Ionic Anti-Viral Intralesional Therapy in Plantar Warts

Abstract Background Warts (verrucas) are an extremely common, benign, and usually self-limited skin disease. Their size ranges from a few millimetres to several centimetres. The normal skin lines are interrupted by skin coloured to brownish-grey proliferations, the diagnosis is established clinically; no supplementary histologic or virologic investigations are needed. Objective The aim of this two armed double blinded randomized clinical trial was to evaluate the clinical efficacy of intralesional combined digoxin and furosemide in the treatment of multiple planter warts. Methods This study included 40 patients with plantar warts, they were divided into 2 groups, 20 patients per group, the first group received intralesional normal saline, one injection session every week for maximum 5 injection sessions. The second group received intralesional combined digoxin and furosemide, one injection session every week for maximum 5 injection sessions. All the patients were recruited from the Dermatology outpatient clinic at Ain-Shams University Hospital and Shobra General Hospital during the period From July 2018 to July 2019. Results There was no statistically significant difference between the 2 studied groups as regard size of wart before treatment. While there was statistically significant difference between the 2 studied groups as regard size of wart after the 5th session. Also there was a steady increase in the response to treatment in group 2 showing an earlier response to treatment and most of patients with excellent and very good response to treatment after the 5th session. There was no statistically significant difference between the 2 studied groups as regard the number of warts before treatment. While there was statistically significant difference between the 2 studied groups as regard the number of warts after the 5th session. There was no statistically significant correlation between age, sex, disease duration and response to treatment (as regard reduction in number of warts) after the 5th session in group 2. While in group 1 there was no reduction in number of warts after the 5th session. There was a statistically significant difference between the number of warts before and after receiving the active treatment in group 1, in group 2 and for both groups together (all patients). Conclusion We concluded from this study that intralesional injection of combined digoxin and furosemide offers effective alternative form of treatment for plantar warts in adults. It is inexpensive and safe to treat plantar warts.

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Zinc supplementation in preterm neonates with jaundice: is it beneficial?

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666201223110241 ◽

2020 ◽

Vol 21 ◽

Author(s):

Mohamed Shawky Elfarargy ◽

Ghada M Al-Ashmawy ◽

Sally Abu-Risha

Keyword(s):

Neonatal Jaundice ◽

Serum Bilirubin ◽

Zinc Supplementation ◽

University Hospital ◽

Preterm Neonates ◽

P Value ◽

Indirect Bilirubin ◽

Significant Difference ◽

Group 2 ◽

Group 1

Background: Neonatal jaundice is a common neonatal disease which had adverse effect in the neonates especially preterm neonates when the level of indirect bilirubin is high enough to pass the blood brain barrier causing bilirubin encephalopathy or kernicterus. Aim: The aim of this study is to investigate the value of zinc (Zn) supplementation in preterm neonates with jaundice and if it will be beneficial or not. Patients and methods: A prospective randomized clinical trial (RCT) study, identification number is TCTR20200504007, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 200 preterm neonates suffering from neonatal jaundice. The studied neonates were divided into 2 groups: group 1, which received Zn and phototherapy, and group 2, which received phototherapy only and did not take Zn. In the group 1, 100 preterm neonates with jaundice received Zn as 0.6 ml(cm3 ) of zinc origin/kg/day orally through oro/nasogastric tube divided into 2 doses (/12 hours) which is equal 1.2 mg elemental zinc/kg/day orally for 10 day. Results: There was no significant difference in serum bilirubin between the 2 groups in the 2nd, 4th and 6th day of admission while the serum bilirubin was significantly decreased in neonates who were treated by Zn and phototherapy in group 1, compared with neonates of group 2 who were treated with phototherapy only in the 8th , 9th and 10th day of admission where the p value was 0.045* ,0.027* and 0.004* respectively. Conclusion: Zn administration in jaundiced preterm neonates is beneficial in decreasing serum bilirubin. Recommendation: Zn supplementation for jaundiced preterm neonates.

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Molecular Imaging in the selection and evaluation of response in patients treated with Radium-223 in six different solid tumors: A single center experience

10.21203/rs.3.rs-19016/v1 ◽

2020 ◽

Author(s):

SEVASTIAN MEDINA-ORNELAS ◽

FRANCISCO OSVALDO GARCIA-PEREZ ◽

MIGUEL Alvarez-Avitia ◽

NORA SOBREVILLA-MORENO ◽

ZAEL SANTANA-RIOS ◽

...

