IMMUNOTHERAPY VERSUS PHARMACOTHERAPY AMONG PATIENTS WITH ALLERGIC RHINITIS BASED ON TOTAL SYMPTOM SCORE AND MEDICATION SCORE.

2021 ◽  
pp. 78-80
Author(s):  
Arun Govind K ◽  
Satyawati Mohindra ◽  
Ashok K. Gupta ◽  
Shaurya Mahendru
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Rescue Medication ◽  
Tertiary Care ◽  
Symptomatic Treatment ◽  
Total Symptom Score ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Course Of Illness ◽  
Medication Score

Objective: To compare efcacy of immunotherapy and pharmacotherapy in patients with allergic rhinitis using total symptom score and rescue medication score. Prospective analysis of outcomes Design: of different treatment modalities in allergic rhinitis patients in a tertiary care centre. Hundred and ten pa Subjects: tients, diagnosed to have allergic rhinitis were included in this study, they were divided into 2 groups based on treatment modality i:e, pharmacotherapy (Group A) and immunotherapy group (Group B). Former contained 76 patients and latter 34 patients The pretreatment mean t Results: otal symptom score (TSS) in pharmacotherapy group was 7.76±3.8 and in immunotherapy group 10.88±2.45. Post treatment mean total symptom score was 7.31±3.68 and 6.29±3.01 respectively. Mean rescue medication score (RMS) in pharmacotherapy group was 0.40±0.22 and immunotherapy was 0.28±0.18. Conclusion: Both pharmacotherapy and immunotherapy was efcacious and safe in treating patients with AR , but the magnitude of reduction was more in immunotherapy group. Regardless of the sensitisation status of the patients (even if the patient is polysensitised ) they responded well with single allergen immunotherapy. Reduction in rescue medication score was statistically signicant in those receiving immunotherapy giving a stable control. Immunotherapy can also be used as anti symptomatic treatment and has the capacity to modify the course of illness

scholarly journals Intralymphatic immunotherapy with tyrosine-adsorbed allergens: a double-blind, placebo-controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hye Jung Park ◽  
Sae-Hoon Kim ◽  
Yoo Seob Shin ◽  
Chul Hwan Park ◽  
Eun-Suk Cho ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Injection Site ◽  
Symptom Score ◽  
Therapeutic Efficacy ◽  
Controlled Trial ◽  
Life Questionnaire ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Medication Score ◽  
Allergen Extracts

Abstract Background Most previous studies used aluminum hydroxide-absorbed allergen extracts in evaluating the potential therapeutic roles of intralymphatic allergen-specific immunotherapy (ILAIT). In this study, we evaluated the therapeutic efficacy and safety of ILAIT with L-tyrosine-adsorbed allergen extracts of Dermatophagoides farinae, D. pteronyssinus, cat, dog, or mixtures thereof, in patients with allergic rhinitis induced by these allergens. Methods In this randomized, double-blind, placebo-controlled trial, study subjects received three intralymphatic injections of L-tyrosine-adsorbed allergen extracts (active group) or saline (placebo group) at 4-week intervals. Results Although ILAIT reduced daily medication use and skin reactivity to HDM and cat allergens at 4 months after treatment, overall symptom score on a visual analog scale (VAS), sinonasal outcome test-20 (SNOT-20), rhinoconjunctivitis quality of life questionnaire (RQLQ), daily symptom score (dSS), daily medication score (dMS), daily symptom medication score (dSMS), nasal reactivity to HDM allergen, and basophil activity to HDM, cat, and dog allergens at 4 months and 1 year after treatment were similar between the treatment and control groups. Intralymphatic injection was more painful than a venous puncture, and pain at the injection site was the most frequent local adverse event (12.8%); dyspnea and wheezing were the most common systemic adverse events (5.3%). Conclusions ILAIT with L-tyrosine-adsorbed allergen extracts does not exhibit profound therapeutic efficacy in allergic rhinitis and can provoke moderate-to-severe systemic reactions and cause pain at the injection site. Trial registration: clinicaltrials.gov: NCT02665754; date of registration: 28 January 2016

scholarly journals CLINICAL PROFILE AND MANAGEMENT OF PATIENTS OF AMOEBIC LIVER ABSCESS IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 5-7
Author(s):  
Rakesh Mishra ◽  
Debabrata Banerjee ◽  
Debarshi Jana
Keyword(s):  
Drug Treatment ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Intestinal Disease ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Early Recovery

