Comparison of the accuracy of two scoring systems in predicting the outcome of organophosphate intoxicated patients admitted to intensive care unit (ICU)

AbstractIntroductionOrganophosphates(OP) are one of the most common causes of poisoning, especially in developing countries, with high morbidity and mortality. As mortality rate of OP poisoning is still high, early diagnosis and appropriate treatment is often life saving. OP is the main cause of poisoning and death in the poison control centre (PCC), Ain Shams University (ASU) in Egypt.ObjectiveTo compare the accuracy of acute physiology and chronic health evaluation score (APACHE IV) and simplified acute physiology score (SAPS II) in the prediction of mortality of patients with organophosphate poisoning (OPP) who required admission to the Intensive Care Unit (ICU) of PCC of ASU between January 1st, 2009 and December 31st, 2009.MethodsA prospective study conducted by collecting data on consecutive patients with acute OPP admitted to the intensive care unit over 12months. Data required to calculate the patients’ predicted mortality by (APACHE) IV and (SAPS) II scoring systems were collected.ResultsNinety patients were recruited in the study with acute OP toxicity. The observed mortality following acute OP toxicity was 13.3% (12 patients). The area under the receiver operator characteristic (ROC) curves of APACHE IV score was better than SAPS II score (0.921±0.054 SE, 0.807±0.078 SE, respectively). APACHE IV and SAPS II scores were significantly higher in the non-survival than in the survival group (P<0.05).ConclusionAPACHE IV and SAPS II scores calculated within the first 24h are good prognostic indicators among patients with acute OP toxicity that required ICU admission with preference to APACHE IV score. APACHE IV and SAPS II scores above 89, 44, respectively within the first 24h are a predictor of poor outcome in patients with acute OP toxicity.RecommendationApplication of APACHE IV and SAPS II scores is a good predictor of high mortality in OP intoxicated patients which helps in proper allocation of resources

Development and validation of a repharsed phase- HPLC method for simultaneous determination of rosiglitazone and glimepiride in combined dosage forms and human plasma

<p>Abstract</p> <p>Background</p> <p>Rosiglitazone (ROZ) and glimepiride (GLM) are antidiabetic agents used in the treatment of type 2 diabetes mellitus. A survey of the literature reveals that only one spectrophotometric method has been reported for the simultaneous determination of ROS and GLM in pharmaceutical preparations. However the reported method suffers from the low sensitivity, for this reason, our target was to develop a simple sensitive HPLC method for the simultaneous determination of ROZ and GLM in their combined dosage forms and plasma.</p> <p>Results</p> <p>A simple reversed phase high performance liquid chromatographic (RP-HPLC) method was developed and validated for the simultaneous determination of Rosiglitazone (ROS) and Glimepiride (GLM) in combined dosage forms and human plasma. The separation was achieved using a 150 mm × 4.6 mm i.d., 5 μm particle size Symmetry^®C18 column. Mobile phase containing a mixture of acetonitrile and 0.02 M phosphate buffer of pH 5 (60: 40, V/V) was pumped at a flow rate of 1 mL/min. UV detection was performed at 235 nm using nicardipine as an internal standard. The method was validated for accuracy, precision, specificity, linearity, and sensitivity. The developed and validated method was successfully used for quantitative analysis of Avandaryl™ tablets. The chromatographic analysis time was approximately 7 min per sample with complete resolution of ROS (t_R= 3.7 min.), GLM (t_R= 4.66 min.), and nicardipine (t_R, 6.37 min). Validation studieswas performed according to ICH Guidelines revealed that the proposed method is specific, rapid, reliable and reproducible. The calibration plots were linear over the concentration ranges 0.10-25 μg/mL and 0.125-12.5 μg/mL with LOD of 0.04 μg/mL for both compounds and limits of quantification 0.13 and 0.11 μg/mL for ROS and GLM respectively.</p> <p>Conclusion</p> <p>The suggested method was successfully applied for the simultaneous analysis of the studied drugs in their co-formulated tablets and human plasma. The mean percentage recoveries in Avandaryl™ tablets were 100.88 ± 1.14 and 100.31 ± 1.93 for ROS and GLM respectively. Statistical comparison of the results with those of the reference method revealed good agreement and proved that there were no significant difference in the accuracy and precision between the two methods respectively. The interference likely to be introduced from some co-administered drugs such as glibenclamide, gliclazide, metformine, pioglitazone and nateglinide was investigated.</p

Biogenic silver nanoparticles eradicate of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) isolated from the sputum of COVID-19 patients

