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Journal of Indian Society of... 2023One of the major techniques to reduce the transmission rate of COVID-19 would be to decrease the viral titers of SARS-CoV-2 in the saliva of infected patients and it is...
BACKGROUND
One of the major techniques to reduce the transmission rate of COVID-19 would be to decrease the viral titers of SARS-CoV-2 in the saliva of infected patients and it is particularly useful in a dental setting. The present study evaluated the change in salivary viral load of COVID-19 patients using povidone iodine (PI), chlorhexidine (CHX), and an herbal extract (RightSure) oral antiviral herbal mouthwash (HM) at clinically recommended duration and concentrations.
MATERIALS AND METHODS
Thirty individuals with SARS-CoV-2 were randomly allocated to three groups: (1) Group 1, PI mouthwash; (2) Group 2, CHX mouthwash; and (3) Group 3, HM mouthwash. A baseline salivary throat sample was collected from all the participants who were later instructed to rinse with their respective mouthwash for 30 s. A second salivary sample was collected 30 min after rinsing. The SARS-CoV-2 viral load was analyzed using real-time reverse-transcription polymerase chain reaction wherein the cyclic threshold (Ct) values were evaluated.
RESULTS
Independent -test analysis reported a statistically significant difference concerning the PI group (before-after comparison) ( < 0.05). The rest of the two study groups failed to report any significant difference in the nucleocapsid gene and open reading frame 1a gene levels.
CONCLUSION
While all three types of mouthwash increased the Ct values, a statistically significant difference was observed with PI mouthwash, indicating that it might potentially reduce the spread of the SARS-CoV-2 virus, especially via aerosol but further studies with larger sample size and longer follow-up periods are required to investigate this relationship.
PubMed: 38434502
DOI: 10.4103/jisp.jisp_469_22 -
BMC Infectious Diseases Mar 2024To assess the efficacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES/HYPOTHESIS
To assess the efficacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle threshold (Ct) values in nasopharyngeal swabs.
STUDY DESIGN
This was an open-label, prospective, randomized, placebo-controlled clinical trial.
SETTING
The study was conducted in King Saud University Medical City, Riyadh, Saudi Arabia, from August 2021 to July 2022.
METHODS
Participants diagnosed with SARS-CoV-2 were randomly assigned to one of three groups, with participants receiving either 0.23% PVP-I, 0.9% normal saline (NS) nasal rinses and mouth washes, or no intervention (control group). Nasopharyngeal swabs were taken 4, 8, 12, and 18 days after the first swab to measure the detectability of the virus and the Ct.
RESULTS
A total of 19 participants were involved in this study. The mean viral survival was 9.8, 12, and 12.6 days for the PVP-I, NS, and control groups, respectively, with a statistically significant difference (p = 0.046). The Ct mean values were 23 ± 3.4, 23.5 ± 6.3, and 26.3 ± 5.9 at the time of recruitment and 25.2 ± 3.5, 15 ± 11.7, and 26.9 ± 6.4 after 4 days for the PVP-I, NS, and control groups, respectively.
CONCLUSIONS
When used continuously at a concentration of 0.23%, PVP-I showed promising results in terms of decreasing the pandemic burden by reducing the period of infectiousness and viral load. However, the use of PVP-I did not result in significantly different changes in the quality-of-life parameters in recently vaccinated and mild COVID-19 patients.
Topics: Humans; COVID-19; Povidone-Iodine; Mouthwashes; SARS-CoV-2; Pilot Projects; Prospective Studies
PubMed: 38429662
DOI: 10.1186/s12879-024-09137-y -
Frontiers in Pediatrics 2024The aim of this study is to summarize and demonstrate the different sterilization methods and surgical techniques for open fractures with impacted bone segments in the...
OBJECTIVE
The aim of this study is to summarize and demonstrate the different sterilization methods and surgical techniques for open fractures with impacted bone segments in the lower limbs.
