Swapnil Lokegaonkar

Abstract

Dermatophytosis is one of the most common cutaneous fungal infections in India. Despite, quite a few numbers of antifungal agents available for treatment, the resistance to antifungals by dermatophytes is increasing day by day as seen by doctors in clinical practice. Itraconazole has shown good results in the treatment of dermatophytosis at doses of 100 mg once a day for 2 weeks and with 200 mg once a day for 7 days. However, there are multiple itraconazole brands available in India. In this study, five different itraconazole brands were evaluated in vitro for MIC values against clinical isolates of Trichophyton mentagrophytes and Trichophyton rubrum by two different methods i.e. broth dilution and disc diffusion tests. It was found that the Reference brand of itraconazole and the test brand of Itraconazole showed least MIC values as compared to other available brands. Keywords: MIC, Itraconazole, Trichophyton mentagrophytes, Trichophyton rubrum broth dilution

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Abstract

Immunology forms the basis for effective treatment strategies and production of vaccines. In COVID 19 immune insufficiency may increase viral replication while uncontrolled immunity may result in tissue damage. The angiotensin converting enzyme receptors on alveolar type 2 cells of lungs act as target cells are the sites of Corona virus attack. These cells through cytokines or interferons initiate an early local response which may control the infection. However, in COVID-19 this interferon response can be subdued or lagging which may allow the COVID virus to escape detection by the innate immunity or depress the downstream reaction leading to unchecked SARS-COV-2 replication. The suppression of host responses leads to increase in pro-inflammatory cytokines and the resulting inflammatory damage leads to a release of suppressive cytokines as a counter regulatory response. This is the cytokine storm. Thus, immuneregulatory treatments that may succeed are the ones that are in real time tuned to the subject's immunophenotype, where immunosuppression may be helpful at some points while immune-stimulation in others.   Keywords: Angiotensin converting enzyme, COVID- 19, Cytokines.

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