Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study.

BACKGROUND: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

CONTEXTE: Des études ont démontré le rôle des expectorations comme un site de transmission du syndrome respiratoire aigu sévère-coronavirus- 2 (SRAS-CoV-2). Cependant, il existe peu de documentation sur l'efficacité virucide des antiseptiques oraux contre le virus du SRASCoV-2. Cette étude a examiné l'efficacité virucide de trois antiseptiques oraux par rapport à un contrôle placebo dans les expectorations de personnes infectées par le SRAS-CoV-2. MÉTHODOLOGIE: Une étude pilote menée auprès d'adultes dont les résultats sont positifs pour le SRAS-CoV-2, tels que déterminés par la réaction en chaîne de la polymérase par transcription inverse (RT-PCR) pendant 7 jours. Les antiseptiques oraux étudiés étaient : Hexetidine (0,1% p/v) ; Thymol (0,063% p/v) et H2O2 (1,5%) par rapport à l'eau stérile déminéralisée (Placebo-contrôle). Le principal critère d'évaluation était la proportion de résultats RT-PCR négatifs 15 minutes, 30 minutes, 1 heure, 2 heures et 4 heures après les interventions antiseptiques orales (AOI) par rapport au contrôle placebo. L'analyse statistique a été réalisée à l'aide du logiciel STATA 15.0, les valeurs p de <0,05 étant considérées comme statistiquement significatives. RÉSULTATS: Les données d'un total de 66 participants qui étaient positifs à la RT-PCR SARS-CoV-2 au départ (0 minute) ont été analysées. Au bout de 15 minutes, la plus forte proportion de négativation des échantillons d'expectoration a été observée dans le groupe Hexedine, 69,2 % des cas positifs au départ par PCR devenant négatifs, contre 46,7 % dans le groupe témoin placebo. En outre, l'H2O2 a démontré son efficacité à 2 heures après l'apparition de la maladie par rapport au groupe placebo (62,5 % contre 37,5 % respectivement) et aux autres antiseptiques oraux. Pour tous les points temporels, les groupes d'antiseptiques oraux comparés au groupe placebo n'ont pas présenté de différence statistiquement significative dans la proportion d'échantillons d'expectoration qui sont devenus négatifs (p>0,05). CONCLUSION: Les résultats de cette étude suggèrent qu'il n'y a pas de différence significative dans la proportion de participants qui sont passés à un statut négatif d'expectoration dans les groupes de traitement à différents moments. Les études futures pourraient comparer les valeurs du titre viral au seuil de cycle (ct) des échantillons d'expectoration afin de déterminer les différences quantitatives. MOTS CLÉS: SRAS-CoV-2, antiseptiques oraux, hexétidine, peroxyde d'hydrogène.

Medication errors in paediatric outpatient prescriptions of a teaching hospital in Nigeria.

BACKGROUND: Proper and adequate pharmacovigilance is lacking in children's drug therapy, especially in developing countries. Therefore these children are at risk of developing adverse reactions to drugs as a result of medication errors. Having a better understanding of the types of error in a teaching hospital would be an important step toward quality improvement in children drug therapy. OBJECTIVES: This study was aimed at identifying the medication errors most frequently committed in the paediatric outpatient prescriptions at the Lagos State University Teaching Hospital, Ikeja and to suggest effective strategies for reducing these errors. METHODS: A total of 2,000 paediatric outpatient prescriptions randomly selected from five months prescriptions were studied. Information extracted from the prescription forms are age, sex and the drug prescription proper (adequacy of the dosage and duration of use; generic or trade name prescription; using abbreviation or acronym; prescribing injections in millilitres or milligram, syrup or suspensions in millilitres or milligram, tablets in unit numbers or milligram; and giving instructions on how to use the drugs in the case of drug-drug, drug-disease or drug-food interactions). RESULTS: A total of 1944 prescriptions met the criteria for inclusion in the study. Antimalarials (89.9%), analgesics (66.4%), vitamin B complex (61.5%) and antibiotics (41.4%) were the most prescribed drugs. Errors identified are inadequate medication dosing duration; omission of age, dosage, and duration of drug use; improper dosaging and prescription of those drugs that could adversely interact. While paracetamol, 94.6% of the analgesics, was prescribed for an average of 3.2 +/- 0.6 days, antibiotics were prescribed for an average of 6.2 +/- 1.0 days. Duration of use was omitted in 24 (2.0%) and 12 (1.5%) prescriptions for paracetamol and antibiotics respectively. Errors of overdosaging and underdosaging were common to most of the commonly prescribed drugs. Underdosage and overdosage were associated with 2518 (38.0%) and 1247 (18.8%) drugs respectively. There was a significant difference in the dosage error made in the prescription of tablets in mg/kg and in unit number of tablets (/2 = 148.42) and in the prescription of syrups/suspensions in millilitre and in mg/kg (/2 = 95.58). Inadequate and omission of the duration of use of the drugs were observed in 1981(28.3%) and 61(0.9%) prescriptions respectively. CONCLUSION: Children presenting to the LASUTH are at a greater risk of adverse drug reactions from overdosage prescriptions and are also facing the risk of treatment inadequacy and failure from underdosage prescriptions. Therefore a monitoring committee is urgently required to be put in place to review all paediatric prescriptions for appropriateness, adequacy and dosage accuracy using the patient's weight, age, and other appropriate indicator(s) before dispensing and/or refill for paediatric patients. Also rational drug prescription should form part of the monthly continuous medical education of the hospital with much focus on the paediatric doctors.

Changes in differently processed soya bean (Glycine max.) and lima bean (Phaseolus lunatus) with particular reference to their chemical composition and their mineral and some inherent anti-nutritional constituents.

The effects of 3 processing techniques: cooking, roasting and autoclaving on the proximate chemical composition, the mineral content and some inherent toxic factors of soya and lima beans were investigated. The processing techniques generally reduced the crude fibre levels and enhanced the extractable fat in the soya and lima beans. The coefficients of variability for crude fibre and ether extract due to the processing techniques of soya and lima beans were 20.9%, 16.0% and 22.3%, 38.1%, respectively. In parallel with decreased ash content in the cooked bean samples, there was a decrease in the K, Mg, Na and P levels relative to the raw bean and also relative to the other processing techniques. Mineral contents of the autoclaved bean samples were generally similar to those of the raw (unprocessed) samples. Under the processing conditions, roasting caused the highest reduction in thioglucoside content (59%) in soya bean while cooking caused the highest reduction in lima bean (78%). Trypsin inhibitor activity (TIA) ranged between 0.59 mg/g sample in the cooked soya bean and 11.6 mg/g sample in the raw bean while the corresponding values for lima bean ranged between 0.59 and 6.3 mg/g sample. Cooking and roasting caused over 90% reduction of TIA, while autoclaving caused 64-69% reduction in both bean samples. Under the assay conditions, haemagglutinating activity was not detected in the cooked and autoclaved soya and lima beans. The need to prevent both functional and nutritional damage to food proteins and other nutrients, resulting from excessive heating, was discussed.