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.

The Antiseptic Efficacy of Povidone-Iodine in Reducing Early Surgical Site Infections in Orthopaedic Implant Surgeries

Background: Surgical site infection (SSI) is a dreaded nightmare for the Orthopaedic surgeon. Preoperative skin cleaning with antiseptics has been shown to reduce the microbial burden of the skin and results in reduced incidence of SSI. However, the ideal skin cleaning agent remains to be established. Aim: To compare the efficacy of Povidone-Iodine/Povidone-Iodine (PI-PI) combination with that of Chlorhexidine-Gluconate/Alcohol (CG-A) combination in re-ducing SSI in Orthopaedic surgeries. Methods: This was a prospective, randomized, double-blinded, controlled study. Subjects that met the selection criteria and gave consent were randomized into PI-PI group (test group) and the CG-A group (control group). Both the patients and the assessors for SSI were blinded to the group a participant belongs. Blocking was done on the type of surgery to cancel the confounding effect of surgery type on SSI. Standard perioperative protocols were applied to both groups. Assessment for features of SSI was done on the 3rd day, 7th day, 14th day, 6th week and 12th-week postoperative period. The diagnosis of SSI was made based on the Centers for Disease and Control (CDC) guidelines. Results: We recruited 124 patients for this study, 62 males and 54 females. The mean age of the subjects was 37.5 years (SD = 14.7 years). Sixty-two subjects were randomized into each group. There was no significant difference in the distribution of the genders in the study arms. Other possible confounders such as duration of hospital stay, use of drains, the surgeon involved and age were evenly distributed in the two groups. Eight patients did not complete the study. The overall incidence of SSI in the study was 2.6%. Subjects in the control group had an SSI of 3.4% while those in the PI-PI group had a rate of 1.8%;however, this was not significant, p = 0.579. Conclusion: Both CG-A and PI-PI combinations are equally efficacious as preoperative skin antiseptic in Orthopaedic implant surgeries.

Wound healing effect of flavonoid rich fraction and luteolin isolated from Martynia annua Linn,on streptozotocin induced diabetic rats

Objective:To evaluate wound healing potential of flavonoid fractions of Martynia annua (M.annua) Linn,leaves in diabetic rats on the basis of folkloric information and preliminary study.Methods:The flavonoid compound luteolin and apigenin were isolated from dried leaves of plant by column chromatography.The two concenlrations(0.2%and 0.5%w/w) of luteolin and flavonoid fraction were selected for topically applied as ointment on diabetic wound. The Povidone Iodine Ointment USP was used as a reference.On 18th days,protein content, hydroxyproline and antioxidants(SOD,CAT and GSH) level in granuloma tissues were determined. Results:The results showed that,percent wound contraction were observed significantly(P【0.01) greater in MAF fraction and 0.5%w/w of luteolin treatment groups.Presence of matured collagen fibres and fibroblasts with better angiogenesis were observed in histopathological studies. Conclusions:In conclusion,our findings suggest that flavonoid fraction(MAF) and luteolin(0.5% w/w) may have potential benefit in enhancing wound healing in diabetic condition,possibly due to Gee-radical scavenging activity of plant.

聚乙烯吡咯烷酮在药物制剂中的应用

聚乙烯吡咯烷酮(polyvinylpyrrolid-one,povidone,PVP)是一种合成高分子聚合物,其乙烯基呈链状联接。

Enhancement of wound healing with roots of Ficus racemosa L.in albino rats

Objective:To establish the wound healing activity of aqueous and ethanolic extract of roots of Ficus racemosa(F.racemosa).Methods:Two models were performed to evaluate the wound healing activity Le.incision and excision models.In incision model the purameler which was carried out was breaking strength of wounded skin.In excision model percentage wound contraction and period of epithelialization were established for both the extracts.Reference standard drug was povidone iodine ointment for comparison with other groups.Results:From the observation in both two models,aqueous extract of F.racemosa was found to have greater wound healing activity in terms of breaking strength in incision model and percentage wound contraction,period of epithelialization in excision model than that of other groups.Conclusions: In conclusion,our findings suggest that aqueous extract of F.racemosa possesses better wound healing ability than the ethanolic extract.

Healing promoting potentials of roots of Ficus benghalensis L.in albino rats

Objective:To screen the wound healing activity of aqueous and ethanolic extract of roots of Ficus benghalensis.Methods:Both the extracts were evaluated for wound healing by three models ie. incision,excision and dead space wound.In incision and dead space the extracts were applied ilaily topically till the 10th post wounding days while in excision model it was till the complete epithelialization process.Standard group were administered Povidone iodine ointment topically daily.The breaking strength,percentage of wound contraction,period of epithelialization,dry granulation weight and hydroxyproline content were observed.Results:The result of the present study showed that both extracts were able to increase the breaking strength(incision model), decrease period of epithelialization.increase percentage wound contraction(excision model), increase hydroxyproline content(Dead space wound model) significantly compared with control group(P【0.05).Conclusions:Based on result we conclude that aqueous extract is more effective than ethanolic extract.However,it is needed more research to be carried out especially on toxicity studies of ethanolic extract.

Carobomer Based Controlled Release Designs of Atorvastatin Calcium Tablets Evaluated Using Quality by Design (QbD) Approach

The study carried out here was focused on developing conventional monolithic controlled release matrix tablet of Atorvastatin calcium using carbomer as release controlling polymer. This system ensures the drug release at the alkaline pH region where the drug has got maximum solubility. Further the study was concentrated on comparing the impact of gelling agent polyvinyl pyrrolidone on drug release. Quality by design tools were considered during formulation development and the polymer concentrations were optimized adopting the statistical tool, design of experiments (DoE). The optimized formulation of present study exhibited desired controlled drug release characteristics in the alkaline pH conditions and at acidic environment the drug dissolution was minimal as intended.

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.