Safety and efficacy of 0.01% hypochlorous acid before cataract phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.

Research progress on root canal irrigation disinfection drugs / 口腔疾病防治

@#Endodontic infection control is crucial to successful root canal treatment. Irrigation is the key step in endodontic procedures, and the application of root canal irrigation and disinfection medications play an important role. How to enhance antibacterial effects and functions in removing tissues while maintaining biocompatibility is a hot topic in endodontics. Currently, insights to address this issue can be split into two categories: one, the modification or combination of conventional endodontic irrigation solutions, and two, the development of novel endodontic irrigation solutions with new technologies and materials, for instance, nanomaterials and natural exacts. However, conventional endodontic irrigation solutions, such as sodium hypochlorite and chlorhexidine, are still the first choice in clinical practice. Most novel endodontic irrigation solutions remain at the pre-clinical laboratory stage. Clinical research and relevant data are required to determine whether various methods can improve endodontic irrigation. From basic research to clinical application is the direction for advancing to the next stage. The present article focuses on research progress on endodontic irrigation, especially concerning its antibacterial mechanism, characteristics and efficacy, to provide a reference for future clinical translation.

Comparative evaluation of efficacy of 10% povidone iodine gel with 2% metronidazole and 1% ornidazole with 0.25% chlorhexidine gel as local drug delivery system in adjunt to nonsurgical periodontal therapy in chronic periodontitis: A randomized, single blind, split-mouth study

Background: Periodontitis is a multi-factorial chronic inflammatory disease of attachment apparatus of teeth with microorganisms playing a major role. To address periodontal disease various strategies have been adopted to target these periodonto-pathogens. Various antimicrobial drugs (systemic as well as local) are effectively used to control the disease. However due to various side effects ofsystemic administration of the drugs like gastro intestinal disturbances, development of resistant organisms, high dosage of the drug required, local delivery of the drug is a better option as the drug is directly delivered at the site of infection with minimum dosage and maximum response achieved thus eliminating all the undesired effects of the drug. Aim: To evaluate the efficacy of 10% povidone iodine with 2% metronidazole and 1% ornidazole with 0.25% chlorhexidine gel as local delivery systems for the reduction in the pocket depth, changes in CAL, gingival inflammation. Materials and methods: A total of 20 patients diagnosed with mild- moderate chronic periodontitis were divided into two groups in a split-mouth study design - Group I and Group II with each group containing 20 sites with probing depth of >5 mm, CAL ?3 mm. In Group I, 10% povidine-iodine gel with 2% metronidazole was delivered inside the pocket and Group II, 1% ornidazole with 0.25% chlorhexidine was used as a local delivery system in adjunct to scaling and root planning. In both groups, medications were delivered at weekly interval for a period of 4 weeks. Baseline and 4 weeks measurements were done and compared for probing pocket depth (PPD), clinical attachment levels (CAL) and gingival inflammation. Results: The results obtained were statistically analyzed. Both groups showed statistically significant improvements in terms of clinical parameters. However, there was statistically insignificant difference when compared between the two groups. The results clearly demonstrate that both povidone iodine with metronidazole and ornidazole with chlorhexidine are also useful in controlling the acute phase of the periodontal disease in adjunct to scaling and root planning (SRP). Conclusion: Both drugs when used as an adjunct to scaling and root planning enhances probing pocket depth reduction, change in clinical attachment levels and gingival inflammation in mild- moderate chronic periodontitis cases.

Siep抯 test: A novel test for checking wound integrity in small-incision cataract surgery

Purpose: This study was conducted to ensure the integrity of surgery wounds. Methods: This was a randomized prospective trial of 300 patients who underwent small-incision cataract surgery (SICS) at our hospital over a one-year period. We used 2�drops of 5% povidone-iodine at the end of each case, not only to disclose any wound leaks but also to sterilize the surface of the eye. Results: Three hundred patients underwent SICS. One hundred ten patients had postoperative wound leak in SICS due to surgical complications. Premature entry comprising 75% (83 cases), followed by floppy iris syndrome comprising 20% (22 cases) and 5% (6 cases) comprising pseudoexfoliation (PXF) syndrome. There was a drop in the number of re-surgeries from 12 to 3 cases since we started implementing this technique. Conclusion: The simple procedure is very handy and economical in identifying the leak and can reduce further complications such as endophthalmitis and re-surgeries. Among residents, this can be a boon where povidone-iodine acts as a riverbank for the outflow of aqueous, outlining the speed, location, and quantity of the leak. Siep抯 test plays an important role in identifying any postoperative wound leaks and also sterilizing the eye surface post surgery.

