scholarly journals Effect of topical tacrolimus ointment on SCORAD index in pediatric atopic dermatitis.

2020 ◽  
Vol 27 (11) ◽  
pp. 2414-2418
Author(s):  
Shazia Bano ◽  
Munazzah Meraj ◽  
Rao Irfan
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Signs ◽  
Case Series ◽  
Systemic Review ◽  
Female Ratio ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Case Series Study ◽  
Co Morbidity ◽  
Morbidity Data

Objectives: To determine topical tacrolimus ointment’s efficacy in atopic dermatitis. Study Design: Descriptive case series study. Setting: Outpatient Department of Dermatology, Liaquat University of Medical and Health Sciences (LUMHS), Civil Hospital, Hyderabad. Period: 12 October 2017 to 12 April 2018. Material & Methods: Consisted of 106 patients. Detailed History was taken from patients and systemic review was also done to assessed any co-morbidity. Data was analyzed through SPSS version 23.0. Results: In this study 71 (66.98%) patients were men and 35 (33.01%) were female; with male to female ratio 2:1. The mean age was 6.1+1.8 years. Clinical signs of patients were erythema 88(83.01%), edema 76(71.69%), Oozing/ crusting 45(42.45%), excoriation 59(55.66%) and lichenification 64(60.37%). Before treatment start the SCORAD index (SCORAD I) mean was 61.8 ± 11.12 (range 7–103): moderate cases were observed in 87(82.07%) patients (SCORAD I 30 – 49) and 19(17.92%) patients had severe AD (SCORAD I ≥50). After treatment, the SCORAD index mean was 35.8 ± 13.15 (range 7–103): 57(53.77%) patients had SCORAD index values ≤30; moderate cases (SCORAD I 30-49) were observed in 42(39.62%) patients and 7(6.60%) patients had severe AD (SCORAD I >50). In 57(53.77%) cases topical tacrolimus ointment (0.1%) showed positive efficacy in atopic dermatitis, while in 49(46.22%) cases observed negative. Conclusion: The application of topical tacrolimus ointment (0.1%) is effective in the treatment of atopic dermatitis in children.

scholarly journals SNAKE BITE

2014 ◽  
Vol 21 (02) ◽  
pp. 290-294
Author(s):  
Ashok Kumar Lohano ◽  
Muhammad Tanveer Alam ◽  
Aftab Ali Zardari ◽  
Mumtaz Ali Shaikh
Keyword(s):  
Respiratory Failure ◽  
Case Series ◽  
Snake Bite ◽  
Systemic Review ◽  
Base Line ◽  
Medical Department ◽  
Female Ratio ◽  
Snake Bites ◽  
Case Series Study ◽  
Co Morbidity

Objective: To determine the frequency of various clinical presentations of snakebitten admitted patients. Study design: Descriptive case series study. Place and duration ofstudy: This study was carried out in General Medicine ward, at Medical department of PeoplesMedical University & Hospital Nawabshah, from September 2011 to March 2012. Methodology:This study consisted of 55 patients admitted through the outpatient department, as well as fromcasualty department of Peoples Medical University & Hospital Nawabshah. Detailed History wastaken from all the patients with special regard to type of snake, age , sex , site , time of bite, timelapsed between bite and reaching to hospital. Detailed clinical examination of local features werefang marks, swelling, bleeding from wound, pain and systemic features like nausea, vomiting,echymosis, drowsiness, discharge from wound, hematuria, ptosis, respiratory failure ofenvenomation. Systemic review was also done to see any co-morbidity. All patients underwentfor base line and specific investigations especially clotting time (CT). Inclusion criteria were thatall diagnosed patients of snake bite, aged > 12 year of either sex admitted with the history ofsnake bite with irrespective of toxicity were included. Patients with history of thorn prick, insectbite were excluded criteria. Results were prepared with help of tables and graphs. Data wasanalyzed through SPSS software. Results: Out of 55 patients included in this study, 39 were men(70.9%) and 16 patients were female (29%); with male to female ratio of 2.4:1. There was widevariation of age ranging from a minimum of >12 year to 60 year. The mean age was 39±5.8 years.In our study mostly patients 35(63.63%) reached hospital within 60 minutes followed by12(21.88%) patients within 30 minutes. 5(9%) patients reached within 90 minutes and onepatients reported more than 120 minutes. Symptoms of patients were pain at the bite side in55(100 %), ecchymosis in 18(32.72%), discharge from wound in 9(16.36%), bleeding from gum in8(4.4%) Nausea and vomiting in 7(12.72 %), hematuria in 11(20%), ptosis in 8(14.54%),drowsiness in 5(9%) and respiratory failure in 5(9%). Conclusions: We conclude that males arecommonly affected than females and the farmers and labourers are the most vulnerable sectionof the population for snake bites. In this study age, presence signs and treatment by faith healersis independent predictors of death in case of snake bite. This may provide important evidence toformulate preventive strategies especially health education.

