Injection Of Penicillin Research Articles

A RETROSPECTIVE ANALYSIS OF 12 CASES OF ORAL SYPHILIS RECENTLY DIAGNOSED AT A SOLE INSITITUTION

Syphilis is an infectious disease caused by the bacterium Treponema pallidum and has 3 classically clinical stages. This disease may mimic several other more common oral mucosa lesions. This study aimed to describe the different oral manifestations of 12 patients diagnosed as having syphilis in the last few years at our institution. Eleven of the 12 syphilis cases presented lesions of secondary syphilis and 1 of primary syphilis. The diagnosis was made through biopsies or/and laboratory tests, and the treatment was conducted by intramuscular injections of benzathine penicillin G with good results. The patients' group examination confirmed the theory that syphilis may resemble several other diseases. Dental surgeons should be aware of the manifestations of oral syphilis, which might be very different from the classical description of mucous patches, to play a desirable key role on the diagnosis and control of this disease. Syphilis is an infectious disease caused by the bacterium Treponema pallidum and has 3 classically clinical stages. This disease may mimic several other more common oral mucosa lesions. This study aimed to describe the different oral manifestations of 12 patients diagnosed as having syphilis in the last few years at our institution. Eleven of the 12 syphilis cases presented lesions of secondary syphilis and 1 of primary syphilis. The diagnosis was made through biopsies or/and laboratory tests, and the treatment was conducted by intramuscular injections of benzathine penicillin G with good results. The patients' group examination confirmed the theory that syphilis may resemble several other diseases. Dental surgeons should be aware of the manifestations of oral syphilis, which might be very different from the classical description of mucous patches, to play a desirable key role on the diagnosis and control of this disease.

Public health and economic perspectives on acute rheumatic fever and rheumatic heart disease.

Public health and economic perspectives on acute rheumatic fever and rheumatic heart disease.

Effect of Sesamum indicum oil in Thyroidectomy-Induced Erectile Dysfunction in Rat

The aim of the present study has been to explore the effect of Sesamum indicum in thyroidectomy-induced erectile dysfunction in rat. The animals were anaesthetized with combination of midazolam and ketamine i.p. , and the thyroid gland was dissected out. The skin was then stitched and the wound was closed. Animals were treated with penicillin injection i.p. for 5 days postoperatively. After 45 days of surgery different groups of animals were treated with sesamum oil at dose levels 2 mL, 3 mL and 5 mL/kg p.o. , and with standard drug sildenafil, respectively, for 28 days. At the end of the study erectile dysfunction-associated physical and biochemical parameters were evaluated to assess the effect of Sesamum indicum in thyroidectomy-induced erectile dysfunction. Thyroidectomy resulted in impairment of sexual function in the rat. Treatment of Sesamum indicum oil caused increase in testosterone level. It also produced significant positive effects on the physical parameters of sexual function such as mount latency, intromission latency, ejaculatory latency, post-ejaculatory interval, mount frequency and intromission frequency. Though the oil did not produce any significant effect on the levels of thyroid hormones, the oil at the doses of 2 mL, 3 mL and 5 mL/kg body weight restored sexual competence to a reasonable extent in which the highest dose produced the maximum response. A combination of Sesamum indicum oil and thyroxin may be recommended for hypothyroidism-associated sexual impairment.

Effect of Intravenous Injection with Different Antibiotic Prophylaxis Against the Intracranial Infection after Craniotomy: A Network Meta-Analysis

