Comparison of efficacy of spironolactone plus oral contraceptives with metformin in patients of PCOS with hirsutism

Objective: To compare the efficacy of spironolactone plus oral contraceptives with metformin in treatment of hirsutism among patients with polycystic ovarian syndrome [PCOS]. Study Design: Randomized controlled trial. Place and Duration of Study: Dermatology department, Military Hospital Rawalpindi, from Jan 2016 to Jul 2016

Material and Methods: A total of 84 women with PCOS and hirsutism with ages ranging between 16 and 50 years were included in the study. Patients with hirsutism due to etiologies other than PCOS like idiopathic hirsutism, Cushing syndrome or late-onset congenital adrenal hyperplasia were excluded. Random allocation of treatment was done, those reporting on even dates were enrolled in group A and those reporting on odd dates were placed in group B. Group A received oral tablet spironolactone 50mg twice a day along with combined oral contraceptive pills [cOCPs] containing levonorgestrel 0.15mg / ethinyl estradiol 0.03mg daily as combination therapy for 6 months, while group B received oral metformin 500mg twice daily for 6 months. Hirsutism scores were determined according to the modified Ferriman-Gallwey [mFG] scoring system [attached as annexure A] and 50% reduction from the baseline was considered effective therapeutic response

Results: The mean age of patients in group A was 32.83 +/- 8.28 years and in group B was 32.57 +/- 8.21 years. The mean duration of disease in group A was 18.84 +/- 7.26 months and in group B was 18.04 +/- 7.11 months. Efficacy in group A was observed in 29 [69.05%] patients while in group B it was observed in 17 [40.48%] patients

Conclusion: The efficacy of spironolactone plus cOCPs combination therapy is better than metformin alone in the treatment of hirsutism among patients of PCOS

Impact of cancer-related fatigue on psychological semiology among cancer patients

Objectives: To identify the impact of cancer-related fatigue on the psychological semiology [including hopelessness, stress, anxiety and depression] among cancer patients

Study design, settings and duration: This cross-sectional study was carried out at oncology departments of various hospitals of Lahore from November 2014 to May 2015

Subjects and Methods: A purposive sample of 200 cancer patients was drawn from the oncology departments of various hospitals of Lahore city. The Chalder Fatigue Scale was used to measure cancer-related fatigue. Depression, Anxiety, Stress Scale and Psychological Capital Scale were used to measure psychological semiology

Results: There were 108 males and 92 female cancer patients with mean age of 41.3 +/- 9.1 years. Findings indicated that cancer-related fatigue had significant negative correlation with hope and significantly positive correlation with depression, anxiety and stress. Result further indicated that both mental and physical fatigue had significant impact on mental health but impact of mental fatigue on stress level of cancer patient were found to be non-significant

Conclusion: Present study revealed significant relationship between cancer-related fatigue, hope, depression, anxiety and stress. It was further concluded that both mental and physical cancer related fatigue had significant impact on psychological semiology among cancer patients

Comparison of oral itraconazole versus topical clotrimazole in treatment of pityriasis versicolor

Objective: To compare the efficacy of single dose of oral itraconazole 400mg with 1% topical clotrimazole in the treatment of pityriasis versicolor

Study Design: Randomized controlled trial.

Place and Duration of Study: Dermatology department, Military Hospital Rawalpindi, from Jun 2015 to Dec 2015

Material and Methods: A total of 60 patients of pityriasis versicolor fulfilling the inclusion criteria were selected from dermatology OPD after written informed consent and approval from the hospital ethical committee

Patients were divided into two treatment groups using random numbers table. Group A received single dose of itraconazole capsule [400mg] and group B received 1% clotrimazole cream twice daily application for 2 weeks

Patient evaluation included detailed history, clinical examination and direct microscopy of skin scrapings for fungal hyphae at the baseline, at the end of 2[nd] and 6[th] week of treatment. Efficacy of treatment was assessed on the basis of clinical and mycological cure

Results: At the end of 2 weeks of treatment, clinical cure was seen in 23 [76.6%] and 29 [96.6%] patients [p=0.05] and mycological cure in 20 [66%] and 26 [86.6%] patients in group A and B respectively [p=0.06]. At follow up [end of 6 week] 21 [70%] and 28 [93.3%] patients were cured clinically [p=0.02] while 18 [60%] and 27 [90%] patients were cured mycologically [p=0.007] in group A and B respectively

Conclusion: Topical clotrimazole [1%] was found more effective than single dose of oral itraconazole in the treatment of pityriasis versicolor

An epidemiological study of prevalence and comorbidity of obsessive compulsive disorder symptoms [SOCD] and stress in Pakistani Adults

Objective: To investigate the prevalence and comorbidity of subclinical obsessive compulsive disorder [SOCD] symptoms and stress across gender, marital and employment statuses

