scholarly journals Efficacy and Safety of Voriconazole in the treatment of resistant cases of Dermatophytosis

2020 ◽  
Vol 2 (Number 1) ◽  
pp. 3-6
Author(s):  
Md. Abdulla-Hel Kafi ◽  
Mohsena Akter ◽  
Rumana Khan ◽  
Syed Shair Ahmed ◽  
Md. Jonayed Hassan ◽  
...  

This is a descriptive type of longitudinal study conducted among Hundred clinically diagnosed cases of dermatophytes attending at skin out patients department of Zainul Haque Sikder Women’s Medical College, Bangladesh from August 2018 to August 2019 to observe the efficacy and safety of voriconazole among the resistant cases of dermatophytosis. Among 100 patients, 40 were males and 60 females between ages 20 and 65 years of all age group with clinical, mycological diagnosis of dermatophytosis. To find out antifungal resistance pattern as well as efficacy and Safety of Voriconazole among dermatophytes. (Skin, hair and nail samples were taken aseptically. All patients were resistant against present treatment options like: fluconazole, itraconazole & terbinafine etc.) All patients were treated with Voriconazole. Duration of treatment of each patient was 4 weeks. Resistance against fluconazole and terbinafine was most common, 85.33% and 58% respectively. 5% resistance against voriconazole was observed in this study. Resistance against fluconazole was noted among all species of dermatophytes, followed by terbinafine. Among 100 patients 80% was fully cure and rest of 15 % were partially cure with 5% resistant of Voriconazole which is seems to be more effective and safer against dermatophytosis.

2019 ◽  
Vol 5 (02) ◽  
pp. 42-45
Author(s):  
Luv Luthra ◽  
Rajendra Prasad ◽  
Ranjith Kumar ◽  
Nivedita Mitta ◽  
Tinku Varghese

Abstract Introduction Nonhealing venous ulcers are one of the most common forms of lower extremity ulcers in the present population. It is cumbersome to treat and is associated with high-morbidity and immense treatment expenses. The current treatments include compression therapy. Four-layer compression dressings have proven to be an effective treatment for venous ulcers. Objective This study aimed to evaluate the efficacy of four-layer compression dressings and to study the rate of healing and duration of treatment with four-layer compression dressings. Materials and Methods A prospective randomized study conducted at MS Ramaiah Medical college which included 70 patients who completed the course of weekly dressings depending on the size of ulcer. The regular four-layer dressings were done by a trained podiatrist in vascular outpatient department (OPD) once a week. The area of the ulcer was calculated using the modified Gilmen formula. Results A total of 70 patients who were compliant with the treatment were included in the study. A considerable percentage (74%) of patients were male and all the ulcers were located at the gaiter area. Most belonged to the age group between 41 to 50 years (25%). The healing rate of ulcers at the end of 4, 8 and 12 weeks were 46.87, 28.12, and 25%, respectively. At the end of 12 weeks, all the ulcers healed.


2017 ◽  
Vol 08 (03) ◽  
pp. 434-438
Author(s):  
B. V. Sandeep ◽  
Manpreet Singh Banga ◽  
Suniti Kumar Saha ◽  
Kaushik Roy

ABSTRACT Objective: To present an overview of varied clinical presentations, investigations and treatment options for Osteolytic skull lesions. Study Design: It is a prospective study. Materials and Methods: We conducted this study from January 2013 to December 2015 in the Department of Neurosurgery, Nil Ratan Sircar Medical College and Hospital, Kolkata. During this period, 14 patients presented with osteolytic skull lesions through the outpatient department. All patients were thoroughly investigated with appropriate hematological and radiological investigations and treated following admission, and surgery was performed in the Neurosurgery Department. All were followed regularly in OPD. Results: Total 14 patients were included in the study. Amongst these 7 were male and 7 female. Age group of patients ranged from 5 to 72 years. Of 14 cases, three cases had dermoid cyst, four cases had metastasis, and one each case had epidermoid cyst, intradiploic meningioma, benign cystic lesion, tuberculosis, histiocytosis X, hemangioma, and osteomyelitis. All underwent diagnostic/therapeutic procedures and referred for Radio or chemotherapy where indicated. Conclusion: All scalp/skull lesions need careful clinical correlation, appropriate radiological investigations to establish diagnosis and subject them to suitable treatment.


