Binary ethosomes for the enhanced topical delivery and antifungal efficacy of ketoconazole

OpenNano, Journal Year: 2023, Volume and Issue: 11, P. 100145 - 100145

Published: March 25, 2023

This work aimed to prepare ketoconazole-loaded ethosomes and binary improve its skin delivery antifungal efficacy. A 32 factorial design was used optimize the formulate ethosomes. Ethosomes were evaluated for particle size, polydispersity index, zeta potential, percent drug entrapment efficiency, release, permeation deposition The size ranged from 78.99±16.72 321.53±10.41 nm decreased by increasing phospholipid ethanol concentrations. index values in range of 0.17±0.01 0.49 ± 0.04. efficiency 36.09±2.66 95.89±0.19 increased concentration while had opposite effect. smaller but similar potential compared with They significantly higher release (∼96%) (∼95%) through rat (93% 90%, respectively). Binary had, respectively 1.9 1.8-fold 5.3- 5.6-fold epidermis/dermis suspension. efficacy drug-loaded hydroalcoholic solution. Collectively, these results confirm nanocarriers enhance given their small sustained enhanced permeability.

Language: Английский

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COVID-19-associated mucormycosis in India: Why such an outbreak?

Journal de Mycologie Médicale, Journal Year: 2023, Volume and Issue: 33(3), P. 101393 - 101393

Published: May 9, 2023

Language: Английский

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Multimodal analysis of the COVID‐19‐associated mucormycosis outbreak in Delhi, India indicates the convergence of clinical and environmental risk factors

Mycoses, Journal Year: 2023, Volume and Issue: 66(6), P. 515 - 526

Published: Feb. 15, 2023

The aetiology of the major outbreak COVID-19-associated mucormycosis (CAM) in India spring 2021 remains incompletely understood. Herein, we provide a multifaceted and multi-institutional analysis clinical, pathogen-related, environmental healthcare-related factors during CAM metropolitan New Delhi area.We reviewed medical records all patients diagnosed with biopsy-proven (n = 50) at 7 hospitals Delhi, NCR area April-June 2021. Two multivariate logistic regression models were used to compare clinical characteristics cases COVID-19-hospitalised contemporary as controls 69). Additionally, meteorological parameters mould spore concentrations outdoor air analysed. Selected hospital fomites cultured. Mucorales isolates from analysed by ITS sequencing whole-genome (WGS).Independent risk for identified previously or newly diabetes mellitus, active cancer severe COVID-19 infection. Supplemental oxygen, remdesivir therapy ICU admission associated reduced risk. incidence peak was preceded an uptick preceding 3-4 weeks that correlated increasing temperature, high evaporation decreasing relative humidity. Rhizopus most common genus isolated, but also two uncommon Mucorales, Lichtheimia ornata. WGS found no clonal population patient isolates. No cultured fomites.An intersection host contributed emergence CAM. Surrogates access advanced treatment lower

Language: Английский

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Incidence and Mortality of COVID-19-Associated Invasive Fungal Infections Among Critically Ill Intubated Patients: A Multicenter Retrospective Cohort Analysis

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(4)

Published: March 28, 2024

Abstract Background An association between coronavirus disease 2019 (COVID-19)–associated invasive fungal infections (CAIFIs) and high mortality among intubated patients has been suggested in previous research. However, some of the current evidence was derived from small case series multicenter studies conducted during different waves COVID-19 pandemic. We examined incidence CAIFIs their associated using a large, database built throughout Methods retrospective analysis National COVID Cohort Collaborative (N3C) collected 76 medical centers United States January 2020 August 2022. Patients were 18 years or older after severe acute respiratory syndrome 2 infection. The primary outcomes all-cause at 90 days. To assess mortality, we fitted Cox proportional hazard models adjusting for confounders via inverse probability weighting. Results Out 4 916 229 with diagnosed study period, 68 383 (1.4%) met our cohort definition. overall CAIFI 2.80% (n = 1934/68 383). Aspergillus (48.2%; n 933/1934) Candida (41.0%; 793/1934) most common causative organisms. who underwent BAL 6.2% 83/1328). Following weighting, caused by (hazard ratio [HR], 2.0; 95% CI, 1.8–2.2) (HR, 1.7; 1.5–1.9) increased mortality. Systemic antifungals reduced 17% 24% Candida. Conclusions modest but higher 90-day patients. modified

Language: Английский

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Rhino-Orbito-Cerebral-Mucormycosis During the COVID-19 Second Wave in 2021 – A Preliminary Report from a Single Hospital

Clinical ophthalmology, Journal Year: 2021, Volume and Issue: Volume 15, P. 3505 - 3514

