Search

Ovarian hyperstimulation syndrome (OHSS) is a disorder that usually occurs with ovulation induction. It is rare in pregnant women and only a very few cases have been reported in spontaneous unstimulated conceptions. We report a case of spontaneous OHSS with primary hypothyroidism in a 19-year-old primigravida, where the imaging and laboratory findings confirmed the diagnosis of “Van Wyk–Grumbach syndrome” with pregnancy. This rare event in pregnancy needs attention, as early institution of thyroid hormone replacement therapy results in resolution of cysts and avoids unnecessary evaluation and surgical misadventures.

Background: COVID-19 infection is a highly contagious disease and has affected a large population. As COVID-19 is a new disease and is having the most devastating effects globally, its emergence and spread, causes confusion, anxiety and fear among the general public. Objectives of the study were to know the preparedness measures adopted by the community by large in the beginning of epidemic of COVID-19 and to find out the perceptions and behavioral change of the community regarding COVID-19.Method: A cross sectional survey was conducted amongst the residents of India from 11th April 20 to 30th May 20. It was an online study. An online semi-structured questionnaire having both open and close ended questions was developed by using Google forms, with a consent form appended to it. Data was collected in Google form and was reentered in MS excel and analyzed using EPIINFO.Results: Out of 301 study participants majority i.e., 162 (53.8%) of them were male. Majority of the participants were in the age group of 21-30. Occupation status of the respondents revealed that doctor accounted for 125 (41.5%). Only, 24 (8%) had chronic illness. Awareness regarding COVID-19 was 297 (98.7%).Conclusions: Perceptions have a great role in behavioral change.

Background: Iodine deficiency (IDD) is the world’s most prevalent cause of brain damage. glaciations, flooding, rivers lead to deficiency of iodine in crops grown on iodine. Diet low in iodine can result in stillbirth and abortions and many more sequelae. Objectives of the research work were to study the prevalence of IDD amongst 6-12 years children by clinical examination and to determine the concentration of iodine in salt sample at consumer level. Also, to determine the urinary iodine excretion amongst 6-12 years age group children.Methods: It was a cross sectional study conducted in the government schools of Sagar district among school children of 6-12 years of age. Total 2700 school children from 30 villages were included using PPS sampling. Students were clinically examined and their urine samples were taken for MUIC estimation.Results: Prevalence of goiter was more in 10 to 11 years of age (14.07%) and less in 8 to 9 years age group (7.59%). Overall prevalence of goiter in district Sagar is 10.51%.Conclusions: Despite NIDDCP, there is still dearth of awareness among general public about the usage and storage of iodized salt which is the root cause of Iodine deficiency.

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder among women of fertile age. The incidence of PCOS as claimed by various observer ranges from 2.2% to as high as 26%. India is considered as an emerging epidemic area for PCOS and limited studies are done. Hence aim of this study is to find the prevalence of PCOS and determine the associated determining factors in adolescent girls.Methods: All the girls aged 15-24 years were approached and after undergoing detailed history, examination and investigations were further diagnosed as PCOS. The study subjects were then classified into two group: the PCOS and non-PCOS group and compared to determine significant differences as per the Rotterdam criteria.Results: The prevalence of PCOS was 7.5%, 18.68% and 11.18% as per NIH, Rotterdam and AES criteria respectively. BMI more than 30, waist circumference > 80 cm, hyperandrogenic manifestations, menstrual irregularity (oligomenorrhea) and family history of PCOS and DM showed statistically significant association with PCOS. Serum LH, LH/FSH ratio, S. Testosterones, serum insulin and HOMA-IR had significant association with PCOS. No significant association of Fasting blood sugar levels and deranged lipid profile was found with PCOS.Conclusions: PCOS is an emerging disorder during adolescents and hence awareness creation, early screening in order to inculcate early life style modifications and prevent metabolic and reproductive complications of this disease.

