Drug Prophylaxis Research Articles

Tromboprofilaxia na cirurgia de varizes dos membros inferiores no Brasil

BackgroundDespite all the investment in primary venous thromboembolism (VTE) prophylaxis for surgical patients in recent years, there are still no specific guidelines for those who undergo procedures to treat lower limb varicose veins.ObjectivesTo evaluate the profile of VTE prophylaxis practices among Brazilian vascular surgeons conducting lower limb varicose vein procedures.MethodsSurvey design, sending an electronic questionnaire to Brazilian vascular surgeons. Respondents were divided between those who perform saphenous vein treatment with conventional surgery and those who perform thermoablation for the purpose of comparison between groups.ResultsOf 765 respondents, 405 (53%) treat saphenous veins with conventional surgery for, 44 (6%) with foam, and 199 (26%) with thermoablation (endolaser or radiofrequency). Surgeons who perform thermoablation prescribed more pharmacoprophylaxis after varicose vein surgery than those who perform conventional surgery (67/199, 34% vs. 112/405, 28%; p = 0.002). The thermoablation group stratifies patients for thromboembolism risk more frequently than the conventional surgery group (102/199, 51% vs. 179/405, 44%; p = 0.004). Both groups use enoxaparin as the most frequent drug for prophylaxis, but the thermoablation group uses proportionally more direct oral anticoagulants than the conventional surgery group (26% vs. 10%, p<0.001).ConclusionsBrazilian vascular surgeons who perform saphenous vein treatment by thermoablation prescribe pharmacoprophylaxis more frequently and for a longer period than those who use conventional surgery.

Efficacy of Drug Prophylaxis of Deep Venous Thrombosis during Perioperative Period of Total Knee Arthroplasty

To study the application of anticoagulant drugs in patients with kneeosteoarthritis (KOA) during perioperative period, and prevent the occurrence of deep venous thrombosisDVT in patients after Total knee arthroplastyTKA. In recent years, TKA has gradually become a routine orthopedic surgery. Due to the increase of surgery in clinical patients, postoperative clinical complications have become a problem that we should pay attention to. Especially lower extremity VTE and DVT are important problems for hospitalized patients. It is hoped that through scientific and technological progress and accumulation of clinical experience, the clinical incidence of DVT in patients after KOA can be further reduced, so that patients can successfully pass the recovery period. This article reviews the application of anticoagulants to prevent DVT after knee arthroplasty, aiming to provide reference for clinicians.

Opportunities and Challenges of Generic Pre-Exposure Prophylaxis Drugs for HIV.

Antiretroviral pre-exposure prophylaxis (PrEP) is protective against HIV. Low utilization rates amongst HIV vulnerable populations are due in part to the high cost of PrEP. Generic PrEP offers the potential to improve health at significantly reduced costs. In this study, we examine early utilization patterns and prices for generic PrEP. We discuss the opportunities and challenges for generic PrEP to improve health among HIV vulnerable populations.

Occurrence of bacteraemia following oral and maxillofacial surgical procedures in Port Harcourt, Nigeria.

