scholarly journals Narrowband Ultraviolet B Phototherapy versus Excimer Laser in the Treatment of Vitiligo: A Retrospective Analysis

Author(s):  
Esmaeel Alsayed Mohamed ◽  
Nisha V Parmar ◽  
Amani Al Falasi

Introduction: Vitiligo is an acquired autoimmune disorder of depigmentation with a global prevalence of 1%. Phototherapy with Narrowband Ultraviolet B (NBUVB) light and excimer laser are both FDA approved treatments for vitiligo. Studies comparing the two modalities are few in patients with different skin colors. Aim: To compare the efficacy and safety of NBUVB versus excimer laser in vitiligo in terms of re-pigmentation achieved during treatment and side effects. Materials and Methods: This study was a retrospective chart review of vitiligo patients attending the phototherapy unit from January 2016 to August 2018. Patient profiles including age, gender, site and extent of vitiligo, type of phototherapy treatment (NBUVB vs excimer laser), sessions per week, sessions required for onset of repigmentation, sites of repigmentation, and side effects were noted. Qualitative variables were analysed using Chi-square test. Quantitative variables were analysed using mean and Standard Deviation (SD). A p-value of <0.05 was considered statistically significant. Results: A total of 146 patients aged 4-70 years were included. Ninety-six patients received excimer laser and 50 patients were on NBUVB. Initial repigmentation occurred after a mean±SD of 28.91±16.61 sessions in the NBUVB group and 24.26±17.57 sessions in the excimer laser group. The difference was not statistically significant (p=0.18). Repigmentation occurred faster on the face followed by the trunk in both groups. Side effects were higher with excimer laser compared to NBUVB (90.6% versus 76%) and the difference was statistically significant (p=0.017). Side effects were, however, mild and did not warrant treatment discontinuation. Conclusion: Number of sessions required for onset of repigmentation was similar in both groups. Side effects, although more frequent with excimer laser, were mild and required dose reduction rather than discontinuation of treatment.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A823-A824
Author(s):  
Meghna Shah ◽  
Rachael Proumen ◽  
Akhila Sunkara ◽  
Runa Acharya ◽  
Amy Patel

Abstract Treatment of hypothyroidism is predominantly with levothyroxine due to its ability to generate stable T3 levels and its long half-life. Many patients report continued hypothyroid symptoms despite normal TSH values on levothyroxine and request to switch to desiccated animal thyroid extract. Desiccated thyroid extract is less used for fear of side effects and risks. There are only a handful of studies available comparing desiccated animal thyroid extract to levothyroxine. We conducted a retrospective study on 250 hypothyroid patients over the age of 18 who presented to our clinic from 2008-2018. We excluded patients who had a history of thyroid cancer and documented non-adherence. We analyzed 125 patients on levothyroxine (males=43, females=82) and 125 patients who were on levothyroxine but chose to switch to Armour Thyroid (males=7, females=118). We examined the following variables; when comparisons of proportions were made between the two groups, N-1 chi square test was used to determine significance. 1. Reason for change to Armour Thyroid from levothyroxine: Top reasons were fatigue (n=51/125, 40.8%), inability to lose weight (n=32/125, 25.6%), mental fog (n=8/125, 6.4%), hair loss (n=8/125, 6.4%) and desire for a natural product (n=7/125, 5.6%) 2. Percentage of patients complaining of fatigue/weight gain in euthyroid state: 16/125 (12.8%) of patients on Armour Thyroid and 29/125 (23.2%) of patients on levothyroxine had complaints of fatigue and weight gain with a normal TSH. This 10.4% difference was significant (p value=0.033, 95% CI 0.84% to 19.8%). 3. Presence of side effects: 24/125 (19.2%) patients on Armour Thyroid discontinued it before 6 months. The top reasons were no improvement of symptoms (n=9/24, 37.5%), palpitations (n=5/24, 20.8%), worsening anxiety (n=3/24, 12.5%), cost (n=2/24, 8.33%), and loss of appetite (n=2/24, 8.33%). 5/125 (4.00%) patients on levothyroxine chose to discontinue it before 6 months. The reasons included presence of palpitations (n=3/5, 60.0%), hair loss (n=1/5, 20.0%), and gluten intolerance (n=1/5, 20.0%). A total of 11/125 (8.8%) had adverse effects from Armour Thyroid while 4/125 (3.2%) of patients on levothyroxine had adverse effects to the medication. The difference of 5.6% leaned toward clinical significance and trended toward being statistically significant (p value=0.06, CI -0.4842% to 12.1677%). Our research shows that patients generally feel better on Armour Thyroid compared to levothyroxine. Armour Thyroid is an effective medication to use for patients who remain symptomatic on levothyroxine and should be considered as a viable option in clinical practice. However, our study also indicated that patients may have more adverse effects on Armour Thyroid when compared to levothyroxine and further studies are needed comparing the two medications. Limitations of our study include the retrospective nature of the study and the sample size.


