ABSTRACT
Background and Aim: The use of ultrasound has immensely increased the safety toward regional blocks and central venous access and has been considered as the standard of care for securing central access. The aim of this study is to estimate the prevalence of occult spinal dysraphism using ultrasound in children less than 2 years of age undergoing elective urogenital or anorectal surgery. Material and Methods: The lumbosacral region of 159 American Society of Anesthesiologists (ASA) category I/II patients, posted for elective urogenital and anorectal surgery was scanned with ultrasound, prior to giving caudal block. Results: The prevalence of occult spina bifida was 3% in our study. There was no statistically significant association of cutaneous marker with abnormal scan. Conclusion: Prevalence of occult spina bifida was ten-times higher in our study than in the general population. Perioperative ultrasound screening of the lower spinal anatomy by anesthesiologist done prior to performing neuraxial block is worthwhile in ruling out occult spinal anomalies in high-risk children of occult spinal dysraphism.
ABSTRACT
The objective of this study was to evaluate the anti-inflammatory effect of Latilactobacillus sakei SMFM2017-NK1 (LS1), L. sakei SMFM2017-NK3 (LS2), and Limosilactobacillus fermentum SMFM2017-NK2 (LF) on colitis using an animal model. DSS (dextran sulfate sodium salt) was orally injected into C57BL/6N mice to induce inflammation in the colon for seven days. Colitis mice models were treated with LS1, LS2, and LF, respectively, and Lacticaseibacillus rhamnosus GG (LGG) was used as a positive control. During oral administration of lactic acid bacteria, the weights of the mice were measured, and the disease activity index (DAI) score was determined by judging the degree of diarrhea and bloody stool. When comparing the differences between the minimum weight after DSS administration and the maximum weight after lactic acid bacteriaadministration were compared, the LF-treated group showed the highest weight gain at 8.91%. The DAI scores of the LF, LS2, and LGG groups were lower than that of the control group. After sacrifice, mRNA expression levels for proinflammatory cytokines (TNF-α, IL-1ß, IL-6, and IFN-γ) and mediators (iNOS and COX-2) in the colon were measured. LF was selected as a superior strain for anti-inflammation in the colon. It was further analyzed to determine its biochemical characteristics, cytotoxicity, and thermal stability. Catalase and oxidase activities for LF were negative. In cytotoxicity and heat stability tests, the LF group had higher cell viability than the LGG group. The genome of LF was obtained, and 5682 CDS, 114 tRNA, 2 RNA, and 5 repeat regions were predicted. Especially, LF could be distinguished from the other three L. fermentum strains based on taxonomic profiling, specific orthologous genes of the strain, and genomic variants. The results of this study suggest that L. fermentum SMFM2017-NK2 is a novel strain with an anti-inflammatory effect on colitis.
ABSTRACT
Preoperative fasting period is the prescribed time prior to any procedure done either under general anaesthesia, regional anaesthesia or sedation, when oral intake of liquids or solids are not allowed. This mandatory fasting is a safety precaution that helps to protect from pulmonary aspiration of gastric contents which may occur any time during anaesthesia. We searched PUBMED for English language articles using keywords including child, paediatric, anaesthesia, fasting, preoperative, gastric emptying. We also hand searched references from relevant review articles and major society guidelines. Association of Paediatric Anaesthesiologists of Great Britain and Ireland (APAGBI), the French Language Society of Paediatric Anaesthesiologists and the European Society of Paediatric Anesthetists recommends clear fluid intake upto one hour prior to elective surgery unless specific contraindications exists. Current guidelines recommend fasting duration of 4 hours for breastmilk, 6 hours for milk and light meals and 8 hours for fatty meals. The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend that oral intake can be initiated within hours of surgery in most patients. While fluids can be started almost immediately, the introduction of solids should be done more cautiously.