2020 ◽  
Vol 14 (1) ◽  
pp. 16-19
Author(s):  
Sumitendra Kumar Sarkar ◽  
Krishna Gopal Sen ◽  
Md Kamal Mostofa ◽  
Md Habibur Rahman

Psoriasis is a chronic papulosquamous disorder with remissions and exacerbations. Varied estimates of the population prevalence of the disease in different parts of the world range from 0.1 - 3%. It is not uncommon in our country. Although there are no treatment options offering a complete cure, a number of options exist for providing symptomatic relief, inducing as well as prolonging remission. Various systemic therapies such as methotrexate, acitretin, cyclosporine, and biologic agents can be used. A review of pharmacokinetics, safety and a discussion of relapse rate establish acitretin, an aromatic retinoid as an efficacious, convenient, oral monotherapy for initial and maintenance of severe psoriasis. A prospective clinical trial was conducted to find out the efficacy and safety of acitretin as monotherapy in the treatment of moderate to severe plaque type psoriasis (PASI range 10-42). Thirty two clinically diagnosed cases of moderate to severe plaque type psoriasis attending the Skin and VD out patient department of Faridpur Medical College Hospital, Faridpur were selected randomly. Majority (46.9%) were between 61 to 80 years of age and only 3.1% patients were in the <20 years age group. The average age was 57.3 years and range was 19-90 years. Majority (68.8%) of the patients were male and 31.2% patients were female. The male female ratio was 2.2:1. After 8 weeks of treatment with acitretin PASI 50 and PASI 75 response rates were 55% and 24% respectively and after 12 weeks of treatment, PASI 50 and PASI 75 response rates were 75% and 50% respectively. As side effects of the treatment, 4(12.5%) patients developed alopecia, each of xerophthalmia and cheilitis was seen in 3(9.37%) patients, each of fatigue and pruritus was seen in 2(6.25%) patients and only 1(3.12%) patient developed myalgia. This study demonstrates that acitretin as monotherapy is effective and safe in the treatment of moderate to severe plaque type psoriasis. Faridpur Med. Coll. J. Jan 2019;14(1): 16-19


Author(s):  
M. MUHAMMAD IDRIS ◽  
N. DIVYA ◽  
V. PANIMALAR A. VEERAMANI ◽  
BINDU BHASKARAN

Objective: Pterygium is a fibrovascular growth encroaching from the conjunctiva into the cornea. This study deals with the comparison of conjunctival autograft and bare sclera technique as treatment options for pterygium. Methods: This study was done in the ophthalmology department of Saveetha Medical College, Thandalam, Chennai. A total of 100 patients were diagnosed of pterygium was taken for the study, out of which 60 patients were operated on with conjunctival autograft and 40 patients were operated with bare sclera technique. Patients with hypertension, diabetes mellitus were excluded. Post-operative complications and recurrence were noted. All the patients were between the age group of 20-65 y. Results: The mean age of patients operated with conjunctival autograft was 43.6, whereas in bare sclera technique was 46.625. The maximum age was 63 and the minimum age was 23 in conjunctival autograft whereas in bare sclera technique, the maximum age was 64 and the minimum age was 22. The recurrence rate of pterygium in conjunctival autograft was 1 and the recurrence rate of pterygium in bare sclera technique was 4. Conclusion: The present study revealed that conjunctival autograft was a better treatment option compared to the bare sclera technique for excision of pterygium


2019 ◽  
Vol 6 (3) ◽  
pp. 983
Author(s):  
Aasif Aziz Wani ◽  
Munazza Aziz Wani ◽  
Abdus Sami

