Comparison of various regimens of itraconazole in treatment of acute vulvovaginal candidiasis

One of the most striking change in the current scenario is the increasing occurrence of non-albicans vulvovaginal candidiasis (VVC), which is considered as the major cause of recurrence, relapse and chronic VVC in India. In the present study we evaluated the effectiveness of three different regimens of itraconazole in the treatment of acute VVC.The present randomised, three arm comparative clinical study involved 123 women aged 18 years or above with symptomatic acute VVC. These patients were randomised (41 patients in each group) to receive either itraconazole 200 mg twice daily for 1 day (group I), 200 mg twice daily for 2 days (group II) or 100 mg twice daily for 3 days (group III). Effectiveness was evaluated on the basis of clinical cure (total symptom score), mycological cure (negative KOH test). All the groups were effective in relieving signs and symptoms (p<0.05), but on comparison between all groups, there was statistical difference between Group II and Group I & III (p<0.05) and Group III & I (p<0.05). Complete cure i.e. disappearance of signs and symptoms and negative KOH test was maximum in group II (44%) as compared to groups I (12%) and III (17% of the patients). Relapse was least in seen in 11 patients (27%) in Group I, 3 patients (7%) in Group II and 7 patients (17%) in Group III. All the 3 regimens were well tolerated.In the present study, 2 day high dose itraconazole therapy was found to have better effectiveness compared to conventional regimens. Longer duration of therapy might be required to attain even better cure rates, especially when the incidence of Non Albicans vulvovaginal candidiasis is rising in all parts of the country.

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Screening of anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205023 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1803

Author(s):

Biacin Babu ◽

Madhavrao Chavan

Keyword(s):

Albino Rats ◽

High Dose ◽

Anticonvulsant Effect ◽

Low Doses ◽

Test Drug ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

Wistar Albino Rats

Background: Epilepsy is one of the major central nervous system disorders. The parent study aimed to screen the anticonvulsant effect of carvedilol on electrically induced convulsions in Wistar albino rats.Methods: This study was done in Wistar albino rats. A total of 30 rats were divided into 6 groups each of six rats. group-I (0.9% normal saline), group-II diphenylhydantoin (10 mg/kg/BW/ip), group-III carvedilol (1mg/kg/BW/PO), group-IV carvedilol (2 mg/kg/BW/PO) and group-V carvedilol (4 mg/kg/BW/PO). All the groups were administered drugs and subjected to electric shock. Scores of seizures and percentage of protection were recorded to compare between the groups. One was ANOVA (post hoc) followed by Dunnet t test applied to find the statistically significant between the groups.Results: Group-I showed significant difference compared to other groups. Group-II showed significant difference with group-III and IV not with V. High dose of test drug and standard drug showed similar results in percentage of seizures prevention. Control and low doses of test drugs showed significant difference compared to standard and high dose of test drug in seizures prevention.Conclusions: High of carvedilol showed significant seizures prevention compared to low doses and control group.

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High-Dose Ascorbic Acid Decreases Cholesterolemic Factors of an Atherogenic Diet in Guinea Pigs

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.77.2.125 ◽

2007 ◽

Vol 77 (2) ◽

pp. 125-129

Author(s):

Filis ◽

Anastassopoulou ◽

Sigala ◽

Theodorou ◽

Manouras ◽

...

Keyword(s):

