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Introduction: The progression of ferroptosis has been found to be associated with the onset and progression of many diseases. Disruption of iron homeostasis can lead to ferroptosis. We had previously hypothesized that vitamin D may affect serum calcium levels, which in turn regulates ferroptosis by regulating serum iron levels. However, the relationship between serum calcium level and serum iron level is unclear. The purpose of our study was to explore the relationship between serum calcium level and serum iron level among general population in Taizhou, China.

Methods: In this study, a cross-sectional study was conducted. Serum calcium levels and serum iron levels were determined in our work. Pearson's correlation analysis was used to determine the association between serum calcium level and serum iron level.

Results: The results showed that serum iron level was negatively correlated with serum calcium level and age. After controlling for age, sex and marital status, serum iron level was still negatively correlated with serum calcium level.

Conclusions: The results suggest that improving serum calcium levels may be a potential strategy for regulating iron metabolism homeostasis. Whether calcium supplementation can reduce serum iron levels in people with low serum calcium levels needs further investigation.

Background and objectives: Bacterial meningitis is a common serious infectious diseases in children with tough therapy due to resistance to commonly indicated antibacterial therapy. We sought to characterize the bacterial resistance spectrum of Bacterial meningitis in Iraqi pediatric patients.

Methods: Fifty-seven patients' CSF (cerebrospinal fluid) microbiological data were reviewed before enrollment of children (less than 4 years old), Gram-stain identification, white blood cells, protein, and glucose assays, and growing the bacterial pathogen from CSF or blood samples. A probable case of bacterial meningitis was determined by leukocytosis (>100 cells/mm 3), turbidity, decreased glucose (<40 mg/dl), and raised protein levels (>100 mg/dl), which provided enough evidence to start antibiotic regimen.

Results: Three quarters of the patients diagnosed with meningitis 71.9 % were males, although there was no significant association neither between gender nor age group and drug resistance. There was a significant association between the level of hemoglobin (low level of Hb) and drug resistance (single 68.3%, multiple 29.3%, P value 0.004). Also, there was a significant association between vaccination (unvaccinated patient) and drug resistance (multiple drug resistance) (100%, P value 0.001).

Conclusion: This study offers valuable new insights into the characteristics and prognoses of individuals with varying degrees of therapy resistance.

Despite the significance of anatomical variability in various specialties, there is currently limited research dedicated to this topic. Most studies focus on the brain, with only a small number examining the human skull, primarily in relation to anatomical variability in childhood.

Aim: Therefore, the aim of our work is to determine the individual anatomical variability of the lateral dimensions of the facial section of the adult human skull.

Materials and methods: The study included 115 skulls of mature individuals, comprising 35 dry bone specimens from the anatomy museum collection and 80 results from human head CT scans without bone tissue pathologies. To detail the craniometric characteristics of the lateral surface of the facial section of the skull, polygons (polygons) were constructed with dividing of the facial section of the skull is into the orbital-frontal, nasal, and maxillary. The facial profilegram of the skull was formed as a set of predetermined dimensions between facial profile points, presenting a continuous line passing through points gl-n-rhi-ns-pr-id-pg, reflecting the shape, dimensions, and position of the cranial profile of mature adults regardless of sex or cranial type.

Results: It was established that the longitudinal anteroposterior dimensions of the facial skull exhibit a certain range of variability in mature individuals depending on gender. For instance, the distance between the points gl-po (glabella-porion) reaches its maximum values in individuals with a brachycranial skull shape, ranging from 107 mm to 130 mm in men and from 104 mm to 128 mm in women. In individuals with a mesocranial skull shape, this parameter gradually decreases to 109-126 mm in men and 107-124 mm in women. A similar decrease is observed in those with a dolichocranial skull shape, where the range is 109-121 mm in men and 109-120 mm in women. The distance between n-po (nasion-porion) in brachycranial and mesocranial individuals remains within 96-123 mm and 102-123 mm, regardless of gender, indicating that this parameter is relatively stable. However, in dolichocranial individuals, this distance decreases to 104-115 mm.

Conclusions: Individual anatomical variability of the anteroposterior lateral dimensions of the facial skeleton in mature individuals has been determined. A more in-depth analysis of the existing range of individual variability in the profile configuration of the facial skull was conducted using sagittal polygons. It was found that the polygons gl-po-n, n-po-rhi, and rhi-po-ns relate to the structure of the bony profile of the orbital-temporal and nasal regions of the facial skull, reflecting the upper, combined orbital-nasal section of the head.

