Visual Outcome among Patients Undergone Manual Small Incision Cataract Surgery Following their Identification in Screening Eye Camp in Jammu Province.

Introduction: One of the documented leading cause ofblindness in India is cataract as many patients with cataract donot have access to hospitals and surgery and to avoid blindnessdue to cataract, the only remedy is to perform hospital basedcataract surgery on a large scale. There is an increase in anumber of cataract patients due to improved quality of life,health indices and increased life expectancy. Study aimedto see the visual outcome and complications among patientsundergone manual SICS with PC-IOL implantation.Material and Methods: The present prospectiveobservational study was conducted on 72 patients who wereselected in various screening eye camps to undergo cataractextraction surgery by manual small incision cataract surgerytechnique with posterior chamber IOL implantation (MSICSwith PC-IOL).Results: Total of 72 eyes of patients who underwent manualsmall incision cataract surgery were studied. Best correctedpreoperative visual acuity of ≥ 6/60 was found in 13 patientswhile postoperatively on day1 total of 60 patients had visualacuity of ≥ 6/60. The final 6th week postoperative bestcorrected visual acuity of 6/12-6/9 was found in 65 patients.Iris prolapse was seen in 3 patients followed by posteriorcapsule rent which was seen in 2 patients. Mild postoperativeuveitis was seen in 20 followed by striate keratopathy in 8patients while hyphaema was seen in 2 patients.Conclusion: MSICS is a safe and effective procedure, due toits low rates of intraoperative and postoperative complicationswhich are easily treatable. Visual acuity is only one measureof the functional success of cataract surgery and the goodpostoperative visual outcomes achieved by our patientsfurther adds on to its benefits as a good surgical technique.MSICS can be performed as procedure of choice for largevolume cataract surgeries

Tinea unguium onychomycosis caused by dermatophytes: a ten-year (2005-2014) retrospective study in a tertiary hospital in Singapore

<p><b>INTRODUCTION</b>Tinea unguium is a common nail infection. We conducted a retrospective ten-year study of the patient demographics and species distribution of dermatophytes causing tinea unguium in a tertiary hospital from Singapore.</p><p><b>METHODS</b>Results of fungal nail cultures were retrieved from our hospital's microbiology department. Samples from nail scrapings and clippings were inoculated onto agar plates (Sabouraud dextrose agar with chloramphenicol and Mycosel agar). Nail specimens that grew dermatophytes were included in the study.</p><p><b>RESULTS</b>Overall, 229 (male: n = 164, 71.6%; female: n = 65, 28.4%) nail specimens grew dermatophytes. Mean patient age was 58 (range 18-93) years. A majority of specimens came from patients aged over 50 years (n = 162, 70.7%) and 60-79 years (n = 100, 43.7%). Ethnically, 160 (69.9%) patients were Chinese, 36 (15.7%) Indian, 18 (7.9%) Malay and 15 (6.6%) of other ethnicities. Among dermatophytes isolated were Trichophyton rubrum (n = 93, 40.6%), Trichophyton mentagrophytes (n = 60, 26.2%), unidentified Trichophyton spp. (n = 57, 24.9%), Trichophyton tonsurans (n = 10, 4.4%), Epidermophyton floccosum (n = 5, 2.2%), Trichophyton verrucosum (n = 2, 0.9%), Trichophyton soudanense (n = 1, 0.4%) and Trichophyton violaceum (n = 1, 0.4%).</p><p><b>CONCLUSION</b>A majority of isolates were from elderly patients. Compared to Singapore's general population, patients of Indian and other ethnicities were over-represented for tinea unguium when compared to Chinese and Malay patients. Trichophyton rubrum was the most common dermatophyte isolated, while Trichophyton verrucosum, Trichophyton violaceum and Trichophyton soudanense were rare causes of tinea unguium.</p>

