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Mahajan VK, Chauhan NS, Rana BS, Mehta KS, Hooda S, Chauhan PS, Kukreja A. The Association Between Chronic Plaque Psoriasis and Nonalcoholic Fatty Liver Disease in Indian Patients: Results of a Pilot Study. J Clin Exp Hepatol 2022; 12:785-792. [PMID: 35677516 PMCID: PMC9168695 DOI: 10.1016/j.jceh.2021.11.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/26/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic dermatosis with potential to cause systemic disease by triggering dysmetabolism, such as metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). We studied the relationship and associations between NAFLD and clinical features, including age, gender, disease duration, and severity of psoriasis in our patients. METHODS This cross-sectional study comprised 61 (m:f, 43:19) patients without pre-existing comorbidities and matched 24 (m:f, 16:8) healthy controls aged between 20 and 68 years. Disease severity was graded as mild, moderate, and severe by psoriasis area and severity index score and body surface area (BSA) involvement. The grades of fatty liver and liver fibrosis were assessed using liver ultrasonography (USG) and transitional vibration-controlled elastography (Fibroscan). RESULTS Overall, 67.2% of patients were aged >40 years, and the duration of disease was <5years in 60.7% of patients. Mild and moderate to severe psoriasis occurred in 78.7% and 21.3% of patients, respectively. BSA was >10% in 57.5% patients. The proportion of NAFLD was 27.9% and 32.8% by USG and Fibroscan compared with 20.8% in controls. Statistically, there was no significant difference or association between the prevalence of NAFLD among patients and controls, and gender, age (mean ± standard deviation, 47.5 ± 13.8 vs. 45.2 ± 15.7), duration, severity of psoriasis, and arthritis between psoriatic patients with and without NAFLD. CONCLUSION This was a pilot study because of the numerosity of sample and highlights trends for possible link between psoriasis and NAFLD, but the results need cautious interpretation and clinical application. Whether NAFLD can be attributed to overall systemic inflammatory process of psoriasis or it occurs as an epiphenomenon of concurrent metabolic syndrome needs elucidation with well-designed studies. Cross-sectional study design, small number of patients, and controls remain major limitations. The study did not compare its findings with liver biopsy.
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Affiliation(s)
- Vikram K. Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India,Address for correspondence: Vikram K Mahajan, Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India.
| | - Narvir S. Chauhan
- Department of Radio Diagnosis, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Baldev S. Rana
- Department of Gastroenterology & Hepatology, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Sheenam Hooda
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Amisha Kukreja
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
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Raj R, Kaur C, Agrawal L, Kumar S, Chauhan PS, Raj SK. Development of a protocol for the elimination of Cyrtanthus elatus virus-A from Narcissus tazetta by in vitro chemotherapy in combination with electrotherapy. J Virol Methods 2021; 300:114368. [PMID: 34808229 DOI: 10.1016/j.jviromet.2021.114368] [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: 01/14/2020] [Revised: 09/09/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
Narcissus (Narcissus tazetta) is a bulbous ornamental plant propagated vegetatively from bulbs. The Cyrtanthus elatus virus-A (CyEV-A) had been reported to cause a severe mosaic and yellow stripe disease in narcissus. Therefore, this study aimed to develop a protocol for the elimination of CyEV-A from infected bulblets by in vitro chemotherapy (30-50 mg/L ribavirin for 30 days) and electrotherapy (10-30 mA for 20 min), individually and in combination, to produce virus-free plants. The regenerated plants obtained from these treatments were screened for the absence of the CyEV-A by reverse-transcription polymerase chain reaction assays using a set of degenerate primers specific for a potyvirus coat protein gene. The results showed that in vitro chemotherapy (30 mg/L ribavirin for 30 days) alone produced 46.0 % (14/30) of virus-free plants, while electrotherapy (20 mA for 20 min) alone produced 40.0 % (12/30) of virus-free plants. In comparison, a combination of chemotherapy (30 mg/L ribavirin for 30 days) and electrotherapy (20 mA for 20 min) produced 50.0 % (15/30) of virus-free plants. The virus-free plants obtained from this combination treatment exhibited better growth and produced more bulbs compared to the other treatments and control. The protocol may be used for the control of the virus disease in narcissus.
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Affiliation(s)
- Rashmi Raj
- Plant Molecular Virology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; AcSIR (Academy of Scientific and Innovative Research), Ghaziabad, 2001002, India
| | - Charanjeet Kaur
- Plant Molecular Virology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; Department of Plant Science, MJP Rohilkhand University, Bareilly, 243006, U.P., India
| | - Lalit Agrawal
- Microbiology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; Department of Agriculture and Allied Sciences, Doon Business School, Dehradun, 248001, India
| | - Susheel Kumar
- Plant Molecular Virology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; Plant Molecular Virology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India
| | - P S Chauhan
- Microbiology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; AcSIR (Academy of Scientific and Innovative Research), Ghaziabad, 2001002, India.
| | - S K Raj
- Plant Molecular Virology Laboratory, CSIR-National Botanical Research Institute, Lucknow, 226001, U.P., India; B-1/66, Sector-G, Janki Puram, Lucknow, 226 021, U. P., India.
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Mahajan VK, Dhattarwal N, Chauhan PS, Mehta KS, Sharma R, Sharma A, Singh VK, Sharma J, Hooda S. The Association of Alcohol Use Disorder and Chronic Plaque Psoriasis: Results of a Pilot Study. Indian Dermatol Online J 2021; 12:128-133. [PMID: 33768034 PMCID: PMC7982022 DOI: 10.4103/idoj.idoj_226_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/10/2020] [Revised: 05/01/2020] [Accepted: 06/28/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Association between alcohol consumption, alcohol use disorder, and clinical features of psoriasis patients has not been adequately studied in the Indian context. Objectives: To study the frequency of alcohol consumption, alcohol use disorder, and its association with age, gender, duration, and severity of psoriasis. Materials and Methods: One hundred and forty-six (M: F 6.3:1) patients completed the Alcohol Use Disorder Identification Test (AUDIT) questionnaire by World Health Organization (WHO). Excessive drinkers, occasional drinkers, and abstainers were defined. AUDIT provided a measure of alcohol consumption, its dependence, and its impact on daily life. The severity of psoriasis was graded as mild, moderate, and severe. Results: Seventy-four (50.7%) patients were aged ≤40 years and 51.4% of patients had the disease for <5 years. Psoriasis was mild in 48.6% and moderate to severe in 51.4% of patients, respectively. Only males (32.9%) were consuming alcohol in varying amounts; 19.9% were occasional drinkers (AUDIT score <8). Other 67.1% of patients completely abstained from alcohol consumption (AUDIT score 0). The remaining 13% were regular drinkers (AUDIT score >8) and had more severe psoriasis compared to patients having AUDIT score <8 (P < 0.05). A high level of alcohol use disorder and alcohol dependence was present in one patient each. Limitations: Few patients, particularly females may not have disclosed their alcohol consumption due to fear of stigmatization. Small number of patients, hospital-based cross-sectional study design, and no follow-up for clinical improvement after cessation of alcohol are other limitations. Conclusions: Alcohol consumption was associated with alcohol use disorder in 32.9% of patients (AUDIT score >8) and significantly severe psoriasis compared to 67.1% abstainers. Whether increased alcohol consumption is a consequence or a risk factor for chronicity of psoriasis needs large linear studies for confirmation.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Niharika Dhattarwal
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Reena Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Vijay K Singh
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Jyotshna Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Sheenam Hooda
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
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Rana A, Mahajan VK, Mehta KS, Chauhan PS, Kumar M, Sharma A, Sharma R, Dhattarwal N, Sondhi M. Cardiomyopathy and echocardiographic abnormalities in Indian patients with psoriasis: Results of a pilot study. Int J Clin Pract 2021; 75:e13756. [PMID: 33064900 DOI: 10.1111/ijcp.13756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/04/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The relationship between psoriasis and cardiomyopathy is understudied in Indian patients. OBJECTIVE We evaluated psoriasis patients for cardiomyopathy and other echocardiographic abnormalities. METHODS About 98 (M:F = 67:31) patients with mild to moderate psoriasis aged 18-75 years (mean ± SD = 42.12 ± 12.79 years) having no pre-existing metabolic syndrome and cardiovascular disorders were studied. X-ray chest, electrocardiogram and echocardiography were performed and interpreted by cardiologist for size of the left and right ventricles, left ventricle ejection fraction, diastolic function, pulmonary artery pressure and valve abnormality/regurgitation and their severity as per current guidelines/recommendations. The cardiomyopathies were defined according to standard diagnostic guidelines. RESULTS Echocardiographic abnormalities were noted in 13 (13.3%) patients aged 19-75 years (mean ± SD = 43.30 ± 15.71 years). The left ventricular diastolic dysfunction (grade 1) was observed in nine patients (moderate severe psoriasis in four patients) and one of them also had concentric left ventricular hypertrophy; a precursor of restrictive cardiomyopathy. Mild tricuspid valve regurgitation was present in other four patients. There was no statistically significant difference in age, gender, duration and the severity of psoriasis when compared with patients having normal echocardiography. The mitral or aortic valves, pulmonary artery pressure, mid-right-ventricular diameter and the left atrial volume showed no abnormality. CONCLUSIONS Psoriasis perhaps plays a role in left ventricular dysfunction and possibly cardiomyopathy even with moderately severe disease and in the absence of clinical symptoms. However, these observations need to be interpreted with caution in the absence of any statistically significant difference between age, gender, duration and severity of psoriasis in the patients having normal and abnormal echocardiography.
