CPC plus CHX mouthwash fails to reduce COVID-19 viral load of saliva

Preprocedural rinsing with cetylpyridinium chloride plus chlorhexidine mouthwash fails to reduce COVID-19 viral load of saliva suggests a new study published in the of Clinical Periodontology.

This study aimed to investigate the efficacy of a 0.05% cetylpyridinium chloride–0.05% chlorhexidine (CPC–CHX) mouthwash in reducing viral load in the saliva as compared with sterile water. Forty SARS-CoV-2 positive patients were asked to dispense 4 mL of saliva. Half the patients rinsed for 60 s with 15 mL CPC–CHX, and the remaining patients rinsed with sterile water (control). Four millilitres of saliva were collected after 15, 30 and 60 min after rinsing. Quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) specific for SARS-CoV-2 nucleocapsid protein were performed. For ELISA, the intact (representing the active virus) to total virus load (I/T) was calculated.Results: SARS-CoV-2 copy numbers/mL from RT-qPCR tended to decrease in the control group, whereas in the CPC–CHX group, an increase was observed after T30. However, mixed linear model analysis revealed no statistical differences between groups (p = .124), time points (p = .616) and vaccinated or non-vaccinated patients (p = .953). Similarly, no impact of group (p = .880), time points (p = .306) and vaccination (p = .711) was observed for I/T ratio values. Within the limitation of this study, there was no evidence that the intervention reduced salivary SARS-CoV-2 viral load during the course of 60 min. Therefore, commonly used pre-procedural rinsing might not be clinically relevant.

Reference: Giulia, B., Viktoria, W., Robert, K., Michael, B., Nadine, L., Jürgen, B., Beryl, S.-H., Jörg, T., & Kathrin, B. (2023). Eligibility and efficacy of a CPC- and CHX-based antiviral mouthwash for the elimination of SARS-CoV-2 from the saliva: A randomized, double-blind, controlled clinical trial. Journal of Clinical Periodontology, 1–9. https://doi.org/10.1111/jcpe.13905

Keywords: Preprocedural, rinsing, with, cetylpyridinium, chloride, plus, chlorhexidine, mouthwash, fails, to, reduce, COVID-19, viral load, saliva, Journal of Clinical Periodontology, Giulia, B., Viktoria, W., Robert, K., Michael, B., Nadine, L., Jürgen, B., Beryl, S.-H., Jörg, T., & Kathrin, B

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Use of computerized insulin order may improve blood sugar control in hospitalized cardiac patients

Saudi Arabia: A recent study published in Cardiovascular Endocrinology & Metabolism has shed light on the effect of implementing computerized insulin order sets for managing hyperglycemia in hospitalized cardiac patients.

The researchers revealed an association between using computerized insulin order sets and potential improvements in fasting and random glycemic control without raising the risk of hypoglycemia or hyperglycemia.

Diabetes is a global health problem affecting 537 million people worldwide, and this number may rise to 783 million in 2045, according to the International Diabetes Federation. Glycemic control is pivotal in managing hospitalized patients with type 2 diabetes mellitus (T2DM), and it presents as a clinical challenge in the cardiac population.

There is no published evidence to determine the effectiveness of insulin order sets to control BGLs in the cardiac population in Saudi Arabia. Considering this, Raed Ehsan Kensara, King Abdullah International Medical Research Center, Saudi Arabia, and colleagues aimed to determine the impact of computerized insulin order sets in type 2 diabetes hospitalized cardiac patients in a quasi-experimental, pre- and post-study design.

The study included T2DM patients hospitalized for at least 3 days. Those undergoing cardiac surgery were excluded. The study’s primary endpoint was determined as the mean difference in random blood glucose level (BGL) before and following the implementation of insulin order sets. The secondary endpoints were to compare the median differences in fasting BGLs and the number of hypoglycemic and hyperglycemic episodes during the first seven days.

The study comprised three phases: pre-implementation, intervention and post-phase. Insulin order sets were integrated into the electronic prescribing system in the intervention phase, and education was provided to the cardiology department. The post-phase included the patient’s post-implementations. During the study period, a total of 194 patients were enrolled.

The study revealed the following findings:

  • The mean random BGL was 11.17 mmol/L, 95% CI, 10.6–11.7 in the pre-phase and 9.5 mmol/L, in the post-phase.
  • The median fasting BGL was 9.2 mmol/L in the pre-phase and 8.5 mmol/L, in the post-phase.
  • The number of hypoglycemic episodes was 24 in pre-phase and 33 in post-phase.

