scholarly journals Comparative Study of Combination of Oral Tranexamic Acid with Modified Kligman’s Formula Versus Oral Tranexamic Acid with Azelaic Acid 15% in the Treatment of Melasma

2021 ◽  
pp. 412-418
Author(s):  
Riddhima Singh ◽  
Praveen Maheshwari
Keyword(s):  
Side Effects ◽  
Tranexamic Acid ◽  
Azelaic Acid ◽  
Severity Index ◽  
Fluocinolone Acetonide ◽  
Once Daily ◽  
Early Results ◽  
Group A ◽  
Group B

Background: Melasma refers to acquired hyper-pigmentary condition effecting skin. Owing to its multifactorial causation and chronicity, there is an increased need for new multimodality therapies to treat melasma more effectively and to prevent the side effects seen with the conventional modalities of treatment. Objectives: Compare efficacy of combining oral Tranexamic Acid and Azelaic Acid 15% with that of Oral Tranexamic Acid (TA) and Modified Kligman’s Formula. Also, to record any adverse effects of combining these agents. Methods: Patients having Melasma who will be coming to Dermatology OPD, AVBRH, Sawangi, Wardha, will be enrolled after considering the various inclusion and exclusion criteria. A detailed history will be asked, which will be followed by a cutaneous examination that includes the calculation of MASI (Melasma Area and Severity Index). One Group (A) - participants will receive - Oral 500 mg Tranexamic acid OD plus Modified Kligman’s Formula (fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2%) cream one time at night only. Second Group (B)- participants will receive -  Oral 500 mg Tranexamic Acid OD plus Azelaic Acid 15% gel once daily at night only. Both groups will also receive Broad-spectrum sunscreen SPF-30 daily (3 hourly). Patients will be called for regular follow up at 4 weeks and 8 weeks (for early results). Clinical photos will be clicked at every follow-up visit and MASI score shall be doocumented. Expected Results: To analyze efficacy of combining Oral TA along with Azelaic Acid 15% and if it provides better results, we can avoid the undesirable side effects that are seen on prescribing the Modified Klingman’s Formula, in Melasma patients. Conclusion: This study will help us in analyzing efficacy of combining Oral TA with Azelaic Acid 15%, therefore will provide a newer treatment modality with lesser side effects and maybe better results than the gold standard- Modified Klingman’s Formula.

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

scholarly journals A COMPARISON OF EFFICACY OF INTRADERMAL TRANEXAMIC ACID WITH TOPICAL 20% AZELAIC ACID IN THE TREATMENT OF MELASMA

2021 ◽  
Vol 71 (2) ◽  
pp. 494-97
Author(s):  
Sayyida Komal ◽  
Asher Ahmed Mashhood ◽  
Muhammad Farooq ◽  
Nida Qayyum
Keyword(s):  
Tranexamic Acid ◽  
Azelaic Acid ◽  
Poor Response ◽  
Severity Index ◽  
Index Score ◽  
Military Hospital ◽  
Severity Index Score ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Intradermal Tranexamic acid and topical 20% Azelaic acid cream in the treatment of melasma. Study Design: Comparative prospective study. Place and Duration of Study: Dermatology department, Combined Military Hospital Peshawar, from Sep 2018 to Mar 2019. Methodology: A total of 116 female patients, at the outpatient department of dermatology at Combined Military Hospital Peshawar, were randomly assigned into two groups; group A (intradermal tranexamic acid) and group B (topical azelaic acid) by lottery method. Patients in group A received intradermal injection, while the participants of group B received topical azelaic acid only, fortnightly for 6 weeks. Melasma area severity index score was calculated for each patient in both groups at the start and at the end of the treatment. Results: The mean Melasma area severity index score in group A (intradermal tranexamic acid) before and at 6 weeks of treatment was 7.10 ± 2.94 and 5.27 ± 2.44, respectively. The mean Melasma area severity index score in group B (topical azelaic acid) before and at 6 weeks of treatment was 7.56 ± 2.57 and 5.76 ± 2.89, respectively. Efficacy of intradermal tranexamic acid, as poor response, good response and excellent response was 27.6%, 41.4% and 31% respectively. While, efficacy of topical azelaic acid group as poor response, good response and excellent response was 62.1%, 20.7% and 17.2% respectively. The difference was statistically significant, (p=0.001). Conclusion: It can be concluded that intradermal tranexamic acid is more effective as compared to topical 20% azelaic acid in..................

