Comparison of efficacy and safety of topical glyceryl trinitrate vs. oral nifedipine in idiopathic perniosis: results of a randomized clinical trial

To compare the therapeutic efficacy and safety of topical vasodilator glyceryl trinitrate [GTN] 0.4% cream, with systemic nifedipine [10-40mg/day] in patients with idiopathic perniosis [IP]. Patients with IP [n=65] were randomized into group A receiving GTN 0.4% cream [n=31] or group B receiving oral nifedipine, 10-40mg/day [n=34]. They were evaluated for improvement in signs and symptoms and any side effects, every 15 days for six weeks. Primary outcome was efficacy and secondary outcome was side effects. 53 patients completed the study protocol. Twenty-three out of 26 [88%] patients in group A whereas 21 out of 27 [77%] in group B had complete clearance of lesions in six weeks [p=0.52]. Clearance of lesions was achieved earlier [10.9 +/- 6 days] in group B as compared to [16.6 +/- 11.5 days] group A [p=0.05]. GTN 0.4% cream is an effective and safe alternative to oral nifedipine in the treatment of IP. Oral nifedipine leads to clearance of lesions earlier than GTN cream

Comparison of mean platelet volume in patients with psoriasis and healthy individuals

To compare mean platelet volume in patients with psoriasis and healthy individuals. This case control study was conducted in outpatients department and indoor of department of Dermatology, DHQ Hospital, Faisalabad. The duration of study was six months. Thirty consecutive patients of psoriais, 20 to 60 years of age and thirty age and gender matched healthy individuals were selected. 2cc venous blood sample from each subject was sent to the pathology laboratory of DHQ Hospital. Mean platelet volume [MPV] was measured as a part of blood complete analysis in Medonic M series Haematology analser. MPV was found higher in the patients of psoriasis as compared to the healthy individuals. The mean value of MPV in the case group was 8.24 +/- 1.22 fl, whereas in the control group, it was 7.29 +/- 0.77 fl [p<0.05]. The study demonstrated that mean platelet volume is increased in patients with psoriasis as compared to healthy individuals. Such patients are at an increased risk of cardiovascular complications

Prevalence and risk factors of HIV in Faisalabad, Pakistan - a retrospective study

Although the magnitude of HIV in Pakistan has been well documented, but no record of HIV prevalence in Faisalabad region exists. A retrospective study was carried out at Sexually Transmitted Infections [STIs] clinic, District Headquarter [DHQ] hospital, Faisalabad, Pakistan to find out the prevalence of HIV and related risk factors. Between March, 2010 and December, 2012, a total of 31040 subjects were either interviewed or their medical records were reviewed. From those recruited by convenient sampling method, written informed consent was obtained and informed about the study protocol. Blood serum was tested for antibodies to HIV-1 and HIV-2 [Enzyme-linked immunosorbent assay, Western Blot]. On the whole, Anti-HIV was demonstrated in 173 [0.557%] of the respondents. This gives an overall HIV prevalence of 557 per 100,000.Averaged age of the patients was 49.5 years [range: 30-45] with 85.55% male. Majority of the patients were urban dwellers [87.28%], divorced or widowed [46.82%] and uneducated [50.28%]. A large proportion [78%] of the patients was injection drug users. Compared to blood donation/transfusion and sexual interactions, injection drug use was the major potential risk factor for HIV infection. Most important finding was higher HIV prevalence in Faisalabad region as compared to the previous assessments at the national level. This reflects an alarming situation necessitating contextual preventive interventions. Precarious practices such as injection drug abuse, blood donation/transfusion needs to be amended and extramarital sexual contacts should be avoided

Prevalence of diabetic dermopathy in type 2 diabetes mellitus patients

Objective: To assess the prevalence of diabetic dermopathy [DD] in type 2 diabetes mellitus [T2DM] patients

Materials and Methods: In a case control study, seventy-six T2DM subjects underwent dermatological examination after written consent. Biochemical measurements included nonfasting plasma glucose [enzymatic kinetic colorimetry] and glycated hemoglobin [glycohemoglobin spectrophotometry]

Results: Only four diabetic patients [5.3%] had hyperpigmented and retracted atrophic scars of DD on the shins. Patients with diabetic dermopathy had longer diabetes duration [8.0 +/- 4.2 years vs.6.73 +/- 5.71years], elevated plasma glucose [13.88 +/- 2.86 mmol./L vs. 12.30 +/- 2.39 mmol./L] and worse glycemic control [HbA1c 12 +/- 2% vs. 11 +/- 1.83%] than that of diabetics without DD. However, step-wise regression analysis illustrated that development of diabetic dermopathy in T2DM patients is not related statistically to duration of diabetes and glycemic control

Conclusion: Even though the prevalence of diabetic dermopathy in present small diabetic population is low, it is mostly presented by poorly controlled T2DM patients. Frequent dermatological analyses and better glycemic control in large populations are needed to improve prognosis and quality of life in these patients

Spectrum of dermatological conditions in a ruralcommunity

Objective: To determine the prevalence ofdermatological conditions in a rural community

Study Design: Cross-sectional descriptive study

Place and Duration of study: Study was conductedin Tehsil Headquater Hospital Bhawhana in May,2011

