Dermoscopic evaluation of therapeutic response to intralesional triamcinolone acetonide in the treatment of Alopecia areata

Background: Alopecia areata is a common auto-immune condition, characterized by circumscribed, patches of hair loss usually of the scalp. There are various treatment modalities available but no treatment is fully curative or preventive. Also, alopecia areata can have devastating effects on the patient’s quality of life and self-esteem. The aim of this study was to determine dermoscopy findings of alopecia areata that could be used as a clinical indicator of disease and also to evaluate the efficacy of intralesional injection Triamcinolone acetonide in the treatment of alopecia areata.Methods: Seventy patients with alopecia areata, aged between 11 and 56 years were injected with intralesional triamcinolone acetonide at a 4 weeks interval. Treatment response was evaluated using re-growth scale approach. Dermlite DL3 dermoscope was used to assess disease activity, response to treatment and side effects. Using Wilcoxon signed rank test, changes were assessed in the severity of the disease during follow-ups.Results: Baseline mean percentage area of scalp involved was 23.21±10.70. All the patients had black dots, 98.6% had yellow dots, 27.1% had broken hair, 74.3% had tapering hair and only 71.4% had vellus hair. At baseline, 15 (21.4%) patients had Alopecia Grading Score (AGS) 1, 29 (41.4%) had score 2 and 26 (37.1%) had a score of 3. Injection Triamcinolone acetonide (5 mg/ml) was injected at 1 cm intervals with 0.1 ml on each site and the procedure was repeated every 4 weeks for a maximum period of 24 weeks. From baseline level to the last follow up, proportion of patients with black dots reduced from 100% to 4.3%, yellow dots from 98.6% to 0%, broken hair from 17% to 0% and tapering hair from 74.3% to 0%. Vellus hair increased from 71.4% to 100%. Overall success rate in terms of achievement of re-growth Ssore 4 at last follow up was 60%.Conclusions: Dermoscopic characteristics, such as black dots, yellow dots, broken hair, tapering hair and clustered short vellus hair are primary indicators of alopecia areata.

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Study the Effect of Ipomea carnea Jacq. Patra swarasa (Leaves Juice) in Treatment of Indralupta (Alopecia Areata): A Pilot Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i37a31971 ◽

2021 ◽

pp. 1-6

Author(s):

Prashant R. Umate ◽

Pramod D. Khobragade ◽

Saurabh Deshmukh ◽

Sonali Wairagade ◽

Minal Kalambe ◽

...

Keyword(s):

Alopecia Areata ◽

Negative Impact ◽

Cost Effective ◽

Treatment Modalities ◽

Rank Test ◽

Signed Rank ◽

Cost Effective Treatment ◽

Signed Rank Test ◽

Life Threatening ◽

Leaf Juice

Introduction: Hair and skin disease create negative impact on individuals. Although such diseases doesn’t have any life threatening effects like systemic diseases still have much more importance as the cosmetic issue concern. Indralupta is a rare entity found in both male, and female at any age which can be correlated with Alopecia areata. There are many treatment modalities are available for the Indralupta (Alopecia areata) but application of leaf juice of Ipomoea carnia is simple and cost effective treatment. Aim &Objective: Study the effect of Ipomea carnea Jacq. patra swarasa (leaves juice) in management of Indralupta (Alopecia Areata). To study the adverse effects of Ipomea carnia leaf juice local application if noted during study. Methodology: Fresh leaf juice will be extracted from clean leaf of Ipomea carnia and apply over the spot where hairs are lost for 15 days at morning before bath. 10 objects will be selected from kaychikitsa OPD randomly and consider for study after their willingness and consent. Outcomes will be assessed with the help of different criteria according to hair texture, Hair fall and scalp area examination. Result: Result will be observed according to criteria and Wilcoxon signed rank test will be a applied. Conclusion: Ipomea carnea will be effective in Indralupta(Alopecia areata).

