Papers by V.NIVEDITA DEVI
Journal of Cutaneous and Aesthetic Surgery, Oct 1, 2020
Indian journal of applied research, Jan 29, 2020
Objective: To report our experience with two tests, anti-cardiolipin antibody test [venereal dise... more Objective: To report our experience with two tests, anti-cardiolipin antibody test [venereal disease reasearch laboratory (VDRL) test] and specific treponemal test (Treponema pallidum hemagglutination assay), used for screening antenatal, high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008. Methods: A total of 14 639 samples received from various patient groups including antenatal cases, patients attending sexually transmitted disease (STD) clinic, blood donors and HIV positive patients were screened. Results: Among the 14 639 samples collected, 103 were positive by VDRL test. Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay. The cumulative seroprevalence over two years was found to be 0.61% in this study. The syphilis seroprevalence reduced from 0.88% in 2006 to 0.40% in 2008. Among the various sub-populations studied, patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%. The seroprevalence decreased significantly from 4.00% in 2006 to 1.39% in 2008. Conclusions: Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence. These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.
Indian Journal of Sexually Transmitted Diseases and AIDS, 2020
A 19-year-old female with untreated syphilis (venereal disease research laboratory test reactive)... more A 19-year-old female with untreated syphilis (venereal disease research laboratory test reactive) delivered a female child at 34 weeks with low birth weight, intrauterine growth retardation, respiratory distress, and bilateral pedal edema. One week later, the baby was found to be having pansystolic murmur confirmed by ECHO as patent ductus arteriosus. At 2 weeks, the baby developed maculopapular rash; hepatomegaly; and swelling of the shoulder, knee, ankle, wrist, and medial end of the clavicle. Both parents and baby were rapid plasma reagin test. X-ray showed Wimberger's sign at the upper end of the tibia. A diagnosis of congenital syphilis was made. The baby became asymptomatic after giving injection benzylpenicillin for 10 days.
Journal of Evidence Based Medicine and Healthcare, 2015
To study herpes zoster in HIV positive patients in relation to CD4 count. 2. To study the various... more To study herpes zoster in HIV positive patients in relation to CD4 count. 2. To study the various clinical presentations, common sites, and demographic characteristics of herpes zoster in HIV. MATERIALS AND METHODS: A study was conducted on 94 HIV patients with a clinical diagnosis herpes zoster attending DVL OPD of Government General Hospital, Kakinada. Severity of rash was graded depending on the number of lesions as mild (<25), moderate (25-50) and severe (>50).Assessment of intensity of pain was done using visual analog scale (VAS), a numerical rating scale marked from 0 to 10 in increasing order of severity. The relation of CD4 count and herpes zoster and complications of zoster were recorded. RESULTS: The maximum incidence of herpes zoster was found in the sexually active age group with higher incidence in males53.1% and urban people 55.3%. Patients with severe rash were 57.4% moderate rash 31.9% and mild rash 10.6%. At the time of presentation, majority 51.06% had vesicular rash. The most common symptom was pricking pain followed by burning sensation and stabbing pain. Most of the patients had thoracic dermatome involvement in 51, cer vical in 18, trigeminal nerve in 16and lumbar in 9. Ophthalmic branch the relation of CD4 count and is involved in 7, maxillary in 5 and mandibular in 4. Majority 18 (19.14%) were in the CD4 range 200-249, 15 between CD4 150-199 and 11 between CD4 350-399. Complications noted were post herpetic neuralgia, secondary bacterial infection, scarring, conjuntivis, facial palasy and keratitis. Multidermatomal involvement is seen in 15.95%.
