Background: Cutaneous warts present a therapeutic challenge because of recurrence and multiplicity and may become a frustrating condition for both patients and physicians. In the past few years, there has been an increase in intralesional immunotherapy for recurrent multiple warts not only because of its encouraging results in the treatment but also due to its ability to clear distant warts and preventing recurrence. Objective: The objective of this study was to evaluate the efficacy and safety of intralesional bacillus Calmette–Guerin (BCG) vaccine immunotherapy in the treatment of recurrent multiple warts. Materials and Methods: This study included 40 adult patients with multiple recurrent extragenital warts of different sizes, numbers, and duration, with or without distant warts. Patients were injected intralesionally with 0.1 ml BCG vaccine into the largest wart at a 3-week interval, directly without a pre-sensitization skin test, until complete clearance or for a maximum of three sessions. Follow-up was done every month for 3 months to detect any recurrence. Results: Out of the 40 patients enrolled in the study, 34 patients completed the treatment protocol of three injections and 3 months of follow-up and six patients discontinued for various reasons. Complete clearance of the lesions was achieved in 25 (73.53%) patients, partial clearance in 8 (23.53%) patients, and no response in 1 (2.94%) patient. Complete response was demonstrated in 75% of those presenting with distant warts. Therapy-related side effects were mild in the form of pain during injection, itching, erythema at the site of injection, and flu-like symptoms. None of the patients with complete response showed recurrence of lesions in a 3-month follow-up period. Conclusion: Intralesional BCG immunotherapy is a safe, effective, and promising treatment modality for recurrent multiple warts.
Introduction: Clostridium difcile infection (CDI) is dened as the presence of diarrheal symptoms and either a stool test result positive for C. difcile toxins or detection of toxigenic C. difcile, or colonoscopic ndings demonstrating pseudomembranous colitis. C.difcile produces toxin A (enterotoxin) and B (cytotoxin), under favorable conditions. Both toxins severely affect GIT. The relationship between the amount of toxins in the feces and the severity of symptoms has been found. Aim & Objectives : To detect C.difcile toxin production in stool samples with laboratory conrmed CDI and to correlate the presence of toxin with disease severity Material & Methods: A prospective laboratory based study done in a tertiary care Medical college and allied hospitals in Gwalior (MP) in a duration of 11 months, which included stool samples of 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected and correlated with the clinical condition. Toxin A & B study were performed on stool sample with ELFA (Enzyme Linked Fluorescent Assay) technology (VIDAS instruments). Results and Discussion: 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected in 08 patients. The toxin positivity rate was 6.79%. All of these hospitalized patients had severe diarrhea and history of administration of broad spectrum antibiotics Conclusion: Signicant toxin load in the fecal samples may be associated with the signicant deterioration of the general condition of the patient.
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