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Lupus Miliaris Disseminatus Faciei
Gharami Ramesh Chandra,Shome Kaushik,Mandal Manoj Kumar,Dadgupta Angira
Indian Journal of Dermatology , 2002,
Abstract: A forty-five year old male presented with acneiform eruptions on his face, biopsy of which revealed the presence of caseating granuloma. The diagnosis was made as lupus miliaris desseminatus faciei, which replased following various therapies. The case is reported for its late onset, persistent and relapsing nature.
Possible use of psyllium husk as a release retardant
Desai Angira,Shidhaye Supriya,Kadam V
Indian Journal of Pharmaceutical Sciences , 2007,
Abstract: Various hydrophilic polymers from synthetic origin such as methylcellulose, PEGs, HPMC as well as those from natural world such as guar gum, tragacanth, xanthan gum have been used to formulate oral sustained release formulations. Psyllium husk has the ability to swell 10-14 times of its original volume and form a hydrogel. It is biocompatible, inexpensive, inert, non-absorbable, environment friendly and easily available. However, its use as a release retardant has not been fully explored. Owing to large dose, high sensitivity to light, moisture and heat and also very short half-life of 1-2 h; formulation of sustained release dosage form of amoxicillin trihydrate is a challenge. Hence the present study has been undertaken to develop sustained release granules as well as matrix tablets of amoxicillin trihydrate using psyllium husk as a primary release retardant. The drug release of these formulations was compared with those containing HPMC K4M.The results showed insignificant difference in t80% value for drug release as assessed by student′s t-test at 5% level of significance. Selected formulations were kept at controlled conditions of 40o/75% RH and 30o/65% RH for a period of 3 mo. Microbiological assay was used as a stability indicating method of assay. Sustained release granules and tablet formulations containing HPMC alone were found to be more stable than the similar formulations containing husk with percent drug content at the end of 3 mo at 40o/ 75% RH being 92.66%, 93.81%, 86.74%, 88.31% and the rate of degradation being 8.46x10-4 d-1, 7.1x10-4 d-1, 1.58x10-3 d-1 and 1.38x10-3 d-1, respectively. Thus it was concluded that psyllium husk can be effectively used as a hydrogel polymer in sustained release formulations. However, there is a need to keep moisture level under control during and after formulation.
Profile of respiratory problems in patients presenting to a referral pulmonary clinic
Dasgupta Angira,Bagchi Anirban,Nag Saikat,Bardhan Sujan
Lung India , 2008,
Abstract: Analysis of OPD data of 2012 patients in a referral pulmonary clinic at Kolkata was done following a protocol-based approach. Obstructive airway diseases (COPD and asthma) were the most common (43%) problem followed by infective lung diseases (15%) including tuberculosis, bronchogenic carcinoma (8%), ILD (4%), haemopty-sis of undiagnosed etiology (4.5%), chronic cough of undiagnosed etiology (6.5%) and pleural diseases (4.6%). Other diseases like obstructive sleep apnoea, sarcoid-osis, systemic diseases with lung involvements etc., and non respiratory problems formed the rest (14.4%).
