Comparative adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo

To compare the adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo. A clinical trial was carried out from January 2013 to December 2013. Total sixty patients of vitiligo were enrolled and 30 of group A patients were treated with low dose oral prednisolone [0.3 mg/kg body weight] daily and 30 of group B patients were treated with oral dexamethasone pulse therapy [10 mg per week] for 16 weeks. During 12 week follow-up, increased body weight, headache, dyspepsia and fatigue were more frequent in group A as compared to group B. Similarly, in group A other side effects noted were acne [33.3%], mooning of face [26.6%], striae [26.6%], hypertrichosis 13.2%, purpura [6.7%] and among the female patients, menstrual abnormality [71.4%] whereas in group B, no patient developed these problems from baseline to follow-up period [p<0.05] Low dose oral prednisolone was found to be associated with more adverse effects than oral dexamethasone pulse therapy in treating vitiligo

Clinico-mycological correlation in onychomycosis in a tertiary level hospital

To correlate the clinical patterns of onychomycosis with the type of mycological agents in onychomycosis. In this cross-sectional study, 120 patients with onychomycosis, attending outpatient department, were selected by purposive type of sampling technique. They were subjected to thorough clinical examination. Nail material was collected for mycological diagnosis by microscopy and culture on dermatophyte test medium. Microscopy was positive in 47 [39.2%] cases, whereas culture yielded Trichophyton rubrum in 53 [44.2%] and T. mentagrophytes in 2 [1.7%] patients. Common clinical nail changes in mycologically proven cases were thickening of nail plate [68.9%], subungual hyperkeratosis [63.9%], onycholysis [55.7%], roughening of nail plate [29.5%], yellowish discoloration [29.5%] and brownish-yellow discoloration [21.3%]. Only, subungual hyperkeratosis was found significantly more in mycologically positive cases [63.9%] than in mycologically negative cases [37.3%], p<0.05. The validity of microscopic examination for prediction of onychomycosis revealed sensitivity [74.5%], specificity [90.8%], accuracy [83.3%], positive predictive values [87.2%] and negative predictive values [80.8%]. There is an insignificant correlation between clinical pattern and mycological diagnosis. No single clinical feature is suggestive of onychomycosis, hence, direct microscopy must always be coupled with fungal culture for accurate diagnosis.

Pattern of contact dermatitis in a tertiary level hospital in Bangladesh

To evaluate the pattern of contact dermatitis [CD] among patients in a tertiary care hospital in Dhaka, Bangladesh. In this cross-sectional study, 120 patients of contact dermatitis, diagnosed clinically were evaluated by detail history and clinical examination. The clinical patterns were correlated with the likely sources of allergens. Mean age was 32.8 +/- 14.0 years and majority of the patients were housewives 36 [30.0%] and students 33 [27.5%]. 60.0% of the patients came from low-middle class. Itching 117 [97.5%] and disfigurement 89 [74.2%] were chief complaints of the patients. 63 [52.5%] patients showed erythematous rash, 42 [35%] vesicular eruption, 34 [28.3%] pustular eruption and 16 [13.3%] post-inflammatory hyperpigmentation. Both hands 69 [57.5%], right hand 41 [34.2%], both feet 50 [41.7], neck and ear 42 [35%] and face 30 [25.0%] were the commonly involved sites. Allergic contact dermatitis [52.5%] was more common than photocontact CD [26.7%] and irritant CD [20.8%]. Regarding the source of contact dermatitis, detergents 88 [73.3%], cooking materials 67 [55.8%], shoes or sandals 61 [50.8%], cosmetics 42 [35%], gold/jewellery 38 [31.7%], insects 29 [24.2%] were the main etiological factors of contact dermatitis. The study highlighted that contact dermatitis depends on patients' occupational exposure of different substances.

Safety of parenteral dexamethasone vs. oral prednisolone in the treatment of pemphigus vulgaris

To observe the safety of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. A clinical trial was carried out in the department of Dermatology and Venereology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty. Among them fifteen patients were treated with injection dexamethasone [group A] and other fifteen were treated with oral prednisolone [group B]. Statistically significant improvement was observed in both groups in all clinical parameters after 6 weeks. But dexamethasone group showed statistically more significant improvement than prednisolone group in all clinical parameters except Nikolsky's sign. Most common adverse effects in both groups were weight gain, increased appetite, puffy face and hyperglycemia. In dexamethasone group other side effect was sleep disturbance. In prednisolone group other side effects were gastritis, sleep disturbance, nausea and vomiting, herpes zoster infection, reactivation of tuberculosis and mood change. Parenteral dexamethasone appears to be safer than oral prednisolone in the management of pemphigus vulgaris with an acceptable efficacy profile

Pulse dose of oral itraconazole is effective in the treatment of onychomycosis

Onychomycosis is a recalcitrant disease of the nails caused by dermatophytes, yeasts, and molds. To see the efficacy of pulse dose of oral itraconazole in the treatment of onychomycosis. It was an open clinical trial which was carried out for a period of 2 years from March 2009 to February 2011, in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University [BSMMU] Dhaka. Bangladesh. Thirty patients with onychomycosis were recruited purposively. 30 patients of onychomycosis were treated with oral itraconazole 400 mg/day, seven days a month for three months. Mean age of the respondents was 36.57 +/- 14.01 years and male to female ratio was 1:1. Among the patients, 36.7% cases had involvement of toenails and 63.3% cases had involvement of fingernails. In 6.7% cases onychomycosis was mild, 80.0% cases moderate and in 13.3% cases severe. Three months after treatment with itraconazole, improvement was found in 66.7% cases and marked improvement in 33.3%. Before treatment, culture was found positive in 30% cases and three months after treatment, culture became negative in 66.7% cases. Monthly one week cycle of oral itraconazole 400 mg daily for 3 months is effective therapeutic option for onychomycosis