scholarly journals Analysis of response of vitiligo to treatment with NBUVB

2019 ◽  
Vol 5 (1) ◽  
pp. 37
Author(s):  
J. Madhava Praveen ◽  
Jatin Sidhwa
Keyword(s):  
Adverse Effects ◽  
Skin Disorder ◽  
Environmental Risks ◽  
Treatment Modalities ◽  
Duration Of Treatment ◽  
Autoimmune Attack ◽  
Self Worth ◽  
Good Treatment Response ◽  
Dynamic Interplay

<p class="abstract"><strong>Background:</strong> Vitiligo is an acquired skin disorder characterised by white (depigmented) patches in the skin, due to the loss of functioning melanocytes. The disease can have devastating consequences on an individual’s relationships with others and internal feelings of self-worth. Vitiligo is caused by a dynamic interplay between genetic and environmental risks that initiates an autoimmune attack on melanocytes in the skin. Long term phototherapy has shown good response in the management of vitiligo. In this study we explore the efficacy of phototherapy in management of our vitiligo patients.</p><p class="abstract"><strong>Methods:</strong> 30 subjects were included in the study. Subjects were started on NBUVB at 300mj/cm<sup>2</sup>. Weekly 3 doses were given. Doses were increased after every 3<sup>rd</sup> sitting by 10%. In case of adverse effects treatment is withheld till resolution of symptoms following which NBUVB is given at 50% of the last dose and patient managed based on the response.<strong></strong></p><p class="abstract"><strong>Results:</strong> A majority of the subjects showed significant and persistent improvement within the first 3 months of initiation of treatment. The proportion of the patients showing improvement increased with duration of treatment.</p><p class="abstract"><strong>Conclusions:</strong> Our study has revealed the standard and significant role the phototherapy plays in the treatment of vitiligo as a monotherapy or as an adjuvant with other treatment modalities. With good treatment response and minimal side effect incidence, phototherapy is an important treatment modality in the management of vitiligo.</p><p> </p>

scholarly journals P709 Is azathioprine safe as long-term treatment in paediatric patients with inflammatory bowel disease?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S573-S573
Author(s):  
M A Martínez Ibeas ◽  
I Bacelo Ruano ◽  
S Rodríguez Manchón ◽  
M Velasco Rodríguez-Belvís ◽  
J F Viada Bris ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Adverse Effects ◽  
Term Treatment ◽  
Tpmt Activity ◽  
Duration Of Treatment ◽  
Median Dosage ◽  
Long Term Treatment ◽  
Inflammatory Bowel

Abstract Background The toxicity of azathioprine (AZA) includes myelosuppression, infections, pancreatitis, photosensitivity, and hepatotoxicity. The aim of this study was to describe the adverse effects profile of azathioprine as long-term treatment in paediatric inflammatory bowel disease (IBD). Methods An observational, descriptive and retrospective study was performed in the paediatric IBD Unit of a tertiary care hospital from September 2008 to December 2018. It was included patients under 18 diagnosed with IBD who were treated with AZA during their follow-up. We recorded epidemiological data, thiopurine methyltransferase (TPMT) enzyme activity, AZA side effects, and the dosage the patients were receiving when these effects took place. Bone marrow suppression (BMS) was defined as leukopenia, thrombocytopenia and/or anaemia. Acute pancreatitis (AP) induced by azathioprine was considered when two of these criteria (Atlanta 2012) were met: lipase increase (&gt; 3 times normal value), congruent signs and symptoms and/or echographic findings, without other possible aetiology and with complete recovery after AZA withdrawal. Results We included 52 patients, being 31 men (59.6%). They were diagnosed with Crohn′s disease (CD) (73%), ulcerative colitis (UC) (21%) and IBD-unclassified (6%). The median TPMT activity was 17 U/ml (14.2–19.2). Up to 63.5% developed adverse effects by AZA with a median time from the beginning of treatment of 11.4 months (2.6–26.4) and a median dosage of 2 mg/kg/day (1.7–2.3). The most frequent side effect was BMS (52%). These patients had a median TPMT activity of 16.9 U/ml (14.2–18.9), the median duration of treatment was 14 months (3.9–27.7), and the median dosage was 2 mg/kg/d (1.8–2.5). BMS was more frequent in patients with UC (p 0.04) and longer treatment (p 0.08). No differences were found according to age, sex or TPMT activity. Up to 11.5% developed AP, the median duration of treatment until its appearance was 1.5 months (0.7–43.3) and the median dosage was 2 mg/kg/d (1.5–2.5). No differences were found related to age, sex, diagnosis or dosage. Other side effects were: 3 flu-like symptoms, 3 opportunistic infections, 2 hypertransaminasemia, and 1 patient with elevated pancreatic enzymes and hyperbilirubinemia. AZA was discontinued in 14 patients (43.8%): in 6 due to AP, in 4 due to severe lymphopenia, in 2 because of Epstein-Barr virus infection, in 1 due to flu-like symptoms and in 1 with several adverse effects. Conclusion More than half of the patients treated with AZA presented side effects, mainly BMS, although most of them were mild and temporary, and the withdrawal of the drug was not necessary. It seems that TPMT activity is not useful to predict BMS, but this adverse effect could be related to a longer treatment.