Author(s):  
Etienne Belinga ◽  
Isidore Tompeen ◽  
Claude Cyrille Noa Ndoua ◽  
Junie Metogo Ntsama ◽  
Sandrine Mendibi ◽  
...  

Background: Uterine synechiae refers to a total or partial union of the inner walls of the uterus resulting from endometrial trauma. It is a cause of reproductive failure. Until now, synechia was not optimally treated and has remained understudied in Cameroon. Objective of present study was to Evaluate the diagnostic, therapeutic and prognostic aspects of uterine synechiae treated by hysteroscopy.Methods: We conducted a descriptive cross-sectional study with an analytical component from January 1st 2015 to July 31st 2017 at Yaounde. All patients diagnosed with uterine synechiae and treated with hysteroscopy were our sample. Sampling was consecutive. The chi-square test was used for the comparison of qualitative variables and Fisher's test for ANOVA variance analysis. The comparison of the averages was made by the Student's test. P-value less than 0.05 was considered as statistically significant.Results: Hysteroscopies were indicated for uterine synechiae in 14.50%. Nulliparous were 56.67%. A history of curettage/aspiration was present in 66.66%. All of the patients had a form of infertility and 83.33% had menstrual disorders. Hysterosalpingography showed a better sensitivity (88%). After hysteroscopic treatment, 63.30% had a complete anatomical restitution. There is a significant correlation between the stage of severity of synechia and anatomical restitution (p=0.008; Spearman correlation coefficient=-0.477).Conclusions: Uterine synechiae represent one-sixth of all indications for hysteroscopy and present clinically as menstrual disorder associated with infertility. A past history of uterine curettage is common. Hysterosalpingography has a better preoperative diagnostic sensitivity. Hysteroscopy allows optimal treatment.


2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Dr Sana Abbas ◽  
Beenish Abbas ◽  
Sidra Amir ◽  
Mehreen Wajahat

Objectives: Vaccinations work with different mechanisms to offer protection against disease; however, process of immunity building can cause symptoms. Therefore, this study aimed to determine the immediate side effects of COVID–19 vaccination in the Pakistani Population. Methods: This cross-sectional analytical study was conducted at Foundation University College of Dentistry, Islamabad from February to April 2021. 0.5 mL per dose of the Covid-19 vaccine was administered to the candidates. These 205 candidates receiving vaccination were then interviewed investigating the adverse effects of the vaccine. Post-vaccination side effects were compared among categorical groups using the Chi-Square test, whereas post-vaccination side effects were compared with age using independent samples T-test. A p-value of ≤0.05 was statistically significant. Results: Among post-vaccination side effects, fever was reported by 69 participants, while 56 of 205 reported soreness, redness, and swelling at the injection site. It was reported by 42/205 participants to have felt chills and rigor, whereas gastrointestinal disturbance and flu-like symptoms were reported in 55/205 and 28/205 participants, respectively. Younger participants were more likely to develop gastrointestinal disturbance and flu-like symptoms following vaccination as compared to older participants. Conclusion: Malaise, headache, and fever were observed to be the most common side effects of the vaccine, moreover there was a linear relationship between manifestations of adverse effects and history of comorbidities. doi: https://doi.org/10.12669/pjms.37.7.4522 How to cite this:Abbas S, Abbas B, Amir S, Wajahat M. Evaluation of adverse effects with COVID-19 vaccination in Pakistan. Pak J Med Sci. 2021;37(7):---------.   doi: https://doi.org/10.12669/pjms.37.7.4522 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.


