Antipyretics Research Articles

COVID-19 in elderly: Management issues

Introduction: COVID 19 has once again brought to the forefront the issue of vulnerability of the geriatric population to diseases. Advanced age itself and comorbidities (obesity, DM, HTN/IHD, COPD, CLD, CKD, immunocompromised states, transplant, malignancy and CHD), which increase with age, are the main risk factors for contracting severe COVID 19. Immunosenescence, unpredictable disease course, atypical symptoms, pathophysiological changes in respiratory system and a state of hypercoagulability associated with aging are responsible for increased severity and mortality of SARS CoV 2 in the elderly. Management: Diagnosis: RT PCR is the gold standard investigation for diagnosis though it has approximately 33% false negative rate. Classification: On the basis of dyspnea, respiratory rate and SpO2 in room air, patients are classified as mild, moderate and severe cases. On the basis of severity of case, investigation and monitoring is planned. Treatment: Mild cases are advised home isolation whereas moderate and severe cases require hospitalization. Mild cases usually subside with use of anti pyretics, immunomodulators (Zinc, Vit C, D), hydration, anti tussives and anti virals (Doxycycline, Ivermectin, Favipiravir). Oxygen therapy and steroids form the mainstay of treatment in moderate and severe cases. Anti coagulants, anti viral (Remdesivir) and monoclonal antibody (Tocilizumab) are used as and when required. Newer drugs like antibody cocktail and 2-DG have also been developed. Chest physiotherapy (proning and spirometric exercise) enhances recovery. Prevention: COVID appropriate behavior (use of mask, hand hygiene and physical distancing) and priority vaccination of elderly are the most important tools to safeguard geriatric population.

Clinical characteristics of SARS-CoV-2 nucleic acid positive patients during infection in Shenzhen

Objective To analyze the clinical characteristics of SARS-CoV-2 positive patients during infection, and we provide reference for clinical diagnosis and treatment. Methods The patients who visited the Special Fever Clinic in Shenzhen Longgang District People’s Hospital from January 22 to February 16, 2020 were selected as the research subjects, and the clinical manifestations of the patients during infection were analyzed retrospectively. Among them, 17 cases (positive group) were diagnosed as COVID-19, which were positive for SARS-CoV-2 nucleic acid, 74 cases (negative group) were diagnosed as non-COVID-19, which were negative for SARS-CoV-2 nucleic acid. We analyze the basic situation, clinical manifestations and drug use of the positive group before seeing a doctor, and to analyze blood routine examination, hs-CRP and imaging features between the two groups, and to do a statistical analysis. Results Among the 17 patients of SARS-CoV-2 nucleic acid testing positive, 9 cases were males, 8 females, patients with underlying diseases were 9 cases, patients with epidemic history 15 cases, patients with abnormal CT images 16 cases (94.12%), patients who had taken anti-inflammatory drugs or antipyretics before consultation 10 cases (58.83%). Regarding the comparison between the two groups, WBC, NEUT# and LYM#, all the three index differences had statistical significance ( P <0.05); the distribution of clinical manifestations at different levels WBC and imaging characteristics, both were statistically significant ( P <0.05). Conclusion Combining the epidemiological history, pre-visit medication, peripheral blood WBC, NEUT#, LYM#, and imaging features, it is helpful for clinicians to provide reference for early diagnosis of COVID-19, to achieve early diagnosis, early isolation, early treatment. 摘要：目的 分析新型冠状病毒肺炎患者发病初期临床表现特点, 为临床诊断治疗提供参考依据。 方法 选取 2020 年 1 月 22 日—2 月 16 日到深圳市龙岗区人民医院特殊发热门诊就诊患者为研究对象, 按新型冠状病毒核酸检测 结果, 阳性为 COVID-19 患者组和阴性为非 COVID-19 患者组, 分析两组基本情况、临床表现、就诊前用药、实验室检查 和影像学特征, 并进行统计学分析。 结果 COVID-19 患者组 17 例, 其中男性 9 例, 女性 8 例, 有基础疾病 9 例, 有明确 的流行病学史 15 例、CT 影像学异常 16 例 (占 94.12%), 就诊前使用过抗感染、退烧药 10 例 (占 58.83%); 两组 WBC、 NEUT#和 LYM#差异有统计学意义 ( P < 0.05); 从两组实验室检查的不同水平分布比较, 两组 WBC 和影像学特征差异有 统计学意义 ( P <0.05) 。 结论 结合流行病学史、就诊前用药情况、外周血 WBC、NEUT#、LYM#以及影像学特点有利于 为临床医师早期诊断新型冠状病毒肺炎提供参考依据, 做到早诊断、早隔离、早治疗。

Prevalence, attitude and practice of self-medication among adolescents and the paradigm of dysmenorrhea self-care management in different countries.

