Comparison of the Efficacy, Safety and Tolerability of Azithromycin and Co-Amoxiclav in the Treatment of Acute Periapical Abscesses

1998 ◽  
Vol 26 (5) ◽  
pp. 257-265 ◽  
Author(s):  
CF Adriaenssen
Keyword(s):  
Soft Tissue ◽  
Adverse Events ◽  
Comparative Study ◽  
Clinical Success ◽  
Point Scale ◽  
Once Daily ◽  
Significant Difference ◽  
Before And After ◽  
Dental Practices

The activity, safety and tolerability of the azalide azithromycin were compared with those of co-amoxiclav in the treatment of acute periapical abscesses in adults in an open, randomized, multicentre comparative study. Patients of either sex, recruited from 106 dental practices in Belgium, were aged between 18 and 75 years and had acute periapical abscesses not requiring drainage, confirmed by radiology. Azithromycin was administered as a 500-mg tablet orally once daily for 3 days ( n = 150) and co-amoxiclav as a 625-mg capsule three times daily, for 5–10 days ( n = 153). Both before and after treatment, masticatory pain, percussion pain, headache, and oedema and redness of soft tissue were graded on a four-point scale. Overall clinical success (cure plus improvement) was seen in 131/144 (91%) evaluable patients receiving azithromycin and in 142/148 (96%) receiving co-amoxiclav (difference not significant). There was no significant difference between the two groups in the incidence or severity of adverse events or in the number of discontinuations because of adverse events.

scholarly journals COMPARISON OF EFFICACY AND SAFETY SILODOSIN 8 MG ONCE DAILY AND SILODOSIN 4 MG TWICE DAILY IN BPH PATIENTS WITH LUTS

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ramzie Nendra Diansyah ◽  
Johan Renaldo ◽  
Wahjoe Djatisoesanto ◽  
Lukman Hakim
Keyword(s):  
Adverse Events ◽  
Side Effect ◽  
Similar Efficacy ◽  
Common Adverse Event ◽  
Common Side Effect ◽  
Urinary Flow ◽  
Once Daily ◽  
Significant Difference ◽  
Male Patients ◽  
Maximum Urinary Flow

Objective: This study was aimed to compare the efficacy and side effect of silodosin 8mg once daily and silodosin 4mg twice daily in BPH-LUTS patients after 4 and 12 weeks. Material & Methods: Single blind randomized controlled trials in 60 male patients aged ≥45 years with BPH-LUTS from July 2017 to October 2017 was divided into groups who received 8mg of silodosin once daily and those who received 4mg of silodosin twice daily. Efficacy and adverse events were evaluated after 4 and 12 weeks of treatment. Results:  There was no significant difference of mean age of the two groups was 67.93 ± 6.49 years and 69.07 ± 6.28 years respectively (p 0.49). Both doses of this drug decreased the International Prostate Symptom Score (IPSS) and significantly increased the maximum urinary flow (Qmax) (p<0.05) but there was no significant differences between the two groups (p>0.05). Ejaculation disorder was the most common side effect in all groups (6.7% and 5%) and there was no significant difference between the two groups (p>0.05). Conclusion: The administration of 8mg of once daily silodosin has similar efficacy as 4mg twice daily silodosin. There were no adverse events differences in the two groups. Ejaculation disorder is the most common adverse event of silodosin administration.

scholarly journals Effect of different Pilates workout endings on the kyphotic and lumbar lordotic angles

2021 ◽  
Vol 34 ◽  
Author(s):  
Jessica Marques da Silva ◽  
Josiele Folletto Bianchin ◽  
Emanuelle Francine Detogni Schmit ◽  
Cláudia Tarragô Candotti ◽  
Adriane Vieira
Keyword(s):  
Soft Tissue ◽  
Spinal Curvature ◽  
Significant Difference ◽  
Thoracic And Lumbar Spine ◽  
Before And After ◽  
Assessment Time ◽  
Pilates Method ◽  
Spine Curvature ◽  
Random Draw ◽  
Soft Tissue Mobilization