Background: Many studies had shown that prophylactic use of antibiotics could significantly reduce the postoperative infection rate of craniotomy. However, the best antibiotic selection for intracranial infection (ICI) prevention had not been clearly assessed in previous studies. Objective: To evaluate the effect of various intravenous injection with different antibiotic prophylaxis against the ICI after craniotomy by bayesian network meta-analysis, and to provide references for preventive medication selection in patients undergoing craniotomy. METHODS: An electronic database search was performed, from inception to December 31st 2018. Randomized controlled trials (RCT) using different intravenous antibiotics (IVA) against the ICI after craniotomy were considered. The study selection and data collection were performed independently by two reviewers. Risk of bias assessment was performed using the Cochrane risk of bias scale. The primary outcome was the incidence rates of ICIs. A network meta-analysis was conducted to compare the effect among the different antibiotic prophylaxis to prevent ICIs after craniotomy. Results: A total of 3214 patients after craniotomy in 11 studies were included, 159 patients experienced postoperative ICI, including 33 patients in the antibacterial group and 126 in the control group. The quality of the studies was good. The consistency test showed that there was no obvious inconsistency between the direct and indirect comparison. The calculate results of bayesian network meta-analysis showed that except fusidic acid, preoperative intravenous injection of cephalosporin, clindamycin, vancomycin, and penicillin can significantly reduce the incidence of ICI after craniotomy, but there is no statistical difference among these four antibacterial drugs. Conclusion: The current evidence shows that low-grade antibacterial drugs can be selected to prevent ICI after craniotomy. However, it still need more high-quality, large sample RCT to confirm. Funding Statement: The authors declare: We had no funding support for this study. Declaration of Interests: The authors state: There is no conflict of interest in relation to this study. Ethics Approval Statement: PROSPERO CRD42019133369, All analyses were based on previously published studies, thus no ethical approval or patient consent was required.

Rheumatic Heart Disease Management: Patients’ Experiences, Health Practices, and Role Performance

Rheumatic Heart Disease (RHD) continues to be a major health hazard in most developing countries as well as sporadically in developed economies. This study aimed to determine the drug regimen therapy of rheumatic heart disease patients and the effects of the illness physically, emotionally, and socially. This qualitative and quantitative study documented the drug regimen therapy management of twenty-seven (27) patients among the eighty-two (82) patients currently receiving the drug regimen for Rheumatic Heart Disease at the Out-Patient Department (OPD) of Cotabato Regional and Medical Center (CRMC) through the interview, observation, self-made questionnaire and focus group discussion. The study found out that RHD patients, who were mostly housewives, feel strong and healthy when complying with the date of Benzathine penicillin and experienced heart palpitation if unable to come on their visit on the 21st or 28th of the month. The effect of RHD physically is feeling of fatigue on the emotional aspect, anxiety in the social aspect, and avoid activities. The current role performance mostly is housewives. On health services received at OPD CRMC mostly, they received an injection of Benzathine Penicillin. The majority have a monthly check-up as their priority in their health practice.

Effects of different drugs on bronchial stenosis by TGF-β/mTOR signaling pathway in rabbit model

Objective: To investigate the effect of different drugs on tracheal stenosis caused by transforming growth factor-β/rapamycin target protein (TGF-β/mTOR) signaling pathway. Methods: Thirty rabbits were randomly divided into normal control group, normal saline group, penicillin group, budesonide group and erythromycin group. The normal control group was not treated,and tracheal stenosis models were established in the other groups. From the 1st to 10th day after modeling, each group was respectively administered with normal saline (0.75 ml/kg, 2 times/d), intramuscular injection of penicillin (40 000 U/kg, 2 times/d), gastric administration of erythromycin (12.5 mg/kg, 2 times/d), inhalation of budesonide (0.05 mg/kg, 2 times/d). Rabbits were sacrificed on the 11th day after surgery, and tracheal specimens were collected to measure the degree of tracheal stenosis. Relative mRNA expression level of interleukin-6 (IL-6), transforming growth factor-β (TGF-β), Type Ⅰ collagen (COL-1), Type Ⅲ collagen (COL-3), and Sirtuin 1 (SIRT-1) were detected by Real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR); protein expression of mTOR, phosphorylated protein kinase B (p-AKT), vascular endothelial growth factor (VEGF),SIRT-1 were detected by immunohistochemical analysis; protein expression of nuclear factor κB (NF-κB),phosphorylated nuclear factor κB (p-NF-κB),protein kinase B (AKT),p-AKT,mTOR were detected by Western blotting. Results: The degree of stenosis of normal control group was (14.02±2.86)%, saline group was (64.14±3.21)%, penicillin group was (49.11±2.96)%, budesonide group was (39.52±2.09)%, erythromycin group was (32.60±4.27)%. The differences between any two groups were statistically significant (all P<0.05). Except between erythromycin group and normal control group, the differences in relative expression of IL-6 mRNA between any two groups (1.00±0.00, 9.02±1.50, 4.25±0.87, 2.53±0.17, 1.31±0.56) was statistically significant (all P<0.05), and the differences in relative expression of TGF-β mRNA among all groups (1.00±0.00, 6.92±0.84, 3.83±0.44, 2.13±0.25, 1.40±0.15) were statistically significant (all P<0.05). The relative expression of SIRT-1 mRNA among all the groups (1.000±0.000, 0.209±0.042, 0.375±0.034, 0.555±0.028, 0.667±0.032) was statistically significant different (all P<0.05); except between erythromycin group and budesonide group,the protein levels of SIRT-1 among all other groups (16.93±2.28, 4.77±1.45, 7.70±0.61, 10.76±1.04, 11.03±1.10) were statistically significant different (all P<0.05). The protein levels of mTOR (9.28±4.56, 58.18±8.12, 44.75±5.56, 32.82±5.99, 24.73±3.56) and p-AKT (16.57±4.86, 61.79±6.66, 42.98±5.99, 32.79±5.34, 24.00±4.40) determined through immunohistochemistry of all groups were statistically significant different (all P<0.05). The protein levels of NF-κB, p-NF-κB, AKT, p-AKT and mTOR determined through Western blotting had the same trend as that of determined through immunohistochemistry. The protein expression of NF-κB,AKT and mTOR in saline group were significantly higher than other groups; those protein expression of erythromycin group was lower than budesonide group and penicillin group. Except between the erythromycin group and the normal control group, the protein expression of mTOR in other groups was statistically significant different (all P<0.05). Conclusion: Penicillin,erythromycin and budesonide can alleviate inflammation by increasing SIRT-1, alleviate tracheal scar hyperplasia induced by TGF-beta/mTOR pathway, and reduce the degree of tracheal stenosis in rabbits.

