scholarly journals Comparison of effects of 5% hydroquinone cream plus non-ablative fractional 1540 erbium YAG laser and 5% hydroquinone cream alone in the treatment of melasma

Author(s):  
Mohammadreza Ranjkesh ◽  
Sanay Azizifard ◽  
Hamideh Azimi alamdari ◽  
Neda Ghorbani Khosroshahi

Background: Melasma is an acquired Hypermelanosis often difficult to treat. In this study, we assessed efficacy and safety of 5% hydroquinone cream plus non-ablative fractional 1540 erbium YAG laser and 5% hydroquinone cream alone in the treatment of melasma Methods: We selected 40 patients of melasma aged between 18 and 60 years for the study. Group 1 were treated with a cream of 5% hydroquinone and group 2 treated with a solution of hydroquinone 5% plus three sessions of non-ablative fractional 1540 erbium YAG laser at monthly interval. Improvement was assessed by the melasma-area-and-severity-index (MASI) score. Results: The two groups did not differ significantly in (MASI( score in the first month of treatment (p = 0/135), while during the second to fifth months, there were significant differences between the two groups (p <0.05) and (MASI( score was more reduced in the second group. The two groups did not show significant differences in the incidence of complications (erythema, hyperpigmentation, hypopigmentation). (p= 0/746, 0/158, 0/574, 0/135, 0/135 respectively, the first month, second month, third month and fourth month) Conclusion: A combination of hydroquinone and laser therapy had better results in the treatment of melasma. But due to some disagreements about the use of lasers in the treatment of melasma we recommend more studies with larger sample size to be taken to definitely show better therapeutic effect of laser.

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Pei-Lin Huang ◽  
I-Ching Lee ◽  
De-Chan Tsai ◽  
Jen-Ho Tsai ◽  
Vincent F. S. Tsai ◽  
...  

Abstract Background To evaluate the efficacy and safety of Holmium YAG laser circumcision in adolescents. Methods Eighty-one patients underwent circumcision for medical reasons, and patients’ requests were collected retrospectively during February 2017 to February 2019. They were divided into two groups: Holmium YAG laser (group 1, n = 41) and conventional group (group 2, n = 40). The guillotine method with a Holmium YAG laser was applied for circumcisions, and all the procedures were performed by a single urologist who was well-experienced with circumcision practices. Results The average age of group 1 was 15.53 ± 7.35 years old, and the average age was 16.34 ± 9.22 years old in group 2. There was no significant difference in age and indications. The average operative time was significantly shorter in group 1 than in group 2 (24.40 ± 3.94 vs. 27.25 ± 4.35 min, p < 0.01). The estimated blood loss was less in group 1 compared to group 2. There were fewer complications in group 1 than in group 2 (3/41 vs. 10/40, p < 0.01) and patients also felt less pain in group 1 (p < 0.01). All patients tolerated this procedure without severe side effects. Conclusions The use of Holmium YAG laser in circumcision is a novel, less complicated, easy, and less painful alternative procedure for circumcision in young males.


2021 ◽  
pp. 1-10
Author(s):  
Ahmed Sleibi ◽  
Anwar R. Tappuni ◽  
Aylin Baysan

Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45–92 years) with primary root caries (<i>n</i> = 184 root carious lesions) and unstimulated salivary flow rate of &#x3c;0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (<i>n</i> = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (<i>n</i> = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (<i>n</i> = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (<i>n</i> = 35) in group 2 (<i>p</i> &#x3c; 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, <i>n</i> = 60, 83.3%) (group 2, <i>n</i> = 66, 74.2%) (<i>p</i> = 0.36), and (group 1, <i>n</i> = 60, 89.6%) (group 2, <i>n</i> = 67, 81.7%, <i>n</i> = 1 soft, 1.2%) (<i>p</i> = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (<i>p</i> &#x3c; 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.


SLEEP ◽  
2019 ◽  
Vol 43 (6) ◽  
Author(s):  
Sina A Gharib ◽  
Amanda L Hurley ◽  
Michael J Rosen ◽  
James C Spilsbury ◽  
Amy E Schell ◽  
...  

