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Superficial Fungal Infection of the Skin in Patients with Rheumatoid Arthritis after Methotrexate Therapy

Author: Firas Elias Douri
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 4 Pages: 352-355
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Fungal infection of the skin is common disorder characterized by recurrent candidal skin infection, tinea cruris ,tinea (pityriasis) versicolor and candidal infection of the nails in patients suffered of rheumatoid arthritis (R.A.) and treated by methotrexate.AIM OF THE STUDY:To discover the fungal skin complications after usage of methotrexate in the treatment of patients with Rheumatoid arthritis.METHOD:Thirty two patients with R.A. were enrolled in the study who received 7.5 mg methotrexate and daily 100mg diclofenac for six months in comparison to 32 patients with R.A. who received only daily100 mg diclofenac as treatment.RESULTS:Ten patients (31.2%) developed fungal infection of the skin and nails, 5 [16%] patients with tinea versicolor of the body, 3 [9%] patients with tinea cruris and [6%] two patients had paronychia .The control group did not develop any skin or nails fungal disorders.CONCLUSION:Superficial fungal infection was a common problem among RA patients treated with methorexate.


Article
Cyclophosphamide and Doxorubicin but Not Methotrexate Responsible For Rapid Development of the Resistance to Ciprofloxacin in Uropathogenic Escherichia Coli in Vitro

Author: Ibtesam Ghadhban Auda
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 71-75
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: The effect of anticancer chemotherapies on mammalian cells had been studied previously but few studies are performed to study the reaction of the bacterial cell toward mutagenic chemotherapies. We sought to study the effect of some anticancer chemotherapies on the rapid development of resistance to ciprofloxacin in ciprofloxacin susceptible uropathogenic E.coli (UPEC) in vitro. METHODS: Two methods of mutation induction are performed, modified Ames test and modified tube method. Cyclophosphamide, doxorubicin and methotrexate (MTX) at plasma concentration tested as mutagenic drugs towards ciprofloxacin resistance in UPEC. Disc diffusion test for antibiotic susceptablity is also used. Chi-square test test and pooled t test are used for statistical analysis. RESULTS: - Antibiotic susceptibility test; Multidrug resistance (70%) was found in the UPEC isolates and is often associated with the isolates of leukemic patients (P<0.05). About 90% of these isolates showed resistance to antibiotics which had been received previously by the leukemic patients during the administration of anticancer chemotherapies (P<0.01). - Mutation induction: In modified Ames test, a growth zone of 25mm and 24mm around the cyclophosphamide and doxorubicin containing discs respectively are developed. But no bacterial growth is noticed around both MTX and control discs. In modified tube method, ciprofloxacin susceptible UPEC developed resistance to it gradually during 72 hours. UPEC in doxorubicin, MTX containing broth and control broth still susceptible. CONCLUSION: We conclude that the mutagenic effect of cyclophosphamide and doxorubicin may be responsible for the relapsing during antibiotic treatment of urinary tract infections in patients treated with these drugs and perhaps other mutagenic anticancer chemotherapies

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