Common Route Research Articles

The Radiological Evaluation of the Anatomy of the Alveolar Antral Artery and the Lateral Wall Thickness Using Cone-Beam Computed Tomography: A Retrospective Study.

This study included CBCT scans from 238 patients. The detection diameter of AAA and distance of the lower border of AAA to the maxillary sinus floor at the first premolar, second premolar, first molar, and second molar locations were evaluated. The route of AAA was observed with novel classification. Furthermore, the distance from the maxillary sinus floor to the alveolar crest at four posterior tooth locations was measured respectively. Moreover, the lateral wall thickness at four locations was assessed. Data were subjected to statistical analysis. AAA was observed in 62.18% of all sinuses. The mean diameter was 0.99±0.21 mm, with significant differences within gender. Half of the route of AAA was intrasinus intraosseous type. The mean distance between the maxillary sinus floor and AAA was 8.00±2.68 mm, with a significant difference between dentate and edentulous status at the first molar location. Distance from the sinus floor to the alveolar ridge crest in edentulous status negatively correlated with the distance from the sinus floor to AAA at the first molar location. The mean thickness of the lateral wall was 2.03±0.91 mm, and the difference in thickness between males and females at the four locations was statistically significant. intrasinus-intraosseous type, is the most common route. Special care should be taken at the first molar location during a lateral window sinus floor elevation. CBCT is highly recommended to before lateral wall maxillary sinus floor elevation.

Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit Subscribers.

Xylazine is an α 2 -agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from people who use drugs (PWUDs). Specifically, we sought to answer the following: (1) What are the demographics of Reddit subscribers reporting exposure to xylazine? (2) Is xylazine a desired additive? And (3) what adverse effects of xylazine are PWUDs experiencing? Natural language processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022. Seventy-six posts were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. Sixty-one participants completed the survey. Of those who disclosed their location, 25 of 50 participants (50%) reported locations in the Northeastern United States. The most common route of xylazine use was intranasal use (57%). Thirty-one of 59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%). Among respondents on these Reddit forums, xylazine seems to be an unwanted adulterant. People who use drugs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This seemed to be more common in the Northeast.

Ultrasound-Mediated Ocular Drug Delivery: From Physics and Instrumentation to Future Directions.

Drug delivery to the anterior and posterior segments of the eye is impeded by anatomical and physiological barriers. Increasingly, the bioeffects produced by ultrasound are being proven effective for mitigating the impact of these barriers on ocular drug delivery, though there does not appear to be a consensus on the most appropriate system configuration and operating parameters for this application. In this review, the fundamental aspects of ultrasound physics most pertinent to drug delivery are presented; the primary phenomena responsible for increased drug delivery efficacy under ultrasound sonication are discussed; an overview of common ocular drug administration routes and the associated ocular barriers is also given before reviewing the current state of the art of ultrasound-mediated ocular drug delivery and its potential future directions.

Catalyst Design through Grafting of Diazonium Salts-A Critical Review on Catalyst Stability.

In the pursuit of designing a reusable catalyst with enhanced catalytic activity, recent studies indicate that electrochemical grafting of diazonium salts is an efficient method of forming heterogeneous catalysts. The aim of this review is to assess the industrial applicability of diazonium-based catalysts with particular emphasis on their mechanical, chemical, and thermal stability. To this end, different approaches to catalyst production via diazonium salt chemistry have been compared, including the immobilization of catalysts by a chemical reaction with a diazonium moiety, the direct use of diazonium salts and nanoparticles as catalysts, the use of diazonium layers to modulate wettability of a carrier, as well as the possibility of transforming the catalyst into the corresponding diazonium salt. After providing descriptions of the most suitable carriers, the most common deactivation routes of catalysts have been discussed. Although diazonium-based catalysts are expected to exhibit good stability owing to the covalent bond created between a catalyst and a post-diazonium layer, this review indicates the paucity of studies that experimentally verify this hypothesis. Therefore, use of diazonium salts appears a promising approach in catalysts formation if more research efforts can focus on assessing their stability and long-term catalytic performance.

