Need For Treatment Research Articles

Diving into drug-screening: zebrafish embryos as an in vivo platform for antimicrobial drug discovery and assessment.

The rise of multidrug-resistant bacteria underlines the need for innovative treatments, yet the introduction of new drugs has stagnated despite numerous antimicrobial discoveries. A major hurdle is a poor correlation between promising in vitro data and in vivo efficacy in animal models, which is essential for clinical development. Early in vivo testing is hindered by the expense and complexity of existing animal models. Therefore, there is a pressing need for cost-effective, rapid preclinical models with high translational value. To overcome these challenges, zebrafish embryos have emerged as an attractive model for infectious disease studies, offering advantages such as ethical alignment, rapid development, ease of maintenance, and genetic manipulability. The zebrafish embryo infection model, involving microinjection or immersion of pathogens and potential antibiotic hit compounds, provides a promising solution for early-stage drug screening. It offers a cost-effective and rapid means of assessing the efficacy, toxicity and mechanism of action of compounds in a whole-organism context. This review discusses the experimental design of this model, but also its benefits and challenges. Additionally, it highlights recently identified compounds in the zebrafish embryo infection model and discusses the relevance of the model in predicting the compound's clinical potential.

Strip Casting of Sm2TM17-Type Alloys for Production of the Metastable SmTM7 Phase

Conventional book casting of Sm2TM17-type alloys (where TM = Co, Fe, Cu, Zr) leads to a coarse, highly segregated microstructure, predominantly due to the slow, variable cooling rate from the mould surface towards the centre of the ingot. These cast alloys require a long homogenisation treatment to remove this segregation and develop a super-saturated, metastable SmTM7-type hexagonal phase. This SmTM7 phase is a vital precursor phase required during magnet production to develop the complex cellular structure responsible for high magnetic properties. In this work, strip casting was employed to facilitate rapid solidification to develop thin flakes (<0.5 mm thick) with a columnar grain structure. Rapid cooling has the potential to produce a homogenous microstructure consisting predominantly of the metastable SmTM7 phase. This could remove or significantly reduce the need for the energy-intensive homogenisation treatment usually required in conventional magnet manufacture. This paper investigates the effect of wheel speed (and hence cooling rate) on flake thickness, microstructure, and phase balance of the cast alloys. It was shown that for wheel speeds between 1.1 and 3.0 m/s, the microstructure showed large variation; however, in all cases, evidence of the columnar SmTM7 phase was presented. The adhesion between the melt and the wheel was deemed to be critical for the nucleation and subsequent columnar growth of SmTM7 grains, where the wheel speed controlled both the flow of the alloy onto the wheel and the thickness of the resultant flake. It was determined that in order to achieve a homogenous columnar SmTM7 structure, the maximum flake thickness should be limited to 270 μm to avoid the formation of equiaxed Sm2TM17 grains through insufficient cooling.

Treatment sequencing and impact of number of treatment lines on survival in follicular lymphoma: A national population‐based study

AbstractFollicular lymphoma (FL) is a clinically heterogeneous disease. The need for treatment, treatment sequencing, number of treatment lines, and its association with survival have not been described in a population‐based setting. We identified all patients diagnosed with FL in the Swedish Lymphoma register from 2007 to 2014, followed until 2020, with detailed data on progression/relapse, transformation, and 2nd and further lines of therapy. During a median follow‐up of 6.8 years, 1226 patients (69%) received 1st systemic treatment, 358 patients (20%) were managed with watch‐and‐wait (WaW) only, and 188 (10%) patients were treated with radiotherapy and did not require additional therapy during the study period. Among patients starting systemic treatment, 496 (40%), 224 (18%), and 88 (7%) received 2nd‐, 3rd‐, or 4th‐line therapy, respectively. The 10‐year cause‐specific cumulative incidence of transformation was 13%. Among patients managed with 1st line R‐single, R‐CHOP, or BR, 54%, 33%, and 29% required 2nd line, respectively. The cumulative probability of starting subsequent treatment within 2 years was 26% after 1st line and 35% after 2nd line treatment. Two‐year OS following 1st, 2nd, 3rd, and 4th line systemic treatment was 84%, 70%, 52%, and 36%, respectively, and remained similar when excluding transformations. We conclude that a substantial proportion of FL patients can be managed with WaW for a long period of time, while patients who require multiple treatment lines constitute a group with a large clinical unmet need. These results constitute valuable real‐world reference data for FL.

