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Laparoendoscopic Transgastric Enucleation of an awkwardly sited Peri-Cardial Gastrointestinal Stromal Tumour (GIST): A Multi- Modal Approach

Kosai NR, Rajan R, Roslani EJ, Sutton PA, Mustafa M, Das S

Clin Ter, 2015 Nov-Dec;166(6):248-52.
PMID: 26794812 DOI: 10.7417/CT.2015.1896

In the modern era of surgery, minimally invasive surgery is increasingly applied for excision of gastrointestinal stromal tumors. Site, size and tumor location are important factors that affect the surgical approach and excision. We performed a laparoendoscopic transgastric enucleation of a 4-cm pericardial endophytic gastrointestinal stromal tumor (GIST) using an energy device. The surgery was successful and post-operative recovery uneventful. No tumor recurrence was detected on surveillance gastroscopy. In the safe hands of a well-trained laparoscopic upper gastrointestinal surgeon, pericardial GIST can be enucleated safely by this method. The avoidance of surgical staplers is not only cost-effective, but also reduces the risk of associated complications.
Resolution of Acanthosis Nigricans Following Curative Gastric Carcinoma Resection

Jagwani AV, Reynu R, Affirul CA, Mustafa MT, Kosai NR

Clin Ter, 2016;167(4):99-100.
PMID: 27598021 DOI: 10.7417/CT.2016.1937

We discuss a 48-year old, who presented with upper epigastrium pain associated with early satiety and significant weight loss. Physical examination revealed a thickening and darkening of skins around the skin folds, scalp, back and front of abdomen. A diagnosis of gastro-esophageal junction adenocarcinoma was confirmed by oesophagogastroduodenoscopy (OGDS) and biopsy. The biopsy of the skin lesion revealed a diagnosis of acanthosis nigricans, He underwent a total gastrectomy followed by adjuvant chemo-radiotherapy. Recovery is unremarkable. Interestingly, the skin lesions disappear following our therapy. We believe this may be attributed to the treatment of the malignancy. We highlight the interesting association, pathophysiology and therapy.
Fulltext Tualang honey ameliorates viral load, CD4 counts and improves quality of life in asymptomatic human immunodeficiency virus infected patients

Wan Yusuf WN, Wan Mohammad WMZ, Gan SH, Mustafa M, Abd Aziz CB, Sulaiman SA

J Tradit Complement Med, 2019 Oct;9(4):249-256.
PMID: 31453119 DOI: 10.1016/j.jtcme.2018.05.003

This is the first study to report on the effects of honey in asymptomatic HIV positive subjects in ameliorating CD4 count, viral load (VL) and quality of life (QOL). It is a randomized, controlled, open labelled study, comparing the effects of Tualang honey (TH) administration for six months at three different doses: 20 g (THL), 40 g (THI) or 60 g (THH) daily compared with control (no administered treatment, THC). Only asymptomatic HIV positive subjects (n=95) having CD4 count 250-600 cell/ml, not on antiretrovirals were enrolled. Blood, (together with QOL questionnaires administration) were investigated at baseline, three and six months (CD4 cell count) while VL was determined only at baseline and six months. Significant reductions in CD4 counts in THL and THC groups (p= 0.003 for both) were seen with no significant reductions in the CD4 counts in THI and THH groups (p=0.447 and 0.053 respectively). There was improvement in VL in THC and THI (130% and 32% respectively) and reductions in THL and THH (26% and 8% respectively). Within and between group analyses for VL indicated significant differences between THL and THH compared to THC. In addition, significant improvement in QOL of groups which received TH was noted. TH has the potential to improve the QOL (physical and psychological) and CD4 counts. There was a trend of lower VL in asymptomatic HIV subjects following TH administration thus supporting the possible role of TH in boosting the immune system by improving CD4 counts, causing VL reductions in HIV positive subjects.
Fulltext HIV multi-drug resistance at first-line antiretroviral failure and subsequent virological response in Asia

Jiamsakul A, Sungkanuparph S, Law M, Kantor R, Praparattanapan J, Li PC, et al.