Revisión sistemática con metaanálisis. Iodo povidona / Systematic Review with Meta-Analysis. Povidone Iodine

Introducción: La descontaminación preoperatoria de la piel es parte de la práctica quirúrgica estándar. La infección del sitio quirúrgico implica un gasto adicional a los sistemas de salud y un incremento en la morbilidad y mortalidad de los pacientes sometidos a cirugía. El iodo povidona es un desinfectante muy utilizado para eliminar la carga bacteriana cutánea. Objetivo: Constatar si el iodo povidona es mejor que otros desinfectantes cutáneos en la reducción de las infecciones del sitio quirúrgico. Métodos: Se realizó una búsqueda en Google Académico, PubMed y Embase utilizando los términos Mesh; iodo povidona, infección del sitio quirúrgico, cirugía, antisépticos locales, unidos por el operador booleano AND y los filtros Adultos, desde 2015, y ensayos clínicos controlados. Se aplicó la escala de Jadad para riesgo de sesgos y el Consort 2010 y la lista de chequeo PRISMA para determinar la calidad del estudio. El riesgo relativo fue la medida de efecto para un IC95 y un error de 0,05. Se incluyeron 8 ensayos clínicos controlados, n= 4800 casos, con la distribución de eventos en los grupos experimental 140/2402 y control 141/2398, para una diferencia no significativa p=0,444. La heterogeneidad fue I2=62,57 por ciento. Conclusiones: No existieron diferencias entre el iodo povidona y el resto de los desinfectantes para disminuir el porcentaje de infecciones del sitio quirúrgico en este estudio(AU)

Introduction: Preoperative skin decontamination is part of standard surgical practice. Surgical site infection implies an additional cost to health systems and an increase in morbidity and mortality of patients undergoing surgery. Povidone iodine is a widely used disinfectant to eliminate the bacterial load on the skin. Objective: To verify if povidone iodine is better than other skin disinfectants in reducing surgical site infections. Methods: A search of articles and controlled clinical trials published since 2015 was carried out in Google Scholar, PubMed and Embase and using terms of the Mesh such as povidone iodine, surgical site infection, surgery, local antiseptics, joined by the Boolean operator AND in addition to Adult filters. The Jadad scale for risk of bias and Consort 2010 and PRISMA checklist were applied to determine the quality of the study. Relative risk was the measure of effect for CI95 and an error of 0.05. Eight controlled clinical trials were included, n= 4800 cases, with the distribution of events in the experimental groups 140/2402 and control 141/2398, for a non-significant difference p=0.444. Heterogeneity was I2=62.57 percent. Conclusions: There were no differences between povidone iodine and the rest of the disinfectants to reduce the percentage of surgical site infections in this study(AU)

Efficacy of 1% clotrimazole drops vs. 1% clotrimazole cream vs 10% povidone-iodine in the treatment of otomycosis - A randomized controlled study

Introduction: Otomycosis is a term used to describe the epithelial infection caused by yeast and filamentous fungi, in the External Auditory Canal (EAC). It is one of the common infections seen in ENT OPD because of its prevalence in hot and humid climate. Due its high recurrence rate and different treatment modalities, it’s important to come out with ideal treatment modality. Aim: To compare efficacy of 1% clotrimazole drops vs. 1% clotrimazole cream vs 10% povidone- iodine in the treatment of otomycosis. Materials and methods: Randomized control study was performed for 2 months on clinically diagnosed otomycosis patients. Total 60 patients were included in the study, which were randomly divided in 3 groups and treated by 1% clotrimazole drops, 1% clotrimazole cream and 10% povidone- iodine respectively. Patients were reviewed after 7 days on the basis of clinical response and symptoms of pain, ear blockage, pruritus and burning sensation. Results: After 7 days of treatment groups treated with 1 % clotimazole drops and cream had good response of 90% and 95% as compared to 10% povidone-iodine group which was 70%. Clotrimazole cream group had more ear blockage complain which was 75% and clotrimazole drops group had more burning sensation complain which was 55%.Conclusion: 1% clotrimazole drops and cream are equally effective in management of otomycosis but 10% povidone-iodine can be considered if patient has complain of ear blockage and burning sensation.

Current Overview for Chemical Disinfection of Dental Impressions and Models based on its Criteria of Usage: A Microbiological Study

