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Register a new userThe Role of Azathioprine in Preventing Relapse During Prednisolone Reduction Period in Pemphigus Vulgaris Patients
دور الأزاثيوبرين في منع النكس خلال مدة تخفيض البريدنيزولون عند مرضى الفقاع الشائع
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خلفية البحث و هدفه: الفقاع الشائع مرض مهدد للحياة ناكس، الخط الأول في علاجه هو الستيروئيدات الجهازية، و نظراً إلى ارتفاع نسبة حدوث التأثيرات الجانبية للستيروئيدات عند مرضى الفقاع الشائع، فقد أُدخلت بعض مثبطات المناعة بوصفها أدوية مساعدة موفرة للستيروئيد، و من مثبطات المناعة هذه يذكر الأزاثيوبرين، و هو الأكثر استخداماً عند الأطباء، و لكن استخدامه لم يكن نتيجة لدراسات دقيقة، و لكن كان اعتماداً على خبرة الأطباء. هذا البحث يدرس علاقة الأزاثيوبرين مع حدوث نكس الفقاع الشائع خلال مدة تخفيض البريدنيزولون. مواد البحث و طرائقه: درس 70 مريض فقاع شائع من المرضى المراجعين لمشفى الأمراض الجلدية و الزهرية السنة الأولى لجمع العينة و المدة المتبقية لمتابعة المرضى,1\8\2008-29\5\2011 الجامعي خلال المدة بين قسموا إلى مجموعتين، الأولى :عولجت بالبريدنيزولون مع الأزاثيوبرين( 30 مريضاً). الثانية: عولجت بالبريدنيزولون وحده( 40 مريضاً). و بعد السيطرة على المرض خفَّضت جرعة البريدنيزولون تدريجيا حتى الوصول إلى الإيقاف، و جرت خلال ذلك متابعة المرضى من حيث النكس . النتائج: لم يلاحظ وجود أي فارق إحصائي ذي مغزى بين المجموعتين من حيث النكس، فإعطاء الأزاثيوبرين لم يقلل من نسبة النكس و لم يقلل من جرعة البريدنيزولون اللازمة لمنع النكس. الاستنتاج :في هذا البحث لم يظهر أي فائدة للأزاثيوبرين في منع النكس أو حتى إطالة مدة الهجوع عند مرضى الفقاع الشائع. لذلك ننصح بالمزيد من الدراسات لتأكيد ذلك ،مع ضرورة الحذر عند إعطائه.
Background& Objective: pemphigus vulgaris is a life threatening relapsing disease, the first line in its treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in pemphigus vulgaris patients ,some immunosuppressant drugs have been introduced as an adjuvant steroid sparing agents , and one of these immunosuppressants is azathioprine, which is the most used drug by therapists, but this use was due to experience and not due to strict studies , this research studies the relationship between azathioprine and relapse in pemphigus vulgaris patients during the prednisolone reduction period. Materials & Methods: 70 pemphigus vulgaris patients have been studied, from the patients of the dermatology university hospital during the period between 1/8/2008 -29/5/2011 (the first year for collecting the sample and the rest for follow-up) they have been divided into 2 groups. The first: were treated with prednisolone plus azathioprine (30 patients ), the second : were treated with prednisolone alone (40 patients ).and after the control of the disease the dose of prednisolone was reduced gradually ,till it was stopped, and patients were observed for relapse. Results: there was no meaningful statistical difference between the two groups in the terms of relapse, as giving azathioprine did not reduce the relapse rate, and did not reduce the prednisolone dose needed to prevent relapse. Conclusion: in this study no use of azathioprine in preventing relapse in pemphigus vulgaris patients, so we advise for more studies to confirm that, and to give more attention during its prescription.
