Wound Infections

Cough is an ongoing problem that affects a large proportion of the human community leading them to seek medical attention. It has been identified as the sixth common reason for hospital outpatient department visits. In classics, descriptions of disease Kasa clearly correlate with bronchitis and its pathophysiology exactly correlates the mechanism of cough reflex. Ayurveda advocates certain remedies to cure and prevent such diseases. Hence the present study has been contemplated to evaluate and verify the effectiveness of the Classical Ayurvedic remedies with special reference to pathogens causing the respiratory tract infections. Among the latest Ayurvedic formulations the Gojihwadi Kwatha which was designed and developed by none other than the famous physician of this era the great Vaidya Yadavji Trikamji Acharya has been selected for the study. This present study entitled "Pharmaceutico-analytical evaluation of modified dosage forms of Gojihwadi Kwatha" was carried out with a view to standardize Gojiwadi kwath and prepare its modified forms viz. Gojihwadi syrup, Gojihwadi granules, and Gojihwadi kwath churna. 12kg Gojihwadi kwaath churna was prepared while 6-liter Gojihwadi syrup and 3 kg Gojihwaadi granules were prepared. Gojihwaadi syrup has viscosity of 34.62 cP, total sugar content of 85.07 %w/w, reducing sugar content of 1.42 %w/w, non-reducing sugar content of 83.65%w/w and pesticide residue value within limits of standard parameter. Gojihwadi granules have total sugar of 78.44%w/w, an average particle size of 34.70. Total bacterial count, Total fungal count, and specific pathogens (E. coli, Salmonella spp, S.aureus, and Ps.aeroginosa) were absent in Gojihwadi kwatha churna, Gojihwadi syrup and Gojihwadi granules. So, it can be concluded that all the modified dosage forms of Gojihwadi kwatha are safe to use.

Goal: Environmental protection is a key issue, and improper disposal of infectious fluids poses irreparable risks to human health and the environment. Infectious waste is any waste that is generated during a diagnostic process, treatment, or research activities that include biological experiments. The management of infectious waste is as vital as its disposal. therefore, it is necessary to use products such as disposable suction bags that collect infectious fluids and prevent them from spreading to the surrounding environment. In this article, we will investigate the issue of nosocomial infections and the methods of preventing the spread of this infection, as well as the management of infectious waste using the new method (disposable suction liner bag) and the old method (permanent suction canisters). Methods: The study was conducted by the AHP Method model, which is one of the multi-criteria decisionmaking methods and analyzes the evaluation of parameters quantitatively and qualitatively; also, to use this method and evaluations, Expert Choice software has been used. Results: It is clear in this study that permanent suction canisters cause hospital infections, increase medical centers' costs, and increase hospitals' infectious waste, which costs 10 to 15 times more than other waste due to its infectiousness. Also, the use of disposable suction liner bags not only reduces and controls hospital infections but also reduces the costs of disposal and disposal of infectious waste and treatment of infectious wastes, as well as saving water, electricity, and human resources. Conclusion: The results of this study allow managers and officials of hospitals and medical centers to know which type of suction canisters to use to improve the level of hospital control and to be familiar with the advantages, disadvantages, risks, and environmental risks caused by suction canisters. to make the best decision in this regard.

The present study was carried out to investigate the effect of clinically used antiseptics on elastase production from Pseudomonas aeruginosa. 39 clinical isolates were collected from wounds 10 (25.64%) and burns 29 (74.35%) from hospitalized patients in Baghdad city. Elastin preparation by the autoclaving method yielded 10.5 gm of elastin powder from (250 gm) of sheep's lungs, 3.6 gm from (50 gm) of sheep's bladder, and sheep's ligamentum nuchae (65 gm) yielded 15 gm. All P. aeruginosa isolates were tested for their ability to produce elastase by being cultivated on elastin nutrient agar and observed for the enzyme's activity. The bacteria that make elastase grew, and a clear border emerged surrounding the growth after 24 hours. 32 (82.05%) of P. aeruginosa isolates produced the enzyme on the elastin nutrient agar. Elastase-producing P. aeruginosa was tested quantitatively using the ELISA reader and spectrophotometer at (A495) to detect the released amount of Congo red dye from the degradation of the elastin Congo red. P. aeruginosa (P41) showed the highest elastolytic activity; thus, it was selected to determine the effect of the sub-MIC of the antiseptics on elastase production. The results showed that acetic acid was the best agent to inhibit elastase production, followed by silver nitrate, hydrogen peroxide and ethanol in descending order.

