ABSTRACT
Introduction The efficacy of cyclosporine in the treatment of psoriasis is well established. However widespread use of it has been limited by concerns over adverse effects such as hypertension, renal impairment and the potential risk of malignancy. The aim of this study is to determine the profile of our local psoriasis patients treated with cyclosporine, their response to treatment, their tolerability and the side-effects experienced. Materials and Methods This is a retrospective study of all psoriasis patients treated with cyclosporine for more than one month from January 1996 to June 2007 at the Department of Dermatology Ipoh Hospital. Results There were a total 21 patients, 8 males and 13 females. Their mean age was 40 years. There were 7 Malays, 10 Chinese and 4 Indians. Cyclosporine was given as the second or third line of treatment. The average starting dose was 2.76mg/kg and maximum dose was 3.89mg/kg. Best response was noted after 3 months of treatment. Thirteen (61.9%) patients had excellent response, 4(19%) had good response, 3 (14.3%) had moderate response and 1(4.8%) had poor response. Thirteen (61.9%) patients developed raised serum creatinine level exceeding 30% of the baseline while on treatment but all of them improved when the dosages of cyclosporine were reduced. None of them developed renal failure. There were 5 patients who had hypertension while on cyclosporine therapy, 2 of them required antihypertensive agents while for the remaining 3, blood pressure normalized after dosage reduction. Other side effects reported include gastrointestinal upset, gum hypertrophy and hypertrichosis. Conclusion Cyclosporine is effective in the treatment of psoriasis but close monitoring of serum creatinine and blood pressure is needed.
ABSTRACT
Background Naevus of Ota was first described in 1939 by Ota M. It is characterized by a bluish-gray mottled hyperpigmentation in the distribution of the trigeminal nerve. It affects between 0.014 - 0.6% of the Asian population. It is not only physically disfiguring but may be associated with tremendous psychosocial impact on the patient. The aim of the study is to determine the demographic data of local patients with naevus of Ota, their response to treatment with Q-switched 1064nm Nd:YAG laser, complications and recurrence. Materials and Methods A retrospective analysis of all patients with naevus of Ota treated with Q-switched 1064nm Nd:YAG laser between January 1998 to December 2007 was conducted at the dermatology clinic, Kuala Lumpur Hospital. Patients’ demographic data, clinical characteristics, response to Q-switched 1064nm Nd:YAG laser and the complications were reviewed. Results A total of 50 patients with naevus of Ota were treated with Q-switched 1064nm Nd:YAG laser. There were 42 female and 8 male patients with a F : M ratio of about 5:1. The mean age of presentation was 31 years old (11-60 years). More than half were Chinese patients (56%) followed by Malays (38%), Indian (2%) and others (4%). Seventy four percent of the patients had Fiztpatrick skin-type IV and the rest skin type V. Ninety two percent of the patients had unilateral trigeminal dermatomal involvement while 8% had bilateral trigeminal dermatomal involvement. Of the 15 patients who were referred to the ophthalmologist, 10 were found to have scleral involvement and none had glaucoma. Patients who had 2 treatments (13 patients) did not have any significant lightening of their lesions. In the remaining 37 patients who had 3 sessions (mean = 5.7, range 3 -15 sessions), 9 patients (24.3%) reported the response as good (51-75% lightening); 17 patients (45.3%) as excellent (>75% lightening) and 8 patients (22%) had near complete lightening (>90%). None reported any complications or recurrence. Conclusion Q-switched 1064nm Nd:YAG laser is an effective and safe treatment modality for patients with naevus of Ota.
ABSTRACT
Objective To sum up operative experience and prevention of complications while resecting the hepatic hilar tumor. Methods 14 cases with hepatic hilar tumor were analyzed in respect of operative method,complications, experience and prevention of complications. Results Some peri-operative complications happened. such as massive hemorrhage in 2 cases,billiary fistula in 1 case,hepatic failure in 1 case and tumor remained at resection edge in 1 case. No patients died during the operation. Conclusion The resection of hepatic hilar tumor is very difficult and risky,safety of surgery can be improved by paying attention to pre-operative evaluation and preparation,as well as carefulness during operation.