scholarly journals A study of clinicopathologic spectrum of vesicobullous disorders

2017 ◽  
Vol 3 (3) ◽  
pp. 355
Author(s):  
Heena Mittal ◽  
Sukhjot Kaur ◽  
Bhavna Garg ◽  
Neena Sood ◽  
Sunil Kumar Gupta ◽  
...  
Keyword(s):  
Pemphigus Vulgaris ◽  
Clinical History ◽  
Final Diagnosis ◽  
Stevens Johnson Syndrome ◽  
Direct Immunofluorescence ◽  
Diagnostic Dilemma ◽  
Dermoepidermal Junction ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Detailed Clinical History

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Blistering diseases are alarming skin conditions. Autoimmune blistering diseases are a group of bullous disorders characterized by pathogenic antibodies directed at the target antigens in the epidermis or dermoepidermal junction.</span><span lang="EN-IN">The objectives were to study the spectrum of histopathological changes by light microscopy, to evaluate the pattern of direct immunofluorescence (DIF) and to correlate clinical, histopathological features and DIF findings of vesiculobullous lesions of the skin or/and mucosa.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was carried out on 110 skin and/or mucosal biopsies with vesicobullous disorders from July 2013 to June 2016. Detailed clinical history, morphology of lesions, site of involvement and other findings were recorded as per proforma.<strong> </strong>These cases were analysed clinically, histopathologically and on immunofluorescence</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Majority of the patients presented in the age group of 41-50 years (30.9%). The male: female ratio was 1:1.15. Pemphigus vulgaris was the most common vesiculobullous disorder constituting 48.2%, followed by Bullous Pemphigoid constituting 27.3%. Dermatitis herpetiformis constituted 8.3%; Pemphigus foliaceous 3.6%, varicella and Stevens Johnson Syndrome both were observed in 2.7% each. DIF was performed in 81 cases out of which only 72 cases (92.6%) showed positivity. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">DIF is a sensitive tool for distinguishing immune mediated bullous diseases from other vesiculobullous disorders especially in cases which pose a diagnostic dilemma both clinically and histologically. The final diagnosis depends on correlation of clinical, histopathological and immunoflourescence findings.</span></p><p class="abstract"> </p>

Randomized phase II study of mogamulizumab (KW-0761) plus VCAP-AMP-VECP (mLSG15) versus mLSG15 alone for newly diagnosed aggressive adult T-cell leukemia-lymphoma (ATL).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8506-8506 ◽  
Author(s):  
Tatsuro Jo ◽  
Takashi Ishida ◽  
Shigeki Takemoto ◽  
Hitoshi Suzushima ◽  
KImiharu Uozumi ◽  
...  
Keyword(s):  
Phase Ii ◽  
Primary Endpoint ◽  
Stevens Johnson Syndrome ◽  
Newly Diagnosed ◽  
Female Ratio ◽  
Adult T Cell Leukemia ◽  
Disease Subtype ◽  
Randomized Phase Ii ◽  
Johnson Syndrome ◽  
Male Female Ratio

8506 Background: Mogamulizumab (Moga), a defucosylated humanized anti-CCR4 antibody, was approved for the treatment of relapsed/refractory ATL in Japan in 2012. This multicenter, randomized, phase II trial was conducted to examine the efficacy of the combination of Moga with standard chemotherapy for untreated aggressive ATL. Methods: Previously untreated patients (pts) with CCR4-positive ATL were randomly assigned to receive mLSG15 plus Moga (arm A) or mLSG15 alone (arm B). The primary endpoint was CR rate (%CR), and secondary endpoints included ORR, PFS, OS and safety. Pts received 4 courses of mLSG15 regimen, with or without a total of 8 doses of Moga (1.0 mg/kg) once every 2 weeks. The planned sample size, 22 pts per arm, provided a probability of 80% that %CR in arm A would have larger %CR when true %CR for arm A is 15% better than that for arm B. Results: Of 54 pts randomized, 53 were treated (arm A: 29; arm B: 24). Male/female ratio was 53/47%, median age was 63 (37-81), and subtype was acute/lymphoma/unfavorable chronic, 70/25/6%. %CR and ORR in arms A and B was 52% (95%CI [CI]; 33, 71) vs. 33% (CI; 16, 55) and 86% (CI; 63, 96) vs. 75% (CI; 53, 90), respectively. The results in arm B were similar to the previously reported %CR of 40% and ORR of 72% with mLSG15 (Tsukasaki et al, JCO 2007). ORR according to the disease subtype, in arms A and B, was 55% vs. 29% for acute, 50% vs. 43% for lymphoma and 33% vs. 0% for unfavorable chronic. Median PFS was 259 days (CI; 197, -) for arm A and 192 days (CI; 147, -) for arm B. Median OS was not reached in both arms. The most common treatment-related AEs in each arm were neutropenia (100%, 96%), thrombocytopenia (100%, 96%), leukopenia (100%, 92%), lymphocytopenia (97%, 96%), anemia (97%, 92%) and febrile neutropenia (90%, 88%). In arm A, skin disorders were more frequent but manageable, and no serious skin disorder like Stevens-Johnson syndrome was observed. There was one treatment-related death, which was not related to Moga. Conclusions: The combination of Moga with mLSG15 was well tolerated and the study met its primary endpoint. These results suggest that Moga with mLSG15 is a rational treatment option for newly diagnosed aggressive ATL. Clinical trial information: NCT01173887.

