Neomycin 0.35% / Triamcinolone 0.1% ear drops

Abstract: Knuckle pads (KPs) are benign hyperkeratotic fibrous thickening skin disorder characterized by nodules or plaques located on the extensor surface of the joints. However, there are no specific treatments for KPs so far. Here, we reported a case of KPs successfully treated with 2% crisaborole ointment combined with triamcinolone acetonide and neomycin plaster. This combined therapy might be a new therapeutic option for KPs. Keywords: knuckle pads, crisaborole, PDE-4 inhibitors, primary, emerging therapy

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Introduction: L.) from Pangalengan, West Java, Indonesia, has shown promise due to its bioactive compounds. However, its potential for wound healing and anti-inflammatory effects, specifically for oral mucosal wounds, remains largely unexplored. Purpose: To evaluate the wound healing and anti-inflammatory activity of Granola potato peel ethanol extract (GPPEE) on the oral mucosa of Wistar rats based on histopathological analysis. Materials and Methods: Forty-eight Wistar rats were wounded on the palatal mucosa using a 4 mm punch biopsy and subsequently divided into four groups: placebo gel, 0.1% triamcinolone acetonide ointment (TCA), 4% GPPEE gel, and 6% GPPEE gel. The rats were euthanized on days 0, 1, 3, 7, and 14. Histopathological parameters assessed included fibroblast proliferation, collagen deposition, angiogenesis, and the presence of inflammatory cells. Results: Phytochemical screening revealed the presence of phenolic compounds, flavonoids, tannins, and alkaloids in the Granola potato peel ethanol extract (GPPEE). Significant differences in the number of inflammatory cells were observed on days 1, 3, 7, and 14 (p<0.05), with the groups treated with 4% and 6% GPPEE gel initially exhibiting pro-inflammatory effects on day 3, followed by significant anti-inflammatory effects on days 7 and 14. The 6% GPPEE gel treatment demonstrated a notable increase in fibroblasts on days 1, 7, and 14 (p<0.05), as well as collagen deposition on days 7 and 14 (p<0.05). However, no significant difference was observed in angiogenesis (p>0.05). Conclusion: The application of 4% and 6% GPPEE gel demonstrated superior wound healing efficacy compared to 0.1% TCA and exhibited comparable anti-inflammatory activity to 0.1% TCA.

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Purpose. We report a case of bacterial keratitis secondary to an undescribed Bergeyella sp. Bergeyella spp. are not easily cultured, and many reports have identified unculturable isolates through broad-range bacterial polymerase chain reaction (PCR). Observations. A healthy 29-year-old male was attempting to repair an acrylic cannabis water pipe when it shattered and a fragment hit him in the left eye. Two weeks later, he presented with foreign body sensation, scleral injection, and photophobia that were refractory to prolonged corticosteroid therapy. Following a subconjunctival triamcinolone injection, the patient developed a hypopyon and multifocal, midstromal, epithelized corneal infiltrates. Broad-range PCR of the aqueous fluid detected deoxyribonucleic acid closely matching the Bergeyella genus. Empiric treatment directed toward gram-negative bacteria led to the clinical resolution of the inflammation. Conclusions and Importance. This is the first reported case of ocular inflammation secondary to a Bergeyella spp.. As broad-range PCR testing becomes more accessible, we anticipate that additional PCR-positive and culture-negative scenarios will occur.