Background: Banknotes are among the objects frequently exchanged between people and can serve as a vehicle for the transmission of infectious agents. Therefore, the present study aimed to isolate and identify potentially pathogenic bacteria on Yemeni banknotes collected from various municipal sources in Aden city, south of Yemen. In addition, the susceptibility of the isolated bacterial species to commonly used antibiotics was tested. A descriptive cross-sectional study was conducted on 240 Yemeni banknotes of various denominations randomly collected from people from different places in Aden city between November 2019 and February 2020. Swabs from the surfaces of banknotes were streaked onto blood agar, chocolate agar, mannitol salt agar and MacConkey agar and incubated at 37 °C for 48 hours. After isolation, bacterial species were identified and tested for their susceptibility to commonly used antibiotics using established techniques. Out of 240 banknotes examined, 98.3% were found to be contaminated with bacteria, with a 95% confidence interval (CI) ranging from 96 to 99. Among the isolated bacteria, 17.4% were Gram-positive cocci, 33% were Gram-negative bacilli and 49.6% were a combination of both. The mean plate counts of bacterial colonies ranged from 163.6±51.0 colony-forming units (CFU)/ml (95% CI: 147.3-179.9) for banknotes with a denomination of 100 Yemeni rials (YRIs) to 257.1±52.0 CFU/ml (95% CI: 240.5-273.7) for banknotes with a denomination of 50 YRIs. Staphylococcus aureus was the most frequently isolated bacterial species, detected

Background: Helicobacter pylori, previously known as Campylobacter pylori, is a gramnegative, flagellated, helical bacterium. Mutants can have a rod or curved rod shape. They are spiral-shaped (curved rod) bacteria (about 3 µm long and about 0.5 µm in diameter) with four to six flagella in the same location. Subject and method: A total number of 50 patients suffering from H pylori (males and females) that selected from private laboratories in Al-Nasiriya city during November 2023 to January 2024. Inclusion criteria of subjects include male and female patients have bacterial infection with age range 7-80 years old. Some patients were positive for diabetes mellitus and the diagnosis was based on the clinical and laboratory examinations under the supervision of specialist physicians. Result: Helicobacter pylori test was performed on patients and the results showed positive for Helicobacter pylori to all patients in percentage (100%), the results showed significant differences between patients in both positive and negative result. P= (0.010) On the other hand, detection of diabetes and the result indicate to 23 of patients in percentage (100%) was positive to diabetes related H. pylori, but 37 of patients was negative to diabetes mellitus and the result appeared significant differences between patients in both positive and negative results. P= (0.

Chronic wounds such as DFUs, VLUs and pressure injuries affect a significant middle-aged population, contributing to high morbidity, reduced quality of life and escalating treatment costs. 1 Complex acute wounds (trauma, burns, surgical dehiscence) require optimized management to prevent chronicity. Traditional care focuses on wound bed preparation such as debridement, infection control, moisture balance, and offloading. 2 However, many wounds stall or refuse to heal due to impaired angiogenesis, persistent inflammation, hypoxia, senescent cells, dysfunctional ECM and biofilm-laden microbiomes. 3 Recent innovations therefore focus on these pathophysiologic factors via biologics, engineered materials, local antimicrobial strategies, and integrated ABSTRACT Chronic wounds [diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), pressure injuries] and complex acute wounds impose substantial morbidity, reduced quality of life and high health-care costs. Many wounds fail to heal because of impaired angiogenesis, persistent inflammation, hypoxia, senescent cells, dysfunctional extracellular matrix (ECM) and biofilm-laden microbiomes. Recent innovations target these pathophysiologic drivers. This narrative review synthesizes contemporary advances in wound care across biologic or regenerative therapies, advanced biomaterials, antimicrobial or anti-biofilm strategies, device-based physical modalities, smart dressings, digital integration and 3D printing or bioprinting. The mechanisms, representative technologies, clinical indications, evidence strength, practical considerations and safety or regulatory challenges are summarized. Biologic approaches include cellular therapies [autologous or allogeneic keratinocytes, fibroblasts, mesenchymal stromal or stem cells (MSCs)], platelet-derived products, engineered skin substitutes and emerging gene or RNA therapies offering targeted modulation of inflammation, angiogenesis and matrix repair. However, they all require rigorous wound bed preparation and patient optimization. Advanced dressings (hydrogels, protease-modulating matrices, electrospun scaffolds, antimicrobial-integrated and oxygen-releasing materials) improve local milieu and enable controlled therapeutic delivery. Antimicrobial strategies addressing biofilms include enzymatic dispersal agents, bacteriophage therapy and local antibiotic delivery systems. However, multimodal use with debridement is superior to single interventions. Device-based modalities [Negative pressure wound therapy (NPWT) and NPWTi, electrical stimulation (ES), photobiomodulation, photodynamic therapy (PDT), oxygen therapies, ultrasound or shockwave] show utility in specific contexts with strongest evidence for NPWT. Smart sensors, closed-loop dressings and AI-enabled digital assessment promise earlier detection and personalized interventions but need outcome validation. 3D printing and bioprinting enable patient-specific scaffolds and tissue constructs but face vascularization and regulatory barriers. Multimodal, evidence-guided, patient-personalized approaches built on optimized systemic care and meticulous wound bed preparation are most likely to improve outcomes. Key needs include standardized endpoints, larger pragmatic trials, cost-effectiveness data and implementation frameworks to ensure safety, regulatory compliance and equitable access.

