Clinical and Mycological Profile of Dermatophytosis

Clinical and Mycological Profile of Dermatophytosis A CLINICAL AND MYCOLOGICAL PROFILE OF DERMATOPHYTOSIS IN KLES DR PRABHAKAR KORE HOSPITAL AND MEDICAL RESEARCH CENTRE, BELGAUM† Dolly M.B.B.S. Department of Dermatology, J.N. Medical College, Belgaum, India B. S. Manjunathswamy M.D .Department of Dermatology, J.N. Medical College, Belgaum, India S.G.Karadesai M.D. Department of Microbiology, J.N. Medical College, Belgaum, India ABSTRACT Aim: To study the clinical and mycological profile of dermatophytosis in tertiary care hospital. Background and objectives: Dermatophytosis, a group of taxonomically closely related keratinophilic fungi called dermatophytes varies with geographical area as well as climatic conditions and there is vide variation in the spectrum of dermatophytic isolates. This study was aimed to understand the clinical and mycological profile of dermatophytosis. Methodology: The present one year cross sectional study from January 2013 to December 2013 was done in the Department of Dermatology, Venereology and Leprosy, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum A total of 125 patients presenting with dermatophyte skin infection were subjected to clinical examination and KOH examination for fungi and culture. Results: The commonest clinical forms noted were Tinea corporis (52%) and Tinea cruris (43.2%). Most of the patients were males (67.2%) (male to female ratio 2:1) and Tinea corporis was the commonest clinical diagnosis (48.81%). The commonest age group was 21 to 30 years (36%) and had Tinea corporis (56%) commonly. 36.8% of the patients had duration of > 35 weeks. The commonest morphological variant was noted as annular (37.6%). The KOH examination was positive in 78.4% cases and culture was positive for fungus in 64.8% of the cases. In patients with positive culture, T. mentagrophyte was the commonest isolate (48.15%). The commonest dermatophyte isolated was Trichophyton (88.64%). Conclusion: There is wide variation in the clinical and mycological profile of dermatophytosis. The detection of emerging organisms may be help in the treatment and adequacy of current pharmacologic regimens. Key words: Dermatophytosis; Mycological profile; Skin infection; Tinea corporis; Tinea cruris; Introduction Dermatophytosis is characterized by the infection of keratinized tissues such as the epidermis, hair and nails. Distribution of dermatophytes varies with geographical area. Further, there is wide variation in the spectrum of dermatophytic isolates. To understand the burden and trend of dermatophytosis, surveillance of the disease plays an important role. Considering the above facts the present study was designed to know the clinical and mycological profile of dermatophytosis so as to elaborate the epidemiological data in the region which will help in understanding the disease pattern and burden which may not only aid in taking adequate measures to prevent the transmission but also help in preventing spread of infection thereby reducing the disease burden. Materials and method This one year cross sectional study of 125 patients presenting with dermatophytes skin infection was conducted in the Department of Dermatology, Venereology and Leprosy, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2013 to December 2013. Patient who are on antifungal treatment and cases who did not provide informed consent were excluded from the study. A detailed history was taken regarding duration and progress of lesion in past age, sex, and occupation. A complete dermatological examination for type of the lesion, morphology and distribution was done along with general physical examination. Clinical material was collected for KOH examination and culture using standard mycological techniques. SDA (Sabourauds Dextrose Agar) with cycloheximide and chloramphenicol were used for culture. The media were incubated at 250C and 370C for a minimum period of three weeks. Positive cultures were examined both macroscopically and microscopically for species identification. Results: Based on the clinical examination findings the commonest clinical forms noted were Tinea corporis, Tinea cruris, Tinea pedis, Tinea unguim, Tinea capitis, Tinea faciei, Tinea mannum and Tinea barbae. Multiple clinical forms were present in almost one fifth of the study population and the commonest clinical form was noted as Tinea cruris with Tinea corporis. Most of the patients were males (67.2%) with male to female ratio of 2:1 and 48.81% of the males had clinical type of Tinea corporis. The commonest age group was 21 to 30 years (36%) and had Tinea corporis (56%) commonly. Most of the patients (36.8%) reported duration of > 35 weeks. Maximum cases were noted in the month of August (16%). The commonest morphological variant was noted as annular (37.6%). The KOH examination for fungus was positive in 78.4% of the cases and culture was positive for fungus in 64.8% of the cases. Among the patients with positive culture, T. mentagrophyte was the commonest isolate noted in 48.15% of the patients. The commonest dermatophyte isolated was noted as Trichophyton (88.64%). Discussion: In our study various clinical forms dermatophytic infections were noted. The commonest clinical form was Tinea corporis (52%) followed by Tinea cruris (43.2%), Tinea pedis (9.60%), Tinea unguim (7.2%), Tinea capitis (2.40%), Tinea faciei and Tinea mannum (1.60% each), and Tinea barbae (0.8%). A recent study from Mysore Karnataka by Surendran KAK et al1 also observed Tinea corporis (44.3%) as the most common clinical pattern. In our study multiple sites were involved among 23 cases. Of these, Tinea cruris and Tinea corporis were present in 17 (73.91%) and Tinea corporis and Tinea pedis in three (13.04%) cases. In the present study males were commonly affected that is, almost two third of the patients (67.2%) were males with male to female ratio of 2:1. Tinea corporis was the commonest clinical type of dermatophytosis among males (48.81%) while in females it accounted among 58.54% of the patients. Sen SS et al2 and Jain N et al3 reported 48% and 37% of the male with Tinea corporis while Bindu V et al4 reported 54.6% of males. In this study, maximum patients belonged to age between 21 to 30 years (36%) and the next common age group was 31 to 40 year (19.2%). This was in accordance with a recent study from Mysore by Surendran KAK et al,1 Karnataka where maximum number of cases encountered in the age group of 16-30 years (44%) followed by the age group of 31-45 years (26%). Other studies by Sen SS et al2 from Guwahati in 2006 and Sahai S et al5 from Lucknow in 2011 also reported commonest age group as 21 to 30 years (44% and 32.4% respectively). Among them 45 patients with age between 21 to 30 years, 25 (56%) had Tinea corporis and 8 (18%) had Tinea cruris. Similar findings were noted by Bindu V et al,4 Singh S et al,2 Sen SS et al2 and Jain N et al.3 In this study maximum cases were noted between June to September (37.6%) with peak in the month of August (16%) which is similar to the findings of Kalla G et al57 and Sumana V et al.6 In this study the commonest morphological variant was noted as Annular (37.6%). The present study KOH examination for fungus and culture was positive in 78.4% and 64.8% of the cases respectively. Of the 98 cases with positive KOH examination for fungus, 81 (82.65%) cases had positive culture. A study by Belukar et al.7 showed culture positivity of 71%, which was much higher and close to the present study. In this study, T. mentagrophyte was the commonest isolate noted in 48.15% of the patients followed by T. Rubrum (43.21%). In a study recent study from Mysore by Surendran KAK et al,1 T. rubrum was the chief organism isolated with a percentage of 67.5% while T. mentagrophytes (20%) isolates were found second in frequency. T. mentagrophytes are relatively more prevalent in south India.1 Conclusion: The KOH examination for fungus was positive in 78.4% of the cases and culture was positive for fungus in 64.8% and in patients with positive culture, T. mentagrophyte was the commonest isolate followed by T. rubrum (43.21%). Overall there is wide variation in the clinical and mycological profile of dermatophytosis. Further KOH examination for fungus and culture play an important role in the diagnosis of dermatophytosis. References 1.Surendran K, Bhat RM, Boloor R, Nandakishore B, Sukumar D. A clinical and mycological study of dermatophytic infections. Indian J Dermatol 2014;59:262-7 2.Sen SS, Rasul ES. Dermatophytosis in Assam. Indian J Med Microbiol 2006;24:77-8. 3.Jain N, Sharma M, Saxena VN. Clinico-mycological profile of dermatophytosis in Jaipur, Rajasthan. Indian J Dermatol Venereol Leprol 2008;74(3):274-5. 4.Bindu V, Pavithran K. Clinico-mycological study of dermatophytosis in Calicut. Indian J Dermatol Venereol Leprol 2002;68(5):259-61. 5.Sahai S, Mishra D. Change in spectrum of dermatophytes isolated from superficial mycoses cases: First report from central India. Indian J Dermatol Venereol Leprol 2011; 77(3): 335-6. 6.Sumana V, Singaracharya MA. Dermatophytosis in Khammam (Khammam district, Andhra Pradesh, India). Indian J Pathol Microbiol 2004;47(2):287-9. 7.sBelukar DD, Barmi RN, Karthikeyan S, Vadhavkar RS. A Mycological study dermatophytosis in Thane. Bombay Hosp J 2004;46:2.

