Randomized double blind study on efficacy of intralesional metronidazole vs intralesional sodium stibogluconate in cutaneous leishmaniasis Kellapatha Patients were reviewed at intervals for 6 months to document the treatment response and for further 6 months to identify relapses. The cure rate at 12 and 24 weeks were assessed using a stratified analysis with chi-squared test. ResultsOut of 100 study participants, 53 who received SSG and 47 who received metranidazole completed the observational period. 39.6% of SSG group and 14.8% of metranidazole group had achieved complete response at 12 weeks. The complete cure rate further increased to 66.03% and 29.78% at 24 weeks respectively (p> 0.05). There were two relapses at further 6 months observational period in SSG group but the relapse rate was zero for metranidazole group. ConclusionsThe standard treatment SSG shows superior efficacy to metranidazole in treating CL caused by leishmania donaovani in Sri Lanka. However Intra-lesional metranidazole showed 29.78 % response rate with no relapses indicating it can be used as an alternative treatment.
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Background Viral warts are a common presentation to a dermatogical practice. The standard treatment is freezing with liquid Nitrogen which is a physical ablative method. Viral wart auto-implantation is a known method in the treatment of viral warts, but not very popular in day to day practice. Methods A randomized controlled trial was carried out at Dermatology unit, Teaching Hospital Anurdhapura to assess the efficacy and safety of auto-implantation when compared to cryotherapy. A total of 120 patients were randomly allocated to the two treatment arms and the response to treatment was assessed monthly for 12 weeks. To achieve the study objective the deductive approach and quantitative analysis were used. Data were analysed using chi square test and, P value<0.05 was taken as significant. ResultsOut of 103 patients who completed the observational period 54 had received cryotherapy and 49 had autoimplantation of warts. At the end of 12 weeks 90.7% of patients who received cryotherapy and 36.7% of patients who had auto-implantation had complete response. Based on the higher cure percentage the preposition was accepted that cryotherapy was a better treatment when compared to auto-implantation. Further analysis revealed that the side effects were less in auto-implantation when compared to cryotherapy. ConclusionCryotherapy gives significantly higher rates of complete response in treating viral warts when compared to autoimplantation (P<0.05). Although inferior to cryotherapy, auto-implantation could be useful in selected cases of viral warts as a treatment option.
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