{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:45:05Z","timestamp":1767109505848},"reference-count":0,"publisher":"Pakistan Medical Association","issue":"10 (Supple-08)","license":[{"start":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:00:00Z","timestamp":1727481600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Pak Med Assoc"],"abstract":"<jats:p>Objective: To evaluate the effectiveness of combining high-intensity focussed ultrasound and a Q-switched neodymium-doped yttrium aluminium garnet 1064nm low-fluence toning laser in the treatment of melasma.\r\nMethod: The experimental study was conducted from November 2020 to August 2021 at the medical physics laboratory, College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised individuals of either gender aged &gt;25 years having mixed form melasma in malar and forehead areas. Each participant received high-intensity focussed ultrasound treatment on the right side. After 2 weeks, Q-switched neodymium-doped yttrium aluminium garnet 1064nm low-fluence toning laser was applied to the melasma patches 4 times at one-week intervals. Melasma area and severity index scores were noted at baseline and at each visit for each patient. Visual analogue scale was used for objective evaluation. After the 4 laser sessions, all the patients completed a 3-month follow-up. Data was analysed using SPSS 24.\r\nResults: Of the 25 subjects, 15(60%) were females and 10(40%) were males. The overall mean age was 41.6\u00b18.46 years (range: 22-60 years). There was a significant improvement with high-intensity focussed ultrasound (p&lt;0.05). In the 3rd laser session, there was a significant difference in melasma area and severity index score of 2.48 for the right side and 3.12 for the left side (p&lt;0.05). In the 4th session, there was a significant difference in melasma area and severity index score of 1.68 for the right side and 2 for the left side (p&lt;0.05). No post-inflammatory hyperpigmentation or rebound was noted.\r\nConclusion: High-intensity focussed ultrasound combined with toning laser was more effective than Q-switched neodymium-doped yttrium aluminium garnet 1064nm low-fluence laser alone in removing difficult melasma from the malar area in the 2nd, 3rd and 4th sessions, and from the forehead in the 3d and 4th sessions.\r\nKey Words: Aluminum, Neodymium, Melanosis, Yttrium<\/jats:p>","DOI":"10.47391\/jpma-bagh-16-75","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T14:13:01Z","timestamp":1728396781000},"page":"S326-S331","source":"Crossref","is-referenced-by-count":1,"title":["Melasma removal using Q-Switched Neodymium-doped Yttrium Aluminium Garnet laser toning and high-intensity focussed ultrasound"],"prefix":"10.47391","volume":"74","author":[{"family":"Shahad Abdulhadi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Mustafa Salih Al Mousawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Wissam Majeed Kattoof","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"26547","published-online":{"date-parts":[[2024,9,28]]},"container-title":["Journal of the Pakistan Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/jpma.org.pk\/index.php\/public_html\/article\/download\/21909\/3740","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jpma.org.pk\/index.php\/public_html\/article\/download\/21909\/3740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T14:13:01Z","timestamp":1728655981000},"score":1,"resource":{"primary":{"URL":"https:\/\/jpma.org.pk\/index.php\/public_html\/article\/view\/21909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,28]]},"references-count":0,"journal-issue":{"issue":"10 (Supple-08)","published-online":{"date-parts":[[2024,9,28]]}},"URL":"https:\/\/doi.org\/10.47391\/jpma-bagh-16-75","relation":{},"ISSN":["0030-9982","0030-9982"],"issn-type":[{"type":"electronic","value":"0030-9982"},{"type":"print","value":"0030-9982"}],"subject":[],"published":{"date-parts":[[2024,9,28]]}}}