Efficacy of Nd:YAG Laser 1064-nm in the Treatment of Onychomycosis.

OBJECTIVE: To assess the effectiveness of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser 1064 nm in the management of onychomycosis. STUDY DESIGN: Descriptive observational study. Place and Duration of the Study: Department of Dermatology, PNS Shifa Hospital, Karachi, Pakistan, from December 2022 to May 2023. METHODOLOGY: Thirty patients, of either gender, aged between 20 and 60 years, with a clinical diagnosis and a positive KOH test for onychomycosis. Long-pulsed 1064-nm Nd:YAG laser therapy was administered to patients. On the basis of nail plate thickness, laser therapy was given once a week for a month at a speed of 25 mm/sec and a spot diameter of 4 mm, with fluencies ranging from 40 - 60 J/cm2. Before and six months' post-treatment, the patients' photos were taken and were evaluated based on dermoscopic results and clinical improvement. RESULTS: The patients' average age was 40.20 ± 15.85 years, and their average duration of disease was 3.0 ± 1.41 years. Six (20%) were males and 24 (80%) cases were females. The most prevalent clinical type was distolateral subungual onychomycosis 22 (73%). Fourteen (46.6%) cases showed excellent improvement, 6 (20%) cases showed good improvement, and 10 (33.3%) cases showed mild improvement. CONCLUSION: Long-pulsed Nd:YAG laser is a safe and efficient option for onychomycosis because of its high clinical cure rates, lack of side effects, and clinical therapeutic efficacy. KEY WORDS: Onychomycosis, Nd:YAG laser 1064-nm, Dermatology, Nail, Lasers in dermatology.

Topical Tacrolimus Ointment Alone versus in Combination with Microneedling for Refractory Stable Vitiligo.

OBJECTIVE: To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable vitiligo. STUDY DESIGN: Comparative cross-sectional study. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from December 2022 to May 2023. METHODOLOGY: The study included 30 clinically diagnosed individuals of either gender who had refractory symptoms and aged between 20 and 60 years. For every patient, two comparable lesions on two comparable limb regions were selected. Group A (right side) received treatment with both topical tacrolimus ointment 0.1% twice daily in addition to microneedling every two weeks, whereas, Group B (left side) was treated with topical tacrolimus ointment 0.1% only. Every lesion was investigated as a separate entity. Both groups were subsequently observed for a further six months. RESULTS: When topical tacrolimus ointment 0.1% was combined with microneedling, the total re-pigmentation rate was substantially higher than the usage of tacrolimus ointment 0.1% alone. Fifty-three percent of lesions treated with topical tacrolimus ointment 0.1% alone and 76.7% of lesions treated with microneedling in conjunction with it showed a good-to-excellent response. No adverse negative effects were noted. During the follow-up period, no problems or recurrences were noted. CONCLUSION: Tacrolimus ointment combined with microneedling is a successful treatment for refractory stable vitiligo. KEY WORDS: Dermapen, Depigmentation, Microneedling, Tacrolimus ointment, Vitiligo.

Shelf-life extension of Fragaria × ananassa Duch. using selenium nanoparticles synthesized from Cassia fistula Linn. leaves.

Fragaria × ananassa Duch. (Strawberry) fruit is susceptible to postharvest diseases, thus decrease in quality attributes, such as physiological and biochemical properties leads to decrease in shelf life. The objective of the present study was to check the effect of Selenium NP's and packaging conditions on the shelf life of strawberry (Fragaria × ananassa Duch) fruits. The shelf life was observed with 4 days intervals and examined for characteristics such as physiological weight loss, moisture content, percentage decay loss, peroxidase, catalase, and DPPH radical scavenging. The quality change of postharvest Fragaria × ananassa Duch. was monitored by the application of selenium nanoparticles (T1 plant extract in 10 mM salt solution, T2 plant extract in 30 mM salt solution, T3 plant extract in 40 mM salt solution, T4 distilled water; control) in different packaging materials (plastic bags, cardboard, and brown paper) at different storage conditions (6°C and 25°C). 10 mM, 20 mM, and 30 mM solution of sodium selenite salt, prepared from 1 M stock solution. Selenium nanoparticles were synthesized using Cassia fistula L. extract and sodium selenite salt solution. Polyvinyl alcohol (PVA) was used as a stabilizer. The nanoparticles were characterized through UV-visible spectroscopy and X-Ray diffractometer (XRD). It was observed that the strawberry Fragaria × ananassa Duch. Treated with T1 (CFE and 10 mM salt solution) stored in plastic packaging at ±6°C showed the best physiological parameters and hence the treatment is recommended for storage without affecting the quality of strawberry fruit up to 16 days.