Economic Interpretaion (C. A. Beard) :: essays research papers

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Establish an E-commerce Business

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Americas role in GB economy essays

America's role in GB economy essays According to T.H. Breen the Americans were a part of a British consumer economy in the 18th century. Before America was even established as a country people were buying British goods. The wealthy Americans tried to copy the tastes and styles of the wealthy British. And with the American economy trying to get started it only makes sense that they relied so heavily on the British for economic ties. The 1740s were a key year in the American economy. It was during this time that British goods flooded the market. T.H. Breen brings out that, By 1772 the Americans were importing British manufactures in record volume. As a result of the growing number of goods entering the American economy it sparked the Americans to produce more things in order to pay for these goods. They began producing more tobacco, rice, indigo, wheat, fish, and tar. The products imported by the British in the beginning were mainly purchased by the upper class Americans. But as time went on there were signs of the lower class purchasing items. This shows that it was not a narrow market but rather everyone in America was fueling the British economy by buying their goods. As America was first starting out there was a definite struggle to get the economy started. The British saw America as an economic gold mine and took full advantage of that. With the Americans lack of production of certain items, therefore creating a dependency, there was a need for the British items as well as many Americans feeling a need to imitate the British style and luxuries. All in all the Americans played a part of the British consumer economy in the 18th century. ...

