Therapeutic Effects of Tranexamic Acid Cream in Comparison to Hydroquinone 4% Cream in Treatment of Melasma: A Split Face Comparative Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Noha Shukry El Dosouky Rakha ◽  
Nermeen Samy Abdel Fattah ◽  
Rania Mahmoud El Husseiny ◽  
Mohamad Abd Al Naeem Sallam
Keyword(s):  
Patient Satisfaction ◽  
Tranexamic Acid ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Average Level ◽  
Therapeutic Effects ◽  
Patient Satisfaction Score ◽  
3D Camera ◽  
Different Types ◽  
Split Face

Abstract Background Melasma is a chronic, acquired pigmentary disorder characterized by gray-brown macules and patches affecting photodistributed part of the face such as the bridge of the nose, cheek, upper lip, forehead, and mandible. It is seen mostly in women of reproductive age group and has an onset usually after pregnancy. However, in around 10% of the cases, males are also affected. Objectives The aim of our study was to assess and compare the therapeutic effects of tranexamic acid cream versus hydroquinone 4% cream in treating patients with melasma. Patients and Methods This prospective split face comparative study included thirty three patients with their age ranging from 18 to 40 years, participated for treatment of different types of melasma, recruited from outpatient clinic of Dermatology department Ain Shams University Hospitals during the period from January to June 2019. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided informed consent. Results Both topical TA and HQ 4% cream were efficient in treatment of different types of melasma as shown by significant decrease in Hemi MASI score, patient satisfaction score, significant decrease in average level of melanin measured by Antera 3D camera and significant decrease in area % of melanin by histopathological evaluation after 3 months of treatment, although slight recurrence of melasma was observed one month after stopping both treatments. Meanwhile, no significant difference was observed in treatment response of TA and HQ regarding Hemi MASI score, patient satisfaction score, average level of melanin (Antera 3D camera). This could be attributed to the small number of included patients. Conclusion We concluded that the TA appears to be a promising therapeutic option in the treatment of melasma. TA has fewer adverse effects, same or even better results in comparison with other melasma targeting therapies as hydroquinone cream.

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

scholarly journals COMPARING THE EFFECTS OF BUPIVACAINE AND ROPIVACAINE INSTILLATION FOR POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LUMBER SPINE SURGERY: A PROSPECTIVE RANDOMISED DOUBLE BLIND STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shashikant Sharma ◽  
T. Prabhakar ◽  
Usha Shukla ◽  
Shagufta Naaz
Keyword(s):  
Heart Rate ◽  
Patient Satisfaction ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Respiratory Rate ◽  
Visual Analogue Score ◽  
Study Groups ◽  
Satisfaction Score ◽  
Patient Satisfaction Score ◽  
Surgeon Satisfaction

As it is a comparative study of Bupivacaine and Ropivacaine therefore Ropivacaine is a long-acting amide local anaesthetic with a potentially improved safety profile when compared to bupivacaine . Ropivacaine is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in a relatively reduced motor blockade. Subject and Methods:  90 patients, who belongs to American society of Anesthesiologist grade I & II of age 18-65 years randomized into three groups (n=30). All three groups received propofol bolus 0.75mg/kg IV followed by IV infusion at 0.025 mg/kg/min. group A received Nalbuphine 50 μg/kg IV bolus, group B fentanyl 1.5 μg/kg IV bolus and group C received Dexmedetomidine infusion 1 μg/kg given over 10 min as bolus followed by 0.1 mg/kg/hr IV infusion for maintenance. Ramsay sedation score and Visual analogue scale measured for sedation and analgesia respectively at 10 minute interval for 1st hour of surgery then every 30 minutes upto the end of surgery. Desired RSS was defined 3-5. Intraoperative hemodynamic variables viz. Heart Rate (HR), Respiratory Rate (RR), Mean Arterial Pressure (MAP) and SPO2 were recorded every 10 min till the end of surgery. Recovery was assessed using Modified Aldrete Score in the recovery room. Time to achieve Aldrete recovery score of 10 was recorded. Patient satisfaction score and Surgeon satisfaction score were noted using a 7-point Likert verbal rating scale. Results: The groups were comparable with respect to demographic parameters. Ramsay sedation was significantly higher in Dexmedetomidine group (P<0.05) than Nalbuphine and fentalyl group, while Visual analogue score was comparable in all three study groups (p>0.05). Heart rate and Mean arterial pressure both significantly decreased in Dexmedetomidine group from the baseline during study period (p<0.05). Respiratory rate and SPO2 were comparable in all three groups. In this study MAP was never <60 mmhg, SPO2 was never <94% and Respiratory rate was never <12 bpm. Time to achieve modified alderate score in Dexmedetomidine (0.93±2.33 min) was significantly least as compare to Nalbuphine (1.80±2.65) & Fentanyl group (3.50±4.76) (p=0.016). Patient satisfaction score in Dexmedetomidine was significantly higher (6.53±0.44) (p=0.005). Surgeon satisfaction score in Dexmedetomidine was also significantly higher (6.73±0.52) (p=0.000). Two patients in Dexmedetomidine group had episode of bradycardia which was managed with injection Atropine 0.6 mg effectively Conclusion: From these observations and analyses of the present study, it can be inferred that: ❖ Sedation in Dexmedetomidine was acceptable when used for MAC for middle ear surgeries. ❖ Visual analogue score was similar in all three study groups. ❖ Heart rate & Mean arterial pressure in Dexmedetomidine was lower than baseline value. ❖ Changes in Respiratory rate and SPO2 were similar in all three study groups. ❖ Time to achieve Modified alderate score of 10 in group Dexmedetomidine was least, suggesting quicker recovery from anesthesia. ❖ Patient and surgeon satisfaction score in Dexmedetomidine was significantly higher. Keywords: Dexmedetomidine, Nalbuphine, Bupivacaine, Ropivacaine