Keyword(s):

Prostate Cancer ◽

Solid Tumors ◽

Tumor Burden ◽

Response To Treatment ◽

Radium 223 ◽

Pet Ct ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Objective: Evaluate impact after 223 Ra therapy and 18 F-NaF (sodium fluoride) PET/CT in the selection and evaluation of response in patients treated with 223 Ra in six different solid tumors. Material and Methods: Twenty patients with metastatic castration-resistant prostate cancer (mCRPC), seven metastatic castration-sensitive prostate cancer (mCSPC), three osteosarcoma, two breast cancer, two non-small cell lung cancer (NSCLC), one chondrosarcoma, one chordoma and one patient lung neuroendocrine carcinoma. Three groups of study were defined according total skeletal tumor-burden obtained by 18 F-NaF PET/CT, group 1 <1000cm 3 , group 2 1001–2999cm 3 and group 3 >3000cm 3 VOI´s. A semi-quantitative comparison was performed measuring the SUVmax values of VOIs values in all bone metastases in each patient previous to receive the first cycle of 223 Ra, after 3 and 6 cycles. Results: 30 patients non-progress disease was documented after 24±4 weeks. 8 patients progress disease was presented after three cycles of 223 Ra, two patients with osteosarcoma, four patients with mCRPC, one patient with chondrosarcoma and one patient with NSCLC. Group 1 patients showed better response rates compared to group 3 (p<0.05). Group 2 patients who showed improvement clinical and radiological, had prostate malignancies compared to those in the same group, but non-prostatic malignancies (p<0.05). No significant difference in group 2 patients compared to group 3 (p<0.67). Symptomatic skeletal-related event was observed in 7 patients. Conclusion: 18 F-NaF PET/CT allows to identify patients who show osteoblastic bone activity and discard or confirm progression in the interval PET/CT image, allowing change of treatment, reducing costs. High tumor-burden strongly suggests a poor response to treatment

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Endolymphatic irradiation in preparation for renal transplantation: a 26-year's follow-up

Sao Paulo Medical Journal ◽

10.1590/s1516-31801998000300004 ◽

1998 ◽

Vol 116 (3) ◽

pp. 1710-1714 ◽

Cited By ~ 1

Author(s):

Maria Margarida Galvão ◽

Zulma Fernandes Peixinho ◽

Nelson Figueiredo Mendes ◽

Luiz Estevão Ianhez ◽

Emil Sabbaga

Keyword(s):

Specific Activity ◽

Graft Loss ◽

Treated Group ◽

University Hospital ◽

Control Group ◽

Kidney Graft ◽

Significant Difference ◽

Group 2 ◽

Group 1

OBJECTIVE: The aim of the present study was to analyze the long-term evolution of patients submitted to endolymphatic irradiation as a pre-transplant preparation. SETTING: Referral center of university hospital. DESIGN: Case-control study. MAIN OUTCOMES MEASURES: The study was designed to evaluate the incidence of rejection, kidney loss, leukopenia, infection, and graft survival in the group treated (group 1) prior to surgery, compared to a control group (group 2) composed of patients under identical clinical conditions (sex, age, type of donor, immunosuppressive therapy and time of transplant) that did not undergo treatment preparation. PATIENTS: Patients were selected from amongst transplantation candidates on a long-term waiting list, some with a high level of antibodies against panel. The control group was chosen from amongst recently transplanted patients. Patients in the treated group received lipoiodine containing 131I with specific activity ranging between 4 and 6 mCu/ml. RESULTS: A significant difference between the two groups was found with regard to the incidence of rejection crises (21.0% in group 1 and 73.6% in group 2; P= 0.003), and the maintenance dose of azathioprine (smaller in group 1; P< 0.01). As to kidney graft loss due to rejection, a tendency to significance could be identified (10.5% in group 1 and 42.1% in group 2; P= 0.063); however, the difference was not significant between the two groups in terms of reversibility of rejection episodes during the first 60 post-transplant days. CONCLUSIONS: The authors concluded that this method, besides being relatively innocuous (there was no compromising of either the thyroid gland or of gonad function and there was no increase in tumor incidence), has an extended immunosuppressive effect, and can be indicated for cadaveric renal allograft recipients, especially those showing high panel reactivity.