Synergistic denitrification and Mn cycle driven by sulfur autotrophy significantly enhanced nitrogen removal

Due to the low C/N and high NO3−-N content in tailwater of wastewater treatment plants, the need for further denitrification treatment attracted wide attention. To achieve deep denitrification of tailwater with low C/N and high NO3−-N, a novel sulfur-manganese carbonate ore denitrification (SMCD) biological reactor was constructed. The denitrification performance of SMCD reactor was significantly higher than that of sulfur denitrification and manganese carbonate ore denitrification reactors. Across the study, the removal efficiencies of TN and NO3−-N were above 90%, and without NO2−-N accumulation in the SMCD reactor. Quantitative results of functional genes showed that SMCD reactor were conducive to realize complete denitrification. Besides, manganese autotrophic denitrification (MAD) process occurred in the SMCD reactor. By analyzing the nitrogen as well as SO42- and Mn(Ⅱ) concentrations along the height, it was found that the conversion between Mn(II) and Mn(IV) was stable during Stage Ⅲ (C/N=1). The microbiota in the SMCD reactor was distinctly different from that in the controls. Thiobacillus, Thermomonas, and an unclassified member in family cvE6 were the dominant members of SMCD reactor. Besides, Thermomonas, Dokdonella, and Simplicispira were identified as potential Mn oxidizers. The SMCD reactor exhibited a significant synergistic denitrification effect by coupling sulfur autotrophic denitrification and MAD process, which provided an effective solution for the deep denitrification of low C/N tailwater.

Spontaneous union of neglected proximal pole scaphoid fracture: A case report

Scaphoid fractures are the most common carpal bone fractures and usually occur due to trauma, typically a fall on an outstretched hand. The scaphoid bone is integral to wrist biomechanics, linking the proximal carpal row to the distal row. Neglected scaphoid fractures can lead to significant long-term complications, with degenerative changes likely to occur. The most common consequence of a neglected scaphoid fracture is known as scaphoid non-union advanced collapse, which typically begins within five years following the injury. It is widely accepted that scaphoid fractures, in general, should be treated to avoid long-term complications. Many surgeons aggressively treat proximal pole fractures with surgical fixation due to the high risk of avascular necrosis. Although some surgeons may consider a period of immobilization, none would argue against the need for treatment of proximal pole fractures, either through immobilization or surgical fixation. In this case, we present an instance of spontaneous union of a neglected proximal pole fracture non-union in a mature adult. This report aims to provide awareness of the possible spontaneous union of neglected proximal pole scaphoid fracture. It also challenges the call for acute aggressive surgical intervention in such fractures. Radiographs and magnetic resonance imaging scan images before and after union are presented, along with a review of the available literature.

Ictal-Interictal Continuum in the Pediatric Intensive Care Unit.

