Role of autologous platelet rich plasma [PRP] in limied alopecia areata in local population

Objective: To evaluate the efficacy and safety of autologous platelet rich plasma [PRP] in treatment of limited alopecia areata in local population

Methods: We performed a prospective study of 20 patients with Alopecia Areata. Both females and males with one or multiple patches of alopecia were included. Autologous PRP was injected once a month for three months. Primary endpoint was regrowth of hair. Digital phtographs were taken before treatment and after each visit. Patients were further followed up for 6 months after treatment for any relapse or side effect. Results were assessed clinically and using digital photographs

Results: Out of 20 patients, 6 [30%] had excellent response, 5 [25%] with good response, 4 [20%] with fair and 5 [25%] poor response. Mild pain at the site of injection was noted for 5 to 30 min at injection site. No other side effect was noted nor reported by any of the patients. Patient compliance and satisfaction was good and all patients completed the treatment

Conclusion: PRP is safe, low-cost and effective treatment of alopecia areata

Disseminated superficial actinic porokeratosis: a case report

Disseminated superficial actinic porokeratosis [DSAP] is characterized by small, atrophic patches with distinctive keratin rims that occur on sun-exposed areas of the extremities, shoulders, and back. The diagnosis is based on the histopathologic finding of a cornoid lamella, absence of a granular layer, and often a thin epidermis. It is associated with exposure to ultraviolet radiation. We report a case of DSAP in our setting

Efficacy and safety of ablative fractional carbon dioxide laser for acne scars

Acne may lead to long term squelae including physical scars. Lasers have been used with variable degree of success but literature pertaining to Asian population is sparse. To evaluate the efficacy and safety of carbon dioxide [CO[2]] fractional laser in the treatment of acne scars in the local population. Twenty patients with mild to moderate atrophic acne scars were registered and subjected to monthly fractional CO[2] laser resurfacing for six sessions and final evaluation was done six months after the last treatment. More than 71% patients showed variable degree of improvement. No severe long term complications were noted in any patient. Study suggests that CO[2] Fractional laser may prove a useful addition in the management of acne scars in our patients as well

Oral mucosal lesions in complete denture wearers

To determine the frequency of oral lesions related to gender, age, the length of time of denture usage, the balance of denture and cleaning methods. 106 patients who had old complete dentures and came to Dental Department to have new complete dentures were registered in the study. Frequency in relation to different factors was estimated. Cleaning methods and frequency were divided into 3 subgroups respectively as tooth brush and tooth paste/soap, denture cleansing tablets and sodium carbonate and 3 times a day, every day, every 3 days and once a week. Distributions of oral lesions in different areas were noted. The data obtained were evaluated by one-way ANOVA u test, student t test. The level of statistical significance was set at p<0.05. In 106 patients [51 men and 55 women], 37-80 years of age with a mean age of 60.28 years, oral lesions were present more as the age increases, the more lesions were observed In female patients and associated with unstable dentures. The patients displayed statistically significant difference in presence of oral lesions with the method of cleaning and the way the patients used their dentures. The complete denture wearers should be educated about the importance of periodic examination due to changes of supporting tissues and early detection of mucosal lesions to maintain their oral and denture hygiene in optimum level

Male androgenetic alopecia treated with finasteride

Dihydrotestosterone causes micronization of scalp hair follicles, resulting in androgenetic alopecia. Finasteride inhibits type II 5alpha-reductase, thereby, decreasing the conversion of testosterone to dihydrotestosterone. To determine the efficacy of finasteride in male androgenetic alopecia. 16 men from 18-42yrs of age with moderate vertex pattern hair loss received 1mg finasteride daily for 2 yrs. Efficacy was determined by patients self assessments, investigator assessment and assessment of clinical photographs, safety was assessed by clinical analysis of adverse experience if any. After 6 months-1yr treatment, there was a significant improvement in patient, investigator and photographic assessment. Efficacy was improved and maintained throughout the second year of the study. Finasteride was generally well tolerated. In men with male pattern hair loss finasteride 1mg for 2 yrs slowed the progression of hair fall and increased hair growth

Perception of healthcare quality management in hospitals amongst medical professionals of al-Qassim region in Saudi Arabia