Objectives: The aims of this study were to compare the efficacy of two proven chemical disinfectants, glutaraldehyde and povidone iodine on dental impression and models by determining the reduction in the microbial load, and to compare changes in the physical properties of the models after adding the disinfectants. Materials and Methods: Irreversible hydrocolloid upper impressions of 90 patients were made and divided into 3 groups of 30 samples each; Group A––Control group; Impressions were run under clean tap water before pouring the model. Group B––2% Glutaraldehyde sprayed on the impression and left in situ for 10 min before pouring the model. Group C –10 ml of (5%) povidone iodine incorporated into the gypsum before pouring the model. Models from all three groups were subjected to microbiological assessment at three different time intervals, T0––24 h, T1––1 month and T2––3 months of storage by comparing the colony forming units (CFUs) of bacteria and fungi. The compressive strength of 5 models from each group was also analyzed in Newton’s/mm2. Results: 2% Glutaraldehyde proved more effective than povidone iodine after 24 h of storage (T1), however at the end of 1 month (T1) and 3 months (T2) the Povidone group showed the maximum disinfection. Both the disinfectants caused a reduction in the compressive strength of the model with the povidone iodine group showing the maximum reduction. Conclusion: Although povidone iodine was the most effective disinfectant after 3 months, it showed a significant reduction in the compressive strength and caused discoloration of the model. 2% Glutaraldehyde proved to be the choice of disinfectant with minimal adverse effects

Povidona Yodada como Antiséptico Oral en la Reducción de la Carga Viral del SARS-CoV-2: Revisión de la Literatura

RESUMEN: Se ha sugerido que el uso de antisépticos orales podría reducir la carga viral del virus SARS-CoV-2 en los pacientes durante la atención dental, pero sin evidencia que avale su efectividad. Dada la vulnerabilidad del virus a la oxidac ión, se ha recomendado el uso de colutorios que contengan agentes oxidantes como la povidona yodada. El objetivo de la presente revisión fue determinar la efectividad del uso de povidona yodada como antiséptico oral en la disminución de la carga viral del virus SARS-CoV-2. Se realizó una búsqueda bibliográfica en PubMed, Biblioteca Virtual en Salud, SciELO, Web of Science y EBSCO host. Se incluyeron estudios clínicos en pacientes con COVID-19 y estudios in vitro con cepas del virus que utilizaran colutorios de povidona yodada como forma de intervención, publicados entre enero del 2019 y enero del 2021. La selección de los artículos se realizó en dos etapas por dos autores de manera independiente. Luego de eliminar los artículos duplicados, se mantuvieron 53 referencias. Finalmente se incluyeron 2 estudios in vivo y 5 estudios in vitro para la revisión cualitativa. En los estudios in vitro, todas las concentraciones de povidona yodada evidenciaron una actividad virucida eficaz en los distintos tiempos de exposición, donde la mínima concentración efectiva correspondió a 0,5 % en 15 segundos. Los estudios in vivo presentaron resultados positivos hacia el uso de povidona yodada, pero con tamaños muestrales pequeños y una gran heterogeneidad en su metodología. En conclusión el uso profiláctico de povidona yodada como colutorio contra el virus SARS-CoV-2 es respaldado por los trabajos in vitro, con tiempos de aplicación fácilmente realizables en la atención dental, pero se requiere de un mayor número de ensayos controlados aleatorizados para comprobar su efectividad en la práctica clínica.

ABSTRACT: It has been suggested that the use of oral antiseptics could reduce the viral load of SARS-CoV-2 virus in patients during dental care, but without evidence to support its effectiveness. The objective of this study was to determine the effectiveness of povidone iodine mouthwash in reducing the viral load of SARS-CoV-2 virus. A literature search was conducted in PubMed, Biblioteca Virtual enSalud, SciELO, Web of Science and EBSCOhost. Clinical studies in patients with COVID-19 or in vitro studies with SARS-CoV-2 strains that used povidone-iodine mouthwash as a form of intervention, published between January 2019 and January 2021, were included. The selection of articles was carried out in two phases by two authors independently. After removing duplicate articles, 53 references were kept. Finally, 2 in vivo studies and 5 in vitro studies were included for the qualitative review. In the in vitro studies, all concentrations of povidone iodine showed effective virucidal activity at the different exposure times, where the minimum effective concentration corresponded to 0.5 % in 15 seconds. In vivo studies showed positive results towards the use of povidone iodine, but with small sample sizes and great heterogeneity in their methodology. The prophylactic use of povidone iodine mouthwash against the SARS-CoV- 2 virus is supported by in vitro studies, with application times easily achievable in dental care, but a large number of randomized controlled trials are required to verify its effectiveness in clinical practice.

Relación del uso de colutorios bucales con la disminución de la carga viral del SARS-CoV-2 en la práctica odontológica: tema de revision / Relationship of the use of mouthwashes with the decrease in the viral load of SARS-CoV-2 in dental practice: review topic

Resumen Actualmente, el odontólogo es uno de los profesionales de la salud con mayor riesgo de contagio de la COVID-19 debido a su contacto directo con la cavidad bucal. La alta exposición a los aerosoles, generados por los instrumentos rotatorios, en pacientes con la COVID-19, eleva el contacto con la carga viral del SARS-CoV-2 en los procedimientos de rutina. Se ha descrito que los colutorios bucales, previos a la atención odontológica, podrían ser soluciones efectivas para la reducción del contagio pese a su poca evidencia clínica. Los colutorios con cloruro de cetilpiridinio (CPC), peróxido de hidrógeno (H2O2), povidona yodada (PVP-I) y gluconato de clorhexidina (CHX) muestran un gran potencial para reducir la carga viral del SARS- CoV-2 en los aerosoles generados a partir de la saliva durante la consulta odontológica. Por lo expuesto, el presente artículo tuvo por objetivo hacer una revisión de la información científica actual sobre la relación del uso de los colutorios bucales con la disminución de la carga viral del SARS-CoV-2.

