Drug Therapy

Onychomycosis is difficult to permanently cure. Treatment failures and relapses are common, which exacerbate the problem [8-10].

In order for an antifungal drug to be effective, it must presumably disseminate throughout the nail plate, nail bed and other locations occupied by the fungi, and reach concentrations that will eliminate the pathogen. This can be especially difficult when the nail plate has lifted from the bed (onycholysis). Unlike damaged skin that can repair itself, the nail plate cannot, therefore results of therapeutic treatment are not evident until new nail growth occurs and is clear of infection. Toe nails typically take about 1 year to fully grow out.

Because of the length of time required to observe new nail growth, clinical trials typically take around 9-12 months (either 3 months systemic treatment with 6-9 months follow up or 6-9 months topical treatment with 3-6 months follow up). During this time, the infected nails can be monitored for growth of new clear nail and for presence of viable dermatophytes. Efficacy is usually recorded in one of three ways: mycological cure, clinical cure or complete cure. Standard definitions of these cures are not completely uniform; each report usually provides the criteria that were used in the study. A mycological cure is defined by the extent of eradication of the fungi. It is assessed by removing a section of nail and screening for the presence of dermatophytes by microscopy and by culturing the nail for growth of dermatophytes in vitro. A clinical cure is defined by the extent of new nail growth at the proximal fold which is visibly clear of infection. A complete cure is defined when a patient has a mycological cure and clinical cure. Obviously, a complete cure is most desirable but hindering this is the fact that in many cases more than one digit is infected and not every digit may be cleared of infection.

Onychomycosis is treated both systemically and topically. Current systemic treatments include terbinafine (1), itraconazole (2) and griseofulvin (3). Current topical treatments include ciclopirox (4), amorolfine (5) and tioconazole (6).

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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