Superficial Fungal Infections Research Articles

Efficacy and Safety of Amorolfine Lotion 0.25% w/v Compared to Amorolfine Cream 0.25% w/w in Patients With Superficial Fungal Infections of the Skin: A Multi-center, Randomized, Open-Label, Active-Controlled, Non-inferiority Phase III Clinical Trial

Efficacy and Safety of Amorolfine Lotion 0.25% w/v Compared to Amorolfine Cream 0.25% w/w in Patients With Superficial Fungal Infections of the Skin: A Multi-center, Randomized, Open-Label, Active-Controlled, Non-inferiority Phase III Clinical Trial

A Pilot Real-World Study of Ultrasonography Findings of Hidradenitis Suppurativa in Indian Patients and Its Diagnostic and Therapeutic Implications

Abstract Introduction Hidradenitis suppurativa (HS) is a multifactorial chronic inflammatory follicular disorder affecting apocrine gland-bearing areas of the body. We conducted an observational study to assess the ultrasonography (USG) findings in suspected HS patients at a tertiary care center in North India over 6 months. Aim The aim of this article was to study the USG findings in HS and correlate clinical and USG findings and scoring systems in HS with stage wise treatments. Materials and Methods All patients with a clinical suspicion of HS underwent an USG examination after clinical examination with a probe of 18 Hz frequency. Hurley's staging of patients was used to stage clinically, and the HS-SOS scoring and Doppler changes were assessed on USG. The treatment was revised in case of a change in the USG grading of severity. Results A total of 23 patients suspected of HS underwent USG evaluation, of which 12 (52%) were male and 9 (48%) were females, with the mean age being 25.3 years (range: 14–40 years). Based on the HS clinical grading, eleven patients (47.8%) were Hurley's stage I, six patients (26%) were stage II, and six patients (26%) were stage III. USG demonstrated that three patients had been misdiagnosed and had folliculitis (8.6%) and Crohn's disease (4.3%). Out of the remaining twenty patients with USG features of HS, based on HS SOS grading, three patients (15%) were grade I, seven (35%) were grade II, and ten (50%) were grade III. Of these, nineteen patients (95%) had axillary involvement, which was bilateral in 84% of cases. The other region affected was the groin in five patients (26.3%), while two had inframammary involvement (10.5%). On further characterization of the type of lesion, nodules (41; 40.6%) were the most common type of lesion by sinuses and thickened hair follicles in 31 (30.6%) patients. Based on USG findings, the management of 26% of patients was changed from medical to surgical intervention. Conclusion USG and Doppler are noninvasive bedside tools for the examination of HS, which helps to rule out differentials and delineate the extent and depth of the disease better by picking up subclinical lesions and help in determining disease activity by Doppler, which in turn helps in planning appropriate medical and surgical management of patients. It also identifies radiological parameters that help identify patients who could fail medical management.

Assessing the impact of authorisation process as a regulatory tool in the European REACH regulation: A study on improving occupational safety for applying companies.

This study looks into the effectiveness of the authorisation procedure as a regulatory instrument within the framework of the European REACH regulation. It highlights its impact on enhancing occupational safety and health for both applicants and companies utilising the substances. This procedure encompasses manufacturers, importers, and downstream users of substances, as well as representatives of foreign manufacturers who are also eligible to seek authorisation. When applying for authorisation, the ECHA Risk Assessment Committee (RAC) assesses the risks associated with the intended uses of the substance, including the appropriateness and effectiveness of the Occupational Conditions (OCs) and Risk Management Measures (RMMs) described in the application and the risks posed by potential alternatives. If the RAC determines that the OCs/RMMs are inadequate for managing or controlling the risk, or if the measures to protect workers are deemed insufficient, it may recommend additional measures to enhance occupational safety and health or environmental protection. The 398 processed Applications for Authorisation (AfA) that have been submitted to date were examined to determine these recommended measures, categorised as Conditions for use, Monitoring arrangements, and Recommendations for Review Reports. Overall, a significant improvement concerning occupational safety and health seems necessary, as indicated by the large number of measures recommended by the ECHA Committee for Risk Assessment (RAC) and ECHA Committee for Socio-economic Analysis (SEAC) or supplemented by the European Commission. In addition to the proposed measures, a short assessment provided by the committees as to whether the operational conditions and risk management measures are adequate in controlling the risks is also included in the study.

