scholarly journals Comparison of Rupatadine Monotherapy and Combined Levocetirizine with Ranitidine Dual Therapy for the Treatment of Chronic Idiopathic Urticaria

2021 ◽  
Vol 6 (2) ◽  
pp. 01-07
Author(s):  
Richmond Ronald Gomes ◽  
Kaniz Rahman ◽  
Dilruba Aktar ◽  
SM Matiur Rahman ◽  
Sharif M Rahman

Background: Effective treatment for chronic idiopathic urticaria (CIU) with conventional combined therapy comprising H1 and H2 antihistamine is effective but associated with high relapse rate. Newer H1 blocker rupatadine alone is similarly effective with less relapse rate. Also it is convenient for the patient as similar efficacy is obtained with single dosage compared to 3 times dosing in combined therapy. This study was done to compare the traditional treatment with levocetirizine and ranitidine to a newly introduced antihistamine rupatadine for CIU. Materials and Methods: The study was a hospital based prospective randomized control trial among 40 patients with CIU in Dermatology and Venereology department of Bangabandhu Sheikh Mujib Medical University(BSMMU), Dhaka from April 2020 to September 2020.Forty patients of CIU were randomly enrolled into two equal groups (group A and B). Patients of group-A were treated with 5 mg of levocetirizine once daily plus 150 mg of ranitidine twice orally daily and group-B were treated with rupatadine 10 mg once daily for one month. The efficacy was assessed 1st and 4th week during treatment and 4 weeks after completion of treatment by observing reduction of itching, regression of the size and shape of lesions and appearance of new lesions. Adverse effects and patient satisfaction were also noted. Results: 75% patients in group A and 80% patients in group B responded to treatment (p>0.05).80% in group A and 85% in group B showed improvement in itching in the first week (p>0.05). . At the end of 4 weeks 95% showed improvement in each group. Appearance of new lesions in first week was 10% and 5% (p>0.05) and at 4th week, 5% and 0% respectively (p>0.05). 75% in group A and 80% in group B had regression in their lesions at the end of first week (p>0.05). At the end of 4th week, it was 85% and 90% (p>0.05). 40% in group A and 25% in group B had relapse of itching at follow up (p<0.05). Relapse of lesions were 35% and 20% (p<0.05). Overall occurrence of side effects (3 compared to 1) was more in group A. Conclusion: The result of the present study show that both conventional treatment with levocetirizine and ranitidine combination and newer agent rupatadine alone has similar efficacy in reducing clinical sign and symptoms of CIU. But rupatadine has significantly reduced the relapse rate and so it is a more efficacious and also safer option with less adverse effects for the treatment of CIU in comparison to conventional treatment. Rupatadine is also more convenient option for patients in term of dosage schedule.

2020 ◽  
Vol 75 (11) ◽  
pp. 3327-3333
Author(s):  
Leonardo Calza ◽  
Vincenzo Colangeli ◽  
Marco Borderi ◽  
Diletta Testi ◽  
Bianca Granozzi ◽  
...  

Abstract Background Antiretroviral dual regimens including lamivudine and one boosted PI or dolutegravir are warranted in order to optimize combination ART (cART), prevent long-term toxicity and reduce the cost of treatments. Objectives We hypothesized that a maintenance dual regimen of lamivudine plus raltegravir would be effective and as well tolerated as the dual maintenance combination of lamivudine plus dolutegravir. Methods We performed an observational, retrospective study of HIV-infected patients on suppressive ART who switched to a dual regimen containing lamivudine 300 mg once daily plus raltegravir 1200 mg once daily or dolutegravir 50 mg once daily. Results In total, 109 patients (79 men; mean age 46.4 years; mean CD4+ T lymphocyte count 605 cells/mm3) were enrolled. Overall, 50 subjects switched to lamivudine plus raltegravir (Group A) and 59 to lamivudine plus dolutegravir (Group B). After 12 months, 45 patients (90%) in Group A and 52 (88.1%) in Group B had HIV RNA &lt;20 copies/mL. No patients had severe adverse effects in either group, and the percentages of patients with mild adverse effects were comparable, except for a higher incidence of headache and sleeping disturbances in Group B than in Group A (30.5% versus 14%, P &lt; 0.001). A comparable and non-significant weight increase was reported in both groups (+1.91 kg in Group A and +2.28 kg in Group B). Conclusions In our study, dual therapies containing lamivudine plus raltegravir or dolutegravir in virologically suppressed patients showed high and comparable efficacy, as well as good tolerability.