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Neurodermatitis and chronic eczema are characterized by severe itching and can lead to complications such as skin infections and folliculitis. Current treatment primarily involves glucocorticoid analogs which may be associated with side effects and lack of effective delivery strategies. The suspended ointment developed in this study aims to address these issues, offering improved therapeutic outcomes. The present study aimed to investigate the relationship between formulation/process variables versus the content uniformity and viscosity of neomycin sulfate and triamcinolone acetonide ointments and to explore the feasibility of using an in vitro approach to assess product sameness. Monofactor analysis was used to evaluate the impact of formulation and process variables. The new formulation was evaluated in terms of the prescription process, quality, stability, in vitro drug release behavior, and distribution of skin. The optimal prescription composition was 0.54% neomycin sulfate, 0.10% triamcinolone acetonide, 5.08% substrate A and 94.28% liquid paraffin. Quality and stability assessments confirmed that the formulation met the required standards for appearance and composition. Mathematical modeling of the drug release profile indicated that the release kinetics evaluated using the vertical diffusion cell method, closely aligned with first-order kinetics. Raman spectroscopy confirmed the successful penetration of triamcinolone acetonide into the skin, triamcinolone acetonide works primarily in the skin. Furthermore, skin irritation tests demonstrated that the formulation caused no detectable irritation. These results demonstrate that it can be a promising drug in treating neurodermatitis and chronic eczema.

Abstract licence: CC BY-NC-ND

Purpose: Refractory periorbital dermatitis has a chronic course with exacerbations leading to discomfort and cosmetic issues, yet characterization of treatment options is limited. Aims: The objective was to present comprehensive demographic data and medical management of a series of patients with refractory periorbital dermatitis. Settings and Design: Retrospective review identified patients treated at a single institution from January 2010 to August 2020. Methods: Descriptive analyses were performed. Demographic data and treatment history were reviewed and data including medication, use, date of use and discontinued use, reason for discontinuation (if applicable), refractory status, formulation, concentration, and dose frequency were extracted. Statistical Analysis Used: Descriptive analyses. Results: Forty-five patients were included. The average age at first diagnosis was 60.3 years (sd 14.9). 82.2% were women and 84.4% identified as Caucasian. Triamcinolone cream was most frequently used followed by tobramycin-dexamethasone, tacrolimus, and neomycin-polymyxin-dexamethasone. Less than 30% of patients on triamcinolone were refractory. 13.3% of patients used topical hydrocortisone, with over 80% of these patients experiencing refractory episodes of persistent irritation and erythema. Most patients were refractory during initial use or the first recurrence of periorbital dermatitis flare. Conclusions: By better characterizing the diverse treatment regimens in a unique subset of refractory patients, we hope to better inform potential courses of medical management for periorbital dermatitis.

Abstract licence: CC BY-NC-SA

This report aims to describe a case of tumor-like lymphoplasmacytic conjunctivitis in a 7-year-old spayed-female Pomeranian. On complete ophthalmic examination, a mass with papillary projections was noted on the bulbar surface of the right third eyelid. Debulking of the mass was performed while preserving as much of the third eyelid as possible. On the histopathological examination, the mass was diagnosed as lymphoplasmacytic conjunctivitis with mild epithelial hyperplasia. Although a slight regrowth of the mass was noted 3 weeks after surgery, intralesional injection of triamcinolone acetonide led to its disappearance. There was no further recurrence after 5 months.

Abstract licence: CC BY-NC-SA

Background: Acute otitis externa (AOE) is a common condition with multiple available treatments. This study aimed to compare gauze strips soaked in triamcinolone, neomycin, and nystatin with conventional eardrops for the treatment of AOE. Methods: This experimental study included patients with AOE referred to the Otolaryngology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, 2014-2015. Based on their signs and symptoms, patients were divided into two clinical groups of mild to moderate and moderate to severe AOE. Patients treated with polymyxin B, neomycin, and hydrocortisone (polymyxin NH), or ciprofloxacin plus betamethasone eardrops were regarded as controls (conventional eardrops), and those whose ear canal had been filled with a gauze strip soaked in triamcinolone, neomycin, and nystatin (triamcinolone NN) were regarded as cases. Results: A total of 76 ears were included in this study (36 and 40 cases with mild to moderate and moderate to severe AOE, respectively). After 24 hours, in both clinical groups with mild to moderate and moderate to severe AOE, response to treatment with triamcinolone NN-soaked gauze strips was significantly higher than conventional eardrops (94.4% vs. 11.1%, P&lt;0.001 and 80% vs. 10%, P&lt;0.001, respectively). Conclusion: Patients with mild to severe AOE appear to rapidly respond to gauze strips soaked in triamcinolone, neomycin, and nystatin.

