Efficacy of Salbutamol in Mixed Obstructive and Restrictive Pattern Spirometry.

Background Salbutamol is a short acting ß2 agonist bronchodilator most commonly used for management of asthma and chronic obstructive pulmonary disease. Besides the disease state, it is also used for bronchodilator reversibility in spirometry. The spirometry reading show one of the four patterns i.e. normal, obstructive, restrictive and combined or mixed (obstructive-restrictive). Objective To determine the efficacy of salbutamol in mixed obstructive and restrictive pattern spirometry. Method A descriptive cross sectional study was conducted at Nepal Medical College and Teaching Hospital (NMCTH) for a period of 9 months. A total of 70 patients who presented with symptoms of respiratory disease in medicine outpatient department (OPD) in which spirometry was performed were selected. Of the 70 patients, 35 with mixed pattern spirometry were selected as cases and remaining 35 with normal spirometry were selected as control. After taking informed consent, spirometry parameter were measured before and after salbutamol therapy. Data was collected from medicine department, pulmonary function test (PFT) unit. All the data were entered in statistical package for social sciences (SPSS version 20) and Forced expiratory volume in first second (FEV1 ), Forced vital capacity (FVC), FEV1 /FVC and Peak expiratory flow rate (PEFR) were analyzed. Result There was significant difference (p<0.05) in spirometry parameters (i.e. FEV1 , FVC, PEFR) when after salbutamol therapy was compared from before therapy. Statistical significance was also seen in percentage change in spirometry parameter (i.e. %FEV1 change, %FVC change, % change in ratio of FEV1 /FVC and %PEFR change) between case and control groups. Conclusion Salbutamol is an effective bronchodilator in mixed pattern or combined obstructiverestrictive lung disease.

Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants.

BACKGROUND: Hand hygiene is important for interrupting transmission of viruses through hands. Effectiveness of alcohol-based hand disinfectant has been shown for bacteria but their effectiveness in reducing transmission of viruses is ambiguous. AIM: To test efficacy of alcohol hand disinfectant against human enteric and respiratory viruses and to compare efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against norovirus. METHODS: Efficacies of a propanol and an ethanol-based hand disinfectant against human enteric and respiratory viruses were tested in carrier tests. Efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against noroviruses GI.4, GII.4, and MNV1 were tested using finger pad tests. FINDINGS: The alcohol-based hand disinfectant reduced the infectivity of rotavirus and influenza A virus completely within 30s whereas poliovirus Sabin 1, adenovirus type 5, parechovirus 1, and MNV1 infectivity were reduced <3 log10 within 3 min. MNV1 infectivity reduction by washing hands with soap and water for 30s (>3.0 ± 0.4 log10) was significantly higher than treating hands with alcohol (2.8 ± 1.5 log10). Washing with soap and water for 30s removed genomic copies of MNV1 (>5 log10), noroviruses GI.4 (>6 log10), and GII.4 (4 log10) completely from all finger pads. Treating hands with propanol-based hand disinfectant showed little or no reduction to complete reduction with mean genomic copy reduction of noroviruses GI.4, GII.4, and MNV1 being >2.6, >3.3, and >1.2 log10 polymerase chain reaction units respectively. CONCLUSIONS: Washing hands with soap and water is better than using alcohol-based hand disinfectants in removing noroviruses from hands.

Thermal stability of structurally different viruses with proven or potential relevance to food safety.

AIMS: To collect comparative data on thermal stability of structurally different viruses with proven or potential relevance to food safety. METHODS AND RESULTS: Suspensions with poliovirus Sabin1, adenovirus type5, parechovirus1, human norovirus (NoV) GII.4, murine NoV (MNV1) and human influenza A (H1N1) viruses were heated at 56 and 73°C. Infectivity was tested by culture assay for all but human NoV GII.4 that cannot be cultivated in vitro. Time to first log(10) reduction (TFL-value) was calculated based on best fit using the monophasic, biphasic or Weibull models. The Weibull model provided the best fit at 56°C for all viruses except influenza virus. The TFL at 56°C varied between a high of 27 min (parechovirus) to a low of 10 s (adenovirus) and ranked parechovirus > influenza > MNV1 > poliovirus > adenovirus. The monophasic model best described the behaviour of the viruses at 73°C, in which case the TFL was MNV1(62s) > influenza > adenovirus > parechovirus > poliovirus(14s). CONCLUSIONS: Viruses do not follow log-linear thermal inactivation kinetics and the thermostability of parechovirus and influenza virus is similar to that of proven foodborne viruses. SIGNIFICANCE AND IMPACT OF THE STUDY: Resistant fractions of viruses may remain infectious in thermal inactivation processes and inactivation of newly discovered or enveloped viruses in thermal food preparation processes should not be assumed without further testing.

Virucidal efficacy of hydrogen peroxide vapour disinfection.

BACKGROUND: Viral contamination of surfaces is thought to be important in transmission. Chemical disinfection can be an effective means of intervention, but little is known about the virucidal efficacy of hydrogen peroxide vapour (HPV) against enteric and respiratory viruses. AIM: To measure the virucidal efficacy of HPV against respiratory and enteric viruses on materials representing those found in institutions and homes. METHODS: Poliovirus, human norovirus genogroup II.4 (GII.4), murine norovirus 1, rotavirus, adenovirus and influenza A (H1N1) virus dried on to stainless steel, framing panel and gauze carriers were exposed to HPV 127 ppm for 1h at room temperature in an isolator. Poliovirus was also exposed to HPV at different locations in a room. The virucidal effect was measured by comparing recoverable viral titres against unexposed controls. Polymerase chain reaction was used to evaluate the effect of HPV on viral genome reduction. FINDINGS: HPV disinfection resulted in complete inactivation of all viruses tested, characterized by >4 log(10) reduction in infectious particles for poliovirus, rotavirus, adenovirus and murine norovirus on stainless steel and framing panel carriers, and >2 log(10) reduction for influenza A virus on stainless steel and framing panel carriers, and for all viruses on gauze carriers. Complete inactivation of poliovirus was demonstrated at several locations in the room. Reductions in viral genomes were minimal on framing panel and gauze carriers but significant on stainless steel carriers; human norovirus GII.4 genome was most resistant to HPV treatment. CONCLUSION: HPV could be an effective virucidal against enteric and respiratory viruses contaminating in-house environments.