scholarly journals Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?

Author(s):  
Karan Malhotra ◽  
Kallappa C. Herakal

Background: Androgenetic alopecia is the most common cause of chronic hair loss. The FDA approved treatment for male androgenetic alopecia are Finasteride and Minoxidil. But many patients do not respond to these medications. Microneedling is a recent modality that releases several growth factors and enhances penetration of minoxidil, thereby promoting hair growth.Methods: 60 patients, aged 21-40 years, with androgenetic alopecia were divided into 2 groups. In group A, patients were subjected to microneedling twice monthly, immediately followed by application of topical 5% minoxidil solution over the scalp and then 1 ml twice daily. In group B, patients were treated with application of 1ml of topical 5% minoxidil solution over the scalp twice daily. The results were evaluated based on patient’s and physician’s assessment based on the standardized 7-point evaluation scale.Results: Patients in group A showed statistically significant improvement (p value<0.05) compared to group B. Headache and erythema were the most common side effects encountered in both the groups.Conclusions: Microneedling with 5% minoxidil is a safe, simple and cost-effective modality and is a promising treatment option for patients with androgenetic alopecia. It showed much better results when compared to use of topical 5% minoxidil solution alone.

Author(s):  
Nida Khan ◽  
Anita M. Kant ◽  
Pooja C. Thukral ◽  
Mohammad Saquib

Background: To compare the effectiveness, side effects, and patient satisfaction of buccal versus vaginal misoprostol administration in first trimester abortions.Methods: Women opting for first trimester abortion received oral Mifepristone followed 48 hours latermisoprostol. Group A received Misoprostol via buccal route whereas group B received Misoprostol vaginally. A comparative analysis using SPSS was done.Results: Giving 800µg Misoprostol by either buccal or vaginal route after oral Mifepristone have comparable efficacy in terms of complete abortion rate (96% in buccal group versus 98% in vaginal group; p value = 0.495), failure rate being statistically similar (4% versus 2%). Drug abortion interval was comparable in the two groups. (11.16 hour in buccal group and 12.32 hours in vaginal group). Few side effects like nausea and vomiting, shivering, diarrohea was significantly higher with vaginal Misoprostol while abdominal cramps, altered taste were found more with the buccal group.Conclusions: Buccal Misoprostol is comfortable and easier to administer when compared to other routes and it has potential to be developed as a self-administered regimen. Buccal Misoprostol is as efficacious as vaginal Misoprostol with significantly lesser side effects up to 7 weeks of period of gestation.


Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Bimochan Piya ◽  
Abhishek Bhattarai

Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones. Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group. Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively.  It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient. Conclusion:  The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.


Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.


Author(s):  
Shrikrushna Vasant Chavan ◽  
Niraj Nilkanth Mahajan ◽  
Arundhati Gundu Tilve

Background: Sublingual Misoprostol 200 ug 4 hrly is as effective or less effective than vaginal Misoprostol 200ug 4hrly with 200mg oral Mifepristone in termination of second trimester pregnancy.To compare effectiveness, side-effects, and patient satisfaction of sublingual vs vaginal misoprostol administration.Methods: It was prospective randomized open label study. 60 women 13-20 weeks of gestation with a valid legal indication for termination of pregnancy as per MTP act in INDIA were enrolled for study, randomly divided into Group A- Sublingual (n=30) group B-Vaginal (n=30). For group A, 200 mg of Mifepristone was given, 48h later Misoprostol 200 µg was given sublingually 4hrly up to a maximum of 5 doses. If abortion does not occur, the pregnancy was terminated with vaginal misoprostol, in group A. Same procedure repeated in group B. If abortion fails to occur after 5 doses, then second course of vaginal misoprostol was given in group B. Failure of procedure was defined as failed expulsion of foetus at 48 hrs. Results: Mean induction-abortion interval in vaginal group was 12.8±4.38h and 11.47±4.42h in sublingual group was comparable with insignificant p value (p=0.136). All the side effects were comparable in both groups. The overall success rate was 93.3% in the sublingual group while it was 100% in the vaginal group.Conclusion: Vaginal misoprostol with oral mifepristone priming in second -trimester medical abortion has a shorter time to pregnancy termination compared with a sublingual regimen. However, both the routes are equally effective for induction of abortion.


