Introduction: Infection risk from the misuse of multi-dose medicinal products is a seriousproblem which affects final consumer health and may impact on thereputation of pharmaceutical companies adversely.Objectives:The current study aimed to trace the most important contributing factors in the infection transfer through the application of two selected types of medicinal topical creamsfor the treatment of skin disease conditions.Methods: One type of the product that was subjected to the present study is anti-psoriatic while the other is steroidal anti-inflammatory antimicrobial creams that were packed in Aluminum tubes with orifice diameter of 0.173 cm2, approximately. The simulation study – conducted on these topical creams - integrated preservative efficacy test (PET) with dose-response model of infection to demonstrate the probability of infection that could occur due to unintentional transmission of pathogenic bacteria to damaged or injured skin of the patient.Results:The studied model showed that although both products possessed antimicrobial power activity against standard strain microorganisms, yet the critical factor is the hygienic control of hands and fingers during application of the cream on the affected area.Conclusion:The medicinal products itself were little affected by microbial contamination when they were enclosed in their primary packaging materials as was observed by the in-use study. However, the most important part was that portion of the product that was transferred to the patient skin. From the simulation study, it was expected that the situation could be aggravated if the hyiegenic practice was underestimated by hospital staff.
Vitamin D deficiency is a major health problem in the Saudi population. A negative association between blood pressure and vitamin D level has been suggested in several clinical and epidemiological studies and evidence for an effect of vitamin D in lowering blood pressure was reported. These findings indicate that 1,25(OH)2D3 deficiency may play a role in the pathogenesis of hypertension through its effect on the renin-angiotensin system. We are the first to investigate the correlation between blood pressure or renin concentration and vitamin D status in the Saudi population METHODS: we included 201 healthy Saudi premenopausal females (20-45 years old). Blood pressure was measured by a standardized method using an automated blood pressure monitor (BPTru). Fasting blood samples were collected from each participant after 20 minutes of rest in the seated position. Serum cholicalciferol, PTH and renin concentration were measured by sandwich chemiluminescence immunoassaymethod (DiaSorin, Italy). RESULTS: The analysis included 192 subjects who were normotensive (blood pressure <140/90 mmHg). A total of 34% of women had a severe deficiency (vitamin D ≤ 12.5 nmol/L); 41% had moderate deficiency (vitamin D levels between 12.5 - 25 nmol/L); 23% had mild deficiency (vitamin D level ≥ 25 - < 50 nmol/L); and 2% had insufficiency (vitamin D level ≥ 50 - ≤ 75 nmol/L). None had a sufficient level of ≥75 nmol/L. The systolic blood pressure ranged from 79-130.5mmHg and the diastolic from 48.5-85.5 mmHg. Both systolic and diastolic blood pressures were significantly higher in women that were in the lower 2 quartiles of vitamin D. However, linear regression analysis adjusting for potential confounders showed that 25(OH)D level was not a predictor of either systolic or diastolic blood pressures. A negative correlation (although not significant) was found between vitamin D level and plasma renin concentration in this study group. CONCLUSION: Vitamin D deficiency was highly prevalent among the study group. Vitamin D was a not a predictor of either systolic or diastolic blood pressure. There was a negative correlation between vitamin D level and renin concentration although not statically significant. It is possible that any underlying relationship was obscured by the relatively young age group or due to the narrow blood pressure range of the studied population. A larger sample size including hypertensive subjects may be needed.
Obesity is a major health problem that is increasing in an alarming rate and is associated with an increased prevalence of cardiovascular morbidity and mortality. New strategies to combat obesity epidemic are urgently needed, but gaps in understanding of obesity pathogenesis continue to limit progress in this goal. This review aims at discussing the neural aspects of obesity and the brain potential role in energy balance ,also to contribute in the complex solution of obesity puzzle on neurological basis. The hypothalamic region of the brain is the center that plays an important role in the control of feeding and its related behaviors. A better understanding of its role and how it is affected by neuroendocrine and adipokines signaling might be helpful in developing new pharmacological therapy for obesity. Also, this article highlights different mechanisms by which altered brain signaling and hypothalamic inflammation predispose to diet –induced obesity.
The aim of this research was to investigate the macro- and microelements composition in the cerebrospinal fluid and in the blood serum of patients, with different consequences of TBI before and after complex treatment, with the use of endolumbal and intracystal introduction of ozone and pyracetam in dynamics.Macro- and microelements composition was investigated in the cerebrospinal fluid and serum of 83 patients. State of neurological disorders in patients evaluated by the Glasgow Outcome Scale was extended. Thus, positive changes may be noted in the metabolism of macro- and microelements in the blood serum and cerebrospinal fluid of patients who were treated according to our suggested methods – endolumbal introductions of nootropic ozone mixture and endocystal introductions of ozone.
