Publications by authors named "Sadia Masood"

28 Publications

  • Page 1 of 1

Impact of acne on quality of life in young Pakistani adults and its relationship with severity: A multicenter study.

Pak J Med Sci 2021 May-Jun;37(3):727-732

Dr. Saadia Tabassum, MBBS, FCPS. Assistant Professor of Dermatology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Objectives: The current study aimed to determine the effect of acne vulgaris on quality of life of young adults and to assess the correlation between acne severity and impairment of quality of life (QOLI).

Methods: In this multi-center cross-sectional study, 163 young adults with acne vulgaris were assessed for severity and quality of life impairment between December 2016 and May 2017 at three tertiary care hospitals. Cardiff Acne Disability Index (CADI) was used to assess the quality of life while the severity of acne measured by Global Acne Grading System (GAGS). Data were collected on standardized forms, with CADI, GAGS scores, and sociodemographic data and analyzed using SPSS version 9. The quantitative variables were presented as means, median and qualitative variables expressed as frequency and percentages. P-value ≤0.05 was considered as statistically significant.

Results: Out of 163 patients enrolled in this study, the mean age was 21.6 ± 4.9 years and 124 were females and 39 males. In mild QOLI, 56 (87.5%) cases were affected with mild, 11 (13.4%) with moderate and 1 (1.5%) case had severe acne. While, in moderate QOLI, 8(12.5%) cases were of mild, 60 (73.2%) were moderate and 6 (35.3%) cases affected with severe acne. The severe impairment of QOL noted in 11 (13.4%) moderate and 10 (58.8%) severe acne cases. The relationship between sex was statistically significant, (P<0.001). The result showed significant correlation between severity of acne vulgaris and the quality of life impairment of these patients (P<0.001).

Conclusion: This study showed significant correlation between acne vulgaris and quality of life impairment. Cardiff acne disability index has proven to be a reliable tool to assess the quality of life. It is recommended to be used routinely in dermatology clinics to provide tailored treatment to individuals because mild disease may be disproportionately distressing for patients.
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http://dx.doi.org/10.12669/pjms.37.3.2819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155408PMC
June 2021

Prevalence of Clinical Spectrum of Cutaneous Adverse Drug Reactions in Patients Presenting at a Tertiary Care Hospital in Pakistan.

Cureus 2021 Apr 19;13(4):e14568. Epub 2021 Apr 19.

Biostatistics and Epidemiology, Aga Khan University Hospital, Karachi, PAK.

Introduction: Cutaneous adverse drug reactions (CADRs) are the most common adverse drug reactions reported in the literature. CADRs have resulted in disabling infirmities during hospitalization and complications following outdoor drug therapy. The pattern of CADRs and the responsible drugs usually changes with the introduction of newer drugs and evolving clinical practices. Moreover, several international studies showed variable prevalence, emphasizing the need for local data in light of different socioeconomic and demographic practices. Therefore, the purpose of this study is to evaluate the prevalence of adverse cutaneous drug reactions and identify the clinical spectrum and any potential risk factors.

Methodology: The current study is a descriptive cross-sectional study conducted at Aga Khan University Hospital, Pakistan. One hundred ninety-three patients who met the study inclusion criteria were included. Data were collected from patients on a proforma after taking informed consent. Quantitative data were presented as simple descriptive statistics giving mean and standard deviation, while qualitative variables were presented as frequency and percentages. Effect modifiers were controlled through stratification to highlight the effect of these on the outcome variable. The post-stratification chi-square test was applied and the p-value of ≤0.05 was statistically significant.

Results: A total of 193 patients who had cutaneous adverse drug reactions were included in the study. The mean age in this study was 47.78±8.33 years. One hundred eight (56%) were male and 85 (44%) were female. Out of 193 patients, 135 (69.9%), 50 (25.9%), 24 (12.4%), 12 (6.2%), 20 (10.4%), 11 (5.7%) and six (3.1%) had maculopapular rash, acneiform eruptions, Stevens-Johnson syndrome, erythema multiform, urticaria, fixed drug eruptions and toxic epidermal necrolysis, respectively.

Conclusion: CADRs are a common clinical presentation and awareness and knowledge about their diagnosis and prevention is important. It can be assumed that in our local setup, the clinical trends and medications causing ADRs are strikingly similar to those found in other countries. Physicians commonly come across these cases and they should be well aware of the clinical spectrum of skin reactions to enable early diagnosis and management.
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http://dx.doi.org/10.7759/cureus.14568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133508PMC
April 2021

Waardenburg Syndrome Type-II in Twin Siblings: An Unusual Audio-Pigmentary Disorder.

