Geographic Tongue - Does Candida Play a Role in its Pathogenesis

Summary Background/Aim: Geographic tongue (GT), a benign self-limiting condition (inflammation) is commonly seen in practice. Although quite easy for clinical diagnosis, in clinical practice it is commonly misdiagnosed and treated as Candida infection. The main aim of this study was to compare the prevalence of Candida spp. on tongue in patients with GT and subjects with clinically healthy oral mucosa. Additional aims were to evaluate subjective symptoms, uncontrolled usage of prescribed or non-prescribed antifungal topical medications and the presence of the cancerophobia or other health concerns in patients with GT. Material and Methods: A total of 70 subjects were divided into two groups: Group B- patients with diagnosed Geographic tongue and group A - aged and gender matched controls with clinically health oral mucosa. Anamnestic charts designed for this study included information about symptoms (measured by Visual Analogue Scale), previous knowledge or fear about presence of GT and received therapy for this condition. Detection of Candida spp. from tongue was done using sterile cotton swab and Sabouraud dextrose agar. Results: At the time of this study, 18 (52.94%) of subjects with GT were aware of having this condition and even 12 of them (66.7%) used topical antifungal drugs prescribed by physician. Also, 66.7% of them experienced fear about the presence of GT at some moment. Detection of Candida spp. was similarly distributed in both groups (22.2% in group A and 17.6% in group B). Conclusions: Geographic tongue has frequently been treated by topical antifungal drugs. In this study, GT was not associated with presence of Candida spp.

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The Effect of Use of Anidulafungin on Failure of Weaning Due to Ventilator-associated Pneumonia which Complicate Contused Lungs

The Open Anesthesia Journal ◽

10.2174/2589645801812010073 ◽

2018 ◽

Vol 12 (1) ◽

pp. 73-84

Author(s):

Mohamed Gaber Ibrahium Mostafa Allam

Keyword(s):

Broad Spectrum ◽

Antifungal Drugs ◽

Lung Contusion ◽

Prolonged Treatment ◽

Double Blind Study ◽

Ventilator Associated Pneumonia ◽

Double Blind ◽

Broad Spectrum Antibiotics ◽

Group A ◽

Group B

Introduction:Failure of weaning is considered one of the most difficult challenges facing any intensivist especially in the devitalized lung due to infected lung contusion. Unsatisfactory results with prolonged treatment with the proper broad-spectrum antibiotics raise the point of exclusion of candidemia or suspected pulmonary candidiasis which is considered a major problem not only because of increasing rate (2-10 per 1000 ICU admission) but also because of difficult diagnosis. Patients with failure of weaning due to unresolved VAP after receiving broad-spectrum antibiotics for more than 10 days especially in preexisting severe lung contusion should be put on empirical systemic antifungal. Echinocandins are a new class of antifungal drugs used as a reliable class for empirical systemic antifungal treatment.Aim of Work:The study aims to evaluate and compare the effect of the use of anidulafungin on weaning from the ventilator due VAP which complicates traumatized contused lungs after 2 weeks from ventilation.Patients and Methods:This was a prospective double-blind study done on 200 patients admitted to King Abdulaziz Specialized Hospital, Taif, KSA between March 2015 and August 2018 in surgical ICU with the failure of weaning due to Ventilator Associated Pneumonia (VAP) complicate contused lungs. Group (A) 100 patients started on antibiotics regimen according to qualitative culture for 2 weeks while group (B) 100 patients received anidulafungin with the antibiotics regimen.In this study, diagnosis of lung contusion was made by Computerized Axial Tomography (CT) chest while both VAP was diagnosed by a modified Clinical Pulmonary Infection Score (CPIS). A score of 6 or more was considered VAP.Results:Comparing the data of the patients in the 3 studied periods (1st5 days, 2nd5 days and last 4 days) controlled tracheal secretion was recorded in 15, 38 and 46 patients in group A respectively in the 3 studied periods compared to 28, 75 and 83 in group B. Less parenchymatous lung infiltration in the chest X-ray found was in 12, 40 and 48 patients in group A compared to 24, 88 and 91 patients in group B. Improvement of the hypoxic index in 48, 76 and 85 patients in group A was compared to 66, 90 and 98 patients in B. Normalization of temperature in 16, 36 and 54 patients in group A while 40, 76 and 90 patients in B and reduction of total leucocytic count in 18, 35 and 57 patients in group A while 38, 70 and 87 patients in group B were observed. There were 15 out of 98 patients in Group A not weaned while only 5 out of 100 patients in group B failed to be weaned from mechanical ventilation within the study period (2 weeks).Conclusion:The use of anidulafungin with proper antibiotics in patients with failure of weaning due to VAP complicate contused lung efficiently treated VAP and reduced the morbidity by accelerating the weaning from the ventilator compared to the use of proper antibiotics alone.

