Improvement In Oxygen Saturation Research Articles

Polyvinyl alcohol-chitosan based oleanolic acid nanofibers against bacterial infection: In vitro studies and in vivo evaluation by optical and laser Doppler imaging modalities

The present work focuses on the fabrication of polyvinyl alcohol-chitosan-loaded oleanolic acid-nanofibers (PVA-CS-OLA-NFs) for bacterial infection. The prepared PVA-CS-OLA-NFs were characterized for contact angle, SEM, AFM, XRD, FTIR, and TGA. The solid-state characterization and in vitro performance evaluation of nanofibers reveal consistent interconnection and diameters ranging from 102 ± 9.5 to 386 ± 11.6 nm. The nanofibers have a flat surface topography and exhibit efficient drug entrapment. Moreover, the in vitro release profile of PVA-CS-OLA-NFs was found to be 51.82 ± 1.49 % at 24 h. Furthermore, the hemocompatibility study showed that the developed PVA-CS-OLA-NFs are non-hemolytic to human blood. The PVA-CS-OLA-NFs demonstrate remarkable antibacterial capabilities, as evidenced by their MBC and MIC values, which range from 128 and 32 μg/mL, against the strains of S. aureus. The in-vivo fluorescence optical imaging showed the sustained PVA-CS-OLA-NFs release at the wound site infected with S. aureus for a longer duration of time. Moreover, the PVA-CS-OLA-NFs showed superior wound healing performance against S. aureus infected wounds compared to the marketed formulation. Further, the laser Doppler imaging system improved oxygen saturation, blood supply, and wound healing by providing real-time blood flow and oxygen saturation information.

The protein disulfide isomerase A3 and osteopontin axis promotes influenza-induced lung remodelling.

Fibrotic lung remodelling after a respiratory viral infection represents a debilitating clinical sequela. Studying or managing viral-fibrotic sequela remains challenging, due to limited therapeutic options and lack of understanding of mechanisms. This study determined whether protein disulfide isomerase A3 (PDIA3) and secreted phosphoprotein 1 (SPP1), which are associated with pulmonary fibrosis, can promote influenza-induced lung fibrotic remodelling and whether inhibition of PDIA3 or SPP1 can resolve viral-mediated fibrotic remodelling. A retrospective analysis of TriNetX data sets was conducted. Serum from healthy controls and influenza A virus (IAV)-infected patients was analysed. An inhibitor of PDIA3, punicalagin, and a neutralizing antibody for SPP1 were administered in mice. Macrophage cells treated with macrophage colony-stimulating factor (M-CSF) were used as a cell culture model. The TriNetX data set showed an increase in lung fibrosis and decline in lung function in flu-infected acute respiratory distress syndrome (ARDS) patients compared with non-ARDS patients. Serum samples revealed a significant increase in SPP1 and PDIA3 in influenza-infected patients. Lung PDIA3 and SPP1 expression increased following viral infection in mouse models. Punicalagin administration 2 weeks after IAV infection in mice caused a significant decrease in lung fibrosis and improved oxygen saturation. Administration of neutralizing SPP1 antibody decreased lung fibrosis. Inhibition of PDIA3 decreased SPP1secretion from macrophages, in association with diminished disulfide bonds in SPP1. The PDIA3-SPP1 axis promotes post-influenza lung fibrosis in mice and that pharmacological inhibition of PDIA3 or SPP1 can treat virus-induced lung fibrotic sequela.

Efficacy of zinc as an adjuvant therapy in acute pneumonia in children of age 2 months to 2 years: A randomized controlled trial