Background: Diabetes mellitus (DM) is a rapidly growing health problem in India. Diet and physical activity are important modifiable risk factors affecting the incidence, severity and management of DM. The aim of the study was to assess diet of diabetes mellitus patients. 87 adults from a cohort of diabetic patients attending the Medical Clinics at the Hamidia Hospital Bhopal were invited for the study.Methods: Information about their nutritional status & food consumption pattern was taken by 24-hour dietary recall and food frequency questionnaire. Data was analysed using Epi Info and MS Excel. Frequency counts and percentages were used to describe the demographic characteristics of the participants while the significance difference in between male and female participants. The significance level was set at P

BACKGROUND Treatment of resistant vitiligo is challenging. A few well-researched studies have shown variable results with surgical and other therapeutic strategies. OBJECTIVE To evaluate the usefulness of a less-painful method of repigmentation of vitiligo patches. PATIENTS AND METHODS Forty vitiligo patches in 22 consecutive patients with resistant vitiligo presenting at a vitiligo clinic of a university teaching medical school in New Delhi, India, were treated with microdermabrasion followed by topical 5% 5-fluorouracil (5-FU). RESULTS One-third of the patches showed more than 50% repigmentation, and one-fourth showed more than 75% repigmentation. Gratifying results were obtained in seven patches after a single session. CONCLUSION Microdermabrasion is adjunctive with topical 5% 5-FU in the treatment of resistant vitiligo patches. Further well-controlled randomized trials are required to validate the observations of the study. The authors have indicated no significant interest with commercial supporters.

Nail dyschromias have a wide variety of presentation. There are numerous causes of discoloration of the nail affecting the nail plate, nail attachments, or the substance of the nail. The chromonychia may also be caused due to the exogenous deposition of pigments over the nail plate. Careful examination of the nail and few bed side tests may help in identifying the root cause of the nail dyschromia and many a times unravels some underlying systemic disorder too.

An investigation of free convection flow of an elastico-viscous fluid past a uniformly accelerated plate with periodic temperature variation has been carried out. The solutions in a closed form have been derived for temperature, velocity, penetration distance, rate of heat transfer, and skin friction by the Laplace transform technique. A parametric study of all involved parameters is conducted and representative results are illustrated.

This paper presents an analytical study of the transient hydromagnetic natural convection flow past a vertical plate embedded in a porous medium, taking account of the presence of mass diffusion and fluctuating temperature about time at the plate. The governing equations are solved in closed form by the Laplace-transform technique. The results are obtained for temperature, velocity, penetration distance, Nusselt number and skin-friction. The effects of various parameters are discussed on the flow variables and presented by graphs.

Introduction: Prevalence of sexually transmitted infection shows regional variations. Though a rising trend of prevalence of viral STI s has been observed, syphilis still continues to remain a commonly diagnosed STI. Aim: To study the current status of acquired syphilis in a tertiary care hospital. Materials and Methods: Retrospective analysis of all the cases of acquired syphilis registered in our hospital from 2005 to 2009 was done. Complete epidemiological, clinical, and investigational data were recorded and assessed. Observation: Total of 570 cases attended the STI clinic from year 2005 to 2009. 42 (7.36%) cases were diagnosed as syphilis. There were 32 (74%) males and 11 (26%) were females. 25 (60%) were married. Only two patients were less than 15 years of age. Primary syphilis was diagnosed in 21 (50%), secondary in 10 (24%), and latent in 11 (26%) cases. Two (9.5%) of primary syphilis showed multiple chancre. Concomitant primary chancre and lesions of secondary syphilis were seen in 2 (20%) patients. Secondary syphilis presented as condyloma lata (50%), maculo-papular rash (40%), and lues maligna in one patient who was HIV positive. Mixed infection was diagnosed in eight patients of which herpes genitalis was the commonest. Two patients were serologically positive for HIV. Conclusion: Incidence of syphilis had shown a constant trend over last 5 years. In lieu of change in trends of sexual practices, condyloma was the commonest presentation of secondary syphilis. Pustular syphilis was observed in association with HIV and could be a marker of the immune-deficient state.