In the quasi-experimental, pre- and post-study, “we found that the designed subcutaneous insulin treatment protocol integrated as order sets into the hospital computerized prescriber order entry (CPOE) system positively affected improving random and fasting BGLs in cardiac diabetic patients without increasing hypoglycemia risk,” the researchers wrote.

“Future research directions are to design insulin treatment protocols for glycemic control in the critical care setting, implement the protocol as an order set and then evaluate the impact of the insulin order sets in this population,” they concluded.

Reference:

Kensara, Raed Ehsana,b; Ismail, Sherina,b,c; Aseeri, Mohammeda,b,d; Hasan, Hania,b; Al Rahimi, Jamilahb,d,e; Zarif, Hawazenb,d,f; El Khansa, Saraa,b. The impact of the implementation of computerized insulin order sets for the control of hyperglycemia in hospitalized cardiac patients. Cardiovascular Endocrinology & Metabolism 13(1):e02961, March 2024. | DOI: 10.1097/XCE.0000000000000296

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BMI may independently predict non-calcified plaque presence among patients with a CAC 0: Study

Iraq: The presence of non-calcified plaque in patients with a coronary calcium score of 0 is associated with diabetes mellitus, advanced age, high body mass index (BMI), and increased pericardial fat volume (PFV), a recent study has revealed.

The researchers revealed that after multivariate adjustment, increased body mass index remained a significant predictor for the presence of non-calcified plaque. The findings were published online in the Indian Heart Journal on December 19, 2023.

CAC = 0 in patients with low-intermediate risk for coronary artery disease (CAD) confers a low risk of mortality and morbidity after 10 years of follow-up as reported in large cohort studies. However, a CAC score of 0 does not consider the presence of non-calcified plaques, which cannot be detected by routine CAC scan or conventional angiography and may have prognostic implications when identified by CT coronary angiography.

The early stage of coronary atherosclerosis involves non-calcified coronary plaque formation, which is linked with increased shear stress and positive remodelling of the coronary vessel. This type of coronary plaque is more likely to rupture and form a thrombus, likely causing acute coronary syndrome or sudden cardiac death compared to calcified plaque, which represents a late phase of coronary atherosclerosis and a more stable lesion. Hence, identifying the potential predictors of non-calcified plaque is important for risk stratification and risk factor control in patients with suspected CAD, specifically when CAC = 0.

Abdulameer A. Al-Mosawi, University of Kufa, Najaf, Iraq, and colleagues therefore aimed to assess the association of PFV and classical coronary risk factors with non-calcified plaque presence in patients with suspected coronary artery disease and CAC = 0 in a retrospective study conducted between January 2013 and April 2022.

The study involved 811 patients with chest pain suggestive of angina. They underwent CT coronary angiography for the assessment of CAD. Of these, the analysis included 417 with CAC = 0.

The study led to the following findings:

  • Patients with non-calcified plaque were older (54 ± 9 versus 50 ± 10) and had a higher prevalence of diabetes mellitus (31% versus 17%), high BMI (29.9 versus 28.3), and increased PFV (123 cm3 versus 99 cm3) compared to patients without plaque.
  • In multivariate regression analysis, high BMI [OR = 1.1] was an independent predictor of non-calcified coronary plaque presence among patients with CAC = 0 after adjustment to variables in the univariate analysis.

“In patients with CAC = 0, diabetes mellitus, advanced age, high BMI, and increased PFV were all associated with the presence of non-calcified plaque,” the researchers wrote. “After multivariate adjustment, increased BMI remained a significant independent predictor for non-calcified plaque presence.”

Reference:

Al-Mosawi, A. A., Nafakhi, H., & Alabayechi, Y. S. (2023). Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0. Indian Heart Journal. https://doi.org/10.1016/j.ihj.2023.12.006

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Use of triangle tip-jet knife for peroral endoscopic myotomy effective in patients with achalasia

A recent study unveiled a novel modification to the Triangle Tip Knife J (TTJ), a tool commonly utilized in peroral endoscopic myotomy (POEM) procedures for esophageal motility disorders like achalasia. This study was published in the journal of Gastrointestinal Endoscopy by Kimoto Y. and colleagues.