Abstract Obstructive sleep apnea (OSA) has been linked to dysregulated metabolic states, and treatment of sleep apnea may improve these conditions. Subcutaneous adipose tissue is a readily samplable fat depot that plays an important role in regulating metabolism. However, neither the pathophysiologic consequences of OSA nor the effects of continuous positive airway pressure (CPAP) in altering this compartment’s molecular pathways are understood. This study aimed to systematically identify subcutaneous adipose tissue transcriptional programs modulated in OSA and in response to its effective treatment with CPAP. Two subject groups were investigated: Study Group 1 was comprised of 10 OSA and 8 controls; Study Group 2 included 24 individuals with OSA studied at baseline and following CPAP. For each subject, genome-wide gene expression measurement of subcutaneous fat was performed. Differentially activated pathways elicited by OSA (Group 1) and in response to its treatment (Group 2) were determined using network and Gene Set Enrichment Analysis (GSEA). In Group 2, treatment of OSA with CPAP improved apnea-hypopnea index, daytime sleepiness, and blood pressure, but not anthropometric measures. In Group 1, GSEA revealed many up-regulated gene sets in OSA subjects, most of which were involved in immuno-inflammatory (e.g. interferon-γ signaling), transcription, and metabolic processes such as adipogenesis. Unexpectedly, CPAP therapy in Group 2 subjects was also associated with up-regulation of several immune pathways as well as cholesterol biosynthesis. Collectively, our findings demonstrate that OSA alters distinct inflammatory and metabolic programs in subcutaneous fat, but these transcriptional signatures are not reversed with short-term effective therapy.


2021 ◽  
Vol 13 (3) ◽  
pp. 200-210
Author(s):  
A. G. Prityko ◽  
K. V. Osipova ◽  
P. L. Sokolov ◽  
E. A. Ezhova ◽  
I. G. Kotel’nikova ◽  
...  

Objective: to prove the therapeutic equivalence and similar safety profile of “Sibazon, rectal solution” (international nonproprietary name: diazepam) and “Sibazon, solution for intravenous and intramuscular administration” in children with primary generalized and bilateral tonic, clonic and tonic-clonic seizures.Material and methods. An open-label, randomized clinical trial on efficacy and safety was conducted in 20 patients suffering from epilepsy with generalized seizures aged 1 to 17 years. Clinical blood and urine tests, biochemical blood analysis were used for diagnostics (glucose, total protein, albumin, total bilirubin, cholesterol, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase, alkaline phosphatase, creatinine, urea, creatinine clearance), as well as data on electrocardiographic (ECG) and electroencephalographic (EEG) studies. The patients were divided into two groups: in Group 1 (n=8), a rectal solution was used, in Group 2 (n=12) – a solution for intravenous and intramuscular administration.Results. The number of cases in which seizures were completed within 10 minutes after using the drug without resuming within subsequent 60 minutes, in Group 1 was 7 (87.5%), and in Group 2 – 9 (75.0%) (Fisher exact test (FET): p=0.617). Repeated primary generalized or bilateral tonic/clonic/tonic-clonic seizures within 24 hours after drug administration, in Group 1 were absent in 5 (62.5%) patients, in Group 2 – in 6 (50%) (FET: p=0.670); within 48 hours after drug administration – in 5 (62.5%) and 7 (58.3%) children, respectively (FET: p=1.00). Physical examination revealed no pathology in all patients at the final visit. While comparing ECG and EEG data at the final visit, no inter-group differences were found by the number of children with deviations from the norm. The results of laboratory studies confirmed that using the studied drugs had no negative effect on the main indicators of clinical and biochemical blood tests as well as clinical urine analysis.Conclusion. The effectiveness of the rectal form of Sibazon in relieving pediatric generalized epileptic seizures is comparable to that of Sibazon for intramuscular administration. The drug rectal form, due to easy-to-use administration, is preferable for outpatient practice. “Sibazon, rectal solution” is safe and has good tolerability.


2021 ◽  
pp. 106-117
Author(s):  
S. K. Zyryanov ◽  
O. I. Butranova ◽  
A. V. Ershov ◽  
Z. Sh. Manasova