Role of Sertaconazole in the Treatment of Dermatophytosis

Dermatophytosis is a major health burden worldwide and is now increasing day by day. Dermatophytosis is also becoming increasingly unresponsive to topical conventional antifungals now a day. Newer topical antifungals may be more effective in these patients. Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that may be effective and beneficial in improving the quality of life for the patient with dermatophytoses. It is indicated in the European Union(EU) for the treatment of superficial skin mycoses such as dermatophytosis (including tinea corporis, tinea cruris, tinea manus, tinea barbae and tinea pedis), cutaneous candidiasis, pityriasis versicolor and seborrhoeic dermatitis of the scalp, and in the US for tinea pedis only. Sertaconazole has broad-spectrum antifungal activity against dermatophytes of the Trichophyton, Epidermophyton and Microsporum genera, and yeasts of the genera Candida and Cryptococcus; additionally, it is effective against opportunistic filamentous fungi and Gram-positive bacteria. Moreover, the antifungal activity of sertaconazole is maintained in clinical isolates of dermatophytes that show reduced susceptibility to other azoles. While the drug has good dermal penetration, this is not associated with systemic absorption. In clinical trials in patients with superficial mycoses, 2% sertaconazole cream applied twice daily was effective in the eradication of a range of dermatophytoses, and a significantly greater proportion of patients were cured compared with those receiving 2% miconazole cream twice-daily treatment. Both as a topical cream and suppository preparation, sertaconazole was generally well tolerated. Sertaconazole is a well-established antifungal agent, which is now available in a variety of formulations, and remains a useful treatment option particularly in patients with fungal infections resistant to other azoles. Medicine Today 2023 Vol.36 (1): 62-66

Agency under German Occupation: Conservationist Policy-Making in The Netherlands, 1940–1945

The paper provides a political history of nature conservation in the Netherlands during the Second World War, 1940–1945. Nature and nature conservation were not mere victims of Nazi German oppression or destruction; rather, conservationist organisations clearly had agency under difficult circumstances. The movement’s leaders were accustomed to using informal contacts, semi-formal arrangements and back channel deals with government authorities and agencies, and continued to exert influence on the new Department of Education, Science and Protection of Culture with considerable success after 1940. Although these consultation structures and the Department’s power to impose measures by decree could not always prevent severe damage, this story sheds new light on the history of the nature conservation movement as an historical actor in its own right under the conditions of war and occupation. This article was published open access under a CC BY licence: https://creativecommons.org/licences/by/4.0 .

Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions.

Hand infection is a rare complication in patients with diabetes. Its clinical outcomes depend on the severity of hand infection caused by bacteria, but the difference in bacterial species in the regional disparity is unknown. The purpose of this study was to explore the influence of tropical and nontropical regions on bacterial species and clinical outcomes for diabetic hand. A systematic literature review was conducted using PubMed, EMBASE, Web of Science, and Google Scholar. Moreover, the bacterial species and clinical outcomes were analyzed with respect to multicenter wound care in China (nontropical regions). Both mixed bacteria (31.2% vs. 16.6%, p = 0.014) and fungi (7.5% vs. 0.8%, p = 0.017) in the nontropical region were significantly more prevalent than those in the tropical region. Staphylococcus and Streptococcus spp. were dominant in gram-positive bacteria, and Klebsiella, Escherichia coli, Proteus and Pseudomonas in gram-negative bacteria occupied the next majority in the two regions. The rate of surgical treatment in the patients was 31.2% in the nontropical region, which was significantly higher than the 11.4% in the tropical region (p = 0.001). Although the overall mortality was not significantly different, there was atendencytobeincreased in tropical regions (6.3%) compared with nontropical regions (0.9%). However, amputation (32.9% vs. 31.3%, p = 0.762) and disability (6.3% vs. 12.2%, p = 0.138) were not significantly different between the two regions. Similar numbers of cases were reported, and the most common bacteria were similar in tropical and nontropical regions in patients with diabetic hand. There were more species of bacteria in the nontropical region, and their distribution was basically similar, except for fungi, which had differences between the two regions. The present study also showed that surgical treatment and mortality were inversely correlated because delays in debridement and surgery can deteriorate deep infections, eventually leading to amputation and even death.

