human
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: operative site infection is one of the most common complications of obstetrical and gynecological surgeries such as hysterectomy and cesarean section . the use of prophylactic antibiotics in hysterectomy and cesarean section in our hospital is not standardized and is determined by the consultant in charge of the unit . the most commonly used regimens are ciprofloxacin - metronidazole ( cip - met ) and ceftriaxone - metronidazole ( cef - met ) . considering this background , this study was performed to compare the effectiveness of the cip - met regimen versus the cef - met regimen in preventing infection following various obstetrical and gynecological surgeries . this retrospective study was conducted at the obstetrics and gynecology department , guru gobind singh hospital , jamnagar . data of six months ( june 2010 to december 2010 ) were collected . with prior permission , records of 1084 patients who had undergone vaginal or abdominal hysterectomy , laparoscopy , laparotomy , elective or emergency cesarean section were noted . we excluded case records of those patients who had any associated medical illness like diabetes mellitus , chronic obstructive pulmonary disease , etc . we divided the patients into two groups , who were given one of the two regimens : group 1 ( n = 534 ) was given ciprofloxacin 200 mg intravenous infusion 12 - hourly plus metronidazole 500 mg intravenous infusion 8 - hourly for 48 h or till oral intake by patients , followed by tablet ( ciprofloxacin 500 mg 12 - hourly plus metronidazole 400 mg 8 - hourly ) to complete five days treatment . group 2 ( n = 550 ) was given injection ceftriaxone 1 g intravenously daily plus injection metronidazole 500 mg intravenous infusion 8 - hourly for 48 h or till oral intake by patients , followed by tablet ( cefixime 200 mg 12 - hourly plus metronidazole 400 mg 8 - hourly ) to complete five days treatment . the records of patients were checked for occurrence of wound infection in the postoperative period . wound infection rates were analyzed statistically by fisher 's exact test and yates continuity corrected chi - square test using graphpad prism version 5.01 software . out of the total 1084 case records , the distribution of patients according to type of surgery such as cesarean section , laparoscopy , hysterectomy and laparotomy is listed in table 1 . the age for obstetrics patients in our study ranged from 18 - 40 years , while for gynecology patients the age was up to 60 years . incidence of postoperative wound infections in obstetric and gynecological surgeries is recorded in table 3 . while the overall infection rate of all the surgical procedures in both the groups was 3.6 % ( 39 infections in 1084 patients ) , the infection rates in group 1 and group 2 were 5.81 % ( 31 infections in 534 patients ) and 0.7 % ( eight infections in 550 patients ) respectively ( p = 0.0001 , confidence interval ( ci ) 95 % 1.909.17 , odds ratio 4.18 ) . comparative analysis of the total duration , cost and adverse events of antimicrobial therapy is summarized in table 4 . distribution of patients according to the type of surgery analysis of risk factors for infections ( n = 1084 ) incidence of postoperative wound infections in obstetric and gynecological surgeries comparative analysis of the total duration , cost and adverse events of antimicrobial therapya number of studies indicate that chemoprophylaxis can be justified in dirty or contaminated surgical procedures , where the incidence of wound infection is high and these include less than 10 % of all surgical procedures . postoperative infection in surgical sites in obstetric and gynecological settings has been higher as compared to other specialties because of the contaminated nature of most obstetric and gynecological procedures . consideration of prophylactic antibiotics has been suggested for all elective cesarean deliveries in which the combined incidence of endometritis and wound infection exceeds 5 % . a recent review of the literature concluded that a narrow spectrum agent prior to incision or an extended spectrum regimen ( with metronidazole ) after cord clamp offers the best outcome for patients in cesarean deliveries . nowadays ciprofloxacin - metronidazole and cephalosporin - metronidazole combinations are chosen by surgeons to prevent wound infection following major abdominal surgical procedures . in our study , it was observed that the rate of postoperative infection was significantly higher in group 1 than group 2 ( p = 0.0001 ) . this might be due to development of resistance to ciprofloxacin by anaerobes which are the potential pathogens in the vaginal flora . on the other hand , low incidence of postoperative infection seen in group 2 in our study might be attributed to the effectiveness of third - generation cephalosporins in mixed aerobic - anaerobic infections . postoperative infection is not only dependent on antibiotic use but also on many other factors , such as