ABSTRACT
Objective: To compare the efficacy of oral zinc sulfate [ZnSO4] with intramuscular meglumine antimoniate [MA] in the treatment of cutaneous leishmaniasis
Study Design: Randomized controlled trial
Place and Duration of Study: Dermatology Department, Military Hospital, Rawalpindi from 1st May 2013 to 1st Jan 2014
Material and Methods: Eighty patients of cutaneous leishmaniasis from dermatology OPD fulfilling the inclusion criteria were selected after informed consent and permission from Hospital Ethical Committee. Using simple randomization patients were assigned into two treatment groups. Group A received oral zinc sulfate in a dose of 10 mg/kg/day during 45-day period in three divided doses, and group B received systemic MA [glucantime] 20 mg/kg/day intramuscularly for 20 days. The size and induration of lesions was measured by ruler and palpation respectively. Patients were followed up till the end of treatment. Three patients were excluded from the study due to discontinuation of treatment. Acceptable cure indicated efficacy at the end of treatment duration
Results: In group A 14 [35.9%] patients had moderate improvement followed by total clearance in 12 [30.8%] patients. In group B, majority of the patients i.e. 26 [68.4%] patients had total clearance followed by moderate improvement in 9 [23.7%] patients. Group B had significantly better response as compared to group A. Efficacy of the drug was significantly higher in group B as compared to group A [p = 0.001]
Conclusion: Oral zinc sulfate 10mg/kg is not better than intramuscular MA in treatment of cutaneous leishmaniasis but can be considered as a treatment option if MA cannot be used
ABSTRACT
Objective: To find out common precipitating factors leading to hepatic encephalopathy in selected known cases of cirrhosis of liver .Design: It is a descriptive study comprising patients selected through non-probability convenient sampling. Setting: Department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Period: From January 2000 to December 2002
Subject: Fifty [50] known cases of cirrhosis of liver with encephalopathy
Main Outcome Measures: One or more precipitating factors leading to hepatic encephalopathy, grades of encephalopathy, etiology of cirrhosis of liver
Results: Thirty two [64%] patients were male and 18 [36%] females. The commonest age group involved was between 40-49 years [26%]. Most of the patients [46%] were in grade-IV encephalopathy. HBV [46%] was the commonest cause of cirrhosis. The most common precipitating factor of encephalopathy was gastrointestinal bleeding in 20[40%] patients. Other precipitating factors detected were, infections in 15[30%] patients, combination of gastrointestinal bleeding and infections in 7[14%], constipation in 3[6%], gastrointestinal bleeding and constipation in 2[4%], infections and constipation in 2[4%] and abdominal paracentesis in 1 [2%]patients
Conclusion: Gastrointestinal bleeding is the most common precipitating factor of encephalopathy followed by infections