ABSTRACT
Background: Post kala-azar dermal leishmaniasis (PKDL) is a recognized dermatologic complication of successfully treated visceral leishmaniasis (VL). PKDL lesions are suspected to be important reservoirs for VL transmission in Sudan. Prolonged treatment schedules, feeling of general well-being and the social stigmata of PKDL prevent most patients seeking treatment. The mainstay of treatment is cardiotoxic sodium stibogluconate (SSG) for 60-120 days. Recently, liposomal amphotericin B (Ambisome®) and immunochemotherapy gave promising results. Ambisome® is expensive and difficult to prepare under field conditions. Paromomycin/SSG combination has been shown to be safe, efficacious and can save time in VL treatment. This study aims to prove that Paromomycin/SSG combination can cure and reduce PKDL treatment duration. Methods: We are reporting nine cases of patients with PKDL lesions of ≥6 months duration who were diagnosed by clinical signs, histopathological/immunohistochemical and PCR. Results: Patients’ mean age was 11.7 ± 4.3 years. A third of the patients (3/9; 33.3%) who failed previous SSG treatment of 2-3 months duration responded completely to 40 days of paromomycin/SSG combination. The majority of patients (5/9; 55.6%) responded completely to 30 days of the combination. One patient (1/9; 11.1%) relapsed following 30 days paromomycin/SSG combination. Conclusion: It was concluded that paromomycin/SSG combination for 30 days is time-saving, safe and efficacious for PKDL treatment.
ABSTRACT
Objective: to assess the awareness of people regarding diabetes and their practices about the disease so that a comprehensive education program may be designed to give awareness to the diabetic patients and contribute towards reduction of the complications of the disease
Material and Methods: a cross sectional study which included 714 patients with known type 2 diabetes conducted in Shalimar Hospital, Lahore. The technique used was non probability purposive sampling. A simple questionnaire was distributed in the diabetic clinic and a diabetic nurse filled the questionnaire by asking questions from the patients
Results: mean age was 50.5+/-24.11 years. There were 25.5% males and 7 4.5% females. A large number [37 .2%] were uneducated and only 16.1 % had education above grade 10. Regarding the economic status, 62.9% fell into grade 1 economic status and 12.9% in grade 4. In the study 64.1 % of the patients thought that the disease had no cure. 84.8% of the patients were of the opinion that the disease and the medication would decrease with time. Only 35% patients knew that it may affect different organs of the body irreversibly. 69% of the patients did not walk at all
Conclusion: in a tertiary setup in Lahore, one of the most prosperous cities of Pakistan, the awareness level is quite poor even amongst the people who are suffering from diabetes. The overall education level in our patient group is also very poor. If the awareness level of diabetic patient's remains as it is today, many new faces of diabetic complications will unveil each year. There is a need for an effective disease management program in the country
ABSTRACT
Objective: to assess the awareness of people regarding diabetes and their practices about the disease so that a comprehensive education program may be designed to give awareness to the diabetic patients and contribute towards reduction of the complications of the disease
Material and Methods: a cross sectional study which included 714 patients with known type 2 diabetes conducted in Shalimar Hospital, Lahore. The technique used was non probability purposive sampling. A simple questionnaire was distributed in the diabetic clinic and a diabetic nurse filled the questionnaire by asking questions from the patients
Results: mean age was 50.5.+/-24.11 years. There were 25.5% males and 7 4.5% females. A large number [37.2%] were uneducated and only 16.1 % had education above grade 10. Regarding the economic status, 62.9% fell into grade 1 economic status and 12.9% in grade 4. In the study 64.1 % of the patients thought that the disease had no cure. 84.8% of the patients were of the opinion that the disease and the medication would decrease with time. Only 35% patients knew that it may affect different organs of the body irreversibly. 69% of the patients did not walk at all
Conclusion: in a tertiary setup in Lahore, one of the most prosperous cities of Pakistan, the awareness level is quite poor even amongst the people who are suffering from diabetes. The overall education level in our patient group is also very poor. If the awareness level of diabetic patient's remains as it is today, many new faces of diabetic complications will unveil each year. There is a need for an effective disease management program in the country