Could Toxomplasma gondii infection be dangerous? - Systematic review

Introduction: Toxoplasma gondii is an intracellular protozoan commonly found in humans in the form of three main forms: tachyzoite, tissue cyst and oocyst. The definitive host is the Felidae family, and one of the intermediate hosts is humans. The most common routes of infection are ingestion of raw or undercooked meat, water and food contaminated with oocysts. Among the forms of infection, we distinguish between the acquired form and the much more dangerous congenital form. Aim of the study: The objective of the study was to rewiev the literature describing the dangerous impact of Toxoplasma gondii infection on human.Methods and materials: : We reviewed the literature available in the PubMed database, using the key words: "toxoplasma gondii"; "congenital toxoplasmosis"; "pregnacy".Results: T. gondii infection is particularly dangerous in pregnant women, due to the high risk of vertical transmission of the infection to the developing fetus. The clinical presentation of congenital toxoplasmosis depends on the gestational age at which the infection occurred. Pathognomonic signs of congenital toxoplasmosis include Sabin-Pinkerton Triad, which includes inflammation of the retina and choroid of the eye, dilatation of the brain's ventricular system and intracranial calcifications. Available pharmacotherapy works on tachyzoites present in the initial phase of acquired infection, congenital infection and reactivated infection in immunodeficient patients, available drugs do not work on tissue cysts.Conclusion: The consequences of Toxoplasma gondii infection are particularly dangerous for the fetus, so pregnant women should pay special attention to hand hygiene and thorough washing of the food they eat. For this reason, it is extremely important to educate pregnant women about health issues and draw attention to the possible consequences of T.gondii infection.

P30 A longitudinal perspective of antimicrobial resistance evolution within urinary tract infection-based clinical trials

Abstract Background The mainstay treatments for urinary tract infections (UTIs) are nitrofurantoin and trimethoprim. The common route to acquire trimethoprim resistance (TriR) is via horizontal transfer of the trimethoprim-insensitive dihydrofolate reductase: dfrA. In contrast, nitrofurantoin resistance (NitR) requires the inactivation of two chromosomally encoded nitroreductases: nfsA and nfsB. The difference in antimicrobial resistance (AMR) evolution is reflected in community surveillance data: NitR incidence = ∼10% and for TriR > 30%. Longitudinal clinical UTI trials provide a unique opportunity to monitor in situ evolution of AMR and correlate its appearance to trial outcomes and the impact on uropathogens. Objectives To explore the in situ AMR evolution and its impact in Escherichia coli isolates from patients participating in the clinical trials: AnTIC and ALTAR. AnTIC was an open label randomized trial assessing the efficacy of antibiotic prophylaxis use in clean intermittent self-catheterizing patients. ALTAR compared the efficacy of the non-antibiotic alternative methenamine hippurate to antibiotic prophylaxis to treat recurrent UTIs. Methods The investigation of the evolution of nitrofurantoin and trimethoprim resistance in E. coli used general microbiology techniques, bioinformatic genome analysis and genetics to model known AMR mutations in susceptible E. coli strains. Results Trimethoprim resistance amongst E. coli trial isolates was driven by 14 out of ∼45 known dfrA allelic variants; the most common being dfrA1 and dfrA17. Growth analysis identified an allelic bias when strains were exposed to sub-MIC concentrations of trimethoprim. Growth rate analysis identified a 2%–10% slower doubling time for nitrofurantoin-resistant strains: NitS: 20.8 ± 0.7 min compared to NitR: 23 ± 0.8 min. Statistically, these data suggested no fitness advantage of evolved strains compared to the sensitive predecessor (P value = 0.13). Genetic manipulation of E. coli to mimic NitR evolution, however, supported a selective advantage. Conclusions Longitudinal sampling during antibiotic based clinical trials has provided a new perspective to the response of E. coli to UTI-related antibiotics. Correlation of nitrofurantoin response to pharmacokinetic data suggests that the low incidence of E. coli NitR is driven by selection not fitness. However, fitness correlates to dfrA allele carriage and could potentially be exploited to benefit the use of trimethoprim if other antibiotics are impeded by AMR.

Insights into Magnetic Resonance Imaging Findings in Central Nervous System Paracoccidioidomycosis: A Comprehensive Review.

