Laparoscopic repair of a strangulated Bochdalek hernia

Background Bochdalek herniae are rare. They are usually repaired by open abdominal surgery or by a thoracic video-assisted approach. When strangulated and in a compromised patient the options are fewer. Aim To describe a case treated by a laparoscopic approach. Results The procedure was technically difficult, but the patient recovered without recurrence. Conclusion Laparoscopic repair is possible even with strangulation.     

Insulin analogue levemir and development of pancreatic adenocarcinoma: a case report and literature review

There is an association between insulin analogues, glargine, lispro and aspart and the incidence of malignancies. A 76 year-old female patient with history of diabetes, hypertension and hyperlipidemia presented with flank pain after using insulin Levemir as part of her management. CT abdomen revealed pancreatic mass and endoscopic ultrasound- guided FNA aspiration biopsy showed pancreatic adenocarcinoma. It was not clear whether the insulin analogue initiated the tumor or helped the growth of pre-existing malignant foci. Then we concluded that case presented raises an indicator of possible association between using insulin analogue and initiation of malignancies, or stimulation of malignant foci.     

Effects of heating, storage, and ultraviolet exposure on antimicrobial activity of garlic juice

This study was designed to investigate the effect of heating, storage, and ultraviolet exposure on antimicrobial activity of garlic juice and its bacteriocidal activity against common human pathogens. Antimicrobial activity of fresh garlic juice was tested against Escherichia coli, Staphylococcus aureus, Streptococcus hemolyticus B, S. hemolyticus A, Klebsiella sp., Shigella dysenteriae, and Candida albicans using the disc method. The dilution method was performed by addition of garlic juice to broth media to obtain 1-100% concentrations as vol/vol or wt/vol. Garlic juice was used after 24 hours of storage at 4 degrees C, heating to 100 degrees C for 5 minutes, 10 minutes, 30 minutes, and 60 minutes, heating to 80 degrees C for 60 minutes, and 4 hours of exposure to ultraviolet light. Re-culture of specimens taken from garlic-induced negative media was performed in fresh broth free of garlic juice. Results showed that all the isolates were sensitive to fresh garlic juice; the most sensitive was C. albicans, and the least sensitive was S. hemolyticus A. Heating to 100 degrees C for 30 and 60 minutes completely abolished the antimicrobial activity, while heating for 5 and 10 minutes, storage for 24 hours, and 4 hours of ultraviolet exposure decreased it. Garlic juice was bactericidal at concentrations of 5% and more. Thus garlic juice has marked antimicrobial activity that makes it a potential agent to be tested in clinical trials. The antimicrobial activity was compromised by storage and heating; therefore it is advisable to use fresh garlic and avoid boiling it for more than 5 minutes during cooking.     

Ultra-low microcurrent therapy: A novel approach for treatment of chronic resistant wounds

This study was undertaken to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT) device for the management of chronic wounds. In this study, 23 patients with chronic skin ulcers and 2 with abdominal dehiscence that was present for an average of 16.5 mo, who were not responsive to standard conservative treatment in a hospital setting, were treated with the EPRT device. Wounds were treated with direct current (maximum of 3 mA) of 1 polarity for 11.5 min and then with a current of the opposite polarity for another 11.5 min. Treatment was applied through ultra-low microcurrents (in the mA to nA range) conducted through special wraps applied above and below the wound. The results revealed that 34.8% of cases achieved complete wound healing after an average of 45.6 h of treatment, and 39.1 % achieved ≥50% healing after an average of 39.7 h of treatment. Several patients achieved significant results after 1 to 2 treatments. The EPRT device not only accelerated healing but also appeared to negate the effect of a person’s age on wound healing.     

Breathing During Sleep in Patients with Myotonic Dystrophy and Non-myotonic Respiratory Muscle Weakness

Sleep apnoea and hypopnoea have been reported in myotonic dystrophy,but it is unclear whether this is simply attributable to therespiratory muscle weakness which is common in this condition.We therefore investigated whether breathing and oxygenationduring sleep were more abnormal in patients with myotonic dystrophythan in patients with non-myotonic muscle weakness. Seven subjectswere studied in each of three groups: normal controls, myotonicdystrophy and non-myotonic weakness. Patients in the lattergroup were chosen to represent a similar range of severity ofrespiratory muscle weakness to those with myotonic dystrophy.Detailed polysoranography was performed; the severity of breathingdisorders during sleep was quantified in terms of the frequenciesof apnoea and hypopnoea and the degree of arterial desaturation.The myotonic patients showed more frequent apnoea and hypopnoeaand more severe desaturation than the other two groups; theresults in the non-myotonic patients were generally intermediate.The results suggest that abnormal breathing during sleep iscommon in myotonic dystrophy and is not due solely to the directeffects of respiratory muscle weakness. Somnolence, which isa well recognized symptom of myotonic dystrophy, was not clearlyattributable to the sleep apnoea/hypopnoea syndrome nor to abnormalsleep architecture in the myotonic patients.     

