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1.

Introduction

Pin site infection is the commonest complication of Ilizarov external fixation. The aim of the study was to examine if use of antiseptics was superior over control and further if daily dressing was superior to weekly dressing in regular pin site care in reducing the burden of pin site infection in Ilizarov fixators.

Patients and methods

A total of 114 patients (2363 pin sites) were randomised to receive regular pin site care alone (30 patients, 638 pin sites) or with additional application of povidone iodine (27 patients, 561 pin sites), silver sulfadiazine (27 patients, 570 pin sites) and chlorhexidine (30 patients, 594 pin sites). The pin tracts were sub-randomised to receive daily (1212 pin sites) or weekly (1151 pin sites) dressings. The primary outcome was pin site infection days rate across all four groups. The secondary outcomes were - mean duration to first episode of infection, differences between daily and weekly dressing groups, mean duration of antibiotic therapy and incidence of re-interventions and sequelae. We also recorded frequency of bacterial pathogens in all microbiological samples submitted. Block randomization using computer-generated random numbers was used. The assessor of outcome was blinded.

Results

All patients completed the study. Pin site infection rate days per 1000 pin site days observed was marginally less in chlorhexidine group, but was not statistically significant compared to other antiseptics and control group (Absolute value in control, povidone iodine, silver sulphadiazine and chlorhexidine groups were respectively 2.04?±?4.27, 2.04?±?3.65, 1.85?±?3.37, 1.37?±?2.35, p value 0.92). Daily dressing category showed slightly less pin site infection days rate within each group and overall, but this was also not statistically significant (1.56?±?3.99 versus 2.10?±?5.1, p value 0.35). There was no statistically significant difference among the groups with regard to other secondary outcomes. Methicillin Sensitive Staphylococcus aureus was the most common bacterial pathogen isolated.

Conclusion

Use of antiseptics does not offer any advantage in regular pin site care in Ilizarov external fixation and daily pin site care is not superior to weekly pin site care. Empirical therapy in early and low grade pin site infections must be targeted against Staphylococcus.  相似文献   
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ABSTRACT

Background

The interlimb coupling, coordination between the limbs, gets hampered in post-stroke hemiparesis. Most of the poststroke motor regimes primarily focus on the more affected limb.  相似文献   
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Indian Journal of Pediatrics - Youth and adolescents are the priority population to target the interventions as risky behaviors persist and they contribute to almost half of the new Human...  相似文献   
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To compare 0.5% centbucridine and 2% lignocaine (with adrenaline) as local anesthetic agents for dental treatment procedures in 12 to 14 y old children. A split mouth, triple blind randomised controlled trial design was adopted for this study. Fifty six children between 12 to 14 y of age requiring bilateral administration of inferior alveolar nerve block (IANB) were recruited for this study. The mandibular quadrants were randomly allotted to the drug being administered. Standardised protocol for local anesthesia administration was used. The primary outcomes assessed were onset, duration and depth of anesthesia using the pre-validated Visual Analog scale and effect on perioperative pulse rate using a pulse oximeter. There was no significant difference between centbucridine and lignocaine with respect to their mean onset [(105.181 and 99.727 s respectively), (p = 0.647)], duration of action [(91.931 and 91.613 min respectively), (p = 0.931)] and depth of anesthesia at 10, 30 and 60 min. Centbucridine showed a statistically significant drop in the pulse rate at 10 (p < 0.001) and 30 min (p < 0.001). There was no significant difference between 0.5% centbucridine and 2% lignocaine with respect to onset, duration and depth of anesthesia.  相似文献   
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A 6‐month‐old girl presented with an irregular nodule on the right lateral neck. The lesion, which superficially resembled a lymphangioma or mastocytoma, had been present since birth but had recently been growing. The patient was referred for surgical resection. Microscopic findings were compatible with a recently described rare hamartoma termed “panfollicular nevus,” which is a well‐circumscribed lesion containing aberrantly differentiated, clustered hair follicles in high density.  相似文献   
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