Severe brimonidine eye drop intoxication in a neonate as an accidental oral ingestion

Brimonidine tartrate eye drops are a topical agent used to treat glaucoma in children over 2 years of age and adults. It is banned for children younger than 2 years of age because post-marketing studies have shown serious side effects. Colic is common in infants, which worries parents. And parents often use herbal and chemical medicines to solve this problem. We present a 12-day-old newborn with brimonidine eye drop intoxication, in which the drug was mistakenly administered orally to treat the colic problem.

Insights into the mechanism of Cymbopogan martinii essential oil in topical therapy of acne vulgaris

Aim: The present study investigated the essential oil of Cymbopogan martinii (palmarosa oil; PRO) as a potential topical therapy in acne vulgaris. Materials & methods: GC-MS profiling and biocompatibility studies of PRO were undertaken. The antimicrobial potential was assessed against Cutibacterium acnes. anti-inflammatory, antityrosinase activity and lipid peroxidation were also evaluated. Results: Geraniol was identified as the major phytoconstituent, and the oil was found to be safe for topical application. The minimum inhibitory concentration and minimum bactericidal concentration values were noted as 16 μl/ml. PRO reduced the cytokine levels of TNF-α, IL-12 and IL-8 and inhibited tyrosinase. A low concentration of the oil (up to 0.5 μl/ml) produced malondialdehyde levels equivalent to that of untreated cells. Conclusion: PRO may prove useful as a natural topical agent in the management of acne.

Perawatan Luka Penderita Kusta Dengan Daun Tetanus (Leea Aequata L) Pengobatan Tradisonal Suku Karo

ABSTRAK Kusta merupakan penyakit yang disebabkan oleh mycobacterium leprae. Penyakit kusta pada stadium lanjut sering disertai luka akibat terjadinya kerusakan saraf pada daerah kaki yang menimbulkan gangguan sensibilitas kelumpuhan otot dan luka penderita kusta sering infeksi dan sulit untuk disembuhkan karena pasien sering terlambat datang untuk berobat. Perawatan luka kusta dengan menggunakan agen topikal yang tepat merupakan faktor terpenting dalam penyembuhan Luka penderita Kusta . Tujuan dilakukannya penelitian ini diharapkan dapat meningkatkan pengetahuan masyarakat terhadap pentingnya perawatan luka pada penderita kusta di pusat Rehabilitasi kusta Desa Galang. Adapun kegiatan yang dilakukan yaitu berupa pemeriksaan kesehatan dan juga perawatan luka penderita kusta dengan menggunakan obat tradisional tambar tetanus (LEEA AEQUATA L). Penderita kusta yang mengikuti perawatan luka sebanyak 34 orang. Masyarakat sangat antusias dalam mengikuti perawatan luka yang dilaksanakan serta akan berupaya melaksanakannya secara mandiri dirumah untuk meningkatkan status kesehatan penderita kusta. Kata Kunci : Penderita Kusta, Luka , LEEA AEQUATA L. ABSTRACT Leprosy is a disease caused by mycobacterium leprae. Leprosy at an advanced stage is often accompanied by injuries due to nerve damage in the leg area which causes impaired sensibility, muscle paralysis, and leprosy wounds are often infected and difficult to heal because patients often come late for treatment. The treatment of leprosy wounds by using the right topical agent is the most important factor in the healing of leprosy wounds. The purpose of this research is expected to increase public knowledge of the importance of wound care for people with leprosy at the Leprosy Rehabilitation Center in Galang Village. The activities carried out are in the form of health checks and also the treatment of leprosy wounds using the traditional tambar tetanus medicine(LEEA AEQUATA L). The community is very enthusiastic about participating in the counseling that is carried out and will try to implement it independently which can improve the health status of leprosy sufferers. Keywords: Leprosy Patients, Wounds, LEEA AEQUATA L.

Phonophoresis Plus Topical Nitroglycerin or Hydrocortisone for the Management of Plantar Fasciitis, Which Topical Agent is Superior?

