Efficacy, safety and cost effectiveness of levocetrizine and ebastine in allergic rhinitis: a comparative study

Background: Allergic rhinitis is a ubiquitous aliment affecting a large population of individuals. The mainstay of treatment includes antihistamines and topical steroids. With a large assortment available, the choice of the drugs needs to be non-random and evidenced based. Hence this study was undertaken to compare Levocetrezine and Ebastine in terms of efficacy, safety and cost effectiveness in treatment of allergic rhinitis.Methods: Newly diagnosed patients with allergic rhinitis were categorized into two groups and treated with Levocetrizine 5mg and Ebastine 20mg per day respectively. Severity of the symptoms at the commencement and at the end of second and the fourth weeks of therapy were assessed using a four-point Likert scale and assigning a Total Nasal Symptoms Score (TNSS). The primary efficacy measure was mean change from baseline TNSS at each follow up visit. Change in TNSS was compared using Independent sample test. Adverse effects in both the groups were compared using Chi square test. Cost effectiveness was inferred by calculation of the Average Cost Effectiveness Ratio.Results: A total of 159 patients 84 from Levocetrizine group (L group) and 75 from the Ebastine group (E group) were available for study. At the end of second week, the E group showed a better reduction in TNSS(p-0.04). However, both the groups showed similar reduction in TNSS at the concluding visit (p-value of 0.09). The incidence of adverse effects was significantly higher in the L than in E. Levocetrezine was found to be more cost effective than Ebastine.Conclusions: Levocterezine and Ebastine are equally efficacious in treatment of allergic rhinitis. Hence treatment will have to be personalized to the individual patients based on other factors such as adverse drug effects and cost effectiveness

Sclerosing Stromal Tumor of Ovary: A Rare Case Report

Sclerosing stromal tumour (SST) is a rare benign ovarian tumor of the sex cord stromal type, occurring predominantly in the second and third decades of life. This tumour is characterized microscopically by having a pseudolobular pattern with cellular areas separated by hypocellular densely hyalinised, edematous stroma interspersed with few prominent blood vessels. Histopathological features which differentiate it from other stromal tumors. We are presenting this case because of its rarity and its simulation with various other ovarian tumours; here we have made an effort to highlight the histomorphological features and microscopic differential diagnoses of this rare tumou

Cellular variant of benign fibrous histiocytoma: A case report

Benign fibrous histiocytoma or dermatofibroma is one of the most common types of benign, cutaneous, soft tissue tumors, most often found in the middle-aged adults. The diagnosis of dermatofibroma/benign fibrous histiocytoma is usually straightforward if the typical morphological features are present. However, some diagnostic difficulties may arise when one is dealing with some unusual morphological variants. Among these variants, cellular fibrous histiocytoma (CFH) may represent a diagnostic challenge because there is a risk of it being confused with other benign or malignant dermal tumours. Careful histopathological examination with the clear knowledge of this variant is important to avoid a misdiagnosis of a possibly more aggressive tumor. We are hereby briefly highlighting the intriguing nature of cellular benign fibrous histiocytoma with which we have encountered

Hailey-Hailey Disease: A Case Study Report with Review of Literature

Hailey-Hailey disease (HHD), also called as familial benign chronic pemphigus, is a rare autosomal dominant blistering skin disease with waxing and waning in its clinical course. It is characterized by the presence of flaccid vesiculo-pustules, crusted erosions or expanding plaques in the areas of friction such as neck, axilla, groins, and perineum. Histopathologically shows suprabasal separations, inconspicuous dyskeratosis, acantholytic cells within the epidermis, giving a dilapidated brick wall appearance. Here we have discussed about the clinical and histopathological features of HHD and various differential diagnosis for this disease

