COMPARATIVE EFFICACY AND SAFETY OF SYSTEMIC TERBINAFINE AND ITRACONAZOLE IN RECALCITRANT TINEA CRURIS

2021 ◽  
pp. 42-45
Author(s):  
Vasudha Sharma ◽  
Navyug Raj Singh ◽  
Tejinder Kaur ◽  
Inderpal Singh Grover
Keyword(s):  
Treatment Failure ◽  
Bacterial Infections ◽  
Small Sample Size ◽  
Treatment Options ◽  
Small Sample ◽  
Open Label ◽  
Tinea Cruris ◽  
Complete Cure ◽  
Institutional Ethics ◽  
Group B

Background: The prevalence of recalcitrant tinea is increasing despite available treatment options. Itraconazole and terbinane are the most commonly prescribed agents for tinea. The relative efcacy of both the drugs is under focus and no standard guidelines exist for the recalcitrant tinea. Objective:To compare their relative efcacy and safety of itraconazole and terbinane in recalcitrant tinea cruris patients. Methods: A prospective, randomized, open label study recruited 100 recalcitrant tinea cruris patients of 18-65 years age at dermatology OPD at GNDH hospital, Amritsar, India after obtaining Institutional Ethics Committee approval. Patients who consented for study and follow up were included. Impaired hepatic/ renal function, secondary bacterial infections or deep mycoses patients were excluded. After randomization, group Acomprised of 50 patients who were put on capsule itraconazole 100 mg BD and group B of 50 patients on tablet terbinane 250 mg OD for eight weeks. The treatment response was assessed as Complete cure, Treatment failure based on clinical (PGAScore) and mycological (KOH Smear) prole. Results: Itraconazole resulted in complete cure in 28 patients whereas terbinane cured 14 patients completely (p <0.05). Treatment failure were observed as 1 and 8 (itraconazole and terbinane respectively, p < 0.05). Both drugs had comparable safety prole with no serious adverse effects. Limitations of the study were short duration, small sample size and non-blinding. Conclusion:Itraconazole seems relatively more efcacious than terbinane in the treatment recalcitrant tinea cruris cases

scholarly journals Analgesic efficacy of meloxicam with or without a buprenorphine patch in cats after ovariohysterectomy

2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Small Sample Size ◽  
Analgesic Efficacy ◽  
Small Sample ◽  
Visual Analogue Scale Pain ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Group A ◽  
Group B

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.

scholarly journals A comparative trial between the therapeutic efficacy of topical 2% sertaconazole cream and 1% terbinafine cream in the treatment of tinea cruris/tinea corporis

2017 ◽  
Vol 3 (1) ◽  
pp. 59
Author(s):  
Sumyuktha J. ◽  
Murali Narasimhan ◽  
Parveen Basher Ahamed
Keyword(s):  
Comparative Trial ◽  
Treated Group ◽  
Tinea Corporis ◽  
Fungal Culture ◽  
Tinea Cruris ◽  
Complete Cure ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Cure Rates

<p class="abstract"><strong>Background:</strong> Skin infections caused by dermatophyte fungi account for 6% of dermatology consultations at our hospital and 3 to 4% worldwide. A variety of antifungal agents are available for topical use. Terbinafine 1% cream is considered the first line topical medication in the treatment of dermatophytosis. Sertaconazole 2% cream is a relatively new drug having antifungal as well as antiflammatory property. In this prospective study we sought to compare the safety and efficacy of topical 2% Sertaconazole and 1% Terbinafine creams in the treatment of localized tinea cruris and/or tinea corporis<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> In this study, 80 patients were randomized into two groups of 40 each. Group A received 2% Sertaconazole cream while group B received Terbinafine 1% cream topical application twice daily for 4 weeks. Patients were followed up at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks for clinical, mycological (KOH mount and fungal culture) and complete cure (both clinical and mycological).<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients studied was 27.97 years. Complete cure was achieved in 59.5% and 80% in group A and 71.4% and 90.9% in group B at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks respectively. Significant P values were observed if the results were compared within the group, between baseline and 2 weeks, baseline and 4<sup>th</sup> week and also 2<sup>nd</sup> and 4<sup>th</sup> week. Clinically significant side effects were not observed in both the groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Although higher cure rates were observed in the Terbinafine treated group, the results were not statistically significant. It can be concluded from our study that Sertaconazole 2% cream is similar in efficacy to Terbinafine 1% cream in the treatment of localized tinea cruris and corporis<span lang="EN-IN">.</span></p>

scholarly journals The Incidence of Mosaicism for Individual Chromosome in Human Blastocysts Is Correlated With Chromosome Length

