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Arora S, Das P, Kumar Singh G, Arora G, Bellad P. Combining platelet rich plasma with ablative laser for post acne scars: A review. Indian J Dermatol Venereol Leprol 2024; 0:1-11. [PMID: 38595005 DOI: 10.25259/ijdvl_549_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/25/2023] [Indexed: 04/11/2024]
Abstract
Background Acne scars are one of the most common sequelae of inflammatory acne. It commonly affects adolescents and young adults and hence is associated with significant psychological morbidity. It is historically resistant to oral as well as surgical modalities. In the last two decades, ablative lasers (fractional or otherwise) have proven to be effective in management of acne scars. Some studies have proven the efficacy of platelet rich plasma in reducing the adverse effects and improving the efficacy of lasers. Objective Review of the studies combining platelet rich plasma with ablative laser for post acne scars. Methods A literature review of the MEDLINE database for studies evaluating the combination of ablative lasers with platelet rich plasma was performed. Only studies with higher levels of evidence (randomised controlled trials and comparative studies) were included in this review. Results Adding intradermal platelet rich plasma to fractional ablative lasers in the management of post acne scars increases clinical efficacy, reduces downtime as well as frequency and duration of ablative lasers related adverse effects. The efficacy of topical platelet rich plasma is less as compared to intradermal platelet rich plasma. Limitations The studies analysed are heterogeneous in nature with varied protocols and duration of follow up. Conclusions It is recommended to combine the ablative lasers with intradermal platelet rich plasma for better clinical response and reduce adverse effects as well as downtime.
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Affiliation(s)
- Sandeep Arora
- Department of Dermatology, Base Hospital, New Delhi, India
| | - Pankaj Das
- Base Hospital Delhi Cantt and Army College of Medical Sciences (ACMS), New Delhi, India
| | | | - Gulhima Arora
- Department of Dermatology, Mehekta Gul Dermaclinic, Safdarjung Enclave, New Delhi, India
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Arora G, Khandpur S, Bansal A, Shetty B, Agrawal S, Saha S, Sachdeva S, Gupta M, Sharma A, Monalisa K, Bhandari M, Bagrodia A. Authors' reply. Indian J Dermatol Venereol Leprol 2023; 89:781-782. [PMID: 37655732 DOI: 10.25259/ijdvl_807_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, Safdarjung Enclave, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Bhavishya Shetty
- Department of Dermatology, Maulana Azad Medical College, Balmiki Basti, New Delhi, India
| | - Sonia Agrawal
- Department of Dermatology, UCMS and GTBH, Vivek Vihar, Delhi, India
| | - Sushobhan Saha
- Department of Dermatology, UCMS and GTBH, Dilshad Garden, New Delhi, Delhi, India
| | - Soumya Sachdeva
- Department of Dermatology and Venereology, ABVIMS and Dr. RML Hospital, New Delhi, India
| | - Meghna Gupta
- Department of Dermatology, Maulana Azad Medical College, Uttar Pradesh, UP, India
| | - Ananya Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kumari Monalisa
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India
| | - Molisha Bhandari
- Department of Dermatology and Venereology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Law Apartment, Delhi, India
| | - Anjali Bagrodia
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India
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Arora G, Arora S. Medical Aesthetics - Current Trends and a Review of Its Applications. Indian Dermatol Online J 2023; 14:309-319. [PMID: 37266088 PMCID: PMC10231726 DOI: 10.4103/idoj.idoj_264_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 06/03/2023] Open
Abstract
Medical aesthetics is the use of a procedure or product for a therapeutic indication which is conventionally used for aesthetics. Several medical conditions are now being treated with products, procedures or equipment that are conventionally used for aesthetic indications. This has widened the scope of treatment modalities available for dermatologists to treat various indications that fall outside the purview of aesthetic dermatology. The authors present aesthetic treatment modalities and procedures which can be used for medical aesthetics, their present-day status and usefulness in field of therapeutics with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology Consultant Dermatologist, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences, Delhi Cantt, India
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Shetty NS, Parcha V, Pampana A, Kalra R, Pandey A, Morris A, Prabhu S, Arora G, Arora P. Incident heart failure risk reclassification with race-$$$independent estimated glomerular filtration rate: an NHLBI pooled cohorts analysis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00016-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Arora G, Khandpur S, Bansal A, Shetty B, Aggarwal S, Saha S, Sachdeva S, Gupta M, Sharma A, Monalisa K, Bhandari M, Bagrodia A. Current understanding of frictional dermatoses: A review. Indian J Dermatol Venereol Leprol 2023; 89:170-188. [PMID: 36461803 DOI: 10.25259/ijdvl_519_2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/01/2021] [Indexed: 11/11/2022]
Abstract
Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as 'a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.' The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms 'frictional dermatitis,' 'friction and skin,' 'dermatoses and culture,' 'clothing dermatitis,' 'friction melanosis,' 'PPE induced dermatoses in COVID-19 era,' etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.
