Sterile Gloves Research Articles

Frequency of Port Site Wound Infection with and Without End Gloves Techniques of Retrieval of Gallbladder in Pouch

Background: The gallbladder is a hollow organ that sits just beneath the right lobe of the liver. Chief functioning of gallbladder is to store gall, also known as bile that is required for digestion of food. Removing gallbladder through small incision in the abdomen is called laparoscopic cholecystectomy. Among benefits of cholecystectomy are decreased need for postoperative analgesia, decreased postoperative pain and shortened hospital stay from 1 week to less than 24 hours. Objective: To compare the frequency of port site wound infection with and without endogloves techniques of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis. Design: It was a randomized controlled trial. Study Settings: This study was conducted at Department of General Surgery, Midland Doctors Medical Institute Tandali Muzaffarabad from July 2019 to July 2021 Material and Methods: A total of 260 cases who fulfilled inclusion criteria were enrolled in the study through wards of Department of General Surgery. Written informed consent was obtained from all the patients. Two groups were made by random division of patients. Conventional laparoscopic cholecystectomy was performed in patients of group I. Through umbilical port gall-bladder was retrieved in these patients, exactly spot on by a sterile surgical hand glove endobag. Vicryl “O” with J-shaped needle was used to close 10mm umbilical port (fascial defect) and 5mm ports were conventionally closed. In patients of group II, conventional laparoscopic cholecystectomy was performed and gall-bladder was retrieved as in patients of group I but without using surgical sterile hand glove endobag. Results: The mean age of the patients in study group was 48.09±15.402 years and in control group it was 47.51±16.48 years. Male to female ratio was 1.06:1. The post-op wound infection was found in 11 (4.23%) patients. Statistically significant difference was found in groups (P<0.05). Conclusion: The use of endoglove technique of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis is safe, cheap, simple and potentially reduces significant port site wound infection compared to without endogloves. Keywords: Laparoscopic Cholecystectomy, Endoglove, Gallbladder (GB).

Survey of Intravitreal Injection Techniques and Treatment Protocols Among Members of the Turkish Ophthalmological Association.

Objectives:To describe the intravitreal injection (IVI) techniques, practices, and treatment protocols of ophthalmologists in Turkey from May 20, 2020 to June 4, 2020.Materials and Methods:All members of the Turkish Ophthalmological Association were contacted by e-mail to complete an anonymous, 47-question internet-based survey.Results:Thirteen percent of the participants prescribed prophylactic antibiotics pre-injection, 63.8% (406/636) used antibiotic drops immediately after injection, and 91.8% prescribed topical antibiotics. The majority of IVI procedures were performed in an operating room (65.3%) or clean room (33.6%). Most surgeons used sterile gloves, masks, sterile drape, sterile fenestrated cover, and sterile eyelid speculum. Multispecialists (M) preferred to wear sterile gloves more than retina specialists (RS) (99.0% vs. 95.3%; p=0.004). Also, M prescribed antibiotics more than RS (93.7% vs. 88.8%; p=0.029). RS dilated the pupil more frequently than M (48.3% vs. 39.0%) (p=0.020). RS were more familiar to use different quadrants (right p=0.012; left p=0.001). Most surgeons (82.8%) did not perform injections in both eyes on the same day.Conclusion:Ophthalmologists in Turkey employ a wide range of techniques in care before, during, and after IVI. In addition, IVI techniques and treatment protocols differed between RS and M. Further research is needed to elucidate best practice patterns.

To Study Effect of Education Programme on Central Venous Site Care Among ICU Nurses in Selected Hospital

To Study Effect of Education Programme on Central Venous Site Care Among ICU Nurses in Selected Hospital

Bacterial meningitis without pyrexia after spinal anesthasia for caesarean section: A case report.

