Red Patches Research Articles

Morbus Hansen Multibacillary Type Mid Borderline: A Case Report

Background: Morbus Hansen (MH) is a granulomatous infectious disease caused by an obligate intracellular pathogenic bacterium, Mycobacterium leprae (M. leprae). Cardinal signs of Hansen's morbus (MH) include patches of numb skin, thickening of the peripheral nerves, and acid-fast bacteria (AFB) on a skin smear or biopsy. This case report aims to establish the diagnosis of mid borderline (BB) MH with clinical and histopathological examination.
 Case presentation: A 44-year-old woman presented with red patches on her face and body 1 month ago. Madarosis and multiple erythematous plaques confluent, poorly demarcated, raised edges, atrophic center with some smooth shiny and some rough surfaces found in the facial region and superior extremities et al. bilateral inferior with bilateral auricular infiltrates. A sensory examination of the lesion showed decreased sensitivity to pain and temperature. Skin-slit smear examination showed AFB with bacterial index (IB) +2 and morphological index (IM) 30%. On histopathological examination with hematoxylin and eosin staining, Grenz zone appeared, epithelioid granuloma affecting the epidermis, no lymphocytes, and no giant Langhans cells were found, and nerves were surrounded by lymphocytes and granulomas. On fite-faraco staining, BTA was obtained with IB +3 and IM 30%. The diagnosis of MH type BB was established, and the patient was given multidrug therapy (MDT) multibacillary (MB).
 Conclusion: Morbus Hansen type BB has a typical histopathological picture of granulomas composed of mature epithelioid cells, Grenz zone, AFB, enlarged and swollen nerves surrounded by lymphocytes or infiltrated with granulomas without damage. After 3 months of therapy, there was a decrease in IB and IM on AFB examination.

Exacerbation of Psoriasis Vulgaris Induced by Vaccine COVID-19 in HIV Patient: A Case Report

Background: Psoriasis is a chronic and inflammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis.
 Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9.
 Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented efficacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops.

Evaluation of ecological conservation red line from the perspective of ecological security pattern: Taking Zhejiang Province, China as an example

To investigate the scientificity of the ecological conservation red line in Zhejiang Province, we evaluated the ecological effect based on the concept of ecosystem processes from the perspective of ecological security pattern. On the basis of clarifying the triple connotation of the ecological conservation red line, we constructed an evaluation index system to identify ecological sources and evaluate the importance of red line patches with InVEST model and net primary productivity quantitative analysis. Minimum resistance model and gravity model were used to construct the ecological corridors and evaluate the connectivity of red line. Moreover, landscape pattern index and overlay analysis were applied to evaluate the fragmentation and coordination of red line. The results showed that, from the perspective of ecological importance, the protection scale in Zhejiang Province was relatively large, but 13.5% of the red line areas were not of high importance. About 40% of the provincial ecological sources were not included in the ecological conservation red line. From the perspective of spatial structure, the connectivity of the ecological conservation red line was insufficient. The protection rate of the first-level ecological corridor was less than 15%. The red line patches in some counties and cities were relatively broken. From the perspective of natural-social system coordination, cross-administrative red line areas were well connected. However, it was still necessary to pay attention to the fact that the conflict between supply and demand in the plain area had led to spatial mismatch and fragmentation of red line. Using the ecological security pattern for reference, we put forward the relevant strategies of red line optimization and adjustment, which could provide scientific reference for ecological space management.

SURGICAL MAPPING OF EXTENSIVE POTENTIALLY MALIGNANT ORAL DISORDER WITH TOLUIDINE BLUE STAIN: A CASE REPORT

A 66-year-old male patient who was an ex-smoker and ex-drinker presented with a main complaint of "tongue pain" for 6 months. Physical examination revealed an extensive heterogeneous plaque with mixed white and red patches, irregular borders, and with the largest diameter of 5 cm, located at the left lateral border of the tongue and floor of mouth. Based on the characteristics of the lesion, the clinical diagnosis was leukoplakia. The lesion was mapped using the toluidine blue stain; 4 areas were stained positive, and 2 areas were subjected to incisional biopsy. Histopathologic analysis revealed epithelial dysplasia and squamous cell carcinoma. The definite diagnosis was squamous cell carcinoma. The patient was referred to the head and neck surgery service, where he underwent partial glossectomy and is being followed up with no evidence of recurrence. Toluidine blue stain is important for selection of the incisional biopsy area in extensive heterogeneous lesions suspected of potentially malignant oral disorders and oral cancer.