age , nutritional status , hygienic condition , anemic status , duration of operation , blood loss during operation and amount of blood transfusion . in the present studya greater number of infections ( 26 out of 39 ) were observed in those operations in which the average duration of surgery was between 30 - 120 min ( p 0.0001 ) . the surgeries in which all operative wound infections were recorded ( i.e. 39 ) , were performed within 120 min . it was also observed that the majority of the infections ( 34 out of 39 ) were found in patients of low socioeconomic status ( p = 0.043 ) . similarly , a higher rate of infections ( 33 out 39 ) were noted in patients who were anemic ( p = 0.023 ) [ table 2 ] . therefore , it could be surmised that prolonged duration of surgery , lower socioeconomic status of the patient and anemia were also responsible for development of infections in our study . thirteen and nine cases of mild nausea and vomiting were reported in group 1 and group 2 respectively . these adverse events found in our study most likely could be due to metronidazole therapy . adopting a cost - effective regimen would save hospital time and days of bed occupancy . for a patient , this would prevent pain and anxiety associated with infection . it will also prevent the loss of time and the loss of daily earnings by reducing the hospital stay of the patient . this retrospective study indicates that though the cip - met regimen was slightly more cost - effective ( difference of indian rupees 10.00 ) , the rate of postoperative infection which was the primary concern was significantly higher with this regimen . this suggests that the cef - met regimen was better than the cip - met regimen to control operative site wound infection rates in obstetrical and gynecological surgeries . hence , ceftriaxone should be a part of the essential medicine formulary of the hospital .
output:

agent
objective : to compare the effectiveness of the ciprofloxacin - metronidazole ( cip - met ) regimen with the ceftriaxone - metronidazole ( cef - met ) regimen for operative site infection control in women undergoing obstetrical and gynecological surgeries.materials and methods : one thousand and eighty - four case records of women who had undergone various obstetrical and gynecological surgeries who were given cip - met regimen and cef - met regimen were analyzed in predesigned and pretested proforma . patients who were given cip - met regimen and cef - met regimen were classified as group 1 and group 2 respectively . the mode of administration of both the regimens was noted . numbers of wound infections were recorded in the respective groups . socioeconomic status and hemoglobin level of the patients were noted . other data such as hospital stay , duration of operation were also noted.results : out of a total of 1084 case records , 31 ( 5.8 % ) and eight ( 0.7 % ) patients contracted wound infections in group 1 and group 2 respectively ( p = 0.0001 ) . conclusion : the cef - met regimen was found superior to the cip - met regimen to control operative site infection in obstetrical and gynecological surgeries .
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: operative site infection is one of the most common complications of obstetrical and gynecological surgeries such as hysterectomy and cesarean section . the use of prophylactic antibiotics in hysterectomy and cesarean section in our hospital is not standardized and is determined by the consultant in charge of the unit . the most commonly used regimens are ciprofloxacin - metronidazole ( cip - met ) and ceftriaxone - metronidazole ( cef - met ) . considering this background , this study was performed to compare the effectiveness of the cip - met regimen versus the cef - met regimen in preventing infection following various obstetrical and gynecological surgeries . this retrospective study was conducted at the obstetrics and gynecology department , guru gobind singh hospital , jamnagar . data of six months ( june 2010 to december 2010 ) were collected . with prior permission , records of 1084 patients who had undergone vaginal or abdominal hysterectomy , laparoscopy , laparotomy , elective or emergency cesarean section were noted . we excluded case records of those patients who had any associated medical illness like diabetes mellitus , chronic obstructive pulmonary disease , etc . we divided the patients into two groups , who were given one of the two regimens : group 1 ( n = 534 ) was given ciprofloxacin 200 mg intravenous infusion 12 - hourly plus metronidazole 500 mg intravenous infusion 8 - hourly for 48 h or till oral intake by patients , followed by tablet ( ciprofloxacin 500 mg 12 - hourly plus metronidazole 400 mg 8 - hourly ) to complete five days treatment . group 2 ( n = 550 ) was given injection ceftriaxone 1 g intravenously daily plus injection metronidazole 500 mg intravenous infusion 8 - hourly for 48 h or till oral intake by patients , followed by tablet ( cefixime 200 mg 12 - hourly plus metronidazole 