Evaluation of Low-Dose Gentamicin Once Daily Dosing Regimen at A General Hospital in Malaysia

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Ab Rahman A F ◽  
Md Sahak N. ◽  
Ali A. M.
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Low Dose ◽  
Dosing Regimen ◽  
Once Daily ◽  
Neutropenic Sepsis ◽  
Wide Acceptance ◽  
The Mean ◽  
Initiation Of Therapy ◽  
Almost All

Objective: Once daily dosing (ODD) aminoglycoside is gaining wide acceptance as an alternative way of dosing. In our setting it is the regimen of choice whenever gentamicin is indicated. The objective of this study was to evaluate the practice of gentamicin ODD in a public hospital in Malaysia. Methods: We conducted a retrospective review of medical records of patients on gentamicin ODD who were admitted to Hospital Melaka during January 2002 until March 2010. All adult patients who were on ODD gentamicin with various level of renal function were included in the study. Patients on gentamicin less than 72 hours and pregnant women were excluded. Results: From 110 patients, 75 (68.2%) were male and 35 (31.8%) were female. Indications for ODD gentamicin included pneumonia, 34 (31.0%) neutropenic sepsis, 27 (24.5%) and sepsis, 11 (10.0%). The mean dose and duration of gentamicin was 3.2 mg/kg/day and 7 days, respectively. Almost all patients were on gentamicin combined with other antibiotics. Clinical cure based on fever resolution was found in 89.1% of patients treated with ODD. Resolution of fever took an average of 48 hours after initiation of therapy. The evaluation for bacteriologic cure could not be performed because of insufficient data on culture and sensitivity. Out of 38 patients with analyzable serum creatinine data, four patients might have developed nephrotoxicity. Conclusion: In our setting, lower dosages of ODD gentamicin when used in combination with other antibiotics seemed to be effective and safe in treating most gram negative infections.

Vitamin B-6 Vitamer Levels in Plasma and Related Symptoms in Hemodialysis Subjects Taking low- and High-Dose Renal Multivitamin Supplements

2012 ◽  
Vol 82 (2) ◽  
pp. 130-136 ◽  
Author(s):  
Clement ◽  
Boylan ◽  
Miller ◽  
Driskell ◽  
Giraud ◽  
...  
Keyword(s):  
Medical Records ◽  
Low Dose ◽  
Vitamin B ◽  
High Dose ◽  
Vitamin Supplement ◽  
Pyridoxine Hydrochloride ◽  
Cluster Group ◽  
The Mean ◽  
Multivitamin Supplements ◽  
High Dose Vitamin

Introduction: The purpose of this study was to evaluate the B-6 vitamers in plasma and related symptoms in hemodialysis subjects taking high- or low-dose vitamins. Methods: A total of 24 hemodialysis (HD) subjects were divided into two groups. Twelve subjects received a high-dose vitamin supplement [50 mg pyridoxine hydrochloride (PN-HCl) /tablet] and 12 received a low-dose vitamin supplements containing (10 mg PN-HCl/tablet) for 6+ months. Plasma B-6 vitamers were analyzed using HPLC. Other data were obtained from subjects’ medical records. Subjects were assessed for vitamin B-6 related symptoms. Cluster analysis was used to form symptom groups. Student t-tests and analysis of variance were used to determine differences (p < 0.05) in group means. Results: The mean ±SD plasma B-6 vitamer and 4-pyridoxic acid concentrations (nmol/L) were as follows in the 10-mg and 50-mg PN-HCl groups, respectively: pyridoxal- 5’-phosphate (PLP) 10 ± 3 and 16 ± 8 (p = 0.04); pyridoxal (PL) 50 ± 96 and 68 ± 06; pyridoxine (PN) 26 ± 50 and 191 ± 107; and 4-pyridoxic acid (4-PA) 43 ± 64 and 99 ± 361. The cluster group with a significantly higher (p = 0.04) plasma 4-PA concentration of 167 ± 697 nmol/L reported more tingling hands, tachycardia, and diarrhea. Conclusion: Plasma PLP levels and symptoms related to B-6 in HD subjects are impacted by dose of PN-HCl.

scholarly journals The Crazy-paving Pattern in Chest CT of Coronavirus Disease 2019 Patients; an Alarming Sign for Hospitalization 

