Chalazion is one of the most common eyelid masses seen by ophthalmologists in outpatient clinics. It presents with slowly growing painless cystic lesion affecting eyelids. Chalazion arises due to obstruction of the meibomian gland ducts leading to retained secretion. The exact incidence of chalazion is variable among the studies and it differs depending on certain predisposing factors. Many factors ae known to predispose to chalazion formation including hormonal changes during puberty and pregnancy, viral and bacterial infection, rosacea, exposure to air pollutants, poor eyelid hygiene, chronic blepharitis, seborrheic dermatitis, eyelid trauma, immune deficiency states, eyelid trauma, hyperlipidemia, tuberculosis, and leishmaniasis. This article will review these factors as well as the incidence of chalazion.
Acute Vasitis a rare condition, but one that can present with a diagnostic dilemma, if not recognized and managed appropriately, may lead to unnecessary surgical interventions with consequent morbidity for the patient. A 27 year old healthy male, presented with left scrotal pain associated with inguinoscrotal swelling. Physical examination revealed left scrotum tenderness and swelling extended along left inguinal area. CT showed multi loculated cystic fluid collection within left seminal vesicle. Acute Vasitis is a rare differential diagnosis for acute scrotum and This case report summarizes the importance of identifying it and how imaging can prevent unnecessary surgical intervention.
ObjectivesTo evaluate through a systematic review the effectiveness of electronic methods in monitoring adherence to regular inhaled corticosteroids (ICS) alone or in combination with long-acting β2-agonists (LABAs) and their effect on clinical outcomes.DesignA narrative systematic review.Data sourcesMEDLINE, EMBASE, Cochrane Database of Systematic Reviews and Web of Science were searched through up to 10 July 2022.Eligibility criteriaWe included peer-reviewed studies of qualitative and quantitative outcomes that compared the effect of electronic methods to routine non-electronic monitoring intervention or placebo among children and adults with asthma on medication adherence rates to regular ICS alone or in combination with LABA, asthma control and asthma exacerbations.Data extraction and synthesisData extraction was performed according to a predetermined sheet specific to the review objectives. The risk of bias was assessed using the Cochrane Risk of Bias Tool for randomised controlled trials and the Risk of Bias in Systematic Reviews tool for systematic reviews. Meta-analysis was not possible based on the findings of the scoping search; however, a narrative review was performed to allow for the grouping of results based on asthma inhaler adherence rates, asthma control and exacerbations.ResultsSix articles comprising 98 studies published from 1998 to 2022 in the USA, Canada and the UK were included. Compared with the control, electronic monitoring devices (EMDs) showed a 23% adherence improvement, mean difference (MD) of 23%, 95% CI 10.84 to 34.16, p=0.0002. Asthmatic children were 1.5 times more likely to be adherent using EMDs compared with non-EMD users (RR=1.5, 95% CI 1.19 to 1.9) (p<0.001). Mobile devices and text message reminders (MHealth) showed a 12% adherence improvement (MD 12%, 95% CI 6.22 to 18.03) (p<0.0001), alongside a small to medium improvement in asthma control (standardised mean difference (SMD) 0.31, 95% CI 0.17 to 0.44), small improvement in asthma-related quality of life (SMD 0.26) (p=0.007) and variable risk reduction in asthma exacerbations for digital health (risk ratio 0.53, 95% CI 0.32 to 0.91) (p=0.02) compared with EMDs, which showed insignificant differences (risk ratio 0.89, 95% CI 0.45 to 1.75) (p=0.72). Technologies combined yielded variable adherence effects, with an SMD for eHealth of 0.41, 95% CI 0.02 to 0.79, and MD for digital health was 14.66% higher than the control, 95% CI 7.74 to 21.57. Heterogeneity between studies was significant (eHealth I2=98%, digital I2=94%).ConclusionElectronic methods improved adherence to inhaled medications in asthma. EMDs appear to be the most effective technology, followed by mHealth. The adherence improvement was associated with a small clinical improvement. There was inconsistent overlapping of terminology describing electronic methods that require standardisation. Data on the cost-effectiveness of electronic devices and their utilisation in severe asthma are lacking and require further research.PROSPERO registration numberCRD42022303069.
Introduction: Lichenoid granulomatous dermatitis (LGD) is widely encountered lesions with both oral as well as dermal manifestation. Present study was done to evaluate lichenoid granulomatous stomatitis cases. Materials and methods: 226 biopsies were exposed to special stains such as acid-fast bacilli (AFB), immunohistochemical staining for CD 68 and Grocott methenamine-silver (GMS), and periodic acid‐Schiff (PAS) stains. Results: Out of 226 patients, males were 84 and females were 142. Maximum cases were seen in age group 40–60 years (122) followed by >60 years (56) and 20–40 years (48). The common site was buccal mucosa seen in 128 (56.6%) cases followed by vestibule in 30 (13.2%), gingiva in 26 (11.5%), tongue in 20 (8.8%), lip in 12 (5.3%) and palate in 10 (4.4%). The common lesion was oral lichen planus seen in 142 (62.8%), carcinoma in situ in 12 (5.3%), squamous cell carcinoma in 8 (3.53%), pemphigus vulgaris in 10 (4.42%), leukoplakia in 24 (10.6%) and pemphigoid in 30 (13.2%) cases. Most lesions were of type I seen in 117 (51.7%) cases. Conclusion: Lichenoid granulomatous dermatitis poses variety of clinical as well as oral features. A long standing follows up and consideration of differential diagnosis is mandatory for better management of patients.
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