Use Of Chlorhexidine Research Articles

Inhibition of Acanthamoeba polyphaga by chlorhexidine-mediated oxidative stress response

Acanthamoeba keratitis is a severe corneal infection caused by a ubiquitous opportunistic protozoan pathogen known as acanthamoeba. For the last decade, the approach to treating this infection typically includes the use of polyhexamethylene biguanide (0.02%) and/or chlorhexidine (Chx) (0.02%). Although chlorhexidine is reportedly effective, its mode of action towards this type of cell is not clear. The aim of this work was to study the effect of chlorhexidine on the oxidative status of Acanthamoeba polyphaga. The effect of chlorhexidine (Chx) on the oxidative state of Acanthamoeba polyphaga was studied using different antiradical methods including ABTS, DPPH and FRAP and measuring the activity of a couple of antioxidant enzyme namely SOD, NADH-FRD and SDH. The chlorhexidine was able to induce oxidative imbalance in cells by over expression of reactive oxygen species and/or inhibiting the antioxidant enzymes. In addition to enhancing the antiradical activity in response to oxidative stress, the present drug was able to reduce the activity of two antioxidant enzymes, superoxide dismutase (SOD) and reduced flavin adenine dinucleotide-fumarate reductase (NADH-FRD), to 30% and 40%, respectively. We could observe an increase of the antiradical capacity of cell's lysate supernatant, to cope with the overproduction of ROS. The imbalance state The inhibition of both SOD and NADH-FRD activities could have a major role in cell oxidative imbalance.

Evaluation of the Antimicrobial Activity of Magnetized Water and Its Comparison with Chlorhexidine 0.2% in Young Children for 3 Weeks

The goal of this study was to compare the effects of magnetized water and 0.2% chlorhexidine mouthwash on gingivitis and plaque prevention in children aged 12-15 years for a period of 21 days. A total of 24 youngsters between the ages of 12 and 15 years were chosen. A computer-generated random number sequence was used to split the research participants into two groups. Magnetized water was utilized as a mouthrinse in Category 1, while 0.2% chlorhexidine was employed in Category 2. Water purified with reverse osmosis was stored in glass bottles, which were then put near the magnets to create magnetic water. The magnets had 1000 Gauss power. The bottles were put for a period of 24 hours. The youngsters were given 140 mL of mouthrinse. These mouthrinses were to be used at home, they were told. The Gilmore Turesky adaptation of Quigley Hein's plaque index was used to assess the plaque whereas the gingival index recommended by Loe and Sillness was utilized to assess the gingiva. The plaque index and gingival index were analyzed at baseline, 14 days, and 21 days, as well as history and examination for adverse effects such as bitter taste, brownish discoloration, and so on, were recorded. The trial lasted 21 days with a follow-up period of another 21 days. Both magnetic water and chlorhexidine were similarly successful in managing periodontal and gingival infections; however, magnetized water had less side effects, such as a bitter metallic taste and brown stains. Because of its well-accepted flavor, softer nature, and lower frequency of brown stains, magnetized water can be a safer and more acceptable alternative to chlorhexidine mouthwashes, especially in youngsters. The use of chlorhexidine as a mouthrinse in the oral cavity has been linked to side effects. These side effects are mostly localized, such as brownish discoloration of teeth, alterations in taste perception, and erosion of the oral mucosa. As chlorhexidine has such negative side effects, it was necessary to do research, particularly in children, to identify a replacement that is similarly efficient against germs but does not have these side effects. Water treated with a magnetic field (magnetized water) was compared with chlorhexidine in the current study.

Influence of chlorhexidine, propolis, pulpal pressure simulation, and aging on dentin bond strength.

