Surgical Sterilization Research Articles

Conceptual review of asepsis, antisepsis & sterilization in Ayurveda

Sterilization is the process of freeing an article, a surface or a medium of all microorganisms. Asepsis is the state of being free from or keeping away disease-producing microorganisms like bacteria, viruses, etc. For the success of any surgical treatment Sterilization and Aseptic precautions are of prime importance. Lack of sterilization and aseptic precautions leads to complications, infection, delayed wound healing, etc. Now a days in modern era there are various chemical & physical methods of sterilization. But the concept of ancient Sterilization and Asepsis is same, cost effective, having medicinal values also. The ancient Acharyas used Agni (Fire), Kwath (Decoction) & various medicated fumigating yogs to protect Atur (patient) from different organisms. The ancient Acharyas mentioned various Dhoopan with Rkashoghanyadravyas for sterilization of OT rooms with that explain some aseptic precautions. So, an effort is made to establish an Ayurvedic sterilization and Aseptic Technique in this era.

Feline parasites and the emergence of feline lungworm in the Portland metropolitan area, Oregon, USA 2016-2017.

ObjectivesThe aim of this study was to determine the prevalence of internal parasites in feral and free-roaming owned cats in the region of Portland, Oregon, USA.MethodsFecal samples from asymptomatic cats were opportunistically collected from feral cats presented for surgical sterilization (n = 46), as well as free-roaming owned cats (n = 86) presented to primary care clinics. Fecal analysis was performed using the Baermann technique, centrifugal flotation, fluorescent auramine and fluorescent antibody for Giardia species.ResultsLungworm infection was identified in 24.2% of owned cats and 17.2% of feral cats. At least 11 unique parasite species were identified in this study. Taenia species and Toxocara cati were identified in higher proportions in feral cats, whereas Giardia species were significantly higher in owned cats.Conclusions and relevanceThe prevalence of lungworm was higher than has been previously documented in other areas of the USA. In addition, feral cats were infected with a higher percentage of Toxocara species and Taenia but a significantly lower percentage of Giardia species.

Trends in Surgical Patents Held by Surgeons From 1993 to 2018.

This study aims to quantify the number of patent-holding surgeons and determine their specialty demographics. The number of intellectual property filings related to surgery has exponentially increased over the past 40 years, yet surgeon inventor status among these inventions remains poorly defined. A query of the United States Patent and Trademark Office (USPTO) Patent Full-Text and Image Database was performed over the years 1993 to 2018. Patents related to surgery were defined as surgical devices, implantables, dressings, introducers, and sterilization equipment based on Cooperative Patent Classification (CPC) code. Inventor names were cross-indexed with names of active Fellows in the American College of Surgeons (FACS) as of 2019. Surgeon inventors were identified and differences between specialty and sex were evaluated. A total of 275,260 patents related to surgery were issued over the study period. The number of surgical patents has increased by 462% from 4593 per year to 21,241 per year. A total of 9008 patents were held by a total of 2164 surgeons (4% of FACS). This represents 3.3% of all surgical patents with a mean of 5 patents (range 1-346) per patent-holding surgeon. Specialties with the largest number of patent holders include neurosurgery (9%) and orthopedic surgery (8%). Ninety-seven percent of patent-holding surgeons were male. 3.3% of patents related to surgery involve a surgeon inventor, and although the number of surgical patents has shown an exponential increase, surgeon involvement in these inventions has grown minimally. Surgical innovation training may offer an opportunity to reduce these discrepancies and increase surgeon involvement as patent holders.