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Response to treatment with intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligo articular juvenile idiopathic arthritis

Pediatric Rheumatology ◽

10.1186/s12969-021-00520-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Rana Harhay ◽

Wajiha Jeelani ◽

Barbine Tchamba Agbor Agbor ◽

Teresa Hennon ◽

Brian H. Wrotniak ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Side Effects ◽

Triamcinolone Acetonide ◽

The United States ◽

Response To Treatment ◽

Joint Injection ◽

Triamcinolone Hexacetonide ◽

Active Arthritis ◽

General Response

Abstract Background Oligo-articular juvenile idiopathic arthritis (Oligo JIA) is the most common subtype of juvenile idiopathic arthritis. Intra-articular corticosteroid (IAC) injection is a mainstay treatment of oligo JIA providing pain relief, improving mobility and preventing further joint destruction in the majority of patients. In 2015, production of triamcinolone hexacetonide (TH) an intra-articular corticosteroid was discontinued in the United States leading to use of triamcinolone acetonide (TA) as an alternative. In this study, we compared response to treatment in children with oligo JIA who underwent therapy with intra-articular TA and TH injection. Methods Our study is a retrospective chart review of children with oligo JIA who were treated with IAC injections with TH between January 2012 and June 2015 and TA between J uly 2015 and December 2018. The two groups were followed at John R. Oishei Children’s Hospital of Buffalo and were evaluated for response to treatment, side effects and predictors of response including duration of disease before treatment, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). Response to treatment was defined as at least 6 months follow up without evidence of active arthritis in injected joints. Patients were considered to be non-responders if they continued to show active arthritis during their first follow up after joint injection. The primary objective was to evaluate whether there was a significant difference in rate of response between TH and TA. Results Forty-nine patients, 38 female and 11 male with oligo JIA were included in the study. The average age was 6.7 years. A total of 111 joints were injected includin g 78 knees, 13 ankles, 9 wrists, 4 hips, 4 elbows, 2 TMJ and one subtalar joint. In the TA group, 49% (29/59) did not show response to injection compared to 27% (14/52) in the TH group. After 6 months, response rates were better for individuals injected with TH compared to TA (73% vs. 51%). In general, response to intra-articular TH was superior to TA with P = .016 using chi-square test of independence. This difference in outcome was not influenced by other variables such as duration of illness before treatment (P value 0.784) or elevated ESR and CRP. No difference in side effects between the two groups were noted. Conclusion Our results in conjunction with prior published data suggests that TH intra-articular joint injection in oligo JIA is superior to TA, although future controlled trials are necessary for confirmation. An effective, long lasting treatment can have a great impact on the outcome of these children.

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Clinical and doppler monitoring of patients with Takayasu arteritis with ITAS 2010 and CDUS-K score respectively following medical intervention: a 12 months follow-up study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184415 ◽

2018 ◽

Vol 6 (11) ◽

pp. 3602

Author(s):

Debanjali Sinha ◽

Sumantro Mondal ◽

Arijit Nag ◽

Debasish Lahiri ◽

Alakendu Ghosh

Keyword(s):

Disease Activity ◽

Disease Progression ◽

Takayasu Arteritis ◽

Medical Intervention ◽

Matched Pair ◽

Rank Test ◽

Colour Doppler ◽

Signed Rank ◽

Signed Rank Test

Background: The objective of the present study was to monitor the disease activity of Takayasu arteritis clinically by the Indian Takayasu Activity Score 2010 (ITAS) and ultra sonographically by Colour Doppler Ultrasound-Kolkata (CDUS-K) Score after 12months of treatment with methotrexate and steroid, and to find the correlation between these two scores.Methods: Around 25 Angiographically proven Takayasu arteritis patients were treated with Methotrexate (15mg weekly) and Steroids (1mg/kg/day for 6weeks and then tapered) for 12months. Wilcoxon matched pair signed rank test was done to assess the change in ITAS 2010 with treatment. A correlation study was done between ITAS 2010 and change in CDUS-K scores at the end of 12months.Results: By Wilcoxon’s matched pair signed rank test, a non-significant change of ITAS 2010 (p=0.066) was observed at the end of 12months, which means that the treatment helps to control the disease progression by preventing a significant increase in ITAS 2010. Strong correlation (correlation coefficient of 0.878, 95% CI = 0.602 to 1.000) was found between the ITAS 2010 and change in CDUS-K scores at 12months follow up.Conclusions: The combination of Methotrexate and steroids helps to control the disease progression in Takayasu arteritis. Colour doppler ultrasonography may serve as a reliable and safe surrogate disease activity measure at follow up, as it avoids the radioactivity exposure and invasiveness of angiography.