The Epidemiology of Household Rodenticides Poisoning in Hong Kong and its Risk Factors for Developing Coagulopathy

2014 ◽  
Vol 21 (6) ◽  
pp. 339-345 ◽  
Author(s):  
N Othman ◽  
Ck Chan ◽  
Fl Lau
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Emergency Departments ◽  
Multiple Logistic Regression Analysis ◽  
Case Series ◽  
Female Ratio ◽  
Intentional Ingestion ◽  
Accident And Emergency ◽  
Case Series Study ◽  
Clinically Significant

Objective To (1) describe the epidemiology of household rodenticides poisoning in Hong Kong, (2) evaluate the proportion of patients who have develop coagulopathy after rodenticide poisoning, (3) identify the risk factors for developing coagulopathy in rodenticide poisoning. Design Case series study. Setting Sixteen accident and emergency departments in Hong Kong. Patients Patients with household rodenticide ingestion who presented to accident and emergency departments during the period from July 2008 to February 2012. Results 110 patients were reported to have rodenticide exposure during the study period. Eighty-seven patients were included in the final analysis. The mean age was 40.1 and the male-to-female ratio was 1.29:1 (49:38). Most patients (91%) took the rodenticide intentionally. Sixty-nine patients (79%) exposed to anticoagulants type of rodenticide based on history or laboratory findings. The ingredient of the rodenticide ingested in 18 patients (21%) was untraceable. The only clinically significant presentation reported after rodenticide exposure was coagulopathy. Thirty-one patients (36%) developed coagulopathy with an international normalised ratio greater or equal to 1.3. Clinical significant bleeding was only observed in one patient. Presence of coagulopathy in rodenticide poisoning was significantly associated with older patient, intentional ingestion, ingestion of warfarin, ingestion of more than one pack and presence of co-ingestion. Multiple logistic regression analysis showed that only two factors were independent predictor of coagulopathy: Ingestion of warfarin rodenticide (p=0.001, odds ratio [OR] = 18.20, 95% confidence interval [CI]=3.44-96.42), and ingestion of more than one pack of rodenticide (p=0.02, OR=10.01, 95% CI=1.43-69.87). Conclusions Clinically significant household rodenticide poisoning in Hong Kong is solely related to ingestion of anticoagulant type of rodenticide. Patients who have ingested warfarin rodenticide and higher ingestion dose are more likely in developing coagulopathy. (Hong Kong j.emerg.med. 2014;21:339-345)

scholarly journals When To Start Tacrolimus Ointment For Vernal Keratoconjunctivitis? A Proposed Treatment Protocol

2021 ◽  
Author(s):  
Roee Arnon ◽  
Irit Rozen - Knisbacher ◽  
Tal Yahalomi ◽  
Nir Stanescu ◽  
Yulia Niazov ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Treatment Protocol ◽  
Topical Steroid ◽  
Case Series ◽  
Topical Steroids ◽  
Line Treatment ◽  
Tacrolimus Ointment ◽  
Disease Remission ◽  
The Mean ◽  
Topical Treatments

Abstract PurposeThe aim of this study was to compare treatment regimens of tacrolimus and of topical steroids for VKC and suggest a treatment protocol according to our clinical experience.MethodsThis retrospective, nonrandomized case series enrolled 85 Patients with VKC. Patients were classified clinically according to severity (mild, moderate, severe) and were treated according to a suggested protocol. Analysis was made according to treatment received: tacrolimus ointment as first line treatment (tacrolimus 1st line), tacrolimus ointment after topical steroid drops treatment (tacrolimus 2nd line) and topical steroid drops or artificial tears alone (topical steroid and tears group). Results Significant improvements in clinical signs and symptoms were achieved under tacrolimus treatment 14 months in the moderate group and 5 months in the severe group. The longest duration of treatment was for tacrolimus 2nd line group (p=0.031) and the mean number of visits in the clinic was the highest. The mean number of topical treatments per day was higher in the topical steroid and tears group (2.6 times) than in the two tacrolimus groups (1.3 times for both). The mean time needed to achieve disease remission or relief did not differ between the tacrolimus 1st line and 2nd line groups.ConclusionTacrolimus treatment is effective and safe for VKC. Tacrolimus as 1st line treatment may be preferred for severe cases, for faster disease remission compared to tacrolimus as 2nd line treatment; and with fewer topical treatments per day compared to topical steroids.

scholarly journals TO DETERMINE THE FREQUENCY OF VISCERAL LEISHMANIASIS IN PERIPHERAL CYTOPENIC PATIENT IN PATHOLOGY DEPARTMENT HAYATABAD MEDICAL COMPLEX.

