ABSTRACT
Background and objective The negligible side effects of paracetamol along with its ease of availability have catapulted paracetamol to be a widely used medication in emergency room management to reduce pain and subsequent elevations in blood pressure (BP). Our study aimed to address the challenges in informed clinical decision-making in the emergency room following paracetamol intravenous infusion. Methods This was a retrospective cross-sectional study involving the extraction of data from electronic medical records of patients who received intravenous paracetamol infusion between January 2022 and May 2022. Demographic information and BP-related data were collected for analysis. Results We initially considered a total of 162 patient records, with 132 of them eventually meeting the inclusion criteria. Among patients receiving paracetamol infusion for 15 minutes or less, 34% showed a drop of 1-5 mmHg in systolic BP (SBP), while 26% experienced a drop of 6-10 mmHg. However, infusion time longer than 16 minutes did not significantly reduce SBP. Diastolic BP (DBP) was not significantly affected by the duration of the paracetamol infusion. Analysis of the drop in SBP revealed no significant associations with age, gender, or ethnicity. Mean arterial pressure (MAP) was not significantly affected by the duration of paracetamol infusion. Conclusion Our findings suggest that intravenous paracetamol infusion does not significantly lower BP in adults in the emergency room, except for infusions of shorter durations. However, various factors, including infusion rate, patient characteristics, and concomitant medications, may influence BP measurements. The study emphasizes the need for establishing standardized criteria and conducting further research to assess intravenous paracetamol's hemodynamic effects accurately.
ABSTRACT
The ability to perform effectively in the gastrointestinal tract (GIT) is one of the most significant criteria in the selection of potential probiotic bacteria. Thus, the present study aimed to investigate the potential probiotic characteristics of some selected lactic acid bacteria (LAB) isolated from vegetable products. Probiotic characteristics included tolerance to acid and bile, cholesterol-removing ability, bile salt hydrolysis, resistance against lysozyme and antibiotics, production of exopolysaccharides (EPS), antimicrobial and hemolytic activities, and cell surface characteristics (auto-aggregation, co-aggregation, and hydrophobicity). The survival rate of isolates after G120 ranged from 8.0 to 8.6 Log10 CFU/mL. After the intestinal phase (IN-120), the bacterial count ranged from 7.3 to 8.5 Log10 CFU/mL. The bile tolerance rates ranged from 17.8 to 51.1%, 33.6 to 63.9%, and 55.9 to 72.5% for cholic acid, oxgall, and taurocholic acid, respectively. Isolates F1, F8, F23, and F37 were able to reduce cholesterol (>30%) from the broth. The auto-aggregation average rate increased significantly after 24 h for all isolates, while two isolates showed the highest hydrophobicity values. Moreover, isolates had attachment capabilities comparable to those of HT-29 cells, with an average of 8.03 Log10 CFU/mL after 2 h. All isolates were resistant to lysozyme and vancomycin, and 8 out of the 17 selected isolates displayed an ability to produce exopolysaccharides (EPS). Based on 16S rRNA sequencing, LAB isolates were identified as Enterococcus faecium, E. durans, E. lactis, and Pediococcus acidilactici.
