Diabetes is a metabolic disorder caused by abnormal release of or sensitivity to the insulin hormone, with loss of blood glucose control. Un controlled diabetes can have devastating effects on many organ systems including cardiovascular, neurologic, ocular, and renal, with its impact on skin, hair, and nail. diabetes mellitus is a predisposing factor for onychomycosis (OM),paronychia and ingrowing toe nail defects. In the present study evaluation of the prevalence and types of nail changes was done. Materials and Methods: During a 1 year study period (June 2018 to May 2019), patients with diabetes mellitus were screened for toenail changes. Demographic, social, and clinical data were recorded. Informed written consent was taken. Fungal infection was confirmed by nail clippings microscopy. Results: Of the 60 patients most common nail changes are subungual hyperkeratosis, onycholysis, and onychomycosis, and less common changes are Twenty nail dystrophy, Dorsal pterygium, Terry's nail in liver disease and diabetes mellitus and Subungual wart. Conclusions: Physicians who care for diabetic patients should not ignore nail changes. Careful global evaluation of patients with diabetes should include observation of nail changes.
Blood flow was s t u d i e d hy venous occlusion plethysmoeraphy i n 1 3 i n f a n t s r g q u i r i n g e i t h e r continuous p o s i t i v e airwhy p r e s s u r e (CPAP) o r a s s i s t e d v e n t i l a t i o n f o r hyaline vembrhne d i s e a s e .I n f a t s were s t u d i e d a t one t o 5 days of age. Ind i v i d u a l i n f a n t s were s t u d i e d on up t o 4 d i f f e r e n t days. The system used c o n s i s t e d of a blood pressure cuff a p p l i e d t o t h e t h i g h and a mercury strxain gauge a p p l i e d c i r c u m f e r e n t i a l l y t o t h e mid-calf (Kidd e t a l , 1966). A r t e r i a l blooc pressure (EP) was measured d i r e c t l y . Venous occlusion was accomplished ky i n f l a t i n g t h e c u f f t o a pressure below t h a t of t h e d i a s t o l i c BP. Blood flow ranged from 3.8 t o 14.2 r n l / l C O gnl of t i s s u e / minute. For each i n f a n t , values were reproducikle on a giver. day, but l a b i l e from day t o day. The observed values were h i g h e r t h a n t h o s e r e p o r t e d by Kidd e t a l , p o s s i b l y becduse of changing p r a c t i c e s regarding intravencus f l u i d s and blood t r a n s f u s i o n . Changes i n blood flow could not be p r e d i c t e d from changes i n BP, c e n t r a l h e c a t o c r i t , o r volume of blood withdrawn f o r l a b o r a t o r y s t u d i e s . Blood l a c t a t e , base d e f i c i t o r requirements f o r intravenous bicarbonate could not be pred i c t e d from bloo6 flow. CPAP a t p r e s s u r e s up t o 6 cm Hz0 d i d not s i g n i f i c a n t l y reduce blood flow. A low blood flow i n t h e f i r s t 24 hours suggested t h a t blooC t r a n s f u s i o n wasmorelrkely t o be r e q u i r e d subsequently during t h e course of t h e ?isease.PULMONARY BLOOD FLOW (PBF) I N LAMBS WITH HYALINE MEMBRANE DISEASE (HMD). Alexander C. Allen, Dora A . Stinson, Hugh M. MacDonald and Paul M. Taylor. Univ. of P i t t s b u r g h Sch. of Med. Maaee-Womens Hosp., Dept. of P e d i a t r i c s , P i t t s b u r g h , Pa.-~f f e c t i v e P B F '~~ lo" during t h e course of HMD (~h u e t a l , P e d i a t r i c s , s : 7 3 3 , 1965). I t i s not known whether t h i s change i s c e n t r a l i n t h e e t i o l o g i c chain of events o r simply a secondary phenomenon. T o t a l PBF was measured during t h e f i r s t 4 h r of l i f e i n lambs with and without HMD.At 129-133 days' g e s t a t i o n a pre-calibrated electromagnetic flow transducer w i t h non-occlusive zero was implanted on the p o s t d u c t a l port i o n of t h e comnon pulmonary a r t e r y of 8 f e t a l lambs which were r e t u r n e d t o t h e amniotic c a v i t y f o r 7 days and then del i v e r e d by C-section a t 136-140 days' g e s t a t i o n . A f t e r b i r t h a Swan-Ganz c a t h e t e r was f l o a t e d i n t o a branch pulmonary a rt e r y f o r pressure measurements. By c l i n i c a l and blood gas c r it e r i a , 4 lambs had no d i s t r e s s o r developed mild HMD; 4 developed moderate o r s e v e r e HMD. PBF increa...