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Affiliation(s)
- Ashwani Rana
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Mukul Kumar
- Department of Cardiology, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Anuj Sharma
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Reena Sharma
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Niharika Dhattarwal
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
| | - Megha Sondhi
- Department of Dermatology, Venereology & Leprosy, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, Kangra (Tanda), India
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Vashist S, Mahajan VK, Mehta KS, Chauhan PS, Yadav RS, Sharma SB, Sharma V, Sharma A, Chowdhary B, Kumar P. Association of Psoriasis with Autoimmune Disorders: Results of a Pilot Study. Indian Dermatol Online J 2020; 11:753-759. [PMID: 33235841 PMCID: PMC7678535 DOI: 10.4103/idoj.idoj_648_19] [Citation(s) in RCA: 9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/11/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Association of psoriasis with other autoimmune diseases remains an ongoing research subject. OBJECTIVES To investigate the association of psoriasis with other autoimmune disorders. MATERIALS AND METHODS We studied 80 (M: F 57:23) psoriasis patients aged 13-75 years for concurrent autoimmune disorders. After clinical examination, hemogram, fasting blood sugar, HbA1c, thyroid function tests, anti-TPO antibody, rheumatoid factor, anti-tTG antibody, anti-CCP antibody, ANA, anti-dsDNA antibody, anti-Ro antibody, and fecal calprotectin were estimated. RESULTS Mild-to-moderate and severe psoriasis was present in 86.3% and 13.8% patients, respectively. Psoriatic arthritis was present in 3.8% patients, all of whom also had severe psoriasis. Only 37 (46.3%) patients had clinical and/or sero-abnormality suggestive of autoimmune disorders; vitiligo in 3.8%, type-1 diabetes mellitus (DM) in 1.3%, and type-2 DM in 6.3% patients. Sero-positivity reflecting subclinical autoimmunity was noted for anti-CCP antibodies (in 2.5%), rheumatoid factor (in 2.5%), hypo- or hyper-thyroidism (in 8.8%), anti-TPO antibodies (in 5.0%), anti-tTG antibody (in 1.3%), ANA (in 5.0%), anti-dsDNA antibody (in 2.5%), and anti-Ro antibody in 11.3% patients. Elevated fecal calprotectin levels suggestive of inflammatory bowel disease (IBD) occurred in 11.2% of 27 patients. Multiple abnormalities happened in 2.5% patients. CONCLUSION Apparently psoriasis patients seem to have a predilection for other autoimmune disorders particularly for vitiligo, diabetes mellitus, autoimmune thyroiditis, rheumatoid arthritis, and IBD. However, association between psoriasis and other autoimmune disorders at best remains tenuous for want of strong evidence. Nevertheless, screening for them will improve overall management of these patients. Cross-sectional study design and small number of study subjects remain important limitations.
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Affiliation(s)
- Sanket Vashist
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikram K. Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rajinder S. Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Satya Bhushan Sharma
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Bhumika Chowdhary
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Prabal Kumar
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Dhattarwal N, Mahajan VK, Mehta KS, Chauhan PS, Yadav RS, Sharma SB, Sharma A, Sharma R, Rana A, Sondhi M. The association of anti-gliadin and anti-transglutaminase antibodies and chronic plaque psoriasis in Indian patients: Preliminary results of a descriptive cross-sectional study. Australas J Dermatol 2020; 61:e378-e382. [PMID: 32397002 DOI: 10.1111/ajd.13308] [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: 03/04/2020] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Gluten sensitivity among psoriasis patients and its association with gender, age, disease duration and severity of psoriasis are under studied in Indians. OBJECTIVE To examine association among serum levels of anti-tTG and anti-gliadin antibodies and clinical features including gender, age, duration and severity of psoriasis. METHODS Serum levels of anti-transglutaminase and anti-gliadin antibodies were measured quantitatively in 80 (M:F 57:23) psoriasis patients aged 15 to 83 years and matched healthy subjects. RESULTS Forty-five (56.3%) patients were aged ≥41years, duration of disease was >5years in 43(53.8%) patients, and 22 (27.5%) patients had moderate-to-severe psoriasis. Two (2.5%) patients had arthritis and elevated serum anti-gliadin antibody. Significantly more patients than controls had elevated serum anti-gliadin antibody (67.5% vs. 2.5%) and anti-transglutaminase antibody levels (62.5% vs. 0%). Two patients, each with mild and moderate-to-severe psoriasis, had highly elevated serum anti-gliadin antibody and symptoms akin to coeliac disease. Except for a longer duration of psoriasis in patients with elevated anti-gliadin antibodies, there was no statistically significant difference in gender, age, and severity of psoriasis when compared with patients having normal levels. CONCLUSION Significant elevation of serum anti-transglutaminase and anti-gliadin antibodies levels is noted in psoriasis patients reflecting a possible link. However, results need careful interpretation for any significance of gluten sensitivity in pathogenesis of psoriasis/arthritis or as a stand-alone risk factor for chronicity/severity of psoriasis or whether gluten-free diet will be ameliorating. Small number of subjects, cross-sectional study design, lack of pathological/endoscopic diagnosis and follow-up are study limitations.
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Affiliation(s)
- Niharika Dhattarwal
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Vikram K Mahajan
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Karaninder S Mehta
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Pushpinder S Chauhan
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Rajinder S Yadav
- Department of, Biochemistry, Dr. R. P. Govt. Medical College, Kangra, India
| | | | - Anuj Sharma
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Reena Sharma
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Ashwani Rana
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Megha Sondhi
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
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Chowdhary B, Mahajan VK, Mehta KS, Chauhan PS, Sharma V, Sharma A, Vashist S, Kumar P. Therapeutic efficacy and safety of oral tranexamic acid 250 mg once a day versus 500 mg twice a day: a comparative study. Arch Dermatol Res 2020; 313:109-117. [PMID: 32356007 DOI: 10.1007/s00403-020-02078-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/28/2019] [Revised: 04/02/2020] [Accepted: 04/17/2020] [Indexed: 01/19/2023]
Abstract
Oral tranexamic acid (TXA) 250 mg twice daily has been used effectively for 4 weeks to 6 months to treat melasma. As relapses are frequent on discontinuation, a minimum effective dose of TXA that can be used safely for long time remains unknown. We compared the efficacy of oral TXA 250 mg once daily and 500 mg twice daily given for 16 weeks in 132 (m:f 23:109) adults with melasma. 42 patients in Group-A (TXA 250 mg/d) and 46 patients in Group-B (TXA 500 mg twice/d) completed the study. They were followed up at 4-week interval for percentage reduction in baseline Melasma Area Severity Index (MASI) and at 24 and 28 weeks for relapse. Therapeutic response, for both as per-protocol and intention-to-treat analysis, was scored as very good (> 75% reduction), good (51-75% reduction), moderate (25-50% reduction), mild (< 25% reduction) or no improvement. Reduction in mean MASI score at 4 weeks was not statistically significant in Group-A but it decreased significantly 8 weeks onwards and was comparable with that in Group-B. The relapse rate was higher in Group-B (10.8%) than Group-A (4.7%) at the end of 28 weeks. Oligomenorrhoea and abdominal discomfort in few patients did not necessitate treatment discontinuation. TXA 500 mg twice daily showed early reduction in mean MASI score compared to 250 mg given once daily with comparable safety and therapeutic efficacy at 16 weeks. Open-label cross-sectional design, no control arm, small number of patients in each group, MASI score being subjective assessment tool, short duration of treatment and follow-up are study limitations.
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Affiliation(s)
- Bhumika Chowdhary
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India.
