Study of cutaneous manifestations in patients with polycystic ovarian syndrome attending a tertiary care centre

Background: Polycystic ovary syndrome (PCOS) is a multisystem metabolic disorder, which has a significant impact on the quality of life as well as fertility.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372429/#ref1">1</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372429/#ref2">2</a> Acne, hirsutism, androgenetic alopecia, acanthosis nigricans, seborrhea are commonly associated with cutaneous manifestations of PCOS. To identify cutaneous manifestations, their incidence and frequency in patients with PCOS in different age groups.Methods: An institutional based prospective study. Seventy PCOS patients attending out-patient departments of DVL and Obstetrics and Gynaecology, NRI Medical College and General Hospital, Guntur, fulfilling the inclusion criteria were included in the study and examined for the presence of cutaneous manifestations in the two year study period between January 2017 and December 2018.Results: In the present study, 70 patients with PCOS were taken up and the commonest age group affected was 21-25 years (42.8%). Positive family history of PCOS was observed in 12.8%. The commonest cutaneous manifestation was acne vulgaris (57.14 %). Obesity was present in 47.14% of the patients and all of them were found to have striae. Hirsutism was observed in 47.14% of the total patients studied and the majority of them had terminal hair in the chin region and upper lip. Acanthosis nigricans was present in 34.28%, seborrhoea in 21.42% and acrochordons in 17.14% of the patients. Of the 70 patients, 15.7% were overweight and 47.14% were obesity.Conclusions: The cutaneous manifestations of PCOS reserves major role in its management by Dermatologist. Recognizing PCOS in women presenting with hyperandrogenism offers a significant opportunity to begin a life-long conversation about prevention and treatment of a condition that has a multi-system impact on affected women.

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Clinico-epidemiological study of melasma in tertiary care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20202662 ◽

2020 ◽

Vol 6 (4) ◽

pp. 544

Author(s):

Nishtha H. Patel ◽

Narendra Gangaiah ◽

Veena Thimappa ◽

Pavithra Gundappa

Keyword(s):

Oral Contraceptive ◽

Tertiary Care ◽

Positive Family History ◽

Sun Exposure ◽

Tertiary Care Centre ◽

Oral Contraceptive Pills ◽

Medical College ◽

Contraceptive Pills ◽

The Face ◽

History Of

Background: Melasma is common pigmentary disorder and affect patient quality of life due to its presentation over the face. It mostly affects sun exposed area and present as grey-brown pigmentation over the face.Methods: In this observational or descriptive study, total 110 patients were enrolled which was carried out in the Department of Dermatology from February 2019 to January 2020 at Sri Siddhartha Medical College and Sciences, Tumkur, Karnataka.Results: Mean age group affected was 31-40 years of age (41.8%). Out of 110 patients 18 patients were male and 92 patients were females. Total 15 patients had positive family history (13.6%). 30 patients had history of taking oral contraceptive pills (27.3%). 22 patients had sun exposure history (20%). 59 patients had epidermal pigmentation (53.6%) and 62 patients had malar region distribution (56.4%).Conclusions: During third decade of life, females were more commonly affected. Pathogenesis of melasma is multifactorial. In our study, we found that oral contraceptive pills and sun exposure may predispose or trigger the melasma. Most common area affected was malar. Epidermal pigmentation was more common.

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Cutaneous manifestations in obese patients and non-obese controls in a tertiary care centre: a case-control study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20194633 ◽

2019 ◽

Vol 5 (4) ◽

pp. 695

Author(s):

Raghuveer Chekuri ◽

Thameena Mohamed

Keyword(s):

Acanthosis Nigricans ◽

Tertiary Care ◽

Control Group ◽

Obese Patients ◽

Striae Distensae ◽

Tertiary Care Centre ◽

Cutaneous Manifestations ◽

High Prevalence ◽

Skin Conditions ◽

And Function

Background: Obesity has emerged as one of the most serious public health concerns in the 21st century. It is responsible for varied changes in structure and function of different components of skin. Skin care of obese patients deserves particular attention, not only because of high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient’s quality of life.Methods: Two hundred patients with BMI ≥30 kg/m2 and two hundred age and sex matched controls (BMI: 18.5-24.9 kg/m2) were included in this study.Results: Compared to the control group, obese patients were having higher prevalence of various skin conditions of which most common were acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections.Conclusions: There is increased incidence and severity of cutaneous manifestations like acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections in obese patients than control subjects. These can be used as markers for the early detection of various components of metabolic syndrome.

