scholarly journals Methotrexate plus narrow band ultraviolet B (NBUVB) versus methotrexate alone in the treatment of moderate to severe plaque psoriasis: A randomized clinical trial

2016 ◽  
Vol 13 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Dhan Keshar Khadka ◽  
S Agrawal ◽  
T K Dhali
Keyword(s):  
Plaque Psoriasis ◽  
Negative Impact ◽  
Ultraviolet B ◽  
Plaque Type ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of combination of methotrexate/narrowband ultraviolet B (NBUVB) phototherapy in the treatment of psoriasis has been rarely assessed. Objectives: To compare the therapeutic efficacy of methotrexate plus NBUVB phototherapy combination vs.  methotrexate  in  the  treatment  of  moderate  to  severe  chronic  plaque  psoriasis. Material and methods: Seventy-nine patients with chronic plaque-type psoriasis (body surface area involvement >2%) were randomized to receive either methotrexate/NBUVB phototherapy (group A) or methotrexate (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI75) Score or up to 12weeks, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of adverse effect, DLQI and relapse.Results: Of 79 patients, 69 completed the treatment period and follow-up. PASI 75 was achieved in 35/39(89%) patients in group A and 34/40(85%) patients in group B (P=0.052). The mean number of weeks (P = 0.031), the mean cumulative dose of NBUVB (8.2±3.5J/cm2)) and the mean number of phototherapy sessions (12±3)) required to achieve PASI 75 were less in group A compared with group B. There was no significant difference in the number of patients who relapsed during the follow- up period (P = 0.68). Conclusion: Combination of methotrexate and NBUVB phototherapy provides more rapid clinical improvement compared with methotrexate monotherapy in the treatment for chronic plaque-type psoriasis.NJDVL Vol. 13, No. 1, 2015 Page: 12-23

scholarly journals Methotrexate Versus Methotrexate Plus Folic Acid in the Treatment of Moderate to Severe Plaque Psoriasis: A Randomized Clinical-Trial

2016 ◽  
Vol 14 (1) ◽  
pp. 29-36
Author(s):  
D.K. Khadka ◽  
S. Agrawal ◽  
T.K. Dhali
Keyword(s):  
Adverse Effect ◽  
Folic Acid ◽  
Plaque Psoriasis ◽  
Negative Impact ◽  
Severity Index ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of methotrexate versus combination of methotrexate plus folic acid in the treatment of psoriasis has been rarely assessed.Objectives: To compare the efficacy of methotrexate versus methotrexate plus folic acid in the treatment of moderate to severe chronic plaque psoriasisMaterial and Methods: Eighty patients with moderate to severe chronic plaque psoriasis were randomized to receive either methotrexate (group A) or methotrexate plus folic acid (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI 75) score or upto 3 months, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of relapse, DLQI and adverse effects.Results: Of 80 patients, 71 completed the treatment and follow up period (33 in group A, and 38 in group B). PASI 75 was achieved in 34/40(85%) patients in group A and 32/40(80%) patients in group B (P < 0.142). There was statistically significant number of patients who had greater adverse effect in methotrexate than in methotrexate plus folic acid (p=0.020). There was significant difference in the number of patients who relapsed during the follow-up period (P = 0.013) with more relapse in group B.Conclusion: Combination of methotrexate and folic acid developed lesser adverse effect and greater relapse in comparison to methotrexate alone.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.29-36

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles

2021 ◽  
pp. 112067212110334
Author(s):  
Bu Ki Kim ◽  
Young Taek Chung
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Implantable Collamer Lens ◽  
Retrospective Case ◽  
Significant Difference ◽  
Lens Implantation ◽  
Group A ◽  
The Mean ◽  
Group B

Purpose: To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Setting: Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Design: Retrospective case series. Methods: This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). Results: At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. Conclusions: The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.