Background: Pneumonia is the most common Illness affecting infants and children globally. Childhood pneumonia has been identified as the major “forgotten killer of children” by UNICEF and the WHO. The WHO and United Nations Children’s Fund (UNICEF) in 2013, published the integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD) which outlined a framework for ending preventable child deaths due to diarrhoea and pneumonia by 2025. Zinc is a vital micro element that is essential for a variety of fundamental biological processes due to its function as a transition metal, cofactor, structural component, and signalling molecule. Zinc is also an essential component of antibacterial immunity. The impaired immunocompetence due to low zinc states enhances the establishment of a particular infection due to a reduction in the clearance of infectious agents. Recommend zinc nutritional intake is 10-20mg/day for children. It is estimated that 17-20% of the world’s population may be zinc deficient. Zinc deficiency is common among children in developing countries because of inadequate food intake, particularly from animal source and limited bioavailability from local diet. It has been proposed that zinc can be a real potential in the prevention of pneumonia morbidity and mortality. Objective: To study the effect of zinc supplementation as an adjuvant therapy on outcome of pneumonia. Method: We conducted a randomised controlled trial from march 2023 to february 2024. All children in the the age group of 2 months to 2 years, who presented with the features of pneumonia to the department of Paediatrics in Akash institute of medical sciences and research centre Devanhalli, Bangalore rural. Ethics consent was obtained from Institutional ethical committee. Demographic details such as name, age, gender along with clinical profile was taken. After admission, detailed history and physical and systemic examination were carried out and necessary data collected. Sample size being 50 cases, they were divided in two groups as case group (zinc group) and control group by stratified randomisation, 25 participants being in each group. Enrolled children were given standard treatment for pneumonia in the form of oxygen, intravenous fluids, bronchodilators, parenteral antibiotics. Enteral feeds were started once the child respiratory distress improved, oxygen saturations greater than 93%, baby was able to tolerate feed. Zinc group received 20 mg of elemental zinc per day as a single dose for 7 days. Result : Out of the total 50 cases, two groups were divided with 25 cases in zinc group and 25 cases in non-zinc group. In zinc group 6 cases (50%) took 24-48 hours for disappearance of symptoms, another 3 cases (26%) less than 24 hours, in 1 case time for disappearance of symptoms was 48-72 hours, another case which took 72-96 hours. The mean duration of time taken for disappearance of danger signs was 42.33 ± 13.89 hours. In the non-zinc group (36%) 5 cases took 24-48 hours for disappearance of danger signs, 3 cases (22%) which took 48-72 hours and 2 cases (14%) which took 96-120 hours, 2 more cases (14%) which took 120-144 hours. The mean duration of hospital stay in non-zinc group was 62.28 ± 10.84 hours which is comparatively more than that of zinc group. Conclusion: This study concluded that zinc supplementation shortens the time taken for resolution of respiratory distress and resolution of symptoms. However, it was not found to be of much help in improving oxygen saturation. It also did not show any significant decrease in time taken for disappearance of danger signs and duration of hospital stay.

The Effect of Prone Position on Patients with Covid-19: Case Study

Purpose: Evaluation of the prone position in the awake patient with a nasal cannula and diagnosed with Covid-19 in improving oxygen saturation. Methodology: Case study of a patient diagnosed with Sars Cov-2, Covid-19 through a pulmonary Ct with bilateral pneumonia and initial value of C-Reactive protein=38.01mg/l. This patient was treated in outpatient conditions (at home) in the period of October 2020. Result: The standard deviation in terms of oxygen uptake from day one to day eight had significant improvements from SD=94±1.8Sa(O2) to SD=95.7±2.0Sa(O2). Also, nasal cannula oxygen levels had significant reductions from SD=4.1±0.4 liters on day 1 to SD=1.2±0.2 liters. The pvalue results are significant with a value of p=<0.001, so the prone position was better compared to the supin position. Conclusion: The prone position in our patient's case was effective in improving blood oxygen saturation. Received: 2 June 2024 / Accepted: 25 July 2024 / Published: 29 July 2024

Effectiveness of Continuous Positive Airway Pressure in Alleviating Hypoxemia and Improving Exertional Capacity at Altitude.

