Comparison of in-vitro susceptibility of sarcopties scabieivar hominis to 5% permethrin and 1 % lindane

To measure in-vitro susceptibility of Sarcopties Scabieivar Hominis to 5% permethrin and 1% lindane.Study Design: Randomized controlled trials. Study was carried out at Dermatology Department, Military Hospital, Rawalpindi from January 2012 to June 2012. A total of 60 mites from 60 patients were taken for assay. Mites from every patient were randomly allocated to two groups i.e. group A [5% permethrin] and group B [1% lindane]. Permethrin and lindane were applied in a thin film over a glass slide. Live mites were then gently transferred to the glass slide and covered with a lid. Mites were inspected for leg movements at time interval of 1hr, 2hrs, 3hrs, 4hrs and 5hrs. Death was declared once all leg movements had ceased. All mites which died within 5 hours had been declared as susceptible to drugs, while mites having active leg movements even after 5 hours of drug application were considered as non-susceptible. A total of 93.33% [n=28] of mites in group-A died within 5 hours of application of permethrin [susceptible] and 6.67% [n=2] of mites in group-A were alive after 5 hours of drug application [resistant] While 53.33% [n=16] of mites in group-B died within 5 hours of application of lindane [susceptible] and 46.67% [n=14] of mites in group-B did not die after 5 hours [non-susceptible], [p value < 0.001]. Permethrin is more effective as compared to lindane against Sarcopties Scabei in terms of in-vitro susceptibility

Efficacy of clarithromycin in pityriasis rosea

To determine the efficacy of clarithromycin in the treatment of Pityriasis Rosea [PR]. Double blind randomized controlled trial. Dermatology OPD, Military Hospital, Rawalpindi, from July 2008 to July 2009. Patients aged above 10 years, diagnosed with PR, were randomly assigned to two groups of 30 each to receive either clarithromycin or similar-looking placebo for one week. Neither the patient nor the treating physician knew to which group the patient belonged. Patients were assessed at 1, 2, 4 and 6 weeks after presentation and compared for complete, partial or no response. Among the 60 patients, no significant difference was found between the two groups at 2 weeks after presentation [p = 0.598]. In the placebo group, complete response was seen in 20 [66.7%], partial response in 3 [10.0%] while no response was seen in 7 [23.3%]. In clarithromycin group, there was complete response in 23 [76.7%], partial response in 3 [10.0%] and no response in 4 [13.3%] patients. Clarithromycin is not effective in treatment of pityriasis rosea

Frequency of HCV infection in different dermatological disorders

Hepatitis C Virus [HCV] has estimated affected nearly 3% of the world population. Studies in Pakistan have shown a somewhat higher prevalence. The objective of this study was to determine the frequency of hepatitis C virus infection in patients with dermatological disorders, known to be associated with HCV infection. This was a descriptive study, conducted at Departments of Dermatology, Military Hospital, Rawalpindi and PNS Shifa, Karachi from September 2003 to November 2005. There were 355 patients of the dermatologic disorders mentioned above. HCV status was determined by the presence of anti-HCV antibodies in the serum, by third generation ELISA. In this study 14% of lichen planus, 8% of generalised pruritus, 7.8% of urticaria, 8.7% of prurigo, and 50% of porphyria cutanea tarda patients had underlying HCV infection. None of the patients of leukocytoclastic vasculitis, erythema multiforme or erythema nodosum had anti-HCV antibodies. No patient of mixed cryoglobulinaemia or polyarteritis nodosa was seen during the study period. Patients of lichen planus, generalised pruritus, urticaria, prurigo, and porphyria cutanea tarda have increased frequency of HCV infection compared to normal population of our country. In contrast, none of the patients of leukocytoclastic vasculitis, erythema multiforme or erythema nodosum had HCV infection.

Frequency of nail changes in patients with psoriasis reporting to PNS, Shifa Naval Hospital, Karachi

To evaluate the frequency of nail involvement in psoriatic patients in local population and to evaluate major patient characteristics with nail psoriasis. One hundred consecutive patients with psoriasis in dermatology out/inpatient department participated in the study. Study duration was over one year from July 2007 to July 2008. Nail changes were present in 71 [71%] patients. Out of the 100 psoriatic patients. The most common nail abnormality observed on both fingernails and toenails was pitting followed by onycholysis. Patients with psoriatic nail changes were significantly older than psoriatic patient without nail changes. Duration of psoriasis was significantly higher in patients with psoriatic nail changes. Fungal infection was positive in 9% of patients with nail changes. Dystrophic nails are frequently found in psoriatic individuals. Frequency of nail involvement in our patient is probably similar to those in their European and American counterparts. Among various nail changes pitting and onycholysis are the most common finding. Fungal colonization of psoriatic nails is a quite frequent clinical problem and should be taken into consideration by dermatologists working with psoriatic patient