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Sanket Vashist
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
| | - Prabal Kumar
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), 176001, Himachal Pradesh, India
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Chauhan S, Mahajan VK, Mehta KS, Yadav RS, Chauhan PS, Bhushan S, Sharma V, Sharma A, Wadhwa D, Sharma A. Clinicoepidemiologic Features of Chronic Spontaneous Urticaria in Patients with Elevated Plasma D-Dimer Levels versus those without It: A Case-Control Cross-Sectional Study of 100 Indian Patients. Indian Dermatol Online J 2019; 10:632-638. [PMID: 32195199 PMCID: PMC6859760 DOI: 10.4103/idoj.idoj_505_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 01/19/2023] Open
Abstract
Background Activated coagulation cascade is implicated in urticaria pathogenesis marked by high plasma D-dimer, a marker of fibrinolysis, levels correlating with high urticaria activity score (UAS) and poor therapeutic outcome. Methods Quantitative plasma D-dimer levels and coagulation parameters in 100 (male:female ratio 1:3) Indian patients with chronic spontaneous urticaria and age- and gender-matched healthy controls were compared. The clinicoepidemiologic features of chronic urticaria were then compared among patients with normal (≤0.2 mg/L) and elevated (≥0.3 mg/L) plasma D-dimer levels. Results Plasma D-dimer in 23% patients and 4% controls and prothrombin time and activated partial thromboplastin time in 63% and 5% patients, respectively, were significantly higher compared with 58% and 1% of controls, respectively. About 18 of 72 (25%) patients with high UAS of ≥16-42 were compared with 5 of 28 (17.8%) patients with UAS7 of ≤15. Patients with elevated plasma D-dimer levels had significantly more systemic symptoms (86.9% vs. 81.8%) compared with patients with normal plasma D-dimer levels. Conclusion A subset of patients with chronic urticaria have elevated plasma D-dimer levels and exhibit higher UAS7 and systemic symptoms that may influence long-term prognosis and therapeutic choices. Small number of patients, a cross-sectional nature of study, lack of treatment outcome measures, information on self-medication, and unavailability of specific parameters for coagulation pathway activation remain few limitations of this study.
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Affiliation(s)
- Shailja Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rajinder S Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Dhaarna Wadhwa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Aditi Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Manvi S, Mahajan VK, Mehta KS, Yadav RS, Bhushan S, Chauhan PS. Psoriasis and Co-morbidities: Is Hyperhomocystienemia the Common Link? J Assoc Physicians India 2019; 67:29-32. [PMID: 31309792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Hyperhomocystienemia is a plausible common link between psoriasis and associated co-morbidities. AIM To assess and compare serum homocystiene levels in 160(M:F 94:66) patients aged 18-70 years with chronic plaque psoriasis of varying severity with or without metabolic syndrome, cardiovascular and thyroid disorders and controls. The 155 controls (M:F 97:58) were healthy volunteers aged between 18 and 66 years. RESULTS Overall, 123 (76.9%) psoriasis patients with or without co-morbidities and 87 (56.1%) controls had elevated serum homocystiene levels; 23.48±14.37 and 18.74±12.59 (mean±SD) µmol/L, respectively. Eighty-one (58%) patients had associated co-morbidities with mean serum homocystiene levels of 22.65±13.70 µmol/L.The difference between psoriasis patients with or without comorbidities and controls was statistically significant. CONCLUSIONS Hyperhomocystienemia in psoriasis patients with or without comorbidities versus healthy controls suggests its possible dysregulation in psoriasis. The significance of hyperhomocystienemia as an independent risk factor for cardiovascular or other comorbidities in psoriasis patients remains tenuous at best. Well-designed studies will perhaps resolve this issue.
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Affiliation(s)
- Sujaya Manvi
- Resident, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh
| | - Vikram K Mahajan
- Prof., Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh; *Corresponding Author
| | - Karaninder S Mehta
- Assoc. Prof., Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh
| | - R S Yadav
- Prof., Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh
| | - Satya Bhushan
- Asst. Prof., Departments of Dermatology, Venereology & Leprosy and Biochemistry, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh
| | - Pushpinder S Chauhan
- Asst. Prof., Departments of Dermatology, Venereology & Leprosy and Biochemistry, Dr. R.P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh
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Wadhwa D, Mahajan VK, Mehta KS, Chauhan PS, Yadav RS, Bhushan S, Sharma V, Sharma A, Sharma A, Chauhan S. Malondialdehyde, lipoprotein-a, lipoprotein ratios, comprehensive lipid tetrad index and atherogenic index as surrogate markers for cardiovascular disease in patients with psoriasis: a case–control study. Arch Dermatol Res 2019; 311:287-297. [PMID: 30830310 DOI: 10.1007/s00403-019-01896-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Dhaarna Wadhwa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India.
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Rajinder S Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Anuj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Aditi Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Shailja Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
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Agnello AC, Potysz A, Fourdrin C, Huguenot D, Chauhan PS. Impact of pyrometallurgical slags on sunflower growth, metal accumulation and rhizosphere microbial communities. Chemosphere 2018; 208:626-639. [PMID: 29894964 DOI: 10.1016/j.chemosphere.2018.06.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 05/07/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
Metallurgical exploitation originates metal-rich by-products termed slags, which are often disposed in the environment being a source of heavy metal pollution. Despite the environmental risk that this may pose for living organisms, little is known about the impact of slags on biotic components of the ecosystem like plants and rhizosphere microbial communities. In this study, metal-rich (Cu, Pb, Zn) granulated slags (GS) derived from Cu production process, were used for a leaching test in the presence of the soil pore solution, showing that soil solution enhanced the release of Cu from GS. A pot experiment was conducted using as growing substrate for sunflower (Helianthus annuus) a 50% w/w mix of an agricultural soil and GS. Bioavailability of metals in soil was, in increasing order: Pb < Zn < Cu. Sunflower was able to grow in the presence of GS and accumulated metals preferentially in above-ground tissues. Microbial diversity was assessed in rhizosphere and bulk soil using community level physiological profiling (CLPP) and 16S rRNA gene based denaturing gradient gel electrophoresis (DGGE) analyses, which demonstrated a shift in the diversity of microbial communities induced by GS. Overall, these results suggest that metallurgical wastes should not be considered inert when dumped in the soil. Implications from this study are expected to contribute to the development of sustainable practices for the management of pyrometallurgical slags, possibly involving a phytomanagement approach.
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Affiliation(s)
- A C Agnello
- Université Paris-Est, Laboratoire Géomatériaux et Environnement (EA 4508), UPEM, 5 Bd Descartes 77454 Marne-la-Vallée, France.
| | - A Potysz
- Institute of Geological Sciences, University of Wrocław, Cybulskiego 30, 50-205 Wrocław, Poland.
| | - C Fourdrin
- Université Paris-Est, Laboratoire Géomatériaux et Environnement (EA 4508), UPEM, 5 Bd Descartes 77454 Marne-la-Vallée, France.
| | - D Huguenot
- Université Paris-Est, Laboratoire Géomatériaux et Environnement (EA 4508), UPEM, 5 Bd Descartes 77454 Marne-la-Vallée, France.
| | - P S Chauhan
- CSIR-National Botanical Research Institute, Rana Pratap Marg, Lucknow, U.P. 226001, India.
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Sharma A, Mahajan VK, Mehta KS, Chauhan PS, Sharma V, Sharma A, Wadhwa D, Chauhan S. Pesticide contact dermatitis in agricultural workers of Himachal Pradesh (India). Contact Dermatitis 2018; 79:213-217. [PMID: 29974480 DOI: 10.1111/cod.13049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 04/25/2018] [Accepted: 05/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Aditi Sharma
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Vikram K. Mahajan
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Vikas Sharma
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Anuj Sharma
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Dhaarna Wadhwa
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
| | - Shailja Chauhan
- Department of Dermatology, Venereology & Leprosy; Dr R. P. Government Medical College; Kangra (Tanda) H.P. India
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Rashpa RS, Mahajan VK, Kumar P, Mehta KS, Chauhan PS, Rawat R, Sharma V. Mucocutaneous Manifestations in Patients with Chronic Kidney Disease: A Cross-sectional Study. Indian Dermatol Online J 2018; 9:20-26. [PMID: 29441293 PMCID: PMC5803936 DOI: 10.4103/idoj.idoj_160_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Chronic kidney disease (CKD)-associated mucocutaneous manifestations significantly impair the quality of life but often remain understudied. They may also vary across regions, socioeconomic and nutritional status, and racial differences. Objectives: To study the patterns of mucocutaneous disorders and their prevalence in CKD patients irrespective of clinical stage or dialysis status. Materials and Methods: 122 (M:F = 77:45) patients aged 21‒85 (Mean ± SD = 57.5 ± 14.0) years having CKD for 3 month to 5 years were studied for mucocutaneous manifestations. Fifty (41%) patients were on hemodialysis for 1‒42 months. Detailed medical history, clinical and mucocutaneous examination, and lab investigations were performed. KOH mounts, skin biopsy, Gram's and Giemsa staining, bacterial or fungal cultures were performed as required. Results: Xerosis in 93 (76.2%), skin pallor in 61 (50%), pruritus in 57 (46.7%), pigmentation in 47 (38.5%), and purpura in 18 (14.8%) patients were the major dermatoses. Bullous lesions and perforating folliculitis occurred in 3 (2.5%) patients each. Major nail abnormalities were pallor (in 35.2%), absent lunula (in 23.8%), nail discoloration (in 18%), and “half-and-half nails” in 16.4% patients, respectively. Hair abnormalities included sparse scalp and body hairs (in 35.2% and 13.1%, respectively) and lusterless hair in 12.3% patients. Coated tongue (in 14.8%), xerostomia (in 12.3%), and macroglossia with teeth indention (in 7.4%) patients were the mucosal manifestations. Conclusions: Xerosis, pruritus, skin pallor/pigmentary changes, nail pallor, absent lunula, nail discoloration, sparse hairs, coated tongue, xerostomia, macroglossia, and infections were the most common mucocutaneous manifestations in the studied patients irrespective of hemodialysis status. Cold and dry climates might be additional aggravators for xerosis/pruritus. Lifelong follow-up may be needed to reduce the morbidity associated with CKD/hemodialysis specific dermatoses appearing over a period.