This modification involved adapting the TTJ with a disposable clip sheath, termed TTJ with hood attachment (TTJ-H). The study aimed to compare the safety and efficacy of TTJ and TTJ-H in POEM treatments. The retrospective cohort study, using a 1:1 propensity score matching, delved into several key parameters among 196 patients who underwent POEM between January 2021 and June 2023. The comparison between TTJ and TTJ-H revealed notable findings:

  • Procedure time reduction: TTJ-H exhibited a significant decrease in the mean procedure time from 93.5 to 80.2 minutes, marking a notable 14% reduction (P = 0.012).

  • Enhanced myotomy efficiency: The use of TTJ-H improved myotomy efficiency substantially, displaying a 16% increase from 2.76 to 2.32 minutes per centimeter (P < 0.001).

  • Reduced coagulation forceps usage: TTJ-H demonstrated a remarkable reduction in coagulation forceps usage for hemostasis, dropping from 3.87 to 0.55, showcasing an impressive 86% decrease (P < 0.001).

Overall, the study findings suggest that incorporating the TTJ-H modification into POEM procedures can yield several advantages, including reduced procedure time, improved myotomy efficiency, and decreased reliance on coagulation forceps. These enhancements not only contribute to procedural streamlining but also potentially reduce overall costs associated with the treatment.

This innovative adaptation offers promise in optimizing the efficacy and safety of endoscopic surgeries for esophageal motility disorders. The potential to minimize procedure duration and enhance precision holds substantial implications for patients undergoing these interventions.

Reference:

Kimoto, Y., Inoue, H., Shimamura, Y., Azuma, D., Ushikubo, K., Yamamoto, K., Okada, H., Nishikawa, Y., Tanaka, I., Jandee, S., Navarro, M. J., & Onimaru, M. Hood attached vs conventional triangular tip-jet knife in peroral endoscopic myotomy: a propensity score matching cohort study. Gastrointestinal Endoscopy,2023. https://doi.org/10.1016/j.gie.2023.12.001

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Extended use of inclisiran safe and efficacious among refractory dyslipidemia in patients with increased CV risk

A recent study sheds light on the safety profile of inclisiran, an innovative agent designed to reduce low-density lipoprotein cholesterol (LDL-C). The research aimed to provide comprehensive evidence on the long-term safety of inclisiran, a small interfering RNA agent with promising implications for managing dyslipidemia. This study was published in the Journal Of The American College Of Cardiology by Scott Wright and colleagues.

The post hoc analysis encompassed patients treated with 300 mg inclisiran sodium or placebo across completed (ORION-1, -3, -5, -9, -10, and -11) and ongoing (ORION-8) trials. Key findings from the study:

  • Patient Cohort: The analysis involved 3,576 patients receiving inclisiran for up to 6 years and 1,968 patients on placebo for up to 1.5 years, accounting for 9,982.1 and 2,647.7 patient-years of exposure, respectively. Baseline characteristics were similar across groups, ensuring a balanced comparison.

  • Safety Assessment: Kaplan-Meier analyses revealed that treatment-emergent adverse events (TEAEs), particularly serious ones or those leading to discontinuation, as well as hepatic, muscle, and kidney-related events, exhibited comparable rates between inclisiran and placebo groups for up to 1.5 years. Notably, trends continued favorably for inclisiran beyond this timeframe.

  • Cardiovascular Events: Fewer major cardiovascular events were reported as TEAEs with inclisiran during the observed period, hinting at potential cardiovascular benefits beyond cholesterol reduction.

  • Antidrug Antibodies: Treatment-induced antidrug antibodies were infrequent with inclisiran, reported in 4.6% of cases, with only a small fraction showing persistence (1.4%). Importantly, the presence of these antibodies did not associate with a higher incidence of TEAEs leading to drug discontinuation or serious TEAEs.

The study’s conclusive findings emphasize the favorable long-term safety profile of inclisiran in a diverse patient population with dyslipidemia. This robust evidence underscores the absence of new safety concerns and reiterates the promising safety profile of inclisiran as a therapeutic option for managing cholesterol levels.

The study’s comprehensive analysis, spanning multiple trials and years of patient data, provides valuable insights into inclisiran’s safety landscape. These findings contribute significantly to validating inclisiran’s safety, fostering confidence in its use for patients grappling with dyslipidemia.

