Efficacy of propranolol in infantile hemangioma

Hemangiomas, are the most common benign tumors of infancy. Despite their selflimited course, infantile capillary hemangiomas can cause local complications e.g. pain, ulceration, bleeding etc. The usual treatments include oral/intralesional steroids, alpha interferon, cytotoxins, pulsed dye laser and cosmetic surgery resection. These treatments are not free of multiple complications and toxic side effects. We report our experience with the use of propranolol in 2 children with haemangiomas along with review of relevant literature. Both the hemangioma cases promptly responded to low-dose oral propranolol. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22561 Bang Med J (Khulna) 2014; 47 : 32-35

Download Full-text

Ultra-Low Dose Oral Naltrexone Decreases Side Effects and Potentiates the Effect of Methadone

Journal of Pain and Symptom Management ◽

10.1016/s0885-3924(03)00139-8 ◽

2003 ◽

Vol 25 (6) ◽

pp. 491-494 ◽

Cited By ~ 32

Author(s):

Ricardo A Cruciani ◽

David Lussier ◽

Debra Miller-Saultz ◽

Dimitry M Arbuck

Keyword(s):

Side Effects ◽

Low Dose ◽

Oral Naltrexone ◽

Dose Oral

Download Full-text

Avascular Necrosis after Oral Corticosteroids in Otolaryngology: Case Report and Review of the Literature

Allergy & Rhinology ◽

10.2500/ar.2016.7.0142 ◽

2016 ◽

Vol 7 (1) ◽

pp. ar.2016.7.0142 ◽

Cited By ~ 8

Author(s):

Patrick Kennedy ◽

Ahmed Bassiouni ◽

Alkis Psaltis ◽

Jastin Antisdel ◽

Joseph Brunworth

Keyword(s):

Case Report ◽

Total Dose ◽

Avascular Necrosis ◽

Low Dose ◽

Relevant Literature ◽

Oral Prednisone ◽

Review Of The Literature ◽

Median Total Dose ◽

Oral Corticosteroids ◽

Dose Oral

Objective In this report, we present a rare case of avascular necrosis (AVN) in an otherwise healthy 42-year-old male patient treated with low dose oral corticosteroids for his bronchitis. A systematic review of the literature related to AVN and corticosteroids was performed. Case Report Forty-two-year-old male with no underlying conditions predisposing him to AVN who had been treated four years before for chronic bronchitis with two courses of oral prednisone therapy presented with bilateral AVN of the hips. Methods An OVID database search of the terms “low total dose,” “corticosteroids,” and “avascular necrosis” was performed. Two PubMed searches of various permutations of “low-dose,” “corticosteroids,” “avascular necrosis,” and “osteonecrosis” were also performed. Results were then narrowed to relevant articles. Results Median total dose of oral corticosteroids in patients with AVN in reviewed articles was 981 mg, with lowest reported association at 105 mg. Median duration of therapy was 16 days with shortest course of six days. Conclusion There is emerging data linking AVN with corticosteroid doses previously thought to be safe. After reviewing the relevant literature, it is our consensus to inform all patients regarding AVN before oral corticosteroid use.

Download Full-text

Ultra-low-dose oral contraceptive pill: a new approach to a conventional requirement

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170006 ◽

2017 ◽

Vol 6 (2) ◽

pp. 364

Author(s):

Meenakshi Ahuja ◽

Pramod Pujari

Keyword(s):

Side Effects ◽

Low Dose ◽

Oral Contraceptive Pill ◽

New Approach ◽

Breakthrough Bleeding ◽

Free Interval ◽

Dose Oral ◽

Hormonal Fluctuations ◽

Reversible Method ◽

Dose Oral Contraceptive

Combined oral contraceptives (COCs) offer a convenient, safe, effective, and reversible method of contraception. However, their use is limited by side effects. Several strategies have been suggested to make COC use more acceptable among women. Reduction in the dose of estrogen is a commonly accepted approach to reduce the side effects of COC. Use of newer generation of progestins, such as gestodene, reduces the androgenic side effects generally associated with progestogens. Furthermore, reduction in hormone-free interval, as a 24/4 regimen, can reduce the risk of escape ovulation (hence preventing contraceptive failure) and breakthrough bleeding. It also reduces hormonal fluctuations, thereby reducing the withdrawal symptoms. A COC with gestodene 60 µg and ethinylestradiol (EE) 15 µg offers the lowest hormonal dose in 24/4 treatment regimen. This regimen has been shown to offer good contraceptive efficacy and cycle control. With the progress of treatment cycles, the incidence of breakthrough bleeding reduces. Gestodene/EE low dose 24/4 regimen was associated with lower incidence of estrogen-related adverse events, such as headache, breast tenderness, and nausea. Furthermore, COCs containing low dose of estrogen have not been associated with any adverse effect on haemostasis in healthy women. Ultra-low-dose COCs can be considered in women who are at risk of developing estrogen-related side effects.

