scholarly journals A study of verapamil in treatment of keloid

Author(s):  
Yogesh M. Shah ◽  
Adit M. Garg ◽  
Gaurav Paliwal ◽  
Amir S. Ansari ◽  
Chandni Jain ◽  
...  

<p class="abstract"><strong>Background:</strong> Keloid is a common presentation in clinical practice. Symptoms due to keloid are mild, but disfigurement and functional impairment can be severe. It is difficult to treat. Intralesional, injection triamcinolone acetonide, has limited efficacy, causes adverse effects such as local dermal atrophy, telengiectasia and hypopigmentation. Injection verapamil is reported to have similar efficacy, but lesser side effects, and is cheaper. Aim was to study efficacy and adverse effects of intralesional verapamil in treatment of keloid.</p><p class="abstract"><strong>Methods:</strong> An open label study on 25 patients of keloid, either gender, age 11 to 55 years at a medical college hospital. Injection verapamil 2.5 mg/ml was administered intralesionally, at an interval of 3 weeks, for a total of 6 sittings, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement. The statistical analysis was done using SPSS version 21.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Median duration of keloids was 8 months. The mean VSS score before treatment was 7.68 which reduced to 4.28 after treatment. Mean percentage change in VSS score was 46.21%, very highly significant (p&lt;0.001). Physician’s assessment was ‘very good’ in 32.0% and 'excellent' in 8.0%. The complaint of post-procedure pain was present in almost all.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional injection verapamil, gives very good to excellent improvement in 40% of patients of keloid. Post injection pain persists for more than 24 hours. Drug does not cause local dermal atrophy or hypopigmentation.</p>

2018 ◽  
Vol 5 (3) ◽  
pp. 868 ◽  
Author(s):  
Adit M. Garg ◽  
Yogesh M. Shah ◽  
Alok Garg ◽  
Shazia Zaidi ◽  
Kshitij Saxena ◽  
...  

Background: Management of keloid is difficult as well as challenging. Intralesional triamcinolone acetonide (TAC) injections have remained a gold standard in non-surgical management of keloid. TAC is generally used in the concentration of 40mg/ml, which causes adverse effects such as local dermal atrophy and hypopigmentation. Aim was to study efficacy and adverse effects of TAC in treatment of keloid, in a lesser concentration of 20mg/ml.Methods: An open label study was conducted from November 2015 to May 2017 on 25 subjects of either gender, in the age group 11-55 years, at a medical college hospital. Intralesional injection TAC 20 was administered in the keloid at an interval of 3 weeks, for a total of 6 sessions, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement and SPSS 21 for statistical analysis.Results: Mean age of keloid subjects was 30.72 years and median duration of keloid was 8 months. The mean VSS score before treatment was 8.36 which reduced to 3.20 after treatment. Mean percentage change in VSS score was 62.79%, which was very highly significant (p <0.001). Physician’s assessment was ‘Very Good’ in 52.0% and ‘Excellent’ in 5 (20%). Adverse effect of atrophy was seen in 3 (12%), hypopigmentation in 11 (44%) and telangiectasia in 4 (16%).Conclusions: Intralesional injection triamcinolone acetonide 20mg/ml gives very good to excellent improvement in the majority of patients of keloid. Local adverse effects seen were hypopigmentation, atrophy and telengiectasia.


2020 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Ankita Singh ◽  
Bijay Aryal ◽  
Sushma Deo

Introduction: Primary dysmenorrhea has been reported as the most common cause of regular absenteeism among young women. Pain affects daily activities and quality of life. The aim of the study was to compare the efficacy between mefenamic acid (Meftal) and ginger capsules (Remezy) among Basic Sciences Students of Nepalgunj Medical College (NGMC), Chisapani. Adverse effects, if any, were also observed in both Meftal and ginger groups. Methodology: This was a prospective cross-sectional study conducted from July 2018 to February 2019. Out of 104 students, 87 were suffering menstrual pain. These 87 individuals received Mefenamic acid (Meftal) 500mg twice a day for three days and the same 87 individuals, in their next month of period, took ginger capsules (Remezy) 500mg twice daily for three days. Medication was started on the first day of their menstruation. The severity of pain before and after the medication was recorded with the help of a multi-dimensional scoring system (MSS). All the data were directly entered into SPSS 20.0 and compiled, analyzed and expressed in tables and charts. Results: Out of 104, 87 (83.7%) students had experienced menstrual pain. The mean±S.D age of the students was 19.64±1.02 while the mean±S.D menarche age was 13.21±1.01. The pain severity of dysmenorrhea was significantly reduced (p<0.05) with both meftal and ginger intake in both the first and second months consecutively. However, a comparison of efficacy between the two medications showed no statistically significant difference (p>0.05). Adverse effects were found to be significantly higher in students receiving meftal tablets.     Conclusion: A high proportion of students had dysmenorrhea. Similar efficacy of ginger and meftal was observed with minimal adverse effects in ginger. Findings suggest the need for educating students on appropriate and effective management of dysmenorrhea.


2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117


2013 ◽  
Vol 8 (1) ◽  
pp. 02-04
Author(s):  
Md Abdur Rashid ◽  
KH Anowar Hossain ◽  
AKM Rafiqul Islam

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 90°± 20°. Against the rule (ATR) astigmatism was considered when steep meridian at 180°±20°. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16887 Faridpur Med. Coll. J. 2013;8(1): 02-04


2018 ◽  
Vol 29 (2) ◽  
pp. 1-5
Author(s):  
M Moksedur Rahman ◽  
M Abdullah ◽  
M Moazzem Hossain ◽  
MA Siddique ◽  
M Nessa ◽  
...  

