This covers them all....Mercola, Becker, Cesar and a few more.

[dottiesyrky]

The statistics given in the hospital admissions reference studies give wide ranges, dependent on many factors....ages, hospitals etcetera etc. This is not an exact science and we should not quibble about range subsets as we are not comparing apples with apples. Within a 1-20 % range, an individual subset range could well be 15-20%? Not a valid quibble in my view.
I gather that these numbers are meant to give a broad idea of the extent of the problem and that individual studies could well be different from the mean value.
As a physical scientist, medical science reports seem very inexact to me. With good reason as people are not machines.
We still need to answer the question re the validity of the saliva allergy test and I look forward to knowing the result of the ongoing literature and other research being conducted here.

[pstinard]

Originally Posted by dottiesyrky

The statistics given in the hospital admissions reference studies give wide ranges, dependent on many factors....ages, hospitals etcetera etc. This is not an exact science and we should not quibble about range subsets as we are not comparing apples with apples. Within a 1-20 % range, an individual subset range could well be 15-20%? Not a valid quibble in my view.
I gather that these numbers are meant to give a broad idea of the extent of the problem and that individual studies could well be different from the mean value.
As a physical scientist, medical science reports seem very inexact to me. With good reason as people are not machines.
We still need to answer the question re the validity of the saliva allergy test and I look forward to knowing the result of the ongoing literature and other research being conducted here.

I agree. Since there ARE studies that show a higher percentage, I'm not willing to quibble either. I do think that people need to take charge of their own health care and ask more questions about drugs and treatment options, and also keep in mind that no drug is 100% risk free. That goes for dogs as well as humans. Well, humans have to ask their vets on behalf of the dogs .

And getting back to the Nutriscan saliva food intolerance test, I'll remain vigilant and keep following up on the leads we have so far .

[dottiesyrky]

Thank you. The decisions we have to make medically for ourselves and our pets are fraught with difficulty as many procedures and meds have hazards that are not always predictable.
Good luck with the Nutriscan investigation

[yorkietalkjilly]

Originally Posted by pstinard

We concluded amongst ourselves that a peer-reviewed clinical study with experimental and control groups would be needed to demonstrate that the Nutriscan test works. Nothing has disproved the test yet. Dr. Remillard and the Skeptvet have said that they would take a look at Dr. Dodds' work (Dr. Remillard will check out the Canine Nutrigenomics book; and Skeptvet will look at the Nutriscan test and the Canine Nutrigenomics book) and get back to us. Gail plans to follow up with Dr. Dodds directly to see if a peer-reviewed study will be coming out soon.

Ah, thank you so much for that information - that's all I wanted to know was whether it had been proven to be a thoroughly useless but expensive test for most dogs or the jury was still out from the scientific community in this discipline. I'll admit it sounds like a bit of a yearly money-game at this point but my dog's not in desperate shape with all types of vet care failing him so I'll wait to hear what happens with any further study.

Apparently Dr. Remillard and the Skeptvet are highly reputable, non-biased resources that most on the forum trust? I've only heard of Dr. Remillard via posts but not the Skeptvet before this thread. I've started to learn more but have limited time online - just am on in spurts, not long enough to properly research. I think Dr. Remillard usually treats dogs like Tibbe with diet changes and until recently, he's been unable to eat anything different without a very bad result so I've been scared to sign on with that regimen so far. He gets so sick so quickly and it's weeks until he's well.

My Tibbe's had some itching, some hair loss, very bad odor despite frequent bathing, some paw chewing, pus-y eyes at times and a hot spot at two different times so I need to learn more about food sensitivity diagnostics and treatments in case it returns. He's got IBS and MVD. I need to find a way to treat any return of the bad itching, etc., without having him vomiting and running diarrhea or ticking off his IBS and /or MVD.

For the first time, after taking antibiotics and prescription shampoo for his bad odor earlier this year and starting him on a combination of OTC products with more than a little trepidation, Dogzymes Max Probiotics and coconut oil(both sent to me by lisaly(Lisa) on his food, he's not itching badly(scratches 2-3 x daily), not losing hair, not paw-chewing and is finally able to accept more of his hepatic kibble food per meal - which prior to the probiotics and coconut oil additives, was virtually impossible. He could tolerate only a limited amount of the Hill's canned hepatic and then would itch up to 10+ times a day afterward, was rubbing his head to scratch his face and developed the hot spots. Less of the Hill's canned hepatic, he'd stop itching, paw-licking but get lethargic, refuse food, spit up bile.

I thought I'd try the Hill's Hepatic kibble to see if that would work better for any reason but I'd add one or two kibbles of the Hill's I/D hepatic kibble food to his meal and he was soon vomiting and having pus-y stools or diarrhea - all 3 times I tried it. It didn't seem coincidental.

Now, after being on the probiotics and coconut oil for a few months, he's eating half and half of the hepatic kibble and Hill's I/D GI and friskier and happier than I've seen him in the longest time. I'm hesitant to say for sure it's the OTC food additives but the vet agreed with me trying them might be worth it if they helped him and for the longest time now since he's had MVD, he's been nausea/vomiting- and lethargy-free. I'm beginning to think the only thing I changed has been to add the food additives and they could be making the difference.

So, though I never thought I'd say it, I'm beginning to be open to learning more about other treatment methods for the time being, at least. For the first time in a long time, Tibbe's doing really well. He'll go in next in June for a check-up to evaluate whether he should remain on the probiotics and coconut oil. I hope he has no systemic damage since they seem to be making a difference where nothing else that he can tolerate has.

[pstinard]

Originally Posted by yorkietalkjilly

Ah, thank you so much for that information - that's all I wanted to know was whether it had been proven to be a thoroughly useless but expensive test for most dogs or the jury was still out from the scientific community in this discipline. I'll admit it sounds like a bit of a yearly money-game at this point but my dog's not in desperate shape with all types of vet care failing him so I'll wait to hear what happens with any further study.

Apparently Dr. Remillard and the Skeptvet are highly reputable, non-biased resources that most on the forum trust? I've only heard of Dr. Remillard via posts but not the Skeptvet before this thread. I've started to learn more but have limited time online - just am on in spurts, not long enough to properly research. I think Dr. Remillard usually treats dogs like Tibbe with diet changes and until recently, he's been unable to eat anything different without a very bad result so I've been scared to sign on with that regimen so far. He gets so sick so quickly and it's weeks until he's well.

My Tibbe's had some itching, some hair loss, very bad odor despite frequent bathing, some paw chewing, pus-y eyes at times and a hot spot at two different times so I need to learn more about food sensitivity diagnostics and treatments in case it returns. He's got IBS and MVD. I need to find a way to treat any return of the bad itching, etc., without having him vomiting and running diarrhea or ticking off his IBS and /or MVD.

For the first time, after taking antibiotics and prescription shampoo for his bad odor earlier this year and starting him on a combination of OTC products with more than a little trepidation, Dogzymes Max Probiotics and coconut oil(both sent to me by lisaly(Lisa) on his food, he's not itching badly(scratches 2-3 x daily), not losing hair, not paw-chewing and is finally able to accept more of his hepatic kibble food per meal - which prior to the probiotics and coconut oil additives, was virtually impossible. He could tolerate only a limited amount of the Hill's canned hepatic and then would itch up to 10+ times a day afterward, was rubbing his head to scratch his face and developed the hot spots. Less of the Hill's canned hepatic, he'd stop itching, paw-licking but get lethargic, refuse food, spit up bile.

I thought I'd try the Hill's Hepatic kibble to see if that would work better for any reason but I'd add one or two kibbles of the Hill's I/D hepatic kibble food to his meal and he was soon vomiting and having pus-y stools or diarrhea - all 3 times I tried it. It didn't seem coincidental.

Now, after being on the probiotics and coconut oil for a few months, he's eating half and half of the hepatic kibble and Hill's I/D GI and friskier and happier than I've seen him in the longest time. I'm hesitant to say for sure it's the OTC food additives but the vet agreed with me trying them might be worth it if they helped him and for the longest time now since he's had MVD, he's been nausea/vomiting- and lethargy-free. I'm beginning to think the only thing I changed has been to add the food additives and they could be making the difference.

So, though I never thought I'd say it, I'm beginning to be open to learning more about other treatment methods for the time being, at least. For the first time in a long time, Tibbe's doing really well. He'll go in next in June for a check-up to evaluate whether he should remain on the probiotics and coconut oil. I hope he has no systemic damage since they seem to be making a difference where nothing else that he can tolerate has.

Wow, that's a lot of ups and downs for poor Tibbe. I'm glad that he's doing better. I'd be very cautious about changing the diet if you've found something that works for him.

The jury is still out on the Nutriscan test, but if you did get it done, and the the test did recommend a dietary change, that *could* throw Tibble out of whack again. In Tibbe's case, I'd only do it as a last resort, after every other option has been exhausted. In the meantime, we're trying to get answers on Nutriscan, and hopefully there will a definitive answer before Tibbe needs to consider alternative options.

BTW, Dr. Remillard is a very reputable veterinarian nutritionist. The Skeptvet, Dr. Brennen McKenzie, is a proponent of evidence-based veterinary medicine, and he writes a lot about whether or not various alternative forms of veterinary medicine are safe, effective, and proven.

[yorkietalkjilly]

Originally Posted by pstinard

Wow, that's a lot of ups and downs for poor Tibbe. I'm glad that he's doing better. I'd be very cautious about changing the diet if you've found something that works for him.

The jury is still out on the Nutriscan test, but if you did get it done, and the the test did recommend a dietary change, that *could* throw Tibble out of whack again. In Tibbe's case, I'd only do it as a last resort, after every other option has been exhausted. In the meantime, we're trying to get answers on Nutriscan, and hopefully there will a definitive answer before Tibbe needs to consider alternative options.

BTW, Dr. Remillard is a very reputable veterinarian nutritionist. The Skeptvet, Dr. Brennen McKenzie, is a proponent of evidence-based veterinary medicine, and he writes a lot about whether or not various alternative forms of veterinary medicine are safe, effective, and proven.

Thank you for your patience and information questions. Phil, is it? Thanks for all who have posted here, the pro's and con's of these type of alternative medicines and dog handling issues.

No, I'll not try the test until I know whether it's a valid test with worthy results that can lead to really helping a dog. Thanks for the information on the two vets - GTK. Good resources to check out. I'd particularly like to check out on their websites for info or links to research to find out if probiotics and coconut oil are harmful to dogs or MVD dogs in the long term, side-effects and try to weigh that vs. what help they might be giving Tibbe now, etc. I did use posts on YT and do a Google search on both before I started him on either of them and couldn't find anything that jumped out for MVD dogs. My vet okayed trying out both and then do an exam, bloodwork during his regular bi-annual check-up in June and again in December.

Right now, I'm learning more little by little as I can be online and enjoying my wired little terrier as he hasn't been for quite some time - well - and apparently, it's due to his 2 food additives (?); but of course, it could be coincidence - maybe that's the nature of IBS and MVD and food sensitivities - to take a sudden time-out and give the dog a real break and before long, it all returns in force. At least I don't think Tibbe is having a placebo effect - he doesn't even know he's getting them. But I'm going to continue to give the OTC additives to him until I have a reason to stop as he seems to be doing better than ever before with no other explanation his vets or I are aware of. We'll see how his June check-up goes.

[ladyjane]

Originally Posted by gemy

FDA has a lot of warts and so does the Canadian equivalent!/ Don't tell me that drugs such as thalidimide which underwent FDA approval based on *scientific trials* and oh yes how about Vioxx? again approved by FDA and its Canadian counterpart balderdash at the minimum science gets it wrong and somehow our watchdogs are anything but a watchdog! A independent oversight organization needs private funding not bloody funding by the big Pharma companies//// That laughs at bias.


Do you know that anywhere between 15-20% of hospital admissions are for drug interactions!!! That is prescription Rx drug interactions.


That is a huge number! And where is the public outrage about this?


Where are the studies that show why this is so???????


Oh I have taken drugs that could have toxic effects on my liver, heart and kidneys, and now no more - as those self same drugs have negatively affected one of those organs. Oh yes you get the very very very brief laugh at informed consent to these drugs - but I knew because of my research how toxic they were ! Now because of my liver values I am off them for awhile - and we shall see if my liver recovers! How-ever as the drugs DID NOT work and relatively recent research over the past 10yrs show that they have at best50% efficacy but oh yes the biologics similar toxicity but have shown some promise to actually treat the ms disease is about 1500-1800 monthly which is now a crap shoot (not to mention unaffordable)- sic because of my liver values - oh yes thank you very much western science.

