scholarly journals A Clinico-Etiological Study of Erythroderma in Adults in a Tertiary Care Centre

2021 ◽  
Vol 10 (37) ◽  
pp. 3213-3219
Author(s):  
Jagaragallu Amrutha ◽  
Narasimha Rao Netha Gurram ◽  
Padmaja Pinjala ◽  
Bhumesh Kumar Katakam ◽  
Rajeev Singh Thakur

BACKGROUND Erythroderma is a clinical entity that may cause severe systemic manifestations. The difficulty with erythroderma lies in finding the underlying aetiology. It is imperative to demonstrate precise aetiology whenever possible so that distinct therapy may be initiated. At times, despite finding the aetiology, relapses constitute a great menace. The purpose of our study was to assess the clinical profile and aetiology of erythroderma. Besides, the study also illustrated factors leading to relapses; such studies are rare in literature. METHODS This hospital-based, cross-sectional study included 88 patients of erythroderma of either sex and age more than 18 years; their clinical, laboratory, histopathological findings, treatment and outcome were studied. RESULTS The mean age of onset was 47.3 ± 12.35 years with the male to female ratio being 2.38:1. The most common cause of erythroderma was pre-existing dermatoses (67 %) followed by drugs (10.2 %), infections (3.4 %), malignancies (4.54 %), and idiopathic (14.7 %). Psoriasis was the predominant aetiology (45.4 %) among the pre-existing dermatoses with a maximum number of relapses (P = 0.02). Psoriasis was significantly associated with pruritus (P = 0.001), subungual hyperkeratosis (P = 0.0001), palmoplantar keratoderma (P = 0.001). Clinicohistological association was found in 64.6 % of cases. Mortality was seen in 6.8 % of cases. CONCLUSIONS As in previous studies, pre-existing dermatoses were the most common causes in our study; albeit, a special emphasis on factors leading to relapses was given to prevent further episodes. The most common factor of relapse was uncontrolled comorbid disorders (diabetes and hypertension) followed by medication nonadherence. Hence, our study suggests a need for more effective comorbidity management and creating awareness regarding judicial use of drugs which can go far in preventing mortality and morbidity. KEY WORDS Erythroderma, Adults, Aetiology, Relapses, Comorbidities.

Author(s):  
Harish Gangaraju ◽  
Raghu M. T. ◽  
Yogendra M. ◽  
Virupakshappa H. E. ◽  
Ashwini S. ◽  
...  

<p class="abstract"><strong>Background:</strong> Erythroderma is a cutaneous morphological reaction pattern of skin having many underlying causes and finding the etiology helps in the proper management of erythroderma cases.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was performed at the department of dermatology, Basaveshwara Medical College, Hospital and Research center, Chitradurga. Authors studied 30 consecutive cases of erythroderma from July 2017 to June 2019 with respect to the epidemiological, clinical and histological data. Clinico-histological correlation was analyzed for etiology of erythroderma.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of onset was 35.03 years with a male to female ratio of 3:2. In addition to erythrema and scaling that were present in all patinets, other co-existent features included were pruritus (43.3%), fever (23.3%), and edema (16.7%). Of the pre-existing dermatoses, psoriasis was the most common (36.6%) disease followed by eczema (26.7%), drug-induced erythroderma (16.7%), colloidan baby (3.3%), pityriasisrubrapilaris (3.3%) and in 13.3% of cases, etiology could not be ascertained. Clinico-histopathological correlation could be established in 73.3% of cases.</p><p class="abstract"><strong>Conclusions:</strong> In all erythroderma cases cutaneous features were identical irrespective of etiology. Detailed history, clinico-histopathological examination and other necessary haematological investigations helps to establish the etiology of erythroderma which helps in further management.</p>


2012 ◽  
Vol 5 ◽  
pp. CMAMD.S9803 ◽  
Author(s):  
Al-Bishri Jamal ◽  
Al-Harthi Salma ◽  
Al-Sofiani Wafa ◽  
Almutairi Ghadah ◽  
AlOsaimi Roaa

Objective To determine the appropriateness (both indications and adequate dosage regimen via creatinine clearance estimation) of allopurinol by physicians of different specialties in a tertiary care centre. Patients and Methods In this cross sectional study computerized clinical records of 156 adult patients who were prescribed allopurinol from 12th November to 11th December, 2011 were retrieved from Al Hada Hospital Taif Saudi Arabia. Main outcome variables were approprsiate indications of allopurinol, prescribing physician's specialty, and dosage of allopurinol. The prescribed dosages were categorized into correct and incorrect dose adjustments based on creatinine clearance estimation. The SPSS version 16 was utilized for data analyses. Results The mean (±SD) age was 58.15 (±14.99) years. There were 105 (67.3%) males and 51 (32.7%) females with male to female ratio being 2:1. Allopurinol was frequently prescribed by nephrologists and family physicians in this study. Out of 156 patients, 46 (29.5%) patients received allopurinol with appropriate indications. Eighty-five (54.5%) patients were received allopurinol without dose adjustment based on their creatinine clearance estimation; among them, 21 (13.5%) received allopurinol with appropriate indications. Conclusion The inappropriate use of allopurinol (both the indication and prescribed dosage) is still a major problem in a large tertiary care centre. Furthermore, the specialty of physicians is also a contributory factor in this inappropriateness.


