Aseptic Measures Research Articles

Double J Ureteral stent removal in children non cystoscopically: A preferred innovation.

Objective: To determine the feasibility of non cystoscopic removal of double J ureteral (DJ) stent using a foley catheter with suture in children in terms of success rate, number of attempts required and complications. Study Design: Cross Sectional study. Setting: Department of Pediatric Surgery, Services Hospital, Lahore. Period: August 2022 to August 2023. Methods: All the children who underwent DJ stent placement for any urological procedure were included if DJ stent was seen in the bladder postoperatively. After informed consent, under sedation and aseptic measures, the foley catheter with suture already passed through its eye, was introduced per urethral after adequate lubrication. The foley was given five to six rotations in clockwise direction for right sided and anti-clockwise for left sided stents respectively and pulled out keeping traction on the suture. In case of three failed attempts, a cystoscope was introduced under general anesthesia and the stent was removed. Successful removal, number of attempts needed, time taken, and post removal complications were noted to determine feasibility of the procedure. Results: Out of twenty patients, 17 patients (85%) underwent successful removal of DJ stent. The failure rate was 15% as three patients required cystoscope assisted removal. In 13 patients (76.5%) DJ stent was removed in first attempt, whereas in 4(23.5%) patients it required two attempts. Mean time taken was 8.83±7.33 minutes. Complications were noted in 2 patients (10%). Conclusion: Removal of DJ stent in children without cystoscope, using a foley catheter with suture is a safe and feasible procedure with a high success rate and should be attempted in selected cases.

Hands-On And Mobile App-Based Training Of Second Phase MBBS Students Regarding Blood Sample Collection For Routine Tests And Culture

Background Aseptic measures during blood sampling should be strictly enforced as identification of the true pathogen can act as life-saving measure in patients. Contamination during collection can produce erroneous results which can lead to unnecessary antibiotic usage. Thus, adequate training must be imparted so that the MBBS students can learn the correct technique and develop appropriate skills. This pre-post interventional study thus assessed the students’ and faculties’perception on venous blood sampling through hands on exercises on a simulated model and learning through digital module among MBBS students. Methodology The knowledge of the students was assessed through a questionnaire while practical skills through OSPE using a pre-validated checklist in the pre-intervention phase. The intervention comprised of students being trained in small batches regarding blood sample collection on a mannequin followed by biomedical waste disposal and spillage management. A digital intervention module for self-directed learning was shared with the students to reinforce their learning. This was followed by post interventional assessment of theoretical knowledge and practical skills. Results Paired sample t-test showed a statistically significant improvement in the knowledge scores and OSPE skills in the post-intervention phase. About 91% students opined that they were well trained. All the faculty opined that this training was immensely useful to students for future practical applications. Conclusion The current study demonstrated effectiveness of intervention among the medical students under the new curriculum through hands-on and digital module-based training on accurate blood sampling procedure.

Efficacy of Glycyrrhizin as an Intracanal Medicament on Bacterial Load Reduction in Primary Infected Root Canals: A Randomized Clinical Trial.

This study was done to clinically investigate the efficacy of glycyrrhizin-based intracanal medication (ICM) compared to calcium hydroxide Ca(OH)2 and Ledermix on the bacterial counts inside the root canals of necrotic teeth with chronic periapical periodontitis. Thirty-six patients having single-rooted and single-canaled necrotic teeth with chronic periapical periodontitis were enrolled in this research. Aseptic control measures were taken before clinical steps. Access cavity preparation was done. First bacteriological samples (S1) were collected immediately after access cavity preparation and before cleaning and shaping inside the root canals. Cleaning and shaping were performed on the root canals. Patients were randomly allocated into 3 groups according to the type of intracanal medicament used [Ca(OH)2, Ledermix, Glycyrrhizin]. Second bacteriological samples (S2) were collected after 1 week from placing the ICMs. S1 and S2 were transferred to the lab of microbiology for culturing on blood agar dishes in anaerobic conditions, and the bacteria on the plates were enumerated as colony-forming units (CFUs) by the manual counting method. The anti-bacterial efficacy of the ICM was estimated by the percentage reduction in the bacterial colonies from S1 to S2. All tested ICM documented a significant reduction in the CFUs from S1 to S2 (p < 0.05). Regarding S1, there was no significant difference between the three tested materials (p > 0.05). Regarding S2, Glycyrrhizin and Ledermix showed significantly lower CFUs than Ca(OH)2. There was no significant difference between Glycyrrhizin and Ledermix. Under the conditions of the present study, Glycyrrhizin and Ledermix showed comparable antimicrobial effects that were better than the commonly used Ca(OH)2 ICM. Glycyrrhizin may be a promising ICM. Herbal medicine can be considered as an alternative antimicrobial material for root canal disinfection because it has many benefits, like low toxicity, absence of microbial resistance, and favorable antimicrobial efficacy. This study highlights the clinical efficacy of Glycyrrhizin as a promising ICM. How to cite this article: Eltantawi AR, Abdel-Razik GM, Elhawary YM, et al. Efficacy of Glycyrrhizin as an Intracanal Medicament on Bacterial Load Reduction in Primary Infected Root Canals: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(6):540-546.