Animal bites, especially hyena bites, can lead to severe injuries and cause significant morbidity and disabilities to a patient, most commonly in low-and middle-income countries. In South Sudan, the most common type of hyena is the Spotted Hyena (Crocuta crocuta). The management of severe injuries due to a hyena bite is multidisciplinary and challenging in low-and middle-income countries (LMIC). Acute emergency conditions like active bleeding and sepsis should be treated, the wound should be cleaned, debrided from devitalized tissue, and reconstructive procedures should be done when the wound is clean. Hyena bite injuries can range from mild to severe injuries. We present a case of an 11-year-old female patient who presented to our emergency room with a wound on the left hand and right buttock after she was attacked by a hyena three days prior and was referred from Tonj Hospital, Warrap State. The patient underwent debridement as well as second-look debridement and is awaiting reconstructive surgery. This case report highlighted the emergency management of complex hyena injuries and the importance of prompt intervention in the overall outcomes.

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in infants and young children worldwide. Hospital studies show high RSV rates, while community cases remain underreported. This Minireview seeks to address the critical data gap by synthesizing available RSV literature within the context of Yemen's health system. It explores national and regional epidemiological patterns, identifies risk factors unique to the Yemeni population, and examines barriers to effective surveillance and immunization. Factors like indoor air pollution, tobacco smoke, poor nutrition, and crowded living conditions make the problem worse. Yemen's health system struggles to respond due to conflict, limited resources, and weak surveillance. While new tools like RSV vaccines and monoclonal antibodies are now available in wealthy countries, Minireview Article

Accurate semantic segmentation of foot ulcers is essential for automated wound monitoring, yet boundary delineation remains challenging due to tissue heterogeneity and poor contrast with surrounding skin. To overcome the limitations of standard intensity-based networks, we present LSS-LTCNet: an ante-hoc explainable framework synergizing deterministic structural priors with continuous-time neural dynamics. Our architecture departs from traditional black-box models by employing a Local Self-Similarity (LSS) mechanism that extracts dense, illumination-invariant texture descriptors to explicitly disentangle necrotic tissue from background artifacts. To enforce topological precision, we introduce a Liquid Time-Constant (LTC) refinement module that treats boundary evolution as an ODEgoverned dynamic system, iteratively refining masks over continuous time-steps. Comprehensive evaluation on the MICCAI FUSeg dataset demonstrates that LSS-LTCNet achieves state-of-the-art boundary alignment, securing a peak Dice score of 86.96% and an exceptional 95th percentile Hausdorff Distance (HD95) of 8.91 pixels. Requiring merely 25.70M parameters, the model significantly outperforms heavier U-Net and transformer baselines in efficiency. By providing inherent visual audit trails alongside high-fidelity predictions, LSS-LTCNet offers a robust and transparent solution for computer-aided diagnosis in mobile healthcare (mHealth) settings.

This study was planned so as to evaluate whether magnetic field exposure has any significant effect on the pentylenetetrazol (PTZ)-induced seizures. Mice were exposed to 50 Hz, 2 G (0.2 mT) magnetic field in glass cages for 1 h. Sham exposure was produced by turning off the current while the animals were in the same exposure volume. Then, PTZ was administered intraperitoneally (i.p.) at a dose of 60 mg/kg and the animals were observed for 30 min. Subsequently, the latency to seizure onset, total seizure duration, the number of seizure episodes and mortality were recorded for each subject. There was no evidence for a significant effect of the 50 Hz magnetic field on the mean number of PTZ induced seizures, seizure latency, total seizure duration and mortality (P \ 0.05). As a conclusion the present study failed to provide any further support for a therapeutic potential of magnetic field.

Background: Cutaneous Scedosporium infection represents an extremely rare opportunistic fungal complication in solid-organ transplant recipients, often mimicking post-transplant skin malignancies due to chronic immunosuppression. Case presentation: A 75-year-old woman, kidney transplanted in 2022 for IgA nephropathy on tacrolimus, mycophenolate, and prednisone, developed progressive firm nodular lesions on the left lower limb over two months. Punch biopsy revealed granulomatous inflammation with septate hyphae on Gomori-Grocott stain; culture confirmed Scedosporium spp. CT excluded dissemination. Conclusion: Voriconazole (6 mg/kg loading dose, then 4 mg/kg maintenance dose) combined with surgical debridement, negative-pressure wound therapy, and skin grafting achieved complete healing at three months, with no recurrence at 12 months. Early biopsy is crucial to differentiate this rare entity from squamous cell carcinoma, enabling multidisciplinary success.

Background: Hypertonic saline solutions are used in medicine for their osmotic effects. Topical application of 3% sodium chloride (NaCl) solution has been described in surgical wound care for irrigation, oedema control and cleansing. Objective: To review mechanisms of action, clinical uses, efficacy, safety, practical guidance and research gaps relating specifically to 3% hypertonic saline in surgical wound management. Methods: Narrative synthesis of preclinical data, clinical reports, guideline statements and comparative literature on wound irrigation and hyperosmotic topical therapies. Results: 3% NaCl (≈513 mOsm/L) exerts osmotic effects that can reduce interstitial oedema and promote exudate movement, provides modest antimicrobial activity through osmotic stress and can assist mechanical cleansing when used for irrigation or wet-to-dry applications. Compared with isotonic saline, evidence for superior infection prevention or faster healing is limited and heterogeneous. Potential benefits include reduced wound oedema, facilitation of drainage from exudative wounds, tracts and improved patient comfort in some contexts. Safety considerations include local stinging, irritation, potential for local cellular dehydration and impaired granulation with prolonged or repeated exposure and rarely systemic hypernatremia if large-surface-area wounds are irrigated extensively or large volumes are absorbed. Current evidence supports selective short-term use of 3% hypertonic saline as an adjunct to standard surgical wound care rather than routine replacement of normal saline or antiseptics. Conclusion: 3% hypertonic saline may be useful as an adjunct for irrigation of oedematous or highly exudative superficial surgical wounds and for short-term oedema control, but routine use is not supported by high-quality comparative data. Clinicians should use limited volumes, monitor local and systemic effects and prefer isotonic saline for routine lavage when antimicrobial effect or tissue preservation is prioritized. Well-designed clinical trials comparing 3% NaCl with isotonic saline and antiseptics for defined surgical wound indications are needed.