scholarly journals COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

2022 ◽  
Vol 12 (6) ◽  
pp. 6-11
Author(s):  
Vinayaka A.M. ◽  
Gayathri G.V. ◽  
Triveni M.G.
Keyword(s):  
Clinical Trial ◽  
Plaque Index ◽  
Age Group ◽  
Chlorhexidine Digluconate ◽  
Gingival Index ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

PROSPECTIVE RANDOMIZED STUDY ON TWO DOSE FRACTIONATION REGIMENS OF HIGH DOSE RATE BRACHYTHERAPY FOR CARCINOMA CERVIX: COMPARISON OF CLINICAL RESPONSE AND COMPLICATIONS IN ORGANS AT RISK

2017 ◽  
Vol 2 (01) ◽  
Author(s):  
Saurabh Goswami ◽  
Piyush Kumar ◽  
Arvind Kumar Chauhan ◽  
Jitendra Nigam ◽  
D. P. Singh
Keyword(s):  
External Beam Radiotherapy ◽  
Equivalent Dose ◽  
Dose Fractionation ◽  
External Beam ◽  
Cancer Cervix ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: Cancer Cervix is treated with a combination of external beam radiotherapy and intracavitary brachytherapy. With the recent American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix, at least Equivalent Dose 2 > 80 Gy for patients with complete response or partial response with residual disease less than 4cm is recommended. For non responders or those with tumors larger than 4cm at the time of brachytherapy, tumor dose escalation to an Equivalent Dose 2 of 85-90 Gy is recommended to point A. Present study was designed to see the feasibility of these guidelines in terms of local tumor control and toxicities to rectum and bladder in our group of patients. Material and Methods: Fifty patients of biopsy proven cancer cervix were enrolled. After pre-treatment evaluation all patients were delivered external beam radiotherapy 50 Gy in 25 fractions at 200 cGy/day with concurrent cisplatin on weekly basis. Patients were then randomized into three applications (Group A), four applications (Group B) of HDR Brachytherapy of 6 Gy each so that total treatment time does not exceed 8 weeks. BED and LQED were calculated and assessment of response and complications were assessed. Statistical analysis was done using Chi square test. Results: Mean age of the patients was 50 years. No significant hematological toxicities and radiation reactions were seen during external beam radiotherapy. The mean BED of group A for tumor, rectum and bladder was 137.3 Gy, 112.53 Gy and 103.23 Gy respectively and of group B was 155.3 Gy, 120.98 Gy and 111.95 Gy respectively. The mean EQD2 in group A at tumor, rectum and bladder was 74 Gy, 54.08 Gy and 61.94 Gy respectively and in group B was 82 Gy, 59.18 Gy, and 66.60 Gy respectively. There was no statistically significant difference in local response and early and late bladder reactions in both the groups. Conclusion: In a follow up of six months we did not find any significant difference in toxicities of rectum and bladder. Long term follow up is needed to see for late rectal and bladder toxicities.

scholarly journals Comparison of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 9 (34) ◽  
pp. 91-95
Author(s):  
Ramiya Ramachandran Kaipuzha ◽  
Nirmal Coumare Venkataramanujam ◽  
Padmanabhan Karthikeyan ◽  
Davis Thomas Pulimoottil
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Mucosal Injury ◽  
Sinus Surgery ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time ◽  
Sinonasal Polyposis

AbstractOBJECTIVE. To study and compare the benefits of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery in terms of subjective and objective improvement in symptoms of nasal polyposis.MATERIAL AND METHODS. This study involved 60 patients with bilateral sinonasal polyposis scheduled to undergo Endoscopic Sinus Surgery. The patients were randomized into two groups: Group A -Conventional endoscopic sinus surgery and Group B -Microdebrider-assisted endoscopic sinus surgery.RESULTS. There was a significant difference in the mean VAS at 3 months postoperatively in Group B, but no significant difference at 6 months postoperatively following either of the two methods. The mean time for surgery (p<0.01) and the mean intraoperative blood loss (p<0.01) were significantly lower in Group B.CONCLUSION. A well-trained surgeon with proper anatomical knowledge, good instruments, hypotensive anaesthesia, minimal mucosal injury and regular proper follow-up will have similar postoperative results with both methods.