Self-medication (SM) is an important worldwide public health issue affecting children and adolescents. The pattern of SM varies in different communities, affected by factors such as age, sex, income, expense, self-care orientation, educational level and medical knowledge. It is a fairly common practice: for minor health problems, it often provides cheap, rapid, and convenient solutions, outside of the health care system of many countries. Painkillers, antipyretics, cough medicines, cold preparations, dermatological products, nutritional supplements and antibiotics are the drugs most frequently used. Potential risks include incorrect self-diagnosis, improper dosage, inappropriate choice of therapy, masking of severe disease and drug interactions. Lack of awareness of warnings and precautions, storage conditions, the recommended shelf-life and adverse reactions increase the risk of side effects. Little is known about the SM of dysmenorrhea by adolescent girls. Attitudes towards treatment are influenced by cultural, ethnic, and religious factors. Some girls discuss dysmenorrhea with family and friends, and the majority may not seek medical advice. As dysmenorrhea is a common problem for adolescents, it is essential that these girls be aware of the normal and abnormal symptoms of menstruation. In the light of these findings, the roles of family, school, health professionals and health authorities are of utmost importance for the implementation of measures to approach this health problem in a more efficient way. (www.actabiomedica.it)

Effects of Peripheral Cold Application and Antipyretics on Hemodynamic Parameters in Febrile ICU Patients Diagnosed with Hospital-Acquired Infections

Background: Accurately assessing hemodynamic parameters plays an important role in preventing complications during and after interventions related to a fever in febrile patients. There are not enough studies related on the effects of peripheral cold application (PCA) and antipyretics (APs) on hemodynamic parameters in febrile patients. Objectives: The aim was to determine the effects of PCA and APs on hemodynamic parameters in febrile ICU patients diagnosed with hospital-acquired infections (HAIs). Methods: In this retrospective study, the archive documents of the 346 adult ICU patients diagnosed with HAIs of a university hospital in Turkey were evalauted. Body temperature (BT), systolic/diastolic blood pressure (SBP/DBP), pulse rate (PR), respiratory rate (RR), and arterial O2Sat (aO2sat) changes one hour before, during, and one hour after application of PCA or APs were evalauted. Results: The incidence of HIAs was 4.16%. A total of 46% of the patients had a bacteremia infection and causative microorganisms in 16.8% were Acinetobacter spp. BT, DBS, PR, and aO2Sat changes one hour before, during, and one hour after PCA were significantly different. In addition, BT, RR, and aO2Sat changes one hour before, during, and one hour after APs were also significantly different (P < 0.05). More decrease in SBP and DBP were observed between during and one hour after APs compare with PCA. Conclusions: BT and hemodynamic parameters, especially SBP and DBP changes, were higher in APs compared with PCA. Knowledge regarding the effects of APs on BT and hemodynamic parameters will be of benefit to the ICU staff in terms of quality of care in febrile patients. The ICU staff should be proactive in ensuring that they have an evidence-based management plan for the prevention of HIAs and management of fever that conforms to the relevant clinical guidelines and integrates multidisciplinary care.

Prescription pattern among Iranian community dwelling older adults.

Aim To assess prescription pattern among Iranian communitydwelling older adults. Methods This cross-sectional study employed a cluster random sampling to obtain a sample of 1591 patients aged 60 years and over referred to pharmacies in Tehran, 2017. Data were collected using a questionnaire: socio-demographic characteristics, type of pharmacy visited, the municipal district, the university covering the pharmacy, the number and names of prescribed drugs, drug category, type of insurances and physician's socio-demographic profile (age, gender, type of specialization, and work experience). Results The mean age of the patients was 70.51±7.84. A total of 5838 drugs were prescribed, giving an average of 3.73±2.24 drugs per patient (ranging of 1-15). Polypharmacy was noticed in 32.4% patients. Cardiovascular drugs accounted for 20.8% of the prescriptions, antidiabetics 8.8%, nutritional agents and vitamins 7.6%, and analgesics, anti-inflammatory drugs and antipyretics accounted for 7.5%. Conclusion Developing educational programs on geriatric pharmacology general practitioners and more supervision among community-dwelling older adults might have effects on prescription pattern. There is a need for prescriber training and retraining with emphasis on the geriatric population.

