Significance of fermented rice beverage on management of antibiotic associated diarrhea (AAD) on Wistar rats

Antibiotic associated diarrhoea (AAD) is caused mostly by disruption of the physiological gut microflora. One potential strategy to prevent this is the concurrent use of probiotic bacteria or yeast. Tribal populations of West Garo Hill region of Meghalaya use locally available unique microflora to prepare fermented food products whichserve as a potential source of novel probiotic organisms and bioactive compounds. In this context, here, we have evaluated the potentiality of laboratory made functional fermented rice beverage in mitigating AAD on animal models viz. Wistar rats. The animal models were administered with fermented rice beverage (test group A1), combination of indigenous Lactobacillus isolates (test group A2), a yeast isolate (test group A3), loperamide (test group STD), normal control (test group NC) and disease control (test group DC). Furthermore, various diarrhea assessment parameters were checked from each group followed by analysis of fecal microbiome, haematological parameters, histopathology of colon, liver and cecal short chain fatty acids (SCFAs) determination. NC and A1 was least affected by AAD induction with a faecal consistency score of 1 on the final day of the study. After day 10, a significant reduction (P <0.05) in the faecal water content was observed in A1, A2 and STD till day 15. Compared to the NC, a slight decrease in body weight was found in the rest of five test groups at day 5, 10 and 15. Except NC, the remaining five test groups showed a significant decrease of lactobacilli and yeast counts in faecal microbiota at 5th day. An increase in the enterococci and coliform counts indicated severe diarrheal condition but A1 reported with significant increase (P <0.05) in the population of Lactobacillus at day 15. An increase in red blood corpuscles, haemoglobin, packed cell volume, mean cell haemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration was observed. During the histopathology analysis of colon and liver, normal layers of mucosa, submucosa, muscularis and serous with absence of any abnormal changes or lesions was seen in A1. The cecal concentrations of lactate, acetate and propionate were significantly higher in A1 as compared to the other test groups. Therefore, fermented rice beverage possesses potential to be used in inhibition of antibiotic associated diarrhea with further clinical investigations.

Rupture of the triceps tendon - A case series / 中华创伤杂志(英文版)

Triceps rupture is the least common among all tendon injuries. The usual mechanism of injury is a fall on an outstretched hand, although direct contact injuries have also been reported to cause this injury. The diagnosis of acute triceps tendon rupture may be missed, which can result in prolonged disability and delayed operative management. We presented three cases of acute triceps tendon rupture each at different site showing the spectrum of injury to the muscle and mechanism of injury and management were also discussed.

Kojic Acid Peptide: A New Compound with Anti-Tyrosinase Potential

BACKGROUND: Kojic acid was used for decades in the cosmetic industry as an antimelanogenic agent. However, there are two major drawbacks of Kojic acid, one is cytotoxicity and second are instability on storage. These limitations led the scientist to synthesize the active Kojic acid peptides. OBJECTIVE: In the present study, we synthesize and investigate the effect of five Kojic acid peptides to overcome the limitation of Kojic acid. METHODS: The peptide was analyzed and purified by high-performance liquid chromatography and matrix-assisted laser desorption ionization time of flight mass spectroscopy. Further, the tyrosinase activities of the Kojic acid and Kojic acid peptides were compared. The toxicity was measured and the melanin content is recorded in B16F10 mouse melanoma cells. RESULTS: Maximum tyrosinase activity was measured by Kojic acid peptides. Therefore, Kojic acid peptides were subjected to melanin assay and cytotoxicity assay and finally the stability of the Kojic acid peptide was measured. CONCLUSION: It was observed that this newly synthesized Kojic acid peptide is stable and potent to inhibit the tyrosinase activity and melanin content of B16F10 mouse melanoma cells without exhibiting cell toxicity. Together, these preliminary results suggest that a further exploration is being needed to establish Kojic acid peptide as antimelanogenic agent.

