A Randomized Study to Evaluate the Efficacy and Adverse Effects of Cryotherapy Combined with Intralesional Steroids, Intralesional Bleomycin Combined with Steroids and Fractional CO2 Laser in Keloids
Bibliographic record
Abstract
Abstract Background: Despite the availability of various treatment modalities, the treatment of keloids is often incomplete, with a high recurrence rate. The present study was undertaken to assess the efficacy and safety of cryotherapy combined with intralesional steroid injections (Cy + ILS), intralesional combined bleomycin and steroids (ILB + S), and fractional carbon dioxide laser (Fr CO 2 ) in keloid management. Patients and Methods: Ninety cases with keloids were enrolled and randomly divided into three groups of 30 patients each. The baseline severity of keloids was graded using the Vancouver scar scale (VSS) and high-frequency ultrasonography (HFUS). Group A, B, and C patients were treated with Cy + ILS, ILB + S, and Fr CO 2 , respectively for four sittings at 4-week intervals. Improvement in VSS score was calculated after 4, 8, 12, and 16 weeks, and with HFUS after 16 weeks. At each visit, adverse effects, if any, were noted. Statistical analysis was done using Chi-square test and ANOVA. Results: At the end of 16 weeks, the reductions in VSS in Cy + ILS, ILB + S, and Fr CO 2 groups were 5.12 (60.09%), 5.84 (69.30%), and 3.06 (38.3%), respectively ( P = 0.00). The difference in mean VSS reduction after 16 weeks between ILB + S and Cy + ILS was not significant ( P = 0.28), whereas ILB + S and Cy + ILS were more efficacious than Fr CO 2 ( P = 0.01 and P = 0.02, respectively). The incidence of adverse effects was comparable between ILB + S and Fr CO 2 ( P = 0.11) but higher with Cy + ILS ( P = 0.04). Limitations: Small sample size, non-blinded design, and short follow-up period. Conclusion: ILB + S may be considered as the first-line treatment option for keloids in view of its satisfactory efficacy, and excellent safety profile.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".