Leap forward in the treatment of Pythium insidiosum keratitis

2018 ◽  
Vol 102 (12) ◽  
pp. 1629-1633 ◽  
Author(s):  
Bhupesh Bagga ◽  
Savitri Sharma ◽  
Sai Jeevan Madhuri Guda ◽  
Ritu Nagpal ◽  
Joveeta Joseph ◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
Disc Diffusion ◽  
Pythium Insidiosum ◽  
Exact Test ◽  
Number Of Patients ◽  
Lost To Follow Up ◽  
Diffusion Assay ◽  
Culture Positive

BackgroundPythium insidiosum is a parafungus that causes keratitis resembling fungal keratitis. This study compares outcome in a large cohort of patients with P insidiosum keratitis treated with antifungal drugs, to a pilot group treated with antibacterial antibiotics.MethodsBetween January 2014 and December 2016, 114 patients with culture positive P insidiosum keratitis were included in the study. A subset of culture isolates was tested in vitro for response to nine antibacterial antibiotics by disc diffusion and E test. Patients were treated with topical natamycin in 2014, 2015 and up until mid 2016. Thereafter, the patients received a combination of topical linezolid and topical and oral azithromycin. Therapeutic penetrating keratoplasty (TPK) was done for patients not responding to medical therapy.ResultsIn vitro disc diffusion assay showed linezolid to be most effective. The rate of TPK was significantly higher in 2015 compared with 2016 (43/45, 95.6% vs 22/32, 68.8%; p=0.002). Eighteen patients were treated with antibacterial and 14 were treated with antifungal antibiotic in 2016. One patient was lost to follow-up in each group. The rate of TPK was higher and proportion of healed ulcers was lower (p=0.21, Fisher’s exact test) in the group on antifungal therapy (TPK—11/13, 84.6%; Healed—2/13, 15.3%) compared with the group on antibacterial therapy (TPK—11/17, 64.7%; Healed—6/17, 35.2%).ConclusionsWe report favourable but not statistically significant response of P insidiosum keratitis to antibacterial agents in a pilot series of patients. Further evaluation of this strategy in larger number of patients is recommended.

scholarly journals Antifungal effects of 3-(4-Phenyl-thiazol-2-yl)-2-thioxo-2, 3-dihydro-1H-quinazolin-4-one against Aspergillus Species

2018 ◽  
Author(s):  
Desh D. Singh ◽  
V. K. Tiwari ◽  
Rambir Singh ◽  
G L Sharam ◽  
Rajesh Dabur
Keyword(s):  
Antifungal Activity ◽  
Protein Profile ◽  
Antifungal Drugs ◽  
Secretory Proteins ◽  
Disc Diffusion ◽  
Disc Diffusion Assay ◽  
Dilution Assay ◽  
Number Of Patients ◽  
Diffusion Assay ◽  
Microbroth Dilution

AbstractAspergillus infections have become an important health problem with the increasing number of patients. Available antifungal drugs are lack with their spectrum, toxic or immunosuppressive in nature, so that need to develop new compound with high efficacy. To evaluate antifungal efficacy of synthesized compound and to identify the protein profile of Aspergillus fumigatus treated with antifungal. Clinical isolates of A. fumigatus, A. flavus and A. niger were cultured and efficacy of compound were conducted by Disc Diffusion Assay (DDA), Microbroth Dilution Assay (MDA). Percent of spore germination inhibition assay (PSGI), Time kill analysis and toxicity assay. The culture filtrate containing secretory proteins was collected after 24 h growth and expression of downregulated proteins were identified. We developed a new and useful quinazoline derivatives expected to antifungal activity. The result of anti-Aspergillus evolution revealed that one of the 3-(4-Phenyl-thiazol-2-yl)-2-thioxo-2, 3-dihydro-1H-quinazolin-4-one (DDVKT4Q) exhibited appreciable activity. The potency of compound was found concentration of 3.125 µg/disc by disc diffusion assay (DDA) and 15.625 µg/ml. by Microbroth Dilution Assay (MDA). The compound was nontoxic up to concentration 625 µg/ml and its lysed only 35.9% of human erythrocytes, at the highest dose tested. It’s observed that the treatment of pathogen with DDVKT-4Q targeted the expression of four proteins having molecular weights 18 kDa 37 KDa and 43 KDa proteins was completely inhibited or down regulated by the compound the extra cellular. The novel compound DDVKT-4Q, having antifungal activity Can be exploited further to develop new ideal antimycotic drugs.

scholarly journals Potential Antifungal Activity against Pythium insidiosum of Isoflavonoids from the Stems of Dalbergia cultrata