Abstract It is currently known that the dentist is one of the health professionals with the highest risk of contagion of COVID-19 due to its direct contact with the oral cavity. High exposure to aerosols generated by rotating instruments in COVID-19 patients increases contact with the SARS-CoV-2 viral load in routine procedures. It has been described that mouthwashes prior to dental care could be effective solutions to reduce contagion despite their little clinical evidence. Mouthwashes with cetylpyridinium chloride (CPC), hydrogen peroxide (H2O2), povidone-iodine (PVP-I) and chlorhexidine gluconate (CHX) show great potential to reduce the viralload of SARS-CoV-2 in the aerosols generated from saliva during the dental visit. Therefore, the objective of this article was to review the current scientific information on the relationship of the use of mouthwashes with the decrease in the viral load of SARS-CoV-2.

Study on germiculture and drug intervention in cataract patients before and during surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the age-related cataract patients' eyelid margin and conjunctival sac bacterial distribution and eliminating effects of different antibiotic eye drops and conjunctival sac washing fluid. <p>METHODS: A total of 216 age-related cataract patients(216 eyes)who were hospitalized for operation in our hospital were enrolled from January 2015 to November 2015, and randomly divided into three groups(72 eyes respectively): Patients in group A were treated with 3g/L tobramycin eye drop; group B were treated with 5g/L levofloxacin eye drop and group C were treated with both two eye drops before surgery. And then each group was randomly divided into two groups: moxifloxacin group(110 eyes)and povidone iodine group(106 eyes). After the routine disinfection and before the formal start of the operation, the conjunctival sac was irrigated with 1.6g/L moxifloxacin or 5g/L povidone iodine respectively. The conjunctival sac and lid margin specimen were collected before admission without any treatment, before and after conjunctival sac irrigation for germicultures and drug susceptibility tests, at the end of operation, conjunctival sac specimen and aqueous humor were collected for germicultures and drug susceptibility tests.<p>RESULTS:The germiculture positive rate of eyelid margin was 86.6% and the bacterial culture positive rate of conjunctival sac was 25.0% before operation. In groups A, B and C before and after topical antibiotics application, the germiculture positive rate of eyelid margin was 86.1% and 36.1%, 84.7% and 31.9%, 88.9% and 30.6% respectively; the germiculture positive rate of conjunctival sac was 25.0% and 11.1%,26.4% and 11.1%,23.6% and 8.3% respectively. In moxifloxacin group and povidone iodine group before and after conjunctival sac irrigation, the germiculture positive rate of eyelid margin was 33.6% and 10.9%, 32.1% and 10.4% respectively; the germiculture positive rate of conjunctival sac was 10.0% and 0, 10.4% and 0 respectively.<p>CONCLUSION: Both 5g/L levofloxacin eye drop and 3g/L tobramycin eye drop are effective in diminishing conjunctival sac or eyelid margin bacterium before cataract sugery, the combined effect is better. Both 5g/L PVP-I and 1.6g/L moxifloxacin can be used to irrigate conjunctival sac before cataract surgery.

Qualitative Evaluation and Wound Healing Potential of Selected Medicinal Plants by Excision Wound Model

Objective: The aim of the paper was to assess the wound healing potential of three medicinal plants using the excision wound healing model on albino rat. Materials and Methods: Soxhlet extraction method was utilized for the partition of the constituent of interest. Qualitative analysis and phytochemical screening were performed for the detection of tannins, alkaloids, resins, flavonoids, glycosides, steroids, proteins, carbohydrates, and amino acids. Three plants extract used for the ointment formulation and prepared by the addition of extract of Artocarpus heterophyllus,Murraya koenigii, and Punica granatum inpolyethylene glycol ointment base. Three ointment formulations and six extracts with 5% and 10% extract concentration have been used. Excision wound rat model utilized for the wound healing potential. Results and Conclusion: All three plants, including A. heterophyllus Lam.,M. koenigii Linn., and P. granatum Linn.extracted for the active constituent. The pharmacological evaluation on the excision wound healing model suggested that Group-I animals showed 52.09% of healing, whereas povidone-iodine treated animals showed 100.00% healing. On the other hand, the ointment formulation treated F-1 showed 96.47% of wound healing, F-2 showed 97.68% healing, and F-3 showed 99.11% healing. The overall healing results can be represented as following: Control <MKL5 <MKL10 <PGB5 <PGB10 <AHP5 <AHP10 <F-1 <F-2 <F-3 <Standard. F3 ointment formulation is better than the F2 and F1 formulation in wound healing potential as compared to others. Discussion: These studies have indicated that ointment formulations of A. heterophyllus, M. koenigii, P. granatum have been utilized for wound healing potential and it is safer for topical application. Excision wound healing model suggested that the three individual plant extract has shown the wound healing potential, although the prepared ointment formulations F3 have best and synergistic action than the individual. The ointment formulations containing plant extracts in 10% amount have better wound healing potential.