Paracoccidioidomycosis (PCM) is a infection caused by the thermodimorphic fungus Paracoccidioides spp. (P. lutzii and, mainly, P. brasiliensis). This infection predominantly affects rural male workers aged between 30 and 50 years old who deal with soil on daily activities. Clinically, the disease is classified as acute/subacute phase, which evolves rapidly, secondary to dissemination of the fungus through to the phagocytic-mononuclear system, leading to fever, weight loss, and anorexia, associated with hepatosplenomegaly and lymphadenopathy, which can be complicated with suppuration and fistulization; and chronic phase, which corresponds to 74% to 95% of symptomatic cases, with a common pulmonary involvement. Central nervous system involvement is almost always a characteristic of the chronic form. Inhalation is the most common route of primary infection, usually affecting the lungs, forming the primary complex. From the primary complex, hematogenic dissemination can occur to any organ, including the brain and spinal cord. Although PCM of the central nervous system diagnosis is usually based on histopathological analysis and the imaging features are not specific for PCM, computed tomography and magnetic resonance imaging can demonstrate evidences of granuloma, abscess, meningitis, or a combination of these lesions, contributing to a preoperative diagnosis, especially when considered in conjunction with epidemiology. In this article, we review the pathophysiology, clinical manifestations and imaging aspects of neuro-PCM.

Evaluation of energy consumption in mobile ad hoc network routing protocols

Rapidly evolving wireless network technology continues to be one of the focal points in academic research. Mobile Ad hoc Networks (MANETs) consist of mobile nodes and the efficient transmission of data among these nodes is crucial for the network's operation. In this study, four of the most common routing protocols, namely AODV(Ad Hoc On-Demand Distance Vector), DSR(Dynamic Source Routing), OLSR(Optimized Link State Routing), and DSDV(Destination-Sequenced Distance Vector) were evaluated using different scenarios in the NS-2 simulation environment. As known, the lifetime of a wireless network is proportional to the battery limits of its nodes. Therefore, the choice of routing protocol for mobile ad hoc networks is critical for the network's lifetime. In this study, the energy consumption of the aforementioned routing protocols was analyzed under different conditions, and it was concluded that table-driven routing protocols, especially DSDV, demonstrated the best energy performance in various scenarios.

Correlation between biological and mechanical properties of extracellular matrix from colorectal peritoneal metastases in human tissues

Peritoneal metastases (PM) are common routes of dissemination for colorectal cancer (CRC) and remain a lethal disease with a poor prognosis. The properties of the extracellular matrix (ECM) are important in cancer development; studying their changes is crucial to understand CRC-PM development. We studied the elastic properties of ECMs derived from human samples of normal and neoplastic PM by atomic force microscopy (AFM); results were correlated with patient clinical data and expression of ECM components related to metastatic spread. We show that PM progression is accompanied by stiffening of the ECM, increased cancer associated fibroblasts (CAF) activity and increased deposition and crosslinking in neoplastic matrices; on the other hand, softer regions are also found in neoplastic ECMs on the same scales. Our results support the hypothesis that local changes in the normal ECM can create the ground for growth and spread from the tumour of invading metastatic cells. We have found correlations between the mechanical properties (relative stiffening between normal and neoplastic ECM) of the ECM and patients’ clinical data, like age, sex, presence of protein activating mutations in BRAF and KRAS genes and tumour grade. Our findings suggest that the mechanical phenotyping of PM-ECM has the potential to predict tumour development.

The Effect of Sonication Parameters on the Thickness of the Produced MoS2 Nano-Flakes

Liquid Phase Exfoliation (LPE) is a common route to produce two-dimensional MoS2 nanosheets. In this research, MoS2 powder is exfoliated by an ultrasonic probe (sonicator) in a water-ethanol solution. It is reported that MoS2 as a prototype 2D Transition Metal Dichalcogenide, has a band gap that increases with a decreasing number of layers. There are some factors that affect the average band gap energy value and the thickness of the exfoliated flakes. We varied different parameters of the ultrasonic probe like power, pulse percentage and time duration of sonication to investigate the effects on the number of MoS2 layers. Our findings from the UV-Visible spectra, SEM, FESEM and TEM images indicate that the minimum thickness for these samples was acquired at 50% of the input power of the sonicator we used (65 W) and the optimum pulse percentage is 50%. The current study also found that the average amount of band gap increased with an increase in sonication time, and then remained unchanged after 60 minutes.

