The efficacy of oral versus parentral vitamin D in treatment of nutritional rickets

Rickets is the most common form of metabolic bone disease in children. Vitamin D deficiency rickets is clearly a problem in breast-fed infants who do not receive enough vitamin D or adequate sunshine exposure. The study was carried out on 30 patients who had clinical evidence of rickets. Patients were divided into three equal groups. Group A received 600,000U IM once; group B received 20,000U IM three times a week for two weeks and group C received 2000U/day orally for a month. The aim of this study was to compare the effect of different doses of ergocalciferol on serum calcium, phosphorous and alkaline phosphatase. Results show that the serum alkaline phosphatase concentration significantly decreased more in the group B compared to group A and group B (p=0.013 and p=0.001, respectively). Patients who received the intramuscular dose responded promptly, whereas infants who received the oral dosages had less response. [Med-Science 2012; 1(4.000): 244-53

Toxicity and biochemical changes in the honey bee Apis mellifera exposed to four insecticides under laboratory conditions

International audienceThe toxicity and biochemical changes in honey bees (Apis mellifera) treated with four insecticides—acetamiprid, dinotefuran, pymetrozine, and pyridalyl—were evaluated under controlled laboratory conditions. Foraging bees were exposed to different dosages of tested insecticides by oral feeding at different dosages recommended by the manufacturers for agricultural crops in Egypt (0.01-, 0.02-, 0.04-, 0.1-, and onefold). Moreover, the acute toxicity of these insecticides was evaluated by topical application on the thorax of foragers to calculate the LD50 values. The specific activities of acetylcholinesterase (AChE), carboxylesterase, glutathione S-transferase (GST), and polyphenol oxidase (PPO) were measured in different tissues of surviving foragers after 24 h of treatment to explore the possible mode of action of insecticides and honey bees' strategies for detoxification and tolerance. The results indicated that regardless of how the bees were exposed to insecticides, dinotefuran was extremely toxic to adult A. mellifera (topical LD50 = 0.0006 μg/bee and oral feeding LC50 = 1.29 mg/L). Pyridalyl showed moderate toxicity compared to dinotefuran at the recommended application rate; however, acetamiprid and pymetrozine were relatively less toxic to bees (<25 % mortality at the recommended application rates). Data showed that tested insecticides varied in their influence on AChE, carboxylesterase, GST, and PPO activities that were highly correlated to their toxicity against A. mellifera. The biochemical analysis of carboxylesterase and GST showed that these enzymes detoxified the low doses of acetamiprid, pymetrozine, and pyridalyl, but not dinotefuran. Overall, our results are valuable not only in evaluating the toxicity of common insecticides onto honey bees, but also in highlighting the validity of enzymes activities as proper indicators for exposure to agrochemicals

PROSPECTIVE STUDY ON THE EFFECT OF PHARMACEUTICAL CARE ON MATERNAL AND FETAL OUTCOMES IN GESTATIONAL AND PREGESTATIONAL DIABETIC PATIENTS

Objective: The prevalence of diabetes in pregnancy has increased in the U. S. The majority is gestational diabetes mellitus (GDM), with the remainder primarily preexisting type 1 diabetes and type 2 diabetes (pregestational diabetes, PGDM). The present study investigates the demographics and clinical differences between both types. Methods: This prospective study was conducted on ninety pregnant females with normal menstrual cycles before pregnancy. Demographics, oral glucose tolerance test (OGTT), and HbA1c were assessed. Results: There was a significant difference in the term of Oral glucose tolerance test Week 24 during fasting, Oral glucose tolerance test Week 24 after one hour, Oral glucose tolerance test Week 24 after two hours, Oral glucose tolerance test Week 24 after three hours, Oral glucose tolerance test Week 28 during fasting, Oral glucose tolerance test Week 28 after one hour, Oral glucose tolerance test Week 28 after two hours, Oral glucose tolerance test Week 28 after three hours, HbA1c week 24 and HbA1c week 28; p-value&lt;0.05. Conclusion: pregnant women in this study who needed insulin were educated to self-monitoring of blood glucose, diet control, medication adherence, and exercise, and we adjusted the needed insulin dose for them with restrictive follow-up