Hospital transfers for evaluation and treatment of hand infections: Are all transfers necessary?

BackgroundHand infections represent a common hand condition in the emergency department and one that frequently requires a hand specialist. The purpose of our study is to analyze hospital transfers for hand infections with a primary outcome being potential clinically avoidable transfers and to identify areas for improvement in the care of hand infections. MethodsRetrospective review of The Texas Healthcare Information Collection Database from 2015 to 2019. We analyzed all transfers for hand infections. Statistical analyses included: Transfer diagnosis, surgical interventions, length of stay (LOS), the day of the week that the transfer was initiated and whether or not the transfer or centralization was necessary or potentially avoidable. ResultsA total of 3489 patients were transferred from one hospital to another for the management of a hand infection. 1628 (46.6 ​%) underwent at least one surgical intervention and 1861 (53.3 ​%) were treated non-operatively. Patients undergoing operative interventions had a lower LOS compared to those non-operatively. Transfers admitted during the weekend had decreased average LOS relative to non-weekend transfers, but a 94.7 ​% increased odds of receiving a relevant surgical intervention during the hospital admission. Nearly all patients were transferred to urban region hospitals. Of total, 1194 (34.22 ​%) were considered potentially avoidable centralizations, which we defined as transfer that resulted in no surgical intervention and discharge to home within 72 ​h. ConclusionsAlthough the reason for centralization was unknown, our analysis showed a high number of transfers that could have been potentially avoidable. We propose the development of specific guidelines, and perhaps the use of remote consultations for areas where hand specialist are not reliably available to help optimize the care of patient with hand infections.

MANAGEMENT OF DADRU KUSHTHA THROUGH AYURVEDA – A CASE REPORT

Skin being the largest and a protective covering of all our internal organs is susceptible to many harmful environmental factors causing different kinds of bacterial, viral and fungal infections. All the skin disease in Ayurveda has been classified into Mahakushtha and Kshudra Kushtha. Dadru is one among them. As per modern perspective “Superficial fungal infection of skin” is the most common dermatological manifestation affecting up to 15% of world‟s population in all age groups. In present time, antifungal treatment is based on systemic and topical medications which may lead to many side effects and relapse too. Fungal infections are more demoralizing to the patients due to their appearance, recurrence, chronicity, and negative psychological impact. Keeping this fact in mind below mentioned study drafted to focuses on Ayurvedic Shamana and Shodhan Chikitsa in Dadru Kushtha. AIM AND OBJECTIVES –To evaluate the effect of Shodhana and Shamana Chikitsa in Dadru Kushtha. MATERIAL AND METHODS- It will be collected from classical Ayurvedic texts as well from previous research works / thesis, Internet sources, research articles and modern sciences text. DISSCUSSION AND CONCLUSIONS- On the basis of signs and symptoms we can correlated the Dadru Kushtha to Tinea Cruris. In This case report, a 67 yr old male patient came with complaints of Dadru Kushtha, which is closely similar to the presentation of Tinea Cruris infection. The present case showed significant improvement with Ayurvedic Shodhan, Shaman and Bahiparimarjan (topical) Chikitsa in Dadru.

Bedroom Concentrations and Emissions of Volatile Organic Compounds during Sleep.

Because humans spend about one-third of their time asleep in their bedrooms and are themselves emission sources of volatile organic compounds (VOCs), it is important to specifically characterize the composition of the bedroom air that they experience during sleep. This work uses real-time indoor and outdoor measurements of volatile organic compounds (VOCs) to examine concentration enhancements in bedroom air during sleep and to calculate VOC emission rates associated with sleeping occupants. Gaseous VOCs were measured with proton-transfer reaction time-of-flight mass spectrometry during a multiweek residential monitoring campaign under normal occupancy conditions. Results indicate high emissions of nearly 100 VOCs and other species in the bedroom during sleeping periods as compared to the levels in other rooms of the same residence. Air change rates for the bedroom and, correspondingly, emission rates of sleeping-associated VOCs were determined for two bounding conditions: (1) air exchange between the bedroom and outdoors only and (2) air exchange between the bedroom and other indoor spaces only (as represented by measurements in the kitchen). VOCs from skin oil oxidation and personal care products were present, revealing that many emission pathways can be important occupant-associated emission factors affecting bedroom air composition in addition to direct emissions from building materials and furnishings.