400 mg 8 - hourly ) to complete five days treatment . the records of patients were checked for occurrence of wound infection in the postoperative period . wound infection rates were analyzed statistically by fisher 's exact test and yates continuity corrected chi - square test using graphpad prism version 5.01 software . out of the total 1084 case records , the distribution of patients according to type of surgery such as cesarean section , laparoscopy , hysterectomy and laparotomy is listed in table 1 . the age for obstetrics patients in our study ranged from 18 - 40 years , while for gynecology patients the age was up to 60 years . incidence of postoperative wound infections in obstetric and gynecological surgeries is recorded in table 3 . while the overall infection rate of all the surgical procedures in both the groups was 3.6 % ( 39 infections in 1084 patients ) , the infection rates in group 1 and group 2 were 5.81 % ( 31 infections in 534 patients ) and 0.7 % ( eight infections in 550 patients ) respectively ( p = 0.0001 , confidence interval ( ci ) 95 % 1.909.17 , odds ratio 4.18 ) . comparative analysis of the total duration , cost and adverse events of antimicrobial therapy is summarized in table 4 . distribution of patients according to the type of surgery analysis of risk factors for infections ( n = 1084 ) incidence of postoperative wound infections in obstetric and gynecological surgeries comparative analysis of the total duration , cost and adverse events of antimicrobial therapya number of studies indicate that chemoprophylaxis can be justified in dirty or contaminated surgical procedures , where the incidence of wound infection is high and these include less than 10 % of all surgical procedures . postoperative infection in surgical sites in obstetric and gynecological settings has been higher as compared to other specialties because of the contaminated nature of most obstetric and gynecological procedures . consideration of prophylactic antibiotics has been suggested for all elective cesarean deliveries in which the combined incidence of endometritis and wound infection exceeds 5 % . a recent review of the literature concluded that a narrow spectrum agent prior to incision or an extended spectrum regimen ( with metronidazole ) after cord clamp offers the best outcome for patients in cesarean deliveries . nowadays ciprofloxacin - metronidazole and cephalosporin - metronidazole combinations are chosen by surgeons to prevent wound infection following major abdominal surgical procedures . in our study , it was observed that the rate of postoperative infection was significantly higher in group 1 than group 2 ( p = 0.0001 ) . this might be due to development of resistance to ciprofloxacin by anaerobes which are the potential pathogens in the vaginal flora . on the other hand , low incidence of postoperative infection seen in group 2 in our study might be attributed to the effectiveness of third - generation cephalosporins in mixed aerobic - anaerobic infections . postoperative infection is not only dependent on antibiotic use but also on many other factors , such as age , nutritional status , hygienic condition , anemic status , duration of operation , blood loss during operation and amount of blood transfusion . in the present studya greater number of infections ( 26 out of 39 ) were observed in those operations in which the average duration of surgery was between 30 - 120 min ( p 0.0001 ) . the surgeries in which all operative wound infections were recorded ( i.e. 39 ) , were performed within 120 min . it was also observed that the majority of the infections ( 34 out of 39 ) were found in patients of low socioeconomic status ( p = 0.043 ) . similarly , a higher rate of infections ( 33 out 39 ) were noted in patients who were anemic ( p = 0.023 ) [ table 2 ] . therefore , it could be surmised that prolonged duration of surgery , lower socioeconomic status of the patient and anemia were also responsible for development of infections in our study . thirteen and nine cases of mild nausea and vomiting were reported in group 1 and group 2 respectively . these adverse events found in our study most likely could be due to metronidazole therapy . adopting a cost - effective regimen would save hospital time and days of bed occupancy . for a patient , this would prevent pain and anxiety associated with infection . it will also prevent the loss of time and the loss of daily earnings by reducing the hospital stay of the patient . this retrospective study indicates that though the cip - met regimen was slightly more cost - effective ( difference of indian rupees 10.00 ) , the rate of postoperative infection which was the primary concern was significantly higher with this regimen . this suggests that the cef - met regimen was better than the cip - met regimen to control operative site wound infection rates in obstetrical and gynecological surgeries . hence , ceftriaxone should be a part of the essential medicine formulary of the hospital .
output:
