scholarly journals Erythroderma: a clinico etiological study of 77 patients in a tertiary care centre in Kerala

Author(s):  
Abin Abraham Itty ◽  
Rajiv Sridharan ◽  
Anoop Thyvalappil ◽  
Bindurani Sudhamani

<p class="abstract"><strong>Background:</strong> Erythroderma is defined as generalized erythema and scaling of the skin affecting more than 90% of body surface area. Identification of the underlying disease process represents one of the most complex challenges in proper patient care.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was done in Department of Dermatology in a Tertiary Care Centre. History, clinical findings and investigations of erythroderma patients were recorded and clinic-histopathological correlation was analyzed by kappa coefficient (К).<strong></strong></p><p class="abstract"><strong>Results:</strong> Erythroderma was more prevalent in elderly males with a mean age of 64.56 years and a male to female ratio of 3:1. A clinical evidence of pre-existing dermatoses was found in 65 patients, commonest being eczema (41.3%) followed by psoriasis (40.3%). Evidence of a trigger was seen in 54.54% patients, commonest being the use of ayurvedic medications (42.8%). Clinico-histopathological correlation was seen in 53.9% cases.</p><p class="abstract"><strong>Conclusions:</strong> Although the clinical presentation of erythroderma is similar, etiological factors are varied and it depends largely on the population studied. Most commonly, erythroderma is due to generalization of pre-existing dermatoses as seen in our study. Hence careful evaluation of clinical clues and histopathological correlation plays a pivotal role in diagnosis of the primary cause and the effective management of erythroderma.</p>

Author(s):  
Seema Meena ◽  
Sukriti . ◽  
Sonal Bhati ◽  
Abha Patni

Background: Bone marrow aspiration (BMA) is a minimally invasive technique performed in a variety of hematological disorders. It is considered essential for the diagnosis and management of haematological disorders. BMA is usually sufficient to diagnose nutritional anemia and most of the leukemias. Aims & Objectives: To study the spectrum of hematological disorders diagnosed on BMA in a tertiary care centre, Udaipur. Material & Methods:  The present study was conducted in the hematology section of department of Pathology, RNT Medical College & MB Hospital, Udaipur for a period of one year from June 2018 to May 2019. A total of 123 cases of suspected hematological disorders underwent the process of BMA from posterior superior iliac spine under local anesthesia. Exclusion criteria of our study included aspirates of dry tap. BMA smears were stained with Giemsa stain for morphologic examination. Result: The present study included 123 cases. Male to female ratio in our study was 1.6:1. Anemia (45.5%) was the most common hematological disorder in our study, iron deficiency anemia being the most common followed by megaloblastic anemia. Chronic myeloid leukemia (26.01%) was the most common hematological malignancy in our study. Conclusion: Bone marrow aspiration is a useful diagnostic procedure in hematological practice for the diagnosis of both hematological and non-hematological conditions. Rapid and early diagnosis of malignancies are critical for proper initiation of treatment and to control the disease. Keywords: Bone Marrow Aspiration, Hematological disorders, Leukemias


2012 ◽  
Vol 4 (2) ◽  
pp. 256-262 ◽  
Author(s):  
R Sitaula Kharel ◽  
S Aryal ◽  
S N Joshi ◽  
J K Shrestha

Objectives: To study the demographic profile, clinical presentations, management and visual outcome of retinal vasculitis in a tertiary eye care center of Nepal Materials and methods: A retrospective, record based study of retinal vasculitis cases in the retina clinic of a tertiary care centre in Nepal from January 2009 to January 2011 was carried out. Results of the study were compared to those from the study conducted in a similar set- up between 1998 and 2000. Results: Sixty-nine eyes of 51affected patients were evaluated in the study. The male/female ratio was 2.64:1 vs 19:1 a decade ago (p=0.0027). The mean age of the patients was 33.53 ± 12.29 years in the present study. Bilateral ocular involvement was present in 18 cases (35.3%) vs 56.14% in the past decade (p=0044).The common symptoms were dimness of vision (29.4%), floaters (25.5 %) and flashes of light (3.92%). Seventy-one eyes (69.6%) had the best corrected visual acuity of 6/18 or better. Four eyes (3.92 %) had no light perception. Vascular sheathing was the most common finding (32.35%), followed by vitritis (30.39%). Corticosteroids were primarily used to manage retinal vasculitis (39.21%). No association of retinal vasculitis with tuberculosis was found.Conclusion: The demographic pattern and clinical presentation of idiopathic retinal vasculitis has changed over a decade period in Nepal.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6541 Nepal J Ophthalmol 2012; 4 (2): 256-262  


