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Adjunctive affects of systemic amoxicillin and metronidazole with scaling and root planning

Author: Dr.Barzan Abdulwahab Atrooshi B.D.S M.Sc. periodontology * د.بارزان عبد الوهلب
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2008 Volume: 5 Issue: 1 Pages: 14-25
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Aims: The objective of this study was to investigate the effect of the systemic administration of metronidazole and amoxicillin as an adjunct to initial periodontal therapy in patients with moderate to severe chronic periodontitis.Methods and Materials: This randomized, double blind study, involved 50 adult patients with untreated periodontitis who were randomly assigned to receive either a full-mouth scaling and root planning along with systemic metronidazole and amoxicillin (T group) or scaling and root planning with a placebo (P group). Clinical measurements including probing depth (PD), clinical attachment levels (CAL), Plaque Index (PI), and Bleeding Index (BI) were recorded at baseline and six to eight weeks after therapy. The deepest pocket was selected and samples for microbiological testing were taken. Patients received coded study medications of either 500 mg amoxicillin in combination with 250 mg metronidazole or an identical placebo every eight hours for seven days following scaling and root planning.Results: There was a significant change in PD , CAL, PI, and BI in the T group compared to the placebo group after therapy. Parallel to the clinical changes, treatment significantly reduced the number of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and P. intermedia (Pi) compared with baseline in the T group. However, in the P group only the Pi colony count was reduced significantly (P=0.0001). After therapy, there was a significant difference between the T and P groups in the number of patients negative for Aa, Pg, and Pi.Conclusions: The significant differences between treatment and placebo groups are in line with other studies and support the considerable adjunctive benefits of the combination of amoxicillin and metronidazole in the treatment of chronic periodontitis.


Article
The Role of Serial Serum C-Reactive Protein in the Diagnosis and Duration of Antibiotic Therapy in Neonatal Sepsis

Author: Zuhair M. Al-Musawi
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2008 Volume: 11 Issue: 2 Pages: 33-40
Publisher: University of Kufa جامعة الكوفة

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Abstract

ABSTRACTBackground : the management of neonatal sepsis(N.S.) especially in developing countries is problematic. There is no single reliable marker of infection available at the present. C-reactive protein (CRP) has long been used as a marker of infection. Serial measurements of CRP are recommended as a guide for duration of antibiotic therapy. Objective : to evaluate the serial CRP measurements as a guide line for diagnosis and monitoring therapy and determining the duration of antibiotic treatment in suspected neonatal sepsis.Methods : Two hundreds neonates with clinical diagnosis of neonatal sepsis (patients group) and 200 neonates admitted or visited the outpatient clinic of the hospital for causes other than neonatal sepsis (control group) were enrolled in this prospective study. Blood culture & serial CRP were done for all patients group while single CRP was done for control group.Results : Of 200 infants (patients group), 90 (45%) had positive blood culture. CRP was negative on first and third day in 54 neonates (27%) of patients group while it was positive in 8 neonates (4%) of control group. CRP had sensitivity of (73%) and specificity of (96%). It's positive predictive value was (94.8%) whereas it's negative predictive value was (78%).Conclusion : single negative CRP value does not exclude N.S. and two negative CRP values, 24 hours apart can exclude the probability of N.S. and allow pediatricians to discontinue antibiotics.

الخلفية : تشخيص و علاج الأنتان ألوليدي و خصوصاً في الدول النامية صعب و لا يوجد فحص موثوق به للاستدلال على الإصابة في الوقت الحاضر. بروتين c التفاعلي لطالما استخدم كعلامة للإنتان يوصى بقياس البروتين c التفاعلي المتسلسل كدليل للتشخيص وتحديد فترة العلاج بالمضادات الحيوية.الهدف : تقييم قياس البروتين c التفاعلي كدليل لتشخيص و مراقبة و تحديد فترة العلاج بالمضادات الحيوية للانتا ن ألوليدي.الطرق :200 طفل حديث الولادة مشخص سريريا كانتان وليدي (مجموعة المرضى) و 200 طفل حديث الولادة ادخل المستشفى أو زار العيادة الخارجية لأسباب أخرى (المجموعة الضابطة) أشركوا في هذه الدراسة المستقبلية. زرع الدم و فحص البروتين c التفاعلي اجري لكافة الأطفال في مجموعة المرضى بينما اجري فحص البروتين c التفاعلي مرة واحدة لأطفال المجموعة الضابطة.النتائج : من 200 طفل حديث الولادة (مجموعة المرضى). 90 (45%) كان زرع الدم موجباً. فحص البروتين c التفاعلي كان سالبا ً في اليوم الأول و الثالث عند 54 (27%) طفل حديث الولادة في مجموعة المرضى بينما كان الفحص موجبا ً لدى 8 أطفال (4%) من ألمجموعه الضابطة. فحص البروتين c التفاعلي يملك درجة حساسية 73% و درجة نوعية 96% بينما قيمته التنبئية الموجبة 94.8% و قيمته التنبئية السالبة 78%.الاستنتاج : فحص واحد للبروتين c التفاعلي لا ينفي الإصابة بالانتان ألوليدي بينما فحصان سالبان ليومين متتالين يستبعدان الإصابة بالإنتان ألوليدي و يمكن الطبيب المعالج من إيقاف المضادات الحيوي

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