Post-heretic neuralgia; intra-lesional triamcinolone in the treatment

Objectives: To assess the efficacy of intra-lesional triamcinolone in for the treatment of Post Herpetic Neuralgia. Study Design: Prospective interventional study. Setting: Dermatology Department of Dow University Hospital. Period: July 2014 to June 2015

Patients and Methods: Twenty nine patients with diagnosis of Post Herpetic Neuralgia were included after taking written and informed consent. An insulin syringe was used for the injections and the medicines were injected intralesionally. The mixture contained 30/70% of triamcinolone to xylocaine ratio for local infiltration in post herpetic scars. Pain relief assessment was done with the help of visual analogue scale [VAS] after two months. Mean pain score before therapy and after therapy was compared with one sample student t test

Results: Out of total 29 patients 14 were male and 15 were females. The mean age +/- SD was found to be 45.9 +/- 15.4 years. The most common region involved was Chest. The mean +/- SD duration of Symptoms was 5.58 +/- 1.80 weeks. The mean pain score before therapy was 6.86 +/- 1.66 which after one month of therapy reduced to 3.72 +/- 1.86. The reduction in pain was statistically significant [p<0.001]

Conclusion: Post Herpetic Neuralgia can be effectively treated by the local infiltration of a mixture of triamcinolone and lignocaine. It is recommended that long-term follow-up studies should be done with corticosteroids only or in combination with local anesthetics to additionally evaluate the effectiveness of such treatment in postherpetic neuralgia

Eczema; frequency of different types in a tertiary care hospital

Objectives: To determine the frequency of different types of eczema in patients presenting in a tertiary care hospital. Study Design: Cross sectional descriptive type of study. Setting: Hamdard University Hospital Karachi. Period: January 2013 till December 2013

Patients and Methods: All new cases of any type of eczema were registered by nonprobability convenient sampling. Total 192 patients of both genders and all ages were enrolled after taking informed consent. Diagnosis was made on detailed history and clinical examination by consultant dermatologist. All specific and relevant investigations were done according to requirement. Patients were divided in two groups, exogenous eczema and endogenous eczema, for convenience. Data was analyzed by the latest version of SPSS

Results: There were 192 patients, out of which 52.08% were males and 47.91% females. Out of the total presented patients 50% had endogenous eczema, 43.37% had exogenous eczema and 25.62% had unspecified eczema. In endogenous group 11.45% had hand dermatitis followed by seborrhoeic dermatitis, atopic dermatitis and asteatotic eczema in descending frequency of presentation. Pityriasis alba, discoid eczema and pompholyx were seen less frequent. In exogenous eczema allergic contact dermatitis was seen in 14.06% patients, while irritant contact dermatitis in 11.45% patients. Infective eczema and photo-allergic eczema were seen in small number of patients

Conclusion: It was found in this study that allergic contact dermatitis was most common type of eczema followed by other types. Whatever the type is, eczema can be treated, symptoms can be relieved and recurrences can be prevented by appropriate therapy. All types of eczema affect patient's quality of life adversely. However, they can be prevented by educating patients and their relatives to take adequate safety measures like using good quality emollients prophylactically

Pregnancy; a study on frequency of skin changes during physiologic and pathologic

To determine frequency and pattern of skin changes during pregnancy. Cross sectional study. Outpatient department of Dermatology and Gynaecology at Dow University Hospital, Ojha campus in Karachi. May 10, 2013 and January 10, 2014. [8 months]. It comprises 80 consecutive pregnant women with skin problem, who presented in outpatient department of Dermatology with referral cases from Obs and Gynae outpatient department.Information was collected on predesigned questionnaire after taking informed consent. Total 80 pregnant women were included in study with different skin problems. The results indicate thatmost of women 72.5% presented during third trimester and 43.8% women were primigravida. Striagravidarum and lneanigra was commonest physiological changes, reported in 54%, 52% women consecutively. Eczema,utricaria and candidiasis were reported in 16.3% and 15% and 15% women consecutively. Prurigo of pregnancy was reported in 17.5% followed by pruritic folliculitis of pregnancy in 6.3% women. This study concluded that skin changes during pregnancy are frequent in Pakistani women. These changes could be physiological or pathological