Antibiotic Resistance Mechanisms and Strategies for Combating Resistance in Germany

Purpose: The aim of the study was to explore antibiotic resistance mechanisms and strategies for combating resistance in Germany Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: antibiotic resistance represents a complex and evolving challenge to public health in Germany. Mechanisms such as efflux pumps, mobile genetic elements, and enzymatic degradation contribute to the resilience of bacteria against antibiotics. However, strategic interventions have been identified to combat resistance effectively. Exploration of alternative therapies like bacteriophage therapy offers promising avenues for addressing antibiotic-resistant infections, especially in light of increasing resistance rates. Unique Contribution to Theory, Practice and Policy: Evolutionary theory of antibiotic resistance & Game Theory in Antibiotic Stewardship may be used to anchor future studies on antibiotic resistance mechanisms and strategies for combating resistance in Germany. Implement antimicrobial stewardship programs across healthcare settings to optimize antibiotic use. These programs should involve prescriber education, antibiotic guidelines, and regular audits to promote appropriate prescribing practices and minimize unnecessary antibiotic exposure. Prioritize infection prevention measures, including hand hygiene, environmental cleaning, and infection control protocols, to reduce the spread of resistant pathogens within healthcare facilities and communities. Enact policies to regulate the use of antibiotics in human health, veterinary medicine, and agriculture. This includes restrictions on antibiotic use in food production, bans on over-the-counter antibiotic sales, and incentives for the development of new antibiotics.

Evaluation of Mixer of Essential Oils and their Standard Components against Fungi Causing Superficial Mycosis in Human

Evaluation of Mixer of Essential Oils and their Standard Components against Fungi Causing Superficial Mycosis in Human

Atypical and Unpredictable Superficial Mycosis Presentations: A Narrative Review.

While typically exhibiting characteristic features, fungal infections can sometimes present in an unusual context, having improbable localization (eyelid, face, or joint); mimicking other skin diseases such as eczema, psoriasis, or mycosis fungoides; and appearing with unexpected color, shape, or distribution. The emergence of such a challenging clinical picture is attributed to the complex interplay of host characteristics (hygiene and aging population), environment (climate change), advances in medical procedures, and agent factors (fungal resistance and species emergence). We aim to provide a better understanding of unusual epidemiological contexts and atypical manifestations of fungal superficial diseases, knowing that there is no pre-established clinical guide for these conditions. Thus, a literature examination was performed to provide a comprehensive analysis on rare and atypical superficial mycosis as well as an update on certain fungal clinical manifestations and their significance. The research and standard data extraction were performed using PubMed, Medline, Scopus, and EMBASE databases, and a total of 222 articles were identified. This review covers published research findings for the past six months.

Occupational Health and Safety Conditions Among SMEs: A Case Study Based in The District of BA, FIJI

After the implementation of the Occupational Health and Safety (OHS) Act in Fiji, larger organisations mainly managed to enforce the required section of the Act into their organisations through incorporation and amendment of policies and procedures, whereas Small and Medium Enterprises (SMEs) still struggle with basic administrative requirements and arising OHS issues. They face a variety of issues including OHS. Hence, their priority largely shifts to operation and smooth running of the businesses. The OHS issues are quite visible as the SMEs play a pivotal role in the Fijian economy, where more than half of the population are employed by the SMEs. This research is focused in the area of OHS in SMEs. A mixed method research was used to get the perspective of the participants for better understanding of the subject where both, qualitative and quantitative analysis were done to derive conclusions. For qualitative sampling, there were 20 participants including the employers and the employees, whereas for quantitative sampling, a total of 53 people including the employers and employees participated. For data collection, employers and employees from different companies in Ba, Fiji was selected. The results showed that for this research, qualitative methods gave better perspective of the participants about OHS conditions after which the solutions/recommendations were derived. Therefore, this study can be used for further research in the area to promote continuous improvements in the SMEs.

Myotonometry in machinery operators and its relationship with postural ergonomic risk.

