Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

BACKGROUND: The reasons for the development of postoperative reactive inflammation under optimal conditions for the operation are errors in the surgical technique and the presence of viscoelastic residues. The likelihood of developing ophthalmic hypertension exists with the use of viscoelastic of any type. Its incomplete evacuation can be explained by the difficult visualization due to its transparency. Analysis of the dependence of the postoperative period course on the quality of viscoelastic removal at phacoemulsification can be considered to be relevant and expedient. AIM: The aim was to study the type of the postoperative period course depending on the quality of viscoelastics removal at phacoemulsification. MATERIALS AND METHODS: 104 eyes of randomly chosen patients who underwent femto-laser assisted phacoemulsification, divided into 2 groups according to ophthalmic viscoelastics characteristics (colored or transparent). Both groups were split into 2 subgroups each depending on method of viscoelastics removal. Tonometry and biomicroscopy were performed 3 hours after phacoemulsification and on the post-op Day 1. Patients with Tyndall effect were examined daily until its disappearance. RESULTS: At comparable preoperative IOP indices, its elevation 3 hours after surgery took place in subgroups 2a and 2b, the highest being in subgroup 2a. The greatest number of eyes with Tyndall effect, at all follow-up periods, was found in subgroup 2a, the lowest in subgroup 1b. The total number of eyes with keratopathy (as epitheliopathy) observed 3 hours after surgery was 7, four of them being from subgroup 2a. CONCLUSIONS: The conducted research showed that the type of early postoperative period course of phacoemulsification depends on visualization possibility of the viscoelastic and of the method of its removal. Minimal changes of hydrodynamics and maximal number of eyes with absence of inflammation took place when using colored viscoelastic and impulse irrigation method.

STRESS AND CONSTIPATION (VIBANDHA) - CRITICAL REVIEW

Thoughts and emotions triggered by stress can have an effect on stomach and bowel movement. Physical signs and symptoms of stress overload include chest pain, rapid heartbeat, loss of sexual drive, diarrhoea/ constipation. In this article we have tried to enlighten the association of stress and constipation. The mainly observed clinical features of Vibandha are Hard Stools, Excessive Straining, Sense of Incomplete Evacuation, Flatulence and Lower Abdominal Fullness. The stress hormone may contribute to constipation.

Improvement in Outlet Obstructive Constipation Symptoms After Vaginal Stent Treatment for Rectocele

Objective. The objective is to determine the possible improvement in outlet obstructive constipation symptoms after vaginal stent treatment for rectocele. Methods. Female patients with rectocele (n = 156) accompanied with outlet obstructive constipation were selected in this study. Longo’s obstructed defecation syndrome (ODS) questionnaire, rectoanal pressures, and rectal balloon expulsion (BET) were evaluated at baseline, 1 month follow-up, and 6 months follow-up. Moreover, the side effects and the potential reasons for giving up treatment were also detected. Results. Vaginal stent significantly decreased the straining intensity, shortened the straining extensity time, decreased the use of laxatives, and alleviated the symptoms of incomplete evacuation ( P < .05). The vaginal stent also increased the rectal pressure and shortened the balloon expulsion time ( P < .05). Conclusions. As an effective, feasible, and safe procedure, the vaginal stent can be recommended as a treatment of choice for rectocele combined with outlet obstructive constipation.

To study the relation between constipation and Majja dhatu mala, a literary review.

Constipation is major problem in the society. It refers to bowel movements that are infrequent or hard to pass1The stool is often hard and dry may be associated with abdominal pain ,bloating , and feeling of incomplete evacuation. Constipation may cause hemorrhoids or anal fissures. Forceful evacuation or taking purgatives to pass the stool is very common thing we found in society. Actually passage of stool is very natural process and it should not be forced or painful. But it should be like hot knife cut through butter. According to Ayurveda stool is the solid waste generated after digestion of food , it is called as major digestion. As well as in the minor digestion i.e. metabolic leveled digestion Majja Dhatu Mala (waste product in formation of Majja Dhatu) is generated, which helps smooth passage of stool.

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

INFLUENCE OF DRINKING A PROBIOTIC FERMENTED MILK BEVERAGE CONTAINING BIFIDOBACTERIUM ANIMALIS ON THE SYMPTOMS OF CONSTIPATION

ABSTRACT BACKGROUND Constipation is a chronic problem in many patients all over the world. OBJECTIVE - To evaluate the effect of consumption of a probiotic fermented milk beverage containing Bifidobacterium animalis on the symptoms of constipation. METHODS - This randomized, double-blind controlled trial included 49 female patients aged 20 to 50 years and diagnosed with constipation according to the ROME III criteria (Diagnostic Criteria for Functional Gastrointestinal Disorders) and the Bristol Stool Form Scale. The patients were randomized into two groups: the intervention group received the probiotic fermented milk beverage and the control group received non-probiotic milk. Participants were instructed to ingest 150 mL of the beverages during 60 days. At the end of this period, patients were assessed again by the ROME III criteria and Bristol scale. The Wilcoxon test was used to evaluate pre and post-intervention results of the ROME III criteria and Bristol scale. The statistical significance level was considered as 5% ( P ≤0.05). RESULTS - The intervention group showed improvement in the following criteria: straining during a bowel movement ( P <0.001), feeling of incomplete evacuation ( P <0.001) and difficulty in passing stool ( P <0.014), in addition to Bristol scale results ( P <0.001). In the control group, improvements were observed in the following criteria: straining during a bowel movement ( P <0.001), feeling of incomplete evacuation ( P <0.001) and difficulty in passing stool ( P <0.025), in addition to Bristol scale results ( P <0.001). No statistically significant post-intervention differences were observed between the two groups for the Rome III criteria and Bristol scale. CONCLUSION - The results show that the consumption of milk resulted in the improvement of constipation symptoms, regardless of the probiotic culture.