Pattern and prevalence of psychiatric disorders among patients attending dermatology OPD.

BACKGROUND: Consideration of psychiatric and psychosocial factors is important for the management and prevention of dermatologic disorders. Dermatology patients suffer commonly from psychiatric comorbidity. AIM: To study pattern and prevalence of psychiatric disorders among patient attending dermatology OPD. METHODS: The study was carried out in Psychiatry department of NIMS Medical College, Jaipur, Rajasthan, a north State of India. The sample was taken from Dermatology department of Medical College. All the participants were diagnosed/confirmed cases of skin diseases. Socio-demographic data was collected. Patients scoring more than 12 on GHQ were examined for presence of psychiatric illness. Clinical interview & Mental Status Examination (MSE) of these patients was carried out to ascertain diagnosis according to ICD-10. FINDINGS: As per ICD-10 diagnosis 34.2% of total sample were diagnosed with definite Psychiatric comorbidity. Maximum number of cases were of Depression 36.32% (N=146) followed by Anxiety disorder 18.41% (74) and 7.96% (N=32) with Somatoform disorder. Obsessive compulsive disorder was diagnosed in 6.47% (N=26) followed by Adjustment disorder 4.98% (N=20) and Alcohol dependence syndrome 4.98% (N=20). Minimum number of cases belonged to Schizophrenia 2.99% (N=12) and Bipolar Affective Disorder 2.99% (N=12). No diagnosis was found in 14.93% (N=60). CONCLUSION: Significant psychiatric comorbidity exists in patients of dermatology. Biopsychosocial approach to patients with skin disease should be sought by liaison between psychiatrist and dermatologist.

Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study.

BACKGROUND: Acne scarring causes cosmetic discomfort, depression, low self-esteem and reduced quality of life. Microneedling is an established treatment for scars, although the efficacy of platelet-rich plasma (PRP) has not been explored much. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of platelet-rich plasma (PRP) combined with microneedling for the treatment of atrophic acne scars. METHODS: Fifty patients of 17-32 years of age with atrophic acne scars were enrolled. Microneedling was performed on both halves of the face. Intradermal injections as well as topical application of PRP was given on right half of the face, while the left half of the face was treated with intradermal administration of distilled water. Three treatment sessions were given at an interval of 1 month consecutively. Goodman's Quantitative scale and Quantitative scale were used for the final evaluation of results. RESULTS: Right and left halves showed 62.20% and 45.84% improvement, respectively, on Goodman's Quantitative scale. Goodman's Qualitative scale showed excellent response in 20 (40%) patients and good response in 30 (60%) patients over right half of the face, while the left half of the face showed excellent response in 5 (10%) patients, good response in 42 (6%) patients and poor response in three patients. CONCLUSION: We conclude that PRP has efficacy in the management of atrophic acne scars. It can be combined with microneedling to enhance the final clinical outcomes in comparison with microneedling alone.

Dose related efficacy of gabapentin in acute herpetic neuralgia among geriatric patients.

BACKGROUND: Herpes zoster is an intractable painful condition, more severe in elderly patients. The pain during the first 30 days of onset is known as Acute Herpetic Neuralgia. Multiple treatments using non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and tricyclic anti-depressants are available, but their side effects limit their use in geriatric patients. Gabapentin is also used in chronic neuropathic pain; however, its role in acute herpetic neuralgia is less explored. AIM: This study was aimed to determine dose related efficacy and safety of gabapentin in reducing pain of acute herpetic neuralgia in geriatric patients. MATERIALS AND METHODS: In this placebo-controlled, four-week trial including 56 subjects, 42 patients received gabapentin in the dosage of 300 mg (n=15), 600 mg (n=14), and 900 mg(n=13) per day in divided doses and 14 patients received placebo within 72 hours of onset of herpes zoster. RESULTS: Subjects receiving gabapentin had a statistically significant reduction (P<0.0001) in visual analog scale (VAS) score as compared to placebo, emphasizing the efficacy of gabapentin in the treatment of acute pain associated with herpes zoster on each assessment (weeks 1, 2, 3, and 4). Gabapentin in doses of 600 mg/day and 900 mg/day was better than 300 mg/day in each visit. However, no difference was observed between gabapentin 600 mg/day and 900 mg/day group at any point of time (P>0.05). CONCLUSION: The results of this study show that gabapentin is effective in acute herpetic neuralgia in different doses with 600 mg/day being the more appropriate dose in terms of safety and efficacy.

A study on efficacy of Pregabalin in acute Herpetic Neuralgia.

BACKGROUND: Herpes zoster is an intractable painful condition. The pain during first thirty days of onset is known as acute herpetic neuralgia. Multiple treatments using NSAIDS, opioids and tricyclic antidepressants are available but the role of pregabalin in acute Herpetic Neuralgia is not assessed in any of Indian studies. PURPOSE: This study was aimed to determine efficacy and safety of Pregabalin in reducing pain of acute Herpetic Neuralgia. METHODS: In this placebo-controlled 4 week trial including 45 subjects, 23 patients received Pregabalin in the dosage of 150 mg/day in divided doses and 22 patients received placebo within 72 hours of onset of Herpes zoster. RESULTS: Subjects receiving Pregabalin had a statistically significant reduction (p<0.0001) in visual analogue scale(VAS) score as compared to placebo, indicating the efficacy of Pregabalin in the treatment of acute pain associated with Herpes zoster. Side effects most commonly noted were somnolence and dizziness. CONCLUSION: The results of this study indicate that Pregabalin is effective in relieving pain of acute Herpetic Neuralgia.