Online ISSN: 2515-8260

Keywords : Corticosteroids


EFFICACY AND SAFETY OF LOW DOSE ORAL ISOTRETINOIN FOR THE TREATMENT OF STEROID INDUCED ROSACEA- A RETROSPECTIVE STUDY

Chandrashekar B S , Rashmi Sriram, Harsha G T ,Sapna Bhaskar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 681-689

Background: The excessive, regular use of topical fluorinated steroids on the face often produces an array of skin complications, including an eruption clinically indistinguishable from rosacea-‘steroid-induced rosacea like eruption ’  or iatrosacea . Although it was believed that only high potency topical steroids could produce SIRD, it is important to note that topical hydrocortisone 1% can also cause such an eruption after prolonged use. Objective: To assess the efficacy and tolerability  of low dose oral Isotretinoin for  steroid induced  rosacea- like eruption. Methodology: A retrospective registry/ photographic analysis  of 30 patients enrolled between Jan 2013 to Jan 2014 was done at  Cutis academy. Case records and photographs  of 30 patients between the age group of 15- 45 years   clinically diagnosed with steroid induced rosacea  on  low dose oral isotretinoin 20mg alternate days for 3 months were analysed. Patients were evaluated by a rosacea clinical score at weeks 0, 6,  and 12 weeks. Results: A total of  30 patients (23females and 7 males) were enrolled in this study.  The mean age of the study population was 30.1+/- 14.8 (14 to 45) years. Among the 30 patients, 2  dropped out due to side effects of  treatment such as dryness and itching. According to seven point static score, Investigator global assessment of steroid induced rosacea eruption at baseline was 5.36+/- 1.1. This score decreased to 3.2 +/-0.8 at week 6, then 0.73 +/-0.6 at week 12.The difference of IGA between week 0, week 2, and week 6 was statistically significant.(p<0-0001) . At baseline the 16 patients had ratings of ‘severe’ , 7 patients had ratings of  ‘moderate to severe’, 2 patients had rating of ‘moderate’, 3 patients had rating of ‘mild to moderate’ .Conclusion : Low dose oral isotretinoin with cessation /avoidance of topical steroid use as well as the avoidance of other agents known to aggravate rosacea is proved to be an   effective alternative mode of treatment of steroid rosacea like eruption.

POST COVID MUCORMYCOSIS: AN OVERVIEW OF AETIOLOGICAL FACTORS

Beladakere Channaiah Vijayalakshmi, Anand Shalini, Thuraganur KapaniGowda Shashikala, Honnavara Govindaiah Manjunath, Govinda Rao Dinesh, Nagaraj Kokila, Anand Poornima

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1815-1822

Background and objectives:  During the second wave of corona virus pandemic, we saw an increase in the case reports of rhino-orbital mucormycosis in patients with coronavirus disease (COVID -19) or in patients who had recovered from COVID -19 infection. We evaluated the patient characteristics and predisposing factors in these patients having mucormycosis.
Materials and method: This retrospective observational study included 84 patients with mucormycosis diagnosed during their course of COVID-19 illness between May 2021 to July 2021.Data regarding demography, underlying medical condition, extent of involvement of mucormycosis, COVID-19 status and treatment taken during COVID-19 illness were collected.
Results: Eighty-four patients presented with mucormycosis out of which 59 patients were males and 25 females. Majority were in the age group of 40-60 years (71.4%). Rhino-orbital was the most common form of mucormycosis. Intracranial spread was noted in 16 patients. Hyperglycemia at presentation (either pre-existing or new onset diabetes mellitus) was the single most important risk factor observed in majority of these cases (80 patients / 95.23%) followed by history of Corticosteroid use in 68 patients (80.95%) and oxygen administration during their course of treatment for COVID-19 illness in 64 patients. (76.19%)
Conclusion:The association between coronavirus and mucormycosis must be given serious consideration. Uncontrolled diabetes and over-zealous use of corticosteroids are the two most important factors aggravating the illness. All efforts must be made to maintain optimal glucose levels in COVID-19 patients and use corticosteroids judiciously.

A hospital based assessment of the effects of various topical agents in chronic plaque type psoriasis

Dr. Shribhagawan Rolaniya, Dr. Apeksha Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1005-1008

Aim: To determine the effect of various topical agents in chronic plaque type psoriasis.
Materials and Methods: The study was carried out on patients having chronic plaque type psoriasis vulgaris came to Department of Skin & VD, Medini Rai Medical College, Palamu, Jharkhand, India. Total 300 patients were enrolled and were divided into three groups comprising of 100 patients in each group. Group A patients were asked to apply ammonium lactate twice a day, Group B patients were asked to apply ammonium lactate in morning and clobetasol propionate in evening, Group C patients were asked to apply topical ammonium lactate in morning and calcipotriol in evening.
Results: Physician global assessment scale shows that in Group A, 39% patients had excellent response, 15% patients had good response, and 21% patients had fair response whereas 25% patients had poor response. In group B, 35% patients had excellent response, 29% patients had good response, and 17% patients had fair response whereas 19% patients had poor response. In group C, 31% patients had excellent response, 28% patients had good response, and 22% patients had fair response whereas 19% patients had poor response.
Conclusion: Combination therapy is effective, well tolerated with minimal side effects and better compliance was seen with patients. Ammonium lactate 12% can also be considered as one of the topical option as a monotherapy and also as a maintenance therapy.

Advanced treatment regimes and application of regenerative medicine for human male infertility treatment

A.S Vickram; G.V. Sree Charan; P. Venkatasaikumar; M. Kusuma; P.N. Ramya Bhargavi; G. Gulothungan; S. Thanigaivel; P. Jeyanthi; R. Nanmaran

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 5746-5766

Male reproductive organ and other assessory sex glands plays an massive role in sperm production process, sperm maturation process, maintaining the entry of sperm cells in the female reproductive tract and until child birth. Many events could happen properly from semen ejaculation until it reaches the oozyte for proper fertilization. Any problem during the process of semen reaching female reproductive tract could men responsible. Overall 20 to 35 % of men contribute to the infertility. Clinical evidence suggests that tissue engineering and regenerative medicine could help men achieve the fertility status. Congenital abnormalities, iatrogenic injuries, trauma and other chronic conditions could be treated by regenerative medicine. Recently stem cell therapy has been emerging in the file of male infertility treatment regimes. In case of trauma, penile reconstruction, testes reconstruction available as most advanced treatment regime. Here we summarized the important findings and functions of testes, penile and scrotum reconstruction techniques, organ based regeneration for various male infertile disorders. Non-obstructive azoospermia conditions will be very tough to diagnose and this review comprises the important treatment regimes available for non-obstructive azoospermia. Antioxidants therapy, trace elements therapy, oral administration of carnitines and its potential applications were carefully elucidated for idiopathic conditions. We also summarized the role of prebiotics and probiotics as treatment regime for male infertility. All advanced treatments methods available were in general summarized in this review.