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Terbinafine Tablets for Fungal Infections

Terbinafine hydrochloride is a synthetic drug which is very hydrophobic in nature. This is the reason it tends to accumulate inside nails, skin and fatty tissues.

The drug is available in the form of a white crystalline powder. It is very soluble in dichlromethane, methanol and ethanol and is only slightly soluble in water.

How does it work at the cellular level?

This drug falls under the category of allylamines. Its basic function is to inhibit ergosterol synthesis by preventing the formation of an integral part of the fungal cell wall. This changes the permeability of the cell wall and causes fungal cells to die.

When is Terbinafine prescribed?

This medicine is recommended especially for the treatment of the dermatophyte group of fungi. It is available both in oral and topical form for the treatment of:

  • Fungal nail infections
  • Jock itch
  • Athlete’s foot
  • Ringworm infections

The effectiveness of this medicine can be judged by the fact that it takes only half the time in producing results when compared to other antifungals.

You can find out more about its proper use at the Mayo Clinic website.

What is the prescribed dose for fungal nail infections?

The dose for oral administration is 250 mg tablets in case of onychomycosis (fungal nail infection). Topical creams are also effective in fighting away the successive deposition of fungal layers within the deep layers of the skin. This is available online from Private Doctor Direct.

What is the epidemiology of fungal nail infections?

Onychomycosis which is also known by the name of tinea unguium and dermatophytic onychomycosis is the most commonly occurring nail disease. It is responsible for causing more than half the nail abnormalities amongst all factions of the population. It is prevalent in more than ten percent of the population.

This infection is characterized by the presence of thickening and discoloration of the nail. This means that the nail may turn yellow, white or black. It may start chipping away and may start to come off in pieces. In some cases, the finger can become affected too.

If the infection is not treated, the skin of the finger and the nail bed may become inflamed causing pain to the sufferer. Additionally, the presence of foul smell only aggravates the discomfort of the situation. The sufferer is most likely to suffer from psychosocial problems due to the appearance and the smell of the nail. Since this infection is deep rooted inside the nail bed, the response to oral treatment is more profound as compared to topical treatment.

Fungal nail infections are more fully described at the NHS Choices website.

How to use Terbinafine Orally?

This medicine can be taken with or without food once or twice a day or as prescribed by your doctor. It may take many months for the infection to completely disappear. Likewise, it will take time for new nail tissue to replace the old one. Discontinuing or altering treatment doses is strictly ill advised.

How to use tropical Terbinafine?

The topical form of this medicine should not be ingested. Before application, the affected area should be cleaned. A very thin layer of the medicine should be applied on the affected area. Washing hands immediately after application of the medicine is strongly suggested. Contact your doctor if there is no improvement in the state of the disease after two weeks of treatment.

Keeping the medicine away from sensitive areas such as the nose, eyes, vagina and mouth is advised.

Dry Eye Syndrome

It is easy for people to experience dry eyes these days.

Dry eyes can be caused by high heat, wearing contact lenses for too long, dust and wind and aging. It could also be a symptom of other more serious problems.

In any case, the common experience is feeling the eye irritated, redness in the eye and the feeling of a foreign object in the eye.

Dry eye is ultimately due to the eye not being able to produce enough moisture due to one of the aforementioned problems. Staring at a computer screen can also affect the eye in this way, because people tend to blink less when looking at a screen. If you combine multiple common causes that everybody can be easily exposed to (heat, contact lens wearing, and computer) then you might understand why you eye has been feeling very dry for the past few days.

What to do

  • Drink plenty of water: water can help producing more moisture in the eye.
  • Avoid wearing contact lenses: if possible, switch back to your glasses for a few days.
  • Limit staring at the computer: this is a hard one if you work in an office. However, try to take small eye breaks (i.e. look at something else for a little while every 10 to 15 minutes), or consciously try make the effort to blink more when looking at the screen. You might also want to consider changing the settings in your computer so that your screen is not too bright, and adjusting the screen to a father distance.
  • Buy Artificial Tears: they might help moisture the eye more quickly. For best results, apply them without having your contact lenses on.
  • Get omega-3 fatty acids: you can take them as a supplement or you can have meals based on salmon or sardines. These acids help reduce the risk of dry eyes

If you think your dry eyes are due to the hot environment:

Other ways to reduce dry eyes are to buy a set of sunglasses that might help get rid of the problem as they help lock moisture in, especially if you know your dry eyes are due to the environment. Another option is to buy a humidifier and/or an air cleaner.

Obviously, if you think you got dry eyes after wearing contact lenses, you might want to consider switching to another brand. In the same way, if you are taking medication that you think has affected your eye in this way, talk to your doctor as you might want to discontinue it.

More information on dry eyes can be found on this page: http://www.allaboutvision.com/conditions/dryeye.htm

In any case, if you are worried, your lifestyle is getting affected by the condition or if you think you’ve had dry eyes for a long time, talk to your optometrist.

Strabismus

What is strabismus?

