adjunct therapy
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2022 ◽  
Vol 5 (1) ◽  
pp. e1-e11
Author(s):  
Sathi Maiti ◽  
Laura M Periman ◽  
Natasha Balani

PurposeTo report a case of dupilumab induced ocular surface disease (DIOSD) managed with intense pulsed light (IPL) as an effective adjunct therapy to topical steroids and topical immunomodulator lifitegrast.MethodsDiscussion of a patient’s case with accompanying anterior segment and meibography photos with diagnosed DIOSD for which adjunct therapy with IPL was an effective treatment after limited relief from and difficulty with adherence to traditional treatment with topical steroids and lifitegrast ophthalmic solutions. ConclusionThis case demonstrates the complexity of management required to treat patients with DIOSD and its chronic nature. IPL as a nonpharmaceutical adjunct therapy to topical steroids and immunomodulators in the treatment of DIOSD showed improved signs and symptoms of DIOSD.


2021 ◽  
Vol 11 (2) ◽  
pp. 127-129
Author(s):  
Shallu Bansal ◽  
Akshay Mishra ◽  
Madhulika Bagde ◽  
Abhishekh Kumar

Treatment of this condition involves sequestrectomy and debridement of the necrosed bone and extraction of the involved teeth with antibiotic therapy and adjunct therapy. Cranial bones and brain might get involved in maxillary osteomyelities.


Author(s):  
N.D. Shah ◽  
A.U. Bhikane ◽  
R.K. Jadhav ◽  
S.G. Chavhan

Background: In view of common occurrence of haemoprotozoan infections leading to severe haemolytic anaemia and increased case fatality rate in cattle in study area the present investigation was planned to evaluate efficacy of whole blood transfusion as an adjunct therapy in severe cases of hemolytic anaemia in cattle. Method: Sixteen cattle suffering from one or other haemoprotozoan infections induced haemolytic anaemia and having haemoglobin values less than 5 gm/dl were randomly divided in to two treatment groups. Group A (n=8) cattle were treated with standard treatment of haemoprotozoan infection without blood transfusion while group B (n=8) cattle were treated with whole blood transfusion in addition to standard treatment for haemoprotozoan infections. Result: Clinical and haematological parameters revealed rapid improvement in group B cattle as compared to group A cattle. The survival rate was significantly higher in group B cattle (100%) as compared to group A cattle (62.5%). The haemoglobin and haematocrit values were also found significantly higher in group B as compared to group A at 12 hours as well as on 21st day post treatment. Thus, it is concluded that, whole blood transfusion could be used as an adjunct therapy to hasten clinical recovery and to increase the survivability in cattle suffering from severe haemolytic anaemia due to haemoprotozoan infections.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Zainab Ridha ◽  
Marc-Antoine Bédard ◽  
Anna Smyrnova ◽  
Olivier Drouin ◽  
Aniela Pruteanu ◽  
...  

Abstract Background The Global Initiative for Asthma has only recently added tiotropium bromide as adjunct controller therapy in severe asthma (Step 4 or 5) in adults (2015) and children (2019). Although not yet approved for pediatric use by Health Canada, it has been occasionally offered by asthma specialists as a therapeutic trial in children with troublesome asthma or treatment for adverse effects. The objective of this study was to describe the indications and real-life clinical experience in initiating tiotropium in children with asthma. Methods We designed a retrospective mixed-method case series study of children aged 1–17 years who initiated tiotropium in our tertiary-care centre between 2013 and 2020. Clinical information was extracted from electronic medical records and tiotropium dispensing, from drug claims. Parents/children and physicians independently completed a questionnaire about treatment goals, perceived efficacy, safety, satisfaction, and lessons learned. Results The 34 (11 females; 23 males) children had a median (range) age of 9.1 (1.4–17.8) years. Children were primarily on Step 4 (85%) or 5 (6%) prior to tiotropium initiation, yet most (84%) did not increase their treatment step after tiotropium initiation. The physicians’ treatment goals were to improve asthma control, alleviate adverse effects of current therapy, and/or improve lung function. The most improved symptoms were coughing/moist cough, difficulty breathing, whistling breath, and bronchial secretions/mucus. Although most parents and physicians reported a significant benefit with tiotropium bromide, physicians particularly remarked, as their “lesson learned’, on the improvement in chronic symptoms in asthmatic children, particularly those with prominent moist cough and in lung function, in those with seemingly none (or incompletely) reversible obstruction as well as the ability to decrease the ICS and/or LABA dose to lessen adverse effects. A few physicians raised caution on the risk of lower adherence with an additional inhaler. Conclusion In children with severe asthma on Step 4 or 5, tiotropium bromide was primarily used as substitute, rather than additional, adjunct therapy to improve asthma control, alleviate adverse effects, and/or to improve lung function. The latter two indications, combined with its perceived effectiveness in children with prominent moist cough, also suggest additional indications of tiotropium to be formally explored.


2021 ◽  
pp. 096452842110506
Author(s):  
Hyaehwan Kim ◽  
Ronald Markert ◽  
Kathryn Burtson

Introduction: The Department of Defense has been training primary care providers in battlefield acupuncture (BFA), a subtype of auricular acupuncture, as an adjunct therapy for pain management. Methods: The objective of this study was to evaluate the effectiveness and safety of BFA for pain management in an outpatient Internal Medicine clinic staffed by resident physicians. The target population for this single-center prospective cohort study were military beneficiaries at a medical treatment facility located at the Wright-Patterson Air Force Base. Participants who met inclusion criteria were treated with BFA in addition to routine standard care for pain (n = 69). The control group was composed of participants who received routine standard care only without BFA (n = 27). Pain was assessed by a self-reported pain scale (0–10) at the time of encounter, immediately after BFA (for the intervention group), then at 24 and 48 h afterwards. Results: Mean pain for the intervention group decreased from 5.45 before BFA to 3.29 immediately following BFA to 2.21 at 24 h and to 2.10 at 48 h (p < 0.001). Thus, at all three post-treatment time points, mean decrease in pain surpassed a two-point reduction, deemed to be a clinically important difference. The BFA group had a greater reduction in pain compared to the no intervention group at 24 h (3.14 vs 0.59, p < 0.001) and at 48 h (3.26 vs 0.96, p < 0.001). Four intervention group participants (6%) reported an adverse reaction (three with pain at the insertion site) or complication (one with superficial infection). Conclusion: BFA provided by Internal Medicine residents appears to be a safe and effective adjunct therapy for pain management in an outpatient setting, but requires further validation by randomized controlled trials.


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