2020 ◽  
Vol 9 (2) ◽  
pp. 82-87
Author(s):  
Sumera Akram ◽  
Muhammad Ahmed Khan ◽  
Abdul Rehman ◽  
Hassan Bin Usman ◽  
Ali Abbas

Background: Streptococcal tonsillitis is a common pediatric ailment which is faced by physicians on a daily basis and is associated with disastrous complications if not treated adequately. The objective of this study was to compare the efficacy, safety and cost-effectiveness of intravenous co-amoxiclav with benzyl penicillin in the treatment of severe streptococcal tonsillitis in children. Material and Methods: This Randomized Controlled Trial was carried out at CMH Mardan, Khyber Pakhtunkhwa from January 2018 to November 2019. A total of 310 children with severe tonsillitis, aged between 5 to 15 years were selected from outpatient department of Combined Military Hospital Mardan. The cases were divided into two groups. Injection co-amoxiclav was given to patients in Group A (n=155) and injection benzyl penicillin was administered to patients in Group B (n=155). Both groups were compared in terms of effectiveness of treatment, safety and cost effectiveness. All the data was assessed with help of SPSS (Statistical Package for Social Sciences) version 21. Chi square and independent T test were used with P-value < 0.05 taken as statistically significant. Results: There were 310 children with severe tonsillitis, 155 in each group. Mean age in Group A was 9.35 ± 3.17 years and in Group B, 9.96 ± 2.96 years, respectively. In Group A, 2 cases developed hypersensitivity to injection co-amoxiclav after initial test dose as compared to 3 cases in Group B. Mean duration for complete resolution of symptoms (i.e. hospital stay) was 4.13 ± 0.375 days for Group A as compared to 4.09 ± 0.377 days for Group B (P=0.458). Mean cost of antibiotic drugs for each child in Group A was Rs. 965.88 ± 298 and in Group B was Rs. 152.36 ± 53. Benzyl penicillin was found to be significantly cost effective as compared to co-amoxiclav (P=0.000). Conclusions: Both the drugs have similar efficacy and safety profile in the treatment of severe streptococcal tonsillitis in children. However, benzyl penicillin is more cost effective than co-amoxiclav in our study population.


2019 ◽  
Vol 6 (5) ◽  
pp. 1716
Author(s):  
Anurag Bijalwan ◽  
Pradeep Singhal ◽  
Syed Altamash

Background: Post-operative adequate analgesia plays an important role in early mobilization, short hospital stay and patient satisfaction in laparoscopic cholecystectomy. The use of opioids for providing postoperative analgesia has been marked by side effects like vomiting, nausea, sedation, respiratory distress, etc. hence, alternate drugs like paracetamol (PCM) and diclofenac are commonly used. In this study, we have compared the analgesic efficacy and any associated side effects of the two commonly used non-opioid NSAIDS namely paracetamol and diclofenac.Methods: We compared 50 patients undergoing laparoscopic cholecystectomy in ASA I and II. They were randomly divided into two groups, Group A and Group B. Group A was administered intravenous PCM and Group B was administered injection diclofenac sodium. Postoperatively, these patients were assessed for pain, blood pressure, respiratory rate, and presence of any side effects like nausea, vomiting or any respiratory discomfort.Results: The mean DBP, MAP and VAS score was significantly (p-value <0.05) in Group A as compared to Group B patients at 4, 8, 12 and 24 hours postoperatively. There was no statistically significant difference in mean SBP and O2 saturation in both groups. The mean pulse rate was lower in Group A as compared to Group B at 8, 12 and 24 hours.Conclusions: This study concluded that postoperative PCM infusion provided better analgesia for a prolonged period of time with minimal side effects. 


