scholarly journals Efficacy of amoxicillin-clavulanic acid versus ceftriaxone in children hospitalized under 5 years of age with uncomplicated community acquired pneumonia.

2020 ◽  
Vol 27 (11) ◽  
pp. 2339-2344
Author(s):  
Huriya Abid ◽  
Wajiha Rizwan ◽  
Irfan Naeem ◽  
Aysha Mansoor Lodhi ◽  
Muhammad Nasir Rana
Keyword(s):  
Clavulanic Acid ◽  
Controlled Trial ◽  
Community Acquired Pneumonia ◽  
Duration Of Symptoms ◽  
Treatment Groups ◽  
Acid Versus ◽  
Group A ◽  
Amoxicillin Clavulanic Acid ◽  
Group B ◽  
Children Under 5

Objectives: Community acquired pneumonia (CAP) is considered to be the commonest reason for hospitalization among children. Pneumonia is the leading cause of mortality among children in Pakistan in children, causing 33% of all deaths in infants and 37% of all deaths in children 1 to 4 years. The aim of current study was to compare efficacy of amoxicillin-clavulanic acid versus ceftriaxone among children under 5 years of age, hospitalized having uncomplicated CAP. Study Design: Randomized Controlled trial (RCT). Setting: Department of Pediatric Medicine, The Children Hospital and Institute of Child Health, Lahore. Period: 01/01/2019 to 30/06/2019. Material & Methods: A total of 210 (105 in each group) children aged between 2 to 60 months, diagnosed having CAP were randomly allocated into either Group-A (received IV amoxicillin-clavulanic acid) or Group B (received IV ceftriaxone). Efficacy in terms of response of both treatment groups was noted after 5 days treatment. Results: Overall, mean age was noted as 14.68±15.7 months. Majority (n=131, 32.4%) were male and aged between 1 to 12 months (n=135, 64.3%). Mean duration of symptoms was noted as 3.60±1.69 days. Efficacy was significantly higher in children treated with ceftriaxone as compared to those treated with Amoxicillin/Clavulanic acid (96.2% vs. 76.2%; p<0.001). This difference was significant across all age, gender and duration of symptom groups (p<0.05). Conclusion: The efficacy was significantly higher in children treated with ceftriaxone as compared to Amoxicillin/Clavulanic acid.

Ziv-aflibercept versus bevacizumab administration prior to diabetic vitrectomy: a randomised and controlled trial

2019 ◽  
pp. bjophthalmol-2018-313313
Author(s):  
Isaac Aleman ◽  
Javier Castillo Velazquez ◽  
Sloan W Rush ◽  
Ryan B Rush
Keyword(s):  
Postoperative Period ◽  
Controlled Trial ◽  
Intraoperative Complications ◽  
Secondary Outcome ◽  
Interval Group ◽  
Treatment Groups ◽  
Study Interval ◽  
Group A ◽  
Group B

PurposeTo compare the effectiveness of intravitreal ziv-aflibercept (IVZ) to intravitreal bevacizumab (IVB) administered preoperatively to patients undergoing pars plana vitrectomy (PPV) for severe manifestations of proliferative diabetic retinopathy (PDR).DesignRandomised clinical trial (RCT).MethodsTwo hundred and six patients with PDR-related complications requiring PPV were randomised into one of two treatment groups: Group A received IVZ (1.25 mg/0.05 mL) 1–10 days before PPV, while Group B received IVB (1.25 mg/0.05 mL) 1–10 days before PPV. The primary outcome was best-corrected visual acuity (BCVA) at 6 months follow-up. Secondary outcome measures were perioperative tractional retinal detachment (TRD) rates, surgical times, intraoperative and postoperative complications and incidence of unplanned PPV during the 6 month study interval.ResultsOne hundred and seventy three subjects underwent PPV and completed the 6-month follow-up interval. Group A subjects had better BCVA at 6 months (p=0.0035), shorter surgical times (p=0.0013) and were less likely to have a recurrence of vitreous haemorrhaging in the postoperative period (p=0.0101) when compared with subjects in Group B. There were no significant differences among the treatment groups with regards to baseline characteristics, perioperative TRD development, intraoperative complications and incidence of unplanned PPV during the 6 month study interval.ConclusionsThis RCT demonstrated better final visual outcomes, shorter operating times and less vitreous haemorrhage recurrences in the postoperative period when subjects received IVZ compared to IVB prior to PPV for the treatment of PDR-related complications.

scholarly journals SURGICAL SITE INFECTION

2018 ◽  
Vol 25 (01) ◽  
pp. 1-4
Author(s):  
Syed Muhammad Nauman ◽  
Yousaf Haroon ◽  
Asrar Ahmad ◽  
Irum Saleem
Keyword(s):  
Antibiotic Prophylaxis ◽  
Controlled Trial ◽  
Wound Infection Rate ◽  
Low Risk ◽  
Military Hospital ◽  
Site Infection ◽  
Duration Of Symptoms ◽  
Group A ◽  
The Difference ◽  
Group B

