A comparative study of oral Ketoconazole versus Itraconazole in the treatment of Tinea versicolor

Tinea (pityriasis) versicolor is a superficial fungal infection and one of the most commonly found pigmentary disorders of the skin caused by the yeast Malassezia. Multiple topical as well as systemic therapies are available for treatment. Systemic therapies are used for extensive disease, frequent relapse or where topical agents have failed. The aim that translates the rationale of the study was to compare the efficacy, safety, tolerability and cost effectiveness of oral ketoconazole dose 200mg daily for 7 days versus a single dose of 400 mg of itraconazole in the treatment of tinea versicolor. A total of 64 patients (aged 18-50 years) were selected for the study from the period of June 2019 to November 2019 in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Bangladesh. Cases having extensive involvement were diagnosed clinically and confirmed by wood's lamp and KOH microscopy was taken. Patients were randomly allocated into equal groups. Group A was given oral ketoconazole dose 200mg daily for 7 days and Group B has given a single dose of 400 mg of itraconazole. 47 (73.4%) male and 17(26.6%) female were included in the study. The mean age of group A was 29.2(SD±8.6) and in group B 28.2(SD±8.5) years. The mean duration of the disease in group A was 3.9(±2.7) months and 3.5(±2.2) months in group B. In group A clinical responders was found cure 25(78.1%), improvement 5(15.6%) and failure in 2(6.2%) and in group B it was found cure 22(68.8%), improvement 7(21.87%) and failure 3(9.4%) at one month. At two months in the group A clinical responder was found to cure 22(68.8%), improvement 5(15.6%), failure in 3(9.4%) and relapse 2(6.2%). In group B it was found cure 18(56.2%), improvement 6(18.75%), failure 4(12.5%) and relapse 4(12.5%). Both oral ketoconazole dose 200mg daily for 7 days versus single dose 400 mg of itraconazole can be effective in the treatment of tinea versicolor with extensive involvement. CBMJ 2020 July: Vol. 09 No. 02 P: 26-33

Hydatid cyst of the liver with portal thrombosis: A case report

The extensive involvement of the liver due to hydatid cyst and it’s invasion to the portal vein and resulted portal vein thrombosis are rare complications of hydatid cyst. The diagnosis and treatment of hydatid liver cyst and its rare complication such as thrombosis in infected patients should be critically considered.

Accuracy of French census population estimates

The French population census method evolved in the early 2000s. Few studies have been published on the quality of the population estimates produced by this new method, apart from a few observing sample variance resulting from the introduction of a survey in large municipalities. However, the French census is subject to numerous quality controls throughout the process: development of a housing register, preparation of the collection, the collection itself and the post-collection, adjustment and estimation operations. The extensive involvement of stakeholders (municipalities and INSEE) in the preparation and conduct of the census leads to a very good understanding of the process. The many checks carried out throughout the process guarantee that the estimates produced are of a high quality. In addition, the census benefits from a very low non-response rate (3.9% in 2019). However, some features are not yet well known. Although many instructions are included in questionnaires, the answers given by enumerated persons are imperfect due to misunderstandings, an inability to adapt questions to real-life situations, or deliberately incorrect answers.

Multiple anatomic sites of infarction in a pediatric patient with M. pneumoniae infection, a case report

Background Although M. pneumoniae (M. pneumoniae) infections have been associated with various extrapulmonary manifestations, there have been very few documented cases of thrombotic events in pediatrics, and none to our knowledge with such extensive involvement as the patient described here. We aim to contribute to the urgency of discovering the mechanism of the coagulopathy associated with M. pneumoniae infections. Case presentation This 10-year-old boy was admitted after 2 weeks of fever, sore throat, worsening cough, and progressive neck and back pain. During hospitalization, he developed clots in several different organs: bilateral pulmonary emboli, cardiac vegetations, multiple splenic infarcts, and deep venous thromboses in three of four extremities. He was treated with long-term antibiotics and anticoagulation, and fully recovered. Conclusions This is the first case known to us of a child with an extensive number of thrombotic events in multiple anatomic sites associated with M. pneumoniae infection. The mechanism by which M. pneumoniae infection is related to thrombotic events is not fully understood, but there is evidence that the interplay between the coagulation pathways and the complement cascade may be significant. This patient underwent extensive investigation, and was found to have significant coagulopathy, but minimal complement abnormalities. By better understanding the mechanisms involved in complications of M. pneumoniae infection, the clinician can more effectively investigate the progression of this disease saving time, money, morbidity, and mortality.

