Search

Background and purpose: Preventing ventilator-associated pneumonia (VAP) as one of the most common and also the most fatal complications caused by intubation and mechanical ventilation in intensive care units (ICU) has always been emphasized in countless studies. Chlorhexidine mouthwash is commonly used as a gold standard in the control of dental plaques and prevention of VAP. Given the increasing prevalence of gram-negative infections due to resistance to commonly used antibiotics and the associated complications, this study aimed to investigate and compare the impact of tea tree oil/aloe vera herbal mouthwash, known for its antibacterial and anti-inflammatory properties, on the occurrence of ventilator-associated pneumonia. Materials and methods: This study is a double-blind randomized clinical trial. 62 intubated patients, aged from 16 to 65 and hospitalized in the intensive care units of Hazrat Waliasr Hospital in Arak City in 2023, were assigned using a simple randomization method in two interventions (tea tree oil/aloe vera mouthwash) and control groups (chlorhexidine mouthwash). Mouthwash bottles were covered before distribution. None of the patients, colleagues (nurses), and the specialist determining the final result of the study were aware of the allocation of patients in the intervention or control group. Oral care in both groups was performed by washing hands, wearing gloves, evaluating the mouth condition, adjusting the pressure of the endotracheal tube cuff (20-30 Cm.H2O), brushing with a soft toothbrush, mouthwash twice daily and open suctioning of oral and subglottic secretions. Lastly, at intervals of 3 days (to assess the incidence of early VAP) and 7 days (to assess the incidence of late VAP) after the intervention, the modified clinical pulmonary infection score (MCPIS) was calculated and a score greater than or equal to 6 was considered as a diagnosis of pneumonia. This tool has been utilized in similar studies and its validity and reliability have been confirmed. Eventually, the data was statistically analyzed using the chi-square test, independent t-test, and repeated measures test to investigate the effect of the intervention over time with SPSS version 20 software. Results: According to the results, 64.5% of the participants were male and 35.5% of them were female. There was no statistically significant difference between the two groups in terms of average age, gender, reason for admission, history of underlying diseases, invasive interventions, average number of drugs and antibiotics, type and amount of nutrition, and duration of mechanical ventilation. The incidence of early-onset pneumonia was 9.7% in the intervention group and 12.9% in the control group. Although the incidence was lower in the intervention group, there was no statistically significant difference between the two groups (P-value=0.99). The incidence of late-onset pneumonia in the intervention group was 12.9% and 16.1% in the control group. Despite of lower incidence of late-onset pneumonia in the intervention group, there was no statistically significant difference (P-value=1.00). Moreover, according to the results of Bonferroni's paired comparisons test, the difference in the average MCPIS score between 3 days and 7 days later in the intervention group was not significant and did not increase significantly (P-value=0.06), which means that in this group, the effect of the intervention can be seen at this time. Conclusion: Oral care using tea tree oil/aloe vera mouthwash or 0.2% chlorhexidine has no preference or significant advantage over each other, and both can be effective in reducing ventilator-associated pneumonia. Considering the lower incidence of early and late pneumonia in the intervention group, it is recommended to conduct studies with a larger sample size and also use accurate oral assessment tools to confirm the removal of dental plaque (plaque score) in this population of patients. (Clinical Trials Registry Number: IRCT20210104049936N1)

