Background: Melasma is hyper-pigmentation of skin, usually seen in young female adults, and previous studies have established substantial psychosocial burden associated with this disease. Aim: To measure the frequency of depression in melasma patients and its correlation with severity of melasma Study Design: Descriptive cross-sectional study. Place and duration of study: Dermatology OPD, HIT Hospital Taxila from 1st January 2021 to 31st August 2021 Methods: One hundred consecutive patients of melasma diagnosed by a skin specialist were enrolled. Elderly patients aged >60 years, those with previous psychiatric disease or chronic illnesses and on long term streroids were not included. After getting written informed consent, enrolled patients were screened for depression using Patient Health Questionnaire 9 (PHQ-9) Results: There were 17 males and 83 females. The mean age was 41.5±8.14 years. On MASI scale for assessing severity of melasma, 38 patients scored mild, 51 scored moderate and 11 scored severe. Using Patient Health Questionnaire 9 (PHQ-9) in patients with melasma, 18 patients didn’t have depression, 38 had mild depression, 31 had moderate depression, 6 had moderately severe depression and 7 had severe depression. Conclusion: The frequency of depression is quite high in patients suffering from melasma. It indicates a need for prompt diagnosis, appropriate intervention at correct time to ensure patient’s compliance to therapy to improve his disease outcome. Keywords: Depression, Melasma, Frequency
Objective: To investigate the experience of timely thesis completion by the graduates of the Master of Health Professions Education (MHPE) program in Pakistan.Study Design: Qualitative interpretative study design.Settings: Riphah University Islamabad and HITEC-IMS Taxila.Duration: May 2018 to June 2019.Materials and Methods: Data was collected by semi-structured interviews. All interviews were carried out in person. Detailed notes were taken, and conversations were audio-recorded. Three authors analyzed data independently using iterative thematic analysis. Inconsistencies were resolved through discussion.Results: Two major themes out of five were identified: Intrinsic attributes of the graduates and the role of the supervisor. including sub-themes of intrinsic motivation, self-regulation, age of the participant, supervisor-trainee relationship, supervisor’s availability, supervisor’s commitment, personality traits of the supervisor. Periods of face-to-face contact sessions were considered to increase internal motivation during which participants believe to have greater self-regulation. Positive relationship with a committed supervisor who was readily available and had a friendly, yet professional attitude aided in the completion of the thesis on time while a supervisor lacking these traits posed challenges for the graduates.Conclusion: Several factors were identified which influenced thesis completion among the graduates of MHPE in Pakistan. The five major ones consisted of the following, 1) Research Project-Related Problems; 2) Support System; 3) Supervisor Guidance; 4) Attributes of the Researcher; 5) Conducive Research Environment. These results can help influence policies to evaluate and improve this program.
Background: Psoriasis is a recurrent disfiguring skin disease, associated with abnormal lipid metabolism and with high occurrence of cardiovascular complications. This linked to the extent of disease, as it is often seen in those patients who have larger body areas involved with psoriasis. Objective: To estimate frequency of dyslipidemia in psoriatic patients and to determine the frequency of dyslipidemia in psoriatic patients based on the severity of disease. Study Design: Cross-sectional study Place and Duration of Study: Department of Dermatology, Fauji Foundation Hospital Rawalpindi from 1stMarch 2017 to 30th September 2017. Methodology: One hundred and fifty cases were enrolled. All cases were enrolled and 3ml of blood was collected following 12 hrs of fasting for determination of lipid profile. Blood sample was sent to the Hospital laboratory and reports were verified by senior pathologists. Severity of psoriasis was determined according to PASI score. Results: Age of participants was between 18-60 years with mean 38.88±12.26 years and 29 (19.33%) male and 121 (80.67%) female cases. According to severity of disease, 50 (33.3%) cases had mild, 70 (46.7%) had moderate and 30(20%) cases had severe Psoriasis. The mean cholesterol, triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) was 12.91 ± 2.17, 8.93 ± 2.90, 5.0 ± 2.28 and 1.98 ± 0.31 respectively. There were 100(66.7%) cases who had dyslipidemia and 50(33.3%) had normal lipid profile. Conclusion: Frequency of dyslipidemia is very high and is associated with severity of psoriasis. Keywords: Psoriasis, Dyslipidemia, Lipid profile and Cardiovascular disease.
Objective: The objective of our study was to determine the frequency of depression, anxiety, and stress in females presenting for laser treatment of hirsutism at a dermatology clinic. Materials and Methods: This was a cross-sectional descriptive study. 152 female participants of all ages presenting for laser treatment of hirsutism to the dermatology department –removed for blind review--from June 2019 to Dec 2019, were included using a consecutive convenient sampling technique. Patients having an FG (Ferriman and Gallwey) score of 8 or more, were included whereas those having any underlying cause (as assessed by history and examination and laboratory investigations where required) for both hirsutism and psychological disorder were excluded. The participants were given an Urdu version of the DASS 21 (depression, anxiety, and stress scale) to complete. Results: The participants had a mean age of 30.22 (SD = 9.17). The prevalence of depression, anxiety, and stress in the sample was found to be 13.2%, 23.7%, and 17.8%, respectively. Mean depression, anxiety, and stress scores on DASS 21 were 4.43(SD=4.87, Cut-off= 10), 4.34(SD=5.12, Cut-off= 8), and 8.21(SD=6.26, Cut-off=15), respectively, indicating that the scores were within the normal range. Anxiety was the most common illness in the sample and both depression and stress showed a decline with advancing age up till 45years of age. No statistically significant association was found between the severity of hirsutism and depression, stress, and anxiety scores. Conclusion: Psychological morbidity was found to be lower in patients of idiopathic hirsutism presenting for laser treatment. The long-term efficacy of laser treatment needs further evaluation in future research.
Background: Serum ferritin is a good indicator of quantifying the risk of hair loss among women. Iron lead to low serum ferritin level; therefore, a low serum ferritin level can precisely point toward iron deficiency. Objectives: To determine the mean serum ferritin levels in female patients with androgenetic alopecia. Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Dermatology, Fauji Foundation Hospital, Rawalpindi from 2nd October 2018 to 1st April 2019. Methodology: One hundred female patients with androgenic alopecia of all ages after puberty were included. Patients with scarring and other non-scarring alopecia, who had taken iron, vitamin B12, folic acid or multivitamin supplements, anticoagulants, anti-thyroid drugs, antimitotic drugs and oral contraceptives were excluded. After aseptic measures,5 ml of venous blood was drawn, into sterile and disposable plastic syringes. Serum ferritin was measured by enzyme immunoassay (EIA) test, based on sandwich ELISA. Results: Mean age was 33.94±6.29 years and 65 (65.0%) of patients ranged from 36 to 50 years. Average duration of disease was 6.25±2.43 months. Mean weight was 58.77±9.17 kg. Mean serum ferritin levels in female patients with androgenetic alopecia was 33.10±42.99ng/ml. Conclusion: Serum ferritin levels in female patients with androgenetic alopecia are low. Keywords: Androgenic alopecia, Serum ferritin levels
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