Comparing the Effectiveness of Oral Formulation of Tranexamic Acid in Treating Melasma versus Topical Treatmentlike Kojic Acid

2021 ◽  
Vol 15 (6) ◽  
pp. 1372-1375
Author(s):  
M. Sheikh ◽  
R. Majeed ◽  
W. Iqbal
Keyword(s):  
Tranexamic Acid ◽  
Topical Treatment ◽  
Kojic Acid ◽  
Severity Index ◽  
Oral Formulation ◽  
Effective Treatment Modality ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Index Comparison

Aim: To compare the efficacy and safety of oral tranexamic acid with topical kojic acid in treatment of melasma. Method: This study was an interventional, randomized control trial done in Department of Dermatology Akhtar Saeed Trust Hospital Lahore from January 2020 till June 2020. 40 patients with moderate to severe melasma were enrolled for this study. These were divided into two groups A and B. In group A 20 patients were given oral tranexamic acid along with topical treatment and in group B, 20 patients were treated only with topical treatment. Oral tranexamic acid was given in dosage of 250 mg twice a day for 3 months and then follow-up was done at 8th and 12th wks. The evaluation of effectiveness of treatment was done with MASI(Melasma Area Severity Index). Comparison was done in the mean of the MASI scores obtained in both groups. Result: In both groups female patients were more in number. The mean age of patients in group A was 29.75 years & in group B it was 32.55 years. MASI scoring was done in both groups at baseline and at 8th& 12th wks. There was a significant decrease in this score in group A patients with oral tranexamic acid (12.08±2.8 vs 9.1±2.2 at 8th wk. andvs 8.2±2.0 at 12thwk.; P <0.05for both). Whereas in group B patients the decrease in mean MASI score was significant at 8thwk.& insignificant at 12th wk. (12.6±2.9 vs 10.9±2.4at 8th wk. and vs 10.3±2.4at 12th wk.; p<0.05 for former but p>0.05 for later). Conclusion: Oral tranexamic acid is a safe and effective treatment modality for treating moderate to severe melasma. Keywords: Melasma, oral tranexamic acid

scholarly journals A PROSPECTIVE STUDY TO ANALYSE THE SIDE EFFECTS OF OLMESARTAN MEDOXOMIL AND ENALAPRIL IN HYPERTENSIVE SUBJECTS

2018 ◽  
Vol 11 (12) ◽  
pp. 258
Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Postural Hypotension ◽  
Olmesartan Medoxomil ◽  
National Commission ◽  
Group A ◽  
Group B ◽  
Taste Alteration ◽  
A Prospective Study

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.

scholarly journals Short Practical Regimen of Acupuncture for Melasma: A Prospective Cohort Study in a Tertiary Hospital in Thailand

2021 ◽  
Vol 9 ◽  
Author(s):  
Thanan Supasiri ◽  
Nuntida Salakshna ◽  
Krit Pongpirul
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Severity Index ◽  
Tertiary Hospital ◽  
Optimal Number ◽  
Significant Difference ◽  
Patient Reported ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Acupuncture shows benefits for patients with melasma, although no optimal number of sessions have been determined.Methods: The prospective observational study was conducted in melasma patients who were treated with acupuncture procedures two times a week and were evaluated after the 5th and the 10th sessions of acupuncture, with a 1-week follow-up after the last session. Participants Groups A and B received five and 10 acupuncture sessions, respectively. Melasma was assessed by using the melanin index (MI), melasma area and severity index (MASI), patient-reported improvement scores, and acupuncture-related adverse events.Results: Out of 113 participants, 67 received five sessions of acupuncture treatment while 39 received 10 sessions. At 1 week after five sessions of acupuncture in Group A, the mean MI decreased by 28.7 (95% CI −38.5 to −18.8, p &lt; 0.001), whereas the median MASI decreased by 3.4 (95% CI −6.9 to −1.2, p &lt; 0.001) points. At 1 week after ten sessions of acupuncture in Group B, the mean MI decreased by 31.3 (95% CI −45 to −17.6, p &lt; 0.001), whereas the median MASI decreased by 5.4 (95%CI −9.9 to −3, p &lt; 0.001) points. The first five sessions of acupuncture had a higher incremental effect than the last five sessions, although there was no statistically significant difference. Twenty-nine participants reported minor side effects. Group B had a risk ratio (RR) of having adverse events 1.8 times (95% CI 1.0–3.4, p = 0.05) compared with Group A.Conclusion: Short acupuncture regimens of 5–10 sessions in melasma seem to be effective and practical with minor side effects.

