Publications by authors named "Moizza Tahir"

7 Publications

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Dermatology Life Quality Index In Patients Of Psoriasis And Its Correlation With Severity Of Disease.

J Ayub Med Coll Abbottabad 2020 Jan- Mar;32(1):64-67

Department of Anesthesiology, Ayub Medical Complex, Abbottabad, Pakistan.

Background: Patient suffering from psoriasis can be severely affected in their day to day activities and it may also result in reduced work efficiency and absenteeism from work leading to financial burden on the patient's family. This study was conducted using Dermatology Life Quality Index to assess the quality of life of a patient suffering from psoriasis being treated at a military hospital.

Methods: This cross-sectional study was conducted in the outpatient unit of Department of Dermatology, Combined Military Hospital Abbottabad from 1st October 2013 to 31stJune 2014. The demographic data and Dermatology Life Quality Index of patients of psoriasis were recorded using a standard questionnaire and their final score was calculated to assess the effect of disease on patient's life. Extent/ severity of disease were assessed according to the body surface area involved. The data was analysed using SPSS- 18. Mean and SD for numerical variables and frequencies and percentages for categorical were calculated.

Results: A total of 160 patients fulfilling the inclusion criteria were included in the study. Mean age of the patients was 40.48 years (±12.58 years) with minimum age of 18 years and maximum of 74 years. 118 patients were males were (73.8%) and 42 were females (26.2%). Twenty (12.5%) patients had no effect on their life by the disease while 5 (3.1%) had extremely large effect. Most patients, i.e., 68 (42.5%) had moderate effect on their lives. 69 patients had mild psoriasis as per body surface area involved, 70 had moderate disease and 21 had severe disease.

Conclusions: Psoriasis affects quality of life of patients not only physically but also psychologically and financially even when patients are under treatment. Psychological aspects also need to be addressed while treating the physical morbidity.
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October 2020

Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis.

Pak J Med Sci 2019 Nov-Dec;35(6):1669-1673

Dr. Faisal Manzoor, MCPS, FCPS. Department of Dermatology and Otolaryngology, Combined Military Hospital, Quetta, Pakistan.

Background & Objective: Cutaneous leishmaniasis (CL) is endemic in developing countries like Pakistan. Pentavalent antimonials are still drug of choice, despite being toxic and intolerable for patients. Second line treatments have been extensively studied but the results of their efficacy are conflicting. This, to our knowledge, will be the first study in this regard. Our objective was to determine if combination of oral itraconazole with intralesional (IL) meglumine antimoniate (MA) reduces the duration of treatment for cutaneous leishmaniasis, as compared to intralesional MA alone.

Methods: A randomized controlled trial (single blinded) was carried out from August 2017 till December 2017 on 69 patients who fulfilled inclusion criteria. They were assigned to Group-A or B by lottery method. Group-A patients received IL MA once a week while Group-B received oral itraconazole 200mg, once daily, for six weeks along with similar regimen of IL MA as Group-A. The patients were assessed every three weeks by the blinded assessor till clinical cure was achieved. A follow up visit, two months after clinical cure was done to look for relapse of the disease.

Results: Thirty patients in Group-A and 35 patients in Group-B completed the study. At 3, 6, 9 and 12 weeks the patients were assessed for: no, partial or complete response and results of the two groups were compared for statistical significance. The p-values of 0.20, 0.57 and 0.11 at 3, 6 and 9 weeks, respectively, depict that there was no significant difference at any step of assessment between the two groups in terms of healing. The p values of each t test was>0.05 refuting the hypothesis.

Conclusion: Combination of oral itraconazole with intralesional MA offered no benefit over intralesional MA alone in the management of cutaneous leishmaniasis in terms of duration of therapy.
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November 2019

Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan.

Pak J Med Sci 2019 Mar-Apr;35(2):495-499

Dr. Rabia Ghafoor, FCPS(Derm), SCE(UK), Assistant Professor of Dermatology, Jinnah Post Graduate of Medical Sciences, Karachi, Pakistan.