J Int AIDS Soc, 2014;17:19053.
PMID: 25141905 DOI: 10.7448/IAS.17.1.19053

First-line antiretroviral therapy (ART) failure often results from the development of resistance-associated mutations (RAMs). Three patterns, including thymidine analogue mutations (TAMs), 69 Insertion (69Ins) and the Q151M complex, are associated with resistance to multiple-nucleoside reverse transcriptase inhibitors (NRTIs) and may compromise treatment options for second-line ART.
Fulltext Factors associated with suboptimal adherence to antiretroviral therapy in Asia

Jiamsakul A, Kumarasamy N, Ditangco R, Li PC, Phanuphak P, Sirisanthana T, et al.

J Int AIDS Soc, 2014;17:18911.
PMID: 24836775 DOI: 10.7448/IAS.17.1.18911

Adherence to antiretroviral therapy (ART) plays an important role in treatment outcomes. It is crucial to identify factors influencing adherence in order to optimize treatment responses. The aim of this study was to assess the rates of, and factors associated with, suboptimal adherence (SubAdh) in the first 24 months of ART in an Asian HIV cohort.
Fulltext Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV-positive patients

Kiertiburanakul S, Boettiger D, Lee MP, Omar SF, Tanuma J, Ng OT, et al.

J Int AIDS Soc, 2014;17(1):18804.
PMID: 24598459 DOI: 18804

INTRODUCTION: Although antiretroviral therapy (ART) has been rapidly scaled up in Asia, most HIV-positive patients in the region still present with late-stage HIV disease. We aimed to determine trends of pre-ART CD4 levels over time in Asian HIV-positive patients and to determine factors associated with late ART initiation.
METHODS: Data from two regional cohort observational databases were analyzed for trends in median CD4 cell counts at ART initiation and the proportion of late ART initiation (CD4 cell counts <200 cells/mm(3) or prior AIDS diagnosis). Predictors for late ART initiation and mortality were determined.
RESULTS: A total of 2737 HIV-positive ART-naïve patients from 22 sites in 13 Asian countries and territories were eligible. The overall median (IQR) CD4 cell count at ART initiation was 150 (46-241) cells/mm(3). Median CD4 cell counts at ART initiation increased over time, from a low point of 115 cells/mm(3) in 2008 to a peak of 302 cells/mm(3) after 2011 (p for trend 0.002). The proportion of patients with late ART initiation significantly decreased over time from 79.1% before 2007 to 36.3% after 2011 (p for trend <0.001). Factors associated with late ART initiation were year of ART initiation (e.g. 2010 vs. before 2007; OR 0.40, 95% CI 0.27-0.59; p<0.001), sex (male vs. female; OR 1.51, 95% CI 1.18-1.93; p=0.001) and HIV exposure risk (heterosexual vs. homosexual; OR 1.66, 95% CI 1.24-2.23; p=0.001 and intravenous drug use vs. homosexual; OR 3.03, 95% CI 1.77-5.21; p<0.001). Factors associated with mortality after ART initiation were late ART initiation (HR 2.13, 95% CI 1.19-3.79; p=0.010), sex (male vs. female; HR 2.12, 95% CI 1.31-3.43; p=0.002), age (≥51 vs. ≤30 years; HR 3.91, 95% CI 2.18-7.04; p<0.001) and hepatitis C serostatus (positive vs. negative; HR 2.48, 95% CI 1.-4.36; p=0.035).
CONCLUSIONS: Median CD4 cell count at ART initiation among Asian patients significantly increases over time but the proportion of patients with late ART initiation is still significant. ART initiation at higher CD4 cell counts remains a challenge. Strategic interventions to increase earlier diagnosis of HIV infection and prompt more rapid linkage to ART must be implemented.
A Retrospective Study on the Fracture Toughness of the Coronal Restorations in Endodontically Restored Teeth. An Original Research

Lavanya Priya KP, Gill S, Banik A, Marvaniya J, Marella K, Anusha Y, et al.