Introduction and importancyMeningitis happening in post spinal anesthesia is rare. But it has potentially life threatening or permanent neurological sequel if delayed or left untreated. The cause can be infectious or noninfectious. In this case, uncommon pathogen is described causing bacterial meningitis. Incidence varies from 0% to 0.04%.Case presentationA term pregnant lady came to the Operation room (OR) for an emergency caesarian section(C/S) because of cervical dystocia. She has no history of known medical illness. The anesthetist planned to administer spinal anesthesia. Under aseptic technique, the senior anesthetist wore a tight-fitting surgical mask, cap, and sterile gloves after hand hygiene with alcohol-based solutions.In sitting positioning between L(lumbar) 3 and L4 interspaces 10 mg bupivacaine +10 μg fentanyl was administered. Surgery and anesthesia were uneventful, 16 h into the postoperative period the mother develop severe headache, agitation, confusion, and forgetfulness.She has no fever but meningeal sign was positive. Lumbar puncture (LP) reveals purulent cerebrospinal fluid (CSF).Immediately, empirical treatment began. CSF sent for analysis and Culture, hematology, urinalysis, and organ function tests requested. Diagnosis was confirmed by clinical picture, low CSF glucose, and high body fluid protein, culture growth; showed Escherichia coli (E.coli). Treatment was instituted and patient has recovered fully.Clinical discussionE.coli is a very rare cause of bacterial meningitis but manifests a similar clinical picture like other bacterial meningitis but in our case no pyrexia. We believe there is a sterility breach somewhere in the process. The use of hospital sterilized spinal set, multidose antiseptics; institute sterility practice might be challenged.ConclusionThe use of modern packaging is recommended. Despite absent of pyrexia empiric treatment must start earlier besides the application of national guideline developed by the Joint Commission of different associations including America society of regional anesthesia (ASRA) is recommended.

Compliance With The Use of Personal Protective Equipment Against The Transmission of Covid-19 in Medical Personnel

Hospitals are included in the criteria for workplaces with hazards that can have an impact on health, both for health workers as well as for visitors and hospital patients, especially during the COVID-19 pandemic. Therefore, compliance and completeness of the use of PPE, especially in the Covid19 isolation room is very important. This research is a descriptive observational study, with a population and sample of 16 people. The survey was conducted using a developed questionnaire. Data collection was carried out using instruments in the form of questionnaires and observation checklist sheets. The survey was conducted using a developed questionnaire. Compliance and completeness of the use of PPE for inpatients in COVID-19 isolation at FMC Hospital is 100%. The respondents which are medical staff use complete level 3 PPE which consists of eye protection and face shield, head cover/head cap, N95 mask or equivalent, Coverall / Gown/apron, sterile rubber surgical gloves disposable, boots/rubber boots. But the incidence of COVID-19 transmission is 40% for inpatients medical staff in isolation for COVID-19. The possibility of transmission does not come from the workplace but can occur in daily routines and social activities. Compliance and completeness in the use of PPE for inpatients in COVID-19 isolation in FMC Hospital are high (100%), the incidence of being infected with COVID-19 in medical personnel does not only occur in the work environment.

COVID-19 Exposure During Neurology Practice: Results of American Academy of Neurology Survey.

To determine the exposure risk for coronavirus 2019 (COVID-19) during neurology practice. Neurological manifestations of COVID-19 are increasingly being recognized mandating high level of participation by neurologists. An American Academy of Neurology survey inquiring about various aspects of COVID-19 exposure was sent to a random sample of 800 active American Academy of Neurology members who work in the United States. Use of second tier protection (1 or more including sterile gloves, surgical gown, protective goggles/face shield but not N95 mask) or maximum protection (N95 mask in addition to second tier protection) during clinical encounter with suspected/confirmed COVID-19 patients was inquired. Of the 81 respondents, 38% indicated exposure to COVID-19 at work, 1% at home, and none outside of work/home. Of the 28 respondents who did experience at least 1 symptom of COVID-19, tiredness (32%) or diarrhea (8%) were reported. One respondent tested positive out of 12 (17%) of respondents who were tested for COVID-19 within the last 2 weeks. One respondent received health care at an emergency department/urgent care or was hospitalized related to COVID-19. When seeing patients, maximum protection personal protective equipment was used either always or most of the times by 16% of respondents in outpatient setting and 56% of respondents in inpatient settings, respectively. The data could enhance our knowledge of the factors that contribute to COVID-19 exposure during neurology practice in United States, and inform education and advocacy efforts to neurology providers, trainees, and patients in this unprecedented pandemic.

Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study

Objective: Central venous access is a common procedure performed in many clinical settings for a variety of indications. Yet, thereare multiple complications related to central venous catheter use. Significant morbidity and mortality can result from complicationsrelated to central venous catheters. Therefore, safety and effectiveness of central venous catheter care by nurses is crucial. The aim ofthis study was to evaluate the intensive care nursing skills associated with central venous catheter care.Materials and Methods: This observational study was conducted with 37 volunteer nurses who were employed in adult intensive careunits of three hospitals in Istanbul, Turkey. A total of 111 observations were collected by using the Nurses’ Descriptive CharacteristicsForm and the Intensive Care Nurses’ Central Venous Catheter Care Skills Observation Checklist.Results: The average age of the nurses was 33.2 ± 5.9 years. The study showed that 93.7% nurses had performed the hand hygienebefore starting the central venous catheter care but seldom after the procedure. Sterile gloves were not used by majority of the nursesduring the care. They almost never disinfected the catheter hub, and they did not adequately obey the rules after completing the careprocedure.Conclusions: This study demonstrated that nurses had inadequate skills of central venous catheter care. We recommend that nurses’skills must be enriched with professional theoretical and practical trainings.

Non-sterile examination gloves and sterile surgical gloves: which are more sustainable?

Healthcare professionals should consider environmental sustainability when using personal protective equipment (PPE). One of the most frequently used items of PPE in medical settings are gloves. This study aims to quantify the environmental impact of sterile versus non-sterile gloves using the life cycle assessment (LCA) methodology. This study used three glove types: non-sterile gloves and sterile gloves (latex and latex-free). Sixteen different environmental impact categories were used to demonstrate the impact of each glove type. Non-sterile gloves had the least environmental impact in all categories. The two types of sterile gloves, non-latex (synthetic rubber) and latex (natural rubber), performed similarly, although the non-latex gloves had a greater impact on ozone depletion, mineral use and ionizing radiation. For climate change impact, sterile latex gloves were 11.6 times higher than non-sterile gloves. This study found that for both sterile type gloves (latex and non-latex), the manufacture of the gloves contributes to the most considerable environmental impact, with an average of 64.37% for sterile latex gloves and 60.48% for non-latex sterile gloves. Using the LCA methodology, this study quantitatively demonstrated the environmental impact of sterile versus non-sterile gloves.

A Comparison of the Bacterial Contamination of the Surface of Cleanroom Operators’ Garments following Donning with and without Gloves

Background Specialist cleanroom garments are a potential vector for transmission of microorganisms within these facilities. In order to maintain the low bioburden of such clothing it has been perceived best practice for operators to dress wearing sterile cleanroom gloves. However, the efficacy of such glove use upon the resultant bacterial contamination of the surface of cleanroom garments has not previously been evaluated. Aim To compare surface bacterial contamination of cleanroom garments following their donning by operators dressing with or without gloves. Methods Following prior handwashing and systematic donning of cleanroom clothing by operators dressing wearing either no gloves, non-sterile nitrile gloves or sterile cleanroom latex gloves, a direct agar contact method was immediately undertaken to test garment surfaces at 7 specific sites. Following incubation bacterial levels were suitably quantified. Findings Comparing levels of growth displayed on plates used to test the surface of cleanroom garments worn by operators dressing with no gloves, non–sterile gloves or sterile cleanroom gloves, no significant difference was observed between the percentage of contact plates displaying growth and the levels of growth observed on plates, from any of the sites tested. Conclusion Omission of gloves in line with a systematic handwashing procedure prior to the cleanroom garment donning process, may result in modest economic and environmental gain coupled with a slightly less burdensome procedure. However, this is reliant on rigorous adherence to handwashing protocol and assessment of associated risk factors.