Strabismus (often called crossed eyes or squint) is a disorder that affects the eye muscles, causing the eyes to look in different directions and on different things at any one time. Either one or both eyes may look inwards, outwards, upwards or downwards. This misalignment may occur all or some of the time, and may affect the same eye always or alternate between the eyes.

How common is strabismus?

Strabismus is estimated to occur in up to 5% of children, although adults can also develop the problem.

What does strabismus do to eyesight?

Early in the disorder, people with strabismus experience double vision and confusion because the eyes are not focusing on the same thing. Eventually, the view from the ‘turned’ eye will be ignored (suppressed) by the brain as it tries to prevent seeing double. The view of the world is not three-dimensional; it lacks depth and distance. Left untreated, constant eye turning can result in reduced vision in the eye (or Amblyopia, also known as lazy eye).

What causes strabismus?

While strabismus tends to occur in children at a young age, it may also develop in older children and in adults. Complications and injuries to the eye muscle are causes of strabismus. However, strabismus frequently arises from defects in nerves that send signals to the eye muscles or in the part of the brain that controls eye movements. Strabismus is a heritable condition and therefore can run in families. It can occur in people with other disorders, such as Down syndrome and cerebral palsy, or who have had a stroke or head trauma. Strabismus may also arise in people who continually try to correct their far-sighted vision.

Testing for strabismus

Normally, it is advised that all children have their eyes examined at about nine months of age. However, regardless of age, advice should be sought for any notable eye problem.

A complete medical history of the patient is taken, including family history of eye problems and the patient’s general health, other diagnoses and medicines. Essential to the diagnosis, is a detailed history of the eye problem, such as when it began and the nature of the eye turning. For a confirmed diagnosis of strabismus, the eyes are given a thorough examination. This includes observing the eye parts, and tests for visual acuity, alignment, focusing, and refraction (lens strength).

How is strabismus treated?

Treatment of strabismus is necessary as it will not disappear with age and may worsen. Treatment aims to improve the alignment of the eye and enable the eyes to move in a coordinated fashion. It will depend on the characteristics of the condition.

Prescription eye glasses may be used to get rid of eye turn and other problems with vision, such as farsightedness. An eye patch can be worn over the ‘good’ eye to encourage the ‘lazy’ one to function properly. Prism lenses, which change the course of light entering the eye and reduce the extent of eye movement required for the eye to focus, can sometimes correct the problem. Lenses may be all that is needed when the condition is mild but, more often, vision therapy and/or surgery are also required.

Vision therapy aims to improve movement, coordination and focusing of the eyes. The series of eye exercises re-establishes normal vision by educating the eyes and the brain to function together, the eyes to move together, and the brain to effectively merge the images from both eyes into one. Vision therapy is very effective and the improvement is long-lasting.

Surgery performed on the eye muscles aims to align the eyes and make the turned eye appear straight. It involves altering the length or moving the eye muscles. Surgery improves the cosmetic appearance of the eye but may not correct vision, particularly if the problem is not with the eye muscles only. This means that vision therapy may also be recommended to coordinate eye and brain functioning.

‘Lazy Eye’ treated playing Tetris?

This week we want to discuss a recent study that suggests that amblyopia, commonly known as ‘lazy eye’, can be treated by playing tetris.

First, though, it is best to discuss and talk about what the condition actually is.

What is Amblyopia?

Amblyopia is a lower-to-standard acquisition of images through vision. It can happen because the optic nerve is not transmitting the visual messages properly, or when the brain stops acquiring the image from one eye.
Why would the brain do that?
The brain can stop getting an image from one of the eyes because of different reasons. For instance, it could be due to strabismus. In this case, it happens when the brain perceives the images from the two eyes to be different (i.e. it understands that double-vision is occurring).
How can Amblyopia be treated?

Amblyopia is not an intrinsic neurological problem. Rather, it is an acquired bad habit. In patients with amblyopia there is nothing wrong with the eye itself. Hence, because it is a problem of developmental nature, the brain can be re-taught to “see” from the weaker eye.
Since now, most of the treatments were thought to be effective only in children. The main treatment was to occlude the strongest eye, either with an eye-patch or by applying drops of atropine. This would force the brain to acquire the image from the weakest eye, and would strengthen the communication between the two.
What is this new research showing?

The aforementioned treatment applications have not been successful with the majority of adults. This recent academic report, however, has found a new approach that can help adults with amblyopia. This report was published in the journal Current Biology and conducted by Li et al. The researchers have found that the brain still maintains a level of plasticity in adulthood. However, it has not been tackled in the right way. This research suggests that covering the strongest eye might be detrimental, indeed, to curing amblyopia. What these researchers did was to force the eyes to work together.

Why tetris?

Here’s where tetris comes along: one eye was forced to see the blocks falling and the other eye was only allowed to see the ground where they would fall. After two weeks, patients had already improved vision. Further studies are needed to confirm whether covering the strongest eye might indeed not be the best treatment to cure amblyopia. In any case, this remains an interesting research. The journal article of this research can be found here.