Common birth marks; to identify the frequency in infants presenting to out patient of Tertiary Care Hospital

Objectives: To identify the frequency of common birthmarks presenting in outpatients department of dermatology until and to increase awareness among doctor about the common phenomena

Patients and Study Design: A cross sectional study

Setting: OPD of Dermatology department of Dow University Hospital

Period: January 2014 till October 2014

Methods: During a year, by using non-probability convenient sampling only 100 patients of both genders were enrolled in the study after ensuring inclusion, exclusion criteria. Complete history was recorded and a thorough general physical and cutaneous examination was performed. Information was collected on predesigned questionnaire after taking informed consent. Data Analysis was carried out on SPSS statistics software

Results: Out of 100 patients, 43% were males and 57% were females. In 69.6% patients, the birthmarks were noticed around time of delivery, 28.3% patients were noticed within 1[st] year of life and 2.2% later in 5 year. Pigmented birthmarks were identified in 65.2% patients while 34.8 % have vascular birthmarks.71.1% had no changes in color during life span. While 37.8% had 1-3 cms birthmark and 45.7% have reported an increase in birthmark

Conclusions: We found birthmarks benign; they may grow with age but they do not need treatment unless there is concern either cosmetically or they have pain and discharge

Frequency of subclinical hypothyroidism in patients with proliferative diabetic retinopathy

To determine the frequency of subclinical hypothyroidism in patients with proliferative diabetic retinopathy. Cross Sectional Study. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2012 to 31[st] December 2012. One hundred and nineteen patients attending the medicalOPD Dow University of Health Sciences were included in study. 119 patients were enrolled in study .47.1% were male and 52.9% were female patients mean age was 55.75 +/- 7.85 years, Mean HbA1[c] value was 8.02 +/- 1.46%, Subclinical hypothyroidism was identified in 26.9% the patients. Subclinical hypothyroidism is associated with the development of proliferative diabetic retinopathy in the patients suffering from type 2 diabetics

Serum magnesium level in migraineurs versus non migraineurs

The objective is to observe relationship between low serum magnesium level and Migraine. Prospective Observational. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2013 to 31[st] December 2014. One hundred and fifty patients attending the medical and Neurology OPD at Dow University Hospital were included in study. They were diagnosed according to International Headache Society [HIS] criteria for migraine headache. 150 patients were enrolled in study 49 [32.7%] were male and 101 [67.3%] were female patients mean age was 28 [ +/- 6.2] years, After excluding other causes migraine was diagnosed in 102 [68%] patients. Out of 102 patients 71 [69.7%] were have low serum magnesium level. In the remaining patients with non migrainous headache, only 6 patients [12.5%] have low serum magnesium level because of some other causes for example medications. Migraine is frequently associated with Serum low level of Magnesium compare to patient with nonmigrainous headache

Chronic hepatitis C virus; dermatological manifestations of interferon plus ribavirin therapy in patients

To determine the frequency and pattern of dermatological manifestations in patients receiving interferon and ribavarin for hepatitis C. The study was conducted in the Dermatology out patients department [OPD] of Dow University Hospital Karachi from April -November 2013.Patients diagnosed with hepatitis C who received interferon a[3 MIU subcutaneously thrice weekly] plus ribavirin [1200 mg daily for 24 weeks].Detailed history and dermatological examination including mucous membrane, hair and nails was performed initially and then monthly for six months and findings were recorded. A total of 109 patients were included in the study. Frequency of various skin diseases in these patients werepruritis 44[40.36%], transient alopecia 14[12.84%],generalized morbiliform rash in 22 [20.18%],photosensitivity in 8[7.33%], secondary hyperpigmentation in 17[15.59%] patients. Lichen Planus was observed in 6 [5.50%] patients while brittle nails were seen in 5 [4.58%], glossitis in 4[3.66%],chelitis in 8[7.33%]and generalized exfoliating dermatitis in 9[8.25%] patients. Apthous ulceration was observed in 7 [6.42%] patients. HCV and its treatment with interferon plus ribavirin is associated with significant dermatological complications. Physicians should be aware of these side effects and patients should be counseled before starting treatment