To analyze the association between occupational ergonomic risk, personal characteristics, and working conditions with the biomechanical properties of stiffness and muscular tone in the paravertebral muscles of electric pallet jack and forklift operators in the industrial sector. A total of 75 industrial sector machine operators were evaluated in 2021. Personal characteristics and working conditions were assessed through a questionnaire. Ergonomic risk was assessed using the Rapid Entire Body Assessment (REBA) method, and biomechanical properties of stiffness and muscular tone were obtained using the Myoton Pro device. Stiffness in paravertebral muscles was compared based on the operated machine and observed ergonomic risk. A multilevel linear regression model was employed to quantify the relationship, with mean differences and 95% CI calculated. Very high ergonomic risk was found in 75% of the electric pallet truck drivers. In this group with the highest ergonomic risk, an association between biomechanical properties and older workers was observed. Additionally, among electric pallet truck drivers, stiffness (mean difference 335.9N/m, 95% CI: 46.4 (3.4 to 110.0), P < 0.05) and paravertebral muscle tone (mean difference 17.5 Hz, 95% CI: 1.4 (0.1 to 3.4), P < 0.05) showed statistically significant differences in the very high ergonomic risk category compared to the high-risk category. No significant differences were observed in any of the analyzed variables among forklift drivers. Workers operating electric pallet trucks with very high ergonomic risk according to the REBA method and aged over 40 yr are associated with increased muscle stiffness and tone.

A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood.

Hypertension is one of the main concerns in public health, since it is related with increased morbidity, and potential years of life lost in addition to loss of quality of life. This study aimed to assess: (1) the distribution of indicators of life course SEP in a cohort of Colombian patients with hypertension and (2) to assess the association of life course SEP and control of hypertension among this cohort of patients. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). Mother occupation and housing conditions were measured with the Event History Calendar. Mother educational level was measured with the questionnaire developed by the Project on Ethnicity and Race in Latin America (PERLA). Socioeconomic position during adulthood was measured using education, occupation, and income level based in the MacArthur Network. The group with a higher lifelong social position and the group of lower lifelong social position showed better control of hypertension (OR = 1.21; p <0.05; OR = 1.33; p < .05, respectively) compared to those whose social position throughout life varied the most. No statistical differences were found in the relations between single lifetime social position variables, and hypertension control in the three time points analyzed. These findings warrant further research to deeper our understanding on the role of a multidimensional and cumulative approach of social position in hypertension control.

Occupational health risk for women employed in industries with harmful working conditions

The preservation and strengthening of the health of the able-bodied population is the most important indicator of the socio-economic potential of the country.&#x0D; A modern working woman experiences the complex impact of adverse factors of the production environment and the labor process, which are potentially dangerous to health, contribute to the formation of production-related and occupational diseases.&#x0D; The study aims to analyze the occupational health risk of women employed in jobs with harmful working conditions at the processing plant of the mining and processing plant and the petrochemical complex of the Republic of Bashkortostan.&#x0D; Materials and methods. The authors studied the state of health by analyzing the occupational risk of female workers in contact with harmful production factors of a processing enterprise (407 people) and a petrochemical complex (473 people). The experts used clinical, functional, clinical and statistical research methods in their work and analyzed the levels and structure of chronic non-communicable diseases to determine the degree of industrial conditionality. The calculations were performed using the Microsoft Excel program.&#x0D; The combined effect of a complex of harmful production factors of the mining and processing plant (dust of polymetallic ores, chemicals, noise and severity of labor — class of working conditions 3.1) contributes to the development of chronic non-communicable diseases in female workers in 80.3±2.0% of cases, versus 54.6±4.4% of cases in the control group. A number of identified diseases have the character of production-related, while a very high degree of its conditionality is characteristic of diseases of the musculoskeletal system and connective tissue (RR — relative risk = 4.3, EF — etiological proportion = 75%), a high degree was inherent in respiratory diseases (RR=3.1; EF=67.7%). Diseases of the circulatory system (RR=1.6, EF=37.5%) and diseases of the nervous system (RR=1.58, EF=36.7%) had an average degree of occupational &#x0D; conditionality.&#x0D; In the workers of the main group of the petrochemical complex, chronic non–communicable diseases were diagnosed significantly more often than in the control, respectively — 84.0±1.7 and 67.0±3.5% of cases, p&lt;0.01. The combined effect on the workers of the complex of chemicals in combination with the intensity of the labor process associated with the 3-shift nature of work (class of working conditions 3.1), was the cause of the industrial conditionality of diseases of the nervous system, circulatory system, blood, digestive organs of moderate degree.&#x0D; Female employees of the enterprises of the concentrating plant of the mining and processing plant and the petrochemical complex, engaged in work with harmful working conditions, represent a "risk group" for the occurrence of changes from various organs and systems, depending on the current etiological production factors. Based on the indicators of the degree of occupational conditionality of a number of diseases in female workers, mining and petrochemical complexes belong to industries with a high and medium occupational risk of health disorders.&#x0D; Ethics. The survey of female employees was conducted with their informed consent, approved by the bioethical committee of the Institute. The fundamental documents are: "Ethical principles of conducting scientific medical research with human participation" (amendments 2008) of the Helsinki Declaration, as well as "Rules of Clinical Practice in the Russian Federation" (approved by Order of the Ministry of Health dated 06/19/2003 No. 266).

