Comparison of topical 0.03% tacrolimus with 0.05% clobetasol in treatment of vitiligo

Objective: To compare the efficacy and safety of topical tacrolimus ointment with topical clobetasol ointment in vitiligo patients

Methods: This quasi-experimental study was carried out in outpatient, Department of Dermatology Unit-II, KMEU/ Mayo Hospital, Lahore. Sixty patients above 12 years were selected by non-probability purposieve sampling method and were divided into two equal groups. Patients having lesions of less than 2 years of duration were included. After obtaining an informed consent, patients in group I were treated with twice daily application of 0.1% tacrolimus ointment and group II with clobetasol ointement for a period of six months. If no response was obtained, treatment was stopped after three months

Results Repigmentation was seen in 15 [50%] patients in tacrolimus group and 27 [90.0%] in clobetasol group. Contact dermatitis was noted in one patient in ecah group and acneiform eruption was recorded in one patients in the clobetasol group

Conclusion: Topically, clobetasol remains to be an effective therapy in vitiligo. Topical tacrolimus was not effective in our patients. Intermittent use of clobetasol is as safe as continuous use of tacrolimus

Effect of topical steroids on mucociliary clearance and nasal symptom score

Allergic rhinitis is one of the most common ENT diseases in Faisalabad. The affects of topical steroids on nasal mucosal environment has not been studied reliably. To see the affects of topical steroids on symptom score and mucociliary clearance in Allergic Rhinitis. To see whether symptom score change with change in mucociliary clearance after topical application of steroids. A quasi-experimental study. ENT Unit, Madina Teaching Hospital, Faisalabad [a tertiary care hospital]. [sample, sampling technique]: Non-probability convenience sampling. Fifty patients in total. Saccharine with dye: india ink [Indigocarmine] application on anterior end of inferior turbinate to check mucociliary clearance. [Main outcome measures]: To assess change in mucociliary clearance time and symptom score [total as well as individual] before and after application of steroid at one, three and six months in patients having allergic rhinitis. Each nasal symptom was scored as zero to 3 on a severity scale [absent-mild-moderatesevere]. Patients were tested for nasal mucociliary clearance and symptom score before and after application of steroid. The results showed statistically significant difference in these groups. 1.Topical steroids modify the nasal mucosal environment in terms of mucociliary clearance and thus affects the patients quality of life in terms of allergic rhinitis symptom score 2. More long term follow up and wider studies are required to study the definite affects of steroids on nasal mucosa

dangerous alliance; hypertension and non-insulin dependent diabetes mellitus [NIDDM] the prevalence of hypertension in NIDDM

Early therapeutic intervention for hypertension is the key for modifying prognosis and complications in patients with non-insulin dependent diabetes mellitus [NIDDM]. In order to investigate the prevalence of hypertension in non-insulin dependent diabetes mellitus [NIDDM], one hundred patients of NIDDM admitted in medical wards of Nishtar Hospital Multan were examined during the period from January 2006 to December 2006. There were 46 males and 54 females- Their ages varied from 30 years to 65 years [mean age 48.4 +/- 9.3 years]. Their weight varied from 50 to 100 Kg [mean weight 68.2 +/- 8.5 Kg]. 46% of cases of NIDDM occurred in subjects with age < 50 years while 54% patients were above age 50, Frequency of diabetic nephropathy, retinopathy, neuropathy and cardiovascular disease was 24%, 36%, 30% and 26%. 56% of the patients had proteinuria, 30% were microalbuminuric while 26% were macroalbuminuric. Prevalence of hypertension was 30%. Hypertension was more prevalent in elderly diabetics, [mean age 53.13 +/- 7.8], in patients with longer duration of diabetics [mean duration 7.66 +/- 2.84 years] and in patients who had higher body weight [mean body weight 72 +/- 6.37 Kg]. Retinopathy, ischemic heart disease and neuropathy occurred more frequently in diabetic hypertensive patients. Their prevalence rates were 66.6%, 85%, 53.3% respectively. Diabetes and hypertension are frequently associated with each other. Hypertension has a prevalence rate of 30% in patients with non-insulin dependent diabetes mellitus. Hypertension commonly occurs in elderly diabetic patients. At age more than 50 years it has prevalence rate of 63% whereas in patients with age less than 50 years, it has a prevalence rate of 27%

Diabetes and other cardiovascular risk factors in local population

To determine the presence of diabetes mellitus and other conventional coronary heart disease risk factors in patients with acute coronary events in local population. Multan Institute of Cardiology, Multan. This study included 1028 patients with unstable angina or myocardial infarction [MI] during the period from April 2006 to January 2007 attending the outdoor of MIC, Multan. Out of all patients 35.8% were female, 30% were diabetics, 42% were smoker and 91% were hypertensive. Twenty four percent had MI and 76% had unstable angina. MI was significantly higher in diabetic patients. Ninety seven per cent of all patients had at least one of the cardiovascular risk factors [hypertension, smoking, diabetes, high cholesterol and low HDL cholesterol levels]. In this study 38 out 40 patients with acute coronary event have at least one of conventional cardiac risk factors. Diabetes and hypertension are leading risk factors, which may directly or indirectly interfere and predict more serious complications of coronary heart disease

clinical study of 40 cases of Parkinson's disease

Parkinson's disease is an important and common neurological disorder. The concept of Parkinson's disease [PD] as a specific morbid entity is historically a clinical one. In 1817, Dr James Parkinson published an essay on "the shaking palsy". Before 1817 the term shaking palsy had been vaguely employed by medical practitioners to describe a mass of clinically undifferentiated illnesses in which tremor were a prominent symptom. It was Parkinson who accurately delineated the disease. Although he omitted the characteristic mask like face, he defined the tremor and other main features including weakness rigidity and shuffling gait. The eponymic title "Parkinson's disease" by which we know the condition today did not come into use until the end of 19[th] century and was first so used by the celebrated French neurologist Charcot