Clinico-mycological profile of tinea capitis and its comparative response to griseofulvin versus terbinafine.

BACKGROUND AND PURPOSE: Tinea capitis is the most common superficial mycosis in children. This disease is a contagious infection with worldwide distribution and is occasionally associated with permanent alopecia. The treatment of this infection usually requires the administration of appropriate oral antifungal agents. The current study was conducted to evaluate the clinico-mycological profile of tinea capitis and compare the efficiency of oral griseofulvin and terbinafine in the treatment of this disease. MATERIALS AND METHODS: This study was conducted on 69 patients, including 23 females (33.3%) and 46 males (66.7%), clinically suspected of tinea capitis. After the confirmation of tinea capitis diagnosis through direct examination, the subjects were randomly assigned into two groups of griseofulvin and terbinafine. Demographic data, clinical and mycological characteristics, and therapeutic outcome were recorded for both groups. RESULTS: According to the results, tinea capitis was more common in children younger than 15 years (73.9%), athletes (37.7%), and males (66.7%), and those with frontal involvement (34.8%), non-inflammatory type (68.1%), endothrix (69.6%), and Trichophyton tonsurans species (41.7%). The griseofulvin and terbinafine groups had the treatment success rates of 90.9% and 80.6%, respectively (P= 0.311). The griseofulvin group had a shorter therapeutic course than the terbinafine group (P=0.129). CONCLUSION: Although our findings demonstrated that both griseofulvin and terbinafine were effective in the treatment of tinea capitis, griseofulvin showed a little higher efficacy in this regard. Consideration of some variables, such as age, associated risk factors, clinical type, hair involvement pattern, and dominant pathogenic species, is important in the determination of the drugs.

Preparation, Physicochemical Characterization and Anti-fungal Evaluation of Nystatin-Loaded PLGA-Glucosamine Nanoparticles.

PURPOSE: Nystatin loaded PLGA and PLGA-Glucosamine nanoparticles were formulated. PLGA were functionalized with Glucosamine (PLGA-GlcN) to enhance the adhesion of nanoparticles to Candida Albicans (C.albicans) cell walls. METHOD: Quasi-emulsion solvent diffusion method was employed using PLGA and PLGA-GlcN with various drug-polymer ratios for the preparation of nanoparticles. The nanoparticles were evaluated for size, zeta potential, polydispersity index, drug crystallinity, loading efficiency and release properties. DSC, SEM, XRPD, 1H-NMR, and FT-IR were performed to analyze the physicochemical properties of the nanoparticles. Antifungal activity of the nanoparticles was evaluated by determination of MICs against C.albicans. RESULTS: The spectra of 1H-NMR and FT-IR analysis ensured GlcN functionalization on PLGA nanoparticles. SEM characterization confirmed that particles were in the nanosize range and the particle size for PLGA and PLGA-GlcN nanoparticles were in the range of 108.63 ± 4.5 to 168.8 ± 5.65 nm and 208.76 ± 16.85 nm, respectively. DSC and XRPD analysis ensured reduction of the drug crystallinity in the nanoparticles. PLGA-GlcN nanoparticles exhibit higher antifungal activity than PLGA nanoparticles. CONCLUSION: PLGA-GlcN nanoparticles showed more antifungal activity with appropriate physicochemical properties than pure Nystatin and PLGA nanoparticles.

The Incidence of Onychomycosis Infection among Patients Referred to Hospitals in Kermanshah Province, Western Iran.

