, Etawah, India from a period of July 2015 to July 2017 were included in the study.Results: Out of 110 patients, 79 were males 31 were females. Age group varied from 8-80 years. Most common dermatomes involved were thoracic followed by ophthalmic division of trigeminal nerve. 33.6% of patients showed HIV seropositivity. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were above the age of 60 years. Post herpetic neuralgia was more commonly seen in seropositive individuals as compared to seronegative individuals.Conclusions: Disseminated zoster and multi-dermatomal involvement were encountered in immuno-compromised individuals. Post herpetic neuralgia was seen in elderly patients, especially in case of ophthalmic zoster.

Download Full-text

Study of pregnancy outcome of threatened abortion and its correlation with risk factors in a tertiary care hospital of Mumbai, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184514 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4598

Author(s):

Dipali S. Sivasane ◽

Rekha G. Daver

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Pregnancy Loss ◽

Demographic Data ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Number Of Patients ◽

Significant Difference ◽

Threatened Abortion

Background: Early pregnancy loss is very common and, in most cases, it can be considered as nature’s method to select for a genetically normal offspring. Threatened abortion is a relatively common complication during pregnancy, occurring in approximately 20% of all pregnancies. Maternal age, Outcome of previous pregnancies, health of mother, any infection etc can be decisive factors in the risk of pregnancy loss.Methods: The present study was a cross sectional study where patients admitted with threatened abortion were interviewed using pretested semi-structured questionnaire after the treatment. Outcome of pregnancy was recorded. Their basic socio-demographic data along with possible risk factors were recorded. TORCH Ig M and Ig G were done in all patients.Results: Out of 95 patients admitted with threatened abortion, 42 (44%) patients undergone abortion whereas in 53 (56%) patients, pregnancy was continued. Out of total 60 patients admitted with the complain of only vaginal spotting, in 39 pregnancy continued and in 21 patients pregnancy was aborted. (p-value<0.05). 50.52% were from age group of 21 to 25 years of age. It was also seen that after 35 years of age, significant number of patients aborted. Out of these 11 patients with high BMI, pregnancy was continued only one patient. Out of total 20 patients positive for IgM of toxoplasma infection, pregnancy was aborted in 13 (65%) patients. Out of total 15 patients positive for IgM of cytomegalo virus infection, pregnancy was continued in 11 (73.3%) patients.Conclusions: Patients of threatened abortion with only symptom of spotting per vagina have good chances of continuation of the pregnancy. Increased maternal age above 35, Overweight and bad obstetric history are also associated with pregnancy loss. Though there was no statistically significant difference it was evident that among all TORCH infections, IgM toxoplasma and Rubella are associated more with pregnancy loss.

Download Full-text

EFFICACY OF SUPPLEMENTATION OF PROBIOTICS ALONG WITH ANTIMICROBIAL AGENTS IN VULVOVAGINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i12.43269 ◽

2021 ◽

pp. 119-122

Author(s):

DEEPA PATIL ◽

GEETHA S ◽

RAGHUPRASADA MALLADAR SHIVAMURTHY ◽

UMAKANT N PATIL

Keyword(s):

Antimicrobial Agents ◽

Standard Treatment ◽

Tertiary Care ◽

Saccharomyces Boulardii ◽

P Value ◽

Care Hospital ◽

Recurrence Rates ◽

Institutional Ethics ◽

Number Of Patients ◽

Symptoms And Signs

Objectives: The objectives of the study were to ascertain the efficacy of probiotics along with antimicrobials in the treatment of vulvovaginitis and to evaluate the rate of recurrence. Methods: The study was done on 60 patients who were randomly selected and divided into two groups of 30 each. Prior permission from the Institutional Ethics Committee and higher authorities was obtained before conducting the study. One group received standard treatment including antibacterial, antiviral, and antifungal as per the gynecologist discretion and in other group along with standard treatment, probiotic capsules containing combination of Saccharomyces boulardii, Lactobacillus sporogenes (50 million), Streptococcus faecalis (30 million), Clostridium butyricum (2 million), and Bacillus mesentericus (1 million) given orally twice daily and followed up for a period of 3 months. The drugs were started on the 5th day after menstruation taking starting of the bleeding as day 1. Results: The parameters compared were symptoms and signs (significantly reduced – p-value), clue cells (significantly reduced in number), and recurrence rates (significantly reduced), in 80% of patients smears which were not consistent with BV. Maximum number of patients showed negative KOH mount (71.5%), saline wet mount was negative in 80% of patients in antimicrobial agents + probiotics group. Conclusion: From the present interventional study, probiotics along with antimicrobial agents showed better improvement than antimicrobial agents alone. Hence, supplementation of probiotics along with antimicrobial agents provides better efficacy than antimicrobial agents alone in treating vulvovaginal infections.