Fabrication of a protein-dextran conjugates formed oral nanoemulsion and its application to deliver the essential oil from Alpinia zerumbet Fructus

The injury of vascular endothelial cells caused by high glucose (HG) is one of the driving factors of vascular complications of diabetes. Oral administration is the most common route of administration for the treatment of diabetes and its vascular complications. Essential oil extracts from Chinese medicine possess potential therapeutic effects on vascular endothelial injury. However, low solubility and volatility of essential oils generally result in poor oral absorption. Development of nanocarriers for essential oils is a promising strategy to overcome the physiological barriers of oral absorption. In this study, a nanoemulsion composed of bovine serum albumin (BSA)-dextran sulfate (DS) conjugate and sodium deoxycholate (SD) was constructed. The nanoemulsions were verified with promoted oral absorption and prolonged circulation time. After the primary evaluation of the nanoemulsion, essential oil from Alpinia zerumbet Fructus (EOFAZ)-loaded nanoemulsion (denoted as EOFAZ@BD5/S) was prepared and characterized. Compared to the free EOFAZ, EOFAZ@BD5/S increased the protective effects on HG-induced HUVEC injury in vitro and ameliorative effects on the vascular endothelium disorder and tunica media fibroelastosis in a T2DM mouse model. Collectively, this study provides a nanoemulsion for the oral delivery of essential oils, which holds strong promise in the treatment of diabetes-induced vascular endothelial injury.

Formal Synthesis of Ecteinascidin 743 from N-Cbz-l-tyrosine.

A formal total synthesis of ecteinascidin 743 and lurbinectedin is achieved. Key features involve a Pictet-Spengler cyclization coupling of the tetrahydroisoquinoline and phenylalaninol moieties prepared by a common route with high yield and selectivity, a Parikh-Doering oxidation with good chemoselectivity and functionality tolerance, and a light-mediated A-ring elaboration of pentacyclic methoxyquinone substrates. By the approach, the known advanced intermediate (4-step conversion to Et-743) can be obtained conveniently in 21 total steps from N-Cbz-l-tyrosine.

1,2,4]triazolo[4,3-a]quinoxaline as Novel Scaffold in the Imiqualines Family: Candidates with Cytotoxic Activities on Melanoma Cell Lines.

Cutaneous melanoma is one of the most aggressive human cancers and is the deadliest form of skin cancer, essentially due to metastases. Novel therapies are always required, since cutaneous melanoma develop resistance to oncogenic pathway inhibition treatment. The Imiqualine family is composed of heterocycles diversely substituted around imidazo[1,2-a]quinoxaline, imidazo[1,2-a]pyrazine, imidazo[1,5-a]quinoxaline, and pyrazolo[1,5-a]quinoxaline scaffolds, which display interesting activities on a panel of cancer cell lines, especially melanoma cell lines. We have designed and prepared novel compounds based on the [1,2,4]triazolo[4,3-a]quinoxaline scaffold through a common synthetic route, using 1-chloro-2-hydrazinoquinoxaline and an appropriate aldehyde. Cyclization is ensured by an oxidation-reduction mechanism using chloranil. The substituents on positions 1 and 8 were chosen based on previous structure-activity relationship (SAR) studies conducted within our heterocyclic Imiqualine family. Physicochemical parameters of all compounds have also been predicted. A375 melanoma cell line viability has been evaluated for 16 compounds. Among them, three novel [1,2,4]triazolo[4,3-a]quinoxalines display cytotoxic activities. Compounds 16a and 16b demonstrate relative activities in the micromolar range (respectively, 3158 nM and 3527 nM). Compound 17a shows the best EC50 of the novel series (365 nM), even if EAPB02303 remains the lead of the entire Imiqualine family (3 nM).

Pneumatosis: Appearances on CT Imaging.

Pneumatosis is a general term used to designate the presence of spontaneous air or gas leaks into the body's compartments. In this paper, we provide an overview of gas originating from different sites and present the most common routes by which air may escape free to surrounding or distant tissues. On the basis of 45 interesting clinical cases, we discuss the CT imaging characteristics of thoracic and spinal pneumatosis, better known as pneumomediastinum and pneumorrhachis. In addition, we present craniocervical pneumatosis manifesting as subcutaneous emphysema. Isolated pneumatosis was diagnosed in 12 (27%) of the 45 patients, manifesting as craniocervical free air or pneumoperitoneum. In 28 (62%) patients with pneumomediastinum, 12 (43%) had concomitant pneumothorax. Soft tissue emphysema was seen in 24 (52%) patients. One of the patients with generalized pneumatosis had craniocervical and extensive soft tissue emphysema, in conjunction with pneumomediastinum, pneumothorax, and pneumoperitoneum. Intraspinal pneumatosis was always coupled with pneumomediastinum. Pneumatosis may not be as uncommon as it seems, and indeed, this condition may need to be recognized early as it can be an alarming sign of serious pathology.