Background and purpose: Preventing ventilator-associated pneumonia (VAP) as one of the most common and also the most fatal complications caused by intubation and mechanical ventilation in intensive care units (ICU) has always been emphasized in countless studies. Chlorhexidine mouthwash is commonly used as a gold standard in the control of dental plaques and prevention of VAP. Given the increasing prevalence of gram-negative infections due to resistance to commonly used antibiotics and the associated complications, this study aimed to investigate and compare the impact of tea tree oil/aloe vera herbal mouthwash, known for its antibacterial and anti-inflammatory properties, on the occurrence of ventilator-associated pneumonia. Materials and methods: This study is a double-blind randomized clinical trial. 62 intubated patients, aged from 16 to 65 and hospitalized in the intensive care units of Hazrat Waliasr Hospital in Arak City in 2023, were assigned using a simple randomization method in two interventions (tea tree oil/aloe vera mouthwash) and control groups (chlorhexidine mouthwash). Mouthwash bottles were covered before distribution. None of the patients, colleagues (nurses), and the specialist determining the final result of the study were aware of the allocation of patients in the intervention or control group. Oral care in both groups was performed by washing hands, wearing gloves, evaluating the mouth condition, adjusting the pressure of the endotracheal tube cuff (20-30 Cm.H2O), brushing with a soft toothbrush, mouthwash twice daily and open suctioning of oral and subglottic secretions. Lastly, at intervals of 3 days (to assess the incidence of early VAP) and 7 days (to assess the incidence of late VAP) after the intervention, the modified clinical pulmonary infection score (MCPIS) was calculated and a score greater than or equal to 6 was considered as a diagnosis of pneumonia. This tool has been utilized in similar studies and its validity and reliability have been confirmed. Eventually, the data was statistically analyzed using the chi-square test, independent t-test, and repeated measures test to investigate the effect of the intervention over time with SPSS version 20 software. Results: According to the results, 64.5% of the participants were male and 35.5% of them were female. There was no statistically significant difference between the two groups in terms of average age, gender, reason for admission, history of underlying diseases, invasive interventions, average number of drugs and antibiotics, type and amount of nutrition, and duration of mechanical ventilation. The incidence of early-onset pneumonia was 9.7% in the intervention group and 12.9% in the control group. Although the incidence was lower in the intervention group, there was no statistically significant difference between the two groups (P-value=0.99). The incidence of late-onset pneumonia in the intervention group was 12.9% and 16.1% in the control group. Despite of lower incidence of lateonset pneumonia in the intervention group, there was no statistically significant difference (P-value=1.00). Moreover, according to the results of Bonferroni's paired comparisons test, the difference in the average MCPIS score between 3 days and 7 days later in the intervention group was not significant and did not increase significantly (P-value=0.06), which means that in this group, the effect of the intervention can be seen at this time. Conclusion: Oral care using tea tree oil/aloe vera mouthwash or 0.2% chlorhexidine has no preference or significant advantage over each other, and both can be effective in reducing ventilator-associated pneumonia. Considering the lower incidence of early and late pneumonia in the intervention group, it is recommended to conduct studies with a larger sample size and also use accurate oral assessment tools to confirm the removal of dental plaque (plaque score) in this population of patients. [ABSTRACT FROM AUTHOR]

Objective: One of the most typical ways of transmitting the infection is by hand; thus, much emphasis has been placed on hand hygiene. In this regard, this study aimed to determine the effect of tea tree oil and lavender on bacterial samples found in nurses’ hands. Methods: This quasi-experimental study was performed on all nurses working in ICU wards. The samples were selected by an easy non-probability sampling method. The research tools were demographic information questionnaires and a bacterial culture registration form. In the intervention phase, on the first day in the first experimental group, 2 drops of lavender oil, on the second day, 2 drops of tea tree oil, and on the third day, 2 drops of distilled water were poured on the nurse’s palm, and their hands were massaged for 10 seconds. Before and after the intervention, culture samples were taken from each group. The obtained data were analyzed with the Chi-square test, paired t test, and ANOVA in SPSS software v. 20 at a significant level of less than 0.05. Results: The most common organisms isolated at the beginning of the study were Staphylococcus epidermidis (76.8%), Staphylococcus aureus (8.8%), Klebsiella spp. (7.9%), and Escherichia coli (6.5%). The use of lavender oil and tea tree has been effective in reducing the microbial load of the palm. Hand massage with lavender oil had less effect on reducing germs (P=0.003), but tea tree oil had a more significant reduction of pathogens (P=0.001). Conclusion: Lavender and tea tree oil reduced the microbial load of nurses. Both methods have been effective, but the effect of tea tree oil was more significant. Therefore, their use in handwashing is recommended to eliminate palm bacteria in ICU staff.

