Severe vitamin D deficiency and rickets are highly prevalent among children with congenital ichthyosis. We report an incidental observation of a dramatic and excellent clinical response with regard to skin scaling and stiffness in children with congenital ichthyosis after short-term high-dose vitamin D supplementation that has not been previously described. Seven children with congenital ichthyosis (5 with autosomal recessive congenital ichthyosis; 2 with epidermolytic ichthyosis) and severe vitamin D deficiency (and/or rickets) were given 60 000 IU of oral cholecalciferol daily for 10 days under supervision. All children were subsequently put on recommended daily allowance of 400 to 600 IU of cholecalciferol. The main outcome measures observed and studied were reduction in skin scaling and stiffness of the extremities. All cases had severe vitamin D deficiency (serum 25-hydroxyvitamin D < 4 ng/mL) and secondary hyperparathyroidism. Six patients had clinical and radiologic evidence of rickets. Significant improvement in scaling was noticeable by day 5, showing further improvement by day 10, in 6 of the 7 cases. At 1 month, the skin had become near normal in all the cases of autosomal recessive congenital ichthyosis. Remarkable reduction in stiffness was also observed in all children. Supplementation with high-dose vitamin D followed by recommended daily allowance appears to be an effective form of therapy in the management of congenital ichthyosis with vitamin D deficiency.
Background Vitiligo manifests as hypo-to de-pigmented macules, which are sometimes associated with leukotrichia. For complete cosmetic improvement, the repigmentation of leukotrichia is an important component. Methods This randomized controlled trial included patients with stable vitiligo with leukotrichia. Two vitiligo patches in each patient were randomized to receive either of the two procedures. The patients were followed up for 9 months posttransplantation. The efficacy of hair follicle cell suspension (HFCS) with epidermal cell suspension (ECS) in repigmentation of leukotrichia and skin in vitiligo was compared. Results A total of 20 patients underwent the procedure, and 19 completed the follow-up. The area of the vitiligo patch and the number of leukotrichia in the patches were comparable between the two groups. There was a significant difference in the mean AE S.D. number of cells transplanted between the two groups (5.06 9 10 5 in HFCS vs. 39.8 9 10 5 in ECS, P < 0.0001). The percentage viability of cells and proportion of melanocytes were comparable between the two groups. A total of 10 patients in HFCS and eight patients in ECS had repigmentation of leukotrichia. The mean AE S.D. percentages of depigmented hair showing repigmentation at nine months were 7.42 AE 11.62% in HFCS and 11.42 AE 17.90% in ECS (P = 0.4195), whereas the mean AE S.D. percentage repigmentation of vitiligo patches was 61.58 AE 42.68% in HFCS and 78.68 AE 30.03% in ECS (P = 0.1618). Conclusions The mean number of cells transplanted in the HFCS group was about eight times less than those in ECS. ECS was better than HFCS in repigmentation of leukotrichia and vitiligo, although the difference was not statistically significant.
Background: Bacterial vaginosis (BV) is the most prevalent cause of abnormal vaginal discharge among pre-menopausal women and associated with adversities of sexual and reproductive health. The present study aimed to identify potential epidemiological and behavioural risk factors and clinical predictors of BV among women in Delhi, India. Methods: A cross-sectional study was conducted to assess 283 non-pregnant women aged 18–45 years for BV using Nugent’s scoring criteria. Information on demographics, sexual behaviours, hygiene practices and clinical symptoms was obtained and evaluated for their association with Nugent-BV status. Results: A positive diagnosis for Nugent-BV was made in 69 (24.4%) participants, 55 (19.4%) were intermediate and 159 (65.2%) were negative for Nugent-BV. Infertility ( p = .02) and recent unprotected sexual exposure ( p = .02) were strongly associated with Nugent-BV. On the other hand, women who reported regular use of condoms during intercourse were more likely to test negative ( p = .03). None of the patient complaints, however, had any significant correlation with Nugent-BV diagnosis. Conclusion: Women in their reproductive years share the highest burden of adversities associated with bacterial vaginosis. History of infertility, recent unprotected sexual exposure and frequent use of condoms were correlates having significant associations with Nugent-BV.
Bacterial vaginosis (BV) is diagnosed by the microbiological Nugent scoring method or clinical Amsel’s criteria. Assessment of 404 vaginal samples (293 women) identified 110 (27.2%), 108 (26.7%) and 161 (39.9%) samples to be BV-positive using Nugent’s method, standard Amsel’s criteria and simplified Amsel’s criteria respectively. The sensitivity, specificity, and kappa statistic (κ) for standard and simplified Amsel’s criteria were 71.8% (95% CI=62.4–80.0), 90.1% (95% CI=62.4–86.1), 0.62 (95% CI=0.53–0.72) and 88.2% (95% CI=80.6–93.6), 78.2% (95% CI=73.1–82.8), 0.58 (95% CI=0.49–0.67), respectively. A combination of vaginal pH and clue cells exhibited the highest concordance (κ=0.64, 95% CI=0.54–0.74) with Nugent’s method and may be used for simplified BV diagnosis.
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