RESUMO
Background@#Atrial tachycardia poses challenges in patient management due to the associated risks of stroke and systemic embolism. While anticoagulation is recommended in atrial fibrillation (AF), its role in atrial tachycardia remains less defined. This prospective study aimed to evaluate the efficacy and safety of apixaban, a direct oral anticoagulant, in individuals diagnosed with left-sided atrial tachycardias. @*Methods@#Patients diagnosed with left-sided atrial tachycardia (n = 439) were observed over 3 years. Baseline characteristics, medication regimens, and clinical outcomes were assessed. Apixaban-treated individuals (n = 213) received standard or reduced dosages, while the control group (n = 226) received standard care. Primary outcomes included stroke, systemic embolism, bleeding, and mortality rates. @*Results@#Baseline characteristics were comparable between groups. The apixaban cohort showed a lower incidence of stroke (7.0% vs. 9.3%, p = 0.027) and decreased all-cause mortality (11.7% vs. 12.8%, p = 0.012) compared to controls.No significant differences were found in major bleeding or systemic embolization between groups. @*Conclusion@#Apixaban demonstrated a potential benefit in reducing stroke and mortality rates in patients with leftsided atrial tachycardia. While requiring further validation, these findings suggest a potential role for apixaban in anticoagulation strategies for atrial tachycardia management.
RESUMO
The current study was designed to evaluate mucoadhesive buccal tablet containing metronidazole [MTZ] for local action aided by Hydroxypropylmethylcellulose K4M [HPMC] and Carbopol 940® [CP] as mucoadhesive polymers with other ingredients like sodium starch glycolate [SSG], polyvinyl pyrollidone K30 [PVP] as disintegrant and binders respectively. Formulations [F1-F8] were prepared by direct compression method and characterized for different physicochemical parameters. Results showed that the average weight and friability were within USP limits. Maximum mucoadhesive time was observed for F2 [14 hr] containing moderate amount of HPMC and CP used in the study. Up most mucoadhesive strength value was observed with F3 containing highest amount of HPMC used. Results indicated that high amount of HPMC was linked with the moderate to higher mucoadhesive strength and time. Maximum swelling index was observed in F7 [191.3%]. Only F1-F3 showed complete in vitro MTZ release within 3 hr. Formulations containing PVP released MTZ incompletely over time while SSG released earlier. Formulation F1 was considered best in terms of MTZ release [100.5%] with diffusion based Korsmeyer-Peppas release kinetics. Therefore, MTZ exhibiting best physicochemical characters in mucoadhesive buccal tablet was found in F1 containing HPMC and CP in amounts of 37.5 mg and 25 mg, respectively, for local action
RESUMO
Escherichia coli [E. coli] are normal flora of the intestines of most animals, including humans. Most strains are harmless and beneficial to host by preventing the establishment of pathogenic bacteria within the intestine. However, some E. coli strains can cause a wide variety of intestinal and extra-intestinal diseases, such as diarrhoea, urinary tract infections, septicaemia, neonatal meningitis and renal complications
Several virulence factors including toxins, adhesins, serine proteases, etc. have been reported in these highly adapted clones
The present study was designed to enumerate toxin genotype through PCR assay in local clinical isolates of E. coli. A total of 37 E. coli strains were collected from different clinical laboratories of Karachi and examined for the presence of shiga toxin 1 [stxl] and shiga toxin 2 [stx2] genes of Eenterohemorrhagic E. Coli [EHEC] and heat stable [sf] and healt labile [If] toxin genes of enterotoxigenic E. Coli [ETEC]
It was observed that 16 strains out of 37 carried one or more type of toxin genes
The presence of stxl gene was significantly higher as it was positive in 10 isolates compared to others toxins
Two in above stxl positive strains were also carrying for stx2 gene. Six out of 37 isolates were positive for It gene, and none of the strains are carrying st gene
Although, the study was carried out with fewer isolates, yet it demonstrated the trend of dispersion of toxin genes and findings can be used to correlate the gastro-intestinal infections and their complications in Pakistan