Laser and Light Sources in the Treatment of Onychomycosis / 대한의진균학회지

Onychomycosis is a common fungal infection of the nails and there is wide distribution across the continent. Aside from Trichophyton rubrum (88%) being the main causative agent, other dermatophytes, yeasts or non-dermatophyte molds can affect nails and adjacent tissues and cause sundry symptoms: subungual hyperkeratosis, onycholysis, nail thickening, discoloration, malodorous condition. Oral antifungal agents are the mainstay treatment for onychomycosis but undesirable side effects, such as hepatotoxicity, remain a main reason for drug withdrawal. Moreover, other modalities as a reliable treatment option are disappointing with a low cure rate. The advancement in laser and light technology has opened a new field of opportunity for the treatment of refractory skin disease. As supported in clinical studies, neodymium-doped yttrium aluminium garnet laser, diode laser, fractional carbon dioxide laser, and erbium:glass laser have produced a favorable outcome, with or without additional agents, for the treatment of onychomycosis. But the mechanism is still unclear and reliable data are relatively scarce despite the potential as an alternative armamentarium. To date, as with laser therapy, there have been only a few studies conducted concerning the role of light therapy in the superficial fungal infection. Herein we aimed to review the medical literature on laser and light therapy of onychomycosis and provide our point of view for health providers and researchers.

Topical Treatment of Onychomycosis / 대한의진균학회지

Onychomycosis is one of the most common diseases of the nails caused by dermatophytes, yeasts, and non-dermatophytic molds. Among the onychomycosis, tinea unguium occurred by dermatophytes such as Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum. Treatment options of onychomycosis include oral and topical antifungal agents, surgery or a combination therapy of theses modalities. The complete remission of onychomycosis requires long-term treatment with systemic and topical antifungal agents and recurrences and re-infections are common. In this review, we provide insights on the topical antifungal agents in onychomycosis and introduce new topical antifungal agents.

Comparative efficacy of continuous and pulse dose terbinafifine regimes in toenail dermatophytosis: A randomized double-blind trial.

Introduction: Dermatophytes are the most frequently implicated agents in toenail onychomycosis and oral terbinafi ne has shown the best cure rates in this condition. The pharmacokinetics of terbinafi ne favors its effi cacy in pulse dosing. Objectives: To compare the effi cacy of terbinafi ne in continuous and pulse dosing schedules in the treatment of toenail dermatophytosis. Methods: Seventy-six patients of potassium hydroxide (KOH) and culture positive dermatophyte toenail onychomycosis were randomly allocated to two treatment groups receiving either continuous terbinafi ne 250 mg daily for 12 weeks or 3 pulses of terbinafi ne (each of 500mg daily for a week) repeated every 4 weeks. Patients were followed up at 4, 8 and12 weeks during treatment and post-treatment at 24 weeks. At each visit, a KOH mount and culture were performed. In each patient, improvement in a target nail was assessed using a clinical score; total scores for all nails and global assessments by physician and patient were also recorded. Mycological, clinical and complete cure rates, clinical effectivity and treatment failure rates were then compared. Results: The declines in target nail and total scores from baseline were signifi cant at each follow-up visit in both the treatment groups. However, the inter-group difference was statistically insignifi cant. The same was true for global assessment indices, clinical effectivity as well as clinical, mycological, and complete cure rates. Limitations: The short follow-up in our study may have led to lower cure rates being recorded. Conclusion: Terbinafi ne in pulse dosing is as effective as continuous dosing in the treatment of dermatophyte toenail onychomycosis.

A Case of Ingrown Toenail Associated with Tinea Unguium Treated with K-D(R) Wire / 대한의진균학회지

Ingrown toenail is a common disorder resulting from various etiologies including excessive external pressure, ill-fitting footwear, and improper nail-trimming techniques. Patients commonly present with pain in the affected nail but with progression, drainage, infection and difficulty walking occur. It is often difficult to manage and frequently recurs, despite the multitude of treatment techniques that have been reported. Conservative therapy is a reasonable approach in patients with a mild to moderate ingrown toenail that do not have significant pain, substantial erythema, or purulent drainage from the lateral nail edge. We report a case of ingrown toenail in a 45-year-old female treated with K-D(R) wire, a corrective device. After application of K-D(R) wire for 3 weeks, ingrown toenail healed and the nail deformity was corrected.