scholarly journals A Comparative Study of Topical 3% Tranexamic Acid and 35% Glycolic Acid in Melasma and Review of Literature

2021 ◽  
pp. 238-246
Author(s):  
S. Soundarya ◽  
N. Devanand ◽  
Vaishnavi Sabapathi ◽  
Jayakar Thomas
Keyword(s):  
Side Effects ◽  
Tranexamic Acid ◽  
Glycolic Acid ◽  
Acid Group ◽  
Mean Value ◽  
Entire Study ◽  
Group A ◽  
The Mean ◽  
Acid Gel ◽  
Group B

Aim: To compare the efficacy and safety of topical 3% tranexamic acid gel vs 35% glycolic acid peel in the treatment of melasma over face. Materials and Methods: This is an open labelled, Randomised Controlled Trial(RCT) conducted on 60 patients. Patients were randomly divided equally into 2 groups – Group A and Group B. Patients of Group A  used topical 3% tranexamic acid gel twice a day and Group B patients were treated with 35% glycolic acid peel with a contact period of 5 minutes once in every 2 weeks. Patients were assessed every month for a period of 3 months and recurrence was assessed for the next consecutive 3 months following the treatment. Patients were asked to use a broad spectrum sunscreen before sun exposure during the entire study. Assessment of reduction in pigmentation was made by MASI score, subjective and objective valuation (blind observer) and photographic comparison. Safety profile was assessed by the side effects. Results: The mean value of Melasma Area and Severity Index(MASI) score for glycolic acid group at baseline was 14.41 which reduced to 7.05 at end of 3rd month. In tranexamic acid group, the mean value of MASI score at baseline was 14.58 which reduced to 5.96 at the end of 3rd month. The mean percentage of improvement in MASI score in glycolic acid group 52% whereas in tranexamic acid group it is 61%.  The side effects were minimal in this study. Side effects were more in glycolic acid group than tranexamic acid group.  A total of 8 patients had recurrence during follow up. In glycolic acid group, 5 patients had recurrence whereas in tranexamic acid group, only 3 patients had recurrence. The percentage of recurrence in glycolic acid group is 16.7 % whereas in glycolic acid group it is 10.7%. Conclusion: Tranexamic acid is a novel emerging therapy for melasma. In this study it has been found that topical 3% tranexamic acid is equally efficacious as 35% glycolic acid peel with minimal side effects in the treatment of melasma.

scholarly journals Effect of doxycycline on stifle lameness: a preliminary clinical observation in twelve dogs

2011 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Kei Hayashi ◽  
Joseph D. Frank ◽  
Paul A. Manley ◽  
Peter Muir
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Positive Outcome ◽  
Presumptive Diagnosis ◽  
Once Daily ◽  
Doxycycline Treatment ◽  
History Of ◽  
Group A ◽  
Group B

The clinical efficacy of oral doxycycline was evaluated in twelve dogs with stifle arthritis and a presumptive diagnosis of early cruciate disease. Doxycycline (2.5-4.5 mg/kg once daily) was administered orally for 3 to 8 weeks. Eight dogs, who presented prior to the treatment with clinical signs of 4 weeks or fewer duration (group B), had a good response to doxycycline, whereas four dogs with a longer history of lameness (group A) had a poor response. The follow-up periods ranged from 2 to 12 months after discontinuation of the doxycycline treatment (median=6.5 months, 3 months in group A, and 9.5 months in group B). There was a significant correlation between the duration of lameness and the subjective grading of clinical improvement. In 68% of these cases of dogs with stifle arthritis (8/12), the oral administration of doxycycline resulted in the improvement of lameness, even after discontinuation of doxycycline. Careful selection of patients based on the duration of their lameness appears to be crucial in order to achieve a positive outcome.

scholarly journals Comparison between Allopurinol and Febuxostat in management of gout patients - a prospective study

2012 ◽  
Vol 10 (4) ◽  
pp. 257-259 ◽  
Author(s):  
KK Singal ◽  
S Goyal ◽  
P Gupta ◽  
BK Aggawal
Keyword(s):  
Side Effects ◽  
Serum Urate ◽  
End Point ◽  
Daily Dose ◽  
Group A ◽  
Baseline Values ◽  
Group B ◽  
A Prospective Study ◽  
Gout Flare