Introduction: Amoebiasis is caused by the protozoan Entamoeba histolytica. Most infections are asymptomatic; clinical manifestations include amoebic dysentery and extra intestinal disease. Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Amoebae establish hepatic infection by ascending the portal venous system. Aim: To study various aspects of Amoebic Liver Abscess like demographic profiles, clinical presentations, association with intestinal disease, radiological and laboratory findings, treatment modalities and complications. Materials and Methods: A hospital based prospective observational study was performed in the Department of Internal Medicine, Command Hospital (Eastern Command), Kolkata, from Jan 2018 to Jun 2019. All confirmed cases of amoebic liver abscess above the age of 18 years admitted in Command Hospital (EC) were included in this study. The patient were then subsequently followed up for 01 year with USG abdomen every 03 monthly. Results: Total 40 patients of Amoebic Liver Abscess with age more than 18 year were enrolled in the study. The age ranged from 26 to 70 years (mean age 46.2 year). Male patients were dominated over female. 80.0 % were from rural background. About 55% patients were addicted to alcohol & 25.0 % were known diabetics at presentation. In all, 07 (17.5%) patients with abscess size of 6 cm to 10 cm (Vol> 300 cc) were treated by needle aspiration and drug therapy. Remaining 17(42.5%) patients with abscess size more than 10 cm were treated with pigtail drainage and drug. Conclusion: There is significant advantage of pigtail drainage with drug treatment over needle aspiration with drug and only with drug treatment in terms of decrease in lesion size and early recovery.

scholarly journals Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

2020 ◽  
Vol 9 (2) ◽  
pp. 516
Author(s):  
Shrusti Parmar ◽  
Nalini Sharma ◽  
Vimla Dhakar
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Public Health Issue ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Early Presentation

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.

scholarly journals Liver abscess: presentation and an assesment of the outcome with various treatment modalities

2019 ◽  
Vol 6 (7) ◽  
pp. 2556 ◽  
Author(s):  
Sreeramulu P. N. ◽  
Srinivasan Dorai Swamy ◽  
Vikranth Suresh N. ◽  
Suma S.
Keyword(s):  
Liver Abscess ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Continuous Drainage ◽  
Right Lobe ◽  
Upper Abdominal

Background: Liver abscess is a disease of frequent occurrence which is important in the differential diagnosis of upper abdominal and right lower respiratory tract diseases. Liver abscess are space occupying lesion in liver which has a higher incidence of mortality and morbidity. The aim is to study the clinical presentation and compare the outcomes of various treatment modalities.Methods: A Retrospective Study was conducted over a period of 3 years from November 2016 to October 2019, in tertiary care centre, R. L. Jalappa hospital, Tamaka, Kolar, Karnataka, India. 46 cases of liver abscesses were studied. Complete clinical details about the clinical presentation of the cases, investigative work up and treatment modalities adopted were collected. The associated morbidity and mortality of all patients were reviewed.Results: In our study, the mean age was 49.5 years which included male patients most commonly. Pyogenic liver abscess was more common than amoebic liver abscess. Right lobe of the liver was most commonly involved. The common treatment modality was continuous drainage of the abscess cavity by the percutaneous insertion of a pig tail catheter. Surgical intervention for the rupture was done in one patient.Conclusions: In our experience of managing liver abscess, pyogenic liver abscess involving right lobe of the liver was common with the presentation of upper abdominal pain, high grade fever with chills and tender hepatomegaly. Ultrasound abdomen is very useful investigative tool in diagnosis and also in intervention and in the follow up of the condition and to evaluate progression or resolution.

scholarly journals Use of Triamcinolone in keloid

2021 ◽  
Author(s):  
Shwetha B. ◽  
Sathyaki D. C.
Keyword(s):  
Recurrence Rate ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Weekly Interval ◽  
Treatment Modalities ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Triamcinolone Injection

