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Antibiotics in ICU: The Challenges of Use, Cost and Response in a Tertiary Care Hospital ICU中的抗生素:三级护理医院的使用、成本和反应的挑战
Pub Date : 2017-07-01 DOI: 10.47648/jmsr.2017.v2702.06
R. A. Perveen, M. Nasir, N. Farha, M. A. Islam
Antibiotic resistance can lead to increased morbidity, mortality, length of hospital stay, and healthcare expenditures. The study is designed to observe the challenges of antibiotic consumption, related costs, and their resistance pattern in critically ill patients. The study was conducted in ICU from July 2016 to December 2016, at Holy Family Red Crescent Medical College Hospital. The demographic data, antibiotic sensitivity report, the administration of different classes of antibiotics as well as individual drugs and their costs were recorded. In 216 patients, meropenem was the most commonly prescribed antibiotic followed by levofloxacin and ceftriaxone. Meropenem with one or more class of antibiotics had the higher cost (BDT 1,985 and BDT 2,800 per day per patient). Though the cephalosporins are the initial choice as the safest, cheaper antibiotics in developed countries, high rate of resistance was observed in this ICU. The overall sterilization and strict control of nosocomial infections may play a vital role in overcoming the challenges. Use of local antibiogram, narrow-spectrum antibiotics, infectious disease specialist consultation, and restricted authorization to prescribe antibiotics can effectively shift the antibiotic sensitivity and minimize the cost in ICU stay.
抗生素耐药性会导致发病率、死亡率、住院时间和医疗支出增加。这项研究旨在观察危重患者抗生素消费、相关费用及其耐药性模式的挑战。该研究于2016年7月至2016年12月在圣家红新月医学院医院的重症监护室进行。记录了人口统计学数据、抗生素敏感性报告、不同类别抗生素的给药情况以及个别药物及其成本。在216名患者中,美罗培南是最常见的处方抗生素,其次是左氧氟沙星和头孢曲松。美罗培南与一种或多种抗生素的成本较高(每位患者每天BDT 1985和BDT 2800)。尽管头孢菌素是发达国家最安全、最便宜的抗生素的首选,但在该重症监护室中观察到了高耐药率。全面消毒和严格控制医院感染可能在克服挑战方面发挥至关重要的作用。使用本地抗生素谱、窄谱抗生素、传染病专家咨询和限制性授权开抗生素可以有效地改变抗生素敏感性,并最大限度地降低ICU住院成本。
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引用次数: 3
The Neuroprotective Effects of Alcoholic Extract of Levisticum Officinale on Alpha Motoneurons Degeneration After Sciatic Nerve Compression in Male Rats 脑残醇提物对雄性大鼠坐骨神经受压后α运动神经元变性的神经保护作用
Pub Date : 2017-06-20 DOI: 10.13005/BPJ/1150
Salman Mahmoudzehi, Gol Mohammad Dorrazehi, S. Jamalzehi, A. H. Khabbaz, F. Ghorbani, Abdollah Hooti, Abdolvahed Ghorbani Dadkani, Mehrdad Mahmoudi Souran
As peripheral neurons are injured, several inflammatory factors will be released from the fiber of the injured nervous leading to morphological and biochemical changes in the injured point. This changes ultimately results in the Wallerian degeneration of the cell bodies of these neurons in the spinal cord which are involved in retrograde reaction. Levisticum officinale is one of the herbs that has been traditionally used for treatment of many diseases. Many studies have confirmed the anti-inflammatory and anti-oxidant effects of this plant. It is expected that the extract of Levisticum officinale would have a significant role in the restoration of nervous system injuries. The purpose of this study was to investigate the effects of the alcoholic extract of Levisticum officinale on the neuron protection of the sciatic nerves of injured rats. In this study, the ethanolic extract was obtained from Levisticum officinale. Then the rats were randomly divided into 5 groups, each containing 6 rats, including two control and compression groups and three treatment groups treated with 50, 75 and 100 mg/kg doses of the extract. Sciatic nerve in compression and treatment groups was exposed to compression for 60 seconds, and the ethanolic extract was injected intraperitoneally in the first, second and third weeks. The spinal cord of the rats were sampled and the neurons of the samples were counted using a dissector method after tissue passaging and staining. Meanwhile, the density of motoneurons was measured. T-test analysis was performed by using SPSS software. The density of α motoneurons in compression group decreased significantly as compared to the control group (p<0.001). The density of α motoneurons in all treatment groups with 50,75 and 100 extract doses was significantly increased as compared to the compression group (p<0.01). The highest neuron protection was observed in the treatment group with 100 mg/kg dose as compared to the compression group. Conclusion: Ethanolic extract of Levisticum officinale has neuron protective and restorative effects on the injuries of the peripheral nerves such as compression.