Background: Prevalence extension of antibiotic resistant bacteria has raised concerns about control of infections especially nosocomial infections. Many attempts have been done to replace antibiotics or limit their use. The use of antimicrobial agents produced by bacteria as antibiotic replacement has been promising in recent years. The goal of this study was to isolate Bacillus strains and evaluate their antimicrobial activity against some standard pathogens and clinical antibiotic resistant strains. In the present study, Bacillus strains were isolated from various resources and identified by 16S rDNA PCR method. Then, the phylogenetic tree of the isolates was constructed and antimicrobial activity of the isolates was investigated against some standard pathogens and clinical antibiotic resistant strains using spotting and well diffusion methods. Results: Eight Bacillus strains were isolated from 15 different samples. Based on the molecular identification, the isolates were identified as B.pumilus, B.coagulans, B.licheniformis, B.endophitycus and B.amiloliquefaciens. The results showed that isolates have antimicrobial activity against meticilin-resistant Staphylococcus aureus, vancomycin resistant enterococci, Klebsiella, Acinetobacter, Salmonella, Shigella, Listeria, Streptococcus and Escherichia coli. In this study, isolated Bacillus strains produced antimicrobial agents against pathogens and antibiotic resistant strains and inhibited their growth.

Background: The Point-of-Sale (POS) machine is a portable, computerized device widely used to facilitate financial transactions. Despite its convenience, POS machines have been reported to harbor various microorganisms due to frequent handling by multiple users, thereby posing a potential risk of infection. This concern is heightened by the increasing prevalence of multidrugresistant bacteria, which limits the effectiveness of commonly used antibiotics and represents a significant public health threat. Understanding the extent of microbial contamination and the associated risk factors of POS machines is therefore critical, particularly in urban settings such as Kano Metropolis, Nigeria. Objectives: This study assessed the prevalence of MDR bacterial contamination on POS machines in Kano Metropolis and identified associated risk factors. Methods: A cross-sectional mixed-methods design was employed. Swab samples were collected from 50 POS machines across various sectors, and bacterial isolates were identified using standard microbiological techniques. Antibiotic susceptibility testing followed CLSI guidelines. A structured questionnaire was administered to 100 vendors and users to evaluate hygiene practices and awareness of MDR bacteria. Data were analyzed using descriptive statistics and logistic regression to identify contamination risk factors. Results: All sampled POS machines (100%) were contaminated. Twenty bacterial isolates were recovered, including Bacillus spp. (30%), Staphylococcus aureus (25%), Klebsiella spp. (15%), Pseudomonas aeruginosa (10%), coagulase-negative staphylococci (10%), Enterobacter spp. (5%), and Proteus spp. (5%). Multidrug resistance was observed in 60% of isolates. Poor cleaning and disinfection practices and limited awareness of MDR bacteria among users were significantly associated with contamination. Conclusion: POS machines in Kano Metropolis are heavily contaminated with MDR bacteria. Public health interventions, including targeted hygiene education, routine cleaning protocols, and surveillance of antimicrobial resistance on frequently handled devices, are urgently needed to reduce the risk of pathogen transmission.

In the last few years, many researchers have been investigating the theoretical and experimental aspects of the of the use of the electromagnetic field and its effects on living organisms, and this is evidenced by the number of scientific papers published in different journals; however, there are no reports of a therapy that combines the use of the magnetostatic field (permanent magnets) and cryotherapy for the treatment of knee synovitis. The objective of this work lies in the design and simulation of a magnetic knee brace, with permanent magnets, for the treatment of SRP. It is concluded that magnetic induction generated by the configuration of the knee brace is feasible for this pathology and with cryotherapy it has high analgesic and anti-inflammatory effectiveness, since it relieves pain and inflammation caused by knee injuries (arthritis, osteoarthritis, SRP); and accelerates the rehabilitation time of athletes/physical exercise practitioners, with respect to conventional treatment; which has a direct impact on the patient's quality of life, mainly in the work, social and economic spheres.

This study was conducted to isolate antibiotic producing fungi in soil samples collected from Bayero University, Kano. Soil samples were suspended in deionised distilled water and inoculated on potato dextrose agar (PDA) by spread-plate method for the isolation of fungi. Primary screening of antibiotic producers was conducted using agar well diffusion method. All the isolates were identified to be in the genus Aspergillus . Out of the sixty (60) fungal isolates, three (3) species ( A. flavus , A. fumigatus and A. niger ) were selected for fermentation process and extraction of metabolites using ethyl acetate. The extracts were dried and subjected to disc diffusion assay against Streptococcus pneumoniae , Staphylococcus aureus , E. coli and Pseudomonas aeruginosa . The extracts showed inhibitory activity against all the test organisms at concentration of 1000μg and 800μg with little or no activity at 600μg against the tests organisms. Highest activity was observed from the metabolite...