Cureus 2020 Oct 10;12(10):e10889. Epub 2020 Oct 10.

Nephrology, Aga Khan University Hospital, Karachi, PAK.

Waardenburg syndrome (WS) is an interesting inherited audio-pigmentary disorder. The syndrome shows no gender, racial, or ethnic predilection. This unique disorder is characterized by pigmentary abnormalities, deafness, and neural crest-derived tissue defect. WS can be recognized by some specific clinical features that appear after birth; not all affected individuals possess all the clinical features. It has four clinical sub types based on the mutant gene and characteristic morphology. These morphological features are broad nasal root, white forelock, the difference in the colour of eyes, congenital leukoderma, and sensorineural deafness. We report an interesting case of WS in twin boys who fulfill the criteria of WS-II. Our cases have four major criteria (white forelock, heterochromia, sensorineural hearing loss, first degree relative with WS), and 1 minor criterion to establish the diagnosis of WS-II. Most clinical features of WS-II except sensorineural deafness are benign and do not need any intervention but severe deafness can be a serious problem. The current report is unique and is a rare case of WS in twin infants. We present this case for its rarity, relative paucity of literature, and also to emphasize the clinical presentation of this extremely rare disease in twins.
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http://dx.doi.org/10.7759/cureus.10889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652366PMC
October 2020

Erythema Annulare Centrifugum: A Rare Skin Manifestation of Hashimoto Thyroiditis.

Cureus 2020 Aug 20;12(8):e9906. Epub 2020 Aug 20.

Histopathology, The Aga Khan University, Karachi, PAK.

Erythema annulare centrifugum (EAC) is an unusual skin condition appearing as recurrent erythematous annular eruptions associated with autoimmune disorders, infections, and various neoplastic conditions. We present a very rarely reported association of EAC with Hashimoto thyroiditis (HT) in a young male. A 26-year-old male recently diagnosed as case of HT presented in the dermatology clinic with nine-month history of non-itchy persistent annular lesions on the body. The morphology and biopsy of lesions confirmed the diagnosis of EAC. HT is a part of the spectrum of autoimmune thyroid diseases with its own specific cutaneous manifestations. Our case also depicts the impact of antigen-antibody related immunological reaction, which might be involved in the development of both HT and EAC, and it could be the stages of the same pathological condition of two different clinical presentations.
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http://dx.doi.org/10.7759/cureus.9906DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505531PMC
August 2020

How Nutrition can help to fight against COVID-19 Pandemic.

Pak J Med Sci 2020 May;36(COVID19-S4):S121-S123

Sadia Masood, MBBS, FCPS, MHPE. FAIMER Fellow Assistant Professor, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Currently Covid-19 pandemic is a leading challenge across the globe. It is mandatory to attain and maintain good nutritional status to fight against virus. Nutritional status of individual is affected by several factors such as age, sex, health status, life style and medications. Nutritional status of individuals has been used as resilience towards destabilization during this COVID-19 pandemic. Optimal nutrition and dietary nutrient intake impact the immune system, therefore the only sustainable way to survive in current context is to strengthen the immune system. There is no evidence found that supplement can cure the immune system except Vit C, which is one of the best way to improve immune system. A proper diet can ensure that the body is in proper state to defeat the virus. However along with the dietary management guidelines the food safety management and good food practices is compulsory. This article explores the importance of nutrition to boost immunity and gives some professional and authentic dietary guidelines about nutrition and food safety to withstand COVID-19.
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http://dx.doi.org/10.12669/pjms.36.COVID19-S4.2776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306972PMC
May 2020

COVID-19 Pandemic & Skin Care Guidelines for Health Care Professionals.

Pak J Med Sci 2020 May;36(COVID19-S4):S115-S117

Palwasha Jalil, MBBS. Chief Resident Dermatology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.