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Accidental tramadol ingestion in children admitted in tertiary care centre

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20195200 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2661

Author(s):

Vadlakonda Sruthi ◽

Annaladasu Narendra

Keyword(s):

Pediatric Population ◽

Care Center ◽

Tertiary Care ◽

Ventilatory Support ◽

Case Series ◽

Pediatric Intensive Care ◽

Hemodynamic Instability ◽

Tertiary Care Centre ◽

Medical College ◽

History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

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Status of Vitamin D among Patients Visiting a Tertiary Care Centre in Rupandehi, Nepal

International Journal of Applied Sciences and Biotechnology ◽

10.3126/ijasbt.v9i4.40425 ◽

2021 ◽

Vol 9 (4) ◽

pp. 256-260

Author(s):

Tirtha Narayan Shah ◽

Amar Kumar Sinha ◽

Krishna Kumar Jha ◽

Ram Jiban Prasad

Keyword(s):

Vitamin D ◽

Tertiary Care ◽

Age Groups ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

Target Population ◽

Tertiary Care Centre ◽

Medical College ◽

Serum Vitamin D ◽

High Level

Serum vitamin D is one of the fat-soluble vitamin which has the role in maintenance of calcium and phosphorus levels and ultimately proper bone health and various physiological processes. Although many studies prevail hypovitaminosis D, we focused to find out the pattern of elevated or decreased serum vitamin D level as its deficiency and surplus have adverse effects to our health.. For this, a retrospective study was done from the records present in a hospital laboratory of Devdaha Medical College and Research Institute (DMCRI), Rupandehi, Nepal from January 2018 to December 2020 where 201 participants with 70.1% male and 29.9% female with different age groups were present. From total participants, 14.9% had deficient, 42.8% had insufficient, 35.3% had sufficient and 7% had high level of serum vitamin D. Male had 2.9% deficient and 14,9% insufficient vitamin D whereas female had 11.9% deficient, 27.8% insufficient and 7.0% surplus vitamin D. The greater prevalence of hypovitaminosis D in the females than the males could be overcome by the necessary strategies in the form of further studies and judicious supplementation vitamin D in the target population by monitoring the level of serum vitamin D. Int. J. Appl. Sci. Biotechnol. Vol 9(4): 256-260.

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Aural foreign bodies and their management: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201076 ◽

2020 ◽

Vol 6 (4) ◽

pp. 646

Author(s):

Padma Harini ◽

Suneel Kudamala

Keyword(s):

Foreign Bodies ◽

Incidental Finding ◽

Tertiary Care ◽

Age Groups ◽

Paediatric Population ◽

Outpatient Department ◽

Tertiary Care Centre ◽

Female Ratio ◽

History Of ◽

Male To Female

Background: Aural foreign bodies (FB) are a common presentation at ENT outpatient department mostly seen in paediatric population. Some are easily managed while others should be dealt with caution and extreme care. The objectives of the study were to analyze the types of aural FB, their incidence in different age groups and evaluate management methods.Methods: This is a prospective descriptive study on patients of all age groups with aural FB presenting to the ENT Outpatient Department in a tertiary care centre for a period of 1 year. The clinical presentation, type of FB, incidence in different age groups and management methods were analyzed. Results: 200 patients aged 2-78 years were evaluated. Age group of under 15 years was most affected (70%). Male to female ratio was 1:1.326. Majority (104 out of 200) presented with a history of FB insertion in the ear while others presented with aural pain and discharge. In 10 cases, ear foreign body was an incidental finding. Most common FB was seeds in children and cotton buds, bird feathers in adults. Most of the cases were managed without anaesthesia with use of headlight. Ear probes were used in 45% cases followed by forceps, suction and syringing in remainder.Conclusions: Most of the aural foreign bodies can be managed in the outpatient department itself without any anaesthesia under direct vision of headlight with the help of simple instruments without any complications.

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Frequency of Polycystic Ovary Syndrome among the Students of a Medical College in Dhaka City

International Journal of Diabetes & Metabolic Disorders ◽

10.33140/ijdmd.05.03.04 ◽

2020 ◽

Vol 5 (3) ◽

Keyword(s):

