This study compared the efficacy and adverse effects of chloroquine, quinine, and artesunate in treating uncomplicated Plasmodium falciparum malaria in Northeast India. Artesunate showed the fastest fever and parasite clearance times, with 100% parasite clearance within 48 hours and minimal adverse effects. Quinine was almost as effective but had more side effects like nausea and vomiting. Chloroquine had slower clearance times and 8% of patients showed resistance, suggesting it is no longer effective as a first-line treatment in the region due to high resistance. The study concludes that artesunate is the most efficacious and best tolerated antimalarial for treating uncomplicated falciparum malaria in
Video at https://www.youtube.com/watch?v=2rQKMD_5po0
Part of the "Hypoxemia in the Ward Patient with COVID-19" talks in Frederick Southwick's Coursera MOOC on COVID-19, "COVID-19 - A clinical update".
"Dr. Ben Geisler, Hospitalist at Massachusetts General Hospital and Harvard Medical School faculty member reviews the current treatments for COVID-19. He first discusses the management of fluid replacement and diuretics, as well as the indications for bronchodilators and antibiotics. He emphasizes the importance of DVT anticoagulation prophylaxis. He next reviews the potential role of statins, evidence with regards angiotensin converting enzyme inhibitors, and NSAIDS. He next reviews the current indications for the agents of proven efficacy: Remdesivir and Dexamethasone. Finally he discusses the dilemma of equipoise and the best resources for staying up to date with this ever changing topic."
In this iteration, we have added baricitinib and tocilizumab/IL-6 inhibitors.
Mgh COVID-19 Treatment Guidance March 17, 2020Ken Yale
This document was developed by members of the ID division at MGH in conjunction with pharmacy, radiology, and other medicine divisions to provide guidance to frontline clinicians caring for patients with COVID-19. This document covers potential off-label and/or experimental use of medications and immunosuppression management for transplant patients as well as a suggested laboratory work up. It does NOT cover recommendations for infection control, PPE, management of hypoxemia or other complications in patients with COVID-19. This is a living document that will be updated in real time as more data emerge.
Pre-ASCO Seminar: (Re)Defining Value in Cancer Care: Priorities for Patients, Providers, and Health Systems
Panel: International Experience with Health Technology Assessment (HTA) & Lessons for the United States,
Video at https://www.youtube.com/watch?v=2rQKMD_5po0
Part of the "Hypoxemia in the Ward Patient with COVID-19" talks in Frederick Southwick's Coursera MOOC on COVID-19, "COVID-19 - A clinical update".
"Dr. Ben Geisler, Hospitalist at Massachusetts General Hospital and Harvard Medical School faculty member reviews the current treatments for COVID-19. He first discusses the management of fluid replacement and diuretics, as well as the indications for bronchodilators and antibiotics. He emphasizes the importance of DVT anticoagulation prophylaxis. He next reviews the potential role of statins, evidence with regards angiotensin converting enzyme inhibitors, and NSAIDS. He next reviews the current indications for the agents of proven efficacy: Remdesivir and Dexamethasone. Finally he discusses the dilemma of equipoise and the best resources for staying up to date with this ever changing topic."
In this iteration, we have added baricitinib and tocilizumab/IL-6 inhibitors.
Mgh COVID-19 Treatment Guidance March 17, 2020Ken Yale
This document was developed by members of the ID division at MGH in conjunction with pharmacy, radiology, and other medicine divisions to provide guidance to frontline clinicians caring for patients with COVID-19. This document covers potential off-label and/or experimental use of medications and immunosuppression management for transplant patients as well as a suggested laboratory work up. It does NOT cover recommendations for infection control, PPE, management of hypoxemia or other complications in patients with COVID-19. This is a living document that will be updated in real time as more data emerge.
Pre-ASCO Seminar: (Re)Defining Value in Cancer Care: Priorities for Patients, Providers, and Health Systems
Panel: International Experience with Health Technology Assessment (HTA) & Lessons for the United States,
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
This is a presentation about medical error with the following Objectives:
1- Learn step-by-step what to do when medical error occurs and how to report it
2- Learn how to identify root cause of a medical error and how to prevent its recurrence
3- Motivate your colleagues to foster a patient safety culture
Background: It is often difficult to predict which newborn with HIE will develop neurological sequlae so there is an urgent need for predictors for adverse neurological outcomes in these infants. Aim of Study: To evaluate the serum levels of serum amyloid A (SAA) protein in newborns with HIE during the first week of life and after 3 and 6 months of follow up to assess its correlation with degree of HIE neurological sequlee. Patients and Methods; This case-control study was conducted on 72 infants; group (1) included 36 full term neonates diagnosed as HIE and group (2)included 36 age and sex matched, infants as a control group, Serum amyloid A by ELIZA technique was measured at post natal age of 1 and 7 days, CT scan was done in justified cases .with follow up at age of 3 and 6 months for neurological sequlee. Results: SAA protein level was elevated in the asphyxiated group in comparison to the control group at day 1 and day 7, SAA level was significantly correlated to the Sarnat scoring system of HIE. SAA level significantly differ on follow up of developmental milestone at age of 3 and 6 months. ROC curve for validity of SAA for severity of HIE at cut off point > 25μg/ml at day 1 and at cut off point > 20 μg/ml at day 7 of HIE diagnosis reported sensitivity 100% and specificity 100% .Conclusion: SAA correlates with the severity of HIE and higher SAA expression is a prognostic marker for morbidity in these infants.