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.
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May 2019

Exploring practices of Dermatologists in Ethical Dilemmas in Pakistan: A narrative analysis.

Pak J Med Sci 2018 Mar-Apr;34(2):374-379

Prof. Dr. Rehan Ahmed Khan, MBBS(Pak), FCPS (Pak), FRCS (Ire), M-HPE, M.Sc.HPE, PhD(Scholar) Assistant Dean of Medical Education, Professor of Surgery, Islamic International Medical College.

Background And Objective: Specialists in dermatology come across ethical issues in their practice. The topic is subjective so dialogue and reflection is required. The main objective of this study was to explore how dermatologists deal with ethical dilemmas in their clinical practice.

Methods: This was a qualitative narrative analysis. It was conducted by involving dermatologists working in tertiary care hospitals across Pakistan from January to June 2017. Open ended semi structured in-depth interviews of twelve dermatologists were recorded and transcribed manually through transcribers verbatim. Thematic interactional analysis was done by NVivo 11.

Results: Ethical dilemmas were narrated. Thematic analysis showed that compromises in standard medical and ethical practices were made on academics and training. Ethics were left to individual choice. Consultation of patients suffered due to quality of patient physician relationships and breeched patient's confidentiality. In cosmetic dermatology unrestrained role of media, injudicious procedures and improper counseling created difficulties. Pharmaceuticals relation revolved around conflict of interest. In sexually transmitted diseases disclosure were difficult due to sociocultural limitations. In teledermatology practices patient's confidentiality and consent were compromised while consultation remained challenging for dermatologists being visual only.

Conclusion: Dilemmas appearing in everyday life needs peer discussion, reflections and protocols that should be role modeled.
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May 2018

Langerhan cell histiocytosis: a child presenting with nine months history of fever.

J Ayub Med Coll Abbottabad 2014 Oct-Dec;26(4):633-5

We report a case of Langerhan Cell Histiocytosis in a three and a half years old child. The child presented with history of low grade fever, off and on for 9 months. There was 2 months history of progressive pallor and 5 days history of epistaxis. Blood complete picture revealed pancytopenia and the patient was referred to a paediatric oncologist. Initial diagnosis of acute lymphoblastic leukaemia (ALL), Lymphoma and disseminated Tuberculosis (TB) was made on basis of initial investigations. Coetaneous involvement occurred 7 months later along with Diabetes Insipidis, bone changes and pulmonary involvement.
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March 2015

Orf with unusual features.

J Coll Physicians Surg Pak 2014 Nov;24 Suppl 3:S174-5

Classified Medical Specialist, Combined Military Hospital, Rawalpindi.

We describe a case of Orf in an immunocompetent man with no history of direct contact with farm animals. The patient presented with numerous large lesions on hands and feet including a lesion in the subungual area. Later on multiple lesions with more bizarre morphology developed on the trunk. The diagnosis was suspected on clinical appearance of the lesion and confirmed later by histopathology. We consider contact with contaminated soil as the possible source of infection as virus can survive in pastures. Awareness of unusual clinical patterns of known entities is important to avoid unnecessary interventions.
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November 2014

Kindler's syndrome: a report of five cases in a family.

J Coll Physicians Surg Pak 2014 Oct;24(10):763-5

Department of Dermatology, PNS Shifa, Karachi.

Kindler's Syndrome (KS) is a rare genodermatosis with autosomal recessive mode of inheritance. The disease results from homozygous mutations on both alleles of the FERMT-1 gene (also known as KIND-1 gene) that encodes the protein Kindlin-1 (kindlerin). Clinical features include a constellation of early infantile skin blistering and mild photosensitivity, which improves with age, and progressive poikiloderma with widespread cutaneous atrophy. The differential diagnosis of Kindler syndrome include other congenital poikilodermatous and photosensitive conditions including Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. We herein, report the presence of the Kindler's syndrome in 5 out of 7 children of consanguineous parents. To authors' knowledge, this is the first report of Kindler's syndrome involving 5 members of a family.
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October 2014