Ascorbic Acid ◽

Guinea Pigs ◽

Low Dose ◽

Plasma Concentrations ◽

Atherogenic Diet ◽

High Dose ◽

Low Density ◽

Group Iii ◽

Group I ◽

Group Ii

Background: The study evaluates the effect of a high supplemental dose of ascorbic acid (AA) on plasma concentrations of total cholesterol (TC), triglycerides (TG), total lipids (TL), and lipoprotein fractions high-density, very-low-density-, and low-density lipoprotein (HDL, VLDL, LDL) in guinea pigs fed with atherogenic diet. Methods: Group I consisted of 5 normally fed guinea pigs plus a low dose of AA (1 mg/100 g/day), group II consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a low dose of AA (1 mg/100 g/day), and group III consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a high dose of AA (30 mg/100 g/day). Cholesterolemic factors concentrations were determined after nine weeks. Results: Concentrations of TC, TG, TL, LDL, and VLDL were increased in group II compared to group I (p < 0.01 for all differences). Supplementation with a high dose of AA resulted in decreased concentrations of TC (p < 0.01), TG (p < 0.01), TL (p < 0.01), and LDL (p < 0.01) in group III compared to group II. Additionally, concentration of HDL was increased in group III compared to group II (p < 0.01). Conclusion: High-dose AA supplementation to an atherogenic diet decreases concentrations of TC, TG, TL, and LDL and increases concentration of HDL compared to low-dose AA.

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The effect of apple (Malus Domestica) juice on the damage of mice liver cells due to paracetamol treatment

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol21no2.14095 ◽

2009 ◽

Vol 21 (2) ◽

Author(s):

Anthony Hartanto ◽

Murnisari Dardjan ◽

Silvi Kintawati

Keyword(s):

Liver Damage ◽

Malus Domestica ◽

Apple Juice ◽

Liver Cells ◽

High Dose ◽

Toxic Agent ◽

Group Iii ◽

Group I ◽

Group Ii ◽

Mice Liver

The liver is an important organ for body metabolism process. Liver disease is one of serious health problems in developing countries including Indonesia. Liver damage is caused by viral infection, toxic agent exposure (medications, alcohol), hormonal disturbance, neoplasm and autoimmune diseases. The use of high dose paracetamol to reduce pain also leads to liver damage. Apple (Malus domestica) juice is a natural anti oxidant agent. This laboratory experimental study was performed to discover the effect of giving apple juice on damaged cell regeneration due to the use of paracetamol. The study was performed in 21 male mice from Swiss-Webster strain that were divided into group I, II, and III. Group, I served as control while group II received 1 mg/ml paracetamol dose for 5 days and Group III received 1 mg/ml paracetamol for 5 days and 1 ml of apple juice on the 5th to 10th day. The observation of the mice liver cells was conducted using a light microscope with 400x magnification to get the number of necrotic liver cells per view field. The results of this study showed a difference in the number of necrotic liver cells between Group II and III. ANOVA statistical test ( = 0.05) concluded that apple juice significantly helps regeneration process in damaged liver cells caused by paracetamol.

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Prevention of Cisplatin-Induced Emesis by the Oral Neurokinin-1 Antagonist, MK-869, in Combination With Granisetron and Dexamethasone or With Dexamethasone Alone

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.6.1759 ◽

2001 ◽

Vol 19 (6) ◽

pp. 1759-1767 ◽

Cited By ~ 168

Author(s):

Daniel Campos ◽

Jose Rodrigues Pereira ◽

Rick R. Reinhardt ◽

Carlos Carracedo ◽

Sergio Poli ◽

...

Keyword(s):