Author(s):  
Saradha K. Perumal ◽  
Sudha R. Gopinath

<p class="abstract"><strong>Background:</strong> Psoriasis is a chronic immune mediated inflammatory condition of the skin. Palmoplantar psoriasis (PPP) is a clinical variant of plaque psoriasis affecting palms and soles extending to the wrist and the margins of the soles and heels. This study was done to find out the prevalence of palmoplantar psoriasis in our setting. The aim of the study was to determine the prevalence, demographic features and other co-morbidities of the palmoplantar plaque psoriasis in a tertiary care centre.</p><p class="abstract"><strong>Methods:</strong> We conducted retrospective study for a period of one year (January 2017 to December 2017) on palmoplantar plaque psoriasis patients attending the dermatology OPD.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 552 enrolled psoriasis patients, 85 were clinically diagnosed to have palmoplantar psoriasis. The mean age of the patient was 45 years. Most of them belong to 4<sup>th</sup>, 5<sup>th </sup>and 6<sup>th</sup> decade of life. The male to female ratio was 1:2.26. The duration of the disease was more than one year in 73% of patients at the study time. Occupation of the patients included house-wives (50%), manual labourers (36%) and office goers, (13%). Hyperkeratotic plaque type psoriasis with scaling and fissures was the predominant morphological pattern recorded. Dyslipidemia (22%), overweight and obesity (56%), hypothyroidism (6%) and diabetes mellitus (12%) were the observed co-morbidities in this study.</p><p class="abstract"><strong>Conclusions:</strong> The prevalence of palmoplantar psoriasis (0.09%) was low in our study. Palmoplantar psoriasis affected middle aged adults and had a female predominance in this study. Overweight, obesity, dyslipidemia, diabetes mellitus and hypothyroidism were the co-morbid conditions observed in this study. Being a relapsing and chronic condition the disease poses a poor quality of life than plaque type psoriasis.</p>


2021 ◽  
pp. 5-7
Author(s):  
Nilesh Mohan ◽  
Vandana Parasar ◽  
Ankita Singh ◽  
Rakhi Kusumesh

AIM: To determine the prevalence and risk factors of dry eye among patients of a tertiary care centre in eastern India. Symptoms of dry eye are encountered as one of the most frequent complains among the patients attending the outpatient department in ophthalmology commonly presenting as ocular discomfort, burning sensation and foreign body sensation.Prevalence of this entity is still not known in our study population due to lack of specificity of symptoms and diagnostic criteria. MATERIALS AND METHODS: A prospective, observational, cross-sectional study was conducted among patients attending ophthalmology OPD in a tertiary care teaching hospital of Bihar. 4116 (16.64%) patients with dry eye symptoms were examined after taking informed consent. RESULTS: 1620 (6.55%) patients were found to have dry eye based on McMonnies questionnaire, Schirmer's test and tear film breakup time.There were 1180 female and 440 male with dry eye.Male to female ratio was 2.7:1.Non-tribals were affected more commonly than tribals. Students, outdoor workers and office worker with professional constituted over fifty percent of dry eye cases. CONCLUSION: Prevalence of dry eye was more in females and elderly as compared to male and younger population respectively.Burning sensation and ocular discomfort was the most common presenting complains.


Author(s):  
Mohan M. Desai ◽  
Deven R. Kuruwa ◽  
Easwar Elango ◽  
Roshan Wade

<p class="abstract"><strong>Background: </strong>Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.</p><p class="abstract"><strong>Methods: </strong>Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.</p><p class="abstract"><strong>Results: </strong>43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.</p><p class="abstract"><strong>Conclusions: </strong>Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.</p>


2021 ◽  
Vol 10 (37) ◽  
pp. 3213-3219
Author(s):  
Jagaragallu Amrutha ◽  
Narasimha Rao Netha Gurram ◽  
Padmaja Pinjala ◽  
Bhumesh Kumar Katakam ◽  
Rajeev Singh Thakur