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Affiliation(s)
- Rattan S Rashpa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Pankaj Kumar
- Department of Internal Medicine, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Himachal Pradesh, India
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Kohli S, Mahajan VK, Rana BS, Mehta KS, Raina RK, Chauhan PS, Sharma V, Rawat R. Clinicoepidemiologic Features of Chronic Urticaria in Patients with versus without Subclinical Helicobacter pylori Infection: A Cross-Sectional Study of 150 Patients. Int Arch Allergy Immunol 2018; 175:114-120. [PMID: 29346794 DOI: 10.1159/000485893] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/30/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Helicobacter pylori infection is linked to chronic urticaria in nearly 60% of patients. We studied clinicoepidemiologic features in patients with chronic urticaria with and without H. pylori infection. METHODS Endoscopic antral biopsy for the rapid urease test (RUT) and histopathology, and serum IgG ELISA for H. pylori infection were performed in 150 patients (male:female ratio 1:2.4) of chronic urticaria aged 18-68 years. Clinicoepidemiologic features including age, gender, age of onset and duration, frequency and distribution of wheals, urticaria severity score, and systemic symptoms were analyzed in patients with and without H. pylori. The results of serum IgG ELISA for H. pylori were compared with 106 age- and gender-matched healthy adult controls. RESULTS The RUT in 84 patients (56%), histopathology in 76 patients (50.6%), and H. pylori IgG ELISA in 94 patients (62.6%) were positive. H. pylori IgG ELISA was positive only in 35 (33%) controls, suggesting that chronic urticaria patients were more likely to have asymptomatic H. pylori infection than normal controls. Although not statistically significant, patients with H. pylori had a higher mean urticaria severity score, number of urticaria/angioedema episodes per year, and involvement of more body sites, particularly the scalp, palms, and soles. The constitutional or gastrointestinal symptoms were statistically higher in patients with H. pylori infection than those without it. CONCLUSION A subset of chronic urticaria patients appears to have asymptomatic H. pylori infection. However, its implications in chronicity, recurrences, the severity of urticaria, other systemic manifestations, and management remains conjectural in view of 33% of controls also having positive H. pylori ELISA and the endemicity of infection in developing countries.
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Affiliation(s)
- Sakshi Kohli
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Govt. Medical College, Kangra, India
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Gupta S, Mahajan VK, Yadav RS, Mehta KS, Bhushan S, Chauhan PS, Rawat R, Sharma V. Evaluation of Serum Vitamin D Levels in Patients with Systemic Sclerosis and Healthy Controls: Results of a Pilot Study. Indian Dermatol Online J 2018; 9:250-255. [PMID: 30050814 PMCID: PMC6042194 DOI: 10.4103/idoj.idoj_328_17] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The anti-inflammatory, immunomodulatory, and anti-proliferative effects of vitamin D in pathogenesis of autoimmune diseases have been highlighted in recent years but implications of vitamin D deficiency in systemic sclerosis (SSc) remain understudied. Objectives To evaluate serum vitamin D levels in SSc patients and matched controls. Materials and Methods Serum vitamin D levels were estimated in 38 (M:F 5:33) patients aged 23-70 years of untreated SSc and age and gender matched healthy controls. Clinical and investigative evaluation for skin sclerosis by modified Rodnan skin score (mRSS), presence of digital ulcers, Raynaud's phenomenon, type of auto-antibodies, systemic involvement, and serum vitamin D levels were performed. Serum vitamin D levels were defined as normal (30-100 ng/ml), insufficient (10-30 ng/ml), and deficient (<10 ng/ml). Results Serum vitamin D levels (median ± IQR) were 19.5 ± 77.8 ng/ml in 38 patients and 100 ± 31.3 ng/ml in controls each. Vitamin D deficiency in 13 (34.2%) and insufficiency in 10 (26.3%) patients were identified. Only 2 (5.3%) controls had vitamin D insufficiency and the difference was statistically significant (P = 0.001). An inverse relationship was observed between mRSS and serum vitamin D levels. Conclusions Patients with SSc have significantly lower serum vitamin D levels than healthy controls. Serum vitamin D levels do not correlate well with age, gender, disease duration or its variants, type of auto antibodies, presence of digital ulceration, or systemic involvement but has inverse correlation with skin sclerosis. Better-designed studies will perhaps resolve issues of potential benefits of vitamin D supplementation in modification of disease activity or severity in SSc.
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Affiliation(s)
- Sarita Gupta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Rajinder S Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
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A S, Chauhan PS, Anandham R, Han GH, Sa T. Erratum to: Isolation, Characterization, and Use for Plant Growth Promotion Under Salt Stress, of ACC Deaminase-Producing Halotolerant Bacteria Derived from Coastal Soil. J Microbiol Biotechnol 2017; 27:1724. [PMID: 28958134 DOI: 10.4014/jmb.2017.2709.1724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This erratum is being published to correct the error in the name of the strain in the paper by Siddikee et al. The name of the strain B. iodinum should be corrected as B. linens in title 'Isolation, Characterization, and Use for Plant Growth Promotion Under Salt Stress, of ACC Deaminase-Producing Halotolerant Bacteria Derived from Coastal Soil'.
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Affiliation(s)
- Siddikee A
- Department of Agricultural Microbiology, Agricultural College and Research Institute, Tamil Nadu Agricultural University, Republic of India
| | - P S Chauhan
- Department of Agricultural Microbiology, Agricultural College and Research Institute, Tamil Nadu Agricultural University, Republic of India
| | | | - Gwang-Hyun Han
- Department of Agricultural Microbiology, Agricultural College and Research Institute, Tamil Nadu Agricultural University, Republic of India
| | - Tongmin Sa
- Department of Agricultural Microbiology, Agricultural College and Research Institute, Tamil Nadu Agricultural University, Republic of India
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Mahajan VK, Raina RK, Singh S, Rashpa RS, Sood A, Chauhan PS, Mehta KS, Rawat R, Sharma V. Case Report: Histoplasmosis in Himachal Pradesh (India): An Emerging Endemic Focus. Am J Trop Med Hyg 2017; 97:1749-1756. [PMID: 29016342 DOI: 10.4269/ajtmh.17-0432] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We describe four cases of histoplasmosis indigenous to Himachal Pradesh (India) that will be of considerable public health interest. A 48-year-old human immunodeficiency virus (HIV)-negative man with cervical and mediastinal lymphadenopathy, hepatosplenomegaly, adrenal mass, and bone marrow involvement was treated as disseminated tuberculosis without benefit. Progressive disseminated histoplasmosis was diagnosed from the fungus in smears from adrenal mass. Another 37-year-old HIV-positive man was on treatment of suspected pulmonary tuberculosis. He developed numerous erythema nodosum leprosum-like mucocutanous lesions accompanied by fever, generalized lymphadenopathy, and weight loss. Pulmonary histoplasmosis with cutaneous dissemination was diagnosed when skin lesions showed the fungus in smears, histopathology, and mycologic culture. Both were successfully treated with amphotericin B/itraconazole. Third patient, a 46-year-old HIV-negative man, had oropharyngeal lesions, cervical lymphadenopathy, intermittent fever, hepatosplenomegaly, and deteriorating general health. Progressive disseminated oropharyngeal histoplasmosis was diagnosed from the fungus in smears and mycologic cultures from oropharyngeal lesions and cervical lymph node aspirates. He died despite initiating treatment with oral itraconazole. Another 32-year-old man 3 months after roadside trauma developed a large ulcer with exuberant granulation tissue over left thigh without evidence of immunosuppression/systemic involvement. He was treated successfully with surgical excision of ulcer under amphotericin B/itraconazole coverage as primary cutaneous histoplasmosis confirmed pathologically and mycologically. A clinical suspicion remains paramount for early diagnosis of histoplasmosis particularly in a nonendemic area. Most importantly, with such diverse clinical presentation and therapeutic outcome selection of an appropriate and customized treatment schedule is a discretion the treating clinicians need to make.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rashmi Kaul Raina
- Department of Pathology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Suman Singh
- Department of Pathology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rattan Sagar Rashpa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anuradha Sood
- Department of Microbiology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Khatri G, Mahajan VK, Mehta KS, Sharma KK, Bhushan S, Chauhan PS. Serum prolactin levels in patients with psoriasis: Results of a pilot study. Indian J Med Res 2017. [PMID: 28639603 PMCID: PMC5501059 DOI: 10.4103/ijmr.ijmr_814_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Gaytri Khatri
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
| | - Krishan Kumar Sharma
- Department of Biochemistry, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda) 176 002, Himachal Pradesh, India
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Shiny TN, Mahajan VK, Mehta KS, Chauhan PS, Rawat R, Sharma R. Patch testing and cross sensitivity study of adverse cutaneous drug reactions due to anticonvulsants: A preliminary report. World J Methodol 2017; 7:25-32. [PMID: 28396847 PMCID: PMC5366936 DOI: 10.5662/wjm.v7.i1.25] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/21/2017] [Accepted: 03/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the utility of patch test and cross-sensitivity patterns in patients with adverse cutaneous drug reactions (ACDR) from common anticonvulsants.