Attitudes toward Family Planning among HIV-Positive Pregnant Women Enrolled in a Prevention of Mother-To-Child Transmission Study in Kisumu, Kenya
Victor Akelo, Sonali Girde, Craig B. Borkowf, Frank Angira, Kevin Achola, Richard Lando, Lisa A. Mills, Timothy K. Thomas, Shirley Lee Lecher
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0066593
Abstract: Background Preventing unintended pregnancies among HIV-positive women through family planning (FP) reduces pregnancy-related morbidity and mortality, decreases the number of pediatric HIV infections, and has also proven to be a cost-effective way to prevent mother-to-child HIV transmission. A key element of a comprehensive HIV prevention agenda, aimed at avoiding unintended pregnancies, is recognizing the attitudes towards FP among HIV-positive women and their spouse or partner. In this study, we analyze FP attitudes among HIV-infected pregnant women enrolled in a PMTCT clinical trial in Western Kenya. Methods and Findings Baseline data were collected on 522 HIV-positive pregnant women using structured questionnaires. Associations between demographic variables and the future intention to use FP were examined using Fisher's exact tests and permutation tests. Most participants (87%) indicated that they intended to use FP. However, only 8% indicated condoms as a preferred FP method, and 59% of current pregnancies were unintended. Factors associated with positive intentions to use FP were: marital status (p = 0.04), having talked to their spouse or partner about FP (p<0.001), perceived spouse or partner approval of FP (p<0.001), previous use of a FP method (p = 0.006), attitude toward the current pregnancy (p = 0.02), disclosure of a sexually transmitted infection (STI) diagnosis (p = 0.03) and ethnic group (p = 0.03). Conclusion A significant gap exists between future FP intentions and current FP practices. Support and approval by the spouse or partner are key elements of FP intentions. Counseling services should be offered to both members of a couple to increase FP use, especially given the high number of unplanned pregnancies among HIV-positive women. Condoms should be promoted as part of a dual use method for HIV and STI prevention and for contraception. Integration of individual and couple FP services into routine HIV care, treatment and support services is needed in order to avoid unintended pregnancies and to prevent mother-to-child HIV transmission.
Outcomes in a Cohort of Women Who Discontinued Maternal Triple-Antiretroviral Regimens Initially Used to Prevent Mother-to-Child Transmission during Pregnancy and Breastfeeding—Kenya, 2003–2009
Timothy D. Minniear, Sonali Girde, Frank Angira, Lisa A. Mills, Clement Zeh, Philip J. Peters, Rose Masaba, Richard Lando, Timothy K. Thomas, Allan W. Taylor, for the Kisumu Breastfeeding Study Team
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093556
Abstract: Background In 2012, the World Health Organization (WHO) amended their 2010 guidelines for women receiving limited duration, triple-antiretroviral drug regimens during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV (tARV-PMTCT) (Option B) to include the option to continue lifelong combination antiretroviral therapy (cART) (Option B+). We evaluated clinical and CD4 outcomes in women who had received antiretrovirals for prevention of mother-to-child transmission and then discontinued antiretrovirals 6-months postpartum. Methods and Findings The Kisumu Breastfeeding Study, 2003–2009, was a prospective, non-randomized, open-label clinical trial of tARV-PMTCT in ARV-na?ve, Kenyan women. Women received tARV-PMTCT from 34 weeks' gestation until 6-months postpartum when women were instructed to discontinue breastfeeding. Women with CD4 count (CD4) <250cells/mm3 or WHO stage III/IV prior to 6-months postpartum continued cART indefinitely. We estimated the change in CD4 after discontinuing tARV-PMTCT and the adjusted relative risk [aRR] for factors associated with declines in maternal CD4. We compared maternal and infant outcomes following weaning–when tARV-PMTCT discontinued–by maternal ARV status through 24-months postpartum. Compared with women who continued cART, discontinuing antiretrovirals was associated with infant HIV transmission and death (10.1% vs. 2.4%; P = 0.03). Among women who discontinued antiretrovirals, CD4<500 cells/mm3 at either initiation (21.8% vs. 1.5%; P = 0.002; aRR: 9.8; 95%-confidence interval [CI]: 2.4–40.6) or discontinuation (36.9% vs. 8.3%; P<0.0001; aRR: 4.4; 95%-CI: 1.9–5.0) were each associated with increased risk of women requiring cART for their own health within 6 months after discontinuing. Conclusions Considering the serious health risks to the woman's infant and the brief reprieve from cART gained by stopping, every country should evaluate the need for and feasibility to implement WHO Option B+ for PMTCT. Evaluating CD4 at antiretroviral initiation or 6-months postpartum can identify pregnant women who would most benefit from continuing cART in settings unable to implement WHO Option B+.
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