11 research outputs found
Hydroxyurea as an alternative therapy for psoriasis
Background: Methotrexate is the drug of choice in extensive psoriasis
in developing countries. In patients who can not take methotrexate
either due to intolerance or concomitant liver disease, there is an
urgent need for an alternative affordable and accessible drug. Aims: To
evaluate the therapeutic efficacy and safety of hydroxyurea as an
alternative in the management of patients with extensive psoriasis.
Methods: A prospective study was carried out over 16 months on 34
patients with chronic plaque psoriasis (>20% body surface area
involvement), erythrodermic or generalized pustular psoriasis who were
partially responsive or non-responsive to the conventional topical and
systemic modalities of therapy. Besides doing a baseline hemogram,
liver and renal function tests, and urine analysis, these tests were
frequently repeated during the course of therapy. Hydroxyurea was
started at 1 g daily and increased to 1.5 g, if required. The
therapeutic response was evaluated by a global assessment made by the
patient and physician and regular PASI scoring. Results: Good to
excellent response was observed in 25 (73.5%) patients, less than 50%
response in 7 (20.6%) patients, while 2 (5.9%) patients were lost to
follow up. The mean PASI score was reduced by 76% at 10-12 weeks.
Therapy was discontinued in 3 patients due to leukopenia that recovered
on discontinuation of hydroxyurea. Patients were followed up to 1 year
and relapse was observed in 5 patients. The duration of remission
varied from 6 months to 1 year. Conclusion: Hydroxyurea is an effective
and reasonably safe second line agent for psoriasis
Cardiovascular Risk Factor and Coronary Artery Disease Prevalencein Patients of Rheumatic and Nonrheumatic Valvular Heart Disease-A Study from Major Centre in North Eastern India
Abstract Introduction:Indian data about the prevalence ofCoronary artery disease(CAD) in patients with valvular heart disease are limited. Prevalence of CAD in valvular heart disease is unknown in North Easter
Study - Hydroxyurea as an alternative therapy for psoriasis
Methotrexate is the drug of choice in extensive psoriasis in developing countries. In patients who can not take methotrexate either due to intolerance or concomitant liver disease, there is an urgent need for an alternative af fordable and accessible drug. Aims: To evaluate the therapeutic efficacy and safety of hydroxyurea as an alternative in the management of patients with extensive psoriasis. Methods: A prospective study was carried out over 16 months on 34 patients with chronic plaque psoriasis (>20% body surface area involvement), erythrodermic or generalized pustular psoriasis who were partially responsive or non-responsive to the conventional topical and systemic modalities of therapy. Besides doing a baseline hemogram, liver and renal function tests, and urine analysis, these tests were frequently repeated during the course of therapy. Hydroxyurea was started at 1 g daily and increased to 1.5 g, if required. The therapeutic response was evaluated by a global assessment made by the patient and hysician and regular PASI scoring. Results: Good to excellent response was observed in 25 (73.5%) patients, less than 50% response in 7 (20.6%) patients, while 2 (5.9%) patients were lost to follow up. The mean PASI score was reduced by 76% at 10-12 weeks. Therapy was discontinued in 3 patients due to leukopenia that recovered on discontinuation of hydroxyurea. Patients were followed up to 1 year and relapse was observed in 5 patients. The duration of remission varied from 6 months to 1 year. Conclusion: Hydroxyurea is an effective and reasonably safe second line agent for psoriasis
Efficacy and Safety of Angiotensin Receptor Neprilysin Inhibitor versus Angiotensin Converting Enzyme Inhibitor in Heart Failure with Reduced Ejection Fraction- A Prospective Observational Study from a Major Tertiary Care Hospital, Assam, India
Introduction: Angiotensin Receptor Neprilysin Inhibitor (ARNI)
has shown to reduce morbidity and mortality in comparison to
Angiotensin Converting Enzyme Inhibitors (ACEI) inpatients of
Heart Failure with Reduced Ejection Fraction (HFrEF). However,
the use of ARNI in real-world practice is limited and has not been
studied in North Eastern Indian population
Aim: To compare the efficacy and safety of ARNI with ACEI in
the management of symptomatic chronic HFrEF in North Eastern
Indian population.
Materials and Methods: The prospective observational study
was conducted in the Department of Cardiology at Gauhati
Medical College, Guwahati, Assam, India, from April 2019 to
October 2020. The study included patients with diagnosis of
chronic HFrEF <40%, on ACEI therapy and who had atleast one
hospitalisation for Acute Decompensated Heart Failure (ADHF)
in the last 6 months. A total of 63 patients were included in
this study. Three patients were lost on follow-up. Out of the 60
patients who were included in the final analysis, 30 patients each
were included in two groups i.e, ARNI group and ACEI group. As
perdiscretion of the treating physician, the patients were started
on ARNI 50 mg twice daily which consist of Sacubitril/Valsartan
(24/26 mg), along with other anti-heart failure medications, and
they were compared with the patients who continued on ACEI.
Uptitration was considered with the aim to double the dose till
the target dose was achieved at every 2-4 weeks at the treating
physician’s discretion The endpoints included the rate of repeat
HF hospitalisation, mortality, renal outcomes and quality of life.
All statistical analyses were performed using Statistical Package
for Social Sciences (SPSS, IBM) software version 20.0.
Results: The demographics and clinical characteristics were
comparable between the groups. The dose of ARNI was uptitrated to a maximum of 100 mg twice daily in 11 patients.