Treatment Patterns for Targeted Therapies, Non-Targeted Therapies, and Drug Holidays in Patients with Psoriasis.

IntroductionWe aimed to evaluate US treatment patterns and, more specifically, switch patterns among patients with psoriasis (PsO) who initiated treatment with targeted therapy (TT) and subsequently switched to another therapy.MethodsThis retrospective study used IBM® MarketScan® Commercial and Medicare Databases (1/1/2006–3/31/2020) to evaluate treatment patterns in biologic- and apremilast-naive patients with PsO. TT included apremilast, adalimumab, etanercept, infliximab, ustekinumab, or other biologics (certolizumab pegol, secukinumab, brodalumab, ixekizumab, guselkumab, or tildrakizumab). Adults with ≥ 1 prescription for a TT, ≥ 2 PsO claims separated by ≥ 1 day on or before the index date (date of first TT prescription), and continuous medical and pharmacy enrollment for 1 year before and 2 years after the index date were eligible. Non-targeted therapy (NTT) was defined as non-targeted oral systemic treatment, topical treatment, phototherapy, or no treatment. Kaplan–Meier (KM) analysis was used to estimate time to reinitiation of TT (24-month continuous enrollment post-index was not required).ResultsA total of 11,526 patients with PsO were included; mean [standard deviation (SD)] age and Charlson Comorbidity Index score were 48.3 (12.8) years and 0.9 (1.43), respectively. During the follow-up, 69.2% of the patients were treated with NTT. Median time to first NTT, for those who received NTT, was 205 days (longest: adalimumab, 252 days). Among patients who switched to NTT after initiating treatment with TT, 52.6% reinitiated treatment with TT (least common: apremilast, 45.6%), with a median time to reinitiation of 106 days (longest: other biologics, 136 days). For all patients on NTT, the probability of reinitiating any TT was 60.7% at 24 months.ConclusionsPsO treatment is often cyclical in nature. Patients frequently experience drug holidays or transition back to TT after using NTT. The consideration of real-world treatment patterns in future economic models may provide new insights into the clinical effectiveness and value of PsO treatments.

Herbal Products for Acne Vulgaris: A Review

Acne is a prevalent skin condition that affects a considerable portion of the population, primarily teenagers and young adults. In most cases, it causes pimples on the face, neck, and upper back. A variety of red and flaky skin patches, as well as blackheads, whiteheads, nodules, and pustules, characterize this condition. Acne has a significant cutaneous and psychological illness burden, and its pathophysiology and current therapies are challenging. The severity of acne varies, and some people are more likely to get it because of their genes. Acne inflammation has been linked to the pus-forming bacteria Propionibacterium acnes (P. acne). In the past century, many treatment options have been available in the market that could be taken in oral or topical treatment options. Plant extracts that are useful in treating acne have recently gained popularity as a natural acne treatment alternative. This article aims to discover how antibacterial herbal medicines work against the things that cause acne vulgaris. Pathogenic reasons are high sebum production, pilosebaceous duct calcification, dysbiosis, and inflammation. As part of the treatment, synthetic drugs with significant side effects must be taken continuously throughout the year. Because of this, the safest, most effective medications are needed for therapy. Medications made from plant extracts, such as herbal ones, are a safe alternative to synthetic drugs. The herbal plants in this article are research-based, using active components of the plants that have anti-inflammatory, antibacterial properties and reduce sebum production to help treat or alleviate acne. Hence, herbal therapy aims to give people access to safe, effective, and cost- effective medicines. The current review summarizes different herbal products' roles in treating acne, where many databases were gathered and searched to find every medicinal plant with anti-acne action and provide effective treatment options for individuals who opt to consider herbal medication for acne

Koinfeksi Sifilis Sekunder, <i>Condyloma Acuminata</i> dan <i>Human Immundeficiency Virus</i> (HIV) pada Pria Homoseksual