One year randomized controlled trial to compare the effectiveness of honey dressing versus povidone iodine dressing for diabetic foot ulcer at Dr. Prabhakar Kore Hospital and MRC, Belagavi

Background: The objective of the study is to find out the effect of honey dressing versus povidone iodine dressing for reduction of wound size in diabetic foot ulcer.Methods: This randomized controlled trial was done in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital, Belagavi from January 2017 to December 2017. 64 patients were randomized into 32 group each undergoing unprocessed honey dressing and other group undergoing povidone iodine dressing.Results: The mean wound size in honey dressing was 23.16 cm2 and 23.03 cm2 in povidone dressings  at baseline, 23.16 cm2 and 22.94 cm2 at 1st day follow up, 23.16 cm2 and 22.94 cm2 at 3rd day follow up, 19.38 cm2 and  20.28 cm2 at 5th day follow up, 16.13 cm2 and 17.06 cm2 at 7th day follow up, 12.44 cm2 and  16.13 cm2 at 10th day follow up and the end of 15th day, it was 10.69 cm2 and 15.06 cm2 respectively in honey dressing group and povidone dressing group. The difference in the wound size in honey dressing group and povidone dressing group at 1st day, 3rd day, 5th day, 7th day, 10th day follow up period were statistically not significant (p>0.05). The difference in the wound size in honey dressing group at 15th day follow up period were statistically significant (p<0.05).Conclusions: This study shows more favorable results with honey dressing for reduction of wound size in diabetic foot ulcers.

Oxidative damage effect of povidone-iodine on corneal epithelial cells / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the oxidative damage effect of povidone iodine on corneal epithelial cells. <p>METHODS:To study the oxidative damage effect of different concentrations of povidone iodine, the cultured epithelial cells were randomly divided into control group, low concentration group, medium concentration group and high concentration group. To study the oxidative damage effect of disinfection time of povidone iodine, the cultured corneal epithelial cells were randomly divided into control group, short time group, medium time group and long time group. Malondialdehyde(MDA)and superoxide dismutase(SOD)were detected by ELISA, cell viability was detected by CCK-8 method and inverted microscope, and apoptotic rate was detected by flow cytometry. <p>RESULTS: The higher concentration of povidone iodine was associated with the higher MDA content, the lower SOD content, the lower cell activities and the higher apoptotic rate of the corneal epithelial cells, which was in a dose-independent manner. The differences among four groups were statistically significant(all <i>P</i><0.01). The longer disinfection time of povidone iodine was related with the higher MDA content, the lower SOD content, the lower cell activities and the higher apoptotic rate of corneal epithelial cells, which was in a time-independent manner. The differences among four groups were statistically significant(all <i>P</i><0.01). <p>CONCLUSION: The oxidative damage of povidone iodine on corneal epithelial cells were in a dose independent and time dependent manner.

Effect of Pleurodesis with 2% Povidone-Iodine in a Tertiary Care Centre, Mahabubnagar, Telangana

Background: Tetracycline, talc, and bleomycin have been proved to be effective in recurrent spontaneous pneumothorax andmalignant pleural effusion. Recent studies have shown the efficacy of 2% betadine in pleurodesis.Objective: The objective of this study was to find out the success rate of 2% betadine in pleurodesis in patients with recurrentspontaneous pneumothorax and malignant pleural effusions.Materials and Methods: The study was conducted in SVS Medical College, Mahabubnagar Dist., Telangana, during the periodof May 2016 - Feb 2019. Patients with malignant pleural effusion and recurrent spontaneous pneumothorax were taken intoconsideration. About 2% betadine with xylocaine was used in this study.Results: A total of 26 patients underwent pleurodesis. Eighteen patients had malignant pleural effusion and eight patients hadrecurrent spontaneous pneumothorax. Of 26 patients, 23 (88.5%) patients had successful pleurodesis. Among 23 patients whohad underwent successful pleurodesis, 16 had malignant pleural effusion and seven had recurrent spontaneous pneumothorax.Conclusion: In our observation, we have seen that pleurodesis with 2% betadine is very effective and inexpensive in pleurodesiswithout many complications

Effects of topical azithromycin, moxifloxacin, and povidone iodine on conjunctival bacterial flora in patients undergoing intravitreal injection / Os efeitos da azitromicina tópica, moxifloxacina e iodopovidona na flora bacteriana conjuntival em injeções intravítreas

ABSTRACT Purpose: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. Methods: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. Results: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). Conclusion: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.

