SummaryBackgroundSurgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.MethodsThis international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.FindingsBetween Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).InterpretationCountries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.FundingDFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant,...
The present study designed to evaluate the healing power of platelet-rich fibrin (PRF) in terms of pain control and mucosal repair. A randomised, controlled, pilot clinical trial was conducted on 16 patients randomly distributed with 1:1 allocation ratio into two groups. The treatment group received PRF minced and mixed with orabase and the control group received clobetasol propionate 0.05% mixed with orabase. Pain reduction was evaluated as primary outcome along with mucositis healing as secondary outcome. A statistically significant difference in pain reduction was observed between the two groups (p ≤ 0.05). The clinical results at Day 7 has shown that PRF group had 100% pain reduction while, CP group had 32.5% reduction from base line.PRF offered superior clinical results providing rapid pain alleviation and accelerated ulcer healing compared to corticosteroids. K E Y W O R D S benign mucous membrane pemphigoid, clobetasol propionate, oral ulcers, pemphigus vulgaris, platelet-rich fibrin, Stevens-Johnson syndrome 1 | INTRODUCTION Long standing oral ulcers that fail to respond to classical steroid therapy is a clinical problem that needs applicable intervention. A good example of the long standing ulcers is represented by blistering skin diseases. These are immune mediated diseases associated with oral mucositis and ulceration. Despite being immune mediated, each has
Aim: There is a deficiency in the data concerning the clinical forms of methotrexate-induced oral ulcers. This study was conducted to stratify clinical forms of methotrexate-induced oral ulcers in rheumatoid arthritis patients. Methods: This study included rheumatoid arthritis patients receiving methotrexate as monotherapy. All eligible patients were subjected to thorough clinical examination and full history to identify oral events. Drug history, dose, and duration of MTX were recorded.Results: Among 794 rheumatoid arthritis patients, mean methotrexate dose and duration were 14.3 mg/week and 5.2 years, respectively. Oral ulcers were detected in 6.2% of the patients and 30% of the patients reported previous oral ulcers. Among the detected oral ulcers, 44.9% manifested as deep irregular ulcers, 30.6% presented as aphthous-like ulcers, 14.3% were diffuse mucositis, and 10.2% appeared as lichenoid reaction. Conclusion: Methotrexate-induced oral ulceration could be localized or generalized. Localized forms were more noticed than generalized forms. Higher doses and longer durations of methotrexate were detected among patients with generalized oral ulcers.
Objective: stratification of mandibular condylar head morphologic and dimensional variation in both genders. Materials and methods:This is a retrospective study included 800 subject. Sample assignment into two groups with block randomization for gender and age using a computer software. The CBCT of the participants were interpreted for classification of the condylar head shape and condylar head dimensions in terms of height, antro-posterior length and mediolateral width. Results:In regards to the condylar shape, there was no statistically significant difference between males and females at P-value >0.05. The condylar head height and width were found to be statistically significant between males and females at P-value <0.001. The highest mean value was found in males. Eventually, there was no statistically significant difference in anteroposterior parameter between males and females groups (p>0.05) on both sides. Conclusions:Within the limitation of the present study sample, the radiographic analysis has shown that there is no difference in condylar head morphology between males and females. In regards to dimensional variation the condylar head was found to be significantly wider and higher in males.
Objective Reporting the oral symptoms of COVID-19 and correlate the occurrence of these symptoms with various possible etiologic factors. Methods A cross-sectional web-based survey targeted Medical doctors infected with COVID-19. The survey questioned the diagnosis of the disease, the severity of the disease symptoms, the oral symptoms along with drug and medical history. A total sample of 312 response were analyzed and correlated with various factors including the patients’ age, sex, medical history, drug history, hospitalization and severity of COVID-19 symptoms. Results Oral manifestations were reported in 72.5% of the participants. The most common oral manifestations were dysgeusia in 76% of patients which was partial in 64% of the participants. Xerostomia was reported in 41.6% of cases. Aphthous stomatitis and recurrent herpetic infections were also reported. The occurrence of oral symptoms was increased among population with previous medical history with no evidence of correlation with any other factors regarding gender, certain medications or oral hygiene. Conclusion The most common oral manifestations of COVID-19 are dysgeusia and xerostomia and the occurrence of oral manifestations is increased in patients with previous medical condition. Clinical relevance: awareness of the possible symptoms and medical conditions that may potentiate the severity of oral symptoms during COVID-19 infection allows targeting the precise mechanism to treat the oral symptoms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.