Biologics in Asthma: Generics, reimbursement, and market potential Pharma Intelligence
While asthma has traditionally been considered a well-established market, there are still a number of key unmet needs that could drive further development, particularly among biologics.
In this complimentary webinar, our Datamonitor Healthcare analyst will discuss current and pending biologics being used to treat chronic asthma, including pricing and reimbursement issues, performance projections, targeted patient groups, and the impact of generics on the market.
View and listen to full webinar for free here https://www.youtube.com/watch?v=bNlUE-VH6Tc
Provides information on selecting an initial antiretroviral therapy (ART) regimen for patients with HIV, including clinical recommendations and key points regarding available ART regimens, general principles and considerations, specific factors to discuss with patients, special considerations for comorbid conditions, laboratory testing, and dose adjustments for renal and hepatic impairment.
Find more information at https://www.hivguidelines.org/antiretroviral-therapy/what-to-start/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
Malaria diagnosis and management case based study tGovindRankawat1
P. Vivax schizont
The diagnosis of P. vivax malaria is later confirmed by review of a blood smear available from the first episode (Figure), and by a PCR positive for P. vivax on blood collected during the current episode.
The microscopic diagnosis of P. vivax is based on the following:
The infected red cells are enlarged and deformed;
The schizont shown contains 20 merozoites (schizonts of P. malariae and P. ovale have fewer merozoites; and in P. falciparum, schizonts are not usually seen in the peripheral blood);
The round gametocyte shown, contained in an enlarged red cell. (In this case, the typical Schüffner’s dots were not visible, probably due to staining problems.)
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
This is a presentation about medical error with the following Objectives:
1- Learn step-by-step what to do when medical error occurs and how to report it
2- Learn how to identify root cause of a medical error and how to prevent its recurrence
3- Motivate your colleagues to foster a patient safety culture
Background: It is often difficult to predict which newborn with HIE will develop neurological sequlae so there is an urgent need for predictors for adverse neurological outcomes in these infants. Aim of Study: To evaluate the serum levels of serum amyloid A (SAA) protein in newborns with HIE during the first week of life and after 3 and 6 months of follow up to assess its correlation with degree of HIE neurological sequlee. Patients and Methods; This case-control study was conducted on 72 infants; group (1) included 36 full term neonates diagnosed as HIE and group (2)included 36 age and sex matched, infants as a control group, Serum amyloid A by ELIZA technique was measured at post natal age of 1 and 7 days, CT scan was done in justified cases .with follow up at age of 3 and 6 months for neurological sequlee. Results: SAA protein level was elevated in the asphyxiated group in comparison to the control group at day 1 and day 7, SAA level was significantly correlated to the Sarnat scoring system of HIE. SAA level significantly differ on follow up of developmental milestone at age of 3 and 6 months. ROC curve for validity of SAA for severity of HIE at cut off point > 25μg/ml at day 1 and at cut off point > 20 μg/ml at day 7 of HIE diagnosis reported sensitivity 100% and specificity 100% .Conclusion: SAA correlates with the severity of HIE and higher SAA expression is a prognostic marker for morbidity in these infants.
Biologics in Asthma: Generics, reimbursement, and market potential Pharma Intelligence
While asthma has traditionally been considered a well-established market, there are still a number of key unmet needs that could drive further development, particularly among biologics.
In this complimentary webinar, our Datamonitor Healthcare analyst will discuss current and pending biologics being used to treat chronic asthma, including pricing and reimbursement issues, performance projections, targeted patient groups, and the impact of generics on the market.
View and listen to full webinar for free here https://www.youtube.com/watch?v=bNlUE-VH6Tc
Provides information on selecting an initial antiretroviral therapy (ART) regimen for patients with HIV, including clinical recommendations and key points regarding available ART regimens, general principles and considerations, specific factors to discuss with patients, special considerations for comorbid conditions, laboratory testing, and dose adjustments for renal and hepatic impairment.
