AIM:We sought to describe the types and frequencies of surgeries conducted in our newly commissioned hospital and to correlate procedure types with length of hospital stay and postoperative complications. MATERIAL & METHODS:This study is a retrospective quantitative chart review design, using patient records. It's conducted in a newly commissioned tertiary care academic hospital. Following systematic screening of medical records, approximately 377 patients were expected to satisfy the eligibility criteria. All extracted data were coded and entered into Microsoft Excel for initial collection and verification. Statistical analysis was completed using IBM SPSS Statistics, version 27. RESULTS:A total of 377 patients underwent general surgical procedures, with a mean age of 35.81 years (SD±14.44). Male patients comprised 58.9% and Saudi nationals 82.8%. The most common procedures were laparoscopic cholecystectomy (22.8%), inguinal hernia repair (13.3%), and epidermal cyst excision (13.0%). General anaesthesia predominated (44.0%), with a significant association between anaesthesia type and procedure (p<0.001). Most cases (94.4%) were managed as day surgery (p=0.035). we noted that no postoperative complications were recorded at 30-day follow-up, as zero incidence of surgical site infection, urinary tract infection, deep vein thrombosis, readmission, or reoperation. CONCLUSIONS:This study documents the primary surgical profile of a recently commissioned tertiary hospital, revealing a diverse, mainly elective cases with zero postoperative complications, readmissions, or reoperations. These results reproduce effective perioperative preparation from the beginning and found a respected starting point for ongoing excellence benchmarking and hospital development.
BACKGROUND:Tamsulosin and 5α-reductase inhibitors (finasteride and dutasteride) are widely prescribed for benign prostatic hyperplasia (BPH). However, their systemic effects on metabolic, renal, and hepatic functions remain incompletely understood. OBJECTIVE:To evaluate the safety profile of tamsulosin monotherapy compared with combination therapies (tamsulosin plus finasteride or dutasteride) on lipid profile, renal function, liver enzymes, and bilirubin levels in men with BPH. METHODS:This cross-sectional study included 102 male participants aged >50 years, divided into five groups: healthy controls (n=26), newly diagnosed treatment-naïve BPH (n=25), BPH receiving tamsulosin monotherapy >3 months (n=26), BPH receiving tamsulosin+finasteride >3 months (n=11), and BPH receiving tamsulosin+dutasteride >3 months (n=14). Serum lipid profile (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL, atherogenic index), renal function (urea, creatinine, eGFR, uACR), liver function (ALT, AST, ALP, GGT, albumin), and bilirubin fractions (total, direct, indirect) were measured using standardized automated methods. RESULTS:Lipid profile parameters showed no significant differences between treatment groups and controls, with all values remaining within desirable ranges. Renal function tests, including serum urea, creatinine, eGFR, and urinary albumin-to-creatinine ratio, demonstrated no clinically significant alterations across all BPH treatment groups compared to controls. Liver enzymes (ALT, AST, ALP, GGT) and serum albumin levels remained within normal limits across all groups. Total, direct, and indirect bilirubin concentrations showed no significant elevation, indicating preserved hepatic excretory function. Notably, no statistically significant differences were observed between tamsulosin monotherapy and combination therapy groups for any of the measured parameters. CONCLUSION:Tamsulosin administered alone or in combination with finasteride or dutasteride for more than three months demonstrated non-significant differences in the measured biochemical parameters among the studied groups represented by no adverse effects on lipid metabolism, renal function, liver enzymes, or bilirubin homeostasis. These findings support the safe use of these therapeutic regimens in elderly BPH patients, including those with underlying metabolic or organ function concerns. Further prospective longitudinal studies with larger sample sizes are warranted to confirm these observations.
