scholarly journals Efficacy and Safety of Miltefosine in Treatment of Post-Kala-Azar Dermal Leishmaniasis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shyam Sundar ◽  
Anup Singh ◽  
Jaya Chakravarty ◽  
Madhukar Rai
Keyword(s):  
Adverse Effect ◽  
Visceral Leishmaniasis ◽  
Exploratory Study ◽  
Protocol Analysis ◽  
Complete Disappearance ◽  
Efficacy And Safety ◽  
Kala Azar ◽  
One Year

Background. Long regimens for the treatment of post-kala-azar dermal leishmaniasis (PKDL) result in noncompliance. A safe, effective, and acceptable regimen for the treatment of PKDL is still to be developed. Miltefosine has been found to be effective in the treatment of Visceral Leishmaniasis (VL). Hence, its efficacy was tested in patients of PKDL.Methods. In this exploratory study, 33 patients with PKDL aged 10 years and above were administered miltefosine (50 mg for those weighing <25 kg or 100 mg in divided doses for those ≥25 kg and 2.5 mg per kg for children) for 12 weeks and followed up for one year to find out the efficacy.Results. Out of 33 patients, 3 patients withdrew consent. Treatment was stopped due to adverse effect in 1 patient. 28 (96.6%) got cured with complete disappearance of lesion while 1 patient (3.4%) failed treatment by protocol analysis.Conclusion. Miltefosine was found to be effective and safe in the treatment of PKDL.

scholarly journals Efficacy and Safety of Paromomycin in Treatment of Post-Kala-Azar Dermal Leishmaniasis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Shyam Sundar ◽  
Anup Singh ◽  
Anurag Tiwari ◽  
Saurabh Shukla ◽  
Jaya Chakravarty ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Protocol Analysis ◽  
Complete Disappearance ◽  
Efficacy And Safety ◽  
Multidrug Therapy ◽  
Cure Rate ◽  
Duration Of Treatment ◽  
Treatment Regimens ◽  
Kala Azar ◽  
One Year

Background. Post-kala-azar dermal leishmaniasis (PKDL) plays an important role in maintaining endemicity of visceral leishmaniasis and its transmission. Treatment regimens for PKDL are toxic and require 3-4 months of hospitalization. These long and arduous regimens result in extensive noncompliance. There is an urgent need to develop a safe, effective, and acceptable regimen for the treatment of PKDL. Paromomycin (PM) has been recently approved in India for treatment of visceral leishmaniasis (VL); hence we tested its efficacy in patients with PKDL. Methods. In this exploratory study, 31 patients with PKDL aged 10 years and above were administered PM 11 mg/kg daily intramuscularly for 45  days and followed up for one year. Results. Out of 31 patients, 7 patients were lost to followup at 1  year and 9 (37.5%) got cured with complete disappearance of lesion, while 15 (62.5%) showed no improvement by per protocol analysis. Conclusion. Cure rate with 45 intramuscular injections of PM was unacceptably low though there was no serious side effect of the drug. Whether paromomycin can be used in multidrug therapy to shorten the duration of treatment should be the next logical step for investigation.

scholarly journals Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

2019 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
Ishrat Sharmin ◽  
AKM Quamruzzaman ◽  
Rezina Parveen ◽  
M Abdulah Yusuf ◽  
Rashida Akter Khanam
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Kala Azar ◽  
History Of ◽  
One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

scholarly journals Efficacy and Safety of Paromomycin for Visceral Leishmaniasis: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Pashupati Pokharel ◽  
Rakesh Ghimire ◽  
Pratik Lamichhane
Keyword(s):  
Systematic Review ◽  
Drug Resistance ◽  
Visceral Leishmaniasis ◽  
South America ◽  
South Asia ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
Efficacy And Safety ◽  
Kala Azar ◽  
Resource Limited

Visceral leishmaniasis, also known as kala-azar is one of the most commonly neglected tropical diseases affecting a large number of rural and resource-limited people in South Asia, Africa, and South America. Paromomycin, an aminoglycoside drug, is frequently used for the treatment of visceral leishmaniasis. Despite limited therapies for visceral leishmaniasis and emerging drug resistance, a proper review on the action of paromomycin for kala-azar is lacking. This systematic review aims to look for the efficacy and safety aspects of paromomycin for the treatment of visceral leishmaniasis.

scholarly journals Clinical and haematological parameters associated with patients of visceral leishmaniasis in a district of North Bihar

2017 ◽  
Vol 4 (6) ◽  
pp. 1957
Author(s):  
Kumar Saurabh ◽  
Shilpi Ranjan ◽  
Rajeev Ranjan Prasad
Keyword(s):  
Visceral Leishmaniasis ◽  
Blood Parameters ◽  
Haematological Parameters ◽  
Poor Control ◽  
Medical College ◽  
Kala Azar ◽  
Retrospective Data Collection ◽  
Bleeding Manifestation ◽  
Common Sign ◽  
One Year

Background: Visceral leishmaniasis is highly endemic in West Champaran district of Bihar. This endemicity is supposed to be due to poor hygiene and sanitation and poor control of vectors. This study was done to study clinical and haematological parameters of Kala-azar patients in this area.Methods: A retrospective data collection was done in a medical college of north Bihar. Study duration was one year from January 2016 to December 2016. 43 cases, rk-39 positive from 13 blocks of W. Champaran admitted at medical college were studied for clinical and haematological parameters.Results: Bhitha was the highest affected block (25.58%) followed by Manjhaulia (23.25%) Fever was the commonest presentation whereas splenomegaly was the most common sign. Pallor was seen in 90 % cases and hepatomegaly in 60 % cases. Patients presented with bleeding manifestation in 9.3% cases and lymphadenopathy in 6.9% cases. Among blood parameters anaemia was seen in 93% cases and thrombocytopenia in 83%. Microcytic hypochromic blood picture was the most common peripheral blood picture.Conclusions: Extensive epidemiological investigation is needed to find out hidden cases in this area. 

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

scholarly journals Disappearance of Gastric Hyperplastic Polyps after the Discontinuation of Proton Pump Inhibitor in a Patient with Liver Cirrhosis

2021 ◽  
pp. 202-209
Author(s):  
Kengo Yasugi ◽  
Ken Haruma ◽  
Miwa Kawanaka ◽  
Mitsuhiko Suehiro ◽  
Jun Nakamura ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Upper Gastrointestinal Endoscopy ◽  
Complete Disappearance ◽  
Hyperplastic Polyps ◽  
Cell Hyperplasia ◽  
Greater Curvature ◽  
One Year ◽  
Epithelium Cells

Here, we report on a rare case of gastric hyperplastic polyps which disappeared after the discontinuation of proton pump inhibitor (PPI). The patient was an 83-year-old woman with liver cirrhosis and portal hypertension, along with gastroesophageal reflux disease treated by PPI. An initial upper gastrointestinal endoscopy showed unique polypoid lesions in the greater curvature of the stomach. Biopsy specimens of the lesions were diagnosed as hyperplastic polyps and she was followed. One year later, a second endoscopy showed that the lesions had increased in number and size, and an endoscopic mucosal resection (EMR) was performed for the main polyps. The resected specimens indicated a proliferation of foveolar epithelium cells with an increase of capillary ectasia and parietal cell hyperplasia, which was thought to be induced by hypergastrinemia from the PPI. Three months after the EMR, she was admitted because of bleeding from the remaining polyps along with an increase in new polyps. After conservative treatment, PPI was stopped and rebamipide was used. One year and 6 months later, an endoscopy showed the complete disappearance of all gastric polyps.

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