The present study evaluated the bond strength (μTBS) of dentin treated with chlorhexidine and propolis subjected to simulated pulpal pressure (SPP) and thermocycle aging. One hundred and twenty healthy human molars were sectioned to obtain 2 mm of dentin thickness and were divided into two groups (n=60): SPP (15 cm H2 O) and no SPP (Control group). Dentin surfaces were conditioned with 37% phosphoric acid for 15 s and were divided according to the dentin treatment (n=20): Control; Chlorhexidine gluconate (0.2% for 30 s) and Propolis (aqueous propolis extract for 30 s). Half of the specimens were submitted to 15,000 thermocycle aging (5 ± 2°C and 55 ± 2°C). The samples were sectioned into beams and submitted to μTBS. Data were analyzed by three-way ANOVA (SPP × Dentin treatment × Thermocycle aging) and the Tukey's tests (p < .001). With regard to the SPP, ANOVA revealed that the Control group (32.98 MPa) had significantly higher values of μTBS when compared to the SPP (29.19 MPa). With regard to Thermocycle aging, no aging (34.05 MPa) had significantly higher values of μTBS when compared to the aging (28.12 MPa). With regard to the dentin treatment, Propolis and Chlorhexidine did not statistically influence the results (p > .05). The SPP and thermocycle aging negatively influenced the bond strength between the dentin and resin; the 0.2% chlorhexidine digluconate and aqueous propolis extract solutions did not interfere in the bond strength between the resin and dentin. The use of chlorhexidine and propolis as a dental treatment may not influence the dentin bond strength, but SPP and thermocycle aging may damage the longitudinal dentin bond strength. RESEARCH HIGHLIGHTS: Chlorhexidine and propolis as a dental treatment may not influence the dentin bond strength. Simulated pulpal pressure and thermocycle aging may damage the longitudinal dentin bond strength.

Human factors analysis of the disinfection of central-line needleless connectors

Background: Patients requiring vascular catheters are at risk for bloodstream infections (BSIs), particularly those with central venous access devices (CVADs). Central-line–associated bloodstream infections (CLABSIs) may occur as a result of the introduction of pathogenic microbes during CVAD access procedures, including through the needleless connector. The use of an antiseptic scrub is recommended to disinfect the needleless connector before device access, and this procedure has been shown to reduce the risk for CLABSI. We identified perceived barriers and facilitators and assessed compliance with instructions for use of chlorhexidine or alcohol antisepsis products (CHG or IPA; 5-second scrub time plus 5-second dry time) and alcohol antisepsis products (IPA; facility protocol 15-second scrub time plus let dry) for needleless connector disinfection. Methods: We performed a multiple-methods study involving focus groups composed of a convenience sample of nurses and clinical observations of CVAD needleless-connector access procedures in 3 medical ICUs and 1 surgical ICU at 2 academic medical centers. We used open-ended questions to guide the focus-group discussions. We directly observed nursing staff performing needleless-connector disinfection following a time–motion paradigm using an electronic tool to document the observed needleless-connector access events and to measure needleless-connector antiseptic scrub times and dry times. Results: In total, 8 focus groups involving 28 nurses revealed access to the antiseptic product and lesser workload as best-practice facilitators of needleless-connector disinfection. Identified barriers were often the opposite of the facilitators, particularly the time required per needleless connector access using IPA and knowledge deficits regarding the need for disinfection between multiple needleless-connector accesses. From 36 observations, including a total of 48 access events, we determined that the mean scrub times were below the recommended times, especially for IPA (Table 1). Drying time after use of either antisepsis product was negligible. Conclusions: A lack of access to the disinfection product, emergency situations, and increased workload were perceived barriers to needleless-connector disinfection. Observed scrub times and drying times were shorter than recommended, much more so for IPA. These deficits in the performance of needleless-connector disinfection may increase the risk of CLABSI. Ongoing education and periodic competency evaluation of needleless-connector disinfection are needed to imbed and sustain best practices.Funding: Professional Disposables, Inc.Disclosures: None

PO-621-07 OUTCOMES OF CLORHEXIDINE SCRUBBING WITHOUT CAPSULECTOMY VS. COMPLETE CAPSULECTOMY AFTER LEAD EXTRACTION FOR THE TREATMENT OF CARDIAC IMPLANTABLE DEVICE INFECTION

