Efficacy of Azoles Antifungals in Treatment of Pityriasis Versicolor

Introduction: Pityriasis versicolor is superficial fungal infection. Topical drugs are often effective in treatment of limited disease while systemic drugs are more suitable in extensive cases. The systemic triazole drugs, itraconazole and fluconazole have shown promising results at different doses. Aims: To assess the efficacy and safety of oral fluconazole combined with ketoconazole shampoo and oral itraconazole in the treatment of Pityriasis versicolor. Methods: The study was conducted at department of Dermatology at Nepalgunj Medical College from March 2019 to February 2020. Total 100 patients of both genders with Pityriasis versicolor were randomly allocated into two groups with 50 patients in each group. Patients in Group I received oral fluconazole 300mg a week for two consecutive weeks along with ketoconazole 2% shampoo twice weekly for two weeks while those in Group II received itraconazole 200mg daily for one week. Efficacy was assessed in terms of negative fungal hyphae. The drug is considered safe if no patients were withdrawn for clinical adverse effects or laboratory abnormalities. Results: In this study age ranged from 18 to 50 years with mean age of 31.1 years in Group I and 31.92 years in Group II. Efficacy was seen in 78% of Group I patients as compared to 54% in Group II patients at two weeks and 94% in Group I and 90% in Group II at four weeks. No significant adverse effects were reported in any of the group. Conclusion: Fluconazole along with ketoconazole shampoo is more effective than itraconazole in treatment of pityriasis versicolor with minimal side effects, at lesser cost.

Covishield Vaccine Coverage and its adverse effects among the Staffs of Nepalgunj Medical College Banke

Introduction: The corona virus disease-19 pandemic is an ongoing global health crisis and the greatest challenge we have been facing right now in the most peculiar ways. It has caused huge loss of lives and has severely affected the global economy and financial markets. Vaccines are a new critical tool to fight this voracious battle. They have been released in several parts of the world. Although the safety and efficacy of these vaccines have been discussed, we know very little about the post-vaccination experience outside clinical trial situations. Adequate information about the effects of the vaccine can aware the public remove misconceptions and increase vaccine acceptability. Aims: To know the percentage of Covishield vaccine coverage and its adverse effects among the staffs of Nepalgunj Medical College. Methods: A descriptive cross-sectional study was conducted among the vaccinated 91 out of 116 staff members of Nepalgunj Medical College (NGMC), Baijanath Rural Municipality-1, Banke. Results: Out of 91 persons, 15.4%(14) developed headache, 20%(18) developed fever, and 8.7%(17) developed body aches. Of those who developed post-vaccination side effects 47%(16) of the persons were from age group 36-55years,17%(1) of them between age group 55-65 years, and none above 65 years developed fever. 20%(13) of total male and 35%(5) of total female developed fever within 96 hours after receiving first dose of Covishield AstraZeneca vaccine. Conclusion: Most of the study subjects reported milder side effects which lasted for less than 5 days. No casualties were reported. Local pain and swelling at the injection site, headache and fever were the most common side effects. The side effects were more common in younger individuals and women.

Cytomegalovirus Enteritis Induced by Baricitinib and Tacrolimus: Association or Coincidence?

We read the recent article by Sugawara et al with great interest.1 The authors described a 65-year-old patient with rheumatoid arthritis who had been treated with methotrexate for 14 years without any adverse effects, yet within the last 6 months had developed fever and abdominal pain when treated with 2 mg/day of tacrolimus and 4 mg of baricitinib.

Tissue Distribution, Histopathological and Genotoxic Effects of Magnetite Nanoparticles on Ehrlich Solid Carcinoma

Nanoparticles can potentially cause adverse effects on cellular and molecular level. The present study aimed to investigate the histopathological changes and DNA damage effects of magnetite nanoparticles (MNPs) on female albino mice model with Ehrlich solid carcinoma (ESC). Magnetite nanoparticles coated with L-ascorbic acid (size ~ 25.0 nm) were synthesized and characterized. Mice were treated with MNPs day by day, intraperitoneally (IP), intramuscularly (IM), or intratumorally (IT). Autopsy samples were taken from the solid tumor, thigh muscle, liver, kidney, lung, spleen, and brain for assessment of iron content, histopathological examination, and genotoxicity using comet assay. The liver, spleen, lung, and heart had significantly higher iron content in groups treated IP. On the other hand, tumor, muscles, and the liver had significantly higher iron content in groups treated IT. MNPs induced a significant DNA damage in IT treated ESC. While a significant DNA damage was detected in the liver of the IP treated group, but no significant DNA damage could be detected in the brain. Histopathological findings in ESC revealed a marked tumor necrosis, 50% in group injected IT but 40% in group injected IP and 20% only in untreated tumors. Other findings include inflammatory cell infiltration, dilatation, and congestion of blood vessels of different organs of treated groups in addition to appearance of metastatic cancer cells in the liver of non-treated tumor group. MNPs could have an antitumor effect but it is recommended to be injected intratumorally to be directed to the tumor tissues and reduce its adverse effects on healthy tissues.

Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials

Background The clinical utility of radiofrequency (RF) in patients with knee osteoarthritis (OA) remains unclear. We conducted a meta-analysis to systematically evaluate the efficacy and safety of RF treatment in patients with knee OA. Methods Searches of the PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases were performed through August 30, 2021. The major outcomes from published randomized controlled trials (RCTs) involving patients with knee OA were compared between RF and control groups, including Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Global Perceived Effect (GPE) scale, and adverse effects at available follow-up times. Results Fifteen RCTs involving 1009 patients were included in this meta-analysis, and the results demonstrated that RF treatment correlated with improvements in pain relief (VAS/NRS score, all P < 0.001) and knee function (WOMAC, all P < 0.001) at 1–2, 4, 12, and 24 weeks after treatment as well as patients’ degree of satisfaction with treatment effectiveness (GPE scale, 12 weeks, P < 0.001). OKSs did not differ significantly between the two groups. Moreover, treatment with RF did not significantly increase adverse effects. Subgroup analysis of knee pain indicated that the efficacy of RF treatment targeting the genicular nerve was significantly better than intra-articular RF at 12 weeks after treatment (P = 0.03). Conclusions This meta-analysis showed that RF is an efficacious and safe treatment for relieving knee pain and improving knee function in patients with knee OA.