References used
Mimouni D, Anhalt G J, MD; Deborah L,et al.Treatment of Pemphigus Vulgaris and Pemphigus Foliaceus With ycophenolate Mofetil, Arch Dermatol 2003 June; 139: 739-748
BURTON JL, GREAVES MW, MARKS J,et al. Azathioprine in Pemphigus Vulgaris. B Med J 1970; 3: 84- 86
Chams-Davatchi C, Daneshpazhooh M. Prednisolone dosage in pemphigus vulgaris , J AM ACAD DERMATOL 2005;53(3):547
SCULLY C, DE ALMEIDA O.P, PORTER S R, et al , Pemphigus vulgaris: the manifestations and long-term management of 55 patients with oral lesions, B J Dermatol 1999; 140: 84–89
Olszewska M. Risk of disease relapse after treatment discontinuation in pemphigus Vulgaris. J Am Acad Dermatol Feb 2008; AB84
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Pephigus vulgaris is a recurrent life threatening disease. Its basic treatment is
systemic steroids, after treating the first attack of the disease by systemic steroids we start to reduce the
dose of the steroids gradually. During this reduction th
e desease may flare up, this recurrence is routinely
treated by increasing the dose of the steroids again to control the disease, this study was made to compare
the benefits of tetracycline in controlling the recurrence of pemphigus vulgaris with the routinely used
way which is elevating the dose of prednisolone.
pemphigus vulgaris is a life threatening relapsing disease, the first line in its
treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in
pemphigus vulgaris patients, some immunosuppressant drugs have
been introduced as an adjuvant
steroid sparing agents, and one of these immunosuppressants is methotrexate, and in spite of the lack of
its use in pemphigus vulgaris, a few studies have shown an encouraging results of its use, and have advised
to carry out more studies about it as an immunosuppressant which has been omitted from usage in
pemphigus vulgaris for a long time.
The research aims to identify the role that foreign trade plays in the
Syrian economy,
They are an important part of the national economy, and which is
secured need the economy to build production capacity of capital
goods, and through the discha
rge of the flooding of the need for
domestic demand of the product, and therefore the external sector
developments reflect the productive structure of the national
economy, employment and price and income level. . and also the
effects of economic policies.
The researcher has addressed the economic reforms that directly
affect the foreign trade, and then analyzed the structure of the
foreign trade to discover the real economic potentials and the
necessary requirements for the promotion.
This study included 232 patient with acne between the ages of 12 and 38 years old.
Acne vulgaris was graded using Global Acne Grading System (GAGS). This study was
undertaken to detect the impact of acne vulgaris and related factors that may influe
nce the
quality of life (QoL). QoL was measured using a combination of skin disease-specific
(Dermatological Life Quality Index (DLQI)) and acne-specific (Cardiff Acne Disability
Index (CADI)) questionnaires.
The results showed significant impairment of QoL in acne patients , females were
more affected than the males, there was no association between age and quality of life
impairment and the impact was proportional to the severity of acne, more severe acne is
associated with greater effect on quality of life.
Background: cancer patients experience large physical and emotional challenges
related to side effects of chemotherapy drugs, which make coping and adaptation essential
issue for coping with disease. Aim: this study was conducted to identify coping
strategies
among cancer patients during chemotherapy and its relation with patient's age and gender
Methods: data were collected from 150 patients from Tishreen university hospital by using
brief coping questionnaire in addition to demographical sheet Results : the results
revealed that cancer patients tend to use various coping strategies which are problemfocused
and emotional- focused, reflected positive and negative coping. The most used
coping strategies were active coping strategy (78.66%), followed by seeking social support
for instrumental reasons strategy (76.66%), followed by planning strategy (76%), then
focus on and venting of emotions (75.33%), followed by acceptance strategy (70.66%),
then seeking social support for emotional reasons (68%), then turning to religion (58%).
Also results showed that coping strategies changed according to age and gender changing
(p < 0.05) where women tend to use emotional- focused coping strategies while aged
patients prefer emotional social support and acceptance. Conclusion: emotional issues for
cancer patients during chemotherapy require more concern with ongoing assessment for
adaptation and coping strategies, for designing appropriate interventions agreed with
coping behaviors which cancer patients demonstrate during treatment.
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