Treatment of dermatophyte toenail onychomycosis with itraconazole

Background: Onychomycosis is fungal infection of nail. The prevalence of onychomycosis varies across the world. It is lower in tropical countries (3.8%) than in sub-tropical countries and countries in the temperate zone (23%). The risk of onychomycosis is higher in persons with diabetes mellitus and human immunodeficiency virus infection. Systemic antifungals are recommended for treatment. Topical antifungals are less effective. Different cure rates have been reported by different authors for terbinafine, itraconazole and fluconazole therapy. A variety of regimens (continuous or pulse) have also been suggested.Methods: Here in this study we report a prospective, observational, cohort study of pulse itraconazole therapy in toenail onychomycosis caused by dermatophytes over a period of one year in patients with SCIO scores between 6 to 9.Results: It was observed that mean age of patients was 38.96 years. 57.27 % study subjects had complete clinical improvement to oral itraconazole three pulses regimen. One pulse consisted of 200 mg twice per day given for one week, followed by a three weeks interval. Thus, this regimen was repeated thrice.Conclusions: This study shows the substantial benefit with itraconazole pulse regimen in toenail onychomycosis. The outcome this study is comparable with previously published data and may encourage the usage of itraconazole pulse regimen for the treatment of dermatophyte toenail onychomycosis in adults

Anti-nicotine vaccine: current status

Tobacco abuse has an enormous impact on health. Nicotine is the main substance responsible for dependence on tobacco-containing products. The vast majority of cigarette smokers who try to quit ultimately fail because of high relapse rates. Clearly, novel approaches are needed for the treatment and prevention of nicotine addiction. Having an efficient vaccine that would generate antibodies to sequester the drug and prevent its access to the brain could go a long way toward helping a motivated addict quit an addiction

Olanzapine-induced black hairy tongue: a rare case

Olanzapine is second generation antipsychotic drug. It alters affinities for serotonin and dopamine receptors and provides mild sedating and calming effect. It is indicated for the treatment of schizophrenia, acute mania and the prevention of relapse in bipolar disorder. We present a case report of a 65- year- old man with bipolar disorder I, who developed black hairy tongue following treatment with olanzapine and completely recovered after withdrawal of treatment. Awareness about this particular adverse drug reaction will ensure proper management and avoid unnecessary investigations

A clinical trial of treatment of uncomplicated typhoid fever: efficacy of ceftriaxone-azithromycin combination

Background: Typhoid fever is a systemic infection caused by Gram-negative bacterium Salmonella enterica serovar typhi (S. typhi). It is a major health problem in India. It carries significant morbidity and mortality. Antimicrobial therapy is critical for the management of typhoid fever. Emergence of multidrug-resistant (MDR) and nalidixic acid-resistant (NAR) strains of S. typhi has complicated therapy by limiting treatment options. Hence, this study was conducted to evaluate the efficacy and safety profile of ceftriaxone and azithromycin combination therapy in uncomplicated typhoid fever.Methods: Adults patients of blood culture proven uncomplicated typhoid fever admitted in the medicine ward of Teerthanker Mahaveer Medical College and Research Centre were treated with ceftriaxone intravenously (2 g daily for 14 days) and azithromycin orally (500 mg daily for 7 days). Patients were clinically and bacteriologically evaluated during the study period and follow-up.Results: 96% cure rate was observed. No relapse was recorded.Conclusion: Ceftriaxone-azithromycin combination may be considered as an empirical therapy for treatment of uncomplicated typhoid fever in view of the emergence of MDR and NAR strains of S. typhi

Acute hepatic failure due to dengue: A case report

Dengue is an arboviral disease endemic in many parts of the world. Although it is known to cause hepatic involvement commonly, it only occasionally results in acute hepatic failure. We present the case of a young male who developed acute hepatic failure due to dengue. The differentials and the management is discussed

Concurrent reactive arthritis and myelitis – a case report

Reactive arthritis is a post infectious multisystem illness which usually occurs after episodes of diarrhoea or urinary tract infections. It can cause many manifestations other than the musculoskeletal system including skin, urogenital system and eyes. However the central nervous system is only occasionally involved. We discuss the case of a 32 year old male who presented with myelitis in association with reactive arthritis

A prospective study on sleep disorders related to antidepressant drugs use in a tertiary care teaching hospital

Background: Prescription of antidepressants has been increased from the last decade and responsible for producing sleep disorders as adverse drug reactions (ADRs). Sleep disorders can be divided into 3 large groups: (1) insomnia, (2) primary complaint of daytime sleepiness, and (3) Association of disruptive behaviours during sleep, the disorders of arousal. So active surveillance is needed to access these ADRs.Aims and Objective: To analyze the sleep disturbances as ADRs of various antidepressants prescribed to the patients attending psychiatry outpatient department (OPD).Methods: This prospective study was conducted on patients aged ≤74 years attending Department of Psychiatry OPD and were prescribed Antidepressants for the duration of 8 months (December, 2013-July, 2014). The ADRs reported were confirmed by WHO UMC Causality Assessment Scale.Results: Total number of patients enrolled on the basis of inclusion and exclusion criteria (n=50). Total number of ADRs related to drugs prescribed were found to be n=69. Total number of patients with sleep disturbances as ADRs were found to be n=28.Conclusion: The drug, most frequently implicated to cause sleep disturbances, was mirtazapine. Increased sleep was the most common ADR, found to occur. Unusual ADRs such as sleep talking was also seen

Baixa mortalidade durante surto de dengue em Nova Délhi, na Índia, em 2008: um estudo clínico-bioquímico

Dengue has become a yearly phenomenon in Delhi. Each outbreak is distinct by way of clinical features, morbidity andmortality. The aim of this study is to analyse the clinical and biochemical profile of dengue in the 2008 outbreak at a tertiarycare institution in India. We analysed the medical records of all cases diagnosed as dengue fever during the period of July2008 to December 2008 in a tertiary care hospital. The study consisted of 103 patients - 63% patients were males. The meanage was 22 years. One third of patients had some cutaneous manifestation. 30 patients had hepatomegaly and 8 hadsplenomegaly. Of uncommon features 2 patients had seizures, 1 had polyserositis and one had acute hepatic failure. RaisedSGPT (>60 U/L) was seen in 60% cases. 23 patients had a platelet count of less than 20,000/mm3. There were no deaths. Thepresent outbreak primarily involved the economically productive age group. The current outbreak was characterised byhigh rate of hepatic involvement.A dengue tem se tornado um fenômeno anual em Nova Deli. Cada surto é distinto do outro por meio de características clínicas,morbidade e mortalidade. O objetivo deste estudo é analisar o perfil clínico e laboratorial da dengue na epidemia de 2008 emuma instituição de atendimento terciário na Índia. Foram analisados os prontuários de todos os casos diagnosticados comodengue durante o período de julho de 2008 a dezembro de 2008 em um hospital terciário. O estudo consistiu de 103 pacientes:63% do sexo masculino; idade média de 22 anos. Um terço dos pacientes apresentavam alguma manifestação cutânea, 30pacientes tinham hepatomegalia e 8 tinham esplenomegalia. De características incomuns, 2 pacientes tiveram convulsões, 1tinha poliserosite e 1 tinha insuficiência hepática aguda. Um aumento da SGPT (>60 U/L) foi observado em 60% dos casos. Vintee três pacientes tiveram uma contagem de plaquetas inferior a 20.000/mm3. Não houve mortes. Este surto envolveu indivíduosde faixa etária economicamente produtiva. O surto também foi caracterizado pelo alto índice de comprometimento hepático