Introduction: The effective techniques of surgical intervention that ensure the desired level of weight reduction outcomes (decreased level of obesity) not always improve QOL outcomes, explained by a range of post-surgery complications. There are the specific complications, strongly impacting the QOL of the patients after bariatric surgery and increasing postoperative comorbidity.

Aim: The aim of this retrospective case control study was to evaluate the relative safety of primary LSG performed with standard and modified LSG techniques according to the Clavien-Dindo complication grading system and the rate of long-term complications in patients with BMI>40.

Materials and methods: A total of 497 cases of patients were divided into 2 groups in accordance with the type of LSG performed. The first group (n = 246) were the patients managed with the Standard protocol of LSG and the second group (n = 251) included the patients treated with the modified protocol of the LSG. The prevalence of specific post-bariatric complications and short-term (30-days) complications was calculated and compared in the groups. The long-term complications were assessed after 1-year օf post-operation period in both intervention groups. The relative risk ratio, p-value and CI95% were calculated for all complications. The short-term (30-days) complications assessment in both intervention groups was performed in accordance with Clavien-Dindo classification of surgical complications.

Results: The remarkable reduction of relative risks was registered for the minor and major complications rates. Similarly, the total rates for the minor and major complications demonstrated strong difference between group I and group II (p<0,05). Тhe intraoperative and early (first 72 hours) complications (acute bleeding, and leakage) rates in patients of group I were reliably lower compared to the patients of group II (p<0,05). The RR indicators were 0.123 and 0.121 respectively for acute bleeding and leakage. The indicator of acute obstruction was not essentially different while intergroup comparison was significantly divergent (p<.05). However, the RRR was calculated as 80%. The total rate of intraoperative and first 72 hours complications was 7.3% vs 1.2% in group II. The difference was reliable (p-value<.05) in Gall stone disease, GERD, thrombosis malnutrition and anemia. Comparison of the Renal lithiasis and depression didn't reveal any essential difference between clinical groups (p-value>.05).

Conclusion: The results we received are direct confirmation of the comparatively higher effectiveness of the modified LSG evidenced by a significant reduction of the major and minor complications in patients with BMI>40.

Introduction: The adenoids and palatine tonsils, part of the lymphoid tissue, act as a first line of defense protecting the lower airways and gastrointestinal tract. Adenotonsillar hypertrophy in children may lead to airway obstruction. This study aims to demonstrate the association between adenotonsillar hypertrophy and decreased blood oxygen saturation.

Methods: A retrospective cohort study was conducted among children aged 7-12 years with adenotonsillar hypertrophy and obstructive symptoms, admitted to King Fahad Hospital and Prince Mishari Hospital, Saudi Arabia, for tonsillectomy between July 2023 and January 2024. Exclusion criteria included respiratory diseases, cardiac disease, nasal polyps, nasal septum deviation, chest wall abnormality, and lower airway diseases. The control group included 56 healthy children. An otolaryngologist determined the severity of airway obstruction using the tonsil size. Oxygen saturation was measured using pulse oximetry. The determinants of oxygen saturation were assessed using multiple linear regression, with significance set at p<0.05.

Results: The study included 357 participants, with an even age distribution between 7-9 years (49.6%) and 10-12 years (50.4%), and 52% males. Diagnoses included adenoid hypertrophy (30%), tonsil hypertrophy (35%), both conditions (19%), and the control group (16%). Tonsil sizes ranged from Grade 1 (48%) to Grade 4 (8.4%), with 17% normal. The median oxygen saturation was 96.0% for the adenotonsillar hypertrophy group and 99.0% for the control. Oxygen saturation levels differed significantly across groups (p<0.0001), with lower median saturation in hypertrophy groups than controls. Males had a lower oxygen than females (estimate: -0.338, 95% CI [--0.640, -0.036], p=0.028). Adenoid hypertrophy (estimate: -3.863, 95% CI [-5.241, -2.484], p<0.001), tonsil hypertrophy (estimate: -3.631, 95% CI [-5.053, -2.208], p<0.001) and having both conditions (estimate: -3.777, 95% CI [-5.3.7, -2.247], p<0.001) was associated with lower oxygen saturation. Grade 1 tonsil size was associated with an increase in oxygen saturation (estimate = 2.905, 95% CI [1.616, 4.194], p<0.001). In contrast, Grade 4 tonsil size was linked to lower oxygen saturation (estimate=-4.848, 95% CI [-6.367, -3.329], p<0.001). Grades 2 and 3 were not significantly associated with changes in oxygen saturation.

