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Objective:To investigate short-term efficacy and safety of subcutaneous injection of dupilumab in the treatment of moderate-to-severe childhood atopic dermatitis (AD) .Methods:A retrospective study was conducted on clinical data from children who were diagnosed with moderate-to-severe AD and subcutaneously injected with dupilumab in Department of Dermatology, Beijing Children′s Hospital, Capital Medical University from March 2021 to August 2021. Changes in the Eczema Area and Severity Index (EASI), itch Numeric Rating Scale (NRS) score, SCORing Atopic Dermatitis (SCORAD) index, and Dermatology Family quality of life Index (DFI) were analyzed before and 4 weeks after the first subcutaneous injection of dupilumab. Adverse events were collected during the first injection to the first follow-up visit at week 4 after the start of treatment. Normally distributed measurement indices were compared by using paired t test, non-normally distributed measurement indices were compared by using signed rank test, and logistic regression analysis was used to evaluate the effects of disease duration, eosinophil counts, IgE levels, personal and family history of allergic diseases on EASI50 (≥ 50% decrease in the EASI score) after dupilumab treatment. Results:A total of 39 children were enrolled in this study, including 21 males and 18 females. Twenty-one patients were aged 2 to < 6 years, 18 were aged 6 to < 18 years, and their median age ( Q1, Q3) was 65.0 (53.0, 111.0) months. Four weeks after the single-dose subcutaneous injection of dupilumab, 18 patients (84.85%) achieved ≥ 50% decrease in EASI score, 13 (60.61%) ≥ 75% decrease in EASI score; 18 (75.76%) experienced a decrease of ≥ 4 points in peak NRS, and 20 (81.82%) ≥ 3 points in peak NRS; the SCORAD score decreased by ≥ 50% in 15 (68.75%) patients, and by ≥ 75% in 7 (18.75%). Neither common adverse events such as conjunctivitis, skin infections, injection site reactions, nor serious adverse events were observed in any of the children from the first injection to the first follow-up visit at week 4. Logistic regression analysis showed no significant effect of the disease duration, eosinophil counts, IgE levels, personal or family history of allergic diseases on EASI50 (all P > 0.05) . Conclusion:A single-dose subcutaneous injection of dupilumab can markedly improve pruritus and severity of skin lesions in children with moderate-to-severe AD, and enhance the family quality of life, with favorable short-term safety.
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Objective:To compare the levels of serum 25 Hydroxyvitamin D levels after a single large oral dose (60,000 IU) of different vitamin D3 formulations. Materials and Methods: Ninety?one volunteers with mild vitamin D deficiency (18–29 ng/ml) were selected and randomly assigned to three parallel groups. Groups-I received liquid, Group-II received sachet, and Group-III received tablet formulation of cholecalciferol as a single dose of 60,000 IU orally after 8–10 h of overnight fasting. Serum 25(OH) D concentrations were measured at baseline, 24 h, 7 days, and 14 days after drug administration. Various hematology and biochemical parameters were also assessed for baseline safety evaluation. Results: Baseline serum 25(OH) D concentrations in Groups I (liquid), II (sachet), and III (tablet) was 24.75 ± 4.77 ng/mL, 23.25 ± 4.15 ng/mL, and 23.18 ± 5.52 ng/mL, respectively. After supplemented with three formulations, only tablet group after 24 h showed increase in serum 25-OH-D concentration of 8.07 units from its baseline. Whereas after 7th day, no significant difference in absorption was observed but after 14 th day, all three groups showed increase in serum 25-OH-D concentration, in which tablet group (50.10 ± 94.99 ng/ml) showed highest increase in absorption (26.92 units) from their baseline values. During intergroup comparison between three formulations at the time of investigation, only liquid group after 24 h showed increased serum concentration by P values (0.03, 0.02) as compared to sachet and tablet group. However, After 7th and 14th day, there was no statistically difference was observed between three groups. Conclusion: Single oral dose of 60,000 IU dose of vitamin D liquid formulation has higher absorption value as after 24 h and tablet formulation showed higher absorption after 7th days. In emergency paucity of vitamin D, these observations findings can have critical conclusions to state the suitable dietary formulation of vitamin D.
