We present a nonautonomous compartmental model that incorporates vaccination and accounts for the seasonal transmission of typhoid fever. The dynamics of the system are governed by the basic ...reproductive number R0. This demonstrates the global stability of the disease-free solution if R0<1. On the contrary, if R0>1, the disease persists and positive periodic solutions exist. Numerical simulations validate our theoretical findings. To accurately fit typhoid fever data in Taiwan from 2008 to 2023, we use the model and estimate its parameters using Latin hypercube sampling and least squares techniques. A sensitivity analysis reveals the significant influence of parameters such as infection rates on the reproduction number. Increasing vaccination coverage, despite challenges in developing countries, reduces typhoid cases. Accessible and highly effective vaccines play a critical role in suppressing the epidemic, outweighing concerns about the efficacy of the vaccine. Investigating possible parameter changes in Taiwan highlights the importance of monitoring and managing transmission rates to prevent recurring annual epidemics.
Mathematical models play a crucial role in predicting disease dynamics and estimating key quantities. Non-autonomous models offer the advantage of capturing temporal variations and changes in the ...system. In this study, we analyzed the transmission of typhoid fever in a population using a compartmental model that accounted for dynamic changes occurring periodically in the environment. First, we determined the basic reproduction number, R0, for the periodic model and derived the time-average reproduction rate, R0, for the non-autonomous model as well as the basic reproduction number, R0A, for the autonomous model. We conducted an analysis to examine the global stability of the disease-free solution and endemic periodic solutions. Our findings demonstrated that when R0<1, the disease-free solution was globally asymptotically stable, indicating the extinction of typhoid fever. Conversely, when R0>1, the disease became endemic in the population, confirming the existence of positive periodic solutions. We also presented numerical simulations that supported these theoretical results. Furthermore, we conducted a sensitivity analysis of R0A, R0 and the infected compartments, aiming to assess the impact of model parameters on these quantities. Our results showed that the human-to-human infection rate has a significant impact on the reproduction number, while the environment-to-human infection rate and the bacteria excretion rate affect long-cycle infections. Moreover, we examined the effects of parameter modifications and how they impact the implementing of efficient control strategies to combat TyF. Although our model is limited by the lack of precise parameter values, the qualitative results remain consistent even with alternative parameter settings.
Ciprofloxacin (CFX) and ketoprofen (KPN) are used widely in combination in veterinary interventions for bacterial infections, so in this study the effect of KPN was studied on the efficacy of CFX, by ...measuring its plasma concentration and pharmacokinetic parameters in 7-10 day-old chickens. The analgesic median effective dose (ED50) of KPN was determined to be 1.62 mg/kg, IM, in the chickens. The preferable analgesic dose of KPN to be used with CFX was 4 mg/kg, IM, which differs significantly from KPN 2 mg/kg, IM,. The CFX plasma concentrations alone (8 mg/kg, IM) measured at different times (0.5, 1, 2, 4 and 24 hours) were 3.31, 3.60, 3.21, 2.70 and 0.17 μg/mL while its concentration was elevated by 53, 54, 90, 107 and 418 % when coadministered with KPN (4 mg/kg, IM) to 5.05, 5.53, 6.10, 5.59 and 0.88 μg/mL in the chickens, respectively. CFX pharmacokinetic parameters, such as the area under the curve (AUC), the area under the moment curve (AUMC), mean residence time (MRT), half-life (t1/2β), Tmax, and Cmax increased when KPN was coadministered with CFX by 129, 289, 70, 49, 100 and 69 %, whereas the elimination rate constant (Kel), the volume of distribution at steady state (Vss) and clearance (Cl) decreased by 36, 34 and 58 %, respectively. It was concluded that coadministration of KPN alters the plasma concentration and the pharmacokinetic parameters of CFX, suggesting that the CFX dose can be reduced when used with KPN to achieve the desired concentration of CFX in the plasma, as an antibacterial for treatment of infected animals.
To investigate the knowledge, attitudes and practices of primary care physicians towards prostate cancer counseling and screening.