2021 ◽  
Vol 11 ◽  
Author(s):  
Tzu-Hsuan Chuang ◽  
Ya-Ping Chang ◽  
Meng-Ju Lee ◽  
Huai-Ling Wang ◽  
Hsing-Hua Lai ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Chromosome Length ◽  
Small Sample ◽  
Individual Chromosome ◽  
Preimplantation Genetic Testing ◽  
Comprehensive Chromosome Screening ◽  
Mosaic Embryo ◽  
Group A ◽  
Group B ◽  
Mosaic Aneuploidy

Mosaicism, known as partial aneuploidies, mostly originates from mitotic errors during the post-zygotic stage; it consists of different cell lineages within a human embryo. The incidence of mosaicism has not been shown to correlate with maternal age, and its correlation with individual chromosome characteristics has not been well investigated. In this study, the results of preimplantation genetic testing for aneuploidy (PGT-A) derived from 4,036 blastocysts (930 IVF couples) were collected from 2015 to 2017. Via next-generation sequencing for comprehensive chromosome screening, embryo ploidy was identified as aneuploid, mosaic, and euploid. Total mosaicism was classified into two categories: “mosaic euploid/aneuploidy” (with mosaic aneuploidy between 20 and 80%) and “mosaic and aneuploidy” (a uniformly abnormal embryo superimposed with mosaic aneuploidies). Frequency of mosaicism was analyzed according to the function of chromosomal lengths, which divides involved chromosomes into three groups: group A (156–249 Mb), group B (102–145 Mb), and group C (51–90 Mb). The results show that the aneuploidy was more frequent in group C than in group A and group B (A: 23.7%, B: 35.1, 41.2%, p &lt; 0.0001), while the mosaicism was more frequent in group A and group B than in group C [(Mosaic euploid/aneuploid) A: 14.6%, B: 12.4%, C: 9.9%, p &lt; 0.0001; (mosaic and aneuploid) A: 21.3%, B: 22.9%, C: 18.9%, p &lt; 0.0001; (Total mosaicism) A: 35.9%, B: 35.3%, C: 28.8%, p &lt; 0.0001]. The significantly higher frequency of aneuploidy was on the shorter chromosome (&lt; 90 Mb), and that of mosaicism was on the longer chromosomes (&gt; 100 Mb). The length association did not reach significance in the patients with advanced age (≥ 36 years), and of the chromosome-specific mosaicism rate, the highest prevalence was on chromosome 14 (5.8%), 1 (5.7%), and 9 (5.6%). Although the length association was observed via group comparison, there may be affecting mechanisms other than chromosomes length. Eventually, twenty patients with mosaic embryo cryotransfers resulted in six live births. No significant correlation was observed between the transfer outcomes and chromosome length; however, the analysis was limited by small sample size.

scholarly journals Bipolar Disorder and Comorbid Use of Illicit Substances

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1256
Author(s):  
Ulrich W. Preuss ◽  
Martin Schaefer ◽  
Christoph Born ◽  
Heinz Grunze
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Best Practices ◽  
Multidisciplinary Approach ◽  
Small Sample Size ◽  
Basic Research ◽  
Small Sample ◽  
Epigenetic Alterations ◽  
Open Label ◽  
Addictive Disorders

Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at higher risk of addictive disorders, but recent data suggest common neurobiological and genetic underpinnings and epigenetic alterations. In the absence of specific diagnostic instruments, the clinical interview is conducive for the diagnosis. Treating SUD in bipolar disorder requires a comprehensive and multidisciplinary approach. Most treatment trials focus on single drugs, such as cannabis alone or in combination with alcohol, cocaine, or amphetamines. Synopsis of data provides limited evidence that lithium and valproate are effective for the treatment of mood symptoms in cannabis users and may reduce substance use. Furthermore, the neuroprotective agent citicoline may reduce cocaine consumption in BD subjects. However, many of the available studies had an open-label design and were of modest to small sample size. The very few available psychotherapeutic trials indicate no significant differences in outcomes between BD with or without SUD. Although SUD is one of the most important comorbidities in BD with a significant influence on clinical outcome, there is still a lack both of basic research and clinical trials, allowing for evidence-based and specific best practices.

scholarly journals Comparison of efficacy of topical alcaftadine (0.25%) versus olopatadine (0.1%) in allergic conjunctivitis

2022 ◽  
Vol 7 (4) ◽  
pp. 630-633
Author(s):  
Kiran Kumar L ◽  
M S Smitha Gowda
Keyword(s):  
Allergic Conjunctivitis ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Outcome Variable ◽  
Eye Drops ◽  
Open Label ◽  
Parallel Group ◽  
Significant Efficacy ◽  
Group B ◽  
Olopatadine Hydrochloride

The most common atopic ocular condition in clinical practice is allergic conjunctivitis. One of the preferred treatment options for allergic Conjunctivitis is anti histamines eye drops. The study purpose is to compare the clinical efficacy between topical alcaftadine 0.25% and olopatadine hydrochloride 0.1% in allergic conjunctivitis patients.A prospective, randomized, open label, parallel group, comparative study was conducted on 60 Patients with bilateral allergic conjunctivitis (30 in each group) after taking an informed written consentand was evaluated from May 2018 to November 2018. Patients were randomized into 2 groups of 30 each, group A received topical Alcaftadine 0.25% twice daily and patients in Group B received topical olopatadine hydrochloride 0.1% twice daily for 2 weeks. The patients were evaluated on first visit (baseline) followed by 7 and 14 day after starting the treatment. At each visit signs and symptoms were evaluated and rated using a scale from 0-3(0-Absent, 1- mild, 2 moderate and 3- severe). The change from baseline in the mean scores of itching, hyperemia, photophobia and tearing on day 14 is the primary outcome variable.: The signs and symptoms of allergic conjunctivitis were reduced by 2 weeks from baseline after using both the drugs. Relative significant efficacy was achieved in alcaftadine group for Itching, hyperemia and photophobia, but not for tearing (p=0.3). When compared to 0.1% olopatadine hydrochloride, 0.25% alcaftadine is more effective in reducing the symptoms of all types of allergic conjunctivitis except those mentioned in exclusion criteria.

scholarly journals Clinical and criminological characteristics of patients with organic mental disorders who had repeatedly committed socially dangerous acts

2014 ◽  
Vol 95 (1) ◽  
pp. 49-54
Author(s):  
S N Popov ◽  
I N Vinnikova
Keyword(s):  
Mental Disorders ◽  
Criminal Behavior ◽  
Small Sample Size ◽  
Small Sample ◽  
Compulsory Treatment ◽  
Sexual Crimes ◽  
Organic Mental Disorders ◽  
Hospital Patients ◽  
Group A ◽  
Group B

