Annular Lichenoid Dermatitis (of Youth)

About 20 years after its first description, Annular Lichenoid Dermatitis of Youth (ALDY) is recognized as a distinctive lichenoid dermatosis with specific clinical and histological features. The disease occurs mostly in young persons all over the world, runs a chronic course, and has an obscure etiopathogenesis. Clinically, lesions consist of persistent, asymptomatic erythematous macules and round-oval annular patches with a red-violaceous non-scaling border and central hypopigmentation, mostly localized on the groin and flanks. Histology shows a peculiar lichenoid dermatitis characterized by irregular epidermal hyperplasia with an alternation of thinned and quadrangular rete ridges and a dense band-like lichenoid infiltrate of lymphocytes in the papillary dermis. Typically, there is infiltration of lymphocytes into the lower epidermal layers with massive necrosis/apoptosis of keratinocytes, which is limited to the tips of rete ridges. Dermal lymphocytes are usually CD3+, CD4+, while most of the intraepidermal T cells are CD8+. Analysis of TCR-γ-chain gene rearrangement displayed polyclonality in all cases examined. Differential diagnosis mainly includes morphea, mycosis fungoides, annular erythemas and inflammatory lesions of vitiligo. Topical corticosteroids and topical tacrolimus represent the most effective drugs for ALDY treatment.

EFFECT OF KUNJAL KRIYA AND AGASTYA HARITKI RASAYANA IN TAMAKA SHWASA W.S.R BRONCHIAL ASTHMA: A CASE STUDY

Tamaka Shwasa (Bronchial asthma) is one of the stressful medical conditions of today's era and is well known for its episodic and chronic course which affects the whole human race. Tamaka shwasa is a disease in which the pa- tient experiences severe symptoms of respiratory distress with extreme weakness, fatigue and mental glooming. Tamaka Shwasa can be correlated with the disease Bronchial Asthma based on its features & etiopathogenesis. Here the sincere effort has been made using Kunjal kriya a shodhana chikitsa and Agastya Haritaki as Rasayana. Rasayana plays an important role in the rejuvenation of body tissues and providing strength to patients. A male patient of Age 40 years with a history of Tamaka shwasa from last 5 years. The Patient has all classical symptoms like Shwasakashtata, Kasa, Kaphashteevan, Aruchi, Parshvashula, Asino Labhate Saukhyam, Ghurghuraka comes at O.P.D of Govt. Ayurvedic Hospital Model Gram Ludhiana, On Auscultation of chest wheezing present bilater- ally in lungs. The patient was using short-acting Bronchodilator puffs almost 3-4 puffs in a day. So, this case of Tamaka shwasa is treated with Kunjal Kriya a Yogic Shodhana Karma once a week followed by Rasayana for four weeks. All this was done after examination of Bala of the Patient. In this case, it was observed patient got good relief in all cardinal symptoms of Tamaka shwasa. Keywords: Rasayana, Kunjal Kriya, Tamaka Shwasa

Pulmonary Hypertensive Changes Secondary to COVID-19 Pneumonia in a Chronically SARS-CoV-2-Infected Bilateral Lung Explant

COVID-19, the syndrome caused by the novel coronavirus SARS-CoV-2, has spread throughout the world, causing the death of at least three million people. For the over 81 million who have recovered, however, the long-term effects are only beginning to manifest. We performed a bilateral lung transplant on a 31-year-old male patient for chronic hypoxic respiratory failure, severe pulmonary hypertension and radiographically identified pulmonary fibrosis five months after an acute COVID-19 infection. The explant demonstrated moderate pulmonary vascular remodeling with intimal thickening and medial hypertrophy throughout, consistent with pulmonary hypertension. The parenchyma demonstrated an organizing lung injury in the proliferative phase, with severe fibrosis, histiocytic proliferation, type II pneumocyte hyperplasia, and alveolar loss consistent with known COVID-19 pneumonia complications. This report highlights a novel histologic finding in severe, chronic COVID-19. Although the findings in acute COVID-19 pneumonia have been well-examined at autopsy, the chronic course of this complex disease is not yet understood. The case presented herein suggests that COVID-induced pulmonary hypertension may become more common as more patients survive severe SARS-CoV-2-related pneumonia. Pulmonologists and pulmonary pathologists should be aware of this possible association and look for the clinical, radiographic, and histologic criteria in the appropriate clinical setting.

The Effect of Obesity on Musculosceletal System

Obesity arises and persists during an excessive long-term pos- itive energy balance. Risk factors for the development of obe- sity are, in particular: ahigh-calorie diet, low physical activity; adaptation to asedentary lifestyle; irregular diet. The most commonly used criterion for assessing obesity is the Body Mass Index – BMI. The incidence of obesity in Europe is be- tween 10% to 25% in women, while more than 50% of the pop- ulation in most European countries is overweight and obese. The effect of obesity on the musculoskeletal system is demon- strable in patients who suffer its consequences during their life. Long-term overweight is the cause of excessive strain on bones, joints and muscles, which over time, due to the chronic course of obesity, affects almost every obese individual. Obesity prevention programs, the development of a healthy lifestyle, healthy eating and exercise-related activities are our common goals for preventing obesity.

