Transition from homogeneous to inhomogeneous limit cycles : Effect of local filtering in coupled oscillators

10 pages, 8 FigsPeer reviewedPublisher PD

Lichen Planus-like Eruption Resulting from a Jellyfish Sting

Introduction: Contact with a jellyfish can cause a wide variety of conditions, ranging from cutaneous eruption to fatal cardiovascular and respiratory collapse. Cutaneous features can be both acute and chronic. We report a case of persistent lichen planus-like eruption in a young boy after a jellyfish sting, a hitherto unreported occurrence. Case presentation: A 15-year-old boy presented with multiple lichen planus-like violaceous papules over the lower part of his left thigh on the anterior aspect and also over the patellar region. He had a history of a jellyfish sting over his lower limbs incurred while bathing in the sea 4 weeks prior to presentation. Histopathology revealed a predominantly perivascular mononuclear cell infiltrate immediately beneath the dermoepidermal junction underneath the hyperplastic epidermis. The lesions significantly subsided with topical corticosteroid application. Conclusion: This case report demonstrates a new variant of chronic cutaneous change following a jellyfish sting. We report it because of its uniqueness and we believe that physicians should be aware of the possibility of an aquatic animal-induced disease when dealing with lesions with lichen planus-like morphology.&nbsp

A comparative study of the conduction velocity of motor and sensory fibres of ulnar and median nerves among leprosy patients and normal subjects

Background: Leprosy and the associated scourge have affected humanity for thousands of years. One of the most debilitating consequences of leprosy is peripheral neuropathy. Nerve Conduction Velocity study provides us with a non-invasive modality to assess peripheral nerve involvement in leprosy.Methods: With this in mind, a cross-sectional observational study was conducted including 30 leprosy patients as "Cases" and 30 age-matched healthy subjects, not suffering from any kind of neurological disorders, as "Controls". Using a digital electromyography machine, the Latency, Amplitude and Conduction Velocities of Motor and Sensory fibres of Ulnar and Median nerves were recorded. The results were compared among controls and cases using suitable statistical tests (descriptive statistics and significance testing using unpaired t-test).Results: In this study, with regard to Sensory Nerve conduction Velocity (SNCV), statistically very significant difference was noted in case of right (p 0.0011) and left (p 0.0037) ulnar nerves among controls and cases. The difference in the amplitude of Motor Action potential (MAP) with regard to right median nerve, among cases and controls, was also statistically significant (p 0.0127). Further the amplitude of Sensory Nerve Action Potential (SNAP) values were higher among cases compared to controls.Conclusions: As such, the findings of this study (and which is also corroborated by many previous studies) lead us to the conclusion that NCV studies can detect lepromatous neuropathy much before the emergence of frank clinical signs and this type of neuropathy is predominantly demyelinating in nature with occasional axonal loss

Lichen planus-like eruption resulting from a jellyfish sting: a case report

<p>Abstract</p> <p>Introduction</p> <p>Contact with a jellyfish can cause a wide variety of conditions, ranging from cutaneous eruption to fatal cardiovascular and respiratory collapse. Cutaneous features can be both acute and chronic. We report a case of persistent lichen planus-like eruption in a young boy after a jellyfish sting, a hitherto unreported occurrence.</p> <p>Case presentation</p> <p>A 15-year-old boy presented with multiple lichen planus-like violaceous papules over the lower part of his left thigh on the anterior aspect and also over the patellar region. He had a history of a jellyfish sting over his lower limbs incurred while bathing in the sea four weeks prior to presentation. Histopathology revealed a predominantly perivascular mononuclear cell infiltrate immediately beneath the dermoepidermal junction underneath the hyperplastic epidermis. The lesions significantly subsided with topical corticosteroid application.</p> <p>Conclusion</p> <p>This case report demonstrates a new variant of chronic cutaneous change following a jellyfish sting. We report it because of its uniqueness and we believe that physicians should be aware of the possibility of an aquatic animal-induced disease when dealing with lesions with lichen planus-like morphology.</p

Challenges of Anaesthetic Management in Endoscopic Sinus Surgery in Post COVID Rhino Orbital Cerebral Mucormycosis Patients

Introduction Mucormycosis is a potentially lethal opportunistic, angioinvasive fungal infection with rapid progression and high mortality and predisposed by diabetes mellitus, corticosteroid other immunosuppressive drugs, haematological malignancies, haematological stem cell transplantation, solid organ transplantation and iron overdose. The aim of our study is to consider the challenge in providing anaesthesia in endoscopic sinus surgery for rhino orbital cerebral mucormycosis in post COVID patient. Materials and Methods A total of 20 patients after being COVID negative, posted for endoscopic debridement of paranasal sinuses and also of orbital contents were analysed with respect to outcome after surgery considering the comorbidities of the patients and toxic effect of antifungal drug. Patients’ comorbidities were optimised through preoperative evaluation prior to surgery. Adequate monitoring of haemodynamic status during intraoperative period and optimum anaesthetic management was provided in endoscopic sinus surgery. The patients were managed in recovery room in post operative period and their outcome was reviewed. Results Our patients posed 3 challenges: a) difficult airway in view of palatal perforation b) long standing diabetes mellitus with associated metabolic complications c) administration of amphotericin B could interact with anaesthetic agents and produced adverse outcome. After surgery mortality was experienced in 10% of cases. Conclusion Awareness of warning symptoms and signs, a high index of suspicion, early diagnosis and initiation of full dose of liposomal Amphotericin B and meticulous surgical management may help to optimise the outcome of ROCM in the setting of COVID 19 infection