The ictal-interictal continuum (IIC) consists of several electroencephalogram (EEG) patterns that are common in critically ill adults. Studies focused on the IIC are limited in critically ill children and have focused primarily on associations with electrographic seizures (ESs). We report the incidence of the IIC in the pediatric intensive care unit (PICU). We then compare IIC patterns to rhythmic and periodic patterns (RPP) not meeting IIC criteria looking for associations with acute cerebral abnormalities, ES, and in-hospital mortality. This was a retrospective review of prospectively collected data for patients admitted to the PICU at Children's National Hospital from July 2021 to January 2023 with continuous EEG. We excluded patients with known epilepsy and cerebral injury prior to presentation. All patients were screened for RPP. The American Clinical Neurophysiology Society standardized Critical Care EEG terminology for the IIC was applied to each RPP. Associations between IIC and RPP not meeting IIC criteria, with clinical and EEG variables, were calculated using odds ratios (ORs). Of 201 patients, 21% (42/201) had RPP and 12% (24/201) met IIC criteria. Among patients with an IIC pattern, the median age was 3.4years (interquartile range (IQR) 0.6-12years). Sixty-seven percent (16/24) of patients met a single IIC criterion, whereas the remainder met two criteria. ESs were identified in 83% (20/24) of patients and cerebral injury was identified in 96% (23/24) of patients with IIC patterns. When comparing patients with IIC patterns with those with RPP not qualifying as an IIC pattern, both patterns were associated with acute cerebral abnormalities (IIC OR 26 [95% confidence interval {CI} 3.4-197], p = 0.0016 vs. RPP OR 3.5 [95% CI 1.1-11], p = 0.03), however, only the IIC was associated with ES (OR 121 [95% CI 33-451], p < 0.0001) versus RPP (OR 1.3 [0.4-5], p = 0.7). Rhythmic and periodic patterns and subsequently the IIC are commonly seen in the PICU and carry a high association with cerebral injury. Additionally, the IIC, seen in more than 10% of critically ill children, is associated with ES. The independent impact of RPP and IIC patterns on secondary brain injury and need for treatment of these patterns independent of ES requires further study.

Gianotti-Crosti syndrome mimicking scabies.

This case report highlights a case of a 65-year-old woman who presented to our clinic with suspicion of refractory scabies. She had undergone multiple treatments without improvement. However, the clinical condition was not scabies but rather Gianotti-Crosti Syndrome (GCS), leading to rapid clinical improvement and avoiding the need for further unnecessary tests and treatments. GCS is a postviral exanthem characterized by symmetrical, red papules on the extremities and buttocks, typically occurring in children but can also affect adults. It is crucial for every physician to distinguish it from other causes of rash, including scabies, to ensure an accurate diagnosis and appropriate management.

Rhein kills Actinobacillus pleuropneumoniae, reduces biofilm formation, and effectively treats bacterial lung infections in mice.

Background. Actinobacillus pleuropneumoniae, a member of the Pasteurellaceae family, is known for its highly infectious nature and is the primary causative agent of infectious pleuropneumonia in pigs. This disease poses a considerable threat to the global pig industry and leads to substantial economic losses due to reduced productivity, increased mortality rates, and the need for extensive veterinary care and treatment. Due to the emergence of multi-drug-resistant strains, Chinese herbal medicine is considered one of the best alternatives to antibiotics due to its unique mechanism of action and other properties. As a type of Chinese herbal medicine, Rhein has the advantages of a wide antibacterial spectrum and is less likely to develop drug resistance, which can perfectly solve the limitations of current antibacterial treatments.Methods. The killing effect of Rhein on A. pleuropneumoniae was detected by fluorescence quantification of differential expression changes of key genes, and scanning electron microscopy was used to observe the changes in A. pleuropneumoniae status after Rhein treatment. Establishing a mouse model to observe the treatment of Rhein after A. pleuropneumoniae infection.Results. Here, in this study, we found that Rhein had a good killing effect on A. pleuropneumoniae and that the MIC was 25 µg ml-1. After 3 h of action, Rhein (4×MIC) completely kills A. pleuropneumoniae and Rhein has good stability. In addition, the treatment with Rhein (1×MIC) significantly reduced the formation of bacterial biofilms. Therapeutic evaluation in a murine model showed that Rhein protects mice from A. pleuropneumoniae and relieves lung inflammation. Quantitative RT-PCR (Quantitative reverse transcription polymerase chain reaction is a molecular biology technique that combines both reverse transcription and polymerase chain reaction methods to quantitatively detect the amount of a specific RNA molecule) results showed that Rhein treatment significantly downregulated the expression of the IL-18 (Interleukin refers to a class of cytokines produced by white blood cells), TNF-α, p65 and p38 genes. Along with the downregulation of genes such as IL-18, it means that Rhein has an inhibitory effect on the expression of these genes, thereby reducing the activation of inflammatory cells and the production of inflammatory mediators. This helps reduce inflammation and protects tissue from further damage.Conclusions. This study reports the activity of Rhein against A. pleuropneumoniae and its mechanism, and reveals the ability of Rhein to treat A. pleuropneumoniae infection in mice, laying the foundation for the development of new drugs for bacterial infections.

