Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMEZv
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OZVHfp
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spaOtX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfHOD
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25w5fZc
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGR7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYsce
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9LqyS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMEiP
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1sYnZme
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGDCM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYIbl
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spalIh
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfI5c
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25w4SxD
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGlvu
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMjg6
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xH1ks
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfIlI
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqC4l2
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMqYP
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqCyr7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfM51
via IFTTT

FOXP3+ CD4 T-cell maturity and responses to microbial stimulation alter with age and associate with early life gut colonization

Publication date: Available online 30 May 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Sophia Björkander, Maria A. Johansson, Lena Hell, Gintare Lasaviciute, Caroline Nilsson, Ulrika Holmlund, Eva Sverremark-Ekström

Teaser

Peripheral CD4⁺FOXP3⁺ T-cells from children are immature and less responsive to S. aureus. Early gut colonization with S. aureus and lactobacilli associates with the functional phenotype of FOXP3⁺ cells, implying involvement of microbes in immune-maturation.


from Allergy and Immunology via xlomafota13 on Inoreader http://ift.tt/1spaZFF

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVX5rg
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMTKy
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqCgke
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfnzA
via IFTTT

Dendritic Cells as Vaccines: Key Regulators of Tolerance and Immunity

from Inflammation via xlomafota13 on Inoreader http://ift.tt/1soWqCc


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGIpY
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xNagw
via IFTTT

Correcting for H2O interference using a RAD7 electrostatic collection-based silicon detector

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): G. De Simone, C. Lucchetti, G. Galli, P. Tuccimei
The effect of water molecules on the electrostatic collection of ²¹⁸Po ions onto the surface of silicon detectors (neutralization) is evaluated through the comparison with a scintillation cell (ZnS), not affected by air humidity. A radon monitor (RAD7, Durridge Company) was connected to a stainless steel radon chamber, equipped with the scintillation cell. Radon gas, extracted from an acidified RaCl2 source, was injected into the chamber and the amount of water molecules in the system was alternatively lowered or increased (from 0.00075 to 0.014 g of water in RAD7) by connecting the chamber to a desiccant or to a bubbling water bottle. The relative efficiency of the silicon detector with respect to the scintillation cell decreases with the growth of water molecules inside RAD7. This dependence, with a fixed i) electrostatic chamber geometry and ii) nominal high voltage, diverges during the humidification or the drying phase because it is in turn influenced by the length of interaction of polonium atoms with water molecules, which impacts on the size of ²¹⁸Po clusters and thus on the neutralization process. For water contents higher that 0.01 g in RAD7, this effect is greatly enhanced. Temperature in the investigated range (18.5–35.6 °C) does not affect the efficiency of electrostatic collection-based silicon detectors.Based on these experiments, admitting a certain error on the efficiency (from 1.8 to 7.5%, depending on the water content), proper corrections were developed to adjust soil radon readings, when a desiccant is removed. This operation is necessary if recent Non-Aqueous Phase Liquids (NAPLs) leakage has occurred in the subsoil to avoid the sorption and possible later release of radon by Drierite, with related partition between the solid and liquid phases (water and NAPL).



from Radiology via xlomafota13 on Inoreader http://ift.tt/1XKWQhG


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1TUm4Jg
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYl0v
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spb8sH
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfIlz
via IFTTT

Manual of Dietetic Practice 5e & Case Studies Set

This is a set comprising of the Manual of Dietetic Practice, 5th Edition and Dietetic and Nutrition Case Studies Read More...

from #Dental via xlomafota13 on Inoreader http://ift.tt/1OZPQXk
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1qZjXbw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYiSm
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9LIWk
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMxDP
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVSIMS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGjU
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZXVqS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spb5gw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfJpI
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTogM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGTla
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYjpn
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9KLNR
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xM6cD
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMEZv
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OZVHfp
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spaOtX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfHOD
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGR7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYsce
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9LqyS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xMEiP
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGDCM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYIbl
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spalIh
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/22vfI5c
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGlvu
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xH1ks
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqC4l2
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqCyr7
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UqCgke
via IFTTT

