Background & Objective: Cutaneous Leishmaniasis (CL) is endemic in Baluchistan and treated traditionally with Meglumine antimoniate. Miltefosine appears appealing therapy in cutaneous Leishmaniasis. Our objective was to evaluate safety and efficacy of Miltifossine in treatment of cutaneous Leishmaniasis. Methods: This experimental study was conducted from 10 September 2017 to 10 May 2018 at Combined Military Hospital Quetta. Total of 42 patients were recruited by purposive sampling technique. Lesional skin smears were stained with giemsa for Leishmania amastigotes under magnification (100 x).Complete blood count, serum urea, creatinine, bilirubin, aspartate aminotransferases (AST), alanine aminotransferase (ALT) were done at the beginning of treatment and then weekly, thereafter. Cap Miltefosine 50 mg (2.5mg/kg) were given as directly observed therapy .Daily observation during treatment phase was done for clinical side effects of therapy. Clinical response was documented at two weeks then at eight weeks. Photographs were taken before and after the therapy. Data was analyzed by SPSS 16. Results: Complete clinical response was observed in 39 (92.9%) patients and partial clinical response in 1(2.4%) patient. Two patients were lost to follow up at eight weeks. No significant derangements in laboratory profile were noted before and after treatment. Mean duration of treatment was 23.47+SD 4.44 days. Sixteen patients (38.1%) took Miltefosine for 28 days, 12 (28.6%) for 21 days and 9 (25%) for 25 days. Conclusion: Miltefosine is safe and cost effective treatment for cutaneous Leishmaniasis. It is effective in CL cases not susceptible to antimony compounds. How to cite this:Tahir M, Bashir U, Hafeez J, Ghafoor R. Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.54 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.
The COVID-19 pandemic has had a damaging impact on global health. Post-infection, patients may experience mental health difficulties and therefore require suitable psychological treatment and support. The objective of this study was to identify the psychological impact of COVID-19 on patients who were recovering from the physical effects of the disease, and to examine socio-demographic correlates within one month of treatment at a tertiary healthcare facility in Pakistan. A cross-sectional study was employed that utilized the Depression Anxiety Stress Scale-21 and Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5. A questionnaire was administered to 250 patients, with data collected over three months. Mild to extremely severe scores of depression, anxiety and stress were reported by approximately 43%, 52% and 42% of participants, respectively, and 8% developed PTSD. The incidence of depression, anxiety, stress or PTSD was not significantly associated with gender, age or previous interaction with COVID-19 patients. Depression was significantly associated with levels of education, severity of COVID-19 disease and a patient’s current condition. Anxiety was associated with healthcare worker status. The severity of disease and a patient’s current condition were also linked to the levels of anxiety, stress and the presence of PTSD. Collectively, these results indicate that a high percentage of patients recovering from COVID-19 experience psychological distress.
Background: Since beauty standards have widely change over the last few decades, women feel self-conscious about having unwanted hair that leads to low self-esteem and some develop depression. Although hirsutism can be emotionally distressing, it can be treated. Females have a lot of pressure to undergo painful procedures of hair removing like plucking, treading and creams that can temporarily remove or reduce the visibility of unwanted facial and body hair. In the past two decades of digital technology, lasers have modernized their use in the treatment of many skin conditions including hirsutism. As intense pulsed light is economical and more cost effective, it can be a more suitable option for those who cannot meet the high expenses of laser treatment. Objective: To evaluate the efficiency of intense pulsed light in females with hirsutism. Study Design: Place and Duration of Study: Department of Dermatology, HIT Hospital Taxila from 1st October 2020 to 30th September 2021. Methodology: Sixty patients of idiopathic hirsutism more than 15 years of age were enrolled. Both the history and examination were done. Diagnosis of idiopathic hirsutism was made on clinical examination using and necessary investigations. Those who had photosensitivity, hormonal therapy or hormonal disturbance, infertility, white hair hirsute, pregnancy, and history of keloid or hypertrophic scar were excluded from the study. Treatment was given for six sessions, with one month apart. Parameters of IPL were adjusted according to (Fitzpatrick) skin type, the density of hair, and fluency, the fluence will be increased subsequently depending upon the response of the patient. Post treatment, participants were evaluated and a 4-point scale was used to grade the results. Patients were told to revisit after 6 months to assess the regrowth of hair on face. Conclusion: Intense pulsed light is the cheap, effective and safe option for hirsutism that a third world country like ours needed where the socio-economic status is relatively low. Keywords: Idiopathic hirsutism, Intense pulsed light (IPL), Fitzpatrick skin type