A prospective study of 130 patients attending the Government Dental and Maxillofacial Hospital (now Maxillofacial unit, Rivers State University Teaching Hospital), Port Harcourt, between August 2018 and September 2019. To examine the factors that affect the occurrence of a bacteremia associated with oral and maxillofacial surgical procedures, and the types of bacteria causing this bacteremia, and establish the need or otherwise for prophylactic antibiotics in, 'at risk' patients. 130 healthy adult patients requiring various oral and maxillofacial surgical procedures under local anesthesia using 2% lidocaine with 1: 100,000 adrenaline, were screened bacteriologically to determine the occurrence of a bacteremia. 5 milliliters of venous blood was collected from the antecubital vein of each patient preoperatively and within 3 minutes postoperatively. The samples collected were cultured and bacteriological identification done and analyzed. Bacteremia was found in 43 (33.1%) of 130 patients postoperatively. In patients undergoing extractions, bacteremia occurred more frequently when teeth were extracted due to inflammatory dental diseases. There was no statistical correlation between the occurrence of a bacteremia and the number of teeth extracted (p>0.05). Of the 70 isolates obtained postoperatively, 5 (6.4%) were aerobes, 51 (65.4%) were facultative anaerobes (including microaerophiles) and 14 (17.9%) were anaerobes. Among the facultative anaerobes (including microaerophiles), the most frequently isolated bacteria genera were species of Staphylococcus (25.7%), Streptococcus spp. (17.1%) and Streptococcus viridans (15.7%) and among the anaerobes, Bacteriodes spp. (8.6%) were the most frequently isolated. All the isolates were sensitive to azithromycin, amikacin, imipenem and meropenem. However, 3 (30%) of the isolates were resistant to amoxicillin, which is a commonly used drug for antimicrobial prophylaxis. This study shows the occurrence of bacteremia in Nigerians following various oral and maxillofacial surgical procedures and that the observed bacteremia was not dependent on the patient's age or gender. This study emphasizes the need for antibiotic prophylaxis in those patients who are at risk of developing complications from bacteremia. Amoxicillin as this study shows will not be an effective antibiotic prophylactic agent in a majority of patients. The author therefore recommends the use of azithromycin as an alternative prophylactic agent in those patients.

Efficacy of Posaconazole for Primary Prophylaxis in the Induction Therapy of Childhood Acute Lymphoblastic Leukemia

To explore the effect of posaconazole in the primary prevention of invasive fungal disease (IFD) in the induction therapy of childhood acute lymphoblastic leukemia (ALL). From August 2018 to November 2020, 144 pediatric patients with ALL treated in Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University were selected, 88 cases received fluconazole as IFD prophylaxis (fluconazole prophylaxis group), 56 cases received posaconazole as IFD prophylaxis (posaconazole prophylaxis group). The incidence of IFD and treatment-related adverse reactions between the two groups were compared, and the safety of posaconazole was evaluated. The incidence of IFD in the fluconazole prophylaxis group was 20.4% (18/88), and in the posaconazole prophylaxis group was 7.1% (4/56). The incidence of IFD between the two groups was statistically significant different(P=0.030). There was no serious adverse reactions in the two groups. The incidence of mild adverse reactions in the posaconazole prophylaxis group (23.2%) was lower than that in the fluconazole prophylaxis group(39.8%), and the difference was statistically significant (P=0.039). There were 12 cases died in the fluconazole prophylaxis group and 4 in the posaconazole prophylaxis group, while no significant difference in the overall survival rate between the two groups (P=0.281). The effect of posaconazole in the primary prophylaxis of IFD is better and incidence of adverse reactions is lower than fluconazole. Posaconazole can be tolerated, and expected to become the first-line primary prophylaxis drug for IFD during the induction remission therapy of childhood ALL.

Chondroitin Sulfate and Fucosylated Chondroitin Sulfate as Stimulators of Hematopoiesis in Cyclophosphamide-Induced Mice

The immunosuppression and inhibition of hematopoiesis are considered to be reasons for the development of complications after intensive chemotherapy and allogeneic hematopoietic stem cell transplantation. Chondroitin sulfate (CS), isolated from the fish Salmo salar, and fucosylated chondroitin sulfate (FCS), isolated from the sea cucumber Apostichopus japonicus, were studied for their roles as stimulators of hematopoiesis in a model of cyclophosphamide-induced immunosuppression in mice. The recombinant protein r G-CSF was applied as a reference. The studied polysaccharides were shown to stimulate the release of white and red blood cells, as well as platelets from bone marrow in immunosuppressed mice, while r G-CSF was only responsible for the significant increase in the level of leucocytes. The analysis of different populations of leucocytes in blood indicated that r G-CSF mainly stimulated the production of neutrophils, whereas in the cases of the studied saccharides, increases in the levels of monocytes, lymphocytes and neutrophils were observed. The normalization of the level of the pro-inflammatory cytokine IL-6 in the serum and the recovery of cell populations in the spleen were observed in immunosuppressed mice following treatment with the polysaccharides. An increase in the proliferative activity of hematopoietic cells CD34(+)CD45(+) was observed following ex vivo polysaccharide exposure. Further study on related oligosaccharides regarding their potential as promising drugs in the complex prophylaxis and therapy of hematopoiesis inhibition after intensive chemotherapy and allogeneic hematopoietic stem cell transplantation seems to be warranted.