BACKGROUND Erythroderma is a clinical entity that may cause severe systemic manifestations. The difficulty with erythroderma lies in finding the underlying aetiology. It is imperative to demonstrate precise aetiology whenever possible so that distinct therapy may be initiated. At times, despite finding the aetiology, relapses constitute a great menace. The purpose of our study was to assess the clinical profile and aetiology of erythroderma. Besides, the study also illustrated factors leading to relapses; such studies are rare in literature. METHODS This hospital-based, cross-sectional study included 88 patients of erythroderma of either sex and age more than 18 years; their clinical, laboratory, histopathological findings, treatment and outcome were studied. RESULTS The mean age of onset was 47.3 ± 12.35 years with the male to female ratio being 2.38:1. The most common cause of erythroderma was pre-existing dermatoses (67 %) followed by drugs (10.2 %), infections (3.4 %), malignancies (4.54 %), and idiopathic (14.7 %). Psoriasis was the predominant aetiology (45.4 %) among the pre-existing dermatoses with a maximum number of relapses (P = 0.02). Psoriasis was significantly associated with pruritus (P = 0.001), subungual hyperkeratosis (P = 0.0001), palmoplantar keratoderma (P = 0.001). Clinicohistological association was found in 64.6 % of cases. Mortality was seen in 6.8 % of cases. CONCLUSIONS As in previous studies, pre-existing dermatoses were the most common causes in our study; albeit, a special emphasis on factors leading to relapses was given to prevent further episodes. The most common factor of relapse was uncontrolled comorbid disorders (diabetes and hypertension) followed by medication nonadherence. Hence, our study suggests a need for more effective comorbidity management and creating awareness regarding judicial use of drugs which can go far in preventing mortality and morbidity. KEY WORDS Erythroderma, Adults, Aetiology, Relapses, Comorbidities.


2021 ◽  
Vol 71 (2) ◽  
pp. 672-75
Author(s):  
Sunila Tashfeen ◽  
Naveed Asif ◽  
Shafia Nasir ◽  
Muhammad Azam ◽  
Zareen Irshad

Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019. Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study. Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders. Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.


Author(s):  
Digamber Chaubey ◽  
Sandip Kumar Rahul ◽  
Ramdhani Yadav ◽  
Vijayendra Kumar ◽  
Nitesh . ◽  
...  

Background: Any criteria (clinical, pathologic, microbiological or histo-pathologic) attributing a case of Paediatric gastrointestinal perforation to Typhoid would be of help in reaching a proper diagnosis to guide appropriate management. Aims and Objectives: To review all cases of Typhoid perforation for their clinical, pathologic and intra-operative findings. Materials and Methods: A retrospective study was conducted on all cases of typhoid perforation (gastrointestinal perforation with positive Widal test) operated at a tertiary care centre from September 2015 to September 2018. Data regarding their clinical findings, investigation results, intraoperative findings, nature of the surgical intervention, postoperative results and histopathological findings were collected from their records and analysed. Results: A total of 13 patients were operated during this period with positive Widal’s test at presentation. 6/13 had single ileal perforation; two patients had multiple ileal perforations; perforation at atypical sites were found in four patients (one each at gastric, duodenal, caecal and rectal); one patient presented with Meckel’s band obstruction with multiple ulcers – this patient was sick and died despite a diverting ileostomy in the postoperative period. While 8/13 patients had primary closure of the perforation site, diversion through ileostomy was performed in five patients. All patients did well in the post-operative period except one patient of multiple ulcers and obstructing Meckel’s band who died in the post-operative period. Conclusion:  On encountering a gastrointestinal perforation, no definite symptomatology or its pattern, no clinical examination findings, no intraoperative characteristics of the perforation and no biopsy can definitively point towards Typhoid as the cause. Therefore, we still have to depend on serological tests in correlation with clinical features to reach a conclusive diagnosis. Cultures and PCR, although sensitive are either time-taking or expensive to guide management. Typhoid perforation can have vivid and atypical presentation depending on the number and site of perforation.


Author(s):  
Ishrat Zuber ◽  
Vaishali Chaurasia

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergency in day-to-day practice. Objectives of present study were to know the incidence of Ectopic pregnancy at Tertiary care centre, the age group, parity and risk factor of ectopic pregnancy, the clinical presentation of ectopic pregnancy and the outcome and management of ectopic pregnancy.Methods: It was a retrospective study conducted at Chirayu Medical College and Hospital, Bhopal from 1st June 2009 to 31st May 2014. A total of 42 patients with ectopic pregnancy were analyzed on clinical presentation, clinical findings, investigations, operative findings and outcome.Results: A majority of women (64.29%) were in the age group of 21-30 years and 78.57% were multigravida. Commonest risk factors were previous history of abortion (23.80%) and pelvic inflammatory disease (14.28%) Amenorrhea (92.85%) and pain abdomen (89.22%) were the most common presenting symptoms. Ampulla of fallopian tube was the commonest site (45.23%). Unilateral salpingectomy was performed in 40.47% patients. There were no maternal deaths and majority (80.96%) were discharged within seven days.Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.


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