scholarly journals Steroid induced psychiatric adverse effects: an overview of risk factors, clinical features and management

2020 ◽  
Vol 8 (6) ◽  
pp. 2365
Author(s):  
Anant Parasher ◽  
Jeplin Bez
Keyword(s):  
Adverse Effects ◽  
Steroid Therapy ◽  
Wound Repair ◽  
Glucocorticoid Receptors ◽  
Psychiatric Symptoms ◽  
Immunosuppressive Drugs ◽  
Psychotic Symptoms ◽  
Metabolic Disturbances ◽  
Duration Of Treatment

Corticosteroids have been in use since the past five decades as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Adverse effects include growth retardation in children, immunosuppression, hypertension, hyperglycemia, inhibition of wound repair, osteoporosis, metabolic disturbances, glaucoma, and cataracts. The psychiatric effects of steroids are due to the wide expression of Glucocorticoid Receptors in the brain, and their long-term modulation can lead to functional and anatomical alterations along with hippocampal dysfunction. In most cases, the psychiatric symptoms disappear on cessation of steroid therapy; others may require some form of therapeutic management. A search was conducted for clinically relevant articles from 1971 to 2016 by including the terms corticosteroids, mania, depression, psychosis and cognitive defects. About one-fifth of patients receiving high doses of corticosteroids develop psychiatric symptoms. These symptoms are observed to be dose-dependent and generally occur during the first few weeks of therapy. Lithium has a preventive as well as therapeutic role, while antipsychotics are reserved for high risk cases with predominant psychotic symptoms. Psychiatric effects of long term steroid therapy have become increasingly common nowadays due to long duration of treatment of many chronic respiratory and orthopedic illnesses. Reduction in the dose or complete discontinuation of steroid therapy has been proven beneficial in many patients. Among the therapeutic options, lithium has a definitive role, both in the prevention as well as treatment of psychiatric symptoms. Better co-ordination between the physician and psychiatrist can go a long way to improve the quality of life in these patients. 

scholarly journals Positive and Negative Effects of Antipsychotic Medication: An International Online Survey of 832 Recipients

2019 ◽  
Vol 14 (3) ◽  
pp. 173-181 ◽  
Author(s):  
John Read ◽  
James Williams
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Antipsychotic Medication ◽  
Online Survey ◽  
Negative Effects ◽  
Duration Of Treatment ◽  
Direct To Consumer ◽  
Poor Outcomes