Public spaces in Pakistani society are gendered as they are traditionally considered a male dominated space. Any sight of a woman sitting in a dhabba is met with unpleasant glances and amorous stares. Sadia Khatri, however, subverts these standards in her story “City Of Mitr” where she presents quintessentially opiniated females who learn to navigate their place in public spaces. In this article, we aim to analyse Khatri’s story by drawing upon Elizabeth Grosz’s concept of bodies-cities to establish how the city imposes limits on women’s bodies and how these limits can be negotiated. By drawing upon Helene Cixous and Karen Barad, we argue that our language is responsible for patriarchal binary thinking, thereby maintaining the male/female binary and this discursivity is not limited to language only, it has a material existence. Thus, it is responsible for shaping out identities and reflects in the way how we construct the material world around us. But if we change the language through which the world is constructed, it would also change the way we think about it. As a result, it would manifest in how we imagine our cities and architecture. David Harvey that since we believe that society is made and re-imagined, then it can also be remade and reimagined. Through this article, we attempt to show how Khatri re-imagines the city from the perspective of women. And how Pakistani women, like Khatri’s mitris, can reclaim the public spaces if the language by which the world is structured is changed. Key words: public spaces, gendered, city, body, language, architecture
Background: Hirsutism is a medical condition characterized by presence of excessive terminal (coarse) hair among females in androgen-dependent areas. psychological well-being of females is negatively influenced by hirsutism. Poly cystic ovarian syndrome (PCOS) is the most common cause of hirsutism. However, hirsutism is found to exist without any underlying cause and is known as idiopathic hirsutism (IH). Studies have shown correlation between skin type and hirsutism among PCOS cohorts; however, no such relationship is known to exist between skin type and idiopathic hirsutism. Objective: To determine association between skin type and idiopathic hirsutism. Study Design: Case control study Place and Duration of Study: Department of Dermatology, HIT Hospital Taxila from 1st March 2019 to 29th February 2020. Methodology: 118 cases and 133 controls were included in study after informed consent. Skin type was determined by Fitzpatrick skin type (FST) rating scale ranging from I to IV. Modified Ferriman-Gallwey (mFG) visual four-point scale was used to quantify hirsutism into mild, moderate and severe. Results: Mean age of cases and controls was 31.01±9.5 years and 28.01±9.7 years respectively. Seventy four (62.7%) of cases and 88 (66.2%) controls had type III skin type. Eighty (67.8%) had mild (8-15) hirsutism. Statistically insignificant (P<0.05) association was found to exist between skin type and idiopathic hirsutism and severity of hirsutism. However, a statistically significant {P<0.05) association existed between hirsutism and BMI. Conclusion: Idiopathic hirsutism is found to have no association with skin type III or IV among Caucasians. However, this finding needs further investigation involving diverse population including representation from all skin types (I and II) Key Words: Idiopathic hirsutism, Skin types, PCOS, Hyperandrogenemia
Objective: To test the effectiveness of autoinoculation of a wart in patients with multiple viral warts. Study Design: An experimental study.
Aim: To find out association of herpes zoster and changes in disease course like incidence of post-herpetic neuralgia with Covid-19 vaccination. Study design: Cross-sectional, observational study. Place and duration of study: Outpatient Department of Dermatology, CMH and PEMH Rawalpindi from 1st January 2021 to 30th September 2021. Methodology: Seventy three patients presenting with herpes zoster selected by convenience sampling after their verbal and written consent. Demographics, Covid-19 vaccination history, type of vaccination, dermatome effected, co-morbids and presence of post herpetic neuralgia were recorded in them. Results: Mean age of participants was 48.09±15.73 years with 50 (68.5%) were males and 23 (31.5%) were females. 33 (45.2%) were vaccinated and 36 (49.3%) were non-vaccinated against covid-19. Maximum patients were vaccinated with Sinopharm i.e. 19(57.6%).8 (24.2%) patients developed the lesions after first dose and 25(75.8%) after 2nd dose of vaccination. Conclusion: Herpes zoster risk is increased with covid-19 vaccination. Key words: Herpes Zoster, Covid-19 vaccination
Objective: To compare the efficacy of double-dose oral Terbinafine and Itraconazole in treating dermatophytic infections. Study Design: Randomized controlled trial (ClinicalTrials.gov: NCT04880980).Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Mar 2022. Methodology: One hundred and twenty patients with dermatophyte infections of the skin (i.e., tinea corporis and cruris) diagnosed by clinical presentation and KOH mount were included in this study. After randomization, patients were divided into two groups. Group-A was managed with double-dose oral Terbinafine, while Group-B was managed with double-dose oral Itraconazole. Clinical response and side effects were seen and recorded initially at two weeks and then at four weeks.Efficacy and adverse effects were compared in both groups at the end of four weeks. Results: Out of 120 patients with dermatophyte infections of the skin included in the study, 59(49.2%) took double-dose oral Terbinafine while 61(50.8%) took double-dose oral Itraconazole after randomization. It was revealed that Itraconazole was more efficacious in achieving cure at the end of 4-weeks as compared to double dose Terbinafine (p-value=0.001), while adverse effects studied were not statistically significant or different in both the groups (p-value>0.005). Conclusion: This randomized controlled trial showed that double dose oral Itraconazole was more efficacious in treating dermatophyte infections of the skin (i.e., Tinea corporis and cruris) compared to double dose oral Terbinafine. Adverse effects were minimal in both groups and were not specially related to any of these medications.
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