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Treatment of Chalazian: a Comparative Cross-sectional Study

Europasian Journal of Medical Sciences ◽

10.46405/ejms.v1i1.3 ◽

2019 ◽

Vol 1 (1) ◽

pp. 5-9

Author(s):

Binita Bhattarai ◽

Koshal Shrestha ◽

Sushila Patel ◽

Laxmi Devi Manandhar ◽

Rosy Karki ◽

...

Keyword(s):

Triamcinolone Acetonide ◽

Complete Resolution ◽

Cross Sectional Study ◽

Meibomian Gland ◽

Intralesional Injection ◽

Cross Sectional ◽

Female Ratio ◽

Male Female Ratio ◽

Eye Symptoms

Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland

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A New Biomarker Tool for Risk Stratification in “De Novo” Acute Heart Failure (OROME)

10.21203/rs.3.rs-154510/v1 ◽

2021 ◽

Author(s):

Rosa Agra Bermejo ◽

Carla Cacho-Antonio ◽

Eva Gonzalez-Babarro ◽

Adriana Rozados-Luis ◽

Marinela Couselo-Seijas ◽

...

Keyword(s):

Heart Failure ◽

Predictive Model ◽

De Novo ◽

Acute Phase Reactant ◽

Rank Test ◽

Post Discharge ◽

Kaplan Meier ◽

Acute Phase Reactant Protein ◽

Severity Of The Disease

Abstract Background: Inflammation is one of the mechanisms involved on heart failure (HF) pathophysiology. Thus, the acute phase reactant protein, orosomucoid, was associated with a worse post-discharge prognosis in de novo acute HF (AHF). However, the presence of anti-inflammatory adipokine, omentin, might protect and reduce the severity of the disease. We wanted to evaluate the value of omentin and orosomucoid combination for stratifying risk of these patients.Methods and Results: Two independent cohorts of patients admitted for de novo AHF in two centers were included in the study (n=218). Orosomucoid and omentin circulating levels were determined by ELISA at discharge. Patients were follow-up for 317 (3-575) days. A predictive model was determined for primary endpoint, death and/or HF readmission. Differences in survival were evaluated using a Log-rank test. According cut-off values of orosomucoid and omentin, patients were classified on UpDown (high orosomucoid and low omentin levels), equal (both proteins high or low) and DownUp (low orosomucoid and high omentin levels). The Kaplan Meier determined worse prognosis for the UpDown group (Long-rank test p=0.02). The predictive model that includes the combination of orosomucoid and omentin groups (OROME) + NT-proBNP values achieved a higher C-index=0.84 than the predictive model with NT-proBNP (C-index=0.80) or OROME (C-index=0.79) or orosomucoid alone (C-index=0.80). Conclusions: The orosomucoid and omentin determination stratifies de novo AHF patients in high, mild and low risk of rehospitalization and/or death for HF. Its combination with NT-proBNP improves its predictive value in this group of patients.

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The effect of lumbosacral manipulation on growing pains

Health SA Gesondheid ◽

10.4102/hsag.v20i1.922 ◽

2015 ◽

Vol 20 (1) ◽

Author(s):

Dawid De Beer ◽

Charmaine M. Bester

Keyword(s):

Tibialis Anterior Muscle ◽

Specific Treatment ◽

Conclusive Evidence ◽

Self Report ◽

Response To Treatment ◽

Rank Test ◽

Positive Effects ◽

Pressure Algometer ◽

Growing Pains

Background: Growing pains are a frequent clinical presentation that continues to puzzle practitioners, with very little conclusive evidence in any medical field, including chiropractic.Objective: The aim of this study was to determine whether lumbosacral manipulations have an effect on growing pain symptoms.Methods: Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of 15 participants each. Group 1 received lumbosacral manipulations to restricted joints as determined by motion palpation, while Group 2 never received any professional intervention. Often parent(s)/guardian(s) of children who suffer from growing pains will rub the child's legs and offer verbal reassurance in an attempt to console their children. Parent(s)/guardian(s) of both groups were encouraged to continue to do this throughout the duration of the trial. Instructions were given to the parents so that the same rubbing technique and rubbing cream (aqueous cream) were used. Subjective changes were tracked using a pain diary that the parent(s)/guardian(s) were asked to complete, a six-week post-study follow-up question regarding children's growing pains and the Oucher self-report pain scale. Objective measures consisted of pressure algometer readings of the tibialis anterior muscle belly.Results: The statistical data was analysed using the Friedman test, Manne—Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, the group that received lumbosacral manipulations proved to show a quicker response to treatment; and the post study follow-up of this same group showed markedly more positive feedback than the group that did not receive the treatment. These results highlighted the positive effects of chiropractic manipulation on growing pain symptoms.Conclusion: The results from this study, specifically the feedback from parent(s)/guardians(s) and the pain diaries, indicated that spinal manipulation is beneficial in the treatment of growing pains. The results also showed that other methods of treating growing pains, such as simple leg rubs, may also bring relief.

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The Impact of Cannabis in the Early Stages of Schizophrenia: A 3-Year Longitudinal Study on Cannabis Influence on Relapse Rates

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2137 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S196-S197

Author(s):

M. Gomez Revuelta ◽

M. Juncal Ruiz ◽

O. Porta Olivares ◽

V. Gajardo Galan ◽

G. Pardo de Santayana Jenaro ◽

...

Keyword(s):

Intervention Program ◽

Response To Treatment ◽

Rank Test ◽

First Episode ◽

Term Outcome ◽

Long Term Outcome ◽

Early Stages ◽

Increased Risk ◽

The Impact

IntroductionThe first five years after the onset of a first episode of psychosis (FEP) are crucial for long term outcome. In this period, the risk of relapse is particularly high. Consequences of relapse include an increased risk of neurotoxicity, chronicity, hospitalization, decreased response to treatment, increased economic burden and functional impairment.ObjectivesTo discern the influence of cannabis on relapse as it may contribute to adopt specific measures in patients during early stages of the illness.Material and methodsPAFIP is an early intervention program for patients with a FEP. Between January 2005 and January 2011, 163 patients were recruited for this study. They were followed-up during 3 years at intervals of three months. The sample was divided into three groups: (1) those non-cannabis users neither before the FEP nor during follow-up (nn), (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences between the three groups were observed but a trend (P = 0.057) towards a more enduring survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log Rank Test results will be included in the final poster).ConclusionsCannabis has a detrimental effect on schizophrenia. The interruption of its use could contribute to improve the outcome of the disease, as the results of our study suggest.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Phase II trial of erlotinib in elderly patients (age > 70) with previously untreated advanced non-small cell lung cancer (NSCLC): An analysis of quality of life and symptom response

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7168 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7168-7168 ◽

Cited By ~ 1

Author(s):

D. M. Jackman ◽

B. Yeap ◽

J. Lucca ◽

P. A. Ostler ◽

L. K. Morse ◽

...

Keyword(s):

Elderly Patients ◽

Phase Ii ◽

Primary Endpoint ◽

Survival Benefit ◽

Rank Test ◽

Symptom Improvement ◽

First Line Therapy ◽

Signed Rank Test ◽

Symptom Response

7168 Background: Elderly patients derive survival benefit but significant toxicity from chemotherapy for NSCLC. Erlotinib is associated with reasonable toxicity and has a survival benefit for relapsed patients previously treated with 1–2 chemotherapy regimens. This targeted agent may prove an effective and well-tolerated first-line therapy in elderly patients with advanced disease. Methods: 80 patients (chemo-naïve, age ≥ 70, PS 0–2, stage IIIB/IV NSCLC) were treated with erlotinib 150 mg/d as part of a phase II study. Primary endpoint was survival. QoL was a secondary endpoint, as assessed by LCSS at baseline and q4 weeks until progression. The primary endpoint of QoL analysis was to determine changes from baseline in LCSS score. Patients were eligible for QoL analysis if they completed an LCSS questionnaire at baseline and ≥ 1 other monthly follow-up visit. Each of 9 items was assessed on a 100mm visual analog scale from 0 (best) to 100 (worst); symptom improvement or worsening was based on a change of ≥ 10mm, with decreased scores implying improvement. Score differences between the baseline and best follow-up response of each subscale and total LCSS are assessed by the signed rank test. Results: 64 patients (80%) were eligible for QoL analysis. There was a trend towards improvement in QoL, based on the total LCSS score. Statistically significant improvements in dyspnea, cough, fatigue, and pain were seen, both in terms of median changes from baseline and the proportion of patients improved (Table). No patients were symptomatic for hemoptysis at baseline, so improvement could not be calculated. Conclusions: Erlotinib in elderly patients with advanced NSCLC was associated with encouraging survival (10.9 mo), a trend towards improved QoL, and statistically significant improvements in key symptoms of dyspnea, cough, fatigue, and pain. Mixed effects longitudinal modeling showing changes in LCSS over time will be presented at the conference. [Table: see text] [Table: see text]

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Two-year outcomes of intravitreal ziv-aflibercept

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311591 ◽

2018 ◽

Vol 102 (10) ◽

pp. 1387-1390 ◽

Cited By ~ 17

Author(s):

Ahmad M Mansour ◽

Mohammed Ashraf ◽

Abdulrazzak Charbaji ◽

Muhammad H Younis ◽

Ahmed A Souka ◽

...

