Effect of hyoscine butyl-bromide on the duration of active phase of labor: A randomized-controlled trial

Objective

Hyoscine butyl bromide (HBB) is known for its antispasmodic action and has been in use for over five decades, there is however no consensus on its effectiveness in the labor process. The aim of this study was to determine the effect of HBB on the duration of the active phase of labor.

Prevalence and characteristics of aquagenic pruritus in a young African population

Background

The internet is an increasingly important tool for physicians, but the extent to which it is used by dermatologists is unknown. We aimed to investigate the utilization of the internet by dermatologists in Saudi Arabia for medical purposes during their daily practice and to clarify the reasons for its use and non-use.

Methods

A self-administered questionnaire was distributed to all 160 dermatologists attending the National Dermatology conference in 2007.

Results

A total of 107 questionnaires were completed. Sixty-two percent of respondents had access to the internet in the workplace. The use of the internet to update medical knowledge was reported by 91%. Only 27% had internet access in consultation rooms. The majority of information retrieval occurred outside patient consultation hours (91%). Only 13% reported using the internet during patient consultation. Possible reasons included: lack of access (54%), time pressure (37%), possible interference with the physician-patient relationship (30%), and that use of the internet was too time-consuming (10%). The mean searching time used to solve a clinical problem was 34 ± 3 minutes. Fifty-eight percent used Pubmed; however, 77% of the dermatologists had no training at all in how to use this tool.

Conclusion

Professional medical use of the internet is widespread among dermatologists in Saudi Arabia. Providing access to the internet in the workplace and training of dermatologists to perform effective electronic searches are badly needed to improve the professional medical use of internet, which is expected to lead to better delivery of patient care.     

Catechin,quercetin and taxifolin improve redox and biochemical imbalances in rotenone-induced hepatocellular dysfunction: Relevance for therapy in pesticide-induced liver toxicity?

Hepatotoxicity occurs as a result of adverse effects of some xenobiotics on the liver, which is often the target tissue of toxicity for environmental chemicals. Rotenone, used as a natural pesticide, is an environmental poison reported to cause organ toxicity. This study investigated the protective effect of three flavonoids, catechin, quercetin and taxifolin (2,3-Dihydroquercetin) in rotenone-induced hepatotoxicity. Male Wistar rats were administered rotenone for 10 days followed by post treatment with catechin (5, 10 and 20?mg/kg), quercetin (5, 10 and 20?mg/kg) or taxifolin (0.25, 0.5 and 1?mg/kg), respectively, for 3 days. Bioindices of oxidative stress and hepatocellular injury were measured in serum and tissue homogenate of animals. Rotenone intoxication produced liver damage in rats as reflected in alterations to activities/levels of enzymic and non-enzymic oxidative stress markers and enzymes linked with inflammation, as well as the transaminases, gamma glutamyl transpeptidase, bilirubin, and lactate dehydrogenase. Catechin, quercetin and taxifolin post treatment significantly attenuated these (p?<?0.0001) rotenone-induced imbalances. Comparatively, quercetin displayed the best apparent ameliorative activity. It clearly showed superior activity to catechin. However, taxifolin appeared to show comparable activity to quercetin and better activity than catechin in some of the assays despite being administered at considerably lower doses. The results provide insight on the relative efficacy and structure-activity relationships of the selected flavonoids in ameliorating liver damage and also indicate that additional structural and metabolic factors may be involved in the structure-activity relationships of flavonoids.     

Mechanistic perspective of the oxido‐immunopathologic resolution property of kolaviron in mice influenza pneumonitis

Implicated in influenza‐associated pathology are innate defence overzealousness and unabated secretion of oxidative tissue‐sensitive antimicrobial agents. At different time points, mice were pre‐treated with kolaviron (400 mg/kg), a natural antioxidant and anti‐inflammatory agent, and subsequently challenged with 2 LD₅₀ influenza A/H3N2/Perth/16/09 virus. After euthanasia at day 6, blood, lungs, liver and spleen were collected and processed for biochemical, immunohistochemical and flow cytometric assessment of redo‐inflammatory imbalance, cytokine storm indices and T helper 1 host response. Previously kolaviron was reported to delay mortality onset, improve morbidity and attenuate myeloperoxidase activity and nitric oxide production with minimal impact on viral clearance. This study additionally confirmed nitric oxide, but not hydrogen peroxide, as the major culprit implicated in influenza virus‐induced oxido‐pathology. Systemic effect of the sustained inflammation and nitrosative stress was more prominent in the spleen and lung than in the liver of mice infected with A/H3N2/Perth/16/09. Influential to immunopathology was heightened pulmonary expression of IL‐1β, RANTES, IL‐10, MCP‐1, NF‐κB, iNOS and COX‐2. However, kolaviron combated the influenza‐established nitrative stress, reversed the elicited cytokine storm and restored the oxidized environment to a reductive milieu. Our data also suggest that kolaviron administration early in infection may foster CD4⁺ response. These data indicate that kolaviron may confer disease‐dwindling properties during acute influenza infection via a system‐wide protective approach involving multiple targets especially at the early stage of the infection.     

Methotrexate-induced nausea and vomiting in adolescent and young adult patients

This study aims to determine the prevalence of methotrexate-induced nausea and vomiting in both adolescent and adult patients with inflammatory arthritis. A survey of methotrexate side effects was conducted on patients with inflammatory arthritis. We provided a brief questionnaire to unselected patients with inflammatory arthritis being treated with methotrexate attending adolescent and adult rheumatology clinics. The questions related to the presence, absence, and severity of nausea and vomiting, the temporal relationship with methotrexate and whether anti-emetics had been prescribed. A total of 106 patients from the age of 13 years and above—57 adults (over 20 years) and 49 adolescents (13–19 years) were included in this study. The median age for those experiencing nausea was 19 years (interquartile range (IQR) 7) and for those with no nausea 55 years (IQR 46) (p?<?0.001). Thirty-six out of 49 adolescent patients reported nausea (73 %) compared to only 20/57 adults (35 %) (p?<?0.001). Multiple logistic regression analysis showed that the nausea group had a significantly higher proportion of adolescents (p?=?0.0002), patients taking subcutaneous (SC) methotrexate MTX (p?=?0.002), and patients with duration of MTX of more than 1 year (p?=?0.049). Adolescents were estimated to have over 6 times higher odds of nausea compared to adults (OR 6.31, 95 % CI 2.38 to 16.75, p?=?0.0002) after adjusting for SC MTX and duration of MTX. Only 22 % of adolescents and 10 % of adults were prescribed anti-emetics. There is a higher prevalence of MTX-induced nausea and vomiting in adolescents and younger adult patients with inflammatory arthritis compared to older adults. The role of anti-emetics in the treatment of these symptoms is unclear.     

关于儿童死亡焦虑的初步探讨

利用斯皮尔伯格儿童状态焦虑的图示式、死亡刺激和脸谱对三组４９名儿童进行了死亡焦虑研究。结果表明，不同年龄组死亡焦虑得分存在明显差异，且焦虑水平随被试年龄的增加而升高。不同年龄的儿童对死亡对象的焦虑程度也不同。     

PRIMARY PERITONITIS IN A PARAPLEGIC PATIENT

SUMMARY This report of a paraplegic patient with a primary peritonitis illustrates the difficulty in diagnosis and management these patients pose.