An old entity, a new trigger: Post COVID-19 vaccine Pityriasis rubra pilaris

BACKGROUND: Pityriasis rubra pilaris (PRP) is a rare, acquired, chronic papulosquamous dermatosis which can occur in all ages. PRP can be associated with infection, autoimmunity, drugs and malignancies, and can be idiopathic. OBJECTIVE: PRP following vaccination has been rarely described in the literature. To the best of our knowledge, we report the first case of PRP two weeks following COVID-19 vaccination (Covishield). CASE REPORT: A 72-year-old male presented to the outpatient dermatology department at All India Institute of Medical Sciences – Bhopal with minimally pruritic superficial plaques since one week. The patient was vaccinated against COVID-19 with Covishield two weeks earlier. The lesions developed as erythematous scaly follicular papules and plaques over axilla that rapidly spread to the trunk in the following weeks and involved palms and soles as well as thickening and fissuring. The clinical features suggested PRP. The histopathology showed epidermal acanthosis with hypergranulosis alternating with parakeratosis and orthokeratosis with broad rete ridges with follicular plugging. The patient had started taking topical corticosteroids and emollients, which proved effective. There was no recurrence after receiving a second dose on follow-up. CONCLUSION: In patients presenting with new onset PRP in this COVID-19 era, the possibility of vaccine as a trigger should be taken into consideration, and further dosing should be carefully monitored in view of possible recurrence.

Knowledge on prevention of breast cancer among females attending outpatient department of All India Institute of Medical Sciences, Jodhpur, Rajasthan

Background: Breast cancer is the most common cancer and principal cause of death among females. Breast cancer related awareness and practices of female are known to have crucial contribution in the prevention. The aim of the study was to assess knowledge on prevention of breast cancer among females.Methods: This descriptive study was conducted on females attending outpatient departments of All India Institute of Medical Sciences, Jodhpur, Rajasthan. 70 females within age group of 15-60 year were enrolled in the study via convenience sampling technique. Data was collected through face-to-face interview. Reliability of self-structured knowledge questionnaire was determined by KR 20 method and found reliable (0.84). Data collected was analyzed for frequency, mean, standard deviation and test.Results: Findings showed that most (51%) of the respondents were from age group 15-30 years. Only 14% of the subjects had family history of breast cancer. Most of the subject (81.4%) previously heard about breast cancer. The mean knowledge score was 14.43±2.9. Most of the respondents (74.3%) had average knowledge about prevention of breast cancer whereas only 3% had excellent knowledge levels. Knowledge of subjects about prevention of breast cancer was found to have significant association with level of education and area of living only.Conclusions: Result of the study provided information that maximum number of participants had average knowledge about different aspects about prevention of breast cancer. The knowledge of females was significantly associated with their educational status.

Micro grid for All India Institute of Medical Sciences, Madurai

In 2018, the Government of India approved the establishment of the New All India Institute of Medical Sciences (AIIMS) in Thoppur, Madurai, Tamil Nadu, India. As the most important amenity for continuing primary care and rescue response is a healthcare facility, a secure electricity supply becomes an imperative necessity. Hence, as the energy supplier for the new AIIMS, Madurai, this paper proposes a microgrid combined with the utility grid. The microgrid consists of a 4-MW photovoltaic system, a 1.8-MW wind-turbine energy-conversion system, a backup diesel generator capable of meeting the forecasted maximum demand and a 1-MW battery energy-storage system. The AIIMS Microgrid will have a service providing a capacity of 20 MVA following integration with the utility grid. The proposed microgrid would be the first attempt at healthcare facilities in India since its first day of work to ensure the availability of electricity. It would have a 9.8% return on investment, a 13.6% internal rate of return and a payback period of 6.75 years once it is operational, as well as an attractive levelized cost of energy (LCOE) of USD 0.07547/kWh. It would provide an environmentally friendly atmosphere by avoiding an annual emission of 6 261 132 kg of carbon dioxide, 27 362 kg of sulphur dioxide and 12 838 kg of nitrogen oxides as compared to power supplied entirely from the utility grid.

MANAGEMENT OF BUERGER'S DISEASE THROUGH AYURVEDA- A CASE REPORT

The present case report was about a 50 year-old-male who was diagnosed with Buerger’s disease which is a generalised occlusive vascular diseaseaffecting predominantly males with special predilection to involve the lowerextremities. He presented with complaint of unhealed ulcerations with pain andburning sensation in his right sole for 6 months but not getting satisfactoryrelief even after using conventional medications and advised to get doneamputation. He visited the All India institute of Ayurveda and was treated fortwo months with a combination of Ayurvedic medicines and leech therapy whichshowed significant improvement in patients condition and eventually norecurrence was observed, ulcer healed completely with slight discolouration. Thisshows the effectiveness of Ayurvedic treatment including internal medicinesadministration and leech therapy in preventing amputation and treating othersymptoms which may be useful for clinical practices.

Epidemiology and treatment outcomes of testicular germ cell tumor at tertiary care center in Patna, India: A retrospective analysis

Background: Malignant testicular neoplasm constitutes about 1% of all cancers in male, but malignant germ cell tumors are most common tumors in adolescents and young adult males. In this study we report our experience of testicular germ cell tumors presenting at All India Institute of Medical Sciences, Patna, a tertiary referral centre, with respect to epidemiology, histopathology, management and outcome. Methods: This study was conducted in department of Radiotherapy, All India Institute of Medical Sciences, Patna from August 2014 to September 2019. It was single institution based retrospective study in which data was retrieved from the recorded files & analysed. The study focused on epidemiology and survival outcomes. Results: In this study we analysed, 38 histologically confirmed cases of testicular germ cell tumor. Seminoma and nonseminoma were 50% (19) and 50% (19) respectively. The median age was 31 years. The most common affected age group was 31 to 40 years. Metastasis was present in 50% of patients at presentation. At diagnosis the stage III, II and I were found in 50%, 28.9% and 21.1% respectively. Patients in good risk, intermediate risk and high risk were in 65.8%, 13.2% and 21.1% respectively. The median recurrence free survival (RFS) and overall survival (OS) was 52 months and 71 months respectively. Conclusion: Most of the cases presented with advanced stage and majority of them had undergone high inguinal orchidectomy. The high nodal burden disease at presentation was associated with partial response to standard chemotherapy. It seems that there is the need of alternative chemotherapy regimen especially in nonseminomatous germ cell tumors. Patients presenting with disease confined to locoregional lymph nodes or local disease showed good prognosis.