Abstract

Background: For preventing preterm labor, the recommended duration of atosiban infusion is 48 hours and the patient has to be hospitalized during the course of treatment. The treatment consists of administering one vial of 0.9 ml as a bolus and then an infusion at a rate of 300 mcg/min for 3 hours followed by 100 mcg/min for the next 45 hours, utilizing nine vials of 5 ml. The objective of the study was to evaluate an alternative brief duration (14-hour) of atosiban treatment involving a bolus dose of 0.9 ml followed by an infusion of 300 mcg/min for 2 hours and 100 mcg/min for the next 12 hours utilizing 3 vials of 5 ml. The advantage being that the treatment could be completed in an outpatient setup and be convenient for the patient as well as for the healthcare staff. This would also reduce the overall cost of the treatment. This prospective single-center study was conducted to evaluate the efficacy and safety of an atosiban brief duration (14- hour) treatment regimen to prevent preterm labor.

Methods: A total of 50 patients with symptoms of preterm labor were enrolled in the study. The efficacy of tocolysis was determined by the percentage of patients who remained undelivered up to 48 hours after atosiban therapy initiation and the follow-up of the patients was done up to delivery. Safety was assessed in terms of the number of maternal and fetal adverse events reported.

Results: The mean gestational age at the enrolment was 32.1±2.6 weeks and the delivery were delayed by a mean of 18.13±17.97 days (range 1-62 days). Thirty-five (70%) patients remained undelivered at 48 hours and 29 (58%) at 7 days. No maternal or fetal adverse events were reported during the study.

Conclusions: A favourable safety and efficacy profile of a brief duration atosiban regimen was observed resulting in ease of administration and a shorter stay in the healthcare facility providing convenience to both patient and hospital staff. The overall cost of the therapy was also reduced. Further clinical trials with larger sample size are required to confirm the findings.

Abstract

A group of senior doctors with vast experience in the management of respiratory diseases got together on 25th June 2022 under the leadership of Dr. V. K. Arora, Dr. D. Behera, Dr. Agam Vora, Dr. Parthiv Mehta, Dr. Arindam Kar, Dr. A. Jaychandra, Dr. B. P. Singh, Dr. S. K. Katiyar, Dr. Subhankar Kandi, Dr. J. K. Samaria, Dr. Parvaiz Koul, Dr. Naveed Nazir Shah, Dr. Rukhsana Najeeb, Dr. N. K. Jain, Dr. Sadiq Ahmad, Dr. Mir Faisal, Dr. Rayees Najib and Dr. Bhupesh Dewan under the auspices of the Academy of Advanced Medical Education. It was a very useful discussion, bringing out their personal experiences regarding the use of Aviptadil in Acute respiratory distress syndrome (ARDS) a life-threatening respiratory condition. ARDS is a manifestation of acute injury to the lung, associated with sepsis, pneumonia, severe pulmonary infections, aspiration of gastric contents, major trauma and tuberculosis.

Abstract:

Background: Preterm labor poses a significant challenge within obstetrics, carrying the potential for diverse complications for both maternal and neonatal well-being. Extensive clinical data indicates that atosiban stands as a secure and well-tolerated therapeutic alternative, exhibiting fewer adverse effects on both the mother and fetus compared to other tocolytic treatments. The investigation aimed to assess the feasibility of achieving optimal medical care by employing a solitary atosiban bolus dose. This approach holds the promise of mitigating the necessity for hospitalization, potentially enabling outpatient management of the condition. Aim: The purpose of the study was to assess the efficacy and safety of using a single bolus dose of atosiban to delay premature delivery. Material and Methods: The study included 75 patients experiencing symptoms of preterm labor. These patients were administered a single bolus dose of atosiban (6.5 mg/0.9mL). The study was conducted between August 2019 and July 2023. Results: The study successfully used a single bolus dose of atosiban to delay delivery by up to 48 hours, enabling corticosteroid prophylaxis. The participants' average gestational age was 32.1 weeks. Atosiban effectively delayed delivery in 68% of patients for an average of 13.3 days, with a range of 0-62 days. No adverse effects were reported by either mothers or fetuses during the study period. Conclusion: The study findings suggest that a single bolus dose of atosiban is an effective and safe treatment option for delaying preterm labor. The treatment provides short-term relief for an average of 13 days, with potential benefits over other tocolytics like isoxsuprine, ritodrine, and nifedipine due to fewer side effects. The intravenous bolus dose of atosiban has a quick onset and long-lasting effects, making it convenient for both patients and physicians. The approach is cost-effective and could be repeated after a few days if necessary. Overall, the study demonstrates the potential of using a single bolus dose of atosiban as an outpatient treatment to manage preterm labor effectively, offering benefits in terms of safety, convenience, and cost.

Abstract

Background: The balance of gut microbiota significantly impacts host health. Disruption of the natural gut flora, often caused by infections or the use of broad-spectrum antimicrobial drugs, can lead to dysbiosis, causing gastrointestinal disorders, such as diarrhea. Probiotics show promising outcomes in restoring gut health, but concerns remain about their interaction with antimicrobials and the viability of spores in the intended gut location. To address these uncertainties, the current study was devised to evaluate how well spores-forming bacteria endure and develop in an environment where antimicrobial agents are present.

Materials and Methods: The study investigated the survival and growth of Bacillus coagulans spores under the influence of broad-spectrum antimicrobial agents, Ofloxacin and Ornidazole. To cultivate the spores in the presence of these antimicrobials, a mixture of MRS broth and PNY agar media was used. The number of colonies that developed were measured to assess the extent of spore survival and germination.