Author(s):  
Meenakshi B. ◽  
Shantaraman K. ◽  
Indhumathi M. ◽  
Arumugapandian S. Mohan

Background: Snake-bites are well-known common medical emergencies in many parts of the world. In India 46,000 people are dying every year from snakebites. However, the true scale of mortality and morbidity from snake-bite remains uncertain. This study analyses the clinical profile and outcomes of the snake bite poisoning in patients admitted to this centre.Methods: This cross sectional study analyses the data of 150patients admitted to the Intensive Medical Care Unit of Tirunelveli Medical College Hospital with the history of snake bite between April and September of 2015 as available in their case records.Results: In this study, 42.7% of the patients were in the age group of 18 to 40 years and 64% were males with rural: urban ratio of 2.3: 1. About 82.7% of bites were haematotoxic, 10.7% neurotoxic and the remaining nontoxic bites. About 54% patients recovered completely, 44% had some form of morbidity at discharge and mortality was 2%. Out of 136 patients who were treated with Anti-snake venom (ASV), 9.6% developed ADR. The common ADR was itching and hypotension followed by rigor, breathlessness and edema of lips and eyes.Conclusions: This study highlights the need for early treatment intervention post bite. Imparting health education about early pre-hospital management and transfer to the hospital will help in the prevention of deaths due to snakebite. Identification of the type of snake is essential to decide on the type of toxicity and method of treatment to be instituted.


Author(s):  
Shaheen Farooq ◽  
Anju Kochar ◽  
Rekha Goyal

Background: Visual disability has deep emotional, social and economic impact. Rehabilitation of these individuals needs multidisciplinary approach to provide timely and complete support and improve the quality of life of the individual. Visual disability certification can be recognized as a mean by which social services of visually disabled can be coordinated. Objective was to analyze the demographics, causes and degree of visual disability and reasons of seeking disability certificate amongst visually disabled individuals attending ophthalmology OPD at a Tertiary Care Centre in India.Methods: A cross sectional study of patients seeking visual disability certificate was undertaken on 350 patients (567 eyes). Data were collected using pre set proforma. Cause of blindness was ascertained by complete ophthalmic examination and visually disability certificate was issued according to guidelines provided by Government of India.Results: Male female ratio was 1.9:1. Most of patients were from rural side, illiterate and unemployed. Most common age group was 16-30 years and financial and transport assistance was common reason for which certificate was sought. Corneal opacity was most common cause of blindness and visual impairment.Conclusions: Taking necessary preventive measures with the leading causes being identified can reduce the burden of visual impairment. On one hand increase in ophthalmic care and public education is needed to minimize the avoidable blindness rates ;on other hand strategies should be made to rehabilitate the individuals suffering from the unavoidable blindness. Benefits provided via visual disability certificate can play a pivotal role in rehabilitation of such patients.


Author(s):  
Mohan Kumar Mili ◽  
Tanushree Ghosh ◽  
Shilpi Gupta ◽  
Jyotirmoy Phookan ◽  
Nabajyoti Saikia

Introduction: Epistaxis whether spontaneous or acquired is one of the most common ENT emergencies. Its management can be challenging depending on the origin of bleeding and presence of precipitating factors. Aim: To find out the seasonal variation in epistaxis according to age, gender, region and aetiological factor. Materials and Methods: This cross-sectional study was conducted from June 2019 to June 2020 in a tertiary care centre in Upper Assam. In this study, the seasons were divided according to weather atlas as follows: Winter- December, January, and February; Spring- March and April; Summer- May and June; Rainy season- July, August and September; and Autumn- October and November. Outcome was to find the seasonal variation in epistaxis according to age, gender, region and aetiological factor. The data collected was tabulated in Microsoft Excel Worksheet and the categorical variables were summarised as proportions and percentages. Results: Out of 313 patients, 221 (70.6%) were males and 92 (29.4%) were females. High male preponderance with male to female ratio of 2.4:1 was noticed. Maximum number of patients were seen in month of October 66 cases (21%). Minimum male patients were seen in month of June 2020 (0.6%) 2 cases and minimum number of female patients were seen in the month of February and April (0.3%). Conclusion: The major cause of epistaxis in this region is hypertension, therefore peripheral health facility should be ready for giving treatment.