2020 ◽  
Author(s):  
Mehdi Gholamzadeh Baeis ◽  
Abolfazl Mozafari ◽  
Fatemeh Movaseghi ◽  
Mehdi Yadollahzadeh ◽  
Ahmad Sohrabi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Public Hospital ◽  
Human Beings ◽  
Epidemiological Features ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
The Mean ◽  
Bilateral Lung

Abstract Background: The outbreak of coronavirus disease 2019 (COVID-19) becomes an enormous threat to all human beings. Via this retrospective study conducted on medical records of confirmed COVID-19 pneumonia patients on admission, we investigate the CT manifestation and clinical and laboratory risk factors associated with progression to severe COVID-19 pneumonia and assessed the association among clinical and laboratory records, CT findings, and epidemiological features. The medical records and radiological CT Features of 236 confirmed COVID-19 patients were reviewed at one public hospital and one respiratory clinic in Quom, from 1 August to 30 September 2020. Results: Among a total of 236 confirmed Covid-19 cases, 62 were infected with moderate to severe COVID-19 disease and required hospital admission, and 174 were followed up on outpatient bases. A significant difference was verified in the mean age between outpatients and hospitalized groups. The incidences of bilateral lung involvement, consolidation, linear opacities, crazy-paving pattern, air bronchogram sign, and the number of lobe involvement were significantly higher in hospitalized groups. However, only the crazy-paving pattern was significantly associated with an SpO2 level lower than 90%, with clinical sign of cough severity. Our data indicate that this pattern is also significantly associated with inflammatory levels and the presence of this pattern along with SpO2 level lower than 90%, older age, diabetes, on admission are independent risk factors for COVID-19 progression to severe level.Conclusions: The crazy-paving pattern can predict the severity of COVID-19, which is of great significance for the management and follow-up of COVID-19 pneumonia patients. The clinical factors of aging, male gender, and diabetes, may be risk factors for the crazy-paving pattern, whereas severe coughing is considered to be the most important clinical symptom related to this pattern, and SpO2 level lower than 90%, which is a matter of more severity.

scholarly journals IMPLEMENTATION AND PERFORMANCE OF TRACKERS FOR THE DETECTION OF SURGICAL ADVERSE EVENTS

2020 ◽  
Vol 29 ◽  
Author(s):  
Josemar Batista ◽  
Danieli Parreira da Silva ◽  
Elaine Drehmer de Almeida Cruz
Keyword(s):  
Adverse Events ◽  
Medical Records ◽  
High Performance ◽  
Public Hospital ◽  
Cardiopulmonary Arrest ◽  
Invasive Procedure ◽  
The Mean ◽  
And Performance ◽  
Surgical Adverse Events ◽  
Events Study

ABSTRACT Objective: to identify the frequency and performance of the Canadian Adverse Events Study tracking criteria for the confirmation of surgical adverse events in adult patients. Method: a descriptive and retrospective study conducted in a public hospital in the state of Paraná from May to November 2017. A retrospective review of 192 medical records was conducted using 16 tracking criteria; and the confirmation of adverse events was in charge of a committee of experts composed of a physician and nurses. Data was analyzed by means of descriptive statistics. Results: the mean performance of the trackers was 73.3%. A total of 70 trackers were confirmed in 21.8% of the medical records with adverse events. The mean number of trackers was 0.4 per medical record (varying from zero to three). Adverse reaction to the medication; unplanned return to the operating room; unplanned removal, injury or correction of an organ or structure during surgery or invasive procedure; cardiopulmonary arrest reversed and hospital infection/sepsis were classified as high performance trackers (100.0%). Eight trackers did not contribute to the identification of adverse events. Conclusion: high-performance trackers can assist in detecting adverse events; there is potential to improve the tracking tool, contributing to its performance as a research method in Brazilian hospitals.

scholarly journals Pharmacokinetics of and Short-Term Virologic Response to Low-Dose 400-Milligram Once-Daily Raltegravir Maintenance Therapy

2012 ◽  
Vol 56 (4) ◽  
pp. 1892-1898 ◽  
Author(s):  
Jintanat Ananworanich ◽  
Meena Gorowara ◽  
Anchalee Avihingsanon ◽  
Stephen J. Kerr ◽  
Nadine van Heesch ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Viral Suppression ◽  
Low Dose ◽  
Virologic Response ◽  
Pharmacokinetic Data ◽  
Time Curve ◽  
Once Daily ◽  
Hiv Rna ◽  
The Mean ◽  
To Receive

