Background: Phlebitis is among the most common complications of intravenous therapy. It significantly correlates with the length of hospital stay and mortality rate. Objectives: This study sought to examine the effects of quercetin topical cream on phlebitis caused by peripheral intravenous catheters. Methods: This single-blind randomized controlled trial was done in 2015 on 66 patients hospitalized at the internal medicine ward of Valiasr (PBUH) hospital, Birjand, Iran. The patients were conveniently recruited and randomly allocated to a control and an experimental group. The data collection tool was a five-point phlebitis assessment scale. As soon as the symptoms of phlebitis were observed, the related catheter was removed and the catheter insertion site was treated every twelve hours for 72 hours with either 2% quercetin cream (the experimental group) or a eucerin-based cream (the control group). Friedman, Wilcoxon and Mann-Whitney U tests were run using the SPSS software for data analysis (v. 14.0). Results: There was no significant difference between the groups regarding patients' age (P = 0.068) and gender (P = 0.69). No significant changes were observed in the severity of phlebitis in the control group during the 72-hour course of the study. However, in the quercetin group, the severity of phlebitis decreased significantly after twelve hours from the beginning of the intervention and the trend of its variations was downward (P < 0.001). Consequently, after 72 hours (or six episodes of quercetin cream use), 90% of all phlebitis cases achieved complete recovery without any side effect. Conclusions: 2% Quercetin cream could be effective in treating phlebitis caused by intravenous catheters and can be used as a useful and safe treatment modality for phlebitis management. The positive effects of quercetin on phlebitis appear very soon after its use.
Necrotizing fasciitis is an uncommon disease and a soft tissue infection that spreads along fascial planes with associated inflammation and necrosis. Herein, this study reported necrotizing fasciitis as a rare complication after bone marrow transplantation (BMT) in a Iranian patient and the efficacy of early treatment in improvement it. A 28-year-old lady had known case of first relapse of Hodgkin's lymphoma that admitted for auto-BMT in 2016. Five years ago due to abdominal-pelvic massive lymphadenopathy, she was treated with six courses of ABVD regimen combined with involved filed irradiation. Due to Hodgkin's relapse, the patient was treated with six courses of ICE regimen and after complete remission was selected for auto-BMT. Necrotizing fasciitis was reported by MRI and the patients was treated with combination of a number of antibiotics after fasciectomy. In conclusion, necrotizing fasciitis is a rare complication of BMT, especially autologous type that drug selection and rapid surgical fasciectomy are important decisions for prevention of mortality and morbidity of this complication.
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