OBJECTIVE: To assess the efficacy and safety of glucocorticoid in initial treatment of sudden hearing loss with intratympanic (IT) and systemic ways. METHOD: We searched the database of PubMed, Cochrane, Embase,CBM, CNKI, VIP, Wanfang systematically. Literatures were screened according to the preestablished inclusion and exclusion standards,and all the RCT literatures associated with intratympanic and systemic glucocorticoid in the initial treatment of sudden hearing loss before may 2015 were collected. All the data, which meet the inclusion standards, were analyzed by using Meta-analysis software. RESULT: Among all the qualified literatures, 11 randomized controlled trials were included. A total of 1298 cases were involved, including 521 cases with intratympanic administration, 410 with IV-therapy, and 201 with oral therapy. Meta analysis results showed that there was significant difference of the total effective rate and improvement rate between the intratympanic and systemic administration. Intratympanic injection (P > 0.05) was more effective than systemic administration. There was no significant difference between intratympanic group and oral group (RR = 1.15, 95% CI: 0.92-1.42, P > 0.05). A significant difference of the effective rate occurred between intratympanic group and IV therapy group (RR = 1.17, 95% CI: 1.02-1.34, P < 0.05). The major complications of intratympanic were pain, dizziness/vertigo, which occurred more frequently than systemic therapy group; The major complications of systemic therapy group were hyperglycaemia, loss of appetite and insomnia. CONCLUSION This study shows that the intratympanic (IT) glucocorticoid for sudden deafness is more effective than the systemic administration. But it was not the first choice in clinical treatment. Further studies are warranted.
Administration, Oral ; Glucocorticoids ; administration & dosage ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Hyperglycemia ; Injection, Intratympanic ; Randomized Controlled Trials as Topic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome

The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis. The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment. The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method. Microcrystalline cellulose was used as the filler and its effect was also studied. The prepared dosage forms were evaluated for physicochemical properties, in vitro release studies and mucoadhesive properties using sheep buccal mucosa as a model tissue. Tablets containing 50% of polymers (Carbopol & Noveon) were found to be the best with moderate swelling along with favorable bioadhesion force, residence time and in vitro drug release. The in vitro drug release studies revealed that drug released for 8 h, which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.
Acrylates ; administration & dosage ; chemistry ; pharmacokinetics ; Acrylic Resins ; administration & dosage ; chemistry ; pharmacokinetics ; Adhesiveness ; Administration, Buccal ; Animals ; Candidiasis, Oral ; drug therapy ; Cellulose ; administration & dosage ; chemistry ; Delayed-Action Preparations ; Drug Combinations ; Drug Stability ; Excipients ; Fluconazole ; administration & dosage ; chemistry ; pharmacokinetics ; Mouth Mucosa ; metabolism ; Polymers ; administration & dosage ; Sheep ; Tablets

Idiopathic granulomatous mastitis (IGM) is a rare and chronic benign disease of the breast. Histologically, the disease presents as an intense inflammatory reaction with non-caseated granulomas that are the characteristic symptom of the disease. No consensus exists on the best treatment modality for this disease. In this report, we present a patient with granulomatous mastitis who was treated successfully with low-dose oral and topical steroids. Our aim here is to discuss various approaches for IGM in view of the literature and present treatment with topical steroids, which has not been reported.
Administration, Cutaneous ; Administration, Oral ; Adult ; Biopsy ; Female ; Granulomatous Mastitis/diagnosis/*drug therapy ; Humans ; Magnetic Resonance Imaging ; Steroids/*administration & dosage ; Treatment Outcome