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Affiliation(s)
- Gulhima Arora
- Mehektagul Dermaclinic, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Anuva Bansal
- Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India
| | - Bhavishya Shetty
- Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India
| | - Sonia Aggarwal
- Department of Dermatology and Venereology, University College of Medical Sciences, New Delhi, India
| | - Sushobhan Saha
- Department of Dermatology and Venereology, University College of Medical Sciences, New Delhi, India
| | - Soumya Sachdeva
- Department of Dermatology and Venereology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India
| | - Meghna Gupta
- Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India
| | - Ananya Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Kumari Monalisa
- Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India
| | - Molisha Bhandari
- Department of Dermatology and Venereology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Anjali Bagrodia
- Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India
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Arora G, Taneja J, Bhardwaj P, Goyal S, Naidu K, Yadav SK, Saluja D, Jetly S. Adverse events and Breakthrough infections associated with COVID-19 vaccination in the Indian population. J Med Virol 2022; 94:3147-3154. [PMID: 35261064 PMCID: PMC9088477 DOI: 10.1002/jmv.27708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/20/2022] [Accepted: 03/05/2022] [Indexed: 11/21/2022]
Abstract
Vaccines against COVID‐19 provide immunity to deter severe morbidities associated with the infection. However, it does not prevent infection altogether in all exposed individuals. Furthermore, emerging variants of SARS‐CoV‐2 impose a threat concerning the competency of the vaccines in combating the infection. This study aims to determine the variability in adverse events and the extent of breakthrough infections in the Indian population. A retrospective study was conducted using a pre‐validated questionnaire encompassing social, demographic, general health, the status of SARS‐CoV‐2 infection, vaccination, associated adverse events, and breakthrough infections in the Indian population. Informed consent and ethical approval were obtained as per Indian Council of Medical Research (ICMR) guidelines. Participants, who provided the complete information, were Indian citizens, above 18 years, and if vaccinated, administered with either Covishield or Covaxin, were considered for the study. Data have been compiled in Microsoft Excel and analyzed for statistical differences using STATA 11. The responses from 2051 individuals fulfilling the inclusion criteria were analyzed. Among 2051, 1119 respondents were vaccinated and 932 respondents were non‐vaccinated. Among 1119 vaccinated respondents, 7 were excluded because of missing data. Therefore, out of 1112 vaccinated, 413 experienced adverse events with a major fraction of younger individuals, age 18–40 years, getting affected (74.82%; 309/413). Furthermore, considerably more females than males encountered adverse consequences to vaccination (p < 0.05). Among vaccinated participants, breakthrough infections were observed in 7.91% (88/1112; 57.96% males and 42.04% females) with the older age group, 61 years and above (odds ratio, 3.25 [1.32–8.03]; p = 0.011), and males were found to be at higher risk. Further research is needed to find the age and sex‐related factors in determining vaccine effectiveness and adverse events. Significant higher adverse events following COVID‐19 vaccination in females in comparison to males. Breakthrough infections among Indian population was found to be 7.91%. Older people and males were found to be at high risk for getting breakthrough infections.
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Affiliation(s)
- G Arora
- Delhi School of Public Health, IoE & Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi-110007
| | - J Taneja
- Zoology Department, Daulat Ram College, University of Delhi-110007
| | - P Bhardwaj
- Department of Zoology, University of Delhi-110007
| | - S Goyal
- Manav Rachna International School, Sector 14, Faridabad, Haryana, 121007
| | - K Naidu
- IPCA Laboratories Ltd., Mumbai, 400067
| | - S K Yadav
- Zoology Department, Daulat Ram College, University of Delhi-110007
| | - D Saluja
- Delhi School of Public Health, IoE & Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi-110007
| | - S Jetly
- Department of Biomedical Sciences, Acharya Narendra Dev College, University of Delhi-110019
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Arora S, Paul D, Kumar R, Bhatnagar A, Arora G, Mech S, Suhag DK. Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI). Dermatol Pract Concept 2022; 12:e2022010. [PMID: 35223155 PMCID: PMC8824731 DOI: 10.5826/dpc.1201a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background Nail involvement in psoriasis may be assessed clinically, ultrasonologically, and dermoscopically. The aim of this study was to assess the dermoscopic features of nails in psoriasis, to compare them with the clinical findings, and to correlate them with the Nail Psoriasis Severity Index (NAPSI) score. Methods We recruited 120 patients with psoriatic nail changes for the study. The Psoriasis Area Severity Index (PASI) was used to assess the severity of disease. Clinical and dermoscopic (Derm-Lite DL4, ×10, polarized and non-polarized) nail examination determined NAPSI, modified NAPSI (mNAPSI), and NAPSI determined with dermoscopic findings (dermoscopic NAPSI [dNAPSI] and dermoscopic modified NAPSI [dmNAPSI]) were used to assess severity of nail involvement. Results Subungual hyperkeratosis (50.8%) and nail plate thickening (56.7%) were the commonest clinical nail changes found, and dermoscopically, they were subungual hyperkeratosis and pitting (68.3% each). The average median with interquartile range of PASI and NAPSI scores were 7.5 [5.7–10.8] and 8.0 [6–12], respectively. NAPSI scores increased significantly with the increase in PASI scores (P < 0.001). A comparison of NAPSI and mNAPSI with dNAPSI and dmNAPSI revealed that NAPSI, mNAPSI, and dNAPSI increased significantly with an increase in PASI scores. The dNAPSI scores increased significantly with increased mNAPSI and dmNAPSI, and mNAPSI and dmNAPSI were significantly good predictors of joint involvement in psoriasis. Conclusions Dermoscopy allows for better visualization of nail findings. Evaluating NAPSI and mNAPSI scores in conjunction with dNAPSI and dmNAPSI increases their helps detect early psoriasis, detection of worsening moderate-to-severe psoriasis (PASI >10) and predict joint involvement and their severity.
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Affiliation(s)
- Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences & Base Hospital Delhi Cantt, India
| | | | - Richa Kumar
- Command Hospital Eastern Command Kolkota, India
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Arora G, Patil A, Hooshanginezhad Z, Fritz K, Salavastru C, Kassir M, Goldman MP, Gold MH, Adatto M, Grabbe S, Goldust M. Cellulite: Presentation and Management. J Cosmet Dermatol 2022; 21:1393-1401. [PMID: 35104044 DOI: 10.1111/jocd.14815] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/02/2022] [Accepted: 01/27/2022] [Indexed: 11/30/2022]
Abstract
Cellulite is a common dermatological condition with a female preponderance, affecting up to 90% post-pubertal females. It is characterized with dimpling and denting of the skin surface, giving it a Peau d'orange appearance. Once considered to be a benign physiological isolated skin condition of only an aesthetic concern, cellulite is now considered a pathological entity with systemic associations and a negative psychological impact on patients. Several treatment options from lifestyle modifications, topical cosmetic therapies to energy-based devices have been studied for its treatment. However, treatment remains a challenge despite many new modalities in the armamentarium. Laser and light therapies along with radiofrequency are useful treatment options with good safety profile. Acoustic wave therapy, subcision, and 1440-nm Nd:YAG minimally invasive laser are beneficial in cellulite reduction. Methodological differences in the trials conducted, makes it difficult to compare different treatment modalities. Overall, treatment needs to be individualized based on the patient characteristics and severity of the condition. Combination of treatments is often required in most patients for reducing cellulite.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | | | - Klaus Fritz
- Dermatology and Laser Center, Reduitstr. 13 ,D 76829 Landau, Germany; "Carol Davila" University of Medicine and Pharmacy 37 Dionisie Lupu Str, Bucharest, Romania
| | - Carmen Salavastru
- "Colentina" Clinical Hospital, Pediatric Dermatology Discipline, Dermato-oncology Research Facility, 19-21 Stefan cel Mare Str. Bucharest , Romania; "Carol Davila" University of Medicine and Pharmacy 37 Dionisie Lupu Str, Bucharest, 020021, Romania
| | - Martin Kassir
- Founding director, Worldwide laser institute, Dallas, USA
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA, Department of Dermatology, University of California, San Diego, CA, USA
| | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, TN, USA
| | - Maurice Adatto
- Skinpulse Dermatology and Laser Centre, Geneva, Switzerland
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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Arora S, Arora G. Periorbital rejuvenation: A study on the use of dermal threads as monotherapy, with a review of literature. J Cutan Aesthet Surg 2022; 15:48-57. [PMID: 35655650 PMCID: PMC9153308 DOI: 10.4103/jcas.jcas_221_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The periorbital region, a major impressionable area holds a special place in aging of the face. It reflects chronological aging which are reflected not only as structural changes but also emotive expressions of sadness and tiredness. Dermal threads have been used in combination with other aesthetic procedures, however their use as monotherapy especially in periorbital region needs evaluation.
