Comparison of Analgesic Effects of UST with NSAIDs and without NSAIDs in Patients with De Quervain’s Disease

Background: De Quervain's disease has been described as an entrapment of the extensor pollicis brevis and abductor pollicis longus tendons in the first dorsal compartment of the wrist is a common cause of wrist and hand pain Treatment of the disease consists of pharmacological & non-pharmacological. The non-pharmacological includes immobilization, therapeutic heat and cold, electrical nerve stimulator, thumb stabilizer splint, postural correction at work and the adjustment of tools and equipment. This randomized clinical trial was performed to find out the effects of UST with NSAIDs and without NSAIDs in the patients of De Quervain’s disease. Methods: This randomized clinical trial was performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over a period of six months. Group A-experimental or interventional group and group B-control group by randomization with the help of lottery. Experimental group was managed by activities of daily living (ADLs) instructions, ultrasound therapy (UST) with non-steroidal anti-inflammatory agents (NSAIDs gel), along with thumb spica splint. Control group B received previous management except non-steroidal anti-inflammatory agents (NSAIDs gel). All patients received therapeutic ultrasound in a same dosage (1 watt/ cm 2/min) for 8 minutes. An evaluation was made at initial visit and two weeks interval for 6 weeks. So, there were three follow up visits and these evaluations were performed by the same investigator. In each visit, measurement of pain intensity and disability level were performed by using visual analogue scale (VAS), Tenderness Index and Patient rated wrist evaluation (PRWE) respectively. All results was recorded systematically. A post intervention result was compared with baseline result by SPSS-20 Results: Out of 60 total patients 60(100%) had Finkelstein test positive. Significant difference between Group A and Group B was found at week 4 and Week 6 follow up (P<0.05) whereas other early follow up was non-significant in VAS analysis (p>0.05). Significant difference between Group A and Group B was found at week 4 and week 6 follow up (P<0.05) regarding change of tenderness and PRWE. Conclusion: Regarding treatment of De Quervain's disease, present study shown that UST with NSAIDs gel reduces the morbidity and relief of pain of patients when in comparison to other conventional treatment. TAJ 2019; 32(1): 25-32

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Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2020/v4i230147 ◽

2020 ◽

pp. 37-42

Author(s):

Jayendra R. Gohil ◽

Vishal S. Rathod ◽

Bhoomika D. Rathod

Keyword(s):

Single Dose ◽

Serum Bilirubin ◽

Total Serum Bilirubin ◽

Total Serum ◽

Control Group ◽

Term Neonates ◽

Significant Difference ◽

Group A ◽

Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001, p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

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LAND BASED EXERCISES VERSUS POOL BASED EXERCISES FOR SWIMMER’S SHOULDER IN COMPETITIVE SWIMMERS: RANDOMIZED CLINICAL TRIAL

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i4.1305 ◽

2021 ◽

Vol 10 (4) ◽

pp. 3296-3299

Author(s):

Waqar M. Naqvi

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Shoulder Pain ◽

Pain Disability Index ◽

Pain Disability ◽

Significant Difference ◽

Shoulder Strength ◽

Group A ◽

Group B ◽

Competitive Swimmers

To compare the effect of Land based exercises and Pool based exercises for shoulder strength to reduce shoulder pain in competitive swimmers using Shoulder Pain Disability Index (SPADI) score, Hand-Held dynamometer (HHD), Randomized Clinical trial.29 competitive swimmers with age group between 8 to 18 years were evaluated for shoulder pain using Shoulder Pain Disability Index Score [SPADI] and shoulder strength was evaluated using Hand Held Dynamometer [HHD] before and after the study. Then all the subjects were divided into 2 groups, for Group A Pool based exercises were given and for Group B Land based exercises were given. Statistically there is significant difference in values of outcome measures after the study in both groups but there is more significant difference in Group A than Group B. Pool based exercises showed more significant effect on shoulder pain than land based exercises in swimmer’s shoulder.

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The Effect of Oral Administration of Pistacia Atlantica Kurdica Gum on the Eradication of Helicobacter Pylori in Patients with Dyspepsia: A Randomized Clinical Trial

Global Journal of Health Science ◽

10.5539/gjhs.v9n2p256 ◽

2016 ◽

Vol 9 (2) ◽

pp. 256 ◽

Cited By ~ 1

Author(s):