2018 ◽  
Vol 17 (2) ◽  
pp. 51-57
Author(s):  
Sujeeta Bajracharya ◽  
Bijendra Kumar Rai ◽  
Rajani Giri ◽  
Rinku Joshi

Introduction: Cardiovascular disease (CVD) is one of the leading causes of mortality and morbidity in both developed and developing countries. CVD risk rises to double fold in women after menopause. We aim to stratify menopausal women of our region for having coronary heart disease in next 10 years.   Methods: One year cross sectional study was conducted in General Out Patient Department (GOPD) of a tertiary care centre of Eastern Nepal. The Standard ATP calculator was used and the relevant necessary data was introduced into the calculator and the automated result was collected. Results: Among 272 participants, above 50% had Framingham score 1 to 5%. And the risk was greater within first five years after menopause in 50 to 59 years of age group. Similarly, with advancing age and longer duration of menopause the risk became significantly higher.Conclusions: Besides the established risk factors for CVD, postmenopausal state is additional risk for women and this study emphasises this factor as risk of CVD even in our set up.


2020 ◽  
Vol 8 (3) ◽  
pp. 12-16
Author(s):  
Amol Ramrao Suryavanshi ◽  
Sachin Bapurao Bodhgire ◽  
Shivaji Sangappa Phulari ◽  
Rahul Digambarrao Anerao

Background: Epilepsy is associated with significant mortality and morbidity. It is one of the common causes of childhood hospitalization. Regarding acute seizures episodes, there is limited data form the developing countries. This study aims to study the profile of children presenting with epilepsy at a Tertiary Care Centre. Subjects & Methods: This was a hospital based, prospective cross-sectional study conducted at the ‘epilepsy clinic’ of Paediatric department of a Tertiary Care Center. Total 260 children with epilepsy and having the age of 1 months to 12 years attending to the epilepsy clinic during the study period, were studied for clinical features, types, imaging studies, EEG, etc. Results: Most of the children (59.61%) affected with epilepsy were males. Majority of the cases (108) were in the age group 1 month to 1 year age. It was observed that, 185 cases (71.15%) were born through pre term delivery. It was found that 214 cases (82.31%) had abnormal EEG, 40 cases had abnormal CT scan and 46 cases had abnormal MRI. A significant number of children (60.38%) had generalized tonic clonic seizures. Conclusion: Epilepsy in children is a common indication for hospital admission. Evaluation of the type of seizure type with specific EEG findings and other related investigations helps in early and appropriate initiation of treatment. It is utmost important that the children with seizures should be on regular long term follow up and treatment, for better prognosis and disease outcome.


2019 ◽  
Vol 6 (2) ◽  
pp. 455
Author(s):  
Ashok Kumar Gudagunti ◽  
Ishwar Hasabi ◽  
Arathy S.

Background: Chronic pulmonary obstructive disease (COPD) has been responsible for the decreased quality of life as well as increased morbidity and mortality. Globally it has been estimated that nearly three million die yearly due to COPD and more likely to occupy the third place of mortality by 2030. The objective of the present endeavour was to study clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre.Methods: A hospital based cross sectional study was carried out among 200 cases of COPD. Their detailed history, thorough clinical examination and parameters like hemoglobin, serum creatinine, protein etc were investigated. The presence of co-morbidities was noted.Results: As the age increased the prevalence of the COPD increased and highest was found out to be in the age group of above 60 years of age. Males were more affected with COPD as compared with females. The male to female ratio was found out to be 2.4:1. The smokers were more compared to the non smokers. The prevalence of smoking among COPD was noted to be 66% compared to 34% as non smokers. Least proportion of patients of the COPD had fever i.e. in 22% of the cases. Cough was found in 83% of the cases. Breathlessness was found out to be in 98% of the cases. 15% of the cases of the COPD had diabetes only as the co-morbidity along with COPD and no other co-morbidity.Conclusions: Breathlessness was the most common symptom at presentation and diabetes and hypertension were the most common co-morbidities found.


2020 ◽  
Vol 33 (9) ◽  
pp. 1147-1153
Author(s):  
Fatima Ali Mazahir ◽  
Manal Mustafa Khadora

AbstractObjectivesWe evaluated the spectrum of diseases accompanying congenital hypothyroidism (CH) in the United Arab Emirates and compared them with internationally studied patterns.MethodsThe presented retrospective cross-sectional study took place in two government tertiary care centres. In total, 204 patients with a confirmed diagnosis of CH and a minimum period of follow-up of 1 year were included. Patients with Down syndrome, infants born at <35 weeks of gestation, and babies with TORCH (Toxoplasma gondii, Other viruses [HIV, measles, etc.], Rubella, Cytomegalovirus, and Herpes simplex) infections were subsequently excluded from the study.ResultsOf the subjects with CH, 39% had associated extrathyroidal anomalies (ETAs); among these, 25% had a single anomaly. A significant proportion of Arab males were affected by CH as compared to other ethnic groups. Dyshormonogenesis was the commonest aetiological cause (55%) of CH. Males with an ectopic lingual thyroid gland had significant ETAs as compared to females of the same cohort. The most common ETAs were congenital heart disease (16%), followed by urogenital tract anomalies (14%).ConclusionsDetection of a high rate and variability of ETAs associated with CH necessitates the formulation of a structured screening programme including appropriate clinical, laboratory, and imaging tools to detect ETAs at an earlier stage.


2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.


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