This cross sectional study was conducted in May 2009 to October 2009 ...through a survey questionnaire, which was distributed to all licensed primary care physicians in Riyadh, Saudi Arabia. The study took place in the Princes Al-Johara Al-Ibrahim Center for Cancer Research, King Saud University, Saudi Arabia. Data was obtained from 204 primary care physicians using self-reports of prostate cancer screening practices, knowledge, attitudes towards prostate cancer screening, and continuous medical education preferences. Respondents' characteristics were also collected.
Approximately 54.7% of the respondents were practicing counseling and referring prostate cancer patients. The mean correct knowledge score was 54.3%, their attitude was not strong; the only statement that approximately 70% of physicians agreed upon was about the value of screening, however, the reliability and evidence to support digital rectal examination and prostatic specific antigen were in question. Our primary care physicians had self-confidence in suspecting and referring high-risk patients for screening, but not for management and treatment.
Knowledge and attitude were found to be the most significant predictors that determine physicians' self practice. Physicians' practice towards a screening procedures or early detection of diseases should rely on a good background of information, which in turn enhances their self-efficacy and develops a good and positive attitude towards their practice skills.
Kombinacija ciprofloksacina (CFX) i ketoprofena (KPN) u širokoj je upotrebi u veterinarskom liječenju bakterijskih infekcija. Ovo je istraživanje provedeno kako bi se ustanovio utjecaj KPN-a na ...učinkovitost CFX-a mjerenjem njegove koncentracije u plazmi i farmakokinetičkih pokazatelja u pilića starih između 7 i 10 dana. Procijenjeno je da je prosječna doza analgetičke učinkovitosti (ED50) KPN-a u pilića 1,62 mg/kg, intramuskularno. Poželjna analgetička doza KPN-a bila je 4 mg/kg, intramuskularno, što se znakovito razlikuje od doze KPN-a od 2 mg/kg, intramuskularno,koja se daje s CFX-om. Koncentracije CFX-a u plazmi (8 mg/kg, im.) u različitim vremenima mjerenja (0, 5, 1, 2, 4 i 24 sata) bile su 3,31, 3,60, 3,21, 2,70 i 0,17 μg/mL, a primijenjene zajedno s KPN-om (4 mg/kg, im) porasle su za 53, 54, 90, 107 i 418 % i iznosile 5,05, 5,53, 6,10, 5,59 i 0,88 μg/mL. Farmakokinetički pokazatelji CFX-a, koji uključuju područje ispod krivulje (AUC), područje ispod krivulje momenta (AUMC), prosječno vrijeme zadržavanja (MRT),poluživot (t1/2β), Tmax, i Cmax, porasli su kad je KPN primijenjen s CFX-om za 129, 289, 70, 49, 100 i 69 %, dok su se konstanta brzine eliminacije (Kel), volumen distribucije u stabilnom stanju (Vss) i klirens (Cl) smanjili za 36, 34 i 58 %. Zaključeno je da zajednička primjena KPN-a i CFX-a mijenja koncentraciju u plazmi i farmakokinetička svojstva CFX-a. Navedeno upućuje na to da bi se doza CFX-a mogla smanjiti kad se primjenjuje u kombinaciji s KPN-om, pri čemu se postigla željena koncentracija CFX-a u plazmi kao antibakterijskog lijeka za zaražene živoitnje.
The practice of dispensing drugs in primary healthcare centers has shifted to community pharmacies in Saudi Arabia. These changes increase demand and mandate improving their services; one such is ...establishing pharmacy drive-thru services. To explore the effects of drive-thru services on the pharmacy profession, this study aimed to measure community pharmacists' acceptance, perception, and satisfaction regarding drive-thru services.
This cross-sectional study design was conducted in Saudi Arabia between January 2023 and May 2023—comparing the perception, acceptance, and satisfaction of pharmacists who work in a community pharmacy that provides a drive-thru service versus no drive-thru service. Community pharmacists were invited to complete an online questionnaire consisting of four sections developed from previous studies with some modifications. Descriptive statistical analysis and an independent t-test were utilized to test the difference between the two groups (providing drive-thru service vs. non) in their responses.