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Pruritic Papular Eruption (PPE) of HIV is the commonest cutaneous manifestation seen i... more BACKGROUND Pruritic Papular Eruption (PPE) of HIV is the commonest cutaneous manifestation seen in HIV positive patients. PPE clinically presents as bilaterally symmetrical itchy papules over trunk and extremities especially in late stages of HIV infection posing a therapeutic challenge to the clinician for precise diagnosis and management. Aims and Objectives-The present study was aimed to separate Pruritic papular eruption of HIV (PPE) which is an independent entity that clinically resembles other dermatoses presenting as pruritic papular lesions on the basis of clinical and histopathological data and to correlate with CD4 count. MATERIALS AND METHODS The prospective study is conducted in Department of Dermatology at Rangaraya Medical College, Kakinada, Andhra Pradesh. 78 clinically diagnosed cases of PPE were enrolled in the study after confirming HIV status and evaluated clinicohistopathological spectrum of PPE. CD4 count was done in all cases. RESULTS Out of 78 cases of PPE, 34 were male and 44 were female. 85% of cases belong to 20-40 years age group. Heterosexual route is the major mode of transmission in 74 cases (94.9%). Histopathological concordance was achieved in only 60 cases of PPE (76.92%). Grade-1 only extremities in 5 cases (9%), Grade-2 Trunk and extremities in 33 cases (55%) and Grade-3 generalised in 22 cases (36%). Histology showed hyperkeratosis, acanthosis in 47 cases (78.33%), spongiosis in 38 cases (63.3%) and perivascular, periadnexal, perifollicular infiltration of lymphocytes in all cases of PPE. CD4 counts less than 200 were found in 42 (71.66%) PPE cases. CONCLUSION PPE of HIV is an independent entity distinguished from other conditions like eosinophilic folliculitis and papular urticaria by the involvement of perivascular, periadnexal and perifollicular infiltration of lymphocytes which is the characteristic feature. This work highlights the necessity of histopathology for proper diagnosis and management of PPE in HIV patients.
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Basal Cell Carcinomas (BCC) are the most common amongst the non-melanoma skin cancers.... more BACKGROUND Basal Cell Carcinomas (BCC) are the most common amongst the non-melanoma skin cancers. The existing literatures on BCC are scant in India. BCC are rare in dark skin, because of the inherent photoprotection of melanin and melanosomal dispersion. Risk factors include UV light exposure, ionising radiation, exposure to arsenic, mutations. Although, BCCs have excellent prognosis, if left untreated it causes significant disfigurement and invasion of surrounding tissues. The present study was aimed to evaluate the risk factors, clinical and histopathological spectrum of BCC in Eastern Andhra Pradesh. The objectives were to analyse clinical data with respect to age, sex, occupation, sunlight exposure, anatomical location, size of the lesion, morphological and histopathological subtypes. MATERIALS AND METHODS The present study was conducted in DVL Department, Rangaraya Medical College, Kakinada, Andhra Pradesh. A prospective analysis of 40 cases of BCC in a period of 3 years: January 2014-December 2016 diagnosed and confirmed histopathologically. RESULTS Out of 40 cases, 65% were females. History of exposure to the sunlight was observed in all the cases. One case of 18-year-old female with xeroderma pigmentosum with BCC was seen. Sites noted were forehead (22.5%), ear, nose and infraorbital region (each 15%). Clinically, pigmentation was evident in 19 cases. Morphological types seen were ulcerative (55%), nodular (37.5%), swelling/cyst (5%) and morpheaform (2.5%). Histological types are nodular (57.5%), pigmented (25%), adenoid (7.5%), keratotic (2.5%) and with sebaceous differentiation (2.5%). Recurrent BCCs were seen in two cases. CONCLUSION This study highlights the role of sunlight and farming as aetiological risk factors of BCC and female preponderance. Forehead is the common site of presentation. Nodular and pigmented types (subtype of nodular variant) were common. Early detection of BCC lesions, particularly of small size (< 2 cm) helps in preventing further recurrences.
Aims and Objectives: To study the seroprevalence of HSV infection in patients attending STI clini... more Aims and Objectives: To study the seroprevalence of HSV infection in patients attending STI clinic, Government General Hospital, Kakinada and to note the association of HSV seropositivity with HIV infection and other risk factors. Material and Methods: 82 consecutive STI clinic attendees of both sexes of 15-70 years with STI complaints were included in this study. Serum samples were screened for HSV-1 and HSV-2 type specific IgM and IgG antibodies by ELISA-Euroimmune Kits. Results: Out of 82 patients, 42 females and 40 males, 39 had genital herpes (including 5 cervicitis) and 43 had other STDs like genital candidiasis, non specific urethritis, condyloma acuminata, molluscum contagiosum and erectile dysfunction. Two were seropositive for HSV-1 IgM, 68 (82.9%) for HSV-1 IgG, 4 for HSV-2 IgM and 40(48.8%) for HSV-2 IgG.12 Tzanck smears were positive. All were RPR nonreactive. Discussion: HSV-1 and HSV-2 seropositivity was high in uneducated, urban low socioeconomic people. HSV-2 seropr...
