ABSTRACT
Impetigo is a common childhood skin infection. There are reports of increasing drug resistance to the currently used topical antibiotics including fusidic acid and mupirocin. Retapamulin is a newer topical agent of pleuromutilin class approved by the Food and Drug Administration for treatment of impetigo in children and has been recently made available in the Indian market. It has been demonstrated to have low potential for the development of antibacterial resistance and a high degree of potency against poly drug resistant Gram-positive bacteria found in skin infections including Staphylococcus aureus strains. The drug is safe owing to low systemic absorption and has only minimal side-effect of local irritation at the site of application.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bridged Bicyclo Compounds, Heterocyclic/pharmacology , Impetigo/drug therapy , Staphylococcal Skin Infections/drug therapy , Staphylococcus aureus/drug effects , Administration, Cutaneous , Anti-Bacterial Agents/administration & dosage , Bridged Bicyclo Compounds, Heterocyclic/administration & dosage , Diterpenes , Humans , Ointments/administration & dosage , Treatment OutcomeABSTRACT
Intranasal corticosteroids are recommended as one of the first-line therapies for the treatment of allergic rhinitis (AR), especially when associated with nasal congestion and recurrent symptoms. Fluticasone furoate is a novel enhanced-affinity glucocorticoid for the treatment of AR approved by the Food and Drug Administration in 2007 and recently introduced in India. Fluticasone furoate nasal spray is indicated for the treatment of the symptoms of seasonal and perennial AR in patients aged two years and older. This review summarizes the clinical data on fluticasone furoate nasal spray and discusses its role in the management of AR. Important attributes of fluticasone furoate include low systemic bioavailability (<0.5%), 24-h symptom relief with once-daily dosing, comprehensive coverage of both nasal and ocular symptoms, safety and tolerability with daily use, and availability in a side-actuated device that makes medication delivery simple and consistent. With these properties, fluticasone furoate nasal spray has the potential to enhance patient satisfaction and compliance, thus making it a good choice amongst available intranasal steroids.
Subject(s)
Androstadienes/administration & dosage , Anti-Allergic Agents/administration & dosage , Glucocorticoids/administration & dosage , Rhinitis, Allergic, Perennial/drug therapy , Rhinitis, Allergic, Seasonal/drug therapy , Administration, Inhalation , Administration, Intranasal , Adrenal Cortex Hormones , Aerosols , Androstadienes/adverse effects , Androstadienes/pharmacology , Anti-Allergic Agents/adverse effects , Anti-Allergic Agents/pharmacology , Clinical Trials as Topic , Drug Interactions , Humans , India , Treatment OutcomeABSTRACT
Despite the high prevalence of tuberculosis in adults and children, congenital and perinatal forms of tuberculosis are rare. Four patients with perinatal tuberculosis are described. Diagnosis was made by demonstration of acid-fast bacilli (AFB) on broncho-alveolar lavage (BAL) specimens (two cases), gastric aspirate smear (one case) and lymph node fine-needle aspirate (one case). All of the above specimens were subsequently positive on culture. Two infants died of progressive pulmonary failure, and one of the mothers died, despite the institution of anti-tuberculous therapy. BAL specimen examination for AFB is useful in the diagnosis of perinatal tuberculosis, especially in infants with smear-negative gastric aspirate.
Subject(s)
Bronchoalveolar Lavage Fluid/microbiology , Tuberculosis, Pulmonary/congenital , Female , Humans , Infant , Infant, Newborn , Male , Radiography , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/diagnostic imagingABSTRACT
Plasmodium vivax infection causing severe malaria is increasingly being reported. Six children aged 1.5-11 years with severe vivax malaria who presented with cerebral malaria (three) and severe anaemia (two) are reported; two had altered renal function. Thrombocytopenia was detected in all cases. P. vivax infection should be considered in children presenting with severe malaria.
Subject(s)
Malaria, Vivax/complications , Anemia/parasitology , Child , Child, Preschool , Humans , Infant , Malaria, Cerebral/diagnosis , Malaria, Cerebral/parasitology , Malaria, Vivax/diagnosis , Plasmodium vivax/isolation & purification , Thrombocytopenia/parasitologyABSTRACT
Infection with resistant pathogens can adversely affect clinical, microbiological and economic outcomes. New agents for the treatment of many such serious infections are acutely needed in hospital practice. Tigecycline is a novel glycylcycline antimicrobial for intravenous use. It has an expanded broad-spectrum antibacterial activity including multi-drug resistant pathogens, like methicillin-resistant Staphylococcus aureus , vancomycin-resistant enterococci , multi-drug resistant Streptococcus pneumoniae , extended-spectrum beta-lactamase-producing gram-negative bacteria and Acinetobacter baumannii . Tigecycline however is not active against Proteus, Providencia and Pseudomonas species. Its currently approved indications include complicated skin and skin structure infections and complicated intra-abdominal infections. It has also been found to be effective for the treatment of community- as well as hospital-acquired and ventilator-associated pneumonia and bacteremia, sepsis with shock and urinary tract infections. Tigecycline appears to be a valuable treatment option for the management of superbugs, especially where conventional therapy has failed.
Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Minocycline/analogs & derivatives , Anti-Bacterial Agents/administration & dosage , Drug Administration Schedule , Drug Interactions , Drug Resistance, Multiple, Bacterial , Humans , Minocycline/administration & dosage , Minocycline/pharmacology , Minocycline/therapeutic use , Randomized Controlled Trials as Topic , TigecyclineABSTRACT
Ertapenem is a parenteral carbapenem licensed for use in adults and children more than 3 months of age. It is active against many Gram-positive and negative bacteria, including several anaerobic organisms but has a narrower spectrum of antimicrobial activity, compared with older carbapenems. It is highly stable against nearly all beta-lactamases, including AmpC and extended spectrum beta lactamases. Ertapenem can be given intramuscularly or intravenously and its favourable pharmacokinetic profile allows once daily dosing. Ertapenem has been proven to be clinically and bacteriologically efficacious in randomised controlled trials for the treatment of community acquired infections including complicated intra-abdominal infections, complicated skin and skin-structure infections, acute pelvic infections, complicated urinary tract infections, community-acquired pneumonia and for the prophylaxis of surgical-site infection following elective colorectal surgery. Ertapenem is suited for mild to moderately ill patients with community-acquired infections and for outpatient intravenous antibacterial therapy.
Subject(s)
Anti-Bacterial Agents/pharmacology , beta-Lactams/pharmacology , Adult , Anti-Bacterial Agents/therapeutic use , Child , Community-Acquired Infections/drug therapy , Dose-Response Relationship, Drug , Ertapenem , Female , Gram-Negative Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/drug therapy , Humans , Injections, Intramuscular , Injections, Intravenous , Male , Sensitivity and Specificity , Urinary Tract Infections/drug therapy , beta-Lactams/therapeutic useABSTRACT
The management of Beta Thalassemia, the commonest form of hemolytic anemia in children, has changed significantly in the last few years. With the availability of better transfusion regimen, iron chelation therapy, proper management of complications and good supportive care, it is now possible for a thalassemic child to have a near normal life span with a good quality of life.
Subject(s)
beta-Thalassemia/therapy , Adaptation, Psychological , Bacterial Infections/epidemiology , Cardiovascular Diseases/epidemiology , Chelation Therapy , Child , Comorbidity , Diabetes Mellitus/epidemiology , Fertility , Growth Disorders/epidemiology , Humans , Hypoparathyroidism/epidemiology , Hypothyroidism/epidemiology , Iron Overload/epidemiology , Iron Overload/etiology , Transfusion Reaction , beta-Thalassemia/epidemiology , beta-Thalassemia/physiopathologyABSTRACT
AIMS: To assess the changes in blood haemoglobin concentration and serum iron indices as a consequence of breast operations for cancer in our unit. METHODS: Haematological parameters were measured in 109 patients undergoing definitive operative treatment for breast carcinoma. RESULTS: A mean fall in haemoglobin of 2.1 g (P=0.001) occurred in patients undergoing mastectomy and axillary clearance and of 1.3 g (P<0.001) in patients undergoing wide local excision and axillary clearance. The transferrin saturation (serum iron/total iron binding capacity) in both sets of patients after surgery fell on average to levels that would be expected to impair subsequent red cell production. CONCLUSION: The changes in iron indices that occurred were unrelated to the degree of blood loss consistent with a possible inflammatory effect of the operation. Oral iron therapy is unlikely to be of benefit to operative breast patients if they have normal pre-operative iron stores.
Subject(s)
Breast Neoplasms/surgery , Carcinoma/surgery , Iron Deficiencies , Iron/therapeutic use , Mastectomy , Postoperative Complications/drug therapy , Anemia, Iron-Deficiency/drug therapy , Anemia, Iron-Deficiency/etiology , Blood Loss, Surgical/physiopathology , Female , Hemoglobins/metabolism , Humans , Iron/blood , Middle Aged , Postoperative Complications/etiology , Transferrin/metabolismABSTRACT
Background : Vitiligo is a condition of major social and cosmetic concern in India. An epidemiological study of large number of patients from India was indicated.
ABSTRACT
A 10-year-old girl developed epidermal nevus, shortness of limb, scoliosis, hemiatrophy with history of multiple pathological fractures. Bone biopsy revealed fibrous dysplasia. This is an extremely rare combination of epidermal nevus with fibrous dysplasia.