Complete capsulectomy has been proposed to reduce the risk of reinfection in patients with cardiac implantable electronic device (CIED) infection after transvenous lead extraction (TLE). However, it is time consuming and requires extensive tissue debridement with a potentially higher risk of hematoma formation. To compare the outcomes of chlorhexidine gluconate (CHG) and saline pocket irrigation without capsulectomy vs. capsulectomy after TLE in CIED-related infection. Consecutive patients who underwent TLE for CIED-related infection were included. In the no-capsulectomy group, after complete device removal thorough scrubbing of the generator pocket with 20 cc of 2% CHG followed by irrigation with 1000 cc of saline was undertaken. The pocket was dried, and the wound was closed with separate intradermal absorbable suture. In patients undergoing capsulectomy, extensive tissue debridement aiming for complete removal of the capsule was undertaken. Patients were evaluated 6 weeks after the procedure and every 6 months thereafter. The primary safety outcome was hematoma formation; primary efficacy outcome was reinfection. Secondary outcomes included any adverse reaction to chlorhexidine, need for reintervention, and infection related mortality. A total of 94 patients were included between July 2013 and September 2020 (mean age 67.4±13.1 years; 32 female), out of which 39 patients underwent CHG pocket irrigation and 55 underwent capsulectomy after CIED extraction. Mean follow-up was 673 days. Six patients presented hematomas in the capsulectomy group vs. 0 in the CHG group (9.2%vs 0%, p=0.04). One patient in the CHG group and 3 patients in the capsulectomy group (2.6% vs 5.4%, p=0.49) died of worsening sepsis despite device extraction. There were no cases of reinfection, even though 50 patients (53.2%) had a new device. In patients with CIED infection, the use of CHG without capsulectomy resulted in a lower risk of hematoma formation than standard pocket management with capsulectomy, without increasing the risk of reinfection or any adverse effects associated with chlorhexidine use.

Phytochemical Profile of Antibacterial Agents from Red Betel Leaf (Piper crocatum Ruiz and Pav) against Bacteria in Dental Caries.

Based on data from The Global Burden of Disease Study in 2016, dental and oral health problems, especially dental caries, are a disease experienced by almost half of the world’s population (3.58 billion people). One of the main causes of dental caries is the pathogenesis of Streptococcus mutans. Prevention can be achieved by controlling S. mutans using an antibacterial agent. The most commonly used antibacterial for the treatment of dental caries is chlorhexidine. However, long-term use of chlorhexidine has been reported to cause resistance and some side effects. Therefore, the discovery of a natural antibacterial agent is an urgent need. A natural antibacterial agent that can be used are herbal medicines derived from medicinal plants. Piper crocatum Ruiz and Pav has the potential to be used as a natural antibacterial agent for treating dental and oral health problems. Several studies reported that the leaves of P. crocatum Ruiz and Pav contain secondary metabolites such as essential oils, flavonoids, alkaloids, terpenoids, tannins, and phenolic compounds that are active against S. mutans. This review summarizes some information about P. crocatum Ruiz and Pav, various isolation methods, bioactivity, S. mutans bacteria that cause dental caries, biofilm formation mechanism, antibacterial properties, and the antibacterial mechanism of secondary metabolites in P. crocatum Ruiz and Pav.

Disinfection Procedures and Their Effect on the Microorganism Colonization of Dental Impression Materials: A Systematic Review and Meta-Analysis of In Vitro Studies.

Dental impressions are contaminated with potentially pathogenic microorganisms when they come into contact with patient blood, saliva, and plaque. Numerous disinfectants are used; however, no sole disinfectant can be designated as universal for all the impression materials. Thus, the aim of this study is to systemically review the literature to evaluate the effect of the existing disinfection procedures on the bacterial colonization of dental impression materials. This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed (MEDLINE), Web of Science, Scopus, EMBASE, and SciELO databases were screened up to April 2021. Eligibility criteria included in vitro studies reporting the antibacterial activity of disinfectant solutions in dental impression materials. The meta-analysis was performed using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of α = 0.05. A total of seven studies were included in the meta-analysis. The included studies described the effect of disinfection processes with chlorhexidine gluconate, alcohol, sodium hypochlorite, glutaraldehyde, and hydrogen peroxide in alginate, polyvinyl siloxane, and polyether impression materials. The meta-analyses showed that the use of chlorhexidine, alcohol, glutaraldehyde, and sodium hypochlorite reduced the colony-forming units by a milliliter (CFU/mL) in alginate (p < 0.001). On the other hand, glutaraldehyde, sodium hypochlorite, and alcohol reduced the CFU/mL in polyvinyl siloxane (p < 0.001). Finally, alcohol and glutaraldehyde reduced the CFU/mL in polyether material (p < 0.001). High heterogenicity was observed for the alginate and polyvinyl siloxane materials (I2 = 74%; I2 = 90%). Based on these in vitro studies, the disinfection of impression materials with several disinfection agents reduces the CFU/mL count.

Effectiveness of Oral Probiotics in Reducing S. Mutans Count in Caries-active Children: A Comparison with Chlorhexidine and Herbal Mouthrinse (Hiora®).

AimThe purpose of this study was to compare the reduction in salivary mutans streptococci counts and to evaluate any change in the salivary pH values after the use of oral probiotics, chlorhexidine, and herbal mouthrinse.MethodOral probiotics, chlorhexidine, and herbal mouthrinse [Hiora®] were evaluated for their efficacy against S. mutans in 75 caries-active children, aged 6-14 years.ResultsThe values obtained were subjected to statistical analysis. Oral probiotics showed lesser reduction in the S. mutans count as compared to chlorhexidine but the values were statistically insignificant. Herbal mouthrinse was not as effective as the oral probiotics or chlorhexidine in reducing the S. mutans count.ConclusionOral probiotics show a similar efficacy as the gold standard, chlorhexidine, in reduction of oral S. mutans.How to cite this articleKamble A, Jabin Z, Agarwal N, et al. Effectiveness of Oral Probiotics in Reducing S. Mutans Count in Caries-active Children: A Comparison with Chlorhexidine and Herbal Mouth-rinse (Hiora®). Int J Clin Pediatr Dent 2022;15(S-2):S207-S211.

Incidence and risk factors associated with surgical site infection following cesarian section at Kibungo Referral Hospital, Rwanda – A prospective cohort study

Introduction: Cesarian section (CS) is lifesaving both for the mother and the baby. Worldwide, there has been an increase in the incidence of CS. However, complications may arise postoperatively for both mother and newborn. Our aim was to determine the incidence rate of post-CS surgical site infection (SSI), identify factors associated with SSI, and identify the most frequent microorganisms associated with the presence of post-CS SSI.Methods: This is a prospective cohort study conducted at KRH, including all CS, performed from February to April 2020. Patient’s demographics, operative management, and outcomes were analyzed. Results: A total of 201 patients aged between 15 to 47 years were operated on and 3.48% developed SSI. 90% were from Ngoma district, 47% had secondary education followed by 36% with primary education. The majority (97%) had no comorbidities. Povidone and chlorhexidine combined was the most commonly used disinfectant. 53% were emergencies and 92% of CS were performed by general practitioners. The average duration of operation was between 30 to 45minutes. Showering prior to operation (RR=0.39) at 95% CI [0.005-0.29], not shaving 30 minutes prior to incision (RR: 25.5) at 95% CI [3.5-18.7] and use of both povidone and chlorhexidine for skin preparation (RR= 0.15) at 95% CI [0.1-1.6] are associated with reduced risk of developing SSI. Obstructed labor/dystocia ((RR=4.55) at 95%, CI [1.6-45.4]) increases the infection risk. Staphylococcus aureus was the most frequently isolated microorganism in post-CS SSI patients.Conclusion: Active hospital infection services and adherence to evidence-based guidelines for SSI prevention measures would reduce the post-CS SSI incidence rate and improve patient care.

Surgical site infection prevention bundle in elective colorectal surgery

Surgical Site Infections (SSIs) are responsible for a significant economic burden as well as intangible costs suffered by the patient, with up to 60% deemed preventable. Colorectal patients are disproportionally affected by SSI due the risk of wound contamination with bowel content. We aimed to reduce the rate of superficial SSI after elective colorectal surgery using a bundle of evidence-based interventions. An SSI prevention bundle was implemented in elective colorectal surgery, comprised of triclosan-coated sutures, 2% chlorhexidine skin preparation and use of warmed carbon dioxide (CO2) during laparoscopic procedures. The SSI reduction strategy was prospectively implemented and compared with historical controls. Our primary outcome measure was the overall rate of superficial SSI. Centres for Disease Control and Prevention criteria, which use microbiological evidence in conjunction with clinical features were used as the definition of SSI. The overall SSI rate was 27.4% in the pre-bundle group (N= 208) and 12.5% in the patients who received the SSI prevention bundle (N= 184) (adjusted odds ratio 0.38; confidence interval 0.21-0.67; P<0.001). The median time to SSI diagnosis was postoperative day 8. Overall patient length of stay (LOS) was unchanged from six days at baseline following implementation of the bundle. We have shown successful implementation of an SSI prevention bundle which has reduced superficial SSI rate. We recommend this SSI prevention bundle becomes standard practice in elective colorectal surgery and plan to extend the bundle to emergency general surgery.