Objectives: To compare antibiotic prophylaxis in preventing frequency ofpostoperative surgical site wound infection rate in low risk laparoscopic cholecystectomywith controls. Study design: Randomized Controlled Trial. Setting: Department of Surgery,Combined Military Hospital, Rawalpindi. Duration of study: This study was conducted from11-07-2015 to 10-01-2016. Subjects and methods: A total of 650 patients (325 in each group)were included in the study. Patients in group-A received antibiotic prophylaxis whereas patientsin group-B did not receive any antibiotic prophylaxis. Results: Mean age of the patients was44.91±13.37 and 42.28±13.76 years in group-A and B, respectively. In group-A there were152 patients (46.7%) and in group-B 148 patients (45.5%) were males. In group-A 173 patients(53.3%) and in group-B 177 patients (54.5%) were females. In group-A, superficial site infectionwas seen in 4 patients (1.2%) and in group-B superficial site infection was observed in 13patients (4.0%). The difference between two groups was statistically significant (p=0.027).Mean duration of symptoms was 5.75±0.50 and 5.77±0.92 days in group-A and B, respectively.Stratification with regard to age, gender and duration of symptoms was carried out. Conclusion:In conclusion, we recommend the use of pre-operative prophylactic antibiotics for patientswho are undergoing elective low-risk laparoscopic cholecystectomy inorder to prevent postoperativeinfectious complications.

scholarly journals Use of Antibiotics in Cleft Palate Post Operative Patients

2021 ◽  
Vol 15 (7) ◽  
pp. 1484-1486
Author(s):  
Mufassar Nishat ◽  
Muhammad Ansar Aslam ◽  
Abid Hussain ◽  
Najaf Abbas ◽  
Usman Ul Haq ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Clavulanic Acid ◽  
Oral Intake ◽  
Wound Dehiscence ◽  
Acid Group ◽  
Oral Amoxicillin ◽  
Group A ◽  
Amoxicillin Clavulanic Acid ◽  
Group B ◽  
Oral Metronidazole

Background: Cleft palate surgeries are one of the most common surgeries done by Plastic surgeons. Aim: To determine the role of postoperative antibiotics in terms of incidence of complications in cleft palate surgery. Study Design: Prospective randomized control trial. Place and duration of study: Department of Plastic Surgery, Bashir Hospital, Sialkot from May 2016 to January 2019 Methodology:. Patients were randomly divided into two groups. Both groups received a single dose of injection Ceftriaxone (50mg/kg) about 30 minutes before incision. Group A (n=25) received a 5-day regimen of oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) post operatively. Group B (n=25) received 5-day regimen of oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) plus oral Metronidazole (7.5mg/kg/dose in three divided doses) for 5 days postoperatively. Patients were followed up postoperatively at 2 weeks, 1month and 2 months for complication such as infection and wound dehiscence. Result. .Candidates belonging to Group A, (Amoxicillin + Clavulanic acid group) were reported to have Infection 6 (24%) (P 0.005) and delay oral intake. Candidates who were administered oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) plus oral Metronidazole (7.5mg/kg/dose in three divided doses) 2 patients (8%) had infection in group B which was settled with improvement in oral hygiene. Conclusion: whose candidates who were admitted or stayed for longer duration of time in hospital had insufficient and poor dietary intake. One of the candidates was again admitted due to being dehydrated along with rotavirus whereas group A 24% patients got infected on the other end group B only 8% patients got infected.In net shell, this study revealed that use of postoperative antibiotics (Amoxicillin + Clavulanic acid and metronidazole) can reduce the incidence of infection and results in better surgical outcome of cleft palate surgery Keywords: cleft palate repair, Amoxicillin, Clavulanic acid, Metronidazole, Prophylactic Antibiotics

scholarly journals Comparison of Ciprofloxacin and Amoxicillin/Clavulanic Acid in the Treatment of Chronic Rhinosinusitis

2019 ◽  
Vol 7 (4) ◽  
Author(s):  
Zaimal Shahan ◽  
Ghulam Saqulain ◽  
Jawwad Ahmed
Keyword(s):  
Clavulanic Acid ◽  
Chronic Rhinosinusitis ◽  
P Value ◽  
Chi Square ◽  
Group A ◽  
Amoxicillin Clavulanic Acid ◽  
Study Population ◽  
Chronic Rhino Sinusitis ◽  
Randomized Control ◽  
Group B

Objective: To compare ciprofloxacin with amoxicillin/ clavulanic acid in the treatment of chronic rhinosinusitis (CRS) in terms of frequency of improvement in symptom score.Patients and Methods: This randomized control trial was conducted at Department of Otorhinolaryngology, Capital Hospital Islamabad, from March 2015 to March 2016. Study population included 190 cases of Chronic Rhino Sinusitis (CRS) of either gender, aged 18 to 50 years and excluding confounders, divided in two groups. Group A received Ciprofloxacin 500 mg BD and Group B received Amoxicillin/ clavulanic acid 625 mg TDS for 10 days. Symptom score was recorded at start of treatment and finally at 16th week. Data analysis was done by SPSS 17.0. Chi Square was used to compare improvement of two groups. P-value ≤ 0.05 was considered significant.

