The aim of the present study was to estimate the prevalence of telogen effl uvium (TE) and to evaluate the effi cacy of vitamin D in the treatment of this problem in women belonging to various cities of south Punjab, Pakistan. In the present study, 40 adult women suffering from the problem of TE were included. Each woman was treated with oral vitamin D 3 (200,000 IU) therapy fortnightly and a total of 6 doses were given to each patient. After 15 d of the last dose, the condition of patients was assessed clinically. The mean age of female patients was 32.2Ϯ1.5 y, 42.5% of the patients between 21-30 y of age were found to be more frequently affected with TE compared to 35% females of 31-40 y of age. Results showed signifi cant improvement in hair growth in young (rϭ0.457 pϽ 0.003) women and in those, which do not use sunscreen (rϭϪ0.331 pϽ 0.037) but commonly utilize milk or milk protein (rϭϪ0.311 pϽ0.051). Vitamin D3 therapy resulted in the improvement of the condition in 82.5% (pϽ0.001) patients of TE. The use of oral vitamin D3 (200,000 IU, fortnightly) for 3 mo resulted in signifi cant improvement in hair regrowth in the patient of TE. Results showed improvement in hair growth in young women those do not use sunscreen but commonly utilize milk or milk protein.
Aim: To determine the frequency of non-variceal upper gastro-intestinal bleeding (NVUGIB) in patients of liver cirrhosis. Methods: A total number of 136 patients of liver cirrhosis having upper GI bleeding who presented in medical emergency of Nishtar Hospital Multan were included in this cross-sectional analysis. Gastric Endoscopy was done all patients to determine the presence of NVUGIB in all patients. Data regarding patient’s age, Body mass index (BMI), gender and duration of upper GI bleed was also collected. Results: Mean age was 47.23±9.45 years. Mean body mass index (BMI) was 24.94±3.35 kg/m2. Mean duration of upper UGIB was 3.45±3.03 months. There were 94(69.12%) male and 42(30.88%) female patients. NVUGIB was found in 76(55.88%). There was a significant association of age with NVUGIB. In patients of age 20-49 years, NVUGIB was found in 47(62.7%) patients. In having age 49-65 years, NVUGIB was found in 29(47.5%) patients. Conclusion: NVUGIB in patients with liver cirrhosis is very common and it is more common in younger age patients. So diagnostic endoscopy should be done in liver cirrhosis patients presenting with upper GI bleeding in emergency departments. This will aid in proper diagnosis and in deciding the appropriate treatment in these patients. Keywords: Non-variceal upper gastro-intestinal bleeding, liver cirrhosis, Hepatitis
Objective: To evaluate the efficacy of intradermal tranexamic acid (TA) verses fluocinolone-based triple combination (hydroquinone 4%, tretinoin 0.05%, fluocinolone acetonide 0.01%)therapy in the treatment of melasma. Study Design: Randomized comparative trial Place and Duration: Study was conducted at outpatient dermatology department of Sheikh Zayed hospital Rahim Yar Khan for period of six months i.e from September 2020 to February 2021. Methods: Total 110 patients (age 18-40 year) of both genders having melasma on face were enrolled. Patients details demographics, age, sex and body mass index were recorded after taking written consent. Patients were divided into 2-groups. Group I had 55 patients and received intradermal tranexamic acid and group II had 55 patients andwere given topical fluocinolone-based triple combination (hydroquinone 4%, tretinoin 0.05%, fluocinolone acetonide 0.01%) cream. Follow up was taken for 2-months to determine efficacy and safety. Complete data was analyzed usingSPSS 22.0 version. Results: Out of 110 patients 60 (54.54%) were females and 50 (45.46%) were males. Mean age of the patients in group I was 29.15±5.14 years with mean BMI 24.16±7.22 kg/m2 and in group II mean age was 28.17±5.18 years with mean BMI 23.61±2.48 kg/m2. Most of the patients (85 or 77.27%) had mixed melasma followed by dermal (16 patients /14.54%) and epidermal melasma(9 patients/8.18%). We found that malar-type pattern of melasma was most common, found in 66 (60%) of cases. A decrease in MASI score from baseline (15.4) was found 2.4 in group-Iand 5.6 in group-II. In group II erythema, hypertrichosis, hypopigmentation and acneiform lesions were the side effects found but there was no clinically significant side effect found in group I patients. Conclusion: We found in this study that use of intradermal tranexamic acid (TA) in the treatment of melasma was effective and safe because there were no clinically significant side effects found after this treatment and reduction of MASI score was also significant. Keywords: Triple combination, Melasma, MASI, Intradermal tranexamic acid
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