There is no consensus about the relationships between chorioamnionitis and 3 pulmonary outcomes of concern for preterm infants:respiratory distress syndrome,pneumonia/sepsis,and bronchopulmonary dysplasia.Intrauterine infection increases the risk of neonatal infection including sepsis/pneumonia,also increases the incidence of bronchopulmonary dysplasia,but may reduce the incidence and severity of respiratory distress syndrome.In recent years,translational research with various animal models has been helpful to answer basic questions about the effect of antenatal inflammation on maturation and development of the fetal lung and immune system.Although the mechanisms are not entirely clear,chorioamnionitis predisposes infants to premature birth,neonatal sepsis,and other adverse outcomes.In this article,we reviewed the relationship of intrauterine infection and neonatal pulmonary morbidity.

Paradoxical reactions in tuberculosis have been reported in patients with tuberculous meningitis and appear as intracranial tuberculomas within 14–270 days of starting antituberculous therapy (ATT). Paradoxical reactions are due to the immune response of the host to ATT. They are commonly seen in the intensive phase of chemotherapy. However, paradoxical reactions occurring after completion of ATT are rare. We report 2 patients with tuberculous meningitis who had already completed ATT and then developed tuberculomas.

Entamoeba histolytica, the causative agent for human amoebiasis, is among the most deadly parasites, accounting for the second highest mortality rate among parasitic diseases. Because this parasite dwells in low oxygen tension, for its cultivation, microaerophilic conditions are required to mimick the human gut environment. Several methods developed for optimal growth environment are commercially available and some are conventionally modified in-house which include the Anaerocult A and oil blocking preparation methods. This study was undertaken to compare the reliability of the Anaerocult A and the oil blocking methods in generating anaerobic environment for cultivation of E. histolytica. The trophozoites of E. histolytica HM1: IMSS strains were axenically cultivated in TYI-S-33 medium in culture incubated anaerobically by using Anaerocult A (Merck) and mineral oil blocking method. The outcomes of both methods were determined by the minimum inhibitory concentration (MIC) of metronidazole against E. histolytica by giving a score to the growth pattern of the trophozoites. The reliability of both methods was assessed based on susceptibility testing of E. histolytica to metronidazole. The MIC obtained by both anaerobic condition methods was 6.25ug/ ml, thus showing that oil-blocking method is comparable to the Anaerocult A method and therefore, considered as a reliable method for generating an anaerobic environment for the cultivation of E. histolytica.

The use of medicines in unlicensed and off-label manner for adults is less common with limited research compared to children. This research was carried out to characterise unlicensed and off-label use of medicines in adult intensive care patients of a hospital in Malaysia. Data on medications prescribed to patients were collected from the patients’ medical records and the unlicensed and off-label status for each medicine were determined. Forty nine (73.1%) and 20 (29.9%) patients from a total of 67 patients received at least one medicine in an unlicensed and off-label manner, respectively. The most common reason for off-label use of medicines was higher than the licensed dosing frequency (29.6%). The most common unlicensed and off-label medicine used was amlodipine tablet (5.8%) and IV metoclopromide (11.1%), respectively. Length of stay in the ICU was a significant predictor for unlicensed use of medicines (OR 1.219; 95% CI 1.022-1.456; p=0.028) and number of medication prescribed was a significant predictor for off-labelled use of medicines (OR 1.130; 95% CI 1.010-1.263; p=0.032). There was substantial prescribing of unlicensed medicines compared to off-label medicines in the adult ICU highlighting the need for more research to be carried out considering the critical condition of the patients.

This paper explains how to select the correct statistical test for a research project, clinical trial, or other investigation. It is important that the appropriate statistical analysis is decided upon before starting the study, at the stage of planning itself, to get correct analysis of data. This cannot be decided arbitrarily after the study is over and data has already been collected. Many studies have been rejected due to faulty selection of statistical test. The test to be used depends upon the type of research question being asked. The other determining factors are the type of data being analyzed and the number of groups or data sets involved in the study.