The Prevalence of Autistic Disorder among Children with a Learning Disability

1994 ◽  
Vol 165 (3) ◽  
pp. 395-399 ◽  
Author(s):  
Shoumitro Deb ◽  
K. B. G. Prasad
Keyword(s):  
Learning Disability ◽  
Autistic Disorder ◽  
Rural Areas ◽  
Learning Disabled ◽  
Final Diagnosis ◽  
School Age Children ◽  
Special Schools ◽  
Female Ratio ◽  
North East ◽  
Male Female Ratio

BackgroundIt has been suggested recently that the prevalence of autistic disorder may be rising. No prevalence study specifically among learning disabled children exists and so this study was prompted.Method. 767 children with a learning disability who attended 16 different special schools in the Grampian region of north-east Scotland were studied for a diagnosis of autistic disorder according to the DSM–III–R criteria. The study was conducted in three stages. In the first screening stage, a questionnaire was completed for each child by their teachers. In the second stage, teachers completed another questionnaire based on DSM–III–R criteria for autistic disorder. A final diagnosis was made on the basis of examination and information gathered from the questionnaires.ResultsQuestionnaires were completed for 634 (82.7%) children. 14.3% of children with a learning disability fulfilled the diagnostic criteria for autistic disorder. There was a male: female ratio of 3:1. This gave a 9 per 10 000 minimum prevalence of autistic disorder among all school-age children in the Grampian region. There was a higher prevalence of autistic disorder in the cities compared with rural areas. The prevalence did not change with age but increased with decreasing IQ.

scholarly journals Current possibilities for early diagnosis of systemic lupus erythematosus

2018 ◽  
Vol 12 (3) ◽  
pp. 34-39 ◽  
Author(s):  
V. A. Lila ◽  
V. I. Mazurov ◽  
S. V. Lapin ◽  
A. V. Mazing ◽  
A. N. Moshnikova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Early Diagnosis ◽  
Lupus Erythematosus ◽  
Laboratory Tests ◽  
Final Diagnosis ◽  
Direct Immunofluorescence ◽  
Systemic Lupus ◽  
Immunofluorescence Method ◽  
Dermoepidermal Junction ◽  
Biopsy Specimens

The review presents the data available in the literature on the use of the lupus band test (LBT) for systemic lupus erythematosus (SLE). LBT is a direct immunofluorescence method used to detect immunoglobulins and complement factors in the dermoepidermal junction of skin biopsy specimens. LBT may be applied as one of the diagnostic tests for early diagnosis of SLE in patients without skin manifestations and in those of incomplete SLE. Like the results of other laboratory tests, those of LBT may be taken into account when establishing a final diagnosis only in conjunction with other clinical, immunological and instrumental data.

scholarly journals Etiologies of neonatal cholestasis at a tertiary hospital in Bangladesh