Dendritic Cells as Vaccines: Key Regulators of Tolerance and Immunity

from Inflammation via xlomafota13 on Inoreader http://ift.tt/1soWqCc


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGIpY
via IFTTT

FOXP3+ CD4 T-cell maturity and responses to microbial stimulation alter with age and associate with early life gut colonization

Publication date: Available online 30 May 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Sophia Björkander, Maria A. Johansson, Lena Hell, Gintare Lasaviciute, Caroline Nilsson, Ulrika Holmlund, Eva Sverremark-Ekström

Teaser

Peripheral CD4⁺FOXP3⁺ T-cells from children are immature and less responsive to S. aureus. Early gut colonization with S. aureus and lactobacilli associates with the functional phenotype of FOXP3⁺ cells, implying involvement of microbes in immune-maturation.


from Allergy and Immunology via xlomafota13 on Inoreader http://ift.tt/1spaZFF

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVX5rg
via IFTTT

Correcting for H2O interference using a RAD7 electrostatic collection-based silicon detector

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): G. De Simone, C. Lucchetti, G. Galli, P. Tuccimei
The effect of water molecules on the electrostatic collection of ²¹⁸Po ions onto the surface of silicon detectors (neutralization) is evaluated through the comparison with a scintillation cell (ZnS), not affected by air humidity. A radon monitor (RAD7, Durridge Company) was connected to a stainless steel radon chamber, equipped with the scintillation cell. Radon gas, extracted from an acidified RaCl2 source, was injected into the chamber and the amount of water molecules in the system was alternatively lowered or increased (from 0.00075 to 0.014 g of water in RAD7) by connecting the chamber to a desiccant or to a bubbling water bottle. The relative efficiency of the silicon detector with respect to the scintillation cell decreases with the growth of water molecules inside RAD7. This dependence, with a fixed i) electrostatic chamber geometry and ii) nominal high voltage, diverges during the humidification or the drying phase because it is in turn influenced by the length of interaction of polonium atoms with water molecules, which impacts on the size of ²¹⁸Po clusters and thus on the neutralization process. For water contents higher that 0.01 g in RAD7, this effect is greatly enhanced. Temperature in the investigated range (18.5–35.6 °C) does not affect the efficiency of electrostatic collection-based silicon detectors.Based on these experiments, admitting a certain error on the efficiency (from 1.8 to 7.5%, depending on the water content), proper corrections were developed to adjust soil radon readings, when a desiccant is removed. This operation is necessary if recent Non-Aqueous Phase Liquids (NAPLs) leakage has occurred in the subsoil to avoid the sorption and possible later release of radon by Drierite, with related partition between the solid and liquid phases (water and NAPL).



from Radiology via xlomafota13 on Inoreader http://ift.tt/1XKWQhG


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1TUm4Jg
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYl0v
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spb8sH
via IFTTT

Manual of Dietetic Practice 5e & Case Studies Set

This is a set comprising of the Manual of Dietetic Practice, 5th Edition and Dietetic and Nutrition Case Studies Read More...

from #Dental via xlomafota13 on Inoreader http://ift.tt/1OZPQXk
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1qZjXbw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYiSm
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9LIWk
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVSIMS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGjU
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZXVqS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spb5gw
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTogM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGTla
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYjpn
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9KLNR
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMEZv
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OZVHfp
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spaOtX
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGR7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYsce
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1U9LqyS
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGDCM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYIbl
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1spalIh
via IFTTT

Correcting for H2O interference using a RAD7 electrostatic collection-based silicon detector