1969 ◽  
Vol 4 (2) ◽  
pp. 560-566
Author(s):  
ZARD ALI KHAN ◽  
MOHAMMAD SAJJAD ◽  
IMRAN UD DIN ◽  
MUKAMIL SHAH ◽  
SHAH JEHAN
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Case Series ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Total Leukocyte Count ◽  
Full Blood Count ◽  
Female Ratio ◽  
Pathology Department ◽  
Case Series Study

BACKGROUND: Visceral Leishmaniasis is a chronic disease and was first described in 1903, byLIESHMAN and DONOVAN. The disease is common in tropical and sub tropical areas of the worldwith various hematological manifestations. It is characterized by fever, visceromegaly, weight loss,pancytopenia and hypergammaglobulenemia. The disease is silent killer, invariably killing almost alluntreated patients, but curable with hematological improvement within 4-6 weeks of treatment.OBJECTIVE: To determine the frequency of Visceral Leishmaniasis in patints with cytopenias .MATERIAL AND METHODS: A descriptive study conducted in Pathology department, HayatabadMedical Complex, Hayatabad from September 1, 2012 to August 31, 2013. This study comprises of 126patients, subjected to complete blood counts. Diagnosis were confirmed by finding Amastigote( L/Dbody) from bonemarrow aspirate. All the patients who were referred to pathology Department of thehospital for bone marrow examination, with the results of peripheral blood using automatedHaematology analyzer, Sysmex KX 21 showing cytopenia were included in the study. Consent wastaken from the patient for bone-marrow aspiration procedure. After consent detailed history, physicalexamination was done.Laboratory investigations i.e. full blood count, which includes hemoglobin estimation, white blood cell,red blood, and platelet count.Bone marrow cytology (Giemsa stain) was recorded on the designed profroma.Posterior superior iliac spine (PSIS) was used as the site for aspiration in adults and children over 2years of ageRESULT: Descriptive case series study of 126 patients of peripheral cytopenia. In which 77 (61.1%)patients were males and 49 (38.9%) were female with male to female ratio of 1.57: 1 It was also foundin this study that visceral leishmaniasis was present in 29 (23%) of cases and the male: female were 1.6:1. Result of the automated hematology analyzer of peripheral cytopenic patients in visceralleishmaniasis show that all of the patients were having total leukocyte count less than 4000/cmm(100%). The hemoglobin level wass less than lOgm/dl in 26 cases (87.7%) and more than lOgm/dl inthree cases (10.3%). In case of platelets count, 27 cases (93.1%) were having platelets count less than150000/cmm.CONCLUSION: Incidence of visceral leishmaniasis is highier in children age group 1-10 years, alsomales are more prone than females. Leukopenia is recorded in all (100%) of the cases, followed bythrombocytopenia (93.1%) and anemia (Hb <10gm %) 87.7% cases.KEY WORD: Visceral Leishmaniasis, Kala Azar, Amastigote (L/D body)

scholarly journals CARCINOMA OF URINARY BLADDER;

2017 ◽  
Vol 24 (11) ◽  
pp. 1691-1696
Author(s):  
Khalid Hussain ◽  
Manzoor Ahmad Khan ◽  
Attiq ur Rahman Khan ◽  
Imran Amin ◽  
Muhammad Khalid Butt
Keyword(s):  
Bladder Tumor ◽  
Tnm Classification ◽  
Case Series ◽  
Female Ratio ◽  
Voiding Symptoms ◽  
Case Series Study ◽  
And Gender ◽  
Muscle Invasive ◽  
Male To Female ◽  
Gross Haematuria