886 Healing Hands and Thrifty Plans! A Prospective, Cost-Effective Trial in Abscess Management

Abstract Aim Cutaneous abscesses are ubiquitous presentations requiring surgical drainage in most cases. There is a wide variation across the UK in the surgical practice dealing with such common problem. The aim of this study was to reduce the costs incurred in surgical drainage of acute skin and soft tissue abscess. Method This was a prospective, cost-effective study of the expenses incurred in surgical drainage of acute cutaneous and subcutaneous abscesses treated under the general surgeons' care over one year. Results A consequential saving of £13,962 was achieved during the study period. Between October 2019 and October 2020, 322 patients with soft tissue abscesses were treated by incision and drainage in general surgery. We calculated a total cost of £55.26 per patient for this routine operation. These expenses were based on basic surgical drapes pack, standard surgical gowns, sterile gloves and obtaining and processing the microbiology specimens. We have designed and implemented a new theatre protocol specifically for this procedure, resulting in a substantial reduction of the costs to £11.90 per patient. The total savings of £13,962 do not include savings caused by abscess drainage under local anaesthesia and does not calculate the savings that occurred due to shorter inpatient stay. These extra savings will be calculated and added later. Conclusions Considering the increasing financial burden on the NHS, we could make significant savings of nearly 80% of the operative costs of surgical drainage of a cutaneous abscess. We could achieve that by implementing simple modifications in the current surgical pathways without compromising patients' safety.

Efficacy of ethylene oxide-sterilized waterproof cases for handheld cameras as sterile barriers for intraoperative imaging and recording.

To evaluate the efficacy of ethylene oxide (EtOH) sterilization of 4 different waterproof camera cases and the ability of those sterilized cases to maintain a sterile barrier for intraoperative camera use. 3 action cameras, 1 smartphone, and associated waterproof cases. Cases were inoculated by immersion in medium containing Staphylococcus pseudintermedius, Escherichia coli, and Pseudomonas aeruginosa and then manually cleaned and subjected to EtOH sterilization. Cameras were disinfected, loaded into sterile cases, and sterilely operated for 2 hours. Samples were collected from cases after inoculation, EtOH sterilization, camera loading, and 1 and 2 hours of operation and from all cameras after 2 hours of operation. Procedures were repeated twice, followed by an additional challenge round wherein cameras were purposefully contaminated prior to loading. All samples underwent bacterial culture. All cases were successfully sterilized, and loading of nonsterile cameras into sterile cases caused no contamination when cameras had been disinfected beforehand. Nonpathogenic environmental contaminants were recovered from 6 of 64 culture samples and 2 of 4 room samples. During the challenge round, only the postload sample for 1 case yielded E coli, suggesting sterile glove contamination; however, postload, 1-hour, and 2-hour samples for the GoPro case yielded E coli and S pseudintermedius, suggesting major contamination. Results suggested that the evaluated cases can be safely sterilized with EtOH and used for image acquisition by aseptically prepared surgeons when cameras are disinfected prior to loading. Except for the GoPro camera, camera use did not jeopardize sterile integrity.

Self-Reported Belief, Perceptions, Practice Of Dental Professionals During COVID-19 Pandemic In Chennai: A Cross Sectional Survey