Family History ◽

Polycystic Ovary Syndrome ◽

Acanthosis Nigricans ◽

Polycystic Ovary ◽

Total Testosterone ◽

Dhaka City ◽

Ovary Syndrome ◽

Medical College ◽

Pcos Group ◽

History Of

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder. Only few data are available in Bangladesh. The aim of this study was to find out the frequency of PCOS among the students of a medical college in Dhaka city. Materials & Methods: This cross sectional study was done among the 3rd to 5th year students of Ibrahim Medical College. We used Rotterdam criteria (Revised 2003) for diagnosis of PCOS. After taking written consent, a detailed history including menstrual history was taken. Anthropometric measurements including height in cm, weight in kg, waist circumference (WC) were measured. We assessed hyperandrogenism (H) clinically by hirsutism using a modified Ferriman-Gallway (mFG) method. The presence of acne and acanthosis nigricans was also noted. For biochemical hyperandrogenism we did total testosterone estimation. Blood samples was collected between 08.00 and 10.00 am on Days 2-7 of a spontaneous bleeding episode or randomly in the case of amenorrhea after an overnight fast. The circulating levels of total testosterone, levels were measured by Chemiluminescent Immunoassay (Advia Centaur XPTM). Transabdominal USG (Aloka F37) was done by expert radiologist of department of Radiology, BIRDEM. PCOS group was categorized in 4 different phenotypes based on the presence of oligo-anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P) : (i) Phenotype A (O+ H+ P), (ii) Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Results: Out of 73 girls 27(37%) satisfied Rotterdam’s criteria for PCOS. Phenotype B was more common 16(59.3%) followed by A 5(18.5%) then C 3(11.1%) and D 3(11.1%). Hirsutism was found in 24 (88.8%) girls, menstrual disturbance was also present among 24 (88.8%) girls, serum testosterone was elevated in 6(22.2%) girls, 11(40.7%) had USG findings of polycystic ovaries. The mean BMI (24.70 + 3.7) was significantly high (BMI > 23 kg/ m2) among those who had PCOS (59.86%). Acne & acanthosis nigricans was observed 15(55.6%) & 6(22.2%) girls among PCOS respectively which were not statistically significant. Hypothyroidism was observed 7(25.9%) girls with PCOS. Associated family history of DM found in 21(77.8%) girls with PCOS. Family history of PCOS was present in 7(25.9%) girls in PCOS group. The difference were statistically significant (p<0.05) between two groups. Conclusion: Prevalence of PCOS is 37%, which demonstrates that PCOS is an emerging disorder. This draws attention to the issue of early diagnosis, which could provide opportunity to target the group to prevent future morbidities.

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Pattern of Congenital Overt and Occult Pediatric Surgical Anomalies in a Tertiary Care Centre Over 5 Years

Galore International Journal of Health Sciences and Research ◽

10.52403/gijhsr.20211004 ◽

2021 ◽

Vol 6 (4) ◽

pp. 16-20

Author(s):

Sam Varkey ◽

Aravind C. S ◽

Reeti Rajan

Keyword(s):

Congenital Anomalies ◽

Pediatric Surgery ◽

Hospital Admissions ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Low Socioeconomic ◽

Medical College ◽

Common System ◽

History Of

ongenital anomalies are important cause of infant and childhood deaths, chronic illness and disability. The proportion of deaths and disability due to congenital anomalies has increased, as deaths due to other diseases have decreased over the years due to better health care. Hence it is essential to have basic epidemiological information of these anomalies. This is a hospital based, cross-sectional, record based study, conducted in the Department of Pediatric Surgery, Govt. Medical College Thiruvananthapuram, Kerala. Sample size included 300 children below the age of 12years admitted in the department of pediatric surgery with various major congenital anomalies, over a period of 5 years. More than half of these children were admitted after infancy for treatment, male children were more compared to females. Majority of these children were from low socioeconomic group. Only in 5.6% cases there was a history of consanguineous marriage. In 7.33% there was family history of congenital anomalies. In 32% cases the anomalies were detected in the antenatal period. Most of the anomalies were isolated anomalies. Genitourinary system was the most common system to be involved followed by, gastrointestinal tract. 91.67% children underwent surgical treatment, and only 10.67% children had major complications in postoperative period. This study shows that congenital anomalies are a major cause of hospital admissions in children of all ages. Pattern of anomalies seen in various centers are different. Knowledge of the pattern of congenital anomalies may be useful in planning health services. Keywords: Congenital, Anomalies, Pediatric surgery.

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A study of febrile convulsions with a bacteremia incidence in a tertiary care teaching hospital in Andhra Pradesh

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203648 ◽

2020 ◽

Vol 7 (9) ◽

pp. 1885

Author(s):

Shaik Ateal Saheb

Keyword(s):

Family History ◽

Tertiary Care ◽

Positive Family History ◽

Febrile Convulsion ◽

Clinical History ◽

Health Issues ◽

Febrile Convulsions ◽

Medical College ◽

History Of ◽

History Of Epilepsy

Background: A febrile convulsion is linked with high temperature but without significant underlying health issues. These occur most often in children aged six months to five years. Most of the convulsions last less than five minutes, and within an hour of the occurrence, the child is entirely back to normal.Methods: Sixty children aged 3 months to 5 years admitted to the emergency pediatric ward with a history of convulsion fever with convulsions, in Narayana Medical College and Hospital were taken up for the study with clinical history, clinical examination, laboratory Investigations.Results: Among 60 children in the study group, 15 (25%) of them were aged between 3 months to 12 months, 21 (35%) of them were between 13 months to 24 months. Gender 36 (60%) are male children. 24 (40%) are female children. Family history of convulsions was positive in 18 (30%) of the 60 (100%) cases, and 7 had family history of epilepsy. 42 (70%) are negative. Most of the cases (85%) showed no growth in blood culture.Conclusions: Blood culture should be performed in all children by febrile convulsions, especially those under the stage of two years. Streptococcus pneumonia was the organism isolated from respiratory tract infection in a child with febrile convulsion with significant bacteremia. The symptoms that present can be as harmless as rhinorrhea or cough. Children with a positive family history of afebrile convulsion should be closely monitored and test, as they can develop epilepsy later.

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When the Disease is Known but the Patient is not. Outcome of 118 such Patients at a Tertiary Care Centre

Romanian Neurosurgery ◽

10.2478/romneu-2018-0066 ◽

2018 ◽

Vol 32 (2) ◽

pp. 505-512

Author(s):

Gaurav Jaiswal ◽

Praveen Kumar Tripathi ◽

Vardan Kulshreshtha ◽

Tarun Kumar Gupta

Keyword(s):

Head Injury ◽

Road Traffic ◽

Tertiary Care ◽

Good Recovery ◽

Tertiary Care Centre ◽

Medical College ◽

Discharged Patients ◽

History Of ◽

A Prospective Study ◽

Lost To Follow Up

Abstract This is a prospective study, carried out at the Department of Neurosurgery at M.B.G Hospital, R.N.T Medical College, Udaipur, Rajasthan (India). Many patients with history of trauma with head injury, whose identity cannot be ascertained, are admitted in our hospital. The management of these unattended patients from pre-hospital till discharge, rehabilitation or death is full of difficulties especially when surgical intervention has to be done. From March 16, 2015, until March 30, 2016, 118 consecutive patients unattended patients admitted in our department with history of head injury were enrolled in the study. Out of 118 patients, 107 (91%) were male, most were in the age group of 30-39 years. In majority of patients, 115 (97%) principal cause of head injury was road traffic accident. Majority of the patients 49 (41%) had Glasgow coma scale >13 on admission. Twenty three patients 23 (20%) died in hospital, 71 (60%) patients had good recovery. During the course of treatment identity of 115 patients was established and 92 (78%) patients, who survived were discharged to home. Three (3%) patients were shifted to destitute home. All discharged patients were followed at 1 month and 6 month interval. 78 (82%) & 76 (80%) patients showed good recovery (GOS) at 1 month & 6 month respectively. One patient expired at home within one month of discharge and 6 patients lost to follow up at 6 months.

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A clinico-epidemiological study of polymorphic light eruption in a tertiary care centre in Salem: a region of South India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170798 ◽

2017 ◽

Vol 3 (1) ◽

pp. 113

Author(s):

Eby Chacko ◽

Seethalakshmi Ganga Vellaisamy ◽

Kannan Gopalan ◽

Govindarajan Nanjappachetty

Keyword(s):

Tertiary Care ◽

Positive Family History ◽

Study Data ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Polymorphic Light Eruption ◽

Plaque Type ◽

History Of ◽

Study Population ◽

Symptoms And Signs

Introduction: Polymorphic light eruption (PMLE) is an acquired photodermatosis characterized by a polymorphic eruption ranging from papulovesicular lesions to large plaques. The prevalence of PMLE varies from 5% to 15% in various studies across the world and in India it is 0.56%.Objective: The present study was conducted to study the clinical pattern and to assess the epidemiological aspects of polymorphic light eruption.Material and Method: A cross sectional prospective study was conducted in Dermatology OPD between April 2015 and June 2016. A total of 100 patients with symptoms and signs of PMLE were included in the study. Data were coded and analyzed.Results: Majority of the cases in our study were in the age group of 21 - 30 years (36%). It was more common in females (82%) when compared with males (18%). Occupation of most of the patients (29%) was farmers in our study population. Positive family history of PMLE was seen in 11% of the study population. The commonest form was the papular type (46%) and the second most common type was plaque type (17%). Regarding the distribution of lesions, about 51% of our study subjects had polymorphic lesions confined to only one area of their body mostly forearm (25%) followed by face (12%).Conclusion: The prevalence of PMLE was 1.34% in our study population. Pruritus was the presenting complaint in most of the cases and the rash was mainly seen in areas exposed to sunlight.

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