当外周神经元损伤时,损伤神经的纤维会释放出几种炎症因子,导致损伤点的形态和生化变化。这种变化最终导致脊髓中参与逆行反应的神经元细胞体的Wallerian变性。Levisticum officinale是传统上用于治疗多种疾病的草药之一。许多研究证实了这种植物的抗炎和抗氧化作用。预计中药提取物对神经系统损伤的修复具有重要作用。本研究的目的是为了研究中药老药醇提物对大鼠坐骨神经损伤的神经元保护作用。在本研究中,乙醇提取物是从Levisticumofficinale中获得的。然后将大鼠随机分为5组,每组6只,包括两个对照组和压迫组,以及用50、75和100mg/kg剂量的提取物处理的三个治疗组。压迫组和治疗组的坐骨神经暴露于压迫60秒,并在第一、第二和第三周腹膜内注射乙醇提取物。对大鼠的脊髓进行取样,并在组织传代和染色后使用解剖器方法对样品的神经元进行计数。同时测定运动神经元的密度。采用SPSS软件进行T检验分析。与对照组相比,压迫组的α运动神经元密度显著降低(p<0.001)。与压迫组相比,50、75和100提取物剂量的所有治疗组的α活动神经元密度均显著增加(p<0.01)。与挤压组相比,100 mg/kg剂量的治疗组观察到最高的神经元保护作用组结论:苍耳乙醇提取物对周围神经压迫等损伤具有保护和修复作用。
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引用次数: 3
Influence of Gluteus Maximus Inhibition on Upper Trapezius Overactivity in Chronic Mechanical Neck Pain with Radiculopathy 抑制臀大肌对慢性机械性颈痛伴放射病患者上斜方肌过度活动的影响
Pub Date : 2017-03-01 DOI: 10.16965/IJPR.2017.128
G. Koura, Eman Kamel, Wanees M Badawy, H. Hamada, H. Zakaria
Background: Mechanical neck pain is the most common type of neck pain and commonly to accompany with radiculopathy. Patients of neck pain exhibit greater activation of accessory muscles, (sternocleidomastoid, anterior scalene, and upper trapezius muscles) and may also show changed patterns of motor control of other postural muscles as pelvic muscles for reducing activation of painful muscles of neck. Aim of the study: To determine if there is an association between gluteus maximus inhibition and overactivity of upper fibres of trapezius in patients with chronic mechanical neck pain with radiculopathy. Materials and Methods: Forty female patients participated in this study diagnosed as chronic mechanical neck pain with radiculopathy. Amplitude and onset of muscle activation were assessed by using the surface electromyography (EMG) during prone hip extension test. Results: The results of this study demonstrated that there is no correlation between the amplitude of EMG activity of right and left gluteus maximus and the amplitude of EMG activity of right and left upper trapezius (P<0.05). Conclusion: It can be concluded that the overactivity of the upper trapezius muscle in patients with chronic mechanical neck pain with radiculopathy is not related to the inhibition of the gluteus maximus muscle during prone hip extension test.
