Efficacy of oral tranexamic acid versus triple combination for the treatment of melasma: A prospective, double blinded randomised controlled trial

2021 ◽  
Vol 7 (3) ◽  
pp. 222-227
Author(s):  
Shruti Appannavar ◽  
Rohith ◽  
Gajanan Pise
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Triple Combination ◽  
Once Daily ◽  
Exposed Skin ◽  
Acid Versus ◽  
Significant Difference ◽  
Group B ◽  
Randomised Controlled ◽  
Double Blinded

Melasma is a common acquired hypermelanosis characterized by irregular light to dark brown macules and patches seen mainly in women and over sun-exposed skin on the face. We have undertaken this RCT to compare the efficacy between oral Tranexamic acid and Topical Triple combination as Tranexamic acid is having good safety profile.To compare the therapeutic efficacy of oral Tranexamic acid versus Topical Triple combination for the treatment of Melasma using MASI score. To compare the adverse effects profile of each treatment modality. Total subjects (66 patients) were divided into 2 groups (A and B, each with 33 patients) by simple randomization method.Patients and analysers were blinded to treatments. Group-A received topical triple combination cream once daily (15-minutes) at night for 8 weeks followed by maintenance regimen of biweekly application of product for 4 weeks and oral placebo tablets (calcium gluconate 250mg) twice daily for 12 weeks. Group-B received oral Tranexamic acid tablets 250mg twice daily for 12 weeks with topical placebo cream (Moisturizer) once daily at night for 8 weeks followed by maintenance regimen of biweekly application of product for 4 weeks. MASI score was assessed at baseline and monthly follow-up visits along with simultaneous serial digital photographs, with the recording of side effects. Both groups showed significant decrease in MASI score in each followup visits without any statistically significant difference.In epidermal melasma topical triple combination is preferred over oral tranexamic acid. In dermal and mixed variety oral tranexamic acid is better.

scholarly journals INTRAARTICULAR EPSILON AMINOCAPROIC ACID VERSUS TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

2021 ◽  
Vol 29 (6) ◽  
pp. 312-315
Author(s):  
JOAO PAULO FERNANDES GUERREIRO ◽  
JOSE RODOLFO MARTINES BALBINO ◽  
BRUNO POSSANI RODRIGUES ◽  
MARCUS VINICIUS DANIELI ◽  
ALEXANDRE OLIVEIRA QUEIROZ ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Aminocaproic Acid ◽  
Osteoarthritis Of The Knee ◽  
Significant Difference ◽  
Total Knee ◽  
Double Blinded ◽  
Epsilon Aminocaproic Acid

ABSTRACT Objective: To examine and compare the clinical efficacy of intraarticular epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) in total knee arthroplasty (TKA). Methods: This study was a prospective, single-center, double-blinded randomized controlled trial, including sixty patients with osteoarthritis of the knee divided into two groups of 30 patients. In the TXA group, 1 g of TXA (0.05 g/ml) was applied intraarticularly, and in the EACA group, 4 g of EACA (0.2 g/ml) was applied intraarticularly. Serum hemoglobin (Hgb) and hematocrit (Htb) were measured during the preoperatively and 24 and 48 hours postoperatively. The range of motion and pain were evaluated by clinical examination. To evaluate knee function before and 2 months after surgery, the Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used. Results: In total, 56 (93.3%) patients were evaluated up to the second postoperative month. No significant difference between the groups (p > 0.05) was found in the decrease in Hgb or Htb at 24 or 48 hours. Regarding assessment of the pain, WOMAC score and gain in knee flexion, no significant advantages up to 60 days after surgery (p > 0.05) were found. Conclusions: The decrease in Hgb and Htb during the first 48 hours postoperatively and the risk of transfusion were similar with the intraarticular use of 1 g of TXA and 4 g of EACA in TKA. The possible benefits regarding knee pain, gain in flexion and function were also similar for the two drugs. Level of Evidence II, Randomized, Double-Blinded, Single-Centre, Prospective Clinical Trial.

Bed Exercises following Total Hip Replacement: 1 Year follow-up of a Single-Blinded Randomised Controlled Trial

2009 ◽  
Vol 19 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Toby O. Smith ◽  
Charles J.V. Mann ◽  
Allan Clark ◽  
Simon T. Donell
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Short Form ◽  
Controlled Trial ◽  
Education Programme ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

This paper presents the results of a study assessing whether bed exercises after primary THR (total hip replacement) improves function or quality of life, during the first post-operative year. Sixty patients undergoing primary THR were randomised to receive either a gait re-education programme and bed exercises (Group A) or a gait re-education programme without bed exercises (Group B) post-operatively. The Iowa level of assistance Scale (ILOA) and Short Form-12 Health Survey (SF-12) were assessed at baseline, 3 days, 6 weeks and 1 year post-operatively. There was no statistically significant difference in either ILOA or SF-12 after 1 year between Group A or B. There was no evidence of a subgroup effect by either the surgical approach or prosthesis fixation in either ILOA or SF-12.

scholarly journals Role of Saccharomyces boulardii and Bacillus clausii in reducing the duration of diarrhea: a three-armed randomised controlled trial

2018 ◽  
Vol 5 (5) ◽  
pp. 1811 ◽  
Author(s):  
Vidjeadevan D. ◽  
Vinoth S. ◽  
Ramesh S.
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Saccharomyces Boulardii ◽  
Major Public Health Problem ◽  
Duration Of Stay ◽  
Bacillus Clausii ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

