Co-Infection of HSV in Gonococcal Urethritis Patients

Co-infection with two different pathogens may alter the classical clinical course that manifests infection as single pathogen. In STIs, such co-infection may trigger the reactivation of a latent infection, and syndromic approach may not be insufficient to free the host of the entire gamut of infectivity agents. Present study analyzed appropriate samples for Neisseria gonorrheae and HSV from 200 patients presented to STI clinic. Gonorrhea was detected in 4% and HSV in 5% of patients. 25% of gonorrhea patients had HSV-2 co-infection with an overall 4.5% yield of subclinical HSV cases which would have been missed leading to inappropriate treatment, risk of recurrence and transmission to contacts. Awareness regarding encounter with multiple infections is necessary for effective management

ASSESSMENT OF CYP2D6*10 POLYMORPHISM WITH POST HERPETIC NEURALGIA PATIENTS UNDERGOING TRAMADOL TREATMENT

objective: To evaluate association of CYP2D6*10 polymorphism with respect to demographic characteristics (age at onset, genders and weight), numerical rating scale (NRS) for measuring pain intensity in relation with resting and movement associated pain and adverse drug effects of PHN patients receiving tramadol therapy. Methods: Total 246 patients of PHN (148 males and 98 females) were selected who fulfilled the inclusion/exclusion criteria. Clinicians were recorded numerical rating scores (at rest and with movement), and note down adverse drug side effects during the time of study. All samples were analyzed for CYP2D6*10 polymorphism using PCR-RFLP method. results: We observed genotype distribution of CYP2D6* 10 did not vary significantly with age at onset [non-responders (p=0.317) and responders (p=0.260)], genders[ non-responders (p=0.317) and responders (p=0.949)], and weight [non-responders (p=0.298) and responders (p=0.279)] and also did not find significant role with respect to resting (p=0.428) and movement associated type of pain (p=0.178). In addition, CYP2D6*10 was not associated with adverse effects such as somnolence (p=0.135), dizziness (p=0.178), local site reactions (p=0.535), headache (p=0.502), hypotension (p=0.567) and nausea and vomiting (p=0.268) of analgesic therapy. Therefore we conclude that, CYP2D6*10 may not be a predictor of treatment outcomes of patients with PHN receiving tramadol

A Study of Clinicohistopathological Correlation in Patients of Psoriasis and Psoriasiform Dermatitis

Background: Psoriasis has different clinical variants, which mimic diverse dermatological conditions and may require a histopathological confirmation of the diagnosis. Studies to establish a clinicohistopathological concordance (and its determinants), in psoriasis and psoriasiform dermatitis are lacking. Aims : The present study was designed (a) to correlate the clinicohistopathological features of psoriasis and psoriasiform dermatitis, and (b) to identify determinant(s) that may contribute to the diagnosis of psoriasis and psoriasiform dermatitis. Methods : This was a prospective study involving 100 patients, with a single clinical diagnosis of psoriasis or with psoriasis as one of the differential diagnoses, and its correlation with histopathological features. Results : The clinical features of typical scale (P = 0.0001) and Auspitz′s sign (P = 0.0001), and histological evidence of suprapapillary thinning (P = 0.0001) and absent granular cell layer (P = 0.0001) were found to be statistically significant contributors to the clinicohistological concordance in cases of psoriasis. Vertical orientation of collagen bundles (P = 0.0001) and lymphocytic exocytosis (P = 0.003) were found to be significantly associated with diagnosis of psoriasiform dermatitis. Conclusion : The present study reconfirms the diagnostic accuracy of silvery white scale, Auspitz′s sign, and Koebner′s phenomenon in a clinical setting suggestive of psoriasis. However, in their absence, histological evidence of suprapapillary thinning and absent granular layer, in addition to the Munro microabscess and Kogoj′s abscess, may contribute to the diagnosis of psoriasis. Similarly, vertical orientation of collagen bundles and lymphocytic exocytosis may point toward a diagnosis of psoriasiform dermatitis

A clinicopathological study of cutaneous lichen planus

Background: Lichen planus is an idiopathic subacute or chronic inflammatory disease of the skin, mucous membranes and nails. We studied the clinicopathological profile of lichen planus in Indian population. Methods: A total of 145 cases of histologically diagnosed lichen planus samples were included. Clinical features like age, sex, type of lichen planus, location were recorded in the case record form. Histological features of lichen planus were studied. Results: Out of 145 cases, majority (61%) were of classical lichen planus. Majority of cases were in the age group of 20–40 years and showed female preponderance. Most commonly, violaceous lesions occurred in lichen planus, pigmented in lichen planus pigmentosus, and both violaceous and pigmented in lichen planopilaris. Conclusions: In Indian population, common age of occurrence of lichen planus is lower as compared to western literature, and a large number of cases (28%) are in the paediatric age group (<18 years)

Leprosy scenario at a tertiary level hospital in Delhi: A 5-year retrospective study

Background: Leprosy has been officially eliminated from India since December, 2005; still, there are districts and blocks reporting high prevalence indicating ongoing transmission. The present study aimed at determining the current clinical profile of leprosy from a tertiary level hospital in Delhi. Materials and Methods: A retrospective, record-based study was carried out on patients diagnosed and registered in the leprosy clinic of a tertiary level teaching hospital in East district of Delhi (April 2007 to March 2012). Data regarding demographic details, clinical features, treatment started and complications was analyzed. Results: A total of 849 patients were registered over a 5-year period, with M: F ratio of 2.3:1. 9.3% were children (ͳ14 years). 54.3% patients were immigrants from adjoining states. Multibacillary leprosy was the most common clinical type (86.9%). Borderline tuberculoid leprosy was the most frequent morphologic type, seen in 56.3% followed by borderline-borderline (1.5%), borderline lepromatous (24.9%), lepromatous leprosy (8.1%), pure neuritic (8.1%), histoid and indeterminate leprosy (0.5% each). 37.4% patients presented in reaction (Type I in 30.4% cases and Type II in 7% cases). WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases). Conclusion: Our study offers insight into the current status of the disease in an area of otherwise low prevalence. It is seen that despite statistical elimination, multibacillary disease, leprosy reactions and deformities are commonly seen as presenting manifestations, in contrast to national projected trends. Delhi′s unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations. It highlights the need for continuation of targeted leprosy control activities and active case detection

THE IMPACT OF PHARMACOGENETICS ON ADVERSE DRUG REACTIONS TO PREDICT THE EFFICACY OF TRAMADOL MONOTHERAPY FOR THE TREATMENT OF POST HERPETIC NEURALGIA PATIENTS

Objective: To evaluate the potential role of tramadol treatment with respect to CYP2D6 polymorphism in reducing the incidence of adverse drug reactions.Methods: The study comprised 246 patients of PHN receiving tramadol treatment. Adverse drug events during the time of the study were recorded by the physician. All samples were analyzed for CYP2D6 (*2, *4 and *10) polymorphism using PCR-RFLP method.Results: The CYP2D6 polymorphism did not find significantly among onset at age, genders and weight in non-responders and responders. The CYP2D6*4 polymorphism was significantly associated with somnolence (p=0.009), dizziness (p=0.007), local site reactions (p=0.015), headache (p=0. 039), and nausea and vomiting (p=0. 017). The dizziness (p=0. 029) and headache (p=0. 004) were found associated with CYP2D6*2 both the groups. No associations were observed between adverse events compared with CYP2D6*2 and CYP2D6*10 polymorphisms (p&gt;0.05).Conclusion: CYP2D6*4 polymorphism may be as important drug toxicity marker predictors of experiencing adverse drug reactions as PHN patients undergoing tramadol treatment. Â