A systematic review of maternal exposures and the risk of autism spectrum disorders in their infants

Background Maternal exposures associated with autism spectrum disorder remain poorly understood. Objective The purpose of this systematic review was to assess the current understanding of maternal exposures and their associations with increased or decreased risk of infant autism. Study Design We searched Ovid MEDLINE databases and reference lists in 2021 for studies looking at maternal factors analyzed for an association with ASD. The primary outcome was autism or autism spectrum disorder diagnosis. Exposures were grouped as biomarkers, environmental, occupational, medication, genetic variability, and maternal illnesses and conditions. PRISMA guidelines were followed. Descriptive summary statistics were evaluated. Results Of 433 reports identified, 47 studies published between 2006 and 2021 fulfilled the inclusion criteria. Exposures consistently associated with a significant increased risk of autism spectrum disorder outcomes included: benzoate, 10-hydroxydecanoate, methyl jasmonate, 1-methylhistidine, nonanoic acid, organohalogens, ornithine, polyunsaturated fatty acids, agricultural pesticides, heavy metals (arsenic, cadmium, chromium, lead, low levels of manganese, tin), cigarette smoking, hypotaurine, indoor household pesticides, methanol, newborn complications at delivery, occupational exposures, solvents, strontium, urate, antibiotics, placental differently methylated regions, diabetes, maternal fever, maternal depression, androgen-associated conditions and psychiatric disorders. Factors consistently associated with a significant decreased risk included: quinoline, air conditioning, cesium, copper, 3-hydroxybutanic acid, maternal fruit consumption, mercury, and phenylalanine. Conclusions This review provides evidence that there are several potential pregnancy exposures and biomarkers associated with an autism spectrum disorder diagnosis in children. Genetic mutations may play role in impact of exposures’ risks. Continued work on identifying potential exposures and biomarkers is needed to better counsel pregnant individuals.

Molecular Pathway, Epidemiological Data and Treatment Strategies of Fungal Infection (Mycoses): A Comprehensive Review.

The recent increase in fungal infections is a health crisis. This surge is directly tied to the increase in immunocompromised people caused by changes in medical practice, such as the use of harsh chemotherapy and immunosuppressive medicines. Immunosuppressive disorders such as HIV have exacerbated the situation dramatically. Subcutaneous or superficial fungal infections can harm the skin, keratinous tissues, and mucous membranes. This category includes some of the most common skin disorders that impact millions of people worldwide. Despite the fact that they are seldom fatal, they can have a catastrophic impact on a person's quality of life and, in rare situations, spread to other people or become obtrusive. The majority of fungal infections under the skin and on the surface are simply and quickly cured. An opportunistic organism that preys on a weak host or a natural intruder can both result in systemic fungal infections. Furthermore, it might be exceedingly lethal and dangerous to one's life. Dimorphic fungi may pose a hazard to healthy populations that are not exposed to endemic fungi. Increased surveillance, the availability of quick, noninvasive diagnostic tests, monitoring the emergence of antifungal medication resistance, and research on the pathophysiology, prevention, and management of fungal infections are just a few potential solutions to these new health problems. The goal of this review is to summarize the data available for fungal infections and the different therapies which are involved in their treatment. Additionally, it also summarizes the molecular and scientific data of the plants which contain anti-fungal activity. Data are acquired using Google, PubMed, Scholar, and other online sources.