Background: Pilonidal sinus (PNS) is a common disorder that mainly affects young adults. It can be asymptomatic or presented by discomfort, inflammation, abscess or sinus formation. Despite current advances in surgical techniques, the best option to treat PNS is not yet well defined. Many studies reported techniques that involved excision of the sinus and closure of the deep and superficial layers but leaving the skin open. Aim: We aim to compare between the excision and primary midline closure with suction drain versus the partial closure technique as treatment options for PNS in terms of recovery, wound complications and recurrence rate. Patients and Methods: A prospective comparative study at Ain Shams University Hospitals that included 80 patients with PNS was conducted from January 2018 to June 2019. They were divided randomly into group A; 40 patients that had the midline closed method with suction drain and group B; 40 patients that underwent the partial closure technique. Both groups were followed up for 1 year, detecting healing time, wound complications, return to usual activities and recurrence rate. Results: We detected significant differences between both groups as regards to pain and discomfort postoperatively, favoring the partial closure group. Mean time to wound healing was significantly shorter among group A (14.43 ± 3.13) though mean time of return to usual activities was faster among the partial closure group (14.45 ± 1.15). There were no statistically significant differences between both groups as regards to wound infection, dehiscence or hematoma formation. Wound seroma was more among group A. The partial midline closure technique showed comparable results to the closed method with suction drain in management of PNS disease. Indeed, it shows less postoperative complications and a faster return to usual daily activity. Yet, more studies are required to demonstrate its reproducibility.

The major innate barrier to the establishment of infections in internal tissues is the skin, the disruption of which leads to wound formation. Such wounds can be contaminated by bacterial pathogens thereby hampering the healing process and its management becomes resource demanding. Here, we assess the diversity of potential bacterial pathogens in the infection of different types of wounds among hospitalized patients. Three hundred and twenty wound swab samples were collected and processed via microscopy, and cultured on Blood, MacConkey and Chocolate Agar. Isolates were further confirmed using biochemical tests and Kirby Bauer disc diffusion test was used to determine their antimicrobial susceptibility pattern. 87.5% of samples collected yielded bacterial growth comprising of single bacterial isolates (52.17%) and polymicrobial/mixed growth (47.82%). Staphylococcus aureus (32.61%) was the most prevalent bacterial specie identified. Gram-negative bacteria (62.33%) were the most perva...

Background: One of the most common presentations in the outpatient department is pyogenic or wound infections. Multidrug-Resistant (MDR) bacterial infection is considered as one of the significant risk factor for impaired wound healing. The aim of this study is analysing bacteriological profiles and antibiotic sensitivity patterns from pus samples, and examine how these organisms correlate with patient outcomes. Materials and Methods: During the period of retrospective cross-sectional study, around 940 pus samples from wounded sites were collected and processed in Microbiology department as per the standard guidelines. Clinical data was also analysed to correlate MDRO presence with infection outcomes. All prepared biochemical and streaking media were checked for their sterility. Quality control Strains were used as reference strains for quality control of AST and biochemical tests. Results: Majority of the organisms isolated were Pseudomonas (23.0%), Staphylococcus aureus (21%), E.coli (17.5%), Klebsiella (17.2%). ESBL production was observed more in E.coli (58.4%) followed by Klebsiella (50.9%) and Proteus (24.2%). MBL production was noted in 27.3% isolates of E.coli, 21.1% of Klebsiella and 6.06% of Proteus isolates. ESBL production was observed more in Pseudomonas (52.1%) followed by Acinetobacter (51.6%). MBL production was noted in 32.2% isolates of Pseudomonas, and 41.7% of Acinetobacter isolates. MRSA was noted in 77.08% isolates of wound infections. Conclusion: Our study highlights that MDRO-infected wound require prolonged hospital stays, intensive interventions, and alternative therapies due to limited antibiotic options. Effective antimicrobial stewardship, rapid diagnostics, and strict infection control measures are essential to curb resistance and improve outcomes.

Les plaies cutanées complexes constituent souvent un défi thérapeutique pour le praticien et une source d'inquiétude pour le propriétaire. Des soins relativement simples, une bonne observance des traitements et des grandes règles de prise en charge des plaies permettent d'obtenir des résultats très satisfaisants pour un coût acceptable. A travers l'exemple d'un cas concret, il est rappelé comment une plaie complexe doit être explorée avec minutie, largement drainée, nettoyée et débarrassée de tous corps étrangers lors de sa prise en charge. Son suivi passe par la mise en place de pansements adaptés et la gestion du tissu de granulation. Le traitement peut faire appel à des techniques chirurgicales simples de reconstruction comme la greffe en îlots.

Background Lower respiratory infections (LRIs) remain the world's leading infectious cause of death. This analysis from the Global Burden of Disease Study 2023 provides updated global, regional, and national estimates of LRI incidence, mortality, and disability-adjusted life-years (DALYs), with attribution to 26 pathogens, including 11 newly modelled pathogens.