背景:机械性颈部疼痛是最常见的颈部疼痛类型,通常伴有神经根病。颈部疼痛患者表现出附属肌肉(胸锁乳突肌、前斜角肌和上斜方肌)的更大激活,并且还可能表现出其他姿势肌肉(如骨盆肌肉)的运动控制模式的改变,以减少颈部疼痛肌肉的激活。研究目的:确定慢性机械性颈部疼痛伴神经根病患者的臀大肌抑制和斜方肌上纤维过度活动之间是否存在关联。材料和方法:40名女性患者参与了这项研究,被诊断为慢性机械性颈部疼痛伴神经根病。在俯卧髋关节伸展试验中使用表面肌电图(EMG)评估肌肉激活的幅度和开始。结果:本研究结果表明,左、右臀大肌肌电活动幅度与左、右上斜方肌肌电图活动幅度之间无相关性(P<0.05)俯卧髋关节伸展试验中对臀大肌的抑制作用。
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引用次数: 2
Tissue Doppler Imaging in Cardiology Nowadays: Clinical Applications 组织多普勒成像在心脏病学中的临床应用
Pub Date : 2017-01-01 DOI: 10.15761/CCRR.1000304
M. Nasr, A. Kossaify
Echocardiography is a routine test in cardiology nowadays and Tissue Doppler imaging (TDI) is particularly useful for evaluating myocardial tissue motion; compared to strain imaging, TDI has a higher temporal resolution, is less time consuming, also it has specific clinical applications and benefits: assessment of diastolic function, assessment of left and right ventricular function, evaluation of ventricular dyssynchrony, and evaluation of constrictive/restrictive syndromes.
超声心动图是当今心脏病学的常规检查,组织多普勒成像(TDI)在评估心肌组织运动方面特别有用;与应变成像相比,TDI具有更高的时间分辨率,更少的时间消耗,并且具有特定的临床应用和益处:评估舒张功能,评估左右心室功能,评估心室非同步化,评估收缩/限制性综合征。
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引用次数: 1
Nursing studentsâ experiences of the process of learning during clinical courses in Iran 护理学生在伊朗临床课程学习过程中的经验
Pub Date : 2016-12-22 DOI: 10.5958/2349-2996.2016.00086.0
Salehi Sh, S. A. Naji, P. Afghari
Learning process is the result of interactions between the learners and the learning environment and paying attention to its effective factors could lead it toward achieving the expected results. This study was aimed to explain the experiences of nursing students about learning process during clinical courses. This was a qualitative phenomenology study. Finally 6 main concepts including communication, professional role, moral and ethical, preparation and planning, learning process and evaluation were defined.
学习过程是学习者与学习环境相互作用的结果,关注其有效因素可以使其达到预期的结果。本研究旨在了解护生在临床课程学习过程中的经验。这是一项定性现象学研究。最后定义了沟通、职业角色、道德与伦理、准备与计划、学习过程和评价等6个主要概念。
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引用次数: 4
The Effect of an Educational Self-Care Program on Knowledge and Performance in Patients with Coronary syndrome 自我保健教育计划对冠状动脉综合征患者知识和表现的影响
Pub Date : 2016-06-01 DOI: 10.18869/IAHS.3.2.49
Atefeh Qoli, T. Nasrabadi, Ebrahim Ebrahimi Abianeh
The most important causes for mortality rate and poor quality of life in cardiovascular patients arise from insufficient and inappropriate self-care. This study determines the effect of an educational self- care program on knowledge and performance in patients with Coronary syndrome. This experimental study included 70 patients with Coronary syndrome hospitalized in Qom University hospitals. Patients were randomly assigned to experimental (n=35) and control (n=35) groups. First, background demographic, knowledge and performance data were collected through interview and observation. Then the patients in experiment group received 2 educational sessions each lasting twenty minutes during the hospital stay, and also were given an educational booklet review, while control patients received routine care. Data on all patients’ knowledge and performance was again collected at one month after discharge. The knowledge and performance of two groups were compared using Wilcoxon and Mann- Whitney U tests. There was no statistically significant differences between the two groups in self-care knowledge and performance before intervention. One month after discharge, patients from both groups reported better self care knowledge and performance compared with their baseline, but patients from experimental group reported a significantly more increase in self-care knowledge and performance than patients from the control group(increase in knowledge score= 8/40vs. 0/57; z=-5/39, p< 0/001, in performance score=32/13 vs. 0.98; z= -19/49, p <0/001). This study demonstrated that the application of an instructional self-care program raises the awareness and improves the performance of the patients with Coronary syndrome.