Survival of classic swine fever virus in hams made from the meat of pigs vaccinated with the PAV-250 strain and unvaccinated pigs

2019 ◽  
Vol 10 (3) ◽  
pp. 536-551
Author(s):  
Heidi Amezcua Hempel ◽  
María Salud Rubio Lozano ◽  
Eliseo Manuel Hernández Baumgarten ◽  
Pablo Correa Girón † ◽  
Oscar Torres Ángeles ◽  
...  
Keyword(s):  
Reference Strain ◽  
Clinical Signs ◽  
Classical Swine Fever ◽  
Fever Virus ◽  
Direct Immunofluorescence ◽  
Biometric Analysis ◽  
Treatment Groups ◽  
Group A ◽  
Group B ◽  
Group D

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

Radiofrequency ablation for markedly incompetent perforators versus compression therapy in the management of post-phelebtic venous ulcers: A randomized controlled trial

Vascular ◽  
2021 ◽  
pp. 170853812110100
Author(s):  
Mohamed Shukri Abdelgawad ◽  
Amr M El-Shafei ◽  
Hesham A Sharaf El-Din ◽  
Ehab M Saad ◽  
Tamer A Khafagy ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Radiofrequency Ablation ◽  
Controlled Trial ◽  
Compression Therapy ◽  
Randomized Controlled ◽  
Venous Ulcers ◽  
Group A ◽  
Group B ◽  
To Receive

Background Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. Patients and methods In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients). Follow-up duration required for ulcer healing continued for 24 months post randomization. Results Statistically significant shorter time to healing (ulcer complete healing or satisfactory clinical improvement) between both groups (56 patients, 90.3% of cases in Group A versus 44 patients 77.2% of cases in Group B) over the follow-up period of 24 months was attained ( p  = 0.001). Also, significantly different ulcer recurrence was recorded between both groups, 8 patients (12.9%) in Group A versus 19 patients (33.3%) in Group B ( p = 0.004). Conclusion In absence of deep venous obstruction, the monopolar radiofrequency ablation for incompetent perforators is a feasible and effective method that surpasses the traditional compression protocol for incompetent perforator-induced venous ulcers in terms of time required for healing even in the presence of unresolved deep venous valvular reflux.

scholarly journals Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanyu Yang ◽  
Zefei Zhu ◽  
Hongyu Zheng ◽  
Shifeng He ◽  
Wanyue Zhang ◽  
...  
Keyword(s):  
Thermal Insulation ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Laparoscopic Hysterectomy ◽  
Control Group ◽  
Prospective Randomized Controlled Trial ◽  
Warming Blanket ◽  
Group A ◽  
Insulation Effect ◽  
Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

scholarly journals Management of walled-off necrosis with nasocystic irrigation with hydrogen peroxide versus biflanged metal stent: randomized controlled trial

2021 ◽  
Vol 09 (07) ◽  
pp. E1108-E1115
Author(s):  
Sudhir Maharshi ◽  
Shyam Sunder Sharma ◽  
Sandeep Ratra ◽  
Bharat Sapra ◽  
Dhruv Sharma
Keyword(s):  
Hydrogen Peroxide ◽  
Adverse Events ◽  
Clinical Success ◽  
Controlled Trial ◽  
Procedure Time ◽  
Metal Stent ◽  
Technical Success ◽  
Group A ◽  
Group B ◽  
Walled Off Necrosis

Abstract Background and study aims Walled-off necrosis (WON) is a known complication of acute necrotizing pancreatitis (ANP). There is no study comparing nasocystic irrigation with hydrogen peroxide (H2O2) versus biflanged metal stent (BMS) in the management of WON. The aim of this study was to compare the clinical efficacy of both the treatment strategies. Patients and methods This study was conducted on patients with symptomatic WON who were randomized to nasocystic irrigation with H2O2 (Group A) and BMS placement (Group B). Primary outcomes were clinical and technical success while secondary outcomes were procedure time, adverse events, need for additional procedures, duration of hospitalization, and mortality. Results Fifty patients were randomized into two groups. Group A (n = 25, age 37.8 ± 17.6 years, 16 men) and Group B (n = 25, age 41.8 ± 15.2 years, 17 men). There were no significant differences in baseline characteristics between the two groups. The most common etiology of pancreatitis was alcohol, observed in 27 (54 %) patients. Technical success (100 % vs 96 %, P = 0.98), clinical success (84 % vs 76 %, P = 0.76), requirement of additional procedures (16 % vs 24 %, P = 0.70) and adverse events (4 vs 7, P = 0.06) were comparable in both the groups. The duration to clinical success (34.4 ± 12 vs 14.8 ± 10.8 days, P = 0.001) and procedure time (36 ± 15 vs 18 ± 12 minutes, P = 0.01) were longer in Group A compared to Group B. Conclusions Nasocystic irrigation with H2O2 and BMS are equally effective in the management of WON but time to clinical success and procedure time is longer with nasocystic irrigation.

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

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