Originally Posted by ladyjane

No, I had not heard this. Where are those figures from?

Originally Posted by ladyjane

OK....Gemy said it was 15 - 20% ... this says 5 - 10%. Big difference. I was just wondering where she got her figures.

I just scanned this and will try to concentrate on it later on today. It is an interesting topic.

Thanks, Phil!

I see the word quibbling floating about and see why now...my second post on the topic! I said the words "big difference" and that took away from my original question which was where did Gemy get this information.

The bottom line though is that I wanted to know where the numbers came from. The post had come across to me as that alarming amounts of people were being harmed by prescription drugs.

Phil answered me and at least I understand now that upwards of 1/4 of all hospital admissions are not horrible reactions to prescription meds.
It just alarmed me in the wording is all. Perhaps it might others as well. I am pretty clear now on the numbers...and the reasons.

[pstinard]

Originally Posted by yorkietalkjilly

Thank you for your patience and information questions. Phil, is it? Thanks for all who have posted here, the pro's and con's of these type of alternative medicines and dog handling issues.

No, I'll not try the test until I know whether it's a valid test with worthy results that can lead to really helping a dog. Thanks for the information on the two vets - GTK. Good resources to check out. I'd particularly like to check out on their websites for info or links to research to find out if probiotics and coconut oil are harmful to dogs or MVD dogs in the long term, side-effects and try to weigh that vs. what help they might be giving Tibbe now, etc. I did use posts on YT and do a Google search on both before I started him on either of them and couldn't find anything that jumped out for MVD dogs. My vet okayed trying out both and then do an exam, bloodwork during his regular bi-annual check-up in June and again in December.

Right now, I'm learning more little by little as I can be online and enjoying my wired little terrier as he hasn't been for quite some time - well - and apparently, it's due to his 2 food additives (?); but of course, it could be coincidence - maybe that's the nature of IBS and MVD and food sensitivities - to take a sudden time-out and give the dog a real break and before long, it all returns in force. At least I don't think Tibbe is having a placebo effect - he doesn't even know he's getting them. But I'm going to continue to give the OTC additives to him until I have a reason to stop as he seems to be doing better than ever before with no other explanation his vets or I are aware of. We'll see how his June check-up goes.

I haven't read anything about long term use of coconut oil and probiotics being harmful--at least I don't think that they are harmful for dogs without health issues. I hope that Tibbe's next round of test results are good, and that you can keep on doing what you've been doing to relieve his itching and food sensitivity!

[pstinard]

Originally Posted by yorkietalkjilly

Ah, thank you so much for that information - that's all I wanted to know was whether it had been proven to be a thoroughly useless but expensive test for most dogs or the jury was still out from the scientific community in this discipline. I'll admit it sounds like a bit of a yearly money-game at this point but my dog's not in desperate shape with all types of vet care failing him so I'll wait to hear what happens with any further study.

Apparently Dr. Remillard and the Skeptvet are highly reputable, non-biased resources that most on the forum trust? I've only heard of Dr. Remillard via posts but not the Skeptvet before this thread. I've started to learn more but have limited time online - just am on in spurts, not long enough to properly research. I think Dr. Remillard usually treats dogs like Tibbe with diet changes and until recently, he's been unable to eat anything different without a very bad result so I've been scared to sign on with that regimen so far. He gets so sick so quickly and it's weeks until he's well.

My Tibbe's had some itching, some hair loss, very bad odor despite frequent bathing, some paw chewing, pus-y eyes at times and a hot spot at two different times so I need to learn more about food sensitivity diagnostics and treatments in case it returns. He's got IBS and MVD. I need to find a way to treat any return of the bad itching, etc., without having him vomiting and running diarrhea or ticking off his IBS and /or MVD.

For the first time, after taking antibiotics and prescription shampoo for his bad odor earlier this year and starting him on a combination of OTC products with more than a little trepidation, Dogzymes Max Probiotics and coconut oil(both sent to me by lisaly(Lisa) on his food, he's not itching badly(scratches 2-3 x daily), not losing hair, not paw-chewing and is finally able to accept more of his hepatic kibble food per meal - which prior to the probiotics and coconut oil additives, was virtually impossible. He could tolerate only a limited amount of the Hill's canned hepatic and then would itch up to 10+ times a day afterward, was rubbing his head to scratch his face and developed the hot spots. Less of the Hill's canned hepatic, he'd stop itching, paw-licking but get lethargic, refuse food, spit up bile.

