A prospective, open label, randomized study of efficacy of vitamin A as an add on therapy in the clinical outcome of tuberculosis patients

Background: Tuberculosis is the most prevalent infectious disease in the world. India accounts for nearly one fifth of global incidence of tuberculosis. If untreated the disease may be fatal within five years in 50-65 percent of cases. Many decades of research have shown that severe oxidative stress plays a significant role in tuberculosis patients. Moreover, the malnutrition which is commonly present in patient with tuberculosis can add to the impaired anti oxidant capacity. The present study was to investigate the effect of supplementation of vitamin A with standard treatment on the health status of newly diagnosed sputum positive pulmonary tuberculosis patients.Methods: Phase III, prospective, open, two arm parallel group, outpatient, randomized, active controlled study. Centre of the study was Tuberculosis clinic, Department of Internal medicine, Stanley Medical College Chennai.Duration of the study was for active drug therapy - 2 months, for follow up period - 4 months and for total period - 6 months.Results: In our study it was evident that there was a statistically significant improvement in the Karnofsky’s score, body mass index, mid upper arm circumference in the in the vitamin A supplementation group when compared to the control group at the end of 2 months and 6 months. And also, a statistically significant decrease in C.R.P. levels and E.S.R levels were also observed.Conclusions: This study shows that vitamin A as an add on therapy with regular anti-tuberculosis treatment improves the quality of life and decreases the disease activity in pulmonary tuberculosis patients to a greater extent than with routine standard drug therapy alone

A prospective open label study of efficacy and tolerability of topical tacrolimus in Vitiligo

Background: Vitiligo is a cosmetically and psychologically devastating clinical conundrum with various hypotheses of etiology inclusive of an immunological one too. Long term clinical visits, various adverse effects and cost of therapy are the major limitations of current treatment of vitiligo. Topical Tacrolimus which has been tried and found useful in various skin conditions with immunological basis was evaluated for its efficacy and tolerability compared with the available standard treatment of Topical Betamethasone.Methods: The study was done in the outpatient unit of Department of Dermatology, Stanley medical college, for duration of six months. Newly diagnosed vitiligo patients attending the outpatient clinic were taken for the study. A randomised, open labelled, comparative study of efficacy and tolerability of Topical Tacrolimus in vitiligo was done.Results: Early onset of repigmentation, higher mean repigmentation with no significant side effects systemically or topically were observed in the study group compared to the control group.Conclusions: This study shows that Topical Tacrolimus produces rapid and significant repigmentation with less significant side effects in vitiligo. Topical Tacrolimus is more efficacious and better tolerated than available standard Topical Betamethasone