Abstract Introduction: There are no studies that investigate whether different workout endings of the Pilates method (PM), either prioritizing the activation of powerhouse muscles or the relaxation of muscles trained during the session, affects spinal curvature. Objective: Identify the immediate effect of a PM session that ends with soft tissue mobilization or wall exercises on the kyphotic and lumbar lordotic angles. Methods: A crossover clinical trial with 19 female Pilates practitioners that used a Flexicurve ruler to evaluate thoracic and lumbar spine curvature before and after a PM exercise protocol, and after endings that involved soft tissue mobilization using massage balls or wall exercises. The order of the different endings was chosen by random draw and the study volunteers participated in two interventions, with intervals of seven to ten days between them. Two two-way ANOVAs were performed (one for each postural variable), using the factors “assessment time” (pre-session; post-PE; post-ending) and “type of ending” (soft tissue or wall exercises). Results: There was no significant difference between the assessment times or endings for the kyphotic (p = 0.972; p = 0.747) and lumbar lordotic angles (p = 0.574; p = 0.627), respectively. Conclusion: Pilates instructors can opt for more relaxing or more active endings without affecting the kyphotic and lumbar lordotic angles.

scholarly journals 285. Outcomes and Antibiotic Use in Patients with COVID-19 Admitted to an Intensive Care Unit

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S248-S249
Author(s):  
Megan Petteys ◽  
Leigh Ann Medaris ◽  
Julie E Williamson ◽  
Travis Denmeade ◽  
Rohit Soman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Adverse Events ◽  
Clinical Success ◽  
Antibiotic Use ◽  
World Health ◽  
Icu Patients ◽  
Significant Difference ◽  
Research Grant

Abstract Background Studies have shown the proportion of critically ill patients with COVID-19 receiving empiric antibiotics (ABX) greatly exceeds those with culture-proven bacterial co-infections. However, the benefits of continuing ABX in culture-negative (CxN) cases is unknown; this practice may increase the risks associated with ABX overuse. The purpose of this study was to evaluate outcomes and antibiotic use (AU) in intensive care unit (ICU) patients with COVID-19 based on culture results. Methods This was a multicenter, retrospective cohort study evaluating adults in an ICU for the first episode of ABX initiated following a confirmed COVID-19 diagnosis between September to December 2020. Blood and/or respiratory cultures must have been obtained within 24 hours (h) of ABX initiation. Patients were categorized into three groups: 1) CxN, ABX discontinued ≤ 72 h, 2) CxN, ABX continued &gt; 72 h, or 3) Culture-positive (CxP). Data on AU was obtained from electronic medication administration records. The primary outcome was clinical success, defined as being discharged alive or &gt; 2-point decrease in the World Health Organization Clinical Progression Scale score from day of ABX initiation to day 30. Results A total of 65 patients were included with 35.4% being CxP. ABX were discontinued ≤ 72 h in 23.8% of CxN patients. Methicillin-susceptible Staphylococcus aureus was the most common organism in 52.2% of CxP patients (66.7% respiratory; 16.7% blood; 16.7% both). Anti-methicillin-resistant Staphylococcus aureus and anti-pseudomonal antibiotics were the most prescribed for the initial regimen (Table 1). ABX de-escalation occurred in 58.5% of patients. Initial ABX duration was significantly longer in the CxP group (P &lt; 0.01). No significant difference in clinical success was observed (Table 2). Although not significantly different, the highest rate of adverse events occurred in the CxN and ABX continued &gt; 72 h group (40.6%). Table 1. Antibiotic Use in ICU Patients with COVID-19 Table 2. Clinical Outcomes and Adverse Events in ICU Patients with COVID-19 Conclusion In ICU patients with COVID-19, empiric broad-spectrum ABX are often overutilized with an inertia to de-escalate despite negative culture results, potentially increasing the risk of adverse events. This remains an important area for focused antimicrobial stewardship efforts to mitigate the development of multidrug resistance. Disclosures Christopher Polk, MD, Atea (Research Grant or Support)Gilead (Advisor or Review Panel member, Research Grant or Support)Humanigen (Research Grant or Support)Regeneron (Research Grant or Support)

scholarly journals Comparative Study of Kefir Yogurt-Drink and Sodium Fluoride Mouth Rinse on Salivary Mutans Streptococci