ARNI significantly reduced HF hospitalisation (36.7%
vs. 66.7%; p-value=0.039) and mortality (10% vs. 20%,
p-value=0.038) compared to patients with ACEI. There was a
significant improvement in the KCCQ score in the ARNI group
as compared to the ACEI group (p-value=0.001). Treatment
with ARNI was also associated with a significant improvement
in the New York Heart Association (NYHA) functional class,
serum creatinine, and estimated Glomerular Filtration Rate
(eGFR) and a significant reduction in N-Terminal pro B-type
Natriuretic Peptide (NT-proBNP) level.
Conclusion: In patients with symptomatic HFrEF, shifting to ARNI
from background therapy on ACE inhibitors in comparison with
continuation of ACE inhibitors appeared to be safe and superior
in reducing the risk of death and of hospitalisation, when initiated
on outpatient basis. ARNI could not be uptitrated in two-third of
patients, yet substantial benefits are evident even at low doses in
comparison to ACE inhibitor ramipri
Evaluation of Strawberry (Fragaria × ananassa Duch.) under Rice Fallow as Influenced by Tillage, Stubble Mulch and Nutrient Management
Aims: The experiment was conducted to evaluate the effect of tillage, stubble mulch and nutrient on growth, yield and quality of strawberry.
Study Design: The experiment was conducted using a split plot design, with three main plots, four sub plots and three replications each.
Place and Duration of Study: The field experiment was conducted in ICR farm of Assam Agricultural University, Jorhat during winter season of 2021-22.
Methodology: The experiment consists of 3 main plots each including (bed planting with rice stubble mulch, minimum tillage with rice stubble mulch and conventional tillage practice) and 4 sub plots having (10-7-7 g/m2 N-P-K with 5 kg/m2 FYM, 7.5-5-5 g/m2 N-P-K + vermicompost 200g/m2 in equal split at 10 and 30 DAP, 5-3.5-3.5 g/m2 N-P-K + vermicompost 200g/m2 in equal split at 10 and 30 DAP and 200-20-2 (FYM-lime-wood ash) g/plant in equal split at 10 and 30 DAP).
Results: The results revealed that bed planting with rice stubble mulch was superior over other tillage and mulch treatments in respect of vegetative growth, quality parameters and yield. Application of 200-20-2 (FYM-lime-wood ash) g/plant significantly resulted in maximum vegetative growth and yield. However, best quality parameters like highest TSS, sugars and low acidity were recorded in treatment having 5-3.5-3.5 g/m2 N-P-K + vermicompost 200g/m2.
Conclusion: From this experiment we concluded that bed planting with rice stubble mulch along with application of 200-20-2 (FYM-lime-wood ash) g/plant leads to maximum vegetative growth and yield in strawberry. And rice fallow and stubble mulch technique can be utilized for successful production of annual strawberry for higher return with minimum investment
White Grain Eumycetoma due to Aspergillus flavus in Infancy: A Rare Case Report from Assam
Mycetoma is a slowly progressive, chronic granulomatous infection of skin and subcutaneous tissue caused by traumatic inoculation of either fungi (eumycotic) or bacteria (actinomycotic). The disease is characterized by triad of tumefaction, discharging sinuses and grains. Here, we report a case of eumycetoma in an infant presenting with multiple discharging sinuses in lower limb. Aspirate and biopsy tissue from the sinuses were processed. The discharge revealed presence of white grains. Potassium hydroxide (KOH) mount revealed presence of hyaline septate hyphae. Histopathological examination showed granulation tissue and fungal hyphae. Repeated culture on sabouraud’s dextrose agar (SDA) with chloramphenicol showed growth of Aspergillus flavus on each occasion. Antifungal susceptibility testing was done following Clinical Laboratory Standard Institute (CLSI) M38-A2 protocol and showed high minimum inhibitory concentration (MIC) for fluconazole, caspofungin, anidulofungin and micafungin. The patient responded to itraconazole. Hence, exact categorization of lesion is essential for effective therapy and better prognosis
Prevalence of Vibrio cholerae O1 serogroup in Assam, India: A hospital-based study
Background & objectives: Although cholera remains to be an important public health problem, studies on reliable population-based estimates of laboratory confirmed cholera in endemic areas are limited worldwide. The aim of this hospital-based study was to evaluate the prevalence of Vibrio cholerae serogroup in Assam, India, during 2003-2013.
Methods: Stool samples/rectal swabs were collected from acute watery diarrhoea (AWD) cases during 2003-2013 and processed by standard microbiological procedures. Antibiotic sensitivity test was done following the Clinical and Laboratory Standards Institute guidelines. Year-wise epidemiological trend of cholera was analyzed.
Results: Cholera contributed to 3.93 per cent of AWD cases. In Assam, cholera was found to be more prevalent in the rural areas (6.7%) followed by the tea gardens (5.06%), urban slum (1.9%) and urban areas (1.4%). Highest proportion of cholera (13.7%) was observed in 0-10 yr age group. Of them, 11.5 per cent belonged to 0-5 yr age group.
V. cholerae O1 El Tor serotype Ogawa was the predominant isolate. Multiple drug-resistant isolates of V. cholerae O1 Ogawa were reported in the study.
Interpretation & conclusions: Emergence of resistance amongst V. cholerae towards many antibiotics is a matter of concern. Hence, continuous surveillance for diarrhoeal disorders is necessary to control the future outbreaks of cholera in this region