Effectiveness of oral ivermectin for eradicating infesting mites in patients of scabies

To evaluate the effectiveness of single and two doses of oral ivermectin in scabies by observing its effect on infesting Sarcoptes scabiei. This quasi experimental study, after approval of the hospital ethical committee, was conducted at the Skin Centre, Military Hospital, Rawalpindi, from September 2009 to August 2010. Fifty patients with scabies of up to two month duration having at least ten burrows/papules/nodules each with a visible mite were included in the study. Patients with other concomitant illnesses, pregnancy, lactation and those who had been treated with antiscabies medicines in the previous two months were excluded. Patients with more than six household contacts were also excluded from the study. Patients were given oral ivermectin 200microg/kg [Mectis]. Patients were followed up after a week and previously identified lesions were explored for a living mite. If a living mite was extracted from a lesion, the patient was prescribed another dose of oral ivermectin. At second follow up after a week, demonstration of living mites was considered as treatment failure and the patient was prescribed 5% permethrin cream for topical application. Final review of patients was carried out at the end of fourth week. Out of 50, in 22 [44%] patients, a living mite was isolated at one week follow up. At the end of second week, a living Sarcoptes scabiei was found in 11 [22%] patients. All of these 11 nonresponders were treated with topical application of 5% permethrin lotion. At the end of four weeks 49 patients reported for follow up without any identifiable living mite. One patient who had no mite at the end of first and second week did not report back after four weeks. Oral ivermectin is a convenient remedy for scabies with a cure rate of 56% after a single dose and 78% after two doses, a week apart

Impact of demonstration of extracted sarcoptes scabiei

To evaluate the impact of demonstration of extracted Sarcoptes scabiei to patients on therapeutic outcome. Quasi experimental study. Department of Dermatology, PNS Shifa Karachi, from Jan 2007 to Dec 2007. Sixty patients [36 males, 24 females] with scabies of upto two months duration were included in the study. Patients with other concomitant chronic illnesses and those who had been treated with antiscabies medicines in previous two months were excluded. After informed consent and initial evaluation, diagnosis was confirmed in all the patients by extracting living Sarcoptes scabeii. The mite was extracted after direct identification under a magnifying lens with the help of a sterilized common pin. All patients were fully explained about the disease and method of treatment. Half of the patients [group 1] were shown the extracted living mite under microscope while remaining patients [group 2] were just informed about the disease and mite was not shown to them. Twenty four hour application of 5% permethrin cream [Lotrix] was prescribed for patients as well as their families. Response to treatment was recorded at the end of 2nd and 6th week. Patients with living mites in the lesions during follow up visit were again prescribed 5% permethrin cream after showing them and/or their attendants the extracted living mite. At follow-up visit after two weeks 12 [40%] patients of group one were having itching but no mite could be extracted from the resolving lesions while in group two, 14 [46.7%] patients were having itching [p>0.05]. Treatment failed in six [20%] patients of group two who were found to have living mites in lesions. All patients of both groups were symptom free at the end of six weeks though some had a few residual resolving nodules on genitalia but no mite could be extracted. Convincing the patient about the nature of scabies by showing him the extracted mites at the time of diagnosis significantly improves treatment compliance

Narrow band ultraviolet - B radiation therapy in patients of vitiligo

To determine the efficacy of Narrow Band Ultra Violet B [NB-UVB] therapy to induce repigmentation in vitiligo patients with skin Fitzpatrick phototype IV. Descriptive study. Department of Dermatology, PNS Shifa Karachi, from April 2004 to October 2005. Thirty-five patients were included in the study during a period of eighteen months starting from 23rd April 2004. Each patient had thrice weekly exposure to NB-UVB therapy on nonconsecutive days for a maximum period of one year. Results were evaluated clinically and by comparing digital photographs taken before, during and at the completion of treatment. Improvement was objectively assessed by grading it into four groups depending on percentage of re-pigmentation in the affected areas. Out of the 35 patients, two dropped out and 33 completed the course of therapy successfully. The extent of vitiligo varied from 5% to 40% of body surface area. At the end of one year 9 [27.3%] patients had grade 4 recovery [> 75% repigmentation], 15 [45.4%] had grade 3 recovery [50-75% repigmentation] and the rest had grade 2 recovery [25-50% repigmentation]. No significant side effects were observed during the study period. Narrow-band UVB is a safe and effective treatment option for patients with Vitiligo