A heuristic approach for scheduling advanced air mobility aircraft at vertiports

Recent progress in electric vertical take-off and landing (eVTOL) vehicles suggests that soon these vehicles could safely and efficiently transport people and cargo in urban areas. Therefore, advanced air mobility vehicles could become an alternative means of transport to overcome traffic congestion in cities in the upcoming years. There has been enormous interest from companies and governments in recent years in developing such technologies and enabling markets for new air transportation services. Despite the interest in the topic, little research has been done to address the aircraft scheduling problem in advanced air mobility take-off and landing areas (vertiports). The vertiports serve as the airports of eVTOL vehicles and could experience congestion problems similar to those of airports. This work proposes two optimization models for scheduling departing and landing aircraft at the vertiports’ common ground taxi routes (taxiways), gates, and touchdown and lift-off (TLOF) pads. The mathematical models include advanced air mobility features such as separation rules and blocking constraints. As scheduling objectives, the first model maximizes the vertiport throughput, and the second model minimizes the deviation from the expected take-off/landing time. In addition, as a solution methodology, we developed two heuristic algorithms that use scheduling rules to assign and sequence the aircraft to the vertiport components. Computational results show that the optimization models find optimal schedules for small-sized instances of up to 10 aircraft, while the heuristic algorithms provide good results in terms of solution quality and computational time for large instances.

IODINE AS A POTENTIAL FRONT-LINE DEFENSE AGAINST COVID-19: A LITERATURE REVIEW

The novel coronavirus disease, first identified in 2019 known as COVID-19, is caused by a new strain of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), named SARS-CoV-2. Recent studies showed that the virus may be airborne and spreads through small respiratory droplets of saliva in aerosols, indirect or direct physical contact with the affected individual, in a similar way to the cold and influenza. Emerging studies also demonstrate the importance of the throat along with salivary glands as sites of viral replication and transmission in early COVID-19 infection. The most common route of entry of SARS-CoV-2 is the upper respiratory tract (nasopharynx) that slowly reaches the lower respiratory tract to infect the epithelial cells within the lungs which can cause lung damage and severe respiratory symptoms, if not treated immediately. Averting colonization of the virus in the nasopharynx could be one of the best options to reduce the incidence of severe infection. It has been well-documented that iodine is one of the most effective of all antimicrobials available. Hospitals and medical facilities worldwide use povidone-iodine (PVP-I) as a standard of care in infection control. Several research studies during the ongoing COVID-19 pandemic showed the in vitro and in vivo efficacy of iodine-containing solutions such as PVP-I (Betadine), Iodine-V (Essential Iodine Drops) etc. and other iodine complexes to effectively kill the SARS-CoV-2 virus within few seconds to hours. Few commercially available iodine-containing gargling, mouthwash, and nasal spray solutions have been recommended to use in humans against SARS-CoV-2 infection by experts to prevent viral spread, especially among health workers. The present article aims to summarize these studies and highlights the rationale, safety and recommendations of use of iodine as an effective method to decrease the viral load during the early COVID-19 infection.

Identification of Common Paths for Rideshare Routing by Mining Vehicle Trajectories

Trajectory data generated from various location sensors are increasingly available nowadays, providing comprehensive information on detailed itineraries that can be used in traffic and mobility analyses. This paper presents a study on the identification of underlying traffic stream clusters by exploring vehicle trajectory data. It aims to break down the spatial distribution of mobility flows and recognize the common paths according to which tentative rideshare routes could be set up. A step-by-step methodological framework, which includes map matching, measuring path similarity at the geometry level, trajectory clustering according to overlapping segments, locating trunk routes on the network, and classifying new trajectories on the identified routes, is proposed. An experiment has been conducted using trajectories collected in the real world. The results showed that different traffic streams with regard to direction and travel distance can be identified clearly. Overall, this study offers a comprehensive means of leveraging trajectory data to analyze itinerary patterns and make comparisons between trajectories. Compared with previous efforts, the proposed method is effective in distinguishing between traffic streams even with regard to bidirectional flows along the same route. In addition, it has the capacity to identify the common routes of underlying traffic streams instead of simply picking out single hot links or origin–destination pairs. This study is an example of data-driven research that uses digital trajectories to detect common path issues and offers detailed guidance on its application in this respect.