METHODS Twenty-four (M:F = 13:11) patients aged 18-75 years with ACDR from anticonvulsants were patch tested 3-27 mo after complete recovery using carbamazepine, phenytoin, phenobarbitone, lamotrigine, and sodium valproate in 10%, 20% and 30% conc. in pet. after informed consent. Positive reactions persisting on D3 and D4 were considered significant.
RESULTS Clinical patterns were exanthematous drug rash with or without systemic involvement (DRESS) in 18 (75%), Stevens-Johnsons syndrome/toxic epidermal necrolysis (SJS/TEN) overlap and TEN in 2 (8.3%) patients each, SJS and lichenoid drug eruption in 1 (4.2%) patient each, respectively. The implicated drugs were phenytoin in 14 (58.3%), carbamazepine in 9 (37.5%), phenobarbitone in 2 (8.3%), and lamotrigine in 1 (4.7%) patients, respectively. Twelve (50%) patients elicited positive reactions to implicated drugs; carbamazepine in 6 (50%), phenytoin alone in 4 (33.3%), phenobarbitone alone in 1 (8.3%), and both phenytoin and phenobarbitone in 1 (8.33%) patients, respectively. Cross-reactions occurred in 11 (92%) patients. Six patients with carbamazepine positive patch test reaction showed cross sensitivity with phenobarbitone, sodium valproate and/or lamotrigine. Three (75%) patients among positive phenytoin patch test reactions had cross reactions with phenobarbitone, lamotrigine, and/or valproate.
CONCLUSION Carbamazepine remains the commonest anticonvulsant causing ACDRs and cross-reactions with other anticonvulsants are possible. Drug patch testing appears useful in DRESS for drug imputability and cross-reactions established clinically.
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Kalita J, Misra UK, Bhoi SK, Chauhan PS, Sagar B. Possible role of transforming growth factor β in tuberculous meningitis. Cytokine 2016; 90:124-129. [PMID: 27865204 DOI: 10.1016/j.cyto.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/18/2016] [Revised: 10/07/2016] [Accepted: 11/05/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Transforming growth factor β (TGF-β) is an anti-inflammatory cytokine and its role in hydrocephalus and stoke has been suggested. Tuberculous meningitis (TBM) is associated with exudates, stroke, hydrocephalus and tuberculoma, but the role of TGF-β has not been evaluated in relation to these changes. AIM To evaluate the cerebrospinal fluid (CSF) TGF-β level in the patients with TBM, and correlate these with clinical findings, MRI changes, paradoxical response and outcome at 6months. METHODS TBM patients diagnosed on the basis of clinical, CSF and MRI criteria were prospectively included. The clinical details including duration of illness, seizures, focal motor deficit, Glasgow Coma Scale (GCS) score and stage of TBM were noted. Presence of exudate, hydrocephalus, tuberculoma and infarction in MRI was also noted. MRI was repeated at 3months and presence of paradoxical response was noted. Cerebrospinal fluid TGF-β was measured using ELISA on admission and repeated at 3months and these were compared with 20 controls. RESULTS TGF-β level was significantly higher in TBM compared to the controls (385.76±249.98Vs 177.85±29.03pg/ml, P<0.0001). TGF-β correlated with motor deficit, infarction and tuberculoma on admission but did not correlate with CSF abnormalities, drug induced hepatitis, paradoxical response and outcome. TGF-β level at 3months was significantly lower than the baseline but remained higher than the controls. CONCLUSION CSF TGF-β levels are elevated in TBM and correlate with infarction and tuberculoma.
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Affiliation(s)
- J Kalita
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Road, Lucknow 226014, India
| | - U K Misra
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Road, Lucknow 226014, India.
| | - S K Bhoi
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Road, Lucknow 226014, India
| | - P S Chauhan
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Road, Lucknow 226014, India
| | - Betai Sagar
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Road, Lucknow 226014, India
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Mahajan VK, Sharma AL, Chauhan PS, Mehta KS, Sharma S. SkIndia Quiz 27: Rhinophyma and numerous facial papule and nodules in a 39-year-old woman. Indian Dermatol Online J 2016; 7:350-2. [PMID: 27559531 PMCID: PMC4976436 DOI: 10.4103/2229-5178.182404] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology, Leprosy, Dr. R.P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Anju Lath Sharma
- Department of Dermatology, Venereology, Leprosy, Dr. R.P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology, Leprosy, Dr. R.P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology, Leprosy, Dr. R.P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Saurabh Sharma
- Department of Pathology, Dr. R.P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
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Chauhan PS, Singh R. Ovalbumin-induced allergic inflammation lead to structural alterations in mouse model and protective effects of intranasal curcumin: A comparative study. Allergol Immunopathol (Madr) 2016; 44:246-56. [PMID: 27046748 DOI: 10.1016/j.aller.2016.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 08/01/2015] [Revised: 12/22/2015] [Accepted: 01/03/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Antigen exposure and persistent inflammation leads to structural changes in the asthmatic airways which are collectively termed as "airway remodelling". Presently available asthma medications ameliorate inflammations but are unable to prevent or reverse the airway remodelling process as most of the treatment strategies are only focused on inflammation instead of remodelling. METHODS Curcumin, a phytochemical present in the rhizome of Curcuma longa is well known for its anti-inflammatory activity; however, the main drawback is its poor bioavailability which limits its therapeutic approval. So, the effect of nasal curcumin on acute and chronic asthma has been studied where short exposure to ovalbumin (4 days) represents acute phase whereas repeated exposures for longer (twice per week till 5 weeks) represents chronic asthma. Disodium cromoglycate (DSCG, 50mg/kg, i.p.) and dexamethasone (1mg/kg, i.p.) were used as standard drugs in acute and chronic model of asthma respectively. RESULTS OVA-induced airway inflammation initiated in acute stage led to remodelling due to persistent inflammation, epithelial and sub epithelial thickening (smooth muscle thickening), extracellular matrix (ECM) deposition, goblet cell hyperplasia and mucus plug formation. Intranasal curcumin is effective in inhibiting airway inflammation and remodelling both by maintaining the structural integrity of lungs in terms of inflammation, airway wall thickening and mucus production. CONCLUSION Our findings suggest that curcumin administered through nasal route might prove therapeutically efficient in inhibiting allergic airway inflammations and maintaining structural integrity in the mouse model of allergic asthma. This may lead to the development of curcumin aerosol in near future.
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Affiliation(s)
- P S Chauhan
- Department of Zoology, MMV, Banaras Hindu University, Varanasi 221005, India
| | - R Singh
- Department of Zoology, MMV, Banaras Hindu University, Varanasi 221005, India.
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Singh R, Mahajan VK, Mehta KS, Thakur L, Chauhan PS, Gupta M, Rawat R. Profile of Rheumatological Manifestations in Leprosy in a Tertiary Care Hospital from Himachal Pradesh. Indian J Lepr 2016; 88:13-19. [PMID: 29741821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The rheumatological manifestations of leprosy occur singly or in varying combinations, particularly during lepra reactions. Despite being third most common, these remain under diagnosed and under reported. This study has been carried out to study the spectrum of rheumatological manifestations in leprosy patients. One hundred consecutive patients of leprosy presenting during January to December 2013 were studied for rheumatological manifestations. Complete hemogram, serum biochemistry, urinalysis, rheumatoid factor, ASO titer, C-reactive protein, ANA, and x-rays for hands, feet, chest and involved joints were performed. These 100 (M:F 66:34) patients aged between 16-80 years had indeterminate (2 patients), TT (4 patients), BT (26 patients), BB (2 patients), and LL leprosy (32 patients). 27 patients had rheumatological manifestations; arthritis involving large or small joints in 23 patients being the commonest. 7 of 24 patients in type-1 lepra reaction had enthesitis in 3 patients and oligoarthritis in 4 patients. Rheumatoid arthritis-like polyarthritis was noted in 19 patients with type-2 reaction. Tenosynovitis, dactylitis, bony changes were also noted. Except for one case, these features were present in patients having lepra reactions. Rheumatoid factor in 14, ANA in 15, C-reactive protein in 45 cases was positive. ASO was positive 34 cases. Symmetrical polyarthritis involving small joints of hands and feet, oligoarthritis, enthesitis and dactylitis are common in leprosy particularly with borderline leprosy, type-2 lepra reaction especially in the presence of positive RAfactor.
