Antibiotic usage in pediatric respiratory tract infection

Respiratory tract infections are the worldwide main cause of death in children aging less than 5 years. In developed countries; respiratory tract infections are the leading cause of morbidity, accounted for 20% of medical consultation, 30% of work absenteeism and 75 % of all antibiotic prescription. Upper respiratory tract infections in children, which often associated with viral infection, and in average about 40 – 60 % of children with upper respiratory tract infections were prescribed with antibiotics. The type of antibiotics also varies from hospital to another.The objectives of this study are to describe the pattern, outcome, and cost of antibiotic usage in pediatric respiratory tract infections. A prospective study of pediatrics admitted to Pediatric Ward, Penang Hospital for respiratory tract infections was carried out. Appropriate descriptive analysiswas used. The results showed that penicillin, erythromycin; amoxicillinclavulanate were the most commonly prescribed antibiotics for respiratory tract infections. The average duration of antibiotic therapy 3.0 ± 3.2 days, fever clearance time 2.2 ± 2.4 days, improvement of sign and symptoms 3.7 ± 2.5 days and mean length of stay in the ward was 4.9 ± 2.8 days. The average cost of antibiotics was RM 14.83 ± 83.13, and total cost of respiratory tract infections treatment was RM 98.88 ± 65.87.Key words: antibiotic, respiratory tract infection, pediatric, hospita

Justicialosides A and B, two new flavone glycosides from the leaves of Ruspolia hypocrateriformis (Vahl) Milne-Redh. (Acanthaceae)

Two new flavone glycosides, luteolin 7-O-α-L-rhamnopyranosyl-(1→2)-β-D-xylopyranoside (1) and chrysoeriol 7-O-α-L-rhamnopyranosyl-(1→2)-β-D-xylopyranoside (2), along with five known compounds, luteolin 7-O-β-D-apiofuranosyl-(1→2)-β-D-xylopyranoside (3), grandulosides A and B (4 and 5), luteolin 7-O-[β-D-glucopyranosyl-(1→2)-α-L-rhamnosyl-(1→6)]-β-D-glucopyranoside (6) and 10H-quindoline (7) were isolated from the leaves of Ruspolia hypocrateriformis (Acanthaceae). Their structures were elucidated by spectroscopic means, including 1D and 2D NMR, HRESIMS and by comparison with published data

Four new neo-clerodane diterpenes from the stem bark of Croton oligandrus.

Four new neo-clerodanes, crotonolins C-F (3-6), were isolated from the stem bark of Croton oligandrus together with the known clerodane crotonzambefuran A, the abietanes 7-β-hydroxydehydroabietic acid and 7-oxodehydroabietic acid, and ferulic acid. Their structures were elucidated by spectroscopic analyses including 1D and 2D NMR and HRESIMS and by comparison with previously reported data. The cytotoxicity of the isolated compounds against A549, MCF7, PC3 and PNT2 cells was evaluated using the MTT assay. Only 7-β-hydroxydehydroabietic acid showed a moderate level of activity against PC3 cells with an IC50 value of 68.9 ± 6.6 μM

Subaponeurotic fluid collection (SFC) in an infant

Subaponeurotic fluid collection is an infrequent cause of scalp swelling in infants. We report a 10-week-old male who had a scalp swelling for five days without any recent history of head injury. There was a soft, mobile, non-tender, transilluminating, fluctuant swelling over posterior parieto-occipital area and it was not limited by suture lines. Cranial ultrasonography showed a subaponeurotic collection at the posterior parieto-occipital area without definite communication with the intracranial space or the brain parenchyma. This infant was treatedconservatively. The swelling resolved spontaneously after 4 weeks. The lack of awareness of some doctors in the Emergency Department about this condition may lead to unnecessary investigations, ward admission and intervention. It is hoped that this case report will provide emergency health care professionals the confidence to make accurate diagnosis and treat patient with subaponeurotic fluid collection optimally

Growth inhibitory activity of biflavonoids and diterpenoids from the leaves of the Libyan Juniperus phoenicea against human cancer cells

Three biflavonoids [cupressuflavone (1), amentoflavone (2)and sumaflavone (3)], four diterpenoids [13-epi-cupressic acid (4), imbricatholic acid (5), 3-hydroxy-sandaracopimaric acid (6)and dehydroabietic acid (7)]and onelignan [β-peltatin methyl ether (8)],were isolated from the cytotoxicfractions of the extracts of the leaves of the Libyan Juniperus phoeniceaL. The structures of these compounds were elucidated by spectroscopic means.Cytotoxicity of the compounds 1-6were assessedagainst the human lung cancer cell lineA549 using the MTT assay. Compounds 1and 3showed cytotoxicityagainst the A549cells(IC50= 65 µMand 77 µM, respectively), whereas, compound 2did not show any activity. Diterpenes4-6exhibited weak cytotoxicity against the A549 cells with the IC50values of 159 µM, 263 µMand 223 µM, respectively. The cytotoxicity of each compound was compared with the anticancer drug,etoposide (IC50=61 µM).Cupressuflavone (1)wasevaluatedalso for cytotoxicity against both the human PC3 cancer cell lineand the normal prostatecell line (PNT2), and this compoundrevealed a high degreeof cytotoxic selectivity towards the prostate cancer cells (PC3), with IC50value of 19.9 µM, without any evidence of cytotoxicity towards the normal prostatecell line(PNT2)

