Biomedical subjects

Aamir Haider

Publications and source records attributed to Aamir Haider.

5 recordsLinked to original sources

PubMed2006

Socioeconomic status influences care of patients with acne in Ontario, Canada.

BACKGROUND: Canada's universal health care system is designed to ensure equitable access to medical care based on need rather than socioeconomic status, although a number of studies indicate a preferential access and greater use of specialist services for those patients in higher socioeconomic groups. OBJECTIVES: The primary objective of this study was to determine whether socioeconomic status influences access to specialist care by a dermatologist for the management of acne in Ontario, Canada. A secondary objective was to determine whether the urban-rural dwelling status of patients affects access to specialty care. METHODS: We conducted a population-based cohort study using administrative health care databases covering more than 12 million residents of Ontario. Individuals age 12 to 27 years with a new diagnosis of acne by a general practitioner were identified as belonging to 1 of 5 socioeconomic groups based on median annual neighborhood household income. Patients were then observed for 2 years after the index visit to identify visits to a dermatologist. The main outcome measure was visitation to a dermatologist within 2 years of an initial diagnosis of acne. RESULTS: The study cohort consisted of 295,469 patients given a diagnosis of acne by their primary care physician of which 59,799 (20%) were subsequently referred to a dermatologist. Of those in the lowest income group of less than Can dollars 20,000, 17% were referred to a dermatologist, as compared with 24% in the highest income group of greater than Can dollars 80,000 (P value for trend < .001). Furthermore, patients living in an urban area had a 43% greater likelihood of being referred to a dermatologist (odds ratio 1.43, 95% confidence interval 1.39-1.48) as compared with patients in a rural location. LIMITATIONS: Limitations of our study include imputing socioeconomic status of patients on the basis of median income at the neighborhood level rather than on the basis of data on individual patients. Furthermore, our use of administrative databases did not allow us to characterize the severity of acne in our population cohort and whether that would affect referral patterns. CONCLUSION: Within Canada's universal health care system, those likely to be in lower socioeconomic groups are significantly less likely to visit a dermatologist for specialist consultation.

Acne Vulgaris↗

PubMed2005

Focal hyperhidrosis: diagnosis and management.

Hyperhidrosis, a condition characterized by excessive sweating, can be generalized or focal. Generalized hyperhidrosis involves the entire body and is usually part of an underlying condition, most often an infectious, endocrine or neurologic disorder. Focal hyperhidrosis is idiopathic, occurring in otherwise healthy people. It affects 1 or more body areas, most often the palms, armpits, soles or face. Almost 3% of the general population, largely people aged between 25 and 64 years, experience hyperhidrosis. The condition carries a substantial psychological and social burden, since it interferes with daily activities. However, patients rarely seek a physician's help because many are unaware that they have a treatable medical disorder. Early detection and management of hyperhidrosis can significantly improve a patient's quality of life. There are various topical, systemic, surgical and nonsurgical treatments available with efficacy rates greater than 90%-95%.

Administration, Topical↗

PubMed2004

Treatment of acne vulgaris.

CONTEXT: Management of acne vulgaris by nondermatologists is increasing. Current understanding of the different presentations of acne allows for individualized treatments and improved outcomes. OBJECTIVE: To review the best evidence available for individualized treatment of acne. DATA SOURCES: Search of MEDLINE, EMBASE, and the Cochrane database to search for all English-language articles on acne treatment from 1966 to 2004. STUDY SELECTION: Well-designed randomized controlled trials, meta-analyses, and other systematic reviews are the focus of this article. DATA EXTRACTION: Acne literature is characterized by a lack of standardization with respect to outcome measures and methods used to grade disease severity. DATA SYNTHESIS: Main outcome measures of 29 randomized double-blind trials that were evaluated included reductions in inflammatory, noninflammatory, and total acne lesion counts. Topical retinoids reduce the number of comedones and inflammatory lesions in the range of 40% to 70%. These agents are the mainstay of therapy in patients with comedones only. Other agents, including topical antimicrobials, oral antibiotics, hormonal therapy (in women), and isotretinoin all yield high response rates. Patients with mild to moderate severity inflammatory acne with papules and pustules should be treated with topical antibiotics combined with retinoids. Oral antibiotics are first-line therapy in patients with moderate to severe inflammatory acne while oral isotretinoin is indicated for severe nodular acne, treatment failures, scarring, frequent relapses, or in cases of severe psychological distress. Long-term topical or oral antibiotic therapy should be avoided when feasible to minimize occurrence of bacterial resistance. Isotretinoin is a powerful teratogen mandating strict precautions for use among women of childbearing age. CONCLUSIONS: Acne responses to treatment vary considerably. Frequently more than 1 treatment modality is used concomitantly. Best results are seen when treatments are individualized on the basis of clinical presentation.

Acne Vulgaris↗

PubMed2004

Hyperhidrosis: an approach to diagnosis and management.

Hyperhidrosis is defined as focal or generalized excessive sweating with a prevalence of 2.8% of the general population. This medical condition is associated with significant psychosocial morbidity and has a dramatic impact on activities of daily living. A significant proportion of patients do not consult a physician for this condition. Early diagnosis is essential in order to implement management strategies that have excellent efficacy rates and patient satisfaction.

Humans↗

PubMed2003

Management of dyslipidemia in primary care.

BACKGROUND: Cardiovascular disease remains the leading cause of mortality in Canada. The link between hyperlipidemia and coronary heart disease has been clearly established. There is overwhelming evidence for reductions in coronary events and cardiovascular mortality with lowering of low-density lipoprotein cholesterol (LDL-C). Despite the evidence, hyperlipidemia treatment remains suboptimal. OBJECTIVE: To evaluate compliance with published dyslipidemia guidelines in a primary care setting. The primary outcome measure was target LDL-C level. METHODS: Retrospective chart review of a random selection of 300 patients diagnosed with hyperlipidemia in a large academic family medicine clinic. The primary outcome measure was a target LDL-C level of less than 2.5 mmol/L for patients with diabetes or coronary heart disease. For patients without diabetes or coronary heart disease, Framingham risk assessment tables were used to determine ideal target LDL-C levels. RESULTS: Overall, 53% of patients achieved target LDL-C. Target LDL-C levels were achieved in 48% of patients with diabetes or coronary heart disease. Males were twice as likely to be prescribed lipid lowering therapy than females. Males on lipid lowering therapy were twice as likely as females on lipid lowering therapy to achieve target LDL-C levels. Males with diabetes or coronary heart disease were twice as likely as females with diabetes or coronary heart disease to achieve target LDL-C levels. Only 44% of patients with diabetes or coronary heart disease were prescribed lipid lowering therapy. CONCLUSION: Results from an academic family medicine clinic indicate suboptimal compliance with current dyslipidemia management guidelines. Primary care physicians need to continue to take an aggressive stance on lipid lowering strategies, especially in high-risk patients and females.

Aged↗