The antidepressant effect of whole-body hyperthermia is associated with the classical interleukin-6 signaling pathway

There is urgent need for novel antidepressant treatments that confer therapeutic benefits via engagement with identified mechanistic targets. The objective of the study was to determine whether activation of the classical anti-inflammatory interleukin-6 signaling pathways is associated with the antidepressant effects of whole-body hyperthermia. A 6-week, randomized, double-blind study compared whole-body hyperthermia with a sham condition in a university-based medical center. Medically healthy participants aged 18–65 years who met criteria for major depressive disorder, were free of psychotropic medication use, and had a baseline 17-item Hamilton Depression Rating Scale score ≥ 16 were randomized with 1-to-1 allocation in blocks of 6 to receive whole-body hyperthermia or sham. Of 338 individuals screened, 34 were randomized, 30 received interventions and 26 had ≥ 2 blood draws and depressive symptom assessments. Secondary data analysis examined change in the ratio of IL-6:soluble IL-6 receptor pre-intervention, post-intervention, and at weeks 1 and 4. Hierarchical linear modeling tested whether increased IL-6:soluble IL-6 receptor ratio post-intervention was associated with decreased depressive symptom at weeks 1, 2, 4 and 6 for those randomized to whole-body hyperthermia. Twenty-six individuals were randomized to whole-body hyperthermia [n = 12; 75 % female; age = 37.9 years (SD = 15.3) or sham [n = 14; 57.1 % female; age = 41.1 years (SD = 12.5). When compared to the sham condition, active whole-body hyperthermia only increased the IL-6:soluble IL-6 receptor ratio post-treatment [F(3,72) = 11.73,p < .001], but not pre-intervention or at weeks 1 and 4. Using hierarchical linear modeling, increased IL-6:sIL-6R ratio following whole-body hyperthermia moderated depressive symptoms at weeks 1, 2, 4 and 6, such that increases in the IL-6:soluble IL-6 receptor ratio were associated with decreased depressive symptoms at weeks 1, 2, 4 and 6 for those receiving the active whole-body hyperthermia compared to sham treatment (B = –229.44, t = -3.82,p < .001). Acute activation of classical intereukin-6 signaling might emerge as a heretofore unrecognized novel mechanism that could be harnessed to expand the antidepressant armamentarium.

Telemedicine for Ketogenic Dietary Treatment in Refractory Epilepsy and Inherited Metabolic Disease: State of Play and Future Perspectives.

Ketogenic dietary therapies (KDT) are diets that induce a metabolic condition comparable to fasting. All types of KDT comprise a reduction in carbohydrates whilst dietary fat is increased up to 90% of daily energy expenditure. The amount of protein is normal or slightly increased. KDT are effective, well studied and established as non-pharmacological treatments for pediatric patients with refractory epilepsy and specific inherited metabolic diseases such as Glucose Transporter Type 1 Deficiency Syndrome. Patients and caregivers have to contribute actively to their day-to-day care especially in terms of (self-) calculation and (self-) provision of dietary treatment as well as (self-) measurement of blood glucose and ketones for therapy monitoring. In addition, patients often have to deal with ever-changing drug treatment plans and need to document occurring seizures on a regular basis. With this review, we aim to identify existing tools and features of telemedicine used in the KDT context and further aim to derive implications for further research and development.

Impact of the COVID-19 pandemic on the work of clinical psychologists in Austria: results of a mixed-methods study.

