scholarly journals A Pharmacovigilance Study of Topical Acne Monotherapy with 0.1% Adapalene, and A Molecular Analytical Review of Adapalene in Evidence-Based Dermatopharmacological Treatment

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Dr. Moumita Hazra
Keyword(s):  
Adverse Effects ◽  
Acne Vulgaris ◽  
Global Evaluation ◽  
Evidence Based ◽  
Molecular Pharmacology ◽  
Once Daily ◽  
Significant Evidence ◽  
The Face ◽  
Analytical Review ◽  
User Friendly

Acne vulgaris causes cosmetic impairment. User-friendly anti-acne monotherapy with adapalene has activity against the acne pathophysiology, with very minimal adverse effects. Retinoids, like adapalene, are comedolytic and anti-inflammatory. This study was conducted as a pharmacovigilance study of topical acne monotherapy with 0.1% adapalene, and a molecular analytical review of adapalene in evidence-based dermatopharmacological treatment. A prospective, open- labelled study was done, on 75 patients, with mild to moderate acne. Patients applied 0.1% adapalene topical monotherapy, once daily in the evening, over affected areas on the face, and left overnight. Efficacy was measured by percentage reduction in non-inflammatory, inflammatory and total lesion counts on 0, 15, 30, 60 and 90 days; and severity of lesions was assessed by Investigator’s Global Evaluation Scale and the occurrence of adverse effects like erythyma, dryness, scaling, burning and pruritus, were assessed by the Local Irritation Scale, among the patients receiving the monotherapy. An analytical review of the molecular pharmacology of adapalene in evidence-based dermatopharmacological treatment was thoroughly performed. The patients showed highly significant reduction in total lesion counts from baseline. No serious adverse effects were observed; and the observations were statistically non-significant. The molecular analytical review described significantly effective evidence-based dermatopharmacological response mechanisms of adapalene therapeutics. Topical 0.1% adapalene monotherapy was effective and safe, with significant evidence-based molecular dermatopharmacological efficacy.

scholarly journals Topical Isotretinoin in Acne Vulgaris

2018 ◽  
Vol 29 (2) ◽  
pp. 1-5
Author(s):  
M Moksedur Rahman ◽  
M Abdullah ◽  
M Moazzem Hossain ◽  
MA Siddique ◽  
M Nessa ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Prospective Study ◽  
Acne Vulgaris ◽  
Topical Therapy ◽  
Outpatient Department ◽  
College Hospital ◽  
Once Daily ◽  
Medical College ◽  
Cutaneous Reactions

This study was carried out to evaluate the efficacy, safety and adverse effects of topical isotretinoin 0.05% gel in the treatment of acne vulgaris. This prospective study was undertaken in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi. One hundred patients with mild tomoderate acne vulgaris were enrolled and were instructed to apply isotretinoin 0.05% gel once daily at night for 12 weeks. Patients were followed up at 2,4,8 and 12 weeks for efficacy and tolerability. Efficacy was measured by counting facial inflammatory and noninflammatory lesions and by grading acne severity. Cutaneous tolerance was assessed by determining erythema, scaling and burning with pruritus.Response was excellent in 80%of cases.None of the cutaneous reactions was severe, all were mild and well tolerated.Nobody had to discontinue the therapy for side effects. This study confirms that isotretinoin 0.05% gel is safe and effective topical therapy for mild to moderate acnevulgaris.TAJ 2016; 29(2): 1-5

scholarly journals A Multicenter Open Study on the Tolerability and Efficacy of a Cosmetic Treatment in Mild Acne Vulgaris during the Summer Months

2003 ◽  
Vol 1 (2) ◽  
pp. 85-90 ◽  
Author(s):  
N. Cassano ◽  
M. Carbonara ◽  
M. Grandolfo ◽  
S. Calabretta ◽  
C. Castellana ◽  
...  
Keyword(s):  
Acne Vulgaris ◽  
Sun Exposure ◽  
Good Tolerability ◽  
Once Daily ◽  
Study Product ◽  
The Face ◽  
Alpha Hydroxy Acids ◽  
Patients Experience ◽  
Safe Approach ◽  
General Opinion

