scholarly journals A Study of Nail Changes in Various Dermatosis

2016 ◽  
Vol 11 (1) ◽  
pp. 38-44
Author(s):  
ATM Rezaul Karim ◽  
Shayesta Parvin Sadeque ◽  
Md Abdul Latif Khan ◽  
Md Sayeed Hasan ◽  
Md Abdus Samad Al Azad ◽  
...  

Introduction: Nails act as a window to diagnosis of skin diseases. Various dermatosis affect the nails and the severity of the skin disorder is reflected in the nails. Nail changes are seen in various dermatosis like psoriasis, lichen planus, onychomycosis, collagen vascular disorders, vescicobullous disorders and other papulosquamous disorders.Objectives: The objective of this study is to see the abnormal nail changes in patients’ reporting to the Department of Dermatology and Venereology in Combined Military Hospital, Comilla.Materials and Methods: This is a prospective study, carried out in the department of Dermatology and Venereology, Combined Military Hospital, Comilla from January 2014 to December 2014. Total 250 patients based on nail changes coming for various dermatological conditions were enrolled in this study. A detailed clinical history regarding onset, duration and associated symptoms was asked. A thorough systemic and dermatological examination was conducted and all details were recorded on a special proforma. Routine investigations like haemoglobin concentration (Hb), total leucocyte count (TLC), differential leucocyte count (DLC), ESR, platelet count, urine routine examination, serum urea and creatinine were carried out to confirm the diagnosis. Special investigations like nail clipping for bacteriological and fungal infection and skin biopsy were carried out whenever required.Results: This study showed, out of 250 patients, nail changes were seen in various dermatosis. Maximum number of patients (50%), were of onychomycosis (Fig-1) followed by 12% patients of paronychia (Fig-2), eight percent patients of Psoriasis (Fig-3), eight percent patients of lichen planus (Fig-4) and four percent patient were of Twenty nail dystrophy(Fig-5). Out of 20 patients of psoriasis the most common changes were pitting, subungual hyperkeratosis, onycholysis and discoloration. Out of 20 cases of lichen planus, the most common changes were longitudinal ridging, pterygiumand onycholysis. Twenty nail dystrophy was seen in 10 cases and the commonest cause of twenty nail dystrophy was idiopathic in 40% cases, psoriasis in 30% cases, lichen planus in 20% cases and alopecia areata was seen in 10% cases.Conclusion: A variety of nail changes can occur in various dermatological, systemic and other conditions. The nail unit is capable of only a limited number of reaction patterns; therefore, many diseases share similar changes, but correlation of the nail changes helps dermatologist to reach conclusive diagnosis. Nails remain an under studied and yet quiet accessible structure that lends itself for examination and evaluation. Hence truly said that nails are the windows through which one can look into the health of the patient.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 38-44

2015 ◽  
Vol 10 (1) ◽  
pp. 29-33
Author(s):  
ATM Rezaul Karim ◽  
Md Abdul Latif Khan ◽  
Md Sayeed Hasan ◽  
Moyassaque Ahmed ◽  
Shirajul Islam Khan ◽  
...  

Introduction: It is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear in the skin in different parts of the body. Objective: The objective of this study is to see the efficacy of systemic PUVA in the treatment of vitiligo patient. Methods: This is an prospective longitudinal interventional study, carried out in the depigmented area was assessed according to the department of Dermatology and Venereology, Combined Military Hospital, Dhaka in between the duration of April 2010 to March 2011. Total 25 vitiligo patients based on inclusion criteria like patient with vitiligo affecting more than 5% body surface area, patient having ivory- white fluorescence on Wood’s lamp, patient who was above 15 years of age, patient who had given written consent, patient was not taken any previous treatment etc. Results: This study showed the therapeutic response of study group after 04 weeks of therapy, 05 (20%) patients responsed Fair, 15 (60%) patients responsed Poor and no responsed by 05 (20%) patients. Therapeutic response of study group after 08 weeks of therapy showed that 15 (60%) patients responsed Fair and 10 (40%) patients responsed Poor. It was observed after 12 weeks of therapy that 13 (52%) patients responsed Poor followed by 10 (40%) patients responsed Fair and 02 (08%) patients responsed well. 29 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Therapeutic response of study group after 16 weeks of therapy was 15 (60%) patients responsed Fair, followed by 06 (24%) patients responsed Poor and 04 (16%) patients responsed Good. It was showed that after 20 weeks of therapy 13 (52%) patients responsed Fair, followed by 08 (32%) patients responsed Good, 03 (12%) patients responsed Poor and 01 (04%) patients responsed Excellent. It was observed that after 24 weeks of therapy 12 (48%) patients responsed Good, followed by 08 (32%) patients responsed Fair, 03 (12%) patients responsed Poor and 02 (08%) patients responsed Excellent. Conclusion: Systemic PUVA for the repigmentation of vitiligo seems to be effective. Study needs large number of patients for longer period of duration for confirmation of results. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22900 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014