Triple plating of tibia in a complex bicondylar tibial plateau fracture / 中华创伤杂志(英文版)

High-energy tibial plateau fracture poses a significant challenge and difficulty for orthopaedic surgeons. Fracture of tibial plateau involves major weight bearing joint and may alter knee kinematics. Anatomic reconstruction of the proximal tibial articular surfaces, restoration of the limb axis (limb alignment) and stable fixation permitting early joint motion are the goals of the treatment. In cases of complex bicondylar tibial plateau fractures, isolated lateral plating is frequently associated with varus malalignment and better results have been obtained with bilateral plating through dual incisions. However sometimes a complex type of bicondylar tibial plateau fractures is encountered in which medial plateau has a biplaner fracture in posterior coronal plane as well as sagittal plane. In such fractures it is imperative to fix the medial plateau with buttressing in both planes. One such fracture pattern of the proximal tibia managed by triple plating through dual posteromedial and anterolateral incisions is discussed in this case report with emphasis on mechanisms of this type of injury, surgical approach and management.

Complete palmer lunate enucleation---is proximal row carpectomy or wrist arthrodesis the only choice? / 中华创伤杂志(英文版)

Perilunate dislocations are rare injuries of the wrist and complete dislocation of the lunate is also rare. There is controversy in literature regarding the optimal management of such injuries. Complete lunate enucleation is associated with high rate of osteonecrosis of lunate thus wrist arthrodesis or proximal row carpectomy has been advocated as primary treatment for such injuries. We report a case of transradial styloid complete palmar lunate enucleation in a 25-year-old male patient who sustained injury to the left wrist due to fall on outstretched hand. Carpal row salvage surgery initially by closed reduction and wrist distractor application followed by open reduction and internal fixation with K-wires along with ligamentous repair resulted in restoration of normal wrist anatomy and good functional outcome. As many of these injuries are missed on initial presentation and outcome is poor for missed injuries, prompt diagnosis and early surgical management to restore vascularity of lunate is recommended.

A reliable auditing of postop complication in gastric cancer surgery / 国际外科学杂志

Background Auditing of surgical outcome is controversial due to lack of standard auditing system. POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and mortality)system provides a risk adjusted auditing in surgical practice, which is a reliable scoring system. However it has not been generalized in China, especially in gastric surgery. Present study evaluates the application of POSSUM system to compare surgical outcome of malignant gastric disease between specialized unit and general unit. Methods Retrospective study was performed on 394 patients who underwent surgical intervention for gastric cancer and malignant gastric lymphoma. POSSUM data were collected according to standard criteria described by its original authors. Exponential analysis method was used for data analysis. Observed to Expected morbidity (O:E) ratio was calculated for each unit to give risk adjusted comparison. All the complications were categorized into minor to severe to give an objective view of complications. Results There was significant difference in surgical outcome between specialized unit and general unit. POSSUM predicted morbidity well and O: E ratio of specialized unit was better than general unit. Further more postop stay wassignificantly shorter(P ＜0.001 ) in specialized unit and number of moderate and severe morbidity was significantly lower (P＜0.001) than general unit. Conclusions Surgical outcome of specialized unit was better than general unit. POSSUM can be used for risk adjusted auditing of postop complications in malignant gastric disease, which provides a reliable audit. However morbidity definition in POSSUM should be amended and modification in POSSUM formula may be necessary to fit major surgical interventions like gastric cancer surgery.

Measles outbreak in a vaccinated population in Dhankutta.

A measles outbreak occurred in Dhankutta town in year 2056 Falgun to 2057 Baishak (3 months). A total of 130 cases were registered at the Dhankutta District Hospital. A large proportion of the cases had severe disease with complications and were admitted at the hospital. None of the patients registered at the hospital died. Interestingly, 50.0% of cases were in higher age group (10 years and above) which is an unusual trend in developing countries. All the cases gave history of measles vaccination, which points towards the need for investigation of vaccine efficacy and cold chain efficiency.