Determining the impact of Benzathine penicillin G prophylaxis in children with latent rheumatic heart disease (GOAL trial): Study protocol for a randomized controlled trial

This trial aims to determine if secondary prophylaxis with every-4-week injectable Benzathine penicillin G (BPG) improves outcomes for children diagnosed with latent RHD. This is a randomized controlled trial in consenting children, aged 5 to 17 years in Northern Uganda, confirmed to have borderline RHD or mild definite RHD on echocardiography, according to the 2012 World Heart Federation criteria. Qualifying children will be randomized to every-4-week injectable intramuscular BPG or no medical intervention and followed for a period of 2 years. Ongoing intervention adherence and retention in the trial will be supported through the establishment of peer support groups for participants in the intervention and control arms. A blinded echocardiography adjudication panel consisting of four independent experts will determine the echocardiographic classification at enrollment and trajectory through consensus review. The primary outcome is the proportion of children in the BPG-arm who demonstrate echocardiographic progression of latent RHD compared to those in the control arm. The secondary outcome is the proportion of children in the BPG-arm who demonstrate echocardiographic regression of latent RHD compared to those in the control arm. A sample size of 916 participants will provide 90% power to detect a 50% relative risk reduction assuming a 15% progression in the control group. The planned study duration is from 2018-2021. Policy decisions on the role of echocardiographic screening for RHD have stalled because of the lack of evidence of the benefit of secondary prophylaxis. The results of our study will immediately inform the standard of care for children diagnosed with latent RHD and will shape, over 2-3 years, practical and scalable programs that could substantially decrease the burden of RHD in our lifetime. ClinicalTrials.gov: NCT03346525. Date Registered: November 17, 2017.

Group A Streptococcal Infection, Acute Rheumatic Fever and Rheumatic Heart Disease in the Solomon Islands