2014 ◽  
Vol 15 (2) ◽  
pp. 214-217 ◽  
Author(s):  
Seyyed Ali Asghar Sefidgar ◽  
Ali Akbar Moghadamnia ◽  
Reza Ghadimi ◽  
Leila Shirkhani
Keyword(s):  
Comparative Study ◽  
Sodium Fluoride ◽  
Study Groups ◽  
Mutans Streptococci ◽  
Base Line ◽  
Mouth Rinse ◽  
Chewing Gums ◽  
Significant Difference ◽  
Before And After ◽  
Yogurt Drink

ABSTRACT Aim The level of mutans streptococci (MS) is reduced by regularly consumption of probiotic Kefir drink. The present study aiming at answer to this question ‘may the Kefir drink be considered an alternative to fluoride rinse?’ Materials and Methods Twenty-two healthy volunteers aged 22-32 years with good oral hygiene participated in this study. None of participants had received any antibiotic or antimicrobial agent or professional fluoride therapy within the last month. None of them exhibited active caries lesions. Smokers and subjects who have chewing gums xylitol habit or who were undergoing orthodontic treatment were excluded. In a cross over design with 2 parallel groups, people in group A for 2 weeks received 100 ml of Kefir drink per day, then avoided brushing, eating and drinking for an hour. Simultaneously, people in group B were administered 0.05% sodium fluoride rinse in the same manner. After washout period, people in groups A and B respectively used 0.05% sodium fluoride rinse and Kefir drink. Saliva sampling was performed before and after interventions. The acidity and the count of MS were assessed and data were analyzed statistically. Result There was no significant difference between base line pH values of saliva in study groups (p > 0.05). Although, a significant difference was shown between MS counts before and after interventions (p . 0.0001 and p . 0.0001 for NaF and Kefir respectively), but the equal inhibitory effect was found between study groups (p > 0.05). Conclusion Kefir drink can inhibit salivary MS as well the sodium fluoride rinse. This beverage may be considered an alternative for fluoride rinse. Clinical significance Probiotics containing dairy products was known with anticariogenic properties. These agents may be used in caries control strategies adjunctively. How to cite this article Ghasempour M, Sefidgar SAA, Moghadamnia AA, Ghadimi R, Gharekhani S, Shirkhani L. Comparative Study of Kefir Yogurt-Drink and Sodium Fluoride Mouth Rinse on Salivary Mutans Streptococci. J Contemp Dent Pract 2014;15(2):214-217.

scholarly journals Comparative Therapeutic Efficacy and Safety of Remdesivir monotherapy and its Combination of Lopinavir/Ritonavir in COVID-19 Patients

2021 ◽  
Author(s):  
Marian Boshra ◽  
haitham saeed ◽  
Ahmed E. Abou Warda ◽  
Rania Sarhan
Keyword(s):  
Therapeutic Efficacy ◽  
Laboratory Data ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Infection Treatment ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Severity Of The Disease ◽  
Enzyme Elevation

Objectives: The treatment of COVID-19 infection remains a challenge because till now, there is no approved therapy for it. This study aimed to estimate the difference in the therapeutic efficacy and safety between remdesivir as monotherapy and its use in combination with lopinavir/ritonavir provided with standard supportive care. Methods: This is a prospective randomized cohort study included 1043 adult patients with confirmed moderate and severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol as the first group received IV remdesivir 200 mg on day 1, followed by 100 mg once daily, for 5 days while the second group received lopinavir/ritonavir 400/100 mg twice daily, for 5 days with the same remdesivir regimen in the first group. All laboratory and clinical parameters were assessed before and after treatment duration. Results: There was no significant difference related to improvement parameters such as laboratory data and improvement time between the two groups. On the other hand, hepatotoxicity of the second group (combination) was significantly higher compared with that of the first one. The elevation on liver enzymes was affected by the severity of the disease, the severe cases showed a high enzyme elevation rate. Conclusion: Remdesivir as monotherapy and its use in combination with lopinavir/ritonavir is effective in the management of moderate COVID 19 subjects than severe cases. The combination of remdesivir with lopinavir/ritonavir is not recommended due to the increased hepatotoxicity effect.