Effects of oral wound on the neutrophil lineage in murine bone-marrow: Modulation mechanism hindered by chlorhexidine

ObjectiveThe oral cavity undergoes frequent stress caused by repeated mechanical trauma, and the constant contact of the injured oral mucosa with bacteria leads to the production of various pro-inflammatory cytokines and chemokines. Neutrophils play essential roles in the acute inflammation against the invasive microbiota, and compromised neutrophil recruitment hinders the bacterial clearance and worsens periodontitis. In this study, we aimed to explore whether wounding at the oral cavity would have an impact on the neutrophil lineage, and, if so, whether microbial contamination of the wounded surface plays significant roles. MethodsWe developed a surgical model of an oral wound (palate wound), by a small incision in the hard palate of the mice. We also evaluated the effect of chlorhexidine on oral wound-induced neutrophilia of bone-marrow. ResultsWe demonstrated an increased neutrophilia in the bone-marrow of the oral wound group, as well as decreasedex vivoneutropoietic potential, in both IL-3 and GM-CSF-driven bone-marrow cultures. Washing of the entire oral cavity with chlorhexidine before surgery abolished the bone-marrow neutrophilia in the oral wound group and increased neutropoiesis in culture, relative to the saline-treated oral wound control group. Co-located treatment (both chlorhexidine treatment and wound on the right side of the palate) resulted in significantly reduced bone-marrow neutrophilia, compared to the mismatched treatment (chlorhexidine treatment and wound on opposite sides of the palate). Neither neutrophilia nor decreased neutropoiesis were dependent on glucocorticoid signaling. ConclusionsThe prophylactic use of chlorhexidine ameliorates the neutrophilic response on the bone marrow, restoring the neutrophil numbers.

Efficacy of herbal- versus chlorhexidine-based mouthwashes towards oral hygiene maintenance in patients undergoing fixed orthodontic therapy: A systematic review and meta-analysis.

The review aims to fill the gap in literature by comparing the efficacy of herbal and chlorhexidine-based mouthwashes towards oral hygiene maintenance (OHM) in patients undergoing fixed orthodontic treatment (OT). Indexed databases were searched electronically to include randomized controlled trials (RCTs) for data gathering. The protocol was registered in PROSPERO (CRD42020182497). Risk of bias assessment, quality of evidence investigation and meta-analysis were performed to evaluate reported OHM-related parameters at time points before and after the use of chlorhexidine (control group) and herbal mouthwashes (intervention group). With 95% confidence intervals, mean difference (MD) or standardized mean difference (SMD) was used to estimate effect size. Out of eight RCTs, results from one RCT favoured chlorhexidine and the results from a second RCT favoured herbal mouthwashes. Results from three RCTs showed comparable effects for the respective investigated OHM-related parameters. Chlorhexidine demonstrated higher antimicrobial efficacy against Streptococcusmutans (S.mutans) in two studies, and one RCT found comparable antimicrobial efficacies. Risk of bias was low in two studies, and moderate and high in two studies each. Quality of evidence was very low to moderate for the respective investigated parameters. Sub-group analysis for parameters colony forming units (CFU) {SMD (0.40) [95% CI (-0.22, 1.03)], gingival index (GI) {MD (0.06) [95% CI (-0.08, 0.20)]}, plaque index (PI) {SMD 0.22 [95% CI (-0.23, 0.67)]} before the use of chlorhexidine and herbal mouthwashes remained inconclusive. The comparison between efficacy of herbal and chlorhexidine towards OHM in patients undergoing fixed OT remains debatable.