<p class="abstract"><strong>Background:</strong> Keloids are well known for recurrence. There is no standardized regimen for the treatment of keloids. Many different treatment modalities such as surgical excision, intralesional corticosteroids, radiotherapy, and pressure earrings have been used for keloids. Surgical excision alone may result in recurrence rate of 40-100%. Many different modalities of treatment have been tried to prevent recurrence. Aims and objectives of the study was to evaluate the efficacy of Triamcinolone in preventing recurrence of Keloid.</p><p class="abstract"><strong>Methods: </strong>40 patients who underwent excision of keloid at a tertiary care centre. Surgery alone was performed in 20 patients and surgery with post operative intra lesional Triamcinolone injection was given weekly interval for 6 weeks in another 20 patients. Patients were followed up for the period of 2 years</p><p class="abstract"><strong>Results: </strong>Recurrence was found in 5 patients who underwent excision alone and there was no recurrence among patients who received post operative intra lesional triamcinolone.</p><p class="abstract"><strong>Conclusions: </strong>Multi modality treatment is better to prevent recurrence of Keloid.</p>

scholarly journals Comparison of Sublingual Immunotherapy in Patients With Allergic Rhinitis Sensitive to House Dust Mites in Korea

2019 ◽  
pp. 014556131988259
Author(s):  
Joo Hyun Jung ◽  
Tae Kyu Kang ◽  
Il Gyu Kang ◽  
Seon Tae Kim
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Sublingual Immunotherapy ◽  
House Dust Mites ◽  
Dust Mites ◽  
Immunoglobulin G4 ◽  
Treatment Groups ◽  
Satisfaction Rate ◽  
Medication Score ◽  
Igg4 Level

The aim of this study was to investigate the clinical outcomes of sublingual immunotherapy (SLIT) using 2 kinds of SLIT medications (LAIS and Staloral) in patients with allergic rhinitis for Dermatophagoides pteronyssinus and Dermatophagoides farinae. We have evaluated the patient’s characteristics, safety, and compliance in 293 patients and also analyzed the symptom score, medication score, satisfaction rate, and immunologic measurement in 84 patients who have continued the treatment over 1 year. The symptom scores were significantly improved in both treatment groups, 51% versus 44% (LAIS vs Starloral) at 1 year ( P < .05). The medication score was also significantly decreased in both treatment groups ( P < .05), 50.8% versus 60%. The subjective improvement score was 44.4% versus 46.1%, and satisfaction rate was 29% versus 40% ( P < .05). The serum immunoglobulin G4 (IgG4) level was significantly increased in Staloral group ( P < .05). The adverse events were 6.2% versus 33.3% and the compliance was 37.7% versus 25.1%. In conclusion, the improvements in symptom score and medication scores were not significant different between 2 SLIT medications at 1 year. LAIS was more compliant, less side effects and Staloral has shown increased satisfaction rate and IgG4 level.

scholarly journals Coexistence of Allergic Rhinitis in Children Attending Paediatric Asthma Clinic

2019 ◽  
Vol 39 (3) ◽  
pp. 142-146
Author(s):  
Rajesh Kumar Singh ◽  
Ashish Kumar Simalti
Keyword(s):  
Allergic Rhinitis ◽  
Epidemiological Study ◽  
Age Of Onset ◽  
Tertiary Care ◽  
North India ◽  
Tertiary Care Centre ◽  
Global Initiative For Asthma ◽  
Co Morbidity ◽  
Prospective Epidemiological Study ◽  
Global Initiative

Introduction: Asthma and allergic rhinitis are considered manifestations of the chronic inflammatory respiratory syndrome of the common airways or united airways disease. We conducted a prospective epidemiological study to evaluate the prevalence of allergic rhinitis among children already diagnosed as having asthma. Methods: A prospective epidemiological study was carried out during 2015 to 2016 at a tertiary care centre in North India. The severity of asthma was classified according to the Global Initiative for Asthma (GINA) report & allergic rhinitis according to Allergic Rhinitis and Its Impact on Asthma (ARIA). Results: A total of 64 children were screened. After excluding five subjects (7.8%), 59 subjects with asthma were analysed. We could not find any definitive correlation between severity of asthma to severity of allergic rhinitis (p > 0.05). The prevalence of co morbidity of asthma and allergic rhinitis was maximum when onset of asthma was between three to six years (70%), was 40% for < three years and 50% when age of onset was six to nine years. The age of onset of asthma in children having asthma only was five years and that of children with both asthma and allergic rhinitis was 5.5 years. This difference was not significant (p > 0.05).  Conclusion: There was a high prevalence of co morbidity (50.84%) of allergic rhinitis among patients with asthma. A positive correlation was found between duration and severity of asthma, but this was not observed for allergic rhinitis. In most cases asthma preceded or started with AR.

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