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): G. De Simone, C. Lucchetti, G. Galli, P. Tuccimei
The effect of water molecules on the electrostatic collection of ²¹⁸Po ions onto the surface of silicon detectors (neutralization) is evaluated through the comparison with a scintillation cell (ZnS), not affected by air humidity. A radon monitor (RAD7, Durridge Company) was connected to a stainless steel radon chamber, equipped with the scintillation cell. Radon gas, extracted from an acidified RaCl2 source, was injected into the chamber and the amount of water molecules in the system was alternatively lowered or increased (from 0.00075 to 0.014 g of water in RAD7) by connecting the chamber to a desiccant or to a bubbling water bottle. The relative efficiency of the silicon detector with respect to the scintillation cell decreases with the growth of water molecules inside RAD7. This dependence, with a fixed i) electrostatic chamber geometry and ii) nominal high voltage, diverges during the humidification or the drying phase because it is in turn influenced by the length of interaction of polonium atoms with water molecules, which impacts on the size of ²¹⁸Po clusters and thus on the neutralization process. For water contents higher that 0.01 g in RAD7, this effect is greatly enhanced. Temperature in the investigated range (18.5–35.6 °C) does not affect the efficiency of electrostatic collection-based silicon detectors.Based on these experiments, admitting a certain error on the efficiency (from 1.8 to 7.5%, depending on the water content), proper corrections were developed to adjust soil radon readings, when a desiccant is removed. This operation is necessary if recent Non-Aqueous Phase Liquids (NAPLs) leakage has occurred in the subsoil to avoid the sorption and possible later release of radon by Drierite, with related partition between the solid and liquid phases (water and NAPL).



from Radiology via xlomafota13 on Inoreader http://ift.tt/1XKWQhG


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1TUm4Jg
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYl0v
via IFTTT

Manual of Dietetic Practice 5e & Case Studies Set

This is a set comprising of the Manual of Dietetic Practice, 5th Edition and Dietetic and Nutrition Case Studies Read More...

from #Dental via xlomafota13 on Inoreader http://ift.tt/1OZPQXk
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1qZjXbw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYiSm
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVSIMS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGjU
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZXVqS
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTogM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGTla
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYjpn
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMEZv
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OZVHfp
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGDCM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYIbl
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGR7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/27ZYsce
via IFTTT

Correcting for H2O interference using a RAD7 electrostatic collection-based silicon detector

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): G. De Simone, C. Lucchetti, G. Galli, P. Tuccimei
The effect of water molecules on the electrostatic collection of ²¹⁸Po ions onto the surface of silicon detectors (neutralization) is evaluated through the comparison with a scintillation cell (ZnS), not affected by air humidity. A radon monitor (RAD7, Durridge Company) was connected to a stainless steel radon chamber, equipped with the scintillation cell. Radon gas, extracted from an acidified RaCl2 source, was injected into the chamber and the amount of water molecules in the system was alternatively lowered or increased (from 0.00075 to 0.014 g of water in RAD7) by connecting the chamber to a desiccant or to a bubbling water bottle. The relative efficiency of the silicon detector with respect to the scintillation cell decreases with the growth of water molecules inside RAD7. This dependence, with a fixed i) electrostatic chamber geometry and ii) nominal high voltage, diverges during the humidification or the drying phase because it is in turn influenced by the length of interaction of polonium atoms with water molecules, which impacts on the size of ²¹⁸Po clusters and thus on the neutralization process. For water contents higher that 0.01 g in RAD7, this effect is greatly enhanced. Temperature in the investigated range (18.5–35.6 °C) does not affect the efficiency of electrostatic collection-based silicon detectors.Based on these experiments, admitting a certain error on the efficiency (from 1.8 to 7.5%, depending on the water content), proper corrections were developed to adjust soil radon readings, when a desiccant is removed. This operation is necessary if recent Non-Aqueous Phase Liquids (NAPLs) leakage has occurred in the subsoil to avoid the sorption and possible later release of radon by Drierite, with related partition between the solid and liquid phases (water and NAPL).



from Radiology via xlomafota13 on Inoreader http://ift.tt/1XKWQhG


from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1TUm4Jg
via IFTTT

Manual of Dietetic Practice 5e & Case Studies Set

This is a set comprising of the Manual of Dietetic Practice, 5th Edition and Dietetic and Nutrition Case Studies Read More...

from #Dental via xlomafota13 on Inoreader http://ift.tt/1OZPQXk
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1qZjXbw
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVSIMS
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGjU
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTogM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGTla
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMEZv
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/25xGDCM
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UeMGR7
via IFTTT