CYSTOID MACULAR EDEMA AFTER FOUR-POINT SCLERAL FIXATION OF INTRAOCULAR LENS.

To assess the incidence of cystoid macular edema (CME) associated with 4-point Gore-Tex suture intraocular lens (IOL) scleral fixation, before and after institution of routine intravitreal triamcinolone acetonide prophylaxis and long-term topical nonsteroidal anti-inflammatory drug usage. Consecutive patients were included after IOL implantation with concurrent pars plana vitrectomy for spontaneous IOL dislocation due to pseudoexfoliation syndrome. We compared short-term prophylactic nonsteroidal anti-inflammatory drugs only (Group A) to prophylactic intravitreal triamcinolone acetonide and long-term nonsteroidal anti-inflammatory drugs (Group B). Twenty-six eyes of 26 patients with pseudoexfoliation syndrome and spontaneous IOL dislocation were studied. Mean logMAR visual acuity improved from 1.27 ± 0.80 (20/375 Snellen equivalent) preoperatively to 0.46 ± 0.39 (Snellen 20/43) postoperatively (P < 0.001). Visual outcomes were similar for Groups A and B. In Group A, 10/16 eyes had CME, 4/16 had chronic CME longer than 6 months, and 1 longer than 12 months. In Group B, 1/10 had CME (which was both chronic and refractory). In eyes with pseudoexfoliation syndrome and spontaneous IOL dislocation, 4-point Gore-Tex suture IOL ab externo fixation yielded good visual outcomes, although CME was observed more than reported elsewhere. Prophylactic intravitreal triamcinolone acetonide and long-term nonsteroidal anti-inflammatory drugs seem to reduce the risk of postoperative CME.

Применение местных гемостатических препаратов для профилактики гематом ложа электрокардиостимулятора

BACKGROUND: Prevention of pacemaker pocket hematoma is an urgent problem of modern cardiovascular surgery. A method of prevention of hematomas may be application of local hemostatic agents. One of such means is incomplete silver salt of polyacrylic acid, registered in the Russian Federation as a medical product under the trade name “Hemoblock”. AIM: To evaluate the efficacy and safety of partial silver salt of polyacrylic acid (Hemoblock®) as a hemostatic drug for prophylaxis of pacemaker (PM) pocket hematoma. MATERIALS AND METHODS: The study included 29 patients (18 men) with average age of 72.8 ± 9.8 years and indications for PM implantation. The patients were divided into 2 groups, partial silver salt of polyacrylic acid was used during the PM implantation in group A, 0.9% NaCl solution was used in group B. Anticoagulant therapy was not cancelled. In the postoperative period, patients underwent a daily examination by a surgeon, on the 3th–5th day — an ultrasound of soft tissues in the area of the PM pocket to diagnose hemorrhagic complications. After 1 month, a control examination of the postoperative wound and an assessment of the PM function were performed. RESULTS: In 1 (6.3%) patient in group B, a PM pocket hematoma was found which required drainage in the dressing room and increased the period of hospitalization after surgery to 7 days. Soft tissue imbibition with blood was observed in 9 (56.3%) group B patients. No PM pocket hematomas and imbibition of soft tissues were observed in group A. PM implantation with uninterrupted anticoagulant therapy without the use of hemostatic agents increases the risk of soft tissue imbibition with blood by 2.3 times (p = 0.001, r = 0.605, RR 2.3, 95% CI 1.3–4). Age, gender, body mass index, body surface area, left ventricular ejection fraction, type of anticoagulation therapy, indication for PM implantation, type of PM, and the peculiarities of the operation did not influence the risk of development of PM pocket hematoma or soft tissue imbibition with blood (p &gt; 0.05). CONCLUSION: The use of a partial silver salt of polyacrylic acid (Hemoblock®) can reduce the risk of development of hematomas and soft tissue imbibition with blood in the area of the pacemaker pocket and does not lead to the development of infectious complications and allergic reactions.

Oncologists' attitudes towards prophylaxis of cancer associated venous thromboembolism: A prospective, descriptive study.