Background: The objective of our study was to determine the prevalence of Pseudomonas aeruginosa in the isolates of postoperative wound and its susceptibility pattern to commonly used antibiotics. Materials and Methods: During a 2-year period, specimens were received as postoperative wound swabs in Microbiology Laboratory, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India. Result: Of the 300 bacterial isolates, 89 (29.6%) were P. aeruginosa, followed by Escherichia coli (61, 20.3%), Klebsiella spp. (50, 16.6%), Staphylococcus aureus (43, 14.3%), Proteus spp. (19, 6.3%), Acinetobacter spp. (9, 3.0%), and Citrobacter freundii (2, 0.6%). There was no growth in 27 (9.0%) specimens. Conclusion: P. aeruginosa isolation was higher in male patients and most common in the age group of 21-40 years. The susceptibility pattern showed the organism to be most commonly susceptible to imipenem, followed by meropenem, cefoperazone/sulbactam, ticarcillin/clavulanate, and amikacin.Keywo...

he application of low-intensity ultrasound is a therapeutic method that has shown positive effects on bone cell proliferation and acceleration in the process of fracture healing. Furthermore, ultrasound has engendered great interest because of its low cost, portability, ease of handling, and noninvasive nature. It is particularly attractive as a therapeutic treatment because it uses nonionizing radiation waves. Using low-intensity ultrasound in surgical treatments has been estimated to induce cost savings of 40% per case, due to a reduction in expenses for secondary procedures and in costs related to workers' compensation. Among noninvasive treatments, ultrasonic energy is one of the most commonly used physical adjuvants in physical therapy and regenerative medicine to treat several diseases. Its therapeutic effects have proved very beneficial in treating a wide variety of conditions,

Background: Deep sternal wound infections (DSWIs) are rare but life-threatening complications following coronary artery bypass grafting (CABG), especially among patients with comorbidities such as diabetes mellitus. These infections significantly affect morbidity, prolong hospitalization, and require intensive, multidisciplinary management. Case Presentation: A 59-year-old female with a known history of poorly controlled type 2 diabetes mellitus was admitted to CMC Hospital in Erbil, Iraq, following elective CABG surgery. Postoperatively, the patient developed a nonhealing thoracic wound, with incomplete sternal closure and clinical signs of deep infection, including purulent discharge, erythema, and systemic fever. Microbiological analysis of wound swabs identified a polymicrobial infection involving Staphylococcus aureus and Pseudomonas aeruginosa. The patient was managed with surgical debridement, targeted antibiotic therapy based on culture sensitivity, and advanced wound care using negative-pressure wound therapy (NPWT). Discussion: This case illustrates the increased susceptibility of diabetic patients to postoperative wound infections due to impaired immunity and delayed healing. It emphasizes the importance of early detection, thorough microbiological assessment, and an individualized, evidence-based treatment plan. Preoperative glycemic control, stringent intraoperative asepsis, and prompt postoperative wound monitoring are essential to minimize the risk of DSWIs. Conclusion: Deep sternal wound infections following CABG present significant clinical challenges, particularly in diabetic patients. This case from CMC Hospital in Erbil, Iraq, underscores the need for timely intervention, multidisciplinary care, and the integration of advanced wound management strategies to improve clinical outcomes.

Background: The incidence of diabetes is rising in low-and middle-income countries, with many cases undiagnosed until complications, such as diabetic foot ulcers (DFUs), manifest. Effective management of DFUs requires a multidisciplinary approach involving various Healthcare Professionals (HCPs) such as doctors, nurses, physician assistants, and disease control officers among others. This study assessed the factors influencing the management of DFUs among HCPs at the primary healthcare level in the Bosomtwe District, Ghana. Methodology: A cross-sectional study where a quantitative approach was used across three purposively selected health facilities. A sample size of 231 respondents was selected using a simple random sampling technique. Data were collected using self-designed, pretested questionnaires and analyzed using descriptive and inferential statistics with STATA version 16. Results: Majority (71%) of the participants were registered nurses, with no podiatrist available in the district. While 69.5% of the respondents had general knowledge about managing DFUs, they lacked specific knowledge on dressings and offloading devices. Nearly all the respondents (99.75%) did not follow evidence-based guidelines for DFU management due to the absence of a universal protocol. However, there is a strong association between regularly consulting evidence-based guidelines and better DFU management outcomes (P < 0.001, odds ratio [OR] = 0.36, confidence interval [CI] =0.17-0.72). Furthermore, challenges in HCPs adhering to these guidelines (P = 0.001, OR: 0.03 CI = 0.04-0.22), patient difficulties in following treatments (P < 0.001, OR = 0.04, CI = 0.02-0.81), and low confidence in diagnosing DFUs (P < 0.001 OR = 0.65, CI = 0.55-0.76) are also significantly linked to poorer management outcomes. Conclusion: The study revealed major gaps in knowledge and adherence to guidelines in DFU management among HCPs in the Bosomtwe District. The study also found that lack of universal protocols, low diagnostic confidence, and patient noncompliance are some of the issues relating to poor DFU management. Standardized protocols, targeted training, and better patient education are needed to improve outcomes according to the study.