Transradial artery approach in STEMI patients reperfused early and late by either primary PCI or pharmaco-invasive approach

The purpose of the study was to investigate the safety and efficacy of transradial artery approach (TRA) in STEMI patients who reperfused early (≤3 h from symptoms onset) or late (>3 h from symptoms onset) by either PPCI or pharmaco-invasive strategy (PI), thrombolysis followed by CA. Therefore, a total 143 STEMI patients (who were presented within 12 h from symptoms onset or 12–24 h with an evidence of ongoing ischemia or suffered from an acute STEMI were randomized for either PI or PPCI. Eighty-two patients were assigned to PI arm while the rest assigned were to PPCI arm. Patients who were taken to a non-PCI capable hospital received streptokinase and were then transferred to our Hospital for CA. TRA was used in the catheterization laboratory for all patients. Each arm was divided according to reperfusion time into early and late subgroups. A primary endpoint was death, shock, congestive heart failure, or reinfarction up to 30 days. There was a non-significant difference regarding LVEF in both arms. Myocardium wall preservation was significant in the early PI arm (P = 0.023). TIMI flow had no discrepancy between both arms (P = 0.569). Mean procedural and fluoroscopic time were 35.1 ± 6.1 and 6.3 ± 0.9 min. There were no reported entry site complications. There was no difference in primary endpoint complications (P = 0.326) considering the different times of patients’ reperfusion (early; P = 0.696 vs. late; P = 0.424). In conclusion, it is safe and effective to use TRA in STEMI patients who reperfused by either early or late PPCI or PI. We recommend PI for STEMI patients with delay presentation if PPCI is not available. Keywords: ST-myocardial infarction, Primary PCI, Pharmaco-invasive, Transradial approach, Streptokinas

Effect of Nebulizer Designs on Aerosol Delivery During Non-Invasive Mechanical Ventilation: A Modeling Study of In Vitro Data

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s41030-017-0033-7">https://link.springer.com/article/10.1007/s41030-017-0033-7</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

The Outcomes and Adverse Drug Patterns of Immunomodulators and Thrombopoietin Receptor Agonists in Primary Immune Thrombocytopenia Egyptian Patients with Hemorrhage Comorbidity

Immune thrombocytopenia (ITP) treatment has evolved recently. However, none of the treatments have only benefits without drawbacks. This study aimed to compare the clinical outcomes and adverse drug patterns of Eltrombopag, Romiplostim, Prednisolone + Azathioprine, High Dose-dexamethasone (HD-DXM) (control group), and Rituximab in primary ITP Egyptian patients. All patients were initiated with corticosteroids, HD-DXM, as a first-line treatment for the first month immediately following diagnosis. Four hundred sixty-seven ITP patients were randomly assigned to five groups. The outcome measures were judged at baseline, at the end of treatment (6 months), and after an additional 6-month free treatment period. The follow-up period for which relapse is noted was 6 months after the end of treatment. Eltrombopag and Romiplostim resulted in a significantly higher incidence of sustained response than Rituximab, HD-DXM, and Prednisolone + Azathioprine (55.2% and 50.6% vs. 29.2%, 29.1%, and 18%, respectively; p-value p-value < 0.01). We also describe 23 reports of pulmonary hypertension with Prednisolone+ Azathioprine and 13 reports with HD-DXM. The thrombotic events occurred in 16.6% and 13% of patients who received Eltrombopag and Romiplostim treatment, respectively. Most patients had at least one or two risk factors (92.8% of cases). Corticosteroids are effective first-line therapy in primary ITP patients. However, relapse is frequent. Eltrombopag and Romiplostim are safer and more effective than Prednisolone, HD-DXM, and Rituximab. They might be reasonable beneficial options after a one-month HD-DXM regimen