Methods: A cross-sectional research was conducted from December, 2016 to March 2017 at two universities of cosmopolitan city Lahore. Two self-report scales measuring SOCD symptoms and stress were used to collect data from 377 adults selected through simple random sampling technique, proportionately distributed across gender, marital and employment status

Results: From the total sample, 52% reported low level of stress and 48% faced high level of stress

Significant differences in prevalence were observed across marital and employment statuses whereas for men and women, it was observed same [24%]. Comorbidity of high level of SOCD symptoms and high level of stress was seen 34%

Conclusion: Significant prevalence and comorbidity exists between SOCD symptoms and stress and more studies addressing diverse population are needed

Relationship of life events and psychiatric symptoms among adolescents

Background: There is a relationship between life events and the psychiatric symptoms. Depressive feelings and anxious thoughts are common in this perspective with significant gender difference

Objective: To correlate between life events and psychiatric symptoms among adolescents and explore if they are gender related

Study design, settings and duration: Cross sectional study conducted in Government and private schools and colleges of Gujranwala from January to March, 2014

Subjects and Methods: One hundred and fifty male and female students of both public and private sector school and colleges of Gujranwala region were enrolled using purposive sampling technique. The translated and validated version of Negative Life Events Scale [including components of Friends, Money, Course, Teachers, Parents, Students, Relatives, Health, Academics and Course Interest] and the Four Dimensional Symptoms Questionnaire [consist of four set of symptoms including depression, distress, somatisation and anxiety] were used for data collection

Results: Out of 150 participants, 75 were females and 80 males with a mean age of 16 years [SD 5.02]. Female participants had more depressive feelings and were more anxious as compared to males; moreover, the females were less experienced in negative life events as compared to males. Negative life events were significantly associated with psychiatric symptoms

Conclusion: Negative life events were directly related to depression and anxiety feelings and were associated with somatisation and distress

Peer victimization and psychiatric symptoms among adolescents

Objective: This study was conducted to explore the impact of peer victimization on psychiatric symptoms among adolescents

Subjects and Methods: Survey research design was used in the current study conducted from January 2014 to May 2014. A purposive sample of 400 adolescents was drawn from various government and private schools and colleges of Sargodha. Multidimensional Peer Victimization Scale [consists of four subscales including physical victimization, social manipulation, verbal victimization and attack on property] and Depression Anxiety Stress Scale [consists of three different set of symptoms including depression, anxiety and stress] were used. Data were analyzed using SPSS [Version 20.0]

Results: A total of 400 adolescents aged 14 to 18 were studied. Of whom, 200 were females and 200 males. Peer victimization showed strong association with psychiatric symptoms among adolescents. Significant gender differences were found on all variables but males had high mean verbal victimization and social manipulation than females

Conclusion: Peer victimization had significant impact on development of psychiatric symptoms among adolescents

Well-being and post-traumatic stress disorder due to natural and man-made disasters on adults

Research has shown that man-made disasters effect people more severely than natural disasters. Females are affected more severely as compared to males in disasters. The most prominent effects are low well-being and high post traumatic stress disorder [PTSD]. To compare the differences in well-being and PTSD among adults exposed to natural and man-made disasters. This cross-sectional survey was conducted on 150 young adults exposed to flood in Punjab [50], terrorism in KPK [50] and suicide bombing [terrorism] in Islamabad [50]. Adults exposed to natural disaster like flood scored significantly higher on well-being as compared to adults exposed to man-made disaster like terrorism and suicide bombing. Post-traumatic stress disorder was more in terrorism exposed adults as compared to flood exposed adults. Within gender, females adapted better to man-made disasters. Adults exposed to natural disaster adapt better than those exposed to man-made disaster and females adapt to man-made disasters better than men

Impact of facebook addiction on narcissistic behavior and self-esteem among students

To investigate the relationship between Facebook addiction, narcissism and self-esteem and to see if gender played any role in this equation. The correlational study was conducted from February to March 2013 at the Department of Psychology, University of Sargodha, Punjab, Pakistan. Using convenient sampling, two equal groups of male and female students were enrolled from different departments of the university. Bergen Facebook Addiction Scale, Hypersensitive Narcissism Scale and Rosenberg's Self-esteem Scale were used for evaluation. SPSS 17 was used for statistical analysis. Of the 200 subjects in the study, 100[50%] each were males and females. Facebook addiction was positively correlated with narcissism[r=0.20; p<0.05] and negatively with self-esteem[r=-0.18; p<0.05]. Relationship between narcissism and self-esteem was non-significant[r=0.05; p>0.05]. Facebook addiction was a significant predictor of narcissistic behaviour [beta=0.202; p<0.001] and low self-esteem [beta=-0.18; p<0.001]. There were no significant gender differences in the three variables [p>0.05 each]. Facebook addiction was a significant predictor of narcissistic behaviour and low levels of self-esteem among students