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Mani VE, Chauhan PS, Kalita J, Bhoi SK, Misra UK. Is VEGF a marker of severity of scrub typhus infection? Eur J Clin Microbiol Infect Dis 2016; 35:305-10. [PMID: 26718940 DOI: 10.1007/s10096-015-2546-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/07/2015] [Indexed: 01/19/2023]
Abstract
Vascular endothelial growth factor (VEGF) and its receptors have been reported as severity markers of septicemia. Scrub typhus (ST) results in multi-organ dysfunction but the role of VEGF has not been evaluated. We report VEGF and its receptors in ST and its correlation with severity, outcome and laboratory findings. Thirty patients with ST diagnosed by solid phase immune chromatographic assay and Weil-Felix tests were included. Their clinical details, Glasgow Coma Scale (GCS), SOFA and modified Rankin Scale (mRS) scores and laboratory findings were noted. VEGF, VEGFR1 and VEGFR2 were done by ELISA at admission and repeated at 1 month. Outcome was defined at 1 month. Serum VEGF and VEGF-R1 levels were significantly higher and VEGFR2 was significantly lower in the ST patients compared to the controls. These levels significantly improved at 1 month. VEGF level correlated with SOFA score (p = 0.05) and SGPT (p = 0.04). VEGFR1 correlated with hemoglobin (p = 0.04), platelet count (p = 0.03), serum CK (p = 0.001), weakness (p = 0.04) and mRS score (p = 0.04). VEGFR2 did not correlate with any clinical or laboratory parameters. All the patients recovered with doxycycline. Serum VEGF and VEGFR1 levels increased in ST and suggest disease severity but do not predict outcome.
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Affiliation(s)
- V E Mani
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India
| | - P S Chauhan
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India
| | - J Kalita
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India.
| | - S K Bhoi
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India
| | - U K Misra
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India
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Abstract
Background: Erythema dyschromicum perstans, a rare dermatosis of obscure etiopathogenesis and significant cosmetic morbidity, have no satisfactory treatment. Observations: Two patients with having characteristic asymptomatic and slowly progressive, slate-grey macular lesions with distinct red borders involving the face, neck, upper trunk and limbs were diagnosed clinicopathologically as erythema dyschromicum perstans. Both were treated successfully with topical tacrolimus 0.1% ointment. Conclusions: Overall, response to several therapeutic modalities including clofazimine and dapsone therapy is said to vary from complete failure to variable or inconsistent. Topical tarolimus provides an effective and safe alternative therapeutic option in erythema dyschromicum perstans.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Anju Lath Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
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Abhinav C, Mahajan VK, Mehta KS, Chauhan PS, Gupta M, Rawat R. Weekly methotrexate versus daily isotretinoin to treat moderate-to-severe chronic plaque psoriasis: a comparative study. Our Dermatol Online 2015. [DOI: 10.7241/ourd.20154.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Mahajan VK, Khatri G, Chauhan PS, Mehta KS, Raina R, Gupta M. Progressive Symmetric Erythrokeratoderma Having Overlapping Features With Erythrokeratoderma Variabilis and Lesional Hypertrichosis: Is Nomenclature "Erythrokeratoderma Variabilis Progressiva" More Appropriate? Indian J Dermatol 2015; 60:410-1. [PMID: 26288417 PMCID: PMC4533547 DOI: 10.4103/0019-5154.160499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Gayatri Khatri
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Rashmi Raina
- Department of Pathology, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India. E-mail:
| | - Mrinal Gupta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
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Abstract
BACKGROUND The contact allergic reactions from p-phenylenediamine (PPD) in hair dyes vary from mild contact dermatitis to severe life- threatening events (angioedema, bronchospasm, asthma, renal impairment). OBJECTIVES To study the clinical patterns and PPD contact sensitivity in patients with hair-dye dermatitis. MATERIALS AND METHODS Eighty (M:F 47:33) consecutive patients aged between 18 and 74 years suspected to have contact allergy from hair dye were studied by patch testing with Indian Standard Series including p-phenylenediamine (PPD, 1.0% pet). RESULTS 54 Fifty-four (M:F 21:33) patients showed positive patch tests from PPD. Eight of these patients also showed positive patch test reaction from fragrance mix, thiuram mix, paraben mix, or colophony. Fifty-seven (71%) patients affected were aged older than 40 years. The duration of dermatitis varied from < 1 month to > 1 year with exacerbation following hair coloring. Forty-nine patients had dermatitis of scalp and/or scalp margins and 23 patients had face and neck dermatitis. Periorbital dermatitis, chronic actinic dermatitis, and erythema multiforme-like lesions were seen in 4, 2, and 1 patients, respectively. CONCLUSIONS Hair dyes and PPD constitute a significant cause of contact dermatitis. There is an urgent need for creating consumer awareness regarding hair-dyes contact sensitivity and the significance of performing sensitivity testing prior to actual use.
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Affiliation(s)
- Mrinal Gupta
- Department of Dermatology, Venereology and Leprosy, Dr. Rajendra Prasad, Government Medical College, Tanda, Himachal Pradesh, India
| | - Vikram K. Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. Rajendra Prasad, Government Medical College, Tanda, Himachal Pradesh, India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. Rajendra Prasad, Government Medical College, Tanda, Himachal Pradesh, India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. Rajendra Prasad, Government Medical College, Tanda, Himachal Pradesh, India
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Gupta M, Mahajan VK, Mehta KS, Chauhan PS, Rawat R. Peroxisome proliferator-activated receptors (PPARs) and PPAR agonists: the ‘future’ in dermatology therapeutics? Arch Dermatol Res 2015; 307:767-80. [PMID: 25986745 DOI: 10.1007/s00403-015-1571-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/11/2015] [Accepted: 05/05/2015] [Indexed: 01/10/2023]
Affiliation(s)
- Mrinal Gupta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, 176001, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, 176001, Himachal Pradesh, India.
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, 176001, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, 176001, Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, 176001, Himachal Pradesh, India
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Gayatri Khatri
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Ravinder Singh
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India
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Abstract
This paper describes a typical case of poikiloderma vasculare atrophicans (PVA) in a 48-year-old female. Histologically, the features were suggestive of PVA with the absence of Pautrier's microabscess or atypical lymphoid cells. The biopsy specimen was positive for cluster of differentiation (CD) 8 on immunohistochemical staining. Its exact pathogenesis remains obscure, and it remains unclear whether PVA actually is mycosis fungoides (MF), a forme fruste of MF, or a distinct and benign dermatosis with CD8+ phenotype that can perhaps be labeled as PVA. However, it has a long benign clinical course without progression to tumor stage of MF in most cases, and its status within the spectrum of cutaneous T-cell lymphoma remains poorly understood. Yet it is imperative to distinguish PVA from poikilodermic MF.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. RP Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. RP Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. RP Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anju Lath Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. RP Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Mahajan VK, Singh R, Mehta KS, Chauhan PS, Sharma S, Gupta M, Rawat R. Idiopathic hypereosinophilic syndrome: a rare cause of erythroderma. J Dermatol Case Rep 2014; 8:108-14. [PMID: 25621091 DOI: 10.3315/jdcr.2014.1185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 10/28/2014] [Accepted: 12/08/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Idiopathic hypereosinophilic syndrome (HES) is a rare and potentially lethal disorder characterized by persistently elevated eosinophil counts without any underlying causes. Two variants, the myeloproliferative and lymphocytic hypereosinophilic syndrome, have been identified. The symptoms are variable and related to the organs involved (cardiovascular system, skin, central and peripheral nervous system, gastrointestinal tract, eyes). Skin lesions can be the dominating and/or presenting symptom in about 50% of patients. MAIN OBSERVATIONS We describe a 54-year-old man with a 12-year history of skin lesions, clinically consistent with psoriasis and psoriatic erythroderma. The patient was treated with methotrexate with no response. He experienced intense pruritus, dry/coarse skin and palmoplantar hyperkeratosis. Histopathology showed spongiotic dermatitis with no epidermotropism. Inflammatory infiltrates in upper dermis consisted predominantly of lymphocytes and eosinophils. Peripheral and tissue eosinophilia, immunophenotyping, and results of FIP1L1-PDGFRA gene analysis were suggestive of lymphocytic HES. The patient was treated with hydroxycarbamide (1 g/day), prednisolone (40 mg/day) and antihistamines with improvement. CONCLUSIONS HES requires early treatment to prevent severe damage of targeted organs. The pleomorphic dermatological manifestations may delay the diagnosis. This case shows the importance of wide differential diagnosis of erythroderma. In this article we discuss the diagnostic criteria, the recommended work-up and management of idiopathic hypereosinophilic syndrome variants.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Ravinder Singh
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Saurabh Sharma
- Department of Pathology, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Mrinal Gupta
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
| | - Ritu Rawat
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh - 176001, India
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Mahajan VK, Abhinav C, Mehta KS, Chauhan PS. Erythema nodosum leprosum mimicking Sweet's syndrome: an uncommon presentation. LEPROSY REV 2014; 85:322-7. [PMID: 25675656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Erythema nodosum leprosum (ENL) lesions may uncommonly develop ulceration, necrosis, pustulation or bullae. This 60 year-old female was hospitalised with previously undiagnosed multibacillary (BL) leprosy and Sweet's syndrome-like ENL, a presentation that is rarely reported. In addition to skin lesions simulating Sweet's syndrome, she had anaemia, elevated ESR, and a peripheral leucocytosis with neutrophilia, the laboratory features of Sweet's syndrome. The final diagnosis was made from chronic iridocyclitis, presence of lepra bacilli in slit-skin smears, and histology. The pathogenesis of Sweet's-like ENL remains conjectural. In Sweet's syndrome a complex interplay of various cytokines leading to an abundance of pro- inflammatory cytokines in the target tissues has been postulated to initiate an abnormal tissue response to certain antigens; such findings may eventually explain these uncommon lepra reactions as well.