I thought I'd try the Hill's Hepatic kibble to see if that would work better for any reason but I'd add one or two kibbles of the Hill's I/D hepatic kibble food to his meal and he was soon vomiting and having pus-y stools or diarrhea - all 3 times I tried it. It didn't seem coincidental.

Now, after being on the probiotics and coconut oil for a few months, he's eating half and half of the hepatic kibble and Hill's I/D GI and friskier and happier than I've seen him in the longest time. I'm hesitant to say for sure it's the OTC food additives but the vet agreed with me trying them might be worth it if they helped him and for the longest time now since he's had MVD, he's been nausea/vomiting- and lethargy-free. I'm beginning to think the only thing I changed has been to add the food additives and they could be making the difference.

So, though I never thought I'd say it, I'm beginning to be open to learning more about other treatment methods for the time being, at least. For the first time in a long time, Tibbe's doing really well. He'll go in next in June for a check-up to evaluate whether he should remain on the probiotics and coconut oil. I hope he has no systemic damage since they seem to be making a difference where nothing else that he can tolerate has.

Hi Jeanie,

I did a little followup on the use of probiotics and coconut oil for dog skin problems. There is one peer-reviewed article on the use of probiotics to treat skin conditions in dogs, and it was quite favorable, although they only gave it to beagle puppies. They cited the need for additional research in a broader group of dogs, but it was promising: Early exposure to probiotics in a canine model of atopic dermatitis has long-term clinical and immunological effects

Conclusion: In summary, in this follow-up study in our canine model, a positive clinical effect was found after oral administration of LGG [Lactobacillus rhamnosus GG] in highly predisposed atopic Beagles. Although no changes in TGF-β1 were found, a significantly lower production of IL-10 was evident in PBMC from probiotics-exposed dogs after allergen stimulation. We conclude that this model could be beneficial to aid in the evaluation of the immune mechanisms involved with probiotics administration and analyze the impact of genetic background. Additional studies with larger number of dogs are warranted to better assess the protective effects of probiotics against development of allergies.

There are no peer-reviewed studies yet on the use of coconut oil to treat skin allergies. All of the anecdotal information is good, however, and if your vet says that it's okay to feed Tibbe coconut oil, I would say go for it! Good luck with Tibbe, and keep us posted on his June test results!

[yorkietalkjilly]

Originally Posted by pstinard

Hi Jeanie,

I did a little followup on the use of probiotics and coconut oil for dog skin problems. There is one peer-reviewed article on the use of probiotics to treat skin conditions in dogs, and it was quite favorable, although they only gave it to beagle puppies. They cited the need for additional research in a broader group of dogs, but it was promising: Early exposure to probiotics in a canine model of atopic dermatitis has long-term clinical and immunological effects

Conclusion: In summary, in this follow-up study in our canine model, a positive clinical effect was found after oral administration of LGG [Lactobacillus rhamnosus GG] in highly predisposed atopic Beagles. Although no changes in TGF-β1 were found, a significantly lower production of IL-10 was evident in PBMC from probiotics-exposed dogs after allergen stimulation. We conclude that this model could be beneficial to aid in the evaluation of the immune mechanisms involved with probiotics administration and analyze the impact of genetic background. Additional studies with larger number of dogs are warranted to better assess the protective effects of probiotics against development of allergies.

There are no peer-reviewed studies yet on the use of coconut oil to treat skin allergies. All of the anecdotal information is good, however, and if your vet says that it's okay to feed Tibbe coconut oil, I would say go for it! Good luck with Tibbe, and keep us posted on his June test results!

I really appreciate the time you took to find and review both additives for me. The way so many members here work to help others and give support is phenomenal! YT really has some special members who are here just to help out and give of themselves. I'm so glad to have found YT.

Having a dog with MVD and IBS who needs to eat a certain kind of diet for both conditions and to find that the MVD diet really causes a lot of itching, skin discomfort and really scary IBS bouts if I veer from the Hill's is so disheartening. Trying to find a health middle road that doesn't tick off one condition over the other is like walking a tight rope. I truly want to thank you and can't wait to read this through. Have a wonderful evening, Phil. Hugs to you and beautiful Bella!