BACKGROUND: Onychomycosis is a nail disorder associated with aesthetic problems, discomfort, physical injury and loss of dexterity. The purpose of the present study was to isolate and identify the causative fungi of onychomycosis in 2402 patients in Kermanshah Province, western Iran in 1994 to 2010. METHODS: Mycologic assessment was carried out by standard methods including either microscopic or cultural procedures. RESULTS: Direct microscopy of the nail clips was positive in 1086 (45.2%) and fingernail and toenail onychomycoses were recognized in 773 (71.1%) and 313 (28.8%), respectively. Yeasts were detected in 853 (78.5%), dermatophytes in 201 (18.5%) and non-dermatophyte fungi in 32 (2.9%) patients. The results of fungal culture showed Candida albicans isolated in 384 (45.0%) and other Candida spp. isolated in 361 (54.0%) of the cases as the most common agents of onychomycosis while among dermatophytes, Trichophyton rubrum was found in 63 (37.0%) of the cases as the main dermatophytic agent followed by T. mentagrophytes 32 (15.9%) and Epidermophyton flocosum 30 (17.6%). Among the non-dermatophyte moulds, Aspergillus flavus was the most prevalent species 12 (37.5%) followed by A. niger 8 (25.0%) and A. fumigatus 4 (12.5%). Moreover, 139 (12.8%) samples with positive direct microscopy yielded no growth. The highest rate of onychomycosis was found in patients between 30-40 years of age. CONCLUSION: In sum, the current results identified the aetiological agents and primary epidemiological aspects of onychomycosis in west Iran.

Anti-candidal activity of Astragalus verus in the in vitro and in vivo guinea pig models of cutaneous and systemic candidiasis

This study was design to evaluate the anti-candidal activity of Astragalus verus Olivier, Fabaceae (Av). The GC/MS analysis of essential oils of Av showed that aqueous extract contains thymol while hexadecanoic acid, 1,2-benzenedicarboxylic acid, diisooctyl ester and phytol were found as major components of methanol and acetone extracts. The aqueous extract showed anti-candidal activity in the concentration 320 mg/mL using disc diffusion method and its minimum inhibitory concentration (MIC) was 160 mg/mL. To induce cutaneous candidiasis, the dorsum of immunocompromised guinea pigs was infected with Candida albicans and animals were divided into five groups (n=5 for each): NC, received a vehicle; PC, received topical ketoconazole 2% and three other groups which received topical 10, 20 and 40% aqueous extract of Av. On ninth day postinfection, skins were cultured and colony forming unite per gram (CFU/g) skin was recorded. Systemic candidiasis was obtained by intravenous inoculation of C. albicans, 4000 CFU/g body weight. Here, animals have been divided into five groups like cutaneous candidiasis but their medications have been delivered in drinking water for ten days before induction of infection. On second day postinfection, all internal tissues were taken for determining CFU/g tissue. The aqueous extract (40%) prevented heavy burden of C. albicans in tissues and skin in oral and topical application, respectively. The results indicate that Av represents a potential source of anti-candidal drug.

Antifungal activities of Astragalus verus Olivier. against Trichophyton verrucosum on in vitro and in vivo guinea pig model of dermatophytosis.

Astragalus verus Olivier, Fabaceae has been used against ringworm in Kurdish ethnomedicine throughout millennia. The objective of this study was to evaluate the effects of A. verus extracts against Trichophyton verrucosum on in vitro and in vivo guinea pig model of dermatophytosis. The skin of albino guinea pigs was infected with T. verrucosum (1.0×10(7) conidia) and animals were divided into five groups (n=5 for each): negative control (NC), received a vehicle; positive control (PC), received topical terbinafine 1.0% and three other groups: AE10%, AE20% and AE40% which received topical 10%, 20% and 40% aqueous extract of A. verus, respectively. Evaluation of clinical efficacy was performed 72h after completion of a 7-day treatment regimen. Higher significant antifungal activities were observed in aqueous extract in the concentration 320 mg ml(-1) compared with acetone and methanol extracts. The aqueous extract showed minimum inhibitory concentration at 160 mg ml(-1) . Lower clinical scores indicate improved efficacy compared with NC. The lesion scores significantly declined in AE20%, AE40% and PC groups in comparison with NC group. The lesion scores in AE10% and AE20% groups were significantly higher than that of PC group. The AE10% group (18.3%) and AE20% group (39.43%) and AE40% group (66.19%) showed clinical efficacies compared with PC group (76.05%). In conclusion, aqueous extract showed promising antidermatophytic activity.