title: A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis.
abstract: OBJECTIVE
  Talc is an effective and widely used agent for chemical pleurodesis. However, limited availability and high cost hamper the routine use of talc in resource poor countries. In this study, we compared the efficacy and safety of iodopovidone with that of cosmetic talc, for chemical pleurodesis.
  
  
  METHODS
  Patients with recurrent pleural effusions and/or spontaneous pneumothorax were prospectively randomized to undergo pleurodesis with cosmetic talc (5g) or iodopovidone (20mL of a 10% solution) by tube thoracostomy. The cosmetic talc was pretested for impurities (asbestos-free) and particle size (20-60µm), using energy dispersive analysis by X-ray and scanning electron microscopy. The success rate (complete or partial), time to pleurodesis and safety of these two agents was compared.
  
  
  RESULTS
  Pleurodesis was performed in 73 patients (39 with iodopovidone, 34 with cosmetic talc; 56 men, 17 women; mean age 51.7 years; 38 pleural effusions, 35 pneumothoraces). A complete response was obtained in all patients with pneumothorax in both the iodopovidone and talc groups. Among patients with pleural effusions, a complete response was observed in 16/19 and 15/19 patients in the iodopovidone and talc groups, respectively. A partial response was observed in two additional patients from each group. The time to pleurodesis was similar in the two groups. Minor side-effects (fever, chest pain) were observed with similar frequencies in the two groups. None of the patients experienced hypotension or ARDS.
  
  
  CONCLUSIONS
  Iodopovidone and cosmetic talc are equally efficacious and safe agents for chemical pleurodesis.
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. riteshpgi@gmail.com
authors: Ritesh
authors: R
authors: Agarwal
authors: Abinash S
authors: AS
authors: Paul
authors: Ashutosh N
authors: AN
authors: Aggarwal
authors: Dheeraj
authors: D
authors: Gupta
authors: Surinder K
authors: SK
authors: Jindal