Materials and Methods: 300 patientsbelonging to Tehsil Bhawana and surroundingvillages reported in the camp. Forty three patientsboth male and female had dermatological conditionsand were included in the study. They wereevaluated, diagnosed and given treatment forvarious dermatological conditions

Results: Meanage of patients was 24.48 +/- 14.48. Out of thesePatients 17 patients [39.53%] had Scabies,6[13.95%] had Acne Vulgaris, 5[11.6%] hadurticaria, 4 patients [9.3%] had contact dermatitis, 2[4.6%] had pemphigus vulgaris [PV], 2 [4.6%]hadburn injuries, 2 [4.6%] had seborrhic dermatitis and1 patient [2.3%] each of vitiligo and Helmenthicinfections, 3 patients [6.9%] had lichen planus [LP]

Conclusion: Scabies is the most prevalentdermatological condition in rural communities andthe scenario can be improved by improvement in thehygienic conditions and the general publicawareness

Sexually transmitted infections in Pakistan

Sexually transmitted infections [STIs] represent a major global health problem leading to morbidity, mortality and stigma. Prior to this study there was no information on the prevalence and knowledge of STIs in Faisalabad, Pakistan. Prospective, cross-sectional study in patients attending STI clinics from July 2006 to September 2009. After obtaining consent, patients completed structured questionnaires used for behavioral surveys. Blood and urethral swabs were collected and tested for syphilis, gonococcus, genital herpes, chlamydia and chancroid. Mean [standard deviation] age of the 1532 participants was 38.9 [9.4] years, including 37.8 [10.2] years for males and 35.5 [6.3] years females. Male gender [n=1276, 83.3%], low socioeconomic class [n=1026, 67.0%] and residence in rural suburbs [n=970, 63.3%] were more common. Most [n=913, 59.6%] were aware of the modes of transmission of STIs and the associated complications, 20% [n=306] were condom users, and 21.2% [n=324] had knowledge of safe sex. Opposite-sex partners were preferred by 972 [63.4%] patients, while 29.9% [n=458] had both homosexual and heterosexual sex partners. Syphilis was present in 29.5% of patients [n=452]; gonorrhea, in 13% [n=200], HSV-2, in 3.2% [n=49], chlamydia, in 4.7% [n=72] and chancroid, in 1.3% [n=20]. This report establishes baseline local prevalence rates for STIs. Syphilis emerged as the most prevalent STI in Faisalabad. Population-based studies are required to study the epidemiology of STIs, along with initiation of national health-education campaign

Anxiety, depression and self-esteem among chronic skin patients

Objectives: The study was designed to examine anxiety, depression and self-esteem among patients of chronic skin diseases and to explore the split up of patients as per gender

Study Design: Correlational Study

Duration and the Place of the Study: The study was conduced from February 2010 to April 2010 in outdoor of dermatology DHQ hospital Faisalabad and Nishtar Hospital Multan

Patients and Methods: All patients who consented [in case of minors consent taken from guardians/ parents] were included in this correlational study. All patients who refused to participate in the study were excluded and patients who suffering from chronic medical or surgical problems were also excluded.160 patients with different skin diseases participated in it through purposive convenient sampling technique. Anxiety, depression and selfesteem were assessed by using test booklet was comprised of Zung Self-Rating Anxiety Scale, Zung Self-Rating Depression Scale, Rosenberg Self- Esteem Scale and Informed Consent form. The diagnostic criteria of DSM IV TR were employed while demographic variables were recorded on a demographic sheet. SPSS version 10 was used to analyze the raw data by correlation coefficient and the independent-samples t-tests

Results: Results showed that there were positive relationship between anxiety and depression [P<0.05] and negative relationship between depression and selfesteem among chronic skin patients [P<0.01]. It was also found that there is significant difference on anxiety scale among female patients of chronic skin diseases [M=43.18, SD=5.72], and male patients of chronic skin diseases [M=44.71, SD=4.86], where t [158] = 1.798, p=0.037, N=160. Results also showed that female patients of chronic skin diseases have higher level of depression as compared to male patients of chronic skin diseases [M=56.89, 53.81], [SD=5.08, 4.13], where [t=-4.118, df=158, p=0.001] and female patients of skin diseases have lower level of self-esteem as compared to male patients of chronic skin diseases [M=10.64, 11.91], [SD=2.67, 2.66], where [t=2.990, df=158, p=0.0015]

Conclusion: As the psychiatric co morbidity anxiety, depression and self-esteem in patients suffering from chronic skin diseases is so frequent hence the doctors dealing with such patients should be better trained in assessment and management of these disorders

Ketotifen in chronic idiopathic urticaria

This is an open prospective study to see the efficacy and safety of ketotifen in chronic idiopathic urticaria in twenty patients including 9[45%] males and 11[55%] females of 9 years to 49 years of age [Average 28.6 years]. Duration of disease varied from 2 months to 5 years. One mg of ketotifen twice daily was given for 4 weeks with 3 month follow up. Ketotifen was effective and safe and effectively reduced the need of concomitant therapy in the treatment of chronic idiopathic urticaria