Keywords : Steroids
A cross-sectional assessment of the dermoscopic features of TSDF and to correlate them with potency and duration of application of the TCS
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 4, Pages 335-339
This study was undertaken to characterize dermoscopic features of TSDF and to correlate them with potency and duration of application of the TCS.
Methods: The present study was conducted in the department of skin. Sample size of 100 cases was included in the study. Patients (18 years or above) with clinical symptoms and signs suggestive of TSDF (redness, itching, acne, burning, swelling, photosensitivity, pigmentation and atrophy) and with history of application of TCS on the face for a period of more than one month were included in the study after obtaining written informed consent.
Results: In the present study, Females (80, 80%) constituted the majority as compared to males. Most of the patients belonged to the age group of 18–30 years (50, 50%) with a mean age of 32.8 ± 8.2 years. Seventy Five (75%) patients had received some form of formal education, while 25 (25%) patients were illiterate. Presenting complaints of the patients were redness in 80 (80%), itching in 70 (70%), pigmentation in 60 (60%), burning in 64 (64%) and acne in 35 (35%) patients. Duration of TCS application ranged from one month to 25 years with 50 (50%) patients having applied TCS for over one year.
Conclusion: Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse
Requirement of Vitamin D in Patients with Nephrotic Syndrome on Long Term Steroid
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 848-858
Introduction: Nephrotic Syndrome is characterised by nephrotic range proteinuria and the triad of clinical findings i.e., hypoalbuminemia, edema and hyperlipidemia. Glucocorticoid-sensitive nephrotic syndrome remits completely and quickly in response to glucocorticoids. Steroids are known to cause osteoporosis and loss of bone mineral density in NS patients. So, we decided to study requirement of vitamin D in nephrotic syndrome in patients who are on remission during steroid therapy and Comparison of normal and high dose of vitamin D supplementation to achieve normal vitamin D level in nephrotic syndrome patient, in remission on prednisolone therapy.
Material And Methods: The present descriptive observational study, was conducted amongst 31 patients from August 2014 to August 2016 in the pediatric department of tertiary care centre on both indoor (IPD) and outdoor (OPD) patients of Nephrotic syndrome those who are in remission on steroid. Patients having normal 25 OH Vitamin D level were included in study. These patients were randomly divided in two groups using random sampling by lottery method. a. First group was given vitamin D therapy as 20, 000 IU/month (600IU/day) for three months b. Second group was given 60,000 IU /month (2000IU/day) for three month.
Results: Out of 31 patients in this study, mean age at inclusion in group A was 5.4 years whereas, it was 7.2 years in group B. Majority 12 of the patients were having SDNS as diagnosis. Both the groups showed elevated levels of 25(OH) after supplementation. The levels of serum ionic calcium levels were not affected in both the groups, but the mean values of serum Ionic Calcium was found to be on higher side after Calcium supplementation especially in group B. The serum values were not affected in both groups.
Conclusion: The results concludes that there is no need for vitamin D supplementation in higher doses in steroid-sensitive nephrotic syndrome in patients those who are in remission and on minimal dose of steroids. So, dosage of vitamin D should be according to Recommended Dietary Allowances (RDA) when patient is on minimal dose of steroids.
EDTA INDUCED PSEUDOTHROMBOCYTOPENIA(PTCP): A PROSPECTIVE STUDY AT TERTIARY CARE HOSPITAL
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 96-102
Background -Spurious thrombocytopenia or pseudothrombocytopenia (PTCP) is a well
known in vitro phenomenon that occurs when the anticoagulant used while testing the blood
samples causes clumping of platelets which results in spuriously low platelet count with
automated haematology analyser. It occurs most often in EDTA anticoagulated blood,
however other anticoagulants though to a lesser extent have also been implicated in several
reports. Clinical consequences include unnecessary platelet transfusions, bone marrow
aspiration and inappropriate treatment like administration of steroids.
Material and methods –This is a hospital based prospective study in department of clinical
pathology for one year duration from January 2021 to December 2021.
Results – A total of 82 were found to have EDTA induced pseudothrombocytopenia in the
study period. The total case load during the study period was 2581 cases. The incidence of
PTCP in our study being, 3.1%. Males accounted for 45% and females accounted for 55 %
with male to female ratio of 2.5: 3.
Mean platelet count in EDTA anticoagulated samples with PTCP was 39,333/mm3 mean
platelet count in sodium citrate sample was 1,78,666/mm3, and mean platelet count manually
was 2,10,552/mm3. Citrate anticoagulated samples showed higher values as compared to
EDTA.
Conclusion -EDTA-PTCP is a common pre analytical error encountered in routine clinical
laboratory practise. EDTA-PTCP should be suspected in all cases with a low platelet count
but without any clinical bleeding manifestations. Platelet counts should be reviewed in all
such cases to prevent unnecessary clinical interventions and treatment. Simple, inexpensive
and diagnostic method of peripheral smear examination remains gold standard.
Nimesulide induced flaring in psoriasis
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 3, Pages 3840-3842
Background: Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. It is a widely used and well tolerated non steroid anti-inflammatory drug that also has analgesic and antipyretic properties. The most frequently reported side effects concern the GI tract. Pruritus and skin rash are the most common cutaneous adverse reactions. Case report: This is a case report of a 58 years old patient who came to ER with develop wheal, multiple joint pain sparing PIP/DIP joint, fever, generalized weakness, decrease oral intake afternimesulide ingestion.He also gave a history of psoriatic arthritis.He was managed with intravenous steroids, antibiotics, antihistaminic & iv analgesics Result:After 2days of medications his general condition improved, joint pain reduced, appetite improved and discharged on oral medicationsConclusion: Drug induced flare is common cutaneous drug reaction, often misdiagnosed. A detailed history taking and physical examination are the key to suspect this condition.