2016 ◽  
Vol 12 (2) ◽  
pp. 66-70
Author(s):  
Md Shameem Haidar ◽  
Md Abdur Razzak

Introduction: The seronegative arthritis is a heterogeneous group of inflammatory rheumatic diseases with predominant involvement of axial, peripheral joints and enthesitis. All of these have some distinct as well as some overlapping features, characteristic peripheral asymmetrical lower limb involvement and a negative rheumatoid factor. Involvement of joints is usually oligoarticular but rarely polyarthritis may be present. Diagnosis is usually made from clinical features rather than investigations. Objective: To evaluate the seronegative arthritis clinicopathologically by collecting and analyzing the relevant informations. Materials and Methods: A descriptive cross-sectional prospective study was conducted at Combined Military Hospital, Chittagong from November 2015 to October 2016. A total 74 patients of suspected seronegative arthritis were included. Detail socio-demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously to confirm the aetiology of seronegative arthritis. Results: Maximum number of patients was in the 3rd to 4th decade (62.1%), mean age of the patient was 37.4±8.7 and 38.7±8.1 years in male and female respectively. Malefemale ratio was 2.65:1. Symmetrical sacroiliitis was found in 15(20.2%) patients, asymmetrical sacroiliitis in 36(48.6%) and in 23(31.2%) cases sacroiliac joint was not involved. Common aetiology for seronegative arthritis showed that, reactive arthritis recognized in majority of patients 29 (39.1%) and second most common cause was seronegative rheumatoid arthritis in 23(31%) patients. Conclusion: The Seronegative arthritis is a social, economical and health-care burden. Patients who develop 66 JAFMC Bangladesh. Vol 12, No 2 (December) 2016 arthritis have high disability, discomfort and loss of quality of life. Seronegative arthritis is an interesting group of related conditions with overlapping features and genetic and familial association. That may alert the primary care physician to attain possible diagnosis of spondyloarthritis and to consider a rheumatological opinion. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 66-70


2015 ◽  
Vol 9 (2) ◽  
pp. 43-48
Author(s):  
Nazmul Huda Khan ◽  
Mushtaq Ahmad ◽  
Farial Naima Rahman ◽  
Mohammad Ali ◽  
Mahbubur Rahman

Introduction: Armed Forces personnel suffer from various patterns of injuries during their military training activities which may lead to considerable mortality & morbidity. The high incidence of injuries places a substantial burden on the health care delivery system. Successful treatment outcome and modifications can reduce the operational, fiscal, and health impact of these problems. Objective: To find out the types, causes and morbidity pattern of common injuries received by the members of Bangladesh Armed Forces during their military activities. Methods: This is a descriptive retrospective study carried out to explore the injuries amongst Bangladesh Armed Forces personnel due to military duties. The study population (193) included all injured indoor cases treated in Combined Military Hospital (CMH) Dhaka during the period of January 2009 to December 2009. Data was collected by reviewing the case sheets of patients and analyzed with the help of SPSS Version 11.5. Results: Numbers of Injured subjects amongst the Army personnel were 132(68.4%) followed by 34(17.6%) in Navy and 27(14%) in Air Force. Among them 82(42.5%) belonged to fighting group, 50(25.9%) supporting and 61(31.6%) service group. Knee injury constituted the highest number of patients i.e. 43(22%), followed by 43 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 33(17%) Armand 25(13%) foot injuries. About one fourth, 53(27.5%) cases sustained injury in sports ground followed by 50(25.9%) in operation area and 28(14.5%) in training ground. Physical training events PT/Drill caused maximum injury 7(3.6%) followed by crossing 6ft wall 5(2.6%), horizontal rope 4(2.1%). Maximum duration of hospital stay among the cases were 1-2 weeks in 65(33.7%) followed by 3-4 weeks in 56(29%) and 1-3 months in 41(21.2%) cases. Eighty two (42.5%) injured cases suffered for 3 to 6 months followed by 43(24.4%) for 6 months to1 year. Out of all cases 72(37.3%) were recommended for medical category C, 2(1%) for category B, 11(5%) were Medically Boarded Out (MBO). Conclusion: The study revealed that musculoskeletal injuries especially in knee, foot, shoulder, forearm, ankle, lower leg and patella are prevalent in armed forces personnel. The high incidence of injuries places a substantial burden on the health care delivery system and leads to many lost training days. Careful study and analysis in this regard definitely will explore new dimension to prevent and combat this preventable health burden. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21825 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013


