Efficacy of betadine vaginal toileting before caesarean section in postoperative infections

Background: The objective of the current study was to evaluate the efficacy of preoperative betadine vaginal toileting in reducing post caesarean infections (endometritis, febrile illness, wound sepsis).Methods: This prospective longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 3 months among 200 women who underwent caesarean delivery. Inclusion criteria were defined as women undergoing caesarean section. Exclusion criteria included placenta previa, active genital herpes, cord prolapse, chorioamnionitis, allergy to iodine. After taking informed consent, subjects were divided into two groups by simple randomization method using computer generated random numbers- Group 1 (case) - subjects who underwent 5% povidone iodine sponge stick cleansing in all the fornices and walls of vagina for 30 seconds after foley’s catheter insertion and before abdominal scrubbing. Group 2 (control) - subjects who didn't receive betadine vaginal toileting before caesarean section Subjects were followed for 10 days postpartum (or till suture removal/ discharge from hospital, whichever was late). Demographic data, operative details and postoperative parameters were compared between the two groups.Results: Both groups were matched for baseline patients’ characteristics (age, BMI, gestational age, operative time). Women who received preoperative betadine vaginal toileting had markedly less incidence of endometritis (case-3%, control-10%, p<0.05), overall postoperative morbidity (case-13%, control-33%, p<0.001). Incidence of postoperative febrile illness (case-6%, control-12%, p>0.05) and wound sepsis (case-5%, control-12%, p>0.05) were found to be less but not significant between both groups.Conclusions: Preoperative vaginal cleansing helps in reducing postoperative morbidity by decreasing incidence of postoperative infection.

Comparison of response to treatment of otomycosis using topical betadine and clotrimazole drops

INTRODUCTION:Otomycosis is the fungal infection of EAC (External Auditory Canal) that is very commonly seen in Ear , Nose and Throat clinics .Local debridement and antifungals , topical or systemic is the treatment of choice but recurrences are very common and resistant to treatment.METHODS:Total 220 patients, divided into two groups each 110 in 'A' and 'B' were subjected to betadine (povidone - iodine )10% solution and Clotrimazole (1 %) drops treatment and response of treatment assessed on 5th , 10th and 20th day and analyzed.RESULTS :Out of 110 patients in each group on 5th day 21.8 % patients in group 'A', and 23.6 % in group B' showed no response. 70.9 % in group 'A' and 72.7 % in group 'B' were showed good response at evaluation of 20th day of treatment.CONCLUSION :In our study, betadine (10% solution) and Clotrimazole (1 %) drops were equally effective in treatment of otomycosis. Betadine(10% solution) is low cost, non-ototoxic, nonresistant and equally effective in bacterial and fungal infection. That's why this study support betadine 10% solution as treatment of choice for otomycosis specially in developing countries

Evaluation of wound healing activity of Hibiscus rosa sinensis linn in albino rats

Background: From debridement to the appearance of healthy granulation tissue is the maximum time during which the patient suffers more economically and psychologically. Due to high cost expenditure in hospitalisation, dressing material cost and loss of daily earnings during this period which puts a psychological pressure over patient and family especially in India where majority of the population is still below poverty line. Also access to quick treatment is yet not possible to majority of population living in rural with no access to basic healthcare.Methods: It was an experimental study wherein Wistar rat models were used to check for the wound healing property of Hibiscus Rosa Sinensis (HRS) compared with one of the common standard drugs of treatment for available today, betadine. To observe the wound healing property of the HRS flower extract, the experiment was divided into 2 parts i.e. excision wound model and incision wound model. The groups were treated with respective medication along with a control group of rats.Results: At the end of the experiment, it was observed that HRS flower extract increased the wound breaking strength as compared to control but not as effectively as compared to the betadine ointment.Conclusions: HRS flower extract helps in early epithelization and helps in decreasing the wound size. Betadine is associated with adverse events like life threatening allergic reactions, water retention, etc.

Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment / Comparação da taxa de recuperação de otomicose com o uso de tratamento tópico com betadina e clotrimazol

Abstract Introduction Otomycosis is a common diseases that can be associated with many complications including involvement of the inner ear and mortality in rare cases. Management of otomycosis can be challenging, and requires a close follow-up. Treatment options for otomycosis include local debridement, local and systemic antifungal agents and utilization of topical antiseptics. Objective This study was designed to compare the recovery rate of otomycosis using two therapeutic methods; topical betadine (Povidone-iodine) and clotrimazole. Methods In this single-blind clinical trial, 204 patients with otomycosis were selected using a non-probability convenient sampling method and were randomly assigned to two treatment groups of topical betadine and clotrimazole (102 patients in each group). Response to treatment was assessed at 4, 10 and 20 days after treatment. Data were analyzed using the independent t-test, Chi-Square and Fisher exact test in SPSS v.18 software, at a significance level of p < 0.05. Results The results showed that out of 204 patients with otomycosis, fungi type isolated included Aspergillus in 151 cases (74%), and Candida albicans in 53 patients (26%). On the fourth day after treatment, 13 patients (13.1%) in the group treated with betadine and 10 patients (9.8%) in the group treated with clotrimazole showed a good clinical response to treatment (p = 0.75). A good response to treatment was reported for 44 (43.1%) and 47 patients (46.1%) on the tenth day after the treatment (p = 0.85); and 70 (68.6%) and 68 patients (67.6%) on the twentieth day after treatment (p = 0.46) in the groups treated with betadine and clotrimazole, respectively. The response to treatment was thus not significantly different in the two groups. Conclusion In the present study the efficacy of betadine and clotrimazole was the same for the treatment of otomycosis. The result of this study supports the use of betadine as an effective antifungal in otomycosis treatment, helping to avoid the emergence of resistant organisms.

Resumo Introdução A otomicose é uma das doenças comuns associadas a muitas complicações, como envolvimento da orelha interna e mortalidade em casos raros. O tratamento da otomicose pode ser realmente desafiador e requer um acompanhamento rigoroso. As opções de tratamento para otomicose podem incluir desbridamento local, agentes antifúngicos locais e sistêmicos e uso de antissépticos tópicos, os medicamentos tópicos recomendados para o tratamento da otomicose. Objetivo Comparar a taxa de recuperação de otomicose utilizando dois métodos terapêuticos de betadina tópica (povidona-iodo) e clotrimazol. Método Neste ensaio clínico simples cego, 204 pacientes com otomicose foram selecionados utilizando-se método de amostragem de não probabilidade conveniente e randomizados para dois grupos de tratamento, com betadina tópica e com clotrimazol (102 pacientes em cada grupo). A resposta ao tratamento foi avaliada aos 4, 10 e 20 dias após o tratamento. Os dados foram analisados utilizando o teste t independente, qui-quadrado e teste de Fisher no software SPSS v.18, com nível de significância de p < 0,05. Resultados Os resultados mostraram que dos 204 pacientes com otomicose, os tipos de fungos isolados incluíram Aspergillus em 151 casos (74%) e Candida albicans em 53 pacientes (26%). No quarto dia após o tratamento, 13 pacientes (13,1%) no grupo tratado com betadina e 10 pacientes (9,8%) no grupo tratado com clotrimazol apresentaram boa resposta ao tratamento (p = 0,75). Uma boa resposta ao tratamento foi relatada para 44 (43,1%) e 47 pacientes (46,1%) no décimo dia após o tratamento (p = 0,85); e 70 (68,6%) e 68 pacientes (67,6%) no vigésimo dia após o tratamento (p = 0,46) no grupo tratado com betadina e clotrimazol, respectivamente. Assim, a resposta ao tratamento não foi significativamente diferente nos dois grupos. Conclusão No presente estudo, a eficácia da betadina e do clotrimazol foi a mesma no tratamento da otomicose. O resultado deste estudo apoia o uso de betadina como um antifúngico eficaz no tratamento da otomicose que pode ajudar a evitar o surgimento de organismos resistentes.

