Generalized morphea - a case report

Generalized morphea is a subtype of morphea in which widespread sclerotic plaques are seen without systemic involvement. We are reporting a case of 10-year-old boy with generalized morphea for 6 years

Negative association of serum IL-6 and IL-17 with type-II diabetes retinopathy

Diabetes mellitus [DM] is a health concern which leads to complications such as retinopathy. Pakistan has 6.9 million people living with DM and this toll will be doubled by 2025. To determine serum IL-6 and IL-17 of type 2 diabetes mellitus [T2DM] patients with retinopathy. In this cross-sectional case- control study, 212 subjects enrolled which were categorized into 3 groups. Group-I included 30 subjects without diabetes, group-II consisted of 30 subjects with T2DM without retinopathy and group-III consisted of 152 subjects with T2DM and retinopathy. Serum IL-6 and IL-17 levels were determined by ELISA. Data was analysed using SPSS 17.0 and one way ANOVA to observe group mean differences. Longer mean duration of disease was detected in group-III than group-II [p=0.007]. Highest IL-6 level was detected in group-II and highest IL-17 level was detected in group-I. For IL-6, significant differences were detected among groups in total, between Group-I and Group-III and between Group-II and Group-III [p<0.0001 each]. Regarding IL-17, significant differences were found among groups in total [p=0.002] and between Group-I and Group-III [p=0.001]. No significant difference in the percentages of HbA1c observed between groups. Age, gender and duration of diabetes contribute to T2DM retinopathy. Serum IL-6 and IL-17 were inversely associated with T2DM retinopathy

Treatment seeking behavior in patients suffering from melasma

Introduction: Melasma is a common hypermelanosis that typically involves sun exposed areas in the face. Genetic, hormonal and UV radiations are important factors in its pathogenesis. Usually patients with melasma seek medical advice late after they have made their skin worse. So awareness regarding treatment of melasma is needed

Objective: To determine treatment seeking behavior in patients with Melasma

Study Design: Descriptive case series

Setting: Dermatology department of DHQ, Allied Hospital Faisalabad and Sir Ganga Ram Hospital Lahore

Methodology: By using non-probability consecutive sampling 104 individuals having melasma age ranges from 18-47 years of both gender were included. Questions asked from the patients regarding their treatment attitude included contact with doctor, self medication or any remedy, level of education and living background

Results: Out of 104 patients 103[99%] were females and 1[1%] male with mean age was 30.13 +/- 7.71. 26[25%] consulted skin specialists in public sector hospitals. 26[25%] patients used self medication. 17[16.3%] patients took no treatment. 13[12.5%] patients took advice from beauticians. 10[9.6%] patients consulted skin specialist in private sector hospitals.6 [5.8%] patients took advice from general practioners. Of 104 patients 89[85.6%] patients did not use any sunscreens as part of treatment. Out of 79[76%] patients who belong to urban area 21[26.6%] patients first consulted skin specialist in public sector. Regarding education 7[38.9%] illiterate and 5[41.7%] intermediate patients used self medication, 3[42.9%] primary educated patients did not consulted to any one, 6[33.3%] middle passed patients consulted beauticians, 6[26.1%] matriculate and 4[44.4%] graduate patients consulted skin specialist in public sector while 5[29.4%] post graduate patients first consulted skin specialist in private sector

Conclusion: Based on the knowledge obtained from the patients, it was observed that patients having melasma have no idea about the disease and whom they should consult after appearance of melisma

Effect of anemia and hyperhomocysteinemia on mortality of patients on hemodialysis

Anemia and hyperhomocysteinemia are risk factor of mortality of patients on dialysis. This study was conducted to assess the relationship of hemoglobin and homocysteine levels and mortality of patients on hemodialysis. Fifty patients on hemodialysis and 20 healthy individuals were enrolled in the study. Blood samples were drawn for measurement of hematological parameters, serum iron, serum ferritin, transferrin saturation, and homocysteine levels. The patients were followed up for 1 year to determine the mortality rate and evaluate its association with anemia and hyperhomocysteinemia. The majority the patients [54%] were not on erythropoietin therapy. Forty-three patients [86%] were anemic [hemoglobin < 11 g/dL]. Serum ferritin was high [> 500 ng/mL] in 33 patients [66%]. Mortality was 28% in 1 year [33% in anemic patients versus no death among patients with a hemoglobin level greater than 11 g/dL]. The relative risk of mortality was increased by 1.58 with every 1 g/dL decrease in hemoglobin level. All of the patients had a high homocysteine level, and a significant difference was observed between the homocysteine levels of the patients on hemodialysis and the control group [P < .001]. Hyperhomocysteinemia did not affect mortality. In multivariate Cox regression analysis, only hemoglobin level was associated with mortality. Almost all of our patients on hemodialysis were anemic and this condition was a risk factor of mortality. Iron stores, however, were adequate in more than half of the patients. The reason of anemia could be untreated erythropoietin deficiency. Hyperhomocysteinemia was present in the majority of the patients, but it did not independently affect mortality