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Background: Health care associated infections (HAIs) present a significant source of preventable morbidity and mortality. More than 30% of all HAIS are represented by surgical site infections (SSIs) making them most common sub types between 1.9% and 2.7% of all surgical patients. Joseph Lister “the man who made surgery safe” introduced antiseptic method for safe surgeries. As many are now considering antibiotics “wonder drug” which covers the surgical techniques and having asepsis. Extensive indiscriminate use of antibiotics has resulted in developing resistance.Methods: Study conducted in about 100 cases in various surgical units having various surgical procedures. Only clean cases are taken. A single stat dose of first generation cephalosporin 1gm given IV at the time of giving anesthesia. Postoperative any signs and symptoms like infections, fever with chills, wound discharge are observed. If any evidence of wound infection is present, accordingly sent for culture and sensitivity and suitable antibiotics are given.Results: In our study 5 patients had fever with serous discharge 2 patients showed no growth, 3 patients had got growth positive (2- staphylococcus aurous, 1- pseudomonas). Hence our infection rate is 3%.Conclusions: Single dose prophylaxis has got definite advantage to overcome the postoperative wound sepsis. Prolonged antibiotic therapy should be avoided as it has got no added advantages over single dose antibiotic.
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Background: The advent of antimicrobial therapy has offered an important adjuvant to the prevention of surgical infection. In spite of vast accumulation of research and review published there are still conflicting views. Some study shows multiple doses require for the eradication of microorganisms in the wound. While numerous authors have reported that single dose of an appropriate antibiotic is effective, but there has been no direct comparison of one dose against three doses regimens. Objective was to study about effect and safety of single dose of antibiotic against routine multiple dose regimens in clean and clean-contaminated abdominal surgeries.Methods: Patients recruited in the study according to specific inclusion and exclusion criteria. The participants were divided in two groups: group I and group II. Group I was given single dose of injection cefotaxime. While another group was given 5 days course of injection cefotaxime and injection amikacin or injection ciprofloxacin and injection metronidazole. Postoperative wound was assessed by Southampton wound grading system.Results: The rate of wound infection on 3rd day was for 16.30% for group I and 13.82% for group II. The infection rate decrease on 7th post-operative day and it was 13.04% for group I and 11.7% for group II.Conclusions: Long course of antibiotic as prophylaxis has no added advantage. Good operative technique plays a major role in preventing infections. Single dose antibiotic regimen has comparable infection rate for clean surgical cases and it saves lot of money in this era of cost containment.
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Background: Magnesium sulphate is anticonvulsant of choice for eclampsia. Single dose magnesium sulphate therapy was tried for the management of Eclampsia and Imminent Eclampsia considering the low body mass index of Indian population.Methods: A prospective interventional study comprising of total 80 patients having either eclampsia or imminent eclampsia, to whom the Pritchard or a single dose MgSO4 was given alternatively in a tertiary hospital from October 2014 to October 2017. Serum magnesium levels, maternal and perinatal outcome and recurrence of convulsions were evaluated using Student- t test and chi square test.Results: Mean Serum Magnesium levels in eclampsia and imminent eclampsia group at 0 min, 30 min, 4 hours in Pritchard regimen were 1.96mg/dl, 5.85mg/dl, 4.68mg/dl while in single dose regimen it was 1.78mg/dl, 462mg/dl, 3.63mg/dl respectively. Those who received Pritchard regimen showed higher level of Serum magnesium levels at 30 minutes and 4 hours than those receiving single dose. By applying T-test it was found that there is a significant difference in serum magnesium levels range in both group but no statistical difference in the control of convulsions in both groups.Conclusions: With increased and almost widespread use of magnesium sulfate in obstetrics there has been concerns regarding its safety. In the study, although P-values are not significant because of small sample size, there is considerable difference in serum magnesium levels 30 min and 4 hours, recurrence of convulsions and maternal morbidity between Pritchard regimen and single dose regimen. The goal which was achieved with Pritchard regimen previously, now can be achieved with single dose regimen in Indian women. Single dose magnesium sulphate is safe and effective in controlling convulsions with improved maternal and perinatal outcome.