To assess awareness about quality affairs and observe trends in physicians to adopt quality measures. Physician's role in providing quality health care is emphasized by identifying it as a separate block for implementation process. Hospitals that successfully involve physicians in the continuous quality improvement program will experience more implementation success than hospitals that do not involve them. Physicians have been traditionally suspicious of organized efforts to improve clinical care and they find its demand inconsistent, time consuming, bureaucratic and irrelevant to the improvement of care. A questionnaire was developed which included general comments about quality in health care. It was distributed to physicians working in the hospitals of Al-Qassim region in Saudi Arabia. The data were analyzed by a computer statistical package. A total of 283 physicians responded from nine hospitals of Al-Qassim. Results showed deficient knowledge but positive attitude in adopting quality measures in day to day health practice

Pre-operative anxiety in patients admitted for elective surgery in King Saud hospital, Unaizah, Al-Qassim Kingdom of Saudi Arabia

To assess the Pre-Operative Anxiety and to further the planning of health education and counseling programme. Background; Hospitalized patients generally feel frightened and vulnerable at the thought of impending surgery which can produce fear and anxiety related to pain perception. Pain can grow out of proportion to its physical intensity due to unfamiliar environment, loss of privacy, separation from social structure or communication difficulties due to cultural and/or language barriers. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. Studies show, [depending upon the intensity of inquiry], that from 40% to 85% of patients are apprehensive before surgery. It is claimed that an informative and comforting pre-operative visit may replace many milligrams of anxiolytic medication. Methodology: A survey form was designed to record the patient's point of view. One hundred consecutive patients > 12 years of age belonging to both sexes admitted for elective surgery were enrolled for interview. Fifty five% of the total number of patients expressed the fear of operation. The younger age group [< 38 years] were more apprehensive compared to elderly. The differences in this degree of fear did not correlate with the gender or level of literacy

Genitourinary infections: a leading cause of chronic urticaria in married females

Chronic urticaria [CU] is a common clinical problem in dermatological practice. Characterized by intense itching and fleeting erythematous weals, the condition persists beyond six weeks. It can occur at any age and in both sexes. Many etiological agents may be held responsible, but in a sizeable number of patients it is difficult to reach a definitive cause. It was our clinical impression that CU in married ladies was commonly related to genitourinary tract infections [GUTIs] but no clinical details were available. Therefore we designed this study to work out causes of urticaria in married ladies, and the possible role of GUTIs in this condition. All the married ladies with urticaria of more than 6 weeks were enrolled from outdoor clinics of dermatology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital and Allama Iqbal Medical college, Jinnah Hospital Lahore, over a period of 18 months. They were thoroughly investigated, managed and findings were recorded. Along with recurrent weals, almost half of the patients had additional symptoms. GUTIs lead to CU in 39 ladies, drugs in 13, scabies in 6, helminthiasis in 3, intrauterine contraceptive device [copper T] in 2, dental caries, chronic hepatitis, amoebiasis and chronic sinusitis 1 patient each. In 36 cases no cause was found for CU and were labelled as idiopathic. It is therefore concluded that GUTIs are an important cause of CU and should be looked for while investigating such a case

Erythroderma in children

Erythroderma is not an uncommon condition Also known as exfoliative dermatitis. it is characterized by erytherma and/or scaling and may occur in both sexes and all ages. It has a long list of causes and attributes significant morbidity and mortality in dermatological practice. As there exists no previous clinicoetiological record of pediatric erythroderma in the country, we carried out this clinical study to find out the etiological implications in our pediatric population. Patients and methods: All the pediatric erythrodermic patients of both sexes were enrolled from inpatients and outdoor clinics of dermatology and pediatric departments of Allama Iqbal Medical College, Jinnah Hospital, Lahore, and Pediatric depatment of King Edward Medical College, Mayo Hospital, Lahore over a period of 20 months. These were thoroughly investigated and findings were recorded on a specially designed proforma. Of the 46 cases 34 [73.9%] were boys and 12 [26.1%] girls. These included neonates, infants and children. Generalized itching and nail and hair changes were seen in more than 58% cases. Four uses had mucosal involvement as well, Endogenous eczemas proved to be the most common cause unlike that seen in adults. Papulosquamous disorders, adverse drug reactions, skin and systemic infections, pemphigus, disorders of keratinization, deficiency states and infestations were the other less common causes