2013 ◽  
Vol 20 (05) ◽  
pp. 804-809
Author(s):  
RAHEEL IFTIKHAR ◽  
SULTAN MEHMOOD KAMRAN ◽  
KUMAIL ABBASS, ◽  
Ehtesham Haider,

Objective: To determine frequency of Hypomagnesaemia in patients of type 2 diabetes mellitus in our population. DataSource: Random selection of DM II patients from Outpatient Department CMH, Kharian. Design: Cross sectional study. Setting:Combined Military Hospital Kharian, Department of Medicine. Duration of study: January 2011 to December 2011. Materials &Methods: We selected outdoor patients of DM-2 from both gender between 40 to 70 yrs of age by random sampling. Those selected,were subjected to blood fasting and random glucose measurements as well as serum magnesium levels. Blood samples were collectedusing full aseptic measures and within one hour, samples were transported to Armed Forces institute of Pathology (AFIP) for analysis.Serum magnesium level estimation was done by timed endpoint method using calmagite dye. DXC 600 automated analyzer was used.The results were verified by Pathologist. Results: The overall frequency of Hypomagnesemia was 32.2% (124 out of the 385 subjects)using the cutoff value of less than 0.6mmol/l for Hypomagnesaemia, whereas 67.8% (261 out of the 385 individual) had normal serummagnesium levels. Conclusions: Significant number of patients with type 2 diabetes mellitus suffers from Hypomagnesaemia. Thesepatients have increased risk risk of poor Glycemic control and diabetic complications due to Hypomagnesemia. Therefore, it isrecommended that serum magnesium levels should be checked regularly in patients with type 2 diabetes mellitus and oral magnesiumreplacement should be done.


2011 ◽  
Vol 3 (2) ◽  
pp. 258-263 ◽  
Author(s):  
N. V. Bhatkar

The principle source of chromium in water bodies is discharged from industries which use large amount of chromates or dichromates. The freshwater fish, Labeo rohita was used as a model in the present studies to investigate the responses to chromium metal salt contamination in water bodies as it is the most common fish consumed widely in India. Haematological tests were carried out as these are the important diagnostic tools and are equally valuable as indicators of disease or stress due to pollutants and environmental fluctuations. The fishLabeo rohita were exposed to sublethal concentration of chromium chloride for 10, 20 and 30 days to study alterations in certain haematological parameters. The parameters under study were total erythrocyte count (TEC), haemoglobin (Hb gm%), total leucocyte count (TLC), differential leucocyte count (DLC) and pack cell volume (PCV). The studies revealed that chromium chloride-treated Labeo rohita exhibited decreased levels of total erythrocyte count (TEC), haemoglobinn (Hb gm%) and PCV whereas, total leucocyte count (TLC) was increased under thestress of chromium metal The decreased WBC count found after 30 days along with depleted Hb content and RBC count indicate dysfunctioning of haemopoietic systems along with dysleucopoiesis. Leucocytosis observed after 10 and 20 days exposure has been considered to be an adaptation to meet stressful conditions by animals. Increase in macrophages and basophils appears to be protective response during chromium exposure. An increasing trend in the mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were evident in fish exposed to sublethal doses of chromium chloride when compared with the control.


2011 ◽  
Vol 3 (1) ◽  
pp. 33-38
Author(s):  
Miroslav Ž. Dinić ◽  
Lidija Kandolf-Sekulović ◽  
Radoš D. Zečević