scholarly journals Lumbar canal stenosis: analyzing the role of stabilization and the futility of decompression as treatment

2019 ◽  
Vol 46 (5) ◽  
pp. E7 ◽  
Author(s):  
Atul Goel ◽  
Shashi Ranjan ◽  
Abhidha Shah ◽  
Abhinandan Patil ◽  
Ravikiran Vutha
Keyword(s):  
Patient Satisfaction ◽  
Nodal Point ◽  
Satisfaction Score ◽  
Spinal Instability ◽  
Fixation Technique ◽  
Patient Satisfaction Score ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Spinal Segments

OBJECTIVEThe authors report their current experience with their previously published novel form of treatment in 70 cases of lumbar canal stenosis. The treatment consisted of only fixation of the spinal segments by the transarticular screw fixation technique. No bone, ligament, osteophyte, or disc resection was done for spinal canal and neural foraminal decompression. The proposed treatment is based on the concept that vertical instability that results in telescoping of the facets on physical activity forms the nodal point of pathogenesis of lumbar canal stenosis.METHODSDuring the period June 2014 to May 2018, 70 patients presenting with the classically described symptoms of lumbar canal stenosis were treated surgically by only fixation of involved spinal segments. Apart from clinical and radiological guides, instability was diagnosed on the basis of physical observation of the status of articulation by direct manipulation of bones of the region. The operation involved transarticular insertion of 2 or 3 screws for each articulation. The Oswestry Disability Index and visual analog scale were used to assess the patients before and after surgery and at follow-up. Additionally, a personalized patient satisfaction score was used to assess the outcome of surgery.RESULTSClinical symptomatic recovery was observed in all patients in the immediate postoperative period. During the average follow-up period, 100% of patients had varying degrees of symptomatic relief. The patient satisfaction score suggested that all patients were very satisfied with the surgical procedure. The transarticular fixation technique provided strong spinal segment fixation and a reliable ground for bone arthrodesis. No patient needed any additional modality of treatment or reoperation for recurrence of symptoms.CONCLUSIONSSpinal instability is the nodal point of pathogenesis of spinal degeneration–related lumbar canal stenosis. Only fixation of the involved spinal segments is necessary—decompression by bone or soft-tissue resection is not necessary.

Factors Influencing Patient Satisfaction after Microvascular Decompression for Hemifacial Spasm: A Focus on Residual Spasms

2021 ◽  
pp. 1-9
Author(s):  
Jeong-A Lee ◽  
Doo-Sik Kong ◽  
Soo Jung Kim ◽  
Seunghoon Lee ◽  
Sang-Ku Park ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Surgical Outcomes ◽  
Social Life ◽  
Interpersonal Relationship ◽  
Psychological Problem ◽  
Satisfaction Score ◽  
Patient Satisfaction Score ◽  
Significant Difference

<b><i>Introduction:</i></b> Patients with hemifacial spasm (HFS) experience improvement in symptoms after microvascular decompression (MVD); however, patient satisfaction is sometimes low. This study aimed to analyze the relationship between residual spasms and patient satisfaction, identify factors affecting satisfaction, and investigate the degree of improvement in spasms which result in patient satisfaction after surgery. <b><i>Methods:</i></b> 297 patients who completed a questionnaire after MVD for HFS between March 2020 and June 2020 were included. Information on surgical outcomes and patient satisfaction was collected using the questionnaire, and their relationships were analyzed. <b><i>Results:</i></b> Among the 297 patients, the mean residual spasm percentage and patient satisfaction score were negatively correlated with 14.0% and 8.8 points, respectively. In addition to residual spasms, discomfort caused by persistent spasms, psychological problem-solving, better social life, and interpersonal relationship improvement were associated with satisfaction. There was no significant association between the presence of complications and satisfaction. There was no significant difference in the satisfaction score at up to 30% residual spasm, and the patients with 0–30% residual spasm had a satisfaction score of 7 points or higher. <b><i>Conclusion:</i></b> Residual spasms and discomfort from residual spasms decreased patient satisfaction after MVD for HFS. It is then necessary to perform accurate surgical resolution to improve surgical outcomes and provide adequate management to reduce postoperative discomfort and anxiety, and ultimately to enhance satisfaction. Residual spasms of up to 30% compared with the preoperative severity can be considered a good outcome when evaluating surgical outcomes.