Preoperative vaginal cleansing with chlorhexidine vs placebo in patients with rupture of membranes: a prospective, randomized, double-blind, placebo-control study

XXX OBJECTIVE: This study aimed to demonstrate that vaginal cleansing with a 4% chlorhexidine solution before cesarean delivery in patients with a history of rupture of membranes prevents postoperative infectious complications (endometritis, surgical site infections). A total of 204 patients with premature rupture of membranes or who were in labor for more than 6 hours after membranes ruptured were randomized before a cesarean delivery to preoperative vaginal cleansing with a chlorhexidine solution (n=97 patients) or to placebo cleansing with saline solution (n=107 patients). The management of the rupture of membranes and the cesarean delivery procedure were conducted according to standard local protocols for both groups, including the use of antibiotics. Vaginal cleansing with chlorhexidine reduced the risk for endometritis after cesarean delivery in patients with rupture of membranes when compared with placebo cleansing (chlorhexidine, 7.21% vs placebo, 18.8%; relative risk, 0.39; 95% confidence interval, 0.17-0.87; P=.015). Likewise, there was a statistically significant reduction in the number of cases of puerperal fever (chlorhexidine, 9.28% vs placebo, 19.8%; relative risk, 0.47; 95% confidence interval, 0.23-0.98; P=.037). There was a statistical difference between the groups in prolongation of hospitalization for >72 hours (chlorhexidine, 1.03% vs placebo, 7.55%; relative risk, 0.14; 95% confidence interval, 0.02-1.08; P=.02), although the confidence interval suggests that the effect was by chance. There were no statistical differences in surgical site infection at 7 days (chlorhexidine, 1.03% vs placebo, 0.94%; relative risk, 1.1; 95% confidence interval, 0.07-17.4; P=.94) and 15 days after the procedure (chlorhexidine, 1.03% vs placebo, 0%; relative risk, 3.31 [using a continuity correction]; 95% confidence interval, 0.14-80.21; P=.29). The use of chlorhexidine for vaginal cleansing before a cesarean delivery in patients with rupture of membranes reduced the risk for endometritis and puerperal fever. It also reduced the number of cases that required hospitalization for more than 3 days, but the confidence interval suggests that it could be by chance. It has no effect on the number of cases with surgical site infection.

Prevention of Periprosthetic Joint Infection in Total Hip and Knee Replacement: One European Consensus.

Periprosthetic joint infection (PJI) is a devastating complication in total hip and knee replacement. Its prevention is key to decrease the incidence and avoid some consequences that seriously impact patients and health systems. In view of the variety of recommendations and guidelines, we decided to conduct an expert, peer-reviewed European consensus analysis about the pre-, intra-, and postoperative prevention of PJI. A multinational group of practicing orthopedic experts developed a series of 47 consensus statements in 6 main groups of intervention, and a 2-stage Delphi approach was launched with a threshold for agreement at 75% and for very high agreement at more than 90%. A total of 306 orthopedic surgeon responses were gathered from 9 countries. Consensus was reached for 42/47 statements, 31/47 of which achieved a very high consensus. Many preoperative actions gathered strong consensus, although areas like the use of alcoholic chlorhexidine or the timing of hair removal did not attain strong consensus, despite available evidence. Intra- and postoperative actions showed more variability regarding incise drapes, skin suturing techniques, and wound follow-up. This study confirms an important consensus among orthopedic surgeons across Europe in many areas well known to contribute to the prevention of PJI; however, there are still grounds for improvement.

Meta-Analysis the Effect of Chlorhexidine and Povidone Iodine Mouthwashes on Viral Load SARS-CoV-2-Saliva