METHODS
A retrospective analysis was conducted on the clinical characteristics, treatment methods, and outcomes of a case involving a 10.5 cm extruded segment of the femur in a 9-year-old male with a right femoral comminuted fracture treated at our center. Additionally, a retrospective review and summary were conducted on all reported cases of open fractures with impacted bone segments in the lower limbs.
RESULTS
Our center treated a 9-year and 11-month-old male child who presented with a Gustilo type IIIB open fracture of the femur along with a large segment of the femur being ejected as a result of a car accident. The child was resuscitated to correct hypovolemic shock, underwent emergency wound debridement, and had Ilizarov external fixation of the femur. The ejected femur segment was sterilized using ethylene oxide and re-implanted four days after the injury. A literature review showed that out of the cases of open fractures with impacted bone segments in the lower limbs, there were 14 cases involving the femur and 5 cases involving the tibia. Among them, sterilization was performed using povidone-iodine in 6 cases, high-pressure steam sterilization in 3 cases, and other methods including gamma-ray irradiation and soaking in antibacterial solution were used in the remaining cases. In terms of surgical methods, 7 cases were fixed with locking plates, 3 cases were fixed with external fixation devices, 1 case was immobilized in a cast, 1 case was fixed with an intramedullary rod, and 4 cases involved a combination of external fixation and internal fixation. The average time for re-implantation was 7.6 days after the injury. There were no serious complications such as infection or non-union observed in any of the cases during follow-up.
CONCLUSION
Ethylene oxide can be considered a reliable choice for the reimplantation of displaced bone segments in open fractures after sterilization.
PubMed: 38425662
DOI: 10.3389/fped.2024.1333575 -
Journal of Ayub Medical College,... 2023A surgical site infection (SSI) is a wound infection caused by pathogens, particularly bacteria, that occurs within 30 days of the surgery. Various methods have been... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A surgical site infection (SSI) is a wound infection caused by pathogens, particularly bacteria, that occurs within 30 days of the surgery. Various methods have been employed to minimise infection rates of infection one of which is intra-operative wound irrigation. This study aims to compare the frequency of surgical site infections after wound irrigation of contaminated and dirty wounds with normal saline and aqueous povidone-iodine solutions.
METHODS
This randomized controlled trial was carried out in the surgical department of Federal Government Polyclinic Hospital from January to December 2022. A total of 180 patients were randomly divided into two equal groups using blocked randomization. Group A had normal saline irrigation while Group B had aqueous povidone-iodine irrigation before surgical incision closure. Patients were followed till 30th post-operative day. Data was collected, entered and analyzed using SPSS 20.0.
RESULTS
A total of 180 patients were recruited in this study, equally divided into Group A and Group B with 90 patients each. Fifty-three patients (58.9%) from group-A and 58 patients (64.4%) from group-B were having contaminated wounds and 37 patients (41.1%) and 32 patients (35.6%) had dirty wounds respectively. Surgical site infection was found in 29 patients (32.2%) of group-A and 26 patients (28.8%) of group-B (p=0.627). there was no significant difference between the two groups concerning surgical site infection.
CONCLUSIONS
Irrigation of surgical wounds with aqueous povidone-iodine solution before primary closure was statistically similar to normal saline in preventing surgical site infections in contaminated and dirty wounds.
Topics: Humans; Povidone-Iodine; Surgical Wound Infection; Saline Solution; Anti-Infective Agents, Local; Therapeutic Irrigation
PubMed: 38404074
DOI: 10.55519/JAMC-03-12158 -
American Journal of Medical Quality :...Surgical site infections (SSI) remain a cause of morbidity, prolonged hospitalization, surgical readmission, and death. Nasal colonization with methicillin-resistant...
Surgical site infections (SSI) remain a cause of morbidity, prolonged hospitalization, surgical readmission, and death. Nasal colonization with methicillin-resistant Staphylococcal aureus is a frequent cause of device-related SSI and nasal mupirocin has been used for prevention. More recently, povidone-iodine nasal swabs have become an alternative. It is cheaper, ensures compliance and there are no concerns regarding antimicrobial resistance. However, its adoption was suboptimal in a community hospital system in southwestern Ohio, especially in neurosurgery and vascular surgery. Quality improvement techniques, including solicitation of stakeholder input, surgeons and perioperative nurses' education, and the use of reminders to order and administer the povidone-iodine nasal swabs improved physician ordering and nurse administration compliance, leading to fewer infections. The interventions continued after the project was completed, sustaining decreases in neurosurgery and vascular surgery, and fewer SSI through the first years of the pandemic. Despite the complexity of these surgeries, simple interventions were effective in addressing the problem.