A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression

Background: Subgrouping methods have the potential to support treatment decision making for patients with depression. Such approaches have not been used to study the continued course of depression or likelihood of relapse following treatment. Method: Data from individual participants of seven randomised controlled trials were analysed. Latent profile analysis was used to identify subgroups based on baseline characteristics. Associations between profiles and odds of both continued chronic depression and relapse up to one year post-treatment were explored. Differences in outcomes were investigated within profiles for those treated with antidepressants, psychological therapy, and usual care. Results: Seven profiles were identified; profiles with higher symptom severity and long durations of both anxiety and depression at baseline were at higher risk of relapse and of chronic depression. Members of profile five (likely long durations of depression and anxiety, moderately-severe symptoms, and past antidepressant use) appeared to have better outcomes with psychological therapies: antidepressants vs. psychological therapies (OR (95% CI) for relapse = 2.92 (1.24–6.87), chronic course = 2.27 (1.27–4.06)) and usual care vs. psychological therapies (relapse = 2.51 (1.16–5.40), chronic course = 1.98 (1.16–3.37)). Conclusions: Profiles at greater risk of poor outcomes could benefit from more intensive treatment and frequent monitoring. Patients in profile five may benefit more from psychological therapies than other treatments.

First Report of Two Cases of Löfgren’s Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality?

Sarcoidosis can present as an acute form or take a chronic course. One of the acute presentations is Löfgren’s syndrome (LS), consisting of the symptom triad of bilateral hilar lymphadenopathy, erythema nodosum, and ankle periarthritis. In addition, there are occasional reports of sarcoid-like reactions following drug exposures. Nevertheless, reports of sarcoidosis or LS after vaccination have not been published. Here, we report two cases of de novo LS in a temporal association with different vaccines against the new coronavirus SARS-CoV-2. One patient developed the first symptoms three days after the second vaccination (first vaccination ChadOx-1, Astra Zeneca; second vaccination CX-024414, Moderna); in the second patient, symptoms started 28 days after the first vaccination (ChadOx-1, Astra Zeneca). Both patients eventually required treatment with glucocorticoids. Both patients achieved clinical improvement with treatment. In conclusion, we report the first two cases of LS shortly after SARS-CoV-2 vaccination.

Diagnostic value of the determination of protein fractions and sialic acid in the disease "no pulse"

The essence of the disease "lack of pulse" is the progressive panarteritis of large vessels with their inflammatory infiltration, gradual hardening and desolation. This disease belongs to the group of collagen, with which it has in common in pathogenesis, recurrent chronic course, predominant lesion of young people.

Methacryloyl-GlcNAc Derivatives Copolymerized with Dimethacrylamide as a Novel Antibacterial and Biocompatible Coating

Improving medical implants with functional polymer coatings is an effective way to further improve the level of medical care. Antibacterial and biofilm-preventing properties are particularly desirable in the area of wound healing, since there is a generally high risk of infection, often with a chronic course in the case of biofilm formation. To prevent this we here report a polymeric design of polymer-bound N-acetyl-glucosamine-oligoethylene glycol residues that mimic a cationic, antibacterial, and biocompatible chitosan surface. The combination of easy to use, crosslinkable, thin, potentially 3D-printable polymethacrylate layering with antibacterial and biocompatible functional components will be particularly advantageous in the medical field to support a wide range of implants as well as wound dressings. Different polymers containing a N-acetylglucosamine-methacryloyl residue with oligoethylene glycol linkers and a methacryloyl benzophenone crosslinker were synthesized by free radical polymerization. The functional monomers and corresponding polymers were characterized by 1H, 13C NMR, and infrared (IR) spectroscopy. The polymers showed no cytotoxic or antiadhesive effects on fibroblasts as demonstrated by extract and direct contact cell culture methods. Biofilm formation was reduced by up to 70% and antibacterial growth by 1.2 log, particularly for the 5% GlcNAc-4EG polymer, as observed for Escherichia coli and Staphylococcus aureus as clinically relevant Gram-negative and Gram-positive model pathogens.

A Comparative Clinical Study to Evaluate the Efficacy of Guduchyadi Kashaya and Rajrukshadipachana Kashaya in the Management of Eka Kushta w.s.r to Psoriasis

In Ayurveda, all skin diseases have been described under the umbrella of Kushtha. Ekakusta is considered as the most commonest skin disease that can affect an individual. Acharya Charak has described the involvement of Vata-Kapha in Eka Kushtha. In the present study Eka kushtha is compared with psoriasis due to resemblance of signs symptoms and causative factors with it. Psoriasis is a papulosquamous disorder of the skin, characterized by sharply defined erythematosquamous lesions this illness exhibits a prompt response if treated carefully, left it may run a very chronic course extending into larger area of the body. Ayurveda focuses more on curative management than palliative management. The drug used in the treatment of Ayurveda does not have complications like modern treatment. Repeated Sodhana prevent the recurrence of the disease. Similarly various preparations have been advocated for the management of Psoriasis. The drugs used in this study are Guduchyadi Kashaya & Rajrukshadi Pachana Kashaya. Both the Kashayas are said to be effective in skin diseases. As per Yogaratnakara, Guduchyadhi Kwath has been mentioned as one of the drug having curative effect on all types of Kustha. Hence for present study the orally Guduchyadi Kwath is taken for EkaKustha treatment. The drugs in Guduchyadi Kwatha are Kusthaghana, Twachya, Swedal, Tridosh shamaka, as well as with Rasayan properties, which is beneficial to break down the pathogenesis of disease. As per Gadanigraha, as mentioned in Kayachikitsakhanda, Rajvrukshadipachana Kashaya is mentioned for the treatment of Ekakushtha. Ingredients in Rajvrukshadi Pachana Kashaya reduce Kapha dosha and most of them act on the skin. Kwatha dravyas are Rasadushtihara, Kaphapittahara, Deepana, Twachya, and also having antibacterial, antimicrobial, antiparasitic and anti-inflammatory properties, Hence, it is helpful for clearing the skin infections.

Stihl's disease in an adult

In 1897, the English pediatrician Still described a peculiar disease characterized by multiple swelling of the joints due to damage to the periarticular soft parts, swelling of the lymph glands, enlargement of the spleen and chronic course.