Evaluation of Ceftriaxone Use for Hospitalized Patients in Ethiopia: The Case of a Referral Hospital

 

Negese Sewagegn*, G/ Mariam Ayichew, Amsale Miskir, Asmamaw Degarege, Omer Mohammed, Tenaw Andualem

Background: Microorganisms resistance has grown due to frequent and misuse of antimicrobial agents both in humans and animals resulting in global public health and economic threats. We evaluated the prescribing practices of ceftriaxone at inpatients, Felege hiwot referral hospital in Ethiopia. 
Methods: We retrospectively reviewed the prescribing practices of ceftriaxone in 127 in patients who received ceftriaxone between April 1, 20015 and June 30, 2015. Ceftriaxone use evaluation was based on standards set by World health organization. The criteria used in this evaluation were indication for use; the dose, frequency, duration, contraindication and interaction. The presence of a single error in either of the individual criteria was considered as inappropriate use. 
Results: The overall evaluation of use of ceftriaxone was inappropriate in 88 cases (70.0%) which seems higher than other hospitals in Ethiopia. Inappropriate use of ceftriaxone by diagnosis were, acute abdomen 23 (79.3%), pneumonia 19 (67.9%), sepsis 12 (75.0%), trauma 8 (80.0%), obstructed labor 7 (53.9%), elective surgical cases 6 (75.0%), meningitis 4 (44.4%), lower urinary tract infection 3 (100.0%), upper urinary tract infection 1 (50.0%), and others 5 (55.6%). The inappropriate use of ceftriaxone by the different units of inpatients were surgery 41cases (74.5%), internal medicine 19 cases (65.5%), gynecology and obstetrics 20 (74.1%), and pediatrics 8 (50%). Most of the durations of prescribing showed a high rate of inappropriateness which accounts 60 cases (47.2%) of the total inappropriateness followed by frequency 11 (8.7%), interaction 9 (7.1%), indication 6 (4.7%) and contraindication 2 (1.6%) respectively. 
Conclusions: Inappropriate prescribing of ceftriaxone was higher compared to other hospitals in Ethiopia. Antimicrobial stewardship in general and prudent prescribing of ceftriaxone in particular is needed to improve its useful life. This research can be extrapolated to other antimicrobials and health facilities for appropriate interventions.

 The Plasma Kinetic of Tumor Biomarkers: Experience of the Oran EHU

 

H. Chadou*, I. Senhadji , Inh.Bakhti, Benabdellah, Bensayeh, Lazreg, H. Fetati, Fzn.Mekaouche, N. Belbouche, F. Boudia, Toumi

The success of therapeutic control of tumor processes depends on their early diagnosis. It is therefore necessary to develop both reliable and simple methods for identifying tumors from the early stages of evolution. This demand is at the basis of the development of biological markers of cancer called tumor markers (TM) [2,10,11]. The range of measurable tumor markers expand day by day, although some of them are not discriminative of a benign or malignant process, their utility remains considerable in the assessment of therapeutic effect and the surveillance of the disease evolution after treatment [10,8,11,12]. The Interpretation of the serum levels of TM is based on the kinetics’ notion is more sensitive and relevant than that based on the static threshold [5,9,11], the later value of which is neither adapted to the nature of the treatment nor the precocity of the signal even the assay reagents used as well. Within this study, “CHADOU TUMOR MARKER KINETIC” or CHA-TM KINETIC software was developed by Dr H. CHADOU. It allows automatically plotting the tumor marker evolution curves within time function [3, 10, 11], as well as the calculation of the biological parameters associated with each marker (initial concentration, apparent half-life [7,8,11], nadir, doubling time) [1,4,8,410,11,12]. The objective of this work is to demonstrate, through a case study, the importance of this software in the management of patients with different cancers such as breast, ovarian cancer and digestive cancers, at the University Hospital 1st November 1954 - ORAN (EHUO)

New Strategies for Treatment of Alzheimer’s Disease

 

Mennat- Allah Abdelsamed* 

Alzheimer's disease is a degenerative disease and one of diseases that related to ageing and mostly happened with elderly people , and one of diseases that was has no determinant treatment , but now a days many new strategies have been discovered in the treatment of Alzheimer include drugs reduced amyloid peptide (AB) production , drugs prevent AB aggregation , drugs reduce inflammation associated with Alzheimer, cholinesterase inhibitor and N-methyl-d-aspartate ( NMDA ) antagonist like memantine, Indoleamine 2, 3-dioxygenase( IDO) inhibitor such as Coptisine which is a traditional Chinese medicinal prescription, and others some of it be approved in clinical trial and others still under investigation.

