Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor

Background: Feet odor is a common sociomedical problem that affects the feet of human beings of different etiological factors. Multiple modalities of therapy have been used in the treatment of feet odor. Objective: To evaluate the efficacy and safety of topical 15% zinc sulfate solution in the treatment of feet odor. Patients and Methods: This single blind, placebo, controlled therapeutic study was conducted at the Department of Dermatology-Baghdad Teaching Hospital, from March 2010 to July 2011. A total of 108 (88 males and 20 females) patients with feet odor were enrolled and were divided into 2 groups: Group A: treated with 15% zinc sulfate solution. Group B: treated with distilled water as placebo control group. Full history and examination were carried out including all relevant points. Four scoring had been used to assess the severity of odor in patients with bared feet Score 0: no odor, Score 1: mild odor, Score 2: moderate odor and Score 3: severe odor. Zinc sulfate solution 15% was applied to sole and toe webs once daily for two weeks, three times per week for next two weeks and followed by single application weekly as maintenance after clearance of odor for two months. Patients were seen every two weeks to be examined and to score the odor again and to record side effects. Results: Group A: Fifty patients completed the study, their ages ranged from 8 - 68 (33 + 14.5) years, while the duration of the disease ranged from 1 - 180 (7.22 + 38.24) months. The complete clearance of feet odor after two weeks of therapy was 35 (70%) patients which was similar to two months maintenance therapy 35 (70%) and was highly statistically significant (p value = 0.0000001). Group B: Fifty patients received the placebo solution, their ages ranged from 16 - 75 (32.6 + 13.4) years, while the duration of the disease ranged from 1 - 180 (43.7 + 47.65) months. The complete clearance of feet odor was in 1 (2%) patient after two weeks therapy and after two months maintenance therapy. No side effects were recorded. Conclusions: Topical 15% zinc sulfate solution had an effective therapeutic and prophylactic action against feet odor.

Neonatal isovaleric acidemia in China: A case report and review of literature

BACKGROUND Isovaleric acidemia(IVA)is a rare autosomal recessive inherited organic acidemia caused by a genetic deficiency of isovaleryl-CoA dehydrogenase(IVD).Its morbidity is low,but mortality is high.There is no effective cure for this disease.Early identification of IVA using clinical features can significantly slow disease progression and reduce mortality.Here we report a Chinese neonate with two mutations of IVD and share valuable information on this disease.CASE SUMMARY A 12-day-old male neonate with“poor response for 1 d and repeated convulsions accompanied by high muscle tension for 6 h”was hospitalized.The patient was the first child of nonconsanguineous ethnic Chinese parents.He was delivered by cesarean section due to breech position at 39+1 wk of gestation with a birth weight of 3.27 kg.Initially,he suffered from dyspnea and rhinobyon,and at 10 d after birth the patient suddenly developed poor feeding,low response,lethargy and seizures.Organic acid analysis of blood and urine by tandem mass spectrometry and gas chromatography mass spectrometry showed extremely high concentrations of isovaleryl glycine.The patient had an acute episode of IVA causing severe metabolic stress and eventually died.CONCLUSION A new case of an IVA patient carrying c.1193G>A(p.Arg398Gln)and c.1208A>G(p.Try403Cys)mutations is reported in China.