RESUMO Objetivo: Comparar os efeitos de iodopovidona tópico a 5% com azitromicina e moxifloxacina profiláticas sobre a flora bacteriana em pacientes submetidos à injeção intravítrea. Métodos: Um total de 132 pacientes foram aleatoriamente designados para receber tratamento com azitromicina ou moxifloxacina ou nenhum tratamento (grupo controle). No total, 528 amostras foram obtidas no momento na admissão, 4 dias antes da injeção intravítrea, 4 dias após a injeção intravítrea e 8 dias após a injeção intravítrea. As amostras foram imediatamente enviadas para o laboratório de microbiologia para incubação. Resultados: O microorganismo mais frequentemente observado foi o Staphylococcus coagulase-negativo (23,8%). Quando os resultados das amostras obtidas no dia 4 antes da injeção foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi significativamente menor no grupo mo xifloxacina, em comparação com os controles (p=0,049). Acinetobacter baumannii continuou a crescer após a administração de azitromicina (p=0,033). Quando os resultados de 4 dias após a injeção intravítrea foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi maior no controle, em comparação com pacientes que receberam azitromicina ou moxifloxacina (p=0,004). A taxa de erradicação também foi significativamente maior no grupo moxifloxacina do que no grupo controle (p=0,001). As amostras obtidas no dia 8 após injeção intravítrea mostraram níveis semelhantes de crescimento bacteriano em todos os grupos (p=0,217). Conclusão: A moxifloxacina foi mais eficaz do que 5% de iodopovidona no controle do crescimento da flora bacteriana conjuntival. O uso de moxifloxacina em combinação com 5% de iodopovidona resultou em um efeito sinérgico.

Povidone-Iodine Pleurodesis for Chylothorax in an Extremely Low Birth Weight Infant

Chylothorax, the accumulation of chyle in the pleural space, is a rare condition, but can lead to serious complications in neonates. Conservative therapy for chylothorax includes enteral feeding with medium-chain triglyceride-enriched diet or parenteral nutrition and administration of octreotide. Surgical management is considered in cases where there is no response to conservative therapy; however, the standardized approach to refractory neonatal chylothorax is still controversial. Chemical pleurodesis can be used when medical therapies for chylothorax fail, to avoid more invasive surgical procedures. We report an extremely preterm infant born at 26 weeks of gestation with refractory chylothorax after patent ductus arteriosus ligation. The infant was successfully treated with pleurodesis using 4% povidone-iodine, without long-term side effects.

Efficacy of povidone-iodine with different concentration in preparation for cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of povidone iodine with different concentration and exposure time in preparation for cataract surgery. The effect of PI on reducing the conjunctival bacterial load before cataract surgery was observed. The effect of PI on the ocular surface was also valued. In order to provide a theoretical support for clinical standardization of PI, the optimum concentration and irrigation time of PI were screened. <p>METHODS: From June 2015 to June 2017 cataract surgery was performed in 270 cases 270 eyes. According to the concentration(0.5%, 0.1%, 0.05%)of the PI the patients were randomly divided into three groups(A, B, C,). Group A was randomly divided into three subgroups(A1, A2, A3)respectively according to different irrigation time: 30s, 1min and 2min. group B and group C were divided to subgroups similar to group A. In all groups, the conjunctiva was flush irrigate with 3ML of PI of the respective concentration. Conjunctival specimens were obtained before PI irrigation and after PI irrigation. The change of conjunctival sac bacterial flora and bacterial culture positive rate were studied. Tear break up time(BUT), cornea fluorescein staining(CFS)were evaluated 3d preoperative and 1d, 3d, 1wk, 1mo, 3mo postoperative. <p>RESULTS:(1)The change of conjunctival sac bacterial flora. A total of 12 species of conjunctival sac bacteria were cultured before PI irrigation including 9 Gram positive bacteria and 3 Gram negative bacteria. A total of 4 species of conjunctival sac bacteria were cultured after PI irrigation including 2 Gram positive bacteria and 2 Gram negative bacteria.(2)Comparison of the positive rate of bacterial culture in conjunctival sac. Positive conjunctival sac culture for 15 eyes before PI irrigation, 5 eyes show positive after washing, the amount of positive bacteria culture was lower(<i>P</i><0.05).(3)No endophthalmitis was found in all patients at the last follow-up. The BUT in all groups except the groups of 0.5g/L, 30s and 5g/L, 2min were restored to preoperative level at 3mo after surgery, The BUT in group 0.5g/L, 30s was restored to preoperative level 1mo after surgery, while the BUT in groups 5g/L, 2min, was still not restored to preoperative level 3mo after surgery. The CFS in all groups recovered to preoperative level at 1mo after surgery.<p>CONCLUSION: 0.5g/L PI with 30s irrigation time may effectively reduce the conjunctival sac bacteria. Compared with other groups, its damage to the eye surface is smaller. It is safe and effective in preparation for cataract surgery.