High Dose ◽

Delayed Emesis ◽

Double Blind ◽

Acute Emesis ◽

Group Iii ◽

Group I ◽

Efficacy Parameter ◽

Group Ii ◽

Neurokinin 1 ◽

Present Trial

PURPOSE: The NK1-receptor antagonist MK-869 (L-754,030) has demonstrated antiemetic activity in humans receiving chemotherapy. Objectives of the present trial included the first assessment of oral MK-869 plus dexamethasone compared with a 5HT3 antagonist plus dexamethasone for prevention of acute and delayed emesis after high-dose cisplatin. Furthermore, the study sought to confirm that addition of MK-869 to a 5HT3 antagonist plus dexamethasone was more effective than just the 5HT3 antagonist plus dexamethasone for prevention of acute and delayed emesis. METHODS: This multicenter, double-blind, parallel-group trial in 351 cisplatin-naïve patients evaluated prevention of acute (0 to 24 hours) and delayed emesis (primary efficacy parameter; days 2 to 5) after cisplatin (≥70 mg/m2). Patients were randomized to four groups (I to IV) (n = number randomized; number evaluable): granisetron (10 μg/kg intravenously) pre-cisplatin followed by placebo on days 2 to 5 (group I) (n = 90; 90); granisetron and MK-869 (400 mg PO [by mouth]) pre-cisplatin, followed by MK-869 (300 mg PO) on days 2 to 5 (group II) (n = 86; 84); MK-869 (400 mg PO) the evening before and pre-cisplatin, followed by MK-869 (300 mg PO) on days 2 to 5 (group III) (n = 89; 88); or MK-869 (400 mg PO) pre-cisplatin, followed by MK-869 (300 mg PO) on days 2 to 5 (group IV) (n = 86; 84). All patients also received dexamethasone (20 mg PO) before cisplatin. Additional medication was available to treat emesis or nausea at any time. RESULTS: In the acute period, 57%, 80%, 46%, and 43% of patients were without emesis in groups I, II, III, and IV, respectively (P < .01 for group II v group I). In the delayed period, the proportion of patients without emesis in groups I, II, III, and IV was 29%, 63%, 51%, and 57%, respectively (P < .01 for groups II, III, and IV v group I). The distribution of nausea scores in the delayed period was lower when comparing group II with group I (P < .05 for days 1 to 5 and days 2 to 5). One serious adverse event (dizziness) was rated as possibly related to MK-869. CONCLUSION: Once daily oral administration of MK-869 was effective in reducing delayed emesis and nausea after high-dose cisplatin. However, the combination of the 5HT3 antagonist plus dexamethasone was numerically superior to MK-869 plus dexamethasone in reducing acute emesis. Confirming and extending previous findings, the triple combination of a 5HT3 antagonist, MK-869, and dexamethasone provided the best control of acute emesis.

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Current role of low molecular weight heparin in the treatment of acute ischemic stroke

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20175174 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1599

Author(s):

Karan Singh

Keyword(s):

Ischemic Stroke ◽

Placebo Group ◽

Acute Ischemic Stroke ◽

Group Iv ◽

Control Group ◽

High Dose ◽

Mortality And Morbidity ◽

Group Iii ◽

Group I ◽

Group Ii

Background: Nevertheless, several studies of LMWH in acute ischemic stroke have been neutral with regard to their primary outcomes, and it remains unclear whether these drugs should be used routinely or not. Our present trial endeavors to study the efficacy of LMWH (low and high dose dalteparin) in patients with progressive ischemic stroke in terms of morbidity and mortality as compared to control group and to compare it with AS+CLOP, with respect to these event rates, at the end of treatment.Methods: Our study was performed on 38 patients of acute ischemic stroke admitted to LLR and associated Hospitals, G. S. V. M. Medical College, Kanpur and who were assigned randomly to any of the four treatment groups (0.4ml dalteparin, 0.8ml of dalteparin, O ml of placebo and aspirin +clopidogrel 150+75 mg). The standard error of proportion method and Chi square test was applied.Results: 70% of patients in group I, 62.5% in Group II and 60% Group III presented with stroke in evolution at presentation as compared to only 30% in the placebo group. 75% of patients in group I, 66.66% in group II, 50% in Group III and 33.34% in group IV had a complete recovery. 25% of patients in Group-I, 33.34% in Group-II, 50% in Group III and 66.66% in Group-IV had an incomplete recovery.Conclusions: There is no significant reduction in the mortality and morbidity amongst LMWH groups at the end of treatment and end of trial as compared to the AS+CLOP, or placebo group or even amongst the low and high dose LMWH groups.

