Raloxifene, sold under the brand name Evista among others, is a medication used to prevent and treat osteoporosis in postmenopausal women and those on glucocorticoids. For osteoporosis it is less preferred than bisphosphonates. It is also used to reduce the risk of breast cancer in those at high risk. It is taken by mouth.Common side effects include hot flashes, leg cramps, swelling, and joint pain. Severe side effects may include blood clots and stroke. Use during pregnancy may harm the baby. The medication may worsen menstrual symptoms. Raloxifene is a selective estrogen receptor modulator (SERM) and therefore a mixed agonist–antagonist of the estrogen receptor (ER). It has estrogenic effects in bone and antiestrogenic effects in the breasts and uterus.Raloxifene was approved for medical use in the United States in 1997. It is available as a generic medication. In 2017, it was the 330th most commonly prescribed medication in the United States, with more than 900 thousand prescriptions. Medical uses
Raloxifene is used for the treatment and prevention of osteoporosis in postmenopausal women. It is used at a dosage of 60 mg/day for both the prevention and treatment of osteoporosis. In the case of either osteoporosis prevention or treatment, supplemental calcium and vitamin D should be added to the diet if daily intake is inadequate.Raloxifene is used to reduce the risk of breast cancer in postmenopausal women. It is used at a dosage of 60 mg/day for this indication.
Otomycosis  is a fungal ear infection, a superficial mycotic infection of the outer ear canal. It is more common in tropical countries. The infection may be either subacute or acute and is characterized by malodorous discharge, inflammation, pruritus, scaling, and severe discomfort. The mycosis results in inflammation, superficial epithelial exfoliation, masses of debris containing hyphae, suppuration, and pain. Diagnosis
Otoscopy (exam of the ear) is best done with a binocular microscope that provides adequate lighting, depth perception, and the ability to instrument the ear to comfortably remove the fungus. Findings range from scattered saprophytic fungal colonies of various colors, causing no symptoms, to densely packed fungal debris, often intermixed with cerumen (wax), filling the entire canal and involving the tympanic membrane (eardrum). The fungus can cling to the skin and tympanic membrane, presumably because of invading hyphae, and can require significant time to accomplish complete removal. Cause
Most fungal ear infections are caused by Aspergillus niger, Aspergillus fumigatus, Penicillium and Candida albicans.Otomycosis commonly results from overuse of antibacterial ear drops, which should never be used for more than 7 days. In such cases the fungus is an opportunist that results from antibacterial suppression of the normal bacterial flora, combined with the steroid the drops also contain. Signs and Symptoms
Otomycosis does not usually cause as much canal skin edema as does acute bacterial external otitis. While a severe pressure type of pain is a prominent feature of advanced cases, the ear is usually much less tender, if at all, to traction or tragal pressure.