Background: Leishmania is a trypanosomatid protozoan which is transmitted by the female Phlebotomus sand fly. Leishmaniasis is prevalent in four continents and is considered to be endemic in 88 countries, 72 of which are developing countries. It is estimated that it’s global prevalence and incidence is 12 millions and 500 thousands respectively. The recommended drugs used for the treatment of this disease are mainly ineffective, toxic and exhibit many side effects. Based on some studies,tea tree oil that is a yellow color liquid with spicy odor exhibit antibacterial and antifungal activity, so, we evaluated it’s anti-leishmanial effect. Materials and Methods: Tea tree oil was purchased from Dr Jahangiri pharmaceutical company and it’s various concentrations (mg/ml800, mg/ml400, mg/ml200, mg/ml100) were prepared in 1ml volume of TSB solvent in 15ml test tubes, then 9 ml of RPMI-1640 medium and 1×106 promastigotes was added to each tube, as a final volume of 10 ml. These tubes were incubated at 23o c for 72 hours and number of parasites in the first 6 hours once every hour and after that every 24 hours were counted by hemocytometer. Results: Lethal dose of tea tree oil for 50% of promastigotes ( IC50 ) is 337 mg/ml, while the 800 mg/ml of this extract can killed 95% of the parasites after 24 hours of incubation, and it’s lower concentrations of this extract showed dose-dependent leishmanicidal activity. Glucantime as positive control drug at concentration of 300 mg/ml killed all the promastigotes, while the number of promastigotes in negative control tubes was increase during the incubation period. Conclusion: Anti-Leishmanial activity of tea tree oil with IC50 of 337 mg/ml and 95% lethality of 800 mg/ml is promising and further study for analyse the active ingredients of this oil and evaluation of it’s anti-leishmanial effect, particularly in laboratory animal is recommended.

Background: Leishmania is a trypanosomatid protozoan which is transmitted by the female Phlebotomus sand fly. Leishmaniasis is prevalent in four continents and is considered to be endemic in 88 countries, 72 of which are developing countries. It is estimated that it's global prevalence and incidence is 12 millions and 500 thousands respectively. The recommended drugs used for the treatment of this disease are mainly ineffective, toxic and exhibit many side effects. Based on some studies,tea tree oil that is a yellow color liquid with spicy odor exhibit antibacterial and antifungal activity, so, we evaluated it's anti-leishmanial effect. Materials and Methods: Tea tree oil was purchased from Dr Jahangiri pharmaceutical company and it's various concentrations (mg/ml800, mg/ml400, mg/ml200, mg/ml100) were prepared in 1ml volume of TSB solvent in 15ml test tubes, then 9 ml of RPMI-1640 medium and 1×106 promastigotes was added to each tube, as a final volume of 10 ml. These tubes were incubated at 23o c for 72 hours and number of parasites in the first 6 hours once every hour and after that every 24 hours were counted by hemocytometer. Results: Lethal dose of tea tree oil for 50% of promastigotes ( IC50 ) is 337 mg/ml, while the 800 mg/ml of this extract can killed 95% of the parasites after 24 hours of incubation, and it's lower concentrations of this extract showed dose-dependent leishmanicidal activity. Glucantime as positive control drug at concentration of 300 mg/ml killed all the promastigotes, while the number of promastigotes in negative control tubes was increase during the incubation period. Conclusion: Anti-Leishmanial activity of tea tree oil with IC50 of 337 mg/ml and 95% lethality of 800 mg/ml is promising and further study for analyse the active ingredients of this oil and evaluation of it's anti-leishmanial effect, particularly in laboratory animal is recommended. [ABSTRACT FROM AUTHOR]