Reference:

Wright, R. S., Koenig, W., Landmesser, U., Leiter, L. A., Raal, F. J., Schwartz, G. G., Lesogor, A., Maheux, P., Stratz, C., Zang, X., & Ray, K. K. Safety and tolerability of inclisiran for treatment of hypercholesterolemia in 7 clinical trials. Journal of the American College of Cardiology,2023;82(24):2251–2261. https://doi.org/10.1016/j.jacc.2023.10.007

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Aficamten improved outcomes for patients with obstructive hypertrophic cardiomyopathy: Phase 3 SEQUOIA-HCM trial

USA: The pivotal Phase 3 clinical trial (SEQUOIA-HCM) of aficamten in patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM) has yielded positive results, as announced by drugmaker Cytokinetics.

The top-line results from the SEQUOIA-HCM trial showed that aficamten, a novel cardiac myosin inhibitor, improved outcomes for patients with symptomatic obstructive HCM. The full results from SEQUOIA-HCM will be presented at an upcoming medical conference in 2024.
Aficamten, when added to standard care, led to a “clinically meaningful” increase in exercise capacity after 24 weeks of treatment, indicated by a significant rise in peak oxygen uptake during cardiopulmonary exercise testing (least square mean difference 1.74 mL/kg/min). The company reported that the results were consistent across all prespecified subgroups.
Aficamten improved all 10 prespecified secondary endpoints, which included assessments of heart failure symptoms, changes in provoked left ventricular outflow tract (LVOT) gradients, NYHA functional class, guideline eligibility for septal reduction therapy, and exercise workload.
The therapy was found to be well-tolerated, with a rate of treatment-emergent serious adverse events of 5.6% in the aficamten arm and 9.3% in the placebo arm. The proportion of patients who developed an LVEF of less than 50% was 3.5% with aficamten and 0.7% with placebo, although the researchers did not observe any cases of worsening heart failure and no treatment interruptions due to low LVEF, Cytokinetics said.
“The results from SEQUOIA-HCM meet our high expectations for both safety and efficacy, demonstrating that aficamten added to standard of care therapy had a positive impact on exercise capacity as well as rapid and sustained effects on symptoms and functional class in patients with obstructive HCM while maintaining tolerability and safety that we have previously observed,” said Fady I. Malik, M.D., Ph.D., Cytokinetics’ Executive Vice President of Research & Development.
“We believe these results are consistent with those observed in REDWOOD-HCM, the Phase 2 clinical trial of aficamten, and FOREST-HCM, the ongoing open-label extension clinical trial, and may reflect a profile enabling of aficamten to become the cardiac myosin inhibitor of choice among physicians and patients.”
Cytokinetics aims to make aficamten, the second cardiac myosin inhibitor on the market. The first, mavacamten (Camzyos; Bristol Myers Squibb), for patients with symptomatic obstructive HCM, was approved by the FDA in April 2022. Aficamten has been designated a breakthrough therapy by the US Food and Drug Administration and the National Medical Products Administration in China.
The SEQUOIA-HCM trial included 282 patients who had symptomatic HCM and LVOT obstruction. Previously, in the REDWOOD-HCM Open Label Extension study, the drug was shown to reduce LVOT gradients improve patient-measured health status and relieve heart failure symptoms.
Aficamten is also being assessed in two other ongoing phase III trials—MAPLE-HCM in patients with obstructive HCM (compared with metoprolol) and ACACIA-HCM in patients with symptomatic nonobstructive HCM.
“Cardiac myosin inhibition represents an exciting new therapy option for patients with symptomatic obstructive HCM,” said Martin Maron, M.D., Director, Hypertrophic Cardiomyopathy Center, Lahey Hospital and Medical Center, Burlington, MA; Tufts University School of Medicine, and National Principal Investigator of SEQUOIA-HCM.
“A therapy like aficamten that improves exercise capacity in a clinically meaningful manner, absent low LVEF events that interrupt treatment, should be a welcome addition for HCM patients and the clinicians who treat them.”

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Nirsevimab effective in preventing hospitalization for RSV associated lower RTI in infants

Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in young children and infants, leading to hospitalization.

According to a study published in the New England Journal of Medicine, Nirsevimab protected infants against hospitalization for RSV-related lower respiratory infections in conditions that approximated real-world settings.

The aim of the study was to establish safety and efficacy of nirsevimab (monoclonal antibody) in preventing hospitalizations for RSV-related lower respiratory tract infections in healthy infants.