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Background: The objective of this study is to determine the success rate of oral methotrexate in Hospital Shah Alam for the past 2 years.Methods: This is a cross-sectional study using secondary data obtained from medical record office in Hospital Shah Alam on patients with ectopic pregnancy. A total of 35 patients who fulfilled the criteria for medical management were selected. They were prescribed with oral methotrexate with the dose of 60 mg given in 3 divided doses every 2 hours using the standard tablet of 2.5mg. Follow up was done at day 4, day 7 and till HCG level achieve less than 20 iu/litre.Results: 29 patients were successfully treated with oral methotrexate 60 mg (82.8%). Another 6 patients had to undergo laparoscopic surgery with confirmed leaking, ruptured tubal pregnancy. 4 patients needed second dose of Methotrexate due to rising HCG level and all of them were successfully treated after the second dose. The side effects of oral methotrexate were tolerated well by all patients. There are numbers of predictors for success which are the level of HCG <4000 iu/litre, size of mass <4cm, no abdominal pain during early presentation and decrease of HCG level in between day 4 to day 7 after oral methotrexate.Conclusions: The success rate of oral methotrexate for stable ectopic pregnancy is good making it a suitable option for clinical settings which has no specialised equipment to handle cytotoxic drugs.
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ABSTRACT Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.
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Humans , Male , Female , Child , Mass Vaccination/methods , Hepatitis A Vaccines/administration & dosage , Hepatitis A Antibodies/blood , Hepatitis A/prevention & control , Brazil/epidemiology , Program Evaluation , Logistic Models , Seroepidemiologic Studies , Retrospective Studies , Immunoenzyme Techniques , Immunization Schedule , Hepatitis A Virus, Human/immunology , Hepatitis A Vaccines/immunology , Dried Blood Spot Testing , Hepatitis A/epidemiologyABSTRACT
The yellow fever (YF) vaccine has been used since the 1930s to prevent YF, which is a severe infectious disease caused by the yellow fever virus (YFV), and mainly transmitted by Culicidae mosquitoes from the genera Aedes and Haemagogus . Until 2013, the World Health Organization (WHO) recommended the administration of a vaccine dose every ten years. A new recommendation of a single vaccine dose to confer life-long protection against YFV infection has since been established. Recent evidence published elsewhere suggests that at least a second dose is needed to fully protect against YF disease. Here, we discuss the feasibility of administering multiple doses, the necessity for a new and modern vaccine, and recommend that the WHO conveys a meeting to discuss YFV vaccination strategies for people living in or travelling to endemic areas.
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Humans , Yellow Fever/prevention & control , Yellow fever virus/immunology , Immunization Schedule , Antibodies, Neutralizing/immunology , Yellow Fever Vaccine/administration & dosage , Yellow Fever Vaccine/immunologyABSTRACT
ABSTRACT Repirinast is a new, synthetic, disodium cromoglycate-like antiallergic agent for oral administration in humans. This study evaluated the safety, tolerability and pharmacokinetics of repirinast tablets in healthy Chinese volunteers. This was a phase I, open-label, randomized, single- and multiple-dose study. Subjects were assigned to receive a single dose of repirinast tablet at either 150, 300, or 450 mg, or multiple doses of 150 mg twice daily for 5 days. Plasma samples were analyzed with LC-MS/MS. Pharmacokinetic parameters of active metabolite MY-1250 (deesterified repirinast) were calculated using non-compartmental analysis with WinNonlin software. Statistical analysis was performed using SPSS software. All adverse events (AEs) were mild and of limited duration. No serious adverse event (SAE), death or withdrawal from the study was observed. In the single-dose study, Cmax was reached at about 0.75 hour, and the mean t1/2 was approximately 16.21 hours. Area under curve (AUC) and Cmax increased with dose escalation, but dose proportionality was not observed over the range of 150 to 450 mg. In the multiple-dose study, the steady-state was reached within 3 days with no accumulation. Repirinast tablet was well tolerated in healthy Chinese subjects.
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Humans , Male , Female , Adult , Tablets/classification , China/ethnology , Repeated Dose , Single Dose/methods , Randomized Controlled Trial , Anti-Allergic Agents/analysis , Anti-Allergic Agents/pharmacokineticsABSTRACT
OBJECTIVE: The aim of this study was to assess the analgesic effect of a single application of low-level laser therapy (LLLT) on spontaneous pain and pain on chewing after placement of initial archwires. METHODS: Forty-two patients (26 women, 16 men) were randomly recruited for this split-mouth randomized clinical trial. Each patient received super-elastic nickel-titanium (NiTi) initial archwires (0.012, 0.014, 0.016, and 0.018-inch [in]) in the maxilla for leveling and alignment for an interval of 4 weeks between archwires. One side of the mouth was randomly designated as experimental, while the other side served as placebo. After insertion of each archwire, the experimental side was irradiated with a diode laser for 3 seconds each on 5 points facially and palatally per tooth, from the central incisor to first molar. On the placebo side, the laser device was held the same way but without laser application. A numerical rating scale was used to assess the intensity of spontaneous and masticatory pain for the following 7 days. The Mann-Whitney U test was used to compare pain scores between sides. RESULTS: Patients in the LLLT group exhibited significantly lower mean scores for spontaneous pain after insertion of the initial two archwires (0.012-in and 0.014-in NiTi; p < 0.05), while there was no significant difference for 0.016-in and 0.018-in wires between the LLLT and placebo groups. LLLT significantly reduced chewing pain scores (p < 0.05) for all archwires. CONCLUSIONS: A single dose of LLLT considerably lessened postoperative pain accompanying the placement of super-elastic NiTi wires for initial alignment and leveling.