Abstract Group A Streptococcal (GAS) infection of the upper respiratory tract (and possibly skin) can trigger Acute Rheumatic Fever (ARF), an autoimmune condition if left untreated. Severe or recurrent attacks of ARF that also remain untreated, can lead to a type of permanent cardiac damage known as Rheumatic Heart Disease (RHD). RHD remains a significant cause of morbidity and mortality globally and is rare in developed countries. In Australia, New Zealand (NZ) and the Pacific Region, the disease burden of ARF and RHD amongst Indigenous and Pacific communities remain one of the highest in the world, usually affecting children and young adults. Since a GAS vaccine remains unavailable, the most effective recommended treatment and management strategy to prevent further GAS infections that can lead to ARF and RHD constitute of painful monthly intramuscular injections of Benzathine Penicillin G (BPG). These BPG injections are administered for at least 10 years or more and are referred to as secondary prophylaxis (SP). Due to the pain, formulation and other issues associated with regular BPG injections, adherence to SP remains problematic globally. A new Penicillin that supports better adherence to SP is urgently needed. This work sought to further understand the local context in the Solomon Islands concerning GAS, ARF and RHD. Preliminary findings indicate very high ARF and RHD rates present in the local setting, in addition to issues with access to ARF/RHD prevention measures with BPG. An electronic database to monitor ARF and RHD as a national disease register will be of clinical relevance to the local setting in the Solomon Islands. Research efforts in the Pacific Region contributing towards the generation of a new Penicillin for BPG SP will be of benefit.

The effect of fluoxetine on penicillin-induced epileptiform activity

AimDepression is the most frequent psychiatric comorbidity in patients with epilepsy.Fluoxetine is the most widely used selective serotonin reuptake inhibitor (SSRI) in depression. The aim of the present study was to evaluate the dose-dependent effect of fluoxetine on penicillin-induced seizure by electrocorticogram (ECoG), a model for simple partial epilepsy. MethodThe epileptiform activity was induced by intracortical (i.c.) microinjection of penicillin into the left sensorimotor cortex. Thirty minutes after penicillin injection, 5, 10, or 20 mg/kg doses of fluoxetine were administered intraperitoneally (i.p.). An ECoG recording was performed for 180 min using the data acquisition system. The frequency and the amplitude of the epileptiform activity were analyzed. ResultsPenicillin induced bilateral spikes and spike–wave complexes within 2–5 min. The 5 and 10 mg/kg doses of fluoxetine significantly reduced the frequency (58%, p < 0.05 and 69%, p < 0.01, 40 and 50 min after fluoxetine injection, respectively) and amplitude (60%, p < 0.01 and 73%, p < 0.05, 40 and 120 min after fluoxetine injection, respectively) of epileptiform activity compared with penicillin-induced seizure group (control). Five-milligram fluoxetine (i.p.) was the most effective dose to decrease frequency and amplitude on penicillin-induced epileptiform activity. However, a higher fluoxetine dose (20 mg/kg) significantly increased frequency (147%, p < 0.01) and amplitude (123%, p < 0.05) of epileptiform activity 40 and 120 min after fluoxetine administration compared with control group. Also, bursts of population spikes were seen in 20 mg/kg fluoxetine doses. ConclusionResults of the present study indicate that low and moderate fluoxetine doses have an anticonvulsant effect while high doses have proconvulsant effect on penicillin-induced epileptic activity.

Patterns, outcomes and trends in hospital visits of un-operated and operated children with rheumatic heart disease in Sudan.

Rheumatic heart disease (RHD) is an important public health problem in Sudan. Clinical and echocardiographic findings from an RHD registry in Khartoum (January 2005-March 2018) are described. Operated and un-operated children were prospectively followed. The quality of life (QOL) for children who had surgery was evaluated using pediatric QOL cardiac module. A total of 818 children (51% males) were included, patients were clustered in White Nile and Kordofan area. RHD was found in 78% and acute rheumatic fever (ARF) in 22% of cases. RHD was severe in 65% and the most common lesion was mitral regurgitation (MR) in 37%. Follow-up of 107 un-operated children for a mean of 2 years revealed major complications in 38% including a mortality of 14%. Severe valve dysfunction tended to remain unchanged. There were 3 deaths in children with severe valve lesions immediately following benzathine penicillin injections. Only 19% of patients underwent surgery with an average post-operative mortality of 10.5% in the last 8 years. Of those, only 34 were reached for follow-up (23%), all were in New York Heart Association (NYHA) class 1, however adverse outcomes were observed including noncompliance with benzathine penicillin and warfarin (51% and 29% respectively) and more than mild valve dysfunction in 35%. All children who had valve surgery have a good QOL scores. In the last 3 years, the outpatient visits, admissions and mortality rates decreased by 20%, 48% and 22% respectively. RHD is clustered in certain areas and presents with severe valve lesions with a high mortality for un-operated patients. Operative mortality improved over the last years but the follow-up rates are poor and adverse outcomes are common. There is an apparent trend of decline in the number of patients with RHD seen at referral hospitals.

