Surendran K A K

Abstract

Introduction: Sexually Transmitted Diseases (STD) shows various trends in different parts of the country and constitute a major public health problem for both developing and developed countries. STD‘s increases the risk of transmission of Human Immuno Deficiency virus (HIV) infection causing immense need to understand the patterns of STD‘s prevailing in the regions of a country for proper planning and implementation of STD control strategies. Aim: To know the pattern of STDs and to analyze the changes during a 7 year period among patients attending the STD clinic at the tertiary care centre. Materials and Methods: A retrospective analysis of data collected from the clinical records of patients attending the STD clinic of a tertiary care hospital, Mysuru over a period of 7 years (from Jan 2010 to Dec 2016). Results: During this 7 years period, a total of 1,98,991 patients attended Skin and STD Department on out-patient basis, among them 2,111(1.06%) were STD patients [1057 males and 1054 females]. Majority were married (89.86%). The most common STD in males was balanoposthitis (32.92%) and in females was vaginal /cervical discharge (28.42%). Among genital ulcer diseases herpes genitalis was most common and increased gradually while Syphillis and Chancroid declined during the study period. Gonococcal urethritis was seen among 4.69% and LGV only in 0.14% (3 cases). HIV seropositivity in the study population was 7.25%. Conclusion: Bacterial STD‘s showed a gradual reduction in number while fungal and viral STD‘s showed increasing trends. Keywords: Changing trends of STD s, Syphilis, Herpes genitalis

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Abstract

Context: Chronic urticaria is one of the most challenging and frustrating therapeutic problem faced by a dermatologist. The simplest screening method to identify chronic autoimmune urticaria was found to be the autologous serum skin test (ASST). Autologous serum therapy (AST) is helpful in chronic urticaria. Aims: To evaluate the efficacy of autologous serum therapy (AST) in patients with chronic urticaria. Settings and Design: Prospective study at a tertiary care centre. Materials and Methods: The study group included 30 adult patients presenting with chronic urticaria. Six separate parameters of disease activity and severity were recorded according to Urticaria Total Severity Score (UTSS) at baseline (0 week) and at the end of treatment (9 weeks). Nine doses of Autologous serum were given intramuscularly at an interval of 1 week. Results were assessed based on the percentage decrease in the UTSS. Statistical analysis used: Wilcoxon Signed rank test. Results: Among 30 patients, ASST was positive in 15 patients (50%) and negative in 15 patients (50%). 11 patients (36%) had 31-60% response, 7 patients (23%) had 61-90% response, 4 patients (13%) had 10-30% response and 8 patients (26%) had no response. Among 15 ASST positive patients, 8 patients (53%) had 31-60% response, 3(20%) patients had 61-90% whereas among 15 ASST negative patients only 3 (20%) patients had 31-60% response and 4(26.67%) patients had 61-90%. Conclusions: AST was found to be effective in the treatment of chronic urticaria. There was statistically significant response both in ASST positive and negative patients. Key Messages: Autologous serum injection therapy still remains as a cheap, effective and potentially curative therapeutic modality even today in chronic urticaria. Keywords: Autologous serum therapy, Urticaria, Autologous serum skin test

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