Basidiobolomycosis classically presents as a noninflammatory, nonulcerated, nontender woody indurated mass without much contiguous spread. It is almost always seen in an immunocompetent host younger than 20. We report a case of a 9-month-old baby with a rapidly expanding malignant presentation of basidiobolomycosis with nonhealing ulcers and spread to underlying muscles, mimicking lymphoma. She responded poorly to itraconazole alone but showed dramatic improvement with a combination therapy of itraconazole and potassium iodide. The case also highlights an early acquisition of the infection at 1 month of age.

We analyze the transient hydromagnetic and thermal behavior of free convection flow past an impulsively started vertical plate which is embedded in a porous medium. The governing equations are solved in closed form by the Laplace-transform technique. A parametric study illustrating the influence of various parameters on the temperature, velocity as well as on the skin-friction and rate of heat transfer is conducted. The results of this parametric study are shown graphically.

Pachydermoperiostosis is a primary form of hypertrophic osteoarthropathy, which presents with pachydermia, digital clubbing, and radiologic periostosis. Pachydermoperiostosis occurs owing to mutations of the gene encoding for 15-hydroxyprostaglandin dehydrogenase (15HPGD). Clinical manifestations of PDP are thought to relate to excessive collagen formation and dysregulation of matrix proteins because of fibroblastic hyperactivation. We present a very rare case of the complete form of pachydermoperiostosis in a young Indian male.

This paper presents an analysis of combined heat and mass transfer flow past an oscillating vertical plate under the action of radiation effects and chemical reaction when heat is supplied to the plate at constant rate. The governing equations are solved in closed form by Laplace-transform technique. The results are obtained for temperature, concentration, velocity, skin friction, Nusselt number, and Sherwood number. The effects of various parameters on flow variables are illustrated graphically, and the physical aspects of the problem are discussed.

Cutaneous sporotrichosis, also known as “Rose Gardener's disease,” caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

Skin is one of the most frequently involved organs in human immunodeficiency virus (HIV) infection, and mucocutaneous manifestations may be one of the earliest markers of AIDS. The prevalence of cutaneous abnormalities in HIV approaches nearly 90%. Mucocutaneous manifestations may also act as a prognostic marker of HIV infection. Children are increasingly being affected by HIV infection and it is important to realize the presence of the infection early in the disease process as their immune status is not mature enough to handle the stress of various infections. Skin manifestations can serve as early markers and prognostic indicators of HIV infection. This review highlights the epidemiology, transmission, pathogenesis, and the mucocutaneous manifestations of HIV infection in children.

The specific dermatoses of pregnancy represent a heterogenous group of ill-defined pruritic skin diseases, unique to pregnancy and post partum period.The aim of our study was epidemiological and clinical evaluation of various specific dermatoses of pregnancy.All patients visiting our antenatal clinic were screened for various pruritic skin conditions and those with specific pregnancy dermatoses were identified and evaluated.Out of 1430 patients screened, nearly 5% (70 cases) patients had specific dermatoses of pregnancy. Intra hepatic cholestasis was the commonest specific pregnancy dermatoses.Specific dermatoses of pregnancy can be diagnosed primarily on the basis of clinical features. All of these, except intra hepatic cholestasis, do not have any effect on normal course of pregnancy.

Focal dermal hypoplasia, also known popularly as Goltz syndrome, is a multisystem disorder characterized by linear or reticulate atrophic macules with fat herniation that is associated with various cutaneous and extracutaneous anomalies. We present a case of a patient with Goltz syndrome who exhibits a classical presentation, associated with exopthalmos major and malrotation of the gut. A brief overview of the syndrome is also presented in an attempt to incorporate all associated anomalies reported so far.