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Arora G, Arora S. Rejuvenating earlobe esthetics with dermal fillers. J Cosmet Dermatol 2021; 21:2788-2792. [PMID: 34687587 DOI: 10.1111/jocd.14552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/11/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The external ear plays a significant aesthetic role in the appearance of the face. Chronological and extrinsic aging effects on the ear lobe get further pronounced since routine surgical aesthetic procedures for the face do not address these morphological changes. Ear adornment with jewelry and piercings further cause sagging of the ear lobe and stretch the ear piercing. Dermal fillers offer a viable option for ear lobe rejuvenation by increasing its volume and addressing the morphological changes with minimal adverse effects or downtime associated with surgery. AIMS The authors aim to review the choice of dermal fillers used for ear lobule correction. The anatomy and its implications on techniques used for ear lobe rejuvenation are elaborated in this article based on the authors experience and reported literature. METHODS All patients who had received ear lobe fillers were evaluated, treated and followed up. Literature review of experience of treating patients with hyaluronic acid fillers for ear lobule correction and their rejuvenation was reviewed. RESULTS Hyaluronic acid fillers are a quick and easy method to restore the youthfulness and aesthetic ideals of the ear lobe. They address all the parameters of aging, volume deficit, reduction in the number and depth of creases and improvement in the number of wrinkles which surgical correction may not address. They can also be used for prejuvenation in younger populations expected to wear heavier ear jewelry. The results are immediate, long-lasting and the side effects and downtime are minimal.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences & Base Hospital, Delhi Cantonment, India
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Arora G, Kassir M, Patil A, Sadeghi P, Gold MH, Adatto M, Grabbe S, Goldust M. Treatment of Axillary hyperhidrosis. J Cosmet Dermatol 2021; 21:62-70. [PMID: 34416078 DOI: 10.1111/jocd.14378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Axillary hyperhidrosis characterized by excessive sweating in the axillary regions is a frustrating chronic autonomic disorder leading to social embarrassment, impaired quality of life and usually associated with palmoplantar hyperhidrosis. Identifying the condition and its cause is central to the management. AIM The aim of this article is to discuss treatment options for axillary hyperhidrosis. METHODS Comprehensive literature search using PubMed and Google Scholar was performed to review relevant published articles related to diagnosis and treatment of axillary hyperhidrosis. RESULTS Treatment modalities for axillary hyperhydrosis vary from topical and systemic agents to injectables, newer devices and surgical measures. None except for physical measures using devices or surgery, which destroys the sweat glands to remove them, is possibly permanent and most are associated with attendant side effects. CONCLUSION Several treatments including medical and surgical option are available for the treatment of axillary hyperhydrosis. Patient education is important component of its management. Individualized approach of management is necessary for optimal outcome of treatment.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | | | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Payam Sadeghi
- Department of Plastic Surgery, Cleveland Clinic, Cleveland Clinic Main Campus, Cleveland, Ohio, USA
| | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA
| | - Maurice Adatto
- Skinpulse Dermatology and Laser Centre, Geneva, Switzerland
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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Arora S, Das P, Arora G. Systematic Review and Recommendations to Combine Newer Therapies With Conventional Therapy in Psoriatic Disease. Front Med (Lausanne) 2021; 8:696597. [PMID: 34490293 PMCID: PMC8416676 DOI: 10.3389/fmed.2021.696597] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/28/2021] [Indexed: 01/16/2023] Open
Abstract
Background: Psoriasis continues to have unmet needs in its management despite introduction of newer molecules. Monotherapy with these newer agents may not achieve therapeutic goals in all cases, hence necessitating their combinations with other molecules. Improved understanding of newer as well as conventional treatment modalities and experiences in their combinations hence necessitates therapeutic guidelines for their use in psoriasis. Objective: To review the combinations of treatments reported in literature and recommendations for their use based on best current evidence in literature. Methods: A literature review of MEDLINE database for studies evaluating combinations of newer therapies with conventional therapies in psoriasis was done. Newer therapies were identified as biologic disease modifying anti rheumatic drugs and other molecules such as apremilast while conventional therapies included methotrexate, cyclosporine, or retinoids, phototherapy and others. The therapeutic guidelines are proposed with the aim to provide evidenced based approach to combine newer and conventional agents in day-to-day psoriasis management. Findings: Combination of acitretin and narrow band ultraviolet B (NB-UVB)/Psoralen with ultraviolet A (PUVA) achieves faster clearance and allows reduction of dose of the latter. A variable outcome is reported of methotrexate with TNF-α inhibitors vs. TNF-α inhibitors alone, although addition of methotrexate appears to reduce immunogenicity of TNF-α inhibitors thereby preventing formation of anti-drug antibodies especially in case of infliximab. While combination of acitretin and PUVA is beneficial, combining TNF-α inhibitors and phototherapy too produces better and faster results but long term risks of Non Melanoma Skin Cancers (NMSCs) may preclude their use together. Combination of cyclosporine and phototherapy is not recommended due to greater chances of NMSCs. Adding phototherapy to Fumaric Acid Esters (FAEs) improves efficacy. Apremilast can be safely combined with available biologic agents in patients with plaque psoriasis or psoriatic arthritis not responding adequately to biologics alone. Hydroxyurea and acitretin may be used together increasing their efficacy and reducing doses of both and hence their adverse effects. Conclusion: Selected clinical scenarios shall benefit from combinations therapies, improving efficacy of both conventional and newer agents and at the same time helping reduce toxicity of higher dosages when used individually.
