Context:Psoriasis has an impact on psychology of the patients. There is a dearth of studies regarding this field in eastern India.Aims and Objectives:The primary objective of this study is to evaluate the psychiatric morbidity in psoriasis and secondary objective is to assess the morbidity in all eight dimensions of psychosocial and physical aspects, i.e. cognitive, social, discomfort, limitations, depression, fear, embarrassment and anger.Settings and Design:Institutional based case control study.Materials and Methods:Forty-eight patients of psoriasis and equal number of healthy controls were included in the study. Self-reporting questionnaire-24 (SRQ-24) and skindex (A 61-item survey questionnaire) were used to assess the psychiatric morbidity in both groups.Statistical Analysis Used:“MedCalc version 10.2.0.0” (by Acacialaan 22, B-8400, Ostend, Belgium) was used as statistical software. Chi-square test was used as a test of significance.Results:The SRQ assessed psychiatric morbidity in the study group was 62.5%, compared with 18.5% in the control group. This difference was statistically significant (P < 0.001). Guttate psoriasis had maximum association with psychiatric morbidity (100%), followed by plaque type (63.6%) and palmoplantar type (42.8%). According to the skindex, the most common psychiatric morbidity in psoriasis patients was anger (58.3%), followed by discomfort (52.08%), social problem (52.08%), cognitive impairment (50%), embarrassment (50%), physical limitation (47.91%), fear (47.91%) and depression (43.75%). The skindex observed psychiatric morbidity among the case and control group was statistically significant for all the parameters (P < 0.0001).Conclusion:Psoriasis has a high degree of psychiatric morbidity and the extent of this co-morbidity is even greater than hitherto thought of.
Introduction:Trophic ulcer is a dreaded complication of leprosy. Secondary infection compounds the damage to the already neglected ulcer.Aims:To find out the bacterial pathogens in the isolates from trophic ulcers of leprosy and to find the drug sensitivity of the aerobic isolates so as to start a suitable antibiotic therapy.Methodology:An institution-based, cross-sectional study done over a period of 2 years. Swab was taken from the deeper part of the ulcer. It was put on a suitable culture media. Bacteriological profile was determined and antibiogram was done subsequently.Results:Sixty patients with trophic ulcer secondary to leprosy were screened, among which all were screened for aerobic isolates and 38 were screened for anaerobic isolates. Among the aerobic isolates, 88% of patients were culture-positive. The most common organism was Staphylococcus aureus (37.7%), followed by Pseudomonas aeruginosa (22.64%), Proteus mirabilis (15.09%), Escherischia coli (13.2%), Klebsiella (9.43%). Maximum overall sensitivity was seen with amikacin (93.1%) and linezolid (89.65%). Maximum overall resistance was noted with cotrimoxazole (58.62%) and coamoxiclav (51.72%). Among the 38 patients cultured for anaerobic isolates, 17 were culture-positive for anaerobic organisms. Isolates showing Peptococcus were 6 (15.7%), purely Peptostreptococcus were 4 (10.5%), purely bacteroides were 3 (7.8%), and mixed growths were 4 (10.5%).Conclusion:Secondary bacterial infection is quite common in leprosy trophic ulcers. The most common organism was Staphylococcus aureus. Isolates were mostly sensitive to amikacin and linezolid and resistant to cotrimoxazole and coamoxiclav. Anaerobic isolates were not uncommon, with Peptococcus being the most common among them.
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