scholarly journals Role of Zinc in Patients Presenting with Recurrent Hepatic Encephalopathy in Medical Unit of Tertiarycare Hospital Lahore

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Asma Kamal ◽  
Asifa Kamal ◽  
Naeem Afzal ◽  
Shazia Siddique ◽  
Khadija Tahir
Keyword(s):  
Hepatic Encephalopathy ◽  
Zinc Supplementation ◽  
Mean Value ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Improved Outcome

Abstract Objective: To observe the effects of zinc replacement on hepatic encephaopahty. To reducce hospital admission and heath burden by reducing episodes of recurrent hepatic encephalopathy. Methods: This study was carried out on 160 patients presenting with hepatic encephalopathy in medical ward of services hospital Lahore. The aim of the study was to assess the role of zinc in the improvement of encephalopathy. Results: The mean age of patients in group A was 55.78 and that in group B was 56.88years.There was significant difference in mean value of hepatic encephalopathy grade in both groups A and B after 3 months of follow up (p.value 0.027) indicating zinc is beneficial in treatment of hepatic encephalopathy. Conclusion: Our study showed that zinc replacement improved outcome in patients with Hepatic encephalopathy. Key words: Hepatic encephalopathy, zinc supplementation, chronic liver disease.

scholarly journals Efficacy of topical Calcipotriol versus combination of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis

2015 ◽  
Vol 10 (1) ◽  
pp. 74-79
Author(s):  
Md Shirajul Islam Khan ◽  
Md Nasir Uddin ◽  
Md Abdul Latif Khan ◽  
Rowshan Ara ◽  
Lubna Khondker
Keyword(s):  
Combination Therapy ◽  
Plaque Psoriasis ◽  
Military Hospital ◽  
P Value ◽  
Base Line ◽  
Plaque Type ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: The effectiveness of various topical agents for the treatment of plaque psoriasis is limited and the results are somewhat not satisfactory to some extent. Topical Calcipotriol can be used either monotherapy or combination therapy with betamethasone. This topical agent has “corticosteroid-sparing” benefit and reduction of side effects, duration of treatment and also relapse rates when used as combination therapy for the treatment of psoriasis. Objectives: The present study was conducted to compare the clinical efficacy between the topical Calcipotriol and combined formulation of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis. Materials and Methods: A clinical trial was carried out from January 2011 to Jan 2014 in outpatient department of Dermatology and Venereology, combined military hospital- Dhaka and Jessore Cantonment and Bangabandhu sheikh Mujib Medical University, Dhaka. Patients of plaque type psoriasis were the study population. Consequitive type of non-probability sampling method was followed in this study. Patients were divided into two groups.Group A was treated with topical Calcipotriol (0.005%) ointment and group B with combination of topical Calcipotriol plus Betamethasone ointment. Results: The mean percentage of Psoriasis Area and Severity Index (PASI) reduction after 4th week of treatment was 39.4 and 35.4 in group A and group B (p value >0.05) and after 8th week of 74 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 therapy was 59.6 in-group A and 60.7 in-group B respectively. The mean baseline PASI score was 6.7±4.5 and after 8th week it was 2.0 ±1.4 for group A and mean baseline PASI score was 5.5 ±4.2 and after 8th week it was 2.5±1.4 for group B. There was statistically significant reduction in PASI score from base line after 8th week of treatment in both treatment groups (p < 0.001). After 8th week of treatment moderate response was 22(73.3%) in group A and 18(60%) in group B. Very good response was 4 (13.3%) in group A and 8 (26.7%) in group B and minimal response of treatment occurs equally 4 (13.3%) in group A and group B. Conclusion: In the light of the findings of this study, topical Calcipotriol(0.005%) alone or combination with Betamethasone is individually effective for the treatment of plaque psoriasis but combination therapy is more effective than monotherapy. Therefore it may be recommended that monotherapy can be replaced by combination therapy in treating plaque psoriasis. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22929 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