Surgical sterilization impacts on behavior of coyote pairs

Coyotes (Canis latrans) involved in depredation of livestock, an act frequently resulting in human-wildlife conflict, often do so out of necessity for provisioning pups. Surgical sterilization methods such as vasectomy that preserve gonadal hormones have been successful in reducing depredation by free-ranging coyotes while allowing individuals to maintain territoriality and mate fidelity. However, use of these methods remain costly and ineffective for wide-scale use. Given the alternative proposal of using chemical sterilization techniques, we investigated whether the use of hormone-altering sterilization methods impacted behavior of captive coyote pairs (i.e., male-female pair bonds). Our objective was to evaluate behavior and reproductive hormones of mated coyote pairs that had received different surgical sterilization treatments. We assigned mated pairs of captive coyotes to different sterilization treatment groups (vasectomy, spay, neuter, ovary-sparing spay, and intact) and coded their behavior as the time spent in resting versus active (i.e., walking, running, scent communication, and aggressive interactions) behaviors. Additionally, hormone concentrations were analyzed to determine effectiveness of hormone-altering treatment, given the potential role of gonadal hormones in regulating behavior. The study was repeated across three breeding seasons. The top model comparing time spent active versus resting was the null model, although the model that included whether sterilization type altered hormones and year also had a ΔAIC of < 2.0. Testosterone concentrations between neutered and vasectomized or intact males was significantly different, indicating sterilization treatment was successful and the different sterilization techniques impact hormones differently; there were no statistical difference for estradiol or progesterone levels among female treatment groups. No sterilized pairs produced pups, but the intact pairs did. Although there are potentially some differences in behavior across sterilization treatment types, our results suggest sterilization of coyotes holds potential as a future management strategy as behavior did not differ among different treatments. Potential difference across years suggest further research is necessary to determine potential extraneous factors influencing behavior and the effect of treatment on territoriality on free-ranging coyotes.

Feral rabbit populations in a peri-urban area: insights about invasion dynamics and potential management strategies

Where introduced, the European rabbit Oryctolagus cuniculus is considered among the most destructive and invasive species. To date, research focused mostly on populations of wild rabbit, whereas little is known on feral domestic rabbit populations. In this work, we reported the establishment of two self-sustaining populations of feral rabbits in Italy. Direct observations were conducted to assess rabbit range expansion and population increase over time. We also evaluated prey-predator interactions between rabbits and native red foxes Vulpes vulpes, by means of camera trapping and the analysis of fox scats. Moreover, we also assessed the social perception towards feral rabbits and the acceptability of various management options through the administration of a structured questionnaire to park visitors. Rabbit populations increased between 2018 and 2019, as well as the size of the invaded range. Rabbits are predated by foxes, but they seem to have adapted their activity rhythms to minimize the risk of predation, becoming diurnal. Park visitors loved rabbits and deemed them to be a positive presence in the park, which deserve to live there. Surgical sterilization of rabbits was the only management option which was partially supported. Feral domestic rabbits, albeit a neglected species in invasion biology, can become extremely successful invaders of urban green areas: in < 5 years, rabbits were able to colonize our study area and become a food resource for native predators and also an iconic species. These three points raise concerns about the potential impacts of invasive feral rabbits in European urban green areas and call for further research in this direction.

Short Term Safety, Immunogenicity, and Reproductive Effects of Combined Vaccination With Anti-GnRH (Gonacon) and Rabies Vaccines in Female Feral Cats.

Overpopulation of free-roaming cats is a major problem leading to negative impacts on animal health and welfare, public nuisance, transmission of zoonotic diseases, and well-documented harm to wildlife. Surgical sterilization had failed to provide a practical solution to free-roaming cats' overpopulation under field conditions; therefore, efficient and safe non-surgical immunocontraception methods are aspired. Rabies is a deadly virus that may infect people and animals. However, the safety and efficacy of combined vaccination with anti-GnRH and rabies vaccines in feral cats, which often suffer from disrupted health conditions and experienced high stress level, has never been studied. Therefore, our objective was to examine the short-term safety and efficacy of anti-GnRH vaccine (Gonacon), in combination with rabies vaccine in female feral cats. Mature feral female cats were captured and divided into the following groups: (I) GonaconX1-Rabies: queens vaccinated with both Gonacon and rabies (n = 5); (II) GonaconX2-Rabies: queens vaccinated twice with Gonacon (3 weeks apart) and with Rabies (n = 4); (III) OVx-Rabies: queens ovariohysterectomized and vaccinated with rabies (n = 4); (IV) Intact-Rabies: queens vaccinated against rabies and remained intact (n = 3). Comprehensive veterinary examinations and blood tests were performed every 2 weeks for 14 weeks. Data were analyzed by Repeated-Measures-ANOVA or Fisher-Exact-Test. There were neither systemic nor local adverse reactions at the vaccination sites. Blood count (PCV, TS, RBC, HGB, HCT, WBC) and chemistry (Total protein, Total globulin, Albumin, Urea, Creatinine, Creatine kinase, Bilirubin, GGT, ALT, AST) analyses revealed no differences among groups. There were no differences in serum rabies antibodies titers among groups, and queens kept a protective titer (>0.5 IU/mL) starting at 2–4 weeks after vaccination. Anti-GnRH antibodies were detected in all Gonacon-vaccinated queens, excluding one queen (GonaconX2-Rabies group). Anti-müllerian hormone serum concentrations reduced significantly after ovariohysterectomy, as well as gradually following vaccination with Gonacon, but it remained high in intact queens. Evaluation of vaginal cytology and ovarian histology suggested that reproductive cyclicity was suppressed in Gonacon-vaccinated queens. Our results support the conclusion that in the short term, the combined vaccination with Gonacon and rabies is safe and effective in female feral cats. However, further long-term studies are warranted to test this immunologic regimen in feral cats.

