ABSTRACT
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
ABSTRACT
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