Strickland, Brian, Elan Small, Mary Ryan, and Ryan Paterson. Effectiveness of continuous positive airway pressure in alleviating hypoxemia and improving exertional capacity at altitude. High Alt Med Biol. 00:000-000, 2024. Introduction: Decreased oxygen saturation and exercise tolerance are commonly experienced at high altitude. Continuous positive airway pressure (CPAP) devices have become increasingly portable and battery powered, providing a potentially unique new therapeutic modality for treatment of altitude-related illnesses. This study evaluated the potential use of CPAP devices to improve and maintain oxygen saturation at altitude, both at rest and with exertion, to evaluate the feasibility of using this device at altitude. Methods: Subjects were taken to Mount Blue Sky and monitored while they hiked to the summit (4,350 m), maintaining a consistent level of exertion. Subjects hiked for 0.7 km both with and without CPAP set to 10 cmH2O pressure. Continuous vital signs were collected during the hike and recovery period. Results: All subjects completed the hike wearing CPAP devices at a vigorous level of exertion. Mean oxygen saturation of the CPAP group (M = 83.8%, SD = 3.72) was significantly higher than that of the control group during exertion (M = 78.7%, SD = 2.97); p = 0.005. Recovery after exertion was quicker in the CPAP group than the control group. Three subjects experienced claustrophobia requiring a brief pause, but were able to complete their exercise trial without removing equipment or experiencing adverse events. When pauses from claustrophobia were excluded, there was no difference in completion time between the groups (p = 0.06). Conclusion: CPAP reliably improved oxygen saturation at rest and during vigorous exertion at high altitude. Its ability to correct hypoxemia, even with physical exertion, may prove useful after further study as a portable self-carried device to prevent and treat altitude-related illness, or to improve safety in high-altitude rescues.

Efficacy of sarilumab and dexamethasone co-administration for lowering multiple blood biomarkers in the treatment of cytokine release syndrome in hospitalized COVID-19 patients.

The current study was planned to explore the potential synergistic role of the co-administration of sarilumab and dexamethasone in reducing blood biomarkers associated with cytokine release syndrome in hospitalised patients of coronavirus disease-2019. The sample comprised 22 patients hospitalised with severe and critical severity levels and who were treated with sarilumab and dexamethasone. Positive responses were seen in blood biomarkers, including decreased interleukin-6 alpha levels and improved oxygen saturation. Tumour necrosis factor, Ddimer, C-reactive protein, ferritin and lymphocyte count also showed positive responses in patients who survived than those who died. Lactate dehydrogenase levels fluctuated with improvement among the survivors, but had limited effectiveness in those who died. The findings suggested promising avenues for future treatment strategies in patients with severe coronavirus disease-2019 and cytokine release syndrome.

Home Based Walking Exercise For Nursing Interventions

Chronic Obstructive Pulmonary Disease (COPD) is a lung condition characterized by persistent and typically progressive respiratory symptoms and airflow limitation. This disease is associated with an excessive chronic inflammatory response in the airways and lung parenchyma due to exposure to harmful gases or particles. The objective of this study is to evaluate the changes in oxygen saturation and activity tolerance in COPD patients before and after performing home-based walking exercises, pursed lips breathing, and effective coughing. The research method used a descriptive design in the form of a case report with a nursing process approach. The instruments used included assessment sheets and oximetry to measure oxygen saturation. The study subjects were patients with COPD. The results showed that before the intervention, the patient's (Mrs. E) oxygen saturation was 96%, and she reported difficulty engaging in activities due to fatigue and shortness of breath. After three days of intervention, her oxygen saturation increased to 99%, and she was able to perform outdoor activities without experiencing shortness of breath. In conclusion, home-based walking exercises, pursed lips breathing, and effective coughing can improve oxygen saturation, increase activity tolerance, and reduce dyspnea and fatigue

Application of 30 Degree Head Up Position in Non-Hemorrhagic Stroke Patients in Improving Oxygen Saturation in the Stroke Unit Room of the Gunung Jati Hospital Cirebon

Application of 30 Degree Head Up Position in Non-Hemorrhagic Stroke Patients in Improving Oxygen Saturation in the Stroke Unit Room of the Gunung Jati Hospital Cirebon

Increased Oxygen Saturation Is Associated with Decreased Sympathetic Nervous System Activity in Individuals Given Bacteriotherapy at High Altitude

