A Case Of 13-Year-Old Girl With Prolidase Deficiency.

Prolidase deficiency is a rare autosomal recessive disorder characterized by recurrent and nonhealing skin ulcers along with facial dysmorphism and mental retardation. We report a 13-year-old girl who has clinical manifestation of Proliodase deficiency. It is a very rare disorder and no such case has been reported so far from Pakistan.

Efficacy of Trichloro-Acetic Acid Peel Alone Versus Combined Topical Magnesium Ascorbyl Phosphate for Epidermal Melasma.

OBJECTIVE: To compare the efficacy in terms of reduction in melasma area and severity index (MASI) score by more than 10 of a combination of 20% trichloro-acetic acid peel plus 5% topical magnesium ascorbyl phosphate versus 20% trichloroacetic acid peel alone in the treatment of epidermal melasma. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Department of Dermatology, Lady Reading Hospital (LRH), Peshawar, from May 2012 to May 2013. METHODOLOGY: Patients aged 18 - 65 years, with Fitzpatrick skin type III-V were divided into two equal groups having 74 patients each. Detailed history was taken and Wood's lamp examination done to rule out mixed and dermal melasma. Melasma area and severity index (MASI) score was calculated for every patient. Priming was done for all patients with tretinoin cream applied once daily at night for 2 weeks, and to use a broad spectrum sun block cream before sun exposure. Patients in group Awere subjected to combined treatment, i.e. trichloro-acetic acid peel 20% (weekly) plus magnesium ascorbyl phosphate cream (applied once daily), while patients in group B were subjected to trichloro-acetic acid peel 20% (weekly) alone. Treatment was continued for 6 weeks. After completion of treatment, MASI score was recalculated. Proportion of patients with significant MASI score reduction was compared using chi-square test with significance at p < 0.05. RESULTS: Male and female patients were 11 (14.9%) and 63 (85.1%), respectively in group A, whereas 13 (17.6%) and 61 (82.4%) in group B. The mean age in group Awas 30.28 ±8.08 years, and 29.36 ±6.84 years in group B. Significant MASI score reduction in group Awas seen in 60 (81.1%) patients and in group B 49 (66.2%, p= 0.040). CONCLUSION: Combination of trichloro-acetic acid peel and topical magnesium ascorbyl phosphate cream was significantly more effective than trichloro-acetic acid peel alone in treatment of melasma.

Cryptosporidiosis Among Children Of District Skardu, Pakistan.

BACKGROUND: Cryptosporidiosis is a common cause of persistent diarrhoea in children in developing countries. Previously it was thought to be a major pathogenic organism in immuno-compromised children, but recent studies have shown it to be a common infectious agent in immune-competent children as well. METHODS: This descriptive case-series was carried out at Combined Military Hospital Skardu, Pakistan from August 2014 to June 2015. Fifty-three children aged 12 months to 12 years with history of persistent watery diarrhoea for more than 2 weeks, with no blood or mucous in it and no other systemic findings, were included in the study. RESULTS: We examined 53 stool specimens from children with persistent diarrhoea for the presence of cryptosporidium as well other pathogenic organisms. There were 22 (41.5%) females and 31 (58.5%) males. Out of 53 samples, 11 (20.8%) samples were found to be positive for cryptosporidium. Twenty-seven (50.9%) samples were found to be negative for any intestinal pathogen. CONCLUSIONS: It is concluded from this study that cryptosporidium is a very common infectious organism of persistent diarrhoea in this part of the country.