Download Full-text

Incidence of Vitamin D Deficiency in Patients with Female Pattern Hair Loss (FPHL)

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i37b32019 ◽

2021 ◽

pp. 48-53

Author(s):

Erum Siddiqui ◽

Shakila Yousuf ◽

Sumbul Nisar ◽

Faryal Hussain Memon ◽

Anum Sharif ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Hair Loss ◽

Vitamin D3 ◽

Economic Status ◽

Tertiary Care ◽

Serum Levels ◽

Care Hospital ◽

Cross Sectional ◽

Female Pattern Hair Loss

Background: Female pattern hair loss is also observed in women without increased androgen levels. Vitamin D is a factor that has recently been considered in dealing with these patients. Deficiency of Vitamin D might be correlated with diffuse hair loss. Objective: To determine the frequency of serum levels of Vitamin D3 in patients with female pattern of hair loss (FPHL) at tertiary care hospital Karachi. Methodology: This cross-sectional research was conducted upon a sample of 163 female patients (chosen via non-probability – consecutive sampling) presenting to the Dept. of Dermatology, Abbasi Shaheed Hospital, Karachi from 29th July 2018 to 28 th January 2019, with a clinical diagnosis of FPHL. Data was recorded onto a structured questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, and inferences obtained from blood tests (CBC, serum ferritin, TSH level and vitamin D level). Serum 25 OH Vitamin D level < 20 was taken as deficient, 21-29 was insufficient and over 30 was sufficient. Data was analyzed using SPSS. v. 21.0. Results: The mean age was 30.39±6.36 years. Mean FPHL duration was 5.85±2.89 months. Total 63.2% patients were classified as mild, 26.45% patients were classified as moderate and 10.4% patients were classified as severe. Total 73% patients were found as vitamin D deficient, 22.1% as vitamin D insufficient and 4.9% as vitamin D sufficient. Significant association of vitamin D deficiency was observed with education status, vitamin D intake since past 6 months, and socio economic status. Conclusion: Results showed high vitamin D3 deficiency (73.0%) among patients with female pattern of hair loss (FPHL).

Download Full-text

Frequency of Retinopathy in low birth weight infant at tertiary care hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.4001 ◽

2020 ◽

Vol 27 (02) ◽

pp. 365-370

Author(s):

Muhammad Younis Tahir ◽

Iftikhar Ahmad ◽

Soufia Farrukh

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Oxygen Supplementation ◽

Low Birth Weight Infant ◽

Number Of Patients ◽

Department Of Ophthalmology

Objectives: To find out the frequency of retinopathy in low birth weight infant presenting at tertiary care hospital, Bahawalpur. Study Design: Cross sectional study. Setting: Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur. Period: From July 2018 to December 2018. Material & Methods: Neonatal eye examination was performed for ROP. Results: Total 78 neonates were recruited for present study and ROP was assessed. Mean gestational age of neonates was 32.54 ± 3.79 weeks. Mean weight was 1445.51 ± 517.373 grams. Out of 78 neonates, ROP was observed in 28 (36%) neonates. ROP was found in 27 (42.19%) neonates of premature group and in 1 (7.14%) neonates of at term group. ROP was found in 1 (3.23%), 5 (29.41%) and 22 (73.33%) neonates respectively in weight group 1500-2500 g, 1000-1500 g and <1000 g group. Male neonates were 35 (44.87%) and female neonates were 43 (55.13%). Development of ROP was not significantly (P = 0.248) associated with gender of the neonates. Statistically significant association between ROP and oxygen supplementation was observed with p value 0.021. Conclusion: Results showed higher number of patients with ROP. Association of development of ROP with gestation was highly significant. Oxygen supplementation and oxygen concentration was also associated with ROP. Findings also showed no effect of gender and duration of hospital stay on ROP.