Introduction: Histoid Hansen is rare but a well-defined entity with specific clinical, histopathological, and bacteriological features. The incidence has been reported to vary from 1-2% amongst total leprosy patients. Methodology: We performed a retrospective analysis of the records of patients identified as histoid Hansen on the basis of clinico-histopathological criteria, who attended the Hansen clinic from 2000-2009. Results: A total of 962 leprosy patients attended the Hansen clinic from 2000-2009, and of these, 11 (1.14%) were diagnosed as histoid Hansen. The youngest patient on record was 14 years of age. Nearly 70% of the patients were untreated and the rest were on multidrug therapy (MDT) before development of histoid lesions. Three patients showed Erythema nodusum leposum (ENL) reaction. Conclusion: India has achieved elimination of leprosy, but new cases of histoid are still recorded with the same incidence rate. Reactions are not uncommon in such forms, and may be a transition phase to manifest lepromatous leprosy. A thorough knowledge and early detection is needed for this uncommon variant of leprosy which can pose a threat to our elimination drive.

Ascher syndrome is a rare disease described by Ascher, an ophthalmologist from Prague, in 1920. We report a case of an 8-year-old child, who presented with recalcitrant recurrent swelling of bilateral upper eyelids, probably a forme fruste of Ascher syndrome.

Faun tail nevus describes abnormal lumbar hypertrichosis, which may overlie on occult spinal abnormality and be a marker of asymptomatic underlying spinal dysraphism. We report a case of faun tail nevus, with dermal pits along with aplasia cutis congenita and asymptomatic spina bifida occulta, tethered conus, and diastematomyelia, a constellation of findings which to our knowledge has not been previously reported.

Patients with chronic headache associated with ocular symptoms regularly seek ophthalmologists' opinions. We report an unusual case of chronic paroxysmal hemicrania (CPH), a rare but well-described variant of cluster headache in a female presenting to an eye department with recurrent episodes of severe unilateral periorbital swelling with a chronic history of headaches. Clinical features, review of literature, and therapeutic response to indomethacin helped to establish the diagnosis as CPH. This is the first report of severe orbital inflammation with CPH to our knowledge.

Background: Men who have sex with men (MSMs) are a vulnerable population for spread of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). Apart from being important for HIV transmission, they tend to have a different distribution patterns of STDs. Few Indian studies have looked into this aspect. Objective: We retrospectively analyzed the available data on MSM from Suraksha clinic of a tertiary care hospital in a metropolitan city from 2004 to 2010. Materials and Methods: A total of 75 MSM constituting 11.4% of the total 660 patients visited our Suraksha clinic in these 6 years. The clinical and behavioral profile of each patient along with the pattern of STDs was evaluated. Observations and Results: 75% of the MSMs were promiscuous; one-third of them indulging in only homosexual activities. Syphilis was the most common STD, followed by condyloma acuminata, herpes genitalis, and gonorrhea. On comparing the data on the STD profiles of the heterosexual males, predisposition toward bacterial STDs among MSMs was observed. Conclusion: Identification of MSMs is important as most of them are bisexual and promiscuous, thereby playing a role in spread of STDs in vast number of partners. The profile of STDs also differs in MSM, which makes it all the more important to identify them.

A middle-aged hypertensive male, with a fatty liver and chronic alcohol intake, relocated to a high altitude of 2100 m above sea level; in the first winter season, he developed bluish skin lesions over the tip of the nose, margins of both ear lobes, both knees, and subungual location. Systemic examination was unremarkable. Skin biopsy showed thrombi in dermal vessels without any evidence of vasculitis; immunofluorescence was negative. Investigations revealed mild elevation in plasma homocysteine levels, weakly positive antinuclear antibodies and elevated antiphospholipid antibodies, methylene tetrahydrofolate reductase C677T heterozygosity, and protein S deficiency. The patient received prednisolone for 2 weeks, aspirin and pentoxyphylline for 3 months, and continues to be on folic acid and vitamin B6. After 3 months, antiphospholipid antibodies and antinuclear antibody levels were normal. Isolated distal cutaneous thrombosis is an uncommon entity and precipitation by extreme cold in a hypertensive male with three thrombophilic states - one transient, one hereditary, and one acquired - is fascinating.