Find more information at https://www.hivguidelines.org/antiretroviral-therapy/what-to-start/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
Malaria diagnosis and management case based study tGovindRankawat1
P. Vivax schizont
The diagnosis of P. vivax malaria is later confirmed by review of a blood smear available from the first episode (Figure), and by a PCR positive for P. vivax on blood collected during the current episode.
The microscopic diagnosis of P. vivax is based on the following:
The infected red cells are enlarged and deformed;
The schizont shown contains 20 merozoites (schizonts of P. malariae and P. ovale have fewer merozoites; and in P. falciparum, schizonts are not usually seen in the peripheral blood);
The round gametocyte shown, contained in an enlarged red cell. (In this case, the typical Schüffner’s dots were not visible, probably due to staining problems.)
Safety and efficacy of aflibercept in combination with fluorouracil, leucovor...Mary Ondinee Manalo Igot
Safety and efficacy of aflibercept in combination with fluorouracil, leucovorin and irinotecan in the treatment of Asian patients with metastatic colorectal cancer
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
A Comparative Study of the Efficacy of 5 Days and 14 Days Ceftriaxone Therapy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A COMPARATIVE STUDY ON EFFICACY AND ADVERSE EFFECTS OF ANTIMALARIALS WITH SPECIAL EMPHASIS ON PARASITE CLEARANCE TIME
1. A COMPARATIVE STUDY ON EFFICACY AND ADVERSE EFFECTS OF ANTIMALARIALS WITH SPECIAL EMPHASIS ON PARASITE CLEARANCE TIME Dr. Tanoy Bose Co-Authors: Laskar B, Kalita BC, Das S, Dutta A Department of Medicine Assam Medical College, Dibrugarh
2. Introduction & Epidemiology ~ 2 million laboratory confirmed cases/yr but case incidence is 30 fold or more underestimated. † 40-50% is P.falciparum. † P. falciparum: Majority parasite (>60%) in NE India: hot spot for proliferation and corridor for spread of drug-resistant malaria to rest of peninsular India. ‡ NVBDC still depends on Chloroquine to combat malaria ; RESULT: Pf has taken deep roots in malaria endemic regions. § Continuation of an outdated drug in Rx of all P.f cases : counterproductive in fighting drug res malaria & containment of Pf. § Trends of malaria transmission and species composition in the Sonapur Primary Health Centre, Kamrup district, Assam for the years (1991-2007). Pf, Plasmodium falciparum; Pv, Plasmodium vivax; SPR, slide positivity rate.‡ † NATIONAL ANTI MALARIA DRUG POLICY (2007) ‡ Rolling back malaria is possible.V. Dev, G.C. Doley & A. P. Dash: Indian J Med Res 128, July 2008, pp 82-83 § Battling malaria iceberg with chloroquine in India Vinod P Sharma :Malaria Journal 2007,6:105
3. Objectives: To study the efficacy of enteral and parenteralantimalarials on parasite density and parasite clearance time Their short term adverse effects in patients admitted with malaria in a teaching hospital of a malaria endemic region.
4. Methodology A hospital based nonrandomised observational study Study Duration: August 2006 to July 2007, Assam Medical College & Hospital 165 patients were selected from OPD & Indoor on the basis of slide positivity for Plasmodium falciparum malaria by multiple observers. Divided into 3 groups, each group receiving Chloroquine (Group A) Oral: 25 mg/Kg over 3 days Quinine (Group B) I.V: 20mg/Kg load X 4hrs f/b 10mg/Kg 8hourly until oral Rx ( Total 7 d) Artesunate (Group C) I.V: 2.4mg/Kg f/b 1.2mg/Kg at 12h,24h & daily X 5days Clinical assessment and parasitological assessment was done before the initiation of treatment and at day 1, 2, 3, 7, and 14 of treatment and followed up at day 21 and 28 Resistant cases were treated as per WHO Malaria 2006 Guidelines Data analysed and interpreted by a single observer
5.
6. Coexistent other Systemic illness revealed on Clinical and laboratory evidence
19. Take Home Message Artesunate is the most efficacious and least toxic antimalarial and is associated with early recovery & discharge from hospital Parenteral Quinine though almost equally efficacious as artesunate, it’s use is associated with important adverse effects and needs close monitoring In management of uncomplicated falciparum malaria, the high prevalence of chloroquine resistance should be kept in mind by the clinicians
20. THANK YOU The Department Of Medicine, Assam Medical College,Dibrugarh
