A comparative study of Fractional co2 laser combined with topical methotrexate versus Fractional co2 laser combined with topical [Calcipotriol + Betamethasone] in the treatment of nail psoriasis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Adel Shahin ◽  
Ahmed Abd -Elfattah Afify ◽  
Mahmoud Gamal El - Sadek El-Banna
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Co2 Laser ◽  
Negative Impact ◽  
Negative Consequences ◽  
University Hospitals ◽  
Nail Psoriasis ◽  
Fractional Co2 Laser ◽  
Clinical Difference ◽  
Calcipotriol Betamethasone

Abstract Background Nail psoriasis is a distressing clinical condition as it is known that psoriasis on visible areas of the skin, such as the face, hands and nails, may have a substantial negative impact on physical, psychological, and social dimensions of quality of life. The additional negative consequences of nail involvement in psoriasis are pain, inability to grasp small objects, tie shoe laces or button clothes, and cause an altered sense of fine touch. Objective To evaluate and compare the efficacy, safety and side effects of co2 laser combined with topical methotrexate in one side and topical (calcipotriol +betamethasone) in the other side of the patient for the treatment of nail psoriasis. Patients and Methods This comparative pilot study included 20 patients with nail psoriasis. They were recruited from the dermatology out-patient clinic of Ain–Shams University Hospitals, during the period from March 2019 till October 2019. The study was approved by Research Ethical Committee of Ain Shams University (FMASU M S 71/2019) and fulfilled all the ethical aspects required for a human research. Results Our study revealed that both medications showed marked statistical and clinical improvement of the nail condition in a period of 2 months when applied topically after nail exposure to fractional co2 laser which facilitated the delivery of both medications through the nail plates to the site of the psoriasis inflammation in therapeutic concentrations by creating pores through the nails. There was no statistical or clinical difference between both medications regarding the improvement of the NAPSI scores or the level of patient satisfaction. However, there were some nail symptoms that didn’t show any improvement as (sub-ungual hyperkeratosis and nail ridging). Conclusion Our treatment protocol’s side effects based mainly on the action of fractional co2 laser which caused pain and nail bleeding during sessions for some of the patients in each group, while topical methotrexate caused nail yellowish discoloration for the all involved group. However, these side effects lasted for very short time and didn’t have any impact on the level of the patient satisfaction. There was no statistical difference in the level of the patient satisfaction between both groups.

scholarly journals The effectiveness of Fractional CO2 laser and long-pulsed ND- YAG laser in managing striae

2021 ◽  
Author(s):  
Hendawy AF ◽  
Aly DG ◽  
Shokeir HA ◽  
Samy NA
Keyword(s):  
Side Effects ◽  
Clinical Improvement ◽  
Co2 Laser ◽  
Nd:Yag Laser ◽  
The Other ◽  
Yag Laser ◽  
Fractional Co2 Laser ◽  
Pregnant Females ◽  
Significant Difference ◽  
Significant Clinical Improvement

Abstract Background: Striae Distansae (SD) are a disfiguring dermal condition, characterized by linear bands of atrophic skin, occurring at sites of dermal damage caused by stretching. They affect adolescents and more than 70% of pregnant females due to stretching of the skin. Aims: To evaluate and to compare the efficacy of 1, 064 nm Long Pulsed Nd: YAG laser and Fractional CO2 laser in the management of SD. Patients/Methods: Thirty female patients with bilateral symmetrical SD were treated with Fractional CO2 laser on one side and long-pulsed Nd: YAG laser on the other side. All patients received 3 sessions at 3 weeks interval. Global Aesthetic improvement scale (GAIS) and was used to evaluate improvement 3 months post treatment. Four mm punch biopsies were taken from each side before treatment and 3 months after the last session to measure epidermal and collagen thickness. Findings: More significant clinical improvement was noted with the Nd:YAG laser than Fractional CO2 laser. Both GAIS and satisfaction score were significantly higher in the Nd:YAG laser treated side epidermal and collagen thickness were evidently increased in the Nd: YAG laser treated lesions than those treated by Fractional CO2 laser with no significant difference. Conclusions: Long pulsed Nd-YAG laser is clinically more effective than the Fractional CO2 laser in treating SD without serious side effects, although there was no significant difference between them histopathologically.