Introduction: Men who have sex with men (MSM) have higher risk of contracting sexually transmitted infections (STIs) such as syphilis, one of chronic and systemic STI. HIV and HPV infection can be risk factors for syphilis infection, while coinfection between syphilis and HIV facilitates the course of the two diseases. Case: A 22-year-old homosexual man complained of red scaly patches on both palms and feet, no itching, hair loss and lumps in the genital area. Examination revealed nonscarring alopecia on occipital region, bilateral patches with multiple erythematous plaques partly confluent hyperpigmentation and an overlying scale on palmar and plantar region, also multiple nodule papules with pale red smooth surface on perineal region. The acetowhite examination at the verrucous lesion was positive. The results of the CD4 examination was 112 cells/µl, VDRL/RPR was reactive 1:256; and TPHA was also reactive >1:5,120. Histopathological examination of the skin showed the features of skin syphilis and condyloma acuminata. Immunohistochemistry test revealed brownish Spirochaeta. The patient was diagnosed with secondary syphilis coinfection, condyloma acuminata, and HIV. Conclusion: We found a case of MSM patient that was coinfected with secondary syphilis, condyloma acuminata, and HIV. HPV and HIV infection are often coexisting because they both increase the risk of sexually transmitted infections.

Mid-Borderline Leprosy with Mild Type 1 Reaction in Children: A Case Report

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Cases of leprosy in children are rarely found because of the long incubation period of Mycobacterium leprae. Purpose: To report a case of mid-borderline leprosy with a mild type 1 reaction in a seven-years-old girl patient. Case: A 7-years-old girl patient presented with multiple red and white patches on her face, body, arms, legs, and buttocks since 6 months before. There was no itching, numbness, painr fever. There was no thickening of peripheral nerves and no nerve function impairment. Her grandmother was suspected to have leprosy, but she had never been treated and had already passed away. From the acid fast bacilli (AFB) examination, the bacterial index (BI) was 1+ and the morphological index (MI) was 2%. A serologic test examination was also performed and the result were Immunoglobulin (Ig) G 3716 u/ml and IgG 284 u/ml. The patient got multidrugs therapy for 12 months and after 9 months of treatment, the pre-existing patches became erythematous, thickened, and felt pain when touched, but there was no fever. In the presence of pain, oral ibuprofen was then administered and the patches began to improveDiscussion: Due to the possibility of leprosy reaction, it is important to immediately give prompt treatment to children with type 1 leprosy reaction that is associated with neuritis and leads to deformities. Conclusion: Early diagnosis and therapy for a type 1 leprosy reaction are very important to prevent deformities.

Exploration of the functional properties of red cuticle patch of redclaw crayfish (Cherax quadricarinatus) by histological and transcriptomic analysis

The redclaw crayfish (Cherax quadricarinatus) is being farmed on an increasing scale in various tropical and subtropical regions. The most distinctive feature of the adult male redclaw crayfish is the red cuticle patch on the lateral cuticle of the chelae. It is an important indicator of the health status, reproduction, and resistance to predators of this species, but little is known about its functional properties. In this study, we used redclaw crayfish (45.35 ± 16.74 g) as experimental subjects. Histological comparison of the red cuticle patch on male redclaw crayfish chelae with the cuticle on female redclaw crayfish chelae revealed that the red cuticle patch lacked exocuticle. High performance liquid chromatography analysis demonstrated that the concentration of free astaxanthin in the red cuticle patch was much higher than that in the chelae of female redclaw crayfish. Further analysis of transcriptome data from epithelial tissue of the chelae revealed that genes related to chela structure were highly expressed in the red cuticle patch of males. Immunity-related genes were not specifically expressed in the red cuticle patch, and immune- and growth-related genes that require calcium ion for activation were down-regulated in the patch. Our results indicated that regulation of genes related to astaxanthin binding was not a single up- or down-regulation mode. This study demonstrated structural differences in the chela cuticle between male and female redclaw crayfish and revealed the molecular basis for the functional properties of the red cuticle patch.

Identifying the influence of surface texture waveforms on colors of polished surfaces using an explainable AI approach

An explainable artificial intelligence approach based on consolidating the Local Interpretable and Model-agnostic Explanation (LIME) model outputs was devised to discern the influence of the surface morphology on the colors exhibited by stainless-steel 304 parts polished with a Magnetic Abrasive Finishing (MAF) process. The MAF polishing process was used to create two regions, each appearing either blue or red to the naked eye. The color distribution was microscopically heterogeneous, i.e., some red microscale patches were dispersed in blue regions, and vice versa. The surface morphology was represented in the frequency domain (using a 2D Fourier transform) to capture the harmonic surface patterns, such as the feed and lay marks from the polishing process. A Convolutional Neural Network (CNN) was employed to identify the color of the region from the frequency characteristics of the surface morphology. The CNN was able to predict the observed colors with test accuracies exceeding 99%, suggesting that the frequency characteristics of the surface morphology of the red regions are distinctly different from those of the blue regions. A LIME model was constructed around each small segment within each region of the surface to identify the frequency features that are influential for differentiating between the colors. To deal with the effect of heterogeneity, an algorithm based on the query by experts was used to reconcile the local influences and gather the global explanations of the frequency characteristics that inform the blue versus red regions. We found that the dominant morphological features in the red regions are those that capture the polishing lay patterns underlying surface structure, whereas those in the blue regions capture the non-uniform and high-frequency waveform patterns, such as those result when oxide films form due to the intense polishing conditions.

