scholarly journals Efficacy of photodynamic therapy in the treatment of cutaneous leishmaniasis

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Mahvish Aftab Khan ◽  
Sehrish Aftab ◽  
Nadia Shams ◽  
Rahmat Ullah Khan
Keyword(s):  
Photodynamic Therapy ◽  
Cutaneous Leishmaniasis ◽  
Case Reports ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ethical Approval ◽  
Mean Size ◽  
Duration Of Disease ◽  
Photosensitizing Agent ◽  
Study Setting

Introduction: A limited number of case reports have studies the efficacy of Photodynamic Therapy (PDT) in management of Cutaneous Leishmaniasis (CL). Topical PDT is an innovative mode of therapy that works on principle of selective uptake of photosensitizing agent by CL lesions. Current study was conducted to determine efficacy of topical photodynamic therapy of CL. Study Design: Descriptive cross sectional study. Setting: Dermatology outdoor clinic PIMS Islamabad. Period: July 2015 to Jan 2016. Materials & Methods: Total 75 patients (>12 years) of either gender with biopsy proven CL lesions were included after ethical approval.  Pregnant or lactating women, those with sensitivity to light or photo sensitizer were excluded. The selected cases were administered once a week sessions of topical 5-ALA PDT therapy. This therapy was continued till 4 weeks and efficacy was observed at 6th week; efficacy labeled as yes if there was no erythema with resolution of papules, plaques or nodules, surrounded by normal healthy skin clinically and the histo-pathological smears revealing absence of amastigotes, otherwise labeled as non-effective. Results: Mean age was 24.37+7.43 years. There were 44(58.67%) females and 31(41.33%) males. Mean duration of disease was 40.29+11.73 days and mean size of lesion was 19.69+9.88 mm. Effective PDT outcome was seen in 67(89.33%) patients at 6th week of therapy. Conclusion: This study concluded that topical photodynamic therapy is an effective method for treatment of Cutaneous Leishmaniasis.

scholarly journals Prevalence of hyponetremia in cirrhotic patients with encephalopathy.

2021 ◽  
Vol 28 (09) ◽  
pp. 1308-1314
Author(s):  
Tauqeer Shaikh ◽  
Hamid Ali Kalwar ◽  
Ghulam Mujtaba ◽  
Adeel Rahat ◽  
Kamaran Ali ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Neurological Impairment ◽  
Cross Sectional Study ◽  
Common Finding ◽  
National Hospital ◽  
Cross Sectional ◽  
Early Management ◽  
Ethical Approval ◽  
Cirrhotic Patients ◽  
Study Setting

Objective: To Determine the frequency of hyponatremia in cirrhotic patients with encephalopathy. Study Design: Cross Sectional Study. Setting: Department of Gastroenterology Liaquat National Hospital Karachi. Period: 6 Dec 2017 to 6 June 2018. Material & Methods: All those fulfilling the inclusion criteria and admitted in the Gastroenterology department of Liaquat National Hospital Karachi were taken in the study after their ethical approval alongside an informed and written consent. Brief history was taken, clinical examination was done, and serum sodium level was delivered to the institutional laboratory to reach the outcome i-e hyponatremia. Results: - A number of 369 patients having encephalopathy were taken into study. 207 patients (56.1%) were males and 162 patients (43.9%) were females with an average age of 50.03+10.333 years. Hyponatremia was seen in 138 patients (37.4%). Conclusion: Dilutional hyponatremia is a common finding in liver cirrhosis patients with encephalopathy leading to neurological impairment, hepatorenal syndrome, osteoporosis and high mortality. Therefore, early management of hyponatremia is key to prevent liver cirrhosis related complications.

scholarly journals METHOTREXATE;

2017 ◽  
Vol 24 (04) ◽  
pp. 607-611
Author(s):  
Muhammad Yasir Qureshi ◽  
Zaheer Hussain Memon ◽  
Ishrat Bibi
Keyword(s):  
Plaque Psoriasis ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Pasi Score ◽  
History Of ◽  
Duration Of Disease ◽  
Study Setting