This study included 380 community pharmacists, of whom 33 % provided drive-thru services and 67 % did not. Pharmacists' perceptions of drive-thru services differed significantly. Those with drive-thru services perceived lower convenience for delivering drug information and patient counseling, and they were concerned about the potential impact on their health effects (M = 3.15, SD = 1.34) compared to those without (M = 3.58, SD = 1.10), t (378) = -3.32, p < 0.01). However, they recognized the convenience of serving sick patients, the elderly, disabled individuals, and mothers with children in cars (M = 3.71, SD = 1.17), which was higher than those without (M = 4.04, SD = 1.21), t (378) = -2.70, p < 0.01). Regarding the current pharmacy layout suitability, pharmacists with drive-thru services found it more suitable (M = 3.13, SD = 1.14) than those without (M = 2.49, SD = 1.14), t (378) = 5.1, p < 0.01). However, the two groups had no significant difference in overall satisfaction.
Pharmacists working in pharmacies offering drive-thru services recognized certain benefits but also expressed concerns about health effects and decreased convenience for counseling. These findings provide valuable insights for policymakers and pharmacy management, highlighting the nuanced views of pharmacists in adopting drive-thru services.
Cardiovascular disease is the leading cause of death and disability worldwide. It is a general term used to describe a group of disorders that affect the heart or blood vessels. This study aimed to ...evaluate the prevalence and predictors of polypharmacy in patients with heart failure.
We conducted a cross-sectional study in a tertiary hospital in Saudi Arabia. Data was extracted from an electronic database between January 2019, and December 2022. The study included all adult patients with heart failure who visited outpatient clinics; individuals with cancer were excluded. The outcome variable in our study was “polypharmacy” which was defined as the use of eight or more medications. Descriptive analysis was performed using frequencies and percentages for categorical variables. In addition, Multivariate logistic regression was used to assess the covariates associated with polypharmacy.
A total of 331 patients with heart failure were included in this study. The prevalence of polypharmacy among our HF population was 39.88 %. Most participants were male (60.73 %), and 60 years or older (68 %). The most frequently used medications were beta-blockers (67.98 %) and diuretics (58.31 %), whereas the least frequently used medications were hydralazine and histamine H2 blockers (5.74, and 3.02 %, respectively). Polypharmacy was likely to be a non-significantly higher in individuals aged between 60 and 69 years (adjusted odds ratio (AOR) = 1.52; 95 % confidence interval (CI) 0.78–2.98) and suffering from hypertension (AOR = 1.48; 95 % CI 0.83–2.64). However, patients with heart failure and diabetes mellitus had a significant six-fold higher of polypharmacy than those without diabetes mellitus (AOR = 6.55; 95 % CI 3.71–11.56).
Patients with heart failure often use multiple medications. Patients with heart failure together with diabetes have a higher risk of polypharmacy. Therefore, healthcare professionals should manage polypharmacy to improve the outcomes in patients with heart failure.
Hepatotoxicity caused by chemotherapeutic drugs (e.g., doxorubicin) is of critical concern in cancer therapy. This study focused on investigating the modulatory effects of diosmin against ...doxorubicin-induced hepatotoxicity in Male Wistar rats. Male Wistar rats were randomly divided into four groups: Group I was served as control, Group II was treated with doxorubicin (20 mg/kg, intraperitoneal, i.p.), Group III was treated with a combination of doxorubicin and low-dose diosmin (100 mg/kg orally), and Group IV was treated with a combination of doxorubicin and high-dose diosmin (200 mg/kg orally) supplementation. A single dose of doxorubicin (i.p.) caused hepatic impairment, as shown by increases in the concentrations of serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. Doxorubicin produced histological abnormalities in the liver. In addition, a single injection of doxorubicin increased lipid peroxidation and reduced glutathione, catalase, and superoxide dismutase (SOD) levels. Importantly, pre-treatment with diosmin restored hepatic antioxidant factors and serum enzymatic activities and reduced the inflammatory and apoptotic-mediated proteins and genes. These findings demonstrate that diosmin has a protective effect against doxorubicin-induced hepatotoxicity.