2020 ◽  
Vol 32 (7) ◽  
pp. 1788-1792
Author(s):  
Thurdpong Sribuhom ◽  
Yordhathai Thongsri ◽  
Chavi Yenjai
Keyword(s):  
Antifungal Activity ◽  
Antifungal Drugs ◽  
Biochanin A ◽  
Spectroscopic Techniques ◽  
Disc Diffusion ◽  
Pythium Insidiosum ◽  
Isolation And Characterization ◽  
Diffusion Assay ◽  
Mic Value

Chemical investigation of Dalbergia cultrata Grah. stems growing in Thailand resulted in the isolation and characterization of 14 known compounds, including tectorigenin (1), calycosin (2), pratensein (3), afromosin (4), irilin D (5), biochanin A (6), daidzein (7), formononetin (8), 8-O-methylretusin (9), 7,3′-dihydroxy-5′-methoxyisoflavone (10), (3S)-sativanone (11), (3S)-violanone (12), erycibenin D (13) and isoliquiritigenin (14). Their structures were established mainly based on NMR spectroscopic techniques and physical properties. The isolated compounds were evaluated for antifungal activity against Pythium insidiosum using disc diffusion assay. Antifungal drugs available now are not effective to treat this microorganism. It was found that compound 1 exhibited stronger antifungal activity than amphotericin-B standard with an MIC value of 10 μg/disc.

scholarly journals Remeex® System Effectiveness in Male Patients with Stress Urinary Incontinence

2021 ◽  
Vol 10 (10) ◽  
pp. 2121
Author(s):  
Gerardo-Alfonso Márquez-Sánchez ◽  
Bárbara-Yolanda Padilla-Fernández ◽  
Miguel Perán-Teruel ◽  
Pedro Navalón-Verdejo ◽  
Sebastián Valverde-Martínez ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Surgical Techniques ◽  
High Survival ◽  
Complication Rates ◽  
Exact Test ◽  
Number Of Patients ◽  
Male Stress Urinary Incontinence ◽  
Group B

Background: When conservative management fails, patients with stress urinary incontinence (SUI) are considered for surgical treatment. Simpler, more economical and less invasive surgical techniques, such as the Remeex® system, have been developed. Objectives: To analyze the objective effectiveness of the Remeex® system in the treatment of male stress urinary incontinence. To study survival and complication rates of the Remeex® system in male SUI patients. Materials and methods: Prospective observational study between July 2015 and May 2020. Group A (n = 7; GA) patients with mild SUI. Group B (n = 22; GB) patients with moderate SUI. Group C (n = 18; GC) patients with severe SUI. Effectiveness was assessed by the number of patients achieving complete and partial dryness. Complete dryness was defined as patients using 0–1 safety pads per day; partial dryness as a >50% reduction in the number of pads used. Results were analyzed using descriptive statistics, Student’s t-test. Chi2, Fisher’s exact test, ANOVA, and multivariate analysis. Significance was set at p < 0.05. Results: Mean age 69.76 years, mean follow-up 33.52 months. Objective effectiveness was observed in 89.36% of patients with incontinence. The effectiveness was 85.71% in GA, 90.91% in GB and 88.89% in GC. There were no significant differences among groups (p = 1.0000). 34.04% of patients with an implant required at least one readjustment, while 66.00% did not require any. There were no significant differences among groups (p = 0.113) Chi2 = 4.352. 95.74% of implants remained in place by the end of follow-up. We observed complications in 17.02% of patients. Conclusions: Remeex® system is an effective and safe method for male stress urinary incontinence treatment, regardless of the severity of the incontinence, with high survival and low complication and removal rates. System readjustments are required in one-third of the cases.

scholarly journals Spectrum and theIn VitroAntifungal Susceptibility Pattern of Yeast Isolates in Ethiopian HIV Patients with Oropharyngeal Candidiasis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Birhan Moges ◽  
Adane Bitew ◽  
Aster Shewaamare
Keyword(s):  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Assay Method ◽  
Cryptococcus Laurentii ◽  
Susceptibility Pattern ◽  
Test Procedures ◽  
Disk Diffusion Assay ◽  
Diffusion Assay

Background.In Ethiopia, little is known regarding the distribution and thein vitroantifungal susceptibility profile of yeasts.Objective.This study was undertaken to determine the spectrum and thein vitroantifungal susceptibility pattern of yeasts isolated from HIV infected patients with OPC.Method.Oral pharyngeal swabs taken from oral lesions of study subjects were inoculated onto Sabouraud Dextrose Agar. Yeasts were identified by employing conventional test procedures and the susceptibility of yeasts to antifungal agents was evaluated by disk diffusion assay method.Result.One hundred and fifty-five yeast isolates were recovered of which 91 isolates were from patients that were not under HAART and 64 were from patients that were under HAART.C. albicanswas the most frequently isolated species followed byC. glabrata, C. tropicalis, C. krusei, C. kefyr, Cryptococcus laurentii, and Rhodotorulaspecies. Irrespective of yeasts isolated and identified, 5.8%, 5.8%, 12.3%, 8.4%, 0.6%, and 1.3% of the isolates were resistant to amphotericin B, clotrimazole, fluconazole, ketoconazole, miconazole, and nystatin, respectively.Conclusion.Yeast colonization rate of 69.2% and 31% resistance to six antifungal agents was documented. These highlight the need for nationwide study on the epidemiology of OPC and resistance to antifungal drugs.