Comparison of serum zinc levels between healthy and malnourished children

To compare serum zinc levels of healthy and malnourished children. Prospective study. Department of Pediatrics and Dermatology Allied/DHQ Hospital Punjab Medical College Faisalabad between July 2006 to September 2006. Serum zinc levels of 150 children between the ages of 2 months to 14 years of either sex were studied, out of which 75 hospitalized children were suffering from malnutrition while 75 healthy children were taken as control from the outdoor. Both groups were further divided into three age groups 2 months to 4 years, 5-10 years and 11-14 years. Verbal consent was taken from all the parents. All the details of children were enrolled on a specific proforma designed for the study. No ethical issue was involved. Malnourished children were classified and sub-grouped according to modified Gomez classification. Serum zinc levels were measured at HiTech Laboratory, Agriculture University, Faisalabad by Atomic Absorption Spectrophotometry, the most widely used and reliable method. The mean serum zinc level of 75 healthy children was found to be 99.97 micro g/dl [Standard Error +/- 10.2] while mean serum zinc level of 75 malnourished children was 51.2 micro g/dl [ +/- 1.14]. The children suffering from 1st, 2nd and 3rd degree malnutrition were 22, 27 and 26 in number with a mean level of 56.36 micro g/dl [ +/- 2.26], 51.56 micro g/dl [ +/- 1.89] and 46.46 micro g/dl [ +/- 1.36] respectively. Statistical analysis of data was done by calculating P-value with analysis of variance of serum zinc level for degree of malnutrition, age and sex. It showed that serum zinc level of malnourished children is significantly low [P-value = 0.001]. There is a significant difference of serum zinc levels between healthy and malnourished children especially in children with diarrhea and respiratory tract infection. This signifies a proper replacement of zinc as part of management of malnutrition and also during disease process

Epidemiological pattern of acne lesions

To study the epidemiological patterns of different lesions of Acne Vulgaris according to different parameters. Out patient department of Dermatology of DHQ Hospital, and Allied Hospital, Faisalabad. Case descriptive study. [May 2007 to March 2008]. 100 consecutive cases of Acne irrespective of age and sex, presenting in the outdoor and diagnosed by an FCPS Dermatologist were enrolled. The detailed clinical examination and history alongwith other data regarding age, sex, marital status, menstrual problems, skin type, the nature and distribution of lesions were entered on a questionnaire specially designed for this purpose. The teenagers [61%] were having more acne specially females [59%], more in unmarried [85%]. The people with oily skin [82%] were suffering more. Menstrual problems showed a significant [P< 0.01] role

Cutaneous vascular anomalies pattern in neonates and infants

To analyze the patterns of cutaneous vascular anomalies in neonates and infants. To identify the complications arising in various vascular lesions. A descriptive hospital based observational study. Dermatology and pediatric department of DHQ and Allied Hospital PMC, Faisalabad From 1 Feb 2005 to 31 January 2006. 72 consecutive newborns and infants of either sex having any vascular anomaly on cutaneous areas were included in the study. The information regarding size, site, type of lesions, sex of patients, with family history and any complication were recorded on a proforma prepared for this study. Out of 72 infants 25 were male [35%] and 47[65%] were females. Family history was present in 12 cases [17%]. The commonly involved sites were head and neck 45 [62.5%], trunk 18[25%] and upper limb 9[12.5%]. In 59 children [82%] it was single and in 13[18%] the lesions were multiple. The complications observed were ulceration in 13[18%], infection in 8[11%], haemorrhage in 3[4%] and visual impairment in 4[5%], while 56[78%] had no complications