Feasibility of the Oberlin Procedure in Late Presentation Cases of C5-C6 and C5-C7 Brachial Plexus Injuries in Adults

Hand ◽  
2020 ◽  
pp. 155894472091832
Author(s):  
Álvaro B. Cho ◽  
Carlos H. V. Ferreira ◽  
Fernando Towata ◽  
Gabriel C. Almeida ◽  
Luiz Sorrenti ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Late Presentation ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Flexion Strength

Background: Oberlin et al presented a new technique for nerve transfer that completely changed the prognosis of patients with brachial plexus injury. Currently, most of the literature addresses cases submitted to early surgical intervention, before 12 months from injury, showing consistent good results. The aim of this study was to evaluate the feasibility of the Oberlin procedure in late presentation cases (≥12 months), comparing the elbow flexion strength with patients operated earlier. Methods: We retrospectively reviewed 49 patients with partial brachial plexus injuries submitted to the Oberlin procedure. They were divided into 2 groups. Group A included 39 patients operated with <12 months of injury. The mean postoperative follow-up was 22.53 months. The interval from injury to surgery varied from 4 to 11 months (±8.45 months). Group B included 10 patients with surgery ≥12 months after injury. The mean postoperative follow-up was 32 months. The interval from injury to surgery ranged from 12 to 19 months (±15.4 months). Patients were evaluated monthly after surgery and the elbow flexion strength was measured using the British Medical Research Council scale. Results: In Group A, 24 patients presented with either good (M3) or excellent (M4) elbow flexion strength. In Group B, 9 patients presented with either good (M3) or excellent (M4) elbow flexion strength. A significant difference was not seen in the postoperative elbow flexion strength among the 2 groups. Conclusion: Biceps reinnervation with the Oberlin procedure is still feasible and should be attempted after more than 12 months of injury in partial brachial plexus injuries.

scholarly journals Randomised prospective comparative analysis of functional outcome of osteosynthesis of intra-articular distal humerus fracture using triceps reflecting and transolecrenon approach

2020 ◽  
Vol 6 (4) ◽  
pp. 722
Author(s):  
Nuthan Jagadeesh ◽  
Nibin Sanil ◽  
Vishwanath M. S.
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Articular Fractures ◽  
Complex Anatomy ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

<p class="abstract"><strong>Background:</strong> Intra articular fractures of distal humerus is one of the demanding injuries to manage due to its complex anatomy. Open reduction internal fixation is able to achieve painless, stable and mobile joint. This study is aimed at comparing functional outcome of patients treated with triceps reflecting and olecranon osteotomy approach.</p><p class="abstract"><strong>Methods:</strong> A hospital based randomized comparative study of 40 patients who diagnosed with distal humerus intraarticular fracture admitted in our hospital from April 2017 to March 2019. Triceps reflecting approach (group A) was used in 20 patients and olecranon osteotomy approach (group B) in 20 patients. Elbow range of movements and Mayo elbow performance score (MEPS) was used to compare outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean elbow range of motion is 95.8±13.5 degree at 1 year follow up in group A and 94.5±9.3 degree in 1 year follow up at 1 year follow up in group B. The mean MEP score at end of 1 year in group A was 93.8±2.9 and in group B was 91.5±3.2 shows excellent results but there was no statistically significant difference between MEP scores of two groups. We observed 6 patients developed extension lag less than 10 degree in group A which was clinically insignificant to patients and 7 patients developed hardware prominence in group B.</p><p class="abstract"><strong>Conclusions:</strong> Triceps reflecting Bryan Morrey approach is equally effective as olecranon osteotomy approach in treatment of distal humerus intra articular fracture with less complication and operative time.</p>

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