Influence of Lactitol and Psyllium on Bowel Function in Constipated Indian Volunteers: A Randomized, Controlled Trial.

Psyllium and lactitol have been reported to increase fecal volume, moisture content and bowel movement frequency (BMF). However, the benefits of their combined use on constipation has not been examined. The aim of this study was to evaluate the effects of a 4-week intervention with lactitol and/or psyllium on bowel function in constipated volunteers. Adults (N = 172) who were diagnosed with functional constipation per Rome III criteria were randomized to four treatment groups: 10 g lactitol, 3.5 g psyllium, a combination of 10 g lactitol and 3.5 g psyllium, or placebo. The primary endpoint was change in BMF from Day 0 to 28 as compared to placebo. Secondary endpoints were assessed by inventories, including stool consistency, patient assessment of constipation symptoms and quality of life, relief of constipation, 24-h food recall, physical activity, product satisfaction and adverse events (AE). BMF increased by 3.0 BMs with lactitol, by 2.9 with psyllium, and by 3.1 with the combination, but was not different from placebo (3.7 BMs). Other clinical endpoints were similar between treatments. No serious AEs were reported. In conclusion, this study showed a similar effect on relief of constipation in all treatment groups. The treatments that were administered to the volunteers were well tolerated.

Melioidosis: Series of Eight Cases.

OBJECTIVE: Melioidosis caused by the Gram-negative bacterium Burkholderia pseudomallei is a very serious infection and has been sporadically reported from the Indian subcontinent. This disease entity can have acute and chronic presentations involving different organ systems. The purpose of this study is to analyze the risk factors, clinical presentations, therapy and outcome of culture proven cases of melioidosis. METHODS: We carried out a retrospective study of eight culture proven cases of melioidosis at a tertiary care hospital in West Bengal. RESULTS: In this series we have found that melioidosis presents with a variety of symptoms ranging from acute presentations in the form of fulminant septicaemia, multiple abscesses in internal organs, osteomyelitis to more chronic form of the infection masquerading as tuberculosis. Bone and joint involvement are particularly common. Diabetes mellitus and chronic alcoholism are significant risk factors. CONCLUSIONS: India or parts of India are possibly endemic areas for melioidosis. Lack of awareness and the diversity of its presentation are probably responsible for underdiagnosis and under reporting.

Septicaemic melioidosis.

Melioidosis is an emerging infectious disease in our country. It is an important cause of community-acquired 'sepsis syndrome' particularly in patients with underlying immunosuppression which often goes undetected due to lack of awareness resulting in high fatalities. Here we report a case of septicaemic melioidosis in a diabetic patient.