Effects of extreme dose of heat-clearing drugs on the temperature of the patients with postoperative fever

Objective To observe the effect of exteme dose of heat-clearing drugs on temperature in the postoperative fever patients. Methods A total of 70 patients with postoperative fever who met the inclusion criteria were randomly divided into the control group (35 patients) and observation group (35 patients). The observation group was treated with exteme dose of heat-clearing drugs, and the control group was treated with the common dose formula. Both groups were treated for 3 day, and followed up for 3 day. The changing of the temperature before and after treatment, the onset time and time of relieving fever were analyzed. Results Compared with the baseline before the treatment, the 1st day, 2nd after treatment, the highest temperature in observation group at thte 3rd day(37.5 ± 0.5 ℃ vs. 37.6 ± 0.5 ℃, 38.1 ± 0.5 ℃, 38.3 ± 0.5 ℃, F=20.883) was significantly lower; the highest body temperature in the control group at the 3rd day (37.5 ± 0.6 ℃ vs. 37.5 ± 0.5 ℃, 38.1 ± 0.6 ℃, 38.4 ± 0.4 ℃, F=25.088) was significantly lower (P<0.01). At the 3 day in the follow up period, compared with the baseline before the treatment, the 1st day, 2nd after treatment, the highest body temperature in observation group (36.9 ± 0.5 ℃ vs. 37.1 ± 0.2 ℃, 37.3 ± 0.5 ℃, F=7.778) were significantly lower (P<0.01). Conclusions The high of heat-clearing drugs treatment for the postoperative fever can effectively lower the temperature, and there is no obvious difference of the onset time and the time of relieving fever between two groups. Key words: Fever; Postoperative complications; Antipyretics; Traditional Chinese drugs; Body temperature

La fiebre en el niño: una mirada reflexiva a las prácticas de cuidado

Objetivo: Realizar un análisis crítico-reflexivo de las prácticas rutinarias de los profesionales de enfermería y de los cuidadores familiares en el cuidado del niño con fiebre, a fin de incentivar un cuidado basado en evidencia científica que asegure el bienestar infantil.Síntesis de contenido: Se realizó una revisión bibliográfica de artículos científicos publicados entre los años 2007 y 2017, en las bases de datos ebscohost, ScienceDirect, medline, PubMed, cinahl, Web of Science y cuiden®, para lo cual se utilizaron los descriptores y sus combinaciones en español, portugués e inglés Fiebre; Cuidadores; Niño. Se elaboró un compendio de 45 artículos seleccionados y analizados que contenía las prácticas de cuidado con convergencias, divergencias y complementariedades.Los resultados se agruparon en los siguientes cinco temas: Concepción histórica de la fiebre; La fiebrefobia:una concepción en las actuales prácticas de cuidado; El baño de esponja:una práctica ancestral controvertida; El uso de antipiréticos: una rutina en contravía de la salud y la vidade los niños; La fiebre: en busca de una mirada desde su beneficio.Conclusiones: La concepción de la fiebre infantil centrada en el miedo y en el daño permanece. Las acciones de cuidado más comunes, como el baño de esponja y el uso/abuso de antipiréticos, son cuestionadas desde la evidencia científica, demostrando los efectos deletéreos que producen en la salud del niño. El cuidado del niño, después de una evaluación individualizada, deberá enfocarse en el confort, en un ambiente fresco y tranquilo y en el aumento de la ingesta de líquidos para evitar la deshidratación u otras complicaciones.

PATTERN OF SELF MEDICATION AND DRUGS USE BEHAVIOR AMONG UNDERGRADUATE STUDENTS OF MEDICAL AND NON MEDICAL COLLEGES IN A CITY OF NORTH EAST INDIA- A COMPARATIVE STUDY

Objective- The present study was undertaken to assess and compare the practice of self medication and drug use behavior among undergraduate students of medical and non-medical colleges in a city in North-East India. Method- A cross sectional questionnaire based study was conducted among 300 undergraduate students each of medical and non medical colleges of Guwahati city of Assam after taking informed consent . Approval of Institutional Ethical Committee was taken prior to the commencement of the study. Data was collected with a prevalidated questionnaire related to various aspects like class of drugs used for self medication, conditions for which self medication may be employed and their knowledge, attitude and practice of self medication etc. Statistical analysis of the data was done. Result- In our study,71% of medical students and 63% of non medical students practiced self medication which was statistically significant. The most common drugs for self medication were analgesics and anti pyretics. Both medical and non medical students considered non severity of illnesses and quick relief from symptoms as the major reasons for self medication. The major information source for most of medical students who practiced self-medication were textbooks and package inserts. Medical students prefer Allopathic system of medicine and Non medical students are more inclined towards Ayurvedic system.Conclusion- Practice, Knowledge and Awareness about self medication is significantly more in medical students in comparison to non medical students which can be attributed to their medical knowledge.Keywords- Self medication, Questionnaire, Package inserts, Allopathic, Awareness, Pharmacy.