J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S132-S136.
PMID: 37654297 DOI: 10.4103/jpbs.jpbs_436_22

INTRODUCTION: The best treatment for the deeply carious tooth that cannot be restored is by the root canal therapy. This method has saved many patients from the loss of tooth. The common practice is either to deliver a full crown or close the access cavity with restoration. Hence in this study, the clinical longevity of the routine practice is tested for by analyzing the fracture toughness and the survival of the teeth that were restored endodontically with various materials.
MATERIALS AND METHODS: The hospital records were retrospectively evaluated from 2000 to 2010 for a decade. The demographics as well as the survival and the failure rates noted and compared for the various types of the restorations. The number of the walls of the teeth was also compared.
RESULTS: Thousand teeth were considered in the study. Less than 7% of teeth had coronal fractures. Of the 93% teeth that had survived, the most common restoration was Individual post (+ crown) followed by GIC, amalgams, and crowns. The mean survival of the crown+ bridge & gold restoration was highest. The mean survival was 10 ± 2 years for the restored teeth without any fractures at the coronal level. The failure was greatest for the GIC followed by amalgam, and the variations when compared with other restorations were significant. There was no significant difference for the number of the walls on the crown; however, the number of walls present was proportional to the survival rate.
CONCLUSION: The teeth that were covered with a crown were comparatively fracture resistant and had a better survival rate compared to other restorations. GIC showed highest fracture, and the post core with crown had the best survival. Restoration of the lost crown architecture and the reinforcement are the best methods that can be followed for the survivals.
Bacillus cereus as a biotemplating agent for the synthesis of zinc oxide with raspberry- and plate-like structures

Hussein MZ, Azmin WH, Mustafa M, Yahaya AH

J Inorg Biochem, 2009 Aug;103(8):1145-50.
PMID: 19577306 DOI: 10.1016/j.jinorgbio.2009.05.016

Currently the development of green chemistry approach with the use of biomaterial-based activities of microbial cells in the synthesis of various nanostructures has attracted a great attention. In this study, we report on the use of bacterium, Bacillus cereus as a biotemplating agent for the formation of zinc oxide nanoparticles with raspberry- and plate-like structures through a simple thermal decomposition of zinc acetate by maintaining the original pH of the reaction mixtures. Possible mechanism on the formation of the nanostructures is proposed based on the surface chemistry and biochemistry processes involved organic-inorganic interactions between zinc oxide and the microbial cells.
Fulltext An evaluation of the World Health Organization's 1997 and 2009 dengue classifications in hospitalized dengue patients in Malaysia

Zakaria Z, Zainordin NA, Sim BL, Zaid M, Haridan US, Aziz AT, et al.

J Infect Dev Ctries, 2014 Jul;8(7):869-75.
PMID: 25022297 DOI: 10.3855/jidc.4283

INTRODUCTION: The latest revised version of the World Health Organization's dengue classification was released in 2009. A handful of studies have taken initiatives to evaluate the old and revised guidelines to determine early signs and symptoms of severe dengue. This retrospective study aimed to compare the classification of dengue using both the 1997 and 2009 guidelines in a selected cohort of dengue patients from Peninsular Malaysia between 2008 and 2012.
METHODOLOGY: Adult dengue patients were recruited from tertiary hospitals in two different states, Selangor and Kelantan, in Peninsular Malaysia. Their clinical manifestations were assessed.
RESULTS: A total of 281 confirmed dengue patients were enrolled; the mean duration of illness at admission was five days. Of these, 88.6%, 10.7%, and 0.7% were classified according to the 1997 guidelines as having dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), respectively. When the WHO 2009 guidelines were applied, 17.1%, 78.3%, and 4.6% were classified as dengue without warning signs, dengue with warning signs, and severe dengue, respectively.
CONCLUSIONS: Our data suggests that the revised WHO 2009 guidelines stratify a much larger proportion of patients into a category that requires a higher level of medical and nursing care.
Apocynum venetum leaf extract, an antihypertensive herb, inhibits rat aortic contraction induced by angiotensin II: a nitric oxide and superoxide connection

Lau YS, Kwan CY, Ku TC, Hsieh WT, Wang HD, Nishibe S, et al.

J Ethnopharmacol, 2012 Sep 28;143(2):565-71.
PMID: 22835814 DOI: 10.1016/j.jep.2012.07.012

The leaves extract of Apocynum venetum (AVLE), also known as "luobuma", have long been used in traditional Chinese medicine to treat hypertension and depression in parts of China and it has been shown to possess anti-oxidant and anti-lipid peroxidation effects. AVLE (10 μg/ml) has been reported to have a long-lasting endothelium-dependent relaxant effect and this effect has been proposed to be due to its nitric oxide(NO)-releasing and superoxide anion(SOA)-scavenging properties.
Mechanisms of the anti-hypertensive effect of Hibiscus sabdariffa L. calyces

