European Journal of Molecular & Clinical Medicine

Background: Conventional vitiligo treatment on the hands and feet frequently yields
disappointing results. In the face, neck, and truncal areas, various ablative therapy
approaches were tested with positive results.
Material and methods: On 44 individual patients in each group with 44 pair-lesions of
non-segmental vitiligo on both hands, a prospective randomized study was done. In
(Group A) treatment with fractional CO2 laser, NB-UVB phototherapy, and 0.05 %
clobetasol propionate cream and NB-UVB phototherapy and 0.05 % clobetasol
propionate cream was given (Group B). For ten sessions, fractional CO2 laser was used
at four week intervals. NBUVB phototherapy was given twice a week for a total of 20
sessions. Twelve weeks following the last therapy, the patients were assessed. Standard
digital pictures, patient satisfaction, and adverse events were used to assess the
outcomes.
Results: Patients' satisfaction with lesions in group A was much higher than that of
group B. Lesions on dorsal surfaces of hands responded more quickly than those on
ventral surfaces.
Conclusion: In some individuals, combining fractional CO2 laser treatment with NBUVB
phototherapy and topical steroids enhances repigmentation in vitiliginous lesions
on the hands. Patients with vitiligo who have not responded to conventional therapies
may be offered this procedure.

Background: The laparoscopic cholecystectomy (LC) is the gold standard to treat gallstones. The present study was conducted to compare high- and low-pressure carbon dioxide pneumoperitoneum in patients undergoing laparoscopic cholecystectomy (LC).
Materials & Methods: 80 patients undergoing laparoscopic cholecystectomy were divided into 2 groups of 40 each. In group I, the pneumoperitoneum with PaCO2 of 7–10 mmHg and in group II with 12–14 mmHg using standard four-port method was used. Abdominal pain at the site of surgery and shoulder-tip pain were assessed based on the verbal rating scale (VRS). Parameters such as arterial blood pressure, heart rate, and body temperature were recorded during and 1 hour, 6 hours, 12 hours and 24 hours after the surgery.
Results: The mean abdominal pain was 7.8, 6.3, 5.2 and 4.5 and in group II 6.4, 4.1, 5.0 and 2.9 at 1 hour, 6 hours, 12 hours and 24 hours in group I and group II respectively. Nausea/vomiting score was 5.9, 4.5, 3.8 and 2.5 in group I and 4.7, 3.7, 2.6 and 2.1 in group II respectively. Shoulder tip pain in group I was 6.4, 4.6, 3.7 and 2.9 in group I and 6.0, 4.4, 3.2 and 1.9 in group II respectively. The difference was significant (P< 0.05).
Conclusion: Low pressure pneumoperitoneum was found to be betterthan high pressure pneumoperitoneum in patients with laparoscopic cholecystectomy.