Limpeza periuretral na realização do cateterismo urinário de demora: ensaio clínico randomizado / Periurethral cleansing in indwelling urinary catheterization: randomized controlled trial

O cateterismo urinário de demora é um procedimento amplamente utilizado em pacientes internados e está relacionado com altas taxas de bacteriúria assintomática e infecção do trato urinário. Para evitar essas doenças, a limpeza da região periuretral antes da inserção do cateter é uma importante conduta, com fins de reduzir a entrada de microrganismos dessa região através da uretra. Guias de prática clínica recomendam que o cateterismo urinário de demora deva ser realizado com técnica asséptica, porém não há consenso sobre qual solução é mais eficaz para sua realização, com vistas à redução das infecções do trato urinário e da bacteriúria assintomática. O objetivo é de avaliar o efeito da limpeza periuretral nas incidências de bacteriúria assintomática e de infecção do trato urinário com o uso de três soluções (água, sabão e gluconato de clorexidina aquosa 2%; gluconato de clorexidina degermante 2%, água bi-destilada e gluconato de clorexidina aquosa 2%; e povidona-iodo 10% degermante, água bi-destilda e povidona-iodo aquoso 1%) em pacientes adultos internados em hospital terciário submetidos ao cateterismo urinário de demora. Trata-se de uma pesquisa realizada em duas etapas: revisão sistemática da literatura e ensaio clínico randomizado sem mascaramento do pesquisador. Foi realizado em um hospital de grande porte de Belo Horizonte ­ Minas Gerais. A população foi constituída por pacientes internados e que foram elegíveis para serem submetidos ao cateterismo urinário de demora. A amostra foi de 28 pacientes, sendo alocados aleatoriamente nos grupos: sabão (n=11) e grupo antisséptico (n=17). Uroculturas foram coletadas no momento da inserção e 24h após. A incidência global de bacteriúria assintomática foi de 7,14%, no grupo sabão foi de 9,1% e no grupo antissépticos foi de 5,9%. Não houve nenhum caso de infecção do trato urinário. A regressão logística mostrou que não há diferenças estatisticamente significativas nas incidências de bacteriúria assintomática quando realizada a limpeza com sabão ou antisséptico (clorexidina ou povidona-iodo). A redução do risco relativo mostrou uma redução de 36% de adquirir bacteriúria assintomática.(AU)

Indwelling urinary catheterization is a procedure that is used in inpatients and is related to high rates of asymptomatic bacteriuria and urinary tract infection. To prevent these diseases, cleaning the periurethral region prior to catheter insertion is an important approach, reducing the entry of microorganisms from this region through the urethra. Clinical practice guidelines recommend that indwelling urinary catheterization should be performed with aseptic technique, but there is no consensus on which solution is most effective for reducing urinary tract infections. The objective is to evaluate the effect of periurethral cleansing on the incidence of asymptomatic bacteria and urinary tract infections with the use of three solutions (water, soap and 2% aqueous chlorhexidine gluconate; chlorhexidine gluconate 2%, distilled water and 2% aqueous chlorhexidine; and 10% povidone-iodine, distilled water and 1% aqueous povidone-iodine) in adult patients admitted to a tertiary hospital submitted to the indwelling urinary catheterization. This is a two-step research: systematic literature review and randomized clinical trial without researcher's masking. It was performed in a large hospital in Belo Horizonte - MG. The population was composed by inpatients who were eligible to undergo indwelling urinary catheterization. A sample of 28 patients was randomly allocated into groups: soap (n = 11) and antiseptic group (n = 17). Urine cultures were collected at insertion and 24h after. The overall incidence of asymptomatic bacteriuria was 7.14%, on soap group was 9.1% and on antiseptic group was 5.9%. There were no cases of urinary tract infection. Logistic regression showed no statistically significantly differences in the incidence of asymptomatic bacteriuria when cleaned with soap or antiseptic (chlorhexidine or povidone-iodine). A relative risk reduction showed a 36% reduction from acquiring asymptomatic bacteriuria.(AU)

Talco estéril versus yodopovidona en pleurodesis como tratamiento del derrame pleural maligno. Estudio prospectivo no aleatorizado / Sterile talc versus povidone-iodine in pleurodesis as a treatment for malignant pleural effusion. Non-randomized prospective study