Objectives: To determine the efficacy of methotrexate as a treatment option forplaque psoriasis. Study Design: Cross sectional study. Setting: Dermatology Department, ofLiaquat University hospital Hyderabad. Period: 6 month duration from January 2016 to June2016. Material & Methods: All the cases more than 20 years of the age having severe-tomoderatechronic plaque psoriasis were selected in the study. All the patients were underwentcomplete medical history and clinical examination. All the patients with history of severecomorbidities were not included. All the patients were underwent oral methotrexate treatment.All the information as: disease duration, involved site and plaque size was recorded. Efficacywas assessed according to PASI score on starting and after 12 weeks. Results: Patients’ meanage was 40.73 years. Male were found in the majority 75.50%, while 24.50 % were female. Inthis study mean duration of disease was 7.38 + 3.46 months and mean duration of plaque sizewas 6.63+ 2.07. Commonest site involved in psoriasis was scalp+elbow seen in 27(55.1%).Psoriasis show significant good outcome after treatment of methotrexate, 9 patients did notcompeted their treatment in remaining 40 cases starting PASI score was 11.97+1.40 and after12 weeks treatment significantly decreased as 6.48+2.45 and mean of clearance time was8.10+2.02 weeks. Conclusion: Methotrexate showed significant satisfactory results in thetherapy required for plaque psoriasis as well as enhanced quality of life.

scholarly journals Frequency Frequency of adequate haemodialysis at haemodialysis unit Nishtar Hospital Multan.

2019 ◽  
Vol 26 (10) ◽  
pp. 1672-1677
Author(s):  
Shahzad Alam Khan ◽  
Ghulam Abbas
Keyword(s):  
Time Lapse ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hemodialysis Unit ◽  
Study Population ◽  
Duration Of Disease ◽  
Age Range ◽  
Study Setting ◽  
Esrd Patients ◽  
Urea Reduction Ratio

This adequacy of HD is judged by formulas like Urea Reduction Ratio (URR) and Kt/V. Adequate hemodialysis is vital for restoration of body homeostasis towards normal and to avoid potential complications. The aim of the current study was to determine the frequency of adequate hemodialysis at hemodialysis center at Nishtar Hospital Multan. Objectives: The objective of this study was to determine the frequency of adequate hemodialysis at hemodialysis unit Nishtar Hospital Multan. Study Design: Cross-sectional Study. Setting: Department of Medicine, Medical Unit-IV, Nishtar Hospital, Multan. Duration: Six months from 18/01/2018 to 17/07/2018. Material and Methods: This study involved 174 patients undergoing hemodialysis at least 3 sessions in a week for the previous 6 months at hemodialysis center Nishtar Hospital Multan. A formal written consent was taken from every patient. Patient’s demographic details along with duration of disease, calculated Kt/V and adequacy of hemodialysis (Kt/V≥1.2) were recorded in the attached proforma. Data obtained during study were analyzed by using SPSS version 24. Mean and standard deviation were estimated for numerical variables; age, duration of disease, Kt/V values. Frequency and percentage were calculated for categorical variable i-e gender, diabetes mellitus, hypertension, adequate hemodialysis. Stratification was done for parameters like age, gender, diabetes, hypertension and duration of disease. After stratification was done t-test ws applied and value ≤.05 was considered as significant. Results: The age range of our study population was 40-70 years having a mean of 54.24±8.39 years. It included 113 (64.9%) male and 61 (35.1%) female suffers of ESRD. 75 (43.1%) patients were diabetic while 116 (66.7%) patients were hypertensive. The time lapse from diagnosis to dialysis ranged from 6-18 months with a mean of 12.11±3.55 months. The Kt/V value ranged from .80 to 1.90 with a mean of 1.45±.27. Taking a cut-off value of Kt/V≥1.2 for adequate hemodialysis, the frequency of adequate hemodialysis was found to be 85.1% (n=148). Conclusion: The frequency of adequate hemodialysis was found to be 85.1% among ESRD patients undergoing hemodialysis at least 3 times a week for the past 6 months at hemodialysis center Nishtar Hospital Multan. It indicates that Dialysis centre in Nishtar hospital is working effectively.