Cancer-associated venous thromboembolism creates a big burden on both patients and healthcare systems. Clinical guidelines have a consensus on the initiation of prophylactic treatment for hospitalised patients, however a debate still exists for ambulatory cancer patients. Therefore, this study aimed to identify attitudes and practices of medical oncologists on cancer-associated venous thromboembolism management. An online survey consisting of 22 questions was developed by researchers in the view of previous studies and delivered to 100 medical oncologists registered to the national society of medical oncology by e-mail between September and October 2018. Descriptive and statistical analyses were performed using Statistical Package for Social Science (SPSS) version 23.0 (ICM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp). A total of 62 medical oncologists (75.8% male) responded to the survey (response rate of 62%). The most critical three risk factors considered for initiating prophylaxis were prior venous thromboembolism history, immobilisation and tumour/cancer type for inpatients and outpatients (χ2 test, p < 0.001). The first choice of drug for prophylaxis was mostly low molecular weight heparins (n = 60, 96.8%). In the absence of contraindications, physicians initiate prophylaxis 'usually' for inpatients (n = 25, 40.3%) and outpatients (n = 5, 8.1%). However routine use of the Khorana score is not incorporated into the risk assessment process of cancer patients. Attitudes of oncologists towards thromboprophylaxis in cancer patients are consistent with previous studies in the literature. The respondents are aware of the venous thromboembolism risk of cancer patients, however raising awareness on both cancer-associated venous thromboembolism and current guideline recommendations is needed.

The Impact of Alcohol and Illicit Drug use on Adherence to HIV Pre-exposure Prophylaxis among Men who have Sex with Men

<p style="text-align: justify;"><strong>Objectives:</strong> To investigate the degree of Men who have Sex with Men (MSM) adherence to antiretrovirals Tenofovir/Emtricitabine (TFC/FTC), drugs for the Pre-exposure Prophylaxis to the human immunodeficiency virus (PrEP).<strong> Methods:</strong> This is a cross-sectional and retrospective study carried out in a reference service in infectology in Cear&aacute;-Brazil. MSM with at least three recorded medical follow-ups were included in the study. We considered as ideal adherence those users who took at least 80% of the doses within 90 days. Bivariate analysis (X&sup2; or Fisher&rsquo;s exact) was carried out to investigate the association between ideal adherence to PrEP and the use of alcohol and illicit drugs. Results with a p-value &lt;0.05 were taken into consideration. <strong>Results: </strong>A total of 167 individuals participated in the survey. MSM stopped taking 668 doses of PrEP in three months, of which 16.2% (<em>n</em>=27) had an adherence rate &gt;80%. Nevertheless, alcohol and illicit drug use accounted for 41.4% (<em>n</em>=69). Among the most commonly used narcotics were marijuana and cocaine, 42.7% (<em>n</em>=35) and 18.3% (<em>n</em>=15), respectively. It was observed that optimal adherence (&gt;80%) was better in individuals who did not use alcohol and illicit drugs compared to those who did (<em>p</em>=0.003). <strong>Conclusion:</strong> MSM adhered satisfactorily to PrEP; however, it was observed that individuals who used illicit drugs and alcohol when had their degree of adherence to TDF/FTC weakened when compared to those who did not use them. Thus, it becomes necessary to pay attention to such aspects to provide alternatives for increasing adherence in highpriority populations. <p style="text-align: justify;"><strong>Key words: </strong>Alcohol, HIV, Illicit Drugs, Men who have Sex with Men, Risk Groups, Sexuality.

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study.

Objective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Methods This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic drugs (DMARDs), Janus kinase inhibitors, and anti-PCP drugs for prophylaxis. Results Thirteen patients developed PCP, and 333 did not develop PCP. At the initiation of MTX therapy, the PCP group had lower serum albumin levels, a higher frequency of pulmonary disease and administration of DMARDs, and received a higher dosage of prednisolone (PSL) than the non-PCP group. A multivariate Cox regression analysis revealed that the concomitant use of PSL [hazard ratio (HR) 5.50, p=0.003], other DMARDs (HR 5.98, p=0.002), and serum albumin <3.5 mg/dL (HR 4.30, p=0.01) were risk factors for the development of PCP during MTX therapy. Patients with these risk factors had a significantly higher cumulative probability of developing PCP than patients who lacked these risk factors. Conclusion Clinicians should pay close attention to patients with RA who possess risk factors for the development of PCP during MTX therapy.