Comparar el uso del talco estéril versus yodopovidona como agentes químicos en pleurodesis para el tratamiento del derrame pleural maligno.Materiales y Métodos: Estudio clínico, analítico, observacional, prospectivo, el cual incluyó 12 pacientes con diagnóstico clínico e histopatológico de derrame pleural maligno, a quienes se les practicó pleurodesis empleando talco estéril y yodopovidona.Resultados : Edad promedio fue de 46,25 ± 17,3 y la neoplasia primaria más común fue el cáncer de mama, representando el 50% de los casos estudiados. El grupo de pacientes tratados con yodopovidona tuvo 100% de efectividad en la fusión pleural posterior a la pleurodesis, y presentaron menos complicaciones durante el procedimiento y 24 horas posteriores al mismo con respecto al grupo tratado con talco estéril, el cual tuvo un 71,4% de efectividad y un 28,6% de falla al procedimiento; asimismo, estos últimos presentaron mayor porcentaje de complicaciones. Por otra parte, no se evidenció recidiva del derrame pleural en los 30 días de valoración posteriores al procedimiento. Estas diferencias no fueron estadísticamente significativas.Conclusiones : Ambos agentes esclerosantes fueron eficaces para lograr la fusión de las pleuras en pacientes con derrame pleural maligno, siendo el talco estéril el agente con mayor tendencia a producir complicaciones y fallo del procedimiento, en comparación a la yodopovidona(AU)

To compare the use of sterile talc versus povidone-iodine as chemical agents on pleurodesis for the treatment of malignant pleural effusion.Materials and Methods : A total of 12 patients with clinical and histopathologic diagnose of malignant pleural effusion were enrolled in a clinical, analytic, observational and prospective trial, to whom sterile talc and povidone-iodine pleurodesis was applied.Results : The mean age was 46,25 ± 17,3 and the most common primary neoplasm was breast cancer, which was present in 50% of the surveyed cases. The group of patients who received povidone-iodine had 100% of effectiveness on post-pleurodesis pleural fusion, and had fewer complications during the procedure and 24 hours afterwards vis-à-vis the group who received sterile talc powder, which had 74.4% of effectiveness and 28.6% of procedure failure; furthermore, the last mentioned had higher percentage of complications. Moreover, there was no evidence of recurrence of pleural effusion in the 30 days post-procedure assessment.Conclusions : Both sclerosant agents were efficient to accomplish pleural fusion in patients with malignant pleural effusion, with sterile talc being the agent with higher tendency to generate more complications and procedure failure compared to povidone-iodine(AU)

Disinfection effects of secondary irrigation with different concentrations of povidone-iodine on conjunctival sac in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze and evaluate the disinfection effects of secondary irrigation with different concentrations of povidone-iodine on conjunctival sac in cataract surgery.<p>METHODS: A total of 600 cataract patients(600 eyes)who underwent phacoemulsification and intraocular lens implantation in Ophthalmology Department of the hospital during the period from August 2016 to October 2017 were enrolled in the study. Their conjunctival sacs were disinfected for twice with povidone-iodine irrigation before surgery and after opening eyelid. According to different concentrations of povidone-iodine applied in secondary irrigation, the patients were divided into group Ⅰ(320 cases)and group Ⅱ(280 cases), with concentrations of 0.025% and 0.05%, respectively. The conjunctival sac swab specimens were obtained from the two groups after the first and second irrigation to conduct bacterial identification. The subjective comfort and conditions of conjunctival hyperemia and corneal epithelial damage were assessed during second irrigation. The occurrence of endophthalmitis after surgery was statistically analyzed. <p>RESULTS: There was no significant difference in positive rate of bacterial culture between group Ⅰ and group Ⅱ after the first and second irrigation with povidone-iodine(<i>P</i>>0.05). The incidence rates of subjective feelings such as foreign body sensation, itching sense, photophobia and red eye in group Ⅰ were significantly lower than those in group Ⅱ when second irrigation for conjunctival sac(<i>P</i><0.05). After second irrigation for conjunctival sac, degree of conjunctival hyperemia and corneal epithelial damage in group Ⅰ was significantly lower than that in group Ⅱ(<i>P</i><0.05). There were 2 eyes(0.6%)and 1 eye(0.4%)with endophthalmitisin in group Ⅰ and group Ⅱ, respectively(<i>P</i>>0.05). <p>CONCLUSION: There is high-efficiency disinfection effect of 0.025% povidone-iodine. Compared with 0.05% povidone-iodine, there are more advantages in improving subjective comfort, reducing conjunctival hyperemia and corneal epithelial damage, which is more suitable for patients undergoing cataract surgery.