scholarly journals SAT0078 SAFETY OF LOW DOSE METHOTREXATE (MTX) IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 974.2-974
Author(s):  
A. Gunay ◽  
A. Davidson ◽  
I. Colmegna ◽  
D. Lacaille ◽  
H. Loewen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adverse Events ◽  
Low Dose ◽  
Opportunistic Infections ◽  
Case Reports ◽  
Cross Sectional Study ◽  
Study Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

scholarly journals Magnitude of Induced Abortion and Associated Factors among Female Students of Hawassa University, Southern Region, Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Addisu Tadesse Sahile ◽  
Mieraf Shiferaw Beyene
Keyword(s):  
Associated Factors ◽  
Contraceptive Use ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Induced Abortion ◽  
Southern Region ◽  
Cross Sectional ◽  
Study Setting ◽  
Emergency Contraceptives ◽  
Hawassa University

Objectives. This study was aimed at assessing the magnitude of induced abortion and associated factors among students in Hawassa University, southern region, Ethiopia, 2019. Methods. An institutional-based cross-sectional study was conducted among a total of 422 students selected on the bases of a probability simple random sampling method. A pretested structured questionnaire was used to collect data. Analysis was made with SPSS 20. Descriptive summary and inferential statistics (binary logistic regression) were used with a 95% CI and P value of less than 5% as a level of significance. Findings were presented in tables, figure, and texts. Confidentiality of information was also secured. Results. The prevalence of induced abortion in the study setting was 68.7% (95% CI: 64.15%-73.2%). Participants who used emergency contraceptives had 12 times higher odds of undergoing abortion than those who did not use emergency contraceptives at AOR: 11.95, 95% CI: 5.615-25.326, P<001. Conclusions. A higher prevalence of induced abortion was observed in the study setting. Contraceptive use was the predictor of induced abortion identified. Concerned bodies were recommended to work on the identified determinant of induced abortion in the study setting.

Prevalence of Gingival Pigmentation and its Association with Gingival Biotype and Skin Colour

2021 ◽  
Vol 5 (1) ◽  
pp. 19-25
Author(s):  
Arjun Hari Rijal ◽  
Bhageshwar Dhami ◽  
Nashib Pandey ◽  
Deepa Aryal
Keyword(s):  
Strong Association ◽  
Cross Sectional Study ◽  
Skin Colour ◽  
Facial Skin ◽  
Cross Sectional ◽  
Attached Gingiva ◽  
Ethical Approval ◽  
Gingival Epithelium ◽  
Interdental Papilla ◽  
Gingival Biotype

Introduction: The facial appearance depends on several oral and extraoral factors including colour of facial skin and pigmentation of gingival epithelium. The colour of the gingiva varies among individuals and is thought to be associated with cutaneous pigmentation which ranges from light to dark brown or black colour. Objective: To assess the prevalence of physiological gingival pigmentation, gingival biotype and their association with skin colur in Nepalese subjects visiting Kantipur Dental College and Hospital (KDCH). Methods: This was an analytical cross-sectional study which was carried out from February 2020 to June 2020 in all patients of age-group 16 to 80 years visiting the Department of Periodontics at KDCH after ethical approval. Patients were recruited by convenience sampling and examined thoroughly to find out gingival biotype and extent of gingival pigmentation intraorally as well as skin colour extraorally. Results: In this study, 210 patients were examined among which, 105 (50%) were males and 105 (50%) were females. Out of 210, 33 (15.7%) had pink tissue without pigmentation, 84 (40%) had pigmentation only in attached gingiva, 58 (27.6%) in attached gingiva and interdental papilla, 32 (15.2%) had diffuse pigmentation involving all parts of gingiva, 2 (1%) had in marginal gingiva only, and 1 (0.5%) in marginal gingiva and interdental papilla. Conclusion: A strong association was found between gingival pigmentation and facial skin colour in present study (P <0.001). Establishing the pattern of gingival pigmentation in Nepalese population will help to choose a specific depigmentation therapy that will harmonise with skin colour.  