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HEMORRHOIDECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.09.879 ◽

2017 ◽

Vol 24 (09) ◽

pp. 1316-1321

Author(s):

Shibber Ahmed ◽

Ishtiaq Ahmad ◽

Humayun Amjid ◽

Aamir Furqan

Keyword(s):

Hospital Stay ◽

Severe Pain ◽

Conventional Technique ◽

Categorical Variables ◽

P Value ◽

Chi Square ◽

Post Operative Pain ◽

Group A ◽

And Gender ◽

Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

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A comparison of self-esteem between patients undergoing fixed orthodontic treatment, to those not receiving orthodontic treatment

The Journal of Medical Research ◽

10.31254/jmr.2021.7405 ◽

2021 ◽

Vol 7 (4) ◽

pp. 112-115

Author(s):

Maleeha Majid ◽

◽

Maliha Jamshaid ◽

Ghina Rizwan ◽

Zarnab Rizwan ◽

...

Keyword(s):

Sample Size ◽

Orthodontic Treatment ◽

Self Esteem ◽

The Self ◽

The Other ◽

Treatment Need ◽

The Past ◽

Group A ◽

And Gender ◽

Group B

Objective: Comparison of the self-esteem between patients undergoing fixed orthodonticc treatment in the past 6 months or more, to those not receiving orthodontic treatment or the time passed since the commencement of their treatment has been less than six months. Materials and methods: The participants of this study were divided into two groups, group A and group B. The sample size of each group was 75 making the total 150 aged between 16 to 25 years. The malocclusion severity was assessed with the index of orthodontic treatment need aesthetic component (IOTN-AC) which was 6 or more for both groups. Group A involved patients currently receiving no orthodontic treatment or the time elapsed since the start of the treatment was less than 6 months. Group B on the other hand, comprised of patients undergoing orthodontic treatment in the past 6 months or more. Questionnaires were administered among both group A and group B where self-esteem was measured using the Rosenberg Self-esteem (RSE) Scale. Independent Sample T test was applied on both of these variables. Results: The results did not show any statistically significant association between self-esteem and “the time elapsed since the start of the treatment”. Likewise, the additional factors i.e., Age, Education and Gender too had no impact on the Rosenberg score. Conclusion: No association was found between selfesteem of the patients undergoing fixed Orthodontic treatment, to those not receiving it

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Prevalence of psychosocial problems in children with and without epilepsy: A comparative cross-section study.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.04.5800 ◽

2021 ◽

Vol 28 (04) ◽

pp. 557-563

Author(s):

Erum Afzal ◽

Waqas Imran Khan ◽

Mohammad Khalid Iqbal ◽

Kausar Aftab ◽

Tanveer Ahmad

Keyword(s):

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Educational Level ◽

Psychosocial Problems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Epileptic Children ◽

Group A ◽

And Gender ◽

Group B

Objectives: To compare the prevalence of psychosocial problems in children with and without epilepsy. Study Design: Comparative Cross Sectional study. Settings: The Children’s Hospital and The Institute of Child Health Multan (CH & ICH). Period: July 2019 to December 2019. Material & Methods: Fifty-nine patients of either gender, 5 -12 years of age, diagnosed as Epilepsy were included in group A. For the group B the patient of same number, age and gender without epilepsy visiting the general outpatient department of the hospital with acute illness were included. The children having known psychiatric disorder, and intellectual disability were excluded. Educational level of parents, socioeconomic status, Time of onset, type, outcome of epilepsy, number of antiepileptic medicines used and EEG findings were noted. Intelligence Quotient of each patient was calculated. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 20. Result: Out of 118 patients (59 in group A and 59 in group B), 68% (n=73) were male. Mean age of the participants was 10.2years (st dev.±11.1). Patients age ranging between 5-9 years constituted 32% (n=38) while 68% (n=80) were more than 9 to 12 years. Most of the children belonged to low socioeconomic status 66% (n=78). Educational level of parents was below matric in 67.8% (n=80) and 32.2% (n=38) were above matric. In Group A 64.41% (n=38) patients had generalized tonic clonic type of epilepsy, 28.81% (n=17) partial/focal type and 3.39% (n= 2) myoclonic type. In 42% (n=52) of patient’s epilepsy was controlled while in 58% (n=7) patients it was uncontrolled. Psychosocial problems were detected in 59.3% (n=35) patients in epileptic group A while in 23.7% (n=14) in non-epileptic group B. Single use of antiepileptic was important factor causing psychosocial problems in epileptic children. Conclusion: Psychosocial problems are more common in Epileptic children, so psychological evaluation and management must be integral part of their therapy.

