Context:There are very few studies evaluating efficacy of platelet-rich plasma (PRP) in hair restoration and its combination with microneedling. As far as ascertained, there is no study to evaluate efficacy of microneedling with PRP plus topical minoxidil (5%) versus topical minoxidil (5%) alone in androgenetic alopecia (AGA).Aims:This study aims (1) to compare the efficacy of (a) topical minoxidil (5%) alone and (b) topical minoxidil (5%) + microneedling with PRP in men between 18 and 50 years with AGA Grade III to V vertex (Norwood–Hamilton scale) and (2) to perform objective and subjective evaluation based on clinical improvement and photographic evidence.Settings and Design:The study was conducted in the outpatient department of dermatology, venereology, and leprology in tertiary care hospital. It was open, prospective study.Subjects and Methods:Fifty patients with AGA were selected on the basis of inclusion and exclusion criteria. These patients were randomly divided into two groups of 25 patients each and were given following treatment: (i) Group A: topical minoxidil (5%) alone and (ii) Group B: topical minoxidil (5%) + microneedling with platelet-rich plasma (PRP).Statistical Analysis Used:Patients were assessed before starting the treatment and at the end of 6 months on the basis of (a) Patient's self-assessment based on standardized seven-point scale compared with baseline (b) Physician's assessment based on standardized seven-point scale of hair growth compared with baseline.Results:There was a significant improvement (P < 0.05) in both patients' assessment and investigator's assessment in Group B as compared to Group A at the end of 6 months.Conclusions:Microneedling with PRP is safe, effective, and a promising tool for the management of AGA.

Context:Vitiligo surgeries have come a long way from tissue grafts to cultured and non cultured cell transplantation. Extracted hair follicle outer root sheath cell transplantation (EHF ORS) suspension is more enriched with melanocyte. In a hair bulb, there is one melanocyte for every five keratinocytes which is much higher than the epidermal melanin unit.Aims:To analyse the effectiveness of cultured EHF ORS and to perform objective evaluation based on clinical improvement & photographic evidence. To observe any untoward events or side effects.Settings and Design:The study was open and uncontrolled. All the patients were screened at preliminary visit. Reviews were done every two weeks. The endpoint selected was six months post procedure.Materials and Methods:Twenty five patients of stable Vitiligo were included in the study and follicular unit were harvested by Follicular Unit Extraction method. Outer root sheath cells were extracted by trypsinization. The solution was transplanted over dermabraded recipient site. Pressure dressing was given. Patients were followed up regularly.Statistical Analysis Used:Descriptive Statistics, Chi-Square.Results:Mean ± SD repigmentation was 80.15% ± 22.9% with excellent repigmentation (90-100%) in 60% of patients.Conclusions:This method is safe, effective, and simpler than the other methods involving cell culturing and requiring a laboratory set-up but selection of patients is crucial for the success of the outcome.

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Background: This meta-analysis presents a comparison between Computed Tomography Pulmonary Angiography (CTPA) and Magnetic Resonance Angiography (MRA), to diagnose a pulmonary embolism. Computed tomography presents the advantage of imaging the entire thorax, facilitating the diagnosis of conditions that are commonly mistaken for pulmonary embolism, such as pneumonia, aortic dissection, and malignancy. UK and US guidelines have established CT amongst the basic investigations for pulmonary embolism. MRA does not require the use of ionizing radiation or iodinated contrast, thus making it possible for routine use of multiphasic acquisitions as well as for repeated contrast injections Methodology: For the collection of the data, a search was done by two individuals using PubMed, Google Scholar, and Cochrane Library databases for all relevant literature. Full - Text Articles written only in English were considered. Each qualifying paper was independently evaluated by two reviewers. Each article was analyzed for the number of patients, their age, procedure modality, and incidence of the pre decided complications. Results: The results also showed a high positive predictive value of 0.947 or 94.7% for MRA in the diagnosis of Pulmonary embolism, as compared with CTPA. Some analyses have marked MRA to have low specificity. These results establish MRA as a respectable alternative for diagnosis of APE, especially in cases when reducing radiation exposure is desired. However, the gold standard of diagnosis remains Computed Tomography Pulmonary Angiography. Conclusion: As the results show, though MRA has high statistical value for the diagnosis of pulmonary embolism, it also has its drawbacks. MRA cannot be used in severely ill patients as it continues to be challenging, with the longer scan times and multiple breath holds that are required in different MR protocols are difficult to follow in these patients. CTPA remains the gold standard for diagnosis of Pulmonary embolism, with MRA as a secondary test used when CTPA is contraindicated. Key words: Computed Tomography Pulmonary Angiography; Magnetic Resonance Angiography; Pulmonary Embolism; Diagnosis

BACKGROUND Chronic diseases like cerebral palsy (CP) and recurrent diseases like epilepsy in children are a constant burden to the family. Zarit Burden Interview Score (ZBI Score) is one of the oldest and most often used tool, which has been translated and validated in several languages allowing for international comparisons. The purpose of the present study was to determine a statistically valid cutoff score for the Zarit Burden Interview (ZBI) which can be used to screen caregivers at a risk for depression and in need of further assessment and intervention. We wanted to quantify the stress of caregivers and compare the quantum of stress of the caregivers of chronic illness (CP) vs. recurrent illness (epilepsy). METHODS Family caregivers were defined as co-resident family members who assisted with most, if not all, of the patient's daily care needs. Care giver burden, was measured with the Zarit Burden Interview (ZBI; Zarit, Todd, & Zarit, 1986) which consists of 22 items, 21 of which are summed to create a total burden score. Higher score indicates greater burden. RESULTS In present study the mean ZBI score is 47 in group C and 27 in group E. The female care givers are more in number. When male person is taking care, the burden is significant, likely to be due to additional liabilities. It is found that with increase age of caregiver stress and score increase. Care givers with low education and male patients showed high score. CONCLUSIONS Limitation of the study identifies the family caregivers under stress and their need for the management of the stress so that they can impart quality care to the suffering child and improve micro environment of family.