Use of K-Y Jelly on Throat Packs for Postoperative Sore Throat after Nasal Surgery: A Randomized Controlled Trial

Abstract Introduction Postoperative sore throat (POST) is a fairly common side effect of general anesthesia. The K-Y jelly is a well-known lubricant used in many medical procedures. Objective In this randomized study, we evaluated the use of throat packs soaked with K-Y jelly for POST outcomes in patients submitted to nasal surgery. Methods The present double-blinded, randomized, controlled study included 140 ASA I-II patients undergoing nasal surgery under general anesthesia. Patients received either or K-Y jelly or water-soaked X-ray detectable throat packs fully inserted into the mouth to occlude the oropharynx. Results Comparison between the studied groups regarding the severity of POST assessed by visual analog scale revealed significantly lower POST levels in the K-Y jelly group on recovery from anesthesia, and at 2, 4, and 6 hours postoperatively. Conclusions The use of K-Y jelly-soaked throat packs was associated with less severe POST after nasal surgery.

Descriptive Study of School Feeding Practices in Nigerian Children and the Risk of Dental Caries

Background:Nutrition is important in development, growth and maintenance of overall well being of an individual andplays a significant role in children’s cognitive, behavioural and emotional development. Poor diets may initiate or exacerbate chronic diseases including dental caries which has dietary fermentable carbohydrates as one of its aetiologies.Objectives:To describe the school feeding practice in Nigerian schools and relate the contents of their lunch boxes to risk of having dental caries and determine the relationship between socioeconomic factors and the content of lunch boxes.Study Design:This was a descriptive cross sectional study.Methodology:Multistage sampling technique was used in selecting participants from 12 schools in Southern Nigeria. Information on socio-demographic characteristics and contents of lunch boxes were elicited using structured questionnaires. The contents of lunch boxes were categorized as balanced (cooked meals with vegetables or fruits), overloaded (one cooked meal and snacks) and unbalanced-over loaded (no lunchbox, or greater than one snacks). Information elicited were analyzed using SPSS version 22 and the level of significance was set at <0.05 Results:There were 152 (49.8%) males and 153 (50.2%) females with a mean age of 10.1 (+2.2) years who participated in the study. One hundred and fifty two (49.8%) pupils brought lunch boxes to school. The category of meals taken during lunch breaks was mostly [157 (51.5%)]unbalanced-overloaded. There were statistically significant associations between the mothers’ occupation (<0.001), number of siblings (p<0.001), type of school (p=0.001) and the presence of lunch boxes. There was also statistically significant associationbetween the types of schools and contents of lunch packs. Multivariate regression analysis showed that age (OR=0.116, CI=0.030-0.447;p=0.002) and number of siblings (OR=0.286; CI=0.097-0.841; p=0.023) were significant predictors of bringing lunch box to school.Conclusion:Type of school, age of the children, their mothers’ social class/occupation and family size were significantly associated with possessing lunch packs. Their lunch meals were majorly confectioneries thus a high risk to dental caries

Alimentos seleccionados por los padres para los refrigerios de sus hijos en etapa de educación básica en Reynosa, Tamaulipas / Lunch box contents of elementary school children in Reynosa, Tamaulipas

Resumen Los refrigerios que consumen los niños durante el recreo complementan su dieta diaria, y pueden representar un riesgo de obesidad si los padres los preparan con base en alimentos procesados, elevados en azúcar, sal y grasa. El objetivo de este estudio fue identificar el contenido de los refrigerios empacados en casa, así como el estado nutricio de escolares de Reynosa, Tamaulipas, México. Se realizó un estudio descriptivo y transversal. Se trabajó con 769 niños de 12 escuelas públicas de educación básica. Se tomaron peso y talla. Se registraron durante una semana los refrigerios por observación directa, mediante una lista de cotejo. El 44.7 % de los escolares presentó sobrepeso u obesidad. Los alimentos contenidos en los refrigerios fueron el sándwich (50.0 %), tacos (29.5 %) y tortas (14.5 %). Las bebidas azucaradas incluyeron jugo (44 %) y agua saborizada (38.2 %). El 18.8 % llevó frutas, 13.5 % verduras y 31.6 % agua. En promedio, el contenido de energía fue de 327 kcal, por lo tanto, sobrepasaron la recomendación de calorías, e incluían alimentos no saludables (alto contenido de azúcar y grasa en relación a su aportación nutrimental), siendo necesario realizar intervenciones de educación nutricional para promover el consumo de agua y alimentos saludables dentro del entorno escolar, para mejorar la calidad de los hábitos alimenticios, tanto en escuelas de medio tiempo, como de tiempo completo, las cuales, brindan el servicio de alimentación.

