Objective: To compare the efficacy and safety of topical silymarin 0.7% with topical hydroquinone 4% in the treatment of melasma. Place and Duration: This Randomized Controlled Trial was conducted at dermatology OPD of Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad, in a period of one year from April 2020 to April 2021. Patients and Methods: Female patients having melasma were included in the study. The severity of melasma was assessed using MASI score. Group A was treated with silymarin 0.7% cream and group B was treated with topical hydroquinone 4% cream. Treatment was given for 3 months and was followed up for the next 3 months to observe relapse. Clinical efficacy was assessed in terms of percent reduction in MASI score from baseline. Results: The mean age in group A (Silymarin 0.7%) was 35.13 ± 3.87 and in group B (Hydroquinone 4%) was 34.16 ± 3.90. Epidermal type of melasma was most common (76.8% vs 62.5%) in both groups. There was no significant (p-value < 0.05) difference between both groups after one and two months treatment but mean MASI score of Hydroquinone 4% group (10.59 ± 5.74) become significantly (p-value < 0.05) less than Silymarin 0.7% group (8.20 ± 4.41) after 3 months. Similar (p-value > 0.05) therapeutic response was observed after one and two months treatment but it become significantly better in Hydroquinone 4% group after three months treatment. Significantly, (P-value < 0.05) higher adverse effects were detected in patients treated with hydroquinone. There was no difference (P-value > 0.05) in recurrence rate and patients satisfaction between both groups. Conclusion: topical silymarin has equal efficacy for the treatment of melasma with comparatively very less adverse effects as compared to hydroquinone.
Objectives: Patients with psoriasis have higher prevalence of associated medical disorders including psoriatic arthritis, obesity, diabetes, dyslipidemia, thyroid abnormalities and cardiovascular disease. The rationale of current study was to determine prevalence of associated medical co-morbid conditions in psoriasis cases. Study Design: Descriptive cross sectional study. Setting: Dermatology Clinic, Bahawalpur Victoria Hospital. Period: January to July 2015. Material & Methods: Informed consent was obtained from 117 adult patients (>18 years) of both the genders diagnosed with psoriasis for >3 months. Patients with chronic renal failure, chronic liver disease, erythroderma, chromosomal abnormality syndromes and pregnant females were excluded. Blood pressure and body mass index; i.e. BMI=weight (kg)/ height (m2) were documented. Fasting blood sugars, HbA1c, lipid profile and electrocardiogram was done. Results: Mean age was 41.94±11.60 years. Among 117 cases, 66(56.41%) were males and 51(43.59%) were females; male to female ratio was 1.3:1. Diabetes mellitus was found in 53(45.30%), hypertension in 21(17.95%), obesity in 29(24.79%), ischemic heart disease in 62(52.99%) and dyslipidemia in 22(18.80%) patients. Conclusion: Current study concludes that patients with psoriasis have higher prevalence of ischemic heart disease and diabetes mellitus followed by obesity, dyslipidemia and hypertension. It is suggested that psoriasis cases presenting to dermatology department should be assessed for these co-morbid conditions for early diagnosis and management of these conditions.
Introduction: A limited number of case reports have studies the efficacy of Photodynamic Therapy (PDT) in management of Cutaneous Leishmaniasis (CL). Topical PDT is an innovative mode of therapy that works on principle of selective uptake of photosensitizing agent by CL lesions. Current study was conducted to determine efficacy of topical photodynamic therapy of CL. Study Design: Descriptive cross sectional study. Setting: Dermatology outdoor clinic PIMS Islamabad. Period: July 2015 to Jan 2016. Materials & Methods: Total 75 patients (>12 years) of either gender with biopsy proven CL lesions were included after ethical approval. Pregnant or lactating women, those with sensitivity to light or photo sensitizer were excluded. The selected cases were administered once a week sessions of topical 5-ALA PDT therapy. This therapy was continued till 4 weeks and efficacy was observed at 6th week; efficacy labeled as yes if there was no erythema with resolution of papules, plaques or nodules, surrounded by normal healthy skin clinically and the histo-pathological smears revealing absence of amastigotes, otherwise labeled as non-effective. Results: Mean age was 24.37+7.43 years. There were 44(58.67%) females and 31(41.33%) males. Mean duration of disease was 40.29+11.73 days and mean size of lesion was 19.69+9.88 mm. Effective PDT outcome was seen in 67(89.33%) patients at 6th week of therapy. Conclusion: This study concluded that topical photodynamic therapy is an effective method for treatment of Cutaneous Leishmaniasis.
This study studied post-covid healthcare workers' acne vulgaris rates after prolonged face mask use. Methodology: Rawal Institute of Health Sciences Islamabad conducted this cross-sectional study from July 1, 2021, to June 31, 2022. 196 health staff wore masks having no allergies or dermatoses. Dermatologists rated acne according to GAGS (Global Acne Severity System). Skin type, acne history, comedogenic skin care products, acne area, and severity were noted. Counted acne vulgaris. IBM SPSS 25 used chi square test to correlate acne with gender, rank, past acne, and mask type. Results: 32.40±7.5 years for 196. 83 (42.3%) men, 113 (57.7%) women. 95 (48.5%) docs, 61 (31.1%) nurses, 21 (10.7%) aides, 19 (9.7%) paramedics. 94 (48%). 91 (46.4%) used N95 masks and 93 (47.4%) medical masks. 109 (55.6%) wore masks for 5-10 hours, 67 (34.2%) for >10, and 20 (10.2%) for <5. 62 (31.6%) had acne. N95 mask use affected acne, not gender (p<0.05). Conclusion: Mask-wearing healthcare workers have acne vulgaris regardless of gender. N95 masks cause acne.
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