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Aim/Background To develop and validate a sensitive, accurate, simple, precise and cost-effective receptive and understandable method for concurrent evaluation of Gramicidin, Neomycin and Triamcinolone acetonide and their related contaminants via UPLC. Materials and Methods This method includes the separation using a chromatographic Phenyl column (50 mmx2.1 mm, 1.7 µm). A portable stage of 0.1% TEA (Tri-Ethylamine) and acetonitrile in gradient elution mode with 0.5mL/Temperature and minimum flow rate were employed. At 230 nm, UV observations were made. The limitations for Linearity, quantification and recoveries were discovered being within the allowable range. With UPLC, this method was successfully tested and ICH Q2 (R1) recommendations. Results Gramicidin, Neomycin and Triamcinolone acetonide retention times were observed at 9.315 min,3.979 min and 1.697 min respectively. A gradient elution of Triamcinolone acetonide, Neomycin and Gramicidin involves phenyl column that flows from 0.5 mL/min and the column internal temperature were held constant. Mobile phase % TEA likewise acetonitrile was utilised. UV monitoring was brought at 230 nm. Conclusion This study created an entirely new, straightforward, quick, affordable, sensitive and easily accessible UPLC method for the coincident determination of Triamcinolone acetonide, Neomycin and Gramicidin bulky and ointment dose form. This method has the benefits of being less expensive, assessible, reliable, sensitive and reproducible. Under conditions of oxidation, (Neutral, basic and acidic) hydrolysis, photolysis, thermal stress and medicines degradative activities were investigated. The medications were discovered to be solid underheat, unstable, hydrolysis under acid, alkaline and oxidative circumstances. The Final application of the UPLC method to the commercial formulations followed the ICH recommendations.

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The dosage form iotrim (gramicidin, neomycin and triamcinolone) is a combination of two antibiotics (gramicidin and neomycin) and a steroid (triamcinolone). The antibiotics work by killing the bacteria that cause infections. The steroid blocks the action of chemical messengers (prostaglandins) that make the affected area red, swollen and itchy. Consequently, there was still a need to develop a simple, less time consuming and economical method for the simultaneous determination of gramicidin, neomycin and triamcinolone acetonide. The current work is an effort to develop a fast and reproducible LC-MS technique for the simultaneous estimation of gramicidin, neomycin and triamcinolone acetonide. The objective of the present procedure was to validate and develop a precise and accurate liquid chromatography-mass spectrometry (LC-MS) technique for the simultaneous quantification of gramicidin, neomycin and triamcinolone acetonide. Gramicidin, neomycin and triamcinolone acetonide were monitored on Shimadzu-8045 mass spectrometer equipped with electro spray ionization interface. The retention times of gramicidin, neomycin and triamcinolone acetonide were found at 9.145 min, 7.273 min and 2.435 min, respectively. The limit of detection (LOD) results for gramicidin, neomycin and triamcinolone acetonide were observed to be 0.15, 1.5 and 0.6 μg/mL, respectively while the limit of quantification (LOQ) results were observed to be 0.5, 5, 2 μg/mL concentration, respectively. The linear range for gramicidin, neomycin and triamcinolone acetonide were found in the concentration ranges from 1.25-7.5 μg/mL, 12.5-75 μg/mL and 5-30 μg/mL with regression coefficient of 0.9991, 0.9996, 0.9999, respectively. Accuracy values for gramicidin, neomycin and triamcinolone acetonide were found to be in the range of 98.64%, 99.4%, 99.5% respectively. The % RSD for six replicates in precision was less than 2%. According to ICH Q2(R1) recommendations, this method was successfully tested with LC-MS to confirm the chemical structures of newly produced degradation products of triamcinolone acetonide and neomycin. The developed process was validated efficaciously as per ICH guidelines.

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