Abstract: Many aspects of surgical treatment of intestinal malrotation in children remain to be debatable. In the opinion of the majority of the specialists, surgical treatment is required after the diagnosis taking into account serious complications of intestinal malrotation.Purpose. The purpose of this research was to conduct an analysis of surgical tactics and operative treatment method for isolated and associated intestinal malrotations in children.Material and methods. We observed 123 children at the age of one day to 15 years with malrotation during the period of 2002 to 2013.Results. We presented the data from observing 123 children at the age of one day to 15 years with various clinical-anatomic forms of intestinal malrotation over from 2002 to 2013. In 62 patients (50.4%), the evidences of the high intestinal obstruction were prevalent, while 61 (49.6%) showed signs of low intestinal obstruction. 116 patients (94,3%) were given operative intervention: radical – 95(81,9%) and palliative – 21 (18,1%). In 56 % of the cases, various simultaneous surgeries were required. There are proposed differential approaches in relation to anatomic form of malrotation and possibility of the fixation of large intestine in the physiological position.Conclusion. The results obtained from the operative treatment are presented. The lethal outcomes could be reduced from 54.7%, among the patients being observed from 2002 to 2010, to 16,7% in patients being operated during 2011 to 2013.
Nevus lipomatosus superficialis is a rare hamartomatous malformation which is composed of ectopic adipocytes in the dermis. It was first reported in 1921 by Hoffmann and Zurhelle. Two clinical forms of nevus lipomatosus superficialis have been described: classical (multiple) and solitary. Classical form of nevus lipomatosus superficialis is usually found on pelvic girdle, trunk, buttocks and thighs as soft, skin colored papules or nodules. It is usually present at birth or it appears in the first two decades of life. The solitary form of lipomatosus superficialis appears as a solitary papule or nodule on the back, scalp and arms of the patients with late onset. The lesions are usually asymptomatic, however some patients may complain about pain and itching. Malignant transformation of nevus lipomatosis superficialis has not been reported yet. Therefore, surgical intervention is only necessary for the patients who have cosmetic concerns. Recurrence after surgical removal is very rare. Perineum is an uncommon localization for nevus lipomatosus superficialis. Hereby, we report a 55-year-old Caucasian female with a 6x5,5x4 cm mass in the perineal region. The patient had cosmetic concerns, therefore she wanted the lesion to be removed surgically. The lesion was surgically removed. The histopathological evaluation of the specimen revealed nevus lipomatosus superficialis. A solitary type of giant nevus lipomatosus superficialis in the perineal region of a patient over the age of 50 is a very rare condition. Even rarely seen, nevus lipomatosus superficialis should be kept in mind in the differential diagnosis of perineal masses.
Protection of reproductive health of adolescents and youth, i.e., individuals aged 15 to 24 years, is a primary goal of a family planning service as according to WHO estimations (1995), the youth aged 15 to 24 years makes over 14% of the overall population in developed countries.Disorders of a menstrual cycle take a leading place among gynaecologic pathologies of adolescent girls. At the same time, according to WHO data, about 30% of schoolchildren suffer from iron deficiency anemia, which takes one of the first places in the structure of somatic pathologies. On the basis of maternity welfare centre No. 2, 2,456 girls aged 15 to 18 years were examined, and the frequency of occurrence and structure of disorders of a menstrual cycle was studied. In addition to standard methods of examination, all patients undertook USI of small pelvis organs; indicators of a hormonal status, complete blood test, transport fund, and iron stocks were investigated. The study included 285 girls, with various disorders of a menstrual cycle, who had no history of iron deficiency states and exacerbation of chronic diseases. The control group included 69 adolescent girls with a regular menstrual cycle. The most common type of disorder of a menstrual cycle in subjects examined was dysmenorrhea I. Iron deficiency anaemia was found in 5.3% of the subjects examined. The frequency of occurrence of moderate anaemia and latent deficiency of iron of 46.7% and 11.9%, respectively, attracts our attention. Well-timed diagnostics of the states mentioned in adolescent girls can prevent subsequent development of reproductive and somatic pathologies.