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Sharma V, Mahajan VK, Mehta KS, Chauhan PS. Occupational contact dermatitis among construction workers: results of a pilot study. Indian J Dermatol Venereol Leprol 2014; 80:159-61. [PMID: 24685859 DOI: 10.4103/0378-6323.129402] [Citation(s) in RCA: 7] [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] [Indexed: 01/19/2023]
Affiliation(s)
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra, Tanda, Himachal Pradesh, India
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Prabha N, Mahajan VK, Mehta KS, Chauhan PS, Gupta M. Cosmetic contact sensitivity in patients with melasma: results of a pilot study. Dermatol Res Pract 2014; 2014:316219. [PMID: 25132846 PMCID: PMC4123589 DOI: 10.1155/2014/316219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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] [Received: 05/10/2014] [Accepted: 06/29/2014] [Indexed: 01/19/2023] Open
Abstract
Background. Some of the patients with melasma perhaps have pigmented cosmetic dermatitis. However, cosmetic contact sensitivity in melasma remains poorly studied particularly in the Indian context. Objectives. To study cosmetic contact sensitivity in patients with melasma. Materials and Methods. 67 (F : M = 55 : 12) consecutive patients with melasma between 19 and 49 years of age were patch tested sequentially during January-December, 2012, with Indian Cosmetic and Fragrance Series, Indian Sunscreen Series, p-phenylenediamine, and patient's own cosmetic products. Results. 52 (78%) patients were in the age group of 20-40 years. The duration of melasma varied from 1 month to 20 years. Centrofacial, malar, and mandibular patterns were observed in 48 (72%), 18 (27%), and 1 (1%) patients, respectively. Indian Cosmetics and Fragrance Series elicited positive reactions in 29 (43.3%) patients. Cetrimide was the most common contact sensitizers eliciting positivity in 15 (52%) patients, followed by gallate mix in 9 (31%) patients and thiomersal in 7 (24%) patients. Only 2 of the 42 patients showed positive reaction from their own cosmetics while the other 5 patients had irritant reaction. Indian Sunscreen Series did not elicit any positive reaction. Conclusion. Cosmetics contact sensitivity appears as an important cause of melasma not associated with pregnancy, lactation, or hormone therapy.
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Affiliation(s)
- Neel Prabha
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh 176001, India
| | - Vikram K. Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh 176001, India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh 176001, India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh 176001, India
| | - Mrinal Gupta
- Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh 176001, India
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Mahajan VK, Sharma V, Prabha N, Thakur K, Sharma NL, Rudramurthy SM, Chauhan PS, Mehta KS, Abhinav C. A rare case of subcutaneous phaeohyphomycosis caused by aRhytidhysteronspecies: a clinico-therapeutic experience. Int J Dermatol 2014; 53:1485-9. [PMID: 24898242 DOI: 10.1111/ijd.12529] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Vikram K. Mahajan
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Vikas Sharma
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Neel Prabha
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Kamlesh Thakur
- Department of Microbiology; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Nand Lal Sharma
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Shivaprakash M. Rudramurthy
- Department of Mycology Division; Department of Medical Microbiology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - Pushpinder S. Chauhan
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - Karaninder S. Mehta
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
| | - C. Abhinav
- Department of Dermatology; Venereology and Leprosy; Dr Rajendra Prasad Government Medical College; Kangra at Tanda Himachal Pradesh India
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Khatri G, Mahajan VK, Chauhan PS, Mehta KS, Chander B, Gupta M. Plasmoacanthoma of oral cavity and plasma cell cheilitis: two sides of same disorder “oral plasma cell mucositis” ? Our Dermatol Online 2014. [DOI: 10.7241/ourd.20142.42] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mahajan VK, Sharma V, Gupta M, Chauhan PS, Mehta KS, Garg S. Parthenium dermatitis: is parthenolide an effective choice for patch testing? Contact Dermatitis 2014; 70:340-3. [PMID: 24617958 DOI: 10.1111/cod.12194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/12/2013] [Accepted: 12/10/2013] [Indexed: 01/19/2023]
Affiliation(s)
- Vikram K. Mahajan
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
| | - Mrinal Gupta
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
| | - Swati Garg
- Department of Dermatology, Venereology and Leprosy; Dr R. P. Govt. Medical College; Kangra (Tanda) 176001 India
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Abhinav C, Mahajan VK, Mehta KS, Chauhan PS. Angina bullosa hemorrhagica-like lesions: a rare presentation of drug-induced thrombocytopenia. Int J Dermatol 2013; 54:819-22. [PMID: 24320216 DOI: 10.1111/ijd.12143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 09/28/2012] [Accepted: 12/15/2012] [Indexed: 01/19/2023]
Affiliation(s)
- C Abhinav
- Department of Dermatology, Venereology and Leprosy, Dr Rajendra Prasad Government Medical College, Kangra (Tanda), India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr Rajendra Prasad Government Medical College, Kangra (Tanda), India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr Rajendra Prasad Government Medical College, Kangra (Tanda), India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr Rajendra Prasad Government Medical College, Kangra (Tanda), India
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Affiliation(s)
- Yasha Upendra
- Department of Dermatology, Venereology and Leprosy, Kangra (Tanda), Himachal Pradesh, India
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Prabha N, Mahajan VK, Sharma SK, Sharma V, Chauhan PS, Mehta KS, Abhinav C, Khatri G, Chander B, Tuli R. Optic nerve involvement in a borderline lepromatous leprosy patient on multidrug therapy. LEPROSY REV 2013; 84:316-21. [PMID: 24745131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Amidst the plethora of ocular complications of leprosy, involvement of the posterior segment or optic nerve is extremely rare. The mechanism of optic neuritis in leprosy is poorly understood. A 47 year-old man presented with a single lesion suggestive of mid-borderline (BB) leprosy over left periorbital region; the histology showed borderline lepromatous (BL) leprosy with a BI of 3+. After initial improvement with WHO MDT-MB and prednisolone (40 mg/d) he developed sudden and painless diminished vision in the left eye, about 3 weeks later. His visual acuity was 6/9 in the left and 6/6 in the right eye, and there was left optic disc edema, hyperemia and blurred disc margins. Treatment with prednisolone (60 mg/d) along with WHO MDT-MB continued. A month later he returned with painless diminished vision in the other eye as well. Visual acuity was 6/6 in the right and 6/12 in the left eye, and there was right optic disc edema and left optic disc atrophy. CT of the head and MRI of the brain were normal. Inflammatory edema of the orbital connective tissue or other surrounding structures, or direct infiltration of vasa nervosa with resultant vascular occlusion leading to optic nerve ischemia, seems the most plausible explanation of optic nerve involvement in this case.
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Mahajan VK, Chauhan PS, Mehta KS, Abhinav C, Sharma V, Thakur K. Subcutaneous phaeohyphomycosis of the face presenting as rhinoentomophthoramycosis. Int J Dermatol 2013; 52:1105-8. [PMID: 23834722 DOI: 10.1111/ijd.12166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Subcutaneous phaeohyphomycosis is the most common variety of phaeohyphomycosis and presents as asymptomatic or mildly painful, localized cysts, abscesses, or sometimes chromoblastomycosis-like lesions over the feet, legs, or hands in about 60-85% of cases. It usually afflicts adults with some degree of immunosuppression. METHODS We report a 30-year-old man, who presented with features of recurrent sinusitis (episodes of fever, nasal stuffiness, paranasal sinus pain, and tenderness), mucosal hypertrophy of the maxillary sinuses, and mid-face swelling that was freely mobile and suggestive of rhinoentomophthoramycosis. He had no other associated illness. RESULTS Histology suggested tumid lupus erythematosus. The diagnosis was based on Fonsecaea pedrosoi cultured from a biopsy specimen. CONCLUSIONS Combination therapy with itraconazole and saturated solution of potassium iodide (SSKI) was more effective than itraconazole used alone.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), Himachal Pradesh, India.
