Atypical and Unpredictable Superficial Mycosis Presentations: A Narrative Review.

While typically exhibiting characteristic features, fungal infections can sometimes present in an unusual context, having improbable localization (eyelid, face, or joint); mimicking other skin diseases such as eczema, psoriasis, or mycosis fungoides; and appearing with unexpected color, shape, or distribution. The emergence of such a challenging clinical picture is attributed to the complex interplay of host characteristics (hygiene and aging population), environment (climate change), advances in medical procedures, and agent factors (fungal resistance and species emergence). We aim to provide a better understanding of unusual epidemiological contexts and atypical manifestations of fungal superficial diseases, knowing that there is no pre-established clinical guide for these conditions. Thus, a literature examination was performed to provide a comprehensive analysis on rare and atypical superficial mycosis as well as an update on certain fungal clinical manifestations and their significance. The research and standard data extraction were performed using PubMed, Medline, Scopus, and EMBASE databases, and a total of 222 articles were identified. This review covers published research findings for the past six months.

Fungal contamination of medical masks among forensic healthcare workers in the COVID19 era.

Background: Medical masks are widely used in health care settings to protect healthcare workers from respiratory infections, particularly in the context of the recent Covid-19 disease. Methods: A cross-sectional study of 52 used masks collected from 52 forensic healthcare practitioners was conducted to culture for fungal isolation and identification. A study of fungal contamination was conducted by making an impression of the mouth mask cut piece on Sabouraud agar for selective isolation; each health worker completed a questionnaire, which included age, sex, type of mask, and duration of mask use. Results: Twenty five of the 52 used masks tested positive for fungal contamination (48,08%). A total of 44% of the contaminated masks belong to health workers between the ages of 21-30 years. Surgical masks (80%), KN95 (8%), and N95 (4%) were the most contaminated protective devices. Usage duration of 1-2 h was associated with 4% of fungal contamination, while a usage duration of 5-6 h was associated with 36% of fungal contamination. Alternaria sp (32%), Penicillium sp (20%), Aspergillus sp (16%) were the most predominant isolated fungi discovered on the inside areas of the masks. Conclusion: Because fungi are known to cause allergies and serious adverse health effects following recommendations to properly wear a medical mask is critical to preventing fungal contamination, especially among health care workers who are wearing the same mask for a long period during the pandemic.

Fungal carriage of hospital trapped cockroaches: A prospective study.

Cockroaches are considered parasite carriers, and their nocturnal habits and regular contact with various environments make them ideal carriers of diverse fungal species. The aim of this study was to isolate superficial fungi carried by cockroaches trapped at our health care institution. A total of 100 cockroaches were captured from 6 wards of the hospital and were investigated for the presence of fungi on their external surface by using SDA medium. In this survey, 78% of the sampled cockroaches were contaminated with 96 fungi of medical importance, and the fungal prevalence was linked to some hospital areas, such as nephroplogy-haemodialysis p = 0,013 OR = 1367 IC95% (1199-1558), which could be explained by the presence of dialysis devices in which cockroaches can hide. Correlations were found between cockroach fungal contamination and the following variables: kitchen p = 0,026, OR = 1,349, IC95% (1190-1530); toilets p = 0,011, OR = 2,813, IC95% (0,868-9112); and patient rooms p = 0,01, OR = 3,621, IC95% (1322-9920), probably due to cockroaches searching for food among waste, garbage, skin flakes, and hair. The main fungi isolated were Rhizopus sp (21,9%), Candida non candida (16,7%), Aspergillus niger (15,6%), and Lichtheimia sp (12,5%). These results suggest that cockroaches act as carriers of several medically important fungi and could be involved in their transfer to hospital settings. There is a need for better control of these insects, especially in kitchens, bathrooms, and patient rooms.

Évaluation de la prescription et de l'utilisation des benzodiazépines dans la ville de Sidi Bel-Abbès / Evaluation of the prescription and use of benzodiazepines in Sidi Bel-Abbes city