Ajay M, Chai HJ, Mustafa AM, Gilani AH, Mustafa MR

J Ethnopharmacol, 2007 Feb 12;109(3):388-93.
PMID: 16973321

Previous studies have demonstrated the anti-hypertensive effects of Hibiscus sabdariffa L. (HS) in both humans and experimental animals. To explore the mechanisms of the anti-hypertensive effect of the HS, we examined the effects of a crude methanolic extract of the calyces of HS (HSE) on vascular reactivity in isolated aortas from spontaneously hypertensive rats. HSE relaxed, concentration-dependently, KCl (high K(+), 80 mM)- and phenylephrine (PE, 1 microM)-pre-contracted aortic rings, with a greater potency against the alpha(1)-adrenergic receptor agonist. The relaxant effect of HSE was partly dependent on the presence of a functional endothelium as the action was significantly reduced in endothelium-denuded aortic rings. Pretreatment with atropine (1 microM), L-NAME (10 microM) or methylene blue (10 microM), but not indomethacin (10 microM), significantly blocked the relaxant effects of HSE. Endothelium-dependent and -independent relaxations induced by acetylcholine and sodium nitroprusside, respectively, were significantly enhanced in aortic rings pretreated with HSE when compared to those observed in control aortic rings. The present results demonstrated that HSE has a vasodilator effect in the isolated aortic rings of hypertensive rats. These effects are probably mediated through the endothelium-derived nitric oxide-cGMP-relaxant pathway and inhibition of calcium (Ca(2+))-influx into vascular smooth muscle cells. The present data further supports previous in vivo findings and the traditional use of HS as an anti-hypertensive agent.
Influence of high temperature on the performance of aerobic granular sludge in biological treatment of wastewater

Ab Halim MH, Nor Anuar A, Abdul Jamal NS, Azmi SI, Ujang Z, Bob MM

J Environ Manage, 2016 Dec 15;184(Pt 2):271-280.
PMID: 27720606 DOI: 10.1016/j.jenvman.2016.09.079

The effect of temperature on the efficiency of organics and nutrients removal during the cultivation of aerobic granular sludge (AGS) in biological treatment of synthetic wastewater was studied. With this aim, three 3 L sequencing batch reactors (SBRs) with influent loading rate of 1.6 COD g (L d)(-1) were operated at different high temperatures (30, 40 and 50 °C) for simultaneous COD, phosphate and ammonia removal at a complete cycle time of 3 h. The systems were successfully started up and progressed to steady state at different cultivation periods. The statistical comparison of COD, phosphate and ammonia for effluent from the three SBRs revealed that there was a significant difference between groups of all the working temperatures of the bioreactors. The AGS cultivated at different high temperatures also positively correlated with the accumulation of elements including carbon, oxygen, phosphorus, silicon, iron, aluminium, calcium and magnesium that played important roles in the granulation process.
Evaluation of the effect of precursor ratios on the electrochemical performances of binder-free NiMn-phosphate electrodes for supercapattery

Gerard O, Ramesh S, Ramesh K, Numan A, Norhaffis Mustafa M, Khalid M, et al.

J Colloid Interface Sci, 2024 Apr 16;667:585-596.
PMID: 38657542 DOI: 10.1016/j.jcis.2024.04.101

Binary metal phosphate electrodes have been widely studied for energy storage applications due to the synergistic effects of two different transition elements that able to provide better conductivity and stability. Herein, the battery-type binder-free nickel-manganese phosphate (NiMn-phosphate) electrodes were fabricated with different Ni:Mn precursor ratios via microwave-assisted hydrothermal technique for 5 min at 90 °C. Overall, NiMn3P electrode (Ni:Mn = 1:3) showed an outstanding electrochemical performance, displaying the highest specific (areal) capacity at 3 A/g of 1262.4 C/g (0.44 C/cm2), and the smallest charge transfer resistance of 108.8 Ω. The enhanced performance of NiMn3P electrode can be ascribed to the fully grown amorphous nature and small-sized flake and flower structures of NiMn3P electrode material on the nickel foam (NF) surface. This configuration offered a higher number of active sites and a larger exposed area, facilitating efficient electrochemical reactions with the electrolyte. Consequently, the NiMn3P//AC electrode combination was chosen to further investigate its performance in supercapattery. The NiMn3P//AC supercapattery exhibited remarkable energy density of 105.4 Wh/kg and excellent cyclic stability with 84.7% retention after 3000 cycles. These findings underscored the superior electrochemical performance of the battery-type binder-free NiMn3P electrode, and highlight its potential for enhancing the overall performance of supercapattery.
Characterizing the mechanisms of insulin vasodilatation of normal and streptozotocin-induced diabetic rat aorta