Brucella abortus RB51 ΔleuB expressing Salmonella FliC conjugated gonadotropins reduces mouse fetal numbers: A possible feral swine brucellosis immunocontraceptive vaccine

Population and health management of wildlife is a key to environmental health, domestic herd health, and ultimately public health. Many different methods including: surgical sterilization, poison baits, and sponsored hunting programs have been used in the attempt to control populations of various nuisance animal species. Particular interest has been given to immunocontraception through wildlife vaccination protocols. This study specifically looked at the potential immunocontraceptive and protective properties of a Brucella abortus RB51 ΔleuB vaccine expressing Salmonella typhimurium FliC conjugated to porcine follicle stimulating hormone beta subunit (FSHβ) or gonadotropin releasing hormone (GnRH) DNA sequences. B. abortus RB51 ΔleuB pNS4-TrcD-FliC- FSHβ (RB51LFSHβ) and B. abortus RB51 ΔleuB pNS4-TrcD-FliC-GnRH (RB51LGnRH) were tested in a pilot breeding study with BALB/c mice, and a significant reduction in fertility characteristics was observed in both male and female mice. Ultimately, this study provides support to test these vaccine candidates in feral swine, a destructive invasive species in the United States of America.

Pre-scrotal bilateral vasectomy in a dog

A one year old mongrel male dog was presented in VCC Bikaner, for surgical sterilization. Owner wants sterilization of his dog without affecting its sexual behaviour. As per owner’s request a successful surgical sterilization through ligation and removal of a segment of ductus deferens, was performed through inguinal region of presented animal. Dog was recovered completely on 10th day of surgery without any complication of wound dehiscence.

A novel disinfection protocol using ATP testing for lead garments in the electrophysiology lab.

PurposeElectrophysiology procedures pose infection risk and require surgical room sterility. Currently, there is no universally approved protocol for disinfecting lead garments in the electrophysiology laboratory. This study explores the feasibility of using ATP testing to assess the microbial burden of lead aprons and evaluates the impact of a sanitary intervention.MethodsAdenosine triphosphate (ATP) testing is a well-established hospital standard to quantify biological matter on a surface and, by proxy, the microbial burden. It is measured in RLU (relative light units). Pre-intervention ATP testing was performed on 34 lead garments after use for electrophysiology procedures. The thyroid collar, mid-chest vest, and left axillary areas of the garments were swabbed using a Hygiena SystemSure II luminometer with ATP swabs (Hygiena, Camarillo, CA). These sites were then disinfected with disinfectant wipes (PDI Super Sani-cloth Germicidal Disposable Wipe) and ATP testing was repeated.ResultsThe mean duration of garment wear was 213 min. The thyroid collars had the highest mean RLU before intervention, followed by the mid-chest vest and the left axillary areas. The intervention was found to significantly decrease ATP readings for all three sites (p = 0.0002, p = 0.0001, p = 0.0002 respectively). Linear regression modeling to assess the impact of intervention showed a significant correlation with pre-intervention ATP values for all three sites but no correlation with fluoroscopy time, fluoroscopy dose, or total time spent within the procedure.ConclusionsLead garments harbor microbial contamination after use according to ATP testing. A sanitary intervention can decontaminate lead garments and potentially reduce rates of hospital infection.

Comparison of the effect of isopropyl alcohol and chlorhexidine solution rinses on body temperature of female cats undergoing sterilization surgery.