A selective, sensitive and precise assay based on solid phase extraction and liquid chromatography–tandem mass spectrometry (LC–MS/MS) was developed for the simultaneous determination of amiloride (AMI) and hydrochlorothiazide (HCTZ) in human plasma. Sample clean-up with 250 μL of plasma was done on Phenomenex Strata?-X extraction cartridges using their labeled internal standards (AMI-15N3 and HCTZ- 13C,d2). Chromatography was performed on Hypersil Gold C18 (50 mm×3.0 mm, 5 μm) column using acetonitrile with 4.0 mM ammonium formate (pH 4.0, adjusted with 0.1% formic acid) (80:20, v/v) as the mobile phase. Detection was carried out on a triple quadrupole API 5500 mass spectrometer utilizing an electrospray ionization interface and operating in the positive ionization mode for AMI and negative ionization mode for HCTZ. Multiple reaction monitoring was used following the transitions at m/z 230.6/116.0, m/z 233.6/116.0, m/z 296.0/204.9 and m/z 299.0/205.9 for AMI, AMI-15N3, HCTZ and HCTZ-13C,d2, respectively. Calibration curves were linear (r2≥0.9997) over the concentration range of 0.050–50.0 and 0.50–500 ng/mL for AMI and HCTZ, respectively, with acceptable accuracy and precision. The signal-to-noise ratio at the limit of quantitation was ≥14 for both the analytes. The mean recovery of AMI and HCTZ from plasma was 89.0% and 98.7%, respectively. The IS-normalized matrix factors determined for matrix effect ranged from 0.971 to 1.024 for both the analytes. The validated LC–MS/MS method was successfully applied to a bioequivalence study using 5 mg AMI and 50 mg HCTZ fixed dose tablet formulation in 18 healthy Indian volunteers with good reproducibility.

A selective, sensitive and precise assay based on solid phase extraction and liquid chromatography–tandem mass spectrometry (LC–MS/MS) was developed for the simultaneous determination of amiloride (AMI) and hydrochlorothiazide (HCTZ) in human plasma. Sample clean-up with 250 μL of plasma was done on Phenomenex Strata?-X extraction cartridges using their labeled internal standards (AMI-15N3 and HCTZ- 13C,d2). Chromatography was performed on Hypersil Gold C18 (50 mm×3.0 mm, 5 μm) column using acetonitrile with 4.0 mM ammonium formate (pH 4.0, adjusted with 0.1% formic acid) (80:20, v/v) as the mobile phase. Detection was carried out on a triple quadrupole API 5500 mass spectrometer utilizing an electrospray ionization interface and operating in the positive ionization mode for AMI and negative ionization mode for HCTZ. Multiple reaction monitoring was used following the transitions at m/z 230.6/116.0, m/z 233.6/116.0, m/z 296.0/204.9 and m/z 299.0/205.9 for AMI, AMI-15N3, HCTZ and HCTZ-13C,d2, respectively. Calibration curves were linear (r2≥0.9997) over the concentration range of 0.050–50.0 and 0.50–500 ng/mL for AMI and HCTZ, respectively, with acceptable accuracy and precision. The signal-to-noise ratio at the limit of quantitation was ≥14 for both the analytes. The mean recovery of AMI and HCTZ from plasma was 89.0% and 98.7%, respectively. The IS-normalized matrix factors determined for matrix effect ranged from 0.971 to 1.024 for both the analytes. The validated LC–MS/MS method was successfully applied to a bioequivalence study using 5 mg AMI and 50 mg HCTZ fixed dose tablet formulation in 18 healthy Indian volunteers with good reproducibility.

Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
perception ; validity ; chronic disease

A sensitive and selective method has been proposed for the simultaneous determination of amlodipine (AML), valsartan (VAL) and hydrochlorothiazide (HCTZ) in human plasma by liquid chromatography–tandem mass spectrometry (LC–MS/MS). The analytes and their deuterated analogs were quantitatively extracted from 100 μL human plasma by solid phase extraction on Oasis HLB cartridges. The chromatographic separation of the analytes was achieved on a Chromolith RP18e (100 mm × 4.6 mm) analytical column within 2.5 min. The resolution factor between AML and VAL, AML and HCTZ, and VAL and HCTZ was 2.9, 1.5 and 1.4, respectively, under isocratic conditions. The method was validated over a dynamic concentration range of 0.02–20.0 ng/mL for AML, 5.00–10,000 ng/mL for VAL and 0.20–200 ng/mL for HCTZ. Ion-suppression/enhancement effects were investigated by post-column infusion technique. The mean IS-normalized matrix factors for AML, VAL and HCTZ were 0.992, 0.994 and 0.998, respectively. The intra-batch and inter-batch precision (% CV) across quality control levels was ≤ 5.56% and the recovery was in the range of 93.4%–99.6% for all the analytes. The method was successfully applied to a bioequivalence study of 5 mg AML + 160 mg VAL + 12.5 mg HCTZ tablet formulation (test and reference) in 18 healthy Indian males under fasting. The mean log-transformed ratios of Cmax, AUC0–120h and AUC0-inf and their 90% CIs were within 90.2%–102.1%. The assay reproducibility was demonstrated by reanalysis of 90 incurred samples.