Is Regular Probiotic Practice Safe for Management of Sepsis? / 中国结合医学杂志

For decades, the gut has been thought to play an important role in sepsis pathogenesis. Sepsis is a serious life-threatening, chronic condition of an infection caused by dysregulated host immune response in most of the intensive care unit patients. Probiotics have dual roles in polymicrobial sepsis i.e. probiotics may induce sepsis in many cases and may prevent its prognosis in many cases. Experimental evidence from both pre-clinical and clinical studies have demonstrated that probiotic therapy ameliorates various inflammatory mediators such as tumor necrosis factor, interleukin-10 (IL-10), IL-6, etc., in septicemia. In addition, probiotic use was also found to reduce the severity of pathological conditions associated with irritable bowel disorder and prevent development of endocarditis in septicemia. On contrary, probiotic therapy in neonatal and athymic adult mice fail to provide any beneficial effects on mortality and sepsis-induced inflammation. Importantly, in few clinical trials probiotic use was found to aggravate sepsis by promoting inflammatory cascade rather than suppressing it. This review discusses various studies regarding the beneficial or harmful effects associated with probiotic therapy in sepsis.

Maternal history and uterine artery wave form in the prediction of early-onset and late-onset preeclampsia: a cohort study

Background: Pregnancy induced hypertension [PIH] is a significant cause of maternal morbidity and mortality. Pregnancy-induced-hypertension can be prevented by identification of prenatal and antenatal factors. The uterine artery Doppler waveform transforms into a high flow with low resistance at 22-24 wk

Objective: To study the maternal risk factors and uterine artery Doppler waveform in singleton mid-trimester pregnancy and predict the occurrence of pregnancy-induced hypertension

Materials and methods: This is a cohort study comprising of Doppler ultrasound examination of the uterine arteries at 20-23 wk gestation in 697 women with singleton pregnancies attending a routine target scan. The pregnant women were followed up. PIH was recorded in 57 [8.18%] of all pregnancies

Results: Maternal age >34 yr, primiparity, the presence of chronic hypertension was also associated with increased risk of PIH. High pulsatility index [>95th percentile] as compared to low pulsatility index was a good tool for the detection of PIH [sensitivity 91.23% and specificity 99.06%, p<0.05]. Presence of high pulsatility was a significant risk factor for early-onset PIH as compared to late-onset PIH

Conclusion: Uterine artery Doppler can be safely performed at the time of routine target anomaly scan in the second trimester. It is simple, economical, feasible and with good detection rates

Anatomic and anaesthetic considerations of greater palatine nerve block in Indian population

Background: Greater palatine nerve block holds its importance for anaesthesia and analgesia in different maxillofacial surgical procedures. Accuracy in localization of greater palatine foramen is required for its successful implication in regional block, although racial variations exist in various population groups

Aims: To study the morphometry of greater palatine foramen and its location with nearby anatomical landmarks in Indian population. Material and Methods: A total of one hundred dry skulls [60 males and 40 females] were collected and observed for the study. Various parameters were noted from greater palatine foramen on both sides, together with its location with respect to maxillary molar tooth. Along with that the angle between midline maxillary suture and Incisive foramen-Greater palatine foramen is measured

Results: 198 sides were measured and the most common location of greater palatine foramen was found to be medial to third molar tooth [71.21%]. The mean distance from greater palatine foramen to midline maxillary suture on right and left sides were 14.82 +/- 1.34 mm and 14.79 +/- 1.57 mm, statistically insignificant. The angle between midline maxillary suture and incisive foramen-greater palatine foramen was 20.81 degree +/- 2.47 degree on right side and 20.58 degree +/- 2.69 degree on left side.The direction of the opening of greater palatine canal onto the hard palate was observed to be antero-medial in 60.10% of cases

Conclusions: Our study reveals the importance of usage of various anatomical parameters for precise location of greater palatine foramen, establishment of specific measurements in each population group and thereby applying such measurements for successful greater palatine nerve block

Functional performance testing in athletes with functional ankle instability

To determine if functional performance deficits are present in athletes with functional ankle instability [FAI] compared to healthy athletes using various functional performance tests. Sixty two athletes [mean age-21.7 +/- 1.8years; height-168.2 +/- 9.1cm; weight-63.8 +/- l 1.0kg] participated in this case control study. Athletes were divided into two groups: athletes with FAI [FAI group, n=31] and healthy athletes [Non-FAI group, n=31]. The FAI group was further divided into two subgroups: FAI with giving way [FAI-GW], FAI with no giving way [FAI-NGW]. Functional performance was assessed with the single-limb hopping test, figure-of-8 hop test, side-hop test, single-limb hurdle test, square hop test and single hop test. Significant differences [P<0.05] were observed for all the functional performance tests [FPTs] except the single hop test between FAI and Non-FAI groups; between FAI-GW, FAI-NGW and Non-FAI groups. Additionally, the involved limb performed significantly worse [P<0.05] than the contra-lateral uninvolved limb of the FAI-GW group for the above-mentioned FPTs. Significant functional performance deficits were observed in the FAI group in all tests except single hop test with greater deficits observed in the FAI-GW group. Hence, these tests can be used to determine the presence of FAI. However no deficits were identified for the test involving sagittal plane functional activities suggesting that this test can not be used as a criterion to discriminate individuals with FAI. It was further ascertained that functional performance was not affected by limb dominance