Diagnostic value of oral “beefy red” patch combined with fingertip blood mean corpuscular volume in vitamin B12 deficiency

ObjectivesTo investigate the diagnostic value of accessible fingertip mean corpuscular volume (MCV) combined with a visible “beefy red” patch in the diagnosis of vitamin B12 (VB12) deficiency in local clinics and hospitals without in-house clinical laboratories, especially in remote areas.Materials and methodsThe medical history data of patients complaining of oral mucosal pain at the Stomatological Hospital of Southern Medical University were reviewed. All included patients underwent fingertip blood routine examination, specific serological test (serum VB12, folic acid, iron, and ferritin), and detailed oral clinical examinations. According to the results of the serum VB12 test patients were divided into case and control groups. In diagnostic test, the diagnostic value of the “beefy red” patch and elevated MCV in VB12 deficiency was evaluated by the receiver operator characteristic curve.ResultsThere were more female patients than male patients in the case group (serum VB12 level < 148 pmol/L, n = 81) and control group (serum VB12 level ≥ 148 pmol/L, n = 60), mostly middle-aged and elderly patients. There were no statistical differences in gender and age between the two groups. In the case group, the number of individuals with stomach disease was 13, the number of individuals with “beefy red” patch was 78, the number of individuals with oral ulcer was 29, the number of individuals with “MCV > 100fL” and “folic acid < 15.9 nmol/L” were respectively 68 and 5. All were more than that in control group (P < 0.05). The diagnostic test, “beefy red patch” has high sensitivity (0.963) but low specificity(0.883), “MCV > 100 fL” has high specificity (0.933) but low specificity (0.815), and “MCV > 100 fL combined with beefy red patch” has maximal specificity (0.950), and area under the curve (0.949).ConclusionsVisible oral “beefy red” patch combined with accessible fingertip blood MCV could improve the rate of diagnosis in VB12 deficiency, especially in the elderly in local clinics and hospitals without in-house clinical laboratories in China, which is conducive to early disease detection and treatment.

Effectiveness of homoeopathic treatment in case of tinea corporis and tinea cruris: A constitutional approach

Tinea, also known as dermatophytosis or ringworm is fungal infection of the skin. Ringworm infection can affect all age group and both sex which initially presents with red patches on affected were as of the skin and later spreads to other parts of the body. In tropical countries like India dermatophyte infections like Tinea corporis, Tinea cruris is common irrespective of rural or urban population. Moreover they represent a major public health problem in school age children.The present study was undertaken to understand the effectiveness of constitutional treatment in case of Tinea corporis and cruris. Tinea infection is one of the common conditions seen in hostel students of Alva’s education foundation. Hence the study was conducted to assess the tinea infection and the therapeutic effect of our homoeopathic medicine.The study showed that homoeopathic constitutional medicines were effective in treating tinea cruris and tinea corporis.

Awareness and Knowledge of Oral Cancer in Patients Visiting Nobel Medical College Teaching Hospital

Background: Oral cancer is one of the most common life-threatening conditions. Lack of awareness, knowledge, risk factors and early sign and symptom of oral cancer .Thus the aim of present study was to to evaluate the awareness and knowledge about oral cancer among patients.&#x0D; Materials and Methods: The descriptive cross-sectional study was done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from December 2020 to February 2021. Approval was acquired from Institutional Review Committee. A total of 300 patients above 25years of age group were included in the study. Self -administered questionnaire was prepared and distributed to obtain information about patient’s age, gender, education level and occupation. The questions regarded habits, awareness of oral cancer, knowledge of the risk factors, signs and symptoms and source of information about oral cancer.&#x0D; Results: A total of 300 patients participated in this study out of which male was 70%, and the female was 30%. The result of awareness questionnaire showed that 65% of the respondents were heard about oral cancer. The study revealed that 70.3% and 62.6% respectively patients were sable to correctly identify tobacco and smokeless tobacco as risk factor and 64% and 53.5% respectively was able to correctly identify white patch and red patch as signs and symptom of oral cancer. Majority of the respondent 46% yielded awareness and knowledge of oral cancer from media.&#x0D; Conclusion: The present study shows the dental patients had lack of awareness and knowledge about the risk factors and signs and symptom of oral cancer.

