Trends in outpatient anti-arrhythmic prescriptions for atrial fibrillation and left atrial ablation in Australia: 1997-2016.

BACKGROUND: An important aspect of atrial fibrillation (AF) management is the decision whether to adopt a rate or rhythm control strategy. Options for the latter include oral anti-arrhythmic drugs (AAD) or catheter ablation. AIM: To describe the trends in rhythm control for AF in Australia between 1997 and 2016. METHODS: We conducted a retrospective study using prospectively collected data between 1997 and 2016 from the Pharmaceutical Benefit Scheme and Medicare Benefit Schedule websites, which, respectively, contain information pertaining to public AAD prescriptions and rebatable AF ablation procedures performed in Australia. RESULTS: Sotalol and amiodarone remain the most commonly prescribed AAD in Australia, although their use is decreasing. Rates of catheter ablation for AF continue to rise annually with a 48-fold increase from 71 to 3480 since 1997. CONCLUSION: A rhythm control strategy is frequently utilised for AF management in Australia. Consistent with international guidelines which advocate safety over efficacy when choosing a rhythm control strategy, the prescriptions of amiodarone have been consistently decreasing since 2002, whereas sotalol and flecainide prescriptions have largely increased, with a peak in 2015. Catheter ablation per capita has burgeoned 36-fold.

Gellan Gum-Based Bilayer Mucoadhesive Films Loaded with Moxifloxacin Hydrochloride and Clove Oil for Possible Treatment of Periodontitis.

BACKGROUND/OBJECTIVE: Periodontitis is a widely spread oral infection and various antibiotics are utilized for its treatment, but high oral doses and development of antibiotic resistance limit their use. This study was aimed at development of natural polymer-based mucoadhesive bilayer films loaded with moxifloxacin hydrochloride (Mox) and clove essential oil (CEO) to potentially combat bacterial infection associated with periodontitis. METHODS: Films were synthesized by double solvent casting technique having an antibiotic in the gellan gum-based primary layer with clove oil in a hydroxyethyl cellulose-based secondary layer. RESULTS: Prepared films were transparent, flexible, and showed high antibacterial response against both gram-positive and gram-negative bacteria. The films showed excellent pharmaceutical attributes in terms of drug content, folding endurance, swelling index, and mucoadhesive strength. Solid state characterization of formulation showed successful incorporation of drug and oil in separate layers of hydrogel structure. An in-vitro release study showed an initial burst release of drug followed by sustained release for up to 48 hours. CONCLUSION: The prepared mucoadhesive bilayer buccal films could be used as a potential therapeutic option for the management of periodontitis.

Complete closed brachioradialis tendon rupture: a case report.

A complete brachioradialis tendon rupture, as an isolated incident, is extremely rare. Consequently, there is little to no literature on how this can occur and how to treat it. We present the case of a 44-year-old male with a complete, closed brachioradialis tendon rupture following a waterskiing accident. The clinical, imagining and operative findings are outlined alongside management and final outcomes. Our case highlights the effectiveness of a combined surgical and staged physiotherapy approach, for the management of a complete, closed brachioradialis tendon rupture, in an otherwise healthy man.