2015 ◽  
Vol 22 (09) ◽  
pp. 1212-1216
Author(s):  
Abdul Salam Memon ◽  
Shahida Khatoon ◽  
Riaz Ahmed Memon ◽  
Afzal Junejo

Objectives: To study mean platelet volume (MPV) in acute appendicitis andits correlation with leukocyte count. Study Design: Case control study Place and Duration:Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabadfrom January 2013 to February 2014. Subjects and Methods: Subjects with clinical suspicionof acute appendicitis were selected according inclusion and exclusion criteria. A sample of 49acute appendicitis patients and 37 controls were studied. The Blood samples were collected insodium citrate vacutainers and processed on Sysmex KX 21 analyzers. The main analysis wasthe comparison of the difference of MPV between acute appendicitis and controls. Data wasanalyzed on SPSS version 21.0 by student’s t-test, Chi-square test and Pearson’s correlation (r)was used to evaluate association of MPV with platelet counts and leukocytes. A p-value of ≤0.05was taken significant. Results: The mean platelet volume and leukocytes were significantlyelevated in patients with acute appendicitis. MPV and leukocytosis in controls and cases werenoted as 7.93±2.1 vs. 9.10±2.9fl (p=0.0001) and 6980±120 vs. 13980±340 μL-1 respectively.MPV was positively correlated with leukocytosis (r=0.419) (p=0.0001), while Platelets showeda negative correlation. Conclusion: Elevated MPV and leukocytosis are observed in acuteappendicitis. MPV may be exploited for clinical diagnosis of acute appendicitis but in a properclinical context along with leukocytosis.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S432-36
Author(s):  
Sohail Aslam ◽  
Syed Muhammad Asad Shabbir Bukhari ◽  
Adnan Asghar ◽  
Naeem Riaz ◽  
Iftekhar Yousaf ◽  
...  

Objective: To comparison was made between standard (control group) nasopharyngeal sample collection technique for RTPCR and modified technique and the outcome was compared in terms of the proportion of positive results of Rt-PCR tests. Study Design: Double blinded randomized clinical trial. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital Karachi Pakistan, from June and July 2020. Methodology: This study was a newly developed modified technique for nasopharyngeal sampling for RT-PCR tests of COVID-19 suspects. Target population included all patients who developed COVID-19 related symptoms and/or also had history of recent travel or closed contact with Covid-19 patients. Total 1500 nasopharyngeal PCR tests were done by a team of trained technicians. Systemetic probability sampling technique was utilized. Subjects were divided into two groups by using even and odd serial numbers. Proportion of positive test results were compared between two groups by using chi square test. Results: Results were collected for 3000 nasopharyngeal swab sample for RT-PCR testing. Mean age was 31.68 ± 11.89 years. In study group with modified technique, 470 tests were found positive for a total of 1500 samples while only 297 out of 1500 samples were detected positive in control group with standard technique. Chi square test applied to assess the difference between this proportion and it proved that the difference was highly statistically significant (p-value <0.00). Conclusion: we interpret that modified samples collection technique is relatively safe for sample collector of Covid-19 PCR which has got potential benefits to get more genuine results of these......


Author(s):  
Emmanuel A. Adelusi

Introduction: Though changing patterns of tooth extraction have been reported in the literature which included the age, gender, tooth type and indications for extraction, there is still paucity of studies that have examined the variation and changes in the pattern of tooth extraction over a period of time in a given nation. We therefore accessed the pattern and indications of tooth loss in the patients who presented at oral surgery clinic for intra-alveolar tooth extraction over a twelve month period. Methods: This is a prospective cohort study of adult patients tooth extraction between September 2015 and August 2016. Patients’ demographic and clinical data were collected with a structured questionnaire. Data were analyzed using statistical package for social sciences (SPSS) version 23.0. Variables were subjected to Pearson’s chi-square test and P <0.05 was considered statistically significant. Results: A total of 240 adults age range between 18 to 75 years of age with mean age of 36.64 years were included in the analysis. Maxillary teeth (231) and mandibular teeth (326) were extracted in 203 and 263 patients respectively. Caries and its sequelae, 223(93%) were the predominant indication for tooth extractions. Lower second molar (25%), and upper third molar (20%) had the highest frequencies. More female (126, 52.5%) than male (114, 47.5%) had extraction done, the difference is however not statistically significant (X2 =1.67, P Value = 0.195) Conclusions: Dental caries and its sequelae are the most frequent cause of tooth extraction. Tooth extraction was more in Patients in the fourth decade as well as in the Female gender, even though the difference between male and female is not statistically significant. And there is increased in number of male who had extraction done compared to what obtained in the past decades. Left side of the mouth appeared to be more affected.


2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.