导致心血管病人死亡率和生活质量下降的最重要原因是自我护理不足和不适当。本研究旨在探讨自我照护教育对冠状动脉综合征患者的认知及表现之影响。本实验研究包括在库姆大学医院住院的70例冠状动脉综合征患者。患者随机分为实验组(n=35)和对照组(n=35)。首先,通过访谈和观察收集背景人口统计、知识和绩效数据。实验组患者在住院期间接受2次教育,每次20分钟,并给予教育手册复习,对照组患者接受常规护理。出院后一个月再次收集所有患者的知识和表现数据。采用Wilcoxon和Mann- Whitney U检验比较两组的知识和绩效。干预前两组患者的自我护理知识和表现差异无统计学意义。出院1个月后,两组患者的自我保健知识和表现均较基线有所提高,但实验组患者的自我保健知识和表现的提高明显高于对照组(知识得分增加= 8/40vs)。0/57;Z =-5/39, p< 0/001,性能评分=32/13 vs. 0.98;Z = -19/49, p <0/001)。本研究显示,自我照护教学计划的应用,可提高冠状动脉综合征患者的自我照护意识,并改善其表现。
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引用次数: 3
PANCREATIC LIPASE AND α-AMYLASE INHIBITORY POTENTIAL OF MANGOSTEEN (GARCINIA MANGOSTANA LINN.) PERICARP EXTRACT 山竹对胰脂肪酶和α-淀粉酶的抑制作用果皮中提取
Pub Date : 2016-01-01 DOI: 10.5958/2319-5886.2016.00006.0
I. Adnyana, Alkilany Salem Abuzaid, Elin Yulinah Iskandar, N. Kurniati
Background: Obesity is a disorder of lipid metabolism and the enzyme involved in this process could be selectively targeted to develop anti obesity drugs. Inhibition of digestive enzymes is one of the most widely studies mechanisms used to determine the hypolipidemic and hypoglycemic agent of natural products for anti-obesity agent screening. Aims: To evaluate the inhibitory potential of G. mangostana extract, xanthone and α-mangosteen compound toward pancreatic lipase and α-amylase enzyme as once of anti-obesity mechanism. Material and Methods: The IC50 value of the mangosteen pericarp extract, xanthone, and α-mangosteen toward pancreatic lipase and α-amylase were determined in vitro compared to orlistat and acarbose as standard drugs. Results: Mangosteen pericarp extract contains phenol, terpenoid, saponin, flavonoid and tannin. Mangosteen pericarp extract is a more active compound in inhibiting the PPL activity compared to α-mangosteen, and xanthone. Mangosteen pericarp extract shows the higher activity compared to xanthone but still lower activity compared to α-mangosteen. However, its activity is still lower than standard drugs. Conclusions: Our in vitro, confirmed that the mangosteen pericarp extract has the phytochemical bioactive content that possesses anti-obesity potential through pancreatic lipase and α-amylase inhibitory activity.