Introduction: The most common presentation of carcinoma of urinarybladder is haematuria. Almost 80-90% of patients with carcinoma of bladder present eitherwith microscopic or gross haematuria and it is mostly intermittent rather than constant. Somepatients also complain of irritative voiding symptoms such as frequency, urgency and dysuria.Study Design: Descriptive, case series study. Setting: Department of Urology, DHQ Hospital,Gujranwala, Pakistan. Period: July 2015 to June 2016. Materials & Methods: Total 30 patientsirrespective of age and gender with diagnosis of bladder tumor based on clinical symptomsand supported by laboratory tools like Urine cytology, Ultrasound and IVU were included. Thealready diagnosed patients of bladder tumor that have been treated with different modalitieswere excluded. All the tumors were staged according to TNM classification after TURBT andgraded on the basis of histopathology. Results: Mean age was 53.17+16.07SD years. Maleswere 25(83.3%) and females were 5(16.7%). Male to female ratio is 5:1. Twenty eight (93.3%)patients out of 30 presented with painless haematuria. 23(73.33%) patients out of 30 patientswere smokers. 09 (30%) patients had Ta, in which G1 was found in 2 patients and G2 in 7patients. T1 was found in 10 (33.3%) patients, in which G2 was 5(17.3%) and G3 was 5(17.3%)cases. Muscle invasive T2a was diagnosed in 04 patients amongst them G2 and G3 wasdetected in 2(6.6%) patients each respectively. T2b was present in 3 patients, which had G1 in1(3.3%) and G3 in 2(10%) patients. T3b G2 was found 01 patient and T3b G3 was detected in1(3.3%) patient, T4M1 G3 was present in 2(6.6%) patients. Conclusion: This study concludedthat the bladder tumor is quite common with muscle invasive TCC is more common. Painlesshematuria is the commonest presentation and also smoking has a definite association with CAbladder.

scholarly journals The Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

2020 ◽  
Vol 35 (4) ◽  
pp. 229-234
Author(s):  
Hafiza Sadia Imtiaz
Keyword(s):  
Clinical Symptoms ◽  
Clinical Signs ◽  
Vernal Keratoconjunctivitis ◽  
P Value ◽  
Baseline Score ◽  
Assessment Data ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Quasi Experimental ◽  
Written Informed Consent

  Purpose: To determine the efficacy of 0.03% dermatological tacrolimus ointment in patients with refractory vernal keratoconjunctivitis Study Design: Quasi-experimental study Study Place and Duration: Eye Department, DHQ-Teaching Hospital, Gujranwala, Pakistan from April 2018 to March 2019 Material and Methods: After approval from hospital ethical committee and obtaining written informed consent from each patient/guardian, patients of either gender between 4-16 years of age with VKC not responding to conventional treatment for more than 8 weeks or having steroid-induced complications were included in this study. Dermatological tacrolimus ointment 0.03% started to be placed in inferior fornix in BD frequency along with topical lubricants. Patients were followed up on a regular schedule. Individual symptoms score was assessed from the questionnaire and signs score from observer’s clinical assessment. Data were analyzed using SPSS v23.0. P-value <0.05 was considered as statistically significant. Results: 40 eyes of 20 patients were included in this study. Out of which 4(20%) were female and 16 were male (80%). Mean baseline score for clinical symptoms was 6.65±1.81 that reduced to 1.65±0.81 after 12 weeks treatment course of tacrolimus with a significant p-value of 0.006 (p<0.05). Mean baseline score for clinical signs was 5.9±1.59 that improved to 1.80±0.83 after 12 weeks treatment course with a statistically significant p-value of 0.003 (p<0.05). Conclusions: In conclusion, topical tacrolimus dermatological ointment 0.03% is highly effective in refractory VKC and can be safely used as an alternative in VKC patients who are steroid-responders.

scholarly journals Comparison of efficacy and safety between Tacrolimus and Hydrocortisone acetate in 2-5 years old children with atopic dermatitis

2015 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Quazi Salim Yazdi ◽  
Md Shamsul Huda ◽  
Abdul Latif Khan ◽  
Md Sayeed Hasan ◽  
Mushtaq Ahmad ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Armed Forces ◽  
Application Site ◽  
Global Evaluation ◽  
Hydrocortisone Acetate ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Intense Pruritus ◽  
Group 2 ◽  
Group B

Introduction: Atopic dermatitis is a recurrent inflammatory skin disease with intense pruritus as its hallmark symptom. It often follows a chronic, relapsing course. Objectives: This comparative study was done with an aim to find out the efficacy of Tacrolimus and Hydrocortisone acetate in 2-5 year old children with Atopic dermatitis. Methods: This clinical trial was carried out on two equal groups of 60 patients. “Group A” was treated with topical tacrolimus ointment (0.03%) and “group B” with hydrocortisone acetate ointment (1%). Follow up was done at week 1, 2, 4, 8 and 12 of treatment for assessment of improvement and adverse event, which was measured by ‘overall clinical improvement in the physician's global evaluation of clinical response’. Data was collected in a predesigned data collection sheet, and analysis was performed by SPSS program (Version 12). Results: Excellent, marked and moderate improvement were observed in 19 (63.3%), 9 (30.0%), and 2(6.7%) patients of tacrolimus group and 1(3.3%), 2(6.7%) and 27(90.0%) patients of hydrocortisone group respectively. Tacrolimus group had significantly better improvement than hydrocortisone group (p<0.001). Skins burning at application site were observed significantly more in tacrolimus group 8(26.7%) than in hydrocortisone group 2 (6.7%). 53 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: The study showed tacrolimus ointment is more effective than hydrocortisone acetate in the treatment of atopic dermatitis in paediatric patients. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22924 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

scholarly journals HEMORRHAGIC STROKE;