Betadine solution irrigation of gastrointestinal tract for infection prevention during natural orifice transluminal endoscopic surgery / 中华消化内镜杂志

Objective To evaluate the feasibility and efficacy of betadine solution irrigation of gastrointestinal tract for infection prevention during the procedure of natural orifice transluminal endoscopic surgery(NOTES).Methods Twelve female porcine were divided into control group(n =4)to receive lavage with 500 ml normal saline and experimental group(n =8)to undergo lavage with 500 ml normal saline followed by 200 ml betadine solution.Fluid from gastrointestinal tract(5 ml)were collected before and after lavage,and after NOTES for culture.Endoscopy was performed 24 hours after NOTES to observe possible existence of inflammation,ulcer or bleeding.The animals were sacrificed 3 weeks after NOTES to explore intra-peritoneal adhesions,abscesses and other infections.Results One swine died of diaphragmatic injury and the other 11 animals successfully survived for 3 weeks.In trans-gastric approach,the average bacterial load of the fluid was 17.5 x 103 CFU/ml before lavage.In control group,the average bacterial load of the fluid was 2.5 × 103 CFU/ml after lavage and 5.5 × 103 CFU/ml after NOTES,while those in experimental group were 0 CFU/ml and 7.5 CFU/ml,respectively.In trans-colonic approach,the average bacterial load of the fluid before lavage was 76.2 × 103 CFU/ml.In control group,the average bacterial load of the fluid was 19.5 × 103 CFU/ml after lavage and 21 × 103 CFU/ml after NOTES,while those in experimental group were 2.25 × 103 CFU/ml and 1 × 103 CFU/ml,respectively.No inflammation,ulcer or bleeding were observed by endoscopy at 24 hours after NOTES.More adhesion and abscess were found in the control group than in the experimental group.In experimental group with trans-colonic approach,only one case of adhesion was observed.Conclusion It is effective and feasible of using betadine solution irrigation of gastrointestinal tract in infection prevention during the procedure of NOTES.However,further clinical studies assessing the effectiveness and safety are still necessary.

Comparative Efficacy for Dressing Methods of Iodine on Infected Full Thickness Skin Wound in the Mouse

PURPOSE: Iodine has been used for the prevention or management of wound infection as a topical agent. Although iodine was widely used mainly by Betadine(R) and cadexomer iodine, there was no comparative study on the efficacies of dressing methods of iodine. And also it's wound healing effect was not yet clear. The purpose of this study is to compare antibacterial effects and wound healing effects associated with various dressing methods of iodine on infected full thickness skin defect in the mouse. METHODS: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups : group S(dressing with Betadine(R) soaking, n=15), group T (dressing with Betadine(R) topping, n=15), group I(dressing with Iodosorb(R), n=15), group G(control group, dressing with dry gauze, n=15). The size of the wound defects and the grades of wound healing were evaluated in 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. RESULTS: After the wound was left open for twenty-four hours, many Staphylococcus aureus were cultured. The wound defect size was decreased in order of Betadine(R) soaking, Iodosorb(R), Betadine(R) topping and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Betadine(R) soaking, Iodosorb(R), Betadine(R) topping and gauze dressing group, and the difference was statistically significant. Antibacterial effect for S. aureus was increased in order of Iodosorb(R), Betadine(R) soaking, Betadine(R) topping and gauze dressing group, and the difference was statistically significant. CONCLUSION: Selection of the effective dressing method of iodine for infected wounds remains a controversial decision. According to this study, Iodosorb(R) may be most effective method for antibacterial effect and Betadine(R) soaking may be most effective method for infected wound healing. However, further study is necessary to evaluate the clinical efficacy of dressing methods of iodine and to search for the mechanisms that explain their effects.