A Split Face Comparative Study between Intradermal Tranexamic Acid and Erbium-YAG laser in Treatment of Melasma

2020 ◽  
pp. 1-22
Author(s):  
Sarah Otb ◽  
Eman Shaarawy ◽  
Ahmad Sadek ◽  
Noha Abdulla ◽  
Naglaa Agamia ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Comparative Study ◽  
Yag Laser ◽  
Split Face

Evaluation of the Efficacy of Intense Pulsed Light in Skin Rejuvenation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Meram Adel Mohammad ◽  
Rania Mahmoud El-Husseiny ◽  
May Hussein Elsamahy
Keyword(s):  
Patient Satisfaction ◽  
Skin Aging ◽  
Intense Pulsed Light ◽  
University Hospital ◽  
Pulsed Light ◽  
Skin Rejuvenation ◽  
Patient Satisfaction Score ◽  
Dermatology Clinic ◽  
Photodamaged Skin ◽  
3D Camera

Abstract Background The pathology of skin aging is a very complex process. There are extrinsic and intrinsic factors which contribute to the pathogenesis of skin aging. Intrinsic (chronological) aging is caused by inherited genes, and extrinsic aging caused by many external factors such as exposure to the sun. With increasing age, more people are seeking to maintain the health of their skin and the demand for treatment of aged skin has raised.(1) Aim of the Work To evaluate the efficacy of Intense Pulsed Light in skin rejuvenation with assessment by antera 3D camera. Patients and Methods This study is a single arm interventional study which included 21adult housewives female patients complaining of different signs of facial photodamage, their age ranged between 30 -40 years, recruited from outpatient dermatology clinic of Ain Shams University Hospital, from June 2018 to January 2019. Patients were subjected to 4 sessions of IPL treatments 2 weeks apart for skin rejuvenation. Evaluation of treatment response was done through Global Aesthetic Improvement Scale (GAIS), Antera 3D camera and patient satisfaction score. Results There was highly significant decrease in indentation index of wrinkles, roughness index of skin and average level of melanin (average of whole face) measured by Antera 3D camera after last IPL treatment session (p value=0.001). Conclusion IPL is proven to be safe and elicited a significant skin rejuvenating effect without prolonged downtime.It is effective in treating various manifestations of photodamaged skin, as consistently enchoed by patient satisfaction scores, GAIS and Antera 3D camera results.

scholarly journals Patient Satisfaction versus Patient Reported Outcomes

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0014
Author(s):  
Chayanin Angthong
Keyword(s):  
Patient Satisfaction ◽  
Patient Reported Outcomes ◽  
Satisfaction Score ◽  
Successful Outcome ◽  
P Value ◽  
Treatment Level ◽  
Foot And Ankle ◽  
Patient Satisfaction Score ◽  
Sf 36 ◽  
Patient Reported

Category: Other Introduction/Purpose: Several researches focused on patient reported outcomes (PROs), however, little is known about the actual correlation between the patient satisfaction and PROs. The present study is to determine the correlation between patient satisfaction and PROs. Methods: A total of 35 patients with foot and ankle disability participated in this study to complete the data in terms of the patient satisfaction score and PROs. All of them were treated by a single foot and ankle surgeon. The Thai patient satisfaction score or Foot and Ankle Satisfaction Score [FASS] (0 [worst] -100 [best]) consisted of 4 items regarding patient’s perspectives as 1) symptoms, 2) function, 3) other complaints, and 4) recommendation of his/her treatment for other patients. PROs measures consisted of validated Thai visual analogue scale foot and ankle (VASFA) (0 [worst] -100 [best]) and Thai Short Form-36 (SF-36) (0 [worst] -100 [best]). Results: Mean total FASS was 92.0 ± 11.8, 87.7 ± 17.0, 98.6 ± 6.0, 98.6 ± 8.5 and for the items: symptoms, function, other complaints, and recommendation of his/her treatment for other patients, respectively. Mean total FASS was 94.2 ± 6.8. Mean VASFA was 67.7 ± 18.3. Mean SF-36 was 82.7 ± 10.7.There were no significant correlations between mean total FASS and PROs (VASFA [p-value < 0.05], SF-36 [p-value <0.05]). There were no significant correlations between mean FASS in all items and PROs (VASFA, SF-36) with all p-values < 0.05. The significant correlation was found between VASFA and SF-36 (Pearson correlation coefficient = 0.734; p-value<0.01). Conclusion: One of the successful treatment results is the improvement of patient satisfaction. Even if several researches focused on the assessment of PROs to achieve the successful outcome, this kind of measures was no significant correlation with patient satisfaction. PROs were not able to reflect the patient satisfaction following treatments. Patient satisfaction may be related to other parameters, in addition to the PROs, such as the patient expectation, the post-treatment level of physician-patient relationship, the patient’s confidence in his/her physician capability, etc. Further study is needed to clarify these factors.

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