Neonatal sepsis is a global concern with increasing morbidity and mortality. The burden of neonatal sepsis is highest in developing countries, especially in those lacking proper surveillance systems. ...The causative pathogens and their drug-resistance levels vary between countries with emergence of multidrug resistance organisms. Thus, accurate records on the recent trends of organisms causing neonatal sepsis will provide vital information for appropriate intervention. We aimed to investigate neonatal sepsis, identify its associated factors and causative pathogens and to assess the antibiotic susceptibility patterns in Sana'a city, Yemen. A cross-sectional study was conducted on neonates admitted to intensive care units of six hospitals in Sana'a city, Yemen, in the period from January 15, to March 30, 2020. Natal and prenatal medical data were collected using well-structured questionnaire. Neonates were subjected to sepsis work-up including blood culture, complete blood count and C-reactive protein. Organisms were identified by Gram staining and analyzed by the VITEK II system for bacterial bio-typing and antibiotic susceptibility testing. Of the 199-neonates with suspected neonatal sepsis, 154 (77.38%) had culture-proven sepsis. Early-onset neonatal sepsis (EOS) was higher (50.25%; 100/199) than late-onset neonatal sepsis (LOS) (27.13%; 54/199). Multivariable analysis identified vaginal delivery as an independent risk factor for neonatal sepsis p = 0.005. Majority of isolated bacteria (74.39%) were gram-negative with Burkholderia cepacia (39%) and Klebsiella oxytoca (13%) being the most common pathogens of EOS and LOS. The most common gram-positive pathogens were Staphylococcus haemolyticus (9.1%) and Staphylococcus epidermidis (7.1%). B. cepacia showed multidrug resistance except for cefepime. All Klebsiella species isolates (100%) and most Pantoea species (93%) were ESBL and carbapenemase positive. All Escherichia coli and Acinetobacter baumannii isolates were ESBL positive. A significant number of gram-positive bacteria showed resistance to vancomycin. The study findings show a high proportion of neonatal sepsis among neonates admitted to hospitals in Sana'a city with antibiotic-resistant B. cepacia being the single most common pathogen causing EOS and LOS. Findings also emphasize the emerging threat of multidrug-resistant bacteria in neonatal units and will help develop evidence-based management of neonatal sepsis in Yemen.
To investigate the trends of hospital admissions concerning diseases of the eye and adnexa in the United Kingdom in the past 20 years.
An ecological study was conducted using hospital admission data ...taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data for diseases of the eye and adnexa were extracted for the period between April 1999 and March 2019. The trend in hospital admissions was assessed using a Poisson model.
Hospital admission rate for diseases of the eye and adnexa increased by 73.8% from 7.48 (95% CI 7.45-7.50) in 1999 to 13.00 (95% CI 12.97-13.02) in 2019 per 1000 persons, trend test, p < 0.001. The most common cause of hospitalisation for diseases of the eye and adnexa was disorders of the lens (62.3%), followed by disorders of the choroid and retina (14.2%), followed by disorders of the eyelid, lacrimal system and orbit (11.5%). Hospital admission rate among males increased by 91.2% from 6.19 (95% CI 6.16-6.22) in 1999 to 11.83 (95% CI 11.80-11.87) in 2019 per 1000 persons. Hospital admission rate among females increased less sharply by 63.2% from 8.71 (95% CI 8.68-8.75) in 1999 to 14.22 (95% CI 14.18-14.26) in 2019 per 1000 persons.
There are clear gender and age trends in the epidemiology of hospital admissions related to eye and adnexa disorders. Further observational studies are warranted to identify other risk factors for these important causes of hospitalisation and understanding of differential trends.
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