CLINICALAND MYCOLOGICAL PROFILE OF ONYCHOMYCOSIS IN A HILLY STATE OF NORTH - EAST INDIA .

2021 ◽  
pp. 41-43
Author(s):  
Subrata kumar Das ◽  
Saptadipa Das

Background: Onychomycosis is a chronic fungal infection of nger nails and toe nails. It is a non life threatening condition and requires long-term treatment. Mostly patients seek medical care for cosmetic purpose unless it gets secondarily infected and produce pain. Aims: The aim of this study was to determine the prevalence of various causative agents of onychomycosis and to study the clinical and mycological patterns of onychomycosis . Material and Methods: This was a cross sectional observational study which was carried over a period of one year , from December 2019 to November 2020 . A total of 47 patients were included in the study , who visited Dermatology OPD of SMIMS , Sikkim, India. After clinical evaluation , nail samples were subjected for KOH mount and culture. Results:This study included 47 patients of clinically diagnosed onychomycosis , 30 males and 17 males . In the present study maximum number of patients belonged to the age group 30-40 years with 28 patients . Most of the study subjects , 22 were agricultural worker . We found that trauma to the nails was the commonest predisposing factor 17. Out of 47 patients 33 patients were KOH positive and 21 patients were culture positive. Most common type of onychomycosis was Distal lateral subungual onychomycosis with 2 cases . Most common species identied in our study was T.rubram with 5 patients , followed by T. mentagrophytes with 3 patients. Conclusion: Along dermatophytes , NDM and yeasts were also common aetiological agents of onychomycosis. Since onychomycosis can cause physical , psychological and occupational problems, the clinico-epidemiological data can be helpful in development of preventive and diagnostic strategies.

2021 ◽  
Vol 1 (1) ◽  
pp. 23-32
Author(s):  
Godeliva Adriani Hendra ◽  
Martanty Aditya ◽  
Chresiani Destianita Yoedistira

Asthma is an obstructive chronic pulmonary disease which causes shortness of breath and requires distinct diagnostic strategies and treatment management. The disease requires long-term treatment where the patient's condition can hopefully remain under control. There are still many symptom recurrences found in asthma patients due to inaccurate/incomplete procedures in using inhalers. The purpose of this community service is to develop knowledge and understanding of the completeness of usage procedures of Ventolin Inhalers by utilizing videos as visual training to achieve expected therapeutic effect and aid asthma patients in controlling/avoiding asthma relapse. Data collection was carried out through observation in the form of checklists which contained the procedures for using the inhaler, followed by descriptive analysis. The observations were made one month before and after video education. Education in video format was distributed on day one. The video was uploaded to Youtube and contain procedures on how to use the inhaler device. Alternatively, it can also be sent through the patient's WhatsApp account. The data collection process was carried out from April to July 2020. There were changes in the number of patients before and after the provision of video education. This shows the level of knowledge and understanding of asthma patients regarding the completeness of the procedure for using Ventolin Inhaler had increased. Inappropriate usage of inhalers or errors made during the implementation of each step can affect the effectiveness of drug therapy and can cause unwanted side effects.


2018 ◽  
Vol 69 (8) ◽  
pp. 2236-2239
Author(s):  
Marius Moga ◽  
Mark Edward Pogarasteanu ◽  
Dumitru Ferechide ◽  
Antoine Edu ◽  
Chen Feng Ifrim

Gout is a metabolic disease involving the impregnation of joints and other tissues with urate crystals. The onset is often brutal, and it manifests itself with pain and inflammation in the affected joint. The treatment usually involves rest, ice, NSAIDs and anti-gout medication. The long-term treatment involves medication and dietary changes. In the joint, urate crystals are deposited in the synovial, in the cartilage and in the menisci. In the arthroscopic practice, the gouty knee is a rare occurrence. We present a relevant case, that of a 57 years old patient without a prior gout diagnosis where we found urate crystal deposits covering the synovium, cartilage and meniscus, and we discuss the current and recent year Pub Med indexed literature in order to evaluate the possibilities for arthroscopic treatment of this pathology. We looked at the number of patients involved, their characteristics, and the surgical techniques used. We also looked at the temporal relation of the arthroscopic intervention to the recent gout attacks, and at the described lesions that were found. Also, we evaluated the papers for joint liquid analysis, gout drug treatment, and description of clinical aspects involved and associated lesions. Finally, we looked at the follow-up, at the functional scores used to monitor the patient�s evolution, at the associated medication and at the long-term outcomes, if described. We have found opinions to vary. In the end, we draw conclusions pertaining to the practical short-term and long-term use of knee arthroscopy in the treatment of gout.


Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Simone Janett ◽  
Pietro Camozzi ◽  
Gabriëlla G. A. M. Peeters ◽  
Sebastiano A. G. Lava ◽  
Giacomo D. Simonetti ◽  
...  

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Noriyuki Naya ◽  
Keita Fukao ◽  
Akemi Nakamura ◽  
Kohji Nomura ◽  
Seijiro Hara ◽  
...  