2014 ◽  
Vol 21 (06) ◽  
pp. 1204-1208
Author(s):  
Faisal Shahab ◽  
Irfan Murtaza Shahwani ◽  
Shuaib Ansari ◽  
Syed Zulfiquar Ali Shah
Keyword(s):  
Blood Pressure ◽  
Hemorrhagic Stroke ◽  
Case Series ◽  
Health Sciences ◽  
Hypertensive Retinopathy ◽  
Age Group ◽  
Female Ratio ◽  
Case Series Study ◽  
Male To Female ◽  
Series Study

Objectives: To identify the frequency of risk factors in hemorrhagic stroke at Liaquat university of medical and health sciences. Patient and methods: This Descriptive case series study of six months was carried out in the department of medicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of age with hemorrhagic stroke on CT were enrolled in the study after taking consent from caretaker of patients. Detailed history focusing on hypertension, diabetes and smoking and their duration was taken. Blood pressure was recorded and fundoscopy was done to find out diabetic or hypertensive retinopathy. Thorough neurological examination and fasting / random blood glucose level was evaluated while the data was done was analyzed using SPSS version 16. Results: A total of 100 patients were included in the study during study period. 61% of patients were in > 50 years of age group with mean age of 53.4±11 years. A total of 66 (66%) were male; with male to female ratio was 2:1. Hypertension was present in 63% of cases, Diabetes was found in 24% cases and 44 patients were cigarette smokers. Conclusions: It was concluded that high blood pressure, diabetes mellitus and smoking are associated with hemorrhagic stroke.

scholarly journals Spectrum of surgical trauma and associated head injuries at a university hospital in eastern Nepal

2010 ◽  
Vol 01 (01) ◽  
pp. 02-08 ◽  
Author(s):  
A Bajracharya ◽  
A Agrawal ◽  
B R Yam ◽  
C S Agrawal ◽  
Owen Lewis
Keyword(s):  
Road Traffic ◽  
Average Length ◽  
Case Series ◽  
Operative Management ◽  
Health Sciences ◽  
University Hospital ◽  
Surgical Trauma ◽  
Eastern Region ◽  
Female Ratio ◽  
Case Series Study

ABSTRACT Background: Trauma is one of the common surgical emergencies presenting at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal, a tertiary referral center catering to the needs of the population of Eastern Nepal and nearby districts of India. Objective: The objective of this study is to analyze the magnitude, epidemiological, clinical profile and outcome of trauma at B P Koirala Institute of Health Sciences. Materials and Methods: This descriptive case series study includes all patients with history of trauma coming to BPKIHS emergency and referred to the surgery department. We noted the detailed clinical history and examination, demographics, mechanism of injury, nature of injury, time of reporting in emergency, treatment offered (operative or non operative management) and analyzed details of operative procedure (i.e. laparotomy, thoracotomy, craniotomy etc.), average length of hospital stay, morbidity and outcome (according to Glasgow outcome scale). Collected data were analyzed using EpiInfo 2000 statistical software. Results: There were 1848 patients eligible to be included in the study. The mean age of the patients was 28.9 ± 19.3 years. Majority of the patients (38%) belonged to the age group of 21 - 40 years and the male to female ratio was 2.7:1. Most of the trauma victims were students (30%) followed by laborers (27%) and farmers (22%) respectively. The commonest causes of injury were fall from height (39%), road traffic accident (38%) and physical assault (18%); 78% of the patients were managed conservatively and 22% underwent operative management. Postoperative complications were seen in 18%. Wound infection 7.5%, neurological deficit including cerebrospinal fluid (CSF) otrorrhea was seen in 2.2% patients. Good recovery was seen in 84%, moderate disability in 5.2% patients and severe disability in 1.4% patients. The mortally was 6.3% and most of the deaths were related to traumatic brain injuries. Conclusions: In Nepal, trauma-related injury contributes significantly to morbidity and mortality and is the third leading cause of death. There are very few studies on trauma from this country and hence this study will help in understanding the etiology and outcome particularly in the Eastern region of Nepal.

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