2020 ◽  
Vol 60 (2) ◽  
pp. 66-70
Author(s):  
Md. Benzamin ◽  
Mukesh Khadga ◽  
Fahmida Begum ◽  
Md. Rukunuzzaman ◽  
Md. Wahiduzzaman Mazumder ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Parvovirus B19 ◽  
Final Diagnosis ◽  
Tertiary Hospital ◽  
Neonatal Cholestasis ◽  
Lipid Storage Disease ◽  
Female Ratio ◽  
Varicella Zoster ◽  
Male Female Ratio ◽  
Torch Infection

Background Neonatal cholestasis is an important etiology of chronic liver disease in young children. It has a varied etiology. There is considerable delay in presentation and diagnosis of neonatal cholestasis in Bangladesh. Lack of awareness and knowledge among the pediatricians regarding etiological diagnosis and outcome of neonatal cholestasis is the reasons for poor outcome in major portion of cases in Bangladesh. Objective To evaluate the etiological spectrum of neonatal cholestasis. Methods This retrospective study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. We reviewed medical records of children who were diagnosed with neonatal cholestasis. Complete diagnostic profiles of every cases with age of presentation, male-female ratio and final diagnosis were analyzed. Results A total of 114 children with neonatal cholestasis were evaluated. Subjects’ male-female ratio was 1.92: 1.0, and mean age at hospitalization was 92.7 (SD 39.5) days. Biliary atresia was the most common etiology (47.4%), followed by idiopathic neonatal hepatitis/INH (21.9%). Other identified etiologies were, toxoplasmosis, others (syphilis, varicella-zoster, parvovirus b19), rubella, cytomegalovirus (CMV), and herpes/TORCH infection (8.61%), progressive familial intrahepatic cholestasis/PFIC (4.4%), galactosemia (4.4%), choledochal cyst (3.5%),  sepsis (1.8%), urinary tract infection/UTI (1.8%), hypothyroidism (1.8%), lipid storage disease/Niemann-Pick disease (0.9%), non-syndromic paucity of interlobular bile ducts (2.67%), and Caroli’s disease (0.9%). Conclusion  In Bangladesh, neonatal cholestasis cases are most often due to obstructive causes, particularly biliary atresia. Idiopathic (INH), infectious (primarily TORCH), metabolic, and endocrine causes followed in terms of frequency.

scholarly journals Workplace eye safety: a neglected essential

2020 ◽  
Vol 7 (11) ◽  
pp. 4518
Author(s):  
Aastha N. Patel ◽  
Shankar S. Ganvit
Keyword(s):  
Significant Proportion ◽  
Working Hours ◽  
Clinical History ◽  
Significant Loss ◽  
Working Environment ◽  
Age Group ◽  
Female Ratio ◽  
Chemical Hazards ◽  
Detailed Clinical History ◽  
History Of

 Background: An occupational hazard is a hazard experienced in the workplace. This includes many types of hazards like chemical hazards, biological hazards, psychosocial hazards and physical hazards. Occupational ocular trauma holds significant proportion of visual morbidity worldwide. This can be prevented with the use of proper protective eyewear and strict compliance. This survey was conducted to study occupational related ocular hazard in our tertiary health care system hospital having patients involved in various occupations.Methods: A total of 90 occupational ocular injuries were recorded during study period. The age group of the patients to be studied was between 20 to 60 years. Brief history of present complaints, detailed clinical history and occupation history as like type of work, working environment, place, working hours was recorded. Required ophthalmological check-up was done. All valid responses were tabulated and analysed. Appropriate treatment was given.Results: Our study showed that majority (85.6%) of patients were not wearing protective eye equipment. Male to female ratio was approximately 3:1. Major age group affected was between 31-40 years (41.1%). Welders (40%) were more prone to injury occupation wise.Conclusions: Occupational eye injury is often severe and it contributes to significant loss. Incompliance of appropriate protective eye wear can lead to potential eye damage and permanent blindness.

