INCIDENCE OF CATARACT IN DERMATOLOGICAL PATIENTS USING STEROID CREAMS

2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects

Author(s):  
Asha Nyati ◽  
Anil Kumar Singhal ◽  
Devendra Yadav ◽  
Manoj Kumar Sharma

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TCS) are widely misused on face which is associated with significant adverse effects and poor awareness of these effects. The aim of this study was to assess the frequency of misuse of topical corticosteroids, the causes behind it and the most common adverse events resulting from it and to make aware the people about it</p><p class="abstract"><strong>Methods:</strong> This study was conducted at Dermatology Department of Govt. Medical College, Kota during period of one year from July 2015 to June 2016. A total of 670 patients using topical steroids over face were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (72.68%). The most common reason for misuse was melasma (57. 91%) followed by use as a fairness cream (22.38%). Most of the patient used topical steroid cream for duration of 3-6 months (33.13%). Most common age group was 21-30 years (48.20%). Acne form eruption (38.05%) and rebound erythema (28.20%) were the most common adverse effects noted. Patients were ignorant of the ingredients and their side effects.</p><p class="Default"><strong>Conclusions:</strong> Steroids have been misused by patients on their own or by pharmacist and non-dermatologist physicians for various reasons. Topical steroid should not be used on the face unless it is under strict dermatological supervision. </p>


2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.


2021 ◽  
pp. 14-15
Author(s):  
Indira Ananthapadmanab asamy ◽  
V. Pavani Sai Mounika ◽  
K. Vijayakumar ◽  
C.H. Srinivasa Rao

INTRODUCTION: Staphylococcus aureus causes a wide range of infections including skin and soft tissue infections to life-threatening systemic infections like sepsis, endocarditis. This study ais to evaluate the antimicrobial susceptibility pattern of S.aurues among various clinical specimens. METHODS: The study included 326 S.aurues, isolated from various clinical specimens which were subjected to antimicrobial susceptibility testing as per CLSI guidelines. RESULTS: Among the 326 isolates, the highest were from pus specimens (47.85%), and was from Orthopaedics department (28.53%). Among the isolates, 219 (67.17%) were Methicilin resistant. All isolates were sensitive to Vancomycin, and all urine isolates were sensitive to Nitrofurantoin. The highest resistance was towards Penicillin (87.42%), Erythromycin (85.28), and Ciprooxacin (83.13%). CONCLUSION: The most effective way to prevent MRSA infection in every hospital is by performing continuous surveillance of antibiotic resistance and by following an effetive antibiotic policy.


2021 ◽  
Vol 19 (1) ◽  
pp. 25-29
Author(s):  
Manoj Chaudhary ◽  
Sudha Agrawal

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour.   Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face.   Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017.   Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%).   Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.


Author(s):  
Sandhya S. ◽  
Mohanraj P.

Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI).  Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study.Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%.Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.  


2016 ◽  
Vol 4 (1) ◽  
pp. 89
Author(s):  
Atef Nassar

Abamectin and indoxacarb are relatively new insecticides with different mode of action and are applied to control a wide range of plant pests. However, their side effects to mammals are not fully studied. Accordingly, current study aimed to compare the adverse effects of both insecticides against the endocrine biomarkers: triiodothyronine (T3), tetraiodothyronine (T4), follicular-stimulating hormone (FSH), progesterone, and testosterone. These parameters were measured after orally-injecting rats with 1/20 LD50 doses of each of abamectin and indoxacarb for 60 days. Results showed that indoxacarb had pronounced reduction in the contents of T3 and FSH hormones compared to control and abamectin. Also, indoxacarb increased testosterone level compared to abamectin. T4 level was reduced by abamectin treatment compared to indoxacarb. Progesterone content was significantly increased after the abamectin treatment, while it was decreased after the indoxacarb treatment. However, the tested insecticides belong to avermectins and oxadiazine chemical groups that have different mode of action. They showed some similarity in their effect on T3, T4, and FSH, except for the progesterone hormone that showed a contradicting response. These two insecticides were marked as safe but current study highlight the need for caution during their application in the integrated pest management program.


Author(s):  
Ritu Bhat ◽  
Sachin Kolte

Background: Wide range of vulval lesions have been described with similar modes of presentation. Benign and inflammatory lesions form the major chunk. Squamous cell carcinoma is the most reported malignant entity. Aim was to review the vulval lesions received in our departmentMethods: We studied the data from the archives of the Department of Pathology for a period of 5 years from January 2014 to December 2018 for vulval biopsies and specimens sent for histopathological examination. The final diagnoses were divided into non-neoplastic, neoplastic and non- specific.Results: Age of women ranged from 22 to 86 years (mean 54.3±3.6) with the maximum number of patients between 50 to 60 years of age. Most common form of clinical presentation was an itchy white elevated lesion on the vulva (72 cases, 62.6%). The most common site for the lesions was labia minora (90 cases, 78.2%). Non neoplastic lesions were seen in 53 cases and neoplastic lesions were seen in 52 cases. There were 28 (53.8%) benign lesions while 24 cases (46.1%) were malignant. Squamous cell carcinoma was the most frequently diagnosed form accounting for 20 cases (83.3%). Rare tumours like Malignant melanoma, Merkel cell carcinoma and Neuroendocrine carcinoma formed 16.6% (n=4). Seven cases were premalignant. Two cases had non-specific histologic diagnosis showing mild chronic inflammation.Conclusions: Previous studies have reported that non-neoplastic lesions form around 70% of cases. However, in our study we found that the non-neoplastic and neoplastic lesions form equal number of cases (46%) which may be attributed to increased awareness or geographical variation.


2021 ◽  
Vol 6 (2) ◽  

Purpose, Setting and Subjects: We conducted a case report study of a postoperative pediatric patient on total parenteral nutrition managed by a multidisciplinary team in a tertiary care hospital. In October 2020, data of nutritional status, hypophosphatemia, electrolyte and metabolic imbalance, and the role of thiamine supplement were reviewed. Background: Refeeding Syndrome is usually defined as the possibly lethal maldistribution of fluids and electrolytes that could take place in malnourished patients receiving enteral or parenteral refeeding. This is due to hormonal and metabolic disturbances that may lead to critical clinical deterioration. The biochemical key feature of Refeeding Syndrome is hypophosphatemia. In general, the syndrome is complicated and may also incorporate abnormal electrolytes and fluid balance; changes in serum level of protein, glucose, and the metabolism of fat; thiamine deficiency; hypokalemia; and hypomagnesaemia. Case Report: an ex-preterm 6-year-old boy who underwent major intestinal resection due to necrotizing enterocolitis (NEC) during his stormy neonatal period, presented to ED with constipation for 2 days; the patient was admitted in the pediatric ward under combined care with Pediatric Surgery, as a case of large bowel obstruction for conservative management. He had cachexic appearance, global developmental delay (GDD), and faltering growth. Subsequently and during his PICU stay, he suffered a fluctuating course of electrolytes imbalance a few days after commencing total parenteral nutrition (TPN), and developed altered mental status that responded well to thiamine infusions to resume his baseline sensorium within 48 hours. Conclusions: The role of thiamine in Refeeding Syndrome is extremely underestimated, despite the current evidence of its high efficacy. However, the fussy exclusion mechanism to reach the diagnosis is probably the reason behind the delaying of treatment in most of the cases. A wide range of patients are at risk of developing Refeeding Syndrome, especially malnourished children, as in this case report. Categories: Nutrition, Surgery, Pediatrics, Gastroenterology.


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