Needle temperature and pain perception in the treatment of rheumatic heart disease

Aim: Patients with rheumatic heart disease (RHD) are committed to lifelong secondary prophylaxis with antibiotics. The study was conducted to evaluate the effect of cold needle to decrease the pain associated with this injection. Material and methods: A randomised crossover single-blinded study was conducted among 100 patients receiving penicillin with room-temperature needle and cold needle (0–2oC) in random order. Pain was evaluated using numerical pain rating scale and bio-physiological measures. Results: There was a significant decrease in subjective pain score when cold needle was used as compared to room-temperature needle (3.37 ±1.75 vs 5.58 ±1.68, P≤0.0001). Conclusion: Cold needle decreased pain perception of patients receiving intramuscular injection of benzathine penicillin. Pain-reducing technique may be useful in improving compliance of patients receiving benzathine penicillin.

Clinical Profile and Visual Outcomes of Ocular Syphilis: A Five-year Review in Hospital Universiti Sains, Malaysia.

IntroductionOcular syphilis is a sight-threatening condition. It can occur at any stage of syphilis infection, which present either with acute inflammation during the primary, secondary, and early latent stages or with chronic inflammation during tertiary infection, affecting virtually every ocular structure. This study was to report on the clinical presentation of ocular syphilis that presented to eye clinic Hospital Universiti Sains Malaysia.MethodologyThis was a retrospective study where medical records of ocular syphilis patients who attended eye clinic in Hospital Universiti Sains Malaysia from January 2013 to June 2017 were reviewed.ResultsA total of 10 patients (13 eyes) with ocular syphilis were identified out of 106 cases that presented with ocular inflammation. The mean age of presentation was 69.8 ± 6.4 years and seven of them (70%) were female. All patients were Malay and human immunodeficiency virus (HIV) was negative. The ocular manifestations included panuveitis (four eyes, 30.8%), anterior uveitis (two eyes, 15.4%), posterior uveitis (seven eyes, 53.8%) and optic neuritis (two eyes, 15.4%). Seven (53.8%) eyes presented with visual acuity of worse than 6/60, five (38.5%) eyes had visual acuity between 6/15 to 6/60, and one (7.7%) eye had visual acuity of 6/12 or better. Nine patients received an intravenous benzylpenicillin regime and one patient received an intramuscular penicillin injection. Out of 13 eyes affected, 11 (84.6%) eyes had improved visual acuity of at least one Snellen line after treatment. Visual acuity of 6/12 or better increased to four (30.8%) eyes.ConclusionsPosterior uveitis was the commonest presentation of ocular syphilis in HIV-negative patients. Early detection and treatment of ocular syphilis can result in resolution of inflammation and improvement of vision.

The interaction between P2X7Rs and T-type calcium ion channels in penicillin-induced epileptiform activity

Limited information exists on the link between purinergic class P2X7 receptors (P2X7Rs) and calcium ion channels in epilepsy; no data has been reported regarding the interaction between P2X7Rs and T-type calcium ion channels in epilepsy. Thus, this study is an evaluation of the role that T-type calcium ion channels play in the effect of P2X7Rs on penicillin-induced epileptiform activity.In the first set of experiments, P2X7R agonist BzATP (at 25-, 50-, 100- and 200-μg doses), P2X7R antagonist A-438079 (at 5-, 10-, 20- and 40-μg doses) and T-type calcium ion channel antagonist, NNC-550396 were administered for electrophysiological analyses 30 min after penicillin injection (2.5 μl, 500 IU). In the second set of experiments, the effective doses of these substances were used for biochemical analyses. Malondialdehyde (MDA), advanced oxidation protein product (AOPP), glutathione (GSH), glutathione reductase (GR), glutathione peroxide (GPx), catalase (CAT) and superoxide dismutase (SOD) levels were measured in the cerebrum, cerebellum and brainstem of rats. BzATP (100 μg, icv) increased the mean frequency of epileptiform activity, whereas A-438079 (40 μg, icv) and NNC-550396 (30 μg, ic) reduced it. Both A-438079 and NNC-550396 reversed BzATP's proconvulsant action. BzATP increased lipid peroxidation and protein oxidation; it also altered other antioxidant enzymes measured in this study, which were all then reversed via A-438079 and NNC-550396, at least in the cerebrum. The electrophysiological and biochemical analysis of present study suggest that P2X7Rs and its interaction with T-type calcium ion channels play an important role in the experimental model of epilepsy.