BACKGROUND/INTRODUCTION:Heart failure with reduced ejection fraction (HFrEF) represents a major global health burden, accounting for approximately half of all heart failure cases and characterized by high mortality, frequent hospitalizations, and progressive cardiac remodeling. Angiotensin-converting enzyme (ACE) inhibitors constitute a foundational cornerstone in the therapeutic management of HFrEF. Perindopril is a long-acting ACE inhibitor with a highly favorable safety profile; however, robust clinical data evaluating its specific efficacy in HFrEF cohorts remain scarce. AIM:To evaluate the therapeutic efficacy, reverse cardiac remodeling, and clinical outcomes of perindopril versus sacubitril/valsartan in patients with HFrEF in routine clinical practice. METHODS:This retrospective cohort study included 214 HFrEF patients (LVEF<40%, mean age 64.8±11.0 years) treated at Tbilisi Heart Center between 2018 and 2025. Patients received GDMT and were divided into two groups: Perindopril (n=118) and Sacubitril/Valsartan (n=96). Clinical, echocardiographic, and biochemical metrics were assessed at baseline (Visit 1), 2-3 weeks (Visit 2), and 3-6 months (Visit 3). Primary endpoints included changes in LVEF and NYHA functional class. RESULTS:• Both treatment strategies significantly improved LVEF, reduced left ventricular dimensions (LVEDD, LVESD), and decreased pulmonary artery systolic pressure (ANOVA p < 0.01), with major reverse remodeling occurring between Visits 1 and 2. • LVEF increased from 34.3±3.9% to 41.3±7.4% in the perindopril group and from 30.8±5.2% to 33.8±8.1% in the sacubitril/valsartan group. • In multivariable linear regression analysis, treatment group (B=-3.170, p=0.004), baseline LVEF (B=0.381, p=0.005), and de novo heart failure (B=2.966, p=0.005) were independent predictors of follow-up LVEF. • Both cohorts showed significant longitudinal optimization in NYHA functional class (p<0.001). No significant changes in serum potassium or renal function were observed. One-year all-cause mortality did not differ significantly between groups (33.1% vs. 22.9%, p=0.103). CONCLUSION:Perindopril therapy is associated with significant clinical improvement, LVEF recovery, and positive reverse cardiac remodeling in patients with HFrEF. Both perindopril and sacubitril/valsartan demonstrate comparable efficacy in reducing cardiac dimensions and optimizing NYHA functional status. Furthermore, perindopril maintains a favorable safety profile with low nephrotoxicity, confirming its potential as an effective therapeutic option in HFrEF management.
AIM OF THE STUDY:To analyze current mental health problems, assess the prevalence of mental disorders, identify key determinants, and evaluate access to mental health care in different countries. MATERIAL AND METHODS:A narrative analytical review with a comparative synthesis of international and national data on mental health for 2019-2025 was conducted, including scientific publications, reports and estimates from the World Health Organization, Global Burden of Disease, World Mental Health, the Organization for Economic Co-operation and Development, and national data from Ukraine. RESULTS:Mental health significantly affects quality of life, productivity, and social stability. The COVID-19 pandemic, military conflicts, and economic instability have increased the prevalence of depressive, anxiety, and stress-related disorders worldwide. A high global burden of mental disorders and major regional differences were identified. The treatment gap remains especially high in low- and middle-income countries, where less than 10% of the population receives adequate care. In developed countries, coverage reaches 20-40%, although inequalities, long waiting times, and stigmatization persist. In Ukraine, the prevalence of mental disorders is estimated at 31-36% due to socio-economic instability and military conflict. CONCLUSIONS:The findings highlight the need to integrate mental health services into primary health care, expand community-based support models, and implement comprehensive policies to reduce the global burden of mental disorders.
Maxillary transverse deficiency (MTD) in adults is difficult to treat due to partial or complete fusion of the midpalatal suture and the limited effectiveness of conventional orthodontic expansion techniques. Traditional methods often lead mainly to dentoalveolar changes and may cause tooth inclination, periodontal complications, and instability of treatment outcomes. The purpose of this study was to analyze morphometric changes of the maxillary complex in adult patients after treatment with standard and individualized MARPE appliances using cone beam computed tomography (CBCT) and to compare their effectiveness in achieving skeletal expansion. Adult patients with diagnosed maxillary transverse deficiency were treated with either a standard MSE-type Microimplant-Assisted Rapid Palatal Expander (MARPE) or a customized MARPE appliance developed using digital planning. CBCT examinations were performed before treatment and after the expansion phase as part of clinically indicated diagnostic and treatment monitoring protocols. Morphometric analysis included measurements of transverse parameters of the maxillary complex. Statistical analysis was conducted using paired t-tests, the Mann-Whitney U-test, and analysis of variance (ANOVA) with a significance level of p<0.05. Both appliances provided effective maxillary expansion and significant increases in transverse parameters of the upper jaw. However, the individualized MARPE demonstrated greater effectiveness compared to the standard MSE-type appliance in terms of intermolar width gain (4.8±1.5 mm versus 3.4±1.2 mm) and the frequency of midpalatal suture opening (85% versus 60%). CBCT enabled accurate three-dimensional visualization of skeletal changes and objective monitoring of treatment outcomes. The study provides a comparative evaluation of standard and customized MARPE appliances in adult patients based on CBCT morphometric data, emphasizing the advantages of individualized appliance design. Both MARPE systems are effective for treating maxillary transverse deficiency in adults. However, customized MARPE appliances provide more precise positioning, better anatomical adaptation, and potentially greater long-term stability of expansion results.
