The humanistic burden of vitiligo: a systematic literature review of quality-of-life outcomes.

Despite historical mischaracterization as a cosmetic condition, patients with the autoimmune disorder vitiligo experience substantial quality-of-life (QoL) burden. This systematic literature review of peer-reviewed observational and interventional studies describes comprehensive evidence for humanistic burden in patients with vitiligo. PubMed, EMBASE, Scopus and the Cochrane databases were searched through February 10, 2021, to qualitatively assess QoL in vitiligo. Two independent reviewers assessed articles for inclusion and extracted data for qualitative synthesis. A total of 130 included studies were published between 1996 and 2021. Geographical regions with the most studies were Europe (32.3%) and the Middle East (26.9%). Dermatology-specific instruments, including the Dermatology Life Quality Index (DLQI; 80 studies) and its variants for children (CDLQI; 10 studies) and families (FDLQI; 4 studies), as well as Skindex instruments (Skindex-29, 15 studies; Skindex-16, 4 studies), were most commonly used to measure humanistic burden. Vitiligo-specific instruments, including the Vitiligo-specific QoL (VitiQoL; 11 studies) instrument and 22-item Vitiligo Impact Scale (VIS-22; 4 studies), were administered in fewer studies. Among studies that reported total scores for the overall population, a majority revealed moderate or worse effects of vitiligo on patient QoL (DLQI, 35/54 studies; Skindex, 8/8 studies; VitiQoL, 6/6 studies; VIS-22, 3/3 studies). Vitiligo also had a significant impact on the QoL of families and caregivers; 4/4 studies reporting FDLQI scores indicated moderate or worse effects on QoL. In general, treatment significantly (P < 0.05) improved QoL, but there were no trends for types or duration of treatment. Among studies that reported factors significantly (P ≤ 0.05) associated with reduced QoL, female sex and visible lesions and/or lesions in sensitive areas were most common. In summary, vitiligo has clinically meaningful effects on the QoL of patients, highlighting that greater attention should be dedicated to QoL decrement awareness and improvement in patients with vitiligo.

Biopty gun-driven versus manually-driven tru-cut prostate biopsy; any difference in the yield? Ilorin experience.

OBJECTIVES: To report the outcome in the yield of two techniques of prostate biopsy. PATIENTS AND METHODS: The study was a retrospective review of the experience with digitally guided trans-rectal Tru-cut needle biopsy of the prostate using manuallydriven and the Biopty gun-driven methods. The record of patients who had undergone prostate biopsy was retrospectively reviewed from January 2000 to December 2007. Data extracted included the age, the year of biopsy and/or the method of biopsy, the status of the operator and the histology report of tissue obtained. Data was analysed with the aid of SPSS (Version 11.0) software, the Chi-square test was calculated for the variables and statistical significant P value at P < 0.05. RESULTS: A total of 292 prostate biopsies were undertaken during the review period. One hundred and ninety were gun-driven (65.1%) while 34.9% were manually-driven. A total of 55.5% of the specimens were benign prostate hyperplasia while 28.4% were adenocarcinoma of the prostate on histological examination. Thirty-six per cent of the tissues obtained from manually-driven biopsy were not representative as compared with only 4% of tissue from gun-driven biopsies. There was a significant correlation between the method of biopsy and the likelihood of tissue representativeness for histological appraisal (P<0.0001). CONCLUSION: There was a significant difference in the tissue yield between manuallydriven and the gun-driven Tru-cut needle biopsy of the prostate.. Biopty-driven Trucut needle sampling of the prostate is the recommended procedure in this environment.

Prevalence of hallux valgus among youth population in Lagos, Nigeria.

AIMS AND OBJECTIVE: This study was aimed at evaluating the prevalence of Hallux Valgus (HV) and related foot problems among the youth population in Lagos, Nigeria. SUBJECTS AND METHODS: A structured questionnaire was administered to 1, 200 subjects from 10 secondary schools and undergraduate students of the College of Medicine University of Lagos, Lagos, Nigeria. The participants were requested to provide information on demographic data, severity of HV, and the functional limitation imposed on the participants by HV. Nine hundred and seventy (970) of the 979 returned questionnaires were analyzed using descriptive statistics. RESULTS: The prevalence of HV in this study was 15.4% of which 43.6% and 56.4% were male and female respectively. 36 (3.7%) out of total number of participants had bilateral HV (both feet), 57 (5.9%) and 56 (5.8%) had HV on left and right foot only respectively. Eighty four (25.2%) of the 333 (34.3%) subjects that complained of pain at the first metatarsophalangeal joint had HV. Inability to stand for long periods due to pain at the first metatarsophalangeal joint was reported by 90 (9.3%) participants, while 136 (14.0%) reported inability to walk long distances. CONCLUSION: Prevalence of HV among youths in Lagos, Nigeria is low. HV is more common among females and its prevalence increases with age. More attention should be focused on foot pain and deformities. Preventive measures and education on the HV deformity is advocated.