Subject(s)
Female , Humans , Incisor , Lasers, Semiconductor , Low-Level Light Therapy , Mastication , Maxilla , Molar , Mouth , Pain, Postoperative , ToothABSTRACT
Background: Antibiotics are used both pre and post operatively in acute appendicitis for preventing wound infection. It has been observed that the routine use of postoperative antibiotics is not necessary in cases of non-perforated appendicitis as only prophylactic antibiotics are sufficient to prevent wound infection. Aim: The aim of this study was to see the frequency of wound infection with the single dose preoperative antibiotics. Materials and methods: Present observational study was conducted at Department of General Surgery, Govt. Stanley Medical College and Hospital for period of one year. A total of 100 patients with non-perforated appendicitis were followed for wound infection till 8th postoperative day. Results: 100 patients, 64 male and 36 female were included in this study. In entire series, 6 patients were developed wound infection. The infection was minor which settled with conservative therapy. Prophylactic single dose antibiotic is efficacious in 94% patients. Conclusion: Single dose pre-operative antibiotics were found to be effective in controlling postoperative wound infection without the need of extending antibiotics to post-operative period in cases of non-perforated appendicitis.
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Objective To investigate the toxic reaction,toxic organs or target tissues of protamine recombinant human insulin (Insulin NPH),and provide basis for clinical trials by single dose toxicity test in mice,repeated toxicity and immunogenicity of Beagle's dogs,and systemic active allergy in guinea pig.Methods ① Using maximum dose method,mice in single dose toxicity test were sc injected with normal saline (NS),vehicle,and Insulin NPH (2092-2488 IU/kg),the toxic reactions after injection were monitored.② In repeated toxicity study,Beagle's dogs were sc administrated with vehicle,the original (Humulin NPH,1.5 IU/kg)and different doses of Insulin NPH (0.5,1.0 and 1.5 IU/kg) for 30 d continuously,followed by a 14-d recovery.During the administration and recovery period,general observation,local irritation,body weight,anus temperature,blood glucose,and electrocardiogram (ECG) were checked,moreover,hematology,serum biochemistry and urine were detected.Also,organic weights and histopathological examination were conducted.Binding antibodies in dog serum were measured by indirect ELISA method in immunogenicity test.③ In systemic active allergy study,cavies were sc injected with low-and high-dose (4 and 12 IU/kg) Insulin NPH,normal saline and vehicle.Besides,ova as positive control was also included.After five times of sensitization test with above doses,the excitation reactions of iv injection with tripled sensitizing doses were observed.Results No obvious toxicity was observed in mice after injected with 165 times of usual clinical dose of Insulin NPH.Repeated toxicity study of Beagle's dogs revealed that 1.0 IU/kg was the no-toxic-effect dose (NOAEL) for Insulin NPH,which was equivalent to 2 times of clinical dose.No bindingantibodies were found in immunogenicity test.There was no obvious allergic symptom in the active systemic allergy study of guinea pig.Conclusion Under the experimental conditions,no serious toxicity of Insulin NPH is found.
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OBJECTIVE:To study the safety of percutaneous administration of Hongzhi gutong cataplasm. METHODS:Rab-bits were taken for single dose in complete skin irritation test(n=4),single dose in damaged skin irritation test(n=4)and multi-ple doses in complete skin irritation test(n=4). The left and right sides of the skin respectively paste 3 cm×3 cm blank matrix and Hongzhi gutong cataplasm for 24 h(calculated by crude drug of 0.14 g). After removing tape 1,24,48,72 h,the erythema and edema in hair removal site of rabbits in the former 2 tests were observed;after 24 h of administration,the rabbits in the last group were administrated again after exposing the administration area for 1 h,repeated 3 times,the erythema and edema in hair removal site after removing tape the first,second time and 1,24,48,72 h in the third time were respectively observed. RESULTS:In the 3 experiments,the scores of erythema and edema of all rabbits were 0,and skin irritation was evaluated as no irritation. CONCLU-SIONS:Hongzhi gutong cataplasm has no skin irritation in rabbits.
