Cutaneous tuberculosis is a rare manifestation of tuberculosis and accounts to less than 2% of cases of tuberculosis. It can have varied manifestation. An accurate diagnosis can be achieved by clinical examination of lesion and relevant investigation including skin biopsy. The cutaneous tuberculosis responds excellently to anti-tubercular drugs. Here we describe a case of young adult female, with chronic non-healing leg ulcer. A diagnosis of cutaneous tuberculosis was established based on skin biopsy findings and her response to treatment with anti-tubercular drugs.
BACKGROUND AND OBJECTIVES: Cerebrovascular disease is the most common life threatening neurological disease and is a concern in young patients especially in developing countries. This study aims to identify clinical profile, risk factors, aetiology, and radiological profile of patients presented with stroke between the ages of 15-45 years. METHODOLOGY: 50 patients (27 males and 23 females) were included in the study. Detailed history and clinical examination were done and neurological deficits were identified. Other than routine investigations, fasting blood sugar, serum lipid profile, bleeding time, clotting time, HIV, VDRL, lumbar puncture for CSF analysis, homocysteine levels, ANA, APLA, electrocardiography, echocardiogram, carotid doppler and CT/MRI Brain were done for all the patients. RESULT: The sex ratio was 1.17: 1 (M:F), the mean age was 33.12 years and that of male and female patients were 34.74 and 31.22 years respectively. Neurodeficits such as motor deficit was seen in 86% of patients. Decreased in consciousness was seen in 72% of patients. 36% of patients had speech abnormalities. The common cranial nerve involved is VII th cranial nerve in 24% of patients. Cerebellar deficit was seen in 6% of patients. Risk factors such as smoking was seen in 36%, alcohol consumption in 22%, hypertension in 28%, diabetes mellitus in 16%, overweight in 14%, abnormal LDL in 44% and HDL in 38%, OCP in 4% were associated with stroke in young. CT/MRI brain revealed ischemia in 56%, hemorrhage in 24% and cortical venous thrombosis in 20%. Common aetiology found was cardioemboli 26% followed by hypertension in 20%, atherosclerosis in 16%, postpartum cortical venous thrombosis in 12%, homocystinemia in 8%, SLE, OCP, APLA, AV malformation in 2% and undetermined in 10%. INTERPRETATION & CONCLUSION: The major risk factors for stroke in young patients were smoking, alcohol consumption, hypertension and dyslipidemia. Oral contraceptive pill use was associated risk factor in women. Cardioemboli was the most common cause of stroke in young. Cortical vein thrombosis was common among females. KEYWORDS: Stroke; stroke in young; ischemic stroke; intracerebral hemorrhage. INTRODUCTION: Stroke was defined by World Health Organization criteria as rapidly developing clinical signs of focal, at times, global disturbance of cerebral function lasting for more than 24 hours or leading to death with no apparent cause other than vascular origin. 1 Stroke is one of the most important causes of high morbidity and mortality all over the world. The diseases of cerebral blood vessels and the related infarcts and haemorrhages, though principally occur in the elderly, the young are not spared. 1 Data from major Indian hospitals show 24 to 35% of stroke in young of all neurological admissions. 2 The latest available estimates from Indian Council of Medical Research (ICMR)
BACKGROUND AND OBEJECTIVE: Pulmonary arterial hypertension is a wellrecognized entity in patients with cirrhosis of liver. Various studies have reported a prevalence varying from 2-20%. Present study was intended to find the prevalence of pulmonary hypertension in patients with cirrhosis and to look for the risk factors for pulmonary hypertension. METHODOLOGY: 100 consecutive patients with cirrhosis of liver attending outpatient department and admitted in medicine ward at KIMS, Hubli, were taken for study after considering the inclusion and exclusion criteria. The informed written consent was taken from the patients. Detailed history, examination with relevant investigations including ultrasonography abdomen and endoscopy was done. Patients were screened by echocardiography for presence of PAH. RESULTS: Out of 100 patients with cirrhosis 17% were found to have pulmonary arterial hypertension by echocardiography. There was no statistically significant association between the gender, etiology of cirrhosis, portal hypertension, and severity of liver disease with the risk of development of pulmonary arterial hypertension. INTERPRETATION AND CONCLUSION: Due to small sample size risk factors with smaller effect sizes may not have been detected. The prevalence of pulmonary hypertension was noted to be more common in the patients with portal hypertension (18.6%), female sex (26.67%) and Child pugh class C (20%), but was not statistically significant. The high prevalence of pulmonary hypertension in this study may be due to the use of echocardiography, rather than the right heart catheterization for diagnosis of PAH.
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