Reduction In Number Of Entries Research Articles

The Effects of Introducing a Mobile App-Based Procedural Logbook on Trainee Compliance to a Central Venous Catheter Insertion Accreditation Program: Before-and-After Study.

BackgroundTo reduce complications associated with central venous catheter (CVC) insertions, local accreditation programs using a supervised procedural logbook are essential. To increase compliance with such a logbook, a mobile app could provide the ideal platform for training doctors in an adult intensive care unit (ICU).ObjectiveThe aim of this paper was to compare trainee compliance with the completion of a logbook as part of a CVC insertion accreditation program, before and after the introduction of an app-based logbook.MethodsThis is a retrospective observational study of logbook data, before and after the introduction of a purpose-built, app-based, electronic logbook to complement an existing paper-based logbook. Carried out over a 2-year period in the adult ICU of the John Hunter Hospital, Newcastle, NSW, Australia, the participants were ICU trainee medical officers completing a CVC insertion accreditation program. The primary outcome was the proportion of all CVC insertions documented in the patients’ electronic medical records appearing as logbook entries. To assess logbook entry quality, we measured and compared the proportion of logbook entries that were approved by a supervisor and contained a supervisor’s signature for the before and after periods. We also analyzed trainee participation before and after the intervention by comparing the total number of active logbook users, and the proportion of first-time users who logged 3 or more CVC insertions.ResultsOf the 2987 CVC insertions documented in the electronic medical records between April 7, 2019, and April 6, 2021, 2161 (72%) were included and separated into cohorts before and after the app’s introduction. Following the introduction of the app-based logbook, the percentage of CVC insertions appearing as logbook entries increased from 3.6% (38/1059) to 20.5% (226/1102; P<.001). There was no difference in the proportion of supervisor-approved entries containing a supervisor’s signature before and after the introduction of the app, with 76.3% (29/38) and 83.2% (188/226), respectively (P=.31). After the introduction of the app, there was an increase in the percentage of active logbook users from 15.3% (13/85) to 62.8% (54/86; P<.001). Adherence to one’s logbook was similar in both groups with 60% (6/10) of first-time users in the before group and 79.5% (31/39) in the after group going on to log at least 3 or more CVCs during their time working in ICU.ConclusionsThe addition of an electronic app-based logbook to a preexisting paper-based logbook was associated with a higher rate of logbook compliance in trainee doctors undertaking an accreditation program for CVC insertion in an adult ICU. There was a large increase in logbook use observed without a reduction in the quality of logbook entries. The overall trainee participation also improved with an observed increase in active logbook users and no reduction in the average number of entries per user following the introduction of the app. Further studies on app-based logbooks for ICU procedural accreditation programs are warranted.

Evaluation of anxiolytic properties of BacoMind extract of plant Bacopa monnieri Linn. in comparison with diazepam in rodent model

Background: Anxiety is a state characterized by somatic, emotional, cognitive, and behavioral components, associated with significant disability. The pharmacotherapy for anxiety remains limited for achievable safety and tolerability of the medicines. Benzodiazepines use associated with side effects like psychomotor impairment and addiction liability. Due to the ADRs associated with antianxiety drugs, the drug trials have focused on screening herbal medicines that are reportedly used in the treatment of anxiety and which have minimal side effects.Methods: The anxiolytic activity was examined by using the elevated plus maze (EPM) and open field test (OFT), forty Albino wistar strain rats of both sex of weighing 120 to 200 g were divided into four groups of ten rats each.. Group 1 received vehicle (normal saline); group 2 received diazepam (1 mg/kg); groups 3 and 4 received BacoMind™, 30 and 60 mg/kg oral, respectively.Results: Rats treated with diazepam (1 mg/kg, p.o.) showed significant (p&lt;0.001) increase in the percentage of open arms entries and time spent whereas, in closed arm the number of entries and time spent were significantly (p&lt;0.05) decreased. Intraperitonial administration of BacoMind™ extract of plant Bacopa monnieri Linn. exhibited significant (p&lt;0.05) increase in the number of open arm entries and time spent with significant (p&lt;0.05) reduction in number of entries and time spent in the closed arm as compared to group 1. BacoMind™ treated rats also produced significant increase in the number of rearings (p&lt;0.05), assisted rearings and number of squares crossed (p&lt;0.01).Conclusions: BacoMind™ extract of plant Bacopa monnieri Linn possess significant anxiolytic activity in the rats. It can be a promising anxiolytic agent.

Development and evaluation of liposomal formulation containing nimodipine on anxiolytic activity in mice

Nimodipine has been investigated in the treatment of anxiety. Its administration, however, presents a number of limitations, particularly by low bioavailability, low aqueous solubility and photosensitivity. These difficulties can be resolved by the use of nanometer-scale pharmaceutical carriers. The goal of the present study was thus to develop a liposomal formulation containing nimodipine (NMD-Lipo) and evaluate anxiolytic activity using models of anxiety (open-field, light and dark and elevated plus-maze test). The results suggest that administration of NMD-Lipo has no sedative or muscle relaxant effect in animals, since there was no reduction in the number of crossings, grooming and rearings. The increased residence time of the animals treated with NMD-Lipo in the bright field is a reflection of the anxiolytic-like activity of the formulation. Furthermore, the reduction in residence time of rodents treated with the combination of flumazenil and NMD-Lipo in the illuminated box suggests that NMD-Lipo acts on benzodiazepine receptors. The increase in the number of entries and length of stay in the open arms of mice treated with NMD-Lipo suggests that anxiolytic activity of formulation and reduction in number of entries and length of stay in open arms of rodents treated with a combination of flumazenil and NMD-Lipo suggest that NMD-Lipo act on benzodiazepine receptors.

