Background:  Plantar wart is a common viral infection of the plantar surface of the foot. Multiple treatment modalities are available but there is no definitive management option. The aim of this study is to compare topical adapalene gel 0.1% with cryotherapy in patients presenting with plantar warts in terms of time taken for complete clearance of the lesions. Methods: The study was conducted at the department of Dermatology, PNS Shifa Hospital, Karachi from 28th April to 28th October 2020. Eighty-four patients with plantar warts who fulfilled the inclusion and exclusion criteria were included in the study. Approval from the institutional ethical review committee was sought and written informed consent was taken from all the patients. Patients were divided into two groups, A (Adapalene 0.1% gel) and B (Cryotherapy) of 42 patients each. Adapalene gel was applied twice daily under occlusion at home and cryotherapy was done at the clinic after every two weeks. Patients were followed weekly from the onset of treatment and days taken for complete clearance of plantar warts were noted. Both the groups were compared for the outcome, i.e., time taken for complete clearance of lesions. Results: The mean time for complete clearance of plantar warts in group A was 35.619±3.154 days and in group B, it was 50.404±3.178 days. Conclusion: Adapalene gel 0.1% used for the treatment of plantar warts helped in complete clearance of lesions faster than cryotherapy.

BACKGROUND: Acne Vulgaris is a frequently seen dermatological condition having physical and psychosocial implications. Current study aims to assess Quality of life (QoL) in acne patients and study the associated risk factors. METHODOLOGY: This descriptive cross sectional study was conducted in 6 months duration at Dept. of Dermatology, Rawal Institute of Health Sciences Islamabad after ethical approval. Total 205 cases of acne (age>12 years) were included. Patients with severe systemic illness and endocrine disease were excluded. Global Acne Grading Scale (GAGS) was used to grade acne as mild, moderate or severe. Quality of life assessed by Cardiff Acne disability index (CADI) with outcome as no impairment, mild impairment, moderate impairment or severe impairment. Data analyzed via SPSS version 17 withChi-square test applied for significance. The p-value <0.05 considered to be statistically significant. RESULTS: Among 205 acne cases (24% males and 76% females), mean age was 25+5.7 (14-36) years. As per GAGS score; mild acne was present in 45.4%, moderate acne(44%), severe acne (8.35%) and very severe acne (2.4%). As per CADI score, there was no impairment in 7.3%, mild impairment (19.5%), moderate impairment (61%) and severe impairment in (12%). The impaired QoL was found to be associated with gender, socioeconomic class, education, acne grade, obesity and use of alternative medicine (p<0.05). CONCLUSION: Acne vulgaris significantly impairs QoL in adolescents to varying degrees. Higher grade of acne, female gender, obesity, illiteracy and poverty are the proposed risk factors for impaired QoL in acne cases. Early identification of acne cases at risk of impaired Qol may be helpful to take QoL measures like counseling and psychological intervention in parallel with medical management. This may improve the social and psychological wellbeing of acne cases.

To evaluate the effects of zinc on glycemic control and lipid profile in type 2 diabetic patients. Objectives: The zinc deficiency is reported in with diabetes, which increases oxidative stresses leading to complications of diabetes. Previous studies demonstrated that zinc supplementation improved glucose control in patients with diabetes, but limited data is available and single blind trials. Study Design: Randomized Controlled study. Setting: Combined Military Hospital (CMH) Malir Cantt, Karachi. Period: 1st December 2018 to 30th June, 2019. Material & Methods: Patients (n=350) were randomly divided into two groups. The first group (n=175) was supplemented with oral zinc sulfate 30 mg/day and second group (n=175) received placebo for a period of 3 months. Blood samples were taken at baseline and after 3 months to assess fasting blood glucose (FBS), glycosylated hemoglobin (HbA1C %) and serum lipid levels and BMI which were compared by t test for paired samples. Results: The mean age of all subjects was 51.80+10.281 years and male to female ratio was 1.08:1. The mean BMI was 31.74+5.806. There was no statistical difference in age and gender between two groups but more obese patient received placebo. The zinc supplemented group had a significant reduction in FBS (p= 0.032) compared to placebo (p= 0.158). The HbA1C% level reduced significantly in zinc supplemented group (p<0.001).compared to the placebo group (p=0.273). Serum lipid levels reduced significantly in the zinc supplemented group (p<0.001) but no significant changes observed in the placebo group (p=0.395). Conclusions: Zinc supplementation improved glycemic control and decreased levels of serum cholesterol, LDL and triglyceride.

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Introduction: The radiological investigations are not diagnostic of COVID-19 disease but help in management. CT scan is not available worldwide; therefore, x-ray chest (CXR) is ideal for assessment of disease severity using scoring system. This study was conducted to see various CXR findings and relation of severity with outcome. Materials and Methods: This study was conducted at Dallah hospital Saudi Arabia. All admitted confirmed cases of COVID-19, above age of 18-year were included. CXR were done at baseline, after 5-7 days and after 13-15 days. Patient with previous heart failure, chronic obstructive pulmonary diseases or pulmonary fibrosis, Pregnant and lactating ladies were also excluded.Results: Out of total 629 patients 67.6 % were males. There was no statically significant difference in mortality in male to female patients. The mean age was 42.67+15.13 (range 18-83) years. Patients with age more than 50-year were 58.9% and had severe infection (p=0.041) with high mortality (p=0.045). The 63% patients had abnormal CXR at baseline. The common CXR features detected were consolidation (45%), followed by ground glass appearance (43%). Only 0.8% patients had pleural effusion and one patient with pneumothorax. Patients with bilateral lung infiltration was 67.5% and mostly it was in lower zones (63%). The follow-up CXR revealed an increase in severity score related to mortality (p<0.001). Conclusion: In COVID-19 infection CXR may be a predictor of severity of disease and monitoring of disease may be done by serial CXR.