Wilkie’s syndrome: Laparoscopic management – A case report with review of the literature

Superior mesenteric artery (SMA) syndrome also known as Wilkie’s Syndrome is a rare condition characterized by symptoms of small bowel obstruction. It is caused when the angle between the SMA and aorta, also known as the aorto-mesenteric angle, reduces to <25° which, in turn, causes the compression of the third part of the duodenum which traverses between the SMA and the aorta. We, herein, present the case of a 31-year-old female who was diagnosed to have Wilkie’s syndrome. Failing a trial of conservative management, she was ultimately definitively managed by surgery.

A Comparative Clinical, Microbiological and Biochemical Evaluation of Guided Periodontal Pocket Recolonisation (GPR) using Synbiotics as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis: A Pilot Project

Background: With increase in the resistance to antibiotics, the paradigm of periodontal treatment in recent years is slowly shifting from specific bacteria elimination to altering bacterial ecology by probiotics. With this objective in mind, the present study was carried out to assess the use of a symbiotic preparation as a guided pocket recolonisation (GPR) procedure in patients with chronic periodontal disease. Materials and methods: Total 180 patients with chronic periodontitis with presence of true periodontal pockets; 4 mm-6 mm in depth involving minimum 3 or more quadrants were selected and divided into 3 groups wherein the first group only scaling and root planing was done without GPR application; in the 2nd group, GPR was carried out as a single application following SRP and in the 3rd group, multiple applications of GPR with SRP was done. Clinical measurements; microbiological analysis of periodontal pathogens by anaerobic culture and biochemical assessment of alkaline phosphatase and interleukin-6 using ELISA and spectrophotometry was carried out at baseline, 3 and 6 months respectively. Results: All the 3 groups showed significant changes in clinical (p<0.05) as well as in microbiological and biochemical parameters (p<0.05) within the groups. Intergroup comparisons revealed significant changes in group 2 and 3 with biochemical parameters. Positive correlation was observed with clinical parameters and alkaline phosphatase levels and P. intermedia counts in group 1 and 3. Conclusion: Within the limitations of the present study, it could be concluded that symbiotic therapy may have some additional benefit to Scaling and root planing.