The data of the present study suggest that four sessions of transcranial direct current brain stimulation over motor cortex could reduce morphine consumption and pain perception during the postoperative period in total knee arthroplasty.

Sepsis carries a poor prognosis for critically ill patients, even withintensive management. We aimed to determined early predictors of sepsis-related in-hospital mortality and to monitor levels of presepsin and high sensitivity C reactive protein (hsCRP) during admission relative to the applied treatment and the development of complications.An observational study was conducted on 68 intensive care unit (ICU) patients with sepsis. Blood samples from each patient were collected at admission (day 0) for measuring presepsin, hsCRP, biochemical examination, complete blood picture and microbiological culture and at the third day (day 3) for measuring presepsin and hsCRP. Predictors of sepsis-related in-hospital mortality were assessed using regression analysis. Predictive abilities of presepsin and hsCRP were compared using the area under a receiver operating characteristic curve. The Kaplan–Meier method was used to estimate the overall survival rate.Results showed that the sepsis-related in-hospital mortality was 64.6%. The day 0 presepsin and SOFA scores were associated with this mortality. Presepsin levels were significantly higher at days 0 and 3 in non-survivors vs. survivors (p = 0.03 and p < 0.001 respectively) and it decreased over the three days in survivors. Presepsin had a higher prognostic accuracy than hsCRP at all the evaluated times. Overall, in comparison with hsCRP, presepsin was an early predictor of sepsis-related in-hospital mortality in ICU patients. Changes in presepsin concentrations over time may be useful for sepsis monitoring, which in turn could be useful for stratifying high-risk patients on ICU admission that benefit from intensive treatment.

Objective The main purpose of this article was to evaluate the effect of probiotics used as an adjunctive to scaling and root planing (SRP) on the periodontal parameters and matrix metalloproteinase-8 (MMP-8) levels in gingival crevicular fluid (GCF) of chronic periodontitis patients. Materials and Methods A total of 25 chronic periodontitis patients who completed the treatment course of 40 subjects, aged 25 to 58 years, participated in this study. They were categorized into two groups: the first group was treated by SRP while the second group was treated by SRP and probiotic lozenges twice a day for 30 days. All patients were evaluated clinically by measuring the plaque index, bleeding index (BI), pocket depth, clinical attachment loss, and immunologically by assaying GCF/MMP-8 at baseline and 30 days after periodontal management. Results There was a significant improvement in periodontal parameters after SRP treatment with and without probiotic lozenges in both groups. However, there was a significant decrease in the BI (p = 0.05) in SRP and probiotic lozenges group after 30 days compared with SRP alone. In addition, there was a significant decrease in GCF/MMP-8 levels after 30 days in patients managed by SRP only (p = 0.017) compared with the baseline in both groups, whereas a highly significant decrease in patients treated by SRP and probiotics (p = 0.001). Conclusion The current study suggested that the probiotics might have a beneficial effect on clinical and immunological outcomes in the management of chronic periodontitis patients. Further research is needed on a large-scale population and for a long recall time to confirm the response to probiotics as an adjunctive to SRP.

The use of bipolar resectoscope utilizing 0.9% saline as a distention media is not associated with hyponatremia or hyposmolarity unlike monopolar resectoscope utilizing 1.5% glycine distending media in cases with submucous myoma of considerable size.