Researchers randomly assigned 12-month-old infants or younger, born at least 29 weeks gestational age and entering their first RSV season in France, Germany, or the UK, to receive a single intramuscular injection of nirsevimab or standard care before or during the RSV season.

The primary endpoint was hospitalization for RSV-associated lower respiratory tract infection. The secondary endpoint was a very severe RSV-associated lower respiratory tract infection with an oxygen saturation of less than 90% and the need for supplemental oxygen.

Key points from the study are:

  • A total of 8058 infants were randomly assigned: 4037 in Nirsevimab and 4021 in the care group.
  • Eleven infants and 60 infants in the nirsevimab and standard-care group were hospitalized for RSV-associated lower respiratory tract infection. This corresponded to a nirsevimab efficacy of 83.2%.
  • Very severe RSV-associated lower respiratory tract infection occurred in 5 infants in the nirsevimab group, representing its efficacy as 75.7 %.
  • The efficacy of nirsevimab against hospitalization for RSV-associated lower respiratory tract infections in France, Germany, and the UK was 89.6%, 74.2%, and 83.4%, respectively.
  • 86 infants in the nirsevimab group experienced adverse events.

Study limitations include short study duration and trial design.

They found Nirsevimab to be protective against hospitalization for RSV-associated lower respiratory tract infections and against very severe RSV-associated lower respiratory tract infections in infants.

Sanofi and AstraZeneca funded the study.

Reference:

Simon B. Drysdale et al. Nirsevimab for Prevention of Hospitalizations Due to RSV in Infants. (n.d.). N Engl J Med 2023; 389:2425-2435

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Submit safety, efficacy data of Indian Patients: CDSCO Panel Tells AstraZeneca on additional indication of Enhertu 100mg

New Delhi: In response to the drug major AstraZeneca’s proposal for the additional indication of Trastuzumab Deruxtecan Powder Concentrate Solution for Infusion (Enhertu 100mg) to treat adult patients with unresectable or metastatic Non-small cell lung cancer (NSCLC) whose tumors have activated HER2 (ERBB2) mutations and who have received prior systemic therapy, the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has recommended the firm to submit the safety and efficacy data of Indian Patients for the proposed indication.

This came after the firm presented the proposal for the addition of indication for Trastuzumab Deruxtecan Powder for Concentrate for Solution for Infusion (Enhertu 100mg) under the category of life-threatening and unmet need in the country with the request for the waiver of the local clinical trial.
The proposed additional indication is “for the treatment of adult patients with unresectable or metastatic NSCLC whose tumors have activating HER2 (ERBB2) mutations and who have received prior systemic therapy.”

Trastuzumab is a monoclonal antibody against human epidermal growth factor receptor 2 (HER2). Trastuzumab binds to an extracellular domain of this receptor and inhibits HER2 homodimerization, thereby preventing HER2-mediated signaling.

Trastuzumab is a biologic agent primarily used in the treatment of HER2-positive breast cancer. It may be used as adjuvant therapy for localized disease or as first-line therapy for metastatic disease.

Trastuzumab deruxtecan binds to HER2 found on malignant cells, it is internalized and linker cleavage occurs through the actions of lysosomal enzymes. After it is released through cleavage, DXd causes targeted DNA damage and apoptosis in cancer cells, due to the ability to cross cell membranes.

At the recent SEC meeting for Oncology and Hematology held on the 7th and 8th of December 2023, the expert panel reviewed the proposal presented by the drug major AstraZeneca for the addition of indication for Trastuzumab Deruxtecan Powder for Concentrate for Solution for Infusion (Enhertu 100mg).

The committee noted that India is part of an ongoing Phase III global clinical trial.
After detailed deliberation, the committee recommended that the firm should submit the safety and efficacy data of Indian patients for the proposed indication before the committee for consideration of the additional indication.

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Metoclopramide may decrease need for second look Endoscopic Visualization in Active Upper GI Bleeding

In a recent breakthrough study conducted between April 2021 and October 2022, researchers delved into the effectiveness of metoclopramide in improving gastric visualization for patients experiencing active upper gastrointestinal bleeding (UGIB). They found that Metoclopramide did not significantly enhance endoscopic visualization overall but notably reduced the need for a second-look esophagogastroduodenoscopy (EGD) in patients with active UGIB.