Progress in research of influencing factors of prophylaxis drug use after non-occupational exposure to HIV

Non-occupational post-exposure prophylaxis (nPEP), a biological means to block the transmission of HIV, is recommended by European countries, USA and WHO to use in HIV high-risk groups, but its utilization rate is still very low. The information-motivation-behavioral skills model (IMB) can accurately explain the prevalence and change of health behaviors. Based on this model, this paper summarizes the progress in research of the influencing factors for nPEP use to provide a basis for further research to promote the use of nPEP.

Crimean-Congo Hemorrhagic Fever Beyond Ribavirin: A Systematic Review.

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne virus endemic to a vast geographical area spanning from Africa to the shores of the Mediterranean Sea and north to the Balkans. The infection carries a high case fatality rate, which prompts the development of new treatment and prophylactic measures. This review explores the different treatment and prophylactic measures found in recent literature. For this purpose, we used Medical Subject Headings (MeSH) as well as PubMed advanced search. The inclusion criteria included full-text studies conducted on humans and in the English language. We found that plasma exchange was associated with a decrease in mortality rates. Similarly, the use of immunoglobulins proved effective in decreasing the severity and mortality risk. Ribavirin use was determined as a post-exposure prophylaxis drug with no statistically significant difference in oral or intravenous routes of administration. More studies should be conducted on CCHF as the number of outbreaks and endemic areas seem to be on the rise. For the time being, supportive therapy along with adjuvant antivirals appear to be the main course of management of CCHF. However, the need for definitive therapeutic agents and guidelines is warranted.

AML-202: A Single-Center Comparative Clinical Study of Prophylactic Antifungal Therapy of Voriconazole versus Posaconazole in Patients with Acute Myeloid Leukemia Undergoing Remission-Induction Therapy

<h3>Context:</h3> Invasive fungal infections are the main cause of morbidity and mortality in patients with acute myeloid leukemia undergoing induction chemotherapy. Prophylaxis is a commonly used treatment strategy because delay in diagnosis and antifungal treatment increases mortality. Posaconazole is currently the preferred drug for fungal prophylaxis, but it is costly and inappropriate in certain resource-limited Indian settings. Both posaconazole and voriconazole have been used as antifungal prophylaxis, but there are very few studies comparing the efficacy of these two drugs. <h3>Objective:</h3> Primary objectives of the study were to identify invasive fungal infections (IFI), evaluate the requirement of EAFT and its duration, and compare them. Secondary objectives were to compare the induction mortalities and adverse effects of the drugs. <h3>Design:</h3> Retrospective observational study. All adult patients (>18 y) with AML undergoing induction chemotherapy in 3 consecutive years (2014–2016) whose complete clinical and treatment details were available were included in the study. <h3>Setting:</h3> The study was carried out at the Institute of Hematology and Transfusion Medicine, Kolkata, which is a tertiary care center for hematological diseases in East India. <h3>Results:</h3> Data for 67 AML patients (31 in voriconazole and 36 in posaconazole) were analyzed. The adoption of voriconazole as antifungal prophylaxis has resulted in a trend toward decreased incidence of breakthrough IFIs (1 <i>vs</i> 3) and the use of EAFT (23.07% <i>vs</i> 38.09%; p=0.067). All proven IFIs were invasive aspergillosis. Induction mortality rate (7 <i>vs</i> 5; p=0.27), and CR rate (80.76% <i>vs</i> 71.42%; p=0.15) are not statistically different. Drug intolerance is higher with voriconazole (9/31 <i>vs</i> 4/36; p=0.05), and 2 patients had premature discontinuation due to significant side effects. <h3>Conclusion:</h3> In our centre, evidence points toward decreased IFI and EAFT in patients with voriconazole prophylaxis as compared to posaconazole, albeit with some increased drug-related adverse effects. In a resource-limited centre, voriconazole may be a useful alternative to posaconazole as a prophylactic antifungal drug in acute myeloid leukemia.

Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey

ObjectivesTo examine changes in the occurrence of physical sex with non-steady partners among men who have sex with men (MSM) in Belgium during the first weeks of the COVID-19 lockdown...

Knowledge and Practice of Malaria Control Measures among Women Attending Antenatal Clinics in Abakaliki, Nigeria

Background: Pregnant women, children and immune-compromised persons are highly vulnerable to malaria morbidity and mortality. Malaria accounts for about 50% of all clinic attendance in Nigeria and contributes significantly to anaemia in pregnancy, low birth weight, preterm births, still births and perinatal mortality. It is therefore imperative that these highly susceptible groups of people are adequately informed and supported for prevention of malaria at all times. This study assessed the knowledge and practice of malaria control measures among Antenatal Care attendees in Abakaliki.&#x0D; Methods: A descriptive cross-sectional study was conducted in the two biggest hospitals in Abakiliki, among 400 Antenatal Care attendees selected using systematic sampling technique. Data was collected using interviewer administered questionnaire and analyzed using Statistical Package for Social Sciences version 22. Chi-square was used to test for associations between independent and dependent variables. The significance level was set at p&lt; 0.05.&#x0D; Results: The mean age of respondents was 29.2 ± 4.1 years. Majority correctly identified methods of diagnosis of malaria in pregnancy. Although 375(93.7%) of the women constantly owned a long-lasting insecticide treated net, only 187(49.9%) of them always slept under it. While 363(90.7%) of the respondents cleared their surrounding bushes, only 130 (32.5) regularly used in-door insecticide spray and 153(38.3%) always used anti-malaria prophylaxis in the index pregnancy.&#x0D; Conclusion: Knowledge about malarial control measures was high but use of Long-Lasting Insecticide Treated Net with drug prophylaxis was suboptimal. It is therefore recommended that health education on malaria prevention practice be intensified during Antenatal clinic visits.

OTHR-08. Efficacy of anti-epileptic drug prophylaxis on seizure prevention in patients with brain metastases: A systematic review and meta-analysis

Abstract Introduction Seizures can occur in patients with brain metastasis and are often debilitating, leading to morbidity, mortality, and economic burden. Implementation of anti-epileptic drugs (AEDs) prophylaxis remains controversial, and provider dependent as current Level III guidelines recommend against their use. This systematic review gathers the current evidence on the effectiveness of AED prophylaxis on preventing new-onset seizures in patients with BM. Associated adverse effects of AED usage in this population are also reported. Methods Using PRISMA guidelines, a pertinent search was conducted on Embase, PubMed, and Web of Science to identify journal articles that reported AED prophylaxis as a variable to modify seizure frequency in adult patients with BM. Data of interest included AED agent, new-onset seizure frequency, and safety profile. A meta-analysis was performed to calculate odds ratio using Der-Simonian and Laird methods to compare AED group with control for new seizures. Heterogeneity was determined by Cochran Q test and I2. Results Our search returned 175 publications of which 5 retrospective cohort studies met inclusion criteria. A total of 1,292 patients (283 receiving AED prophylaxis, and 1,009 in control group) were included across the studies. AEDs used were phenobarbital, levetiracetam, phenytoin, and valproate. Meta-analysis showed no difference in seizure frequency between the AED and the control group (OR = 0.98; 95%-CI: 0.56–1.72). Heterogeneity: I2 = 7%. Adverse events were not reported in the publications. Conclusion Our meta-analysis suggests that there is no improvement in frequency of new seizures with AED prophylaxis in BM patients, supporting current guidelines. However, the evidence is based on a small patient population and retrospective studies. Additional studies are needed to determine efficacy of prophylaxis with newer AEDs and establish guidelines to target therapies for improving morbidity, mortality, and quality of life in patients with BM.