A Quantitative in Vitro Determination of Relative Phototoxic Potential of Quinolone Antibiotics

Byungse Suh *, Jason J. Suh, Ingi Lee, Tatyana Shapiro, Peter Axelrod, and Allan L. Truant

Quinolones are known to cause phototoxicity which is not readily predictable. Currently there is no dependable method to quantitate the phototoxic potential of these compounds. We constructed an in vitro model to determine phototoxic potential, using eleven quinolones, murine fibroblast cells (3T3) and UVA light. The quinolones included: naladixic acid (NDX), ciprofloxacin (CPX), fleroxacin (FLX), lomefloxacin (LMX), levofloxacin (LVX), ofloxacin (OFX), amifloxacin (AMX), norfloxacin (NFX), sparfloxacin (SPX), enoxacin (ENX), and Bay y3118. Minocycline (MCN) was used as a non-phototoxic standard. Test cells were exposed to quinolones in varying concentrations, followed by exposure to UV light (5-8 joules/cm2 ). Drug and UV controls were treated without quinolone and UV exposure, respectively. Cells were incubated overnight; cellular integrity was measured by neutral red (NR) uptake. Cellular damage induced by test compounds compared with controls was measured, and the drug concentration (µg/ml) which caused a 50% decrease was designated as PTD50. The PTD50 values (in parentheses) for quinolones studied were as follows: ENX (2.5), NDX (5), BAY (7.5), SPX (20), NFX (25), LMX (30), LVX (35), OFX (40), CPX (40), FLX (45), MCN (50), and AMX (>50). This fibroblast-NR assay system may be a useful tool to estimate the relative phototoxic potential of quinolones

Semiempirical Molecular Orbital Calculations for 3d-4f Complexes Towards Artificial Metalloproteins

 

Takashiro Akitsu*, Atsuo Yamazaki

Because computational chemistry for proteins or metalloproteins, docking of ligands into proteins, and small molecules as ligands may be require heavy calculations, low-precision but fast computational methods may be useful actually. Herein we introduce our preliminary results of semiempirical PM7 calculations for chiral Schiff base 3d-4f binuclear metal complexes containing many electrons. Computational simulation of docking of ligands into proteins was used in drug design and discovery in silico commonly. Moreover, metal complexes as well as organic ligands were also treated in new study on protein surface mimetics1 besides purely biochemical protein-protein interactions.2 Recently, not only docking programs such as GOLD3 , the PM6 semi-empirical method was applied to modeling proteins for enhancing docking accuracy4 .
Of course, proteins are large systems composed of many atoms. However, even ligands may be many electron systems when a ligand contains heavy metal atoms such as third transition metals or lanthanide metals. Indeed, we have reported on fluorescence, UV-vis and CD spectral changes by docking of chiral Schiff base 3d (zinc(II)) or the related 3d-4f complexes into lysozyme or HSA proteins experimentally5 . Furthermore, in the course work of organic/inorganic hybrid materials, we have begun to prepare artificial metalloproteins by using various proteins and metal complexes. Here we show results of calculation of the analogous 3d-4f complexes 6,7 not by precise TD-DFT methods but by semiempirical molecular orbital method Sparkle/PM78 and ORCA 9 in a MOPAC2012 package mainly to obtain optimized structures (Fig. 1) towards protein-ligand interaction and simulated UVvis spectra theoretically (Fig. 2). As for Nd(III)-Cu(II) complex, differences of coordination bond distances between crystal structures and calculations were less than 0.0746 and 0.0286 nm for Cu(II) and Nd(III) coordination environments, respectively.
The corresponding values are 0.0027 and 0.0594 nm for La(III)-Ni(II) complex, 0.00050 and 0.0489 nm for La(III)-Cu(II) complex, and 0.0053 and 0.0486 nm for Nd(III)-Ni(II) complex, respectively. Thus acceptable results in structures could be also obtained in considerably shorter time than TD-DFT regardless of so many 4f-electron systems.