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Comparison between different techniques for treatment of sub macular haemorrhage due to Age Related Macular Degeneration

10.21203/rs.2.14176/v1 ◽

2019 ◽

Author(s):

Ahmed Abdelwahab Saad ◽

Daniela Vaideanu-Collins ◽

Lyudmila Kishikova ◽

Marco Isac ◽

Dina Hamada ◽

...

Keyword(s):

Macular Degeneration ◽

Visual Outcome ◽

Age Related Macular Degeneration ◽

University Hospital ◽

James Cook ◽

Age Related ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Group 1

Abstract Background To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of sub macular haemorrhage (SMH) due to Neovascular age related macular degeneration Methods We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 in James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50ug in 0.1 ML), 0.3 ml of pure SF6. 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25ug in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air.Results The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 (p= 0.8734). The mean postoperative BCVA at six months was 0.31 in group 1 and 0.58 in group 2 (p=0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure (p=0.7009).Conclusion Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in AMD. Additional subretinal air doesn't seem to improve the outcome in cases having vitrectcomy.

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The Negligible Effect of Metformin Addition to Letrozole in Treating Overweight Women with PCOS

10.52916/jogs204008 ◽

2020 ◽

pp. 1-6

Author(s):

Mohamed Nabih EL-Gharib

Keyword(s):

Menstrual Cycle ◽

Pregnancy Rate ◽

Polycystic Ovarian Syndrome ◽

Endometrial Thickness ◽

University Hospital ◽

Overweight Women ◽

Significant Difference ◽

Group 2 ◽

Ovarian Syndrome ◽

Group 1

Aim: To compare the effects of letrozole alone and letrozole plus metformin on ovulation induction, endometrial thickness, number of ovarian follicles and, the pregnancy rate in overweight, infertile women with the polycystic ovarian syndrome. Study design: Prospective, randomized clinical trial. Material and methods: This study was conducted on 120 patients with polycystic ovarian syndrome, recruited from the infertility clinic of Tanta University Hospital, January 2017 to December 2019. Sixty women were assigned at random to each group. In a group, 1 patient received only daily 5 mg letrozole between days 3 and 7 of the menstrual cycle, and in group 2, continuous metformin was used at the dose of 500mg/TDS/day for three months; afterward, daily 5 mg letrozole between 3 and 7 days of the menstrual cycle was added to the metformin therapy. The patients were treated until pregnancy occurred, or three cycles were reached without pregnancy. Results: There was an insignificant increase in the cumulative pregnancy rate between the metformin-letrazole and the letrazole group. In the metformin-letrozole group, 28.33% of the patents got pregnant, compared with 25% of the patients in the letrazole group. There was no significant difference between the letrazole and the metforminletrazole group regarding ovulation rate, number of the follicle, endometrial thickness, and progesterone level. Conclusion: The addition of metformin to letrazole does not improve the outcome of overweight PCOS women.

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Evaluation of Clinical Parameters in FMT-Application of a Vibrant Soundbridge® at the Short Incus Process Compared to Conventional FMT-Application

Surgical Case Reports ◽

10.31487/j.scr.2020.05.04 ◽

2020 ◽

pp. 1-4

Author(s):

Markus Pirlich ◽

Andreas Dietz ◽

Markus Pirlich ◽

Viktor Kunz

Keyword(s):

Pure Tone ◽

Revision Rate ◽

University Hospital ◽

Complication Rates ◽

Vibrant Soundbridge ◽

Surgical Time ◽

Pure Tone Audiogram ◽

Significant Difference ◽

Group 2 ◽

Group 1

Background: The application of the Floating Mass Transducer (FMT) of a Vibrant Soundbridge (VSB) to the short incus process is intended to reduce both the surgery time and the complication and revision rate compared to other forms of application. In addition to collecting these parameters, the aim of this study is to investigate the primary audiological outcome of patients with an FMT application to the short process compared to the conventional methods. Methods: The present study retrospectively examined a total of n=36 patients who received a VSB between 01/2015 and 08/2018 at the ENT University Hospital Leipzig. In n=12 patients (group 1) the FMT was coupled to the short process, in n=24 patients (group 2) to other ear structures. The audiological results were evaluated pre- and postoperatively in the pure tone audiogram according to the recommendations of the AAO-HNS (1995) and the intelligibility (Freiburger, monosyllabic) was measured at 65 dB in the speech audiogram. In addition, the revision and complication rates as well as the surgical time were evaluated. Results: The audiological outcome of group 2 was significantly better postoperatively in both the pure tone (p<.001) and speech audiogram (p=.012). The surgery time of group 1 was significantly shorter (p=.002), but with a slightly increased revision rate (p=.519). The complication rate of group 2 was slightly higher, with no statistically significant difference to group 1 (p=.185). Conclusions: The FMT application on the short ambos process does not seem to offer any advantage in terms of audiological outcome, but at the same time is associated with a significantly shorter surgery time. There are no statistically significant differences in revision and complication rates.