A case report of generalised eruptive syringoma: a rare variant of syringoma

<p class="abstract">Syringomas are benign adnexal neoplasm of eccrine sweat duct usually affecting adult women. They present as firm, skin coloured to yellowish papules in a symmetrical distribution over periorbital region. Eruptive syringomas are infrequent and usually appear at uncommon sites. Herein, we report a case of a 21-year old girl with eruptive syringomas with an extensive involvement.</p>

Sovereign Sensibilities and Jewish Refugees

This and the next chapter explore the theme refuge and the ambivalence of Jacob Robinson and Shabtai Rosenne towards the 1951 Refugee Convention. This chapter assesses Robinson’s extensive involvement in drafting of the Convention. Against the backdrop of Robinson’s wartime work, as director of the New York-based Institute of Jewish Affairs, the chapter traces Robinson’s attempts to reconcile the demands of the Zionist creed with his lingering sensibilities with regard to the interests of Jewish refugees. In this regard, the chapter offers a critical reading of the degree to which Robinson was, in fact, representing the position of the Jewish state in this legislative process.

NUAK1 and NUAK2 Fine-Tune TGF-β Signaling

Transforming growth factor-β (TGF-β) signaling plays a key role in governing various cellular processes, extending from cell proliferation and apoptosis to differentiation and migration. Due to this extensive involvement in the regulation of cellular function, aberrant TGF-β signaling is frequently implicated in the formation and progression of tumors. Therefore, a full understanding of the mechanisms of TGF-β signaling and its key components will provide valuable insights into how this intricate signaling cascade can shift towards a detrimental course. In this review, we discuss the interplay between TGF-β signaling and the AMP-activated protein kinase (AMPK)-related NUAK kinase family. We highlight the function and regulation of these kinases with focus on the pivotal role NUAK1 and NUAK2 play in regulating TGF-β signaling. Specifically, TGF-β induces the expression of NUAK1 and NUAK2 that regulates TGF-β signaling output in an opposite manner. Besides the focus on the TGF-β pathway, we also present a broader perspective on the expression and signaling interactions of the NUAK kinases to outline the broader functions of these protein kinases.

A case of pelvic actinomycosis affecting genital, urinary and digestive tracts: a rare misleading diagnosis

Pelvic actinomycosis is an uncommon chronic invasive disease caused by a bacteria of the Actinomyces spp. Its diagnosis constitutes a clinical challenge and is usually reached in the postoperative period after resecting a pelvic mass that usually mimics advanced ovarian cancer. Although pelvic actinomyocosis involving the digestive and genital tract has been commonly described, very few reports have described cases involving both ovaries and requiring partial cystectomy for bladder involvement. Herein, we illustrate a case of pelvic actinomycosis with extensive involvement of multiple pelvic organs, misleading the surgeon into undergoing a complete clearance of the wrongfully thought adnexal malignancy.

Granulomatous Mucormycosis of the Temporal Bone extending Into Temporomandibular Joint and Infratemporal Fossa: A Case Report

Mucormycosis of temporal bone is extremely rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal. We performed a literature review and found only 10 reported cases of temporal bone mucormycosis. We present a case of temporal bone mucormycosis involving the temporomandibular joint and infratemporal fossa in a 53-year-old woman with diabetes mellitus who presented with unbearable otalgia. Computed tomography and magnetic resonance imaging demonstrate inhomogeneous density mass in the parapharyngeal and retropharyngeal space accompanied with lytic bone destruction on the temporomandibular joint. After undergoing a biopsy of the left infratemporal fossa, the patient’s pathology exhibited fungal hyphae consistent with mucormycosis. To our knowledge, this is the first report of temporal bone mucormycosis with extensive involvement of temporomandibular joint and its adjacent structures, which exhibited no otologic or rhinologic signs. A definitive diagnosis is made by biopsy.