HSD45 Effectiveness of Aseptic and Disinfection Measures in Dental Offices in Barranquilla, Colombia

HSD45 Effectiveness of Aseptic and Disinfection Measures in Dental Offices in Barranquilla, Colombia

Role of Prophylactic Negative Pressure Dressings in Determining the Surgical Site Infection (SSI) on Closed Laparotomy Wounds in Abdominal Surgery: Randomized Controlled Open Label Trial: Vacuum Assisted Closure (VAC) Trial in a Tertiary Care Setup

Background: Surgical site infections (SSIs) continue to pose a significant challenge in postoperative care, particularly in abdominal surgeries, due to their prevalence and the associated increase in morbidity, mortality, and healthcare costs. Despite advancements in surgical techniques and aseptic measures, the incidence of SSIs remains high, underscoring the need for innovative preventive strategies. Objective: This study aims to evaluate the efficacy of vacuum-assisted closure (VAC) dressings compared to standard dressing methods in reducing the incidence of surgical site infections in patients undergoing closed laparotomy wounds in abdominal surgeries. Methods: A randomized controlled trial was conducted over six months at Civil Hospital Karachi, involving 116 patients undergoing abdominal surgeries. Participants were randomly assigned to receive either the VAC dressing or standard dressing postoperatively. The primary outcome measured was the incidence of SSIs within 30 days post-surgery, evaluated using the CDC classification and Southampton wound grading system. Data were analyzed using SPSS version 25.0, employing descriptive statistics, independent t-tests, and Chi-square tests for continuous and categorical variables, respectively. Results: The VAC group demonstrated a significantly lower incidence of SSIs (13.8%) compared to the non-VAC group (96.6%), with statistical significance (p &lt; 0.001). Age and BMI showed significant differences between the groups; patients in the VAC group were younger (mean age 30.84 ± 10.71 years) and had a lower BMI (mean 19.69 ± 4.16 kg/m²) compared to the non-VAC group (mean age 37.31 ± 12.83 years, mean BMI 22.07 ± 4.41 kg/m²). The duration of surgery and length of incision did not significantly differ between the groups. Conclusion: The use of vacuum-assisted closure dressings significantly reduces the incidence of surgical site infections in abdominal surgery patients, offering a superior alternative to standard dressings. This method not only enhances patient outcomes but could also lead to a reduction in healthcare costs by minimizing complications associated with SSIs.

Accuracy of point-of-care capillary blood sugar measurements in critically ill patients: An observational study.

Accurately monitoring blood glucose levels is vital for critically ill individuals. Point-of-care (POC) glucose meters are commonly used in local intensive care units (ICUs). This study aimed to assess the precision of POC glucose meter readings in critically ill individuals with specific evaluation in patients with and without shock against the reference standard of venous blood glucose measurements. An observational study was done on adult patients admitted in the ICU at a teaching institution. Capillary blood samples were collected from the patient's fingertip using lancet device with aseptic measures. The sample was analyzed using the GlucoCare Sense Glucometer (RMD Mediaids Limited, Taiwan). At the same time, 2 ml of blood was drawn from the patient's peripheral veins and analyzed by glucose oxidase-peroxidase method as reference. POC glucose measurements averaged 140 ± 20.23 mg/dl, while laboratory values were recorded as 116.10 ± 17.13 mg/dl. The difference between the two methods was 24.34 ± 12.01 mg/dl. A strong correlation (r = 0.805) was found between capillary and laboratory blood glucose levels, indicating a significant association (P < 0.0001). Twenty-two (44%) patients were in shock during the study. The mean difference between laboratory and POC blood glucose levels was higher in patients with circulatory shock (36.82 ± 4.84 mg/dl) than those without shock (14.61 ± 4.49 mg/dl), P < 0.05. POC glucose meters may lead to underdetection of hypoglycemia in critically ill patients, as their values are higher than laboratory values. Moreover, the results showed that POC glucometers are inaccurate for monitoring glucose in hypotensive patients in shock. Standard venous glucose monitoring methods may be more appropriate for these patients.