Introduction. The high incidence of community-acquired pneumonia and the high complication rates in the cases of severe pneumonia actualize the search for new pharmacotherapy tools to improve the effectiveness of standard patient management regimens. A high level of severe inflammatory response underlies the high risk for developing septic complications of pneumonia, along with impaired immune responses.The aim is to evaluate the efficacy of azoximer bromide introduction in the combination therapy regimen for hospitalized patients with moderate to severe community-acquired pneumonia.Materials and methods. A prospective, open label, parallel group, randomized study comparing the efficacy of azoximer bromide introduction in the combination therapy of hospitalized patients with moderate to severe community-acquired pneumonia was conducted at the premises of Federal Scientific and Clinical Center for Reanimatology and Rehabilitation. 30 patients were included in the study group and 37 patients in the comparator group. The baseline characteristics were comparable in both groups. Results. The azoximer bromide introduction in the combination therapy of patients with community-acquired pneumonia led to a statistically significant reduction in the duration of hospital stay (Me (LQ; HQ): 9 (8; 10) days for the study group and 13 (10; 14) days for the comparator group, (p = 0.000078), duration of ICU stay (Me (LQ; HQ) 2 days (1.5; 2.5) and 5 days (5.0; 6.0), respectively, (p = 0.00001), the duration of febrile fever 5 (± 0.6) days versus 10 (± 1.2) days (p = 0.0000), the incidence of acute respiratory failure (13.33% in group 1 versus 37.84% in group 2, p = 0.024) and septic shock (10% in group 1 versus 32.43% in group 2, p = 0.0285).Conclusions. The azoximer bromide introduction in the standard therapy regimen for patients with community-acquired pneumonia allowed to reduce the duration of hospital stay, the duration of ICU stay, the length of febrile fever, the incidence of septic shock and respiratory failure. The possible mechanisms of action may include a reduction of the severe inflammatory reactions and an optimization of the patient's immune response to the infectious process.


Author(s):  
ONER SAKALLIOGLU ◽  
EMRAH GÜLMEZ ◽  
YAVUZ SULTAN SELIM YILDIRIM ◽  
HASAN CETINER ◽  
SERTAC DUZER ◽  
...  

Purpose: The aim of this study to investigate the effect of bromelain-arnica gel combination on periorbital edema and ecchymosis seen after open septorhinoplasty. Methods: Sixty patients who performed open septorhinoplasty with osteotomies were included to the study. These patients were allocated into two groups: in group 1, 30 patients as control and in group 2, 30 patients as study group who were treated with topical bromelain-arnica gel after surgery. Scoring of eyelid edema and peroirbital ecchymosis were evaluated on the first, third and seventh postoperative days using scale of 0 to 4 used by observers. Results: We observed that the administration of topical bromelain-arnica gel after surgery was effective clinically and statistically in decreasing the score of both edema and ecchymosis in open septorhinoplasty with ostetomies. In group 2 patients, periorbital edema and ecchymosis scores were significantly lower compared to control group (p < 0.05). Conclusions: Our results support that topical administration of bromelain and arnica gel combination provided both clinically and statistically significant reduction in periorbital edema and ecchymosis following septorhinoplasty.


EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Giannotti Santoro ◽  
L Segreti ◽  
G Zucchelli ◽  
V Barletta ◽  
F Fiorentini ◽  
...  

Abstract Introduction the management of patients with infection or malfunction of a cardiac implantable electronic device (CIED) may be challenging. Purpose The aim of the study is to evaluate the safety and efficacy of transvenous lead extraction (TLE) in elderly patients. Methods a retrospective analysis of patients who underwent to TLE in our center was performed. Patients were divided in two groups: 1) patients 80 years of age or older, 2) patients younger than 80 years. All patients were treated with manual traction or mechanical dilatation. Results our analysis included 1316 patients, with a total of 2513 leads extracted. Group 1 (≥80 years) counted 202 patients and group 2 (&lt;80 years) 1114 patients. The group of elderly patients presented more comorbidities, as hypertension, chronic kidney disease, atrial fibrillation and pulmonary disease. Patients 80 years of age or older had more pacemakers than ICDs, whereas the dwelling time of the oldest lead, the number of leads and the presence of abandoned leads was similar despite patients age. In group 1 the rate of radiological success for lead was higher than in group 2 (99.0% vs 95.9%; P &lt; 0.001). The clinical success was obtained in 1273 patients (96.7%), without significative differences between groups (98.0% vs 96.4%; P = 0.36). Major complications occurred in 10 patients (0.7%), without significative differences (1.5% vs 0.6%; P = 0.24) (figure 1). Conclusion TLE in elderly patients is a safe and effective procedure. In patients older than 80 years there are not more major complications than in younger patients, and the efficacy of the procedure seems to be superior. Abstract Figure 1


2006 ◽  
Vol 21 (4) ◽  
pp. 258-262 ◽  
Author(s):  
Rodrigo Paschoal Prado ◽  
Richard Eloin Liebano ◽  
Bernardo Hochman ◽  
Carlos Eduardo Pinfildi ◽  
Lydia Masako Ferreira

PURPOSE: To develop an experimental model to be used in the study of low level Laser therapy on viability of random skin flap in rats. METHODS: The sample was 24 Wistar-EPM rats. The random skin flap measured 10 x 4 cm and a plastic sheet was interposed between the flap and donor site. Group 1 (control) underwent sham irradiation with diode laser (830 nm). Group 2 was submitted to laser irradiation with diode laser (830 nm). The animals were submitted to Laser therapy with 36 J/cm² energy density (72 seconds) immediately after the surgery and on the four subsequent days. The probe was usually held in contact with the skin flap surface on a point at 2.5 cm cranial from the flap base. On the seventh postoperative day, the percentage of necrotic area was measured and calculated. RESULTS: Group 1 reached an average necrotic area of 48.86%, Group 2 - 23.14%. After the statistic analysis, compared with the control group, Group 2 showed a statistically significant increase in survival area (p<0.001). CONCLUSION: The experimental model proved to be reliable to be used in the study of effects of low level laser therapy in random skin flap in rats.