Chondroid syringoma of the scalp: a rare skin adnexal tumor

Chondroid syringoma is a rare skin adnexal tumor constituting 0.01% to 0.1% of all primary skin tumors. Herein we report a case of benign chondroid syringoma in a 47-year-old male patient presenting with an asymptomatic, solitary swelling on the scalp. Fineneedle aspiration cytology of the lesion suggested a possibility of skin adnexal tumor. Wide excision of the tumor was performed and histopathology revealed components of both epithelial and mesenchymal origin resembling pleomorphic adenoma of salivary gland.</p

Assessing the Role of MAPH Score in Predicting Acute Coronary Syndrome: A Cross-sectional Study

Introduction: Incorporating the concepts of hyperviscosity, platelet hyperactivity, and age-related risk of Acute Coronary Syndrome (ACS), a new score has been put forward-the Mean platelet volume-Age-total Protein-Haematocrit (MAPH) score, which can determine the increased thrombotic tendency associated with ST-Segment Elevation Myocardial Infarction (STEMI). The MAPH score includes parameters such as Mean Platelet Volume (MPV), age, total protein, and haematocrit. Researchers have found that a high MAPH score is associated with a high thrombus burden in cases with STEMI and Non ST-Elevation Myocardial Infarction (NSTEMI). However, the association between MAPH score and ACS is undefined. Aim: To assess the role of MAPH score in predicting ACS. Materials and Methods: This cross-sectional study was conducted in the Department of Pathology, Srinivas Institute of Medical Sciences and Research Centre Mangalore, Karnataka, India for six months. The study included 100 clinically diagnosed cases of ACS and 100 healthy controls. The demographic data, MPV, total protein, and haematocrit values of all cases and controls were collected and tabulated, and statistical analysis was performed. Receiver Operating Characteristic (ROC) curve analysis was performed on each MAPH score parameter, and cut-off values for each parameter were obtained based on the Youden index. After calculating the MAPH score of cases and controls, multivariate logistic regression analysis was performed to evaluate the role of the MAPH score as an independent predictor of ACS. Results: A statistically significant increase in MPV (p-value =0.017) and total protein (p-value<0.001) was noted among the cases. The calculated cut-off values for MPV, age, total protein, and haematocrit were 8.4 fL, 54 years, 6.8 g/dL, and 49.1%, respectively. A statistically significant increase in the MAPH score was noted among the cases compared to the controls. Finally, multivariate logistic regression analysis identified the MAPH score as an independent predictor of ACS. Conclusion: This was the first study investigating the association between MAPH scores in patients with ACS. The MAPH score was identified as an independent predictor of ACS and can be used as a screening tool to predict and diagnose the condition in primary healthcare settings. This helps to ensure early coronary revascularisation and reduce Coronary Artery Disease (CAD)-related mortality and morbidity to a greater extent

Case Report Desmoplastic Fibroblastoma (Collagenous Fibroma) of Thigh-A Rare Case Report

Abstract: Desmoplastic fibroblastoma (collagenous fibroma) is a rare benign fibrous tumour thought to arise from subcutaneous tissue or skeletal muscle. We herein report a case of elderly female presented with a slow growing non tender mass on anterior aspect of right thigh. Radiological investigation showed a mass in intermuscular plane. Lumpectomy was performed, histopathologic examination of the subsequent specimen confirmed the diagnosis of desmoplastic fibroblastoma

Basal cell adenoma of the salivary gland: Cribriform type, a rare case with review of literature

Basal cell adenoma (BCA) of the salivary glands is a rare benign tumor resembling pleomorphic adenoma, but with a prominent basaloid cell layer. The majority of these tumors arise in the parotid glands and account for only 1% of all salivary gland epithelial tumors. We report one such case of a swelling in the floor of the mouth in a 55-year-old female where BCA is the most likely diagnosis; however, histological variation does show a similarity to malignant adenoid cystic carcinoma, thereby making the diagnosis difficult. The incidence of malignancy is relatively higher in the submandibular, sublingual and minor salivary glands. Approximately, 85% of sublingual gland tumors are malignant. Thus, we should be more careful when making a diagnosis in minor salivary gland tumors. [Arch Clin Exp Surg 2016; 5(4.000): 246-249