The effect of aqueous and ether Chelidonium majus haulms extract on cervical HeLa tumor cells, mammary adenocarcinoma MCF 7 tumor cells and acute lymphoblastic leukemia CEM tumor cells in vitro have been studied. The purpose of this research was to compare the effect of aqueous and ether Chelidonium majus haulms extract on selected tumor cells. Colorimetric MTT assay have been used for the study of the antiproliferative effect of aqueous and ether haulms extract of Chelidonium majus on cell viability in vitro. The results of the experiments have shown the cytotoxic effect of the aqueous and the ether Chelidonium majus haulms extract on the individual tumor cells. The aqueous Chelidonium majus haulms extract was the most effective on CEM cells, it was less effective on MCF 7 cells and it was the least effective on HeLa cells. The ether haulms extract of Chelidonium majus was the most effective at all of studied concentrations on CEM cells and MCF 7 cells in comparison with HeLa cells, where it was significantly effective only at the highest concentration. Aqueous and ether haulms extract of Chelidonium majus tested in vitro indicated their cytotoxic activity. Both haulms extract of Chelidonium majus were more efficient on CEM cells. It is assumed that higher antiproliferative activity of ether haulms extract of Chelidonium majus is the result of higher antiproliferative activity of lipophilic substances. The lipophilic substances pass through membrane and bind to various proteins and change their biological activity.
The purpose of this study was to evaluate the efficacy and safety of FDP in patients with ocular ischemic syndrome.Material and methods. The material for this study is based on results of a comprehensive examination and treatment of 53 patients with a diagnosis OIS. The average age of the patients was 57,8 ± 6,82 year. 19 of them women, 34 men. 27 patients entered to the main group (1) which received standard therapy in combination with intravenous FDP (fructose 1,6-bisphosphate). 26 patients in the control group (2) received standard treatment.Results. In applying the FDP combined with comprehensive therapy in the main group resulted in increased of visual acuity by 32.8%, parameters of retinal sensitivity by 17.8%, reducing the area of scotomas compared with patients of the control group. Optical coherence tomography registered significant changes in the dynamics in patients of the main group - reducing the edema and restoration of RNFL and ONH. Recovery of visual function may have contributed neuroprotective activity of the drug FDP by a protective effect on nerve tissue, reducing the effects of hypoxic stress.Conclusions. The use of standard therapy in combination with FDP in the treatment of ocular ischemic syndrome has a positive effect on the course of the disease, thereby, increase of visual acuity, a decrease in sectoral loss in vision fields, the positive dynamics OCT parameters, improving hemodynamic parameters at Doppler imaging in dynamics.
The widespread introduction of dental implant in the dental practice will determine progress and the future of prosthetic dentistry. At the same time, like any new direction dental implantation has generated a lot of questions and unsolved problems. On many of these issues and problems can be answered only by using morphological methods. Therefore, after the development of a new construction of the dental implant one of the main issues was the question of its interaction with the jawbone and soft tissues of the oral cavity.We performed the experiment on 24 long snout dogs of both sexes, weighing 30-35 kg, with normal bite, at the age of 20-24 months. Animals were divided into 2 groups, according to samples of screw dental implants used in the experiment: basic group - 12 dogs in which were used samples of the new construction of dental implant “Implant.uz” (Uzbekistan); control group – 12 dogs in which were applied screw dental implant system “Dentium” (South Korea). Terms of derivation of animals from experiments were 1, 3, and 6 months.By using morphological techniques were studied implants “Implant.uz” from medical titanium BT-1.00 brand, their interaction with bone of alveolar ridge. “Implant.uz” did not cause pathological changes in the bone tissue of alveolar ridges of jaws and could be an alternative to known dental implants.
The presence of many patients with combined pathology, which according to the WHO is 30-40%, confronts surgeons and gynecologists the problem of possibility of simultaneous correction of this pathology. Relevant is the question of the necessity and safety of invasive techniques, both classic and minimally invasive, using the endosurgical techniques.
Early diagnosis of optic neuritis (ON) is essential to prevent or limit the structural damage and permanent loss of visual function. The aim of this study was to estimate prognostic importance of the neuron-specific enolase (NSE) in blood serum and lachrymal fluid in optic neuritis. The clinical-diagnostic examination was performed on patients with optic neuritis, including optical coherence tomography (OCT) and Visually Evoked Potentials (VEP), MR – tractography, as well as analysis of NSE content in blood serum and in lachrymal fluid.Decreased level of NSE in lachrymal fluid in patients with acute stage of optic neuritis and increased level of NSE in patients with optic neuritis at the stage of transition into atrophy of optic nerve disc were detected. Comparative analysis demonstrated relatively high level of NSE in lachrymal fluid at transitional stage to atrophy as compared to acute phase.