Resume Objectif : Comparer l’efficacite du fentanyl transdermique a celle de l’analgesie usuelle chez les patients ayant subi au moins un pontage mammo-coronarien a l’Hopital Laval. Methodologie : Etude ouverte, controlee et hasardisee aupres de patients ayant eu un ou des pontages mammo-coronariens. Des doses variant de 25 a 50 mcg/h ont ete utilisees et ajustees selon le poids. Des mesures d’echelle visuelle analogue, de consommation d’analgesiques opiaces et de rythme respiratoire ont ete prises. Resultats : Quinze patients ont ete inclus dans le groupe fentanyl transdermique et neuf dans le groupe temoin. Les scores moyens d’echelle visuelle analogue ont ete de 1,91±0,27 et de 3,25±0,40 (p=0,0046) pour les groupes experimental et temoin respectivement. Les sujets du groupe fentanyl transdermique ont consomme moins d’entre-doses en equivalent mg de morphine que le groupe temoin par periode de huit heures (4,8±0,93 mg c. 8,3±1, 22 mg; p=0,0328). Le rythme respiratoire moyen n’a pa...

Wound infections remain a major healthcare challenge, particularly in developing countries. The emergence of multidrug-resistant (MDR) bacteria further complicates treatment and recovery. This study assessed the bacteriological spectrum and antimicrobial resistance patterns of wound pathogens in a tertiary care hospital in Bangladesh. A retrospective study was conducted from January to July 2019 in the Microbiology section of Khwaja Yunus Ali Medical College Hospital, Enayetpur, Bangladesh. A total of 295 wound specimens (swabs and pus aspirates) were processed by standard microbiological methods, and antibiotic susceptibility was determined using the Kirby-Bauer disc diffusion method following CLSI guidelines. Of the 295 samples, 217 (73.5%) showed bacterial growth. Escherichia coli (41%) was the predominant gram-negative isolate, while Staphylococcus aureus (31%) and coagulase-negative staphylococci (13%) were the leading gram-positive pathogens. High levels of resistance were observed, though Imipenem, Meropenem, Amikacin, and Nitrofurantoin were effective against gram-negative bacteria. Gram-positive isolates showed higher sensitivity to Amoxiclav, Gentamicin, and Meropenem. The study highlights the emergence of resistant bacterial pathogens in wound infections. Effective antimicrobial stewardship, regular resistance surveillance, and strengthened infection control practices are essential to curb the spread of MDR organisms in healthcare settings.

Chronic wounds including diabetic foot ulcers, pressure injuries, venous leg ulcers, arterial ulcers, surgical wounds, traumatic wounds, and other chronic conditions represent a significant burden to healthcare systems worldwide. In the United States, Native American communities and Veterans are disproportionately impacted. By expanding access to physicians and nurse practitioners in the field, and by establishing greater collaboration between wound care providers, acute and post-acute providers a significant reduction in amputations, improvement in quality of life, and alleviation of financial burdens on healthcare systems can be achieved.

Background Burn injuries break down skin integrity, increasing the risk of sepsis, a leading cause of morbidity and mortality in burn patients. Rapid differentiation of gram-negative sepsis from Gram-positive sepsis is crucial for timely and effective antibiotic therapy. Serum procalcitonin (PCT) has emerged as a potential biomarker for sepsis differentiation. Objective This study aimed to evaluate the diagnostic accuracy of serum PCT for distinguishing between Gram-negative and Gram-positive sepsis in pediatric burn patients. Methods This cross-sectional study was conducted on 117 pediatric burn patients with positive blood cultures and clinical diagnosis of sepsis based on the American Burn Association criteria. Serum PCT levels were quantified and compared with blood culture results. Diagnostic performance was assessed using the receiver operating characteristic (ROC) curves and determining the optimal cutoff point. Results Gram-negative bacteria were identified in 60.2% of cases, while gram-positive bacteria were detected in 39.8%. The serum PCT level was significantly higher in gram-negative cases than in gram-positive cases (14.58 ng/mL vs 4.62 ng/mL, P<0.001). An optimal cutoff point of 3.15 ng/mL demonstrated 84.3% sensitivity and 57.4% specificity for detecting gram-negative sepsis. Patients with gram-negative sepsis experienced longer hospital stays, elevated inflammatory markers, higher organ dysfunction, and increased mortality rates (31% vs. 2%, P<0.001) than those with gram-positive sepsis. Conclusion Serum PCT has moderate sensitivity but low specificity for differentiating gram-negative from gram-positive sepsis in pediatric burn patients. PCT may be used as a valuable adjunct to clinical and laboratory indicators. Larger multicenter studies are recommended to validate these findings and refine diagnostic algorithms for sepsis management.

Methicillin-resistant Staphylococcus aureus (MRSA), currently a major problem in hospitals worldwide, is one of the most common causes of nosocomial disease through surgical wound infection. MRSA-infected wounds have very low recovery rates and have become more problematic as some antibiotics are not effective against MRSA. Several antimicrobial and anti-inflammatory agents of green algae (Ulva lactuca) in the form of alkaloids, triterpenoids, steroids, saponins, and flavonoids have the potential to accelerate the wound healing process following MRSA wound infection. Various active compounds contained in the U. lactuca extract are thought to have multiple antibacterial and anti-inflammatory properties that can overcome the MRSA antimicrobial resistance and accelerate tissue growth in the wound healing process. This review aims to describe the potential of Ulva lactuca extract against MRSA-infected wound healing.

