PITYRIASIS ROSEA MIMICKING POLYMORPHIC ERUPTIONS OF PREGNANCY

ABSTRACTPityriasis Rosea is a self-limiting skin disorder of unknown etiology affecting women more than men. It is very rare in pregnancy and evidence shows conflicting reports on pregnancy outcomes related to Pityriasis Rosea. But however recent evidence says, pregnancy outcomes are not altered, although clinicians must monitor the patient throughout the gestation for adverse outcomes. Hence, we report a case of Pityriasis Rosea infection in a primigravida, in the first trimester and the follow up done in a tertiary care hospital in Southern India.KEYWORDSRASH, FIRST TRIMESTER, ANOMALY SCAN, HUMAN HERPES VIRU

LAMOTRIGINE INDUCED DRESS SYNDROME

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, is a type of hypersensitivity reaction, mainly due to anti-epileptic drugs. Lamotrigine is a newer broad spectrum antiepileptic that can be used in both children and adults. Lamotrigine induced DRESS syndrome is a rare case with incidence of 1/1000 to 1/10000. This syndrome manifests as rash, fever, tender lymphadenopathies, hepatitis, and eosinophilia. This case highlights the need for early diagnosis and treatment of such a rare and life threatening event because early detection of the condition leads to early recovery of the patient. Further re-exposure to the drug should be avoided. Â

A FATAL CASE OF BILATERAL INTERSTITIAL PNEUMONIA (BLIP): INTERFERON ALPHA 2 A INDUCED.

  Adult T-cell leukemia/lymphoma (ATLL) is a rare lymph proliferative disorder of mature CD4 T-cells caused by the human T-lymph tropic type 1 (HTLV 1) of retrovirus family. Combination of zidovudine and interferon Alfa combination is one of most commonly used regimen. Many drugs are implicated in causing interstitial lung disease. Hence, we report a case of interferon Alfa-induced bilateral interstitial pneumonia in a 32-year-old female patient diagnosed with ATLL with HTLV 1 positivity

PREVALENCE OF DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS: AN OBSERVATIONAL STUDY IN SOUTHERN INDIA

  Objectives: In India, 69.1 million are diabetics as of 2015 compared to 18 million in 1995. Pan India prevalence study in diabetics carried out at 194 centers by All India Ophthalmological Society reported the prevalence of diabetic retinopathy (DR) among diabetics as 21.8%. DR is of two types, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). The severity of NPDR depends on microaneurysms, hemorrhages, cotton wool spots, and beading of veins and can progress to PDR. Inherit characteristic of PDR is neovascularization. The aim of this observational prevalence study is to study the prevalence of diabetic retinopathy in Type 2 diabetic patients attending diabetic clinic and to study the distribution of diabetic retinopathy with respect to age, sex, and duration of disease in a tertiary care hospital in southern India.Methods: This is a retrospective observational study. Age above 20 years and patients diagnosed with Type 2 diabetes mellitus (DM) and examined by the ophthalmologist were included and others excluded. Data documented were analyzed using statistical software SPSS version 16.Results: About 52.07% of patients with Type 2 DM for more than 10 years had diabetic retinopathy and 13.07 % of patients with Type 2 DM for more than 5 years have diabetic retinopathy.Conclusion: India being the diabetic capital of the world and DR being the most common cause for visual impairment and blindness and it becomes empirical to assess the factors for its rising prevalence, which will significantly contribute in reducing the progression of DR

An Epidemiological Analysis of SARS-CoV-2 Genomic Sequences from Different Regions of India

The number of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases is increasing in India. This study looks upon the geographic distribution of the virus clades and variants circulating in different parts of India between January and August 2020. The NPS/OPS from representative positive cases from different states and union territories in India were collected every month through the VRDLs in the country and analyzed using next-generation sequencing. Epidemiological analysis of the 689 SARS-CoV-2 clinical samples revealed GH and GR to be the predominant clades circulating in different states in India. The northern part of India largely reported the ‘GH’ clade, whereas the southern part reported the ‘GR’, with a few exceptions. These sequences also revealed the presence of single independent mutations—E484Q and N440K—from Maharashtra (first observed in March 2020) and Southern Indian States (first observed in May 2020), respectively. Furthermore, this study indicates that the SARS-CoV-2 variant (VOC, VUI, variant of high consequence and double mutant) was not observed during the early phase of virus transmission (January–August). This increased number of variations observed within a short timeframe across the globe suggests virus evolution, which can be a step towards enhanced host adaptation

Pleural effusion guidelines from ICS and NCCP Section 1: Basic principles, laboratory tests and pleural procedures

Pleural effusion is a common problem in our country, and most of these patients need invasive tests as they can’t be evaluated by blood tests alone. The simplest of them is diagnostic pleural aspiration, and diagnostic techniques such as medical thoracoscopy are being performed more frequently than ever before. However, most physicians in India treat pleural effusion empirically, leading to delays in diagnosis, misdiagnosis and complications from wrong treatments. This situation must change, and the adoption of evidence-based protocols is urgently needed. Furthermore, the spectrum of pleural disease in India is different from that in the West, and yet Western guidelines and algorithms are used by Indian physicians. Therefore, India-specific consensus guidelines are needed. To fulfil this need, the Indian Chest Society and the National College of Chest Physicians; the premier societies for pulmonary physicians came together to create this National guideline. This document aims to provide evidence based recommendations on basic principles, initial assessment, diagnostic modalities and management of pleural effusions