Clinical psychologists in Austria shouldered a large part of the massive increase in demand for mental health services caused by the COVID-19 pandemic. This study aimed to find out how the pandemic affected their work and to gather information on how best to support the profession in the event of a crisis. N = 172 Austrian clinical psychologists participated in a cross-sectional online survey between 11 April 2022 and 31 May 2022, including both closed and open-ended questions about their work. Open-ended questions were analyzed using qualitative content analysis. A mixed-methods analysis was conducted to test correlations between the categories derived from the qualitative analysis and professional variables. The analyses revealed that clinical psychologists, especially those with more years of experience, perceived an increased need for clinical psychological treatment, especially for children and adolescents, a lack of coverage for clinical psychological treatment by health insurance, a change to remote treatment formats, and a number of burdens associated with complying with COVID-19 measures. Clinical psychologists reported an urgent need to increase resources in both outpatient and inpatient settings and to promote health insurance coverage. To support the clinical psychology profession in providing high-quality work in times of crisis, there is a need to facilitate more opportunities for team and peer exchange, as well as financial support in the event of loss of income.

In vitro biological evaluation and in silico insights into the antiviral activity of standardized olive leaves extract against SARS-CoV-2.

There is still a great global need for efficient treatments for the management of SARS-CoV-2 illness notwithstanding the availability and efficacy of COVID-19 vaccinations. Olive leaf is an herbal remedy with a potential antiviral activity that could improve the recovery of COVID-19 patients. In this work, the olive leaves major metabolites were screened in silico for their activity against SARS-CoV-2 by molecular docking on several viral targets such as methyl transferase, helicase, Plpro, Mpro, and RdRp. The results of in silico docking study showed that olive leaves phytoconstituents exhibited strong potential antiviral activity against SARS-CoV-2 selected targets. Verbacoside demonstrated a strong inhibition against methyl transferase, helicase, Plpro, Mpro, and RdRp (docking scores = -17.2, -20, -18.2, -19.8, and -21.7 kcal/mol.) respectively. Oleuropein inhibited 5rmm, Mpro, and RdRp (docking scores = -15, -16.6 and -18.6 kcal/mol., respectively) respectively. Apigenin-7-O-glucoside exhibited activity against methyl transferase and RdRp (docking score = -16.1 and -19.4 kcal/mol., respectively) while Luteolin-7-O-glucoside inhibited Plpro and RdRp (docking score = -15.2 and -20 kcal/mol., respectively). The in vitro antiviral assay was carried out on standardized olive leaf extract (SOLE) containing 20% oleuropein and IC50 was calculated. The results revealed that 20% SOLE demonstrated a moderate antiviral activity against SARS-CoV-2 with IC50 of 118.3 μg /mL. Accordingly, olive leaf could be a potential herbal therapy against SARS-CoV-2 but more in vivo and clinical investigations are recommended.

Synthesis of Deuterated Endochin-Like Quinolones.

Malaria continues to be a serious and debilitating disease. The emergence and spread of high-level resistance to multiple antimalarial drugs by Plasmodium falciparum has brought about an urgent need for new treatments that will be active against multidrug resistant malaria infections. One such treatment, ELQ-331 (MMV-167), an alkoxy carbonate prodrug of 4(1H)-quinolone ELQ-300, is currently in preclinical development with the Medicines for Malaria Venture. Clinical development of ELQ-331 or similar compounds will require the availability of isotopically labeled analogs. Unfortunately, a suitable method for the deuteration of these important compounds was not found in the literature. Here, we describe a facile and scalable method for the deuteration of 4(1H)-quinolone ELQ-300, its alkoxycarbonate prodrug ELQ-331, and their respective N-oxides using deuterated acetic acid.