Isopropyl alcohol 70% as a rinse agent for chlorhexidine scrub has been shown to decrease body temperature more quickly than chlorhexidine solution in mice prepared aseptically prior to surgery. For this reason, some high-quality, high-volume (HQHV) surgical sterilization clinics use chlorhexidine solution rather than alcohol. We sought to determine if temperature upon entry to recovery, heat loss per kg and rate of temperature decline during surgery were different between cats rinsed with chlorhexidine solution vs 70% isopropyl alcohol following surgical scrub, and if there were significant predictors of recovery temperature. Female cats admitted for surgery to trap-neuter-return (TNR) clinics at a veterinary college were assigned chlorhexidine solution or alcohol rinse agents via block randomization. Veterinary students and veterinarians performed spay surgeries using HQHV techniques. In recovery, heat support and reversal agents were available for cats with a low body temperature or that were slow to recover. Baseline values, outcome variables and duration of each stage (preparation, surgery, recovery) were assessed using Wilcoxon rank-sum and t-tests. Recovery temperature was evaluated using random effects multiple linear regression. The recovery temperature, heat loss per kg, heat loss per min, need for reversal and need for heat support in recovery were not significantly different between rinse groups. Weight <2.3 kg, body condition score <4, duration of surgery and postinduction temperature were predictors of recovery temperature. The rate of heat loss in the first 30 mins of surgery was slightly lower for cats in the alcohol rinse group and the recovery duration was shorter for cats weighing less <2.3 kg in the alcohol rinse group. There were no clinically meaningful differences in body temperature between chlorhexidine and alcohol rinses. Both chlorhexidine solution and isopropyl alcohol 70% are appropriate rinse agents for aseptic preparation of feline spay surgeries.

THE HUMAN RIGHT TO STERILIZATION: MEDICAL AND LEGAL ASPECT

The aim: To consider the general principles of the human right to sterilization in terms of medicine and law. Materials and methods: Formal-logical methods of analysis and synthesis allowed to reveal the content of the concepts that make up the subject of research, to classify them, as well as to formulate intermediate and general conclusions. The systematic method allowed to study the role and significance of right to sterilization among other human rights and freedoms. Using the historical method, the doctrinal basis of the study was analyzed, and the main stages of the formation of category “right to sterilization” with human participation were identified. Conclusions: The issue of surgical sterilization should not be considered during contractions, as happened in this particular case, but before or after childbirth, because a woman in childbirth can not adequately perceive information and make such important decisions. If this decision is made after delivery, the doctor must make sure that the patient is psychologically healthy. In addition, the consent for surgical sterilization of the spouses must be signed together. Although this procedure follows from the human right to dispose of one’s own body, however, in the presence of marriage, referring to Part 2 of Art. 54 of the IC of Ukraine, which states that all important issues of the family should be resolved by the spouses together, on the basis of equality. If such a decision is made by the wife alone, she must be considered to have committed the wrongful conduct.

Breeding dynamics of overabundant koala (

Abstract Context The koala (Phascolarctos cinereus) sometimes occurs as an overabundant folivore in south-eastern Australia, where high-density populations have caused defoliation of preferred food trees, threatening habitat. Kangaroo Island, South Australia and Budj Bim National Park, Victoria, are two regions where such eruptive population dynamics have arisen. One way of mitigating their damage is through management via fertility control. Aims This paper examines the outcomes of fertility control (surgical sterilisation and treatment with levonorgestrel implants) on breeding dynamics at the population level, using data obtained from two separate koala management programs conducted by State Government wildlife agencies, South Australia Department for Environment and Water and Parks Victoria. Methods The relationships between female body condition, reproductive status, fertility control, age and population density were examined using linear mixed effects models. Population density (koalas/ha) was estimated using annual census data and modelled in a Bayesian framework. Key results Body condition was a key influence on breeding success in female koalas, with sexual maturity being defined by both age and body condition, whereas the effect of reproductive experience was minimal. It is likely that reduced densities have led to decreased intraspecific competition for food resources and territory, leading to increased breeding success at one management site (BBNP) and by allowing females to begin breeding at a lower overall body condition. The reduction in densities to sustainable levels at both management sites, despite differing fertility-control methods, supports the use of the less invasive and more cost-effective levonorgestrel implants as the preferred fertility-control method. Conclusions In addition to contraceptive effects, broad-scale fertility control may have resulted in a compensatory higher breeding success in the untreated population, possibly in response to decreasing densities, increased resource availability or behavioural responses to population management. Implications Although compensatory breeding mechanisms can reduce the effectiveness of fertility control at the population level, ongoing fertility-control management can still be successful at reducing overabundant koala populations to sustainable levels with significant long-term commitment, provided that annual control targets are continuously met.