An alternative treatment for pityriasis versicolor, tinea cruris, tinea corporis and tinea faciei with topical application of honey, olive oil and beeswax mixture: an open pilot study

OBJECTIVE: To evaluate the possible role of honey, olive oil and beeswax in the treatment of skin fungal infections. PATIENTS AND METHODS: Thirty-seven patients with pityriasis versicolor, tinea cruris, tinea corporis and tinea faciei were studied. After clinical evaluation of redness, scaling, pruritis and burning/pain sensation and mycological assessment, honey mixture containing honey, olive oil and beeswax (1:1:1) was applied to the lesions three times daily for a maximum of 4 weeks. RESULTS: Clinical response was obtained in 86% of patients with pityriasis versicolor, 78% of patients with tinea cruris and in 75% of patients with tinea corporis. Mycological cure was obtained in 75, 71 and 62% of patients with PV, tinea cruris and tinea corporis, respectively. The patient with tinea faciei showed clinical and mycological cure 3 weeks after commencement of therapy. CONCLUSION: Honey mixture may have place in the management of these skin conditions and rigorous, controlled trials are justified.     

Increased platelet aggregation due to chilling to 20 degrees C is not related to increased sensitivity to agonists

BACKGROUND: Previous studies suggested that chilled platelets have a greater sensitivity to agonists than do platelets aggregated at 37 degrees C. STUDY DESIGN AND METHODS: Washed platelets were aggregated at 20 or 37 degrees C with ADP (0-20 microM), arachidonic acid (0-200 microM), or the thromboxane mimetic U46619 (0-9 nM). RESULTS: Chilling caused a significant (p < or = 0.05) increase in spontaneous platelet aggregation (> 27% at 20 degrees C vs < 5% at 37 degrees C) and spontaneous dense granule release (> 0.01 nM of ATP at 20 degrees C vs. 0 nM of ATP at 37 degrees C), ADP and U46619 caused a significantly greater aggregation response and dense granule release at 20 degrees C, although there was no change in agonist sensitivity of platelets (effective dose of agonist necessary to induce 50% aggregation [ED50]: 1.00 +/− 0.35 microM ADP at 20 degrees C and 1.63 +/− 0.47 microM ADP at 37 degrees C; 8.26 +/− 3.65 pM U46619 at 20 degrees C and 18.97 +/− 4.82 pM U46619 at 37 degrees C). Platelets aggregated with arachidonic acid showed a significant decrease in aggregation and agonist sensitivity at 20 degrees C (ED50 118.7 +/− 44.4 microM) from those at 37 degrees C (ED50 25.6 +/− 7.2 microM), possibly as a result of the reduced enzymatic activity of cyclooxygenase and thromboxane synthase at the lower temperature. CONCLUSION: The data suggested that washed platelets chilled to 20 degrees C and aggregated are not more sensitive to agonists than are 37 degrees C controls, but rather that chilled platelets undergo greater spontaneous aggregation.     

Effects of natural honey on polymicrobial culture of various human pathogens

Introduction

Honey has a wide range of antimicrobial activity. All previous studies have considered honey''s effect on a single microbe. The present study investigated activity of honey towards a high dose of single or polymicrobial culture.

Material and methods

10 µl specimens of Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Escherichia coli (E. coli) and Candida albicans (C. albicans) were cultured in 10 ml of 10-100% (wt/v) honey diluted in broth. Six types of polymicrobial microbial cultures were prepared by culturing the isolates with each other onto broth (control) and broth containing various concentrations of honey (10-100% wt/v). Microbial growth was assessed on solid plate media after 24 h incubation.

Results

Honey (30-70%) prevents growth of 10 µl specimens of all the isolates. Greater reduction in growth of E. coli was observed when cultured with S. aureus. Culturing of S. aureus with S. pyogenes, C. albicans, or E. coli increased its sensitivity to honey. S. aureus and S. pyogenes increased sensitivity of C. albicans to honey while E. coli and C. albicans decreased sensitivity of S. pyogenes.

Conclusions

It might be concluded that honey prevents and inhibits growth of single and polymicrobial pathogenic cultures. Polymicrobial culture affects growth of the isolates and increases their sensitivity to honey.