Congenital cutaneous candidiasis (CCC) is an extremely rare disorder that presents within the first 6 days of life. The manifestations ranges from diffuse skin eruption without any systemic symptoms to respiratory distress, hepatosplenomegaly, sepsis, and death. We report a neonate who presented with generalized skin eruptions at birth, characterized by erythematous macules and papules. The eruption involved head, face, neck, trunk, and extremities. Candida albicans was demonstrated on direct KOH smear, skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis, which manifests as thrush or diaper dermatitis. The infection is acquired from the maternal genital tract in an ascending fashion. Clinical features, direct smear examination of specimen, and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.
Background:Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication.Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion:To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.
<p class="abstract"><strong>Background:</strong> Rabies is a zoonotic disease caused by lyssavirus and spread through saliva of rabid animal bite. This study was taken to compare primary closure versus non-closure of animal bite wounds.</p><p class="abstract"><strong>Methods:</strong> This is a prospective randomized study. Patients were divided into 2 groups. Group A consisted of patients with non-closure of wounds and group B with primary closure of wounds. Patients were followed up for wound healing time, infection and cosmesis. </p><p class="abstract"><strong>Results:</strong> This study consists of 540 patients (323 males and 217 females). The common age group was paediatric and geriatric age. Most common animal bite was from dogs. The average healing time in non-infected wound in group A versus group B with Lackman’s I and II grading was 10.5±1.25 and 12.5±1.5 days versus 7±1.25 and 8.5±1.5 days respectively. There were 19 cases in group A and 17 cases in group B with infection which subsided with antibiotics in 24 hrs. Cosmesis graded on VSS was better in group B (average 4.03±1.5) as compared to group A (average 2.44±0.185). Only one patient from group A with Lackman’s grade II contacted rabies died 2yrs after the bite.</p><p class="abstract"><strong>Conclusions:</strong> Animal bite wounds over head and neck were found to be more common in paediatric and geriatric population who are more vulnerable. Infection and spread of rabies virus through these wounds can be prevented by thorough debridement and cleaning whereas primary suturing helps in achieving early wound healing and better cosmesis producing a socially and functionally acceptable scar.</p><p class="abstract"> </p>
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