The Novel corona virus is bringing multiple challenges for health care professionals. Skin is the biggest organ and the first line of defense against different infections and external factors. Being the front line warriors, health care professionals are susceptible to various skin conditions due to prolonged use of personal protective equipment. These adverse skin conditions are redness, irritation, itching, contact dermatitis, and aggravation of underlying skin conditions like seborrheic dermatitis and acne vulgaris. In the current global situation, the potential incidence of such adverse dermatological effects does not in any manner cause the HCPs to deviate from the strict specific precautionary hygiene rules. These skin problems are manageable with the few precautionary measures. This article explores the different skin conditions that result from personal hygiene measures and usage of protective gear and will suggest some practical advice about how to manage and protect from these different adverse skin conditions.
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http://dx.doi.org/10.12669/pjms.36.COVID19-S4.2748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306944PMC
May 2020

Bullous Striae Distensae with Prolonged Steroid Use: An Unusual Clinical Presentation.

Indian Dermatol Online J 2020 Mar-Apr;11(2):280-281. Epub 2020 Mar 9.

Department of Dermatology, Aga Khan University Hospital, Karachi, Pakistan.

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http://dx.doi.org/10.4103/idoj.IDOJ_239_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247633PMC
March 2020

Frequency of depression and anxiety among patients with chronic spontaneous urticaria visiting a tertiary care hospital in Karachi, Pakistan.

J Pak Med Assoc 2020 Mar;70(3):511-514

Liaquat National Hospital Karachi, Pakistan.

Objective: To determine the frequency of anxiety and depression among chronic spontaneous urticarial patients presenting at a tertiary care hospital.

Methods: The prospective, cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from February to August 2015, and comprised patients diagnosed with chronic spontaneous urticaria at the dermatology clinic. All the participants were assessed for anxiety and depression using Aga Khan University-Anxiety Depression Scale. Data was collected in face-to-face interview using a structured questionnaire. The association of the condition with different characteristics were calculated after stratification for age, gender, occupation and monthly income. SPSS 19 was used for data analysis..

Results: Of the 146 study participants, 84(57.5%) were males and 62(42.5%) were females. The overall mean age was 39±15.6 years. Of the total, 39(26.7%) had depression and anxiety. Depression and anxiety were more frequent among patients with a positive family history of mental disorders (p=0.02).

Conclusion: Anxiety and depression were found to be considerably common among chronic spontaneous urticaria patients, with patients having a positive family history for mental illnesses particularly vulnerable.
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http://dx.doi.org/10.5455/JPMA.297139DOI Listing
March 2020

First detection and molecular characterization of avian polyomavirus in young parrots in Pakistan.

Vet Res Commun 2019 Nov 11;43(4):197-202. Epub 2019 Jul 11.

Faculty of Veterinary and Animal Sciences, Pir Mahr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan.

Avian polyomavirus (APV) infection, also called as budgerigar fledgling disease (BFD) causes various health problems in many psittacine species which may cause untimely death. The aims of this study were to investigate, for the first time, the detection, molecular characterization and phylogenetic analysis of avian polyomavirus (APV) in Pakistani psittacine birds. In an aviary a disease similar to APV was found and 90% of the nestlings died within a few weeks. Seven to ten-day-old parrot nestlings (n = 3) from the aviary were presented with feather abnormalities, plumage defect and were clinically depressed. Birds died at 11th, 14th and 16th day of age. Samples of hearts, livers, spleen, feathers and kidneys were collected from the dead birds. Samples were analyzed for the presence of APV DNA by using PCR. APV VP1 gene was partially sequenced, and phylogenetic analysis was performed. The APV strain was similar to those previously reported in other areas of the world. The results of this investigation indicate presence of a high frequency of APV infections in psittacine birds in Pakistan.
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http://dx.doi.org/10.1007/s11259-019-09759-7DOI Listing
November 2019

Factors associated with onychomycosis in nail psoriasis: a multicenter study in Pakistan.

Int J Dermatol 2019 Jun 7;58(6):672-678. Epub 2019 Jan 7.

Dermatology Department, Abbassi Shaheed Hospital, Karachi, Pakistan.

Background: Treatment of psoriatic nail disease is challenging, and dystrophic psoriatic nails can get secondarily infected with fungi.

Methods: This 2-year, matched case-control study was conducted at three tertiary care centers of Karachi, Pakistan. Data were collected from patients with nail psoriasis as cases with age- and gender-matched controls. A detailed questionnaire was filled for all study participants. Nail Psoriasis Severity Index (NAPSI) scoring tool was used to assess dystrophy. Fungal infection was inferred by nail clippings for fungal hyphae and culture.

