ABSTRACT
Objectives: Stroke is a medical emergency, the leading cause of death, and a significant cause of disability in developing countries. The primary goals of stroke management focus on reducing disability, which needs prompt treatment in time. Fever, sugar-hyperglycemia, and swallowing (FeSS) bundle are a promising nurse-led composite for reducing disability and death. The present study aims to assess the effect of FeSS bundle care on disability, functional dependency, and death among acute stroke patients. Materials and Methods: A randomized controlled trial was conducted among 104 acute stroke patients, who were admitted within the first 48 h of stroke symptoms and had no previous neurological deficits. Randomization was stratified based on gender and type of stroke. The intervention group received FeSS bundle care, which included nurse-led fever and sugar management for the first 72 h, and a swallowing assessment done within the first 24 h or before the first oral meal. A follow-up assessment was done after 90 days to assess the disability, functional dependency, and mortality status using a modified Rankin scale and Barthel index. Results: No significant difference was noted in the 90-day disability and functional dependency between the groups. A reduction in mortality was noted in the intervention group. The risk ratio for mortality between groups was 2.143 (95% confidence interval: 0.953-4.820). Conclusion: Although no significant reduction in disability, there was a reduction in mortality in the intervention group. Hence, the study suggested the promotion of nurse-led intervention using the FeSS bundle in stroke units.
ABSTRACT
AIM: The aim of this study was to evaluate the antifungal efficacy of a novel endodontic irrigant octenidine against conventional irrigants sodium hypochlorite and EDTA on Candida albicans growth in the young and old population by calculating the number of colonies formed and by qualitative identification of dead/viable fungi by Confocal laser scanning microscopy (CLSM) method. MATERIALS AND METHODS: The total number of samples used in the study was eighty samples after decoronation of the crown portion the middle third of root canal. Each group was subdivided into four subgroups with various irrigation protocols: (A) 17% EDTA + 5.25% NaOCl, (B) 100% Octenisept, (C) 17% EDTA + 5.25% NaOCl + 1% clotrimazole, and (D) phosphate buffer saline. After completion of irrigation ATCC samples (90028) of C. albicans were inoculated with 5 mL of peptone water each and incubated at 37°C for 72 hours to attain the turbidity corresponding to 0.5 McFarland standards CFU. Eight samples were analyzed for the formation of candidal colonies, and two samples for the assessment of viability of Candida by confocal laser scanning microscope in each subgroup. RESULTS: Comparison of antifungal efficacy of endodontic irrigants employed in the young and old populations revealed a significant reduction in the mean values of CFU and the mean values of percentage of non-viable microorganism by CLSM method. A positive relationship was revealed in the younger population which had a better antifungal efficacy than the older population in all the irrigant subgroups evaluated in the study. CONCLUSION: All the endodontic irrigants employed in our study had a good antifungal efficacy against Candida albicans. Octenisept had a maximum antifungal efficacy, while phosphate saline showed the least efficacy in both age groups, which was quantitatively evaluated by CFU method, and the same was confirmed through qualitative evaluation by CLSM method. CLINICAL SIGNIFICANCE: Candida albicans plays a major role in the establishment and pathogenesis of failed root canal treatment. Age-related changes alter the adhesion potential of dentin, in turn influence the outcome of endodontic therapy. Octenidine, a novel antifungal agent, can be substituted over the conventionally used EDTA and NaOCl with less adverse effects.