Epidemiological and mycological profile of superficial mycoses in diabetic patient

Introduction: Superficial mycoses, especially those of nails, scalp and skin, are very common in various countries. The presence of specific terrain, as well as other factors, can affect the prevalence of these. In this sense, diabetic patients are more susceptible to infections especially fungal infections because of changes in the immune system and macro and microvascular changes. The objective of our study was to determine the epidemiological and mycological profile of superficial mycoses in diabetic patients at the Mohammed VI Hospital in Oujda (Morocco). Material and methods: This is a retrospective, observational and descriptive study spread over 34 months, from January 2021 to October 2023 at the Parasitology-Mycology laboratory of the Mohammed VI Hospital Center of Oujda. We collected demographic and mycological data for the included patients. In the laboratory, upon reception of the samples, a direct examination (DE) of the sample was obtained after clarification by KOH to better visualize the mycelial filaments or yeasts and culture on both media: Sabouraud with chloramphenicol and Sabouraud with chloramphenicol and cycloheximide is systematically carried out. Results: We collected 136 diabetic patients referred to our laboratory for suspicion of superficial mycosis. The latter was confirmed in 46 of the 136 diabetic patients (33.82%) referred to our laboratory, which corresponds to 50 lesions among the 166 sites taken, a prevalence of 30.12%. At the mycological examination, the DE allowed the confirmation of the diagnosis of mycoses in 64% (n=32) and showed most often mycelial filaments (n=21; 65.62%) especially at the level of the feet and yeasts were observed in particular at the level of the nails of the hands (n=11; 34.37%). While culture was positive in all cases without exception (100%; n=50), dermatophytes were the most frequently isolated fungi (n=30; 60%), followed by yeasts (n=20; 40%). By species, T. rubrum (n=30; 60%) was the only isolated dermatophyte species, followed by Candida albicans (n=17; 34%). Conclusion: In recent years, we have seen an increase in the prevalence of superficial mycoses in diabetic patients which is why we conducted this study. The results show on the one hand that the most isolated fungi in the superficial mycoses of these patients are dominated by dermatophytes, as T. rubrum represents the most frequently encountered species. Furthermore, the high prevalence of the latter demonstrates the significance of implementing important prevention measures.

Two Decades of Insights into Nontuberculous Mycobacterial Hand Infections.

The objective of our study is to describe the clinical presentation, management, and outcome of a large cohort with nontuberculous mycobacteria (NTM) hand infection. We reviewed the medical records of all adults (≥18 years) managed at the Mayo Clinic (Rochester, MN) for NTM hand infection between 1998 and 2018. Our cohort included 81 patients. The median age was 61.3 (interquartile range 51.7, 69.6) years; 39.5% were immunocompromised, and 67.9% reported a triggering exposure preceding infection. Infection was deep in 64.2% and disseminated in 3.7%. Up to 16.0% received intralesional steroids because of misdiagnosis with an inflammatory process. Immunocompromised patients had deeper infection, and fewer reports of a triggering exposure. Mycobacterium marinum, Mycobacterium avium complex, and Mycobacterium chelonae/abscessus complex were the most common species. The median antibiotic duration was 6.1 (interquartile range 4.6, 9.9) months. Deep infection and infection with species other than M marinum were associated with using a greater number of antibiotics for combination therapy and an extended duration of treatment. Immunosuppression was also associated with longer courses of antibiotic therapy. Surgery was performed in 86.5% and 32.4% required multiple procedures. Ten patients, mostly with superficial infections, were treated with antibiotics alone. The 5-year cumulative rate of treatment failure was 30.3% (95% confidence interval, 20.9-44.0). Immunosuppression and intralesional steroid use were risk factors for failure. Treatment of NTM hand infection usually requires surgery and antibiotics, but antibiotics alone may occasionally be attempted in select cases. Immunosuppression and intralesional steroids are risk factors for treatment failure.