Results: Among 477 participants, 159 cases and 318 controls completed the study. Their mean age was 44 years, and one-third were female. Fungal culture positivity was statistically significant in cases as compared to the control group (P < 0.001). The most frequent species identified was Candida parapsilosis in both cases and controls. Body mass index, NAPSI scoring, socioeconomic status, elevated diastolic blood pressure, smoking status psoriasis among first-degree relatives, and longstanding disease of more than 10 years were significant factors in univariable analysis. Multivariable logistic regression identified independent factors like low to middle socioeconomic status, history of psoriasis in first-degree relative, current smoker, and obesity.

Conclusion: We found nearly one-third of the psoriatic patients with nail involvement having concomitant fungal infection. We emphasize that nail clipping for fungal smear and culture should be advised to those patients with coexisting factors found significant in our study results. This opinion can be incorporated in psoriasis management guidelines for improving treatment of psoriatic nails.
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http://dx.doi.org/10.1111/ijd.14364DOI Listing
June 2019

Ocular manifestation, complications and aetiological factors in Stevens-Johnson syndrome/toxic epidermal necrolysis.

J Pak Med Assoc 2015 Jan;65(1):62-4

Objective: To describe the ocular manifestations of Stevens-Johnson Syndrome/Toxic Epidermal Necrosis among inpatients at a tertiary care hospital.

Methods: The retrospective observational descriptive study was carried out at the Aga Khan University Hospital, Karachi, and comprised data on age, gender, aetiology and ocular findings related to patients diagnosed with Stevens-Johnson Syndrome/Toxic Epidermal Necrosis between January 2000 and December 2011. SPSS 19 was used for statistical analysis.

Results: There were 87 patients; 48(55.2%) of them being males.The overall mean age was 33.2±22.2 years, ranging from 1 month to 84 years. The most common aetiology was idiopathic 20(23%) followed by non-steroidal inflammatory drugs and anti-epileptics 11(12.6%) each. Besides, 84(96.6%) patients had oral mucosal involvement whereas 45(51.7%) had ocular and 27(31.0%) had genital-mucosal involvement. Glassroding was performed in 16(18.4%) patients due to minor conjunctival adhesions.

Conclusion: Ocular manifestations of varying severity were frequent, with drugs being the most common aetiology.
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January 2015

Multiple autoimmune syndromes associated with psoriasis: a rare clinical presentation.

Oman Med J 2014 Mar;29(2):130-1

Department of Medicine, Faculty Office Building, Aga Khan University Hospital, Karachi, Pakistan.

Autoimmune diseases are known to have association with each other but it is very rare to see multiple autoimmune diseases in one patient. The combination of at least three autoimmune diseases in the same patient is referred to as multiple autoimmune syndrome. The case we are reporting features multiple autoimmune syndrome with five different conditions. The patient had type 1 diabetes mellitus, autoimmune hemolytic anemia, systemic lupus erythematosus, vitiligo, and psoriasis. Psoriasis has rarely been reported previously under the spectrum of autoimmune syndrome. Although the relationship of autoimmune conditions with each other has been explored in the past, this case adds yet another dimension to the unique evolution of autoimmune pathologies. The patient presented with a combination of five autoimmune diseases, which makes it consistent type three multiple autoimmune syndromes with the addition of psoriasis. The current case is unique in this aspect that the combination of these five autoimmune disorders has never been reported in the past.
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http://dx.doi.org/10.5001/omj.2014.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976724PMC
March 2014

Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host.

J Infect Dev Ctries 2013 Sep 16;7(9):680-5. Epub 2013 Sep 16.

Aga Khan University and Hospital, Karachi, Pakistan.

Cryptococcosis is a potentially fatal fungal disease caused by variants of Cryptococcus neoformans species.  The respiratory tract is the usual portal of entry, with a peculiar predilection to invade the central nervous system.  The skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation.  The disease is mostly seen in immunodeficiency states.  The diagnosis is frequently unsuspected in immunocompetent patients. We report a case of disseminated cryptococcal meningitis in an immunocompetent young adult. The cutaneous eruption prompted the accurate diagnosis.  The patient, a 20-year-old female, had fever, cough, headache and intractable vomiting for the past two months and was being managed as a case of tuberculous meningitis. Two weeks after starting antituberculous treatment she developed umbilicated papules on the head and neck region. Necessary laboratory workup identified C. neoformans in cerebrospinal fluid (CSF) and skin specimens.  The titers of cryptococcal antigen were measured in CSF and serum for diagnostic and prognostic purposes.  Anti-fungal treatment resulted in regression of the cutaneous lesions and resolution of systemic complaints. The case highlights the need for high degree of suspicion, especially in healthy young adults, in the diagnosis of cryptococcosis. The cutaneous eruptions can be the first manifestation or a diagnostic clue of enormous significance.
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http://dx.doi.org/10.3855/jidc.2622DOI Listing
September 2013

Efficacy of itraconazole versus fluconazole in vaginal candidiasis.