ABSTRACTBecause studies showed similar viral suppression with lower raltegravir doses and because Asians usually have high antiretroviral concentrations, we explored low-dose raltegravir therapy in Thais. Nineteen adults on raltegravir at 400 mg twice daily (BID) with HIV RNA loads of <50 copies/ml were randomized to receive 400 mg once daily (QD) or 800 mg QD for 2 weeks, followed by the other dosing for 2 weeks. Intensive pharmacokinetic analyses were performed, and HIV RNA was monitored. Two patients were excluded from the 400-mg QD analysis due to inevaluable pharmacokinetic data. The mean patient weight was 58 kg. Mean pharmacokinetic values were as follows: for raltegravir given at 400 mg BID, the area under the concentration-time curve from 0 to 12 h (AUC0-12) was 15.6 mg/liter-h and the minimum plasma drug concentration (Ctrough) was 0.22 mg/liter; for raltegravir given at 800 mg QD, the AUC0-24was 33.6 mg/liter-h and theCtroughwas 0.06 mg/liter; and for raltegravir given at 400 mg QD, the AUC0-24was 18.6 mg/liter-h and theCtroughwas 0.08 mg/liter. The HIV RNA load was <50 copies/ml at each dose level. Compared to the adjusted AUC0-24for Westerners on raltegravir at 400 mg BID, Thais on the same dose had double the AUC0-24and those on raltegravir at 400 mg QD had a similar AUC0-24. More patients had aCtroughof <0.021 mg/liter on raltegravir at 400 mg QD (9/17 patients) than on raltegravir at 800 mg QD (1/19 patients) or 400 mg BID (0/19 patients). Seventeen patients used raltegravir at 400 mg QD for a median of 35 weeks; two had confirmed HIV RNA loads between 50 and 200 copies/ml, and both had lowCtroughvalues. Low-dose raltegravir could be a cost-saving option for maintenance therapy in Asians or persons with low body weight. However, raltegravir at 400 mg QD was associated with a lowCtroughand with a risk for HIV viremia. Raltegravir at 200 or 300 mg BID should be studied, but new raltegravir formulations will be needed.

DFT Benchmark Study of the O--O Bond Dissociation Energy in Peroxides Validated with High-Level Ab-Initio Calculations

2019 ◽  
Author(s):  
Danilo Carmona ◽  
Pablo Jaque ◽  
Esteban Vöhringer-Martinez
Keyword(s):  
Reference Value ◽  
Basis Set ◽  
Basis Sets ◽  
Mean Deviation ◽  
Bond Dissociation ◽  
Dissociation Energies ◽  
The Mean ◽  
Experimental Values ◽  
High Level ◽  
Almost All

<div><div><div><p>Peroxides play a central role in many chemical and biological pro- cesses such as the Fenton reaction. The relevance of these compounds lies in the low stability of the O–O bond which upon dissociation results in radical species able to initiate various chemical or biological processes. In this work, a set of 64 DFT functional-basis set combinations has been validated in terms of their capability to describe bond dissociation energies (BDE) for the O–O bond in a database of 14 ROOH peroxides for which experimental values ofBDE are available. Moreover, the electronic contributions to the BDE were obtained for four of the peroxides and the anion H2O2− at the CBS limit at CCSD(T) level with Dunning’s basis sets up to triple–ζ quality provid- ing a reference value for the hydrogen peroxide anion as a model. Almost all the functionals considered here yielded mean absolute deviations around 5.0 kcal mol−1. The smallest values were observed for the ωB97 family and the Minnesota M11 functional with a marked basis set dependence. Despite the mean deviation, order relations among BDE experimental values of peroxides were also considered. The ωB97 family was able to reproduce the relations correctly whereas other functionals presented a marked dependence on the chemical nature of the R group. Interestingly, M11 functional did not show a very good agreement with the established order despite its good performance in the mean error. The obtained results support the use of similar validation strategies for proper prediction of BDE or other molecular properties by DF Tmethods in subsequent related studies.</p></div></div></div>

