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Binesh V.G.,Government Medical College Kottayam | Ambooken B.,Government Medical College Thrissur | Asokan N.,Government Medical College Thrissur | Ajithkumar K.,Government Medical College Thrissur | And 3 more authors.
Indian Journal of Public Health Research and Development | Year: 2016

Background: Acne vulgaris a common cosmetic problem especially in the adolescent age is caused and perpetuated by various endogenous and exogenous factors. Identification of these factors would improve the treatment outcome and prevent recurrences. Aim: To identify various etiological factors in acne vulgaris among out patients attending the Dermatology department of a tertiary care teaching hospital. Materials and Method: 200 registered patients who presented with acne vulgaris and on regular follow up for a period not less than 6 months were classified into three groups, mild, moderate and severe. Detailed history was elicited and clinical examination were done in all cases with hormonal evaluation in clinically relevant cases. Results: 110 females and 90 males participated in the study. 118 (59%) had mild acne, 68 (34%) moderately severe and 14 (7%) severe form of acne. Main endogenous factors observed were genetic predisposition in 64/200 subjects (32%), seborrhoeic dermatitis in 102/200 (51%) and acanthosis nigricans was present in 9/200 (4.5%). Of the 110 females premenstrual exacerbation of acne was observed in 48 (43.6%) and polycystic ovaries in 16 females (14.5%). Main exogenous factors identified were usage of topical comedogenic agents in 102 (51%) subjects, dietary factors in 64 (32%) subjects, emotional stress in 17(8.5%) subjects. Conclusion: A proper evaluation of endogenous and exogenous factors is necessary to prevent persistence or recurrence of acne and long term consequences like scarring, pigmentation and psychological distress. The most common exogenous etiological factor identified in the present study was usage of comedogenic substances and the most prevalent coexistent dermatoses was seborrhoeic dermatitis. Hence these factors need to be addressed in all cases of acne to prevent its recurrence or perpetuation. © 2016, Indian Journal of Public Health Research and Development. All rights reserved.

Nair R.V.,Government Medical College Thiruvananthapuram | Jayapalan S.,Government Medical College Thiruvananthapuram
Clinical Epidemiology and Global Health | Year: 2015

Introduction: Psoriasis is a common papulosquamous skin disease, which presents as a chronic, disfiguring, inflammatory condition of the skin and joints. Most patients require lifetime treatment. Different treatment modalities, both systemic and topical, are available for psoriasis, with varying degrees of effectiveness and safety. Phototherapy is a well-established treatment option for moderate to severe psoriasis. PUVA photochemotherapy is a time-tested treatment option. NBUVB is becoming an accepted modality of treatment. Methods: 30 psoriasis patients with PASI > 10, who attended a tertiary care centre, were randomized into two groups to receive PUVA photochemotherapy and NBUVB therapy, respectively to know whether NBUVB therapy was better than PUVA therapy. The outcome measures were PASI 75, number of treatment exposures, adverse effects and non-compliance. Non-parametric tests were used to analyze the data. Results: 75% of NBUVB-treated and 50% of PUVA-treated patients had disease clearance. The total number of treatment exposures required for disease clearance was 15 for the NBUVB group and 18 for the PUVA group. 25% patients in the NBUVB group and 75% patients in the PUVA group developed the adverse effects and this prevented the patients from continuing the treatment. Conclusion: NBUVB can be considered as the treatment of choice in this particular group of patients taking into account the higher disease clearance rate, lower number of treatment exposures and lesser adverse effects. © 2015 INDIACLEN.

Sindhu R.S.,Government Medical College Thiruvananthapuram | Subhash R.,Government Medical College Thiruvananthapuram | Gireesan P.,Government Medical College Thiruvananthapuram | Raji L.,Government Medical College Thiruvananthapuram | And 4 more authors.
Pancreatology | Year: 2015

Introduction Chronic Pancreatitis (CP) is a heterogenous disease with alcoholic chronic pancreatitis (ACP) dominating in the West, and idiopathic or tropical chronic pancreatitis (TCP) in the tropics. The aim of this study is to assess the feasibility of using a scanning electron microscope (SEM) to analyze the ultra-structural changes in alcoholic and tropical subtypes of CP. Methods Chronic pancreatitis tissue samples were taken from the biopsy samples of 16 patients (seven ACP and nine TCP) who underwent drainage procedures for CP. These samples were subjected to SEM analysis and findings of normal pancreas were compared with those of CP for appreciating differences in their architectural changes. Results Normal architecture of pancreas could be observed as lobules of parenchyma, ductal system and definite loci of Islets of Langerhans (IOL). CP samples showed loss of architecture in the form of severe fibrosis and calcifications. In ACP, the fibrosis was predominantly seen towards the periphery of the gland sparing the periductal areas. These fibres were strangulating and damaging the parenchyma. Crystals were seen over these fibres. In TCP, fibrosis was moderate and uniform throughout the parenchyma. Moreover the crystals were larger and intraluminal. Total fatty replacement of parenchyma was a striking feature in TCP, seen exclusively in diabetics with gross atrophy of IOL. Conclusion SEM gives the real-life pictures of fibrosis, fatty change, ductal changes, calcifications and thus the actual extent of damage in CP better than the ordinary light microscopy. © 2015 IAP and EPC.

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