Objective: To evaluate the activity and tolerability of a probiotic mix of Bacillus subtilis HU58 plus Bacillus coagulans SC208 and Bacillus coagulans SC208 alone compared with placebo in a group of 75 patients suffering from Antibiotic Associated Diarrhea (AAD). Materials and Methods:An open labeled placebo-controlled trial was conducted for Bacillus subtilis HU58 + Bacillus coagulans SC208 in combination and Bacillus coagulans SC208 alone in patients suffering from AAD. Stool consistency was estimated according to Bristol Stool Chart (BSC) and was recorded at baseline, 3 rd day, 7 th day and on 15 th day along with other symptoms like abdominal pain, bloating and flatulence. All enrolled patients were orally administered either a cocktail of Bacillus subtilis HU58 + Bacillus coagulans SC208 (3 X 10 9 CFU/Cap), or Bacillus coagulans SC208 (2 X 10 9 CFU/ Cap) alone or placebo for 7 days. Blood investigations were done at baseline, 3 rd and 7 th day. A final follow up was done on 15 th day. This study was approved by an Independent Ethics Committee and registered with Clinical Trial Registry of India. A written Informed Consent Form was obtained from the patients before enrollment.Results: Patients (n=75) were randomly allocated in three groups; Group A(n=25), received a combination of Bacillus subtilis HU58 + Bacillus coagulans SC208, Group B(n=25) received Bacillus coagulans SC208 alone and Group C (n=25) received the placebo. The Bristol stool scale (Figure 1) which classifies human stool into seven categories was used to measure the consistency of stool during the study. Statistically significant improvement in stool consistency was seen in both the probiotic groups (p<0.0001) as compared to the placebo (p<0.0799). Stool consistency at baseline in all groups was at scale of 6-7. Improvement was observed in Group A (scale 3) and Group B (scale 5). No reduction of scores was observed in group C (scale 7) till 15 th day. The other symptoms like pain in abdomen, bloating and flatulence were also reduced in both group A and group B as compared to group C. Conclusion:Improvement in stool frequency and consistency along with symptoms like pain in abdomen, bloating and flatulence was found in individuals in group A and group B. Data of patients in group A and group B was found to be statistically significant (p value< 0.0001) compared to group C. It was also found that patients receiving the combination of Bacillus subtilis HU58 + Bacillus coagulans SC208 experienced much better relief in terms of stool frequency and consistency along with pain in abdomen, bloating and flatulence than patients receiving only the Bacillus coagulans SC208 strain. This comparison, however, needs to be further studied in detail by conducting double blind randomized study in larger sample size.

The quest for predictable clinical solutions to the problem of gingival recession has led to several important surgical advances this past decade. Site preparation for root coverage procedure has evolved from the original surgical dissection of an open vascular bed, used for the placement of an exposed graft overlying the recipient bed, to the coronally advanced flap and tunnel methods used for submerged grafts. The Pouch and Tunnel technique along with the use of a subepithelial connective graft has proven several benefits including early tissue healing, esthetic results and good patient cooperation. This article emphasizes on the effectiveness of using the pouch technique which improves the success rate for treating gingival recession in a series of 3 cases.

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