scholarly journals Results of early versus standard silicone stent removal following external dacryocystorhinostomy under local anesthesia

2020 ◽  
Vol 17 (3) ◽  
pp. 263-272
Author(s):  
Ben Limbu ◽  
Benjamin Sim ◽  
Mohan K. Shrestha ◽  
Geoffrey Tabin ◽  
Rohit Saiju
Keyword(s):  
Statistical Difference ◽  
Financial Burden ◽  
Controlled Trial ◽  
Silicone Tube ◽  
Number Of Patients ◽  
Tube Removal ◽  
Silicone Stent ◽  
External Dacryocystorhinostomy ◽  
Lost To Follow Up

Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.

Why are patients lost to follow-up in a gynecologic oncology clinic?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17571-e17571 ◽  
Author(s):  
V. C. Garcia ◽  
A. M. Manalo ◽  
J. B. Toral ◽  
M. L. Siasu
Keyword(s):  
Educational Attainment ◽  
Marital Status ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Cancer Type ◽  
Monthly Income ◽  
Family Commitment ◽  
Number Of Patients ◽  
Lost To Follow Up

e17571 Background: The aim of this study is to investigate why patients are lost to follow-up in a gynecologic oncology clinic. Methods: Patients who had been lost to follow up previously, and eventually followed up between April and August 2007 were given a consent form and questionnaire to answer. An approximately equal number of patients who were not lost to follow-up were given the same questionnaire as controls. The first part of the questionnaire included the age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation and monthly income. The second part asked directly the reason why they were lost to follow-up. Data were recorded in a computerized database via Microsoft Excel. Descriptive statistics were presented in mean, median, standard deviation, minimum, maximum and frequencies. Differences between patients who failed to follow-up (LF) and their controls (NLF) with respect to demographics, disease and treatment characteristics were assessed by an x2 test or independent t test, depending on the variable. SPSS version 15 was used to perform all analyses. A p < 0.05 was considered significant. Results: There were 50 patients who were not lost and 52 patients who were lost to follow-up. The demographic characteristics between these two groups; i.e., age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation, and monthly income of patients were all not statistically significant. The most common reason why patients were lost to follow-up was they had no money. Other reasons included: symptoms became better or problems resolved, the follow up was at an inconvenient time and I had family commitment. Conclusions: Patients expressed that the main reason for not following-up was the lack of funds. The majority in these respondents lived below the minimum salary wages. No significant financial relationships to disclose.

Cytomegalovirus pp65 antigenaemia as an indicator of end organ disease in AIDS

1998 ◽  
Vol 9 (9) ◽  
pp. 545-547 ◽  
Author(s):  
E. F. Fox ◽  
N. A. Smith ◽  
P. Rice ◽  
H. Dunn ◽  
B. S. Peters
Keyword(s):  
Predictive Value ◽  
Primary Prophylaxis ◽  
Cd4 Cell Count ◽  
Exact Test ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Cmv Disease ◽  
Lost To Follow Up ◽  
Cd4 Cell

We aim to assess the usefulness of the cytomegalovirus CMV pp65 antigenaemia test, also called the CMV direct antigen test DAT , in the management of patients with advanced human immunodeficiency virus HIV infection; we studied all patients who had pp65 assays between 8 September 1995 and 30 August 1996. Twenty three patients had 31 tests. The mean CD4 cell count was 20 mm 3. The tests were negative in 16 patients, of whom 12 have not developed CMV end organ disease after a mean follow up of 114 days range 14- 269 days , whilst the remaining 4 patients had previously treated CMV disease. Eleven patients had positive tests: 4 had active CMV disease, 2 subsequently developed CMV retinitis, 2 died within a fortnight of multi drug resistant tuberculosis MDR TB , one was lost to follow up and 2 have remained disease free. This test has a positive predictive value of 43 and a negative predictive value of 94 , Fisher s exact test P =0.03. The pp65 antigenaemia assay can be performed in a standard virology laboratory avoiding the problems associated with polymerase chain reaction PCR , a result is available within 5 h, and it is semi quantifiable. However, a large prospective study is required to determine the comparative value and roles of the pp65 antigenaemia assay and DNA PCR in the management of CMV disease, especially with regard to the use of primary prophylaxis and pre emptive therapy.

