Introduction: The presence of bacteria in the form of biofilms poses a problem in the fluid pathways of haemodialysis plants and procedures which are aimed to detach and neutralize biofilms are necessary to improve the patient safety and the quality of the healthcare.The present study was therefore aimed at isolating the organisms which colonized dialysis water systems as biofilms, as well as to study the effect of the sub inhibitory concentrations of chlorine on the biofilms which were produced by these isolates.Methods: Swabs were used to collect the biofilms which were produced on the internal surface of the dialysis tubing from the dialysis units. This study was conducted at the Department of Microbiology, Kasturba Medical College (KMC), Mangalore, India. The cultures were performed on MacConkey's agar and blood agar. The organisms which were isolated were identified and antibiotic sensitivity tests were performed. The biofilm production was done by the microtitre plate method of O'Toole and Kolter. The biofilm production was also studied in the presence of sub inhibitory concentrations of chlorine.Results: Acinetobacter spp and Pseudomonas aeruginosa were the two predominant organisms which colonized the dialysis water systems as biofilms. The sub inhibitory concentrations of chlorine did not bring about any decrease in the biofilm production by the isolates. On the contrary, there was an increase in the biofilm production.
Conclusion:Our study highlighted the importance of using appropriate methods to improve the quality of the water in dialysis units. This in turn, may help in reducing the biofilm formation in the water systems of dialysis units and thus, contribute to the prevention of hospital acquired infections in the patients who need haemodialysis.
The aim of the current systematic review was to compare the Desarda technique with the Lichtenstein technique for the repair of inguinal hernias. A systematic literature search for randomized controlled trials (RCTs) was conducted comparing the Desarda technique and the Lichtenstein technique using electronic databases. The primary outcome evaluated was hernia recurrence and the secondary outcomes evaluated were post-operative complications, time to return to normal activity and operative time in minutes. Five RCTs were included in this meta-analysis, which included a total of 536 patients. There were 310 patients in the Desarda group and 226 patients in the Lichtenstein group. There was no statistically significant difference in terms of hernia recurrence between the two groups (p=0.74). Post-operative complications were significantly more in the Lichtenstein group. There was a lower rate of post-operative seroma following the Desarda technique as compared to Lichtenstein repair (p=0.02). Both Desarda and Lichtenstein had low rates of recurrence following surgery and had acceptable rates of post-operative complications with lower rates noted in the Desarda group.
The gold standard treatment for benign gallbladder disease is laparoscopic cholecystectomy (LC). LC is commonly performed using monopolar diathermy with ligation of the cystic duct and artery with clips. The aim of the current systematic review was to compare harmonic scalpel (HS) with clips in LC. Eligible studies were identified from PubMed, Cochrane library, Embase and Medline and meta-analysis was conducted using Review Manager 5.4. The primary outcome evaluated was bile leak while secondary outcomes evaluated were overall postoperative complications, operative time, conversion to open surgery and gall bladder perforation. Eight randomized control trials met the eligibility criteria which included a total of 1,205 patients. There was no statistically significant difference between the two groups in terms of bile leak (p = 0.56, I 2 =0%). With respect to the operative time (p = 0.004, I 2 =97%), conversion to open surgery (p = 0.02, I 2 =0%) and gall bladder perforation (p = 0.0001, I 2 =26%) HS was superior to clips. HS is an acceptable alternative to the use of clips when ligating the cystic duct.
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