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Affiliation(s)
- Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences & Base Hospital Delhi Cantt, New Delhi, India
| | - Pankaj Das
- Department of Dermatology, Army College of Medical Sciences & Base Hospital Delhi Cantt, New Delhi, India
| | - Gulhima Arora
- Consultant Dermatologist, Mehektagul Dermaclinic, New Delhi, India
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Arora S, Arora G. Recognizing "medical aesthetics" in dermatology: The need of the hour. Indian J Dermatol Venereol Leprol 2021; 87:1-2. [PMID: 33580947 DOI: 10.25259/ijdvl_678_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences and Base Hospital Delhi Cantt, India
| | - Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
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14
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Arora S, Pal R, Suhag D, Dabas R, Arora G, Chand S. KOH wet mount versus cellophane strip without mounting medium for rapid diagnosis in superficial mycoses. Indian J Dermatopathol Diagn Dermatol 2021. [DOI: 10.4103/ijdpdd.ijdpdd_113_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Arora G, Jakhar D, Gupta S. Innovative use of a comedone extractor as an anesthetic tool for intradermal injections on scalp. J Cutan Aesthet Surg 2021; 14:416-417. [PMID: 35283597 PMCID: PMC8906263 DOI: 10.4103/jcas.jcas_239_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Arora G, Arora S, Sadoughifar R, Batra N. Biorevitalization of the skin with skin boosters: Concepts, variables, and limitations. J Cosmet Dermatol 2020; 20:2458-2462. [PMID: 33249741 DOI: 10.1111/jocd.13871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022]
Abstract
Aging leads to diminished capacity in the functionality of all the skin layers, which in turn leads to a structurally weak and esthetically unappealing skin which is dull, dehydrated, and inelastic. Skin boosters can be defined as biological materials or bio-actives that help or encourage the skin to increase or improve its function. Boosters have been used in treating skin structural changes associated with aging as well as other factors such as corticosteroid-induced skin atrophy. Restoring the loss in skin nourishment and vital components is the concept involved in biorevitalization of the skin. The authors aim to present an update and a short review of skin boosters in this commentary.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Command Hospital Air Force Bangalore, Bangalore, India
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17
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Jafferany M, Mkhoyan R, Arora G, Sadoughifar R, Jorgaqi E, Goldust M. Treatment of skin picking disorder: Interdisciplinary role of dermatologist and psychiatrist. Dermatol Ther 2020; 33:e13837. [DOI: 10.1111/dth.13837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Mohammad Jafferany
- Division of Psychodermatology Central Michigan University Saginaw Michigan USA
| | | | - Gulhima Arora
- Division of Dermatology Mehektagul Skin Center New Delhi India
| | | | - Etleva Jorgaqi
- Division of Dermatology Mother Theressa Hospital Tirana Albania
| | - Mohamad Goldust
- Division of Dermatology University of Basel Basel Switzerland
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18
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Dasukil S, Arora G, Shetty S, Degala S. Impact of prolotherapy in temporomandibular joint disorder: a quality of life assessment. Br J Oral Maxillofac Surg 2020; 59:599-604. [PMID: 33750579 DOI: 10.1016/j.bjoms.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
Abstract
Chronic pain and functional impairment associated with temporomandibular joint (TMJ) disorders (TMD) considerably reduce oral health-related quality of life (OHRQoL). In the present study we have assessed the influence of prolotherapy in patients with TMD by the subjective measurement of QoL using the Oral Health Impact Profile-14 (OHIP-14). Twenty-five patients diagnosed with TMD (mean (range) age 38 (18 - 70) years) were included. They had all undergone dextrose prolotherapy to the TMJ at regular time intervals (four times at intervals of two weeks) using the method suggested by Hemwall-Hackett. They were asked to answer the OHIP-14 questionnaire before and two years after prolotherapy. Seven domains of OHRQoL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domain scores and total OHIP-14 scores were compared using inferential statistics (chi squared and Wilcoxon signed rank tests). Prolotherapy was effective over time, as all the domains' mean scores decreased considerably after treatment. The total mean score before prolotherapy was 21.20, which was extensively reduced to 13.08 after prolotherapy (p=0.001). There was statistically significant improvement in all domains, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap (p≤0.005 in all cases). We concluded that prolotherapy has a promising role in the improvement of OHRQoL of patients with TMD, and its beneficial effects persist at least two years after treatment.
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Affiliation(s)
- S Dasukil
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences(AIIMS), Bhubaneswar, Odisha, India.
| | - G Arora
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram.
| | - S Shetty
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore.
| | - S Degala
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore.
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19
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Arora G, Arora S. Platelet-rich plasma-Where do we stand today? A critical narrative review and analysis. Dermatol Ther 2020; 34:e14343. [PMID: 32979292 DOI: 10.1111/dth.14343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022]
Abstract
"Sometimes you have to travel a long way to find what is near." This quote by Paulo Coelho stands true for platelet-rich plasma (PRP) as we know of it today. Large strides have been made to understand this "youth" in blood, but there still seems a long way to go in our understanding of it. Despite advances, clarity in its preparation, biology, and the properties of the final product still remains elusive. The concepts of an ideal number or concentration of platelets in the final enriched plasma, best devices to prepare PRP, an ideal hardware, standard parameters for its preparation, the need for its activation or buffering of the final preparation or whether anticoagulants should be used or not, have evolved, since it was first described. The authors present an analysis of PRP present day status and its usefulness in field of medicine with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar related to PRP, its biology, types, and classifications, preparation, and use.