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Improved Outcome of Acute Leukemia Patients Followed up In out-Patient Setting After High Dose Ara-C (HDAC) Consolidation with Infection Prophylaxis Strategies

Blood ◽

10.1182/blood.v116.21.4363.4363 ◽

2010 ◽

Vol 116 (21) ◽

pp. 4363-4363

Author(s):

Omyma El-Emam ◽

Syed Ziauddin A. Zaidi ◽

Bassim Albeirouti ◽

Abdul-Aziz Al-Humaidi ◽

Ali Al-Shanqeeti

Keyword(s):

Febrile Neutropenia ◽

Antimicrobial Prophylaxis ◽

Early Discharge ◽

High Dose ◽

Infection Prophylaxis ◽

Group Iii ◽

Cohort Group ◽

Group I ◽

Group Ii ◽

Hospital Days

Abstract Abstract 4363 Background: Outpatient care of patients with malignancies has become increasingly common and is driven by health care costs, increased demand for existing inpatient resources, improved supportive care and patient wishes to spend the least amount of time in the inpatient setting. High dose Ara-C/cytosine arabinoside (HIDAC) consolidation is frequently used for most acute leukemias. Typically HIDAC consists of 12 hourly IV administrations of 3 grams/m2 dose of Ara-C every other day for a total of 6 doses. One of the authors (AS) had earlier pioneered the idea of giving HIDAC and discharging the patients for out-patient follow up. Prince Sultan Hematology Oncology Centre (PSHOC), Riyadh adopted “post-HIDAC early discharge” policy in late 2006 and later found that it is safe and has resulted in huge hospital-days saving in comparison to our contemporary policy of keeping the patients in hospital till they recover counts after going through nadir. Lately we have also added G-CSF along with antimicrobial prophylaxis during neutropenia for preventing/reducing the period of febrile neutropenia (FN) after HIDAC chemotherapy. Here we present the results of our practice improvement strategy analysis to evaluate the effectiveness of these new measures. Method: Sixty five patients receiving 96 cycles of HIDAC between October 2004 and March 2009 were divided in three groups: First cohort of 23 patients (group I) were discharged without any kind of prophylaxis after HIDAC (35 cycles); and 30 patients in later cohort (group II) received prophylactic ciprofloxacin, fluconazole and acyclovir once absolute neutrophil count (ANC) dropped to <1.0 × 109/L, and GCSF 300 mcg S/C daily once ANC was <0.5 × 109/L until ANC recovered (>1.0 × 109/L) after HIDAC (44 cycles), and the last cohort (group III) consisted of 12 patients who stayed in the hospital after HIDAC (17 cycles) till count recovery. Discharged patients stayed in the vicinity of Riyadh city and were followed-up in outpatient treatment unit (OTU) every other day. All patients were given detailed instructions and a medical alert card to provide them fast access to emergency care. Any patient who had neutropenic fever or judged as septic was admitted. Data on number of total hospital inpatient days for each HIDAC cycle, type of infection developed, and any mortality & serious morbidity requiring ICU care were recorded. Result: In group I, all of the 23 patients who received 35 cycles of HIDAC were re-admitted in all cycles for febrile neutropenia (33/35) and/or severe thrombocytopenia (2/35) until they recovered. The median of their inpatient hospital days was 15 (range 9–23). There was one septic shock that required 4 days of ICU stay. In group II, 30 patients received 44 cycles of HIDAC along with the prophylaxis and 21/44 (47.7%) cycles were without febrile neutropenia. In 23/44 cycles (52.2 %) febrile neutropenia required shorter admission for a median of 12 days (range 7–23). However 8/10 positive blood cultures in group II revealed ciprofloxacin resistant E. coli, and one each revealed K. pneumonia, and S. viridians. One patient was admitted with non documented fever noted at home, one with dental abscess, and HSV PCR was positive from mouth wash in one patient. In group III comprising of 10 of our historic patients, who received 17 cycles of HIDAC, 11 cycles (64.7%) were associated with FN. Conclusion: The currently reported policy of post-HIDAC early discharge with infection prophylaxis is feasible, safe, and may be more cost effective as it resulted in saving more hospital days: compared to a median of 26 days in group III and a median of 15 days in group I, patients in group II with infection prophylaxis required only a median of 12 days of hospitalization. GCSF and antimicrobial prophylaxis have important value in decreasing the incidence of febrile neutropenia but increase in ciprofloxacin resistant E. coli bacteremia is worrisome and may need change in type of prophylactic antibiotic (e.g. to levofloxacin). Disclosures: No relevant conflicts of interest to declare.

