ABSTRACT
BACKGROUND: There has been a lot of recent search on consideration of psoriasis as a systemic disease, with researchers being of the view that dermatological manifestations represent only a part of the spectrum. Although, there have been plenty of studies from the west reporting an association of psoriasis with the metabolic syndrome, there are no large-scale Indian studies evaluating Asian patients. The present study is an endeavour in this regard. AIM: To investigate the prevalence of metabolic syndrome in Indian patients with newly diagnosed psoriasis at the onset of the disease. METHODS: The study is a prospective clinical case control study, with 100 patients of psoriasis and 100 age-matched healthy controls. 5ml plain venous blood after overnight fasting was obtained by venepuncture. Plasma glucose was tested by glucose oxidase method. Serum cholesterol and triglycerides was estimated by enzymatic method. Metabolic syndrome was diagnosed by the presence of three or more criterion of the National Cholestrol Education Programme's Adult Panel (ATP). The statistical software SAS 9.2 and SPSS 15.0 was used for the analysis of the data. RESULTS: Metabolic syndrome was diagnosed in 8 out of 100 cases and 9 out of 100 controls (p-value: 0.811). We did not find any association of psoriasis with metabolic syndrome in our study. The age of onset of the disease, the duration of the disease and the severity of the disease activity were also not found to be associated with the likelihood of developing metabolic syndrome. CONCLUSION: Our study refuted any association of psoriasis with metabolic syndrome at the onset of disease activity in Indian patients. The plenty of reports from west approving such an association can be explained by increased risk factors like smoking, alcohol consumption, obesity and stress levels. Further, most such studies have been conducted with patients on treatment, while ours is the first study on newly diagnosed patients prior to the initiation of any therapy.
ABSTRACT
BACKGROUND: Over the years, acyclovir has been the oral antiviral agent approved for the treatment of patients with acute herpes zoster,Its effectiveness in lessening the acute signs and symptoms of herpes zoster has been established but the effects on post herpetic neuralgia are less clear cut. Famciclovir is a new member of guanine nucleoside family of drugs. It is a well absorbed oral form of penciclovir with longer half life. This was a open comparative randomized study carried out to compare the safety and efficacy of famciclovir administered at 250mg thrice daily with acyclovir 800mg five times daily for the treatment of acute uncomplicated herpes zoster in immunocompetent individuals aged above 40 years. AIM: To assess the clinical profile of Herpes zoster, compare the efficacy and safety of acyclovir and famciclovir in the treatment of herpes zoster and to describe the effectiveness of acyclovir and famciclovir preventing post herpetic neuralgia. METHODS: A total of 100 newly zoster were randomized in 1:1 ratio into acyclovir and famciclovir groups after inclusion criteria were satisfied.Treatment was initiated within 72 hrs of onset of symptoms and was continued for 7 days and evaluated at the end of each week up to six weeks period for full crusting of the lesions, complete healing of the lesion and loss of acute pain. RESULTS: It was observed that famciclovir was as effective as acyclovir with no significant difference in time taken for full crusting, complete healing of lesions or loss of acute pain. Famciclovir was well tolerated with a better safety profile comparable to that of acyclovir. Constipation, headache, nausea and vomiting were the most commonly reported adverse effects, but constipation was considered to have a possible relationship to treatment. CONCLUSION: In conclusion, oral famciclovir administered three times daily for 7 days during acute zoster infection is as effective as acyclovir, administered 800mg five times daily.In addition it offers significant benefit by providing a well tolerated, cost effective, convenient dosage regime and accelerated rate of lesion resolution and a reduced duration of PHN.