The effect of serotonin on penicillin-induced epileptiform activity

Objective: This study was aimed at examining the epileptiform activity of the 5-HT2 serotonin receptor agonist and antagonist, and 5-hydroxytryptophan (5-HTP) in penicillin-induced epilepsy in albino Wistar rats.Methods: For this purpose, 90 albino male Wistar rats were used in this study. Epileptiform activity was induced by an injection of penicillin, an agonist of GABAA receptor, (500 IU, i.c.) into the somatomotor cortex. Thirty minutes after the injection of penicillin, 2,5-dimethoxy-4-iodoamphetamine (DOI, an agonist of 5-HT2 receptor) (0.5, 1, 2 and 4 mg/kg, i.p.), methysergide, an antagonist of 5-HT2 receptor, (1, 10, 20, 50 and 100 µM, i.c.v.) and 5-HTP, precursor of 5-HT, (25, 50, 75 and 100 mg/kg, i.p.) were administered, respectively.Results: DOI, at the doses of 1 and 2 mg/kg, significantly decreased penicillin-induced epileptiform activity (p < 0.05). Methysergide, at the doses of 20, 50 and 100 µM, significantly increased the mean spike frequency of penicillin-induced epileptiform activity (p < 0.05). The doses of 50, 75 and 100 mg/kg of 5-HTP decreased the mean spike frequency of penicillin-induced epileptiform activity (p < 0.05). The mean of amplitude of penicillin-induced epileptiform activity did not significantly change in any of the groups (p > 0.05).Conclusion: The electrophysiological data from the present study suggest that serotonin 5-HT2 receptors have an important role in controlling penicillin-induced epileptiform activity in the rat.

Community Awareness of Sore Throat and Rheumatic Heart Disease in Northern Ethiopia

Background: Rheumatic heart disease (RHD) remains the leading cardiovascular disease in Ethiopian children and adults. Early treatment of bacterial sore throat is important in primary prevention of acute rheumatic fever (ARF). In Ethiopian population knowledge about RHD and its prevention strategies is expected to be limited but few studies have been done. Methods: To determine awareness of RHD prevention in the community in Northern Ethiopia a descriptive cross-sectional study was conducted in three districts of Tigray, Northern Ethiopia. Using structured questionnaire, adults > 18 years selected by systematic random sampling were interviewed. Findings: A total of 1298 participants were included, 1004 (77·4%) were from rural areas, 978 (75·3%) were female and 823 (60·1%) had no formal education. Only 34 (2·6%) of the participants responded that the cause of sore throat is due to bacteria or virus and 6·2 % knew that there is a relation between sore throat and heart disease. Of the respondents, 43·3% would take children with sore throat to traditional healers, 71·6% had history of uvulectomy in their children or themselves. Only 7·8% answered that penicillin injection is useful in children with sore throat as primary prophylaxis and 8·1% answered that regular penicillin injection is useful as secondary prevention in RHD. Interpretation: These results can help understand the beliefs and practices about sore throat in Northern Ethiopia. We conclude that the community awareness on the cause and the link between bacterial pharyngitis and ARF/RHD is almost non-existent. Funding: Klinikpartnerschaften, Germany, supported the study. Declaration of Interest: None. Ethical Approval: An ethical approval for this study was obtained from Mekelle University Ethical Review Committee of the College of Health Sciences, Northern Ethiopia. A letter of permission was issued from the Tigray Regional Health Bureau and the district health authorities. Verbal informed consent from the household heads was obtained.

The Effect on Pain of Buzzy® and ShotBlocker® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial.

To investigate the effect of Buzzy® and ShotBlocker® on reducing pain induced by intramuscular penicillin injections in children. This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy®=50, ShotBlocker®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised. The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker® and Buzzy® groups. The children in the Buzzy® group had significantly less pain than the children in both the ShotBlocker® and control groups (p<.001). Buzzy® was more effective compared with ShotBlocker® in this study.

