March 9th, 2010
The causative agent for syphilis is Treponema pallidum, a spirochete. Syphilis is still fairly common disease (it is a sexually transmitted disease), despite presence of very effective antibiotics such as penicillin. At present globally more than 10 million people contact syphilis, annually. But there is a sharp decline of more than 95% in the past 50 years in the incidence of syphilis after advent of penicillin therapy to treat syphilis effectively.
The antibiotic of choice for treatment of syphilis is still penicillin for all the stages of syphilis. There is no reported incidence of resistance of Treponema pallidum to penicillin and hence still the drug of choice.
The CDC has given a guideline for treatment of syphilis in the year 2006 which is given below:
- Treatment of syphilis in Primary, secondary, and early latent phase of syphilis is Penicillin G benzathine (a single dose of 2.4 million units intramuscularly).
- Late latent phase, or cardiovascular involvement, CSF (cerebrospinal fluid) analysis should be done. If CSF is normal Penicillin G benzathine 2.4 million units intramuscularly weekly for 3 weeks. If CSF is abnormal it should be treated as neurosyphilis.
- Neurosyphilis, either symptomatic or asymptomatic is to be treated with aqueous penicillin G, 18–24 million units intravenously, given every 4 hourly (3–4 million units) or by continuous intravenous infusion. Alternative regimen is aqueous penicillin G procaine, 2.4 million units intramuscularly plus oral probenecid (500 mg every 6 hourly), both for 10–14 days.
- During pregnancy the treatment is same as with general population and according to stages.
- If patient is sensitive to penicillin, alternative includes Tetracycline hydrochloride (500 mg orally 4 times a day) or doxycycline (100 mg orally two times a day) for 14 days. Penicillin sensitive pregnant patients or patients with neurosyphilis have to be treated with penicillin after desensitization.
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February 25th, 2010
White and glistening teeth are desired by every men and women. Teeth whitening can be also sometimes called (although incorrectly) bleaching of teeth and it is part of cosmetic dentistry, which has become very popular, especially among young generation. You can get teeth whitening solutions at your nearest drug stores (to be used by yourself) or you can get the entire procedure done at your dentist’s clinic.
Many people have used teeth whitening but very few of the general population as well as the users of teeth whitening have adequate knowledge about teeth whitening. Due to lack of adequate knowledge about teeth whitening the misinformation is very much present among people (users as well as non users of teeth whitening). The most common misinformation people have is about the duration a single use of whitening solution or procedure at your dentist’s clinic can give. The fact is you need to use teeth whitening regularly to get a long lasting of permanent white and glistening teeth.
According to USFDA the term “bleaching” of teeth is whitening teeth beyond their natural white color and whitening is to restore natural white color of teeth if they are stained or discolored. But practically almost all the whitening solutions contain bleaching chemicals like hydrogen peroxide. Strictly speaking these whitening solutions containing beaching chemical should be called bleach (according to the USFDA definition), but they are called whitening solutions (most likely, whitening sound better than bleach).
Different individuals use whitening solutions for different purpose. Some use teeth whitening to remove stains and some individuals use teeth whitening to restore natural color and add some glaze in teeth.
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February 23rd, 2010
Hirsutism is generally treated by pharmacological (by use of drugs) means and mechanical or non pharmacological means. The general principle of management of hirsutism is to use mechanical or non pharmacological means of treatment of hirsutism, either alone or along with pharmacological means or by use of drugs. In other words in all cases of hirsutism mechanical or non pharmacological means should be tried and when it fails, pharmacological means should be used.
Mechanical or non pharmacological methods of treatment of hirsutism include removal of hairs by use of chemicals or simply shaving, removal of hair along with root of the hair follicles (by plucking, waxing, electrolysis and by using laser) and bleaching. These mechanical removal of hairs may be painful but use of laser is painless and gives good results, although the long tern efficacy and long term complication of laser treatment of hirsutism is not yet adequately studied. But laser treatment generally gives long lasting effects and in most cases hair removal is permanent. Even if the hair removal is not permanent, it delays the re-growth of hair for long.
The pharmacological treatment of hirsutism includes use of combined oral contraceptive pills, which contain both estrogen and progestin. The estrogen component used is ethinyl estradiol and progestin component used is norgestimate. The commonly used progestin in combined oral contraceptive pill is norgestrel or levonorgestrel, but these two have androgenic effects and not used in hirsutism. The newer generation progestin norgestimate is used in place of norgestrel or levonorgestrel.
Other drugs which are also used in treatment of hirsutism are spironolactone, cyproterone acetate, flutamide etc.
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