BACKGROUND/AIMS: Intranasal mupirocin and chlorhexidine bathing are candidate strategies to prevent healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). In Korea, intranasal mupirocin is not available, and mupirocin ointment, an over-the-counter drug, has been used indiscriminately. Furthermore, because it is covered by health insurance, mupirocin is easy to prescribe within hospitals. METHODS: We performed a mupirocin drug utilization review (DUR) within Hallym University Sacred Heart Hospital. Annual use of mupirocin was investigated between 2003 and 2013, and monthly consumption of mupirocin was assessed during the final 2-year period. The DUR focused on August 2012, the period of highest use of mupirocin. Also, we investigated trends in mupirocin resistance in MRSA between 2011 and 2013. RESULTS: Annual consumption of mupirocin increased from 3,529 tubes in 2003 to 6,475 tubes in 2013. During August 2012, 817 tubes were prescribed to 598 patients; of these, 84.9% were prescribed to outpatients, and 77.6% at the dermatology department. The most common indication was prevention of skin infections (84.9%), and the ointment was combined with systemic antibiotics in 62.9% of cases. The average duration of systemic antibiotic administration was about 7.8 days. The rate of low-level mupirocin resistance in MRSA increased from 8.0% to 22.0%, and that of high-level mupirocin resistance increased from about 4.0% to about 7.5%. CONCLUSIONS: Inappropriate use of mupirocin is prevalent. Considering the increase in resistance and the future application of intranasal mupirocin, prophylactic use of mupirocin in dermatology departments should be reconsidered.
Administration, Cutaneous ; Anti-Bacterial Agents/*administration & dosage/adverse effects ; Drug Prescriptions ; Drug Resistance, Multiple, Bacterial ; Drug Utilization Review ; *Hospitals, University ; Humans ; Inappropriate Prescribing/*trends ; Methicillin-Resistant Staphylococcus aureus/*drug effects ; Microbial Sensitivity Tests ; Mupirocin/*administration & dosage/adverse effects ; Ointments ; Practice Patterns, Physicians'/*trends ; Predictive Value of Tests ; Republic of Korea ; Retrospective Studies ; Staphylococcal Skin Infections/diagnosis/*drug therapy/microbiology ; Time Factors

OBJECTIVE: To explore the best time of intratympanic dexamethasone injection to treat sudden sensorineural hearing loss (SSNHL) as salvage therapy so that to improve the curative efficacy on sudden deafness at the utmost. METHOD: A total of 192 patients with SSNHL were included in this study, among whom 63 cases received the systemic steroid therapy throughout the study, while the other ones were treated with systemic steroid as initial treatment and were given intratympanic steroid administration as salvage treatment starting at different time point. The salvage treatment started on the 3rd day after the beginning of the initial treatment for 29 cases, on the 7th day for 38 cases, on the 14th day for 43 cases, and 1 month later for 19 cases. All the patients were followed up for 2 months. RESULT: The recovery rates and total effective rates showed no statistically significant difference between the patients received only systemic steroid therapy and the ones received intratympanic steroid administration on the 3rd, 7th day and 1 month later after the initial treatment. The recovery rate and total effective rate exhibited statistically significant difference between the patients received intratympanic steroid administration since the 14th day after the initial treatment and the ones received only systemic steroid therapy, with the numerical value of P 0. 037 and 0. 034, respectively. CONCLUSION (1) As an initial management plan, the curative effects. between the intratympanic steroid administration and the systemic steroid therapy were not significantly different. (2) As a salvage treatment, intratympanic steroid was a better choice for patients who have not completely recover from ISSNHL after failure of initial management with systemic steroid only. (3) The best time point of salvage treatment with intratympanic steroid was about 2 weeks after initial management with systemic steroid.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injection, Intratympanic ; Salvage Therapy ; Steroids ; therapeutic use ; Treatment Outcome ; Tympanic Membrane

We aimed to compare the recommendations of the Korean Medication Algorithm Project for Depressive Disorder 2012 (KMAP-DD 2012) with other recently published treatment guidelines for depressive disorder. We reviewed a total of five recently published global treatment guidelines and compared each treatment recommendation of the KMAP-DD 2012 with those in other guidelines. For initial treatment recommendations, there were no significant major differences across guidelines. However, in the case of nonresponse or incomplete response to initial treatment, the second recommended treatment step varied across guidelines. For maintenance therapy, medication dose and duration differed among treatment guidelines. Further, there were several discrepancies in the recommendations for each subtype of depressive disorder across guidelines. For treatment in special populations, there were no significant differences in overall recommendations. This comparison identifies that, by and large, the treatment recommendations of the KMAP-DD 2012 are similar to those of other treatment guidelines and reflect current changes in prescription pattern for depression based on accumulated research data. Further studies will be needed to address several issues identified in our review.
Depression ; Depressive Disorder* ; Drug Therapy ; Prescriptions

