Primary Norfloxacin Prophylaxis for APASL-Defined Acute-on-Chronic Liver Failure: A Placebo-Controlled Double-Blind Randomized Trial.

INTRODUCTION: This study aimed to evaluate the role of prophylactic norfloxacin in preventing bacterial infections and its effect on transplant-free survival (TFS) in patients with acute-on-chronic liver failure (ACLF) identified by the Asian Pacific Association for the Study of the Liver criteria. METHODS: Patients with ACLF included in the study were randomly assigned to receive oral norfloxacin 400 mg or matched placebo once daily for 30 days. The incidence of bacterial infections at days 30 and 90 was the primary outcome, whereas TFS at days 30 and 90 was the secondary outcome. RESULTS: A total of 143 patients were included (72 in the norfloxacin and 71 in the placebo groups). Baseline demographics, biochemical variables, and severity scores were similar between the 2 groups. On Kaplan-Meier analysis, the incidence of bacterial infections at day 30 was 18.1% (95% confidence interval [CI], 10-28.9) and 33.8% (95% CI, 23-46) (P = 0.03); and the incidence of bacterial infections at day 90 was 46% (95% CI, 34-58) and 62% (95% CI, 49.67-73.23) in the norfloxacin and placebo groups, respectively (P = 0.02). On Kaplan-Meier analysis, TFS at day 30 was 77.8% (95% CI, 66.43-86.73) and 64.8% (95% CI, 52.54-75.75) in the norfloxacin and placebo groups, respectively (P = 0.084). Similarly, TFS at day 90 was 58.3% (95% CI, 46.11-69.84) and 43.7% (95% CI, 31.91-55.95), respectively (P = 0.058). Thirty percent of infections were caused by multidrug-resistant organisms. More patients developed concomitant candiduria in the norfloxacin group (25%) than in the placebo group (2.63%). DISCUSSION: Primary norfloxacin prophylaxis effectively prevents bacterial infections in patients with ACLF.

Techniques for remediation of pharmaceutical pollutants using metal organic framework - Review on toxicology, applications, and mechanism.

Treatment of recalcitrant and xenobiotic pharmaceutical compounds in polluted waters have gained significant attention of the environmental scientists. Antibiotics are diffused into the environment widely owing to their high usages, very particularly in the last two years due to over consumption during covid 19 pandemic worldwide. Quinolones are very effective antibiotics, but do not get completely metabolized due to which they pose severe health hazards if discharged without proper treatment. The commonly reported treatment methods for quinolones are adsorption and advanced oxidation methods. In both the treatment methods, metal organic frameworks (MOF) have been proved to be promising materials used as stand-alone or combined technique. Many composite MOF materials synthesized from renewable, natural, and harmless materials by eco-friendly techniques have been reported to be effective in the treatment of quinolones. In the present article, special focus is given on the abatement of norfloxacin and ofloxacin contaminated wastewater using MOFs by adsorption, oxidation/ozonation, photocatalytic degradation, electro-fenton methods, etc. However, integration of adsorption with any advanced oxidation methods was found to be best remediation technique. Of various MOFs reported by several researchers, the MIL-101(Cr)-SO3H composite was able to give 99% removal of norfloxacin by adsorption. The MIL - 88A(Fe) composite and Fe LDH carbon felt cathode were reported to yield 100% degradation of ofloxacin by photo-Fenton and electro-fenton methods respectively. The synthesis methods and mechanism of action of MOFs towards the treatment of norfloxacin and ofloxacin as reported by several investigation reports are also presented.

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection with HIV: clinical case series analysis in North Central Nigeria.

SARS-CoV-2 has created a global public health emergency with significant mortality and morbidity for people living with HIV (PLWH). Preliminary data reveals persons with immune-compromised status are at risk of developing adverse clinical outcomes from SARS-CoV-2. We aimed to characterise clinical outcomes of HIV patients co-infected with SARS-CoV-2 infection in Nasarawa State, North Central Nigeria. We followed four (4) hospitalised HIV patients that tested positive to SARS-CoV-2 in Nasarawa State and characterised their laboratory findings and clinical outcomes. The consent of the cases was sought and they agreed that their clinical data be published. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 nucleic acid were performed using nasopharyngeal swabs (novel coronavirus PCR fluorescence diagnostic kit, BioGerm medical biotechnology) at the Nigeria Centre for Disease Control (NCDC) in Abuja, Nigeria. Our study reveals mild clinical outcome among HIV patients with SARS-CoV-2 co-infection. There is need for a syndemic framework to be used to conceptualise SARS-CoV-2 impact among HIV patients and an urgent need to strengthen healthcare programmes within Nigeria.