Toe Nail Onychomycosis Caused by Trichophyton tonsurans in a Healthy Child / 대한의진균학회지

Trichophyton tonsurans is an anthropophilic dermatophyte that is not yet truly prevalent in Korea. Especially, cases of toe nail infection during childhood are very rare, and no cases have been reported prior to this report. We report a single case of tinea unguium due to T. tonsurans in a healthy child. A 7 year-old patient visited an outpatient clinic presenting with subungual hyperkeratosis of the 1st and 3rd Rt. toe nails, which had first presented at an age of 28 months, and no other symptoms. Numerous hyphae were evident on the KOH smear examination. A confirmative diagnosis of tinea unguium cased by T. tonsurans was made after culturing scales from the toe nail lesion. The patient is currently undergoing follow-up, after being treated with oral terbinafine hydrochloride, without a relapse in symptoms.

Tinea Unguium Hidden by Norwegian Scabies / 대한의진균학회지

Norwegian, or crusted scabies, is a fulminant and highly infectious form of scabies in which a large number of Sarcoptes scabiei mites infest the epidermis. This is often seen in the physically or mentally handicapped, immunocompromised, and institutionalized persons. The characteristic skin lesions in this form are gross scaling and hyperkeratotic plaques with erythematous papules, especially on hands, feet, elbow, and subungual area with varying degrees of pruritus. It may be difficult to differentiate Norwegian scabies from tinea unguium when Norwegian scabies involves nail and subungual area. We report a case of tinea unguium hidden by Norwegian scabies with nail involvement in a 71-year-old patient. This is the first report of such a case in Korea.

Skin and Acupuncture / 全日本鍼灸学会雑誌

The skin has a special significance in acupuncture. In acupuncture, the skin is both a site of both examination and treatment while providing an interface for information exchange with the external world. Various findings that appear on the body surface should not simply be understood as dermatologic findings, but considered as a reflection of the internal condition of the body, the external world and the mental condition. From this perspective, although acupuncture treatment use only simple stimuli, such as needles, and stimulate only specific sites on the body surface, they can produce therapeutic effects and regulate physical and mental functions<BR>In this symposium, we reviewed the relationship between skin and acupuncture by examining acupuncture and moxibustion treatments for specific dermatologic diseases and their clinical effects. As a result, we were able to reaffirm the above relationship from the perspective of an acupuncturist.<BR>The methods and clinical effects of acupuncture and moxibustion treatment were introduced for atopic dermatitis (by Egawa), tinea unguium (by Dr. Menjou), and the dermatologic symptoms of connective tissue diseases (by Dr. Kasuya). Moreover, Dr. Kagawa presented his research results related to the effects of acupunctural stimulation on the condition of the skin. Based on these research results, the possible effects of acupuncture treatment were discussed based on extensive application in fields such as dermatology, cosmetics, and anti-ageing. Regarding the significance of the skin (body surface) within the practice of acupuncture, it was reconfirmed that the skin reflects the condition of the organs and the mind, and examination of the skin may elucidate both mental and physical health. In addition, we also discussed the body surface as a site of both examination and treatment, and investigated the efficacy, potential for further development, and significance of acupuncture, which connect the skin with systemic functions.