The Prognostic Predictors of Airway Stenting in Malignant Airway Involvement From Esophageal Carcinoma.

In locoregional esophageal carcinoma (EC), airway involvement is the most common route of extraesophageal metastasis. The prognosis remains poor even with a multimodality approach. Although airway stenting is well known for restoration of the airway, the survival benefit is still lacking. A total of 37 of patients with airway involvement from EC who underwent airway stenting at a single institution from 2015 to 2020 were retrospectively reviewed. Survival curves after stent placement among different groups were analyzed using Kaplan-Meier method. Of 37 patients, 34 were male, and the mean age was 58.9 years (42 to 80). EC was commonly located at midesophagus (51.4%). The site of airway involvement was left main bronchus (48.6%), trachea (32.4%), multiple sites (16.2%), and right main bronchus (2.7%). The nature of airway involvement was tumor invasion (91.9%), compression (62.2%), and fistula (37.8%). Twenty-three patients (62.2%) had airway involvement at the time of esophageal cancer diagnosis. Only 4 patients underwent esophageal stenting. The median survival time after stent placement was 97 days (5 to 539). Chemotherapy and/or radiotherapy were given before stent placement in 18 patients (48.6%). Treatment-naive before airway stenting and diagnosis of airway involvement at the same time of EC diagnosis were independent predictors for the increased survival after stent placement (P<0.05). Poststent treatment was associated with improved survival (P=0.002). In patients with malignant airway involvement from EC who underwent airway stenting, the prognostic predictors for improved survival were treatment-naive status, receiving treatment after airway stenting, and early-onset of airway involvement.

Prospective observational study on prescription pattern of antibiotics in general ward and intensive care unit in tertiary care hospital

The prescription pattern monitoring facilitate the rational use of drugs in the population. Rational use of drug means patients receive medication appropriate to their clinical needs in closes that meet the individual requirement for an adequate period of time and at an economical price to the individual and overall to the community. Role of Right medicine in the Right manner in the Right patients must be followed while using Antibiotics. Irrational use of medicines is major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicine result in wastage of scarce resource and widespread health hazards. Therefore, appropriate and safe use of antibiotics in healthcare system is more Important. The main objective of the study was to determine the percentage of antibiotics used in general ward and in intensive care unit and to find out most commonly Prescribed antibiotic within 72 hours in intensive care unit, the most common microorganism found in culture sensitivity test and the common route of drug administration in general ward and in intensive care unit. This is a prospective observational study. The study was conducted in tertiary care hospital in Gujarat. The duration of the study was 6 months. Total of 120 patients data was collected from the patient case sheet. Prescription of the patients are collected in designed CRF form and relevant data is analysed to obtain frequency and percentage. Out of 120 patients, majority of patients were male and most commonly used route of administered was Iv. The commonly prescribed antibiotics in general ward was ceftriaxone 28 (29.43%), metronidazole 10 (10.53%), cefoperazone + sulbactum 10 (10.53 %) and Amoxicilin + clavulanic acid 7 (7.37 %) prescribed for different condition. In Intensive care unit, commonly prescribed antibiotics was ceftriaxone 19 (18.1 %), meropenem 15 (14.29 %) and Cefoperazone + sulbactum 12 (11. 44 %). On Discharge Time most of the patients was still on antibiotics therapy.This study analysed 120 prescription and ceftriaxone, cefoperazone + sulbactum, amoxicillin + clavulanic acid, meropenem, cefadroxil ,vancomycin,cefepime + tazobactum piperacilin + tazobactum, doxycycline Cefixime are the hospital formulary. Prescription pattern studies have become a potential tool for evaluating the health care System. This study provides important baseline information on antibiotics use. This study severs to spotlight the current prescribing trends in patients. The use of a single agent and the combination of antibiotics were dependent upon the hospital formulary and protocols and policies for antibiotic use.

Tinea pedis: an updated review.

Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis. A search was conducted in April 2023 in PubMed Clinical Queries using the key terms 'tinea pedis' OR 'athlete's foot'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years. Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale. It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients. Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.