Exposure to low-oxygen conditions (hypoxia), as encountered at high altitudes and in some pathological conditions, results in the activation of various physiological stressors and acclimatization to hypoxia. Previous studies show that administration of a novel probiotic (SLAB51; O2BOOSTER; Hecto, Seoul, South Korea) improves oxygen saturation in severely hypoxemic COVID-19 patients and in healthy participants upon exposure to simulated and terrestrial hypobaric hypoxic. Whether SLAB51 impacts stress responses such as activation of the sympathetic nervous system during high-altitude exposure has not been evaluated. We hypothesized that SLAB51 treatment and the associated increase in oxygen saturation would reduce metrics of heart rate variability (HRV) at high altitude. Volunteers of Latino ancestry (n=17; eight women, nine men) were recruited and completed sea-level and high-altitude measurements (up to four days at the University of California White Mountain Barcroft Research Station, 12,470 ft / 3,801 m). Participants ingested either the SLAB51 probiotic or a placebo (randomized double-blind procedure) upon arrival and throughout their duration at altitude, and oxygen saturation (SpO2), electrocardiogram (EKG), mean arterial blood pressure (MABP), and heart rate (HR) measurements were collected during a fasted state each morning. We performed HRV analysis based on data from 10 minutes of resting EKG recordings, which included evaluations of low-frequency (LF) and high-frequency (HF) bands and their ratio (LF/HF) as an estimation of sympathetic activity. All values were compared between probiotic and placebo groups at high altitude (mean ± SEM). The two groups did not exhibit differences in LF/HF, MABP, and HR on any of the days spent at high altitude; however, during the first evening at high altitude when the treatment groups exhibited differences in SpO2 (separately reported), the probiotic group exhibited a non-significant trend of lower MABP relative to the placebo group (n = 5, 87.3 ± 2.5 and n = 4, 93.5 ± 3.5, respectively; p = 0.078). Additionally, higher SpO2 associated with lower MABP (R2 = 0.33) across all time points at high altitude in the probiotic group, but the opposite relationship was noted in the placebo group (R2 = 0.30). These data suggest potential differences in sympathetic nervous system activation in probiotic and placebo groups, a finding which warrants further investigation in a larger sample of individuals. SLAB51; O2BOOSTER; Hecto, Seoul, South Korea. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

SLAB51 Probiotic Improves Oxygen Saturation and Acute Mountain Sickness Score at High Altitude

Hypobaric hypoxia imposes various challenges at high altitude that initiate differentphysiological responses as part of the acclimatization process. Current interventions foraccelerating and/or improving acclimatization to high altitude are limited. Preliminarystudies of the multi-strain probiotic SLAB51 (O2booster; Hecto, Seoul, South Korea)have shown its potential to improve oxygenation, a crucial component ofacclimatization, in clinical conditions of hypoxemia. We hypothesized that treatment withSLAB51 at high altitude will lead to improved acclimatization as measured by oxygensaturation (SpO2) and scores from the Acute Mountain Sickness (AMS) survey (2018Lake Louise Questionnaire). A group of 17 (9 males, 8 females) healthy Latino/a adultsfrom the San Diego area, ranging from ages 19-63, were taken from sea-level to WhiteMountain Barcroft Station (3800 m) for up to four days. Participants underwent adouble-blind, placebo-controlled study where nine participants consumed the SLAB51probiotic and eight consumed a placebo up to three times a day. SpO2 was measuredusing a forehead pulse oximeter, and an AMS survey score was attained daily. Ouranalyses revealed that SpO2 was significantly higher in participants who received theSLAB51 probiotic at high altitude versus those who received the placebo (Two-wayANOVA, p-value < 1.12e-05). Furthermore, AMS scores were significantly lower inparticipants treated with SLAB51 than those who received the placebo (Two-wayANOVA, p-value < 0.007). Our results indicate that SLAB51 ingestion at high altitudeimproved SpO2 compared to a placebo and may improve acclimatization to high altitude. Funding: LEA Altitude Performance Fund. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

A randomized clinical trial investigating the impact of magnesium supplementation on clinical and biochemical measures in COVID-19 patients

BackgroundThis study sought to examine the impact of magnesium supplementation on clinical outcomes and biochemical factors among hospitalized patients with COVID-19.MethodsThis double-blind, randomized clinical trial was conducted at Razi Hospital, Ahvaz, Iran, between September 2021 and March 2022. Participants aged 18–70 years with moderate disease severity were enrolled. Magnesium supplementation (300 mg daily) was administered to the intervention group, while the control group received a placebo. Clinical outcomes, including the need for oxygen therapy, oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health, were assessed. Blood samples were collected to measure biochemical variables.ResultsThe main result was the count of individuals requiring oxygen therapy. Additional outcomes comprised of oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health. Out of 64 participants, 60 completed the study. The results showed that magnesium supplementation significantly reduced the number of patients requiring oxygen therapy (9 vs. 14; P < 0.001). Moreover, the magnesium group demonstrated improved oxygen saturation compared to the control group (4.55 ± 2.35 vs. 1.8 ± 1.67; P < 0.001). Furthermore, we observed a noteworthy enhancement in the quality of life and depression score in the magnesium group. No significant differences were observed in respiratory rate, fever, hs-CRP, and TNF-α levels (P > 0.05).ConclusionThe findings suggest that magnesium supplementation may have beneficial effects on clinical outcomes and arterial oxygen saturation in COVID-19 patients. More investigation is necessary to delve into its potential mechanisms and long-term effects on patient outcomes.Trial registrationThis study is registered on Iranian Registry of Clinical Trials (IRCT) under identifier IRCT20210413050957N1. (The registration date: May 1, 2021).