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Objective To explore the bio-effects of high single-dose irradiation on MDA-MB-231 xenografts under the same radiation dose.Method Female BALB/c-nu mice bearing 8-9 mm MDA-MB-231 xenografts were randomized into 5 groups:0Gy group (blank control group),high single-dose 8Gy group (8Gy/one fraction/day),high single-dose 10Gy group (10Gy/one fraction/ day),conventional radiation 2Gy × 4 group (8Gy/4 fraction/4d),conventional radiation 2Gy × 5 group (10Gy/5 fraction/5d).The volumes of gross tumors on nude mice were observed every three days.The tumor growth curve of transplanted tumor were also drawn.The 18F -FDG PET/CT imaging of mice bearing MDA-MB-231 xenografts from all radiation groups were performed with detecting the Ki-67 expressions of tumor ceils by immunohistochemistry at 7days and 14days after final irradiation.Results Compared to control group,the tumor growth of all radiation groups were delayed after radiation,especially single high-dose 10Gy groups (P ＜ 0.05).At 7days and 14days after final radiation,the SUVmax (the maximal standardized uptake value) of xenografts in high single-dose groups was lower than that in conventional fractional groups (P ＜ 0.05) under the same radiation dose.And the percent of Ki-67 positive cells after high single-dose irradiation were less than fractioned irradiation at 7,14days after final radiation (P ＜ 0.05).Conclusion At the same dose,high single-dose irradiation inhibits the growth of MDA-MB-231 xenografts more than conventional fraction irradiation.PET/CT also could evaluated the early changes of proliferation activities of MDA-MB-231 breast cancer cells after irradiation.
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BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.
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Humans , Anesthesia, Local , Connective Tissue , Dexamethasone , Molar, Third , Pain, Postoperative , Prospective Studies , Tooth, Impacted , TrismusABSTRACT
BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.
Subject(s)
Humans , Anesthesia, Local , Connective Tissue , Dexamethasone , Molar, Third , Pain, Postoperative , Prospective Studies , Tooth, Impacted , TrismusABSTRACT
OBJECTIVE:To explore the reasons and countermeasures of discrepancy of the account in inventory management of automatic single dose drug dispensing machine. METHODS:The discrepancy information of using sub charter in the process of inventory management from Feb. to Jun. 2014(before management)was collected,the causes were analyzed and countermeasures were put forward and carried out;then management results were evaluated via the discrepancy information from Jul. to Nov. 2014 (after management). RESULTS & CONCLUSIONS:For the relative discrepancy factors such as peeling medicine,adding medi-cine and recording information,etc.,which appeared in each link,the management was strengthened in terms of drug,machine and personnel like limiting scattered drug product rules,modifying the machine parameters settings,strengthening the training and testing of machine operators;and deliver inside account discrepancy rate was decreased from 3.34% to 0.79%. Improvement of the relative system with effective countermeasures can reduce the account sub charter discrepancy rate.
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PURPOSE: To investigate the actual adherence to treatment with preservative-free dorzolamide-timolol fixed combination (DTFC) eyedrops of primary open-angle glaucoma (POAG) patients by counting the number of unused single-dose units of DTFC. METHODS: This study included 34 POAG patients newly prescribed with preservative-free DTFC eyedrops (formulated in single-dose units). The enrolled patients were asked to bring the unused DTFC units on their next visit after 2 weeks of treatment with DTFC. On their second visit, they were asked to complete a questionnaire regarding the self-reported adherence and the number of unused DTFC single-dose units was counted. The actual adherence (%) was calculated by dividing the expected number of used DTFC units by the actual number of used DTFC units. The correlation between the self-reported adherence and the measured adherence was assessed. RESULTS: Twenty-nine (93.5%) patients answered they adhered to the medication by more than 90% and 2 (6.5%) answered they instilled the eyedrops at 80-90% of the dosing schedule. However, after counting the unused DTFC single-dose units, 9 (29.0%) patients showed an actual adherence of <90%. Moreover, the actual adherence of 3 (9.7%) patients was <60%. Unexpectedly, 4 (12.9%) patients showed the actual adherence exceeding 100% (196%, 1 patient; 107-132%, 3 patients). CONCLUSIONS: We demonstrated a large difference between the self-reported and the actual adherence to treatment by counting the unused single-dose units of eyedrops. Preservative-free topical anti-glaucoma medications (formulated in single-dose units) provide clinicians an opportunity to assess the actual adherence of glaucoma patients by counting the unused units of eyedrops.
