Vancomycin AUC-Based Dosing Practices in a Non-Teaching Community Hospital and Associated Outcomes: A One-Year Survey of Uniform Targets for Infections with or without MRSA.

BACKGROUND: Intravenous (IV) vancomycin area under the curve (AUC)-based dosing is used uniformly for Gram-positive organisms in non-teaching community hospitals. However, evidence for using vancomycin AUC-based dosing for non-methicillin-resistant Staphylococcus aureus (non-MRSA) and less serious infections is limited in the literature. A gap in the literature also exists with respect to comparisons between the outcomes that can be derived using the regimens suggested by Bayesian programs and target doses of the AUC of 400-499 and 500-600. METHODS: A retrospective review of all patients hospitalized in a non-teaching community hospital who used AUC-based vancomycin was performed over a 1-year period. RESULTS: Only 17.6% of the included patients had confirmed MRSA. The values for the overall early response rate, 30-day all-cause mortality, and rate of acute kidney injury (AKI) were 50.3%, 11.3%, and 3.8%, respectively, in this population. In regression analysis, compared to non-MRSA infections, a significantly higher rate of early response was seen in patients with MRSA (unadjusted OR = 2.68, 95% CI [1.06-6.76] p = 0.04). Patients in the AUC 400-499 group had a non-significant higher incidence of 30 d mortality and new AKI compared to patients in the AUC 500-600 group. In our Kaplan-Meier survival analysis, there was no statistically significant difference between the comparison groups. CONCLUSIONS: Early response was lower in patients with non-MRSA compared to patients with MRSA despite achieving the AUC target. There was no apparent difference in clinical outcomes between the higher and lower AUC groups. Further large-scale research is needed to confirm these findings.

Origin, spatial distribution, sediment contamination, ecological and health risk evaluation of trace metals in sediments of ship breaking area of Bangladesh.

Eleven trace metals (Cd, Cr, Fe, Mn, Cu, Ni, Co, Zn, As, Pb, and Ag) in sediments of Bangladesh's ship breaking area were measured by an atomic absorption spectrometer to determine origin, contamination extent, spatial distributions, and associated ecological and human health hazards. This study found considerable quantities of Pb, Cd, Mn, Zn, and Cu when compared with standards and high levels of Pb, Cd, Zn, Cu, As, and Ag contamination according to pollution evaluation indices. Different indices indicate most of the sampling sites were highly polluted. However, spatial distribution maps indicate that trace metals were predominantly deposited in the northern and southern region. The ecological risk index revealed that Cd has the highest while Pb and As had moderate risk. Based on the health index values, Zn for both adults and children were higher than the safe limit while Mn, Pb, Cr, As, Fe, Cu, Ni, and Co for children were close to the threshold. The mean total carcinogenic risk values of Cr, As, and Ni for children and Ni for adults exceeded the permissible threshold. The cancer risk possibilities were further assessed using Monte Carlo simulation. Most trace metals have anthropogenic origins, which were attributed to ship breaking activities.

Assessment of groundwater vulnerability for seawater intrusion using DRASTIC model in coastal area at Patuakhali District, Bangladesh.

Seawater intrusion is a growing concern for coastal regions in Bangladesh. Overexploitation of groundwater, low rainfall, a high rate of evaporation, rising sea level, cyclones, storm surges, and shrimp cultivation are the causes of seawater intrusion that polluted the groundwater near the coastal area. High values of EC, TDS, Na+, and Cl- ions in groundwater indicate the seawater intrusion. Piper's Trilinear and Durov diagrams of groundwater indicated that most gathered groundwater show predominantly Na-Cl-type of water. Based on the USSL diagram, it is observed that the salinity of the study area is medium to high and the alkalinity is medium to very high. Also, in view of the Wilcox outline, most of the samples in the area of interest are permissible to doubtful, and doubtful to unsuitable. Chloride is moderately correlated with Na+ (R2 = 0.590) and poorly correlated with (HCO3- + CO32-) (R2 = 0.128), which indicates seawater intrusion. According to a comparison of the levels of Fe and Mn in the groundwater of the study area with those recommended by the World Health Organization (WHO) and Department of the Environment (DOE), twenty-two out of thirty-one samples exceed the acceptable limit for Fe and thirty out of thirty-one samples fall within the acceptable limit for Mn. The calculated water quality index reveals that most samples are of low drinking water quality. The research area's poor water type is found in the north-central and southern parts. The WQI geographic variation map reveals that the study's water has a WQI of more than 100, making it unsuitable for consumption. The final seawater intrusion vulnerability map clearly identifies the moderate to highly vulnerable zone of the study area using DRASTIC index parameters. DRASTIC index parameters revealed that some portions of the northwestern part of the sample area show a moderately vulnerable zone. And the rest of the sampling area indicates the highly vulnerable zone.

The pathogenesis of Nipah virus: A review.

Nipah virus (NiV), an emerging zoonotic virus, has been associated with several outbreaks with high death rates, mainly in South and Southeast Asia. NiV is responsible for Encephalitis and systemic vasculitis, and occasionally respiratory diseases accompanied by it. Though fruit bats are the natural source of NiV, it can be transmitted in a zoonotic manner directly or via an intermediate host (e.g., a pig or horse). Several studies explore the viral mechanism of disease progressions and its overall pathogenesis. However, understanding the pathogenesis and disease dynamics is necessary to develop therapeutic options and vaccines. Thus, in this review, we provide a comprehensive update on the emerging understanding of the pathogenesis of NiV.