Incidence of writing double NSAIDs in a single prescription for osteoarthritis.

2021 ◽  
Vol 28 (05) ◽  
pp. 702-706
Author(s):  
Niaz Hussain Keerio ◽  
Nasrullah Aamir ◽  
Nuresh Kumar ◽  
Masood Ahmad Qureshi ◽  
Hassan Amir us Saqlain ◽  
...  
Keyword(s):  
Elderly Population ◽  
Cross Sectional Study ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Medical College ◽  
Bleeding Ulcers ◽  
Study Setting

 Objective: To determine how frequent NSAIDs are used for osteoarthritic patients because OA is common old age patients and NSAIDs can cause divesting complications on their health. In our study we tried to identify the main reasons and suggest a best possible solution. Study Design: Community Based Cross-sectional study. Setting: Mohammad Medical College and Hospital Mirpurkhas Pakistan. Period:  June 2018 to August 2018. Material & Methods: In this study, we included more than 300 prescriptions written for Osteoarthritis, a degenerative joint disease. Prescriptions collected from hospital pharmacy (80%) and from other pharmacies (20%). Data was collected on preformed proforma and was analyzed in SPSS version 25. Results: Osteoarthritis mainly affects elderly population. NSAIDs are used for pain relief but can cause acute renal failure and GIT bleeding ulcers. In our study 69% patients were prescribed double NSAIDs. Traditional NSAIDs were used 95% of the time and only 5% percent of the time selective cox 2 were used. Along with these NSAIDS only 20% patient were given prophylactically gastroprotective agents like PPI and other medications. Conclusion: Prescription osteoarthritis include multiple NSAID without any protocol and over dosage was observed commonly.

Evaluation of macrolinguistic aspects of the oral discourse in patients with Alzheimer’s disease

2018 ◽  
Vol 31 (9) ◽  
pp. 1343-1353 ◽  
Author(s):  
Juliana Onofre de Lira ◽  
Thaís Soares Cianciarullo Minett ◽  
Paulo Henrique Ferreira Bertolucci ◽  
Karin Zazo Ortiz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Language Processing ◽  
Cross Sectional Study ◽  
Oral Discourse ◽  
Cross Sectional ◽  
Cohesive Devices ◽  
Global Coherence ◽  
Comparison Groups ◽  
Study Setting

ABSTRACTIntroduction:Alzheimer’s disease (AD) is a degenerative syndrome that impairs cognitive functioning, including speech and language. Discourse can be used to analyze language processing, which is organized into microlinguistic and macrolinguistic dimensions.Objectives:To identify the occurrence of changes in the macrolinguistic dimension of oral discourse in AD patients. Design: This was developed as a cross-sectional study. Setting: Outpatient clinic of the Behavioural Neurology Division of São Paulo Federal University.Participants:121 elderly patients, with ≥ 4 years of education, divided into AD and comparison groups.Measurements:The subjects were asked to create a narrative based on seven figures that made up a story. The macrolinguistic aspects of the narratives were analyzed.Results:The performance of the AD group was inferior to that of the comparison group on content-related, no-content-related complete and incomplete propositions as well as macropropositions, main information units, appropriated local and global coherence, cohesive devices and all subtypes, cohesive errors and some of their subtypes. Global coherence, macropropositions and ellipsis subtype of cohesive devices were the variables that best differentiated the groups.Conclusions:Changes were observed in most aspects of the macrolinguistic dimension of oral discourse in patients with AD.

