TUBERCULOUS PERITONITIS PRESENTING AS COLOENTERIC FISTULA

SUMMARY Abdominal tuberculosis can present as tuberculous peritonitis with generalised or loculated ascites, lymphadenitis of the mesenteric or retroperitoneal nodes, or as intestinal tuberculosis. In the last case it could be annular mucosal ulceration, single or multiple strictures or hyperplastic tuberculosis of the bowel, usually involving the terminal ileum or ileocaecal region. Disease higher in the ileum is considered common but involvement of the appendix, stomach, duodenum, jejunum, colon and rectum is unusual. Tuberculous peritonitis presenting as a coloenteric fistula is not a common clinical entity. In this case a patient who presented with peritonitis was found to have tuberculous peritonitis with coloenteric fistula.     

SKIN LESIONS IN HIV-POSITIVE AND HIV-NEGATIVE PATIENTS IN SOUTH INDIA

Background. Various dermatologic conditions have been reported to occur with increased frequency in human immunodeficiency virus (HIV)-positive individuals, but there are only a few studies comparing the prevalences of skin diseases in HIV-positive patients with those in matched HIV-negative controls. Methods. Skin lesions in 129 HIV-positive patients and 258 HIV-negative controls were studied prospectively over an 18-month period from October 1991 to March 1993. Results. Oral Candida, tinea cruris, and ichthyosis were significantly more common in HIV-positive patients compared to controls. Several other dermatologic conditions were found only in the HIV-positive group. Conclusions. The pattern of skin lesions in Indian patients with HIV infection may be different from that in the West.     

A Clinical Study of Childhood Alopecia Areata in Chandigarh, India

Abstract: All new cases of alopecia areata (AA) were studied during the years 1983–1993. Eight hundred forty-one cases were recorded, including 201 (23.9%) children less than 16 years of age. The female:male ratio was 1.4:1 (117 girls, 84 boys) for childhood AA. Alopecia was severe, (hat is, total, universal, or extensive, in 34(16.9%) children. Onset occurred in 77 (38.3%) children between ages 6 and 10 years, In 67 (33.3%) before 5 years of age, and in 57 (28.4%) between 11 and 16 years. Onset before 5 years of age was more often associated with severe alopecia than onset at ages 11 to 16 years (p < 0.01). Onset before 2 years of age was commonly associated with severe alopecia, seen in 6 (55.5%) of 11 children. Twenty-five (12.4%) children had one or more family members with AA. Definite evidence of atopy was obtained In 35 (17.5%) children. Association of atopy with severe alopecia was not statistically significant at Initial presentation (16% vs 23.5% for circumscribed and severe alopecia, respectively; p > 0.05). Nail changes were found In 60 (30%) children and were more frequent in severe alopecia (53%) than in circumscribed alopecia (25.2%, p < 0.001). Associated vittllgo was found in seven (3.5%) children, and one child was hypothyroid. Childhood AA in Chandigarh, India, is remarkably similar to that seen in Western countries, except that an association of atopy with younger age at onset and severe alopecia was not confirmed.     

Suction Blister Induction Time: 15 minutes or 150 minutes?

BACKGROUND: The literature on suction blister is somewhat confusing regarding suction blister induction time (SBIT). To date, various factors influencing the SBIT have not been discussed comprehensively. OBJECTIVE: To determine the effect of diameter of suction syringes/cups on SBIT and review the factors influencing SBIT. METHODS: Five young patients (four females, one male; age range 16-27 years, average age 23 years) were selected for the study. Five suction syringes of 2, 5, 10, 20, and 50 ml capacity (diameter 1, 1. 4, 1.7, 2.2, and 3.2 cm, respectively) were applied on the lateral aspect of the thigh and observed for production of unilocular blister at 15 minute intervals. RESULTS: The average SBIT was 63, 72, 98, 123, and 208 minutes in 2, 5, 10, 20, and 50 ml syringes, respectively. CONCLUSIONS: The SBIT is directly proportional to the diameter of the suction syringe. A literature review suggests that the site of the suction blister, age of the subject, amount of vacuum created, temperature, intradermal injection of saline, corticosteroid-induced atrophy, and pretreatment of the site with PUVA are the important factors influencing the SBIT. Use of 10 or 20 ml syringes as suction cups and -300 mmHg pressure are appropriate choices for suction blister induction and produce blisters in about 1-2 hours.