[ladyjane]

Interesting read:

Why You Trust the Internet More Than Your Doctor - The Daily Beast

From the above link:
Yes, medicines have side effects, but that’s only because they have effects. No treatment that could potentially help you is 100 percent safe, and if anyone claims otherwise, you can be 100 percent assured it is fraud.

[Lovetodream88]

Originally Posted by ladyjane

Interesting read:

Why You Trust the Internet More Than Your Doctor - The Daily Beast

From the above link:
Yes, medicines have side effects, but that’s only because they have effects. No treatment that could potentially help you is 100 percent safe, and if anyone claims otherwise, you can be 100 percent assured it is fraud.

[107barney]

Originally Posted by gracielove

So? I chose to delete it because there is enough bashing going on in this thread. So many of you have no respect for the opinions of others that this forum is going to be a total one sided, lock step bunch of misinformation if it does not stop. Bulling on a Yorkie forum should not be allowed. Opinion is opinion and that is all. Unless someone has facts to back up their opinion it means nothing.

So? Many of us know the vitriol you spewed in your original post, and you call others bullies!!?

[Lovetodream88]

[quote=gracielove;4554201]

Originally Posted by Lovetodream88

Plenty of facts to back it up and didn't see any bullying. It's funny you should say that when you wanted to call me out as a liar when in fact I had proof that I was not lying and you were the one who had there facts mixed up! Yeah still waiting for that apology........[/QUOTE
I did not say anything in that post that was offensive. it is offensive to you because it is contrary to your opinion. Go bully someone else.

Having been the victim of bullying in school and on here I do not believe that you know what it is. Please do look it up because calling things that are not bullying bullying really is offensive for those who have been through it.

[gemy]

Originally Posted by ladyjane

OK....Gemy said it was 15 - 20% ... this says 5 - 10%. Big difference. I was just wondering where she got her figures.

I just scanned this and will try to concentrate on it later on today. It is an interesting topic.

Thanks, Phil!

Sorry Linda playing catch up here. Here is one quick search that yielded the following:


Keywords:

drug interaction;
adverse drug reaction;
hospital admissions;
hospital visits;
pharmacoepidemiology

ABSTRACT

Purpose

To estimate prevalences of hospital admissions/visits associated with actual drug–drug interactions (DDIs) and examine the effect of study design (prospective vs. retrospective), population (all ages or adults), and method of detecting DDIs on reported prevalences.


Methods

PubMed, International Pharmaceutical Abstracts, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature plus, and the Cochrane Database of Systematic Reviews up to October 2013 were searched for observational studies examining actual DDIs, in any language. The outcomes in this study were DDI prevalence rates in total populations, DDI prevalence rates in total adverse drug reaction patients, and frequency (%) of each pair of DDIs.


Results

Thirteen studies met our inclusion criteria. The median DDI prevalence rate for hospital admissions was 1.1% (367 DDI cases/47 976 patients, interquartile range [IQR] 0.4–2.4%). The median DDI prevalence rate for hospital visits was 0.1% (20 DDI cases/23 607 patients, IQR 0.0–0.3%). In adverse drug reaction patients, the median DDI prevalence rate for hospital admissions (308 DDI cases/1683 patients) and hospital visits (8 DDI cases/90 patients) were 22.2% (IQR 16.6–36.0%) and 8.9%, respectively. Medical record, interview, drug interaction screening program, adverse reaction report, and electronic medical record were identified as methods used for detecting DDIs. Non-steroidal anti-inflammatory drugs were most commonly involved in hospital admission associated DDIs, whereas warfarin was frequently involved in DDIs detected at hospital visits as outpatients/emergencies.


Conclusions

Drug–drug interactions are a significant cause of hospital admissions and hospital visits. Improved DDI information gathering could help to reduce such adverse effects from DDIs, especially for patients using non-steroidal anti-inflammatory drugs and warfarin. Copyright © 2014 John Wiley & Sons, Ltd.


Hospital admissions/visits associated with drug–drug interactions: a systematic review and meta-analysis - Dechanont - 2014 - Pharmacoepidemiology and Drug Safety - Wiley Online Library source


In further elaboration the general stats I quoted were likely sourced from med articles that I read which referenced human research/stats as I was reviewing canine research.


The above literature does not pinpoint single drug as my time frees up I will try to search out some literature for you.