Abstract School lunch supplements children's dailydiet and may pose a risk of obesity if they are prepared based on processed foods high in sugar, salt and fat. The aim of this study was to identify the content of lunch packs, as well as the nutritional status of scholars from Reynosa, Tamaulipas, Mexico. To that aim, a descriptive and transversal study was conducted. We worked with 769 children from 12 public elementary schools. Students' size and weight were taken. The contents of their lunch packs were recorded for one week by direct observation through a checklist. 44.7 % of school children were overweight or obese. The foods contained in the lunch packs were sandwich (50.0 %), tacos (29.5 %) and big sandwich (14.5 %). Sugary drinks included juice (44 %) and flavored water (38.2 %). They also contained fruits (18.8 %), vegetables (13.5 %) and water (31.6 %). On average, the energy content was 327 kcal. Therefore, they exceeded the calorie recommendation and included unhealthy foods (high content of sugar and fat in relation to their nutritional contribution). This suggests the need to implement nutrition education intervention programs to promote the consumption of drinking water and healthy foods within the school environment to improve the quality of eating habits.

Monitoreo con indicadores biológicos de rápida lectura de las autoclaves de CEYE de la Facultad de Odontología de la Universidad Tecnológica de México / Rapid-lecture biological indicators´monitoring of CEYE (SAPC) autoclaves of the School of Dentistry of the Technological University of Mexico (UNITEC)

Objetivo: Monitorear la eficacia de las autoclaves y realizar la validación rutinaria de los ciclos de esterilización. Material y métodos: Se realizó un estudio observacional, transversal, cualitativo y prospectivo de tres autoclaves de la Central de Equipos y Esterilización de la Facultad de Odontología de la Universidad Tecnológica de México, incluyéndose 96 biocargas no quirúrgicas y quirúrgicas, de mayo del 2012 hasta abril del 2015. Se realizó una determinación mensual, según lo marca la NOM-013-SSA2-1994 modificación 2006, utilizando indicadores biológicos de rápida lectura (1292 3 M Attest®). La eficacia de la esterilización se definió como la aniquilación biológica producida en estos indicadores, y se realizó a través de un lector óptico automático (3 M Attest 290®), después de tres horas. En todas las lecturas se incluyó un testigo positivo. Resultados: Se obtuvieron resultados negativos en las lecturas de los indicadores biológicos utilizados en las autoclaves, obteniéndose 100% de eficacia en el proceso de esterilización en las biocargas quirúrgicas y no quirúrgicas. Todos los testigos fueron positivos. Conclusiones: Se corroboró la eficacia de las autoclaves de la Central de Equipos y Estirilización de la Facultad de Odontología de la Universidad Tecnológica de México, cumpliendo con la Norma establecida por la Secretaría de Salud.

Objective: To monitor autoclave effectiveness and conduct routine validation of sterilization cycles. Material and methods: An observational, cross-sectioned, qualitative and prospective study of three Sterilization and Packing Center autoclaves of the Technological University of Mexico of the School of Dentistry was conducted. The study included 96 surgical and non-surgical packs, and spanned the period from May 2012 to April 2015. Monthly assessments were conducted, according to Official Mexican Norm stipulation number NOM-013-SSA2-1994, modification 2006, using rapid lecture biological indicators (1292 3 M Attest™). Sterilization efficiency was determined as biological annihilation elicited in these indicators. Effectiveness assessment was conducted after three hours with an automatic optic reader (3 M Attest 290™). A positive witness was included in all readings. Results: Negative results were obtained in biological indicators readings used in autoclaves. A 100% effectiveness was achieved in sterilization processes of surgical and non surgical packs. All witnesses were positive. Conclusions: The effectiveness of Sterilization and Packing Center autoclaves of the Technological University of Mexico of the School of Dentistry was corroborated. The Norm established by the Mexican Health Ministry was complied with.