Keyword(s):

Macular Oedema ◽

Paired Comparison ◽

Central Retinal Artery Occlusion ◽

Diabetic Macular Oedema ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Rank Test ◽

Macular Diseases ◽

Signed Rank Test

AimTo assess the two-year outcome of intravitreal ziv-aflibercept (IVZ) in eyes with macular diseases.MethodsConsecutive subjects with various macular diseases that received six or more of 0.05 mL IVZ (1.25 mg) injections with at least 1 year follow-up were included. Outcome measures were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution) and central macular thickness (CMT) on spectral domain optical coherence tomography. Paired comparison was done using Wilcoxon signed-rank test calculator.Results107 eyes of 91 subjects received IVZ and were followed with mean±SD follow-up interval of 1.48±0.44 months following treat and extend or pro-re-nata protocol. The distribution included neovascular macular degeneration (42 eyes), diabetic macular oedema (32 eyes) and macular oedema secondary to retinal vein occlusion (11 eyes). Fifty eyes were naive, while 57 eyes were previously treated. Combining all disease categories, CMT decreased significantly by 133.0±153.0 µm at the 24-month follow-up (P<0.001) with BCVA gain of 0.35±0.37 at the 24-month follow-up (P<0.001) with mean number of injections of 8.5 at month 12, 2.4 between 12 and 18 month and 1.7 between 18 and 24 month. Ocular and systemic adverse effects included one episode of transient uveitis and one instance of central retinal artery occlusion after 1121 injections.ConclusionsIVZ appears safe and efficacious in the therapy of macular diseases through 2 years.

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Change in cigarette dependence among a cohort of smokers following COVID-19 diagnosis in Kashmir valley: An observational follow-up study

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i11.39636 ◽

2021 ◽

Vol 12 (11) ◽

pp. 22-28

Author(s):

Asif Jeelani ◽

Shafat Sideeq Lone ◽

Hilal Rather

Keyword(s):

Univariate Analysis ◽

Supplemental Oxygen ◽

Rank Test ◽

Newly Diagnosed ◽

Health Providers ◽

Signed Rank ◽

Signed Rank Test ◽

Older Subjects ◽

Cigarette Dependence

Background: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate the change in cigarette dependence among newly diagnosed COVID-19 cases. Aims and Objectives: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate change in cigarette dependence among newly diagnosed COVID-19 cases. Materials and Methods: Study was conducted between October and December 2020 and newly diagnosed male COVID-19 patients who were current smokers at diagnosis were recruited from two hospitals involved in testing and treatment of COVID-19. Baseline socioclinical information was recorded at diagnosis in addition to the estimation of cigarette dependence using Fagerstrom Test for Nicotine Dependence (FTND) and health status using Post-COVID-19 Functional Scale (PCFS). Follow-up was done at 2 weeks after recovery using both FTND and PCFS scales. Wilcoxon signed-rank test, paired t-test, and ANOVA were used for univariate analysis and multivariate regression was done. Results: A total of 171 subjects with mean age of 43.79 years were included in the study. FTND scores decreased significantly from the day of diagnosis to follow-up visit with 79% of subjects reporting a decrease. On univariate analysis, decrease in FTND had a significant association with presence of comorbidity, any symptoms, presence of respiratory symptoms, and if supplemental oxygen was administered. On multivariate analysis, symptomatic COVID-19 disease, higher age, PCFS at baseline, and PCFS at follow-up had a significant association with decreased PCFS values at follow-up. Conclusion: COVID-19 diagnosis was followed by significant decrease in FTND score, particularly for symptomatic and older subjects. Post-COVID follow-up visits should be used asan opportunity by health providers to ensure its sustainability and for achieving cessation.

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