Disseminated intravascular coagulation associated with toxic epidermal necrolysis (Lyell''s syndrome)

Evidence of disseminated intravascular coagulation was recorded in eight patients with toxic epidermal necrolysis (TEN)--Lyell's syndrome. Patients were treated with low doses of heparin in combination with the usual treatment of TEN, i.e. maintenance of fluid and electrolyte balance, systemic corticosteroids, antibiotics and aseptic dressings, in the Intensive Care Unit environment. It is suggested that the alteration of haemostasis and inter-related biological systems, such as activation of components of complement, kinins and immunoglobulins, may affect the outcome of TEN.     

MOTOR RESTLESSNESS

Motor restlessness, characterised by an irresistible urge to move about, can be a manifestation of many underlying disorders. Unfortunately, it is often poorly recognised and underdiagnosed in clinical practice, possibly because patients do not seek medical attention, or their complaints were thought to be secondary to anxiety. While the two major conditions to consider are restless legs syndrome and neuroleptic-induced akathisia, there are many other differential diagnoses. We provide a concise review of the clinical features and diagnostic pitfalls of these conditions. A proper detailed clinical history and examination can often help clinch the diagnosis, as most of these conditions have their unique clinical features.     

Sterile water injection for labour pain: a systematic review and meta-analysis of randomised controlled trials

Background  Up to one-third of labouring women will experience painful 'back labour'. Sterile water injected lateral to the lumbosacral spine is a simple and well-researched approach to this pain.
Objective  To determine if sterile water injection for low back pain compared to placebo or alternative therapy increased or decreased the rate of Caesarean section.
Search strategy  We performed a literature search with no language restriction in four databases: the Cochrane library, EMBASE (1980–2009), Ovid Medline (1950–2009) and CINAHL (1982–2009).
Selection criteria  We included all randomised controlled trials (RCTs) of sterile water injection for labour pain that included outcomes of interest and original data.
Data collection and analysis  We compared Caesarean section rates among women who received sterile water injection in labour with those who received either placebo treatment or another non-pharmacological treatment modality. Other outcomes included pain scores, use of regional analgesia and women's assessment of treatment. We used Revman 5 for the meta-analysis. Data were entered by one reviewer and independently cross-checked. Pooled outcomes were reported as Relative Risk (RR) or Weighted Mean Difference using Mantel–Haenszel fixed-effects model except when the I ² value >50% indicated significant heterogeneity in which case random-effects model was used.
Main results  We included eight RCTs. The Caesarean section rate was 4.6% in the sterile water injection group and 9.9% in the comparison group ( n  =   828) (RR 0.51, 95% CI: 0.30, 0.87).
Conclusion  We believe that a large RCT should be mounted to validate our findings regarding the impact of sterile water injections on mode of delivery.     

Effect of Solanum surattense seed on the oxidative potential of cauda epididymal spermatozoa

Objective

To evaluate the effect of aqueous seed extract of Solanum surattense (S. surattense) on the oxidative potential of cauda epididymal spermatozoa.

Methods

S. surattense seed extract was orally administered at the dosage of 10 mg/kg b.w. for 15 days, after which aspartate transferase (AST), alanine transferase (ALT), glutamate dehydrogenase (GDH), citric acid and iso-citrate dehydrogenase (ICDH) were assayed.

Results

The activity levels of the enzymes AST and ALT, which are considered to be the androgenicity in the sperm suspension, were depleted in the extract fed rats. The activity level of the enzyme ICDH, was reduced significantly in the treated group (P<0.001).

Conclusions

It can be concluded that the oral administration of the aqueous seed extract of S. surattense can deplete the oxidative stress of cauda epididymal spermatozoa in albino rats.     

Changes in multiple health outcomes at 12 and 24 weeks resulting from 12 weeks of exercise counseling with or without dietary counseling in obese adults

OBJECTIVE: We compared health outcomes in obese adults who underwent 12 wk of exercise counseling with or without dietary counseling, followed by 12 wk of observational monitoring. METHODS: Ninety adults (77 women and 13 men; 42.6 +/- 6.0 y; body mass index, 31.5 +/- 2.8 kg/m(2)) were randomly assigned to exercise-only (EX) or diet-plus-exercise (DEX) groups and counseled weekly by exercise physiologists on a 12-wk walking program. DEX subjects were also counseled by dietitians on a hypocaloric diet (-500 kcal/d). From weeks 12 to 24, subjects were monitored but not counseled. At weeks 0, 12, and 24, data collection included body composition (air displacement plethysmography), fitness (maximum oxygen consumption, 3-min step-test, and timed mile), plasma lipids, weight loss efficacy (Weight Efficacy Life-Style Questionnaire), quality of life (Medical Outcomes Study Health Survey-Short Form 36), and mood (Profile of Mood States). RESULTS: At 12 and 24 wk, weight and body mass index decreased in DEX subjects (both P < 0.05) but not in EX subjects. However, lean body mass increased significantly in EX (24 wk, P < 0.05) but not in DEX subjects. In both groups, fat mass decreased (P < 0.05 for EX subjects at 24 wk; P < 0.05 for DEX subjects at 12 and 24 wk) and waist circumference decreased (P < 0.05 for EX subjects at 12 and 24 wk; P < 0.05 for DEX subjects at 12 and 24 wk). At 12 and 24 wk, DEX subjects showed decreased levels of total plasma cholesterol and triacylglycerols (both P < 0.05) and improvements with regard to the Weight Efficacy Life-Style Questionnaire (P < 0.05), three domains of the Medical Outcomes Study Health Survey-Short Form 36 (all P < 0.05), and three domains of the Profile of Mood States (all P < 0.05) that were not seen in EX subjects. CONCLUSIONS: Exercise counseling for 12 wk in obese adults improves some body composition indices that can be sustained over 12 wk of monitoring. The addition of dietary counseling increases improvements in body composition, lipid profiles, and several psychological parameters.