Impact of Early Mobilization Within the Intensive Care Unit After Coronary Artery Bypass Grafting: A Systematic Review

Purpose: Coronary artery bypass grafting (CABG) surgery treats complications from coronary artery diseases, and its recovery traditionally consisted of bedrest. Recent research emphasizes the benefits of early mobilization for hospitalized patients. However, the functional outcomes and effectiveness of early mobilization for persons within the intensive care units after CABG has not been investigated thus far. The objective of this review was to determine the effectiveness of early mobilization in reducing hospital and intensive care unit length of stay (LoS) and improving functional outcomes of persons after CABG. Methods: This study was registered with PROSPERO and followed PRISMA guidelines. PubMed, Embase, CINAHL, and PEDro databases were searched using MeSH terms. Studies with early mobilization interventions for adults in the intensive care unit after CABG that recorded outcomes of LoS or functioning were included. Methodological quality was measured using the PEDro scale and Oxford Level of Evidence. Results: This systematic review collectively addressed 2280 participants through 14 studies in 7 countries. The initiation time frames for early mobilization varied, with the majority beginning within 24 to 48 hours after surgery and interventions were heterogenous. Early mobility was found to be effective in reducing atelectasis, improving oxygen saturation, and decreasing time spent on mechanical ventilation. Among early mobilization participants, the LoS was reduced in all studies; intensive care unit LoS decreased by one day or greater in 6 of 14 studies, and hospital LoS decreased by one day or greater in 5 of 7 studies. Conclusions: Data analysis found that early mobilization achieved better functional outcomes. It was found that implementing early mobilization led to decreased intensive care and hospital lengths of stay, reduced atelectasis and pleural effusion, and improved functional and respiratory outcomes in persons who underwent CABG surgery.

Albuterol as an adjuvant in acute anticholinesterase pesticide poisoning: a randomized, placebo-controlled clinical trial.

Acute anticholinesterase pesticide poisoning is a serious clinical problem, particularly in developing countries. Atropine is the most acceptable treatment for acute anticholinesterase poisoning. However, it only stops fluid production. Albuterol is a beta-2 receptor agonist that can increase fluid removal and speed the return of effective oxygen exchange. This study aims to evaluate the safety and efficacy of nebulized albuterol as an adjuvant therapy in patients with acute anticholinesterase poisoning. This stratified block randomized, single-blinded, placebo-controlled, parallel-group clinical trial was conducted between November 2020 and October 2021. It enrolled 80 patients with acute anticholinesterase pesticide poisoning who were admitted to Tanta University Poison Control Center. Patients were allocated into two groups (40 patients each). The strata were based on the severity of poisoning (moderate and severe). Patients in group I received 10mg of nebulized albuterol. Group II received an equivalent volume of nebulized normal saline. Additionally, standard treatment was provided to both groups. Outcomes included oxygenation, mortality, need for endotracheal intubation and mechanical ventilation, hospital stay duration, time to atropinization, and total doses of atropine and oxime. We found insignificant differences in sociodemographics, exposure characteristics, clinical manifestations, or routine laboratory tests between the studied groups. The median values of oxygen saturation by pulse oximetry were 99% in the albuterol moderate toxicity group and 98% in the control moderate toxicity group. Albuterol significantly improved oxygen saturation in moderate intoxicated patients (P=0.039). Therefore, nebulized albuterol is a safe drug. Moreover, it may improve oxygenation in acute anticholinesterase pesticide poisoning.

The effect of music on pain management in preterm infants during daily painful procedures: a systematic review and meta-analysis.

The present systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the effects of music on pain management in preterm neonates during painful procedures. The PubMed, Embase, Web of Science, EBSCO and Cochrane Library databases were searched to identify relevant articles published from their inception to September 2023. The study search strategy and all other processes were implemented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Four RCTs that satisfied the inclusion criteria were included in this meta-analysis. The music group had significantly lower Premature Infant Pain Profile (PIPP) scores during (RR = -1.21; 95% CI = -2.02--0.40, p = 0.0032) and after painful procedures (RR = -0.65; 95% CI = -1.06--0.23, p = 0.002). The music group showed fewer changes in PIPP scores after invasive operations than did the control group (RR = -2.06; 95% CI -3.16--0.96; p = 0.0002). Moreover, our results showed that music improved oxygen saturation during (RR = 3.04, 95% CI = 1.64-4.44, p < 0.0001) and after painful procedures (RR = 3.50, 95% CI = 2.11-4.90, p < 0.00001). However, the change in peak heart rate during and after painful procedures was not statistically significant (RR = -12.14; 95% CI = -29.70-5.41 p = 0.18; RR = -10.41; 95% CI = -22.72-1.90 p = 0.10). In conclusion, this systematic review demonstrated that music interventions are effective for relieving procedural pain in preterm infants. Our results indicate that music can reduce stress levels and improve blood oxygen saturation. Due to the current limitations, large-scale, prospective RCTs should be performed to validate the present results.

Effects of Acapella versus Blow Bottle Positive Expiratory Pressure on Airway Clearance and Peak Expiratory Flow Rate in Post-Covid-19 Patients

Background: The COVID-19 pandemic has led to significant respiratory complications in affected individuals. Positive Expiratory Pressure (PEP) devices, specifically Acapella and blow bottle devices, have been widely used in respiratory rehabilitation, particularly in patients with pulmonary diseases and post-surgical respiratory complications. However, their efficacy in post COVID-19 patients has been less explored. Objective: This study aimed to compare the effectiveness of Acapella and blow bottle devices in improving oxygen saturation, peak expiratory flow rate, shortness of breath, and six-minute walk distance in post COVID-19 patients. Methods: This randomized clinical trial was conducted at Tehsil hospital Kot Addu over six months. Forty-eight post COVID-19 patients were divided equally into two groups: one group received treatment with the Acapella device, and the other with a blow bottle device. Baseline and post-treatment measurements of oxygen saturation, peak expiratory flow rate, and six-minute walk distance were recorded using a pulse oximeter, peak expiratory flow meter, and six-minute walk test, respectively. Results: On day 1, the Acapella group showed a mean oxygen saturation rank of 20.98 with a sum of ranks of 503.50 (p=0.79), while the Blow Bottle group had a mean rank of 28.02 and a sum of ranks of 672.50. By day 7, the Acapella group's mean rank was 17.31 (sum of ranks = 415.50, p=0.000) compared to the Blow Bottle group's 31.69 (sum of ranks = 760.50). For peak expiratory flow rate, no significant differences were found between the groups at day 1 (Acapella: mean rank = 28.06, sum of ranks = 673.50, p=0.078; Blow Bottle: mean rank = 20.94, sum of ranks = 502.50) and day 7 (Acapella: mean rank = 23.77, sum of ranks = 570.50, p=0.717; Blow Bottle: mean rank = 25.23, sum of ranks = 605.50). Similar trends were observed in the six-minute walk test results. Conclusion: The study found that both Acapella and blow bottle devices effectively improve oxygen saturation in post COVID-19 patients, but do not significantly affect peak expiratory flow rate, shortness of breath, and six-minute walk distance. These findings suggest that while these devices are beneficial for enhancing oxygenation, a more comprehensive respiratory rehabilitation approach is necessary for addressing the full spectrum of respiratory complications in post COVID-19 patients.