背景:肥胖是一种脂质代谢紊乱,参与这一过程的酶可以选择性地靶向开发抗肥胖药物。消化酶的抑制作用是研究最广泛的机制之一,用于确定降血脂和降血糖的天然产物,用于抗肥胖药物的筛选。目的:探讨山竹提取物、山酮和α-山竹复合物对胰脂肪酶和α-淀粉酶的抑制作用及其抗肥胖机制。材料与方法:以山竹果皮提取物、山酮、α-山竹提取物为对照品,体外测定其对胰脂肪酶和α-淀粉酶的IC50值。结果:山竹果皮提取物含有酚、萜类、皂苷、黄酮类和单宁。山竹果皮提取物对PPL活性的抑制作用比α-山竹果皮提取物和山酮更有效。山竹果皮提取物的活性高于山蒽酮,但低于α-山竹果皮提取物的活性。然而,其活性仍低于标准药物。结论:体外实验证实山竹果皮提取物具有抑制胰脂肪酶和α-淀粉酶抑制肥胖的植物化学生物活性。
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引用次数: 32
Cytotoxicity of endodontic sealers-a comparative study using L-929 mouse skin fibroblast cell response-an ex-vivo study 牙髓封闭剂的细胞毒性-利用L-929小鼠皮肤成纤维细胞反应的比较研究-离体研究
Pub Date : 2016-01-01 DOI: 10.5958/2319-5886.2016.00013.8
Aruna Kanaparthy, Rosaiah Kanaparthy
Aim: The objective of the present research was to evaluate and to compare the cytotoxicity of four commonly used endodontic sealers Apexit Plus, AH plus, Sankin, and Endofloss. The cytotoxicity was evaluated after setting of the sealers at different time intervals. Materials and Methods: Mouse skin fibroblasts L-929 was obtained from cell repository centre of national centre for cell science Pune, India. The cells were grown as monolayer cultures in Dulbeccos Modified eagle Medium (DMEM). Each of the test materials were mixed according to the manufactures instruction and was allowed to set. 0.1ml of each of the set sealers was placed in the petriplates in direct contact with the fibroblasts at 24 and 48 hrs intervals and evaluated for cytotoxicity. The percentage viability of the fibroblasts were calculated and evaluated statistically. Results: The statistical analysis revealed that Apexit Plus showed slight to moderate toxicity at 24 and 48 hrs, when compared with other sealers. Sankin showed maximum toxicity at all time intervals. Conclusion: All tested endodontic sealers demonstrated varying amount of cytotoxicity at different time intervals. Apexit Plus showed the least amount of cytotoxicity and Sankin showed the highest level of cytotoxicity.
目的:本研究的目的是评估和比较四种常用的根管密封剂apexexplus, AH Plus, Sankin和Endofloss的细胞毒性。在不同的时间间隔静置封口剂后,评价其细胞毒性。材料与方法:小鼠皮肤成纤维细胞L-929来源于印度浦那国家细胞科学中心细胞库中心。细胞在Dulbeccos Modified eagle Medium (DMEM)中单层培养。每一种测试材料都按照制造商的说明进行混合,并允许设置。每隔24小时和48小时将每种密封剂各0.1ml置于与成纤维细胞直接接触的培养皿中,并评估细胞毒性。对成纤维细胞存活率进行统计和评价。结果:统计分析显示,与其他封口剂相比,apexexplus在24和48小时的毒性为轻度至中度。Sankin在所有时间间隔内都显示出最大的毒性。结论:在不同的时间间隔内,所有的牙髓封闭剂都表现出不同程度的细胞毒性。apexexplus的细胞毒性最小,而Sankin的细胞毒性最高。
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引用次数: 4
Evaluation of peripheral nerve conduction and visual evoked potential in newly diagnosed hypothyroid females. 新诊断甲状腺功能减退的女性周围神经传导和视觉诱发电位的评价。
Pub Date : 2016-01-01 DOI: 10.5958/2319-5886.2016.00010.2
A. Sankareswari, Shreen L Affiya, T. Vigil, S. Naveen, M. Chandrasekhar
Background: Hypothyroidism is a common medical condition in the general population. Usually hypothyroidism has both central and peripheral nerve involvement. The neurologic manifestations occur in conjunction with the systemic features of the disease and may be noted only incidentally. The peripheral neuropathy can be assessed using the sensory motor nerve conduction studies, which is a non-invasive method. Visual Evoked Potentials (VEPs) are electrical potential differences recorded from the scalp in response to visual stimuli. Aim: To study the motor and sensory nerve conduction in the Median nerve and Visual Evoked Potential in the newly diagnosed hypothyroid females. Materials and methods: The sample size is 30. The study design is a cross sectional study. Sensorimotor nerve conduction of the Median nerve and the VEP was done using NEUROSTIM NS2 machine, in the department of Physiology, Meenakshi Medical College, Hospital and Research Institute. The statistical analysis was done by Student unpaired t' test using SPSS software 17 version. Result: There was a significant in the nerve conduction of both motor and sensory components of the cases when compared to the controls. There was statistically significant prolongation of latency P 100 wave of VEP in the study group compared to the control group. Conclusion: Both peripheral and central nervous system are affected in hypothyroidism. To conclude, electrophysiological studies can be useful in the diagnosis of asymptomatic poly neuropathy in hypothyroid patients.