Subramaniam G, Achike FI, Mustafa MR

J Cardiovasc Pharmacol, 2009 Apr;53(4):333-40.
PMID: 19295443 DOI: 10.1097/FJC.0b013e31819fd4a7

The mechanism by which insulin causes vasodilatation remains unclear, so we explored this in aortic rings from normal Wistar Kyoto and streptozotocin-induced diabetic rats. Insulin-induced relaxation of phenylephrine-contracted [endothelium (ED) intact or denuded] aortic rings was recorded in the presence or absence of various drug probes. Insulin relaxant effect was more in ED-intact than in-denuded tissues from normal or diabetic rats. l-NAME or methylene blue partially inhibited insulin effect in ED-intact but not the ED-denuded tissues, whereas indomethacin (cyclooxygenase inhibitor) had no effect on any of the tissues, indicating that insulin induces relaxation by ED-dependent and -independent mechanisms, the former via the NOS-cyclic guanosine monophosphate but not the cyclooxygenase pathway. The voltage-dependent K channel (KV) blocker (4-aminopyridine) inhibited insulin action in all the tissues (normal or diabetic, with or without ED), whereas the selective BKCa blocker, tetraethylammonium, inhibited it in normal (ED intact or denuded) but not in diabetic tissues, indicating that KV mediates insulin action in normal and diabetic tissues, whereas the BKCa mediates it only in normal tissues, with possible pathophysiologic absence in diabetic tissues. The inward rectifier K channel (Kir) blocker (barium chloride) significantly inhibited insulin effect only in ED-intact or -denuded diabetic tissues, whereas the KATP channel blocker, glibenclamide, inhibited it only in the ED-denuded diabetic tissues, suggesting that Kir channels mediate insulin-induced relaxation in ED-intact or -denuded diabetic tissues, whereas the KATP channel mediates it in ED-denuded diabetic tissues. All the agents combined did not abolish insulin action, suggestive of a direct vasodilatory effect. In conclusion, insulin causes vasodilatation in normal and diabetic tissues via ED-dependent and -independent mechanisms differentially modulated by K channels, some of which functions are altered in diabetes and thus are potential therapeutic targets.
Environmental Factors Associated with the Presence of Vibrionaceae in Tropical Cage-Cultured Marine Fishes

Mohamad N, Mustafa M, Amal MNA, Saad MZ, Md Yasin IS, Al-Saari N

J Aquat Anim Health, 2019 06;31(2):154-167.
PMID: 30653742 DOI: 10.1002/aah.10062

This study investigated the environmental factors associated with the presence of Vibrionaceae in economically important cage-cultured tropical marine fishes: the Asian Seabass Lates calcarifer, snapper Lutjanus sp., and hybrid grouper Epinephelus sp. Fish sampling was conducted at monthly intervals between December 2016 and August 2017. The body weight and length of individual fish were measured, and the skin, eye, liver, and kidney were sampled for bacterial isolation and identification. Water physicochemical parameters during the sampling activities were determined, and the enumeration of total Vibrionaceae count was also conducted from water and sediment samples. Nine species of Vibrio were identified, including V. alginolyticus, V. diabolicus, V. harveyi, V. campbellii, V. parahaemolyticus, V. rotiferianus, V. furnissii, V. fluvialis, and V. vulnificus. Photobacterium damselae subsp. damselae was also identified. A total of 73% of the isolated Vibrio belonged to the Harveyi clade, followed by the Vulnificus clade (5.5%) and Cholera clade (0.6%). Highest occurrence of Vibrio spp. and P. damselae subsp. damselae was found in hybrid grouper (72%), followed by Asian Seabass (48%) and snapper (36%). The associations of Vibrio spp. and P. damselae subsp. damselae with the host fish were not species specific. However, fish mortality and fish size showed strong associations with the presence of some Vibrio spp. On average, 60% of the infected cultured fish exhibited at least one clinical sign. Nevertheless, inconsistent associations were observed between the pathogens and water quality. The yearlong occurrence and abundance of Vibrionaceae in the environmental components indicate that they might serve as reservoirs of these pathogens.
Application of lemongrass oil in vapour phase for the effective control of anthracnose of 'Sekaki' papaya