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Clinical and demographic profile of paediatric patients presenting with acute diarrhea

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201635 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1043

Author(s):

Apurva C. Shah ◽

Devendra Sareen ◽

Dileep Kumar Goyal

Keyword(s):

Tertiary Care ◽

Public Health Problem ◽

Rural People ◽

Demographic Profile ◽

Chief Complaints ◽

Male Preponderance ◽

Group A ◽

And Gender ◽

Group B ◽

Study Participants

Background: Diarrhea is a public health problem globally, being the 2nd leading cause of death in children under 5 years. Dehydration as well as malnutrition are also serious consequences of diarrhea. This study was carried out with an aim to focus on the clinical and demographic profile of diarrheal patients of pediatric age.Methods: Infants and children aged 6 months to 5 years were analysed for age and gender distribution, chief complaints, feeding practices, nutritional status and assessment of dehydration; from January 2018 to June 2019 in the Department of Pediatrics of a Tertiary Care Teaching Hospital.Results: Total 150 patients were analysed. Almost 50.67% group A and 41.34% group B patients belonged to toddlerhood. Male preponderance was also noted. Along with diarrhea, vomiting was noted in 22 group A and 21 group B and fever in 19 group A and 29 group B patients. Approximately 41-45% patients had no malnutrition and 55-60% had no dehydration in both the study groups.Conclusions: There is lack of awareness regarding dog bite and its management among the rural people fever and vomiting were most frequently associated with diarrhea. A little less than half of the study participants had some-dehydration. Nearly half of the patients belonged to toddler age group. Majority of the patients were exclusively breast-fed for six months.

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Maternally-Derived Antibody and Seroconversion to Infectious Bronchitis Virus in Chicken

Bangladesh Journal of Microbiology ◽

10.3329/bjm.v25i1.4857 ◽

1970 ◽

Vol 25 (1) ◽

pp. 53-56 ◽

Cited By ~ 1

Author(s):

Narayan Chandra Paul ◽

M Shahidur Rahman Khan ◽

Shaiful Islam ◽

AHM Taslima Akhter ◽

Niraj Kanti Shil

Keyword(s):

Antibody Titre ◽

Infectious Bronchitis Virus ◽

Serum Samples ◽

Infectious Bronchitis ◽

Field Virus ◽

Group A ◽

Enzymelinked Immunosorbent Assay ◽

And Gender ◽

Group B

An investigation was conducted with a view to determining the persistence of maternally-derived antibody (MDA) against infectious bronchitis virus (IBV) in chicks as well as seroconversion of IBV in relation to age and gender of chicks in field condition. Determination of antibody titre was performed by indirect enzymelinked immunosorbent assay (iELISA). The existence of MDA was calculated in Group A (n = 20) and Group B (n = 15) originating from parents vaccinated against IBV and with no such history respectively. In case of group A, titres of serum samples obtained were 5361.23 ± 854.09, 2567.58 ± 763.61, 808 ± 751.361, 432.29 ± 47.11, 178.36 ± 88.28, 184.58 ± 93.6, 80.89 ± 70.11 and 43.55 ± 32.92 on day 1, 5, 9, 13, 17, 21, 25 and 29 days aged birds respectively. On the other hand, sera samples of group B manifested a titre of 3285.18 ± 685.03, 2219.16 ± 419.77, 1783.62 ± 219.84, 589.01 ± 249.63, 186.66 ± 88.21, 178.36 ± 202.02, 105.77 ± 75.69 and 41.34 ± 69.28 on same schedule. It was further revealed that chicks with ancestor of non-vaccinated parents showed higher MDA titre up to 9th day of age. This might have happened due to exposure of field virus to the parent birds. As regards seroconversion, it was observed that 100, 20 and 80% of serum samples collected from chickens of 0-2 weeks, 3-4 weeks and 4 months of age were positive to IBV specific antibody respectively, whereas no serum sample was positive in case of 5-7 weeks aged birds. When considered the gender of birds, it was revealed that sera from the female showed 58.33% seropositivity against 25% from male. Maternally-derived antibody (MDA) might protect the chickens up to 9 days of age and since MDA could interfere vaccination, it should not be performed before such age. Keywords: Maternally-derived antibody (MDA); Infectious bronchitis virus (IBV); antibody titre; Seroconversion; ChicksDOI: http://dx.doi.org/10.3329/bjm.v25i1.4857 Bangladesh J Microbiol, Volume 25, Number 1, June 2008, pp 53-56