Background: Plantar fasciitis (PF) is the most common reason for inferior heel pain. Various approaches have been raised for the treatment of PF; however, none had substantial outcomes. The current study aims to assess and compare phonophoresis outcomes plus topical nitroglycerin versus phonophoresis plus topical hydrocortisone for PF management. Materials and Methods: The current study has been conducted on 65 patients with PF diagnosis, among whom underwent ten every-other-day sessions of treatment with phonophoresis plus 20 mg nitroglycerin (n=33) or 20mg hydrocortisone (n=32), respectively. The Modified Roles and Maudsley (RM) score and the visual analog scale (VAS) were compared between the two groups at baseline, three weeks, and two months after the interventions. Besides, the plantar fascia thickness was measured at baseline and two months after the intervention. Results: The baseline RM (P-value=0.067) and pain severity (P-value=0.057) was similar between the two groups, but other assessments revealed the superiority of phonophoresis plus topical nitroglycerin over topical hydrocortisone (P-value<0.05). The reduction in plantar fascia thickness was more in phonophoresis plus nitroglycerin-treated patients as compared to the latter group (P-value<0.001), but the requirement of additional doses of analgesia was remarkably more in hydrocortisone-treated patients (P-value<0.001). Conclusion: Based on the current study, phonophoresis plus topical nitroglycerin was superior to phonophoresis plus topical hydrocortisone in pain relief, improved quality of life, and decreased fascia thickness. However, further investigations are required to achieve the ultimate outcomes for a more extended period.[GMJ.2021;10:e2072] DOI:10.31661/gmj.v10i0.2072

Investigating auranofin for the treatment of infected diabetic pressure ulcers in mice and dermal toxicity in pigs

Bacterial infection of pressure ulcers (PUs) are a notable source of hospitalization for individuals with diabetes. This study evaluated the safety profile and efficacy of auranofin to treat diabetic PUs infected with methicillin-resistant Staphylococcus aureus (MRSA). PUs were infected with MRSA in diabetic TALLYHO/JngJ mice and then treated with topical auranofin (2%), topical mupirocin (2%), or oral clindamycin (30 mg/kg) for four days. PUs were harvested post-treatment to enumerate bacterial burden and determine expression of cytokines/growth factors. Landrace cross pigs were exposed topically to auranofin (1%, 2%, and 3%) for 4–14 days and evaluated for signs of localized or systemic toxicity. Auranofin eradicated MRSA in PUs within four days (7.92-log10 reduction) in contrast to mupirocin (2.15-log10 reduction) and clindamycin (0.73-log10 reduction). Additionally, auranofin treatment resulted in decreased expression of pro-inflammatory cytokines and increased expression of biomarkers associated with re-epithelization of wounded tissue, confirmed with histopathologic analysis. No significant histopathologic lesions were present on porcine skin sites exposed to topical auranofin. Additionally, minimal accumulation of plasma gold and no systemic toxicity was observed in pigs exposed to topical auranofin. Auranofin appears to be a potent and safe topical agent to further investigate for treatment of mild-to-moderate MRSA-infected diabetic PUs.

The use of herbal preparations as topical therapy during pre- and post-surgery in patients with 3–4 grade hemorrhoids

Introduction. The market presents a huge amount of topical preparations, which manage the clinical manifestations of hemorrhagic disease, and there is also no shortage of means that affect post-operative pain. However, there is no single consensus of patient management in the preoperative period, and there is no generally recognized protocol for the treatment of pain after hemorrhoidectomy.Aim. To determine the effectiveness of using Fleming’s ointment during pre- and post-surgery in patients with 3–4 grade hemorrhoids.Material and methods. 85 patients with a diagnosis of hemorrhoids III–IV grade were divided into 2 groups. The Milligan-Morgan’s hemorrhoidectomy using standard electrocoagulation methods under intravenous anesthesia was performed in all patients. Fleming ointment was used as a topical agent for 2–3 weeks before the operation and for 2.5 weeks after the operation in Group A (43 patients). In group B (42 patients), depending on the prevalence of symptoms, suppositories with phenylephrine, lidocaine, local, hormonal ointments were used, also Liniment Levomekol was used as a local therapy after surgery in the group B. The results were evaluated according to the following criteria: Pain level, symptoms’ degree of the disease against the background of the use of local agents was evaluated by VAS. The multiplicity of the introduction of NSAIDs in 2 groups was considered. The adequacy of the wound healing correlated with the duration of maintaining inflammation in the wound, we also considered the daystay and days of disability.Results. Pain level according to VAS on the 1, 3, 7, 12 days after surgery in patients from group A is 0,6 points lower than in patients from group B. The average number of NSAIDs intake in the postoperative period in Group A was 1,4 times less than in Group B. There was no significant difference in wound reaction, day-stay and days of disability. The symptoms of hemorrhoids, estimated by VASh, were significantly less pronounced in patients who used Fleming ointment (see table 0)Conclusions. Fleming ointment can be recommended as an adequate topical agent in the perioperative management of patients with 3–4 grade hemorrhoids.