Psoriasis Update

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Psoriasis is a complex immune–mediated disease and is a common disorder that affects men and women equally.

Although it can begin at any age, the peak times for disease onset are young adulthood (ages 20 to 30 years) and late middle age (ages 50 to 69 years).

There are multiple clinical subtypes of psoriasis. Plaque psoriasis, the most common presentation of psoriasis, most commonly presents with sharply defined erythematous plaques with overlying silvery scales. The scalp, extensor elbows, knees, and back are common locations for plaque psoriasis lesions.

Psoriatic arthritis occurs in about 30 percent of patients with psoriasis, and precedes the skin manifestations in approximately 15 percent of patients.

A diagnosis of psoriasis can be made by history and physical examination in the vast majority of cases. Occasionally, a skin biopsy is needed to rule out other conditions.

Numerous topical and systemic therapies are available for the treatment of psoriasis. Treatment modalities are chosen on the basis of disease severity, relevant comorbidities, patient preference (including cost and convenience), efficacy and evaluation of individual patient response.

Common Cold

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  • It is benign self–limiting syndrome caused by several viruses.
  • It is one of the most frequent acute illnesses.
  • The term ‘common cold’ refers to a mild upper respiratory viral illness presenting with sneezing, nasal congestion, nasal discharge, low grade fever, headache and malaise.
  • Common cold is not the same as influenza or common sore throat, which can also involve the heart.
  • Common cold affects a pre–school child 5–7 times in a year and adult 2–3 times in a year.
  • It can spread by hand contact, by direct contact with the infected person or by indirect contact with a contaminated environmental surface.
  • It can also spread by small particle droplets that become airborne from sneezing or coughing.
  • It can also be transmitted via large particle droplets that typically require close contact with infected person.
  • Most important is hand to hand transmission of the virus.
  • Infection can also spread through circulating air in commercial airline passenger cabins.
  • Saliva does not spread any cold.
  • The disease is most infectious on the 2nd and 3rd day of illness.
  • However, a person may be infectious for upto two weeks.
  • Normal cold may last for 8–10 days.
  • The diagnosis is based on clinical findings.
  • Common cold can exacerbate asthma in susceptible individuals.

Malaria

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  • Malaria is transmitted by the bite of a female anopheles mosquito.
  • The mosquito bite occurs mainly between dusk and dawn.
  • Malaria can also be transmitted through blood transfusion, or via sharing of contaminated needles.
  • Bed nets are good against malaria as the major malarial vectors bite during the night.
  • The behavior of the mosquitoes may differ. Some may prefer to rest indoors and feed indoors in the night. Some may prefer to rest and feed outdoors earlier in the day.
  • Preventive therapy of malaria can be instituted during pregnancy in high risk areas.
  • The malarial mosquito feeds every third day compared to the dengue mosquito, which feeds three times in a day.
  • Unlike the malarial mosquito, the dengue mosquito bites during the day.
  • Malarial fever presents with chills, especially during afternoon.
  • Spraying of the indoor residential walls and ceiling is effective against mosquitos.
  • DDT is widely used as indoor residential spraying.
  • DDT should not be applied more than once or twice in a year on the walls.
  • Mosquito contact with DDT surface would generally save from lethal exposure outside the house.
  • Public must know that spray may require rearrangement of the furniture. Walls may become streaked with chemical treatment and residual odor from DDT.
  • The other alternative is malathion spray.

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