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Mahajan VK, Sharma AL, Chauhan PS, Mehta KS, Sharma NL. Early treatment with addition of low dose prednisolone to methotrexate improves therapeutic outcome in severe psoriatic arthritis. Indian J Dermatol 2013; 58:240. [PMID: 23723489 PMCID: PMC3667301 DOI: 10.4103/0019-5154.110847] [Citation(s) in RCA: 5] [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: 01/19/2023] Open
Abstract
Psoriatic arthritis (PsA) is increasingly being recognized to cause progressive joint damage and disability. PsA unresponsive to non-steroidal anti-inflammatory drugs (NSAIDs), the conventional first-line choice of treatment, is usually managed with disease-modifying antirheumatic drugs (DMARDs) especially methotrexate. An 18-year-old HIV-negative male had progressively severe PsA of 4-month duration that was nearly confining him to a wheel chair. He did not respond to multiple NSAIDs, alone or in combination with methotrexate (15 mg/week), given for 4 weeks. Addition of prednisolone (10 mg on alternate days) controlled his symptoms within a week. The NSAIDs could be withdrawn after 4 weeks as the treatment progressed. The doses were tapered for methotrexate (5 mg/week) and prednisolone (2.5 mg on alternate days) every 8 weekly subsequently during 15 months of follow-up without recurrence/deformities or drug toxicity. For years, the use of corticosteroids in psoriasis has been criticized for their propensity to exacerbate the skin disease on withdrawal. However, monitored use of corticosteroids, even in low doses, combined with DMARDs may be a good therapeutic option in early stage of the PsA rather than 'steroid rescue' later. This will help in early control of joint inflammation, prevent joint damage and maintain long-term good functional capacity and quality of life. This may be useful when the cost or availability of biologics precludes their use. However, we discourage the use of corticosteroids as monotherapy.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Government Medical College, Kangra, (Tanda), Himachal Pradesh, India
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Sharma S, Chauhan PS, Sharma V, Sharma NL. Dark age vampires or our poor patients. Indian J Dermatol 2013; 58:412. [PMID: 24082237 PMCID: PMC3778832 DOI: 10.4103/0019-5154.117375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Seema Sharma
- From the Department of Paediatrics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, India,Address for correspondence: Dr. Seema Sharma, H No 23, Type 5, Block B, Dr Rajendra Prasad Government Medical College and Hospital, Tanda, India. E-mail:
| | - Pushpinder S Chauhan
- Department of Dermatology, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, India
| | - Vipin Sharma
- Department of Orthopaedics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, India
| | - NL Sharma
- Department of Dermatology, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, India
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Mahajan VK, Chauhan PS, Sharma NL, Sharma AL, Mehta KS. Severe vasculonecrotic erythema nodosum leprosum following thalidomide withdrawal without tapering doses: do we have something unusual? Braz J Infect Dis 2011. [DOI: 10.1016/s1413-8670(11)70148-9] [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: 10/27/2022] Open
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Bhagwat D, Kharya MD, Bani S, Pandey A, Chauhan PS, Kour K, Suri KA, Satti NK, Dutt P. Cyperus scariosus Chloroform Fraction Inhibits T cell Responses in Balb/C Mice. TROP J PHARM RES 2009. [DOI: 10.4314/tjpr.v8i5.48083] [Citation(s) in RCA: 2] [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: 11/17/2022] Open
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Das B, Chauhan PS, Seshadri M. Minimal sharing of Y-chromosome STR haplotypes among five endogamous population groups from western and southwestern India. Hum Biol 2005; 76:743-63. [PMID: 15757245 DOI: 10.1353/hub.2005.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We attempt to address the issue of genetic variation and the pattern of male gene flow among and between five Indian population groups of two different geographic and linguistic affiliations using Y-chromosome markers. We studied 221 males at three Y-chromosome biallelic loci and 184 males for the five Y-chromosome STRs. We observed 111 Y-chromosome STR haplotypes. An analysis of molecular variance (AMOVA) based on Y-chromosome STRs showed that the variation observed between the population groups belonging to two major regions (western and southwestern India) was 0.17%, which was significantly lower than the level of genetic variance among the five populations (0.59%) considered as a single group. Combined haplotype analysis of the five STRs and the biallelic locus 92R7 revealed minimal sharing of haplotypes among these five ethnic groups, irrespective of the similar origin of the linguistic and geographic affiliations; this minimal sharing indicates restricted male gene flow. As a consequence, most of the haplotypes were population specific. Network analysis showed that the haplotypes, which were shared between the populations, seem to have originated from different mutational pathways at different loci. Biallelic markers showed that all five ethnic groups have a similar ancestral origin despite their geographic and linguistic diversity.
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Affiliation(s)
- Birajalaxmi Das
- Low Level Radiation Studies Section, Bio-Science Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India
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Das B, Chauhan PS, Seshadri M. Genetic variation observed at two tetrameric short tandem repeat loci on chromosome 12 (D12S66 and D12S67) among five distinct ethnic groups of India: detection of two new alleles. Ann Hum Biol 2002; 29:513-25. [PMID: 12396371 DOI: 10.1080/03014460110119766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The present investigation reports the genetic variation observed at two tetrameric short tandem repeat (STR) loci on chromosome 12 (D12S66 and D12S67) among five anthropologically distinct population groups of India. SUBJECTS AND METHODS A total of 277 random, normal and healthy volunteers were investigated for the D12S66 locus, and 236 for the locus D12S67, from five ethnic groups of India. Two of these belong to the state of Maharashtra in western India (Konkanastha Brahmins and Marathas) and three from the state of Kerala in South India (Nairs, Ezhavas and Muslims). DNA was extracted from peripheral blood samples, amplified by duplex polymerase chain reaction (PCR) and electrophoresed on 6% denaturing urea (7 M) gel electrophoresis. The analysis was performed on ALF Express DNA sequencer (Amersham Pharmacia Biotech) using Fragment Manager software. Statistical analysis was done by using Arlequin ver. 1.1. RESULTS At D12S66 locus, a total of nine alleles (8-17 repeats) and 27 genotypes were detected with an observed heterozygosity ranging from 0.55 to 0.91. At the D12S67 locus, nine alleles (36-44 repeats) and 33 genotypes were observed with a heterozygosity ranging from 0.74 to 0.89. Both the loci displayed high Power of Discrimination (PD) which ranged from 0.81 to 0.91 and Polymorphic Information Content (PIC) ranging from 0.68 to 0.84. At D12S66, two alleles were detected for the first time in these population groups which were not reported earlier. The level of gene differentiation (G(ST) value, 0.02) was moderate at these two loci, indicating a close relationship among the population groups. CONCLUSIONS From this investigation, it is concluded that both the tetrameric loci are highly polymorphic and informative, and can be used for the characterization of the Indian population groups in addition to other well-studied STR loci.
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Affiliation(s)
- Birajalaxmi Das
- Low Level Radiation Research Laboratory, Cell Biology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400 085, India
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Das B, Ghosh A, Chauhan PS, Seshadri M. Genetic polymorphism study at four minisatellite loci (D1S80, D17S5, D19S20, and APOB) among five Indian population groups. Hum Biol 2002; 74:345-61. [PMID: 12180760 DOI: 10.1353/hub.2002.0028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The present study reports the genetic variation observed among five anthropologically distinct population groups of India, using four highly polymorphic minisatellite loci (D1S80, D17S5, D19S20, and APOB 3' VNTR) in order to examine the effect of geographical and linguistic affiliations on the genetic affinities among these groups. Random individuals from five ethnic groups were studied; the sample size ranged from 235 to 364. The population groups belong to two geographically separated regions of India, the state of Maharashtra (western India) and the state of Kerala (southern India). The two Maharashtrian groups (Konkanastha Brahmins and Marathas) speak "Marathi," an Indo-European language, whereas the three Kerala population groups (Nairs, Ezhavas, and Muslims) speak "Malayalam," an Indo-Dravidian language. Genomic DNA was extracted from peripheral blood samples and analyzed using amplified fragment length polymorphism (Amp-FLP) technique. All four loci displayed high heterozygosity with average heterozygosity in the range of 0.82 to 0.84. The Polymorphic Information Content and Power of Discrimination were > or = 0.75 and > or = 0.80, respectively. The coefficient of gene differentiation was found to be low (average G(ST) = 1.2%; range between 0.6% at D1S80 locus to 1.6% at APOB 3' VNTR locus) across the loci, indicating close affinity among the population groups. The neighbor-joining tree revealed two clear clusters, one for the two Maharashtrian population groups and the other for the three Kerala population groups. The results obtained are in conformity with the geographical and linguistic backgrounds of the studied populations.
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Affiliation(s)
- Birajalaxmi Das
- Cell Biology Division, Bhahha Atomic Research Centre, Trombay, Mumbai, India
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