Comparative Efficacy & Safety of Intralesional Verapamil versus Intralesional Triamcinolone Acetonide as First-Line Therapy for Treating Hypertrophic Scars & Keloids
Bibliographic record
Abstract
Background: Hypertrophic scars and keloids are challenging fibroproliferative disorders with high recurrence rates. Intralesional therapies like verapamil and triamcinolone acetonide are widely used, yet their comparative efficacy and safety as first-line treatments remain underexplored. Objective: To compare the efficacy & safety of Intra lesional Verapamil versus Intra lesional Triamcinolone Acetonide as first-line therapy in treatment of Hypertrophic scars and Keloids. Study Design & Setting: Randomized clinical trial conducted on patients attending OPD of Plastic and reconstructive department of Sheikh Zayed Medical College, Rahim Yar Khan August 2022 to July 2023. Methodology: Patients fulfilling inclusion criteria were selected through non probability purposive sampling. After randomization, the study participants were divided into 2 groups, A and B. Group A given Intra lesional Injection of Verapamil, 2.5 mg/ml every 4 weeks and in Group B, Intralesional Injection of Trimcinolone Acetonide at a dose of 40 mg/ml was given at 4 weeks interval. A total of 6 sessions were done or till the flattening of the scar. Follow up was done after 5 months or till the scar was flattened by calculating Vancouver scar scale. VSS of < 3 was taken as success of treatment. After data collection and analysis, frequencies & percentages were calculated. The success rate of treatment with Intra lesional Injection of verapamil was compared to Intra lesional Injection of Triamcinolone Acetonide, Chi square test and t-tests were used as test of significance for qualitative and quantitative variables respectively. Results: This study conducted on 60 patients showed that most patients having hypertrophic scars and keloids were between ages 12-55 years. 60% affected were males, 45% dark skinned, 55% gave history of burn as most prevalent because whereas most common site of scars was presternal in both the groups (40 and 36.6%). The success of treatment in Group A treated with Intra lesional Injection of Verapamil was 28% versus 72% in patient in Group B this difference was statistically significant. Clinical Implication: Identifying a more effective and safer first-line intralesional agent can significantly improve scar outcomes, reduce recurrence, and guide evidence-based clinical management of keloids and hypertrophic scars. Conclusion: Intra lesional Injection of Triamcinolone Acetonide has better efficacy and safety than Intra lesional Verapamil as 1st line therapy in treating hypertrophic scars and keloids. Keywords: Hypertrophic Scar, Keloid, Intra lesional, First-line therapy, Verapamil,
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".