Microbiome analysis reveals the inducing effect of Pseudomonas on prostatic hyperplasia via activating NF-κB signalling

ABSTRACT Benign prostatic hyperplasia (BPH) is a prevalent disease among middle-aged and elderly males, but its pathogenesis remains unclear. Dysbiosis of the microbiome is increasingly recognized as a significant factor in various human diseases. Prostate tissue also contains a unique microbiome, and its dysbiosis has been proposed to contribute to prostate diseases. Here, we obtained prostate tissues and preoperative catheterized urine from 24 BPH individuals, and 8 normal prostate samples as controls, which followed strict aseptic measures. Using metagenomic next-generation sequencing (mNGS), we found the disparities in the microbiome composition between normal and BPH tissues, with Pseudomonas significantly enriched in BPH tissues, as confirmed by fluorescence in situ hybridization (FISH). Additionally, we showed that the prostate microbiome differed from the urine microbiome. In vitro experiments revealed that lipopolysaccharide (LPS) of Pseudomonas activated NF-κB signalling, leading to inflammation, proliferation, and EMT processes, while inhibiting apoptosis in prostatic cells. Overall, our research determines the presence of microbiome dysbiosis in BPH, and suggests that Pseudomonas, as the dominant microflora, may promote the progression of BPH through LPS activation of NF-κB signalling.

Expression of JAK2 V617F Mutation in BCR - ABL Negative Myeloproliferative Neoplasms

OBJECTIVE: To detect the presence of JAK2V617F mutation in BCR - ABL negative myeloproliferative neoplasms and to stratify high risk patients for targeted therapy.PLACE AND DURATION OF STUDY: Department of Haematology, Armed forces institute of Pathology (AFIP), Rawalpindi, from Dec 2023 to Oct 2023.STUDY DESIGN: Descriptive cross sectional studyMETHODOLOGY: A total of 40 consecutive patients of BCR - ABL 1 negative myeloproliferative disorders were included in the study after being diagnosed according to WHO defined haematological criteria for each disorder and performing bone marrow examination under aseptic measures. Informed consent and ethical approval were obtained from each individual. All patients had their blood samples examined for the G-T point mutation (V617F) in the JAK2 gene located on chromosome 9, utilizing allele-specific real-time qualitative polymerase chain reaction (RT-qPCR). Results were analyzed by using SPSS version 22.RESULTS: Out of total 40 patients included in our study 21(52.5%) had Polycythemia Vera (PV), 15 (37.5%) had Primary myelofibrosis (PMF) and 4 (10%) had Essential thrombocythemia (ET). JAK2 mutation was found in 20 (95.2%) patients of PV, 9 (60%) patients of PMF and 2 (50%) patients of ET with a significant p-value of ˂ 0.001.CONCLUSIONS: JAK2 V617F is a useful clinical marker for establishing diagnosis and separating high risk patients for specific targeted therapy.

Risk factors and outcomes in patients with severe Necrotizing fasciitis admitted to surgical intensive Care unit: a retrospective cohort study from pakistan.

