Safety of 0.1% topical tacrolimus in the treatment of vitiligo.

Cure rates for vitiligo are significantly lower because of problems to different studies have reported different response rate and different adverse effect for the treatment of vitiligo. This study was conducted to evaluate the response rate and adverse effect of topical tacrolimus 0.1% ointment in the treatment of vitiligo patients in the department of Dermatology and venereology, Bangladesh Medical college (BMC), Dhaka from January 2010 to July 2010. In this clinical trial, 30 newly diagnosed vitiligo (focal and segmental) patients, aged between 10 to 50 years were assigned for therapy and to observe the response and adverse effect. Each individual lesion was treated with topical tacrolimus 0.1% ointment twice daily for three months. All the patients completed three months treatment and available for statistical analysis. The highest percentage 13(43.3%) was in the age of 11-20 years. Sex ratio revealed higher in case of female 18(60%), with a male-female ratio 1:1.5 and 5(16.67%) patients had vitiligo among their families. Repigmentation was observed in 8 (26.7%) subjects at the end of 4th week, 15 (50.1%) subjects at 8th week and 25 (83.3%) subjects after 12 weeks of therapy. 25 (83.33%) subjects did not complain any adverse effect (like pruritus, burning etc.) and 5 (16.67%) subjects were suffered from different adverse effect of drug, like pruritus observed in 2 (6.7%) subjects and burning in 6 (20%) subjects. This study found that tacrolimus 0.1% ointment to be safe in the treatment of vitiligo, with reduction in the number of vitiliginous spots by increased repigmentation significantly.

Review of Treatment of Reflex Sympathetic Dystrophy.

A review study was done by searching literature through PubMed. Reflex sympathetic dystrophy is a life altering disease pathogenesis of which are not yet clearly known likewise its management protocol has not been established. Treatment of longstanding Reflex sympathetic dystrophy is empirical and of limited efficacy. This disease may lead to dreadful squeal which may need amputation for their management and few of these patients may even develop suicidal tendency. Patient with Reflex sympathetic dystrophy usually present late. It was found that the clinical presentation of RSD are too much variable, although different modalities of treatment are used either alone or in combination, the outcomes are often unpredictable and of variable efficacy. Understanding of the treatment modalities and proper selection of treatment option are essential for best outcome. Preventive measure does play a role in management of these patients. Option of treatment includes pharmacological method, sympathetic nervous system interruption, use of calcitonin and bisphosphonate. More study is required to find out the mechanism that triggers the pain and other clinical manifestation so that a standardized protocol for its management can be developed.

Changing scenario of transfusion-related viral infections.

OBJECTIVE: To study the changing incidence of blood transfusion-related viral infections consequent to compulsory screening of blood and greater awareness of the problem, over the last five years. METHODS: This is a cross-sectional study carried out at Medical College, Calcutta. Three groups each consisting of 100 subjects were selected for this study. Group A comprised multiple transfused patients who have also received transfusion before 1995. Group B comprised patients who had received transfusions only since 1995. Group C comprised of control patients who have never been transfused. The incidence of HBsAg +ve, anti-HCV +ve and HIV +ve cases were calculated and expressed as percentages and compared using the chi square test. RESULTS: The incidences of HBsAg +ve and anti-HCV +ve cases in the three groups were 20% and 16% in Group A, 7% and 6% in Group B and 4% and 2% in Group C. The difference between Group A and Group B were statistically significant. CONCLUSION: The incidence of HBsAg and anti-HCV positive cases among the multi-transfused has decreased over the last five years.

People living with HIV infection / AIDS - A study on lymph node FNAC and CD4 count.

Between July 1997 and December 2000, 1616 HIV seropositive persons were identified by Western Blot test at the School of Tropical Medicine, Kolkata. Four hundred seventy two (29.2%) of them had generalized lymphadenopathy. CD4 count could be done in only 54 of these 472 subjects (11.4%). These 54 patients, consisting of 40 males (74%) and 14 females (26%) were the subjects of the study. Their mean age was 29.5 years. In all these subjects, FNAC was done from the enlarged lymph nodes (non-inguinal). Reactive hyperplasia was seen in 30 cases (55.5%) whose absolute CD4 count varied between 411-945 cells/microL (median value 670 cells/microL). Evidence of tuberculous lymphadenitis was detected in 22 (41%) with CD4 counts varying between 113 and 422 cells/microL (median value 212 cells/microL). Non-Hodgkin lymphoma was diagnosed in 2 cases (3.7%) with CD4 count 79-113 cells/microL. All patients had evidence of HIV-1 infection, excepting one case of dual infection (HIV-1 and 2).

The utility of waist circumference in assessment of obesity.

The objective of this study was to assess the correlation between waist circumference and waist hip ratio and body mass index. Also to assess if a simple measurement like the waist circumference can be used as an independent indicator for detecting health risk and management. 500 men and 500 women were included in this study from the out patient department and indoor wards of Medical College, Calcutta. Only 7% of the males and 16% of the females had body mass index > or = 25. About 50% of both males and females had waist hip ratio above the desirable range (0.80 for females and 0.95 for males). About 99% of females with, waist circumference > or = 72 cm. had either body mass index > or = 25 or high waist hip ratio > or = 0.80 or both. Similarly 99% of males with waist circumference > or = 80 cm. had either high body mass index > or = 25 or high waist hip ratio > or = 0.90 or both. Waist circumference is simple to assess and can be used as an independent measurement to identify those at risk from either increased body weight or central fat distribution or both.