RESUMO
Background: Facial acne scars are perceived negatively by society; in an era where everyone wants to look their best, acne and its sequelae are a great source of stress driving down self-worth and elevating the risk of depression and anxiety. It affects over 95% of acne patients, particularly in nodulocystic, conglobate, and fulminans varieties. Various treatment modalities are available, but no single modality is 100% curative. Microneedling produces controlled skin injury, releasing various growth factors and setting up a healing cascade, and laying down collagen as a result. Hyaluronic acid plays an important role in wound healing by creating physiological conditions in the extracellular matrix for the proliferation, migration, and organization of dermal cells. Aims and Objectives: To compare the therapeutic efficacy and safety of microneedling alone and microneedling with hyaluronic acid in acne scars. Materials and Methods: Sixty patients of age 18-40 years with clinically diagnosed acne scars were recruited and randomly divided into two groups of 30 each. Three sittings were done at an interval of 3 weeks of microneedling alone to Group A and microneedling with hyaluronic acid to Group B and followed up with two visits 4 weeks apart. Scoring was done with Goodman Quantitative Global Scarring Grade System. Side effects, patient satisfaction score, and pre and postprocedure Dermatological Life Quality Index (DLQI) were also recorded. Results: The female:male ratio was 3:2, mean age was 26.90 ± 4.90 years in Group A and 24.43 ± 5.39 years in Group B. Overall, 60% patients had a duration of 2-5 years, and unmarried patients outnumbered married ones in both groups. The combination morphology of the scars was the most common finding. In Group A mean Goodman Quantitative Global Scarring Grade System score reduced from baseline 24.13 ± 7.96 to 16.3 ± 7.2, and in Group B, from 27.73 ± 7.86 to 18.20 ± 7.12 at 17 weeks, this decrease was gradual and statistically significant. The patient satisfaction score for Group B (6.20 ± 1.45) was only slightly higher than that of Group A (5.73 ± 1.31). DLQI for Group A decreased from 7.77 to 4.10 and in Group B from 7.63 to 5.00. Both procedures were safe, with over 80% patients experiencing no side effects. Conclusion: The majority of patients showed "moderate" improvement in both groups; however, more patients in microneedling with hyaluronic acid group showed "good" and "very good" results at the end of the treatment completion. These are easy, office-based procedures not requiring training or any high-end machine, especially useful in resource-limited setups; the use of hyaluronic acid can enhance the efficacy of microneedling alone.
RESUMO
Introduction: Lichen sclerosus (LS) is a chronic dermatosis frequently located over labial, perineal, and perianal areas. The etiology is multifactorial and includes genetic, autoimmune, hormonal, and infectious aspects. Materials and Methods: A series of twenty genital LS patients was carried out to evaluate the signs, symptoms, complications, and affliction of quality of life. Results: Eighteen out of twenty patients were female between 30 and 73 years and showed smooth, glistening, and whitish plaques. The mean duration was 8.4 years. Itching and burning was the most common symptom (75%) corresponding to excoriation and fissuring of genitalia (75%). Malignancy was seen in two cases (10%). The mean Vulvar Quality of Life Index was 9.2, higher in younger patients. Discussion: LS is a disorder of older age group with female preponderance. It is a source of significant morbidity, and long-standing cases predispose to vulvar malignancy. Conclusion: To conclude, early diagnosis with proper counselling of the patient and his/her partner regarding various aspects of disease are essential for a wholesome approach.
RESUMO
Smoking is a common habit prevalent in both the urban and rural areas in India. Smoking is a well-known risk factor for chronic obstructive pulmonary disease (COPD), a group of lung diseases that includes emphysema and chronic bronchitis. Pulmonary-function tests provide objective, quantifiable measures of lung function. The objective of the present study was to study and compare the pulmonary function tests among smokers and non-smokers in a rural area, to study the role of possible associated factors and relation of type, quantity and duration of smoking on the pulmonary function tests in Rural Maharashtra. The pulmonary function tests were assessed on computerized spirometer in 400 male subjects comprising of 200 smokers and 200 non smokers. Almost all the pulmonary function parameters were significantly reduced in smokers, more commonly in those aged 50 years and above. Obstructive pulmonary impairment was commonest among smokers. Thus by spirometry a spectrum of lung disorders may be detected at an early stage and subsequent morbidity can be minimized.