Necrotizing fasciitis (NF) is a debilitating condition that has high mortality and morbidity even in specialized centres. This study aims to determine risk factors in our local population and identify variables that contribute to mortality in the necrotizing fasciitis patients treated in the surgical intensive care unit of a tertiary care hospital. This retrospective cross-sectional study included 39 patients admitted to the surgical ICU from January 1, 2015 to June 30, 2019. They were analyzed for comorbidities, symptoms at presentation, predisposing factors, location of the infection, microbiological analysis and mortality. There were 27 (69.2%) males and 12 (30.8%) females while the age was distributed as 47.44±15 years. Pain was the most frequently reported symptom (89.7%), followed by swelling (79.5%) and tenderness (77%). Significant predisposing factors included trauma in 14 (35.9%) and Intramuscular injections (IM) in 10 (25.6%) patients. On univariate and multiple logistic regression, patients with chronic kidney disease (AOR:1.27, 95% CI: 0-691.22) and ischemic heart (AOR: 1.55, 95% CI: 0.02-153.26) disease had higher odds of mortality than those with no comorbidity. The overall mortality was 12/39 (30.8%). Intramuscular injections without aseptic measures in our local population are a significant predisposing risk factor for severe necrotizing fasciitis. High laboratory risk Indicators for necrotizing fasciitis and acute physiology and chronic health evaluation II scores at admission were associated with increased mortality.

Clinical profile of corneal ulcers at a tertiary care hospital, North-West Rajasthan, India

Background Corneal ulcer is an inflammatory or more seriously infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. Aim The aim of this study was to evaluate the clinical profile of corneal ulcers at Sardar Patel Medical College and associated group of hospitals, Bikaner, Rajasthan, India. Patients and methods This is a prospective, longitudinal, observational study that was conducted for two years from October 2020 to October 2022. It involved 100 clinically diagnosed corneal ulcer patients, recruited by consecutive sampling, attending the Outpatient Clinic at the Department of Ophthalmology, who were willing to participate in the study. Clinical evaluation included the sociodemographic aspects and the ulcer characteristics, including its location, shape, depth, presence of satellites, and hypopyon. Corneal scraping was performed in 60 cases with full aseptic measures after the instillation of topical anesthetic and the samples were sent to the Microbiology Department for further processing. Results The maximum proportion (52%) of the study population were 41-60 years old, with 58% of the patients being males, and 75% from rural areas. Most of the ulcers (68%) were central or paracentral in location, with 38% being of ameboid shape and 48% being superficial. Based on etiology, 48% were fungal, 32% were bacterial, 16% viral, 1% parasitic, and 3% noninfective. The most common pathogen was Aspergillus fumigatus followed by Staphylococci and viral infection. Conclusion Corneal ulcers were found most commonly in males aged 40–60 years hailing from rural areas engaged in agriculture. The most common etiological agent was Aspergillus fumigatus followed by Staphylococci.

Surgical Excision: An Effective Modality for Intradermal Melanocytic Nevus

Objective: To evaluate the effectiveness of fusiform surgical excision of intradermal melanocytic nevus and to document the aesthetic outcome of post-excisional surgical scar.&#x0D; Study Design: Prospective longitudinal study.&#x0D; Place and Duration of Study: Tertiary Care Hospital, Gujranwala Pakistan, from Apr to Oct 2021.&#x0D; Methodology: Patients with intradermal melanocytic nevus were enrolled after informed consent. Close-up photographs of the nevus and the site post-excision were taken. Local anaesthesia was injected with 2% Lignocaine with Adrenaline under aseptic measures. An elliptical incision with scalpel blade-15 was made around the nevus. The length of the incision was almost three times its width. Nevus and the involved tissue were removed to its full depth. A visual analogue scale was used to assess the scar cosmesis.&#x0D; Results: A total of 37 intradermal melanocytic nevi, were included in the study. The size of the intradermal melanocytic nevus ranged from 0.5-2cm with a duration of 3-10 years. The mean visual analogue scar scale on day 5 of surgical excision was 7.23±1.423, and on day seven was 5.37±0.575. Surgical sutures were removed on day 5 in 13(35.1%) cases and day-7 in 24(64.9%) cases.&#x0D; Conclusion: Surgical excision is an effective treatment modality for intradermal melanocytic nevus.