Rice tablet (Aluminum Phosphide) poisoning

2016 ◽  
Vol 5 (11) ◽  
pp. 5041
Author(s):  
Farkhondeh Jamshidi ◽  
Ahmad Ghorbani ◽  
Sina Darvishi*
Keyword(s):  
Medical Records ◽  
Statistical Tests ◽  
Patient Records ◽  
Demographic Information ◽  
Aluminum Phosphide ◽  
Men And Women ◽  
Significant Difference ◽  
The Mean ◽  
Aluminum Phosphide Poisoning ◽  
Commit Suicide

The abuse of some pesticides especially to suicide is one of the current problems of pesticides. Aluminum phosphide induced poisoning usually happens to suicide and sometimes it is due to accidental occupational exposure and in a few cases it has some criminal intensions. This study is conducted to evaluate patients poisoned with aluminum phosphide. In the present study the medical records of cases of poisoning with rice tablets (aluminum phosphide) hospitalized in Ahvaz Razi hospital is studied. Accordingly, a checklist is prepared that included demographic information of patients (age, gender) and information on patient records (information on poisoning) are completed using the patients’ medical records. The analysis of data is done by SPSS V22. 18 patients poisoned with rice tablet (aluminum phosphide) are studied. Results of the study show that 11 patients are male and seven are female. The mean patient age is 27.06 ±8.04 years that is 28 ±9 and 25 ±6.02 in men and women respectively. Statistical tests show no statistically significant difference in mean age in both genders (P> 0.05). Among patients, 11 subjects took aluminum phosphide to attempt suicide and 3 cases took it unintentionally and of course the reason is not mentioned in four cases. Among the patients who tried to commit suicide by taking aluminum phosphide, 6 cases are male and 5 cases are female that no statistically significant difference is observed between the genders in this respect (P> 0.05). In addition to the study of the complications caused by this poisoning and its mortality, it is recommended to responsible authorities to provide the necessary educations and treatments to prevent this type of poisoning.

scholarly journals Cardiovascular consequences of discontinuing low-dose rivaroxaban in people with chronic coronary or peripheral artery disease

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318758
Author(s):  
Gilles R Dagenais ◽  
Leanne Dyal ◽  
Jacqueline J Bosch ◽  
Darryl P Leong ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Low Dose ◽  
Cardiovascular Death ◽  
Stroke Rate ◽  
Early Stopping ◽  
Peripheral Artery ◽  
Once Daily ◽  
Registration Number ◽  
Artery Disease

ObjectiveIn patients with chronic coronary or peripheral artery disease enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies trial, randomised antithrombotic treatments were stopped after a median follow-up of 23 months because of benefits of the combination of rivaroxaban 2.5 mg two times per day and aspirin 100 mg once daily compared with aspirin 100 mg once daily. We assessed the effect of switching to non-study aspirin at the time of early stopping.MethodsIncident composite of myocardial infarction, stroke or cardiovascular death was estimated per 100 person-years (py) during randomised treatment (n=18 278) and after study treatment discontinuation to non-study aspirin (n=14 068).ResultsDuring randomised treatment, the combination compared with aspirin reduced the composite (2.2 vs 2.9/100 py, HR: 0.76, 95% CI 0.66 to 0.86), stroke (0.5 vs 0.8/100 py, HR: 0.58, 95% CI 0.44 to 0.76) and cardiovascular death (0.9 vs 1.2/100 py, HR: 0.78, 95% CI 0.64 to 0.96). During 1.02 years after early stopping, participants originally randomised to the combination compared with those randomised to aspirin had similar rates of the composite (2.1 vs 2.0/100 py, HR: 1.08, 95% CI 0.84 to 1.39) and cardiovascular death (1.0 vs 0.8/100 py, HR: 1.26, 95% CI 0.85 to 1.86) but higher stroke rate (0.7 vs 0.4/100 py, HR: 1.74, 95% CI 1.05 to 2.87) including a significant increase in ischaemic stroke during the first 6 months after switching to non-study aspirin.ConclusionDiscontinuing study rivaroxaban and aspirin to non-study aspirin was associated with the loss of cardiovascular benefits and a stroke excess.Trial registration numberNCT01776424.

scholarly journals Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany

2021 ◽  
Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Jan Gödeke
Keyword(s):  
Pilonidal Sinus ◽  
Regional Variation ◽  
Disease Incidence ◽  
Age Groups ◽  
Pilonidal Sinus Disease ◽  
National Guidelines ◽  
Reconstructive Procedures ◽  
Sinus Disease ◽  
The Mean ◽  
Almost All

