Assessment of factors related to treatment failure and recurrence of superficial dermatophytosis

Background: Superficial dermatophytosis, commonly known as ringworm, is a fungal infection of the skin, hair, or nails caused by dermatophytes, primarily belonging to the genera Trichophyton, Microsporum, and Epidermophyton. Despite being a superficial infection, the rising incidence of treatment failure and recurrence has become a matter of concern in recent years. Methods: This prospective observational study, conducted at the department of dermatology and venereology of Chittagong Medical College Hospital, aimed to investigate the epidemiological factors associated with treatment failure and recurrent cases of superficial dermatophytosis. The study spanned from March 2022 to February 2023, involving 249 participants diagnosed with Tinea corporis, Tinea cruris, Tinea facies, or Tinea pedis. Factors such as excessive sweating, use of warm water, clothing habits, sharing practices, and topical corticosteroid application were analyzed. Results: The most common age group affected was 21-30 years, with a male preponderance (1.6:1). Excessive sweating, wearing water-soaked garments, and sharing towels were prevalent among participants. After 4 weeks of treatment, 81.5% achieved complete cure, but 52.7% of these cases experienced a recurrence within the subsequent 4 weeks. Multivariate analysis identified sharing towels, family history of dermatophytosis, and past topical steroid use as significant risk factors for treatment failure/recurrence. Conclusions: The study emphasizes the importance of linen (sharing towels) in the transmission of dermatophytosis and highlights the increased risk associated with a family history of the condition. Additionally, the injudicious use of topical steroids emerged as a significant factor contributing to treatment failure and recurrence.

Relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients

Background: Hypertension stands as a widely recognized significant risk factor for cardiovascular disease. In clinical practice, it is advisable to measure blood pressure (BP) in both arms. The increasing attention on inter-arm blood pressure difference (IABPD) stems from its association with cardiovascular disease. This study aimed to assess the relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients. Methods: This cross-sectional study was conducted at the department of cardiology, Chittagong Medical College Hospital from July 2020 to June 2021. The study included 428 cases of previously or newly diagnosed hypertension, selected through convenient sampling. Data analysis was conducted using Microsoft Office tools and statistical package for the social sciences (SPSS) version 23.0. Results: In this study, 8.2% of patients exhibited noteworthy systolic IAD, and 2.3% demonstrated notable diastolic IAD. Median 10-year cardiovascular risk, assessed by Framingham and ASCVD calculators, was 21% and 11% respectively. A positive correlation was observed between sIAD and 10-year cardiovascular risk (p=0.003) and sIAD and 10-year ASCVD risk (p=0.041). Patients with significant sIAD had a higher incidence of ischemic heart disease compared to those without (p=0.041). Multiple regression analysis revealed a significant correlation between 10-year Framingham cardiovascular risk and sIAD (p=0.003). Conclusions: A significant difference in systolic blood pressure between arms is linked to a higher 10-year cardiovascular risk and the presence of cardiovascular disease in well-managed hypertensive patients. So, monitoring sIAD could be an additional factor in predicting future cardiovascular events in patients receiving hypertension treatment.

Correlation of lipoprotein (a) level with severity of coronary lesion in coronary heart disease patients

Background: Cardiovascular diseases (CVDs) are the leading cause of death in developing nations, especially in low and middle-income countries (LMICs). Bangladesh has been undergoing an epidemiological transition from communicable to non-communicable diseases. This study aimed to investigate the association of risk factors with coronary heart disease (CHD) in patients from Bangladesh. Methods: This cross-sectional observational study was conducted in the department of cardiology, Chattogram Medical College and Hospital, Chattogram, Bangladesh from July 2018 to June 2019. A total of 100 patients were enrolled. Results: This cross-sectional study enrolled 100 CHD patients with a mean age of 53.21±10.29 years. The majority were obese (64, 64.0%), and hypertension was the most prevalent risk factor (77, 77.0%), followed by smoking (65, 65.0%) and dyslipidemia (58, 58.0%). Most patients had triple vessel disease (53, 53.0%), and significant CHD (81, 81.0%). Patients with severe CHD had higher levels of blood LDL-C, triglycerides, and Lp(a). Lp(a) levels, history of dyslipidemia, and LDL-C were independently associated with a Gensini score ?20. These findings emphasize the independent association between Lp(a) and CHD severity, warranting greater attention to patients with elevated Lp(a) levels. Conclusions: This study suggested that Lp(a) is an independent risk factor for CHD in patients from Bangladesh. More attention should be paid to such patients with elevated Lp(a) level.