Published: Aug. 1, 2021

Purpose: To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during second wave in India. Patients Methods: A cross-sectional, single-center study was done on 60 cases probable CA-ROCM based clinical features supportive diagnostic nasal endoscopic findings and/or radiologic findings. with recent or active were included. The demographic profile, features, workup (microbiological, pathological radiological) analysed identify triggering for CA-ROCM. Results: age ranged from 29 75 years male–female ratio 3:1. duration between first positive report onset 0 47 days. Forty-nine (81.66%) had infection 11 (18.33%) at presentation. Thirty-five (58%) ocular/orbital involvement In affected eye, 10 no perception light rest visual acuity log MAR +1.5. Ocular manifestations ptosis (29), ophthalmoplegia (23), periocular tenderness edema (33), proptosis (14), black discoloration eyelids (3), facial palsy endophthalmitis (4), retinal artery occlusion (8), disc (4) pallor (5). Twenty-two (25%) neither received steroids nor oxygen. Thirty (50%) managed oxygen while 38 (63.3%) systemic steroids. most common factor diabetes 59 patients. average glycosylated hemoglobin (HbA1c) 10.31 ± 2.59%. Systemic Amphotericin B started all Radical surgical debridement performed 12 remaining planned. Conclusion: SARS-CoV-2 variant accompanying glycaemic dysregulation found be epidemic Keywords: treatment, CA-ROCM, orbital apex syndrome, ophthalmoplegia, arterial occlusion,

Language: Английский

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Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

Journal of Fungi, Journal Year: 2022, Volume and Issue: 8(1), P. 58 - 58

Published: Jan. 6, 2022

Invasive fungal disease (IFD) associated with Coronavirus Disease 2019 (COVID-19) has focussed predominantly on invasive pulmonary aspergillosis. However, increasingly emergent are non-Aspergillus infections including candidiasis, mucormycosis, pneumocystosis, cryptococcosis, and endemic mycoses. These poor outcomes, their management is challenged by delayed diagnosis due to similarities of presentation aspergillosis or non-specific features in already critically ill patients. There been a variability the incidence different IFDs often related heterogeneity patient populations, diagnostic protocols, definitions used classify IFD. Here, we summarise address knowledge gaps epidemiology, risks, diagnosis, COVID-19-associated other than

Language: Английский

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COVID-19 and Plethora of Fungal Infections

Current Fungal Infection Reports, Journal Year: 2022, Volume and Issue: 16(2), P. 47 - 54

Published: April 9, 2022

Language: Английский

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COVID-19-Associated Pulmonary Mucormycosis

Journal of Fungi, Journal Year: 2022, Volume and Issue: 8(7), P. 711 - 711

Published: July 5, 2022

COVID-19-associated mucormycosis (CAM) emerged as an epidemic in certain parts of the world amidst global COVID-19 pandemic. While rhino-orbital was well reported during pandemic, absence routine diagnostic facilities including lower airway sampling, pulmonary probably under-recognized. In this review, we have focused on epidemiology and management (CAPM). CAPM is a deadly disease mortality can be high 80% early clinical suspicion treatment. histopathological examination tissue for angio-invasion cultures remained gold standard diagnosis, there increasing interest molecular serological methods to facilitate diagnosis critically ill patients often, immune-suppressed hosts who cannot readily undergo invasive sampling. Combined medical surgical treatment offers more promise than standalone therapy. Maintaining adequate glycemic control prudent use steroids which double-edged sword are key preventative measures. We would like emphasize urgent need development validation reliable biomarkers diagnostics diagnosis.

Language: Английский

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Mucormycosis and COVID-19-Associated Mucormycosis: Insights of a Deadly but Neglected Mycosis

Journal of Fungi, Journal Year: 2022, Volume and Issue: 8(5), P. 445 - 445

Published: April 25, 2022

The ongoing COVID-19 pandemic has quickly become a health threat worldwide, with high mortality and morbidity among patients comorbidities. This viral infection promotes the perfect setting in for development of opportunistic infections, such as those caused by fungi. Mucormycosis, rare but deadly fungal infection, recently increased its incidence, especially endemic areas, since onset pandemic. COVID-19-associated mucormycosis is an important complication because it mycosis hard to diagnose treat, causing concern COVID-19-infected even already recovered population. risk factors these are related damage SARS-CoV-2 itself, patient’s overstimulated immune response, therapy used treat COVID-19, alterations hyperglycemia, acidosis, endothelial lung damage, immunosuppression. In this review, molecular aspects main explained understand virus–fungi–host interaction highlight importance neglected mycosis.

Language: Английский

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Mucormycosis in Indian COVID-19 Patients: Insight into Its Patho-Genesis, Clinical Manifestation, and Management Strategies

Antibiotics, Journal Year: 2021, Volume and Issue: 10(9), P. 1079 - 1079

Published: Sept. 6, 2021

Mucormycosis in patients who have COVID-19 or are otherwise immunocompromised has become a global problem, causing significant morbidity and mortality. Infection is debilitating fatal, leading to loss of organs emotional trauma. Radiographic manifestations not specific, but diagnosis can be made through microscopic examination materials collected from necrotic lesions. Treatment requires multidisciplinary expertise, as the fungus enters eyes nose may even reach brain. Use many antifungal drugs available limited by considerations resistance toxicity, nanoparticles overcome such limitations reducing toxicity increasing bioavailability. The lipid formulation amphotericin-B (liposomal Am-B) first-line treatment for mucormycosis patients, its high cost low availability prompted shift toward surgery, so that surgical debridement remove all lesions remains hallmark effective COVID-19. This review highlights pathogenesis, clinical manifestation, management

Language: Английский

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