Abstract Purpose Collective evidence from single-centre studies suggests an increasing incidence of pilonidal sinus disease in the last decades, but population-based data is scarce. Methods We analysed administrative case–based principal diagnoses of pilonidal sinus disease and its surgical therapy between 2005 and 2017 in inpatients. Changes were addressed via linear regression. Results The mean rate of inpatient episodes of pilonidal sinus disease per 100,000 men increased from 43 in 2005 to 56 in 2017. In females, the mean rate of inpatient episodes per 100,000 women rose from 14 in 2005 to 18 in 2017. In the whole population, for every case per 100,000 females, there were 3.1 cases per 100,000 males, but the numbers were highly variable between the age groups. There was considerable regional variation within Germany. Rates of inpatient episodes of pilonidal sinus disease were increasing in almost all age groups and both sexes by almost a third. Surgery was dominated by excision of pilonidal sinus without reconstructive procedures, such as flaps, whose share was around 13% of all procedures, despite recommendations of the national guidelines to prefer flap procedures. Conclusion Rates of inpatient episodes of pilonidal sinus disease in Germany rose across almost all age groups and both sexes with relevant regional variation. The underlying causative factors are unknown. Thus, patient-centred research is necessary to explore them. This should also take cases into account that are solely treated office-based in order to obtain a full-spectrum view of pilonidal sinus disease incidence rates.

scholarly journals Survey of Phenolic Acids, Flavonoids and In Vitro Antioxidant Potency Between Fig Peels and Pulps: Chemical and Chemometric Approach

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2574
Author(s):  
Lahcen Hssaini ◽  
Francisca Hernandez ◽  
Manuel Viuda-Martos ◽  
Jamal Charafi ◽  
Rachid Razouk ◽  
...  
Keyword(s):  
Phenolic Acids ◽  
Radical Scavenging ◽  
Fruit Peel ◽  
Mean Values ◽  
Local Cultivar ◽  
Ic50 Values ◽  
The Mean ◽  
Lipid Peroxidation Inhibition ◽  
Almost All

In the present study, chromatic coordinates, phenolic acids, flavonoids and antioxidant capacity assessed by 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonate (ABTS) and lipid peroxidation inhibition capacity (LPIC) essays and their relative IC50 were investigated in 25 fig cultivars growing in Morocco. The aims of this study were to determine (i) the variation in these compounds among light and dark-colored cultivars, (ii) their partitioning between fruit peel and pulp and (iii) to display network connections among these variables. Twelve phenolic compounds (PCs) were isolated in peel extract versus eight in pulp samples. Anthocyanins, mainly cyanidin-3,5-diglucoside and cyanidin-3-O-rutinoside, were the predominant compounds in peels, where the mean concentrations were 75.90 ± 18.76 and 77.97 ± 18.95 µg/g dw, respectively. On the other hand, (−)-epicatechin and cyanidin-3-O-rutinoside were the major compounds in the pulp extracts, where the mean values were 5.23 ± 4.03 and 9.01 ± 5.67 µg/g dw, respectively. A two-dimensional hierarchically clustered heatmap was applied to the dataset to explore correlations in the dataset and similarities between cultivars, without dimensionality reduction. Results showed that anthocyanins, particularly pelargonidin-3-O-rutinoside, cyanidin-3,5-diglucoside and cyanidin-3-O-rutinoside, were the main contributors to the peels’ free radical scavenging capacity. This capacity was particularly higher in the peel of dark-colored figs compared to the fruit pulp. The local cultivar “INRA 1301” showed the most promising phenolic profile due to its very high levels of almost all detected PCs, especially (−)-epicatechin, quercetin-3-O-rutinoside, quercetin-3-O-glucoside, cyanidine-3,5-diglucoside, cyanidine-3-O-rutinoside and pelargonidin-3-O-rutinoside (54.66, 141.08, 35.48, 494.08, 478.66, 12.56 µg/g dw, respectively). Having the darkest figs in the collection (L* = 25.72, c* = 22.09 and h° = 20.99), this cultivar has also combined promising IC50 values, which were of 19.85, 40.58 and 124.78 µg/mL for DPPH, ABTS and LPIC essays, respectively.

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