Incidence of Heterotopic Ossification with NSAID Prophylaxis Is Low After Open and Arthroscopic Hip Preservation Surgery

PurposeWe evaluate the incidence of heterotopic ossification (HO) development with nonsteroidal anti-inflammatory drug (NSAID) prophylaxis in patients after open and arthroscopic hip preservation surgery.MethodsA retrospective review identified patients who underwent hip preservation surgery at a single institution within the past 3 years. Patients who underwent hip arthroscopy with or without periacetabular osteotomy (PAO) or femoral osteotomy (FO) were included. Those who did not receive 3-month postoperative radiographs were excluded. The incidence and Brooker classification (BC) of HO in patients taking Naproxen or another NSAID (meloxicam, celecoxib, indomethacin, or aspirin alone) was assessed using AP radiographs available from 3-, 6-, and 12-month follow-up appointments. Univariate analysis was conducted to compare numerical means and categorical data (significance level P = .05).ResultsA total of 328 hips (284 patients) were included. All patients received hip arthroscopy, while 71 patients (21.6%) received concurrent periacetabular osteotomy (PAO; n = 65) or femoral osteotomy (FO; n = 6). Overall, 276 hips (84.4%) received Naproxen for HO prophylaxis. In total, 5 of 328 hips (1.5%) developed HO (4, BC I; 1, BC III). The rate of HO development was significantly higher in males versus females (4 of 121 (3.31%) vs 1 of 207 (.48%), P = .0441). All 5 patients received arthroscopic cam resection and labral repair, and 1 patient also received PAO. Three patients in the Naproxen group (.91%) developed HO, which was not statistically different from those taking a different NSAID (.61%, P = .1797).ConclusionThe incidence of HO development was low with NSAID prophylaxis after hip preservation surgery.

Nephrotoxicity of Albendazole and Albendazole Loaded Solid Lipid Nanoparticles in Mice with Experimental Hydatidosis.

Purpose: Cystic echinococcosis (CE) is a serious contemporary public health problem. Different CE treatment methods are of considerable importance, with albendazole (ABZ) being one of the most preferred drugs for CE treatment and prophylaxis. In this study, we evaluated the nephrotoxicity caused by ABZ and ABZ-loaded solid lipid nanoparticles (SLNs) in mice with experimental hydatid cyst. Methods: ABZ-loaded SLNs were produced by micro-emulsification and a high shear homogenization technique. Thereafter, we evaluated the physicochemical characterization of the product. Live protoscolices were injected into mice to induce experimental hydatidosis. Mice were then treated with ABZ and ABZ-loaded SLNs. The nephrotoxicity effects were evaluated by biochemical and histopathological surveys. Results: Significantly different blood urea nitrogen (BUN) levels were observed between the two infected groups (ABZ treatment and ABZ-loaded SLN treatment) and the control group. The kidney malondialdehyde (MDA) and glutathione (GSH) levels of the infected groups were not significantly different from those of the control group. The histopathological study revealed nephropathic and pathologic changes in the ABZ and ABZ-loaded SLN groups. Conclusion: ABZ formulated for ABZ-loaded SLNs had a more prominent chemoprophylactic efficacy on CE and fewer side effects than ABZ alone. Neither ABZ nor ABZ-loaded SLNs caused significant biochemical and histopathological defects on the kidney, and all functional biochemical markers stayed within the normal range. Therefore, ABZ-loaded SLNs could be a potential new product for CE treatment.

INDIGENOUS DRUGS FOR EYE DISORDERS IN SHATKALPA ADHYAY OF KASHYAPA SAMHITA

The eye is one of the sense organs with the most important function of vision. Though of prime importance, it is a very delicate and sensitive part of the body and is exposed to the environment. Through ages, different herbs are being used in indian traditional medicine for treating eye disorders. These drugs are termed chakshushyadravyas in ayurveda texts, bruhattrayi as well as laghutrayi. Kashyapasamhita, a text on ayurveda pediatrics contributes a special chapter on six drugs for treating eye disorders in children. The present article reviews indigenous drugs mentioned in the sixth chapter of kalpasthan of kashyapa samhita in the management of eye disorders. Indigenous drugs for eye disorders in shatkalpaadhyay of kashyapasamhita: a review. Out of the six drugs stated by kashyapa for treating eye diseases some are common with other textbooks and well known. They have been traditionally used by local people with good results for years but there is a need to re-establish the use of these drugs in prophylaxis and management of eye conditions in a scientific way including standardization and aseptic use of these drugs.