Application of cold packs associated with ice compress therapy in nursing of surface wound after fractional photothermal therapy on acne scars / 现代临床护理

Objective To explore the efficacy of cold packs combined with ice compress in treatment of pain after erbium fractional photothermal therapy on acne scars. Methods Eighty cases which were confirmed to the criteria were randomized into two groups:treatment group and control group. The treatment group (n=40) treated with cold packs combined with cold icy compress immediately after the surgery for 30~40 mins. The control group (n=40) was given icy compress therapy immediately after the surgery for 30~40 mins. The therapy continued for three days after the surgery on the two groups. The self-feeling symptom and pain relieving time were compared between the two groups. Result The time for pain relief in the wounds and the time for scabbing were both significantly shorter than those in the control group (P<0.01). Conclusion The cold packs combined with ice compress therapy can relieve the pains effectively and it can shorten the recovery time after fractional photothermal therapy.

A Case of Removing an Esophageal Sharp Foreign Body Using a Surgical Glove / 대한소화기내시경학회지

Foreign bodies with a sharp margin in the esophagus are often associated with serious complications, such as bleeding, perforation and mediastinitis in the middle of endoscopic removal, as well as impaction in the esophagus wall. Therefore, safe extraction for such patients is essential. The techniques that are performed with an endoscope have been designed with using a protector hood and overtube. Yet the former is not available in Korea, and the later is uncomfortable and limited in diameter. Press-through-packs (PTPs) are commonly used as a package for drugs and they also usually cause esophageal impaction because they have sharp edges. We report here on a case of an impacted PTP in the upper esophagus, and this was successfully extracted endoscopically with using a surgical glove, which is a better safe alternative to above mentioned removal items.

Avaliação da manutenção da esterilidade de materiais molhados/úmidos após autoclavação e armazenamento / Sterility maintenance assessment of moisturized/wet packs after steam sterilization and storage

Medidas de segurança no processamento e manutenção da esterilidade de materiais odonto-médico-hospitalares são importantes no controle de infecção hospitalar para garantir qualidade na assistência prestada. Materiais molhados/úmidos podem ocorrer, após autoclavação, mesmo quando todas as normas e procedimentos exigidos forem seguidos. Há recomendações consagradas, oficiais e não oficiais, enfatizando que os materiais molhados/úmidos não devem ser utilizados por serem considerados contaminados. Mas, em busca bibliográfica, não foram encontrados trabalhos científicos evidenciando tal risco. Apesar da conduta-padrão ser a re-esterilização de materiais molhados/úmidos, depara-se com algumas situações difíceis de gerenciar, como o paciente já anestesiado na sala operatória e não existir material seguro para substituição nem tão pouco a possibilidade de esperar a re-esterilização. Frente a este problema, propôs-se neste trabalho avaliar o efeito da presença de umidade em materiais autoclavados interferindo na manutenção da esterilidade, após intervalos de tempo de armazenamento. Para tanto, delineou-se um estudo experimental laboratorial randomizado desenvolvido em duas etapas. Na Fase 1, pacotes contendo cinco carreadores de porcelana embalados em diferentes invólucros (algodão tecido, papel grau cirúrgico, SMS e papel crepado) foram encharcados em água bidestilada esterilizada antes do ciclo de autoclavação com secagem interrompida e, após contaminados intencionalmente por Serratia marcescens IAL 1855 106 u.f.c./mL e armazenados por 3, 6, 24, 72 horas, 7, 14 e 30 dias. Frente à constatação de que houve falhas metodológicas relacionadas à desintegração das embalagens por excesso de umidade, optou-se pela realização da Fase 2 onde caixas cirúrgicas perfuradas, com 80% de instrumentais em seu interior foram embaladas em uma folha de SMS e externamente contaminadas com Serratia marcescens ATCC 14756 106 u.f.c./mL, ) após ciclo de autoclavação com secagem interrompida. Estas foram armazenadas durante 30 dias. Como material-teste, nesta fase, foram utilizadas argolas feitas com quatro cilindros de porcelana unidas por 6,0cm de fio SEDA 2. Utilizaram-se oito unidades desses materiais-teste em cada caixa nas seguintes posições: 3 nas posições superior e inferior e 2 na posição intermediária. Como tamanho amostral utilizaram-se 160 unidades-teste para o grupo experimental (secagem interrompida) e 160 para o grupo controle negativo (ciclo completo) sob orientação de um bioestatístico. Estes experimentos foram também acompanhados com controles positivos. Chegou-se às seguintes conclusões: 1. Materiais odonto-médico-hospitalares armazenados em embalagens externas encharcadas são contaminados; 2. As embalagens algodão tecido, papel grau cirúrgico, SMS e papel crepado (do grupo controle negativo) mostraram propriedades de biobarreira eficazes, quando submetidas à autoclavação completa, incluindo secagem, mesmo em contato externo com alta carga de Serratia marcescens IAL 1855; 3. A presença de umidade no interior de caixas cirúrgicas perfuradas, embaladas em uma folha de SMS e autoclavadas não interferiu na manutenção da esterilidade de seu conteúdo mesmo após 30 dias de armazenamento. Longe de contrariar as recomendações de que os materiais devam sair secos, após autoclavação, este trabalho trouxe evidências científicas para a segurança do uso do material molhado/úmido em situações emergenciais. Em que pesem os referenciais teórico-metodológicos utilizados nesta pesquisa, os resultados trouxeram ao enfermeiro e à enfermagem subsídios científicos para tomada de decisão nas situações práticas relacionadas a materiais molhados/úmidos.

