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Background: Oral Abiraterone acetate is a novel antineoplastic agent approved by the FDA for the treatment of metastatic prostate cancer. Abiraterone is an irreversible inhibitor of the 17α-hydroxylase (CYP17) enzyme complex resulting in a reduction of androgens and corticosteroids. It may cause mineralocorticoid excess syndrome; hence, it is prescribed with steroids. Here we describe a case of postoperative severe hypokalemia with unusual presentation in a patient after spine surgery in which abiraterone with prednisolone was continued preoperatively. Anesthetic concerns about the perioperative administration of abiraterone have not been reported in the literature. Case presentation: An 80-year-old male with a known case of metastatic prostate cancer was posted for spine surgery under general anesthesia. Surgery was uneventful and the patient was extubated after ensuring adequate muscle power and respiratory parameters. Postoperatively, the patient developed aphonia, quadriparesis, and respiratory distress leading to reintubation. After evaluation, severe grade 4 hypokalemia was found to be the causative factor. The patient recovered well after potassium and steroid supplementation. Low potassium and cortisol levels indicate a diagnosis of abiraterone-induced hypokalemia. Conclusion: Patients on abiraterone require more stringent and vigilant monitoring of potassium and cortisol levels. In such circumstances, it might be advantageous to add additional steroids or substitute alternative steroids. [ABSTRACT FROM AUTHOR]

Background: Oral Abiraterone acetate is a novel antineoplastic agent approved by the FDA for the treatment of metastatic prostate cancer. Abiraterone is an irreversible inhibitor of the 17α-hydroxylase (CYP17) enzyme complex resulting in a reduction of androgens and corticosteroids. It may cause mineralocorticoid excess syndrome; hence, it is prescribed with steroids. Here we describe a case of postoperative severe hypokalemia with unusual presentation in a patient after spine surgery in which abiraterone with prednisolone was continued preoperatively. Anesthetic concerns about the perioperative administration of abiraterone have not been reported in the literature. Case presentation: An 80-year-old male with a known case of metastatic prostate cancer was posted for spine surgery under general anesthesia. Surgery was uneventful and the patient was extubated after ensuring adequate muscle power and respiratory parameters. Postoperatively, the patient developed aphonia, quadriparesis, and respiratory distress leading to reintubation. After evaluation, severe grade 4 hypokalemia was found to be the causative factor. The patient recovered well after potassium and steroid supplementation. Low potassium and cortisol levels indicate a diagnosis of abiraterone-induced hypokalemia. Conclusion: Patients on abiraterone require more stringent and vigilant monitoring of potassium and cortisol levels. In such circumstances, it might be advantageous to add additional steroids or substitute alternative steroids. [ABSTRACT FROM AUTHOR]

Background: Omega-3 fatty acids have been reported to reduce disease severity in psoriasis in various studies. This study aims to study the effects of omega-3 fatty acid supplementation on the quality of life in psoriasis. Methods: This open, non blinded interventional study divided patients of psoriasis with affected body surface area of less than <10% into two groups of 100 patients each. Group A was given topical paraffin with 1.8 grams of omega-3 fatty acids daily in three divided doses. Group B was advised topical paraffin application once a day. Oral antihistaminics were added as per need. Baseline patient characteristics like age, sex and severity of psoriasis by Psoriasis Area Severity Index and Dermatology Life Quality Index was assessed. The patients were followed up for 12 weeks and change in DLQI was noticed. Results: Baseline DLQI in group A changed by 2.96 points from 11.47 ± 3.90 to 8.51 ± 3.36. (p <0.00001) and by 1.27 points from 11.69 ± 3.75 to 10.42 ± 3.61 in group B (p<0.00001). The change in the DLQI between the two groups was statistically significant (p=0.0002).Conclusion: Omega-3 fatty acids appear to produce a statistically significant improvement in the quality of life in psoriasis patients. [ABSTRACT FROM AUTHOR]

Background: Scarring due to acne is a frequently encountered problem in dermatological outpatient department. Microneedling has been a well-accepted modality for the treatment of atrophic acne scars. Platelet-rich plasma (PRP) is a newer option to investigate. Aims: The aims of this study were (1) to compare the efficacy of combined dermaroller and PRP therapy with dermaroller alone in facial acne scars and (2) to assess the psychosocial impact due to acne scars and its treatment. Methods: A total of 55 patients were included in the study and randomly divided into two groups, Group A: 28 and Group B: 27. Proper counseling was done, and detailed clinical findings were recorded. Patients in Group A were treated with dermaroller alone while Group B patients underwent treatment with a combination of dermaroller and intradermal PRP injections. A total of three sitting were done at monthly interval. Final response was assessed at 1 month after the last sitting. Criteria of evaluation included Goodman and Baron's quantitative scale, visual analog score, and dermatology life quality index scores. Side effects were noted. Results were analyzed using Chi-square test and t-test. Results: Significant percentage improvement was noted in both the groups. However, Group B treated with both modalities had better results when compared with that in the Group A. Conclusion: A combination approach using dermaroller and PRP was a safe and better option than using dermaroller alone in atrophic acne scars for clinical improvement as well as for improvement in dermatology life quality index score. [ABSTRACT FROM AUTHOR]