Ali A, Wee Pheng T, Mustafa MA

J Appl Microbiol, 2015 Jun;118(6):1456-64.
PMID: 25727701 DOI: 10.1111/jam.12782

To evaluate the potential use of lemongrass essential oil vapour as an alternative for synthetic fungicides in controlling anthracnose of papaya.
Fulltext Transmitted drug resistance and antiretroviral treatment outcomes in non-subtype B HIV-1-infected patients in South East Asia

Phanuphak P, Sirivichayakul S, Jiamsakul A, Sungkanuparph S, Kumarasamy N, Lee MP, et al.

J Acquir Immune Defic Syndr, 2014 May 01;66(1):74-9.
PMID: 24413039 DOI: 10.1097/QAI.0000000000000108

BACKGROUND: We compared treatment outcomes of transmitted drug resistance (TDR) in patients on fully or partially sensitive drug regimens.
METHODS: Factors associated with survival and failure were analyzed using Cox proportional hazards and discrete time conditional logistic models.
RESULTS: TDR, found in 60 (4.1%) of 1471 Asian treatment-naive patients, was one of the significant predictors of failure. Patients with TDR to >1 drug in their regimen were >3 times as likely to fail compared to no TDR.
CONCLUSIONS: TDR was associated with failure in the context of non-fully sensitive regimens. Efforts are needed to incorporate resistance testing into national treatment programs.
Determinants of Mortality in First-Ever Stroke Patients in the Suburban Malaysia: A Retrospective Hospital-Based Study, 2005-2011

Wan-Arfah N, Wan Muhamad Amir WA, Muzaimi M, Mustafa M, Naing NN

Iran J Public Health, 2015 Sep;44(9):1291-3.
PMID: 26587506
Spontaneous, extra-dural haematoma causing spinal cord compression

Mustafa M, Subramanian N

Int Orthop, 1996;20(6):383-4.
PMID: 9049770

We describe a patient with acute compression of the spinal cord by a spontaneous extra-dural haematoma. This rare condition is often misdiagnosed. We believe that an urgent MRI scan is indicated in patients presenting with progressive neurological deficit following spinal trauma. This allows the diagnosis of extra-dural haematoma to be made rapidly and for prompt decompression of the cord.
A PROspective study on the Usage patterns of Doripenem in the Asia-Pacific region (PROUD study)

Mustafa M, Chan WM, Lee C, Harijanto E, Loo CM, Van Kinh N, et al.

Int J Antimicrob Agents, 2014 Apr;43(4):353-60.
PMID: 24636429 DOI: 10.1016/j.ijantimicag.2014.01.017

Doripenem is approved in the Asia-Pacific (APAC) region for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP), complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs). Clinical usage of doripenem (500mg intravenously, infused over 1h or 4h every 8h for 5-14 days) in APAC was evaluated in a prospective, open-label, non-comparative, multicentre study of inpatients (≥18 years) with NP, VAP, cIAI or cUTI. A total of 216 [intention-to-treat (ITT)] patients received doripenem: 53 NP (24.5%); 77 VAP (35.6%); 67 cIAI (31.0%); and 19 cUTI (8.8%). Doripenem MIC90 values for Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were 32, 32, 0.094 and 0.64μg/mL, respectively. Doripenem was used most commonly as monotherapy (86.6%) and as second-line therapy (62.0%). The clinical cure rate in clinically evaluable patients was 86.7% at the end of therapy (EOT) and 87.1% at test of cure (TOC) (7-14 days after EOT). In the ITT population, overall clinical cure rates were 66.2% at EOT and 56.5% at TOC. The median duration of hospital stay, intensive care unit (ICU) stay and mechanical ventilation was 20, 12 and 10 days, respectively. Of 146 discharged patients, 7 were re-admitted within 28 days of EOT; 1 VAP patient was re-admitted to the ICU. The all-cause mortality rate was 22.7% (49/216). The most common treatment-related adverse events were diarrhoea (1.4%) and vomiting (1.4%). Doripenem is a viable option for treating APAC patients with NP, VAP, cIAI or cUTI. [ClinicalTrials.gov: NCT 00986102].

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