The improvement of acne vulgaris (AV) during summer months is a general opinion which is not universally accepted as some patients experience no change or even an aggravation of their AV during hot months. Therapeutic management of AV in summer is often difficult; in fact, most traditional anti-acne treatments are contraindicated or poorly tolerated during summer months. In this study we evaluated the tolerability and effectiveness of a cosmetic anti-acne treatment performed for 12 summer weeks in 347 patients (mean age, 19.4 yrs) with mild AV of the face. The study product (Exfoliac®) contained a mixture of alpha hydroxy acids and substances with moisturizing and/or lenitive effects. In the first 4 weeks, Exfoliac® 10 cream was applied twice a day (b.i.d.). The treatment in the following 8 weeks was decided on the basis of dermatologist's assessment of the clinical response and could consist in Exfoliac® 10 cream or Exfoliac® 15 cream, once daily (o.d.) or b.i.d. During the study period, patients used Exfoliac® cleansing gel. The cumulative results indicate a significant improvement of AV lesions and seborrhoea, irrespectively of sun exposure, and a good tolerability, even in sunbathed patients. Adverse reactions, mostly of mild severity, appeared to be independent of sunbathing or use of sunscreens and were observed in a small proportion of cases (6.8% in the first 4 weeks and 5.6% in the last 8 weeks). Our results suggest that this type of treatment is an effective and safe approach to patients with mild AV who require treatment in the summertime.

The Clozapine Handbook

2019 ◽  
Author(s):  
Jonathan M. Meyer ◽  
Stephen M. Stahl
Keyword(s):  
Adverse Effects ◽  
Health Care Professionals ◽  
Psychiatric Hospitalization ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Mental Illnesses ◽  
Evidence Based ◽  
Treatment Resistant ◽  
All Cause Mortality ◽  
User Friendly

Real-world and clinical trial data support that clozapine is the only effective antipsychotic for treatment resistant schizophrenia and other severe mental illnesses. Clozapine also reduces rates of suicidality, psychiatric hospitalization and all-cause mortality. However, clozapine is underutilized for two reasons: misunderstandings of its efficacy benefits and misapprehension of, limited knowledge or misinformation about the management of treatment related risks and adverse effects. In response to worldwide efforts to promote clozapine use, this user-friendly Handbook provides clinicians with evidence-based approaches for patient management, as well as logical approaches to the management of clinical situations and adverse effects. It outlines clearly the rationale for specific management decisions and prioritises the options based on this logic. This Handbook is designed for use by clinicians worldwide and is essential reading for all mental health care professionals.

scholarly journals Use of Lugol’s Solution in the Management of Complex Graves’ Disease-a Small Case Series

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A972-A972
Author(s):  
Rufaro Asefa ◽  
Allison Shane Martin
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Total Thyroidectomy ◽  
Treatment Guidelines ◽  
Case Series ◽  
Graves Disease ◽  
Evidence Based ◽  
Once Daily ◽  
Evidence Based Treatment ◽  
Severe Anxiety

Abstract Background: There are currently no clear guidelines for the peri-operative use of Lugol’s solution (LS) as an alternative to conventional anti-thyroid drug (ATD) therapy in patients with complex Graves’ thyrotoxicosis. Clinical Cases: Case 1 is a 44- year-old woman who presented with symptoms of hyperthyroidism and a moderately enlarged goiter due to Graves disease. She was treated initially with Methimazole 45 mg, once daily which was reduced to 30 mg once daily after a week. She subsequently presented to the emergency department with severe anxiety, sore throat, and a high fever. A blood panel showed evidence of profound agranulocytosis due to Methimazole. Methimazole was stopped and she was treated with a 10-day course of LS followed by a semi-elective total thyroidectomy. Case 2 is a 54-year-old old woman who presented with thyrotoxicosis due to Graves’ disease. She was started on Propylthiouracil (PTU) to which she developed hepatotoxicity and the decision was made to stop PTU. Methimazole was substituted to which she developed a severe desquamating rash hence it had to be stopped immediately. She was given a 10 day course of LS followed by semi-elective total thyroidectomy. Conclusion: In both cases, hyperthyroidism was successfully treated with Lugol’s solution and their surgeries were uneventful with full recovery. Although beneficial, Lugol’s Solution may result in adverse effects such as severe hypothyroidism, escape hyperthyroidism and death. These cases highlight the need for evidence based treatment guidelines for the use of Lugol’s solution in complex hyperthyroid cases.

Cola Beverages: Clinical Uses versus Adverse Effects

2019 ◽  
Vol 15 (2) ◽  
pp. 130-139
Author(s):  
Ehsan T. Moghaddam ◽  
Ali Tafazoli
Keyword(s):  
Adverse Effects ◽  
Health Risks ◽  
Feeding Tube ◽  
Evidence Based ◽  
Journal Articles ◽  
Healthcare Settings ◽  
Pubmed Database ◽  
Excessive Consumption ◽  
Points Of View ◽  
Medical Articles

Background: Excessive consumption of cola beverages is accompanied by numerous public health risks. But besides these well-known adverse effects, recently, several medical articles have been published that show some indications for cola beverages in clinical practice like resolution of gastrointestinal or feeding tube obstructions, increasing bioavailability and palatability of other medications, rehydration and other uses in healthcare settings. These approaches are not without shortcomings and complications. Methods: In this systematic review we tried to explore these new uses for practitioners and also reemphasize on the most evidence-based complications of cola consumption like bone loss and metabolic and cardiovascular adverse effects in cases of misuse and overuse from both clinical and nutritional points of view via searching the PubMed database. Results: We chose 145 journal articles from the most relevant ones plus 30 extra references and categorized their topics in two classes of medical uses and adverse effects. Conclusion: It could be stated that cola beverages have demonstrated interesting uses and benefits in medicine but their use should be regulated as strict as possible.