Particle Filtration Efficiency Testing of Sterilization Wrap Masks.

ObjectivesNon-traditional materials are used for mask construction to address personal protective equipment shortages during the coronavirus disease 2019 (COVID-19) pandemic. Reusable masks made from surgical sterilization wrap represent such an innovative approach with social media frequently referring to them as “N95 alternatives.” This material was tested for particle filtration efficiency and breathability to clarify what role they might have in infection prevention and control.MethodsA heavyweight, double layer sterilization wrap was tested when new and after 2, 4, 6, and 10 autoclave sterilizing cycles and compared with an approved N95 respirator and a surgical mask via testing procedures using a sodium chloride aerosol for N95 efficiency testing similar to 42 CFR 84.181. Pressure testing to indicate breathability was also conducted.ResultsThe particle filtration efficiency for the sterilization wrap ranged between 58% to 66%, with similar performance when new and after sterilizing cycles. The N95 respirator and surgical mask performed at 95% and 68% respectively. Pressure drops for the sterilization wrap, N95 and surgical mask were 10.4 mmH2O, 5.9 mmH2O, and 5.1 mmH2O, respectively, well below the National Institute for Occupational Safety and Health limits of 35 mmH2O during initial inhalation and 25 mmH2O during initial exhalation.ConclusionsThe sterilization wrap’s particle filtration efficiency is much lower than a N95 respirator, but falls within the range of a surgical mask, with acceptable breathability. Performance testing of non-traditional mask materials is crucial to determine potential protection efficacy and for correcting misinterpretation propagated through popular media.

Drivers and facilitators of hunting behaviour in domestic cats and options for management

Abstract Domestic cats Felis catus are distinct from other domesticated animals because their phenotype and genotype are relatively unchanged. While they live with people as pets or pest controllers, they retain capacity for survival independent of human support and readily persist as feral animals. Most cats retain some propensity to express hunting behaviours, even if hunting is not required for nutrition. In some settings, depredation by cats is a threat to biodiversity conservation, leading to attempts to mitigate their impacts. We characterise drivers and facilitators of the hunting behaviour of domestic cats: evolutionary origins, diet, life history, personality and environment. Hunting is driven particularly by evolutionary constraints and associated physiological and nutritional requirements. Proximate causes of variation in hunting behaviours relate to prey availability, husbandry and degree of domestication, while early life history and personality play further roles. We review cat management approaches in terms of effectiveness, feasibility and welfare. Amongst lethal, large‐scale methods of population control, poisoning is most frequently used in cat eradications from islands. Because poisoning is challenged on welfare grounds, euthanasia is used at smaller scales and in inhabited, mainland settings. Non‐lethal approaches, primarily surgical sterilisation, are favoured by cat advocates but entail challenging logistics and scale. In attempts to inhibit predation of wild species by pet cats, owners restrict outdoor access and use collar‐mounted devices, including bells, sonic devices, collar covers and bibs. Other individual‐level interventions, such as dietary and behavioural enrichment, some of which may improve cat welfare, have potential, but effects on hunting remain untested. Understanding and managing the hunting behaviour of cats are complex challenges. We highlight drivers and facilitators of this behaviour, representing starting points for formulating solutions that might be acceptable to cat owners and wider groups of people who value cat welfare, while also being effective for wildlife conservation.

Use of six sigma methodology to reduce surgical site infections in a surgical day care centre in North India