Topics: Humans; Povidone-Iodine; Neurosurgery; Surgical Wound Infection; Hospitals, Community; Hospitals, Teaching
PubMed: 38403957
DOI: 10.1097/JMQ.0000000000000172 -
The Journal of Surgical Research May 2024
Topics: Humans; Anti-Infective Agents, Local; Povidone-Iodine; Ethanol; Chlorhexidine; Surgical Wound Infection; Preoperative Care; Skin
PubMed: 38403530
DOI: 10.1016/j.jss.2024.01.048 -
International Journal of Molecular... Feb 2024Wound management practices have made significant advancements, yet the search for improved antiseptics persists. In our pursuit of solutions that not only prevent...
Wound management practices have made significant advancements, yet the search for improved antiseptics persists. In our pursuit of solutions that not only prevent infections but also address broader aspects of wound care, we investigated the impact of integrating trimethyl chitosan (TMC) into a widely used poly(vinylpyrrolidone)-iodine gel (PVP-I gel). Our study assessed the antimicrobial efficacy of the PVP gel with TMC against , , multidrug-resistant MRSA, and . Additionally, we compared hemostatic effects using a liver puncture bleeding model and evaluated wound healing through histological sections from full-thickness dermal wounds in rats. The results indicate that incorporating TMC into the commercially available PVP-I gel did not compromise its antimicrobial activity. The incorporation of TMC into the PVP-I gel markedly improves its hemostatic activity. The regular application of the PVP-I gel with TMC resulted in an increased blood vessel count in the wound bed and facilitated the development of thicker fibrous tissue with a regenerated epidermal layer. These findings suggest that TMC contributes not only to antimicrobial activity but also to the intricate processes of tissue regeneration. In conclusion, incorporating TMC proves beneficial, making it a valuable additive to commercially available antiseptic agents.
Topics: Rats; Animals; Anti-Infective Agents, Local; Povidone-Iodine; Chitosan; Iodine; Hemostatics; Methicillin-Resistant Staphylococcus aureus; Anti-Infective Agents
PubMed: 38396783
DOI: 10.3390/ijms25042106 -
Canadian Journal of Ophthalmology.... Feb 2024To assess the rate of post-intravitreal injection endophthalmitis between 2 asepsis groups: aqueous chlorhexidine 0.1% and povidone-iodine 5%.
OBJECTIVE
To assess the rate of post-intravitreal injection endophthalmitis between 2 asepsis groups: aqueous chlorhexidine 0.1% and povidone-iodine 5%.
DESIGN
Retrospective, observational cohort study.
PARTICIPANTS
Patients with infectious endophthalmitis post intravitreal injection (n = 58) at a single centre from July 2009 to July 2022.
METHODS
Retrospective chart review of all patients receiving intravitreal injections (216 593 injections) at a single centre over 14 years. Patients from July 2009 to February 2017 received povidone-iodine 5%, and patients from March 2017 to July 2022 received aqueous chlorhexidine 0.1%. Assessed characteristics of endophthalmitis cases included demographics, visual function, intervention type, and microbiological results.
RESULTS
The rate of endophthalmitis was comparable for povidone-iodine (1.4:5000) and aqueous chlorhexidine (1.3:5000) (p = 0.77). Vitreous cultures were negative for 55% of patients. Visual acuity (VA) outcomes did not differ between asepsis groups nor between culture positive/negative groups. Patients having vitrectomy (PPV) had worse final vision (p = 0.08) but there was no VA difference between early and late PPV.
CONCLUSIONS
Aqueous chlorhexidine 0.1% is a viable and safe alternative to povidone-iodine 5% for post-intravitreal injection endophthalmitis prophylaxis and may reduce ocular surface adverse events and discomfort.