Right Temporal Variant Frontotemporal Dementia Misdiagnosed as Schizophrenia

2019 ◽  
Vol 15 (3) ◽  
pp. 223-227
Author(s):  
Mujeeb U. Shad ◽  
Lindsay Howard ◽  
Kristopher Thomas ◽  
Vimal M. Aga
Keyword(s):  
Frontotemporal Dementia ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Neuropsychological Testing ◽  
White Male ◽  
Clinical History ◽  
Final Diagnosis ◽  
Interesting Case ◽  
Behavioral Impairment ◽  
Detailed Clinical History

Background: Schizophrenia-like presentations of frontotemporal dementia (FTD) are well documented in medical literature, especially during the initial stage of the illness. We present an interesting case of middle-aged white male, who was initially misdiagnosed with major depression at age 50 and then with schizophrenia due to florid psychosis typically seen in Mild Behavioral Impairment (MBI). It was not until over 4-years that a detailed clinical history along with specific investigations confirmed the diagnosis of right temporal variant frontotemporal dementia (rtv-FTD). Methods: The unusual presentation of this case warranted 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (FDG-PET) and comprehensive neuropsychological testing to estblish a final diagnosis. Results: The results from neuroimaging and neuropsychological testing supported a diagnosis of rtv-FTD without any evidence for Alzheimer’s dementia. Conclusion: This case illustrates that late-onset atypical psychiatric symptoms should be evaluated for neurocognitive disorders, and the evaluation should include neuroimaging. It is preferable that the neuroimaging findings be personally interpreted by the provider, who therefore needs to be skilled in interpreting neuroimaging studies.

scholarly journals Cutaneous Adverse Drug reactions: A Four-Year Study from Western Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 21-26 ◽  
Author(s):  
S Neupane ◽  
B Basnet
Keyword(s):  
Adverse Drug Reactions ◽  
College Teaching ◽  
Clinical History ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Medical College ◽  
Johnson Syndrome ◽  
Detailed Clinical History ◽  
Life Threatening ◽  
History Of

Background: Cutaneous adverse drug reactions (CADRs) range from minor reactions to several life threatening complications. Objectives: To study the clinical spectrum of cutaneous adverse drug reactions, determine the causative drugs responsible for the reactions and to assess the preventability.Methods: The study was carried out in the Department of Dermatology of Gandaki Medical College Teaching Hospital from June 2011 to June 2015. All the patients attending the Dermatology Outpatient Department and the patients admitted in the wards with suspected cutaneous adverse drug reactions to systemic drugs were included in the study. A detailed clinical history, including the history of drug intake was noted. Each case was assessed for its causality by using the WHO definitions. Data analysis was done using SPSS software.Results: There were 102 patients in total. The mean age of the patient was 32 ±15.7 years. Maximum patients belonged to the 21 to 30 years age group. There were 59 female patients and 43 male patients. Severe type of cutaneous adverse drug reactions was noted in 7.8% of patients. Antibiotics were responsible for most of the cutaneous adverse drug reactions. Cefixime was the most commonly incriminated drug. Exanthematous drug reaction was the most common type seen in 45%. Stevens-Johnson syndrome was the commonest type noted among the serious adverse drug reactions. Drug preventability was noted in 6% of patients.Conclusions: The commonest type of CADR noted was exanthematous type. Antibiotics were the commonest drug group involved in CADR. Six percent of CADR were preventable. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 21-26

scholarly journals An overview of scalp dermatoses in a tertiary care institute

2020 ◽  
Vol 6 (3) ◽  
pp. 304
Author(s):  
Ramesh Aravamuthan ◽  
Sampath Vadivelu ◽  
Shabari Arumugam ◽  
Mukesh Mithran J.
Keyword(s):  
Tertiary Care ◽  
Early Adulthood ◽  
Psychological Impact ◽  
Age Groups ◽  
Clinical History ◽  
High Rate ◽  
Female Ratio ◽  
Detailed Clinical History ◽  
Sebum Production ◽  
Scalp Dermatoses

<p class="abstract"><strong>Background:</strong> The scalp is unique among skin areas in humans, with high follicular density and high rate of sebum production which though providing thermal insulation also creates an environment conducive to superficial mycotic infections and parasitic infestations. As there is a paucity of studies on scalp dermatoses in the Indian and Western literature, a clinical study of these scalp dermatoses can unravel the common clinico-epidemiological manifestations in our population.</p><p class="abstract"><strong>Methods:</strong> This is a prospective observational study conducted for a period of 6 months. All the patients reporting to our department were evaluated for entry into the study and patients having scalp lesions were enrolled. A detailed clinical history and a thorough scalp examination were performed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The incidence of scalp dermatoses is more among adolescents and early adulthood with a male to female ratio 1.8:1. 57% of patients had lesions exclusive to scalp. Scalp was the initial site of presentation in 54.6% of cases who had generalized lesions. Itching (n=107; 53.5%) is the commonest presenting complaint. Among the scalp sites, parietal area was involved the most (73%). The most common dermatoses were psoriasis (21.5%) followed by alopecia areata (11.5%).</p><p class="abstract"><strong>Conclusions:</strong> The scalp dermatoses have significant psychological impact affecting the social profile of the patients. To the best of our knowledge, this is the first Indian study on scalp dermatoses involving all age groups which gives a precise clinical insight into scalp dermatoses.</p>

scholarly journals Evaluation of haematological findings in cases of pancytopenia