Plant-Wide Models for Optimizing the Operation and Maintenance of BTEX-Contaminated Wastewater Treatment and Reuse

Benzene, toluene, ethylbenzene and xylenes, collectively known as BTEX compounds, are significant emerging contaminants in municipal wastewater. Stricter effluent quality regulations necessitate their removal, especially with concerns about organic micropollutant concentrations. Water scarcity further underscores the need for wastewater treatment to ensure safe agricultural or drinking water supplies. Although biological treatment partially reduces BTEX levels through processes like biodegradation and sorption, additional purification using physico-chemical methods is crucial for substantial reduction. This paper aims to outline plant-wide simulation methods for treating BTEX-contaminated sewage and facilitating reuse, adhering to IWA Good Modelling Practice Guidelines. The model, built upon the MiniSumo process model, incorporates equations detailing BTEX metabolism and removal kinetics, informed by an extensive literature review. Using a variant of the Benchmark Simulation Model with granular activated carbon for water reuse, the study examines strategies for improving effluent quality and minimizing operational costs. These strategies include adjusting the sludge retention time and airflow to enhance BTEX degradation and stripping, respectively, and comparing maintenance approaches for the GAC tower.

Mini-dose methotrexate combined with methylprednisolone for the initial treatment of acute GVHD: a multicentre, randomized trial

BackgroundThere is an urgent unmet need for effective initial treatment for acute graft-versus-host disease (aGVHD) adding to the standard first-line therapy with corticosteroids after allogeneic haematopoietic stem cell transplantation (allo-HSCT).MethodsWe performed a multicentre, open-label, randomized, phase 3 study. Eligible patients (aged 15 years or older, had received allo-HSCT for a haematological malignancy, developed aGVHD, and received no previous therapies for aGVHD) were randomly assigned (1:1) to receive either 5 mg/m2 MTX on Days 1, 3, or 8 and then combined with corticosteroids or corticosteroids alone weekly.ResultsThe primary endpoint was the overall response rate (ORR) on Day 10. A total of 157 patients were randomly assigned to receive either MTX plus corticosteroids (n = 78; MTX group) or corticosteroids alone (n = 79; control group). The Day 10 ORR was 97% for the MTX group and 81% for the control group (p = .005). Among patients with mild aGVHD, the Day 10 ORR was 100% for the MTX group and 86% for the control group (p = .001). The 1-year estimated failure-free survival was 69% for the MTX group and 41% for the control group (p = .002). There were no differences in treatment-related adverse events between the two groups.ConclusionsIn conclusion, mini-dose MTX combined with corticosteroids can significantly improve the ORR in patients with aGVHD and is well tolerated, although it did not achieve the prespecified 20% improvement with the addition of MTX.Trial registrationThe trial was registered with clinicaltrials.gov (NCT04960644).

Prosthetic status and Treatment need in Indian population:A Systematic Review

Introduction To examine the prevalence of partial or complete edentulousness in different geographic areas of the Indian population. Materials and Methods An electronic search in PubMed/Medline, Cochrane Library, ScienceDirect, Wiley Online Library, and Google Scholar was conducted to find relevant papers that had been written in English exclusively and published before May 2022. Based on the PICO, the primary research question for this study was ‘What are the prosthetic status and treatment needs of the adult population in India?’ By evaluating the title, abstract, and full text of the articles, if they met the inclusion criteria, the relevance of the articles was verified. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) tool for analytical cross-sectional studies. Result The database search yielded 278 items, of which 123 were discarded due to being irrelevant, duplicates, or lacking data. The remaining 155 full-text articles were assessed for eligibility 20 articles were yielded by manual search and 9 articles were added through a search of a reference list of relevant articles. A total of 151 full-text papers were evaluated for eligibility, with 5 articles being excluded. The current systematic review includes a total of 35 studies. Conclusion The current systematic review states the prevalence of complete edentulousness is comparatively less than partial edentulism, ranging between 0.8% to 14%, except for the tribal population where it is around 42-43%. On the other hand, figures depicting partial edentulism are between 15 to 98% distributed in the different geographical regions. The prosthetic status reported in the studies involved ranges between 3% to 100% with a mean of approximately 35%. Prosthetic treatment need reported overall was between 14% to 100%, in which requirement was found to be more in the maxilla in maximum of the studies included while only a few studies predicted more treatment need in the mandible. The requirement and correlation with gender cannot be established as the figures vary in all the studies included. This research establishes a baseline reference and highlights the lack of attention given to oral health. Key Words: Geographic areas, Population, Prosthetic treatment

