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Objective: To determine the frequency of hypokalemia among COVID-19 patients and assess its impact on the patients management. Study type, settings & duration: It was a cross-sectional study conducted at Mayo Hospital, Lahore from July 2020 to January 2021. Methodology: A total of 212 SARS-COV-2 positive patients who had developed severe disease were enrolled. Based on the level of potassium, the patients were classified as mild, moderate and severe hypokalemia cases. Data was collected using a structured questionnaire including demography, clinical presentations and medication including use of anticoagulant and steroids. Results: Of the total 210, 46 (21.9%) patients had hypokalemia and among them 23 (11%) showed mild, 17 (8.1%) moderate and 6 (2.9%) severe hypokalemia. Out of 210, 17 (23.9%) patients were treated with hydrocortisone, 11 (17.4%) with methylprednisolone and 18 (23.3%) with dexamethasone and no significant difference was seen in development of hypokalemia (p =0.630). Similarly, 39 (21.4%) patients were given enoxaparin and 7 (24.1%) were given heparin, but no significant association was found between the type of anticoagulant being given and hypokalemia (p =0.754). No significant difference was observed with respect to gender in the development of hypokalemia (p =0.782). Conclusion: This study showed that hypokalemia was a significant clinical manifestation among SARS-COV-2 patients. Further it was noted that treatment regime used for COVID-19 management and gender of the patients are not a risk factor for developing the hypokalemia. [ABSTRACT FROM AUTHOR]

Objective To determine the percentage reduction in modified MASI score with combination of microneedling and tranexamic acid in patients of melasma. Methods This descriptive case series involved 66 patients of both genders aged 18-40 years having moderate to severe melasma. These patients were treated by microneedling with tranexamic acid at 0, 4 and 8 weeks. Baseline modified MASI scores at 0 weeks was calculated and outcome was evaluated after 12 weeks in the form of percentage reduction in the initial modified MASI scores, both clinically and photographically. Response was graded as excellent (>75% reduction), very good (50-74%), good (25-49%) and fair (<25%). Results A total of 66 patients with moderate to severe melasma were enrolled. Majority of the patients (53%) showed very good response, 41% had good response, 4.5% had excellent response while only 1.5% patients showed fair response. No serious side effects were noted. Conclusion Microneedling in conjunction with tranexamic acid showed very good response (50-74% improvement) in majority of the patients. [ABSTRACT FROM AUTHOR]