2019 ◽  
Vol 21 (1) ◽  
pp. 7-11
Author(s):  
Kundan Kumar Shrestha ◽  
K Acharya ◽  
RR Joshi ◽  
S Maharjan ◽  
D Adhikari

Computed tomography (CT) of the para-nasal sinuses (PNS) has nowadays become the investigation of choice for the diagnosis of sinonasal diseases. Numerous sinonasal anatomic variants exist and are frequently seen on CT scans. A sound knowledge of these variations is important not only for diagnosis but also for planning surgery in order to avoid complications. The aim of this study is to investigate the frequency of these variations in patients with sinonasal symptoms and also to determine their relation to sinonasal disease if any. A total of 76 patients were included in the study from August 2017 to July 2018 of which 43 (56.6%) were males and while 33 (43.4%) were females with male to female ratio of 1.3:1. The ages of patients ranged from 14 to 72 years with a mean age of 33.2±14.2 years. Out of 76 patients, 68 (89.5%) had at least one type of anatomical variation while 8 (10.5%) had no variation. Only one variation was seen in 39 (51.3%) patients while 29 (38.2%) had two or more variations. The most common variant was deviated nasal septum (DNS), occurring in 49 (64.5%) patients followed by concha bullosa (CB) and agger nasi cell (AN) seen in 15 (19.7%) and 14 (18.4%) patients respectively. Genderwise, anatomical variations were seen more in males but the difference was not statistically significant. Some variations were seen more on the right side while others on the left. Some variations were present bilaterally. The difference was not statistically significant. The presence of DNS was statistically significant in the study population (p value 0.012 in nonparametric chi square test). The age group 14 to 30 years showed maximum variations though not significant statistically. Therefore, during management of patients with sinonasal symptoms, these variations need to be addressed, if required, surgically. Proper knowledge of both common and uncommon sinonasal variations in our community could help in better surgical planning and overall management of sinonasal disorders.


2021 ◽  
pp. 5-6
Author(s):  
Rohit Rohit ◽  
Lokesh Kumar Singh

Aim:-The aim of this study is to analyse the factors causing recurrence of infection in the corneal graft after therapeutic penetrating keratoplasty.Material and Methods:- This study was conducted at Upgraded Department of Ophthalmology, SVBPH,Meerut. This institution performs 120 keratoplasty procedures per year on an average. The study was conducted for a period of one year & 25 patients had reinfection and those who presented with reinfection constituted the sample size complete enumeration.The data thus obtained was compiled and analysed using Statistical Package for Social services (SPSS vs 20). The qualitative variables were analyzed by using frequencies and The qualitative variables were analyzed by using frequencies & percentages & chi square test was used as test of significance.The quantitative variables were presented as measures of central tendency and dispersion. A p value of less than 0.05 was considered as statistically significant Results Initial fungal etiology was the main risk factor for the recurrence of microbial keratitis after TPK in (24%) of the cases followed by persistent epithelial defects (16%),Initial bacterial etiology (12%), Lid abnormalities (8%) ,contact lens use (8%), Secondary ocular hypertension (8%), prior rejection episodes(8%), initial viral etiology (4%) ,peripheral ulcerative keratitis (8%) & suture related problems(4%). Conclusion:- .This study has shown that Fungal keratitis was the main reason for the initial TPK & initial Fungal aetiology was the main risk factor for the reinfection after TPK


Author(s):  
Seyyed Mojtaba Sohrevardi ◽  
Farhad Sarrafzadeh ◽  
Ali Khosravi ◽  
Abdolreza Hassanzadeh

Introdution: Among infectious diseases, tuberculosis is one of the leading causes of death killing in nearly 1.5 million people yearly. Considering the importance of patient co-operation in drug therapy and resistance we decided to evaluate the rate of co-operation of tuberculosis infected patients in regard to their use of anti-tuberculosis drugs in Kerman. Methods: This descriptive study was conducted as a sectional and census study and 80 patients succeeded to finalize it. Demographic information was collected through a questionnaire by patients. To carry out the designed test, a urinary sample was taken from each patient and a few drops of each were added to the drug-specific reagents. On the basis of color variation which is special for rifampin, isoniazid and pyrazinamide, we made a decision on the co-operation of the patients. The collected data were analyzed by the the use of SPSS software version 18 and p-value<0.05 was acceptable. To find out the relation between variables, the Chi-square test was applied. Results: The results of this study showed that the total co-operation rate for patients administered with isoniazid was 70%, rifampin 70%, and pirazinamide 68.1%. The quality of adherence to drug orders with age, knowledge of unwanted adverse effects, opium addiction and duration of drug use had a significant relationship (P <0.05); but  with gender, duration of illness, use of another drug, and the presence of another TB infected in the family, no significant difference was observed. Conclusion: We resulted that factors such as age, addiction and lifestyle, duration of treatment and awareness of side effects influence on the co-operation of the patients on drug usage. So that people over 35 years, addict ones, treated for a long time and in the patients with lack of awareness of drug side effects, their adherence to the treatment regimen was lower.


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