Download Full-text

Comparison of Attendance of Patients Pre-lockdown and during Lockdown in Gynaecology and Antenatal Outpatient Department in a Tertiary Care Hospital of Nadia, West Bengal, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45920.14567 ◽

2021 ◽

Author(s):

Suvobrata Sarkar ◽

Ranita Roy Chowdhury ◽

Jayeeta Mukherji ◽

Manaswita Samanta ◽

Gairik Bera

Keyword(s):

Cancer Detection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Outpatient Department ◽

P Value ◽

Care Hospital ◽

Old Patients ◽

Medical Termination ◽

Number Of Patients ◽

Daily Attendance

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has brought about a paramount change in the life. This has lead to a reduction in the number of routine patients visiting the Outpatient Department (OPD) of various hospitals and this department was no exception. Aim: To compare the attendance of patient in Antenatal Care (ANC) and Gynaecology Out Patient Department (GOPD) between pre-lockdown and lockdown period due to COVID-19 pandemic. Materials and Methods: The study was conducted among patients attending the OPD in ANC and Gynaecology for 70 days lockdown from 23rd March to 31st May and 70 days immediate pre-lockdown period from 12th January to 22nd March 2020. Daily attendance was noted and types of patient attending in different sub clinics in Gynaecology OPD compared. Enrolment of new ANC patient and old booked cases was compared during both periods. Descriptive statistics were used and displayed as percentages. Results: There was a significant reduction in number of patients attending OPD in lockdown period. There was a total of 6088 (87.3%) reduction in number of patients in Gynaecology OPD and 2235 (69.6%) reduction of patients in ANC OPD which was found to be significant with p-value <0.001. Reduction of patient in lockdown days among new ANC was 574 while it was 1661 in case of old patients. The different sub clinics of GOPD like infertility (704), endocrine (1450), uro-gynaecology (656), STD/PID (732), postpartum (597), cancer detection (316), abortion and medical termination of pregnancy (MTP) (330), others (1303) also witnessed a diminution of attendance. Conclusion: COVID-19 caused a significant decrease in footfall of patients in outpatient department due to lockdown, though the percentage of types of patient attending Gynaecology OPD was almost same.

Download Full-text

Clinicoepidemiological Profile of Pityriasis Versicolor in a Tertiary Care Hospital in Kathmandu, Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v21i4.27625 ◽

2019 ◽

Vol 21 (4) ◽

pp. 294-300

Author(s):

S Shrestha ◽

P Koirala ◽

U Timothy

Keyword(s):

Seborrheic Dermatitis ◽

Tertiary Care ◽

College Teaching ◽

Cross Sectional Study ◽

Pityriasis Versicolor ◽

Care Hospital ◽

Tertiary Care Centre ◽

Predisposing Factor ◽

Cross Sectional ◽

Dermatology Department

Pityriasis versicolor (PV) also known as Tinea versicolor is a benign, chronic superficial fungal infection of the skin caused by Malassezia furfur. It is characterized by dyspigmented macules with fine branny scales. The purpose of this study was to assess the epidemiological profile and clinical pattern of PV in a group of patients visiting a tertiary care centre of Nepal. A descriptive cross-sectional study was carried out including 150 patients diagnosed to have PV at the outpatient dermatology department of Nepal Medical College Teaching Hospital. Patients with the diagnosis of PV were included in the study. A detailed history was taken and it was followed by a thorough clinical examination. The findings of history and clinical examinations were documented in a predesigned proforma. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. There was a slight male preponderance with maximum patients of the age group 11 – 20 years. A majority of patients were students. Forty three (28.7%) patients had similar problem in close contacts and 42% had recurrent disease. Wearing of occlusive synthetic clothing was the commonest predisposing factor. Upper chest and upper back were the most involved sites. Hypopigmented macules were the commonest lesions in 72.7%. Coexisting seborrheic dermatitis (commonly pityriasis capitis ) was present in 44.67% of patients. Clinicoepidemiological profile of PV in our setting is similar to many studies done mostly in India. But few findings differ which indicates the need for further studies in Nepal especially from Terai regions where the prevalence is expected to be more.

Download Full-text