Demographic and Clinical Profile of Vernal Keratoconjunctivitis in Teaching Hospital, Kurnool

Introduction: To describe socio - demographic and clinical profile of patients with vernal keratoconjunctivitis (VKC) and to assess the compliance of patients to the treatment of vernal keratoconjunctivitis. Materials and methods: Prospective study of 100 patients with VKC was done. Purposive sampling of 100 Patients with signs and symptoms of VKC were taken, who satisfy inclusion and exclusion criteria. Treatment was given depending on grade of disease. Results: Out of 100 patients 66 were Males and 33 were Females. Mean age at presentation was 9.4 years and 2 patients presented at the age of 28 and 30 year and 60% patients from rural area, 40% from urban. Family history of allergies was noted in 7% patient. History of chronic perennial disease was seen in 57% patients. Mixed form of VKC was seen in 66%, limbal form in 18% and palpebral form in 16%. 47% had mild and 10% had severe disease. Conclusion: VKC is a bilateral disease affects most commonly young males between ages of 6 to 10 years. Male: female ratio of 2:1. Association of family history of allergic disorders are less. For persistent severe disease needs frequent follow-up. KEY WORDS: Allergy, Compliance, Papillae, and Vernal Keratoconjunctivitis.

Hypersensitivity Reactions and Anaphylaxis

Allergic reactions vary in intensity from mild rash or allergic rhinitis to devastating anaphylactic shock. Anaphylaxis, often underrecognized and undertreated, can be a life-threatening syndrome leading to multiorgan dysfunction. This review covers the etiology, pathophysiology, and treatment of severe allergic reactions and anaphylaxis. It is precipitated by exposure to particular allergens—commonly food, medications, insect stings, and environmental exposures—in a previously sensitized individual. Symptoms develop from an IgE-mediated immune response leading to degranulation of mast cells and basophils and the release of preformed mediators, lipid-derived metabolites, and inflammatory cytokines. First-line treatment for anaphylaxis involves epinephrine. Secondary treatments are antihistamines and corticosteroids. Further treatments for patients refractory to standard therapies involve vasopressor agents, nebulized albuterol, and glucagon. Frequency and duration of biphasic reactions are variable, limiting the development of consensus guidelines for monitoring of anaphylactic reactions. Figures show the immune activity and inflammatory pathways in allergic responses, mast cell degranulation, and a depiction of common organs involved and corresponding clinical manifestations. Tables list the criteria for diagnosis of anaphylaxis, classification of hypersensitivity reactions, common clinical manifestations, and etiology and mediators of anaphylaxis. This review contains 4 highly rendered figures, 11 tables, and 43 references. Key words: allergy, anaphylaxis, antihistamine, corticosteroid, epinephrine, mast cells