Introduction: The type of the preparation junction is determined by a number of factors that need to be taken in consideration with CAD/CAM Fixed Prosthodontics: the material of which the construction will be made; the type and condition of the retainer teeth, of their periodontium and the occlusion; the design software, the CAM setting and the type of drills; the working protocol; the type of the cement and the method of cementation. Purpose: The aim of this publication is to describe the optimal preparation junctions for all-ceramic crown and bridge restorations made by CAM 5 - S 2 Impression, VHF. Materials and methods: Suitable are chamfer and shoulder preparation junction with rounded inner angle (width 1 - 1, 5 mm). Trimming of 1.5 – 2 mm dental tissues is necessary on the occlusal surface. The homothetic reduction of teeth is optimal. Results and discussion: The width depends on the size and vitality of the tooth. In stained teeth and those built with metal pins the removal of more tissues provides a greater volume needed to disguise the dark color. Vestibular preparation under the level of the gingiva is preferable to ensure optimal aesthetics. Preparation junction is determined also by the CAD/CAM technology - the type of drills and protocol of impression taking (classical or digital). The creation of a working model with TRIOS, 3Shape intraoral scanner is greatly facilitated by preparation junctions made above the gingival margin. Conclusion: Knowledge about the criteria for selection the preparation junctions is essential for fabrication accurate and aesthetic CAD/CAM restorations.
In recent years there has been a noticeable "rejuvenation" of pelvic organ prolapse. Inconsistency of the pelvic floor muscles, including the omission of sexual organs, is extremely common pathology, observed almost a third of women of reproductive age. The search for effective, convenient methods of contraception for this category of patients is an important problem of modern gynecology.We proposed a method of transvaginal voluntary surgical contraception, produced in conjunction with surgical treatment of descent and prolapse of the vaginal walls. Studied the nearest and long-term results of surgery in 50 women to which, during the surgical treatment of genital prolapse at the same time was performed transvaginal occlusion of the fallopian tubes. Control groups consisted of 30 women to which in the first step before surgical correction of pelvic organ prolapse have been performed minilaparotomy and voluntary surgical sterilization (VSS). Our method consists in penetrating into the abdominal cavity through the anterior vaginal vault, downgrading the fallopian tubes with a hook of Ramathibodi and tubal sterilization by Pomeroy method. Intra - and postoperative complications were not observed. In the late postoperative periods - the effectiveness of the method was 100%. Marked tendency to improve the quality of sexual life tells about the positive impact of elimination of genital prolapse with simultaneous DCA on the quality of life of women.
Creation of productive knowledge is important whereas on the base of this knowledge we can diagnose morphologic and morphometric properties of vascular stromal tissues of myocardium under toxic myocarditis on the bases of clinical symptoms. Consequence of this is a proper therapeutic strategy that will have a life importance for the patients.
Purpose: Usually any research survey can produce better results if it is utilized in local language. The study aimed to measure the inter-consistency, reliability and validity of three measures in Arabic language. Current study is phase I of research project to validate the measures in Arabic language.Material and Method: These three valuable and most widely used scales, Rosenberg self-esteem scale, brief psychological well-being scale and impact of weight on quality of life questionnaire were translated in Arabic language by adapting standard procedure of translation. Data was gathered from female students (N=500) enrolled in bachelors program during the period of November 2014-October 2015.Results: Reliability of the scale was calculated using Cronbach alpha. Psychological well-being scale was found having high reliability of 0.92, whereas, Rosenberg self-esteem scale and Impact of weight on quality of life questionnaire was found having acceptable range of reliability (0.72). All the sub scales of IWQOL-Lite reliability ranges from 0.87-0.95. Three of the scales were found having good content and construct validity.Conclusion: Findings shows that these scales being employed in this study is reliable instrument for measurement of the constructs of interest in Arabic version.
In this article the possibilities of MR tractography in symptomatic epilepsy patients have been presented. We determined the quantitative standards of numerical values of diffusion of white matter in children with symptomatic epilepsy of various etiology. In children with symptomatic epilepsy, the pathological changes of white matter were localized not only in the epileptogenic, but also in the opposite hemisphere. The regions with abnormal white matter FA and ADC values not only matched to limbic circle zones, but also to areas of intra- and interhemispheric connections uniting the frontal, temporal, parietal and occipital lobes of the brain. Determining the specific clusters of brain tracts in symptomatic epilepsy, regardless of etiology, is important to predict the prognosis of the disease and the likely possibility of cognitive impairment. The study proved that symptomatic epilepsy is characterized by a variety of changes in the white matter of the brain tracts that lead to the dissociation of certain regions of the brain, interrupting connections between cortical and subcortical regions and inhibiting the transfer of information. It can be concluded, that diffusion-weighted imaging are much more sensitive to the structural and metabolic changes occurring in the brain, in comparison with conventional MRI images.