Background: The strategy to reduce the risk of transmission of COVID-19 is to reduce the salivary SARS-CoV-2 viral load. Chlorhexidine and povidone iodine mouthwash are common active ingredients in oral antiseptics that have efficient viral activity against salivary SARS-CoV-2. This study aims to combine the results of several effect sizes regarding the effect of using chlorhexidine and povidone iodine mouthwash on the salivary SARS-CoV-2 viral load from various countries. Subject and Method: This study is a meta-analysis with the following PICO model, P: COVID-19 patients. I: use of chlorhexidine and povidone iodine mouthwash. C: no mouthwash. O: salivary SARS-CoV-2 viral load. A search for the articles used in this study was carried out using the keywords “COVID-19” OR “SARS-CoV-2” OR “viral load” OR “SARS-Cov-2 viral load” OR “Chlorhexidine mouthrinse” OR “Povidone Iodine mouthrinse ” OR “Randomized Controlled Trial” OR “RCT” between 2012-2022 from the PubMed, Springerlink, Elsevier, Google Scholar and Wiley Online Library databases. The inclusion criteria used in this study were full-text articles using a Randomized Controlled Trial (RCT) design. The analysis used was multivariate with Standardized Mean Difference (SMD). The articles collected were then critically reviewed using the PRISMA checklist, then the data were analyzed using the Review Manager 5.4 tool. Results: This meta-analysis examined 10 articles with a Randomized Controlled Trial (RCT) study design originating from Singapore, Saudi Arabia, Iran, Brazil, Italy, South Korea and Malaysia. A meta-analysis of 7 articles showed that the use of chlorhexidine mouthwash could reduce salivary SARS-CoV-2 viral load by 0.12 units lower than without the use of mouthwash (SMD= -0.12; 95% CI= -0.33 to 0.09; p=0.250). Meanwhile, 7 articles showed that the use of povidone iodine mouthwash could reduce the salivary SARS-CoV-2 viral load by 0.64 units lower than without the use of mouthwash (SMD= -0.64; 95% CI= -1.51 to 0.23; p=0.150). Conclusion: The use of chlorhexidine and povidone iodine mouthwashes can reduce the amount of salivary SARS-CoV-2 viral Keywords: mouthwash, chlorhexidine, povidone iodine, COVID-19, salivary SARS-CoV-2 viral load. Correspondence: Danti Narulita. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: dantinarulita@yahoo.co.id. Mobile: +6282158818400. Indonesian Journal of Medicine (2022), 07(04): 387-400 https://doi.org/10.26911/theijmed.2022.07.04.04

Исследование ранозаживляющего действия антисептиков на основе гидрозолей наночастиц металлов

The article presents the result of a study of the wound-healing effect of hydrosols of metal nanoparticles (silver and zinc) on a plane wound model in laboratory animals. It was found that an antiseptic agent based on zinc oxide nanoparticles promotes faster healing of a planar skin wound in laboratory rats: faster by 4 days compared to 1 control group. On the 17th day of the experiment, the percentage of wound area reduction (PUP) was 96,10 % in control 1, 98,21 % in control 2, 100,0 % in experiment 1, and 98,49 % in experiment 2. Therefore, the results obtained with the use of an antiseptic agent based on silver nanoparticles are consistent with the results obtained with the use of Chlorhexidine containing silver ions in its composition. According to the results of the histological study, it was found that tissue repair occurred in the best way in animals of the 1st experimental group. Compared with other experimental groups, there was practically no inflammatory process.

Nurses’ and midwives’ knowledge and practice of recommended evidence-based preterm care interventions in rural Kenya

BackgroundApproximately 25% of four million neonatal deaths globally are due to preterm birth, a majority occurring within the first week of life and, 60% in sub-Saharan Africa. Clinical interventions to improve preterm babies’ outcomes are often not used. The study assessed the availability of preterm care guidelines and resources in rural public health facilities in Kenya and nurses/midwives’ knowledge and practice of preterm care interventions as per the current preterm policies and guidelines in Kenya. MethodsA hospital-based cross-sectional design was conducted in 16 health facilities and among 102 nurses and midwives. Data were collected between January and March 2018 using the health assessment checklist and vignettes-based questionnaire. Frequencies and percentages were used to describe participants’ characteristics, availability of guidelines, equipment and medicines, and knowledge, and practice on preterm care interventions. All analyses were performed using Stata 13. ResultsSixteen public health facilities and 102 nurses were assessed. The mean age and period of clinical practice were 36 (SD: 9) and 12 (SD: 10) years, respectively. 71 (70%) participants were females, and 78 (77%) registered nurses. Three-quarters (n = 76, 74.5%) of them had in-service training in newborn care within the last two years, majority 67% (n = 69) worked at health centres/dispensaries. Vitamin K and chlorhexidine were available only in 60.8% and 47.1% of the facilities respectively. Guideline’s availability in facilities were 53%, 43%, and 32% for resuscitation, warmth provision, and breastfeeding within one hour respectively. None of the nurses would practice all the recommended preterm care intervention with 17 (16.7%) practicing none. The practice of the recommended preterm care intervention ranged from 7.6% for initiation of breathing to 29% for cord clamping, 32.4% use of chlorhexidine for cord care, 36.3% immediate feeding and 47.1% thermal protection. ConclusionThere exist gaps in the availability of medicines, equipment and guidelines for care of preterm babies, as well as implementation of evidence-based interventions to enhance the quality of care provided to preterm babies in the study area. We recommend increased provider-focussed strategies for improving the availability and implementation of low-cost high-impact evidence-based interventions for preterm care.

