Efficacy and safety of narrowband ultraviolet B therapy in moderate to severe atopic dermatitis

Atopic dermatitis is an inflammatory skin disorder with a chronic relapsing course. In troublesome cases of moderate and severe atopic dermatitis, phototherapy can be an effective treatment modality. To evaluate the efficacy and safety of narrowband UVB 311nm as a monotherapy in patients with moderate to severe atopic dermatitis. Patients suffering from moderate to severe atopic dermatitis, diagnosed according to criteria described by Hanifin and Rajka between ages of 6-70 were enrolled in the study. Severity of the disease was assessed by using SCORAD score. UVB irradiation was done thrice a week on alternate days. Efficacy was assessed every two weeks by reduction in modified SCORAD score. The mean cumulative dose of 25.91 J/cm[2] UVB at a wavelength of 31 Inm was given in a mean of duration 5.2 weeks treatment. Therapy reduced the atopic dermatitis scores from mean 32.2 [range 20.2-45.5] to 14.2 range [6.2-12.4]. We conclude that narrowband UVB appears to be a promising treatment for AD, but large patient series, different dosing schedules and long- term safety considerations should be carefully evaluated in the future

Biliary atresia: experience in a Military Hospital

The purpose of this case series is to determine the types of biliary atresias presenting to our department, options available to confirm the diagnosis with appropriate management and their results. A total of 12 patients with suspected biliary atresia presented to the Department of Paediatric Surgery at Military Hospital Rawalpindi. Out of them 11 patients underwent surgical intervention. Age of the patients ranged from 6 weeks to 16 weeks [mean age 68.80 days]. One patient was beyond the scope of biliary drainage. Out of 11 patients operated, operative cholangiography revealed patent extrahepatic biliary tree in 6 patients [55%], thus excluding biliary atresia. One patient [9%] had patency of distal biliary tree with proximal obliteration [Type B] and 4 patients [36%] had complete obliteration of extrahepatic ducts [Type A]. These 5 patients of biliary atresia [45%] underwent traditional Kasai portoenterostomy. Two patients [40%] were stable postoperatively, 2 patients [40%] had gradual deterioration after initial improvement, and 1 patient [20%] died in perioperative period