Abstract One hundred years of dermatovenereology of the Serbian Army was celebrated on November 7, 2009, in the amphitheatre of the Military Medical Academy (MMA). The oldest document in possession of the Serbian Armed ForcesMedical Services is dated on St. George’s Day, May 6th, 1869 and represents a “Daily report of military hospitals”. This document clearly shows the number of patients, and what they suffered from. Moreover, this document shows, among other things, how many patients were suffering from “venereal diseases, red wind, mechanical injuries, base wounds, ulcers, lichen and mange“. Until 1909, the Department of Dermatovenereology did not exist as an independent. Today, the Clinic has 2 divisions (a total of 36 beds), as well as the Laboratory for immunodermatology, Surgical unit, GeneralDermatology Outpatient Clinic, Allergology Section, Phototherapy Section, Dermoscopy and Melanoma Outpatient Clinic. The Clinic is the leader in the treatment of psoriasis, autoimmune skin diseases (pemphigus, pemphigoid), severe forms of atopic dermatitis, erythroderma, skin lymphomas and cutaneous manifestations of connective tissue diseases (lupus, dermatomyositis, sclerodermia), and a dermatologic oncology section is being developed, where systemic therapy of melanoma and follow-up of these patients will be done. Regarding the vision of the future, the main task of the Clinic is to ensure continuous improvement in the field of dermatology in Serbia. The plan is to develop the area of photodiagnostics and phototherapy, which are insufficient in the region. Also, further development of dermatological surgery is planned. Further development of Allergology Service is mandatory, as well as establishment of Pediatric Dermatology, Phlebology and Trichology Outpatient Clinic. Continued scientific research is essential for the development of an academic institution and a prerequisite for continuous diagnostic and therapeutic progress, and a permanent pursuit.


2014 ◽  
Vol 9 (1) ◽  
pp. 2-7 ◽  
Author(s):  
MSI Khan ◽  
MN Uddin ◽  
MOR Shah ◽  
L Khondker ◽  
MS Hasan

Introduction: Lichen planus is a common pruritic, inflammatory disease of the skin, mucous membranes, nail and hair follicles. Low dose low molecular weight heparin is administered in the treatment of cutaneous lichen planus. Objective: The objective is to evaluate the efficacy of low dose low molecular weight heparin in the treatment of cutaneous lichen planus. Materials and Methods: An interventional study was carried out in the department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka. Total thirty seven patients of cutaneous lichen planus were selected by purposive type non-probability sampling technique. Data were collected by face to face interview and clinical examination. Results: It was observed that before treatment, the score of cutaneous lichen planus lesion was 6.83 ± 1.30 and after treatment was 3.83 ± 1.18 and ‘t’ test was found statistically significant (P<0.05). Improvement was shown in 26 (70.27%) cases. Out of these, response was good in 23 (88.46%), fair in 2 (7.69%) and poor in 1 (3.85%) cases. Conclusion: The study revealed that low dose low molecular weight heparin has remarkable efficacy profile as treatment option for cutaneous lichen planus. DOI: http://dx.doi.org/10.3329/jafmc.v9i1.18717 Journal of Armed Forces Medical College Bangladesh Vol.9(1) 2013: 2-7


2017 ◽  
Vol 13 (1) ◽  
pp. 75-80
Author(s):  
Md Tariquzzaman ◽  
Golam Mohiuddin Chowdhury ◽  
Md Liakat Ali Hyder

Introduction: Fixed dental prosthesis is becoming more popular for preservation of badly damaged crowns and endodontically treated teeth and also for replacing lost teeth around the world. Complications of fixed dental prosthesis are also becoming very common. Fixed dental prosthesis assures greater retention and stability in addition to comfort. Fixed dental prosthesis is more acceptable to patients when correctly planned and designed which provide predictable function are also enhances the esthetics and psychological well being of the patients. Objective: To assess the complications associated with tooth supported fixed dental prosthesis amongst armed forces personnel reporting to Combined Military Hospital (CMH) Cumilla and Combined Military Hospital (CMH) Dhaka. Materials and Methods: An interview based questionnaire was used for 220 patients followed by clinical oral examination of every individual in this cross sectional study conducted during September 2016 to August 2017 in Combined Military Hospital, Dhaka. Patients soft tissues were checked but the main emphasis was given on recording the information regarding the type of prosthesis being used, material of the prosthesis, location of the prosthesis and the complication present including dental caries, coronal or radicular abutment fracture, root canal treatment failure, periapical lesions, periodontal problems and mechanical failures including occlusal interference, no occlusal contact, decementation of the prosthesis, esthetic problems, porcelain and metal fractures. Periapical radiograph was made to assess mentioned complaints; more so periodontal probing was applied to measure the gingival attachment loss. Results: Approximately 183(83%) patients were using porcelain fused to metal prosthesis with 133(60%) of prosthesis being used in posterior segments of mouth. Complications like dental caries, coronal abutment fracture, radicular abutment fracture, occlusal interferences, root canal failures and decementations were more significantly associated with crowns than bridges (p=0.001). On the other hand esthetic issues, periapical lesions, periodontal problems, porcelain fractures and metal damage were more commonly associated with bridges (p=0.001). All cases of dental caries reported were associated with acrylic crown and bridges, whereas all coronal abutment fractures were associated with metal prosthesis. A significantly higher number of patients who got their fixed dental prosthesis from other sources i.e. paramedics, technicians, dental assistants or unqualified dentists had periapical lesions, decementations, esthetic issues and periodontal diseases. Conclusion: Complications associated with fixed dental prosthesis like root canal failures, decementations, periapical lesions and periodontal disease were more significantly associated with prosthesis fabricated by other sources rather than those acquired from CMHs and private dental care and also in patients using prosthesis for 5 to 10 years. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 75-80


