ABSTRACT
Cutaneous leishmaniasis is an endemic disease in many countries that is caused by different species of Leishmania. Nowadays, standard medication for leishmaniasis is pentavalent antimony compounds that are used intramuscular or intralesional. Though, they are drugs of choice, there are limitations such as hematologic, hepatic, renal and cardiac side effects. This study reviewed hematological, hepatic, and renal side effects of glucantim. The present work was a pre- and post- treatment study on 35 patients with cutaneous leishmaniasis referred to Dermatology Department, Imam Reza Hospital, Mashhad. Their disease was confirmed by direct smear. The patients were treated with intramuscular glucantime 60mg/kg daily for 20 days. Complete blood count [CBC, diff], serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT], blood urea nitrogen [BUN], creatinine[Cr] were evaluted at 3 times: before treatment, on the 20[th] day of treatment course [last day of injection], and a month after the end of treatment. Demographic, laboratory and treatment results, and drug complications were recorded in a questionnaire. Data were analyzed by descriptive statistics. Of 35 patients in this study, 26 completed the course. Red blood cell count, hemoglobin and hematocrit levels significantly reduced [P<0.05], but no significant difference was shown in white blood cell and platelet count. The increase of serum SGOT and SGPT levels were considerable [P<0.05]. Elevated serum levels of Cr and BUN observed in 11.5% and 34.6% of patients, respectively; and renal side effects were more common in females than in males [64% in females VS 10% in males]. Systemic glucantime is associated with hematologic, hepatic, and renal side effects. Therefore, evaluation of hematologic, hepatic and renal statement in patients receiving glucantim, before and during treatment is suggested
ABSTRACT
It has been suggested that calculation of differential renal function [DRF] using 99mTc-DMSA may lead to overestimation of the function of an obstructed kidney. The aim of this study was to evaluate the effect of diuretic administration on the determination of DRF using 99mTc-DMSA scintigraphy in patients with dilated pelvis. Thirty three patients, aged from 2 months to 66 years [19.27 +/- 20.83 years, 22 males, 11 females], in whom unilateral hydronephrosis had been documented by ultrasonography and diuretic renography were included in the study. 99mTc-DMSA scintigraphy was performed in all patients 3 hours after tracer injection. Immediately after the standard study, furosemide was injected in all patients, and 30 min later anterior and posterior images were obtained. DRF was calculated for each patient and from each 99mTc-DMSA study by using the geometric mean method. We did not observe any significant difference in all patients between the DRF values obtained before and after diuretic administration [the DRF value of the affected kidney was thus taken into account][P=0.35]. When we compared DRF values obtained from standard and from diuretic DMSA studies, the mean of the differences was only 0.18% and the SD was only 1.09%. In 17 patients [group1], diuresis renography revealed an obstructive curve pattern while 16 patients [group 2] had a nonobstructive dilated renogram curve pattern. There were again no significant differences between DRF values obtained before and after diuretic injection in each group. In view of our study, diuretic administration seems to be an unnecessary intervention because it has no effect on the accuracy of DRF measurements using 99mTc-DMSA scintigraphy in patients with a dilated collecting system whether it is obstructed or not