Practice patterns, techniques, and outcomes of flexible endoscopic myotomy for Zenker’s diverticulum: a retrospective multicenter study

Endoscopy ◽  
2020 ◽  
Author(s):  
Chetan Mittal ◽  
David L. Diehl ◽  
Peter V. Draganov ◽  
Laith H. Jamil ◽  
Ammara Khalid ◽  
...  
Keyword(s):  
Adverse Events ◽  
Practice Patterns ◽  
Clinical Success ◽  
Zenker’S Diverticulum ◽  
Success Rates ◽  
Zenker's Diverticulum ◽  
Submucosal Dissection ◽  
Significant Difference ◽  
Endoscopic Myotomy ◽  
Needle Knife

Abstract Background Flexible endoscopic myotomy has been increasingly performed for Zenker’s diverticulum using various endoscopic techniques and devices. The main aims of this study were to assess practice patterns and compare outcomes of endoscopic myotomy for Zenker’s diverticulum. Methods Procedures performed at 12 tertiary endoscopy centers from 1/2012 to 12/2018 were reviewed. Patients (≥ 18 years) with Zenker’s diverticulum who had dysphagia and/or regurgitation and underwent endoscopic myotomy were included. Outcomes assessed included technical success, clinical success, and adverse events. Results 161 patients were included. Traditional endoscopic septotomy was performed most frequently (137/161, 85.1 %) followed by submucosal dissection of the septum and myotomy (24/161, 14.9 %). The hook knife (43/161, 26.7 %) and needle-knife (33/161, 20.5 %) were used most frequently. Overall, technical and clinical success rates were 98.1 % (158/161) and 78.1 % (96/123), respectively. Adverse events were noted in 13 patients (8.1 %). There was no significant difference in technical and clinical success between traditional septotomy and submucosal dissection groups (97.1 % vs. 95.8 %, P = 0.56 and 75.2 % vs. 90.9 %, P  = 0.16, respectively). Clinical success was higher with the hook knife (96.7 %) compared with the needle-knife (76.6 %) and insulated tip knife (47.1 %). Outcomes were similar between centers performing > 20, 11 – 20, and ≤ 10 procedures. Conclusions Flexible endoscopic myotomy is an effective therapy for Zenker’s diverticulum, with a low rate of adverse events. There was no significant difference in outcomes between traditional septotomy and a submucosal dissection approach, or with centers with higher volume, though clinical success was higher with the hook knife.

scholarly journals A comparison of outcomes between a lumen-apposing metal stent with electrocautery-enhanced delivery system and a bi-flanged metal stent for drainage of walled-off pancreatic necrosis

2017 ◽  
Vol 05 (12) ◽  
pp. E1189-E1196 ◽  
Author(s):  
Noor Bekkali ◽  
Manu Nayar ◽  
John Leeds ◽  
Richard Charnley ◽  
Matthew Huggett ◽  
...  
Keyword(s):  
Adverse Events ◽  
Delivery System ◽  
Pancreatic Necrosis ◽  
Clinical Success ◽  
Stent Migration ◽  
Metal Stents ◽  
Procedure Time ◽  
Metal Stent ◽  
End Point ◽  
Significant Difference