OBJECTIVE: To observe the efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss (SSNHL). METHOD: A total of 68 patients diagnosed with SSNHL were randomized into group A (45 cases including systemic steroid for 33 cases and systemic steroid + intratympanic steroid as supplementary treatment for 12 cases) and group B (23 cases, initial intratympanic steroid). Then observe the therapeutic effect in two groups. RESULT: The total effective rate was 55.6% in group A and 56.5% in group B. No statistical difference was detected between these two groups (P > 0.05). There was statistical difference after therapy of intratympanic steroid as supplementary treatment for 12 patients due to poor hearing improvement after systemic steroid in group A (P < 0.05). CONCLUSION Both systemic and intratympanic steroid injection for SSNHL are effective. The efficiency of intratympanic steroid injection as supplementary or initial treatment for SSNHL is similar to that of systemic steroid. The intratympanic steroid injection for SSNHL as initial protocol or as supplementary treatment when poor hearing improvement after systemic steroid is recommended.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injection, Intratympanic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome ; Tympanic Membrane

Administration, Cutaneous ; Administration, Oral ; Antiviral Agents ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Genotype ; Hepatitis C, Chronic ; blood ; drug therapy ; pathology ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; RNA, Viral ; blood ; Recombinant Proteins ; Recurrence ; Ribavirin ; administration & dosage ; therapeutic use ; Viral Load

Malignant tumor is one of the main causes for death in the world at present as well as a major disease seriously harming human health and life and restricting the social and economic development. There are many kinds of reports about traditional Chinese medicine patent prescriptions, empirical prescriptions and self-made prescriptions treating cancer, and prescription rules were often analyzed based on medication frequency. Such methods were applicable for discovering dominant experience but hard to have an innovative discovery and knowledge. In this paper, based on the traditional Chinese medicine inheritance assistance system, the software integration of mutual information improvement method, complex system entropy clustering and unsupervised entropy-level clustering data mining methods was adopted to analyze the rules of traditional Chinese medicine prescriptions for cancer. Totally 114 prescriptions were selected, the frequency of herbs in prescription was determined, and 85 core combinations and 13 new prescriptions were indentified. The traditional Chinese medicine inheritance assistance system, as a valuable traditional Chinese medicine research-supporting tool, can be used to record, manage, inquire and analyze prescription data.
Drug Prescriptions ; Humans ; Medicine, Chinese Traditional ; Neoplasms ; drug therapy

OBJECTIVETo analyze the efficacy of Methylprednisolone hemisuccinate intratympanic injection for refractory noise induced deafness.

METHODSOne hundred and twenty cases (215 ears) of noise induced deafness were treated with either hormone group (107 ears) or with non hormone group (108 ears). Following prior interventions, 145 ears went on to receive intratympanic Methylprednisolone hemisuccinate injection twice a week.

RESULTSAfter Intratympanic therapy, the total effective rate was 46.2%. 32 of 71 ears (45.1%) demonstrated hearing improvement in hormone group and 35 of 74 ears (47.3%) in non hormone group. The difference was statistically insignificant (P = 0.788).

CONCLUSIONIntratympanic therapy appears to provide additional treatment benefits for patients with refractory noise induced deafness who have been treated with prior interventions. The outcome is not affected by pretreatment with hormone.

Glucocorticoids ; therapeutic use ; Hearing Loss, Noise-Induced ; drug therapy ; Hearing Tests ; Humans ; Injection, Intratympanic ; Methylprednisolone Hemisuccinate ; therapeutic use ; Noise ; Treatment Outcome