Clinical and radiological risk factors for poor outcomes in patients with spontaneous muscle hematomas

PurposeSpontaneous muscle hematomas (SMH) are frequently seen in the Emergency Department (ED), particularly as a complication of anticoagulation treatments. To date, there are no standard guidelines for the management of this condition in the ED.This work aims to identify clinical-radiological parameters of SMH at risk of poor outcomes. MethodThis is a retrospective, observational cohort study conducted in an urban teaching hospital from 2016 to 2019. A multivariate logistic regression analysis was performed to identify parameters independently associated with an adverse outcome defined as the need for treatment (blood products, TAE, surgery) or hospitalization. The parameters analyzed were hematoma size, anticoagulation therapy, age, and the Charlson Comorbidity Index (CCI). ROC analysis was performed to identify the best cut-off hematoma size value to predict poor outcomes. ResultsOur study enrolled 231 patients aged between 18 and 96 years, with a mean age of 67 years. In our population, 125 patients (54.1 % %) were on anticoagulant therapy.Multivariate analysis showed that an SMH diameter > 5.5 cm was independently associated with poor outcome ((odds Ratio [95 % CI] 4,009 [1,786–9,001], p 0.001). Among clinical parameters, only advanced age was proved to be an independent predictor of adverse outcomes (odds Ratio [95 % CI] 1,035 [1,003–1,069], p = 0.033) ConclusionsOur data suggest that an SMH diameter greater than 5.5 cm on a CT scan and advanced age are predictors of poor outcomes. Surprisingly, anticoagulant therapy seems to play a minor role in the outcome of SMHs.

Concern over Orthodox and First Aids Treatments of Snakebite Victims in Kaltungo L.G.A, Gombe State, Nigeria

Snakebite by venomous snake causes multi-dimensional fast adverse clinical and non-clinical effects; including mortality and morbidity. Hence, the need for urgent first aid and treatments always in such conditions. Unfortunately, most of the bites occur in very remote rural areas with no health facilities at all or poor health facilities where available for proper treatment. So, the alternative as a matter of necessity is self-help by means of traditional methods of “first aid or treatment”. Unfortunately, the disadvantage of such methods far out-weigh the advantages in many ways for many reasons such as toxicity, none efficacy, lack of hygiene, unknown dosage and delay in going for proper health care early, due to hopeful confidence. The Tropical and Sub-Saharan regions of the globe are more affected; Nigeria is inclusive with the high burden in 12 States. This study was aimed at evaluating the level of dependence on some of these traditional methods of first and treatment of snakebite victims in Kaltungo, Gombe State. After getting ethical clearance from the State Ministry of Health and consent of the victims; a simple questionnaire was used to collect relevant information regarding first aids and treatments from 200 snakebite victims. The study showed that 167 (83.5%) of the victims took at least one form of first aid and/or treatment or the other before visiting the health centre for proper care. The first aids/treatments methods include at least one traditional methods – 27 (13.5%), orthodox only – 4 victims (2%), spiritual method only – 3 (1.5%), tourniquet method only – 7 (3.5%) combinations of two or more methods – 126 (63.0%), while 33 (16.5%) only did not take any first aid/treatment at all before getting to the treatment centre.

