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Background: Evidence suggests that up to 21% of patients are dissatisfied after total knee arthroplasty (TKA), but the link between dissatisfaction and use of health care resources is unknown. The objective of this study was to compare costs after TKA between satisfied and dissatisfied patients. Methods: This was a secondary analysis of a randomized clinical trial among patients who underwent primary TKA at our institution between 2015 and 2018. We estimated rates of satisfaction with pain relief and with return to function 1 year postoperatively. Patients prospectively reported use of health care resources 6 weeks, and 3, 6, 9 and 12 months after surgery. We compared costs between satisfied and dissatisfed patients from a public payer and a societal perspective. Results: We included 156 patients in our analysis, of whom 42 (26.9%) were dissatisfed with pain, and 57 (36.5%) were dissatisfied with function. There was no signifcant difference in costs between patients dissatisfied with pain or function compared to satisfied patients from a health care payer perspective. From a societal perspective, patients dissatisfied with pain incurred a mean cost of $21 156.18, compared to $13 453.84 for satisfied patients (mean difference $7702.34, 95% confidence interval [CI] -89.43 to 15 494.11). Similarly, patients dissatisfied with function incurred a mean cost of $19 007.70, compared to $13 523.83 for those who were satisfied (mean difference $5483.87, 95% CI -526.34 to 11 494.10). Conclusion: Dissatisfied patients incurred greater costs than satisfied patients during the first year after TKA. The results justify further evaluation of factors contributing to patient satisfaction that may help to reduce the economic burden of TKA. Contexte : Selon des donnees probantes, jusqu'a 21 % des patients sont insatisfaits a la suite d'une arthroplastie totale du genou (ATG), mais le lien entre l'insatisfaction et le recours a des ressources de soins de sante est inconnu. L'objectif de cette etude etait de comparer les couts a la suite d'une ATG chez les patients satisfaits et les patients insatisfaits. Methodes : Il s'agissait d'une analyse secondaire d'un essai clinique randomise chez des patients ayant subi une ATG primaire dans notre etablissement entre 2015 et 2018. Nous avons estime les taux de satisfaction quant au soulagement de la douleur et a la reprise des activites 1 an apres l'operation. Les patients ont signale de facon prospective le recours a des ressources de soins de sante 6 semaines, 3 mois, 6 mois, 9 mois et 12 mois apres l'intervention chirurgicale. Nous avons compare les couts chez les patients satisfaits et les patients insatisfaits du point de vue societal et selon la perspective du payeur public. Resultats : Au total, 156 patients ont ete inclus dans notre analyse, dont 42 (26,9 %) etaient insatisfaits quant au soulagement de la douleur et 57 (36,5 %) quant a la reprise des activites. Selon la perspective du payeur de soins de sante, il n'y avait aucune difference significative entre les couts chez les patients satisfaits et ceux chez les patients insatisfaits concernant le soulagement de la douleur ou la reprise des activites. Du point de vue societal, les patients insatisfaits quant au soulagement de la douleur ont assume un cout moyen de 21 156,18 $, comparativement a 13 453,84 $ chez les patients satisfaits (difference moyenne 7702,34 $; intervalle de confance [IC] de 95 % -89,43 a 15 494,11). De meme, les patients insatisfaits quant a la reprise des activites ont assume un cout moyen de 19 007,70 $, comparativement a 13 523,83 $ chez les patients satisfaits (difference moyenne 5483,87 $; IC de 95 % -526,34 a 11 494,10). Conclusion : Les patients insatisfaits ont assume des couts plus eleves que les patients satisfaits durant la premiere annee qui a suivi l'ATG. Les resultats obtenus justifent une evaluation plus poussee des facteurs de satisfaction des patients, qui peuvent aider a reduire le fardeau economique de l'ATG., Total knee arthroplasty (TKA) is an effective surgical intervention for patients with advanced osteoarthritis, providing reduced pain, and improved function and quality of life. Despite these benefits, historical evidence suggests [...]

Numerous bacteriocins purified from Lactobacilli have been studied as anticancerous, biocontroling, preservatives, and immunostimulatory. But, antimicrobial potential of Lysinibacillus is not much reported. In this study, a focus was made to isolate and explore therapeutic potential of Lysinibacillus from infant fecal. A total 5 isolates were selected for their antagonistic nature against human pathogen. Amid them, one Bacillus sp. was phenotypically, and molecularly using 16S rRNA gene based identified as Lysinibacillus sphaericus which given with accession numbers MK788143 in NCBI. The strain MK788143 has revealed the 99.89% identity with the Lysinibacillus sphaericus, 99.77% with Lysinibacillus fusiformis and 99.55% Lysinibacillus parviboronicapiens. The isolate showed broad-spectrum antibacterial activity against gram positive (10-14 mm) and gram-negative (9-10 mm) bacteria. Active bacteriocin was extracted at 40% ammonium sulfate precipitation afterward dialysis and further purification was done by gel filtration chromatography. The molecular weight of bacteriocin was obtained nearly 14 kDa by SDS-PAGE. According to physico-biochemical properties, the purified bacteriocin belongs to class I bacteriocin. The bacteriocin was enormously heat stable in the range of 15 to 100°C temperature for 1 hr and stable within the pH range 2-9. In addition, bactericidal activity of purified protein was decreased when treated with proteolytic enzymes i.e. trypsin, proteinase K and pepsin, these results confirmed the peptide nature of isolated bacteriocin. As a reflection of results, the broad-spectrumantagonistic potential and physical stability of bacteriocinmight be applied as an alternative therapeutic as well as food preservative agent to control pathogenic bacterial abundance. [ABSTRACT FROM AUTHOR]

Human milk consists of a diverse microbial community i.e. human-friendly probiotics and commensalbacteria. The current study explored whether viable breast milk microbes are shared between the maternal and infant gut ecosystem via breastfeeding. Healthy lactating mother milk and corresponding neonatal faeces collected from five mothers-neonate pairs at every week's time interval were studied by culture-dependent methods (16S rRNA gene sequencing). Bythe culture-dependent method, a viable isolated strain of Lactobacillus oris, Lysinibacillus sp., Enterococcus mundtii, Bacillus clausii, Enterococcus faecalis, Lactobacillus brevis, Lysinibacillus fusiformis, and Staphylococcus sp. was revealed to be shared among both ecosystems within mother-neonate pair. This study shows that viablemicroflora may be vertically transmitted from mother to infantthrough breastfeeding. Hence, our data support the proposed hypothesis of a newpathway of motherinfant communication, in thatmother gut microflora reaches breast milk by an entero-mammary pathway to develope neonatal gut microflora and maturation of the immune system. [ABSTRACT FROM AUTHOR]

Case Report : A 22 year-old-male presented with complains of progressive, painless dysphagia to solid foods for a period of 3 months was referred to the Department of Radiology, TUTH for a barium swallow examination. He had past history of empirical anti-tubercular treatment twice, initially for pulmonary tuberculosis and later for tubercular cervical lymphadenitis. There is no history of caustic ingestion, operative intervention or any history suggestive of reflux oesophagitis. Sputum for AFB was negative. Detailed clinical history and examination revealed one of rare causes of dysphagia which was later confirmed on investigations. The case report discusses and highlights the importance of clinical history and examination even in the Department of radiodiagnosis for a proper reporting. [ABSTRACT FROM AUTHOR]