Background & Objective: Cutaneous Leishmaniasis (CL) is endemic in Baluchistan and treated traditionally with Meglumine antimoniate. Miltefosine appears appealing therapy in cutaneous Leishmaniasis. Our objective was to evaluate safety and efficacy of Miltifossine in treatment of cutaneous Leishmaniasis. Methods: This experimental study was conducted from 10 September 2017 to 10 May 2018 at Combined Military Hospital Quetta. Total of 42 patients were recruited by purposive sampling technique. Lesional skin smears were stained with giemsa for Leishmania amastigotes under magnification (100 x).Complete blood count, serum urea, creatinine, bilirubin, aspartate aminotransferases (AST), alanine aminotransferase (ALT) were done at the beginning of treatment and then weekly, thereafter. Cap Miltefosine 50 mg (2.5mg/kg) were given as directly observed therapy .Daily observation during treatment phase was done for clinical side effects of therapy. Clinical response was documented at two weeks then at eight weeks. Photographs were taken before and after the therapy. Data was analyzed by SPSS 16. Results: Complete clinical response was observed in 39 (92.9%) patients and partial clinical response in 1(2.4%) patient. Two patients were lost to follow up at eight weeks. No significant derangements in laboratory profile were noted before and after treatment. Mean duration of treatment was 23.47+SD 4.44 days. Sixteen patients (38.1%) took Miltefosine for 28 days, 12 (28.6%) for 21 days and 9 (25%) for 25 days. Conclusion: Miltefosine is safe and cost effective treatment for cutaneous Leishmaniasis. It is effective in CL cases not susceptible to antimony compounds. How to cite this:Tahir M, Bashir U, Hafeez J, Ghafoor R. Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.54 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Objectives: 1. To determine the different frequencies of mucocutaneous manifestations of Chikungunya Fever in a Tertiary care hospital. To determine the associations of positive Chikungunya Fever serology with its mucocuatneous manifestations. Methodology: It was observational cross-sectional study conducted in Department of Dermatology of Jinnah Postgraduate Medical Centre from 15th May 2018 to 15th January 2019. After getting approval from Institutional Review Board, 67 patients were recruited in study by purposive sampling who presented with early and late manifestations of Chikungunya Fever (CF). Different cutaneous manifestations were confirmed by consultant Dermatologist. Photographs were taken after the inform consent of patients. Data was analysed by SPSS 23 and P value was taken significant with < 0.05. Result: The mean age of patients was 30.24±7.89 years. Females and males were 45 (68%) and 20 (31%) respectively. Hyperpigmentation were noted as most frequent finding in 31 (46%), maculopapular rashes ,oral ulcers in 17 (25%), and diffuse hair fall in 14(20%) .Findings like lichenoid eruption in 11 (16%), chick sign in 5 (8%), and erythema of Pinna in 4 (6%) were also recorded. While hair falls, exacerbation of pre-existing dermatoses like psoriasis and acne form eruption were also seen rarely.  There was no significant association was found between clinically suspected cases and serology positive patients of CF. Conclusion: CF presented with important and unusual mucocutaneous findings which are important to diagnose as they help in differentiating it from other viral diseases. We observed that some finding remain long standing and presented months

Objectives: To compare the efficacy of tranexamic acid mesotherapy versus 0.9% normal saline for melasma by split-face study. Methods: It was a non-randomized clinical trial performed at the Dermatology ward of JPMC from September 2018 to June 2019 after getting approval from the Ethical Committee. A total of sixty patients were recruited in the study, who had symmetrical melasma on their faces. Both halves of the face were treated by Injection Tranexamic Acid (TA) with a dose of 4mg/ml and Normal Saline (NS) two weekly for twelve weeks. Hemi Modified Melasma Area and Severity Scoring (H-mMASI) was calculated at the start and end of the study. Analyses were done by SPSS version 23. P < 0.05 was taken as significant. Results: Mean of H-mMASI score was compared on both sides at the end of study, which showed significant reduction in mean score from 3.19 ±2.57 to 1.52 ± 1.2 (P < 0.05) on A side as compared to decline in scores on NS side from 3.46 ± 2.7 to 3.45 ± 2.6 (P > 0.05). Erythema, swelling, and burning were documented as temporary side effects on both sides. Conclusion: Tranexamic Acid (TA) mesotherapy can be considered as the most cost-effective, safe and directly observed therapy for melasma which showed significant improvement when old prior therapies have failed. doi: https://doi.org/10.12669/pjms.36.5.2379 How to cite this:Kaleem S, Ghafoor R, Khan S. Comparison of efficacy of Tranexamic Acid Mesotherapy versus 0.9% normal Saline for Melasma; A split face study in a Tertiary Care Hospital of Karachi. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2379 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To establish the association of androgenetic alopecia (AGA) and the severity of coronavirus disease 2019 .Design: Observational study.Methodology: A total of 300 hospitalized patients of COVID-19 were included.Scoring of AGA was done, and severity of COVID-19 was measured as better and worse hospital outcomes. Correlation between severity of AGA and severity of COVID-19 was noted.Results: Out of 300 patients, 220 (73.33%) were male and 80 (26.67%) were female.

Syphilis is a venereal disease caused by treponema pallidum, historically known as "great mimicker" because of its variable presentations. Secondary syphilis usually presents with maculopapular or papulosquamous rash. Rare manifestations include papulonodular, annular and lichenoid lesions. Nodules are usually found in benign tertiary syphilis. We present a case of a young boy who presented with five months' history of nodular skin lesions and hoarseness of voice. Venereal disease research laboratory (VDRL) was initially negative owing to prozone phenomenon. However, histopathology was confirmatory and he responded to benzathine penicillin. We present this case because of rare clinical presentation with persistent nodular lesions, unusual age group, and negative initial VDRL test.