scholarly journals The epileptic multifactorial patient’s burden. Review of the topic

2016 ◽  
Vol 24 (2) ◽  
pp. 167-172 ◽  
Author(s):  
José Pimentel
Keyword(s):  
Side Effects ◽  
Negative Impact ◽  
The Elderly ◽  
Negative Consequences ◽  
Childbearing Age ◽  
Unexpected Death ◽  
Neurologic Diseases ◽  
Clonic Seizures ◽  
Negative Impacts

Summary Background. Approximately 26% of the burden of neurologic diseases is due to epilepsy. Its negative impact reflects mainly on people with epilepsy (PWE) themselves. Aims. To highlight the negative impacts of epilepsy on the lives of PEW’s so as to identify a realistic approach to their individual needs. Methods. For recently published papers PubMed and MEDLINE databases were used. In addition relevant references mentioned in the searched articles were also considered. Review and discussion. Generalized tonic-clonic seizures and refractory epilepsy are the most important factors burdening PWE’s, resulting in increased injuries and mortality, including Sudden Unexpected Death in Epilepsy (SUDEP). The need of chronic intake of antiepileptic drugs (AEDs) and of epilepsy surgery are also important with regards to potential for side effects, drug interactions, and different surgery risks. PWE harbour more medical and psychiatric comorbidities than the general population and results in a decreased quality of life. Decreased self-esteem and major stigma are also frequent, linked to social, economic and personal negative consequences. Age also plays a role, younger people being more stigmatized given the interdiction to drive or difficulty in getting a job. In the elderly, seizures may have an impact on mental status, mood and sleep. Gender may also contribute, particularly involving women in childbearing age, linked to the fear or depression due to the possibility of AED-induced fertility disturbances, foetal malformations, or breast feeding side-effects. Conclusions. The burden that PWE face must be considered by all people involved in the management of their epilepsy. The causes may be multifactorial, all interconnected and each one influencing the others.

75 Does Topical Steroid after Fractional CO2 Laser Treatment of Scars Make a Clinical Difference?

2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S42-S43
Author(s):  
S A Blome-Eberwein ◽  
D Boorse ◽  
P Pagella ◽  
C Gogal ◽  
M Sobotor
Keyword(s):  
Laser Treatment ◽  
Co2 Laser ◽  
Topical Steroid ◽  
Fractional Co2 Laser ◽  
Clinical Difference ◽  
Co2 Laser Treatment

scholarly journals Efficacy and Side Effects of Fractional Carbon Dioxide Laser for Acne Scars, Keloids, and Striae Albae in the Dermatovenereology Clinic of Tertiary Hospital: A Retrospective Study

2021 ◽  
Vol 33 (1) ◽  
pp. 19
Author(s):  
Riezky Januar Pramitha ◽  
Iskandar Zulkarnain ◽  
Evy Ervianti ◽  
Rahmadewi Rahmadewi ◽  
Afif Nurul Hidayati ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Side Effects ◽  
Co2 Laser ◽  
Carbon Dioxide Laser ◽  
Scar Tissue ◽  
Tertiary Hospital ◽  
Fractional Co2 Laser ◽  
Acne Scars ◽  
Laser Treatments ◽  
Carbon Dioxide Co2

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.

scholarly journals COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
University Hospitals ◽  
Health Crisis ◽  
Patient Satisfaction Questionnaire ◽  
Telephone Consultation ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p< 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p > 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

scholarly journals The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

2021 ◽  
Author(s):  
Marina Yiasemidou
Keyword(s):  
Infection Control ◽  
Surgical Training ◽  
New Technologies ◽  
Negative Impact ◽  
Elective Surgery ◽  
Control Measures ◽  
Negative Consequences ◽  
Surgical Services ◽  
The World ◽  
The Impact

AbstractThe COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and ‘face-to-face’ clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.

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