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Meloxicam induced toxicopathology studies in Wistar rats

Indian Journal of Animal Research ◽

10.18805/ijar.b-3766 ◽

2019 ◽

Author(s):

S. Pramod Bharani ◽

A. K. Naik ◽

S. C. Parija ◽

S. K. Panda

Keyword(s):

Wistar Rats ◽

Hematological Parameters ◽

Clinical Signs ◽

High Dose ◽

Dependent Manner ◽

Group Iii ◽

Group I ◽

Anti Inflammatory ◽

Group Ii ◽

Dose Dependent

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used class of drugs for treating inflammation and pain. Meloxicam has analgesic, anti-inflammatory and antipyretic properties and is a commonly used NSAID in veterinary practice. The present study was done to evaluate effect of meloxicam on toxico-pathological and hematological parameters in Wistar rats. Eighteen Wistar rats were equally divided into three groups i.e. Group I, Group II and Group III. Group I (negative control) rats received only Normal saline (0.9%) @ 1ml/kg. Group II (Low dose) received meloxicam@ 4 mg/kg B.W. and Group III (High dose) rats received meloxicam@8 mg/kg B.W. orally by gavage for 28 days. Dose-dependent clinical signs and lesions were observed after meloxicam treatment. Kidneys and liver were severely hemorrhagic at the high dose, while intestine and stomach had ulcers and erosions. Hematological values were altered after 28 days of administration. Total Erythrocyte Count (TEC), Packed Cell Volume (PCV), Haemoglobin values were decreased and TLC count was significantly increased in both doses of meloxicam treated groups in a dose-dependent manner. It was concluded that meloxicam caused GIT lesions, nephrotoxicity, hepatotoxicity and variation in the hematological parameters at selected dose and duration.

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Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100068035 ◽

1970 ◽

Vol 28 ◽

pp. 208-209

Author(s):

K.K. SEKHRI ◽

C.S. ALEXANDER ◽

H.T. NAGASAWA

Keyword(s):

Osmium Tetroxide ◽

Male Mice ◽

Alcohol Group ◽

Group Iii ◽

Group I ◽

C57bl Mice ◽

Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

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Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615218 ◽

1998 ◽

Vol 80 (09) ◽

pp. 393-398 ◽

Cited By ~ 33

Author(s):

V. Regnault ◽

E. Hachulla ◽

L. Darnige ◽

B. Roussel ◽

J. C. Bensa ◽

...

Keyword(s):

Fluid Phase ◽

Anticardiolipin Antibodies ◽

Dual Reactivity ◽

Group Iii ◽

Important Group ◽

Epitope Specificity ◽

Glycoprotein I ◽

Group I ◽

Group Ii ◽

Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

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Oxygen Fraction Adjustment According to Body Surface Area during Extracorporeal Circulation

The Heart Surgery Forum ◽

10.1532/hsf.1325 ◽

2015 ◽

Vol 18 (3) ◽

pp. 098

Author(s):

Cem Arıtürk ◽

Serpil Ustalar Özgen ◽

Behiç Danışan ◽

Hasan Karabulut ◽

Fevzi Toraman

Keyword(s):

Body Temperature ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Extracorporeal Circulation ◽

Group Iii ◽

Oxygen Fraction ◽

Arterial Blood ◽

Group I ◽

Group Ii

Background: The inspiratory oxygen fraction (FiO2) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO2) to reach hyperoxemic levels (>180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO2 levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO2 levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO2 during cardiac surgery.Methods: After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO2 adjustment strategies applied to the patients in the groups were as follows: FiO2 levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).Results: Mean PaO2 was significantly higher in Group I than in Group II at T2 and T3 (P = .0001 and P = .0001, respectively); in Group I than in Group III at T1 (P = .02); and in Group II than in Group III at T2, T3, and T4 (P = .0001 for all). Conclusion: Adjustment of FiO2 according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO2 between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO2 levels in concordance with the body temperature in the rewarming period.

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