Targeting the Gut Microbiota to Relieve the Symptoms of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common, chronic, functional disorder with a large impact on world population. Its pathophysiology is not completely revealed; however, it is certain that dysregulation of the bidirectional communications between the central nervous system (CNS) and the gut leads to motility disturbances, visceral hypersensitivity, and altered CNS processing characterized by differences in brain structure, connectivity and functional responsiveness. Emerging evidence suggests that gut microbiota exerts a marked influence on the host during health and disease. Gut microbiome disturbances can be also important for development of IBS symptoms and its modulation efficiently contributes to the therapy. In this work, we review the current knowledge about the IBS therapy, the role of gut microbiota in pathogenesis of IBS, and we discuss that its targeting may have significant impact on the effectiveness of IBS therapy.

Use of Bismuth in Irritable Bowel Syndrome

Aim. An evidence review on use of bismuth in irritable bowel syndrome.Key points. Irritable bowel syndrome (IBS) is a common functional disorder significantly impacting the quality of life and social status, i.a., through frequent manifestations of diarrhea. Postinfectious IBS emerges after a bacterial, pro-tozoan or viral intestinal disease. The new coronavirus pandemic supposedly affects most factors involved in functional disorder developments and may serve a fuelling cause of postinfectious IBS. Bismuth salts accumulate cytoprotective, anti-inflammatory and antibacterial properties. Therapeutic efficacy of bismuth compounds has been demonstrated in treatment of diarrhea-accompanied diseases of various etiology, including postinfectious IBS. The use of therapeutic-dosed bismuth preparations is safe and well tolerated by patients.Conclusion. Use of bismuth may be considered a treatment and prevention approach in diarrhea-predominant IBS, both in monotherapy and combined regimens.

Dysphagia, dyspepsia, and hiccups

Dysphagia, or difficulty swallowing, is a complex problem. Although patients may present with dysphagia as an issue that requires palliation, other patients may develop dysphagia as a complication of progressive disease and increasing debilitation. The diagnosis of dyspepsia requires patients to be experiencing one or more of the following four problems: epigastric pain, epigastric burning, postprandial fullness, or early satiety. Dyspepsia may occur either as a functional disorder where the cause is not clear or as a secondary disorder. Hiccup, or more correctly, singultus, is a problem where patients experience a sharp and involuntary contraction of the muscles of inspiration which cause a sudden sharp inspiration and closure of the glottis. For most, this is a short-lived experience. This chapter discusses the definition, prevalence, pathophysiology, causes, presenting problems, investigations, and management of dysphagia, dyspepsia, and hiccups.

Prediction of developing temporomandibular joint dysfunction in patients with maxillary dental anomalies

Objective. To describe the basic predictors of developing dysfunction of temporomandibular joint (TMJ) in patients with maxillary dental anomalies. Materials and methods. An open, prospective, controlled clinical experimental study was carried out; 250 patients aged 18 to 35 (mean age 23.5 2.6 years) with maxillary dental anomalies including 134 persons with temporomandibular joint dysfunction and 116 with normal articular function were examined. Results. A multidimensional disperse analysis permitted to conclude that an extremely high (95100 %) probability of occurring temporomandibular joint dysfunction is determined with the presence of combination of two and more functional disorders with a complex of other (occlusive and cephalometric) preclinical markers of dysfunction; a high (7595 %) probability of development when one functional disorder is associated with a gnathic form of dentition occlusion anomaly; a medium degree (4575 %) of probability of occurring dysfunction with the presence of gnathic form of dentition occlusion anomaly with roentgenological changes in TMJ and the absence of functional signs; a low (1545 %) probability when detecting a dentoalveolar form of occlusion anomaly or dentition anomaly combined with roengenological changes in the joint and the absence of functional disorders; a very low (015 %) probability of dysfunction development with the presence of congested position of incisors, anomalies of separate teeth position in the sagittal plane in the frontal part and the absence of functional disorders. Conclusions. The knowledge of the above-mentioned predisposing factors (signs) of the disturbance of the joint function can be used as an instrument for prediction of the probability of developing the temporomandibular joint dysfunction in patients with maxillary dental anomalies.

