Ceftriaxone-induced hepatotoxicity in patients with common medical infections in Qatar: A retrospective study.

INTRODUCTION: Ceftriaxone, a third-generation cephalosporin, is frequently used for the treatment of various bacterial infections as a broad-spectrum antibiotic for many decades. Although ceftriaxone is a well-tolerated drug in most cases, it can lead to serious liver injury, which can be a real challenge to the treating physician. Given the potentially serious adverse effects that can vary from mild biochemical abnormalities to complete liver failure, we intend to assess the spectrum of liver injury based on biochemical criteria for patients treated with ceftriaxone for common bacterial infections in Qatar. OBJECTIVES: This study aimed to explore the incidence of ceftriaxone-induced liver injury at Hazm Mebaireek General Hospital, Qatar, and to evaluate the relationship of the ceftriaxone dose, if any, with liver dysfunction. METHODS: This retrospective study included hospitalized adult patients treated with ceftriaxone at our hospital from January 2019 to December 2019 and analyzed demographic and clinical data obtained from electronic medical records. This study determined the incidence of liver injury (primary outcome) in patients treated with ceftriaxone (2 g/day) for ≥ 2 consecutive days by reviewing liver function test results until the day of discharge and at the first outpatient follow-up. RESULTS: The final data analysis included a total of 634 patients admitted and treated with ceftriaxone from January 2019 to December 2019.In the multivariate analysis with propensity score adjustment, ceftriaxone was independently associated with liver injury, especially when combined with other agents utilizing hepatic metabolism. CONCLUSIONS: Ceftriaxone was associated with a significantly higher incidence of liver injury (19.7%) when used along with other medications that are metabolized in the liver, as found in the present study compared with other similar studies (approximately 2.9%-13.9%). Furthermore, the incidence was too high to be ignored in clinical practice.

Evolutionary and ecological forces influencing population diversification in Bornean montane passerines.

The mountains of Borneo are well known for their high endemicity and historical role in preserving Southeast Asian rainforest biodiversity, but the diversification of populations inhabiting these mountains is poorly studied. Here we examine the genetic structure of 12 Bornean montane passerines by comparing complete mtDNA ND2 gene sequences of populations spanning the island. Maximum likelihood and Bayesian phylogenetic trees and haplotype networks are examined for common patterns that might signal important historical events or boundaries to dispersal. Morphological and ecological characteristics of each species are also examined using phylogenetic generalized least-squares (PGLS) for correlation with population structure. Populations in only four of the 12 species are subdivided into distinct clades or haplotype groups. Although this subdivision occurred at about the same time in each species (ca. 0.6-0.7Ma), the spatial positioning of the genetic break differs among the species. In two species, northeastern populations are genetically divergent from populations elsewhere on the island. In the other two species, populations in the main Bornean mountain chain, including the northeast, are distinct from those on two isolated peaks in northwestern Borneo. We suggest different historical forces played a role in shaping these two distributions, despite commonality in timing. PGLS analysis showed that only a single characteristic-hand-wing index-is correlated with population structure. Birds with longer wings, and hence potentially more dispersal power, have less population structure. To understand historical forces influencing montane population structure on Borneo, future studies must compare populations across the entirety of Sundaland.

Bird species diversity in the padawan limestone area, sarawak.

Bird surveys were conducted in the Padawan Limestone Area for seven days at each of two study sites, Giam and Danu, from August to December 2008. The purpose of the study was to compare the area's bird species richness and abundance of bird species in other limestone areas and in other forest types. The study also compared the species richness and relative abundance of birds in undisturbed and disturbed areas at both study sites. Twenty mist nets were deployed for 12 hours daily. During this study period, direct observations of birds were also made. In all, 80 species from 34 families were recorded at both sites. At Giam, 120 birds were mist-netted. These birds represented 31 species from 16 families. The direct observations at Giam recorded 13 species from 11 families. In the undisturbed area, 21 species from 13 families were mist-netted, whereas in the disturbed area, 21 species from 10 families were mist-netted. In Danu, a total of 48 birds, representing 25 species from 12 families, were mist-netted. The observations at Danu recorded 34 species from 19 families. Twelve species from 7 families were mist-netted in the undisturbed area, whereas 18 species from 11 families were mist-netted in the disturbed area. Statistical analysis showed that the species diversity index differed significantly between undisturbed and disturbed areas.