Coexistence of Geographic Tongue and Palmoplantar Pustulosis: A Case Report

Palmoplantar pustulosis is strongly suggested the involvement of oral bacteria, but the cause of geographic tongue remains unknown. A 20-year-old female patient described a 1-2 year history of geographic tongue with irregular, smooth, red patches on parts of the tongue. She also presented several pustules, accompanied by delimited erythematous skin patches on both soles. One month after the first visit, when she returned for follow-up, the skin condition had progressed further, and pustules and scales became more prominent. Tongue rinses with commercial mouth washes were tried, but the condition of the lesions fluctuated between improvement and exacerbation. This report presents a rare case of the coexistence of geographic tongue and palmoplantar pustulosis in a young female patient.

Oral Cancer

Oral cancer or mouth cancer is a type of cancer that forms in the oral cavity, resulting in the uncontrolled growth of abnormal cells that damage the surrounding tissue. There are several factors that accelerate oral cancer, including human papillomavirus (HPV) infections, genetic influences, UV light and substance use. Abnormalities, namely white or reddish patches, lumps and chronic sores in the oral cavity, may be noticed by the patient. Nowadays, many means of treatment are available, including surgery, radiation, chemotherapy, and targeted drugs. However, the risk factors can affect people at different levels. The treatment will be applied individually depending on personal physical and mental health conditions. Furthermore, most of the treatments rely on modern technology, they are progressively developing to maximize their efficiency. This article aims to provide an overview of cancer, oral cavity, diagnosis, complications, medical treatments and self-prevention to avoid risk factors. Overall, the authors have analysed and reorganised so that the audience has a broader understanding of this disease.

Psoriasiform skin reaction due to Brazilian keratin treatment: A clinical-dermatoscopic study of 43 patients.

Introduction:Hair straightening products like the Brazilian Keratin Treatment (BKT) contain high concentrations of formaldehyde, and its use is associated with adverse effects. In 2016, seven cases of eczema-like psoriasiform skin reaction secondary to BKT were described for the first time. We aim to investigate the clinical characteristics and dermatoscopic findings of patients with psoriasiform skin reactions due to BKT.Materials and Methods:A cross-sectional study was performed from October 2017 to June 2020. Patients who developed erythema and scales on the scalp following the use of BKT were included. Age, sex, number of BKTs, time elapsed between BKT and the skin reaction, pull test, and dermatoscopic findings were investigated. Descriptive and inferential statistics were used.Results:We found 43 patients with a mean age of 35 ± 10 years, predominantly females in 42 (98%) cases. The mean number of BKTs was 2 ± 2. The mean length of time elapsed to present the reaction was 12 ± 17 months and this was related to the number of BKTs (P = 0.01). The pull test was positive in 37 (86%) patients. The most frequent dermatoscopic findings were perifollicular scales in 42 (98%), red patches in 35 (81%), and peripilar desquamation resembling the outer skin of an onion bulb in 32 (74%).Conclusion:Hair straightening products are widely used and the psoriasiform skin reaction that develops afterward might be underdiagnosed. It is important to investigate the background of BKT in conjunction with the clinical and dermatoscopic findings suggestive of this cutaneous reaction.

Lichen Planus and the Vulvovaginal Gingival Syndrome. Report of a Case and Review of the Literature

<h3>Introduction</h3> Lichen planus is a dermatologic disease that affects both skin and mucosa. Cutaneous lesions of lichen planus present as small polygonal violaceous papules that present most often on the flexor surfaces of the extremities. These lesions may also be present on the vulvar skin and the hair-bearing aspects of the vulva. Lichen planus of the mucous membranes may affect buccal or gingival mucosa and the vulvar vestibule and vagina. Examination of the mouth reveals the white, lacy pattern of hyperkeratotic striae present on buccal mucosa, often bilaterally. The gingiva may be diffusely swollen, erythematous, and exhibit desquamation. In 1982 Pelisse first reported the vulvovaginal gingival syndrome and lichen planus. The main clinical manifestations of the syndrome are a triad of vulvar, vaginal and gingival lichen planus. <h3>Case Report</h3> A sixty-five year old female was referred to the oral surgeon for evaluation of red patches in her mouth. The patient reported that she had a biopsy of her vulvar for which a diagnosis of lichen sclerosis et atrophicus was made. A biopsy of her maxillary gingiva was submitted to the oral pathology laboratory and diagnosed as lichen planus. The vulvar biopsy was sent for comparison. After consultation with Dermatopathology the diagnosis of lichen planus and the vulvovaginal gingival syndrome was made. <h3>Conclusion</h3> We report a case of severe erosive vulvovaginal lichen planus that preceded the onset of gingival lichen planus by nine months. Not uncommonly, patients with severe oral lesions displayed mild genital disease and patients with asymptomatic gingival disease suffered with severe erosive vulvovaginal disease. The diagnosis of vulvovaginal gingival syndrome requires multidisciplinary evaluations by various medical specialists. We have reviewed the literature of this rather rare condition and report an additional case, with the intention of making the practicing clinician aware of this unusual clinical entity.

