Anti-inflammatory effects of topical lactobacillus acidophilus and antibiotic in wound repair on the basis of microscopic parameters: a comparative study in rats

Background: Wound treatment still a task for medical professionals, according to the time advancement. We need to elaborate further new interventions to cope up this common factor of community. The objective of the study was to assess the anti-inflammatory topical role of Lactobacillus acidophilus with antibiotic in wound repair of rats based on of microscopic parameters. This comparative study was conducted in the Department of Anatomy Al-Tibri Medical Collage and Hospital Isra University Karachi Campus from December 2018 to April 2019.Methods: Total 18 male of wistar rats were randomly selected for this study. The study comprised of three topical groups Control, Antibiotic and Lactobacillus acidophilus groups respectively.Results: The samples were taken from the wound site for the preparation of microscopic slides, to count the numbers of neutrophils, lymphocytes and macrophages for the evaluation of anti-inflammatory process in both groups on day 3 and 7. Data obtained were analyzed by SPSS version 20 by applying One Way ANOVA and post hoc Tukey’s test.Conclusions: The results were shown potent anti-inflammatory effects of Lactobacillus acidophilus group in comparison with other conventional therapy. The study concludes that the topical application of Lactobacillus acidophilus had remarkable anti-inflammatory effects in wound management

Limited versus full sternotomy for aortic valve replacement

Copyright \ua9 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. BACKGROUND: Aortic valve disease is a common condition easily treatable with cardiac surgery. This is conventionally performed by opening the sternum (\u27median sternotomy\u27) and replacing the valve under cardiopulmonary bypass. Median sternotomy is well tolerated, but as less invasive options become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access have raised safety concerns with regard to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure. These difficulties may increase operating times, affecting outcome. The benefits of smaller incisions are thought to include decreased pain; improved respiratory mechanics; reductions in wound infections, bleeding, and need for transfusion; shorter intensive care stay; better cosmesis; and a quicker return to normal activity. This is an update of a Cochrane review first published in 2017, with seven new studies. OBJECTIVES: To assess the effects of minimally invasive aortic valve replacement via a limited sternotomy versus conventional aortic valve replacement via median sternotomy in people with aortic valve disease requiring surgical replacement. SEARCH METHODS: We performed searches of CENTRAL, MEDLINE and Embase from inception to August 2021, with no language limitations. We also searched two clinical trials registries and manufacturers\u27 websites. We reviewed references of primary studies to identify any further studies of relevance. SELECTION CRITERIA: We included randomised controlled trials comparing aortic valve replacement via a median sternotomy versus aortic valve replacement via a limited sternotomy. We excluded trials that performed other minimally invasive incisions such as mini-thoracotomies, port access, transapical, transfemoral or robotic procedures. Although some well-conducted prospective and retrospective case-control and cohort studies exist, these were not included in this review. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial papers to extract data, assess quality, and identify risk of bias. A third review author provided arbitration where required. We determined the certainty of evidence using the GRADE methodology and summarised results of patient-relevant outcomes in a summary of findings table. MAIN RESULTS: The review included 14 trials with 1395 participants. Most studies had at least two domains at high risk of bias. We analysed 14 outcomes investigating the effects of minimally invasive limited upper hemi-sternotomy on aortic valve replacement as compared to surgery performed via full median sternotomy. Upper hemi-sternotomy may have little to no effect on mortality versus full median sternotomy (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.45 to 1.94; 10 studies, 985 participants; low-certainty evidence). Upper hemi-sternotomy for aortic valve replacement may increase cardiopulmonary bypass time slightly, although the evidence is very uncertain (mean difference (MD) 10.63 minutes, 95% CI 3.39 to 17.88; 10 studies, 1043 participants; very low-certainty evidence) and may increase aortic cross-clamp time slightly (MD 6.07 minutes, 95% CI 0.79 to 11.35; 12 studies, 1235 participants; very low-certainty evidence), although the evidence is very uncertain. Most studies had at least two domains at high risk of bias. Postoperative blood loss was probably lower in the upper hemi-sternotomy group (MD -153 mL, 95% CI -246 to -60; 8 studies, 767 participants; moderate-certainty evidence). Low-certainty evidence suggested that there may be no change in pain scores by upper hemi-sternotomy (standardised mean difference (SMD) -0.19, 95% CI -0.43 to 0.04; 5 studies, 649 participants). Upper hemi-sternotomy may result in little to no difference in quality of life (MD 0.03 higher, 95% CI 0 to 0.06 higher; 4 studies, 624 participants; low-certainty evidence). Two studies reporting index admission costs concluded that limited sternotomy may be more costly at index admission in the UK National Health Service (MD 1190 GBP more, 95% CI 420 GBP to 1970 GBP, 2 studies, 492 participants; low-certainty evidence). AUTHORS\u27 CONCLUSIONS: The evidence was of very low to moderate certainty. Sample sizes were small and underpowered to demonstrate differences in some outcomes. Clinical heterogeneity was also noted. Considering these limitations, there may be little to no effect on mortality. Differences in extracorporeal support times are uncertain, comparing upper hemi-sternotomy to full sternotomy for aortic valve replacement. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from also performing a robust cost analysis. Growing patient preference for minimally invasive techniques merits thorough quality of life analyses to be included as end points, as well as quantitative measures of physiological reserve

Cerebral Angiography Can Demonstrate Changes in Collateral Flow During Induced Hypertension

AbstractA 52-year-old woman with a large left-hemispheric stroke was transferred to our hospital for possible endovascular treatment. The patient underwent a cerebral angiogram at 7 hours after symptom onset with intent to treat and was found to have occlusion of the proximal M1-segment of the left middle cerebral artery (MCA). At that time it was felt that this was a high-risk patient for mechanical clot retrieval and it was decided to treat her with induced hypertension. The diagnostic catheter was left in place in the left internal carotid artery (ICA) and hypertension was induced in the angiography suite by means of an infusion of neosynephrine. Ten minutes after the goal blood pressure levels had been reached, a repeat left ICA injection was performed, which demonstrated more extensive collateralization of the MCA territory from anterior cerebral artery branches. Mean transit times (MTT) for the left ICA circulation improved from 9.5 seconds prior to induced hypertension to 6.0 seconds. The neosynephrine infusion was continued for a total of 24 hours and the patient showed neurological improvement. We suggest that induced hypertension led to the improved collateralization to the left MCA as evidenced by the improved MTT and augmentation of leptomeningeal collaterals, which in turn led to the patient's clinical improvement

Single view reflectance capture using multiplexed scattering and time-of-flight imaging

This paper introduces the concept of time-of-flight reflectance estimation, and demonstrates a new technique that allows a camera to rapidly acquire reflectance properties of objects from a single view-point, over relatively long distances and without encircling equipment. We measure material properties by indirectly illuminating an object by a laser source, and observing its reflected light indirectly using a time-of-flight camera. The configuration collectively acquires dense angular, but low spatial sampling, within a limited solid angle range - all from a single viewpoint. Our ultra-fast imaging approach captures space-time "streak images" that can separate out different bounces of light based on path length. Entanglements arise in the streak images mixing signals from multiple paths if they have the same total path length. We show how reflectances can be recovered by solving for a linear system of equations and assuming parametric material models; fitting to lower dimensional reflectance models enables us to disentangle measurements. We demonstrate proof-of-concept results of parametric reflectance models for homogeneous and discretized heterogeneous patches, both using simulation and experimental hardware. As compared to lengthy or highly calibrated BRDF acquisition techniques, we demonstrate a device that can rapidly, on the order of seconds, capture meaningful reflectance information. We expect hardware advances to improve the portability and speed of this device.National Science Foundation (U.S.) (Award CCF-0644175)National Science Foundation (U.S.) (Award CCF-0811680)National Science Foundation (U.S.) (Award IIS-1011919)Intel Corporation (PhD Fellowship)Alfred P. Sloan Foundation (Research Fellowship