IMMUNE MODULATING DRUGS USED IN SKIN DISEASE AND MOST BOTHERING SIDE EFFECTS

1. Assistant Professor and Consultant family medicine, Department of Family Medicine, faculty of Medicine, King Abdulaziz university, KSA. 2. Medicinae Baccalaureus Baccalaureus Chirurgiae, bn Sina National College, KSA (postal address: Jjeddah, Al Thaghr neighbourhood 22338. 3. Medical Interns, Ibn Sina National College, KSA. 4. Medical Intern, King Faisal University, KSA. 5. Medical Intern, King Faisal University, KSA. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

69 This is mean this study was a good study Consistent with the accuracy of the figures used in this research, this is logically and computationally consistent with the way the analyst adheres to the data accurately.
Another study: Comparative Safety of Systemic Immuno-modulatory Medications in Adults with Atopic Dermatitis. (Schneeweiss MC, 2019) The objective was: evaluated the comparative risk of serious bacterial and opportunistic infections among users of systemic immuno-modulatory medications in patients with severe AD in routine care, and the result was: The incidence of serious infections was 7.53 per 1,000 (7.18-7.89) among systemic non-biologics and 7.38 per 1,000 (5.68-9.57) among phototherapy treated patients, and 2.6 per 1,000 (0.45-14.3) dupilumab users. (Schneeweiss MC, 2019) But on the other hand the mechanism used in the research in terms of comprehensiveness was superfluous, which leads to dispersion and lack of clarity, there are many drugs that fall under the title immune-modulatory drugs These medications may be a bit similar in the way they work inside the body, but in simplified terms the bodies are not similar in reaction to each drug, This was never evident in this research Research Aim: to determine the percentage success of immune-modulating drugs used in skin disease and most bothering side effects.
Objectives:- 1. To determine how many people used one of the immune-modulating drugs. 2. To study the relationship between the duration of drug use and the appearance of complications 3. To identify the most common complications. 4. The extent of the patient's evaluation of the drug used.

Methodology:-Study design:
This is an analytical cross-sectional study.

Study Setting and period:
This is an analytical cross-sectional study conducted in kingdom of saudia Arabia (Outpatient and in patient.), from 1/4/2019 till 19/10/2019.

Study population and sampling:
Study participants, Inclusion criteria: patient used immune-modulating drugs criteria; patient unused Non immune-modulating drugs.

Sampling Method:-
The study will be carried out by questionnaire.

Sampling size:
Sample size was calculated using OpenEpi for sample size calculation for cross sectional studies, hypothesizing the true answers Accordingly, 530 participants were gathered from the hospital patients. 78.68% of the respondents are females. The results showed that the majority of respondents did not use these drugs 88.30%, The results indicated that most respondents say that thary give the success of the medication more than 5 from 10. prevalence of who do not face any side effects 87.36%.
According to the prevalence study, the results indicated that most respondents who use the drugs use it for hand dermatitis 1.89%. the respondents distributed their responses almost equally to the drugs, the majority of them answered that the duration is from 7-10 days. 2. Disease-related information: used of medication, name of medication, duration, side effects, indication, success of the medication .

Outcome Measures:-
The outcome measure is by counting the ratio of the number of patients have used immune-modulating drugs in skin disease this will be measured using: By determining the extent of the success and side effects associated with used of immune-modulating drugs in skin disease.
Prevalence study: will be carried to test the questionnaire if easily understood and the response of the participants. Data from the cross-sectional study will be used to calculate the sample size. Data Management and Analysis plan: Data will be entered and analyzed using SPSS version 17.0 Descriptive statistics will be performed and categorical data will be displayed as frequencies and percentages while measures of central tendencies and measures and dispersion will be used to summarize continuous variables. Univariate and multivariate analysis will be performed to investigate association between exposure factors and associated disease. statistical significance is set at a P value of 0.05 or less.

Statistical analysis
Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 17. Descriptive statistics were displayed as frequencies and percentages for categorical variables. Measures of central tendencies (the median), and measures and dispersion (minimummaximum) were used to summarize continuous variables, as the continuous variables were not normally distributed when tested by Shapiro-Wilk test. Univariate analysis was performed to investigate the association between the exposure factors with the outcome on the one hand, this was performed using Chi-squared test and Mann-Whitney test. Multivariate analysis to investigate factors independently was performed using binary logistic regression. P value was set at a significance level of < 0.05.

Results:-
In this study, the aim was to determine the percentage success of immune-modulating drugs used in skin disease and most bothering side effects. , 530 patients' participants, were consecutively recruited from in patients' clinics, during a period from 1/4/2019 to 19/10/2019 According to drugs 88.30% of respondents did not use these drugs, The results indicated that most respondents say that thay give the success of the medication more than 5 from 10. prevalence of who do not face any side effects 87.36%. Frequency

Discussion:-
This study was based on a number of 530 participants, from this study as the number of patients have used of immune-modulating drugs in skin disease is 62, The results indicated that most respondents say that thay give the success of the medication more than 5 from 10, 27%. prevalence of who do not face any side effects 87.36%. The current study showed statistically significant (P value is 0.01) and (P value is 0.05),

Conclusion:-
Results showed that 27% of the samples gave the drugs a rating greater than 5 out of 10, and by 21% gave the drugs a rating 10 out of 10.

Recommendation:-
We recommend setting up health education programs about the geriatric diseases specially kidney disease and hypertension, this health problem must be presented broadly and beneficially and, in a way, that everyone understands, as most deal with the kidney disease by ignoring and not being important, work should be done on health conferences and medical discussions on that.

Source of funding: self-funded:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
-I have not used any of these drugs For how long? -7-10 days -15-30 days -More than 30 days -3-6 months -Nothing of the above Select the indication to use? psoriasis -Chronic plaque psoriasis -Atopic eczema -Hand dermatitis -Chronic photosensitivity dermatitis -Lichen planus 80 -Bullous pemphigoid -Drug-induced nummular dermatitis -Nothing of the above Select the side effects? -Low blood counts -Mouth sores -Poor appetite -Skin rash, reddening of the skin -Nausea and vomiting -Alopecia -Skin photosensitivity -None of the above How much do you give an evaluation of the success of this medication from 10? more than 5 less than 5 -10