J Pak Med Assoc 2012 Oct;62(10):1049-52

Department of Dermatology, Baqai Medical University, Karachi.

Objective: To compare the efficacy of fluconazole 150mg single dose and itraconazole 200mg twice for one day in the treatment of acute vulvovaginal candidiasis.

Methods: The study was carried out at the Department of Dermatology, PNS Shifa Hospital, Karachi, from March, 2008 to February 2009 and comprised 60 women with clinical and mycological diagnosis of vaginal candidiasis. Diagnosis was based on history, clinical examination and relevant investigations. The women were divided into two equal groups. After initial assessment, Group 1 was treated with capsule fluconazole 150mg stat, and Group 2 with capsule itraconazole 200mg twice for one day. They were assessed clinically for cure and relapse on day 7 and 21 respectively. All findings were recorded in the proforma. Data was analysed using SPSS 12.

Results: The overall clinical evaluation showed 70% (n = 21) cure rate with itraconazole and 50% (n = 15) with fluconazole. In Group-1, 7 (23.33%) and in Group-2 8 (26.6%) showed some improvement, while 2 (6.66%) in Group 1, and 7 (23%) in Group 2 failed to respond. Relapse was observed in 9 (28.5%) and 16 (53%) of the cured cases in Group 1 and Group 2 respectively.

Conclusion: Itraconazole was found to be more effective in the treatment of vulvovaginal candidiasis compared to fluconazole with high cure and low relapse rate.
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October 2012

Infiltrated leishmaniasis recidivans cutis on the face: a rare clinical presentation.

Trop Doct 2012 Apr 15;42(2):120-1. Epub 2012 Feb 15.

Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Cutaneous leishmaniasis is a protozoan disease caused by Leishmania and transmitted by the bite of some species of sand flies. Usually it presents with variety of clinical manifestations depending on both the infecting species of Leishmania and the immune response of the host. Leishmaniasis recidivans cutis (LRC) is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and its chronic relapsing nature. It is an evolving form of cutaneous leishmaniasis which clinically presents as a spreading of the initial nodule, leading to a plaque formation simulating discoid lupus erythematosus. A clinical course of leishmania recidivans is probably related to changes in cell-mediated immunity leading to localized or diffuse lesions. We report a case that presented with infiltrated, atrophic plaque on a patient's face. Clinically, the lesion resembled the lesion of discoid lupus erythematosus and lupus vulgaris but the cutaneous biopsy proved the diagnosis to be LRC.
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http://dx.doi.org/10.1258/td.2011.110396DOI Listing
April 2012

Exuberant ulcerated lesions of secondary syphilis on the palms--an unusual presentation.

J Ayub Med Coll Abbottabad 2006 Apr-Jun;18(2):80-1

Department of Dermatology, Combined Military Hospital, Bahawalpur.

Ulcerated lesions in secondary syphilis are rare. Exuberant tissue is seen in condylomas of syphilis, which occur in flexural and occluded areas of the body and not in open areas such as palms. We report a case of secondary syphilis that presented with ulcerated exuberant lesions on palms, which on initial examination gave an impression of lesions of Orf and Milker's Nodule.
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October 2006

Reticulated multifocal fixed drug eruption due to mefenamic acid - a new morphological pattern.

J Coll Physicians Surg Pak 2005 Sep;15(9):562-3

Department of Dermatology, Combined Military Hospital, Bahawalpur Cantt., Pakistan.

Fixed drug eruption is a heterogeneous pattern of cutaneous reaction to certain drugs. Different morphological patterns of fixed drug eruption can occur. We describe a new morphology of fixed drug eruption showing a reticulated pattern as a result of ingestion of mefenamic acid and discuss the possible mechanism underlying such an appearance.
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http://dx.doi.org/09.2005/JCPSP.562563DOI Listing
September 2005
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