Chlorhexidine for the Treatment of Peri-Implantitis: Is it a Benison?

Chlorhexidine is the most favored and widely used antimicrobial agent for the treatment of peri-implantitis. But, not many clinicians are aware of its side effects on dental implants and its cytotoxic effects on osteoblasts. The objectives of this review are to study the effect of chlorhexidine on osteoblasts as well as on the surface topography of dental implants. MEDLINE-PubMed (The National Library of Medicine, Washington DC) was used as a search engine. Databases were searched from 2010 to 2020 were explored using the following terms: "dental implant surface," "chlorhexidine mouthwash," "osteoblast cells," "osseointegration." From the total hits obtained, each article along with its cross-reference was manually read and filtered based on the focused question. The inclusion criteria included articles published only in English language involving human studies, randomized control trials, in vitro studies, and review articles. Exclusion criteria included studies published in languages other than English, orthodontic mini-implants, and pilot studies. The final process involved scrutinizing for any duplicate content of the hand searched articles. Following this, data was extracted from the compiled hand searched articles to obtain relevant information for the review. Chlorhexidine alters the surface topography of dental implants and causes cell cytotoxicity. This, in turn, can hinder the re-osseointegration potential and hence cause dental implant failure. It is, therefore, recommended to discourage the use of chlorhexidine as a surface decontaminant for peri-implantitis cases and practice implementing other antimicrobial agents.

Comparativo entre o uso de álcool e clorexidina no protocolo de desinfecção intracanal anterior à instalação de pino de fibra de vidro relacionado ao aumento da adesividade: uma revisão sistemática da literatura

ABSTRACT Introduction: Many clinical failures involving the fiberglass post result from the detachment between the retainer, the root canal and the cement. Thus, the connections that cause a probability of these failures are essential for dentistry. Objective: To compare the efficiency of intracanal disinfection between alcohol and chlorhexidine in the context of minimizing fractures. Methods: The present systematic review registered in PROSPERO under the protocol CRD42021233516 based on a Medical Subject Headings strategy: “((Endodontics OR Root Canal Filling Materials OR Dental Materials) AND Chlorhexidine AND Ethanol AND Dental Bonding)” in the search engines PubMed, Scopus, Web of Science, Cochrane Library, Embase and Lilacs. Studies in Portuguese, English or Spanish were included, without restrictions regarding their methodology and year of publication. Articles that did not report an intracanal hygiene protocol before the procedure, without full publication and orthodontic research were excluded. Results: Six studies were selected according to the inclusion and exclusion criteria. In all, chlorhexidine was used for intracanal cleaning, comparing it with the other groups, and in 4 it was compared with alcohol and other groups. Discussion: The articles used different media and storage times and most used bovine teeth. There was no significant difference between any other characteristics regarding the increase in adhesiveness of the set. Conclusion: There is no difference between the use of alcohol or chlorhexidine as a disinfection method. However, a previous protocol must be established for longer treatment longevity.

The Effect of Oral Care and Chlorhexidine on the Rate of Ventilator Associated Pneumonia (VAP)

OBJECTIVE: Ventilator-associated pneumonia is considered major pneumonia, which develops in the intensive care unit patients following mechanical ventilation for about two days. This study reviews oral care and chlorhexidine effect on ventilator associated pneumonia occurrence.&#x0D; &#x0D; METHODS: A critical review approach was adopted where publications from 2007 to 2017 were considered. These publications were gathered from electronic searches through the different databases, for instance, MEDLINE, EMBASE, CINAHL, and Cochrane Library. This protocol was used for the selection of the studies and their analysis.&#x0D; &#x0D; RESULTS: The review showed that 0.12% Chlorhexidine use assists in reducing bacterial growth. It also suggests that the use of affirmative outcomes for mechanically ventilated patients, including improved patient outcomes, decreased in the duration of the patients&amp;rsquo; hospital stays, and reduced health care cost.