This study was carried out to evaluate the efficacy, safety and adverse effects of topical isotretinoin 0.05% gel in the treatment of acne vulgaris. This prospective study was undertaken in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi. One hundred patients with mild tomoderate acne vulgaris were enrolled and were instructed to apply isotretinoin 0.05% gel once daily at night for 12 weeks. Patients were followed up at 2,4,8 and 12 weeks for efficacy and tolerability. Efficacy was measured by counting facial inflammatory and noninflammatory lesions and by grading acne severity. Cutaneous tolerance was assessed by determining erythema, scaling and burning with pruritus.Response was excellent in 80%of cases.None of the cutaneous reactions was severe, all were mild and well tolerated.Nobody had to discontinue the therapy for side effects. This study confirms that isotretinoin 0.05% gel is safe and effective topical therapy for mild to moderate acnevulgaris.TAJ 2016; 29(2): 1-5


2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117


2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang

Purpose: To investigate the clinical characteristics, diagnosis, differential diagnosis, therapy options, and outcomes of retroperitoneal ganglioneuroma.Methods: In this retrospective study, we collected and analyzed the clinical data of 32 patients diagnosed with retroperitoneal ganglioneuroma and admitted to Peking Union Medical College Hospital from October 2012 to August 2019.Results: Among our 32 cases with retroperitoneal ganglioneuroma, the male-to-female ratio was 1:3 and the mean age was 35. Only 25% of the cases presented with abdominal pain while more than 65% had no specific symptoms. The masses could be found through physical examination in only five patients. Most of the tumors are located near the renal area. They were usually single and displayed an embedded growth pattern with diameters &lt;10 cm, clear borders, and soft texture. For radiological imaging, the majority of tumors demonstrated soft tissue density with mild-to-moderate enhancement on CT imaging and showed hypoecho with moderate blood flow signals in ultrasound. No significantly abnormal laboratory examinations were found in most patients. Of all the 32 patients, 2 chose surveillance after biopsy due to difficulties in operation, while others chose surgical resection. The mean follow-up time was 15.8 months among 26 patients. The tumor remained stable in the surveillance cases. Residual tumors were found in four cases receiving operations with no progress and discomfort. No recurrence was seen in all patients.Conclusions: The retroperitoneal ganglioneuroma is a benign tumor without specific clinical manifestations or significant laboratory findings. Typically, it is shown as low density with a clear border and an embedded growth pattern in radiological imaging. The overall prognosis is good. Surgery is an effective approach with possible severe complications. Incomplete resection or surveillance can be considered for some cases where complete resection is difficult to achieve.


2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.


Author(s):  
B. Khanam ◽  
M. Imran Khan ◽  
Ajay Kumar Singh ◽  
Sumit Solanki ◽  
S.M. Holkar

Background: Few studies have assessed the relation of hyperuricacidemia with the acute coronary syndrome (ACS). This study investigated the association between high uric acid levels with the presence and severity of ACS.  Methods: Three hundred and seventy patients having angiographic evidence of atherosclerosis (CAD + case group) compared to 170 patients with no luminal stenosis (n=110) or with <50% luminal stenosis (n=60) at coronary angiography (CAD – control group). Results: The mean age of the patients was 60 ± 10 years (317 men, 58.7%). Hyperuricacidemia was more likely associated with a trend toward higher vessel scores, indicating a more severe CAD (adjusted OR=1.51, 95% CI=1.09-2.09; P=0.005) in the whole population. A comparison of sex-specific values showed a significant association existed only in men. Conclusions: Asymptomatic hyperuricacidemia may be associated with the presence and severity of ACS. Keywords: Hyperuricacidemia, Severity & Acute Coronary Syndrome.


Author(s):  
Humayoon Akbar ◽  
Sudhakar S. ◽  
Shanthi B. ◽  
Khadeja Bi ◽  
Jayaseelan R. ◽  
...  

BACKGROUND One third of Indians consume alcohol and there is an alarming annual increase in alcohol consumption. Majority of spouses of alcohol dependent males are also the primary care-takers of their husbands and are at risk of domestic violence. Marital dissatisfaction could reduce their involvement in getting their spouses treated for alcohol dependence. Our aim was to study the marital satisfaction among the spouses of patients with alcohol dependence. METHODOLOGY This study was conducted on spouses of male patients with alcohol dependence syndrome attending the psychiatry department of a tertiary care medical college hospital in Kanchipuram District in Tamilnadu. 200 consecutive male patients with alcohol dependence syndrome using the ICD 10 criteria were recruited. Severity of alcohol dependence was assessed using Short Alcohol Dependence Data (SADD). Marital satisfaction among the spouses was assessed using ENRICH Marital Satisfaction (EMS) Scale. Analysis of the data was done using Statistical Package for the Social Sciences (SPSS) version 22.0. RESULTS The mean age of alcohol dependent men and their spouses were 43.05±9.39 and 37.58±8.86 years respectively. Most of the spouses (83.5%) had done their primary education only and 50% were house-wives (unemployed). Majority of men earned between Rs.5000 to 10,000 and most of them were unskilled workers belonging to the lower socio-economic group in the rural areas. The mean SADD and EMS scores were 25.05 ± 8.891 and 31.76 ± 14.45 respectively. 74% of men in our study population were highly dependent on alcohol. Amongst the spouses of men with severe dependence 68.9% reported moderate and 28.3% reported low marital satisfaction. DISCUSSION and CONCLUSION Majority of alcohol dependent men suffered from severe dependence. An inverse relationship between marital satisfaction scores and severity of alcohol dependence was observed. Alcohol dependence and its severity was noted to have an adverse impact on marital satisfaction among spouses of the dependent patients.


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