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Comparison between different techniques for treatment of submacular haemorrhage due to Age-Related Macular Degeneration

European Journal of Ophthalmology ◽

10.1177/1120672120959551 ◽

2020 ◽

pp. 112067212095955

Author(s):

Lyudmila Kishikova ◽

Ahmed Abdelwahab A Saad ◽

Daniela Vaideanu-Collins ◽

Marco Isac ◽

Dina Hamada ◽

...

Keyword(s):

Macular Degeneration ◽

Sulfur Hexafluoride ◽

Visual Outcome ◽

Age Related Macular Degeneration ◽

University Hospital ◽

Age Related ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose: To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of submacular haemorrhage (SMH) due to Neovascular age related macular degeneration. Methods: We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 at James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50 µg in 0.1 ML), 0.3 ml of pure sulfur hexafluoride (SF6). 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25 µg in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air. Results: The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 ( p = 0.8734). The mean postoperative BCVA at 6 months was 0.31 in group 1 and 0.58 in group 2 ( p = 0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure ( p = 0.7009). Conclusion: Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in age-related macular degeneration. Additional subretinal air doesn’t seem to improve the outcome in cases having vitrectomy.

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O10 Characteristics of patients who discontinued baricitinib treatment within 12 months and reasons for discontinuation: real-world data

Rheumatology ◽

10.1093/rheumatology/keab246.009 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

May Nwe Lwin ◽

Christopher Holroyd ◽

Christopher J Edwards

Keyword(s):

Combination Therapy ◽

Real World ◽

Personality Change ◽

University Hospital ◽

P Value ◽

Real World Setting ◽

Advanced Therapy ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Background/Aims Baricitinib is an oral targeted synthetic disease-modifying anti-rheumatic drug (tsDMARD) recommended by the National Institute for Health and Care Excellence (NICE) in the UK for severe rheumatoid arthritis (RA) either as mono- or combination therapy. We wanted to observe the frequency of discontinuation in a real-world setting, the characteristics of patients who stop taking baricitinib, and the reasons for discontinuation. Objective: To describe the characteristics of patients who discontinue baricitinib treatment and the reasons for discontinuation. Methods A real-world retrospective observational study of baricitinib use in RA patients at University Hospital Southampton using local advanced therapy database for data collection. We described the characteristics of patients discontinuing baricitinib therapy and divided patients into two groups. Group 1 (those who discontinued therapy within the first 12 months of use) and group 2 (who continued therapy beyond 12 months) Results From October 2017 to July 2020, a total of 83 patients started baricitinib and were recorded in the database, 55 (66.27%) remain on treatment to date. Among 28 (33.74%) patients who stopped baricitinib, 21 had stopped within 12 months. The reasons for discontinuation were lack of efficacy (64.28%) and AEs (28.57% - 1 tooth infection, 1 urinary tract infection, 1 discitis, 2 chest infection, 1 personality change, 1 deranged liver function and 1 lymphoma). In group 1, the mean (±SD) age was 49.00 (13.65) years, 66.67% were female and 85.71% were previously biologic inadequate responders (IR), 42.86% were receiving monotherapy, with 57.14% being on combination therapy with a csDMARD and 9.52% were using a glucocorticoid. In group 2, 82.26% were female, 61.52 (10.94) years of age and 83.87% were previously biologic IR, 41.94% were on monotherapy and 58.06% on combination therapy with a csDMARD. Patients who discontinued appeared more likely to be younger and male. However, there was no significant difference regarding mono- or combination therapy, disease duration or seropositivity (p-value > 0.05) (Table 1). Conclusion In a real-world setting, baricitinib appears efficacious and well-tolerated in the first year of use by two-thirds of patients. Characteristics such as older age and female gender were associated with continued use. Disclosure M. Lwin: None. C. Holroyd: Honoraria; Lily. Member of speakers’ bureau; Lily. C.J. Edwards: Honoraria; Abbvie, Biogen, BMS, Celgene, Fresenius, GSK, Janssen, Lilly, Mundipharma, Pfizer, Roche, Sanofi, UCB. Member of speakers’ bureau; Abbvie, Biogen, BMS, Celgene, Janssen, Lilly, Sanofi, Pfizer, Roche. Grants/research support; Abbvie, Biogen, Pfizer.