Results: In a simulated environment resembling human intestinal pH, Bacillus coagulans spores exhibited viability. Starting with an initial count of 1.38 billion CFU, the spores multiplied to 8.75 billion CFU at 24 hours and further reached to 86.25 billion CFU at 72 hours in the presence of Ofloxacin and Ornidazole. On the other hand, the viable count reached to the level of 88 billion CFU in the absence of antimicrobial agents.

Conclusion: This study offers evidence that Bacillus coagulans spores are able to remain viable and germinate when co-administered with Ofloxacin and Ornidazole.

Abstract

Objective: This prospective multicentric study was designed to confirm the efficacy and safety of atosiban in preterm labor.

Methods: In a study across 14 sites in India, 406 patients with preterm labor symptoms received up to 48 hours of atosiban infusion. Tocolysis efficacy was gauged by the 72-hour undelivered rate, while safety was assessed via maternal-fetal and neonatal adverse events.

Results: In 400 evaluated patients, the gestation period in 89% of patients was prolonged for more than 48 hours and 83.75% of patients continued their pregnancy up to 72 hours. Amongst the tocolyzed patients, 77% of preterm births were prevented for more than 7 days. The mean duration of gestational period prolongation after the tocolysis was 31.28 days with a mean gestational age at delivery of 35.0 ± 3.15 weeks. Singleton and twin pregnancy prolongation rates for 72 hours were 84.95% and 67.86% respectively. Birth weight of more than 2500 grams was in 54.44% of neonates and an APGAR score of more than 7 after 5 minutes was in 91.82% of neonates. Patients receiving atosiban were more likely to have nausea (2.71%), tachycardia (2.46%), and headache (1.97%). No new or unexpected adverse events were reported in this study.

Abstract

Hemorrhoids, a prevalent medical condition impacting millions globally, fre quently necessitate effective yet minimally invasive treatment methods. This review delves into the prospects of utilizing oral catechins and epicatechins, naturally occurring polyphenolic compounds present in diverse dietary sources, as an innova tive avenue for addressing hemorrhoids. These compounds have antioxidant and anti-inflammatory attributes, which may help alleviate hemorrhoid symptoms. An understanding of the anatomy and pathophysiology of hemorrhoids, emphasizing the need for accessible and versatile treatment options. Subsequently, the focus turns to a detailed exploration of catechin and epicatechin, encompassing their chemical com position, natural origins, and mechanism of action. The core of this review presents a comprehensive analysis of the existing literature, including randomized controlled trials that examine the efficacy of oral catechin and epicatechin supplementation in alleviating hemorrhoidal symptoms. To conclude, this article highlights the potential of oral catechin and epicatechin supplementation as a non-invasive and natural approach to managing hemorrhoids. While promising findings have emerged, further research is essential to solidify their role in hemorrhoid treatment. The comprehen sive assessment of existing literature and critical evaluation of these compounds’ mechanism of action provides valuable insights into their viability as a treatment modality for this common and often distressing medical concern.

Abstract

Background: A trial of empirical acid-suppressive therapy is the usual practice for most patients with symptoms of gastritis in primary care.

Aim: To assess the relative efficacy of Troxipide and Ranitidine in patients with endoscopic gastritis over a four-week period.

Methods: In all, 142 patients were randomized to Troxipide (100 mg tid) or Ranitidine (150 mg bid) for a period of four weeks. The severity of the signs of endoscopic gastritis at baseline and week 4 using a four-point scale and the subjective symptom severity at baseline and week 2 & week 4 using a Visual analog scale (VAS) were documented.

Results: Troxipide was found to be superior to Ranitidine for both, the complete resolution and improvement of endoscopic gastritis. Higher proportion of patients showed complete healing of erosions (88.14%), oozing (96.77%), and edema (93.88%) with Troxipide as compared to Ranitidine (P<.01). Patients receiving Troxipide also showed a greater improvement in the VAS scores for abdominal pain, bloating, and heartburn (P<.01). Both the drugs were found to be well tolerated.

Conclusion: In patients with endoscopic gastritis, Troxipide, with its superior rate of improvement, resolution of signs, and subjective clinical symptoms, can be considered as an alternative to the commonly used antisecretory agents.

Abstract

Background: Empirical therapy with antisecretory agents like PPIs and H2RAs has long been the traditional approach in the initial management of uninvestigated dyspepsia.

Aim: The objective of the study was to examine relief of dyspepsia with lafutidine, a second-generation H2-RA, and rabeprazole and to compare their efficacy.

Methods: This was a randomized, open, comparative trial in adult uninvestigated dyspeptic patients, who had at least moderate severity of symptoms, defined as a score of ≥4 on a 7-point global overall symptom (GOS) scale, and were randomized to receive once daily either lafutidine 10 mg or rabeprazole 20 mg for 4 weeks.

Results: A total of 236 patients were enrolled, out of which 194 patients were included in the analysis. At the end of week 4, a significant difference was observed for symptom relief (lafutidine 89.90% versus rabeprazole 65.26%, P<.01) and symptom resolution (lafutidine 70.71% versus rabeprazole 25.26%, P<.01). Both the drugs were well tolerated.

Conclusion: Both lafutidine and rabeprazole provide symptom relief in patients with heartburn-dominant uninvestigated dyspepsia. The present study confirms the appropriateness of lafutidine as an empiric treatment and superior efficacy for primary care practice patients with dyspepsia.