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Humans , Appointments and Schedules , Glaucoma , Glaucoma, Open-Angle , Ophthalmic Solutions , Surveys and QuestionnairesABSTRACT
Aims To study single dose toxicity of poly-phenols effective parts from Punica granatum,to eval-uate their safety,and thus to provide a theoretical basis for drug development and clinical use.To observe their protective effect on ethanol-induced gastric ulcer in rats.Methods 50 healthy Kunming mice were ran-domly divided into five groups and given different doses of polyphenols’effective parts from Punica granatum via intragastric administration.Toxicity and death in each group of mice were observed and recorded after administration for 14 d.The median lethal dose was calculated by Bliss method.70 rats were randomly di-vided into normal group,model group(constant volume of normal saline),sanjiuweitai particles(1 850 mg· kg-1 )group,colloidal bismuth subcitrate (33 mg · kg-1 )group and polyphenols effective parts from Puni-ca granatum low-dose,medium-dose,high-dose(430, 852,1 704 mg·kg-1 )groups.On the 9th day of 10 days’gavage,all except the normal group were fed ethanol (1.5 mL/only)to induce gastric mucosal inju-ry in rats with acute gastric ulcer.Gastric ulcer index, the rate of ulcer inhibition were calculated for each group.The morphological changes of gastric mucosa were observed.The gastric mucosa levels of PGE2 , NO,SOD and MDA were determined.Results The LD50 and 95%confidence limit of the polyphenols’ef-fective parts from Punica granatum were 8 520.9 mg· kg-1 and 7 291.2 ~9 914.4 mg·kg-1,respectively. Pathology showed that the organs receiving dose of 16 000 mg · kg-1 had different degrees of damage . Compared with the model group,the extract from Puni-ca granatum significantly repaired the gastric mucosa, and significantly increased the gastric mucosa levels of NO and reduced MDA content,and improved SOD content and the levels of PGE2 .Conclousion The dose of 5 063 mg · kg-1 of polyphenols effective part from Punica granatum showed no death.The dose of 16 000 mg · kg-1 of polyphenols effective parts from Punica granatum could cause varying degrees of dam-age in heart,liver,lung,kidney or the death of mice. The LD50 and 95% confidence limit of the polyphenols effective parts from Punica granatum were 8 520.9 mg ·kg-1 and 7 291.2 ~9 914.4 mg·kg-1,respective-ly.The extract from Punica granatum plays a protective role against gastric mucosa damage induced by absolute ethanol,and the mechanism may be related to promo-ting ulcer epithelial cells synthesis,enhancing mucosal regeneration function,regulating NO content and en-hancing antioxidant capacity.
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Objective:To observe the clinical effects of dexmedetomidine(DDM)under monitored anesthesia care(MAC)in oral and maxillofacial patients undergoing percutaneous dilatational tracheostomy(PDT).Methods:38 patients with oral and maxillofa-cial tumor undergoing PDT before surgery were randomly assigned into 2 groups(n =19).Patients in group D received a single-dose DDMof 0.5 μg/kg infused for 10 min;those in group Mreceived 2 mg of midazolam and 1 μg/kg of fentanil.Then all patients were given local anesthesia followed by PDT.MAP,HR and SpO2 were monitored before (T0 )and after drug administration (T1 ),at T2 (skin incision)and T3 (insert dilation catheter).Ramsay scorce,bucking,respiration depression and adverse cardiovascular reaction were recorded.All patients were followed up 24 h postoperatively for the observation of adverse recall of PDT.Results:Compared with T0 ,at T1 ,T2 MAP and HR in group D were lower,but MAP and HR at T3 in group Mwere higher(P <0.05).At T1 ,T2 and T3 ,MAP and HR in group D were significantly lower than those in group M(P <0.05).During operation,the incidence of bucking and respiration depression in group D was lower than that in group M(P <0.05).Conclusion:During PDT operation under MAC,a single-dose dexmedetomidine is effective in stablizing hemodynamics,reducing bucking and respiration depression.