Keerthi Reddy

Youtube and Food Allergy: An Appraisal of the Educational Quality of Information

Food allergy affects an estimated 8% of children and 3% of adults in the United States. Food‐allergic individuals increasingly use the web for medical information. We sought to determine the educational quality of food allergy YouTube videos.

Olopatadine hydrochloride ophthalmic solution for the treatment of allergic conjunctivitis

ABSTRACT Introduction: Olopatadine hydrochloride is an antihistamine and mast cell stabilizer available as oral, intranasal and ocular preparations. Most of the practical applications of olopatadine therapy focus on the treatment of allergic rhinoconjunctivitis via intranasal and ocular routes. Areas covered: This article was created from a comprehensive literature search with information taken from meta-analyses, systematic reviews, and clinical trials of children and adults. The articles that have been selected, evaluate the use of intranasal and ocular antihistamines and their role in allergic rhinoconjunctivitis. Expert opinion: Olopatadine is significantly more effective than placebos in relieving the symptoms of allergic rhinoconjunctivitis. It can function both as a viable alternative or addition to first line therapies such as intranasal steroids and oral antihistamines.

Bullous Fixed Drug Eruption Secondary to Chlorthalidone

A fixed drug eruption (FDE) is a delayed hypersensitivity reaction characterized by solitary or multiple hyperpigmented oval lesions that may affect any part of the body. These lesions have a predilection for the trunk, lips, hands, and genital mucosa, and may recur on the same sites upon introduction of the causative agent. The drugs most commonly associated with FDE are antibiotics, analgesics, and anticonvulsants. We present a case of chlorthalidone-induced bullous FDE. A 60-year-old woman with a medical history of hypertension and seasonal allergic rhinitis presented with a 4-year history of a recurring annual rash. Her only medication was chlorthalidone, which the patient had been taking consistently for the past 15 years. On presentation, she exhibited violaceous, pruritic, painful, 4-cm, circular papules with central blistering (Figure 1, A) located in her eyelids (Figure 1, B), lips (Figure 1, C), trunk, and extremities. The lesions recurred on the same location each year and lasted for approximately 1 week with complete resolution in 1 month (Figure 1, D). Laboratory workup was within normal limits including complete blood cell count with differential, complete metabolic panel, erythrocyte sedimentation rate, C-reactive protein, C3, C4, antinuclear antibody, and urinalysis. Initial biopsy with hematoxylin and eosin stain and immunofluorescence was nonconclusive. She was initially treated with desloratadine 5 mg, hydroxyzine 25 mg, and betamethasone cream daily without improvement. A repeat biopsy from a latephase lesion revealed nonspecific postinflammatory hyperpigmentation. The main differential diagnosis included necrotizing angiitis, erythema multiforme, and Steven-Johnson syndrome. Chlorthalidone was held because of a suspected FDE. Following this intervention, the patient remained lesion free for the last 18 months with the exception of hyperpigmented cutaneous changes on previously affected areas (Figure 1, E). Patch testing and challenge were declined. The patient was instructed to avoid all thiazide-type diuretics and use equally efficacious alternatives.

Poland syndrome: a case report

Poland syndrome (PS) is a rare chest wall developmental anomaly characterised by ipsilateral agenesis/hypoplasia of the sternocostal head of pectoralis major, hypoplasia of nipple or breast, absence of subcutaneous fat, multiple rib abnormalities, elevated and rotated scapula (Sprengel deformity) and ipsilateral digit abnormalities (brachydactyly, syndactyly). These findings vary and all are rarely found in a single individual. Our case involves an 8-year-old boy with no medical history who presented for evaluation of chronic rhinitis. There was no breathing or cardiac complaints on review of systems. Physical examination showed chest asymmetry with right anterior chest wall depression and flattening of the right pectoral region with displaced nipple (figure 1). Abduction of the shoulders showed absence of the sternocostal head of pectoralis major. Hand examination did not show any signs of …