The trial results were published in ‘The American Journal of Gastroenterology.’

Also Read: Urgent Endoscopy for Upper GI Bleeding does not lower mortality, finds NEJM study

The 2021 ACG Guidelines proposed the administration of intravenous (IV) erythromycin before endoscopy as a means to improve the endoscopic view and decrease the necessity for repeat procedures in individuals with upper gastrointestinal bleeding (UGIB). However, there is limited evidence regarding the use of IV metoclopramide, a more readily available option, particularly in patients experiencing ‘active’ UGIB. Hence, researchers from Thailand conducted a double-blind, double-center randomized controlled trial to assess the effectiveness of metoclopramide in enhancing gastric visualization for individuals with active UGIB.

The trial conducted between April 10, 2021, and October 8, 2022, enrolled patients with active UGIB, identified by hematemesis or the presence of fresh blood in the nasogastric tube. Participants were randomly assigned in a concealed 1:1 allocation to receive either metoclopramide or a placebo. The primary outcome measured was ‘adequate visualization’ determined by objective endoscopic visualized gastroduodenal scores (EVS). Secondary outcomes included the mean difference in EVS, duration of esophagogastroduodenoscopy (EGD), immediate hemostasis, the necessity for a second look EGD, units of blood transfusion, length of hospital stay, and 30-day rebleeding rate.

Findings:

  • Out of the 68 eligible patients, three from each group were excluded due to protocol violations.
  • The final analysis included 62 patients with 31 each in the metoclopramide group and the placebo group.
  • There were 77.4% of patients with adequate visualization in the metoclopramide group and 61.6% in the placebo group (odds ratio 2.16 [0.71-6.58], p = 0.16).
  • metoclopramide group reported a significantly lesser need for a second look EGD within 72 hours (3.2% vs. 22.6%, odds ratio 0.11 [0.01-0.99], p = 0.02).
  • Other secondary outcomes did not show considerable differences. However, in a subgroup analysis focusing on gastric lesions, metoclopramide demonstrated a remarkable improvement in the rate of adequate visualization (92.9% vs. 50%, odds ratio 13 [1.32-128.10], p = 0.03) and mean EVS at the fundus (1.79±0.42 vs. 1.29±0.72; p = 0.03).

In conclusion, while metoclopramide did not significantly enhance endoscopic visualization overall, it emerged as a promising contender in reducing the need for a second look at EGD, particularly in cases of active UGIB. The study’s findings provide valuable insights into potential advancements in the treatment of upper gastrointestinal bleeding, paving the way for more targeted and effective interventions in the future.

Also Read: Intrarectal Botox Injections Promising for Treatment of Faecal Incontinence

Take home message:

  • This was a double-blind, randomized, placebo-controlled trial that evaluated the effectiveness of metoclopramide for gastric visualization in patients with active upper gastrointestinal bleeding (UGIB). A total of 62 patients were randomized 1:1 to metoclopramide (n = 31) or placebo (n = 31). Overall, metoclopramide was no better than placebo for improving endoscopic visualization for all active UGIB lesions. However, it improved endoscopic visualization and decreased the need for second-look esophagogastroduodenoscopy in a subgroup of patients with active UGIB owing to gastric lesions.
  • These results should be interpreted with caution because the positive effect of metoclopramide on improving endoscopic visualization and decreasing the need for second-look esophagogastroduodenoscopy within 72 hours was based on a subgroup analysis.

Further reading: Vimonsuntirungsri et al. The efficacy of metoclopramide for gastric visualization by endoscopy in patients with active upper gastrointestinal bleeding: double-blind randomized controlled trial. The American Journal of Gastroenterology. DOI: 10.14309/ajg.0000000000002620

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Delhi Vigilance Dept calls for CBI probe into suspected spurious drugs

The Delhi government’s Directorate of Vigilance has sent the matter of suspected spurious drugs to the Union Home Ministry, urging a thorough investigation by the Central Bureau of Investigation (CBI).

The Directorate of Vigilance, in a formal letter to the Union Home Ministry on Thursday, said, “Assigning the matter if reported supply of not of standard quality drugs to hospital of Government of National Capital Territory of Delhi (GNCTD) to CBI.”

For more details, check out the link given below:

Delhi Vigilance Dept Sends Suspected Spurious Drugs Matter To Health Ministry, Urges CBI Probe

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