Azithromycin 1.5% ophthalmic solution: efficacy and treatment modalities in chronic blepharitis / Solução oftálmica de azitromicina 1,5%: eficácia e modalidades de tratamento em blefarite crônica

PURPOSE: To assess the efficacy of topical 1.5% azithromycin in the treatment of moderate to severe chronic blepharitis and to compare the efficacy of two different treatment modalities. METHODS: A randomized clinical trial included 67 patients with chronic anterior and/or posterior blepharitis, followed-up for 3 months. Signs and symptoms were graded according to severity. Patients were randomized into two groups: 33 patients in group I and 34 patients in group II. Group I patients were treated with topical 1.5% azithromycin twice a day for three days, and Group II patients were treated with topical 1.5% azithromycin twice a day for three days then at bedtime for the rest of the month. All patients were instructed to apply warm compresses and an eye-friendly soap twice daily. RESULTS: Patients in both groups tolerated the treatment with minimal irritation. A significant improvement in signs and symptoms was noted at the one week follow-up visit. Group II showed a more pronounced and longer-lasting improvement that persisted after three months of follow-up. CONCLUSION: Topical 1.5% azithromycin ophthalmic solution is an effective treatment option for chronic blepharitis. In moderate to severe blepharitis, a one month treatment is safe and shows better improvement than the three-day protocol with no significant relapse until three months of follow-up.

OBJETIVO: Avaliar a eficácia do uso tópico de azitromicina 1,5% no tratamento de blefarite crônica moderada a grave, comparando a eficácia de duas diferentes modalidades de tratamento. MÉTODOS: Um ensaio clínico randomizado incluiu 67 pacientes com blefarite anterior e/ou posterior crônica, acompanhados por três meses. Os sinais e sintomas foram classificados de acordo com a gravidade. Os pacientes foram randomizados em dois grupos: 33 pacientes no grupo I e 34 pacientes no grupo II. Os pacientes do grupo I foram tratados com azitromicina tópica 1,5% duas vezes ao dia durante três dias, e os pacientes do grupo II foram tratados com azitromicina tópica 1,5% duas vezes ao dia durante três dias e, em seguida, ao deitar, durante o resto do mês. Todos os pacientes foram instruídos a aplicarem compressas quentes e higiene palpebral duas vezes ao dia. RESULTADOS: Os pacientes em ambos os grupos toleraram o tratamento com irritação mínima. Melhora significativa dos sinais e sintomas foi observada na visita de uma semana de acompanhamento. Grupo II mostrou uma melhora mais acentuada e mais duradoura que persistiu após três meses de acompanhamento. CONCLUSÕES: A solução de azitromicina oftálmica tópica 1,5% é uma opção eficaz de tratamento para a blefarite crônica. Em blefarite moderada a grave, o tratamento de um mês é seguro e demonstrou melhora acentuada em relação ao protocolo de três dias, sem recidiva significante até três meses de acompanhamento.

Mean platelet volume in type II diabetes mellitus, case control study- Gezira central Sudan

Thrombotic disorders are the major complications of diabetes mellitus [DM]. Platelets are considered to play a role in these vaso-occlusive complications. The mean platelet volume [MPV] is recently taken as indicator for platelet reactivity. The aim of this study was to show the state of platelet activity in type II diabetes mellitus by indication of MPV. This study was done in Wad Madani, Gezira State, Sudan 2007. MPV was measured in 100 adult type II diabetic Sudanese patients and 100 adult healthy control subjects matched for age and gender. MPV was found to be significantly higher among the diabetic group [mean 9.9 fl] than the control group [mean 9.0 fl] [P value 0.015]. We conclude that elevated MPV may indicate platelet hyperactivity which may contribute to the vascular complications of type II DM

Assessment of anemia management in regular haemodialysis patients in Gezira hospital for renal diseases and surgery, Wad Medani

This study was conducted to evaluate the status of anemia and its management in regular haemodialysis patients attending Gezira Hospital for Renal Diseases and Surgery [GHRDS], compared to the international guidelines, in order to know where we are standing relative to what should be done, and to try to put our own guidelines according to our situation. So 140 patients [70% of them were males] representing all End Stage Renal Disease patients who are in regular haemodialysis during December 2005. The data was collected from all patients. The data included: age, sex, hemoglobin, Urea Reduction Ratio [URR], is she/he on intravenous iron and erythropoietin. The mean hemoglobin [Hb] level was 7.5g/dl, with a minimum Hb of 2.4g/dl and a maximum of 14.5g/dl. Most of females [95%] of females were anemic and all males have Hb less than 13.5g/dl. About 24% of patients were on intravenous iron supplements, and only 30% of them were taking it regularly, while 20% of patients were on subcutaneous erythropoietin, 50% of them taking it regularly. The main cause for not taking these drugs is poverty. The majority [93%] of patients were receiving two sessions of haemodialysis per week, and the mean URR was 62.5, there was only 41% of patients with URR more than 65%. Despite that anemia in Chronic Kidney Disease [CKD] is multifactorial; however this study indicated that the most important reasons for low Hb level in our patients are: the inadequate assessment of anemia with failure of taking iron and erythropoietin, lack of information about the disease and its complications including anemia and the lines of management among patients and inadequate dialysis. So it is recommended to establish an anemia management team in GHRDS to do proper assessment of anemia and to follow the management, to provide free erythropoietin and intravenous iron for patients, increase dialysis dose to three sessions [12 hours] per week and to establish our own guidelines for management of anemia in CKD in Sudan according to our situation and parameters