INTRODUCTION: There is no study in literature for analyzing acanthosis nigricans (AN) in psychotropic induced obesity or hypercholesterolemia. AIM: To assess the prevalence and explore the predictors and morphological patterns in AN in patients on antipsychotics induced hypercholesterolemia versus those with diabetes mellitus. MATERIALS AND METHODS: 491 schizophrenia patients on second generation antipsychotics were screened. 26 out of 491 patients have AN and cholesterol 200 mg/dl but non-diabetic. We used MannWhitney U-test, Pearsons 2 test, Fischer Exact and Spearmans correlation coefficient. RESULTS: In the group of antipsychotics induced hypercholesterolemia having developed AN in 5.29% (26 out of 491) of individuals, we observed significance of Burkes knuckle (p 0.001), knee (p = 0.002), elbow (p = 0.042) compared to patients without hypercholesterolemia. Interestingly Burkes neck severity (p 0.001), neck texture (p = 0.001) and axilla (p = 0.007) index also showed marked differences on MannWhitney U-test and Wilcoxson W-test. On Spearmans correlation coefficient antipsychotics induced hypercholesterolemia was found to affect most positively and significantly as the emergence of AN specifically for neck texture ( = 0.413, p = 0.003) compared to other bodily regions. CONCLUSION: About 5.29% prevalence of AN in the group having obesity secondary to psychotropic drugs which was significantly less than what even non-obese, insulin dependent diabetic patients who almost had 13.55% prevalence, close to three times. This suggests that diabetes is strongly linked with occurrence of AN lesions and might reflect the continuity in the paradigm of metabolic syndrome as its definitive predictor of severity while obesity is the initiation of phase shift in the process.
Background and Aim: Chronic urticaria is a common distressing dermatosis characterized by spontaneous occurrence of wheals lasting for less than 24 hours, with or without angioedema occurring daily or almost daily for more than 6 weeks. The main aim of the present study is to investigate the positivity of ASST and clinical and severity in chronic idiopathic urticaria. Methodology: A total number of 100 cases of chronic idiopathic urticaria reporting to the Dermatology Venereology Leprology Department, Kamineni institute of medical sciences were studied. Results: 46 of them were females and 54 were males. Maximum cases were in the age group of 21-30 years (33%), followed by age group 31-40 years (26%). The age of the youngest patient was 14 years and that of the oldest was 65 years. Autoantibodies, detected by ASST, were seen in the sera of 43% patients with CIU, comparable to available reports in literature. Presence of autoantibodies was unrelated to gender and the mean age of onset of the disease was earlier in ASST positive patients. Presence of these autoantibodies was significantly associated with more duration of disease, more duration of wheal, frequent attacks of disease and UAS > 5. Angioedema and Abnormal Thyroid profile were significant in ASST positive patients. Dermographism occurred more frequently in ASST Negative patients. There was difference in presentation of clinical symptoms between ASST positive and negative patients but these were not statistically significant. There was difference in CBP, AEC, ESR, RBS Sr IgE Levels and ANA between positive and negative ASST patients, but these results were statistically insignificant. Conclusion: Thus, ASST identifies a sub group of patients with CIU with more severe disease, who are likely to be more symptomatic and would require more aggressive treatment.
Angioedema is a transient, non-pitting oedema that involves subcutaneous or submucosal tissue. Angioedema in children can have varied aetiology and clinical manifestations, unlike that in adults. We report a case of angioedema of penis in a child resulting from insect bite and treated successfully with anti-histamine and leukotriene inhibitor. Penile angioedema should be kept in mind as a differential diagnosis of penile swelling, as early diagnosis and management may prevent fatal complications.
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