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Efficacy of Itraconazole vs Itraconazole Plus Isotretinoin in Treatment of Chronic Tinea

10.53350/pjmhs2115103316 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3316-3318

Author(s):

Naseem Ullah ◽

Abdur Rahim Khan ◽

Kalsoom Aslam ◽

Syed Muhammad Obaid

Keyword(s):

Antifungal Drugs ◽

Large Sample Size ◽

Significant Treatment ◽

Complete Cure ◽

Group A ◽

Oral Itraconazole ◽

Treatment Objective ◽

One Year ◽

Group B ◽

Global Population

Background: About 20 to 25% of the global population is affected by the fungal skin infections. Different antifungal drugs used in traditional doses have developed widespread resistance, necessitating the development of an efficient antifungal treatment. Objective: To assess efficacy of itraconazole vs itraconazole plus isotretinoin in treatment of chronic tinea. Methodology: This was comparative study conducted at the Department of Dermatology Qazi Hussain Ahmad Complex Nowshera and alshifa clinic and skin aesthetic, Nowshera for duration of one year from November 2020 to November 2021. In both group A and B, 40 individuals were taken randomly. Treatment of group A patients was done with oral itraconazole and isotretinoin while patients of group B treatment was done with oral itraconazole alone. All patients were monitored for four weeks to assess their responsiveness to therapy and side effects. Results: Complete cure response was recorded in all the patients of group A, while in group B, complete cure response was recorded in 20 (50%) patients. A statistically significant treatment response was observed between both the groups (p<0.05). There were 22 (55%) individuals in group A and 7 (17.5%) patients in group B who had cheilitis and dryness of the lips as major adverse effects. Conclusion: Our study concludes that combination therapy with oral itraconazole and isotretinoin is efficient and safe for the treatment of chronic tinea. Our study recommends conducting study based on large sample size for better results.

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A Study of Primary Skin Closure by Intradermal Stitches with and Without Adhesive Tapes

Bangladesh Journal of Plastic Surgery ◽

10.3329/bdjps.v3i1.14999 ◽

2013 ◽

Vol 3 (1) ◽

pp. 7-12

Author(s):

B Sarker ◽

LK Lenin ◽

SK Khundkar

Keyword(s):

Plastic Surgery ◽

Visual Analogue Score ◽

Line Length ◽

Adhesive Tape ◽

Skin Closure ◽

College Hospital ◽

Significant Difference ◽

Group A ◽

And Gender ◽

Group B

The study was done to evaluate whether adhesive tape after intradermal skin closure in face and neck produces better aesthetic scar than intradermal skin closure in face and neck without adhesive tape. It was a prospective, interventional, purposive study and was done in department of Plastic Surgery, Dhaka Medical College Hospital (D.M.C.H.) from July 2005 to October 2007. A total of 90 patients was included in the study. In one group (A), face and neck skin was closed by intradermal stitches with Vicryl. In other group (B), face and neck skin was closed by intradermal stitches with Vicryl 6/0, cutting body needle with adhesive tape (Nichistrip). The study included 76 patients. The age range was from 13-45 years. 34 patients were male and 42 patients were female. None of the baseline variables like age and gender was found to be different in two groups (p> 0.05). There was no statistically significant difference between two groups in the distribution of Incision along Langers line, Length of incisions, Gapping and Swelling (p>0.05). Group B (intradermal skin closure in face and neck lesions with adhesive tape) had statistically highly significant difference (p<0.001) visual analogue score than group A (intradermal skin closure in face and neck lesions without adhesive tape). It can be said that intradermal skin closure in face and neck lesions causes better aesthetic scar than intradermal skin closure in face and neck lesions without adhesive tape. Adhesive skin tape has definite value in the plastic surgery and can be regarded as a specific modality for aesthetic scars in face and neck.DOI: http://dx.doi.org/10.3329/bdjps.v3i1.14999 Bangladesh Journal of Plastic Surgery 2012, 3(1): 7-12

