Effects of diquafosol sodium in povidone iodine-induced dry eye model

AIM:To investigate the effects of diquafosol sodium(DQS)for dry eye model induced with povidone-iodine(PI)solution.METHODS:Ten Sprague Dawley rats as the control group.Thirty Sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d,then divided rats into three groups:dry eye group with no treatment(DED group,n=10);phosphate buffer saline treated group(PBS group,n=10);diquafosol treated group(DQS group,n=10).Clinical changes were observed by tear production test,fluorescein staining,tear breakup time(TBUT)test,corneal confocal microscope and ocular surface comprehensive analyzer.Eyeballs were collected on day 10 of treatment for hematoxylin-eosin(HE),periodic acid-Schiff(PAS),and alcian blue staining.TUNEL assay,polymorphonuclear(PMN)and mucin 1(MUC1)immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy.RESULTS:Compared with DED and PBS groups,tear production(7.26±0.440 vs 4.07±0.474 mm;7.26±0.440 vs 3.74±0.280 mm;all P<0.01)and TBUT(7.37±0.383s vs 1.49±0.260s;7.37±0.383s vs 1.42±0.437s;all P<0.01)were significantly increased in DQS group.HE,PAS,and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density(8.45±0.718 vs 5.21±0.813 cells/0.1 mm^(2);8.45±0.718 vs 5.36±0.615 cells/0.1 mm^(2);all P<0.01)increased in DQS group.Confocal microscopy,PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQS group.The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQS group.CONCLUSION:PI instillation can induce goblet cells and mucin loss,epithelial cell apoptosis and inflammation,which are consistent with the pathological manifestations of dry eye.Diquafosol can repair the ocular surface damage caused by PI,reduce corneal inflammation,inhibit corneal epithelial cell apoptosis,promote mucin secretion and maintain tear film stability.

Is the Prophylactic Administration of Povidone Iodine Intranasally Preoperatively in Elective Total Knee Replacement as Effective as MRSA Prophylactic Screening and Mupirocin Treatment?—A Retrospective Analysis

Surgical Site Infections (SSIs) remain a prevalent issue in healthcare. An average of 2% to 4% of all Total Knee Arthroplasties (TKA/TKR) result in a Prosthetic Joint Infection (PJI) (Ashraf et al. , 2018). These surgical site infections cause significant distress to the patient and require extended courses of antibiotic treatment and revision surgery of the infected joint. SSIs also reduce financial reimbursement to the surgery facility and affect the performing surgeon’s performance scores. To prevent surgical infection, healthcare facilities have implemented various screening or decolonization methods to prevent surgical infection to may cause infection. Various treatment methods exist for managing MRSA preoperatively which include Povidone Iodine (PI) application as a universal decolonization method and/or screening every patient pre-operatively for MRSA and treating MRSA-positive patients with Mupirocin ointment. Both interventions are well-established in the literature. At the author’s facility, the elective TKR populations were analyzed while each intervention was implemented. In 2019 TKR patients underwent MRSA swabbing and testing and in 2021 PI decolonization was the decolonization method of choice. The study revealed that MRSA testing and swabbing were better at reducing SSI related to MRSA than Povidone Iodine decolonization.

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

Purpose: To compare the effect of chlorhexidine-alcohol and povidone iodine on surgical site infection (SSI) after caesarean section. Methodology: A randomized control trial of 374 patients (188 in the chlorhexidine-alcohol group and 186 in the povidone iodine group) who had elective caesarean section with no overt risk for SSI was done. Patients were followed up until thirty days after delivery to assess for symptoms and signs of SSI. Results: Fifty-one (13.6%) of the study population developed SSI. Although the incidence of SSI was lower in the chlorhexidine-alcohol group than the povidone iodine group (12.2% vs. 15.1%;p = 0.26);the difference was not statistically significant. The incidence of adverse skin reaction in Chlorhexidine-alcohol vs. povidone iodine was also not statistically significant (4.0% vs. 5.4%;p = 0.40). Conclusion: The study demonstrates that there was no statistically significant difference in antiseptic property and side effect profile of chlorhexidine-alcohol and povidone-iodine when used as skin antisepsis in caesarean section.