Download Full-text

LOW-DOSE ORAL PROPRANOLOL

The Lancet ◽

10.1016/s0140-6736(78)90825-5 ◽

1978 ◽

Vol 311 (8066) ◽

pp. 715

Author(s):

C.F. George

Keyword(s):

Low Dose ◽

Dose Oral ◽

Oral Propranolol

Download Full-text

Comparative Efficacy of Low-Dose Oral Corticosteroids and Oral Mini Pulse Dexamethasone in Patients of Vitiligo

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v11i1.30673 ◽

2016 ◽

Vol 11 (1) ◽

pp. 54-58

Author(s):

Md Shirajul Islam Khan

Keyword(s):

Side Effects ◽

Low Dose ◽

Oral Prednisolone ◽

Oral Dexamethasone ◽

Oral Corticosteroids ◽

Dose Oral ◽

Group A ◽

Pulse Dexamethasone ◽

The Mean ◽

Group B

Introduction: Vitiligo is a common, acquired, discoloration of the skin with unknown etiology. There are numerous treatment options available for vitiligo, but none is universally effective. Systemic corticosteroids suppress immunity and lead to repigmentation but produce unacceptable side effects. Oral corticosteroid low dose treatment may be associated with fewer side effects than usual dose-treatment. Several data also showed that oral dexamethasone pulse treatment was effective in arresting progression of vitiligo yet fails to induce satisfactory repigmentation in the great majority of their patients.Objectives: A clinical trial was carried out to compare the efficacy of low-dose oral corticosteroids and oral mini pulse dexamethasone in patients of vitiligo.Materials and Methods: The study was conducted in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, Bangladesh during January 2013 to December 2013. Total sixty patients of vitiligo were enrolled and divided into group A and group B. Thirty of group A patients were treated with oral prednisolone daily and thirty of group B patients were treated with oral dexamethasone pulse therapy weekly.Results: Out of sixty patients of vitiligo, maximum patients of both groups had progressive type of vitiligo. In Group-A, the duration of illness was an average of 10 months and in group-B, it was an average of 8.20 months. Single lesion was 15 (50%) for Group-A and 14 (46.7%) for Group-B. Multiple lesions were 15 (50%) & 16 (53.6%) for Group-A and Group-B respectively. The study showed that improvement rate was highest for the lesions on the extremities, which was 18 (34.6%) and lowest for back 03 (5.8%). Out of all patients from Group-A, the mean size of the lesions were 8.17cm, 5.90 cm, 4.32 cm and 3.57 cm at 1st visit, 2nd visit, 3rd visit and 4th visit respectively. In Group-B, the mean sizes of the lesions were 7.50 cm, 4.92 cm, 3.00 cm, and 4.75 cm at 1st visit, 2nd visit, 3rd visit and 4th visit respectively. Among the patients 27 (90%) of group-A and 25 (83.3%) of group B were improved after 16th week of treatment, slight response 4(13.3%) and 6(20%), moderate response 22(63.2%) and 18(59.4%) and marked response was 1(3.3%) and 1(3.3%) in group A and group B respectively.Conclusion: The study concluded that both the drugs, oral prednisolone and dexamethasone when used individually, were found to be equally effective in the treatment of vitiligo.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 54-58

Download Full-text

Efficacy and Safety of Ultra Low Dose Oral Contraceptive Pills in Rural Indian Women - A Prospective, Open Label Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/121 ◽

2021 ◽

Vol 8 (11) ◽

pp. 618-622

Author(s):

Sheela Raghavendra Sharma

Keyword(s):

Oral Contraceptive ◽

Side Effects ◽

Low Dose ◽

Ethinyl Estradiol ◽

Indian Women ◽

Oral Contraceptive Pills ◽

Combined Oral Contraceptive ◽

Contraceptive Pills ◽

Dose Oral ◽

Dose Oral Contraceptive

BACKGROUND Combined oral contraceptive pills are the most effective temporary contraception methods and are used by approximately 60 - 80 million eligible women throughout the world. It is the oestrogen component of the combined oral contraceptive (COC) which is responsible for the undesirable and serious side effects such as deep vein thrombosis (DVT) and pulmonary embolism (PE). So, there has been a constant effort to reduce the amount of ethinyl estradiol (EE) while maintaining its contraceptive efficacy. This study was aimed at studying the safety and efficacy of ultralow dose combined oral contraceptive (containing 15 mcg EE + 60 mcg gestodene) in rural Indian women. METHODS The study was done at Rama Medical College, Mandhana, Kanpur, among 70 patients who fulfilled the inclusion criteria. The patients were given ULDOCP and followed up for 6 months. The patients followed the regime of one tablet of ULDOCP daily from day 1 to day 24 of the menstrual cycle with 4 days pill free period before starting the next pack. RESULTS Seventy patients completed the study till 3 months and fifty patients completed the study till 6 months. Break through bleeding (BTB) was the only prominent side effect which was reduced in subsequent cycles and our patients tolerated this well. No pregnancy resulted. The ULDCOP was very well accepted by those women who were counselled about possible side effects and their harmless nature before starting the study. It was found that the users were satisfied with the use of ULDOCP. All side effects were significantly lower after 2 months of use and there were no serious side effects. CONCLUSIONS The 24 / 4 ULDOCP regimen seems to be a safe and effective contraceptive method for use in rural population after properly counselling them. The reduced pill free interval of 4 days offered additional advantages. KEYWORDS Ultra-Low Dose Oral Contraceptive Pills (ULDOCP), Ethinyl Estradiol (EE), Safe Contraception, Gestodene, BTB (Break Through Bleeding)

Download Full-text

Periocular capillary hemangioma treated with low dose oral propranolol - presentation and outcome of 30 patients

Archives of Pathology and Clinical Research ◽

10.29328/journal.apcr.1001027 ◽

2021 ◽

Vol 5 (1) ◽

pp. 037-041

Author(s):

Roy Soma Rani ◽

Nuruddin Murtuza

Keyword(s):

Low Dose ◽

Color Change ◽

Initial Response ◽

Capillary Hemangioma ◽

Response To Treatment ◽

P Value ◽

Outpatient Basis ◽

Cost Effective Treatment ◽

Dose Oral ◽

Oral Propranolol

Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol. Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol. Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis.

Download Full-text