The Bulky Dermoid Cyst of the Floor of the Mouth

Bulky dermoid cysts of the floor of the mouth are very rare and may induce functional disorder. We present a 68-year-old Chinese woman who presented a painless swelling in right mandibular. Physical examination revealed a painless, soft, poor mobility, doughlike mass swelling which was reached to the floor of the mouth, and MRI showed a circumscribed mass of about 20.0×10.0×12.0 cm size. After complete excision of the cyst through an extraoral approach, histology diagnosed dermoid cyst. Dermoid cyst is uncommon found in the floor of the mouth, where there is a soft, painless, associated dyspnea, dysphagia and dysarthria. Imaging may assist diagnosis. Definitive diagnosis is founded on the histology specimen. According to the location and size of the cyst on each occasion, enucleation via intraoral or extraoral approach will be chosen treatment for cyst in the floor of the mouth. Although malignant degeneration of dermoid cyst of the floor of mouth is extremely rare, there are also such a situation reports. Thus, it is important to remove a cyst before the opportunity for malignancy.

Glanzmann's Thrombasthenia: A rare platelet functional disorder

Glanzmann's Thrombasthenia (GT) is a rare inherited autosomal recessive platelet functional disorder. Due to the deficiency of platelet function, it manifests as a bleeding disorder characterized by mucocutaneous hemorrhage of varying severity. It is difficult to diagnose as it closely mimics with others bleeding disorder, so it can be diagnosed after investigations & exclusion of others. Treatment is supportive care with platelet transfusion & proper counseling. With careful supportive care, GT has a very good prognosis. In this report, we describe a 13 years old female with Glanzmann Thrombasthenia. Faridpur Med. Coll. J. 2020;15(2): 103-105

Cadmium Stabilization by Sewage Sludge Incineration Ash

Cadmium (Cd), as a common ingredient in the production process of nickel cadmium batteries, can lead to functional disorder in kidneys, liver, lungs, cardiovascular, immune and reproductive systems. Previous studies have shown that cadmium can be stabilized in ceramic systems using clay as precursor, but the excessive exploitation of nonrenewable clay resources has caused great concerns. Hence, it is essential to find alternatives to substitute nonrenewable clay minerals. Sewage sludge incineration residues, with oxides of aluminum and silicon as major component, have attracted much attention because of the potential resource utilization. In this study, CdO and CdNO 3 was used to simulate cadmium-bearing industrial waste, and the stabilization of cadmium was achieved in ceramic matrix provided by the residues of sewage sludge incineration. Through a 2-hour sintering procedure at temperatures ranging from 800°C to 1000°C, cadmium was found to be incorporated into CdAl 2 Si 2 O 8 . The leachability of cadmium significantly declined in sintered samples when extracted in acidic environment. Meanwhile, samples that were pressed into pellets showed better cadmium stabilization efficiency, compared with powder samples. Therefore, this study suggests a promising technique to stabilize cadmium by the utilization of sewage sludge incineration residues as ceramic precursors. The success implementation of current study will further reduce the environmental burden caused by the release of heavy metals from industrial waste. Moreover, the recycling of sewage sludge incineration residues can be realized, and a waste-to-resource strategy is expected.

Bobble-head doll syndrome with supra-sellar arachnoid cyst

A 19-year-old woman reported progressively worsening involuntary head movements since the age of 7. She had visited multiple hospitals and been labelled as having a functional disorder. Detailed evaluation identified a large supra-sellar arachnoid cyst with hydrocephalus. We made a diagnosis of bobble-head doll syndrome, which is only very rarely associated with suprasellar arachnoid cyst. Her symptoms improved rapidly following endoscopic third ventriculostomy with cyst fenestration and gradual decompression of the ventricles. Clearly, not all suppressible movements should be labelled as psychogenic.