Efficacy of Bravecto® Plus spot-on solution for cats (280 mg/ml fluralaner and 14 mg/ml moxidectin) in the prevention of feline Aelurostrongylus abstrusus infection evaluated in a multi-diagnostic approach

BackgroundAelurostrongylus abstrusus is one of the most important respiratory nematodes of felines. Infections may lead to respiratory clinical signs with varying severity or even death, emphasizing the need for preventive treatment of cats with outdoor access to circumvent patent infections.MethodsTherefore, the preventive efficacy of a spot-on formulation of 280 mg/ml fluralaner and 14 mg/ml moxidectin (Bravecto® Plus spot-on solution for cats, MSD) against A. abstrusus was evaluated in a negative controlled, randomized and partially blinded efficacy study with 28 purpose-bred cats in a non-terminal design. In three different treatment regimes, the minimum recommended dose of 40 mg fluralaner and 2.0 mg moxidectin/kg bodyweight (BW) was administered once at 12, 8 or 4 weeks (study group G1, G2 and G3, respectively) prior to experimental infection with 300 third-stage A. abstrusus larvae, while G4 served as placebo-treated control.ResultsFrom 30 to 46 days post infection (dpi; SD 114 to 130), faeces were sampled to monitor first-stage larvae (L1) excretion for efficacy determination. Secondary efficacy criteria, including respiratory parameters, serological antibody levels and computed tomography (CT) findings, were assessed once before enrolment (SD −7 to −1) and before infection (SD 75 to 83). After infection, CT evaluation was performed once at 47–50 dpi (SD 131 to 134), and respiratory parameters and antibody levels were regularly assessed twice or once a week, respectively (1 up to 78 dpi, SD 85 up to 162). All animals in the control group excreted L1 by 33–37 dpi and remained positive throughout the study period from 41 to 46 dpi (SD 125 to 130). In the treatment groups, only one animal each of G1 and G2 excreted L1 at two consecutive days, and four cats of G1, two of G2 and three of G3 were positive on single occasions. While the geometric mean (GM) of the maximum number of excreted L1 per 5 g of faeces was 7380.89 in the control group (G4), GMs were significantly lower in the treatment groups with 1.63 in G1, 1.37 in G2 and 0.79 in G3. Thus, based on GMs, the reduction in excreted L1 exceeded 99.9% in all three treatment groups. Based on CT severity scores, all lungs of the animals of the control group showed severe pulmonary changes post infection, whereas lungs of the cats of the treatment groups were either unaltered (4 animals), mildly (11 animals), or moderately altered (5 animals). Moreover, seroconversion was observed in all cats of the control group, but not in those of the treatment groups.ConclusionsThe combination of diagnostic methods used in this non-terminal study yielded coherent and reliable results. A single administration of Bravecto® Plus spot-on solution for cats was well tolerated and effective in the prevention of aelurostrongylosis for at least 12 weeks.Graphical

Oral health status of 916 children in Tibetan settlement (Bylakuppe, India): A cross-sectional descriptive study.

Dietary and oral hygiene habits among integrated migrant cultural minorities can vary and could impact susceptibility to caries. This study aimed to assess and compare the oral health status of Tibetan schoolchildren living in the Tibetan settlement of Bylakuppe, India, stratified by type of residence. A descriptive cross-sectional study was conducted among Tibetan schoolchildren attending nine schools in the Bylakuppe region. The study population consisted of 916 children aged 5-17: 702 (76.6%) living in secular houses (LSH) and 214 (23.4%) living in monasteries (LM). The prevalence of dental caries was 70.9%, and the mean value of decayed, missing, filled teeth for mixed and primary dentition (DMFT*; dmft) of LSH children (1.56 ± 2.34/1.74 ± 2.66) was higher than of LM ones (1.14 ± 2.34/0.83 ± 2.80; p < .001). DMFT for LM children (1.46 ± 2.04) was slightly higher than for LSH children (1.38 ± 1.96; p > .05). Among the sample, 99.1% had a good simplified Oral Hygiene Index (OHI) and LM children showed higher rates of good values (99.5% vs. 98.2% in LSH children). Most children needed preventive/routine dental treatment, whereas 16.6% needed urgent dental treatment. In 4.5% of children, oral mucosal lesions were present. This study confirms the high need for dental treatment in the children of the Tibetan settlement investigated.