Introduction :Une forte consommation des benzodiazépines (BZDs) a été remarquée en dehors parfois des règles de recommandations de prescription, ce qui rend leur consommation un problème majeur de santé publique. La présente étude a eu pour objectif d'évaluer la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès. Méthodes-Il s'agissait d'une étude descriptive transversale réalisée du 01 Février 2018 au 30 Juin 2018 évaluant la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès au moyen d'un questionnaire distribué aux patients de l'hôpital psychiatrique, du service de psychiatrie du CHU et aux pharmaciens d'officine.Le critère de jugement principal était l'évaluation de la prescription et de l'utilisation des BZDs dans cette ville. La saisie et l'analyse des données ont été réalisées par le logiciel SPSS. Résultats-Au total, 353 patients traités au moins par une BZD ont été inclus dont 178 hommes. Le taux de prescription des BZDs était de 1.10, des jeunes (59,77 %) et des personnes mariées (60,34%) constituaient les consommateurs privilégiés. La prescription était l'apanage des psychiatres, en monothérapie (07,42%), la molé cule la plus fréquemment prescrite était le Bromazépam (31,07%) et la prise noc turne était la plus importante (49,01%). Les BZDs étaient utilisées pour combattre l'insomnie (25,21%), l'anxiété (16,43%), pour une durée de plus d'une année (57,79 %). Conclusion-La prescription et l'utilisation des BZDs dans la ville de Sidi Bel-Abbès s'est avérée importante. L'insomnie et l'anxiété constituaient les principales raisons de leur utilisation, et le Bromazépam était la molécule la plus fréquemment utilisée .

Introduction-A high consumption of benzodiazepines (BZDs) has been noticed so metimes outside the rules of prescription recommendations, which makes their consumption a major public health problem. The present study aimed to evaluate the prescription and use of BZDs in Sidi Bel-Abbès city. Methods-: This was a descriptive cross-sectional study carried out from February 01st, 2018 to June 30th, 2018 evaluating the prescription and use of BZDs in of Sidi Bel-Abbès by means of a questionnaire distributed to patients from the psychiatric hospital, the CHU psychiatry department and community pharmacists. The primary endpoint was the assessment of the prescription and use of BZDs in this city. Data entry and analysis were performed using SPSS software. Results-A total of 353 patients treated with at least one BZD were included, including 178 men. The prescription rate of BZDs was 1.10, young people (59.77%) and married people (60.34%) were the privileged consumers. The prescription was the prerogative of psychiatrists, in monotherapy (07.42%), the molecule most frequent ly prescribed was Bromazepam (31.07%) and night intake was the most important (49.01%). BZDs were used to combat insomnia (25.21%), anxiety (16.43%), for a period of more than a year (57.79%). Conclusion-The prescription and use of BZDs in Sidi Bel-Abbès has proven to be important. Insomnia and anxiety were the main reasons for their use, and Bromazepam was the most molecule frequently used.

Analysis of Drug-Related Impurties by HPLC in Ciprofloxacin Hydrochloride Raw Material.

Objectives: In this study, we report the quality control results of drug-related impurity analysis of seven raw materials of ciprofloxacin hydrochloride marketed in Algeria. Materials and Methods: According to the European Pharmacopoeia (Eur. Ph.), high-performance liquid chromatography (HPLC) was used to analyze (B, C, D and E) impurities, while thin layer chromatography (TLC) used to control impurity A. Results: HPLC analysis showed that the C1, C2, C3, C4, and C6 samples have individual contents of specified impurities (B, C, D, E), unspecified and the total of all present impurities conform to norms. The C5 sample contains a very high content (0.579%) of impurity C, which is a photodegradation product and the impurities total (0.625%) exceeding limit, while C7 sample has a slightly higher content (0.118%) of unspecified impurity. The control solution of impurity A was not migrated in all developed TLC plates, so the system is not compliant, for this reason, an HPLC analysis protocol was developed. Conclusion: The results showed that impurity A content conformed in all samples except for the C6 sample, which has equal content to the limit. Therefore, we recommend revising the detecting technique of impurity A by TLC in the Eur. Ph. or replacing it with a more sensitive technique such as HPLC.

Delusional Parasitosis in a School Teacher Living in a Rural Area: Parasitological Approach.

Delusional parasitosis is a psychotic illness. Patients often present to dermatologists with scars that are self-inflicted because they attempt to extract the "parasites". We report a 58 -year-old female with an eight-month history of a crawling sensation on her skin and constant generalized itching, which she believed to be caused by insects and worms crawling across her skin. Examination revealed self-inflicted scratches at various stages of healing, which were limited to body parts within easy reach. The patient visited many physicians; it seems that she mutilated in an attempt to remove the offending organisms. She also presented skin scrapings and debris to her doctors, claiming that they contained worms and insects. Light pressure on the lesions did not produce any extrusion of macroparasites, and no parasites such as helminths and insect larvae (myiasis), were observed during microscopy. Thin smear scrapings were stained and examined to rule out parasitic diseases such as leishmaniasis and mycosis; however, no evidence of parasites was found. Our patient was administered with amisulpride 100 mg twice a day, which resulted in the complete remission of delusions after five weeks. The skin lesions were managed with clobetasol propionate ointment. A careful clinical examination combined with parasitological tests can be decisive in diagnosing delusional parasitosis, especially for patients from rural areas.