Influences of Betadine and Hydrogen Peroxide on Vasospasm

Vasospasm influences on final results of microanastomosis such as free flap or replantation. Postoperative vasospasm was induced by multiple factors. Many patients had to be exposed to repetitive use of dressing materials (Betadine, Hydrogen peroxide), because areas that distal to the microanastomotic sites were vulnerable to infection. Spastic abilities of Betadine and Hydrogen peroxide(H2O2) had not been known. We performed experimental study for influences of Betadine and H2O2 on vasospasm after microanastomosis. Twenty Sprague-Dawley rats(300 - 345g) were randomly assigned to one of two groups, one was Betadine(n = 10) and the other was H2O2(n = 10). The femoral arteries were exposed, bilaterally. The left femoral artery was used as a test site(Betadine, H2O2), and the right as a control (normal saline). The initial arterial diameter were measured under a microscopy using vernier calipers, 20 minutes after dissection. Another 20minutes later, Betadine and H2O2, normal saline were dropped. The final arterial diameter were measured, 10 minutes after dropping. Gross examination was done during 10minutes, too. In Group I, the initial mean arterial diameters were 0.775+/-0.075 mm(Lt.), 0.785 +/- 0.041 mm(Rt.) and the final mean arterial diameters were 0.785 +/- 0.068 mm(Lt), 0.785 +/- 0.048 mm(Rt.). In Group II, the initial mean arterial diameters were 0.775 +/- 0.052 mm(Lt.), 0.780 +/- 0.040 mm (Rt.) and the final mean arterial diameters were 0.765 +/- 0.055 mm(Lt.), 0.775 +/- 0.045 mm(Rt.). There was no significant statistical difference between each materials and its control, and no changes on gross examination.We concluded that there is no influences of Betadine and H2O2 on vasospasm after microanastomosis.

Influences of Betadine and Hydrogen Peroxide on Vasospasm

Vasospasm influences on final results of microanastomosis such as free flap or replantation. Postoperative vasospasm was induced by multiple factors. Many patients had to be exposed to repetitive use of dressing materials (Betadine, Hydrogen peroxide), because areas that distal to the microanastomotic sites were vulnerable to infection. Spastic abilities of Betadine and Hydrogen peroxide(H2O2) had not been known. We performed experimental study for influences of Betadine and H2O2 on vasospasm after microanastomosis. Twenty Sprague-Dawley rats(300 - 345g) were randomly assigned to one of two groups, one was Betadine(n = 10) and the other was H2O2(n = 10). The femoral arteries were exposed, bilaterally. The left femoral artery was used as a test site(Betadine, H2O2), and the right as a control (normal saline). The initial arterial diameter were measured under a microscopy using vernier calipers, 20 minutes after dissection. Another 20minutes later, Betadine and H2O2, normal saline were dropped. The final arterial diameter were measured, 10 minutes after dropping. Gross examination was done during 10minutes, too. In Group I, the initial mean arterial diameters were 0.775+/-0.075 mm(Lt.), 0.785 +/- 0.041 mm(Rt.) and the final mean arterial diameters were 0.785 +/- 0.068 mm(Lt), 0.785 +/- 0.048 mm(Rt.). In Group II, the initial mean arterial diameters were 0.775 +/- 0.052 mm(Lt.), 0.780 +/- 0.040 mm (Rt.) and the final mean arterial diameters were 0.765 +/- 0.055 mm(Lt.), 0.775 +/- 0.045 mm(Rt.). There was no significant statistical difference between each materials and its control, and no changes on gross examination.We concluded that there is no influences of Betadine and H2O2 on vasospasm after microanastomosis.

A model for testing antiseptic efficacy: A preliminary study on betadine and germidine.

Efficacy of povidone iodine antiseptic, betadine and germidine, was tested against normal skin flora and four pathogenic bacteria namely S. aureus. S. epidermidis, E. coli and Pseudomonas aeruginosa by a new medel. The study was performed on the volar surface of forearms of ten patients. First of all, the skin flora was cultured then 108 cu/ml. of the tested organisms were applied by a cotton swab and left dried for 1 minute before the culture was repeated. Betadine or germidine was applied over the area previously painted with the organism. The culture was taken 1 to 2 minutes thereafter. The results showed that this model was feasible and convenient. Betadine and germidine are efficacious against normal skin flora and pathogenic bacteria.