Hepatic Tuberculosis in an Immunocompetent Patient- a Diagnostic Challenge

Introduction: Primary hepatic TB is uncommon. It may occur in one of the three forms; Diffuse hepatic involvement with pulmonary or miliary tuberculosis, diffuse hepatic infiltration without recognizable pulmonary involvement or as a focal/local tuberculoma or abscess. The clinical presentation of hepatic TB is non-specific and may present with high-grade fever, upper abdominal pain, weight loss and hepatomegaly. Jaundice is reported in about 1/3rd of patients and is usually obstructive due to extrahepatic obstruction. The diagnosis of hepatic TB is made by the presence of caseating granuloma or AFB in liver biopsy or aspirated fluid. We present the case report of an immunocompetent patient with liver abscess with jaundice and fever. Case Report: A 50 year gentleman who is diabetic and smoker presented with complaints of high grade fever associated with rigors and chills off and on for the last one year, associated with dull localized right hypochondriac pain which was relieved by taking intravascular broad spectrum antibiotics and anti pyretics. He also gives history of jaundice, loss of appetite and lethargy for the last 3 months. On examination he had stable vital signs with jaundice, clubbing of finger nails and pedal edema. Liver span was 17 cm. His laboratory data shows Hb: 13g/dl, WBCs: 14.7.103, Platlets:473.103, ALT: 30, AST:24, Total bilirubin: 8mg, GGT: 70,Alkaline phosphatase 212 mg, Albumin: 3.5g/dl, INR: 1.12,.Workup for Wilson disease, Auto immune hepatitis and Hemochromatosis is negative. HIV serology is negative. CT scan shows two hypo dense lesions of 36 x54 mm and 28 x 45 mm size in segment IV-b and VI of liver. His previous MRI report suggests liver abscess with sub capsular collection and dilated common bile duct and intrahepatic biliary channels for which he underwent ERCP and CBD stenting. PET scan report shows hyper metabolic lesions in liver. Liver biopsy report shows caseating granulomatous inflammation Anti tuberculus treatment was started with Isoniazid,Rifampicine, Ethambutol, pyrazinamide for three months followed by Isoniazid,Rifampicine, Ethambutol for six months. Patient has completed his nine months course of anti-tuberculus treatment and has improved clinically, fever settled and jaundice disappeared within one month of the start of treatment.

A Survey Report on Measles in Pakistan

Abstract Objective: To study the epidemic condition and to know the cause of the epidemic, treatment being provided and cause of increasing deaths due to measles. Study Design: Survey report Place and Duration of Study: Admitted Measles patients in peads department of Jinnah Hospital Lahore, Services Hospital Lahore, General Hospital Lahore, Children Hospital Lahore, Mayo Hospital Lahore, Sir Gangaram Hospital Lahore and Social Security Hospital Lahore during January 2013 to March 2013. Methodology: Admitted patients in peads department of hospitals were visited patients affected with proper signs and symptoms such as High fever, Generalized Maculo pappular rashes, Conjunctivitis and spots on body were studied. Their prescriptions were studied, the medicines given to reduce severity of the symptoms of the disease including Antipyretics, Antibiotics and Oral Antifungals were studied. They were asked whether they were vaccinated for measles or not and their socio economic status including patients' residing conditions were also studied. Results: Most of the patients studied in hospitals had post measles complications and some patients were solely affected by measles. Most of the patients studied were vaccinated according to the EPI schedule and rests were partially vaccinated, non-vaccinated, vaccine was not available to them, they did not have awareness and some parents were careless regarding vaccination. Most patients belonged to the poor class making 61.90 %, rest of the patients belonged to middle and lower middle class. Conclusion: Pneumonia was found to be the most common complication of measles. Most children belonged to poor socio-economic status. Key words: Epidemic, Measles, Vaccination, Immunization, Children.

Annelerin Ateş Düşürücü Kullanma Bilgileri Yeterli mi?

Annelerin Ateş Düşürücü Kullanma Bilgileri Yeterli mi?

Alternating, Combining Antipyretics Supported

Alternating, Combining Antipyretics Supported

Acetaminophen After Vaccination Reduces Antibody Response

Fever is common after vaccination, leading some to recommend prophylactic antipyretics. But do such agents affect vaccine immune response? In an

Prophylactic Acetaminophen Could Lower Response to Childhood Immunizations

Because of concern about febrile seizures or other potential complications, some practitioners prescribe prophylactic antipyretics after routine

Efficacy of alternating antipyretics in children

Efficacy of alternating antipyretics in children

No conclusive evidence on combining antipyretics

No conclusive evidence on combining antipyretics

Antipyretics: Acetaminophen, Ibuprofen, or Both?

Acetaminophen and ibuprofen have each been shown to safely and effectively reduce fever in children, but a regimen alternating the two antipyretics has

Alternating Antipyretics Provides Better Fever Control in Young Children

Acetaminophen and ibuprofen are safe and widely used as antipyretics in children. In this Israeli study, investigators evaluated whether alternating

Antipyretics in the paediatric A&E setting: a review.

Antipyretics in the paediatric A&E setting: a review.

Antipyretics in the paediatric A&amp;E setting: a review

Antipyretics in the paediatric A&amp;E setting: a review