Introduction: Skin disorders are extremely common in HIV individuals. CD4 counts are key markers ... more Introduction: Skin disorders are extremely common in HIV individuals. CD4 counts are key markers for determining the disease process and the risk of opportunistic infections. Aim of the study was to evaluate the pattern of skin disorders in HIV positive children in relation to CD4 counts. Material and Methods: A cross sectional study onHIV infected children attending Government General Hospital Kakinada over a period of 14 months. CD 4 counts were estimated and their severity and atypical presentations correlated with the CD4 counts. Results: 83 patients were enrolled. Of which 39 were male and 44 were female. The most common skin disorder in the study was scabies infestation with secondary impetiginisation. Most common non infectious disorder was generalised xerosis followed by papular pruritic eruption and eosinophilic pustular folliculitis which was associated with a CD4 count below 250. Conclusion: HIV infected children are more prone to develop common childhood infections such ...
Epidermodysplasia Verruciformis (EDV), is a rare autosomal recessive genodermatosis with cases li... more Epidermodysplasia Verruciformis (EDV), is a rare autosomal recessive genodermatosis with cases linked to chromosome X, and attributed to infection by specific types of Human Papilloma Virus (HPV) in immunologically deficient individual. There is an increased prevalence and decreased clearance of HPV infections in HIV infected patients. Malignant change occurs in about 20-30% cases mainly on sun exposed areas. Clinically presents as plane warts, reddish verrucous plaques or pityriasis versicolor like lesions mostly on sun exposed sites. There is no effective treatment. We present an 19 years old married HIV positive female case with asympotamatic hypopigmented macules and flat topped papules on face, neck, trunk and upper extremities since 4months. Punch biopsy of lesion on forearm showed epidermal acanthosis, hypergranulosis, hyperkeratosis, mild papillomatosis, enlarged, and altered keratinocytes with purple-blue cytoplasm suggestive of EDV. After clinico-histopathological correlat...
Background: Cutaneous warts are common dermatological conditions caused by the human papilloma vi... more Background: Cutaneous warts are common dermatological conditions caused by the human papilloma virus (HPV). Immunotherapy has now found a significant place in the treatment of warts because of its non-destructive action, ease of use, and promising results. Objectives:To compare efficacy between intalesional MMR and BCG in treatment of verruca vulgaris. Method: 30 Patients were included in study and divided into two groups. Group1:This group included 15 patients subjected to intralesional MMR. Group 2:This group included 15 patients subjected to intralesional BCG. Only single wart was injected at 2-weeks interval until complete clearance or for a maximum of 5 treatments. Follow up of patients was done every month for 3 months for clinical assessment of results and to show any recurrence. Results: In group1: 73.3% of patients showed complete lesional clearance and 46.6% showed distant lesional clearance . 6% showed erythema around lesion & 26.6% showed hyperpigmentation. In group 2:33...
Objectives. To differentiate between suspicious lesions requiring biopsy and insignificant lesion... more Objectives. To differentiate between suspicious lesions requiring biopsy and insignificant lesions thus reducing the number of biopsies. Methods.Hundred STD outpatients from January to May 2008 were included in the present study. After microscopic examination of wet films, endocervical smear and PAP smear, colposcopic findings without and with green filter, acetowhitening,and Lugol’s iodine uptake were noted as normal, grade 1, 2 and 3. Biopsy was taken from suspicious sites. Colposcopic findings were correlated with PAP smear and biopsy reports. Observations. Dysplasias were common in sexually active multies and HIV positives. Leucorrhoea of erosion cervix, cervical polyps, cervical tears, candidiasis and bacterial vaginosis colposcopically did not require biopsy. Benign grade1 changes (41%) correlated with PAP smear reports (inflammatory36% mild dysplasia 18%). The premalignant grade 2(13%) & grade 3 (5%) colposcopy changes of chronic cervicitis histologically revealed chronic non...
Introduction: External environment, dietary habits and socioeconomic status influence paediatric ... more Introduction: External environment, dietary habits and socioeconomic status influence paediatric skin diseases. A prospective study was conducted from December 2011 to July 2013 to evaluate the prevalence and patterns of genital dermatoses in children attending D.V.L. & Paediatric OPDs, Government General Hospital, Kakinada. Materials and Methods: After informed consent, 200 children of 1-18 years with genital dermatoses confirmed by relevant bed side laboratory investigations were enrolled in the present study. They were grouped based on age as toddlers (1-3years), preschool (3-6 years), school going (6-10 years) and adolescents (9-18 years). Results: Out of 200 children, 132 males and 68 females, 25.9% was school going. Out of 173 children having infective dermatoses, 80.35% were hostel residents, mostly from rural area belonging to low (42.2%) and middle (57.8%) socio-economic status. The most common infective dermatoses in preschool children was bullous impetigo (8.12%) and in a...
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Papers by V.NIVEDITA DEVI