Presented the experience of the application of stable osteosynthesisby three Kirschner wires on diaphyseal fractures of the metacarpal bones at 74 patients.Indications for osteosynthesiswas opened (6%), closed (94%), non-united, mal-unitedfractures and false joints of metacarpal bonesdiaphysis. Patients were performed intraosseous anesthesia atdistal epimetaphysisarea of radial bone.Describeda method of operation extramedullaryosteosynthesis using three Kirschner wires. Also,describedmethod of wedge osteotomy for full recovery of hand function. Good results were obtained in 83.1% of patients, satisfactory at 13.6%, and unsatisfactory results in 3.4% of patients
Introduction: Routine surveillance of colorectal cancer includes serial measurements of CEA levels. Although not routinely indicated Ca 19-9 is also a tool for recurrence. When any of these serum markers is elevated during follow up, this could represent a recurrence. The management of elevated tumor marker levels include clinical exams, endoscopy and conventional imaging –ultrasound, CT, MRI.Objective: To evaluate the positive predictive value of CEA and Ca19-9 as tumor markers for recurrent colorectal cancer in cases where conventional imaging and endoscopic studies fail to localize disease.Materials and methods: A total of 75 patients with elevated CEA and/or Ca19-9 serum levels and negative endoscopic exam as well as negative abdominal CT and Chest X-ray were included in the study. CEA levels were tested in 50 patients. Ca 19-9 was tested in 65 patients. 34 of the patients had both markers tested. All patients underwent whole body 18F-FDG PET/CT. Patients with negative of equivocal PET scan were further followed up (10 to 24 months).Results: Based on the reference standard – the results from PET/CT, if positive and the results from follow-up in cases of negative or equivocal scans, the positive predictive value of Ca 19-9 was 84% and that of CEA -83%. There was no significant difference in the PPV of Ca19-9 and CEA.Conclusion: Elevated CEA and Ca 19-9 levels in patients under active surveillance after operation for colorectal cancer have high positive predictive value for recurrence, even in cases where conventional work-up – endoscopy and CT don’t localize disease.
Background. Main issues of treatment of patients with cicatricial stenosis of trachea (CST) are to increase its efficacy and safety, as well as to determine indications and contraindications for circular resection and reconstructive interventions on the trachea in patients with extended lesions of trachea, with stenoses involving subvocal cords part of larynx and well as multifocal narrowing of the trachea which could improve treatment results and quality of life of patients, to gain recovery and reduce disability and mortality. Material and methods. One hundred two patients aged from 11 to 62 years with CST were surgically treated. Stenotic site length in patients varied from 0,3 to 7 cm. Most frequently (64,2%), CST length of more than 2 cm was observed. In critical and decompensated stenosis with diameter of CST up to 5 mm with the threat of asphyxiation by the first stage we used endoscopic laser-and electric destruction of constriction followed by restricted zone bouging. If long-term rehabilitation was necessary and in case of absence of the conditions to the implementation of circular tracheal resection, we used tracheal stents. Circular resection of the trachea was performed in 24 patients. In case of contraindications, 28 patients underwent reconstructive plastic surgery with dissection the stenosis, excision of scar tissue and formation of trachea lumen in T-tube. After removing T-tube plasty of anterior tracheal wall and of soft tissues of the neck defects was performed using local tissues and grafts with microsurgical techniques. Results. Long-term results of treatment evaluated and studied in a period of 6 months to 5 years in 89 (87.3%) patients. 13 patients continues to one of the stages of complex treatment. Еhe patients are under dynamic endoscopic control. Good results were achieved in the treatment of 71 patients (79.8%), satisfactory - in 12 (13.4%), unsatisfactory results in 6 (6.7%) patients. Conclusions. 1. Patients with CST should undergo multimodal approach depending on degree and localization of narrowing, length and levels of restriction, taking into account severity of associated pathologies using complex of endosurgical, resection and reconstructive treatments. 2. When an extended CST involvement in the process is more than 30–50% of the trachea up to 5-6 cm, it’s possibly to perform circular tracheal resection provided that mobilization of necessary levels is sufficient. 3. In case of multifocal CST in conjunction with subglottic stenosis of the larynx formation of the lumen, it is expedient to form a lumen in the T-tube.