Background: The Aim of the study is to help hospitals reduce their surgical site infection (SSI) by use of six sigma methodology. The study conducted in a Day care surgical centre in North India with an SSI rate of 4.4% was done to ascertain the significant parameters leading to SSI and further rectification of these factors in order to reduce SSI. Methods and materials: A total of 45 surgical cases including 2SSI operated in the centre were followed up. Cases were followed up for cleaning of OT, humidity maintenance, temperature maintenance, OT Traffic, OT door opening frequency during surgery, H/o smoking, H/o diabetes, preoperative showering, surgical Instrument sterilization /disinfection, storage of Instruments, hand washing, skin preparation, hair removal, antibiotic prophylaxis. Fish bone analysis was done followed by pareto analysis which indicated 5 main causes for surgical site infection.1.High Frequency of door opening during surgery.2.High OT traffic.3.Inadequate hand Washing.4.Inadequate humidity maintenance.5.Inadequate sterilization/disinfection of surgical instruments. Hypothesis testing was done to identify the root causes among these 5 parameters and null hypothesis was defined. The statistics were carried on Minitab. For parameters related to high frequency of door opening during surgery and high OT traffic, P-value was 1 and 0.5091 respectively and this association was considered not significant statistically. For inadequate hand washing, P value was 0.0283 and was considered significant. P value for inadequate sterilization/disinfection of instruments was 0. 0455 and was considered significant. P value for inadequate OT humidity maintenance was 0.1919 and was considered not significant. Results: Two parameters comprising of inadequate hand washing and inadequate sterilization/disinfection of instruments were considered statistically significant in our study as causative factor for SSI. Conclusion: Several parameters can be responsible for causing Surgical Site Infection. Six sigma studies can help in defining most crucial parameters as causes for SSI .In our study we were able to define two most important factors responsible for SSI .Special emphasis was laid on strict hand hygiene and proper sterilization/disinfection of surgical instruments to reduce SSI rates .Strict monitoring of these parameters helped us to reduce SSI rates to 0%.

The expected frequency and amount of free peritoneal fluid estimated using the abdominal FAST-applied abdominal fluid scores in healthy adult and juvenile dogs.

To estimate the frequency and amount of free peritoneal fluid in juvenile and adult dogs using the abdominal focused assessment with sonography for trauma (AFAST) abdominal fluid scoring system. Prospective case series. Healthy, privately owned juvenile and adult dogs. Dogs undergoing routine surgical sterilization were evaluated at induction with AFAST and assigned measurements and fluid scores. A surgeon scored the degree of peritoneal fluid found during ovariohysterectomy. Ninety-two dogs were enrolled (46 juveniles and 46 adults). Ninety-three percent and 52% were AFAST positive for peritoneal fluid, respectively. The AFAST-positive view frequency for right lateral recumbency in juveniles was diaphragmatico-hepatic (DH) 100%, spleno-renal (SR) 20%, cysto-colic (CC) 40%, and hepato-renal (HR) 20% versus adults, DH 60%, SR 20%, CC 0%, and HR 0%, respectively. The AFAST-positive view frequency for left lateral recumbency was DH 93%, SR 44%, CC 24%, and HR 12% in juveniles, and DH 50%, SR 3%, CC 3%, and HR 10% in adults. Overall abdominal fluid scores (AFS) in juvenilles were 0 (n=3), 1 (n=14), 2 (n=22), 3 (n=6), and 4 (n=1); and in adults, scores were 0 (n=22), 1 (n=18), 2 (n=6), and 3 and 4 (n=0). The AFS differed between adults and juveniles (P<0.001). Most dogs had maximum fluid dimensions≤3×3mm and width of fluid stripes≤3mm. The AFS was positively correlated to fluid amount observed during ovariohysterectomy with fair agreement (kappa=0.233, P=0.012). This study establishes the frequency and amount of free peritoneal fluid in healthy juvenile and adult dogs during AFAST. Maximum fluid pocket dimensions of≤3×3mm and fluid stripe widths of≤3mm in dogs with AFS 1 and 2 may be normal. The DH view was most frequently positive.

THE ROLE OF CANINE SURGICAL STERILIZATION AND OTHER DOG POPULATION MANAGEMENT STRATEGIES TO COMPLEMENT RABIES PREVENTION AND CONTROL PROGRAMS

Purpose: To assess the role of canine surgical sterilization and other dog population management strategies to complement rabies prevention and control programs.&#x0D; Findings: Rabies is highly fatal viral anthropozoonotic disease which is caused by virus of the genus Lyssavirus and transmitted from rabid animals to humans by bite or scratch from rabid animals. Rabies is preventable and controllable disease through integration of one or more animal population control and vaccination methods. However, the primary focus of a rabies control program in dogs is vaccination by implementation of mass dog vaccination aiming for 70% vaccination in order to promote and maintain levels of protection above thresh hold between campaigns which consequently reduces ongoing transmission. Not only these but also, interlinking of one or more of other DPM tools such as prevention and control of reproduction, acceptable euthanisation, surgical sterilization, education and legislation of responsible dog ownership can create effective DPM programs. In developing country the integration of animal birth control and vaccination is not at grass root level so well coordination of veterinarians, human health professionals and other stake holders are vital.