The Effect of The Combination of Slow Deep Breathing and Humming on Improving Oxygen Saturation of Inpatients With Pneumonia at RSUD Jayapura

Pneumonia is an infectious disease affecting the lower respiratory tract with signs and symptoms such as coughing and shortness of breath. Pneumonia cases in Indonesia are estimated to have 4 million deaths due to pneumonia every year. This study aims to analyze the effectiveness of Slow, Deep Breathing and Humming techniques on changes in oxygen saturation in pneumonia patients at Jayapura Regional Hospital. This quantitative research uses a quasi-experimental pre-test and post-test approach without a control group design. The sample consisted of 30 subjects who were given a slow deep breathing technique intervention of 5 cycles in 15 minutes and humming four cycles in 10 minutes, done once daily for six days. The instruments in the research used the Pulse Oximetry tool. The sampling technique used nonprobability sampling with total sampling. The results showed a difference in SpO2 values before and after the Slow, Deep Breathing, and Humming intervention was carried out in subjects with pneumonia with a p= 0.001 (p &lt; 0.05). It can be interpreted that the Hypothesis (Ha1) is accepted so that it can be concluded that the slow, deep breathing and humming interventions can help improve Sp02. There is a need for further research on nurses' complementary therapy in oxygenation management, where this exercise is one of the nurse's interventions in overcoming decreased SpO2 in pneumonia patients.

Anti-PD-L1 therapy altered inflammation but not survival in a lethal murine hepatitis virus-1 pneumonia model.

Because prior immune checkpoint inhibitor (ICI) therapy in cancer patients presenting with COVID-19 may affect outcomes, we investigated the beta-coronavirus, murine hepatitis virus (MHV)-1, in a lethal pneumonia model in the absence (Study 1) or presence of prior programmed cell death ligand-1 (PD-L1) antibody (PD-L1mAb) treatment (Study 2). In Study 1, animals were inoculated intratracheally with MHV-1 or vehicle and evaluated at day 2, 5, and 10 after infection. In Study 2, uninfected or MHV-1-infected animals were pretreated intraperitoneally with control or PD-L1-blocking antibodies (PD-L1mAb) and evaluated at day 2 and 5 after infection. Each study examined survival, physiologic and histologic parameters, viral titers, lung immunophenotypes, and mediator production. Study 1 results recapitulated the pathogenesis of COVID-19 and revealed increased cell surface expression of checkpoint molecules (PD-L1, PD-1), higher expression of the immune activation marker angiotensin converting enzyme (ACE), but reduced detection of the MHV-1 receptor CD66a on immune cells in the lung, liver, and spleen. In addition to reduced detection of PD-L1 on all immune cells assayed, PD-L1 blockade was associated with increased cell surface expression of PD-1 and ACE, decreased cell surface detection of CD66a, and improved oxygen saturation despite reduced blood glucose levels and increased signs of tissue hypoxia. In the lung, PD-L1mAb promoted S100A9 but inhibited ACE2 production concomitantly with pAKT activation and reduced FOXO1 levels. PD-L1mAb promoted interferon-γ but inhibited IL-5 and granulocyte-macrophagecolony-stimulating factor (GM-CSF) production, contributing to reduced bronchoalveolar lavage levels of eosinophils and neutrophils. In the liver, PD-L1mAb increased viral clearance in association with increased macrophage and lymphocyte recruitment and liver injury. PD-L1mAb increased the production of virally induced mediators of injury, angiogenesis, and neuronal activity that may play role in COVID-19 and ICI-related neurotoxicity. PD-L1mAb did not affect survival in this murine model. In Study 1 and Study 2, ACE was upregulated and CD66a and ACE2 were downregulated by either MHV-1 or PD-L1mAb. CD66a is not only the MHV-1 receptor but also an identified immune checkpoint and a negative regulator of ACE. Crosstalk between CD66a and PD-L1 or ACE/ACE2 may provide insight into ICI therapies. These networks may also play role in the increased production of S100A9 and neurological mediators in response to MHV-1 and/or PD-L1mAb, which warrant further study. Overall, these findings support observational data suggesting that prior ICI treatment does not alter survival in patients presenting with COVID-19.

The pharmacists' interventions after a Drug and Therapeutics Committee (DTC) establishment during the COVID-19 pandemic.