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Catheter-free Period Over 2 Days Is Associated with Better Outcome in Catheter-related Bloodstream Infection due to Candida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.126 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S54-S55

Author(s):

Takahiro Matsuo ◽

Nobuyoshi Mori ◽

Eri Hoshino ◽

Aki Sakurai ◽

Keiichi Furukawa

Keyword(s):

Risk Factors ◽

Bloodstream Infection ◽

Univariate Analysis ◽

Venous Catheter ◽

Antifungal Drugs ◽

Optimal Timing ◽

Exact Test ◽

Group A ◽

Group B ◽

Catheter Related Bloodstream Infection

Abstract Background Regardless of active antifungal drugs, mortality of candidemia remains high. Although it is well-known that central venous catheter (CVC) is one of the most important risk factors of candidemia and should be removed immediately, little is known about optimal timing of CVC replacement after removal. Here, we analyzed contributing risk factors associated with 30-day mortality for catheter-related bloodstream infection (CRBSI) due to candida and optimal timing of CVC replacement. Methods We conducted a retrospective cohort study at St. Luke#129; fs International Hospital between 2004 and 2015. We compared each clinical component in patients who died within 30 days and were alive at 30 days. Also, catheter-free period (from removal to replacement) was compared between group A and B. Fisher#129; fs exact test and Mann–Whitney U test were used in univariate analysis and multivariate linear regression was used for controlling confoundings. Results Among 228 patients (pts) with candidemia, 166 patients (73%) were on CVC at diagnosis. Of them, 144 patients (65%) removed CVC after the result of candidemia. Seventy-one patients (31%) replaced CVC. Fifteen patients (6%) died within 30 days (group A) and 56 patients (25%) were alive at 30 days (group B). Median age was 74 in group A and 72 in group B (P = 0.331) (Table 1). In univariate analysis, hematological malignancy (OR 6.75, 95% CI 1.01–44.9) and CVC replacement < 2-days after removal (OR 5.63, 95% CI 1.16–27.3) showed statistically significant increase in group A vs group B (Table 2). In multivariate analysis, CVC replacement < 2-days was independently associated with 30-day mortality (Table 3). Conclusion This is the first study to demonstrate the optimal timing of CVC replacement in CRBSI due to candida. CVC replacement < 2 days was an independent risk factor for 30-day mortality. Disclosures All authors: No reported disclosures.

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Comparison of the Therapeutic Effect of Treatment with Antibiotics or Nutraceuticals on Clinical Activity and the Fecal Microbiome of Dogs with Acute Diarrhea

Animals ◽

10.3390/ani11061484 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1484

Author(s):

Giulia Pignataro ◽

Roberta Di Prinzio ◽

Paolo Emidio Crisi ◽

Benedetta Belà ◽

Isa Fusaro ◽

...

Keyword(s):

Acute Diarrhea ◽

Severity Index ◽

Fecal Microbiota ◽

Clinical Activity ◽

Fecal Microbiome ◽

Group A ◽

Effect Of Treatment ◽

Global Concern ◽

Group B ◽

Limiting Condition

Dogs with acute diarrhea are often presented to clinical practice and, although this generally represents a self-limiting condition, antibiotics are still frequently used as treatment. The aim of this study was to evaluate the effects in dogs with acute non-hemorrhagic diarrhea of the administration of an antibiotic combination in comparison to a nutraceutical product. Thirty dogs were enrolled and randomly assigned to two groups: 15 dogs (group A) received a nutraceutical commercial product while 15 dogs (group B) received an antimicrobial combination of metronidazole and spiramycin. For each dog, the Canine Acute Diarrhea Severity Index, the fecal microbiota and the Dysbiosis Index were assessed. Both stool consistency and frequency decreased on day 2 in the dogs of group A compared to baseline, while in group B, these parameters significantly decreased at days 3 and 4. The global concern for rising antibiotic resistance associated with indiscriminate use of antimicrobials, in both humans and animals, suggests the necessity of avoiding empirical and injudicious use of these molecules in diarrheic dogs. These results suggest that the nutraceutical treatment had a similar clinical effect compared to the antibiotic formulation, representing a valid antibiotic-sparing therapeutic approach in canine acute diarrhea.

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