Epidemiological features of cutaneous leishmaniasis endemic in hilly areas of district Karak, Khyber-Pakhtunkhwa province of Pakistan.

Cutaneous leishmaniasis is a vector borne infection caused by flagellated parasitic protozoans of the genus Leishmania. This is an emergent threat and endemic in areas of tropic and sub-tropics and has a wider geographical distribution. This study was aimed to find the epidemiological aspects of cutaneous leishmaniasis during the recent epidemic in district Karak in 2018-2019. The suspected patients of leishmaniasis from different areas of district Karak were examined. We came across 803 cases during six-month period from August 2018 to January 2019. A major portion (> 37%; n = 299) of these patients were in age 11-20 years. The infection rate was higher in female (55.3%; n = 803) compared to males (44.6%; n = 803). Both gender and age showed a significant effect on the occurrence of infection. It is concluded that cutaneous leishmaniasis has appeared as a major health issue in district Karak. The current study report CL outbreak in Karak district which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreaks.

Efficacy Of Micro-Needling On Post Acne Scars.

BACKGROUND: Acne effects 80-90% of teenage population all around the world. Resulting scars can lead to facial disfigurement and psychological issues in affected population. To counter this problem many treatment options have been tried including resurfacing lasers, dermabrasion, peeling, fillers, platelet rich plasma therapy etc. All have shown variable results. Among these modalities, micro needling is showing promising results in treatment of acne scars due to collagen induction. This study was conducted to assess efficacy and safety of micro-needling on acne scars. METHODS: In this cross-sectional study a total of 50 patients (female 35, male 15) underwent treatment for post acne scarring, 4 sessions of micro-needling were done under local anaesthesia 3 weeks apart over the span of 2 months. Initial and follow up qualitative assessment was done. Photographs were taken of each patient on their subsequent visit, they were analysed and compared for final results. Grading was done by using Goodman Baron scale. RESULTS: 70% (35) were females and 30% (15) were males with mean age of 27.31±4.41 ranging from 19-35 years. After the treatment of scars, 73% (08) of Grade 4 scars have showed improvement by 2 grades, remaining 27% (03) showed improvement to Grade 3. In 20 patients with Grade 3 scars, 30% (06) showed improvement by 1 grade. Remaining 70% (14) improved by 2 grades. All patients with Grade 2 scar downgraded to grade 1 after treatment. Chi-square test was used to assess pre-treatment and post treatment grading improvement among subjects and was statistically significant. (X2=30.010 p=000).. CONCLUSIONS: Micro needling is an effective tool for aesthetic improvement of post acne scarring.

Efficacy of tranexamic acid in reducing blood loss in total knee replacements.

OBJECTIVE: To assess the efficacy of tranexamic acid in reducing blood loss in total knee replacement. METHODS: The retrospective study was conducted at Quaid-e-Azam International Hospital, Islamabad, Pakistan, and comprised data of patients who underwent total knee replacement between January 2012 and December 2014. The effect of tranexamic acid on postoperative haemoglobin, hematocrit and number of blood units transfused was noted and compared between cases who had received standard dose of tranexamic acid with those who had not received it. SPSS 19 was used for data analysis. RESULTS: A total of 416 knee replacement surgeries were conducted during the study period and involved 254 patients; 76(30%) men and 178(70%) women. The overall mean age was 62.2±9.6 years (range: 36-87 years). Tranexamic acid was used in 162(74%) patients and was not used in 92(36%). When it was used, only 26(16%) patients required blood transfusion, but when it was not used, 35(39.1%) required transfusion (p<0.05). CONCLUSIONS: Tranexamic acid was able to reduce total blood loss and transfusion requirements.