The fractures involving the ankle are common injuries that treated by orthopaedic surgeons. Patients with diabetes who sustain an ankle fracture are at increased risk for complications including higher rates of in hospital mortality, in-hospital postoperative complications and length of stay. There is special concern about the surgical treatment of closed ankle fractures in the diabetic population due to the belief that there may be a greater risk of infection and complications. Medical literature supports the fact that diabetes mellitus impairs the patient&#39;s immune, renal, vascular and nervous systems leading to chronic complications. A common problem in the diabetic patient is the development of ulcers in the foot and ankle region secondary to sensory deficits. Frequently, these ulcers become infected and jeopardize the prognosis of the affected limb. The problem is accentuated when a bone fracture is involved because altered blood flow to the extremity retards soft tissue hea...

Pocket infection of a cardiac device is usually treated by removing the device and re-implanting it in a new site after complete treatment of the infection. This report illustrates a complicated case of pocket infection in the wake of the implantation of a permanent pacemaker (cardiac resynchronization therapy). The patient was treated conservatively through daily irrigation and dressing, broad-spectrum antibiotics, and debridement without the device being removed; the generator was kept out of the pocket for 5 weeks and then re-implanted in the same location successfully.The method of treatment presented herein can be of value, not least in the elderly population who might experience life-threatening events following the replacement of their cardiac devices.

Retrospective analysis of prospectively collected data. To create a data-driven triage system stratifying patients by likelihood of undergoing spinal surgery within one year of presentation. Low back pain (LBP) and radicular lower extremity (LE) symptoms are common musculoskeletal problems. There is currently no standard data-derived triage process based on information that can be obtained prior to the initial physician-patient encounter to direct patients to the optimal physician type. We analyzed patient-reported data from 8006 patients with a chief complaint of LBP and/or LE radicular symptoms who presented to surgeons at a large multidisciplinary spine center between September 1, 2005 and June 30, 2016. Univariate and multivariate analysis identified independent risk factors for undergoing spinal surgery within one year of initial visit. A model incorporating these risk factors was created using a random sample of 80% of the total patients in our cohort, and validated on the rem...

Different techniques have been proposed for wound treatment including laser, electric therapy, EMF therapy (EMFT), ultrasound (US), magnetic field, etc. Recently, EMFs and US have shown great potential for wound treatment. Despite of several evidences about the beneficial effects of EMF and US in wound healing, no definite dose-response existed on the clinical trials applications of these techniques. In addition, the therapeutic outcomes of these techniques can be influenced by different parameters such as intrinsic properties of living organs as well as physical parameters of stimulations. For further development of EMF and US based treatments for wound healing it is necessary to develop more quantitative assessments for wound healing. This paper aims to provide an comparatively overview of the EMFT and US based techniques for wound healing, and highlight their main procedures and underpinning physical principles exerting therapeutic outcomes background. In addition, it compares their efficacies on wound healing.

Background Herein, we report the development of a novel nanogels (NG) system loaded with Azadirachta indica (A. indica) Adrien-Henri de Jussieu (A. Juss.), commonly known as neem, for possible topical treatment of wound infections. Methods To develop A. indica extract-loaded NG, first, extract-loaded nanoparticles (NPs) were produced using poly-ε-caprolactone (PCL) as the nanocarrier polymer. Secondly, the NPs were entwined in chitosan (CS) hydrogel loaded with the extract of A. indica to prepare the loaded NG system. Blank NG was produced without the extract. The developed NG was characterized, and its antibacterial effect was evaluated. Results Phytochemical screening of ethanolic extract of A. indica leaves indicated the presence of saponins, flavonoids, glycosides, tannins, alkaloids, steroids, terpenoids, and anthraquinones. The characterization data revealed that the developed NG formulations are nanosized in the ranges of 140-440 nm and 190-610 nm for blank NG and A. indica extract-loaded NG, respectively, and have mostly spherical structures. The developed NG formulation displayed pH-dependent swelling and erosion that are in direct proportion to the change in pH. Fourier transform infrared spectroscopy (FTIR) showed various characteristic bands of A. indica and formulation excipients, confirming the encapsulation of the extract. The minimum inhibitory concentration (MIC) of the loaded NG was found to be 0.250 ± 0.05 mg/ ml, 0.625 ± 0.15 mg/mL, and 0.250 ± 0.07 mg/mL for Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Salmonella typhi (S. typhi) strains of bacteria, respectively. The NG formulation exhibited significant bacterial inhibition zones which were recorded as 8 ± 2.0 mm (p < 0.05), 16 ± 3.0 mm (p < 0.05), and 6 ± 1.0 mm (p < 0.05) for S. typhi, E. coli, and S. aureus, respectively, as compared with that produced by the crude extract. Conclusions An A. indica extract-loaded NG was successfully developed, and it demonstrated good formulation features, stability under refrigerated and room temperature conditions, as well as useful antibacterial activity that could be used for potential wound infection treatment.