Comparison of effectiveness of topical tacrolimus and betamethasone with soft paraffin in the treatment of patchy alopecia areata

To compare the effectiveness of Topical Tacrolimus and Betamethasone with soft paraffin in the treatment of patchy alopecia areata. Sixty patients with mild to moderate patchy alopecia areata were evaluated in a non-randomized, open label, intention to treat clinical trial. Patients were assigned to Tacrolimus [n=20] or to Betamethasone [n=20] or to soft paraffin [n=20]. All the three groups were advised to apply the treatment on the affected areas twice a day for 12 consecutive weeks. The primary study outcome was to compare the hair regrowth rate. Efficacy was evaluated at weeks 4, 8 and 12, using hair regrowth score [RGS] with a scale ranging from 0 [regrowth<10%] to 4 [regrowth>75%]. Fifty six subjects [93%] completed the study. At week 12, the RGS was 3.5 +/- 0.11in Betamethasone group [p<0.001], 2.2 +/- 0.15 in Tacrolimus group [p<0.005] and 0.85 +/- 0.08 [ns] in control group respectively. RGS>3 was observed in 70% of patients in Betamethasone group as compared to 45% in Tacrolimus group and none of the patients in control group. Betamethasone is more effective than Tacrolimus in promoting hair regrowth as compared with soft paraffin in patients with mild to moderate patchy alopecia areata

Anti hypertensive efficacy of cardioselective beta-blocker atenolol and amlodipine in essential hypertensive patients

High blood pressure increases the risk of cardiovascular disease for millions of people worldwide and there is evidence that the problem is only getting worse. In the past decade, age adjusted rates of strokes incidence have risen. The incidence of end stage renal disease and the prevalence of heart failure have also increased. A major contributor to these trends is inadequate control of blood pressure in the population. The variety of treatments has been established with the passage of time from older to newer class. Researchers with passage of time proved on one side beneficiary drugs but also contraindicated in various types of patients. Keeping in view the necessity of treatment of hypertension at its initial stages in essential hypertensive patients to prevent cardiovascular complications in essential hypertensive patients. In present study the objective was to compare blood pressure lowering effects of cardio selective beta blocker Atenolol with calcium channel blocker Amlodipine in essential hypertensive patients

Proteinuria a target for reno-protection in hypertensive patients with type 2 diabetic nephropathy

To study the response of angiotensin II [ATI] receptor antagonist ARE [Losartan] as monotherapy in diagnosed hypertensive, non-insulin dependent diabetes mellitus [NIDDM] patients with nephropathy [albuminuria]. Department of pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC], Karachi. This study is a randomized trial used to examine the effects of ARB [Losartan] on the renal outcome of 20 diagnosed cases of hypertensive noninsulin dependent diabetes [NIDDM] with base line proteinuria. 20 normal subjects were also selected as control group. Baseline albuminuria is almost linearly related to renal outcome, and is the strongest predictor among all measured well-known baseline risk parameters. The changes in albuminuria in the first 3 months of therapy are roughly linearly related to the degree of long-term renal protection. ARB [Losartan] showed 58% [P<0.001] reduction in proteinuria, 4.7% reduction in serum urea, 7.06% [P<0.01] reduction in serum creatinine, creatinine clearance by 4.72%, serum potassium increases by 5.07% [P<0.01] and FBS reduced by 33.29% I [P<0.001]. Baseline to final change for SBP as well as for, DBP was significantly reduced i.e.19.20% [P<0.001] and 16.16%[p<0.001] respectively. In conclusion, albuminuria should be considered a risk marker for progressive loss of renal function in hypertensive type 2 diabetic patients with nephropathy, as well as a target for therapy. Reduction of residual albuminuria to the lowest achievable level should be viewed as a goal for future renoprotective treatments

Effect of montelukast on patients with mild persistant asthma

To determine the clinical effects of oral montelukast sodium [a leukotriene receptor antagonists] in asthmatic patients aged 15 years and above. This was a 2 month [60 days] study carried out in the Department of Pharmacology and therapeutics, Basic Medical Sciences Institute with collaboration of Chest Medicine, JPMc, Karachi. Patients> 15 years and above suffering from persistant asthma [prebronchodilator FEVI = 60% of the predicted value] and insufficiently controlled on inhaled corticosteroids were included in the study. Total of 100 patients completed the study. The study comprised of two arms of 50 patients each. Group A was the control group on the placebo group receiving inhaled corticosteroids and a placebo drug. Group B was the active group or the drug group receiving inhaled steroids as well as 10 mg montelukast at bed time. Asthma control was assessed by spirometery [name model No.] at the onset i.e. start of the study and then after 60 days i.e. end of the study as per the specifications and guide lines laid down by the global initiative for asthma. Along with this the patients were evaluated weekly in which PEER was measured using a peak expiratorv flow meter. Similarly the ptient was asked to maintain a daily diary in which day time asthma symptoms were recorded along with nocturnal awakenings. use of beta2 agonists use, asthma exacerbations and asthma free days and use of health related resources for worsening asthma symptoms. Montelukast improved airway obstruction FEVJ-PEFR and patients reported end points i.e. day time asthma symptoms, nocturnal awakenings [P<0.001 compared with placebo]. The comparison of difference in mean value of PEFR, FEVI and nocturnal awakenings among two groups from baseline to 811 week was compared by students t-test [test for two independent groups for mean]. 95% confidence interval of the difference of mean was also calculated. Montelukast, compared with placebo significantly improved asthma control during a 8 week treatment period