Severe Urticaria Reaction in Energy Deficient Patient Post-COVID-19 Vaccine

Introduction: There are some reports in the literature demonstrating cases of urticaria reactions after receiving COVID-19 vaccine and they usually ask the patient to do not use the same vaccine again. In study written by me (2019) entitled The Importance of Treating Energy Imbalances and Chakras Energy Deficiencies in Patients with Chronic Urticaria Reactions, I am showing that what has in the background of patients with urticaria, is the lack of energy in the five internal massive organs. Purpose: the purpose of this study is to show that patients with urticaria reactions post COVID-19 vaccine has energy deficient predisposing them to have this kind of reaction and the treatment of this condition, replenishing this lack of energy is important to treat the cause of this abnormal reaction and not just treating the symptoms. Methods: through one case report of patient that had severe urticaria reaction 6 hours after receiving COVID-19 vaccine (Coronavac, having symptoms of giant red patches in the skin of the face, thorax, dorsum, upper limbs). She needs to go to the hospital and they said that her reaction was caused by the use of COVID-19 vaccine. She went to my clinic after this reaction due to other symptoms and I did the chakras’ energy centers measurement. Results: what I found was that she was in the lowest level of energy in all the chakras’ energy centers (rated in one out of eight) with the exception of the seventh that was normal, rated in eight. Treatment using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting and replenishment of these chakras’ energy centers using homeopathy medications according to the theory created by me (2020) entitled Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications were done. Conclusion: the conclusion of this study is that patients with urticaria reactions after receiving COVID-19 vaccinations has energy deficiency in the background and the treatment of this condition, replenishing this energy, is very important to treat the cause of the urticaria symptoms and not just treating the symptoms, avoiding the use of the same vaccine or only using anti-histamine or corticosteroids medications.

A case study on Psoriasis with special reference to Kitibha Kushtha

Background: Psoriasis is a chronic non-infectious autoimmune dermatosis characterized by periodic flare-ups of sharply defined red patches, covered by a silvery, flaky surface. In Psoriasis, relapsing nature is commonly seen, which suggests the need for long-term treatment. Worldwide the prevalence of psoriasis is estimated to be approximately 2–3%. In India, the prevalence of psoriasis may vary from region to region due to variable environmental and genetic factors. Case-A 22year old nulliparous female patient suffering from psoriasis for 4 years visited the hospital for treatment. Considering the signs and symptoms of the disease, it was diagnosed as Kitibha Kushtha and Shodhan – Shaman chikitsa were planned. Conclusion: Repeated Shodhan chikitsa helped in prevention of relapse of psoriasis and internal medications showed significant improvement in all the cardinal symptoms as well as lesions of the patients.

Evaluation of Total Antioxidant Capacity in Al-Daura Oil Refinery Workers and Its Relation to Oral and Periodontal Conditions

Introduction: Total antioxidant capacity (TAC) is an important marker to be measured to explore the effect of oil fume on oral tissue. This study examined the effect of longtime exposure to oil fume on oral and periodontal tissue. Materials and Methods: A total of 52 participants consisted of four groups of 13 participants each. Oral examination and periodontal indices were taken. TAC was analyzed. Results: The study groups showed highly significant differences in plaque, gingival index, and clinical attachment level (P &lt; 0.001) compared to the control. The older workers have shown the highest total antioxidant capacity levels. The oil group has expressed a significant lowest total antioxidant capacity level (P &gt; 0.05) in comparison to the control. Oral lesions including ulcerations and white and red patches were absent in workers. Conclusion: Total antioxidant capacity is an important biomarker in the diagnosis of oral and periodontal diseases.