Background: The global COVID-19 pandemic appears to have catastrophic clinical, fiscal, and social consequences, as well as a significant impact on health-care delivery.Dental hospitals and clinics have been functioning with limited access across most of the world since late March 2020 due to the contamination risks associated with aerosol-generated operations maxi-mizing the risk of exposure to dental professionals. The aim of the study is to assess the self-reported belief, perceptions, practice of dental professionals during COVID-19 pandemic in Chennai. Materials and Method: A cross sectional study was conducted among 400 dental professionals in Chennai using a self-ad-ministered questionnaire. The statistics were computed with the SPSS version 23.0 software. Descriptive statistics, Chi square test were used for assessment. A P value <0.05 was considered statistically significant. Results: The mean age of the study participants was 25.13±4.54 years. About 32.1% of the study population reported to have been tested positive for COVID-19. About 47.5% were extremely concerned that a family member might contract COVID-19. Sterile gloves were reported to be the most used PPE. A statistical significance was observed between different aspects of health and gender (p <0.05). Conclusion: Results from the study conclude that with the dental services resuming, dental professionalsin this study are concerned and perceive the COVID-19 related risks and knowledge well. The findings suggest that mental health, physical health, social health and economic health were affected.To ensure their safety and reduce the psychological pressure on them, adequate and proper protection should be given. S.S Raj©2021.

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy.

Esophagectomy remains the preferred option to achieve curative treatment in advanced esophageal cancer, but the choice of surgical approach remains controversial. A transthoracic approach may improve lymph node dissection, but it has considerable morbidity and respiratory complications. Transhiatal access has been demonstrated as an efficient means of minimizing post-operative complications. Minimally invasive transhiatal esophagectomy may reduce operative trauma and morbidity as well as enhance postoperative recovery with no compromise in cancer recurrence or survival. Nevertheless, it has a technical limitation in terms of cervical esophagus dissection. Thus, a low-cost single-port device was developed to complete upper mediastinal dissection by a transcervical approach during minimally invasive transhiatal esophagectomy. This device uses a nasogastric tube, a number-eight sterile glove, a sterile sponge, and 3 permanent 5-mm trocars. The step-by-step process of transhiatal esophagectomy and the development of this device are described. This technique allows for the dissection of the upper mediastinum, as well as the esophagus over the aortic arch and behind the superior portion of the trachea. The harvesting of lymph nodes along the left recurrent laryngeal nerve and paratracheals was improved.

The use of latex and non-latex gloves and dental equipment in UK and Irish dental hospitals.

Aim To identify glove usage within UK and Ireland dental hospitals as well as the use of latex- and non-latex-containing dental equipment.Method A self-completed questionnaire was disseminated to 16 dental hospitals in the summer of 2017. The survey concerned their current use of latex and non-latex gloves and dental equipment. In addition, information was sought regarding any problems associated with non-latex and latex gloves.Results The questionnaire response rate was 13/16 (81%), of which 100% reported the use of non-latex examination gloves. The majority were using nitrile gloves. Twelve of the 13 dental hospitals would use examination gloves for simple extractions and 11 would use sterile gloves for minor oral surgery. In ten hospitals (77%), the sterile gloves were always non-latex, and again, the majority were nitrile. Latex-containing dental equipment including orthodontic bands, prophylactic polishing cups and dental dam was still being used within some dental hospitals, but to a much lesser extent than non-latex.Conclusion All dental hospitals were using latex-free examination gloves and were showing a move towards latex-free dental equipment. This usage is comparable to what has been seen in general dental practice and follows the trend towards latex-free dentistry.

Impact of sterile gloves on blood-culture contamination rates: A randomized clinical trial

Reducing the blood-culture contamination rate is a constant challenge for health services. This study aimed to analyze whether blood-culture (BC) collection using sterile gloves reduces the contamination rate when compared to the non-sterile gloves, and to compare baseline and intervention periods. A randomized clinical trial, performed in an intensive care unit in Brazil and paired in two groups: sterile (BCs obtained with modified sterile technique: only sterile gloves; no fenestrated drape or dedicated sterile collection kit) and clean (clean technique: usual care with non-sterile gloves). Two paired blood samples were obtained from each patient by trained and calibrated nurses. BCs were processed by conventional microbiological methods and the results were issued by blinded microbiologists. There was no difference (P=1.00) in the contamination rate of BC between the sterile (1%) and clean (1%) groups. However, there was a significant difference (P=0.05; relative risk: 0.17; 95% confidence interval: 0.04-0.70) in the contamination rate between baseline (6.1%; 20/330) and intervention (1%; 2/200). This study suggests that the aseptic care provided in obtaining samples is more important than the sterile technique itself, and highlights the value of standardizing the practices, qualification and calibration of phlebotomists.

Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery.

(1) Background: The sterile latex surgical glove is an important part of protecting both the patient and the surgical team from infections. However, mechanical stress can damage the integrity of the glove material and thus may lead to infections. (2) Method: A total of 896 gloves from 448 surgeries were tested and evaluated by the water tightening test according to EN455 and ASTM D5151-19. (3) Results: From 448 surgeries, 18.8% of the interventions showed glove damage. In vascular surgery, gloves were damaged in 20.8%, in thoracic surgery 9.1%, in laparoscopic interventions 21.7%, in the subgroup hernia surgeries (TAPP) 17.6% and in open interventions 17.6%. A total of 101 damages were found on 896 gloves; one glove could have several damages. During vascular surgery, 60% of the damages were on the subordinated hand of the surgeon, and 73.3% of the damages had a size of 1 mm. In laparoscopic procedures, the subordinated hand was also more frequently affected (61.3%) than the dominant hand; 64.5% of the damages were 1 mm in size. In the hernia surgery subgroup (TAPP), no damage was larger than 1 mm; 66.7% were in the subordinated hand area. The duration of surgery had no influence on the lesion rate. (4) Conclusion: The damage rate in low impact procedures is high and represents an underestimated problem in soft tissue surgery. The use of single gloving can therefore lead to the risk of infection. EN455 and ASTM D5151-19 does not take into consideration the risk of intraoperative lesions. Double gloving and glove change algorithms should be established.

Synthetic rubber sheet to manage exposure keratopathy

PurposeExposure keratopathy often progresses even with conventional various treatments and needs plastic surgery. However, plastic surgery of eye lid is often difficult in cases with poor general condition by cerebrovascular disorders. We will propose a novel method using synthetic rubber sheet to manage the exposure keratopathy under poor general conditions. ObservationsWe treated with synthetic rubber sheet on 9 eyes of 9 patients who suffered from refractory exposure keratopathy due to cerebrovascular disorders. Sheets cut from sterile surgical gloves made of synthetic rubber (SR sheets) were placed directly onto the ocular surface with antibiotic ointment and fixed with gauze and tape. Severity of the exposure keratopathy was scored before and after the application of SR sheet. Covered ocular surface with SR sheet could keep an adequate moist environment and exposure keratopathy was improved in all the cases with no adverse effects during an average observation period of 166.2 days. Conclusions and importanceSterile synthetic rubber sheet cut from surgical gloves is an effective, safe, easy, and economical material to maintain better condition of ocular surface and especially useful for refractory exposure keratopathy under poor general condition.

Surgical hand antisepsis- comparison of alcohol based hand rub (propan-2-ol 45 gm, propan-1-ol 30 gm, mecetronium ethyl-sulphate 0.2gm) and povidone iodine scrub (7.5%)