PubMed: 38387861
DOI: 10.1016/j.jcjo.2024.01.012 -
European Journal of Surgical Oncology :... Apr 2024Intraluminally shed viable tumor cells might contribute to anastomotic recurrence in cancer of the esophagus and the cardia. The study aimed to establish a method of...
OBJECTIVE
Intraluminally shed viable tumor cells might contribute to anastomotic recurrence in cancer of the esophagus and the cardia. The study aimed to establish a method of esophageal washout and, hence, to reduce intraluminal cancer cells before esophageal anastomosis.
METHODS
Forty-eight consecutive patients with esophago-gastric resection for histologically proven cancer of the esophagus or the cardia were included in a prospective, interventional study. Before transection, the esophagus was clamped proximally to the tumor and rinsed with 1:10 diluted povidone-iodine-solution (10 × 30 ml) applied by a transorally inserted 24F-Foley catheter. The first, fifth and tenth portion of the lavage fluid were sent to cytological examination.
RESULTS
Intraoperative frozen sections confirmed clear proximal resection margins of the esophagus. The cytological examination of the fluid recovered from the esophageal washout revealed malignant cells in 13/48 patients (27%). The presence of malignant cells was significantly less likely in patients with neoadjuvant treatment than in patients without neoadjuvant treatment: 2/23 (9%) vs. 11/25 (44%) (p = 0.009). Repetitive washout reduced the probability of detectable malignant cells from 13 to 8 (62%) patients after 5, and further to 4 patients (30%) after 10 washout maneuvers.
CONCLUSIONS
Free malignant cells may be present in the esophageal lumen following intraoperative manipulation of cancers of the esophagus or cardia. Transoral washout of the esophagus is novel, feasible and enables reduction or even elimination of these tumor cells. The reliability of this procedure raises with increasing washout volume. Esophageal washout might be especially worthwhile in patients who do not receive neoadjuvant therapy.
Topics: Humans; Cardia; Esophageal Neoplasms; Prospective Studies; Reproducibility of Results; Carcinoma; Stomach Neoplasms
PubMed: 38377885
DOI: 10.1016/j.ejso.2024.108017 -
Journal Francais D'ophtalmologie Mar 2024To evaluate the peri- and post-intravitreal injection (IVI) symptoms reported by patients who have been repeatedly injected for age-related macular degeneration (AMD)...
PURPOSE
To evaluate the peri- and post-intravitreal injection (IVI) symptoms reported by patients who have been repeatedly injected for age-related macular degeneration (AMD) and to analyze these according to the protocols of the injector.
MATERIALS AND METHODS
Multi-center, cross-sectional, consecutive, analytical survey.
RESULTS
The IVI protocols of 106 injectors differed in terms of the number of instillations of povidone-iodine, its contact time, and rinsing of the ocular surface post-injection. In total, 3,738 patients responded to the survey, 60.1% of whom were women; 36.4% had received more than 20 IVIs; 50.7% of patients reported irritation upon application of povidone-iodine. Post-IVI, depending on the symptom in question, between 44.8% and 57.4% of patients reported symptoms of ocular surface change. The number of instillations of povidone-iodine, its contact time with the ocular surface, and abundant rinsing post-IVI increased the immediate symptoms. Patients who received more IVIs were more prone to experiencing gritty eyes, and the incidence of acute pain increased in patients who had previously received over 20 IVIs. Women and patients previously treated for dry eye or glaucoma were at greater risk of worse symptoms.
CONCLUSION
Comparing injecting centers' practices with patients' self-assessments showed an aggravation of symptoms of ocular surface changes related to povidone-iodine. This survey contributes to providing data for the implementation of a protocol to improve the quality of life of patients injected repeatedly for AMD.
Topics: Humans; Female; Male; Intravitreal Injections; Quality of Life; Cross-Sectional Studies; Povidone-Iodine; Macular Degeneration
PubMed: 38368762
DOI: 10.1016/j.jfo.2024.104075