Hamidollah Afrasiabian ◽

Mohammad Hadi Imanieh ◽

Mohammad Ali Nejati ◽

Alireza Salehi

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Demographic Situation ◽

Significant Difference ◽

Before And After ◽

Group A ◽

H Pylori ◽

Group B ◽

Group D ◽

Common Infections

H. pylori infection is one of the most common infections in the world so that the aim of this study was to evaluate the antimicrobial P. Atlantica Kurdica gum in the eradication of H. pylori. This study is a randomized clinical trial; Patients with positive Urea Breath Test and symptoms of dyspepsia were entered. Patients were randomly divided into four groups. Group A: three drugs including 500 mg of Amoxicillin twice a day (bd), Clarithromycin 500 mg bd and Omeprazole 20 mg (bd) and Group B: Group A drugs plus the capsule containing 1 g of powdered P. Atlantica Kurdica gum (bd). In Group C: the capsule containing 1 g of powdered P. Atlantica Kurdica gum (bd) and Group D: this group took placebo-containing capsule (bd) for 14 days respectively. Dyspeptic symptoms before and after healing period and the UBT results two days before the start of treatment and 30 days after the completion were compared in 4 groups. Patients were not statistically significant difference from each other in the four groups regarding the demographic situation. Moreover, H. pylori eradication rate was 19/24 in Group A, 18/24 in Group B, 10/23 in Group C and 2/24 in Group D. Relieving symptoms of dyspepsia in Groups B and C were significantly higher than in Group D (P=0.025 and p=0.006 respectively). P. Atlantica Kurdica significantly led to the treatment of dyspepsia symptoms and H. pylori eradication.

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Lacrimal stenting versus three-snip punctoplasty for treatment of punctal stenosis or occlusion: An open-label, randomized clinical trial

Medical hypothesis discovery and innovation in ophthalmology ◽

10.51329/mehdiophthal1418 ◽

2021 ◽

Vol 10 (1) ◽

pp. 24-31

Author(s):

Haitham Rashdan ◽

Ali Mahmoud Ismail ◽

Mohammed Ezz-Eldawla ◽

Mohammed Iqbal

Keyword(s):

Clinical Trial ◽

Patient Satisfaction ◽

Randomized Clinical Trial ◽

Open Label ◽

Punctal Plugs ◽

Silicon Tube ◽

Group A ◽

Group B ◽

Punctal Stenosis

Background: To compare the short-term anatomical and functional outcomes of, as well as patient satisfaction with, lacrimal stenting and three-snip punctoplasty for the treatment of punctal stenosis or occlusion. Methods: In this open-label, randomized clinical trial, we included 50 eyes of 30 patients diagnosed with punctal stenosis or occlusion. They were randomly allocated to two groups of 25 eyes each, using central telephone randomization. Group A underwent a lacrimal stenting procedure and was subdivided into two subgroups: Group A1 (13 eyes) received polyvinylpyrrolidone-coated perforated punctal plugs, and Group A2 (12 eyes) received closed intubation using a bicanalicular silicon tube. Group B included 25 eyes that underwent three-snip punctoplasty. All eyes were examined after 1 day, 1 week, 1 month, 3 months, and 6 months. Postoperative anatomical success assessing the punctum size, functional success using the fluorescein disappearance test, and patient satisfaction based on epiphora scoring were recorded. Results: Both study groups were comparable in terms of sex and age distribution. Compared to Group B, Group A had a significantly larger punctum size at one, three, and 6-month postoperatively (P = 0.009, 0.01, and 0.02, respectively). The difference in FDT results was significant between the two groups at all follow-up visits (P = 0.008, 0.0001, 0.003, and 0.002, at postoperative one week, one-months, three-month, and six-month, respectively). Likewise, patient satisfaction was significantly different between both groups at all follow-up visits (P = 0.007, 0.001, 0.005, and 0.002, at postoperative one week, one-months, three-month, and six-month, respectively). Conclusions: Lacrimal stenting is an effective method for the treatment of punctal stenosis or occlusion. Overall, the FDT results and patient satisfaction outcomes were significantly better. Keywords: punctal occlusion, punctal stenosis, epiphora, lacrimal stenting, closed intubation, bicanalicular silicon tube, perforated punctal plugs, three-snip punctoplasty, 3-snip punctoplasty

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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

International Journal of Research in Ayurveda and Pharmacy ◽

10.7897/2277-4343.1206161 ◽

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.

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Efficacy of 0.05% cyclosporine A on the lipid layer and meibomian glands after cataract surgery: A randomized, double-masked study

PLoS ONE ◽

10.1371/journal.pone.0245329 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245329

Author(s):

Min Seung Kang ◽

Jonghoon Shin ◽

Jeong Min Kwon ◽

Jin Huh ◽

Ji Eun Lee

Keyword(s):