Sidharthakadi Lepa in Mukhadushika - A Clinical Study

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Ravindra Angadi ◽  
Rekha J.
Keyword(s):  
Skin Disorder ◽  
Acne Vulgaris ◽  
Response To Therapy ◽  
Inclusion Criteria ◽  
Pilosebaceous Unit ◽  
External Application ◽  
Acne Lesion ◽  
Common Skin ◽  
The Face ◽  
Inflammatory Component

Background: Acne vulgaris is a very common malady of adolescents. It is common enough to be called as a physiological process but is better regarded as a disease due to its inflammatory component and the disfigurement. Acne vulgaris is a common skin disorder of pilosebaceous unit that primarily affects the face which if not treated leads to pigmentation. Mukhadushika is a Kshudra Roga which mainly involves Kapha and Vatadosa with Raktha. This is a common illness affecting 80 % of adolescents. Lepa is one of the external therapies explained in Ayurvedic classics. Objectives: To evaluate the efficacy of Sidharthakadilepa in the management of mukhadushikaw.s.r. to acne vulgaris. Methods: 30 patients fulfilling the inclusion criteria were selected. They were given Sidharthakadi Lepa for external application over face for one month. Patients were observed for changes on 7th, 14th, 21st and 28th day. The response to therapy was evaluated at the end of 28 days by calculating acne lesion score and the efficacy was determined by the percentage reduction in ALS. Results: The analysis revealed that 40% of patients had complete remission, 30% patients showed marked improvement and 30% showed moderate improvement.

The Red Legs RATED tool to improve diagnosis of lower limb cellulitis in the emergency department

2021 ◽  
Vol 30 (12) ◽  
pp. S22-S29
Author(s):  
Gillian O'Brien ◽  
Patricia White
Keyword(s):  
Emergency Department ◽  
Lower Limb ◽  
Treatment Guidelines ◽  
Positive Impact ◽  
Data Gathering ◽  
Pilot Project ◽  
Accurate Diagnosis ◽  
Evidence Based ◽  
Significant Burden ◽  
User Friendly

Background: Lower limb cellulitis poses a significant burden for the Irish healthcare system. Accurate diagnosis is difficult, with a lack of validated evidence-based tools and treatment guidelines, and difficulties distinguishing cellulitis from its imitators. It has been suggested that around 30% of suspected lower limb cellulitis is misdiagnosed. An audit of 132 patients between May 2017 and May 2018 identified a pattern of misdiagnosis in approximately 34% of this cohort. Objective: The aim of this pilot project was to develop a streamlined service for those presenting to the emergency department with red legs/suspected cellulitis, through introduction of the ‘Red Leg RATED’ tool for clinicians. Method: The tool was developed and introduced to emergency department clinicians. Individuals (n=24) presenting with suspected cellulitis over 4 weeks in 2018 were invited to participate in data gathering. Finally, clinician questionnaire feedback regarding the tool was evaluated. Results: Fourteen participants consented, 6 female and 8 male with mean age of 65 years. The tool identified 50% (n=7) as having cellulitis, of those 57% (n=4) required admission, 43% (n=3) were discharged. The remainder who did not have cellulitis (n=7) were discharged. Before introduction of the tool, all would typically have been admitted to hospital for further assessment and management of suspected lower limb cellulitis. Overall, 72% (n=10) of patients who initially presented with suspected cellulitis were discharged, suggesting positive impact of the tool. Clinician feedback suggested all were satisfied with the tool and contents. Conclusion: The Red Leg RATED tool is user friendly and impacts positively on diagnosis treatment and discharge. Further evaluation is warranted.

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

2021 ◽  
Author(s):  
Sonja Heinzelmann ◽  
Daniel Böhringer ◽  
Philip Christian Maier ◽  
Berthold Seitz ◽  
Claus Cursiefen ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Treatment Strategies ◽  
Cost Benefit ◽  
Topical Steroids ◽  
Evidence Based ◽  
Systematic Analysis ◽  
Open Questions ◽  
The Face

Abstract Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.

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