Aim. To perform the comparative analysis of clinical and criminological characteristics of patients with organic mental disorders who had repeatedly committed socially dangerous acts. Methods. 79 patients with diagnosed organic mental disorders who had committed socially dangerous acts, declared insane by the court and underwent compulsory treatment determined by the court as out-patients or in general or specialized mental hospital. Patients who had repeated socially dangerous acts after treatment, were included in the group A (19 patients), patients who had not committed any socially dangerous act after treatment, were included in the group B (60 patients). Results. Patients with organic delusional disorder (21 vs 11.6%) and non-psychotic organic disorders (10.5 vs 5%) were more commonly seen in group A compared to group B. The share of patients with dementia was higher in group B (23.3 vs 5.2%). 8 (42.1%) patients of group A were never prosecuted before, compared to 40 (66.7%) patients from group B. Some crimes were registered only in patients who repeatedly committed crimes: sexual crimes - 1 (5.2%), crimes against administrative order - 2 (10.5%), crimes against public security 5.2% (patient was convicted in illicit firearms manufacturing). Psychopathy-like syndrome was the leading syndrome in patients who committed a socially dangerous act in both A and B groups: 11 (57.9%) and 33 (55%) cases respectively. Hallucinatory delusion was diagnosed in 7 (36.8%) of group A patients and in 17 (28.3%) of group B patients. Majority of the group A patients had further committed only one crime after treatment - 11 (57.9%), 5 (26.3%) committed 2-3 crimes, 3 (15.8%) patients - over 3 crimes. The time gap between the first and further compulsory treatment was between 1 and 3 years in most of the cases (11 patients, 57.9%). 4 (21%) patients were readmitted for repeated compulsory treatment within 1 year, 3 (15.8%) were readmitted from 3 to 5 years and 1 (5.3%) from 5 to 8 years after the initial treatment. Conclusion. There are a number of factors influencing the criminal behavior and re-committing socially dangerous acts in future. Despite the small sample size, it should be noted that patients with dementia do not repeat socially dangerous acts.

scholarly journals An Electronic Teaching Module for Improving Knowledge of Self-Management of Vaso-Occlusive Pain Crises in Patients With Sickle Cell Disease: Pilot Questionnaire Study (Preprint)

2019 ◽  
Author(s):  
Tammie Tam ◽  
Maria R Baer ◽  
Lewis L Hsu ◽  
Jennie Y Law
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Small Sample Size ◽  
Treatment Options ◽  
Small Sample ◽  
Self Management ◽  
Cell Disease ◽  
Teaching Module ◽  
Baseline Knowledge ◽  
Electronic Teaching

BACKGROUND For patients with sickle cell disease (SCD), effective management of vaso-occlusive crises (VOCs) is integral to provision of care, as nearly all affected individuals will suffer from VOCs in their lifetime. A recent systematic review of technological interventions to improve self-management in the care of SCD concluded that electronic health has the potential to improve the care of individuals with SCD. OBJECTIVE The aim of this study was to assess the value of an electronic teaching module (ETM) provided by Emmi Solutions for educating adult SCD patients on VOC self-management and treatment options for SCD. METHODS A pretest assessed adults with SCD for baseline knowledge with regard to self-management of VOCs. Participants then watched the 35-min ETM and completed a posttest and survey on the ETM. RESULTS A total of 20 adults enrolled. Their knowledge scores improved (pretest median 66.5% and posttest median 85%; P<.001). In total, 18 participants (18/20, 90%) agreed that they “learned a lot” or “learned something” from the ETM. The most common topic about which they reported learning was hydroxyurea. A total of 12 participants (12/20, 60%) agreed with the statement that they “would recommend the module to a friend or family member with sickle cell disease.” CONCLUSIONS The ETM is associated with an increase in knowledge in patients with SCD. Limitations of the study include small sample size, no assessment of knowledge before premodule questionnaire completion, and no longitudinal follow-up. Identifying patients with SCD who demonstrate affinity for self-education via an ETM may further enhance utility of this tool to educate and empower patients.

scholarly journals Recurrence after pituitary surgery in adult Cushing’s disease: a systematic review on diagnosis and treatment

Endocrine ◽  
2020 ◽  
Vol 70 (2) ◽  
pp. 218-231
Author(s):  
Leah T. Braun ◽  
German Rubinstein ◽  
Stephanie Zopp ◽  
Frederick Vogel ◽  
Christine Schmid-Tannwald ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Cushing’S Disease ◽  
Small Sample Size ◽  
Case Reports ◽  
Treatment Options ◽  
Pituitary Surgery ◽  
Small Sample ◽  
Bilateral Adrenalectomy ◽  
Cushing's Disease ◽  
Success Rates