Clinical Trial ◽

Cataract Surgery ◽

Cyclosporine A ◽

Ocular Surface ◽

Lipid Layer ◽

Significant Difference ◽

Group A ◽

Meibomian Glands ◽

Group B

Purpose To quantitatively evaluate the effects of 0.05% cyclosporine A (CsA) on lipid layer thickness (LLT) and meibomian glands after cataract surgery using the LipiView® ocular surface interferometer. Methods This study was a prospective randomized double-masked clinical trial conducted by Pusan National University Yangsan Hospital between April 04, 2019, and November 31, 2019. Sixty-two participants were recruited, and 12 of them were not enrolled because they had undergone previous treatments for ocular surface diseases. The participants were adult patients with cataract, exhibiting normal lid position; they did not present any other ocular disease and did not meet the exclusion criteria of the clinical trial. Fifty subjects were enrolled in the study. The randomized subjects received treatment with 0.05% CsA (group A) or 0.5% carboxymethyl cellulose (CMC) (group B) over the 3 months following the cataract surgery. Subjective and objective assessments were performed at preoperative and postoperative visits. Ocular Surface Disease Index (OSDI), tear breakup time (TBUT), and Schirmer’s I test were performed by the same surgeon, and LLT and meiboscore were determined using the LipiView® interferometer. Results Fifty subjects subjects enrolled consisted of men (50%) and women (50%), with a mean (SD) age of 65.94 (10.35) years. Four subjects in group A and five in group B were excluded from the analysis as they were lost to follow-up within 1 month after cataract surgery. Thus, the study comprised 41 eyes of 41 subjects; 21 subjects were treated with CsA and 20 subjects with CMC. Comparing the clinical measurements between groups A and B taken at the last visit, while controlling the effects of the preoperative values, TBUT and LLT showed significant differences (p = 0.035 and p = 0.047, respectively, by ANCOVA). The TBUT between the subjects using CsA and those using CMC after cataract surgery showed a significant difference during follow up (p = 0.003 by repeated measures ANOVA). In the multivariate analysis, preoperative LLT and the use of CsA were found to be independent parameters for postoperative LLT (R2 = 0.303; p = 0.008 and p = 0.045, respectively), whereas the follow-up duration exhibited a positive correlation with the difference between the preoperative and postoperative values of LLT in the group treated with CsA (R2 = 0.738 and p < 0.001). Conclusion Treatment with 0.05% CsA following cataract surgery is effective in improving TBUT and LLT in comparison with 0.5% CMC. A higher preoperative value of LLT and the postoperative use of CsA could be significant determinants of a higher postoperative LLT value. Trial registration ISRCTN registry with ISRCTN 10173448.

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Single Dose or Divided Dose of Polyethylene Glycol in Treatment of Pediatric Functional Constipation: A Randomized Clinical Trial

10.21203/rs.3.rs-977795/v1 ◽

2021 ◽

Author(s):

Heidar Safarpour ◽

Mohammad Hadi Imanieh ◽

naser honar ◽

sajad hekmati ◽

Naeimehossadat Asmarian

Keyword(s):

Clinical Trial ◽

Single Dose ◽

Polyethylene Glycol ◽

Randomized Clinical Trial ◽

Divided Dose ◽

Functional Constipation ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.

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Effectiveness of Chlorhexidine and Metronidazole Gels in the management of gingivitis. A clinical trial

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4236 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Maryam Panhwar ◽

Shazia Perveen Rajpur ◽

Eisha Abrar ◽

Mansour Alqutub ◽

Tariq Abduljabbar

Keyword(s):

Clinical Trial ◽

Subjective Evaluation ◽

Substantial Improvement ◽

Significance Level ◽

Creative Commons ◽

Significant Difference ◽

Group A ◽

Group B ◽

Root Planning

Objectives: The purpose of the present study was to compare the topical application of chlorohexidine (CHX) and Metronidazole (MTZ) gels, individually and in combination in patients with gingivitis for up to 12 weeks follow-up. Methods: The clinical trial was conducted at Liaquat University of Medical Health Sciences (LUMHS) Jamshoro and Hyderabad, Institute of Dentistry from 1st March 2019 to 1st March 2020. Patients were selected based on inclusion criteria. Out of 125 screened patients, ninety-nine patients agreed to participate in the study. At the beginning of study all patients were assessed for gingival inflammation by using gingival index (GI) (Loe and silness, 1963). Scaling root planning (SRP) was performed in all patients. Subjects were randomly selected in three groups (n=33 each). In Group-A CHX gel was applied, Group-B Metronidazole gel was applied and the combination of two was applied to patients of Group-C. Patient follow up was done and gingival parameters were assessed at baseline, fourth week and twelve weeks. Apart from the clinical evaluation, a subjective evaluation was also undertaken. Significance level of 0.05 and a desired study power of at least 80% was estimated. Analysis of Variance (ANOVA) test for comparison was used within groups. Results: A significant improvement in gingival scores was noted in all groups from baseline. At 4 weeks CHX (1.25±0.21) MTZ (1.81±0.38) CHX+MTZ (1.29±0.34) compared to baseline CHX (2.77±0.24) MTZ (2.84±0.54) CHX+MTZ (2.74±0.31) demonstrated substantial improvement (p<0.001). However, gingival scores showed inclination at 12 weeks CHX (1.18±0.41) MTZ (1.21±0.48) CHX+MTZ (1.11±0.14) with no significant difference to week 4 (p>0.001). Conclusion: Local MTZ gel and MTZ+CHX gel showed effectiveness similar to CHX gel application adjunct to scaling and root planning in the treatment of gingivitis. doi: https://doi.org/10.12669/pjms.37.5.4236 How to cite this:Panhwar M, Rajpar SP, Abrar E, Alqutub M, Abduljabbar T. Effectiveness of Chlorhexidine and Metronidazole Gels in the management of gingivitis. A clinical trial. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4236 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Modified technique of end to side distal radio-cephalic shunt to overcome juxta-anastomotic stenosis

