Management of labial adhesion in a developing country—an observational study

Background Labial adhesion is the fusion of the labia minora or majora. The literature reports conservative management. However, the situation may be different in our setup, where management differs due to prevailing circumstances. The present study was conducted to evaluate labial adhesion presentation, management, and outcome in our center. Methods It was a retrospective observational study from January 2015 to January 2020. The patients were evaluated for age at presentation, presenting symptoms, type of adhesions, treatment, recurrence, and follow-up. The treatment included the manual release of labial adhesion and Mupirocin ointment application for 15 days. They were advised to attend the outpatient department after 1 month for evaluation and later on in case of any problem. Results The total number of patients was 150, of which 104 (69.33%) were from rural backgrounds. The complaint was of the absent vaginal opening in all patients. Seventeen (11.33%) were advised ultrasonography of the abdomen elsewhere to look for the presence of internal genital organs. The local examination revealed poor hygiene in 65 (43.33%) patients. The patient with thick adhesions has minor erythema after the release of adhesions. Ten (6.66%) patients had a recurrence managed by repeat release with no recurrence. Conclusion Despite being a benign entity, labial adhesion may be a cause of severe concern. Manual separation and antibiotic ointment may be a viable first option in its management with minimal recurrence. Maintenance of local hygiene may be needed to prevent a recurrence. The overall outcome is excellent.

Study on the Method of Antibiotic Ointment to Control Bacterial Contamination

Aim: To analyze the effective methods of antibiotic ointment to control bacterial growth, and to provide references for the research work of related personnel. Method: In this experiment, membrane filtration method combined with centrifugal precipitation method was used to complete the inspection of antibiotic ointment, and the final result was analyzed. Results: The application of membrane filtration method combined with centrifugal precipitation method to complete the test of antibiotic ointment has a significant effect. The test solution is milky white. The possibility if it can exert the effect of eliminating antibacterial components, so that Pseudomonas aeruginosa and Staphylococcus aureus can show an affecting state in the positive test tube, and colonies can be found after observation. Conclusion: The application of membrane filtration method combined with centrifugal precipitation method to complete the inspection of antibiotic ointment can achieve satisfactory results. The method is simple to operate and has high feasibility. It is worthy of further promotion and application.

Tegaderm transparent dressing (3M) with antibiotic ointment for treatment of infectious corneal ulcer: Antibiotic Wet Therapy

Purpose To retrospectively review cases of infectious corneal ulcer treated with Tegaderm transparent dressing (3M) with an antibiotic ointment. Subjects and methods: A series of 29 eyes of 29 patients with possible infectious corneal keratitis were treated in Wakayama Medical University Hospital between January 1st, 2016 and December 31st, 2018. The age of the patients ranged from 26 to 92 years (mean 68.0 ± 17.8). At the first visit, the corneal infection lesion was scraped from the epithelium to the substantially superficial layer, and the scraped matter was submitted to Gram staining and culture examination. Cases suspected of fungi and Acanthamoeba were examined directly with potassium hydroxide (KOH) treatment. For several days until drug sensitivity results were obtained, initial treatment was Antibiotic Wet Therapy (AWT) with ophthalmic eye ointment and transparent Tegaderm (3M) dressing. We retrospectively reviewed the culture results of corneal scrapings (detected bacteria and drug resistance) and the therapeutic outcome of AWT. Results Nineteen eyes in which the causative bacteria were not identified and five eyes in which the causative bacteria (Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus (MSSA), Streptococcus, Corynebacterium.) were identified were successfully treated using AWT with ofloxacin ointment. methicillin-resistant Staphylococcus aureus (MRSA) was detected in 3 of 5 eyes in which AWT with ofloxacin was not successful, and filamentous fungi were detected in one eye. Two of the three eyes MRSA detected were healed by changing to vancomycin hydrochloride eye ointment, one of which was severely affected and was later enucleated. One eye with filamentous fungi was treated after changing to pimaricin eye ointment. A causative pathogen was not identified in the other eye, but because it was suspected to be fungal the ointment was changed to a pimaricin eye ointment, which led to healing. Conclusion AWT may be an option for initial treatment of corneal infections when the causative organism is unknown.

Integrative approach to a patient following rumenotomy ˗ case report

ABSTRACT Concern with antimicrobial resistance in animal production systems increases the interest toward integrative therapies. The objective of the present report was to report an integrative approach to a goat undergoing rumenotomy. A goat with ruminal acidosis underwent rumenotomy, corrective rumen suture, moxibustion, and treatment of the surgical wound (TFO) with sugar. In the first twenty days, acupuncture was performed on ST36, indirect moxibustion on Sp6 and CV8, and TFO with antibiotic ointment and sugar. The wound contracted 2cm, there was gradual return of ruminal dynamics, and moderate pain. Acupuncture continued from D21 to D50 on Yin tang, BL13, BL20, BL23, and BL22. Although there was drainage of ruminal fluid, the wound contracted 4cm during this period, pain was absent, and ruminal dynamics normal. During the last thirty days, the acupuncture technique surround the dragon was used and BL13 point needled, with complete closure of the wound. The TFO from D21 was performed solely with sugar. During treatment, there was modulation of the inflammatory response, with formation of granulation tissue and neovascularization. On D84, fibrinogen was 100mg/dL. The authors conclude that the use of sugar, acupuncture, and moxibustion contributed to return of normal ruminal motility, wound contraction, and complete tissue reepithelization.