How to assure access of essential RMNCH medicines by looking at policy and systems factors: an analysis of countdown to 2015 countries

BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities.MethodsWe compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation’s Commission on Life Saving Commodities creating a stoplight dashboard to illustrate countries’ environment to assure access. We also developed a dashboard for policy and systems indicators for select countries.ResultsThe commodities we identified as having the fewest barriers to access had been in use longer, including oral rehydration solution and oxytocin injection. Looking across the different systems and policy determinants of access, only Zimbabwe had all 15 commodities on both its essential medicines list and in its standard treatment guidelines, and only Cameroon and Zambia had at least one product registered for each commodity. Senegal alone procured all tracer commodities centrally in the previous year, and 70% of responding countries had costed plans for maternal, newborn, and child health. No country reported recent stock-outs of all the 15 commodities at the central level—countries always had some of the 15 commodities available; however, products with frequent stock-outs included misoprostol, calcium gluconate, penicillin injections, ceftriaxone, and amoxicillin dispersible tablets.ConclusionsThis analysis highlights country deficiencies in policies and systems, such as incoherent policy guidelines, problems in product registration, lack of logistics data, and central-level stock-outs that may affect access to essential RMNCH commodities. To tackle these deficiencies, countries need to integrate commodity-related indicators into other health monitoring activities to improve service quality.

Penicillin Trunk Injection Affects Bacterial Community Structure in Citrus Trees.

Huanglongbing (HLB), caused by Candidatus Liberibacter asiaticus (CLas), an uncultured α-proteobacterium, is the most destructive disease of citrus trees worldwide. In previous studies, trunk injections of penicillin reduced CLas titers and HLB symptoms in citrus. However, antibiotic effects on the whole plant microbial community, which include effects on taxa that interact with CLas, have not yet been addressed. In this study, we investigated the effects of penicillin injection (0, 1000, and 6000mgL-1) on rhizospheric and endophytic bacterial communities of grapefruit trees in field and greenhouse experiments through culture-independent high-throughput sequencing. DNA extractions from petioles and roots were subjected to 16S rRNA high-throughput sequencing, and reads were clustered by sequence similarity into operational taxonomic units (OTUs). Principal coordinates analysis based on weighted-UniFrac distances did not reveal differences in bacterial communities among treatments in any of the sample sources. However, pairwise linear discriminant analysis indicated significant differences in relative abundance of some taxa (including CLas) among treatments. Network analysis showed that penicillin produced major changes in root bacterial community structure by affecting interspecific microbial associations. This study provides new knowledge of the effect of antimicrobial treatments on interspecific relationships in citrus microbial communities.

Pulmonary actinomycosis and hypertrophic osteopathy in a red kangaroo (Macropus rufus)

A five-year-old red kangaroo (Macropus rufus) presented with bilateral, firm thickening of the radius, ulna and metatarsal bones with local tissue hyperthermia. Radiographs revealed a soft tissue opacity left intrathoracic...

Effect of Raspberry on Osteoporosis Model in Ovariectomized Rats

Objective: To investigate the effects of raspberry on various indexes of serum and urine and bone mineral density in rats with osteoporosis. Methods: Female ovariectomized osteoporosis animal model was established by ovariectomy. Rats were completely removed the left ovary, the right removal of 80%, after careful breeding, intramuscular injection of penicillin 800000 u / kg (each 0.1ml) to prevent infection, continuous 3d, 1 day. After that, except for the model blank group, the rats in each group were given gavage for 60 days. The rats in the blank group were given the same amount of normal saline. The rats were fasted on the 58th day, Urine was taken 2h after the last administration on the 60th day. Blood was taken from the eye and the serum was separated. Serum calcium (Ca), phosphorus (P), serum BGP, urinary calcium, phosphorus, creatinine (Cr) and hydroxyproline (HYP) were measured. The tibias on one side of femur on both sides of the rats were used for bone mineral density, pathological examination and biomechanical measurement. Results: Compared with the blank group, serum Ca in the model group decreased significantly. High-dose raspberry group and Xianlinggubao group could significantly reduce the level of serum Ca, and middle-dose raspberry group also decreased serum Ca. Conclusion: The raspberry high, medium and low dose groups have a good intervention on osteoporosis model in ovariectomized rats.