scholarly journals Emotional Well-Being and the Importance for Women with Fear of Birth to have a Known Midwife at Birth

2018 ◽  
Vol 2 (1) ◽  
pp. 01-07
Author(s):  
Ingegerd Hildingsson
Keyword(s):  
Emotional Distress ◽  
Best Practice ◽  
Well Being ◽  
Cross Sectional Study ◽  
Health Issues ◽  
Fear Of Childbirth ◽  
Cross Sectional ◽  
Additional Support ◽  
Study Setting ◽  
Fragmentation Of Care

Background: Previous research has shown that women with fear of childbirth often suffer from other mental health issues. Continuity of caregiver through a known midwife is best practice for pregnant women, and women with childbirth related fear value continuity of care. In Sweden the maternity care is fragmented and women’s opinion remains under-investigated. Objective: The aim of this study was to investigate emotional well-being and the importance of having a known midwife during birth in women referred to counselling for childbirth related fear. Design: Cross sectional study Setting: 3 Swedish hospitals providing counseling for childbirth related fear. Participants: Women who were referred for counseling due to fear of childbirth. Measures: The importance of having a known midwife at birth, background factors, emotional well-being and attitudes. Results: 77 women referred to counseling consented to participate. The majority of women were likely to present with previous or ongoing emotional distress, high levels of anxiety or depressive symptoms, low Sense of Coherence and Major worries. For the majority of women (71%) it was important to have a known midwife at birth and most important for women with high levels of childbirth fear. Conclusion: This study highlights that women referred to counseling due to fear of childbirth might need additional support to cope with their emotional distress. The results also indicated that having a known midwife at birth was important to these women, especially for women with higher fear. The option of having a known midwife during birth is rarely accomplished in Sweden due to the fragmentation of care.

scholarly journals Lag screw cutout in intertrochanteric fractures fixed with DHS.

2020 ◽  
Vol 27 (09) ◽  
pp. 1862-1866
Author(s):  
Muhammad Nasir Ali ◽  
Muhammad Khalid Chishti ◽  
Kashif Siddiq ◽  
Muhammad Hamayun Hameed ◽  
Muhammad Tayyab Waheed ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Intertrochanteric Fractures ◽  
Cross Sectional ◽  
Middle Position ◽  
Lag Screw ◽  
Screw Position ◽  
Hip Screw ◽  
The Mean ◽  
Study Setting

Objectives: To determine the failure of DHS (dynamic hip screw) in terms of lag screw cutout. Study Design: Hospital Based Cross Sectional study. Setting: BVH and Civil Hospital Bahawalpur. Period: From 2013 to 2018. Material & Methods: 273 patients of both genders with age more than 50 years having stable intertrochanteric fractures were included in this study. With the help of C arm, the best possible anatomical reduction and rigid internal fixation was done with 135 degree DHS. Lag screw position and TAD determined on first postoperative day on radiographs (Anteroposterior & Lateral). Failure of fixation was determined on the radiographs during follow up. Lag screw cut-out was the projection of the screw from the femoral head by more than 1mm. Results: The mean age of the patients was 68.6 years (50-88). There were 132 (51.1 %) males and 126 (48.8%) females. Overall lag screw cutout rate was 11.2%. 21(30.8%) had screw cutout while 47 (69.1%) healed successfully among 68 patients with TAD ≥ 25mm. On the other hand 8(4.2%) had screw cutout while 182 (95.7%) healed successfully among 190 patients with TAD < 25mm. Middle middle and inferior middle position had highest success rate (˃ 92%) while inferior posterior position had highest cutout rate (36.2%). Among different age categories high failure rate (17.8%) seen in patients more than 70 years. Conclusion: The incidence of lag screw cutout is 11.2 % and risk of cutout can be minimized by placing lag screw in middle middle or inferior middle position and keeping the TAD < 25mm. More attention during follow up should be paid to patients with age ˃ 70 years.

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