Polycystic ovarian syndrome; acne is common presentation in women in relation to menstrual irregularity a study from hospital in Karachi

Polycystic ovarian syndrome is a common disease among the women in reproductive age group and more common in South Asian women. Clinical presentations include menstrual disorders, subfertility, obesity,hirsutism, acne vulgaris and acanthosis. The objective of study was to investigate co relation between acne and polycystic ovaries and its relation to menstrual irregularity. A total of 56women were enrolled in the study from Outpatient Department of Obs and Gynae and Dermatology, Dow University Hosptial, Ojha campus by convenient sampling. It was cross sectional study, conducted from July 2012 to November 2012.Verbal consent was taken. Sociodemographic information,Anthropometric measurement [height, weight, BMI] and acne severity with affected area, menstrual irregularities were administered on pre designed questionnaire.Pelvic ultrasound for polycystic ovaries and serum LH, FSH in follicular phase of menstrual cycle [2nd day] advised from Dow Radiology and Dow Lab respectively. A total of56 patients of PCOS were enrolled during five month period. The mean age of patient was 21.1 +/- SD 0.994. Frequency of acne was 32 [57.1%].The mean BMI was 19.66 +/- SD 4.54. Face was the commonest area involved in 24 [42.9%], menstrual irregularity was found in 50 [89.4%] women. There was no statistically significant relation seen between acne and oligomenorrhea. [X2 = 0.55, P = 0.45]. It was also determined that there was no co relation seen between the acne and serum testosterone level calculated by independent sample t test.[P = 0.17] but statistically significant association seen between severity of acne and serum LH/FSH ratio, [ttest =3.28, p= 0.004] Acne was found in 32 [57.1%] women with PCOS. The study results revealed a significant association seen between severity of acne and serum LH/FSH ratio. Relation between acne and serum testosterone level was statistically insignificant

Psoralen-ultraviolet a treatment with psoralen-ultraviolet B therapy in the treatment of psoriasis

To compare the conventional psoralen-ultraviolet A treatment with psoralen-ultraviolet B therapy in the treatment of psoriasis. We studied 50 patients of plaque type psoriasis who were selected to receive either conventional psoralen-ultraviolet A or psoralen-ultraviolet B treatment. There was no significant difference between the two treatment groups in the number of patients whose skin cleared of psoriasis or the number of exposures required for clearance. Profile of side effects and disease status was also similar after three months of follow up. Psoralen-ultraviolet B treatment is as effective as conventional psoralen-ultraviolet A in the treatment of psoriasis. Further long term studies are needed to assess the safety of psoralen-ultraviolet B

Cutaneous manifestations in Hepatitis C virus infection

To determine the nature and frequency of cutaneous manifestations in patients of Hepatitis C virus [HCV] infection. One hundred HCV positive patients presenting at Dermatology department of Civil Hospital Karachi from January 2008 to December 2008 were enrolled and evaluated for cutaneous manifestations. Relevant data regarding history, physical examination including skin and its appendages and investigations [complete blood counts, liver function tests, Serum Anti HCV antibodies, ultrasound abdomen] were recorded and analyzed. Out of 100 patients [43% males, 57% females] mean age 41 years [Range 12-70 years], pruritus was the most common dermatological feature seen in 35% patients followed by Lichen planus 12% and idiopathic thrombocytopenic purpura in 8% patients. Less common features were urticaria, alopecia areata, porphyria cutanea tarda and cryoglobulenemia. Pruritus, lichen planus and idiopathic thrombocypenic purpura are common Cutaneous manifestations in patients suffering from HCV infections. These are important and sometimes the only presenting feature of HCV infection, therefore health care providers should be vigilant while examining these patients for underlying HCV disease.