Background: Antipsychotic medication is currently the treatment of choice for psychosis, but few studies directly survey the first-hand experience of recipients. Objective: To ascertain the experiences and opinions of an international sample of users of antipsychotic drugs, regarding positive and negative effects. Methods: An online direct-to-consumer questionnaire was completed by 832 users of antipsychotics, from 30 countries – predominantly USA, UK and Australia. This is the largest such sample to date. Results: Over half (56%) thought, the drugs reduced the problems they were prescribed for, but 27% thought they made them worse. Slightly less people found the drugs generally ‘helpful’ (41%) than found them ‘unhelpful’ (43%). While 35% reported that their ‘quality of life’ was ‘improved’, 54% reported that it was made ‘worse’. The average number of adverse effects reported was 11, with an average of five at the ‘severe’ level. Fourteen effects were reported by 57% or more participants, most commonly: ‘Drowsiness, feeling tired, sedation’ (92%), ‘Loss of motivation’ (86%), ‘Slowed thoughts’ (86%), and ‘Emotional numbing’ (85%). Suicidality was reported to be a side effect by 58%. Older people reported particularly poor outcomes and high levels of adverse effects. Duration of treatment was unrelated to positive outcomes but significantly related to negative outcomes. Most respondents (70%) had tried to stop taking the drugs. The most common reasons people wanted to stop were the side effects (64%) and worries about long-term physical health (52%). Most (70%) did not recall being told anything at all about side effects. Conclusion: Clinical implications are discussed, with a particular focus on the principles of informed consent, and involving patients in decision making about their own lives.

scholarly journals Postcholecystectomy benign biliary stricture: Surgery is the gold standard

2012 ◽  
Vol 03 (S 05) ◽  
pp. 036-039 ◽  
Author(s):  
Sadiq S. Sikora
Keyword(s):  
Bile Duct ◽  
Gold Standard ◽  
Biliary Stricture ◽  
Surgical Repair ◽  
Standard Of Care ◽  
Long Term Results ◽  
Treatment Modalities ◽  
Duration Of Treatment ◽  
Prolonged Duration

AbstractPost cholecystectomy bile duct strictures present a challenge to the treating physicians. Advancement in skills and technology offers alternative treatment modalities to the standard surgical repair. Contemporary series of surgical repair by experienced surgeons report excellent long-term results with <5% restricture rates. Endoscopic therapy is conceptually flawed, is not applicable to all patients, requires prolonged duration of treatment with multiple interventions. Surgical repair by an experienced surgeon is the “Gold Standard” of care in management of postcholecystectomy bile duct strictures.

scholarly journals Long Term Bisphosphonate Use in Osteoporotic Patients; A Step Forward, Two Steps Back

2012 ◽  
Vol 15 (2) ◽  
pp. 305 ◽  
Author(s):  
Pooneh Salari ◽  
Mohammad Abdollahi
Keyword(s):  
Atrial Fibrillation ◽  
Esophageal Cancer ◽  
Adverse Effects ◽  
Term Treatment ◽  
Duration Of Treatment ◽  
Treatment Of Osteoporosis ◽  
Beneficial Effects ◽  
Long Term Treatment ◽  
Prevention And Treatment

Purpose. Bisphosphonates are the main class of drugs widely used in prevention and treatment of osteoporosis. Along with the beneficial effects, recent studies point to the harms of long-term treatment with bisphosphonates. Methods. The most relevant articles reporting serious adverse effects of bisphosphonates were selected and reviewed with the aim of assessing the risk-benefit of bisphosphonates. We searched PubMed, Web of Science, and Scopus using keywords bisphosphonates, risk of fracture, atrial fibrillation, osteonecrosis jaw, esophageal cancer, and adverse effects with no time limitation. We limited our s research to English articles. Results. Our review shows that bisphosphonates reduce vertebral fractures in short term use while in long-term can cause osteonecrosis jaw, esophageal cancer, atrial fibrillation, and increase the risk of atypical fractures and probably adynamic bone disease. There is no consensus on the time limitation of bisphosphonate usage or its long term adverse effects. Thus, more studies on long-term side effects of bisphosphonates are highly recommended. In addition, new approaches for prevention and treatment of osteoporosis seem necessary. Conclusion. Prescribers should act cautionary and consider full assessment of risk-benefit and the duration of treatment. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

The Pharmacologic Management of the Syndrome of Inappropriate Secretion of Antidiuretic Hormone

1986 ◽  
Vol 20 (7-8) ◽  
pp. 527-531 ◽  
Author(s):  
Clyde I. Miyagawa
Keyword(s):  
Adverse Effects ◽  
Antidiuretic Hormone ◽  
Comparative Studies ◽  
Hormone Secretion ◽  
Term Treatment ◽  
Loop Diuretics ◽  
Treatment Modalities ◽  
Study Patient ◽  
Long Term Treatment