2013 ◽  
Vol 39 (1) ◽  
pp. 22-27 ◽  
Author(s):  
SC Hazra ◽  
AM Choudhury ◽  
ATM Asaduzzaman ◽  
HK Paul

The objectives of this study were to compare the adverse outcome of methotrexate and mini pulse betamethasone therapy in the treatment of lichen planus. It was a clinical trial conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Patients in Group-A, (n=23) were treated with methotrexate (10 mg) single morning dose and group-B (n=21) were treated with mini pulse betamethasone (5mg) single morning dose on 2 consecutive days during the period of 12 weeks. Adverse outcomes were measured by clinical examination and laboratory investigations during follow up visits. Anemia 3(14.2%) and edema 12(57.1%) developed in group-B but none in group-A. In group-B, dyspepsia 15(71.4%), acne 10(47.6%), mooning face 8(38.1%), striae 8(38.1%) and hypertrichosis 4(19.0%) developed but none in group-A. Intermittent diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher amog group-B compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A. Laboratory investigations showed abnormality in platelet count and SGPT in group-A but none in group-B. The adverse effects of methotrexate on haematological parameter and liver functions were mild and could be prevented by reducing the dose but the adverse effects of betamethasone were unavoidable. The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15806 Bangladesh Med Res Counc Bull 2013; 39: 22-27


2020 ◽  
pp. 1-4
Author(s):  
Himakshi Bhattacharya ◽  
Bhavna Gadhavi

Background: Osteoarthritis is a chronic degenerative disease. The major symptom of Knee Osteoarthritis Are Pain Decreased Range of Motion and Functional impairment. The purpose of the study is to evaluate the effect of backward cycling and forward cycling in subject with Knee Osteoarthritis. The traditional protocol for treating knee osteoarthritis shows inability to treat the pain, function and range of motion at primary level of treatment. This can eradicate the drawback of generalized protocol. Method: The subject assessed thoroughly would be divided in three group. Group A would be given Conventional Treatment and Forward Cycling. Group B would be given Conventional Treatment and Backward Cycling. Group C would be given only Conventional Treatment. Treatment Duration for all three groups would be for 4 weeks. Then improvement would be evaluated in pain, Function and ROM by taking Post data. Then Pre-and Post data would be compared for final Conclusion. Conclusion: According to the present study the alternative hypothesis is accepted and null hypothesis is rejected. Which suggest that backward cycling proves to manage the symptoms efficiently than forward cycling and single handed conventional protocols.


2021 ◽  
Vol 8 (14) ◽  
pp. 849-853
Author(s):  
Shweta Saurin Mehta ◽  
Nidhiben Sureshbhai Patel

BACKGROUND Supraclavicular brachial plexus block is a reliable, regional anaesthetic technique for upper limb surgeries. Also known as “spinal of upper limb”.1 The present study was conducted to assess the analgesic efficacy of dexamethasone as an adjuvant to 0.5 % ropivacaine for ultrasound sonography (USG) guided brachial plexus block. METHODS 50 adult patients of American Society of Anaesthesiologists (ASA) physical status I and II of both genders, aged 18 - 50 years scheduled for elective upper limb surgeries under brachial plexus block via supraclavicular approach were randomised into 2 groups of 25 patients each to receive either 20 ml of 0.5 % ropivacaine with 2 ml of normal saline (group A) or 20 ml of 0.5 % ropivacaine with 2 ml of dexamethasone (8 mg) (group B). RESULTS Use of ultrasound helps in better visualisation of nerves, needle & spread of local anaesthetic at brachial plexus block site. So, less amount of drug volume is required for the block. Time of onset of sensory and motor block was significantly lower in group B compared to group A. Mean duration of motor and sensory block was significantly longer in group B than group A. The duration of postoperative analgesia was 18.79 ± 2.31 hours in group B & 9.06 ± 0.35 hours in group A, with statistically highly significant difference (P < 0.05). There were no perioperative haemodynamic variations between the two groups and no complication of technique or adverse effects due to dexamethasone occurred. CONCLUSIONS Dexamethasone 8 mg has significantly extended duration of analgesia of brachial plexus block with no adverse effects. KEYWORDS Brachial Plexus Block, Ropivacaine, Dexamethasone, Supraclavicular Approach, Ultrasound Guidance