Comparison of Percutaneous A1 Pulley Release versus Steroid Injection in Terms of Mean Pain Score in Trigger Digits

Objective: To compare percutaneous A1 pulley release and steroid injection in terms of mean pain score in trigger digit. Study Design: Comparative cross- sectional study. Place and Duration of Study: Orthopedic Department Combined Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2018. Methodology: Patients with trigger finger diagnosed clinically in Out Patient Department meeting inclusion and exclusion criteria were included in the study. Patients were randomly allocated to Group A &amp; B by lottery method. Group A had percutaneous release of A1 pulley using a surgical blade 11, after preparation of the skin and injection of 1ml 2% plain Lidocaine. Group B had injection with corticosteroid. Both procedures were carried out in Out Patient Department under strict aseptic measures. Visual analogue score at start and end of the study was recorded. Results: A total of 185 patients were included in this study, 122(66%) were males and females were 63(34%). The mean age of patient was 37.80±11.80 years with range from 15-60 years. Mean score of Group A was 39.16±12.22 years and the mean age Group B was 38.93±10.98 years. 56(30.3%) patient had mild visual analogue score, 96 (51.9%) had moderate visual analogue, 33(17.8%) had severe visual analogue. Conclusion: Percutaneous release was found better option for the treatment of the trigger digit with a high success rate. Surgery should be reserved only for cases refractory to steroid injection technique.

Mean Best Corrected Visual Acuity after Intravitreal Bevacizumab in Patients with Diabetic Macular Edema

Purpose: To determine mean best corrected visual acuity after intravitreal bevacizumab in patients with diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Jinnah Hospital, Lahore and Chaudary Muhammad Akram Hospital Lahore from March 2018 to May 2021. Methods: A total of 200 patients of either gender with diabetic macular edema and age between 40 and 60 years were included in this study. Patients with dense cataract, corneal opacity, uncontrolled diabetes mellitus and those who were treated with pan retinal photocoagulation were excluded. Best corrected Visual Acuity (BCVA) was evaluated with Snellen chart and converted to log MAR. A standard protocol of 0.05 mL of Bevacizumab was prepared from injection Avastin, 100 mg/4 mL vial. Bevacizumab injection was given to all patients, using topical anesthesia, under aseptic measures in the operation theater. A total of 03 injections were given at 1-month interval. After three months, BCVA was recorded. Results were presented in number and percentages. Results: Mean age of the participants was 50.42 ± 6.48 years. Male to female ratio was 1:1.6, with 78 (39.0%) men and 122 (61.0%) women. Mean duration of diabetes mellitus was 5.12 ± 2.23 years. Mean pre-treatment BCVA was 0.51 ± 0.05 and mean post-treatment BCVA at three months was 0.26 ± 0.22. Conclusion: Mean BCVA is increased after intravitreal injection of Bevacizumab in patients with diabetic macular edema.

Botulinum Injection and Sphincterotomy for Management of Anal Fissure in Terms of Healing of Anal Fissure: A Randomized Controlled Trial

Aim: To compare the efficacy of botulinum injection with lateral internal sphincterotomydone for management of anal fissure in terms of healing of anal fissure Study design: Randomized controlled trail Setting and duration: Department of General Surgery, K.E. Medical University, Lahore from April, 2019 to Oct, 2019 Methodology: All 350(175 cases in each group) cases meeting inclusion criteria were enrolled through department of Surgery KEMU. Patients were randomly allocated in two groups, group A and B by Lottery method. Patients in group ‘A’ received treatment with 0.5 ml (20 units) Botulinum toxin injection on each side of anal fissure in the internal anal sphincters under direct vision and digital examination at 3 or 9 o’clock position in lithotomy position under strict aseptic measures by single expert surgeon having at least five years’ post fellowship experience. Patients in group ‘B’ underwent lateral internal anal sphincterotomy under general anesthesia by single expert surgeon also having at least five years’ post fellowship experience. Patients were discharged on 1st post operation day on oral antibiotics, analgesics, stool softeners and were advised sitz bath. In both groups, patients were followed up for 2 months. Results: The mean age of all patients was 43.09 ± 10.68 years while the mean age in Group-A was 43.17±10.32 years and in Group-B was 43.02±11.06 years. The efficacy in Group-A was seen in 158(90.3%) while the efficacy was seen in 114(65.1%) of Group-B, the efficacy of treatment was higher in group-A when compared with Group-B, p-value &lt; 0.001. Conclusion: Botulinum toxin injection for the treatment of anal fissure has yielded higher rates of healing than lateral internal sphincterotomy. This suggests that botulinum injection could provide temporary relief from sphincter spasm, allowing for faster fissure healing and improved quality of life, with fewer risks of complications. Keywords: Sphincterotomy, anal fissure, healing of anal fissure, rectal pain, anal pain, anal surgery