Healthcare systems in developing countries faced significant challenges during COVID-19, grappling with limited resources and staffing shortages. Assessment of the impact of pharmaceutical care expertise, particularly in critical care units during the pandemics, in developing countries remains poorly explored. The principal aim of our study was to assess the impact of the Drug and Therapeutics Committee (DTC), comprising clinical pharmacists, on the incidence, types, and severity of medication errors and associated costs in using COVID-19 medications, especially antibiotics. An interventional pre-post study was carried out at a public isolation hospital in Egypt over 6 months. Out of 499 medication orders, 238 (47.7%) had medication errors, averaging 2.38 errors per patient. The most frequent were prescribing errors (44.9%), specifically incorrect drug choice (57.9%), excessive dosage (29.9%), treatment duplication (4.5%), inadequate dosage (4.5%), and overlooked indications (3.6%). Linezolid and Remdesivir were the most common medications associated with prescribing errors. Pharmacists intervened 315 times, primarily discontinuing medications, reducing doses, introducing new medications, and increasing doses. These actions led to statistically significant cost reductions (p < 0.05) and better clinical outcomes; improved oxygen saturation, decreased fever, stabilised respiratory rates, and normalised white blood cell counts. So, clinical pharmacist interventions made a notable clinical and economic difference (66.34% reduction of the expenses) in antibiotics usage specifically and other medications used in COVID-19 management during the pandemic. Crucially, educational initiatives targeting clinical pharmacists can foster judicious prescribing habits.

Comparison Effects of Postural Drainage and Positive Expiratory Pressure Technique in Community Acquired Pneumonia

Background: Community-acquired pneumonia (CAP) is a major health concern worldwide, leading to substantial hospitalization and morbidity. Physiotherapy interventions like postural drainage and positive expiratory pressure (PEP) are commonly used in managing CAP, but their relative effectiveness in improving respiratory parameters is not fully understood. Objective: The study aimed to compare the effects of postural drainage and PEP techniques on respiratory parameters, specifically pH values and alveolar-arterial oxygen tension, in patients with CAP. Methods: In this randomized clinical trial, 46 patients with mild to moderate CAP were divided into two groups: postural drainage (n=23) and PEP technique (n=23). Data collection occurred pre- and post-intervention in each session, with analysis conducted using SPSS version 23. The Shapiro-Wilk test determined data normality, leading to the use of the Mann-Whitney U test for non-parametric data. Results: Improvements in oxygen saturation were observed in both groups. However, other arterial blood gas parameters, including pH and alveolar-arterial oxygen tension, showed no significant changes post-intervention. Specifically, pH values for the postural drainage group had mean ranks of 21.13, 22.04, 24.74, and 20.70 across sessions, while the PEP technique group showed mean ranks of 25.87, 24.96, 22.26, and 26.30, with p-values ranging from 0.152 to 0.525. Similarly, alveolar-arterial oxygen tension comparisons yielded p-values between 0.056 and 0.231. Conclusion: Both postural drainage and PEP techniques effectively improved oxygen saturation in CAP patients, but they did not significantly impact other respiratory parameters. This suggests their utility in specific areas of respiratory management in CAP, with limitations in broader pulmonary function improvement.

Effectiveness of Pursed Lip Breathing and Alternate-Nostril Breathing in Patients with Respiratory Dysfunction

Respiratory dysfunctions are the diseases or disorders like Asthma, emphysema, bronchitis, lung cancer, pulmonary hypertension, COPD and tuberculosis. Among respiratory dysfunctions, COPD is the most common and may be fatal. Objective: To observe the effectiveness of pursed lip breathing and alternate-nostril breathing in patients of respiratory dysfunction. Methods: This study is aimed to see the effects of PLB and ANB on respiratory outcomes in COPD patients. Qausi Experimental study was completed on 100 participants of age between 24-60 years. Purposive sampling is used to select the population. The participants were selected on the basis of inclusion criteria. Informed consent was taken before the start of exercise. Pulse oximeter was used to assess oxygen saturation values, numeric pain rating scale rating pain from 1-10 , was used to check pain level and Samn-perelli fatigue scale rating fatigue from 1-7 from fully alert till completely exhausted was used respectively. SPSS (version 23) was used for statistical analysis. Findings show that there is marked improvement in respiratory functions including oxygen saturation, pain and fatigue. Results: Outcomes after 4-6 weeks of performing pursed lip breathing shows improvement in oxygen saturation and alternate nostril decreases fatigue and pain with the p-value 0.05 which is highly significant. According to statistics, all respiratory variables are highly significant with the p-value&lt;0.05. Conclusions: It is concluded that pursed lip breathing and alternate nostril breathing is an effective in improving oxygen saturation and respiratory rate. It is an inexpensive, non-pharmacological and easy method and helped in improving respiratory outcomes.