Anxiolytic activity of aerial part hydroethanolic extract of Allium ascalonicum Linn. (Liliaceae) in mice

Background: Allium ascalonicum Linn. (Liliaceae) is a mildly aromatic annual herb used to flavor food. Ethnobotanical survey revealed application of A. ascalonicumin the treatment of central nervous system (CNS) disorders. Objective: To investigate the anxiolytic activity of aerial part hydroethanolic extract of A. ascalonicum. Methods: The hole-board, elevated plus maze, light/dark exploration, open field and social interaction tests were used in this study. Groups of mice were treated orally with distilled water (10 ml/kg), diazepam (1 mg/kg), and A. ascalonicum (50-400 mg/kg). Evaluations were done 1 h post-treatment and the duration of observation was mostly 5 min. In the hole-board test, mice were observed for number/duration of head dips and number of sectional crossings. In the elevated plus maze test, the time spent in the open/closed arms and the number of entries by mice were observed. In the light/dark exploration test, the latency of entry into the dark box, time spent in the light and dark compartments, number of rearing and assisted rearing were determined. In respect of the open field test, observations were made for the number of rearing, assisted rearing, and sectional crossings. In the social interaction test, pairs of mice were observed for number of interactions including sniffing, following, and partner grooming. Results: In the hole-board test, A. ascalonicum significantly (p&lt;0.05, 0.01) increased the number/duration of head dips and number of sectional crossings. In the elevated plus maze test, A. ascalonicum significantly (p&lt;0.05) increased the number of entries into the open arm with corresponding reduction in number of entries into the closed arm. In the light/dark exploration test, A. ascalonicum significantly (p&lt;0.05, 0.01) increased the latency of entry into the dark box, time spent in the light box, and number of rearing and assisted rearing. In respect of the open field test, A. ascalonicum significantly (p&lt;0.05, 0.01) increased the number of sectional crossings and rearing. Considering the social interaction test, A. ascalonicum significantly (p&lt;0.05) increased the number of interactions. Peak anti-anxiety effects were mostly observed at the dose of 100 mg/kg. Conclusion: The aerial part hydroethanolic extract of Allium ascalonicum possesses anxiolytic properties. Keywords: Allium ascalonicum, Liliaceae, anxiolytic activity, medicinal plants, traditional medicine.

Evaluation of Anxiolytic effect of Erythrina mysorensis Gamb. in mice

Aim and Objectives:To evaluate anxiolytic effect of stem bark ethanol and chloroform extracts of Erythrina mysorensis in mice.Materials and Methods:The anxiolytic activity was examined by using the elevated plus maze (EPM) and open field test (OFT), and motor coordination by rotarod test (RRT). Twenty four Swiss albino male mice were divided into four groups of six mice each. Group 1 received vehicle (normal saline); group 2 received diazepam (1 mg/kg); groups 3 and 4 received ethanolic and chloroform extract of Erythrina mysorensis, 200 and 400 mg/kg p.o., respectively.Results:Mice treated with diazepam (1 mg/kg, p.o.) showed significant (P < 0.001) increase ini the percentage of open arms entries and time spent whereas, in closed arm the number of entries and time spent were significantly (P < 0.05) decreased. Oral administration of chloroform and ethanol extract of E. mysorensis exhibited significant (P < 0.05) increase in the number of open arm entries and time spent with significant (P < 0.05) reduction in number of entries and time spent in the closed arm as compared to group 1. Chloroform and ethanol extracts treated mice also produced significant increase in the number of rearings (P < 0.05), assisted rearings and number of squares crossed (P < 0.01). Rotarod test showed significant (P < 0.01) reduction in motor activity at 45 min with diazepam and E. mysorensis extracts (400 mg/kg) as compared to groups 3 and 1.Conclusion:Erythrina mysorensis possess significant anxiolytic activity in the mice. It can be a promising anxiolytic agent.

2-Phenylethylamine, a constituent of chocolate and wine, causes mitochondrial complex-I inhibition, generation of hydroxyl radicals and depletion of striatal biogenic amines leading to psycho-motor dysfunctions in Balb/c mice

Behavioral and neurochemical effects of chronic administration of high doses of 2-phenylethylamine (PEA; 25–75 mg/kg, i.p. for up to 7 days) have been investigated in Balb/c mice. Depression and anxiety, as demonstrated respectively by increased floating time in forced swim test, and reduction in number of entries and the time spent in the open arms in an elevated plus maze were observed in these animals. General motor disabilities in terms of akinesia, catalepsy and decreased swimming ability were also observed in these animals. Acute and sub-acute administration of PEA caused significant, dose-dependent depletion of striatal dopamine, and its metabolites levels. PEA caused dose-dependent generation of hydroxyl radicals in vitro in Fenton's reaction in test tubes, in isolated mitochondrial fraction, and in vivo in the striatum of mice. A significant inhibition of NADH-ubiquinone oxidoreductase (complex-I; EC: 1.6.5.3) activity suggests the inhibition in oxidative phosphorylation in the mitochondria resulting in hydroxyl radical generation. Nissl staining and TH immnunohistochemistry in brain sections failed to show any morphological aberrations in dopaminergic neurons or nerve terminals. Long-term over-consumption of PEA containing food items could be a neurological risk factor having significant pathological relevance to disease conditions such as depression or motor dysfunction. However, per-oral administration of higher doses of PEA (75–125 mg/kg; 7 days) failed to cause such overt neurochemical effects in rats, which suggested safe consumption of food items rich in this trace amine by normal population.