P-011 OPEN PREPERITONEAL APPROACH IN AN INCARCERATED ABSCESSIFIED GARENGEOT HERNIA

Abstract Aim The Garengeot hernia is a a rare entity (incidence 0.15–5%) that appears more frequently in elderly women and contents the vermiform appendix. Different surgical approaches are available but the most appropriate one is unknown. Association or conversion to laparotomy may be needed in complicated cases entailing higher morbimortality. Results 82-year-old female with hypertension, dyslipidemia and left inguinal hernioplasty. She presented acute right inguinal pain with a 1 month of evolution mass associated extended to the limb. Blood tests were normal but CT scan was performed reporting a right incarcerated inguinal hernia with acute perforated and abscessified appendicitis. Besides antibiotics, an open preperitoneal approach was performed. An incarcerated crural hernia was found: the sac was opened, the perforated appendix was reduced and the abscess was debrided. Appendicectomy was performed and after aseptic measures and critical view, a 15×15cm gentamicin impregnated large-pore light-weight polypropylene mesh was placed in the preperitoneal space covering the myopectineal orifice. Patient was successfully discharged 4 days after surgery with no complications after two years of follow-up. Conclusion The treatment of a complicated crural hernia in a septic environment in the emergency room represents a challenge. In an incarcerated and abscessified Garangeot hernia, an open preperitoneal approach (modified Nyhus technique) can be safely performed to confront both pathologies. Not only it allows access to the abdominal cavity through a small incision, avoiding the need for a laparotomy, but also favours an optimal exploration and repair of the myopectineal orifice.

Low-Dose Gamma Radiation Sterilization for Decellularized Tracheal Grafts

One of the main key aspects in ensuring that a transplant evolves correctly is the sterility of the medium. Decellularized tracheal transplantation involves implanting an organ that was originally in contact with the environment, thus not being sterile from the outset. While the decellularization protocol (through detergent exposition [2% sodium dodecyl sulfate], continuous stirring, and osmotic shocks) is conducted in line with aseptic measures, it does not provide sterilization. Therefore, one of the main challenges is ensuring sterility prior to in vivo implantation. Although there are established gamma radiation sterilization protocols for inorganic materials, there are no such measures for organic materials. Additionally, the protocols in place for inorganic materials cannot be applied to organic materials, as the established radiation dose (25 kGy) would completely destroy the implant. This paper studies the effect of an escalated radiation dose in a decellularized rabbit trachea. We maintained the dose range (kGy) and tested escalated doses until finding the minimal dose at which sterilization is achieved. After determining the dose, we studied effects of it on the organ, both histologically and biomechanically. We determined that while 0.5 kGy did not achieve sterility, doses of both 1 kGy and 2 kGy did, with 1 kGy, therefore, being the minimal dose necessary to achieve sterilization. Microscopic studies showed no relevant changes compared to non-sterilized organs. Axial biomechanical characteristics were not altered at all, and only a slight reduction in the force per unit of length that the organ can radially tolerate was observed. We can therefore conclude that 1 kGy achieves complete sterilization of decellularized rabbit trachea with a minimal, if any, effects on the organ.

ASEPSIS BETWEEN THE DENTAL OFFICE AND LABORATORY: A TUNISIAN CROSS-SECTIONAL STUDY

Introduction: For a long time, the prevention of cross-contamination in dentistry has mainly been concentrated in the operating room. Activity related to laboratory work, a potential source of pathogen transmission, is therefore often overlooked. In addition, the practice of prosthodontics often gives the impression that aseptic measures cannot be rigorously applied. Several factors account for this situation. Designing a prosthesis involves handling a certain number of potentially contaminated and heat-sensitive objects (prostheses, impressions, wax tubes, occlusion bites, etc.). The items transferred between the dental office and the dental laboratory as well as the prosthetic instruments constitute the main chain of cross contamination in prosthodontics. Thus, an evaluation of the dentists and prosthetists’ compliance with regard to their asepsis through a cross-sectional study was necessary. Methods: two anonymous questionnaires were distributed. The first was among the dentists and the second to dental prosthetists in the public and private sectors. Results: From the 302 questionnaires distributed, only 220 were filled-in. 78% of the dentists and 37% of the prosthetists know the disinfection protocol of reusable instrumentation. 80.3% of the dentists and 74.1% of the prosthetists disinfect their prosthetic work but with varying percentages according to the group of items (impressions, prosthesis, etc.). 71.5% of the practitioners and 18.5% of the technicians disinfect their laboratory instruments systematically. However, 45% of the dentists and 54% of the prosthetists think they are not exposed to infections. Discussion: The results showed an insufficient level of knowledge and compliance to ensure asepsis of the prosthetic work both in the public and private sectors, contributing to a relatively high level of exposure to infections compared to a Canadian study. Conclusion: Given the insufficient compliance and in order to remedy these deficiencies, a simple decontamination protocol is suggested. Improving awareness and providing continuous training are then required.