1992 ◽  
Vol 20 (4) ◽  
pp. 453-455 ◽  
Author(s):  
E. T. M. Lim ◽  
K. Y. Chong ◽  
B. Singh ◽  
W. Jong

A double-blind study was undertaken to investigate the effect of prewarmed local anaesthetic solution on the latency of onset of caudal blocks. Forty-four (ASA I-II) patients were allocated into two equal groups. In Group A, the local anaesthetic solutions were injected at room temperature (25°C), while in Group B, they were injected at 37°C. All the caudal blocks were performed using 20 ml of lignocaine 1.5% with adrenaline 1:200,000. The speed of onset of perianal analgesia was found to be significantly faster (39%) with the prewarmed local anaesthetic solution (P < 0.05). No adverse effects were observed.


1999 ◽  
Vol 17 (7) ◽  
pp. 2160-2160 ◽  
Author(s):  
Monika Engelhardt ◽  
Hartmut Bertz ◽  
Matthias Afting ◽  
Cornelius F. Waller ◽  
Jürgen Finke

PURPOSE: The efficacy of a high- versus a standard-dose filgrastim (recombinant human granulocyte colony-stimulating factor, or rhG-CSF) regimen to mobilize peripheral-blood progenitor cells (PBPCs) for allogeneic transplantation was investigated in 75 healthy donors. PATIENTS AND METHODS: From December 1994 to December 1997, 75 consecutive donors (median age, 38 years; range, 17 to 67 years) were assigned to two different schedules of rhG-CSF for PBPC mobilization. Fifty donors received 24 μg rhG-CSF/kg body weight (BW) divided into two daily subcutaneous injections (two doses of 12 μg, group A), whereas 25 were treated with 10 μg rhG-CSF once daily (group B). Apheresis was started on day 4 in group A and on day 5 in group B. Target CD34+ cell numbers in apheresis products were ≥ 4 × 106/kg recipient BW. RESULTS: Cytokine priming and collection of PBPCs were equally well tolerated in both groups. Significantly higher CD34+ cell numbers in group A with 3.7 × 106/kg recipient BW/apheresis (0.47 × 106/L apheresis) compared with 2 × 106/kg recipient BW/apheresis (0.25 × 106/L apharesis) in group B were obtained (P < .05). Using standard aphereses (median, 9 L), two doses of 12 μg rhG-CSF/kg allowed collection of ≥ 4 × 106/kg CD34+ cells with two aphereses (range, one to three) in group A versus three aphereses (range, one to six) in group B (P < .015). Donor age, sex, and BW influenced the collection of CD34+ cell numbers: in particular, significantly higher apheresis results were obtained in donors younger than 40 years compared with donors older than 40 years of age (P < .05). In 65 CD34+ selection procedures using avidin-biotin immunoabsorption columns (Ceprate SC System, CellPro, Bothell, WA), a median CD34+ purity of 53%, CD34+ recovery of 40%, and the collection of 2 × 106/kg CD34+ cells/selection were achieved. In group A with higher CD34+ cells/kg/apheresis, CD34+ purity, recovery, and cell yields were 60%, 45%, and 2.3 × 106/kg/selection, respectively, as compared with 48%, 31%, and 0.7 × 106/kg in group B (P < .05). CONCLUSION: Our results demonstrate that twice daily rhG-CSF (two doses of 12 μg/kg BM) compared with once daily rhG-CSF (10 μg/kg BW), in addition to being well tolerated, significantly improves PBPC mobilization, allows the collection of higher numbers of CD34+ cells with one or two standard aphereses, and facilitates subsequent selection procedures in healthy allogeneic donors.


Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Maria N. Negreva ◽  
Atanas P. Penev

ABSTRACT The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.


