Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and mucous membranes. While minor presentations may occur, significant involvement of oral, nasal, eye, vaginal, urethral, gastrointestinal, and lower respiratory mucous membranes may develop in the course of the illness. GI and respiratory involvement may progress to necrosis. Stevens-Johnson syndrome is a serious systemic disorder with the potential for severe morbidity and even death. The syndrome was first described in 1922, when the American pediatricians Albert Mason Stevens and Frank Chambliss Johnson reported the cases of 2 boys aged 7 and 8 years with "an extraordinary, generalized eruption with continued fever, inflamed buccal mucosa, and severe purulent conjunctivitis". Both cases had been misdiagnosed by primary care physicians as hemorrhagic measles. Erythema multiforme (EM), originally described by Von Hebra in 1866, was part of the differential diagnosis in both cases but was excluded because of the 'character of skin lesions, the lack of subjective symptoms, the prolonged high fever, and the terminal heavy crusting". Despite the presence of leucopenia in both cases, Stevens and Johnson in their initial report suspected an infectious disease of unknown etiology as the cause. In 1950, Thomas divided EM into 2 catagories: erythema multiforme minor (Von Hebra) and Erythema multiforme major (EMM). Since 1983, erythema multiforme major and Stevens-Johnson syndrome had been considered synonymous. In the 1990s, however, Bastuji and Roujeau each proposed that Erythema multiforme major and Stevens-Johnson syndrome are 2 distinct disorders. Several investigators propose that Stevens-Johnson syndrome and Toxic epidermal necrolysis (TEN) represent the same disease at different levels of severity. Although several classification schemes have been reported, the simplest breaks the disease down as follows: * Stevens-Johnson syndrome-A "minor form of TEN", with less than 10% body surface area (BSA) detachment. * Overlapping Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN)-Detachment of 10-30% BSA. * Toxic epidermal necrolysis-Detachment of more than 30%BSA.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 31-35
Background: Vitiligo is an acquired, pigmentary skin disorder that is disfiguring and difficult to treat. Phototherapy and the application of topical corticosteroids are most commonly prescribed. However, these therapies are often not effective and the use of corticosteroids on the face may lead to cutaneous atrophy, telangiectasia, and ocular complications. Objective: To evaluate the effectiveness of topical tacrolimus treatment in vitiligo patients. Materials and methods: This prospective, randomized control trial study was conducted among the patients who sought health care in the Dermatology and Venereology out patient department of KYAMC, Enayetpur, Sirajgonj from August 2021 to July 2022. The study was conducted with a view to evaluate the efficacy of topical tacrolimus in vitiligo and to see the adverse effects of topical tacrolimus in the treatment of vitiligo. Results: This study shows 70 patients were enrolled them 32 were male and 38 were female. The mean age was 28.52±10.98 years. Monthly evaluations were performed. Maximum 61 patients (87.1%) achieved varying levels of repigmentation. 28 patients (40.0%) had reported up to 50% repigmentation. Sign and symptoms of erythema (8.6%) and burning (7.1%) were minimal. Conclusion: This study revealed that tacrolimus ointment may be an effective and safe option for the treatment of vitiligo. The ease of topical self-administration with minimal side effects makes this novel immunomodulatory agent a promising addition to the therapeutic armamentarium for vitiligo. Central Medical College Journal Vol 6 No 1 January 2022 Page: 44-48
Background: Hanging signifies an asphyxiation form which, by a noose or another constricting band tightened by body weight, is secondary to compression or restriction of the neck structures. Death due to hanging is always suicidal until and unless otherwise specified. Objective: To evaluate the socio-demographic characteristics in cases of death due to completed hanging in Bangladesh. Materials and Method: This descriptive study was conducted in the Department of Forensic Medicine, Dhaka Medical College Hospital. The period of study was from July 2020 to June 2022. A total number of 167 autopsies were done during this period on dead bodies that died due to hanging. Points regarding knot of ligature material, injury to neck structures, ligature mark, and stomach condition were noted during post-mortem examinations. All information was noted in a structured data sheet. Data were analyzed using a computer-based programme statistical package for social science (SPSS) for windows version 25. Result: This study shows maximum number of hanging cases 34.1% were in the age group of 21-30 years. Among the 167 suicide cases by hanging, the majority (69.5%) were male. Majority (56.9%) of the cases were married. Family disputes were most common motive 66(39.5%) and in females, the most common motive was marriage related harassment, particularly in married women 38(22.8%). Soft material like cloth, saree, orna, and dupatta was the preferred material for hanging in this study (85.6%) followed by firm materials (7.8%) like a rope. Hard material like iron wires, cable wires, etc were used very rarely (2.4%) and the victims who used these were almost always male. Conclusion: This culture has a great socio-economic burden due to the high incidence of suicidal hanging among young adults. The private essence of hanging and convenient access to ligature points and ligature supplies renders suicide avoidance challenging. Marital disappointment, organic disease issues, and dowry abuse are the primary reasons behind suicide hanging. Social, legal and psychiatric interventions are required to prevent suicide. Central Medical College Journal Vol 6 No 2 Jauly 2022 Page: 77-81
Background : Self poisoning with organophosphate pesticides is a major health problem in world wide. Organophosphorus compound poisoning is a very common toxicological emergency encountered at Mirzapur in Tangail. It is particularly common among the rural agricultural worker's which comprise a substantial group of the population of this region.Objective: The objective of this study was to find out the incidence, frequency, pattern of poisoning, outcome and aetiological aspect of Organo phosphorus poisoning patient admitted in Kumudini Women's Medical college Hospital.Methods: A total 366 cases of OPC poisoning were analysed during 1 year from January 2015 to December 2015. The emphasis was given on age, sex, socio-economic status, occupation, motive of poisoning, types of compound consumed its quality, place, distance from referral place and the ultimate outcome.Results: Young population of rural background, particularly agricultural workers were the commonest patients (51.91%). The most common motive of poisoning was with a suicidal intent, both in males (27.59%) and females (66.39%). Financial crisis was one of the most common reasons analysed as the motive behind the poisoning (54.20%). Three hundred forty four Patients recovered and 22 were expired. The major cause of death in these cases was respiratory failure followed by multi-organ failure.Conclusion : Strict of the pesticide act and involving a new policy by the government to educate the public and youth in large about the dangerous, life threatening effects of Organophosphorus compound could help amelerioating the harmful effects of such poisoning.KYAMC Journal Vol. 9, No.-3, October 2018, Page 133-135
Objective: The objective of the study was to explore the profile of Autopsy cases at Rajshahi Medical College. Materials and Methods: This observational study was carried out at Rajshahi Medical College. From January 2021 to June 2021. A total of 248 autopsy cases were included as a sample size during the study. Results: Most of the autopsy cases were found to be male ( 75% ), More than 40.72% death were due to poisoning, followed by suicidal hanging cases (19.76% ),homicide cases (14.51%), different types of accidental cases( 8.47%). In case of road traffic accidents (RTA) 70% cases were by 2-wheelervehicles followed by 25% were by 4-wheeler vehicles, 3% were by heavy vehicles and 2% were pedestrian cases. Death from suicidal hanging were mostly common in the age group 15-25 years, Homicide in47-67 years, poisoning in 47-67 years, Accidental fall from height in 15-25 years and Natural death in the age group of 67 years and above. Conclusion: This study helps to interpret several sorts of medico-legal situations, by policy makers, health care programmers, judiciary and investigation and then takes appropriate action to minimize mortality. KYAMC Journal. 2022;12(04): 205-207
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