Background: Diarrheal disorders along with dysentery constitute the second killer infections in childhood. In fact, more than half of the dysentery cases are recorded in children under 9 years of age. Shigella infection comprises well over 60% of dysentery cases in age group of 6 month to 5 years. Shigella flexneri is the commonest etiology encountered in developing nations. E. coli and campylobacter comprises the second important bacterial isolates in childhood dysentery. The objective of this study was to ascertain the clinical spectrum, etiological profile and local antibiotic sensitivity of the enteropathogens isolated.Methods: 147 serial dysentery cases admitted in GB Panth hospital Srinagar, which is an associated hospital of government medical college Srinagar from October 2014 to September 2015 were taken up for the study. A thorough and detailed history and examination was taken and recorded as per the proforma. Freshly collected stool sample was subjected to gross and microscopic examination; and after due bacteriological instructions was cultured on enrichment and selective media as per the need. Antibiotic sensitivity was done using disc diffusion method.Results: Maximum cases occurred in 1-5 years age group. Malnutrition grades II and III recorded the highest admissions. Most of cases had moderate dehydration. Although not frequent severe anemia, paralytic ileus and renal failure were the commoner complications. Shigella was grown in 12.24% of cases. Among them Shigella flexeneri serotype was encountered in 65% patients. Drug resistance was seen for many of the antibacterials like amoxycillin, ampicillin, norfloxacin, cotrimoxazole and nalidixic acid. However, they were susceptible to ceftriaxone and amikacin in well over 80% cases. E. coli isolates had similar antibiotic sensitivity profiles, with most susceptibility to amikacin and ceftriaxone.Conclusions: Drug sensitivity and resistance pattern is a variable phenomenon and changes from place to place and time to time. Hence there is a need to document the local pattern of an area so as to guide a judicious antibiotic administration. 


2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 298-298
Author(s):  
Jasmine Huynh ◽  
May Thet Cho ◽  
Edward Jae-Hoon Kim ◽  
Min Ren ◽  
Carol Robbins ◽  
...  

298 Background: The treatment landscape for pts with uHCC has recently expanded. However, there is an unmet need for effective treatment options in CPB pts. LEN is approved first-line in uHCC based on the REFLECT study (Child-Pugh A [CPA] pts were allowed, per inclusion criteria). In a prior analysis of REFLECT, pts treated with LEN benefited irrespective of baseline liver function (ALBI grade 1 or 2; Child-Pugh score 5 or 6). To determine outcomes in pts with reduced liver function, we report a post hoc analysis of key efficacy and safety results in LEN-treated pts from REFLECT who progressed to CPB and those who did not within the first 8 weeks of treatment. Methods: In REFLECT, pts with uHCC were randomized 1:1 to LEN (per bodyweight: 12 mg/day for ≥60 kg; 8 mg/day for < 60 kg) or sorafenib (400 mg twice daily) in 28-day cycles. This analysis assessed ORR. Landmark analyses (starting at week 8) of PFS, time-to-progression (TTP), and OS in CPB pts and in pts who remained CPA at 8 weeks post-randomization were also conducted. Tumors were assessed by mRECIST by independent imaging review. Safety was also assessed from baseline. Results: This subgroup analysis included LEN-treated pts (n = 60) who progressed to CPB within the first 8 weeks of treatment (CPB pts) and 413 pts who did not (CPA pts). At baseline, 26.7% and 73.1% of pts had an ALBI grade of 1 and 73.3% and 26.9% of pts had an ALBI grade of 2 in CPB and CPA pts, respectively. ORR was 28.3% (95% CI 16.9–39.7) for CPB pts and 42.9% (95% CI 38.1–47.6) for CPA pts. A landmark analysis showed a median PFS of 3.7 mos (95% CI 1.8–7.4) for CPB pts and 6.5 mos (95% CI 5.6–7.4) for CPA pts from the week 8 timepoint. Landmark analyses at week 8 also showed that the median TTP was 5.6 mos (95% CI 3.5–9.3) for CPB pts and 7.3 mos (95% CI 5.6–7.4) for CPA pts; the median OS was 6.8 mos (95% CI 2.6–10.3) for CPB pts and 13.3 mos (95% CI 11.6–16.1) for CPA pts per week 8 landmark analyses. As expected, efficacy appeared to be greater in CPA pts versus CPB pts; however, OS of 6.8 months in CPB pts after the week 8 landmark is notable. Moreover, median duration of treatment was 3.2 mos for CPB pts and 6.9 mos for CPA pts, thereby suggesting CPB pts can remain on LEN. The incidence of grade ≥3 treatment-related AEs (TRAEs) was 71.7% in CPB pts and 54.7% in CPA pts. TRAEs leading to discontinuation occurred in 18.3% of CPB pts and 7.5% of CPA pts. Conclusions: In this post hoc analysis of pts in REFLECT, we examine the key efficacy and safety results for LEN-treated pts who progressed to CPB by week 8. This post hoc analysis is limited by its descriptive nature; however, the results indicate that further study of LEN in CPB pts with uHCC is warranted. Clinical trial information: NCT01761266.


Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 229-236
Author(s):  
N. Cayne ◽  
G. Jacobowitz ◽  
P. Lamparello ◽  
T. Maldonado ◽  
C. Rockman ◽  
...  

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.


Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.


2012 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Sushmita Roy ◽  
S.M. Shamsuzzaman ◽  
K.Z. Mamun

Rotavirus is one of the leading causes of pediatric diarrhea globally. Accurate and rapid diagnosis of Rotavirus diarrhea should reduce unnecessary use of antibiotics and ultimately reduce drug resistance. Study was designed for rapid diagnosis of Rotavirus antigen in stool sample by ICT (Immunochromatographic test) as well as to observe the seasonal variation of rotavirus infection. This cross sectional study was carried out in the department of Microbiology, Dhaka Medical College from January 2011 to December 2011. Eighty stool samples were collected from Dhaka Shishu Hospital and Dhaka Medical College Hospital. All samples were tested for rotavirus antigen by ICT. Among 80 patients, 42 (52.5%) samples were positive for rotavirus antigen. Among these 42 positive samples, 30 (71.43%) were from 0-12 months of age group, 10 (23.81%) from 13 to 24 months of age group and rest 2 (4.76%) from 25 to 36 months of age group. Rotavirus Ag was detected in stool samples from January to April and another peak episode from October to December. Considering the importance of Rotavirus associated diarrhea, rapid detection of Rotavirus infection in human is substantially needed and should be routinely practiced.DOI: http://dx.doi.org/10.3329/bjmm.v6i1.19354 Bangladesh J Med Microbiol 2012; 06(01): 11-13


1970 ◽  
Vol 40 (1) ◽  
pp. 18-21 ◽  
Author(s):  
MN Hossain ◽  
Z Rahman ◽  
S Akhter

A cross sectional study was carried out at the department of Forensic Medicine in Dhaka Medical College during the period of January 2008 to December 2009. Data were collected from 3rd copy of the post mortem reports which were preserved in the department of Forensic Medicine with the verbal consent of the doctors who performed autopsy report. During this period total 5114 autopsies were conducted. Out of this 970 cases (19%) were suicidal in nature. It was noticed that all suicidal deaths occurred from 10 years to all age group respectively, but top amongst age group of suicidal deaths occurred in between 21 to 30 years of people. Suicidal deaths are more common in female than male. Suicidal deaths due to hanging is highest, next common causes of death due to organophosphorus compund poisoning. Suicidal deaths by hanging is more in female than male but in poisoning cases male are more lvictimised than female. Objectives of our study are to see the occurrence and methods of suicidal death. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9957 BMJ 2011; 40(1): 18-21


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