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Title: Effect of Topical Liquid Nitrogen on Pain Reduction during Intradermal Platelet-Rich Plasma Therapy Scalp in Androgenic Alopecia
Authors: Moizza Tahir, Sadia Malik, Khawar Kamal, Najia Ahmed, Atiya Rahman, Siddiqa Javaid
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2022
Volume: 72
Issue: 5
Language: English
DOI: 10.51253/pafmj.v72i5.7857
Keywords: Androgenic alopeciaPlatelet-rich plasma therapyPainless platelet-rich plasma therapy
Objective: To compare the effect of topical liquid Nitrogen and normal saline on pain during intradermal Platelet-rich Plasma therapy in androgenic alopecia.
Study Design: Prospective Comparative study.
Place and Duration of Study: Tertiary Care Hospital, Gujranwala Pakistan, from Mar to Nov 2021.
Methodology: Sixty-four patients with the clinical diagnosis of androgenic alopecia were enrolled after informed consent.After liquid Nitrogen contact application, Group- A patients opted to receive intradermal Platelet-rich Plasma on the scalp. In contrast, patients in Group-B opted to receive Platelet-rich Plasma after normal Saline topical application for improved pain tolerance.
Results: Out of Sixty-four patients, there were 45(70.3%) males, 19(29.7%) females. Pain in intradermal Platelet-rich Plasma injection of the scalp in Group-A had a median (IQR) score of 4 (3-5), while Group-B had a median (IQR) of 5(3-7.5). Patient satisfaction score at the end of three sessions of PRP in group-A had a median (IQR) of 1.5(1-2), and in Group-B, a median (IQR) of 2(1-2).
Conclusion: Topical liquid Nitrogen application improved pain tolerance during intradermal Platelet-rich Plasma therapy in androgenic alopecia compared to normal saline. Satisfaction of patients with Platelet-rich Plasma therapy between the two groups had no significant difference.
To compare the effect of topical liquid Nitrogen and normal saline on pain during intradermal Platelet-rich Plasma therapy in androgenic alopecia, and to compare patient satisfaction with Platelet-rich Plasma therapy between the two groups.
Prospective comparative study involving 64 patients with androgenic alopecia. Patients were divided into two groups: Group A received intradermal Platelet-rich Plasma (PRP) after topical liquid nitrogen application, and Group B received PRP after topical normal saline application. Pain was assessed using a 10-point numerical rating scale, and patient satisfaction was evaluated on a 4-grade scale. PRP was prepared from autologous blood via centrifugation.
graph TD;
A["Enroll 64 patients with Androgenic Alopecia"] --> B["Divide into Group A"Liquid Nitrogen" and Group B"Normal Saline""];
B --> C["Apply topical agent to scalp"];
C --> D["Administer intradermal PRP injection"];
D --> E["Assess pain using numerical rating scale"];
D --> F["Assess patient satisfaction"];
E --> G["Analyze pain data"];
F --> H["Analyze satisfaction data"];
G --> I["Compare pain scores between groups"];
H --> J["Compare satisfaction scores between groups"];
I --> K["Draw conclusions on pain reduction"];
J --> L["Draw conclusions on patient satisfaction"];
K --> M["Final Report"];
L --> M;
PRP is a recognized treatment for androgenic alopecia, but injection-related pain can be a barrier. Topical liquid nitrogen appears to be an effective and inexpensive method for reducing pain during PRP scalp injections compared to normal saline, without negatively impacting patient satisfaction. The study highlights the need for standardized protocols in PRP preparation and administration.
The median pain score in Group A (liquid nitrogen) was 4 (IQR 3-5), while in Group B (normal saline) it was 5 (IQR 3-7.5). Pain tolerance improved significantly with liquid nitrogen (p=0.030). Patient satisfaction scores were similar between the two groups, with a median of 1.5 (IQR 1-2) in Group A and 2 (IQR 1-2) in Group B, with no statistically significant difference (p=0.197).
Topical liquid nitrogen application improved pain tolerance during intradermal Platelet-rich Plasma therapy for androgenic alopecia compared to normal saline. Patient satisfaction with the PRP therapy procedure showed no significant difference between the two groups.
* The study enrolled 64 patients with androgenic alopecia.
* The study was conducted from March to November 2021.
* The p-value for the difference in pain scores between the two groups was 0.030, indicating a statistically significant improvement with liquid nitrogen.
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