2015 ◽  
Vol 10 (1) ◽  
pp. 93-98
Author(s):  
Md Mostafil Karim ◽  
Shahina Akhter ◽  
Mushtaq Ahmad

Introduction: The lymphoma’s are a group of malignant disease that originate from uninhibited growth of cellular elements normally found in lymphatic tissue. All forms of lymphoma have the potential to spread from their origin in a single node or chain of nodes to other nodes and eventually to disseminate to spleen, liver and bone marrow. Objective: To assess the response rate and to evaluate the toxicity and safety of CHOP regimen. Methods: In this study 50 cases were selected of all age irrespectively and both sexes diagnosed at Combined Military Hospital, Dhaka. A prescribed proforma was used for each patient. It included particulars of the patient, history, physical findings, laboratory investigations (biopsy, cytology, and bone marrow study), ultrasonography and CT-scan in appropriate cases. Results: In this study, starting from July 2009 to June 2010, 50 patients were included. Out of them, 30 patients (60.00%) achieved complete remission, 12 patients (24.00%) had partial remission. Overall responses were 84 percent and 8 patients (16.00%) were non-responder. Two patients (4%) of non-responder died during chemotherapy. Conclusion: In this study a significant number of patients achieved complete and partial remission. The response was rapid and most of the patients achieved complete or partial remission after receiving only 2-3 cycles of therapy. Considering the toxicities, the patients were well-tolerated to CHOP regimen. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22932 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014


2021 ◽  
Vol 8 (2) ◽  
pp. 86-89
Author(s):  
Tejashwini V Basarigidad ◽  
Ganashree C P

Obesity is defined as excessive accumulation of fat in various tissues in the body which causes ill health in the body. The basic cause of obesity is imbalance between calories intake and calories expenditure There is increased intake of calorie rich foods and reduced physical activity due to urbanization all over the world.Body mass index is simple formula to classify obesity in adults. It is defined as person’s weight in kilograms divided by height in meter squares (m).Obesity and elevated BMI are the major causes for development of chronic diseases like stroke, hypertension, Type 2 diabetes and other cardiovascular disorders.BMI is the modifiable risk factors of type 2 diabetes, hypertension, stroke and cardiovascular diseases. This study was undertaken to assess the relationship between BMI and haematological profile among young Indian population. This study comprises 200 participants comprising 100 males and 100 females aged between 18 to 30 years. The design for this study was cross-sectional survey. Ethical approval was taken from ethical committee of BMCH, Chitradurga. Under aseptic precaution, 10 ml of venous blood sample collected from antecubital vein and then transfererd to EDTA tube. Then haematological parameters like PCV, Haemoglobin concetration, RBC, WBC count was estimated using sysmex haematology anlyser.Subjects were grouped into underweight, normal, overweight and obese subjects. Stastical significance was determined by ANOVA. Scheffe post-hoc test was used to determine significance while pearson correlation was used to determine relationship between the variables. Data was analysed using SPSS software and presented as mean± standard deviation. Values of P ≤ 0.05 were considered significant.In our study, PCV is statistically increased in overweight and obese individuals as compared to other BMI groups in both males and females. Total leucocyte count was significantly higher in overweight and obese subjects when compared to normal subjects. We found no change in Haemoglobin concentration and RBC count in all BMI groups.In our study we observed, leucocytosis and higher PCV in overweight and obese individual groups when compared to underweight and normal weight BMI groups. There is direct positive correlation between BMI and total leucocyte count. RBC count and haemoglobin concentration shows no statistical significance among all BMI groups.There is need for promotion of a healthy life style, regular exercise, healthy nutrition, stress free life in young population.


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