In clinical practice in order to Enzyme preparations are used to correct impaired digestive function, which differ in dosage form, chemical structure and mechanisms of action. The article presents a review of the literature about features and advantages of digestive enzyme preparations. Also presented information about new enzyme preparations qualified as dietary supplements. Presented line of enzyme preparations CREGRAN® can be considered as effective means for the treatment of diseases, the therapy of which involves the use of enzymes.
Introduction: Sepsis is a leading cause of death globally, particularly in low and middle-income countries. However, data on adult sepsis in Bhutan remains limited. This study aimed to determine the mortality rate and clinical profile of sepsis patients admitted to the medical ward of the National Referral Hospital in Bhutan. Methods: A cross-sectional study was conducted at the Jigme Dorji Wangchuck National Referral Hospital in 2022. All adult patients with sepsis admitted to the Department of Medicine were included. Data was collected using a structured pro forma and analyzed using Epi Data Analysis version 2.2.2.183 and STATA version 12.1. Results: Among 278 patients with sepsis, the in-hospital mortality rate was 26.6%. Mortality was significantly higher in patients aged over 60 years (p<0.001). Pneumonia was the most common source of infection (39.2%) while spontaneous bacterial peritonitis and bloodstream infections were more strongly associated with mortality (p<0.001). Gram-negative bacteria, particularly Escherichia coli and Klebsiella species were the predominant pathogens. Independent predictors of death included mechanical ventilation (adjusted OR 23.5, 95% CI 11.2–49.2, p<0.001), vasopressor support (adjusted OR 9.78, 95% CI 4.02– 23.8, p<0.001), spontaneous bacterial peritonitis (adjusted OR 3.85, 95% CI 1.43–10.3, p = 0.007 ), and bloodstream infections (adjusted OR 3.62, 95% CI 1.25–10.5, p = 0.018). Conclusion: Mortality was reported in one quarter of patients admitted with sepsis, particularly in the critically ill. Strengthening early recognition, prompt treatment, microbiological diagnostics, and critical care infrastructure are essential to reduce sepsis mortality and improve patient outcomes.
PURPOSE. To study the features of daily fluctuations in the biometric and structural parameters of the optic nerve (ON) in patients with different stages of primary open-angle glaucoma (POAG). METHODS. The study included 105 patients with POAG at various stages. The control group consisted of 20 individuals without glaucoma. Daily patterns of biometric and structural parameters of the ON were analyzed in addition to standard ophthalmic examination. RESULTS. Ultrasonographic examination of the ON over a 12-hour period (from 8:00 to 20:00) revealed a statistically significant reduction in ON thickness, both with and without its sheaths, in patients with advanced POAG compared with the control group (p<0.05). In eyes with advanced glaucoma, acoustic density (AD) of the ON and its sheaths showed a statistically significant increase compared with normal values (p<0.05). CONCLUSION. Marked alterations in the acoustic parameters of the ON characteristic of advanced POAG may indicate pronounced internal structural changes and atrophic damage of the nerve.
BACKGROUND:Despite their prevalence, ward round practices are not well described, leading to challenges in achieving proficiency. We aimed to identify consensus-based content items for conducting ward rounds with older patients with frailty to provide clearer guidelines and enhanced understanding of best practices for medical professionals. METHODS:A nationwide Danish five-round Delphi study was conducted during 2023. Geriatric medicine (30) and medical communication (5) experts were invited to participate. The participants' comments and an iterative thematic approach were used to identify and refine content items and themes, after which participants assessed items for consensus. Consensus was defined as 75% of participants voting 7-9 on a 1-9 Likert scale. Items without consensus returned to the next Delphi round with elimination if no consensus was reached after the second assessment. RESULTS:Delphi study response rates were 26(74%), 21(81%), 18(86%), 13(72%), and 11(85%) in Delphi rounds 1-5, respectively. Experts reached consensus on 108 content items on conducting ward rounds with older patients with frailty. Items were organised into four themes: (1) preparing ward rounds, (2) conducting ward rounds, (3) competencies, (4) circumstances related to the patient group. Ward round preparation and the conduction of ward round detailed the process of managing older inpatients with frailty, including conducting a holistic review of patient history and functional status, as well as improving the environment, such as by reducing noise. Competencies and patient circumstances related to the patient group included knowledge, skills, and attitudes to improve ward round quality, including flexibility in terms of reading patient cues and adjusting content to changes in cognition and alertness and knowledge on how to communicate with patients living with cognitive impairment. CONCLUSIONS:Geriatric medicine and medical communication experts reached consensus on 108 content items for conducting ward rounds with older patients with frailty. The items were grouped into four themes: preparing for ward rounds, conducting ward rounds, required competencies, and patient-related circumstances. The authors believe that this study serves as a valuable resource for medical training and future research.
Bone mass loss due to trauma or disease is a growing problem, requiring biocompatible and structurally stable materials for bone regeneration. In this study, interconnected porous scaffolds were developed from monoacylglyceride (MAG) derived from buriti oil (OB), combined with PEG-400, to examine the feasibility of MAG/PEG-400 as a biomedical scaffold to overcome the disadvantages of traditional implants. Fourier transform infrared (FTIR) analyses confirmed the formation of the scaffolds (Sc1 and Sc2), and scanning electron microscopy (SEM) images revealed porous structures with aver-age pore sizes of 248 and 258 μm, ideal for bone regeneration. The presence of β-carotene in the scaffolds was evidenced by UV-vis, and their thermal stability exceeded 200 °C. MTT assays indicated cell viability comparable to the control, while hemolysis tests revealed higher hemolytic activity in Sc1, possibly due to PEG-400. These OB-based polyurethanes stand out as a promising innovation, providing a suitable cellular microenvironment for bone regeneration and representing a significant contribution to sustainable biomaterials in tissue engineering (TE).
