Background:Pemphigus is a group of chronic autoimmune vesico-bullous disorders in which the epidermis and the basement membrane zone are the focus of attack resulting in cutaneous and mucosal blister formation. Direct immunofluorescence (DIF) test is a very sensitive test for the diagnosisAim:To study the clinico histopathological patterns of pemphigus in eastern India. The study also aims to correlate DIF with clinical and histologic findings as well as severity of skin involvement [scoring systems].Materials and Methods:Total 41 patients were studied over a period of 1 year in the Post-graduate centre of Dermatology in Eastern India. DIF, histopathology and clinical data were correlated.Results:In our study Pemphigus vulgaris (PV) was the predominant type with 32 cases followed by 8 cases of pemphigus foliaceus (PF) and a single case of IgA pemphigus. Mean age at presentation was late middle age. Majority of the patients, 26 (63.41%) initially had cutaneous involvement followed by mucosal involvement. In this study group 36 (87.80%) patients showed acantholytic cells on histopathological examination. Most patients of PV showed suprabasal blister 20 (62.50%) followed by intraspinous 5 (15.62%) and subcorneal 5 (15.62%) blister. In majority 28 (87.50%) of the PV patients IgG and C3 antibodies were deposited throughout the epidermis. The strength of antibody positivity was strong in most of the patients (71.87%). In cases of PF mostly IgG 6 (75%) antibodies were deposited in the upper epidermis. DIF intensity had poor correlation with disease activity/severity except in PF.Conclusion:Almost 85.36% cases of pemphigus were diagnosed clinicopathologically. But 6 cases couldn’t be diagnosed accurately on clinicopathological basis and in them DIF was confirmatory. Two cases of pure mucosal PV and 1 case of IgA pemphigus was confirmed by DIF. Two cases of bullous pemphigoid clinico-histologically mimicking PV were also excluded by DIF. So it appears from our study that DIF is confirmatory for diagnosis of pemphigus in all cases.

<abstract><p>SARS-COV-2 (Coronavirus) viral growth kinetics within-host become a key fact to understand the COVID-19 disease progression and disease severity since the year 2020. Quantitative analysis of the viral dynamics has not yet been able to provide sufficient information on the disease severity in the host. The SARS-CoV-2 dynamics are therefore important to study in the context of immune surveillance by developing a mathematical model. This paper aims to develop such a mathematical model to analyse the interaction between the immune system and SARS-CoV-2 within the host. The model is developed to explore the viral load dynamics within the host by considering the role of natural killer cells and T-cell. Through analytical simplifications, the model is found well-posed and asymptotically stable at disease-free equilibrium. The numerical results demonstrate that the influx of external natural killer (NK) cells alone or integrating with anti-viral therapy plays a vital role in suppressing the SARS-CoV-2 growth within-host. Also, within the host, the virus can not grow if the virus replication rate is below a threshold limit. The developed model will contribute to understanding the disease dynamics and help to establish various potential treatment strategies against COVID-19.</p></abstract>

Various ‘sex-stimulant’ medicines with fancy names and attractive packaging are available over the counter. Most contain phosphodiesterase 5 inhibitors in various strengths, often with herbal additions. These drugs are used erratically by the lay public, driven by folklore that such usage leads to increase in the length, girth or firmness of the penis. Such indiscriminate use by an otherwise healthy population leads to undue side effects.

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