2002 ◽  
Vol 2 ◽  
pp. 1070-1078 ◽  
Author(s):  
Nicolas Padilla ◽  
Rosalinda Diaz ◽  
Alfonso Alarcon ◽  
Roberto Barreda

This study sought to examine whether the administration of quinfamide at 3- or 6-month intervals diminished the frequency ofEntamoeba histolyticacysts in stool samples compared to controls. The prospective, longitudinal, randomized, single-blind study examined children from six primary schools in Celaya and Neutla, Guanajuato. Of the 1,524 students in these schools, we selected participants for the study as follows: Children were included in the study if their parents agreed in writing to the study and if the children demonstrated evidence ofE. histolyticacysts after a parasitoscopic analysis by concentration (PSC) in three samples over consecutive days using Faust’s method. Those included in the study received a single 4.3-g/kg dose of quinfamide, and we performed PSC on days 5, 6, and 7 following dose administration to examine whether quinfamide had affected the presence of the cysts. The study participants who tested negative for cysts were divided into three groups: Group 1 had 102 patients who underwent quinfamide treatment and three CPS analyses after the 12 months of the study; Group 2 had 98 subjects who underwent the quinfamide treatment and three CPS analyses at months 3, 6, 9, and 12 after their entrance into the study; and Group 3 had 102 patients, who underwent the quinfamide treatment and series of three CPS analyses at months 6 and 12 of the study. All participants received the dose of quinfamide after providing stool samples and after a clinical gastrointestinal history was obtained. Further clinical gastrointestinal data were collected 5 days after the quintamide dose was administered. We used EpiInfo 6.0 for statistical analysis, calculatingX2andpvalues for the clinical data and the CPS data after the 12 months concluded. Of the initial samples of 1,524 subjects, 308 (20.2%) had Entamoebic cysts. Of these, six were further eliminated because they did not meet the inclusion requirements. At the conclusion of the study, Group 1 presented with 37.6% of subjects still testing positive for cysts; of Group 2, 12.5% tested positive; and in Group 3, 23.5% of participants tested positive for cysts (X2= 16.8; df = 2;p= 0.0002). For comparisons of groups 1 and 2 and 1 and 3,p> 0.05. We conclude that antiamoebic chemoprophylaxis can be a choice for control of amoebic infection where personal hygiene and food consumption habits are not improving.


Author(s):  
Hemavathi G. ◽  
Jagruthi C.

Background: Mid trimester termination of pregnancy is one of the most controversial areas of gynecological practice. It has moral, emotional, social and technical issues. This study was designed for comparison of efficacy and safety of Mifepristone-Misoprostol combination with exrtaamniotic Ethacridine Lactate-misoprostol for termination of second trimester pregnancy.Methods: The present was undertaken among the patients admitted to hospitals attached to J.J.M. Medical College; Bapuji hospital, Women and Children hospital and Chigateri general hospital Davangere during the study period   from November 2016 - October 2017.  Patients coming for second trimester abortion to above mentioned hospitals were assigned serial number from 1 to 80 and all patients with even number will be allocated to group 1 and all patients with odd number will be allocated in group 2, each group comprising 40 women each.Results: Majority of the cases in both the groups were between 21-25 yrs. Majority of the cases in both the groups were multigravidas. 11 cases from group 1 and 12 cases from group 2 were of gestational age between 14-16 wks. 29 cases from group 1 and 28 cases from group 2 were of gestational age between 18-20 wks. In the present study the mean induction abortion interval for group 1 was 19.56±1.82 hours and group 2 was 14.13±2.72 hours. This was statistically significant. Of the 40 cases in each group, 37 had complete abortion i.e. 92.5% 3 cases (7.5%) from both the groups had incomplete abortion. The side effects were relatively more in more in group 1 when compared to group 2.Conclusions: It was concluded that with this combination success rate was high (92.5 %), with Short induction abortion interval, less rate of incomplete abortion without any major complications.


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