Anticoagulation in venous thromboembolism for the general physician.

Venous thromboembolism (VTE) is frequently encountered across various specialties. The management of VTE has become more nuanced, requiring consideration of several factors when deciding on the choice and duration of anticoagulation. This evidence-based review article summarises the current practice and evidence behind anticoagulation in VTE, incorporating national and international guidelines. Factors influencing decision-making around the choice and duration of anticoagulation, along with special circumstances such as cancer and antiphospholipid syndrome, are discussed. The clinical utility of thrombophilia screening is also addressed.

An in vitro Study on the Antibacterial Efficiency of the Various Composites in the Children: An Original Research.

Background: Many generations of esthetic materials have been introduced in the market, the most popular being the composites. Bioactive restorative materials are a recent development in restorative dentistry. However, the main cause of secondary caries is the development of bacterial plaque on these restorations. Current in vitro study was conducted to assess the antibacterial properties of three common composites. Materials and Methods: Only a single parameter was assessed in this study, which was the bacterial colonies on each of the material blocks that were confined in the same experimental conditions. For this assessment, three composite materials were used that were made into blocks of 10 each. "Beautifil Flow Plus X" and "ACTIVA BioACTIVE" were used as the interventional groups, while "Filtek Z250 XT" was used as the control. Streptococcus mutans was used as an antibacterial test subject, and confocal laser scanning microscopy was used to observe the results. Results: When compared to other groups, ACTIVA BioACTIVE exhibited the highest quantity of dead bacteria on the material surface. There was significant variance among the three composites in the number of live and dead bacterial colonies. Conclusion: The highest antibacterial efficacy among the evaluated materials allows for a conclusion.

Effectiveness Study of Paromomycin IM Injection (PMIM) for the Treatment of Visceral Leishmaniasis (VL) in Bangladesh.

BACKGROUND: This study was conducted in Bangladeshi patients in an outpatient setting to support registration of Paromomycin Intramuscular Injection (PMIM) as a low-cost treatment option in Bangladesh. METHODOLOGY: This Phase IIIb, open-label, multi-center, single-arm trial assessed the efficacy and safety of PMIM administered at 11 mg/kg (paromomycin base) intramuscularly once daily for 21 consecutive days to children and adults with VL in a rural outpatient setting in Bangladesh. Patients ≥5 and ≤55 years were eligible if they had signs and symptoms of VL (intermittent fever, weight loss/decreased appetite, and enlarged spleen), positive rK39 test, and were living in VL-endemic areas. Compliance was the percentage of enrolled patients who received 21 daily injections over no more than 22 days. Efficacy was evaluated by initial clinical response, defined as resolution of fever and reduction of splenomegaly at end of treatment, and final clinical response, defined as the absence of new clinical signs and symptoms of VL 6 months after end of treatment. Safety was assessed by evaluation of adverse events. PRINCIPAL FINDINGS: A total of 120 subjects (49% pediatric) were enrolled. Treatment compliance was 98.3%. Initial clinical response in the Intent-to-Treat population was 98.3%, and final clinical response 6 months after end of treatment was 94.2%. Of the 119 subjects who received ≥1 dose of PMIM, 28.6% reported at least one adverse event. Injection site pain was the most commonly reported adverse event. Reversible renal impairment and/or hearing loss were reported in 2 subjects. CONCLUSIONS/SIGNIFICANCE: PMIM was an effective and safe treatment for VL in Bangladesh. The short treatment duration and lower cost of PMIM compared with other treatment options may make this drug a preferred treatment to be investigated as part of a combination therapy regimen. This study supports the registration of PMIM for use in government health facilities in Bangladesh. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01328457.

Sunitinib-induced severe hypothyroidism with cardiac compromise.

Tyrosine kinase inhibitors (TKI) are an increasingly used class of anti-cancer agent. Sunitinib (sutent(®), Pfizer™, New York) is standard first-line therapy for patients with metastatic renal cancer. It is associated with a number of toxicities, including thyroid dysfunction. We present a case of sunitinib-induced severe hypothyroidism resulting in cardiac compromise. The case highlights the importance of interval thyroid function monitoring for patients on drugs, such as sunitinib and other TKIs.