Abstract Purpose Recurrence after pituitary surgery in Cushing’s disease (CD) is a common problem ranging from 5% (minimum) to 50% (maximum) after initially successful surgery, respectively. In this review, we give an overview of the current literature regarding prevalence, diagnosis, and therapeutic options of recurrent CD. Methods We systematically screened the literature regarding recurrent and persistent Cushing’s disease using the MESH term Cushing’s disease and recurrence. Of 717 results in PubMed, all manuscripts in English and German published between 1980 and April 2020 were screened. Case reports, comments, publications focusing on pediatric CD or CD in veterinary disciplines or studies with very small sample size (patient number < 10) were excluded. Also, papers on CD in pregnancy were not included in this review. Results and conclusions Because of the high incidence of recurrence in CD, annual clinical and biochemical follow-up is paramount. 50% of recurrences occur during the first 50 months after first surgery. In case of recurrence, treatment options include second surgery, pituitary radiation, targeted medical therapy to control hypercortisolism, and bilateral adrenalectomy. Success rates of all these treatment options vary between 25 (some of the medical therapy) and 100% (bilateral adrenalectomy). All treatment options have specific advantages, limitations, and side effects. Therefore, treatment decisions have to be individualized according to the specific needs of the patient.

scholarly journals Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial

2020 ◽  
Vol 6 (4) ◽  
pp. 00460-2020
Author(s):  
Michael G. Crooks ◽  
Jack Elkes ◽  
William Storrar ◽  
Kay Roy ◽  
Mal North ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Small Sample ◽  
Self Management ◽  
Open Label ◽  
Management Interventions ◽  
Randomised Controlled ◽  
The Impact

Self-management interventions in COPD aim to improve patients' knowledge, skills and confidence to make correct decisions, thus improving health status and outcomes. myCOPD is a web-based self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD.We explored the impact of myCOPD in patients with mild–moderate or recently diagnosed COPD through a 12-week, open-label, parallel-group, randomised controlled trial of myCOPD compared with usual care. The co-primary outcomes were between-group differences in mean COPD assessment test (CAT) score at 90 days and critical inhaler errors. Key secondary outcomes were app usage and patient activation measurement (PAM) score.Sixty patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for forced expiratory volume in 1 s (FEV1 % pred) but there was baseline imbalance between groups for exacerbation frequency and CAT score. There was no significant adjusted mean difference in CAT score at study completion, −1.27 (95% CI −4.47–1.92, p=0.44) lower in myCOPD. However, an increase in app use was associated with greater CAT score improvement. The odds of ≥1 critical inhaler error was lower in the myCOPD arm (adjusted OR 0.30 (95% CI 0.09–1.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (95% CI 0.46–5.85) in favour of myCOPD.The small sample size and phenotypic difference between groups limited our ability to demonstrate statistically significant evidence of benefit beyond inhaler technique. However, our findings provide important insights into associations between increased app use and clinically meaningful benefit warranting further study in real world settings.

scholarly journals Current Treatment Options for Metastatic Hormone-Sensitive Prostate Cancer.

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1355 ◽  
Author(s):  
Cattrini ◽  
Castro ◽  
Lozano ◽  
Zanardi ◽  
Rubagotti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Small Sample Size ◽  
Treatment Options ◽  
Current Treatment ◽  
Abiraterone Acetate ◽  
Small Sample ◽  
Phase 3 ◽  
Tumor Patient ◽  
Randomized Controlled ◽  
Hormone Sensitive

The possible treatments options for metastatic hormone-sensitive prostate cancer (mHSPC) have dramatically increased during the last years. The old backbone, which androgen-deprivation therapy (ADT) is the exclusive approach for hormone-naïve patients, has been disrupted. Despite the fact that several high-quality, randomized, controlled phase 3 trials have been conducted in this setting, no direct comparison is currently available among the different strategies. Inadequate power, absence of preplanning and small sample size frequently affect the subgroup analyses according to disease volume or patient’s risk. The choice between ADT alone and ADT combined with docetaxel, abiraterone acetate, enzalutamide, apalutamide or radiotherapy to the primary tumor remains challenging. Factors that are related to the tumor, patient or drug side effects, currently guide these clinical decisions. This comprehensive review aims to indirectly compare the phase 3 trials in the mHSPC setting, in order to extrapolate data useful for treatment selection, providing also perspectives on future biomarkers.

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