RESUMO
Non-cultured epidermal suspension (NCES) is one of the most widely used surgical therapy for stable vitiligo patients in which recipient size preparation plays an important role in the outcome of NCES. The primary objective is to evaluate and compare the efficacy and safety of conventional suspension delivery after manual dermabrasion (CSMD) versus tattooing pen-assisted suspension delivery (TPSD) in NCES. Paired vitiligo units (VU) in 36 patients, matched with respect to size and location were divided into two groups. The VU in Group 1 underwent suspension delivery by CSMD while the VU in Group 2 underwent same by TPSD. All the VU were followed up at regular intervals until 24 weeks. At the end of 24 weeks, 31 VU (86.1%) in Group 1 achieved >75% repigmentation which was significantly higher (p = .02, chi-square test) as compared to 22 VU (61.1%) in Group 2. The color matching in both the groups VU was also comparable (p = .84, chi-square test). The patient global assessment (PGA) was significantly higher in Group 1 VU as compared to Group 2. Treatment response in terms of repigmentation and PGA was significantly better in VU treated with CSMD as compared to TPSD. Recipient site complications were seen more commonly in Group 1 VU as compared to Group 2. Perilesional halo at the recipient site was seen in none of the VU in Group 2 which was significantly lower than 6 VU in Group 1 than (p = .02, chi-square test). Better results may be possible with technical improvisations in tattooing pen needle diameter and depth of penetration.
RESUMO
AIM: The second wave of the coronavirus disease 2019 (COVID-19) pandemic adversely affected an individual's physical and psychological well-being. Events such as nationwide lockdown, isolation, social distancing, loss of jobs, and mortality among close contacts and the neighborhood had a dreadful impact on the psychological well-being of the population. At the time of conducting the present study, limited literature was available on the psychosocial manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Indian population. Hence, the present study was conducted to find out the association between depression, anxiety, stress, and quality of life with inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), D-dimer, serum ferritin, procalcitonin (PCT) in SARS-CoV-2 patients during admission and follow-up in a tertiary care hospital. METHODS: This was an observational analytical study conducted during the second wave of the SARS-CoV-2 pandemic at a designated COVID-19 tertiary care hospital in New Delhi, India. Guidelines provided by the Ministry of Health and Family Welfare; the Government of India, were used for deciding hospital admissions. Sixty patients, confirmed positive by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, aged 18-60 years, were recruited for this study. All study subjects were screened by a rating scale for which the Hindi version of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was employed, and the Hindi version of the 26-item World Health Organization Quality of Life Brief Version (WHOQOL-BREF) was used to assess the quality of life. Special investigations like CRP, IL-6, D-dimer, serum ferritin, and PCT were sent on day one of admission. RESULTS: The prevalence of depression, anxiety, and stress was 63.3%, 85%, and 26.7%, respectively. The mean D-dimer level was found to be 957.32 ± 650.91 ng/ml, mean pro-calcitonin level was 1.04 ± 1.47 ng/ml, mean serum ferritin level was 722.24 ± 486.75 µg/L, mean CRP level was 65.36 ± 35.12 mg/L, and mean IL-6 level was 62.79 ± 49.05 pg/ml. The average score for the physical domain of the WHOQOL-BREF on days 7, 14, and 28 were 66.23, 77.43, and 82.18, respectively. The average score for the psychological domain on days 7, 14, and 28 were 73.93, 78.33, and 86.21, respectively. The average score for social domain on days 7, 14, and 28 were 82.63, 86.38, and 89.73, respectively. The average score for the environmental domain on days 7, 14, and 28 were 78.33, 88.78, and 90.98, respectively. The prevalence and severity of depression were significantly associated with D-dimer, CRP, ferritin, PCT, and Interleukin-6 (p<0.05). The prevalence and severity of anxiety were significantly associated with PCT, IL-6, and CRP (p<0.05). CONCLUSION: SARS-CoV-2 infection adversely affected our study population's mental well-being. An increased prevalence of psychosocial manifestations like depression, anxiety, and stress was noted in participants. We also concluded that increased levels of inflammatory markers (CRP, IL-6, PCT, D-dimer, and serum ferritin) were associated with increased prevalence of psychiatric manifestations like depression.
