Background: Cutaneous and mucosal disorders are of the common problems in patients on long term haemodialysis. The aim of this study was to evaluate the frequency and nature of cutaneous lesions among patients with chronic kidney diseases who received maintenance haemodialysis.Methods: Eighty patients with chronic kidney diseases on haemodialysis were studied. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.Results: The patients were 30 females and 50 males with a mean age of 47.6 years. The duration of haemodialysis was 36±11 months. All patients included in this study had at least one cutaneous manifestation attributable to CRF. The most prevalent findings were xerosis (66.2%) followed by pallor (57.5%), pruritus (51.25%), infections (33.75%), AV shunt dermatitis (16.25%), pigmentary changes (13.75%), purpura, ecchymoses (8.75%) and perforating disorders (2.5%). Hair changes were diffuse alopecia (16.25%), brittles, lustreless hair (3.75%) and sparse body hairs (1.25%). Oral changes were candidiasis (10%), angular cheilitis (3.75%), gingivitis (2.75%), fissured tongue (2.75%) and lichen planus (1.25%). Nail changes were leukonychia (10%), dystrophic nails (7.5%) onychomycosis (6.25%), subungual hyperkeratosis (5%) and half and half nails (1.25%).Conclusions: At least one cutaneous manifestation is found in all CRF patients. The etiology of CRF does not affect the cutaneous, hair or nail abnormalities. Factors such as diagnostic climate and early treatment influence some disorders such as xerosis, pruritus and infections.

Background: Herpes zoster (HZ) occurs due to reactivation of latent Varicella zoster virus infection and affects in dermatomal pattern. HZ affects elderly and immunocompromised population. Some earlier studies shows that HZ is common in diabetes patients. Our aim was to find out incidence of diabetes mellitus in patients with HZ.Methods: Study was done on newly diagnosed HZ patients attending out door of UPUMS Saifai. Inclusion criteria include newly diagnosed case of HZ without previous history of diabetes. Patients with known immunocompromised state like HIV infection, corticosteroid therapy, chemotherapy, neoplastic disease etc were excluded. Fasting, post-prandial blood sugar and HbA1C of all patients done.Results: 22.54% patients with HZ had diabetes and 7.75% patients had impaired glucose tolerance at presentation. Undiagnosed diabetes is common in HZ patients.Conclusions: Our study indicates that incidence of undiagnosed diabetes is high among HZ patients and hence routine screening for diabetes should be done in all HZ patients.

Background: Herpes Zoster, which presents as a localized, painful cutaneous eruption is a common clinical problem, caused by reactivation of latent Varicella Zoster Virus (VZV) and is usually self- limiting in healthy adults. In this era of HIV infection, HIV seropositive patients are at increased risk of severe or disseminated cutaneous or visceral involvement. Aim was to analyse the clinical pattern and epidemiological factors of Herpes Zoster and to know the HIV prevalence among patients with Herpes Zoster.Methods: A total of 110 patients with Herpes Zoster attending dermatology department at Uttar Pradesh university of medical sciences (UPUMS), Saifai, Etawah, India from a period of July 2015 to July 2017 were included in the study.Results: Out of 110 patients, 79 were males 31 were females. Age group varied from 8-80 years. Most common dermatomes involved were thoracic followed by ophthalmic division of trigeminal nerve. 33.6% of patients showed HIV seropositivity. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were above the age of 60 years. Post herpetic neuralgia was more commonly seen in seropositive individuals as compared to seronegative individuals.Conclusions: Disseminated zoster and multi-dermatomal involvement were encountered in immuno-compromised individuals. Post herpetic neuralgia was seen in elderly patients, especially in case of ophthalmic zoster.

Introduction: Posterior circulation territory stroke account for approximately one-fifth of all ischemic strokes. Basilar artery occlusion (BAO) remains a challenging diagnostic entity. BAO is associated with a high mortality rate and cases with spontaneous favorable outcomes are less frequently reported. We aim to assess the mortality and morbidity in BAO patients who presented beyond window period for thrombolytic therapy or interventional procedures. Methods: This study was a prospective observational study conducted at a tertiary care hospital. Thirty two patients admitted to Government Medical College Kota, who presented with a clinical diagnosis of acute basilar artery occlusion supported by imaging evidence (computerized tomography, magnetic resonance imaging or angiography). Demographic details including age, sex, risk factors were recorded for all the patients along with presenting symptoms and clinical signs with radiological correlation. Functional outcome was compared between two groups, namely mechanically ventilated and nonventilated patients. Functional outcome was assessed using modified Ranking scale (mRS) on admission and at the end of 1 month follow up. Results: Total 32 patients were enrolled during the study, which included 17 males and 15 females. Mean age of the enrolled patients was 54.14 years (range 33-67 years). Most common prodromal symptoms were vertigo and headache. Fourteen patients (43.7%) were comatose at the onset of symptoms, 4(12.5%) patients became comatose within 48 hrs of onset and one patient was in locked in state. Cranial nerve abnormalities and Cerebellar signs were observed in 12 and 8 patients respectively. Visual symptoms were observed in 4 patients in the form of either homonymous hemianopia or cortical blindness. Forty six percent patients in the mechanically ventilated group and 64% in the non-ventilated group were hypertensive. Out of all the patients, approximately 34% were diabetic and 38.75% had dyslipidemia. Out of 32 enrolled patients, 15 patients received mechanical ventilator support and 17 patients did not require it. Seven patients in the ventilation supported group while only 3 patients in the nonventilated group showed functional outcome improvement at the end of 1 month follow up. Three patients in without ventilator group deteriorated within seven days and two patients on ventilator supported group were deteriorated after 30 days and died. Five patients had no change in their mRS score at the end of 1month follow up. Conclusion: Prognosis of basilar artery occlusion patients, presenting beyond window period for thrombolysis or intervention, is poor with high mortality and morbidity. Study highlights the need for high index of suspicion for diagnosing basilar artery occlusion and the utility of mechanical ventilation in indicated cases, which may help for better functional outcome.

Background: Skin lesions both benign and malignant occur frequently in renal transplant recipients receiving long term immunosuppressive drugs. Aim was to study cutaneous manifestations in renal transplant recipients (RTRs).Methods: Thirty two patients with chronic kidney diseases who underwent renal transplant were included in the study. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.Results: Out of 32 patients, 23 (71.8%) were male and 9 (28.1%) were females. Skin infections occurred in 84.3% of the patients and most of them were fungal infections (37.5%), followed by viral infection in (31.2%) patients. Oral mucosal changes, hair and nail comprising of (34.3%), (71.8%), (43.7%) patients respectively. Only malignancy seen in one patient was basal cell carcinoma. Drug induced cutaneous manifestations were acneiform eruptions (18.75%), hirsutism (15.6%), hypertrichosis (9.3%), striae (6.25%), gingival hyperplasia (3.12%) and skin atrophy (3.12%).Conclusions: Skin lesions are a significant problem in renal transplant recipients. A careful monitoring of these patients is recommended for early diagnosis and treatment.