The Evaluation of Usefulness of PAS Stain and GMS Stain as Clinical Diagnostic Methods of Tinea unguium / 대한의진균학회지

BACKGROUND: Tinea unguium is a common problem seen in clinical practice. Considering the many differential diagnoses of dystrophic nails, it is important to make a definitive diagnosis of dermatophyte infection before the initiation of antifungal therapy. Potassium hydroxide (KOH) preparation and fungal culture, which are commonly used in the diagnosis of these infections, often yield false-negative results. Recent reports have suggested that nail plate biopsy (Bx) using periodic acid-Schiff (PAS) (Bx/PAS) stain may be a very sensitive technique for the diagnosis of tinea unguium. OBJECTIVE: The purpose of this study was to evaluate the usefulness of PAS and Grocott's methenamine silver (GMS) staining of nail specimen in the diagnosis of tinea unguium as a standard method. METHODS: We evaluated 75 nail specimens from suspected tinea unguium using KOH preparation, biopsy using periodic acid-Schiff stain, and Grocott's methenamine silver stain. RESULTS: Of the 75 nails which were negative on potassium hydroxide mounting, 43 and 39 cases were tested positive respectively on periodic acid-Schiff stain and Grocott's methenamine silver stain. CONCLUSION: Bx/PAS and Bx/GMS are the sensitive methods for the diagnosis of tinea unguium. They are indicated if clinical suspicion of onychomycosis is high and KOH preparation shows no fungal elements.

A Case of Tinea Unguium Caused by Microsporum canis / 대한의진균학회지

Microsporum canis is known to be the main causative agent of tines capitis and tinea corporis in children. Contrary to Trichophyton rubrum and Trichophyton mentagrophytes var. interdigitale, it very rarely infects the nail. In the reported cases of tinea unguium due to Microsporum canis, fingernails were usually affected. We report a patient with tinea unguium of thumb and big toe nails caused by Microsporum canis.

Prevalence of Tinea Pedis of College Students and Their Families in Taegu / 대한피부과학회지

BACKGROUND: Tinea pedis is one of the most comrnon dermatoses in the general population. But its prevalence in the general populat,ion was not yet reported in Korea. OBJECTIVE: Prevalence of tinea pedis and associated tinea unguium were checked in the general population. METHODS: Six hundred fifty eight persons from 179 families of the college students were evaluated. Clinical examinatior. for tinea pedis and onychomycosis and collecting scales from the suspicious lesions of the family members were perforrned by educated college students. Then dermatologists exarnined those specimens mycologically by KOH ~tnount and fungal culture. RESULTS: The results were as follows 1. The prevalence of tinea pedis was 41.2% in the studied 658 persons. 2. Among all 271 patients with tinea pedis, 201 strains of dermatophytes were isolated. They were 143 strains of Trichophyton(T) rubrum, 49 strains of T. mentagrophytes and 9 mixed infections of T. rubrum and T. mentagrophytes. In the co existence of i,inea pedis and tinea unguiurn, isolated species were corresponding. 3. Among 179 families, 143 families (79.9%) had at least one patient with tinea pedis. The isolated species of derrnatophytes in a farnily were one organism, 71.4% and two or more organisms, 28.6% of 77 familiys with more than one patient. CONCLUSION: In our study, the prevalence rate of tinea pedis was 41.2%. That suggests that tinea pedis is a wide spr .ad disease in healthy adult in Korea.

The File Method to Detect the Causative Organisms of Tinea Unguium / 대한피부과학회지

In order to increase the positive rate of cultre for dermatophyte infections of the nails, the authors devised the new file method. It is to perform the KOH mount arid culture with fine subungual hyperkeratotic debris obtained from the hyponycLium after grinding the nail plate from the surface to the bottom using various files, And we compared the result of this new method with that of conventional scraping and punch methods in 40 toenails and ]1 fingernails. The positive rate of culture for tinea unguium by three different methods was as follows: It was 52.5%(21 cases) through conventional scraping method, 70% (28 cases) through punch method and 80% (32 cases) through file method in the 40 toenai ls. lt was 18.2% (2 cases) through punch method, 27. 3% (3 sases) through scraping method and 54. 6%(6 cases) through file method in the 11'fingernails. In conclusion, the file method was found to be a more effective and successful method to detect the causative organisms of tinea unguium and was also easy to handle.