Filtration efficiency of surgical sterilization fabric for respiratory protection during COVID-19 pandemic

BackgroundDue to COVID-19 and high demand for respirators, some healthcare professionals have been using the Halyard H600 fabric as an alternative to N95 respirators without testing the filtration efficiency of the fabric with established scientific methods. The purpose of this study was to assess the efficiency of the Halyard H600 as a respirator filtering material as compared to the NIOSH-certified N95 and P100 filters, and determine if H600 is a good alternative for respiratory protection for healthcare professionals during the COVID-19 pandemic. MethodsThree filter types (Halyard H600, N95, and P100) were challenged with salt particles inside an exposure chamber at a flow rate of 43 LPM and relative humidity of 40 ± 2%. N95 and P100 respirator filters were tested initially to establish the validity of the chamber, followed by the Halyard H600 fabric. Particle penetration was measured using an aerosol spectrometer. The filtration efficiency was calculated for different particle sizes by measuring the particle number concentration upstream and downstream of the filter. The pressure drop across the filter materials was measured using a manometer. ResultsThe efficiency of the P100 for particles ≥250 nm was 100%. The N95 efficiency was 97 ± 1% at 275 nm, 99 ± 0% at 324 nm, and 100% for larger particles. The Halyard H600 fabric had a variable efficiency with an average of 62 ± 28% at 275 nm, 89 ± 8% at 324 nm, and 100% efficiency for particles >450 nm. The pressure drop values for P100 and N95 were 32 and 8 mmH2O, respectively. The Halyard H600 fabric resistance increased dramatically from 30 mmH2O at the start of the exposure to 65 mmH2O after 16-minutes of exposure. ConclusionThe high variability in filter efficiency for particles ≤324 nm and the increased fabric breathing resistance demonstrate that the Halyard H600 has an inferior performance and is not a good substitute for N95 and P100. Thus, the use of the Halyard H600 fabric for respiratory protection is not recommended.

What Should Physicians Consider About American Indian/Alaska Native Women's Reproductive Freedom?

Historically, American Indians and Alaska Natives (AI/AN) have been subjected to a lack of control over various aspects of their lives, including their reproductive health. In discussions of family planning with AI/AN patients, clinicians must consider past violations of reproductive rights and the need for transparent consent. This article explores the following questions: What were historical violations of AI/AN women's reproductive rights? How should physicians express respect for this history and for the autonomy of AI/AN female patients regarding surgical sterilization procedures today?

Evaluating the role of surgical sterilisation in canine rabies control: A systematic review of impact and outcomes.

Current recommendations for the elimination of canine-mediated human rabies focus on mass dog vaccination as the most feasible and cost-effective strategy. However, attempts to control rabies are often combined with canine surgical sterilisation programmes. The added value of sterilisation is widely debated. A systematic review was undertaken to compare the outcomes and impact of vaccination and sterilisation programmes with vaccination only programmes. A systematic search of three electronic databases (CAB s, Medline and Global Health) and grey literature was performed. From 8696 abstracts found, 5554 unique studies were identified, and 16 studies met the inclusion criteria. Eight described vaccination only programmes and eight described vaccination and sterilisation programmes. Indicators of impact measured were dog bites and/or doses of post-exposure prophylaxis administered; numbers of dog and/or human rabies cases; dog population demographic changes; changes in health and welfare of dogs, and indicators related to human behaviour change. The studies were contextually very diverse, programmes being implemented were complex, and there was variation in measurement and reporting of key indicators. Therefore, it was difficult to compare the two types of intervention, and impossible to make an evaluation of the role of sterilisation, using this evidence. Given the large number of vaccination and sterilisation programmes conducted globally, the lack of studies available for review highlights a gap in data collection or reporting, essential for impact assessment. There are several knowledge gaps concerning the impact of the sterilisation component alone, as well as subsequent effects on rabies transmission and control. Prospective studies comparing the outcomes and impact of the two interventions would be required in order to establish any additional contribution of sterilisation, as well as the underlying mechanisms driving any changes. In the absence of such evidence, the priority for rabies control objectives should be implementation of mass vaccination, as currently recommended by the World Health Organisation.