Aim:To assesses the efficacy of a relatively new drug-Febuxostat in management of gout and its comparison with allopurinol. Method: A comparative study of both Allopurinol and Febuxostat was done on 100 patients of gout. Both were studied for efficacy. side effects and for gout flare up. Results: Primary efficacy end point (baseline values) - a serum urate concentration of less than 6.0mg per deciliter at the last three measurements was reached by 54 %( 27/50) of group A patients taking 80mgs of febuxostat and 25 %( 12/50) of group B patients taking allopurinol 300mgs per day (P<0.001) Secondary efficacy end point(follow up values)- At first visit( after 2 weeks of onset of study), the proportions of subjects with serum urate concentration of less than 6.0mg/dl was significantly higher in the group A receiving febuxostat than the group B receiving allopurinol(P<0.001)[Tableno-1]. Conclusion: Febuxostat, at a daily dose was more effective than allopurinol at the commonly used fixed daily dose of 300 mg in lowering serum urate. Results of side effects and gout flare up were similar in both groups. Key words: Allopurinol; febuxostat; uric acid; goutDOI: http://dx.doi.org/10.3329/bjms.v10i4.7522 BJMS 2011; 10 (4): 257-259

Subarachnoid Hemorrhage with Normal Cerebral Panangiography

Neurosurgery ◽  
1983 ◽  
Vol 13 (4) ◽  
pp. 409-411 ◽  
Author(s):  
Claude Béguelin ◽  
Rolf Seiler
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Tranexamic Acid ◽  
Cerebral Vasospasm ◽  
Antifibrinolytic Therapy ◽  
Group A ◽  
Group B ◽  
Almost All

Abstract Forty-two nonhypertensive patients with a proven subarachnoid hemorrhage but normal cerebral panangiography were investigated. The follow-up period was 1 to 5 years, with a mean of 39.1 months. Treatment consisted of 2 weeks of bedrest and sedation, followed by progressive mobilization on the 3rd week. Thirteen patients (Group A) were treated with tranexamic acid, whereas 29 patients (Group B) received no antifibrinolytic therapy. Five patients of Group A died of ischemia caused by cerebral vasospasm. No patient of Group B died, and there was no early rebleeding in either group. Therefore, antifibrinolytic therapy is not indicated in these patients. Only 1 of 42 patients (2.4%) experienced late rebleeding, and he again had normal cerebral panangiography. Reangiography several weeks or months after the first hemorrhage seems not to be indicated. The overall prognosis of the surviving patients was good; almost all were able to return to their previous occupations within 6 months after the hemorrhage.

scholarly journals A comparative study between micro needling with modified Kligman regimen versus micro needling with tranexamic acid in melasma patients

2020 ◽  
Vol 6 (4) ◽  
pp. 520
Author(s):  
Anjum M. Momin ◽  
Ankita A. Mistry ◽  
Jignesh B. Vaishnani
Keyword(s):  
Side Effects ◽  
Tranexamic Acid ◽  
Comparative Study ◽  
Age Group ◽  
Female Predominance ◽  
Group A ◽  
Group B ◽  
Topical Tranexamic Acid ◽  
Facial Type

<p class="abstract"><strong>Background:</strong> Melasma is common, acquired disorder of hyperpigmentation, with female predominance and occurrence of facial involvement mostly. Various modalities of treatment are available including topical, oral and procedural therapies.</p><p class="abstract"><strong>Methods:</strong> Total 46 patients of melasma were studied. They were divided in two groups A and B. Micro needling with derma roller 1.5mm was done once in a month for 3 months. Group A patients received topical Modified Kligman regimen daily at night, while group B patients were advised topical tranexamic acid daily. Topical sunscreen was advised in both group patients. Patients were evaluated clinically and by Modified MASI score, and followed up for 3 more months after completion of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Female predominance was noted with most common age group being 25-40 years. Epidermal type of melasma was common. Centro-facial type of distribution was found mostly in patients. Significant decrease was noted in modified MASI score (p&lt;0.05) which was more and rapid in group A patients.</p><p class="abstract"><strong>Conclusions:</strong> Modified Kligman regimen has better efficacy but tranexamic acid is safer with lesser side effects. Inspite of various treatment arms, melasma is still challenging.</p>

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