2020 ◽  
Vol 8 (12) ◽  
pp. 4311
Author(s):  
Roshny Jacob ◽  
Deepthi M. L. Raj
Keyword(s):  
Bone Marrow ◽  
Disease Process ◽  
Final Diagnosis ◽  
Underlying Disease ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Bone Marrow Study ◽  
Proper Diagnosis ◽  
One Year

Background: Pancytopenia is a clinical condition which poses diagnostic challenge to the haematologist. The aetiology of pancytopenia is varied and depends on many factors. A bone marrow study is highly indicated in cases of pancytopenia and it provides information regarding the underlying disease process. This study was done to learn the causes of pancytopenia and to document how each case was evaluated and followed up.Methods: The present study is a descriptive retrospective one year study on bone marrow samples received in the laboratory. Bone marrow samples included aspirate smears, imprint and trephine and their findings were correlated to arrive at a final diagnosis.Results: Out of the total 28 patients with pancytopenia, 35.71% were from the age group between 61 and 80 years. A male female ratio of 1.5:1 was observed. Most common presenting complaint documented was easy fatiguability. Anisocytosis with macrocytes and ovalocytes were the most common peripheral smear finding. In current study, a cellular marrow was described in 24 (85.71%) cases and hypocellularity in two (7.14%) cases. Final diagnosis was evident in 16 cases, in which the most common cause was acute leukaemia (14.28% each) followed by lymphoma infiltration and myelodysplastic syndromes in 3 cases (10.71%).Conclusions: Bone marrow study helps to arrive at a diagnosis of pancytopenia. But proper technique for sampling, good clinical workup and history taking and clinico haematological correlation is mandatory for the proper diagnosis of a pancytopenia case.

CLINICAL AND RADIOLOGICAL STUDY OF PSORIATIC ARTHRITIS IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 68-70
Author(s):  
Kurimilla Narasimha Prasad ◽  
P.Vijay Sekhar ◽  
Gopinath Mogilicherla ◽  
Boppani Praveen Kumar
Keyword(s):  
Psoriatic Arthritis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Chronic Progressive Disease ◽  
Detailed Clinical History

Introduction: Psoriatic Arthritis (PA) is an autoimmune inammatory disease involving ligaments, tendons, fascia and spinal and/or peripheral joints in association with or without psoriasis of the skin and/or nails. This study done to determine the natural course, clinical presentation and radiological ndings of the disease. To ascertain the incidence of Psoriati Objective: c arthritis, analyse the different clinical manifestations of PA and to evaluate the clinical and radiological correlation in patients. This Materials and Methods: was a non-interventional, cross-sectional study comprised of 12 patients of PA. In all patients, detailed clinical history was taken followed by clinical and radiological examination were done depending on the joint involved. Out of the total attendance of 5801 new patients at Results: tended, 224 patients had psoriasis (5.35%), there were 12 cases of PA detected, thus accounting for 0.21%. Out of the 12 patients of PA, there were 8 males and 4 females. The male to female ratio was found to be 2: 1, The mean age was 40 years. The joints involved were Proximal inter-phalangeal joints of hands in 7 patients (58.34%), Distal interphalangeal joints of hands in 3 patients (25%), Knee joint and ankle joint in each one patient respectively (8.33%). Majority of the patients on radiographic lms, revealed bony erosions, narrowing of joint spaces, minimal periosteal reaction. One case revealed osteoporosis and fusion of PIP-joints. Five cases didn't reveal any abnormal radiological features. This Conclusion: study conrms that PA is a chronic, progressive disease in the majority of patients. Despite clinical improvement with current DMARD treatment, PA results in radiological damage.

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