Abstract Background and study aims Bi-flanged metal stents (BFMS) have shown promise in the drainage of walled-off pancreatic necrosis (WON), but their placement requires multiple steps and the use of other devices. More recently, a novel device consisting of a combined lumen-apposing metal stent (LAMS) and electrocautery-enhanced delivery system has been introduced. The aim of this study was to compare the placement and outcomes of the two devices. Patients and methods This was a retrospective review of consecutive patients undergoing endoscopic ultrasound-guided placement of BFMS or LAMS for drainage of symptomatic WON. Data from procedures between October 2012 and December 2016 were taken from a prospectively maintained database. We compared technical and clinical success, procedure time, costs, and composite end point of significant events (adverse events, stent migration, additional percutaneous drainage) between BFMS and LAMS. Results 72 consecutive patients underwent placement of BFMS (40 patients, 44 stents) or LAMS (32 patients, 33 stents). Technical success was 91 % for BFMS and 97 % for LAMS. Clinical success was 65 % vs. 78 %, respectively. Median in-room procedure time was significantly shorter in the LAMS group (45 minutes [range 30 – 80]) than in the BFMS group (62.5 minutes [range 35 – 135]; P < 0.001) and fewer direct endoscopic necrosectomies (DEN) were performed (median 1 [0 – 2.0] vs. 2 [0 – 3.7], respectively; P = 0.005). If only inpatients were considered (35 BFMS and 19 LAMS), there was no significant difference in DEN 2 (range 0 – 11) and 2 (range 0 – 8), respectively. The composite end point of 32 % vs. 24 % was not significantly different. Median procedural costs for all patients with successful stent placement for WON treatment was €4427 (range 1630 – 12 926) for BFMS vs. €3500 (range 2509 – 13 393) for LAMS (P = 0.10). Conclusion LAMS was superior to BFMS in terms of procedure time, with comparable adverse events, success, and costs.

Endoscopic ultrasound-guided transmural approach versus ERCP-guided transpapillary approach for primary decompression of malignant biliary obstruction: a meta-analysis

Endoscopy ◽  
2019 ◽  
Vol 51 (10) ◽  
pp. 950-960 ◽  
Author(s):  
Kirles Bishay ◽  
Devon Boyne ◽  
Mohammad Yaghoobi ◽  
Mouen A. Khashab ◽  
Risa Shorr ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Ultrasound ◽  
Biliary Obstruction ◽  
Clinical Success ◽  
Meta Analysis ◽  
Malignant Biliary Obstruction ◽  
Sensitivity Analyses ◽  
Ultrasound Guided ◽  
Number Of Patients ◽  
Significant Difference

Abstract Background Primary decompression in patients with malignant biliary obstruction can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) with transpapillary stenting, or, more recently, via transmural endoscopic ultrasound-guided biliary drainage (EUS-BD). It is unclear whether either approach is superior in terms of clinical success or adverse events in the primary setting. Methods A comprehensive systematic electronic search was performed for studies comparing EUS-BD and ERCP as the primary approach with respect to clinical success and any other outcome(s). Pooled relative risks (RRs) and weighted mean differences were obtained as appropriate using DerSimonian and Laird random effects models. Sensitivity analyses were also performed. Results 5 out of 776 studies with a total of 396 patients were included. Overall clinical success was not significantly different between EUS-BD and ERCP (RR 0.98, 95 % confidence interval [CI] 0.93 to 1.03). There was no significant difference in overall adverse events (RR 0.84, 95 %CI 0.35 to 2.01), though results suggested that EUS-BD may be associated with a reduced risk of pancreatitis (RR 0.22, 95 %CI 0.05 to 1.02). There were no significant differences between EUS-BD and ERCP in terms of procedure time or the risk of stent occlusion. Conclusions EUS-BD had similar clinical success rates and occlusion rates to ERCP in the primary decompression of malignant biliary obstruction from meta-analysis including a modest number of patients. EUS-BD may be a practical alternative to the ERCP-guided approach in such patients, but further well-designed prospective studies with larger numbers of patients are required to more clearly delineate potential differences in adverse events and cost.

scholarly journals Comparison of Dental Anxiety While Visiting Dental Clinics before and after Getting Vaccinated in Midst of COVID-19 Pandemic