International Surgery Journal ◽

10.18203/2349-2902.isj20191060 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1029

Author(s):

Haitham Atif ◽

Nehad Abdou Zaid ◽

Abd El-Mieniem Fareed Mohamed ◽

Yehia Mohamed Alkhateep

Keyword(s):

Patency Rate ◽

Intervention Group ◽

Anastomotic Stenosis ◽

Control Group ◽

P Value ◽

Modified Technique ◽

Significant Difference ◽

Group A ◽

Group B

Background: Juxta-anastomotic stenosis (JAS) is one of the predominant causes of arteriovenous fistula (AVF) failure, with the reported incidence of 65%, so that technical modification to alter the outflow vein configuration using the modified technique has been applied to prevent JAS and improve AVF maturation. The aim of the study to evaluate the modified technique of end-to-side distal radiocephalic A-V fistula regarding maturation, patency rate and the resultant juxta-anastomotic stenosis.Methods: This prospective study was carried out on 80 patients with end stage renal disease (ESRD) at vascular surgery unit in general surgery department, Menoufia university hospital that prepared for dialysis. 40 patients "intervention group" underwent the modified technique to establish a functioning radiocephalic fistula; the other group (40 patients, control group) had the conventional technique of end to side radiocephalic fistula. Follow up of patients was over 6 months regarding function, patency rate and development of juxta-anastomotic stenosis.Results: There was statistically significant difference between 2 groups regarding primary failure, patency and JAS. Primary failure was detected in 2 patients in group A and in 5 patients in group B (p-value is 0.04). Considering patency rate, after 3 months the ratio between group A and group B was 37:34 with significant P value of 0.02, and after 6 months the ratio was 35:33 with P value of 0.03. Regarding JAS, by the end of follow up period, 4 patients diagnosed with JAS in group A, while group B had 8 patients, with p value of 0.01.Conclusions: Modified technique of end to side anastomosis for primary radio-cephalic fistula creation has better patency rate and low incidence of JAS than conventional method.

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Evaluation of clinical parameters related to methotrexate therapy in lichen planus

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v6i2.29122 ◽

2016 ◽

Vol 6 (2) ◽

pp. 90

Author(s):

Samaresh Chandra Hazra ◽

Agha Masood Choudhury ◽

Lubna Khondker ◽

Md. Shirajul Islam Khan ◽

Muhammad Munir Rashid

Keyword(s):

Clinical Trial ◽

Lichen Planus ◽

Control Group ◽

Controlled Clinical Trial ◽

Clinical Parameters ◽

Morning Dose ◽

Group A ◽

Group B ◽

And Control

Background: For better management of lichen planus a clinical trial of oral methotrexate is necessary in ow· country. Objective: The objective of this study is to evaluate efficacy and safety ofmethotrexate therapy in the treatment of lichen planus.Methods: It was a prospective randomized controlled clinical trial conducted in the department of Dermatology and Venereology, BSMMU, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Cases (group-A, n=23) were treated with methotrexate (10 mg) single morning dose and control (group-B, n=21) were treated with mini pulse betamethasone (5mg) single morning dose on 2 consecutive days during the period of 12 weeks. Results: Clinical parameters were measured by follow up clinical examination. Morphological lesion of lichen planus improved 95. 7% in group-A and only 28.6% improved in group-B. At the end of study 82.6% bad no complaints of itching in group-A and 100% had no complaints of itching in group-B. 16(69.6%) patients in group-A were completely cured clinically but 10(47.6%) in group-B. Anemia 3(14.2%) and edema 12(57.1 %) developed in group-B but none in group-A. In group-B, dyspepsia 15(71.4%), acne 10(47.6%),mooning face 8(38.1%), striae 8(38.1%) and hypertrichosis 4(19.0%) developed but none in group-A lntermittenr diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher amog group-8 compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A.Conclusion: The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus.

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