Author(s):  
Poonam Bhojwani ◽  
Pragati Meena ◽  
Gajendra Singh Verma

Background: Medical method of abortion is a safe, effective and affordable method for first trimester termination. However, nausea, vomiting, diarhoea, excess bleeding and incomplete abortion are known side effects. The aim of study was to compare the success rate of abortions in both groups, to compare the induction-abortion interval in both groups and to study the side effects of the drugs.Methods: This study was conducted in department of obstetrics and gynecology, NIMS Medical College, Jaipur, India during June 2017-August 2017. Total hundred cases were taken and divided into two groups. Group A was gestational age upto 49 days, Group B was gestational age 50-63 days. Both groups were given tab. mifepristone 200mg. followed by 48 hrs. by 4 tablets of tab misoprostol.Results: The results of the given regimen were highly successful and complete abortion was achieved in 96% and 94% in group A and group B respectively. The difference between two groups was statistically not significant (p value =0.64). Failure rates were seen in only 4% of group A and 6% of group B. Pain abdomen was seen in 16% of group A and 38% of group B patients. The difference between both groups was statistically significant (p value=0.02). Nausea was seen in 10% of group A and 30% of group B patients. The difference between both groups is statistically significant(p value=0.018).Conclusions: First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy.


2021 ◽  
Vol 9 (06) ◽  
pp. 623-629
Author(s):  
Raxita Patel ◽  
◽  
Ami Patel ◽  
Debshree a ◽  
Vaishali Panchal ◽  
...  

Introduction: Management of missed abortion is matter of concern for obstetrician in terms of its methods and complications. Objectives: To compare efficacy, side effects and complications of sublingual and vaginal misoprostol tablet in missed abortion case of less than 20 weeks of gestation. Methods: Total 300 cases were taken, and out of those 300 cases, group A (150cases) included cases who were given sublingual misoprostol tablet, and group B (150 cases) included cases who were given vaginally misoprostol tablet. Observation: Mean gestational age is 7.9 and 8 weeks in Group A and Group B respectively. P value is 0.94. (Not significant). Mean induction abortion interval is 11.6 hours and 12.9 hours in Group A and Group B respectively i.e., the induction abortion interval is slightly short in the Group A. P value is 0.9, means the difference is not statistically significant. Mean dose of misoprostol was 1004.6 microgm and 1080 microgm for group A and group B respectively. P value is 0.029 is significant. Incidence of side effects (nausea, vomiting, unpleasant taste) was higher in group A than group B. P value is <0.05 is significant. Success rate was 86% in group A and 80% in group B. Conclusion: Sublingual and vaginal misoprostol tablet are both equally effective for medical management of missed abortion. Mean dose required for abortion is more in vaginal misoprostol but side-effects are more associated with sublingual misoprostol tablets.


Author(s):  
Kalpna Jain ◽  
J. M. Manoher

Background: Conjunctival autografting after Pterygium excision can be done by fibrin glue or sutures but use of foreign material can cause discomfort and infection. Fibrin glue may cause hypersensitivity reaction and also have risk of viral transmission. To avoid these conjuctival autograft can be applied without suture or glue. Patient’s own blood act as a bioadhesive.Methods: We done a prospective randomized control study of 70 patients, 35 patients allocated in each group. Group A had conjunctival autograft with fibrin glue while group B had conjunctival autografting without glue or sutures.Results: In group A 31 and group B 26 patients had well placed conjunctival autograft while 4 in group A and 9 patients in group B had either displaced or dislodged graft. The results were statistically insignificant with P value of 0.219 and No complication was reported in any patient except recurrence. The 5 patients in group A and 6 in group B had recurrence which is not statistically significant.Conclusions: Graft stability is more with fibrin glue as compare to glueless and sutureless conjunctival autografting but using patients own blood as bioadhesive is safer and cost effective. The rate of recurrence is similar in both the groups.


2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.


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