ABSTRACT
Background: Melasma poses a great challenge as its treatment modalities are unsatisfactory. Treatment using tranexamic acid is a novel concept. Aim: This study aimed to compare the therapeutic efficacy and safety of oral tranexamic acid and tranexamic acid microinjections in patients with melasma. Methods: This is a prospective, randomized, open-label study with a sample size of 64, 32 in each treatment arm. Thirty-two patients were administered localized microinjections (4 mg/ml) of tranexamic acid monthly in 1 arm, while in the other arm, 32 were given oral tranexamic acid 250 mg twice a day. Patients were followed up for 3 consecutive months. Clinical photographs were taken at each visit, and a modified melasma area and severity index scoring was performed at the beginning and end of treatment. Results: Improvement in melasma area and severity index score in the oral group was 57.5% as compared to 43.5% in the intralesional group. All 32 patients in the oral group (100%) showed >50% improvement, out of which 8 showed >75% improvement. In the intralesional group, 17 (53%) patients had >50% improvement, of which 3 had >75% improvement. The remaining 15 patients in this group had <50% improvement. Thus, the oral group showed a more significant response as compared to the intralesional group. No major adverse effects were observed in both the groups. At 6-month follow-up, two patients (6.2%) in the oral group had recurrence as compared to three patients (9.4%) in the intralesional group. Limitations: A small sample size was one of the limitations in this study. The dose of tranexamic acid in microinjections and the frequency of injections could have been increased. Conclusion: Tranexamic acid provides rapid and sustained improvement in the treatment of melasma. It is easily available and affordable. Oral route is undoubtedly efficacious, but the results of microinjections, while encouraging, can probably be enhanced by either increasing the frequency of injections or increasing the concentration of the preparation.
ABSTRACT
Introduction: Physical inactivity has been implicated as a major risk factor for cardiovascular diseases. The healthy lifestyle of medical students could facilitate the formation of healthy physicians who is more likely to give effective preventive counseling to their patients. Therefore, this study was undertaken to assess the knowledge, attitude, and pattern of the physical activity among the medical students. Materials and Methods: A cross-sectional study was conducted amongst 161 eligible sixth semester medical undergraduate students. A pretested questionnaire was used to collect the data. Anthropometric measurements were also taken. The data were fed and coded in Microsoft Excel 2007 and analyzed using SPSS 17.0 and Epi Info software of World Health Organization. Results: Knowledge regarding different types of exercise and anthropometric variables was fairly low among the study participants. Only 9.3% of the students were aware of the recommended level of the physical activity but nearly all (96.27%) were aware of the benefits of it. The attitude of the participants toward the physical activity was favorable, yet only one-third (32.3%) subjects adhered to recommended guidelines. Boys (39.8%) were found to be significantly more active than girls (20.6%) (P = 0.01). Conclusion: The knowledge and practices regarding the physical activity was found to be low amongst the medical students. There is a need to provide an enabling environment for promoting the physical activity amongst them so that can inculcate the same in their patients.