Evaluation of Bensal HP for the treatment of diabetic foot ulcers.
ABSTRACT The extract of oak bark (QRB7) has been used for years as a topical medication with success. QRB7 is the proprietary oak bark extract in Bensal HP. It is indicated as an external treatment for the inflammation and irritation associated with many common forms of dermatitis, including certain eczematoid conditions. These conditions include complications associated with pyodermas, and in the treatment of insect bites, burns, and fungal infections.
To quantitatively measure the difference in diabetic ulcer size reduction when using Bensal HP versus silver sulfadiazine cream (SSC) for topical treatment as an adjunct to conventional treatment.
Private office of the primary author.
Forty diabetic patients with noncellulitic plantar Wagner grade 1 or 2 ulcers and a minimal ankle brachial index of 0.75 were randomly assigned to either the Bensal HP (QRB7) treatment group or SSC control group for 6 weeks of treatment. In addition to either Bensal HP or SSC, all wounds were cultured and treated with debridement at time 0, 2, 4, and 6 weeks and with off-loading.
The combined wound diameter of the Bensal HP group decreased 72.5% compared to 54.7% for the SSC group. There was a statistical significance between the decreases in wound sizes after 6 weeks of treatment (P = .016). The Cohen effect size for the Bensal HP group was 2.06 compared with 1.03 for the SSC group.
In this tightly controlled 6-week study in which no patients were lost to follow-up, Bensal HP seems to be an effective treatment for properly treated diabetic ulcers, outperforming an identical control group whose only difference was SSC as a medication.
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ABSTRACT: MEDICATION SAFETY Overlooked Renal Dosage Adjustments A retrospective analysis of 647 patients at hospital discharge com-pared required renal dosage adjust-ments to dosage actually prescribed. This study was conducted at VieCuri Medical Centre in Venlo, Netherlands. Patient demographics and renal function data were col-lected, and dosage adjustment needs were assessed via the pharmacy-supported discharge counseling ser-vice. The incidence of inappropriate dosing based on renal function was measured at hospital discharge. Thirty-seven percent of patients evaluated during the study period (237/647) had a creatinine clear-ance less than 51 mL/min/1.73 m 2 ; dosage adjustment was warranted in 23.9% (411/1,718) of prescrip-tions. When dosage adjustment should have been performed, more than 40% of prescriptions (169/411; 41.1%) were inappropri-ate for renal function (9.8% of pre-scriptions overall; 169/1,718). Fur-thermore, 60.4% (102/169) of inappropriate prescriptions pos-sessed the potential for moderate or severe clinical consequences, as evaluated by a panel of two clinical pharmacologists and one nephrolo-gist. Study authors also noted a lack of standardized dosing guidelines for agents requiring renal dosage adjustment. The authors also sug-gested that augmenting medication systems by adding dynamic renal dosing alerts would improve moni-toring. Summary: A comparison of suggested renal dosing and actual dosing at hospital discharge revealed that appropriate prescribing may be overlooked. van Dijk EA, Drabbe NRG, Kruijtbosch M, De Smet PAGM. Drug dosage adjust-ments according to renal function at hos-pital discharge. Ann Pharmacother. 2006;40:1254-1260.Hospital pharmacy 12/1122; 41. DOI:10.1310/hpj4311-937
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ABSTRACT: Complementary and alternative medicines (CAMs) are widely used by the general public. Natural products including plant-derived extracts (phytochemicals) and naturally derived substances, such as honey, are an important component of CAM. Here, we review the evidence for their use in wound care. Wound healing is complex and disruption of this process can lead to considerable morbidity, including chronic wounds, infection, and scarring. Natural products have a long history of use in wound care, but there are only a few rigorous studies. With the growing interest in the use of natural products and the belief that they are safer than standard therapies, it is vital to understand the current knowledge of their efficacy and side effects. Natural products possess antioxidant, anti-inflammatory, angiogenic, and cell synthesis-modulating components among many others. However, this complex composition of chemicals may increase the risk for irritant or allergic side effects. Natural products can be much cheaper than conventional treatments, but further study is needed to better understand their efficacy. The type of wound and the potential for side effects need to be carefully considered when choosing a treatment. The research to date is supportive of the use of natural products in wound care. Patients need to be cautioned of potential side effects. Collaborative research between allopathic medicine and medical systems that frequently employ phytochemicals and naturally derived substances, such as Ayurveda and naturopathy, will provide a better understanding of how to integrate natural products into wound care.10/2012; 1(5):213-217. DOI:10.1089/wound.2011.0330