Background: Diarrhea is a major public health problem. Probiotics have been recommended as an add-on therapy for the treatment of diarrhea. Recently Saccharomyces boulardii and Bacillus clausii, yeast and spore forming bacilli are among the probiotics in use for diarrheal disorder.Methods: This was a three armed randomised controlled trial conducted in pediatrics department, in a tertiary level care at Chidambaram. The randomisation was done using permuted blocks method. Of the three groups, Group A received ORS and zinc; Group B ORS, zinc and S. boulardii and Group C ORS, zinc and B. clausii. The outcome variables included duration of diarrhea and duration of stay in hospital.Results: The duration of diarrhea decreased significantly in Group B and C than Group A. Both the probiotics had similar effect in reducing the duration of diarrhea. There was no significant difference in duration of stay at hospital between the groups.Conclusions: Addition of probiotics as an add-on therapy would aid in decreasing the duration of diarrhea rather than giving ORS and zinc alone. The duration of stay in hospital was unaffected by the change in regimen of treatment.

Comparison of the corticosteroid injection and hyaluronate in the treatment of chronic subacromial bursitis: A randomized controlled trial

2021 ◽  
pp. 026921552110077
Author(s):  
Lin-Fen Hsieh ◽  
Yi-Jia Lin ◽  
Wei-Chun Hsu ◽  
Ying-Chen Kuo ◽  
Yu-Chia Liu ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Outcome Measures ◽  
Normal Saline ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Teaching Hospitals ◽  
Saline Injection ◽  
Group B ◽  
Randomised Controlled ◽  
Double Blinded

Objective: To analyse the effectiveness of corticosteroid (CS) and hyaluronic acid (HA) subacromial – subdeltoid (SASD) injection compared with normal saline (NS) in patients with chronic subacromial bursitis (CSB). Design: A prospective three-arm double-blinded randomised controlled trial. Setting: Rehabilitation department of two teaching hospitals. Subjects: Patients with CSB ( N = 186) divided into CS ( N = 68), HA ( N = 60), and NS ( N = 58) groups. Interventions: Three SASD injections under ultrasound guidance: group A, 20 mg of triamcinolone; group B, 2.5 mL of HA; and group C, 2.5 mL of NS. Outcome measures: The primary outcome measures were the pain visual analogue scale (VAS) score at eight weeks. The secondary outcomes were scores on the Shoulder Pain and Disability Index (SPADI) and Shoulder Disability Questionnaire. Results: At eight weeks, the pain VAS scores during activity were 2.56 ± 2.29, 3.65 ± 2.50, and 4.71 ± 2.83 in the CS, HA, and NS groups, respectively (CS vs NS, P < 0.001; HA vs NS, P = 0.013; CS vs HA, P = 0.010). SPADI scores were 40.83 ± 21.75, 36.92 ± 22.78, and 33.35 ± 23.38 in the CS, HA, and NS groups, respectively (CS vs NS, P < 0.001; HA vs NS, P = 0.197; CS vs HA, P = 0.004). Conclusion: Ultrasound-guided corticosteroid injection into the subacromial – subdeltoid bursa was proven to be effective and superior to hyaluronic acid and normal saline injection for treating CSB. Hyaluronic acid injection was only marginally more effective than normal saline injection. Trial Registration: ClinicalTrials.gov: NCT02702206

The influence of hydroxyapatite coating on continuous migration of a Zweymuller-type hip stem: a double-blinded randomised RSA trial with 5-year follow-up

2021 ◽  
pp. 112070002110067
Author(s):  
Daniel Hoornenborg ◽  
Annelieke M C Schweden ◽  
Inger N Sierevelt ◽  
Harm M van der Vis ◽  
GMMJ Kerkhoffs ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Hydroxyapatite Coating ◽  
Time Interval ◽  
Post Surgery ◽  
Initial Surgery ◽  
Long Term Effect ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Double Blinded

Background and purpose: Adding hydroxyapatite to a stem to enhance ingrowth is a matter of debate, even less is known about the long-term effect on stability by adding hydroxyapatite (HA). Continuous migration in the first 2–5 years is an indicator of failed osteointegration or pending failure, enhancing the risk of loosening within 10 years after initial surgery. We performed a double-blinded randomised RSA trial with 5-year follow-up, to compare and analyse migration characteristics of the hydroxyapatite uncoated (HA−) and hydroxyapatite coated (HA+) Zweymuller-type hip stem. Patients and methods: In this single-centre prospective randomised controlled trial 51 patients were randomised to receive either a HA− or a HA+ Zweymuller-type hip stem during total hip replacement. After 5 years, 35 patients were still eligible for follow-up evaluation. The migration pattern was measured by use of radio stereometric analysis (RSA) images up to 2 years to evaluate short-term migration, additionally RSA images were obtained 5 years postoperatively to assess late-term and continuous migration. Furthermore, the improvement of clinical outcome was analysed by HSS and HOOS ADL and pain subscales preoperative and after 5 years. Results: After initial settling of the implant, no significant migration occurred up to 5 years post-surgery for HA+ as well as HA− prostheses. Continuous migration within the 2–5 years’ time interval was not observed for both HA+ nor the HA− group in all directions ( p < 0.05). No significant difference between both groups was observed ( p < 0.10). In both groups the HHS and HOOS improved significantly at 5 years compared to baseline for both groups. Improvement was not altered by the hydroxyapatite coating. No significant difference between both groups was observed ( p > 0.58). Conclusions: Addition of a hydroxyapatite coating did not influence the migration 5 years postoperatively for the Zweymuller-type hip stem. Clinical Trial Protocol number: NL 23524.048.08

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

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