Acute and long-term effects of antibiotics commonly used in laboratory animal medicine on the fecal microbiota

Biomedical research relies on the use of animal models, and the animals used in those models receive medical care, including antibiotics for brief periods of time to treat conditions such as dermatitis, fight wounds, and suspected bacterial pathogens of unknown etiology. As many mouse model phenotypes are sensitive to changes in the gut microbiota, our goal was to examine the effect of antibiotics commonly administered to mice. Therefore, four treatment groups (subcutaneous enrofloxacin for 7 days, oral enrofloxacin for 14 days, oral trimethoprim-sulfamethoxazole for 14 days, and topical triple antibiotic ointment for 14 days) alongside a fifth control group receiving no treatment (n = 12/group) were included in our study. Fecal samples were collected prior to treatment, immediately after two weeks of exposure, and four weeks after cessation of treatment, and subjected to 16S rRNA library sequencing. The entire experimental design was replicated in mice from two different suppliers. As expected, several treatments including enrofloxacin and triple antibiotic ointment substantially decreased the amount of DNA recovered from fecal material, as well as the microbial richness. Notably, many of these effects were long-lasting with diminished gut microbiota (GM) richness four weeks following exposure, in both substrains of mice. Trimethoprim-sulfamethoxazole induced minimal to no discernible changes in the taxonomic composition beyond that seen in control mice. Collectively, these data highlight the need to consider the impact on GM of brief and seemingly routine use of antibiotics in the clinical care of research animals.

Is it necessary to use tobramycin-dexamethasone eye ointment prophylactically in eyes at the end of intraocular surgery?

Background: There are no data available regarding the complications associated with using antibiotic ointment at the end of intraocular surgery. This study aimed to explore the necessity of using ocular tobramycin-dexamethasone prophylactically at the end of intraocular surgery.Methods: This was a retrospective cohort study of patients who received intraocular surgery at Tianjin Medical University General Hospital from January 2015 to December 2017. The patients were grouped according to whether they received tobramycin-dexamethasone eye ointment or not after surgery. The Tobramycin dexamethasone eye ointment was sampled to observe bacterial contamination pathogens at 0.5, 1, 1.5, 2, 2.5, 3, 6, 8, 24, 36, 48, 72, and 168 h after being opened.Results: A total of 3811 eyes in 3811 patients (mean age of 63±12 years) were included: 2397 eyes that received prophylactic tobramycin-dexamethasone eye ointment and 1414 eyes that did not. The overall rate of endophthalmitis was 0.08% (3/3811) in our study, all in the eye ointment group (0.12%, 3/2397); no patients developed endophthalmitis in the non-ointment group (0%, 0/1414)(P=0.184). The anterior chamber reactions 1 day after surgery were more serious in the eye ointment group compared with the non-ointment group (all P<0.05), but there were no statistically significant differences at 1 month postoperatively (all P>0.05). The contamination rate was 0% at all time points over 7 days.Conclusion: We did not observe a statistically significant difference in the incidence of endophthalmitis in patients with or without prophylactic tobramycin-dexamethasone eye ointment. And tobramycin-dexamethasone eye ointment seemed to increase some side effects such as eye secretions increasing and foreign body feeling.

811 Comparison of an Enzymatic Debrider with Antibiotic Ointment in the Outpatient Care of Minor Partial Thickness Burns

Introduction In the U.S. about 450,000 people per year receive medical burn care through hospital emergency departments, hospital outpatient clinics, free-standing urgent care centers and private physician offices. Burns are generally classified in terms of depth and severity. Outpatient management of partial thickness burns normally involves the application of an ointment, which may contain an antibiotic and is widely used in burn care. This clinical study has been designed to prospectively evaluate potential benefits of an enzymatic debrider in partial thickness burn wounds compared to antibiotic only treatment. The primary purpose of this study is to compare an enzymatic debrider with a topical antibiotic ointment in the proportion healed at 3 weeks after initiation of treatment, and time to healing (in weeks). Methods A convenience sample of 20 subjects, aged 19–56, with an acute thermal burn injury less than 72 hours old, and less than 10% TBSA were randomly assigned to outpatient treatment with an enzymatic debrider or a topical antibiotic. The proportion of subjects healed after 3 weeks of treatment was analyzed using ANOVA. In addition, a t-test comparison between the enzymatic debrider and the topical antibiotic was performed. Results For partial thickness burns, the mean time to heal using an enzymatic debrider was 18 days compared to 28 days for the topical antibiotic. However, there was no statistical significance in burn wound closure between subjects receiving an enzymatic debrider compared to a topical antibiotic, t (13) = .677; p = .510. An analysis of variance comparing an enzymatic debrider and a topical antibiotic also showed no statistical significance in time to heal (F=.849, p=374). Conclusions Due to the small sample size, the results from this study do not support the use of an enzymatic debrider versus a topical antibiotic in treating partial thickness burn injuries to advance wound closure or shorten time to heal. The results of this study show clinical significance, with burn wounds healed in 18 days when an enzymatic debrider was used compared to 28 days when a topical antibiotic was used. The lack of statistical significance was due to an under-powered study. Furthermore, partial thickness burns should spontaneously heal within 7–14 days, regardless of the topical treatment, excluding concomitant co-morbidities. Applicability of Research to Practice Continued research is necessary, employing larger sample sizes to adequately compare the use of an enzymatic debrider compared to topical antibiotics in deep partial thickness burn wounds. In addition, outpatient management of deep thickness and full-thickness burn injuries, utilizing sharp debridement in conjunction with enzymatic debridement, in patients who decline surgical treatment of burn wounds should be explored, analyzing time to heal, scar evaluation, and cost analysis,