背景:甲状腺功能减退是普通人群的常见疾病。甲状腺功能减退通常累及中枢和周围神经。神经系统表现与疾病的全身特征同时发生,可能只是偶然注意到。周围神经病变可以通过感觉运动神经传导研究来评估,这是一种非侵入性的方法。视觉诱发电位(VEPs)是在视觉刺激下从头皮记录的电位差。目的:探讨新诊断甲状腺功能减退的女性正中神经运动、感觉神经传导及视觉诱发电位的变化。材料与方法:样本量为30。本研究设计为横断面研究。使用Meenakshi医学院、医院和研究所生理学系NEUROSTIM NS2机器测量正中神经和VEP的感觉运动神经传导。统计分析采用SPSS软件17版学生不配对t检验。结果:与对照组相比,两组患者的运动神经和感觉神经传导均有显著差异。与对照组相比,研究组VEP潜伏期p100波延长有统计学意义。结论:甲减患者外周血及中枢神经系统均受影响。综上所述,电生理研究可用于甲状腺功能减退患者无症状多神经病变的诊断。
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引用次数: 4
BOWEL AID AS SUPPLEMENTARY MANAGEMENT IN MESH COMPLICATION- RELATED PAIN: A CASE REPORT 辅助肠治疗补片并发症相关疼痛1例报告
Pub Date : 2016-01-01 DOI: 10.5958/2319-5886.2016.00027.8
L. Aw, Ishak Zainol, H. Chew, C. W. Yu
Millions of women suffering from urinary incontinence (UI) and pelvic organ prolapse (POP) globally, and many had synthetic sub-urethral procedures which is one of the mainstay therapy of stress urinary incontinence. It is paramount to learn from patients with mesh complications; in this particular case, perineal pain and dyspareunia related to complication of synthetic suburethral sling procedure. This patient has cessation of debilitating pain with the conservative use of bowel aid, and yet she remains to be continent in uresis.
全球有数百万女性患有尿失禁(UI)和盆腔器官脱垂(POP),其中许多人接受了尿道下合成手术,这是治疗压力性尿失禁的主要方法之一。向有补片并发症的患者学习是至关重要的;在这个特殊的病例中,会阴疼痛和性交困难与合成喉下吊索手术的并发症有关。本例患者在保守使用助肠器后,已停止虚弱的疼痛,但她仍有尿潴留。
{"title":"BOWEL AID AS SUPPLEMENTARY MANAGEMENT IN MESH COMPLICATION- RELATED PAIN: A CASE REPORT","authors":"L. Aw, Ishak Zainol, H. Chew, C. W. Yu","doi":"10.5958/2319-5886.2016.00027.8","DOIUrl":"https://doi.org/10.5958/2319-5886.2016.00027.8","url":null,"abstract":"Millions of women suffering from urinary incontinence (UI) and pelvic organ prolapse (POP) globally, and many had synthetic sub-urethral procedures which is one of the mainstay therapy of stress urinary incontinence. It is paramount to learn from patients with mesh complications; in this particular case, perineal pain and dyspareunia related to complication of synthetic suburethral sling procedure. This patient has cessation of debilitating pain with the conservative use of bowel aid, and yet she remains to be continent in uresis.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71080537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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International Journal of Medical Research & Health Sciences
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