2002 ◽  
Vol 30 (02n03) ◽  
pp. 355-367 ◽  
Author(s):  
Mosaburo Kainuma ◽  
Jun Hayashi ◽  
Shinya Sakai ◽  
Kazuaki Imai ◽  
Naoki Mantani ◽  
...  

The purpose of this study was to determine if the adverse effects of interferon (IFN) in hepatitis C patients could be reduced by treatment with Japanese Oriental (Kampo) medicine. Twelve patients with chronic hepatitis C were treated with a combination of IFN-β and either Mao-to or Dai-seiryu-to (groups A and B), and 16 patients were treated with IFN-β alone (group C). Mao-to was administered to eight patients and Dai-seiryu-to was administered to four in groups A and B, respectively. Adverse effects were evaluated by clinical and laboratory examinations. The severity of symptoms was daily self-classified into four categories (1: none, 2: very slight, 3: moderate, and 4: serious), using a questionnaire consisting of 29 items. Scores of symptom such as discomfort and fever in group A, and discomfort, general malaise, paresthesia and arthralgia in group B were significantly lower than those in group C (p > 0.05). In all patients, HCV-RNA was negative at the end of the treatment, and serum alanine aminotransferase (ALT) levels had normalized transiently in all group A and B patients with genotype 1b by 2 weeks after cessation of IFN treatment. This study indicates that Kampo medicines are useful for reducing the adverse effects accompanying IFN treatment in patients with chronic hepatitis C without reducing the antiviral effects.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Biru Ma ◽  
Xiuhua Chen ◽  
Yudan Liang ◽  
Weiquan Ouyang ◽  
Boyan Tang ◽  
...  

Objective. To assess the efficacy of bloodletting therapy (acupoint pricking and cupping) in patients with chronic idiopathic urticaria (CIU) in a randomized, control, parallel-group trial. Methods. A total of 174 patients with CIU enrolled from March 2018 to October 2019 were randomized into three groups: group A treated with bloodletting therapy and ebastine, group B treated with placebo treatment (acupoint pseudopricking and cupping) and ebastine, and group C treated with ebastine only. The intention-to-treat analysis was conducted, and the primary outcome was the effective rate of UAS7 score being reduced to 7 or below after treatment phase. Results. The effective rates at the end of treatment phase were different among the three groups ( P < 0.05 ), which were 73.7% in group A, 45.6% in group B, and 42.9% in group C. Multiple analysis indicated differences between groups A and B ( P < 0.0125 ) and groups A and C ( P < 0.0125 ) and no difference between groups B and C ( P > 0.0125 ). No severe bloodletting therapy-related adverse events were observed. Conclusions. In this study on patients with CIU, one month of bloodletting therapy combined with ebastine is clinically beneficial compared with placebo treatment combined with ebastine and treatment with ebastine only. Thus, bloodletting therapy can be an effective complementary treatment in CIU. This trial is registered with ChiCTR1800015294.


Author(s):  
Ahmed N. Fetih ◽  
Ahmed M. Abbas ◽  
Fatma A. Kamel ◽  
Ihab H. El Nashar

Background: The current study aims to compare the use of tamoxifen and oral contraceptive pills in women using implanon and complain with irregular uterine bleeding.Methods: Women attended family planning clinic using implanon presented by bleeding were invited to participate in the study. They were randomized into two groups: Group A: 100 women received Tamoxifen 10 mg twice daily for 10 days taken at the onset of an episode of bleeding or spotting episode. Group B: 100 women received Combined oral contraceptive pills (microcept) once daily for 21 days take at the onset of an episode of bleeding or spotting episode.Results: No difference regarding the baseline criteria of both groups. No difference between both groups regarding the duration of irregular bleeding in the implanon users (p=0.090). Additionally, the number of bleeding days and spotting in the last month was similar in both groups (p=0.554). The percentage of women who stopped bleeding during the period of treatment is 84% in the tamoxifen group and 92% in the COCs group, but the COCs needs longer treatment time, where the mean of days required to stop bleeding is 5.03±1.8 days in the tamoxifen group and 6.5±2.5 in the COCs group. Headache and nausea were the most prominent adverse effects found in the COCs group (p=0.000).Conclusions: Oral administration of tamoxifen 10 mg twice daily for 10 days is effective on stopping bleeding attacks in implanon users.


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