There have been numerous treatment modalities reported in the literature concerning the acute and chronic treatment of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Water restriction remains the mainstay of therapy. However, patient noncompliance for this regimen often makes additional treatment modalities necessary. In the long-term treatment of chronic SIADH, lithium, demeclocycline, loop diuretics, and urea are helpful, regardless of the origin of the SIADH. The use of lithium is not recommended due to the incidence of digestive, cardiac, thyroid, and central nervous system side effects, as well as the demonstrated superiority of demeclocycline. Urea and loop diuretics, although shown to be effective, have not been used clinically to the extent as demeclocycline, and are not free of adverse effects. Phenytoin is limited in its use to the treatment of SIADH secondary to abnormalities of the hypothalamic-pituitary axis, and plays no role in the treatment of tumor-induced SIADH. Demeclocycline has been shown to be effective in all types of SIADH. The lack of comparative studies of long-term treatment regimens makes the selection of a regimen of choice difficult. At this point loop diuretics or demeclocycline appear to be the regimens of choice based primarily upon case reports and relatively small comparative study patient populations. Further comparative studies are needed in an attempt to identify the most efficacious regimen with the minimal incidence of adverse effects.

PATIENT/CARERS' RECOLLECTION OF MEDICINES RELATED INFORMATION FROM AN OUT-PATIENT CLINIC APPOINTMENT

2016 ◽  
Vol 101 (9) ◽  
pp. e2.49-e2
Author(s):  
Jeff Aston ◽  
Natasha Patel ◽  
Justin Smuels ◽  
Teena Aujla ◽  
Georgia Malesi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Side Effects ◽  
Adverse Effects ◽  
Dose Regimen ◽  
Therapeutic Indication ◽  
Duration Of Treatment ◽  
Convenience Sample ◽  
Related Information ◽  
Clinic Appointment

AimTo identify what medicines related information children/young people or their parents/carers are able to recall following an out-patient clinic appointment.MethodA convenience sample of patients' prescribed at least one new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy.A face-to-face semi-structured questionnaire was administered to participants when they presented with their prescription. The questionnaire included the following themes: names of the medicines, therapeutic indication, dose regimen, duration of treatment and adverse effects.The results were analysed using Microsoft Excel 2013.ResultsOne hundred participants consented and were included in the study. One hundred and forty-five medicines were prescribed in total. Participants were able to recall the names of 96 (66%) medicines and were aware of the therapeutic indication for 142 (97.9%) medicines. The dose regimen was accurately described for 120 (82.8%) medicines with the duration of treatment known for 132 (91%). Participants mentioned that they had been advised about side effects for 44 (30.3%) medicines. Specific counselling points recommended by the BNFc1, were either omitted or not recalled by participants for the following systemic treatments: cetirizine (1), chlorphenamine (1), desmopressin (2), hydroxyzine (2), itraconazole (1), piroxicam (2), methotrexate (1), stiripentol (1) and topiramate (1).ConclusionFollowing an out-patient consultation, where a new medicine is prescribed, children and their parents/carers are usually able to recall the indication, dose regimen and duration of treatment. Few were able to recall, or were told about, possible adverse effects. This may include some important drug specific effects that require vigilance during treatment.Patients, along with families and carers, should be involved in the decision to prescribe a medicine.2 This includes a discussion about the benefits of the medicine on the patient's condition and possible adverse effects.2 Treatment side effects have been shown to be a factor in treatment non-adherence in paediatric long-term medical conditions.3 Practitioners should explain to patients, and their family members or carers where appropriate, how to identify and report medicines-related patient safety incidents.4 However, this study suggests that medical staff may not be comfortable discussing the adverse effects of medicines with patients or their parents/carers.Further research in to the shared decision making process in the paediatric out-patient clinic when a new long-term medicine is prescribed is required to further support medicines adherence and the patient safety agenda.