Introduction: One of the important causes of morbidity and mortality in post-surgical period is surgical site infection [1]. The main carrier of nosocomial and multi-drug resistant bacterial infection in hospital setting are healthcare workers [2]. Surgical site infections are avoidable with proper methodical antisepsis. The traditionally used disinfectant for hand antisepsis is povidone iodine. Newer Alcohol based hand rubs are present in commercial market, there are very few clinical studies that suggest the efficacy and comparison between povidone-iodine and alcohol based hand rubs in the pre surgical settings. There is a need to evaluate the antimicrobial based comparison between the hand antisepsis methods for better surgeon compliance and providing quality treatments to the patients. This study provides a basis in opting for a better alternative amongst the presurgical hand antisepsis methods. Methods: An observational study was conducted at a tertiary care rural hospital. Patients undergoing clean surgeries were included in the study. The subjects representing the surgeons and the paramedical staff (n=200) were divided into two groups of 100 each (povidone iodine and alcohol based hand rub). Samples were then collected using sterile gloves and sterile culture tubes and were sent to the microbiology department for obtaining cultures. The efficacy of surgical hand antisepsis methods were compared, surgical site infection occurrences if found were accessed for seniority of surgeon, noted to deduce any relationship with the organism found on hand swabs and results were calculated. Result: In concern with the two groups of hand antisepsis, bacterial growth profile was obtained, results showed a positive culture of 7% of which 4.5% positive cultures were found in Group A(povidone iodine) for Staphylococcus, Acinetobacter, Pseudomonas spp. and Streptococcus and 2.5% belonged to group B (Alcohol based hand rub) for Staphylococcus and Klebsiella. The statistical comparison of both groups A and B was done to calculate the p value which came out to be 0.267 which is not significant. Conclusion: In 7% hand swabs the culture was positive for bacteria, with staphylococcus being the most common isolated commensal. No significant difference in efficacy of hand antisepsis was established in reducing the bacteria in surgical hand antisepsis protocol. No association was found between type of hand scrub and seniority of the surgeons. Since there was no incidence of surgical site infection in the patients, the better alternative between types of hand rub could not be deduced.

Improving the quality of ground mutton by garlic oil

Objective: The aim of this study is to examine the antimicrobial activity of garlic oil to extend the shelf life of ground mutton stored aerobically at 4 oC for 15 days through its effect on the aerobic plate count and Enterobacteriaceae count that contaminate the meat during its preparation. Design: Observational controlled study. Samples: 7200 g of fresh mutton Procedures:meat sampleswere divided into four equal groups (600 gm each), three, groups were treated with different concentrations of garlic oil (250, 360, and 600 mg/kg) and the last group (without any addition) as a control. The treated samples were thoroughly mixed with garlic oil by hand (with sterile gloves), then the meat of each group was packaged separately in sterile polyethylene bags, marked, and stored aerobically in the refrigerator at 4 oC for 15 days and subjected to microbiological analyses and sensory evaluation. Results:there was a significant decrease in aerobic plate count and Enterobacteriaceae count of treated meat samples in comparison with the untreated samples. Additionally, the use of garlic oil at concentration of 600 mg/kg meat has higher effect than 250 mg/kg and 360 mg/kg during the period of storage. Furthermore, garlic oil also enhanced the sensory characteristics of treated the ground mutton. Conclusion and clinical relevance: we suggest that the addition of garlic oil to fresh mutton during cold storage is potentially useful in improving its quality and extending its shelf-life.

The practice of regional anesthesia in Belgium – a national survey

Background : National surveys are useful to assess the state of regional anaesthesia (RA) practice in a particular country. Given that such information was lacking in Belgium, we conducted a survey to evaluate the Belgian practice of peripheral nerve blocks (PNBs) with a particular focus on its safety aspects. Methods : A survey was sent by email to 1510 Belgian anesthesiologists. No identifying information was collected. Data were collected between September 2019 and October 2019. Results : We collected 324 questionnaires (response rate 21%). Eighty five percent of respondents perform regularly PNB. 99% place a venous access before performing a block, and more than 90% monitor patients with minimum peripheral pulse oximetry. The majority monitor patients for a minimum of 30 minutes after the injection of local anesthetic (LA). Ultrasound-guided technique for RA is used by 89% of respondents. Neurostimulation is totally abandoned by 20% of them. Monitoring of injection pressures is performed by 21% of respondents. More than 50% of respondents use sterile gloves, surgical drapes and a mask. With regards to the solution of LA used, 52% of respondents never mix LAs. An adjuvant is always used by 15% of the respondents while 10% of them never use them. Conclusions : This survey suggests that the practice of PNBs in Belgium is in line with the current international guidelines. This survey can serve as a benchmark for future evaluation and comparison between RA techniques. These observations should be taken into account for the implementation of national guidelines and therefore for the improvement of safety in the practice of PNBs.