Evaluation of Antibiotic Sensitivity in Deep Neck Space Infections

Background Deep neck space infections (DNIs) are a major medical concern in the Indian community. Owing to the complex anatomy of the neck spaces and their communication with each other, accurate diagnosis becomes challenging. A thorough knowledge of the anatomy as well as the microbiological profile and antibiotic sensitivity is imperative to institute the appropriate surgical and medical management to the patient. Due to the advent of broad-spectrum antibiotics, the incidence of these infections have declined considerably over the last couple of decades. However, due to the extensive and unregulated use, the incidence of antibiotic resistance has also been increasing at an alarming pace. Materials and Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology at a tertiary care government hospital in an urban area. All patients who presented to the OPD or emergency over a period of 18 months and who fulfilled the eligibility criteria were included in the study. Pus was collected from the abscess, aseptically by needle aspiration using wide bore (18G) needle and transported under all aseptic measures within 24 hours for culture and sensitivity, KOH mount, and detection of AFB. Antibiotic sensitivity testing was done using the Kirby Bauer disc diffusion method and E-test. Results Staphylococcus aureus as the most common infective organism followed by MRSA in the pediatric age group and Klebsiella pneumoniae in adults. Conclusion Primary knowledge of individual antibiotic sensitivity is imperative to ensure prompt and adequate treatment of the patient with higher chances of complete resolution, concomitantly minimizing the risk of resistance. Inadequate and delayed treatment may lead to swift progression of the disease with significant morbidity and mortality.

Successful management of post parturient complete prolapse of uterus in a non-descript buffalo - A case report

Prolapse is a common ailment associated with parturition in cattle and buffaloes. An eight-year-old, non-descript buffalo with the history of aggressive assistance during parturition was presented at farmers doorstep for third degree complete uterine prolapse. The prolapsed mass haemorrhagic and soiled, the mass was cleaned maintaining all aseptic measures. Animal was restrained and using the three-step management reduction, reposition and retention of the prolapsed mass was undertaken. The blood parameters indicated anaemia, neutrophilia, and eosinophilia, while the serum profile indicated hypocalcaemia. The case was managed rationally by rehydration, supplementation of energy and calcium. The infection and trauma of uterus was managed with antibiotic therapy, analgesics and antiallergics. The animal recovered uneventfully without a relapse of the uterine prolapse.

Frequency of Hyperthyroidism in patients of Atrial Fibrillation

Aim: To find the frequency of hyperthyroidism in patients of atrial fibrillation admitted in Mayo hospital Lahore. Study setting: The study was conducted at Emergency Department, Cardiology Department and Department of Internal Medicine in Mayo Hospital Lahore\ Duration of study: It was from May 20, 2019 to November 20, 2019. Study design: It was Cross-Sectional study\ Methods: patients suffering with atrial fibrillation fulfilling the operational definition and inclusion criteria were enrolled. After aseptic measures, blood sample of 5 ml was drawn from left cubital vein with low sucking pressure. Sample was deposited to Center for Nuclear Medicine (CENUM) Laboratory at Mayo Hospital Lahore for thyroid function tests. Serum Thyroid Stimulating Hormone, Thyroxine and Triiodothyronine levels were noted and hyperthyroidism labeled as per the operational definition. Data was collected by the researcher himself noted on a specially designed proforma and presented in the form of tables and diagrams. Results: The mean value of age in our study was 55.13±14.01 year. In our study 40(42.6%) patients had hyperthyroidism. Conclusion: High frequency of hyperthyroidism in our study, suggests that routine thyroid function tests using sensitive thyroid-stimulating hormone assay with free T4 &amp; free T3 levels is required in all those with acute atrial fibrillation. Keywords: Hyperthyroidism, Atrial Fibrillation.