Comparison of disc diffusion assay with the CLSI reference method (M27-A2) for testing in vitro posaconazole activity against common and uncommon yeasts

2007 ◽  
Vol 61 (1) ◽  
pp. 135-138 ◽  
Author(s):  
E. Canton ◽  
J. Peman ◽  
A. Espinel-Ingroff ◽  
E. Martin-Mazuelos ◽  
A. Carrillo-Munoz ◽  
...  
Keyword(s):  
Reference Method ◽  
Disc Diffusion ◽  
Disc Diffusion Assay ◽  
Diffusion Assay

scholarly journals Lost to follow up and clinical outcomes of HIV adult patients on antiretroviral therapy in care and treatment centres in Tanga City, north-eastern Tanzania

2012 ◽  
Vol 14 (4) ◽  
Author(s):  
Williams H. Makunde ◽  
Filbert Francis ◽  
Bruno P. Mmbando ◽  
Mathias L. Kamugisha ◽  
Acleus M. Rutta ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Scaling Up ◽  
Regional Hospital ◽  
Crucial Aspect ◽  
Number Of Patients ◽  
North Eastern ◽  
Patient Documentation ◽  
Care And Treatment ◽  
Lost To Follow Up

Scaling up of Antiretroviral (ARV) drugs is crucial and should be a perpetual venture in developing countries in-order to increase the survival period of HIV/AIDS individuals. In Tanzania, information on the rate of patients considered as lost to follow up during treatment with ARVs is scarce. The objective of this study was to determine the rate of lost to follow up and treatment outcome among patients attending two care and treatment clinics (CTCs) in Tanga City in north-eastern Tanzania. A descriptive observational study was carried out on cohorts from Tanga AIDS Working Group and Bombo Regional Hospital. The total number of patients identified as “lost to follow up” were 89 of which 14 (15.7%) died. Among those who died, 3 (21.4%) died between the second week and 3 months after ARV initiation. Of those still alive (84.3%; 75/89), 25% (19/75) were still on ARVs, whereas 47 (62.7%) self transferred to other CTCs. Proper patient documentation with actual residence address is a crucial aspect for adherence. Similarly, frequent prompt tracing of patient should be part of any drug interventional programme linking   facility and communities.

scholarly journals Prostate Cancer Burden at the Uganda Cancer Institute

2016 ◽  
Vol 2 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Fred Okuku ◽  
Jackson Orem ◽  
George Holoya ◽  
Chris De Boer ◽  
Cheryl L. Thompson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Stage Iv ◽  
Cord Compression ◽  
Hormonal Manipulation ◽  
Number Of Patients ◽  
Stage Iv Disease ◽  
Metastatic Sites ◽  
Lost To Follow Up

Purpose In Uganda, the incidence of prostate cancer is increasing at a rate of 5.2% annually. Data describing presentation and outcomes for patients with prostate cancer are lacking. Methods A retrospective review of medical records for men with histologically confirmed prostate cancer at the Uganda Cancer Institute (UCI) from January 1 to December 17, 2012, was performed. Results Our sample included 182 men whose mean age was 69.5 years (standard deviation, 9.0 years). Patients who presented to the UCI had lower urinary tract symptoms (73%; n = 131), bone pain (18%; n = 32), increased prostate-specific antigen (PSA; 3%; n = 5), and other symptoms (6%; n = 11). Median baseline PSA was 91.3 ng/mL (interquartile range, 19.5-311.3 ng/mL), and 51.1% of the patients (n = 92) had a PSA value above 100 ng/mL. Gleason score was 9 or 10 in 66.7% of the patients (n = 120). Ninety percent (n = 136) had stage IV disease, and metastatic sites included bone (73%; n = 102), viscera (21%; n = 29), and lymph nodes (4%; n = 5). Spinal cord compression occurred in 30.9% (n = 55), and 5.6% (n = 10) experienced a fracture. A total of 14.9% (n = 27) underwent prostatectomy, and 17.7% (n = 32) received radiotherapy. Gonadotropin-releasing hormone agonist was given to 45.3% (n = 82), 29.2% (n = 53) received diethylstilbestrol, and 26% (n = 47) underwent orchiectomy. Chemotherapy was administered to 21.6% (n = 39), and 52.5% (n = 95) received bisphosphonates. During the 12 months of study, 23.8% of the men (n = 43) died, and 54.4% (n = 98) were lost to follow-up. Conclusion UCI patients commonly present with high PSA, aggressive Gleason scores, and stage IV disease. The primary treatments are hormonal manipulation and chemotherapy. Almost 25% of patients succumb within a year of presentation, and a large number of patients are lost to follow-up.

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