PPARδ is one of the transcription factors that regulate lipid metabolism. Recently, PPARδ agonists have been reported to induce the elevation of plasma HDL-C levels in obese mice, rhesus monkeys as well as humans, indicating their potentials as a new class of HDL-C raising agent. In addition, anti-atherosclerotic effects of PPARδ agonists were reported in LDLR-KO and ApoE-KO mice. In these mice, however, the lipoprotein profiles are greatly different from those in humans in terms of the deficiency in CETP and ApoB100, and thus the anti-inflammatory effects were regarded as a main anti-atherosclerotic mechanism of PPARδ agonists. It has been reported that human ApoB100/CETP transgenic (hApoB100/CETP-Tg) mice have similar lipoprotein profiles with humans. In this study, we used hApoB100/CETP-Tg mice placed under a western diet for evaluation of GW501516, one of the most potent and selective PPARδ agonists, in order to investigate the linkage between HDL-C elevation and anti-atherosclerotic potency. For evaluation of plasma HDL-C levels, the hApoB100/CETP-Tg mice were orally treated with GW501516 for 1 week and its potency was compared with fenofibrate, a PPARα agonist used in the clinic. For evaluation of the anti-atherosclerotic effect, the mice were orally treated with GW501516 for 18 weeks and atherosclerosis at the aortic valves was determined by cross-sectional lesion analysis. Serum lipoprotein parameters were periodically monitored and lipoprotein profiles were analyzed by FPLC method. Treatment with GW501516 resulted in significant elevation of plasma HDL-C levels with more potency compared to fenofibrate (24% and 15% elevation at 10mg/kg, respectively). Serum apoA-I was also increased by the similar ratio as HDL-C, and the particle size of HDL was not changed, suggesting that the numbers of HDL particle are increased by GW501516. Long term treatment of GW501516 (3 and 10 mg/kg) resulted in dose-dependent suppression of atherosclerosis (42 and 57% inhibition, respectively) with a strong correlation with HDL-C elevation (p<0.001). By using hApoB100/CETP-Tg mice, PPARδ was confirmed as a promising target of anti-atherosclerotic therapy as a new class of HDL-C raising agent.


2021 ◽  
pp. 1-8
Author(s):  
Tilman Steinmetz ◽  
Angela Ernst ◽  
Martin Hellmich ◽  
Melanie Heinz ◽  
Uwe Totzke

<b><i>Introduction:</i></b> New drugs for multiple myeloma have considerably increased the options for consecutive treatment lines in regular care. Official treatment guidelines still discuss several regimens per line, and therefore, current practice is of topical interest. Large cross-sectional studies revealed a greater than linear loss of patients reaching consecutive treatment lines of ever decreasing effectiveness. <b><i>Methods:</i></b> In a longitudinal approach, we analyzed data of all 145 multiple myeloma patients treated in our outpatient clinic in Germany between January 1, 2012, and December 31, 2019, using a time-to-event analysis with death as competitive risk. <b><i>Results:</i></b> The estimated incidences of reaching the 2nd, 3rd, 4th, and 5th lines of therapy were 88, 66, 44, and 30%, respectively. Median times to subsequent treatment lines were 34, 18, 14, 13, and 15 months, respectively. <b><i>Discussion:</i></b> Percentages of patients reaching later therapy lines were considerably greater than predicted by cross-sectional studies and median times after the 1st line did not suggest a further decrease in effectiveness, while use of new drug regimens was similar to that reported in cross-sectional studies. <b><i>Conclusion:</i></b> Effectiveness of later therapy lines appears to be underestimated by cross-sectional analyses, and the conveyed focus on 1st-line treatment for multiple myeloma needs to be scrutinized.


1991 ◽  
Vol 1 (3) ◽  
pp. 221-224 ◽  
Author(s):  
José A. Ettedgui ◽  
William H. Neches ◽  
Elfriede Pahl

SummaryCross-sectional echocardiography is an essential tool in the evaluation ofchildren with Kawasaki disease, both in the acute and chronic stages. In the acute phase of the illness, it is valuable for diagnosis and management of pancarditis and for the long-term monitoring of pericardial effusions, left ventricular function, and the rare cases of chronic valvar dysfunction. When coronary arterial abnormalities are detected, echocardiography can serially evaluate long-term treatment with drugs which prevent the aggregation of platelets and monitor the resolution of coronary aneurysms. The value of cross-sectional echocardiography, nonetheless, is very limited in the detection of coronary arterial stenosis. Coronary arteriography is still important for the diagnosis of obstructive lesions in the coronary arteries and should be used in conjunction with cross-sectional echocardiography for the appropriate long- term management of children with Kawasaki disease at high risk of developing coronary arterial stenosis. Perhaps, in the future, high resolution transesophageal echocardiography will allow clear delineation of coronary arterial anatomy and specifically stenosis, but its role in the evaluation and management of children with Kawasaki disease remains to be explored.


Author(s):  
T. Kayia Priscilla Kayina ◽  
M. Shyami Tarao ◽  
Polly Nula

Background: Tuberculosis is a disease of global concern. India with its high burden of Tuberculosis, HIV and HIV-TB co-infection, this disease continue to have tremendous impact on its denizens especially the north-eastern states of the country because of its problem of HIV. It is imperative to understand every aspects of the disease for effective prevention and control.Methods: A retrospective record study of tuberculosis units was conducted.Results: The proportion of males was more as compared to females, with more cases seen with increasing age. Pulmonary TB was seen more among males, whereas extra-pulmonary TB was seen more among females. Favorable treatment outcome was seen in 84.7% of the population. HIV-TB Co-infection was seen 6.5% of the patients, with 46.3% having extra-pulmonary TB. Favorable treatment outcome was seen among them too.Conclusions: More common in males, showing increasing number of patients in older age group with favourable outcomes on treatment in all categories including HIV-TB co-infection patients.


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