One-pot synthesis and negative ion mass spectrometric investigation of a densely functionalized cinnoline, 3-amino-5,7,8-trichloro-6-hydroxycinnoline-4-carbonitrile

Known densely substituted 3-amino-5,7,8-trichloro-6-hydroxycinnoline-4-carbonitrile was synthesized using a new synthetic protocol involving chloranil and malonitrile via quinone methide formation. This one-pot synthesis occurs under base mediated conditions in a polar medium. The method involves condensation of excess malononitrile with chloranil in ethanol at reflux to 2-(2,4,5-trichloro-3-hydroxy-6-oxocyclohexa-2,4-dien-1-ylidene) malononitrile. This is an atom efficient, simple and effective procedure for the preparation of a highly substituted cinnoline that can serve as a relay to antimalarial prototypes

Liquid chromatography mass spectrometry analysis and cytotoxicity of Asparagus adscendens roots against human cancer cell lines

Background: Asparagus adscendens Roxb. (Asparagaceae), is native to the Himalayas. This plant has been used in the prevention and effective treatment of various forms of cancers. Objective: This paper reports, for the first time, on the cytotoxicity of the methanol (MeOH) extract of the roots of A. adscendens and its solid‑phase extraction (SPE) fractions against four human carcinoma cell lines and LC‑ESI‑QTOF‑MS analysis of the SPE fractions. Materials and Methods: Finely powdered roots of A. adscendens were macerated in methanol and extracted through SPE using gradient solvent system (water: methanol) proceeded for analysis on LC‑ESI‑QTOF‑MS and cytotoxicity against four human carcinoma cell lines: breast (MCF7), liver (HEPG2), lung (A549), and urinary bladder (EJ138), using the 3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyltetrazoliumbromide assay. Results: The MeOH extract and four SPE fractions exhibited cytotoxicity against all cell lines with the IC50 values ranging from 6 to 79 μg/mL. As observedin other Asparagus species, the presence of saponins and sapogenins in the SPE fractions was evident in the liquid chromatography‑mass spectrometry data. Conclusion: It is reasonable to assume that the cytotoxicity of the MeOH extract of the roots of A. adscendens and its SPE fractions, at least partly, due to the presence of saponins and their aglycones. This suggests that A. adscendens could be exploited as a potential source of cytotoxic compounds with putative anticancer potential

A cost effectiveness and capacity analysis for the introduction of universal rotavirus vaccination in Kenya : comparison between Rotarix and RotaTeq vaccines

Background Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Methods Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. Results The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Conclusion Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability

Occupational illnesses in the 2009 Zambian labour force survey

<p>Abstract</p> <p>Background</p> <p>Occupational health has received limited research attention in the Southern African Development Community (SADC). Much of the published data in this region come from South Africa and little has been reported north of the Limpopo. The present study was conducted to estimate the burden of occupational illnesses in Zambia and assess factors associated with their occurrence.</p> <p>Methods</p> <p>Data were obtained from the Zambian Labour Force Survey of 2009. Frequencies were used to estimate the prevalence of occupational diseases. Logistic regression analyses were conducted to determine the associations between demographic, social and economic factors and reported illness resulting from occupational exposures. Odds ratios (OR) from bivariate analyses and adjusted odds ratios (AOR) from the multivariate analysis together with their 95% Confidence Intervals (CI) are reported.</p> <p>Results</p> <p>Data on 59,118 persons aged 18 years or older were available for analysis, of which 29805 (50.4%) were males. The proportions of the sample that reported to have suffered from an occupational illness were 12.7% among males and 10.4% among females (p < 0.001). Overall the proportions of respondents who reported suffering from fatigue, fever and chest infections were 38.8%, 21.7% and 17.1%, respectively. About two thirds (69.7%) of the study participants had stayed away from work due to the illness suffered at work; there was no sex differences (p = 0.216). Older age, being male, lower education level, married/cohabiting or once married (separated/divorced/widowed), and paid employee or employer/self employed were positively associated with having suffered from illness.</p> <p>Conclusions</p> <p>The findings from this study call for urgent effort for specific measures to prevent and mitigate the effects of occupational injuries. These interventions may include: public health campaigns, enforcement or change in work policies and regulations. Special attention may have to be made towards those who were more likely to suffer from occupational illnesses.</p