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Zinc Supplementation in Preterm Neonates with Jaundice: Is It Beneficial?

10.21203/rs.3.rs-41014/v1 ◽

2020 ◽

Author(s):

Mohamed Shawky Elfarargy ◽

Ghada Al Ashmawy ◽

Sally Abu-Risha ◽

Haidy Khattab

Keyword(s):

Neonatal Jaundice ◽

Serum Bilirubin ◽

Zinc Supplementation ◽

University Hospital ◽

Preterm Neonates ◽

P Value ◽

Indirect Bilirubin ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Background: Neonatal jaundice is a common neonatal disease which had adverse effect in the neonates especially preterm neonates when the level of indirect bilirubin is high enough to pass the blood brain barrier causing bilirubin encephalopathy or kernicterus. Aim: The aim of this study is to investigate the value of zinc (Zn) supplementation in preterm neonates with jaundice and if it will be beneficial or not. Patients and methods: A prospective randomized clinical trial (RCT) study, identification number is TCTR20200504007, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 200 preterm neonates suffering from neonatal jaundice. The studied neonates were divided into 2 groups: group 1, which received Zn and phototherapy, and group 2, which received phototherapy only and did not take Zn. In the group 1, 100 preterm neonates with jaundice received Zn as 0.6 ml(cm3) of zinc origin/kg/day orally through oro/nasogastric tube divided into 2 doses (/12 hours) which is equal 1.2 mg elemental zinc/kg/day orally for 10 day. Results: There was no significant difference in serum bilirubin between the 2 groups in the 2nd, 4th and 6th day of admission while the serum bilirubin was significantly decreased in neonates who were treated by Zn and phototherapy in group 1, compared with neonates of group 2 who were treated with phototherapy only in the 8th , 9th and 10th day of admission where the p value was 0.045* ,0.027* and 0.004* respectively. Conclusion: Zn administration in jaundiced preterm neonates is beneficial in decreasing serum bilirubin. Recommendation: Zn supplementation for jaundiced preterm neonates.

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Serum CA-125: biomarker of pulmonary tuberculosis activity and evaluation of response to treatment

Clinical & Investigative Medicine ◽

10.25011/cim.v35i4.17151 ◽

2012 ◽

Vol 35 (4) ◽

pp. 223 ◽

Cited By ~ 8

Author(s):

Füsun Şahin ◽

Pinar Yildiz

Keyword(s):

Pulmonary Tuberculosis ◽

Post Treatment ◽

Response To Treatment ◽

Ca 125 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Tuberculosis Activity ◽

Group 1

Purpose: CA-125 is a high molecular weight mucin-like glycoprotein and an ovarian cancer antigen. Elevated CA-125 levels are also seen with various other benign and malignant conditions. In this study, the ability of CA-125 to predict pulmonary tuberculosis activity was investigated. Methods: This analytical study included 42 cases with active tuberculosis (Group 1), 35 cases with inactive tuberculosis (Group 2) and 20 healthy subjects (Group 3). CA-125 measurements were taken in all three groups. Measurements in Group 1 were repeated after completing a two month anti-tuberculosis treatment in 38 of the 42 patients. Results: Mean serum CA-125 level for Group 1 was 76.48±24.71 U/mL, which was significantly higher than levels in Group 2 (20.01±7.89 U/mL) and Group 3 (18.32±2.87 U/mL) (p < 0.001). Of the 38 patients in Group 1 who were studied both pre- and post-treatment, CA-125 levels decreased significantly: from 78.88±24.72 U/mL before treatment to 22.78±8.02 U/mL after treatment (p < 0.001). There was no statistically significant difference between the post-treatment values of Group 1 and either Group 2 and Group 3 values (p > 0.05). Group 2 and Group 3 levels were not significantly different (p > 0.05). The cut-off level for accurate determination of activity was 36.35 U/mL. The sensitivity at this level was 97.6% and specificity was 100%. Conclusion: Our findings suggest that CA-125 can be a beneficial parameter in determination of pulmonary tuberculosis activity and the evaluation of response to treatment.

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