Secondary metabolite compounds from Sida genus and their bioactivity

Plants are the key source for the production of novel therapeutic products for new medicines. The biological properties of the plant species used world wide are mainly accountable for their secondary metabolites obtained from plants. The goal of this analysis is to summarize the chemical composition and biological effects of the genus Sida (Malvaceae) to identify potential research opportunities. This analysis draws on the literature review of scientific journals, and books from libraries, and electronic sources like ScienceDirect, Springer, PubMed, ResearchGate, Google Scholar, and the Website. Some groups of secondary metabolite compounds isolated from the genus Sida include alkaloids, flavonoids, coumarin, and others. Pharmacological experiments found that there are a wide variety of biological activities in extracts and compounds isolated from the genus Sida comprising antimalarial, antiplasmodial, antimicrobial, analgesic, antibacterial, antioxidant, vasorelaxant, wound healing, antifungal activities, the inhibition of quinone reductase, and mouse mammary organ culture.

Clostridium difficile Screening for Colonization During an Outbreak Setting

A rapidly deployed ward-based screen and isolate initiative for Clostridium difficile carriers during an outbreak averted 5 of 10 expected hospital-acquired infections without identified harms. Each infection avoided required screening 197 and isolating 4.4 patients. Targeted C. difficile screening resulted in outbreak mitigation.

Improving detection of intraoperative medical errors (iMEs) and intraoperative adverse events (iAEs) and their contribution to postoperative outcomes

Our knowledge of the types of intraoperative patient safety events, their harm to patients, and relationship to postoperative complications is sparse. This study examined intraoperative medical errors (iMEs) and intraoperative adverse events (iAEs) voluntarily reported by providers using two programs at our hospital: surgical debriefing and incident reporting. Among the 3020 surgical procedures assessed, 142 iMEs and 103 iAEs were reported, yielding an overall rate of 8%. Of these events, 135 (55%) were obtained from incident reporting and 110 (45%) from surgical debriefing. The overall association between intraoperative events (iMEs and iAEs) and 30-day postoperative morbidity was significant (adjusted odds ratio = 1.08 with 95% confidence interval (CI) of (1.03, 1.13). This association was stronger when we included only the iAEs (1.47, 95% CI (1.35, 1.58)). Our findings suggest that hospitals should consider using both programs to obtain a more complete picture of intraoperative patient safety and to reduce postoperative morbidity.

C. difficile Screening for Colonization among Surgical Ward Admissions Is Feasible and Useful

Background

Identification of patients colonized with C. difficile (CDcol) upon admission and initiation of precautions has been shown to decrease hospital-acquired C. difficileinfection (HA-CDI) in a recent study. We implemented a quality improvement program screening new admissions to a surgical service and evaluated risk factors and outcomes associated with CDcol.

Methods

Prospective cohort of all patients admitted to the surgical wards including ICU over a 6 month period 10/16–4/17. Upon admission, a perirectal swab was sent for C diff PCR. Patients with positive screens were placed on contact precautions. CDcol patients were not treated. Testing for CDI was done as usual practice only in patients with diarrhea. Main outcome was prevalence of CDcol and relationship to HA-CDI.

Results

Of 708 surgical admissions, 585 (82.6%) patients were screened, 543 were eligible based on first admission; 19 (3.5%) were colonized. Recent surgical hospitalization (OR 13.2, 95% CI 3.4;52.1) and prior CDI (OR 19.5, 95% CI 2.9;127.7) were independent risk factors for CDcol. Antibiotic and PPI use were not associated. Of those with CDcol, 7 developed CDI (36.8%) compared with 5/524 (0.9%) screen negative patients (adj OR 60, 95% CI 12.6;286). CDcol combined with a prior h/o CDI allowed for detection of 8/12 (75%) cases of HA-CDI compared with 3/12 (25%) if only prior history was available. HA-CDI rates on surgical wards after one month post-implementation were 9.3/10,000 bed days of care compared with 12.2 in 2016 and 12.8 in 2015. No delays in bed flow were identified.

Conclusion

Admission CDcol prevalence was low in our surgical VA population but was strongly associated with development of HA-CDI. Prior CDI was the strongest risk factor for CDcol and HA-CDI. Knowledge of prior CDI and CDcol status identified 75% of patients who developed CDI, 3 times more than knowledge of prior CDI alone. In certain settings, CDcol screening could improve detection and early isolation of potential CDiff spreaders. Implementation required significant support from administration, nursing and the laboratory, and was successful based on screening percentage without impact on bed flow. Impact on facility CDI rates remains to be fully demonstrated.

Disclosures

All authors: No reported disclosures.

Sources of variability contributing to test-retest differences in threshold-based articulation indices

This study was conducted to obtain information on test-retest differences in Articulation Indices (AI) when a clinical threshold-based method is used to calculate AI. The AI was calculated using a nine-frequency-band method on 2 separate days for 209 ears. Standard deviations of test-retest differences were calculated. The standard deviations were greatest when the AI was near 50% and least when the AI was near 0% or 100%. The standard deviations for test-retest AI differences were also dependent on the relationship of the hearing thresholds and speech spectrum. Under the assumption that each dB change in threshold would have an affect on the AI, standard deviations of test-retest differences increased significantly. Test-retest standard deviations for nine-band and five-band methods were approximately equal when only five thresholds were actually measured. A small improvement would be expected if the number of threshold measurements increased from five to nine.