Herbal Medicine for Glioblastoma: Current and Future Prospects

2020 ◽  
Vol 16 (8) ◽  
pp. 1022-1043
Author(s):  
Imran Khan ◽  
Sadaf Mahfooz ◽  
Mustafa A. Hatiboglu
Keyword(s):  
Cell Proliferation ◽  
Survival Rates ◽  
Standard Of Care ◽  
Natural Compounds ◽  
Treatment Modalities ◽  
Normal Brain ◽  
The Central Nervous System ◽  
Cycle Regulation ◽  
Immense Potential

Background: Glioblastoma is one of the most aggressive and devastating tumours of the central nervous system with short survival time. Glioblastoma usually shows fast cell proliferation and invasion of normal brain tissue causing poor prognosis. The present standard of care in patients with glioblastoma includes surgery followed by radiotherapy and temozolomide (TMZ) based chemotherapy. Unfortunately, these approaches are not sufficient to lead a favorable prognosis and survival rates. As the current approaches do not provide a long-term benefit in those patients, new alternative treatments including natural compounds, have drawn attention. Due to their natural origin, they are associated with minimum cellular toxicity towards normal cells and it has become one of the most attractive approaches to treat tumours by natural compounds or phytochemicals. Objective: In the present review, the role of natural compounds or phytochemicals in the treatment of glioblastoma describing their efficacy on various aspects of glioblastoma pathophysiology such as cell proliferation, apoptosis, cell cycle regulation, cellular signaling pathways, chemoresistance and their role in combinatorial therapeutic approaches was described. Methods: Peer-reviewed literature was extracted using Pubmed, EMBASE Ovid and Google Scholar to be reviewed in the present article. Conclusion: Preclinical data available in the literature suggest that phytochemicals hold immense potential to be translated into treatment modalities. However, further clinical studies with conclusive results are required to implement phytochemicals in treatment modalities.

To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in Vicharchika w.s.r to Eczema

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Kulkarni Sharad ◽  
Syeda Ather Fathima ◽  
Naveen B. S.
Keyword(s):  
Incidence Rate ◽  
Clinical Features ◽  
Skin Disease ◽  
Skin Disorder ◽  
Age Groups ◽  
High Rate ◽  
Main Line ◽  
Treatment Modalities ◽  
Skin Disorders

Vicharchika (Eczema) is a skin disorder with predominance of Pitta Kapha Dosha, with clinical features like Kandu, Srava, Pidaka, Shyavata, Rookshata, Raji, Ruja and Daha mainly in the extremities. It is the second commonest skin disease affecting all age groups, with incidence rate of 2-3% and high rate of recurrence. Ayurveda emphasizes Shodhana therapy as the main line of treatment in skin disorders. Raktamokshana is indicated as Rakta is mainly involved in Vicharchika. In the present study, two treatment modalities were selected to find out which is more appropriate.

Clinical Efficacy of Dhatryadi Ghanavati in Shvitra (Vitiligo)

2017 ◽  
Vol 1 (4) ◽  
Author(s):  
Manjiri Walinjkar ◽  
P.D. Londhe ◽  
S. R. Makhare ◽  
Anil Avhad
Keyword(s):  
Clinical Efficacy ◽  
Skin Disorder ◽  
Total Population ◽  
Social Stigma ◽  
Term Treatment ◽  
Effective Therapy ◽  
Long Term Treatment ◽  
Percentage Area ◽  
Effective Remedy

Background: Shvitra (vitiligo) is a kind of skin disorder comprising of white coloured skin patches which is considered as a social stigma. Worldwide prevalence of Vitiligo is observed as 1% of the total population. Due to the chronic nature, long term treatment, lack of uniform effective therapy and unpredictable course the disease is usually very demoralizing for patients. Aim: To study the efficacy of ‘Dhatryadi Ghanavati’ in the management of Shvitra. Materials and Methods: Total 50 patients of Shvitra from OPD and IPD unit of Dr. M.N. Agashe Hospital, Satara were selected and provided with Dhatryadi Ghanavati 1gm B.D. for the duration of 3 months. Results: 100% relief was observed in Daha and Kandu followed by 83.33% relief was observed in Rukshata. 34.51% improvement was seen in number of patches, 34.82% in size of patches and 34.29% in percentage area involved. Color of the patches was improved by 69.01% whereas 44% improvement was seen in hair discoloration. Conclusion: The compound formulation ‘Dhatryadi Ghanavati’ was found as an effective remedy for ‘Shvitra’. The parameters like number of patches, size of patches, percentage area involved and colour of patches showed statistically highly significant results.

Sign in / Sign up

Export Citation Format

Share Document