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 115
Author(s):  
Abhishek Lal ◽  
Sara Saeed ◽  
Naseer Ahmed ◽  
Mohammad Khursheed Alam ◽  
Afsheen Maqsood ◽  
...  
Keyword(s):  
High Risk ◽  
Dental Anxiety ◽  
P Value ◽  
Risk Area ◽  
Cross Sectional ◽  
High Risk Area ◽  
Dental Clinics ◽  
Significant Difference ◽  
Before And After ◽  
Dental Practices

Vaccination is critical to control the rate of coronavirus transmission and infectivity. Dental practices are a high-risk area for contracting coronavirus; this fact generates psychological disturbances amongst patients. In this study, we aimed to assess the levels of anxiety of patients while visiting dental practices before and after getting vaccinated. This cross-sectional study was carried out between March and December 2021. An electronic survey was distributed among the vaccinated individuals who visited dental clinics before and after getting vaccinated. The survey consisted of the following four parts: demographic characteristics, questions related to coronavirus, and anxiety scores before and after getting vaccinated. SPSS-25 was used to perform the statistical analysis, where paired t-test was used to compare the anxiety scores, and Mann–Whitney U test to assess the association of gender with anxiety scores. A p-value of ≤0.05 was considered to be statistically significant. A total of 400 vaccinated individuals participated in this study, with a response rate of 88.23%. The majority of the respondents (71.0%) did not test positive for coronavirus. More than half of the participants (54.0%) reported to not be suffering from any coronavirus-related symptoms. About 100 (25.0%) of the individuals stated that dental clinics are an environment in which there is a high risk of contracting coronavirus. In regards to the comparison of the mean MDAS scores of the participants before and after getting vaccinated, a significant difference (p = 0.001) was found. Vaccination has been recommended for all eligible individuals to control the transmission and infectivity of coronavirus. Vaccinations have decreased the dental anxiety of patients while visiting dental clinics. However, the protective measures are still valid and should be followed, regardless of the vaccination status.

scholarly journals TO EVALUATE EFFICACY AND SAFETY OF RUPATADINE, BILASTINE, AND LEVOCETRIZINE IN ALLERGIC RHINITIS AT TERITARY CARE HOSPITAL, TELANGANA

2021 ◽  
pp. 140-143
Author(s):  
NAGUR SHARONE GRACE ◽  
SYED ARSHADDUDDIN AHMED ◽  
BHUVANESWARI E ◽  
SYED HAMZA QUADRI ◽  
VEENA B ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Events ◽  
Nasal Congestion ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Open Label ◽  
Once Daily ◽  
Significant Difference ◽  
The Mean ◽  
The Government

Objective: Allergic rhinitis (AR) is a heterogeneous disorder characterized by symptoms – sneezing, itching, nasal congestion, and rhinorrhea. The aim of the study is to evaluate the efficacy and safety of rupatadine, bilastine, and levocetirizine in AR. Methods: A prospective, open-label, comparative study was conducted at the Government ENT Hospital, Hyderabad, Telangana. Ninety patients diagnosed with AR were randomized, of whom Group 1 received oral tab. bilastine 20 mg once daily, Group 2 received oral tab. levocetirizine 5 mg once daily, and Group 3 received oral tab. rupatadine with a dose of 10 mg once daily for 2 weeks. The reduction in total nasal symptom score (TNSS) and absolute eosinophil counts (AECs) was compared with baseline and at 2 weeks. Safety was assessed according to adverse events reported during the study period. An analysis of variance was used as a test of significance for the three groups. Results: Overall, 90 cases were included in the study, with 48% of males and 52% of females. All three drugs significantly reduced the TNSS and AEC after treatment compared to before treatment (p<0.05). The mean difference in TNSS and AEC showed no statistically significant difference among the three groups (TNSS: p>0.908 and AEC: p>0.967). In terms of safety, all three drugs showed nearly similar adverse events. Conclusion: In this study, after 2 weeks of follow-up, the three drugs (bilastine, levocetirizine, and rupatadine) showed significant improvement clinically, but the mean reduction in the score of symptoms and AEC was not statistically significant in the treatment of AR.

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