prophylactic role of probiotics for preterm neonates

Background: Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults.

Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis which is the leading causes of death in the neonatal intensive care unit

Objective of the Study: was to provide an overview of the controversies regarding probiotic use in preterm infants and to shed light on the practical considerations for implementation of probiotic supplementation

Methods: A Systematic search in the scientific database [Medline, Scopus, EMBASE, and Google Scholer] from 1990 to 2016 was conducted for all relevant retrospective studies including; retrospective, prospective and randomized controlled trials and cohort studies were analyzed and included based on the preset inclusion and exclusion criteria

Results: The search results yielded 16 studies, 12 of which were RCTs with 2340 premature neonates and 4 meta-analyses with 10227 neonates which showed a significantly decreased incidence of Necrotizing Enterocolitis [NEC] [risk ratio, RR = 0.35, 95% confidence interval, 95% CI, 0.23- 0.54; p = 0.0006] and mortality [RR = 0.46, 95% CI, 0.32-0.67; p < 0.0001]

Sepsis did not differ significantly between the two groups [RR = 0.93, 95% CI, 0.76-1.15; p = 0.05]

Conclusion: there is a strong body of evidence supporting that Probiotic supplementation reduces the risk of NEC and mortality in preterm infants yet there is no sufficient evidence to support the optimal strain, dose and timing need further investigation

Reduced Fertility and Fecundity among Patients with Bipolar I Disorder and Schizophrenia in Egypt

OBJECTIVE: To evaluate reproduction among patients with bipolar I disorder (BP1) or schizophrenia (SZ) in Egypt. METHODS: BP1 patients (n=113) were compared with community based, demographically balanced controls (n=124) and SZ patients (n=79, DSM-IV). All participants were evaluated using structured interviews and corroborative data were obtained from relatives. Standard indices of procreation were included in multivariate analyses that incorporated key demographic variables. RESULTS: Control individuals were significantly more likely to have children than BP1 or SZ patients (controls 46.8%, BP1 15.9%, SZ 17.7%), but the BP1-SZ differences were non-significant. The average number of children for BP1 patients (0.37+/-0.9) and SZ patients (0.38+/-0.9) was significantly lower than for controls (1.04+/-1.48) (BP1 vs controls, p<0.001; SZ vs controls, p<0.001). The frequency of marriages among BP1 patients was nominally higher than the SZ group, but was significantly lower than controls (BP1: 31.9% SZ: 27.8% control: 57.3%). Even among married individuals, BP1 (but not SZ) patients were childless more often than controls (p=0.001). The marital fertility, i.e., the average number of children among patients with conjugal relationships for controls (1.8+/-1.57) was significantly higher than BP1 patients (1.14+/-1.31, p=0.02), but not significantly different from SZ patients (1.36+/-1.32, p=0.2). CONCLUSION: Selected reproductive measures are significantly and substantially reduced among Egyptian BP1 patients. The reproductive indices are similar among BP1 and SZ patients, suggesting a role for general illness related variables. Regardless of the cause/s, the impairment constitutes important, under-investigated disability.

Evaluation of laparoscopic trans-abdominal preperitoneal repair of recurrent inguinal hernia

Fifteen adult male patients with recurrent inguinal hernia were treated with laparoscopic transabdominal preperitorteal repair [TAPP]. Controllable intraoperative complications were recorded in 3 patients [20%] with no conversion to open. No major postoperative complications were encountered. The mean operative time was 77.3 minutes. The mean time of ambulation out of the bed was 10.3 hours and the mean hospital stay was 19.8 hours. The mean time to return to usual social activity was 8.5 days. During the short period of follow up [6-24 months] no recurrence was reported. Long term follow up is needed for proper evaluation of this new procedure