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Affiliation(s)
- Gulhima Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
| | - Sandeep Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
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20
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Godara S, Arora S, Dabas R, Arora G, Renganathan G, Choudhary R. A Comparative Study on the Efficacy of Fractional CO2 Laser and Fractional CO2 Laser with Autologous Platelet-Rich Plasma in Scars. Indian Dermatol Online J 2020; 11:930-936. [PMID: 33344342 PMCID: PMC7734978 DOI: 10.4103/idoj.idoj_174_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/20/2020] [Accepted: 06/28/2020] [Indexed: 11/04/2022] Open
Abstract
Context Surgical correction of scars may not be an ideal solution in all cases and hence it is desirable to have a nonsurgical option available. Autologous platelet-rich plasma (PRP) and fractional carbon dioxide laser (FCL) offer an alternative treatment modality. Aims To compare the efficacy and safety of FCL and intradermal PRP with FCL in the management of postburn and posttraumatic scars. Settings and Design A prospective, randomized, observer-blinded, comparative study was conducted at a hospital skin centre from Oct 2016 to Sep 2018. Subjects and Methods A total of 67 patients with scars were randomly divided into two groups; Group I was treated with four sessions of monthly FCL and Group II was treated with four sessions of PRP and FCL. The patients were assessed using the Patient and Observer Scar Assessment Scale (POSAS) at baseline and 4 weeks after each session. Statistical Analysis Used For continuous variables, the summary statistics of mean ± standard deviation was used; for categorical data, number and percentage were used. Chi-square (χ2) test was used for association between two categorical variables. P value <0.05 was considered to be statistically significant. Results Thirty cases in each group completed the study. There was a significant improvement in the total score of POSAS (p < 0.001) in both groups, but the final difference between the two groups was not statistically significant (p = 0.793 and P = 0.278, respectively). Conclusions Fractional CO2 laser causes significant improvement in scar appearance. PRP in combination with FCL offers no additional advantage.
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Affiliation(s)
- Satish Godara
- Department of Dermatology, Military Hospital, Secunderabad, Telangana, India
| | - Sandeep Arora
- Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Rajeshwari Dabas
- Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Gopi Renganathan
- Department of Plastic and Reconstructive Surgery, Armed Forces Medical College, Pune, Maharashtra, India
| | - Richa Choudhary
- Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India
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21
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Arora G, Jafferany M, Arora S. Balancing aesthetic and conventional dermatology practice in the
COVID
‐19 era. Dermatol Ther 2020; 33:e13620. [PMID: 32431094 PMCID: PMC7267156 DOI: 10.1111/dth.13620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Gulhima Arora
- Department of Dermatology Mehektagul Dermaclinic New Delhi India
| | | | - Sandeep Arora
- Department of Dermatology Command Hospital Air Force Bangalore India
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22
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Murrell DF, Arora G, Rudnicka L, Kassir M, Lotti T, Goldust M. A dermatologist's perspective of the COVID-19 outbreak. Dermatol Ther 2020; 33:e13538. [PMID: 32385938 PMCID: PMC7272968 DOI: 10.1111/dth.13538] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Dedee F Murrell
- Department of Dermatology, St George Hospital, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Torello Lotti
- Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy
| | - Mohamad Goldust
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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23
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Arora G, Arora S, Talathi A, Kandhari R, Joshi V, Langar S, Nagpal S, Shetty VH, Nair RV, Sharma D, Sharma R, Sondhi P. Safer Practice of Aesthetic Dermatology during the COVID-19 Pandemic: Recommendations by SIG Aesthetics (IADVL Academy). Indian Dermatol Online J 2020; 11:534-539. [PMID: 32832438 PMCID: PMC7413460 DOI: 10.4103/idoj.idoj_328_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic caused by the SARS-CoV-2 virus, has changed the homeostasis of the medical world. In this critical phase, in addition to the general recommendations issued by World Health Organization (WHO) for medical practitioners and health care givers, certain other precautions and safe care practices need to be emphasized which are unique to each branch of medicine. Aesthetic dermatology is no exception. With aesthetic treatments on the rise, it is pertinent to formulate safe practices for aesthetic dermatology to protect the doctor, health staff and the patients from getting exposed during this phase and in the aftermath of the pandemic. Recommendations for surgical and dental procedures advice to defer such procedures. This can be extrapolated to aesthetic dermatology also, but once health care services start, there should be some safety recommendations to be followed until we have definitive management or a vaccine for it.
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Affiliation(s)
- Gulhima Arora
- Consultant Dermatologist, ehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Professor and Head, Department of Dermatology, Command Hospital Air Force, Bangalore, India
| | - Abhay Talathi
- Consultant Dermatologist, SkinSpace Clinic, Mumbai, India
| | - Rajat Kandhari
- Consultant Dermatologist, Dr. Kandhari's Skin and Dental Clinic, New Delhi, India
| | - Vineeta Joshi
- Consultant Dermatologist, Dr. Vineeta Joshi's Skin n Hair Clinic, Pune, India
| | - Sonali Langar
- Consultant Dermatologist, Skin Remedies Clinic and Laser Centre, Noida, India
| | - Smita Nagpal
- Consultant Dermatologist, Anya Skin Clinic, Ahmedabad, India
| | - Vinma H Shetty
- Associate Professor, Department of Dermatology, AJ Institute of Medical Sciences, Mangalore, India
| | - Rakhee V Nair
- Associate Professor, Department of Dermatology, Azeezia Medical College, Kollam, India
| | - Divya Sharma
- Consultant Dermatologist, Dr Divya's Skin and Hair Solutions, Bengaluru, India
| | - Rashmi Sharma
- Consultant Dermatologist, Fortis Hospital, New Delhi, India
| | - Prateek Sondhi
- Consultant Dermatologist, Derma Circles Clinic, New Delhi, India
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24
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Arora G, Kroumpouzos G, Kassir M, Jafferany M, Lotti T, Sadoughifar R, Sitkowska Z, Grabbe S, Goldust M. Solidarity and transparency against the COVID-19 pandemic. Dermatol Ther 2020; 33:e13359. [PMID: 32236998 PMCID: PMC7228210 DOI: 10.1111/dth.13359] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/28/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil
| | | | - Mohammad Jafferany
- College of Medicine, Central Michigan University, Saginaw, Michigan, USA
| | - Torello Lotti
- Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy
| | | | - Zuzanna Sitkowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany.,Department of Dermatology and Allergy, University Hospital Basel, Basel, Switzerland
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25
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Arora G, Kassir M, Jafferany M, Galadari H, Lotti T, Satolli F, Sadoughifar R, Sitkowska Z, Goldust M. The COVID-19 outbreak and rheumatologic skin diseases. Dermatol Ther 2020; 33:e13357. [PMID: 32237261 PMCID: PMC7228391 DOI: 10.1111/dth.13357] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | | | - Mohammad Jafferany
- College of Medicine, Central Michigan University, Saginaw, Michigan, USA
| | - Hassan Galadari
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Torello Lotti
- University of Studies Guglielmo Marconi, Rome, Italy
| | | | | | - Zuzanna Sitkowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Mohamad Goldust
- Bidarskincenter, Tehran, Iran.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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26
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Kassir M, Arora G, Galadari H, Kroumpouzos G, Katsambas A, Lotti T, Piccolo D, Grabbe S, Juchems E, Goldust M. Efficacy of 595- and 1319-nm pulsed dye laser in the treatment of acne vulgaris: a narrative review. J COSMET LASER THER 2020; 22:111-114. [PMID: 32516014 DOI: 10.1080/14764172.2020.1774063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Acne is one of the commonest problems of adolescence with almost half of the patients experiencing persistence into adulthood. Pulsed dye lasers (PDL) with wavelengths of 585 and 595 nm targeting hemoglobin have been used for the treatment of this condition and its sequelae. Recent introduction of PDL with a higher wavelength of 1319 nm has been reported to offer some benefit to acne patients. We reviewed the literature on the use of 595-nm and 1319-nm PDL in the management of acne. A PubMed literature search for search terms "pulsed dye laser," "acne laser therapy," "light therapy for acne," "595 nm and acne," "1319 nm and acne" was done. Studies, series and case reports were included. These lasers were compared to other lasers and light sources such as 532-nm Potassium Titanyl Phosphate laser, 585-nm PDLs, 1450-nm diode laser, 1540-nm erbium glass laser, intense-pulsed light (IPL), photodynamic therapy, red and blue light and short-pulsed 1064 nm laser utilized in acne management regarding their efficacy. Improvement in acne grading, scale severity or reduction in lesion count indicated substantial efficacy of the laser system utilized.
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Affiliation(s)
- Martin Kassir
- Department of Dermatology, Worldwide Laser Institute , Dallas, United States
| | - Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic , New Delhi, India
| | - Hassan Galadari
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University , Providence, RI, USA.,Department of Dermatology, Medical School of Jundiaí , São Paulo, Brazil.,GK Dermatology, PC, South Weymouth , MA, USA
| | | | - Torello Lotti
- Department of Dermatology, University of Studies Guglielmo Marconi , Rome, Italy
| | - Domenico Piccolo
- Italian Association Outpatient Dermatologists, Skin Center, Dermo-Aesthetic Lasers Centers , Avezzano, Italy
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University , Mainz, Germany
| | - Eva Juchems
- Department of Dermatology, University Medical Center Mainz , Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz , Mainz, Germany.,Department of Dermatology, University of Rome G. Marconi , Rome, Italy.,Department of Dermatology, University Hospital Basel , Basel, Switzerland
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27
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Arora G, Sahni N. Anesthetic management of a patient with Sheehan's syndrome and twin pregnancy while undergoing a cesarean section. J Postgrad Med 2020; 66:51-53. [PMID: 31929313 PMCID: PMC6970334 DOI: 10.4103/jpgm.jpgm_473_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sheehan's syndrome (SS) is caused by infarction of the pituitary gland usually precipitated by hypotension due to massive uterine hemorrhage during the peripartum period. Once SS develops, it becomes a major comorbidity for the young females and predisposes them to further medical, obstetric, and anesthetic complications. Herein, we report the perioperative anesthetic management of a 28-year-old female, already diagnosed with SS precipitated by urosepsis and septicemic shock in a previous pregnancy, now presenting with twin pregnancy for elective cesarean section. Her magnetic resonance imaging brain revealed pituitary apoplexy and she had hypothyroidism with gestational diabetes mellitus. The overall successful perioperative management of the patient is described along with an emphasis on aggressive management of hypotension due to any cause in the peripartum period to prevent infarction/necrosis of anterior pituitary gland.
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Affiliation(s)
- G Arora
- Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India
| | - N Sahni
- Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India
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28
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Kaur I, Arora G, Jakhar D, Khandpur S. IADVL–Delhi state branch MID- CUTICON 2020: Setting a precedent with its semi-annual E-conference. Indian Dermatol Online J 2020; 11:1044-1047. [PMID: 33344377 PMCID: PMC7734988 DOI: 10.4103/idoj.idoj_425_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/23/2020] [Accepted: 07/17/2020] [Indexed: 11/11/2022] Open
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29
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Arora S, Arora G, Totlani S, Chandra M. Faun tail nevus: A series of 15 cases and their management with Intense Pulse Light. Med J Armed Forces India 2019; 75:389-394. [DOI: 10.1016/j.mjafi.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 06/05/2018] [Indexed: 10/28/2022] Open
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30
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Arora G, Degala S, Dasukil S. Efficacy of buffered local anaesthetics in head and neck infections. Br J Oral Maxillofac Surg 2019; 57:857-860. [PMID: 31563483 DOI: 10.1016/j.bjoms.2019.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/20/2019] [Indexed: 10/25/2022]
Abstract
Lignocaine is one of the most commonly-used agents to anaesthetise an area preoperatively. It can, however, cause undesirable effects such as burning on injection, relatively slow onset, and unreliable, or lack of, numbness when injected into infected tissues as a result of the acidic pH of commercial preparations (the pH is between 3.5 and 7.0 compared with the physiological pH, which is between 7.35 and 7.45). The aim of this comparative study was to evaluate the efficacy of buffered local anaesthetic on infected areas by altering the pH with 8.4% sodium bicarbonate, to measure the pain before and after the injection, and to record the time of onset of anaesthesia. All 60 patients were given 2% lignocaine hydrochloride with adrenaline 1:80,000 and 30 patients were randomly allocated to have 10:1 dilution of 8.4% sodium bicarbonate (study group). Pain was assessed on a visual analogue scale and a verbal rating scale. There was a significant difference in the amount of pain between control and study groups (p=0.025). The mean (SD) time (minutes) to onset of local anaesthesia in the study group was 1.06 (0.25) compared with 2.96 (0.81) in the control group (p<0.001). Our results confirm the efficacy of the buffered local anaesthetic solution in reducing pain on injection and resulting in quicker onset of anaesthesia. Increasing the pH of lignocaine solutions with bicarbonate immediately before use, therefore, should be considered when treating various acute infections of the head and neck.
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Affiliation(s)
- G Arora
- Department of Oral and Maxillofacial surgery, JSS Dental College and Hospital, Mysore.
| | - S Degala
- Department of Oral and Maxillofacial surgery, JSS Dental College and Hospital, Mysore.
| | - S Dasukil
- Department of Oral and Maxillofacial surgery, JSS Dental College and Hospital, Mysore.
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31
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India
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32
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Affiliation(s)
| | - Sandeep Arora
- Department of Dermatology, Command Hospital Air Force, Bengaluru, India
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33
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Arora S, Patil P, Arora G, Mishra R. Herpes zoster: Hand dominance the missing link to unilaterality? Indian Dermatol Online J 2018; 9:212-213. [PMID: 29854652 PMCID: PMC5956879 DOI: 10.4103/idoj.idoj_15_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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34
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Venkatraman A, Hardas S, Patel N, Singh Bajaj N, Arora G, Arora P. Galectin-3: an emerging biomarker in stroke and cerebrovascular diseases. Eur J Neurol 2017; 25:238-246. [PMID: 29053903 DOI: 10.1111/ene.13496] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/16/2017] [Indexed: 01/16/2023]
Abstract
The carbohydrate-binding molecule galectin-3 has garnered significant attention recently as a biomarker for various conditions ranging from cardiac disease to obesity. Although there have been several recent studies investigating its role in stroke and other cerebrovascular diseases, awareness of this emerging biomarker in the wider neurology community is limited. We performed a systematic search in PubMed, Embase, Scopus, CINAHL, Clinicaltrials.gov and the Cochrane library in November and December 2016 for articles related to galectin-3 and cerebrovascular disease. We included both human and pre-clinical studies in order to provide a comprehensive view of the state of the literature on this topic. The majority of the relevant literature focuses on stroke, cerebral ischemia and atherosclerosis, but some recent attention has also been devoted to intracranial and subarachnoid hemorrhage. Higher blood levels of galectin-3 correlate with worse outcomes in atherosclerotic disease as well as in intracranial and subarachnoid hemorrhage in human studies. However, experimental evidence supporting the role of galectin-3 in these phenotypes is not as robust. It is likely that the role of galectin-3 in the inflammatory cascade within the central nervous system following injury is responsible for many of its effects, but its varied physiological functions and multiple sites of expression mean that it may have different effects depending on the nature of the disease condition and the time since injury. In summary, experimental and human research raises the possibility that galectin-3, which is closely linked to the inflammatory cascade, could be of value as a prognostic marker and therapeutic target in cerebrovascular disease.
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Affiliation(s)
- A Venkatraman
- Department of Neurology, Massachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical School, Boston, MA
| | - S Hardas
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - N Patel
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - N Singh Bajaj
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - G Arora
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - P Arora
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.,Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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Panda SK, Panda P, Baisakh P, Mohanty B, Arora G. Study of cardiac functions in diabetes mellitus-2 patients. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.08.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arora S, Kochar S, Arora G, Diwakar D. Undiagnosed Hirsutism Associated Mayer-Rokitansky-Küster-Hauser Syndrome in Dermatology OPD. Indian J Dermatol 2014; 59:623-5. [PMID: 25484406 PMCID: PMC4248513 DOI: 10.4103/0019-5154.143549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sandeep Arora
- Department of Skin, Army College of Medical Sciences and Base Hospital, Delhi Cantonment, New Delhi, India
| | - Sps Kochar
- Department of Obstetrics and Gynaecology, Army College of Medical Sciences and Base Hospital, Delhi Cantonment, New Delhi, India
| | - Gulhima Arora
- Department of Skin, Primus Superspeciality Hospital, Chanakyapuri, New Delhi, India
| | - D Diwakar
- Department of Radiodiagnosis, Army College of Medical Sciences and Base Hospital, Delhi Cantonment, New Delhi, India. E-mail:
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Arora G, Coller R, Hoffman R, Thakur S, Perkins K, Miller L, Wells T. Promoting cultural sensitivity and ethics in the next generation of
physicians using interactive cases. Ann Glob Health 2014. [DOI: 10.1016/j.aogh.2014.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Khanna T, El-Arousy H, Thakur N, Khanna R, Arora G. The Value of Positron Emission Mammography (PEM) in Management of Breast Cancer. Pract Radiat Oncol 2014; 3:S24. [PMID: 24674523 DOI: 10.1016/j.prro.2013.01.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Khanna
- Radiological Institute of The Villages, The Villages, FL
| | - H El-Arousy
- Radiological Institute of The Villages, The Villages, FL
| | - N Thakur
- Radiological Institute of The Villages, The Villages, FL
| | - R Khanna
- Radiological Institute of The Villages, The Villages, FL
| | - G Arora
- Radiological Institute of The Villages, The Villages, FL
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Affiliation(s)
- N Thosani
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Texas 77030, USA.
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Abstract
Background: The ABO blood group antigens are present on the surface of red blood cells and various epithelial cells. As the majority of human cancers are derived from epithelial cells, changes in blood group antigens constitute an important aspect of human cancers. The aim of the study was to establish clinical usefulness of ABO blood group as a predisposing factor in early diagnosis and management of patients with oral precancerous lesions/conditions. Materials and Methods: The study sample consisted of 50 control and 50 oral precancer (25 leukoplakia and 25 Oral Submucous Fibrosis) confirmed by histopathologic examination. All samples were subjected to blood group testing and their prevalence was compared by Z-test using STATA version 8. Results: The "A" blood group was prevalent among the precancerous group. Significant differences on prevalences of blood groups were found (P < 0.05) between control versus leukoplakia and OSMF. Interestingly, 24% gutka chewers who had higher number of grades of dysplasia were falling in "A" blood group. Conclusion: Blood group type should be considered along with other risk factors to understand the individual patient's risk and further studies in larger samples with inclusion of Rh factor is needed to elucidate the relationship with ABO blood group types.
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Affiliation(s)
- S Bhateja
- Department of Oral Medicine Diagnosis and Radiology, Dr. DY Patil Dental College and Hospital, Pune, Maharashtra, India
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Singh G, Arora G, Mannalithara A, Mithal A, Sehgal A, Triadafilopoulos G. Alarmingly poor adherence to low-dose aspirin: a large population-based study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arora S, Arora G, Sahai K, Borde P. Idiopathic CD4 lymphocytopenia presenting as recurrent giant molluscum contagiosum. Indian J Dermatol Venereol Leprol 2013; 79:555. [PMID: 23760345 DOI: 10.4103/0378-6323.113116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Arora S, Arora G, Gupta A, Singh G. Bullous auto erythrocyte sensitization syndrome in alcohol dependence. Indian J Dermatol Venereol Leprol 2013; 79:269. [DOI: 10.4103/0378-6323.107673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Giridhar M, Arora G, Lajpal K, Singh Chahal K. Clinicohistopathological concordance in leprosy - a clinical, histopathological and bacteriological study of 100 cases. Indian J Lepr 2012; 84:217-225. [PMID: 23484336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Leprosy is a treatable chronic infectious disease, prevalent in South Asian countries, especially India. Before labeling a patient as a case of leprosy and starting multidrug treatment for particular type, the clinical findings should be correlated and confirmed with histopathological examination and bacteriological index of skin biopsy. Skin biopsy is an important tool in diagnosing leprosy and determining the type of leprosy. In the present study, one hundred untreated clinically diagnosed cases of leprosy were studied according to Ridley-Jopling scale for confirmation of diagnosis and classification of leprosy. The study was done by routine H & E (Haematoxylin & Eosin) staining and Fite-Faraco's staining for acid-fast bacillus. The data pertaining to age, sex, clinical and histopathological classification of the type of leprosy were collected and analyzed. In analyzing the histopathology of a lesion, special attention was given to the following features, viz., invasion of the epidermis with or without erosion, involvement of the sub-epidermal zone, character and extent of granuloma, density of lymphocytic infiltrate epithelioid cells and other cellular elements, nerve involvement and the presence of Mycobacterium leprae. Histological diagnosis of leprosy was established in 98% of clinically diagnosed cases. Clinicohistopathological concordance was maximum in LL(93.75%) followed by BL(87.5%), TT(78.5%), BT(73.8%) and least in IL(27.78%). Overall, it was 60.23%. Indeterminate type of leprosy was diagnosed more on histologythan on clinical evaluation.
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Affiliation(s)
- M Giridhar
- Department of Pathology, Maharaja Agarsen Medical College, Agroha, Hisar, Haryana.
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Arora G, Mishra SK, Nautiyal B, Pratap SO, Gupta A, Beura CK, Singh DP. Genetics of hyperpigmentation associated with the Fibromelanosis gene (Fm) and analysis of growth and meat quality traits in crosses of native Indian Kadaknath chickens and non-indigenous breeds. Br Poult Sci 2012; 52:675-85. [PMID: 22221233 DOI: 10.1080/00071668.2011.635637] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
1. The study investigated the extent of hyperpigmentation (a trait fixed in native Indian Kadaknath chickens), bodyweight, carcase quality and leanness at 12 weeks of age in F(1) and back-crosses of Kadaknath with White Leghorn, White Plymouth Rock and Aseel Peela chickens. 2. The objective of the study was to determine if hyperpigmentation was affected by the major gene Fibromelanosis (Fm) and to evaluate the effects of different proportions of Kadaknath genes on growth and carcase quality. 3. The pigmentation pattern of skin indicated that Fm behaved as the primary locus affecting dermal-hyperpigmentation and that the sex-linked Id locus produced an epistatic effect. 4. The results suggested that variable allelic forms of Id were acting in different crosses, which resulted in variation in melanosis of the host. However, no conclusive pattern for shank pigmentation could be explained through genotyping of the Id and Fm loci. 5. Analysis of quantitative traits indicated the positive impact of a Kadaknath genomic proportion of 50% or more on meat texture and carcase leanness. Improvement in leanness occurred in White Rock crosses but not in White Leghorn and Aseel Peela crosses. 6. Thigh-meat texture was influenced more by enhanced Kadaknath genomic proportions than the breast-meat. It was concluded that introgression of Kadaknath genomic proportion beyond 50% in a cross with meat-type chickens, irrespective of the impact Fm, brought improvement in meat quality whereas no such advantage was obtained for growth traits. 7. The beneficial impact of the Kadaknath genome on meat quality calls for further studies to identify causative genes for their selective use to improve meat quality in Kadaknath crossbred chickens.
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Affiliation(s)
- G Arora
- Central Avian Research Institute , Izatnagar , Bareilly , India-243122.
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Narayanan G, Arora G, Barbery K, Froud T, Livingstone A, Franceschi D, Hosein P, Rocha Lima C, Yrizarry J. Abstract No. 8: Downstaging locally advanced pancreatic adenocarcinoma (LAPC) with vascular encasement using percutaneous irreversible electroporation (IRE). J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Abstract
BACKGROUND Cutaneous tuberculosis forms a small subset of extrapulmonary tuberculosis. The present study is an attempt to observe the clinico morphological pattern seen in cases of cutaneous tuberculosis over a period of 5 years, and to correlate them with mantoux reactivity and human immunodeficiency virus (HIV) status. METHODS All cases of cutaneous tuberculosis observed among the dermatology in patients and those attending out patient department were included in the study. The basis of diagnosis was clinical, histopathological and microbiological. Intradermal mantoux test and serological test in the form of enzyme-linked immunosorbent assay (ELISA) for tuberculosis was done. HIV screening was carried out in 32 cases. CD4 counts were done in all HIV positive cases. RESULTS A total 0.02% patient attending the dermatology centre had cutaneous tuberculosis. The spectrum of infection included 19 (51%) cases of lupus vulgaris, 7 (19%) cases of papulonecrotic tuberculids, six cases each of tuberculosis verrucosa cutis and scrofuloderma. One case had scrofuloderma and lupus vulgaris and another both scrofuloderma and papulonecrotic tuberculide. One case of lichen scrofulosorum was seen in a seven year old boy. 11 cases revealed evidence of systemic tuberculosis. Seven cases of HIV with CD4 counts between 50-500 cells/μl were observed in this study.
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Affiliation(s)
- S Arora
- Graded Specialist (Dermatology and Venerology), 5 Air Force Hospital, C/o 99 APO, Assam
| | - G Arora
- Dermatologist, Jorhat, Assam
| | - S Kakkar
- Senior Advisor (Pathology and Oncology), Base Hospital, Delhi Cantt-10
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Narayanan G, Arora G, Koshy T, Hanumanthaiah S, Yrizarry J. Abstract No. 110: Trans arterial chemoembolization (TACE) using Irinotecan coated LC beads for treatment of hepatic metastases from colorectal cancer (CRC). J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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