Safety measures in the processing and maintenance of the sterility of medical materials are important in the control of hospital infection in order to guarantee the quality in the given assistance. Moisturized/wet packs can occur after steam sterilization even if all demanded norms and procedures were observed. There are notorious, official and non-official recommendations emphasizing that the moisturized/wet packs do not have to be used due to being considered contaminated. However, a bibliographical search had not found any scientific article evidencing this risk. Although the standard behavior is to resterilize the moisturized/wet packs, some difficult situations to be managed can occur such as the patient is already anesthetized in the operating room and there is not either a backup pack or the possibility to wait for the resterilization. Due to this dilemma, this research aimed to assess the effect of wetness in steam sterilized packs and if the wetness interfere with the maintenance of the sterility after different periods of storage. Therefore, a randomized experimental study developed in two stages was delineated. In the first stage, packs with five porcelain cylinders packed in different packaging systems (woven cotton, peel pouches of plastics, SMS and crepe paper) had been drenched in sterilized bi-distilled water before steam sterilization with drying stage interrupted, intentionally contaminated with Serratia marcescens IAL 1855 106 c.f.u./mL, and then stored by 3, 6, 24, 72 hours, 7, 14 and 30 days. Due to methodological imperfections related to the disintegration of the packaging systems by over wetness, it was decided to accomplish Stage 2 where perforated surgical boxes with 80% of their capacities filled with medical instrumental set, were packed with one leaf of SMS and externally contaminated with Serratia marcescens ATCC 14756 106 c.f.u./mL after a steam sterilization cycle where the drying stage was interrupted. These packs were stored for 30 days. As test materials in this second stage, rings made with 4 porcelain cylinders joined by 6.0 cm of suture silk number 2 had been used. Eight units of these test materials were used in each box in the following positions: 3 in upper and lower positions and 2 in the intermediate position. As sample size, it was used 160 test units for the experimental group (interrupted drying stage) and 160 for the negative control group (complete cycle) under orientation of a biostatistics expert. These experiments were also followed with positive controls. It was concluded: 1. Medical materials stored in external packaging system drenched are contaminated; 2. The packages: woven cotton, peel pouches of plastics, SMS and crepe paper (of the negative group) had shown efficient properties of bio-barrier when submitted to the complete steam sterilization cycle including drying stage, even in external contact with high load of Serratia marcescens IAL 1855; 3. The presence of moisture/wetness in the interior of perforated surgical boxes packed in a SMS leaf and steam sterilized did not interfere with the maintenance of the sterility of their content until after 30 days of storage. Far to oppose the recommendations that the materials must be dry after steam sterilization, this research showed scientific evidences to the safety use of moisturized/wet packs in emergency situations. Respecting the methodological theoretical references used in this research, the results brought for the nurse and the nursing scientific subsidies for decision taking for practical situations related to the moisturized/wet packs.

Unqualified Medical Appliance Packs Checked Before Sterilization:Causes and Countermeasures / 中华医院感染学杂志

OBJECTIVE To analyze the causes of unqualified medical appliance packs before sterilization and to find countermeasures in order to assure their quality,and to avoid emergence of hospital infection and medical tangles. METHODS Totally 320 packs were checked before sterilization from supply room and clinical departments from Jun 1,2004 to Mar 30,2005. RESULTS The rate of unqualified packs checked before sterilization was 14.12% including 460 medical apparatuses unqualified(21.70%). CONCLUSIONS To avoid the emergence of hospital infection and medical tangles,we should strengthen the work of supply room to realize the centralization of sterilization and supply,and make much of personnel′s professional training,normalize job′s process and quality criterion,and intensify professional and systematizing management of medical appliance purged and packed.