ABSTRACT
AIM: To compare the efficacy and tolerability of Xalatan with generic latanoprost (Latoprost) in subjects with primary open angle glaucoma (POAG) or ocular hypertension (OH). MATERIALS AND METHODS: This was a single-center, randomized, open label, crossover, two period comparative study. At the baseline visit, subjects were randomized to two groups. Group A received Xalatan for weeks 1-12 followed by Latoprost for weeks 13-24. Group B received Latoprost for weeks 1-12 followed by Xalatan for weeks 13-24. RESULTS: 30 subjects were recruited, 12 in Group A and 18 in Group B. In subjects administered Xalatan, intraocular pressure (IOP) showed a greater decrease (P < 0.001) from 23.64 +/- 3.13 mmHg at baseline to 14.29 +/- 1.61 mmHg at week 12 (fall of 9.35 +/- 3.55 mmHg, 38.66% +/- 10.29) than that seen in the Latoprost group (22.74 +/- 2.47 mmHg to 16.98 +/- 2.49 mmHg, fall of 5.76 +/- 1.41 mmHg; 25.42% +/- 5.98). In period 2 when subjects were crossed over to Xalatan from Latoprost, there was a further fall from 16.98 +/- 2.49 mmHg to 16.09 +/- 1.49 at week 24 (fall of 0.89 +/- 1.59 mmHg; 4.3% +/- 8.76). However, when subjects were crossed over to Latoprost from Xalatan, the IOP rose from 14.29 +/- 1.61 mmHg to 15.36 +/- 1.71 mmHg at week 24 (8.86% +/- 17.76). There was no significant difference in incidence of conjunctival hyperemia or any other adverse events in both the groups. CONCLUSION: The magnitude of IOP lowering in patients with POAG and OH with Xalatan and Latoprost is different. In our study, the IOP lowering with Xalatan was higher than that with Latoprost.
Subject(s)
Adult , Aged , Antihypertensive Agents/administration & dosage , Cross-Over Studies , Drugs, Generic/administration & dosage , Female , Follow-Up Studies , Glaucoma, Open-Angle/drug therapy , Humans , Intraocular Pressure/drug effects , Male , Middle Aged , Ocular Hypertension/drug therapy , Ophthalmic Solutions , Pilot Projects , Prospective Studies , Prostaglandins F, Synthetic/administration & dosage , Tonometry, Ocular , Treatment OutcomeABSTRACT
To report a case of bilateral emphysematous pyelonephritis [EPN] and emphysematous cystitis in a 64-year-old diabetic male with autosomal-dominant polycystic kidney disease [ADPKD]. A 64-year-old diabetic male presented with worsening of renal function and fluid overload. Diagnosis was confirmed by computerized tomography [CT scan] and conservative management with broad-spectrum antibiotics was instituted. There was good clinical response and repeated CT scan showed complete resolution. This case shows that conservative management is an acceptable alternative to surgery in EPN occurring with ADPKD. However, it is recommended that patients should be closely monitored, both clinically and radiologically, and percutaneous catheter drainage or surgical intervention carried out whenever deemed necessary
Subject(s)
Humans , Male , Cystitis/pathology , Polycystic Kidney, Autosomal Dominant , Pyelonephritis/diagnosis , Pyelonephritis/therapy , Tomography, X-Ray Computed , Diabetes Mellitus , Disease ManagementABSTRACT
To determine the relative importance of clinical presentation, laboratory studies, and ultrasonography in the diagnosis of acute scrotum, and to suggest an effective method of management. Subjects and Forty patients who were hospitalized between January 2002 and December 2002 for acute scrotum were studied with respect to history, physical examination, blood tests, urine analysis including culture, and scrotal ultrasonography with color Doppler study. Epididymitis [n = 24] was the commonest cause of acute scrotum followed by testicular torsion [n = 11], torsion of testicular appendages [n = 4], and idiopathic scrotal edema [n = 1]. Both mean age [40.7 vs. 13.8 years], and average duration of pain at presentation [4.5 days vs. 19.1 h] were higher in patients with epididymitis than in torsion. Onset was usually insidious in epididymitis, sudden in testicular torsion, and variable in torsion of testicular appendages. The majority [87.5%] of patients with epididymitis were managed conservatively. The testis was salvaged in 81.8% of patients with testicular torsion. The accuracy of ultrasonography was only 72.7% in testicular torsion, but was good in epididymitis. Our results show that a careful clinical evaluation, by an experienced examiner, provides the correct diagnosis in acute scrotum rather than ultrasonography. It is of utmost importance to exclude testicular torsion in those who are younger than 16 years and whose pain duration is less than 24 h