Periprosthetic joint infection (PJI) is one of the most serious complications following total knee arthroplasty (TKA). The demand for TKA is rapidly increasing, resulting in a subsequent increase in infections involving knee prosthesis. Despite the existence of common management practices, the best approach for several aspects in the management of periprosthetic knee infection remains controversial. This review examines the current understanding in the management of the following aspects of PJI: preoperative risk stratification, preoperative antibiotics, preoperative skin preparation, outpatient diagnosis, assessing for infection in revision cases, improving culture utility, irrigation and debridement, one and two-stage revision, and patient prognostic information. Moreover, ten strategies for the management of periprosthetic knee infection based on available literature, and experience of the authors were reviewed.
Anti-Bacterial Agents ; Arthroplasty ; Debridement ; Diagnosis ; Humans ; Infection Control ; Joints ; Knee Prosthesis ; Knee ; Outpatients ; Reoperation ; Skin

Approximately 15%−25% of breast lymphatic drainage passes through the internal thoracic (internal mammary) lymphatic system, draining the inner quadrants of the breast. This study aimed to use lymphosonography to identify sentinel lymph nodes (SLNs) in the axillary and internal thoracic lymphatic systems in patients with breast cancer. Seventy-nine patients received subcutaneous ultrasound contrast agent injections around the tumor.Lymphosonography was used to identify SLNs. In 14 of the 79 patients (17.7%), the tumor was located in the inner quadrant of the breast. Lymphosonography identified 217 SLNs in 79 patients, averaging 2.7 SLNs per patient. The 217 identified SLNs in the 79 patients were located in the axillary lymphatic system; none were located in the internal thoracic (internal mammary) lymphatic system, although it was expected in two to four patients (i.e., 4–11 SLNs). These results implied that SLNs associated with breast cancer are predominantly located in the axillary lymphatic system.

Introduction: Safety establishments at the workplace play a vital part in preventing ocular injuries in construction industries. Ocular injuries worsens the quality of life of workers, leading to economic loss. The arising of ocular injuries at emergency departments trigger a public health concern in Malaysia. This study aimed to investigate the factors causing ocular injuries among construction workers in Selangor, Malaysia. Methods: A cross-sectional study was conducted on construction workers in Klang Valley, Malaysia. A validated questionnaire evaluated factors consisting of environmental, behaviour and practice domains (α= 0.70 – 0.90) and Reichert Portable Slit Lamp assessed ocular injuries. Results: A total of 385 workers aged 18 to 65 years old completed the study. The prevalence of ocular injuries was 66.20% (n=255 eyes) which includes foreign body injuries (28.20%), subconjunctival haemorrhage (9.20%), corneal haze (4.75%), laceration (1.78%), corneal burn (1.18%) and traumatic cataract (0.29%). Environmental hazards such as dust 70.40% (n=271, p=0.00), chemical 75.80% ( n= 292, p=0.00), heat 68.10% (n=262, p=0.00), equipment 60.5% (n=233, p=0.00), fall 54.80% (n=211, p=0.00) and limited working space 52.70% (n=203, p=0.00) significantly contributed to the ocular injuries. However, behaviour and awareness did not contribute significantly to ocular injuries (p<0.05). Conclusion: This study shows high prevalence of ocular injuries among construction workers in Klang Valley. The main factors causing ocular injuries are environmental factors. Thus, safety assessments including usage of PPE, training and closed monitoring are required to improve the eye safety and health at the construction sites.