Free Essays on Civil Rights Movement

The Civil Rights Movement The Civil Rights Movement was a very important point in the history of the United States. The self-proclaimed, â€Å"Land of the free† promoted the segregation and mistreatment of the colored people of American whether they be Black, Asian or Hispanic. The Civil Rights Movement was aimed at gaining equality for the Blacks but it came with the added bonus of gaining rights for the other races as well. During this period the eyes of whites and others were opened and started to change the errors in their way. Though the majority might have changed there was still those who believed that all other races were inferior to the White race and treated them poorly and some times just brutally. Thurgood Marshall was the director of legal defense and the educational fund for the N.A.A.C.P., a lawyer, Federal Judge, solicitor general and the first African-American Supreme Court Justice in America. He was also one of the best (if not the best) known black Lawyers in the United States. He played a major role in the civil right movement by winning many cases that led to more rights or improved rights for the black race. As Director of Legal Defense, Marshall fought in the majority of the civil rights cases. The most famous of these cases would be the â€Å"Brown vs. Board of Education† (1954) which resulted in the â€Å"beginning† of the end of segregation in schools and public areas. It was people like Thurgood Marshall that fought for the rights of colored people in the courts. At the age of 26 Dr.Martin Luther King Jr. became the unofficial leader of the civil rights movement in America. His leadership and efforts for racial equality eventually earned him the Nobel Peace Prize in 1964. King’s first taste of the civil rights movement came when Rosa Parks sparked the Montgomery Bus Boycott when she refused to give her seat up to a white man and was arrested for doing so. With Television being a common... Free Essays on Civil Rights Movement Free Essays on Civil Rights Movement The first massive direct action in the civil rights movement came in Montgomery, Alabama in 1955. Under SCLC leadership, the black community boycotted the city’s bus system, which required them to ride at the back of the buses. After many months of boycotting, the U.S Supreme court declared that segregation on public buses was unconstitutional, and the boycott was bought to an end. This was a very significant event for the civil rights movement. It caught the attention of the entire nation. People around the country were made aware of the event because it was launched on such a massive scale and lasted for more than a year. It also set the tone for the civil rights movement, which led to more struggles and protest. There was the school integration in Little Rock, Arkansas in 1957, where nine black students were admitted to Little Rock’s Central High School. President Dwight Eisenhower sent federal troops to enforce desegregation. There were public accommodation sit-ins in North Carolina and Georgia in 1960, when four black college students began protesting racial segregation in restaurants by sitting at â€Å"white only† lunch counters and waiting to be served. There were the freedom riders who traveled around the South in buses to test the effectiveness of the 1960 Supreme Court decision of illegal segregation in bus stations. There was also education and voter registration drives in Mississippi in 1961, which organized voter registration campaigns in black counties. Many of these protests where organized by the student affiliate of SCLC, many northern white liberal supporters, and the SNCC which stands for Student Nonviolent Coordinating Committee. The SNCC was founded in Raleigh, North Carolina in April 1960 to help organize and direct the student sit-in movement. They also concentrated on voter registration, believing that voting was a way to empower blacks so that they could change racist policies in the South. ... Free Essays on Civil Rights Movement The Civil Rights Movement The Civil Rights Movement was a very important point in the history of the United States. The self-proclaimed, â€Å"Land of the free† promoted the segregation and mistreatment of the colored people of American whether they be Black, Asian or Hispanic. The Civil Rights Movement was aimed at gaining equality for the Blacks but it came with the added bonus of gaining rights for the other races as well. During this period the eyes of whites and others were opened and started to change the errors in their way. Though the majority might have changed there was still those who believed that all other races were inferior to the White race and treated them poorly and some times just brutally. Thurgood Marshall was the director of legal defense and the educational fund for the N.A.A.C.P., a lawyer, Federal Judge, solicitor general and the first African-American Supreme Court Justice in America. He was also one of the best (if not the best) known black Lawyers in the United States. He played a major role in the civil right movement by winning many cases that led to more rights or improved rights for the black race. As Director of Legal Defense, Marshall fought in the majority of the civil rights cases. The most famous of these cases would be the â€Å"Brown vs. Board of Education† (1954) which resulted in the â€Å"beginning† of the end of segregation in schools and public areas. It was people like Thurgood Marshall that fought for the rights of colored people in the courts. At the age of 26 Dr.Martin Luther King Jr. became the unofficial leader of the civil rights movement in America. His leadership and efforts for racial equality eventually earned him the Nobel Peace Prize in 1964. King’s first taste of the civil rights movement came when Rosa Parks sparked the Montgomery Bus Boycott when she refused to give her seat up to a white man and was arrested for doing so. With Television being a common...

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