An open randomized comparative study to test the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in the treatment of onychomycosis.

BACKGROUND: Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts and molds. AIMS: To study the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in onychomycosis. METHODS: A clinical comparative study was undertaken on 96 Patients of onychomycosis during the period between August 2005 to July 2006. Forty-eight patients were randomly assigned in group A to receive oral terbinafine 250 mg, one tablet twice daily for seven days every month (pulse therapy); 24 patients in group B to receive oral terbinafine pulse therapy plus topical ciclopirox olamine 8% to be applied once daily at night on all affected nails; and 24 patients in group C to receive oral terbinafine pulse therapy plus topical amorolfine hydrochloride 5% to be applied once weekly at night on all the affected nails. The treatment was continued for four months. The patients were evaluated at four weekly intervals till sixteen weeks and then at 24 and 36 weeks. RESULTS: We observed clinical cure in 71.73, 82.60 and 73.91% patients in groups A, B and C, respectively; Mycological cure rates against dematophytes were 88.9, 88.9 and 85.7 in groups A, B and C, respectively. The yeast mycological cure rates were 66.7, 100 and 50 in groups A, B and C, respectively. In the case of nondermatophytes, the overall response was poor: one out of two cases (50%) responded in group A, while one case each in group B and group C did not respond at all. CONCLUSION: Terbinafine pulse therapy is effective and safe alternative in treatment of onychomycosis due to dermatophytes; and combination therapy with topical ciclopirox or amorolfine do not show any significant difference in efficacy in comparison to monotherapy with oral terbinafine.

No scalpel vasectomy advocacy and community mobilisation--a personal experience.

The so called myths and taboos among the people of India are obstactes controlling population explosion and thereby the nation is being handicapped with economic development. To propagate awareness and information, the NSV Resource Center took up organising mega camps for the acceptance of NSV as the method of family planning and male participation. The awareness material has been developed to bring forth total sociocultural transformation through development of intense desire, strong determination, effective management and inclusion of a zeal of perpetual efforts both among the promoters and acceptors. The information modules have been developed to suit the requirements of various vehicles through which the message has to be spread. Awareness messages are generated through the inputs from sociocultural, economic, ethical, hygienic and administrative acumen. The materials prepared are disseminated through display hoardings, wall writings, distribution of pamphlets, audiovisual clips, face to face counselling, etc. Communication technology serves mobilising and educating people, especially rural populace. Some steps are suggested to reach remotest villages which are elaborated. Counselling is an essential part of motivation to the client. During the last 5 years a significant surge has been noticed in terms of access to new communication technologies. This may be employed to successfully implement the family planning programme.

Blepharochalasis.

A-16-year old female with laxity, atrophy, wrinkling and telangiectases of skin of both upper eyelids is being reported. These changes were preceded by recurrent, painless edema of eye lids, starting at the age of 14 years.

Multiple lentigenes syndrome.

A 23-year-old male with multiple lentigenes, pulmonary stenosis, hyperelasticity of skin, hypermobile metacarpophalangeal joints is reported as a forme fruste form of leopard syndrome.

Extensive unilateral nevus comedonicus with bilateral involvement of face.

An extensive, non-familial, unilateral nevus comedonicus involving right half of the trunk and both sides of the face is being reported, because of its rarity and unusual presentation.

Isolation and subcloning of chitinase clone from chickpea genomic library.

Chickpea genomic library constructed earlier in phage lambda (EMBL-3) was screened for the presence of chitinase clone using tobacco chitinase cDNA as a probe. Positive clones obtained by primary screening of plaques (2 x 10(6)) were ascertained by secondary and tertiary screening. Presence of chitinase insert in the positive clones obtained, was further confirmed by restricting phage DNA with Sal I and then doing southern with tobacco chitinase. The insert band was eluted out and subcloned in puc 19 plasmid.

Agrobacterium mediated genetic transformation of chickpea, Cicer arietinum L.

In leaf and stem explants of chickpea, wild type strains of Agrobacteria were able to induce tumors. These tumors were capable of phytohormone independent growth. A supervirulent strain A281 was found to be most effective. Thus, using an agrobacterium R1601, which carries genes conferring supervirulent phenotype along with a plant selectable marker gene (npt II), transformed calli of chickpea were selected in the presence of 100 micrograms/ml level of kanamycin. Molecular analyses of genomic DNA from transformed calli confirmed the integration of the marker gene into chickpea genome.

Serum iron and total iron binding capacity in leprosy patients.

Serum Iron and total Iron binding capacity was estimated by Ramsay's Method in 40 leprosy patients having different types of leprosy and 20 normal subjects serving as controls. Significantly low serum Iron and total Iron binding capacity were observed in lepromatous leprosy patients.

Construction of chickpea genomic library.

For construction of chickpea genomic library, DNA was isolated, purified on CsCl gradient and size fractionated into 15-20 Kb fragments after restriction with Sau 3A. These fragments were ligated to phage lambda (EMBL-3) vector and the recombinant molecules packaged in vitro into viable phage particles. The recombinant phages were obtained as phages on a P2 lysogen of E. coli (Spi- selection) and amplified to establish a permanent library. This is the first report of the construction of chickpea genomic library.

Study of serum zinc level in leprosy.

Serum Zinc level was estimated in different types of leprosy by 'Dithiazone extraction' method in 75 leprosy patients comprising 15 each of Tuberculoid-Tuberculoid (TT); Borderline Tuberculoid (BT); Borderline Borderline (BB); Borderline Lepromatous (BL) and Lepromatous Lepromatous (LL). These findings were evaluated in comparison to 15 normal subjects serving as controls. Serum zinc level was observed to be significantly low in all types of leprosy except tuberculoid leprosy (TT). No significant difference was observed in serum zinc levels before and after 90 days of dapsone Therapy. The findings of our study are of considerable importance as zinc deficiency can be one of the factors involved in non-specific suppression of cell mediated Immunity (CMI) in lepromatous leprosy.