In recent investigations, secondary bacterial infections were found to be strongly related to mortality in COVID-19 patients. In addition, Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) bacteria played an important role in the series of bacterial infections that accompany infection in COVID-19. The objective of the present study was to investigate the ability of biosynthesized silver nanoparticles from strawberries (Fragaria ananassa L.) leaf extract without a chemical catalyst to inhibit Gram-negative P. aeruginosa and Gram-positive Staph aureus isolated from COVID-19 patient’s sputum. A wide range of measurements was performed on the synthesized AgNPs, including UV–vis, SEM, TEM, EDX, DLS, ζ -potential, XRD, and FTIR. UV-Visible spectral showed the absorbance at the wavelength 398 nm with an increase in the color intensity of the mixture after 8 h passed at the time of preparation confirming the high stability of the FA-AgNPs in the dark at room temperature. SEM and TEM measurements confirmed AgNPs with size ranges of ∼40-∼50 nm, whereas the DLS study confirmed their average hydrodynamic size as ∼53 nm. Furthermore, Ag NPs. EDX analysis showed the presence of the following elements: oxygen (40.46%), and silver (59.54%). Biosynthesized FA-AgNPs (ζ = −17.5 ± 3.1 mV) showed concentration-dependent antimicrobial activity for 48 h in both pathogenic strains. MTT tests showed concentration-dependent and line-specific effects of FA-AgNPs on cancer MCF-7 and normal liver WRL-68 cell cultures. According to the results, synthetic FA-AgNPs obtained through an environmentally friendly biological process are inexpensive and may inhibit the growth of bacteria isolated from COVID-19 patients

Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries

Abstract Background Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. Methods A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. Results A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%). Conclusion COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered

Residual and Past Entropy for Concomitants of Ordered Random Variables of Morgenstern Family

For a system, which is observed at time t, the residual and past entropies measure the uncertainty about the remaining and the past life of the distribution, respectively. In this paper, we have presented the residual and past entropy of Morgenstern family based on the concomitants of the different types of generalized order statistics (gos) and give the linear transformation of such model. Characterization results for these dynamic entropies for concomitants of ordered random variables have been considered

Blood, serum glucose and renal parameters in lead-loaded albino rats and treatment with some chelating agents and natural oils

This study investigated lead impact on blood, serum glucose and kidney function and the efficacy of treatment with chelating agents meso-2, 3-dimercaptosuccinic acid (DMSA), calcium disodium ethylenediaminetetraacetic acid (CaNa_2-EDTA) and natural olive and garlic oils to reduce lead toxicity in albino rats. Oral administration of 1000 or 2000 ppm lead acetate significantly decreased red blood cell count, hemoglobin level and hematocrit value at 20, 40 and 60 days compared with control groups (rats administered deionized water and 1000 or 2000 ppm sodium acetate). Serum glucose was also decreased significantly with both doses of lead acetate administration. In contrast, serum urea, uric acid and creatinine were significantly increased. Garlic or olive oils (1 ml/kg body weight/day, each) alleviated the previous changes in blood, serum glucose and renal parameters, whereas DMSA (50 mg/kg body weight/day) or CaNa_2-EDTA (100 mg/kg body weight/day) reversed such changes to near the control levels. Although chemical therapy is more efficient in reducing lead toxicity, natural products with their fewer side effects are still preferable

Evaluation of ethical and legal perspectives of physician–patient relationship on Arabic Health Websites

AbstractIntroductionThe internet is becoming an increasingly popular tool for health seekers. Research on health websites raises ethical debate about the quality of information on the Websites. This work aimed to evaluate Arabic Health Websites from ethical and legal perspectives and evaluate the physician–patient relationship on the web.MethodsThis is a descriptive study. A Google and Yahoo search for the term “Arabic Health Websites” in Arabic language was performed and 430 relevant websites were accessed. They were evaluated using a checklist designed by research team based on E-Health Code of Ethics, 2000 to evaluate candor, honesty, quality of information, privacy, informed consent and professionalism in online healthcare.ResultsAuthors were mentioned in 21.4% of sample and 90% of sites did not mention when the information was last updated. It was noticed that 9.5% of sites mentioned collects data from users and whether data is shared with others or not. The limitations of consultation were mentioned in only 17.7%. The present study revealed that 42.5% of websites assured that healthcare providers obey the laws and regulations governing professional licensing and prescribing.ConclusionThis study revealed poor coverage of most evaluated items

Inference on Constant-Stress Accelerated Life Testing Based on Geometric Process for Extension of the Exponential Distribution under Type-II Progressive Censoring

In this paper, the geometric process is introduced as a constant-stress accelerated model to analyze a series of life data that obtained from several increasing stress levels. The geometric process (GP) model is assumed when the lifetime of test units follows an extension of the exponential distribution. Based on progressive censoring, the maximum likelihood estimates (MLEs) and Bayes estimates (BEs) of the model parameters are obtained. Moreover, a real dataset is analyzed to illustrate the proposed procedures. In addition, the approximate, bootstrap and credible confidence intervals (CIs) of the estimators are constructed. Finally, simulation studies are carried out to investigate the precision of the MLEs and BEs for the parameters involved