Background: Melasma is a very common skin problem that is much more prevalent in women. In our society, it results in many psycho-social implications and eventually leads to an impaired quality of life. Many treatment modalities have been developed for it. However, in recent years resistant forms of melasma have emerged that are unresponsive to the usual first line treatment options. Thus, this study is being conducted to explore new treatment modalities for this disease by using micro-needling with vitamin C and tranexamic acid. Methods: Thirty patients participated in this non-randomized clinical trial including 11 males and 19 females. All patients received Tranexamic acid via micro-needling on right side of the face and Vitamin C on the left side. A total of three biweekly sessions were performed. Patients’ response was evaluated at week 2, 4 and 6 on the basis of Physician Global Assessment, Patient Global Assessment, modified Melasma Area Severity Index and clinical assessment. Paired sample t-tests were used to calculate the difference in the means of two groups at 2, 4 and 6 weeks and p-value of <0.05 was considered significant. Results: After first session, there was more improvement observed with tranexamic acid. At the end of 6 weeks, modified Melasma Area Severity Index, Physician Global Assessment and Patient Global Assessment showed significant improvement with both tranexamic acid and vitamin C. However, the difference between them was not statistically significant (p>0.05). Conclusion: Both Tranexamic acid and Vitamin C are potent therapies for melasma as an adjuvant to micro-needling.
Human induced pluripotent stem cells (hiPSCs) are a promising approach to study neurological and neuropsychiatric diseases. Most methods to record the activity of these cells have major drawbacks as they are invasive or they do not allow single cell resolution. Genetically encoded voltage indicators (GEVIs) open the path to high throughput visualization of undisturbed neuronal activity. However, conventional GEVIs perturb membrane integrity through inserting multiple copies of transmembrane domains into the plasma membrane. To circumvent large add-ons to the plasma membrane, we used a minimally invasive novel hybrid dark quencher GEVI to record the physiological and pathological firing patterns of hiPSCs-derived sensory neurons from patients with inherited erythromelalgia, a chronic pain condition associated with recurrent attacks of redness and swelling in the distal extremities. We observed considerable differences in action potential firing patterns between patient and control neurons that were previously overlooked with other recording methods. Our system also performed well in hiPSC-derived forebrain neurons where it detected spontaneous synchronous bursting behavior, thus opening the path to future applications in other cell types and disease models including Parkinson’s disease, Alzheimer’s disease, epilepsy, and schizophrenia, conditions associated with disturbances of neuronal activity and synchrony.
Schmidt's syndrome constitutes Addison's disease in conjunction with autoimmune hypothyroidism or type 1 diabetes mellitus. It has misleading symptomology and an unclear order of presentation of symptoms. This often results in missed and late diagnosis. Chronic kidney disease is a rarely reported phenomenon in Schmidt's syndrome. Multiple factors may have the potential to cause renal failure, such as Addison's disease and/or hypothyroidism, the understanding of which is still evolving. A 45-year-old gentleman who is a known case of Schmidt's syndrome presented to us with fatigue, anorexia, and weight gain. Further evaluation revealed a picture of chronic kidney disease. We would like to alert fellow peers of this potential complication and the importance of screening as well as timely diagnosis.
doi: https://doi.org/10.12669/pjms.37.7.4489 How to cite this: Hamid MAB, Tariq S. Challenges of COVID-19 Vaccination Delivery in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4489
Renal cell carcinoma (RCC) is a common malignancy in elderly males. Metastatic spread of this cancer is not an uncommon occurrence, even after nephrectomy. Lung, bone, liver, and brain are the most frequently involved sites. Such a type of presentation mostly occurs within five years after nephrectomy however, cases have been reported later as well. Here, we report a case of metastatic renal cell carcinoma that presented in the form of a lung growth 28 years after nephrectomy. This highlights the importance to consider relapsed metastatic renal cancer in the differential, even decades after its surgical removal.
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