Methotrexate induced chronic hepatotoxicity

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Hemalatha Thiyagarajan, Seema P. Mohamed Ali, Karunai Kadhir Veluchamy.
55 year old male patient diagnosed to have psoriasis 2.5 years ago and was started on methotrexate 5 mg thrice weekly. Patient was symptomatically better and continued methotrexate without proper follow up. 2 months ago patient experienced abdominal pain and distension. Skin lesions worsened on discontinuing methotrexate but later subsided with treatment. 1 week ago, patient had abdominal pain, bleeding and ascites. Cumulative dose of methotrexate 1.8g; Liver function tests: total bilirubin- 2.0; direct - 1.0; platelet count: 58,000 cells/cu.mm; ascitic tap done and fresh frozen plasma was infused.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5uqs
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVSIMS
via IFTTT

Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Ravi Shankar Manchukonda, Chandrakantha Thippeswamy, Neha Krishnegowda, Narasimhamurthy Kalenahally Muthahanumaiah.
Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies) have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine) and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBinV
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTogM
via IFTTT

Proteinase 3-antineutrophil cytoplasmic antibody positive necrotizing vasculitis induced by ciprofloxacin

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Khalid Ahmed, Syeda Atia Qudsia, Syed Hani Abidi, Rabia Malik, Muhammad Awais, Abdul Rehman.
Granulomatosis with polyangiitis (Wegeners), microscopic polyangitis, and eosinophilic granulomatosis with polyangiitis are commonly grouped together as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitides. Many drugs and infections can induce serologic positivity for ANCA, while a few can precipitate overt ANCA-positive vasculitis. Although fluoroquinolones have been reported to cause ANCA-negative leukocytoclastic vasculitis (LCV), fluoroquinolones are not known to induce proteinase 3-ANCA (PR3-ANCA)-positive vasculitis. Here, we present the case of a middle-aged man who developed severe headache, purpura on legs and numbness in hands and feet after taking ofloxacin for 5 days. Subsequently, he was diagnosed with ANCA-negative LCV and treated with steroids and immunosuppressants. Thirteen years later, he inadvertently received intravenous ciprofloxacin and developed severe headache and epistaxis. Serologic testing at that time revealed elevated titers of PR3-ANCA. Biopsy of nasal septum revealed a mixed mononuclear and polymorphonuclear infiltrate without evidence of granuloma formation. He was treated with steroids and immunosuppressive therapy. Over the next several years, he remained stable with residual hearing loss and nasal septal deformity. This case provides the first evidence for a PR3-ANCA-positive necrotizing vasculitis induced by ciprofloxacin.


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp56bw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTqte
via IFTTT

Phenytoin induced drug rash with eosinophilia and systemic symptoms syndrome: a case report

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Yogesh Devaraj, Sathyanarayana Dasegowda Belagola, Ranga Swaroop Mukunda, Ravi Shankar Manchukonda, Puneetha Basavanaik, Aneesa K. Hasanabba, Priyanka Kumari.
DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. Although the death rate can reach 10%, rapid diagnosis and prompt withdrawal of the offending drug is the key to limit morbidity and mortality. The potential role of corticosteroids remains controversial. We report a case of a 45-year-old male patient who suffered a head injury, for which he was prescribed phenytoin. Five weeks later he developed features of DRESS syndrome including facial and peri-orbital oedema, generalized erythematous, maculo-papular rash, conjunctivitis, inguinal lymphadenopathy, leucocytosis, eosinophilia and elevated liver enzymes. Skin biopsy revealed acanthosis and spongiosis of epidermis and dense inflammatory cell infiltrate comprising eosinophils and lymphocytes. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that phenytoin was a probable cause for the adverse drug reaction (score-7). Phenytoin was immediately stopped and patient was treated with systemic corticosteroids. The patient improved dramatically within the next few days. Early recognition of symptoms of DRESS and immediate withdrawal of the offending drug followed by prompt treatment with corticosteroids and other supportive measures will ensure quick recovery and will avoid fatal outcomes.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UqBzHB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1RHTgxX
via IFTTT

Steroid induced central serous retinopathy following follicular unit extraction in androgenic alopecia

2016-05-31T00-28-17Z
Source: International Journal of Basic & Clinical Pharmacology
Rakesh Tilak Raj, Rajnish Raj, Anuradha Raj.
Dermatologists for various conditions and procedures commonly use corticosteroids worldwide. The development of central serous retinopathy is a lesser known complication occurring in


from Scope via xlomafota13 on Inoreader http://ift.tt/1sp5hnt
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1WVTt8D
via IFTTT