Conclusion: Adenotonsillar hypertrophy is significantly associated with decreased blood oxygen saturation and related cardiopulmonary complications in children. Early adenotonsillectomy may be of benefit in preventing these complications and improving oxygen saturation levels.

Background: Control of rifampicin-resistant tuberculosis (RR-MTB) requires novel technologies for restoring the anti-TB efficacy of priority drugs. We sought to evaluate the ability of nanotechnology application in the recovery of the anti-tuberculosis efficacy of rifampicin.

Methods: Nanocomposite- standard dose of rifampicin and 20 nm silver nanoparticles (AgNPs) suspension solution of 6 different concentrations: 0.25%; 0.5%; 1%; 2.5%; 5%; and 10%, were supplemented to 70 rifampicin-resistant mycobacterium tuberculosis (RR-MTB) isolates. The control arm consisted of 35 RR-MTB isolates and AgNPs suspension with identical concentrations. The inhibitory effect of nanocomposites was evaluated by MTB growth rate using the BACTECTM MGIT 960TM. The safety assessment of single-use AgNPs was conducted in experimental animals.

Results: The suppression process of AgNPs on RR-MTB isolates started with 2,5% nanocomposite solution application and full suppression was achieved in 5% and 10% nanocomposite solutions. A standard dose of rifampicin and a 2.5% solution of AgNPs increased the minimal inhibitory effect on RR-MTB by 10% (total 80%) vs the isolated use of a 2.5% solution of AgNPs (70%). An experiment on animals revealed the complete safety of a single injection of ultra-high doses of AgNPs.

Conclusion: The study showed the potentiating effect of AgNPs in overcoming the resistance of MTB to rifampicin providing a scientific basis for further research.

Physical and mental health play an important role in managing and characterizing a person's quality of life (QOL) and physical activity is proposed as one of the ways to improve QOL and well-being. This study aimed to quantify the effect of different fitness training programs and frequency on health-related quality of life (HRQOL). The percentage of participants with high levels of fitness is higher among men than women. There is an association between the level of PF activity and age. Аs expected, PF activity is lower in the elderly compared to the younger and middle-aged participants. From the HRQOL domains, low general health and mental health scores. High and medium-frequency training can presumably help improve the total quality of life scores, as well as scores for Physical and Mental components, significantly affecting domains PF, GH, VT, RE and MH. To improve the SF domain, high-frequency training is preferable. These results can become important for the implementation of programs aimed at improving the HRQOL of the population.

Aim: The aim of the article is to analyze the current state of functioning of the medical information space of Ukraine in order to formulate scientifically sound proposals aimed at improving the implementation of medical reform.

Materials and methods: The study is based on the analysis of literary sources of Ukrainian and international scientists, Ukrainian and foreign legislation and judicial practice. The article uses general theoretical and special methods of scientific cognition: theoretical analysis, systemic and structural, analysis and synthesis, sociological and statistical, logical and semantic, comparative and legal, method of ascent from the abstract to the concrete, forecasting and generalization.

Results: One of the key categories of the reform of the Ukrainian national medical sphere - the unified medical information space and its constituent elements - is studied. The electronic health care system, which stores medical data about patients in a single place and ensures their exchange between medical institutions, is analyzed. Emphasis is placed on the possibilities of using telemedicine and artificial intelligence, which play a key role in the development of the unified medical information space in accordance with global trends. The importance of legislative provision of efficiency and safety of the unified medical space is emphasized. It is about regulating the protection of personal data, establishing technical standards and requirements for medical information systems, ensuring confidentiality, integrity and data availability of the unified medical information space.

Conclusions: Conclusions are drawn about the importance of proper functioning of each of the elements of the unified medical information space, both individually and in conjunction with each other. The authors' vision of improving the existing system of the unified medical information space is presented.

Introduction: Despite being highly preventable, cervical cancer (CC) is the eighth most prevalent form of female cancer in Armenia and the second most common malignancy among those aged 15 to 44. In Armenia, there is an age-standardized incidence of 7.8 per 100,000 females, and an age-standardized mortality of 4.6 per 100,000 females. Globally, the CC is the 4th most common cancer among women. Its incidence was 604,127 new cases and 341,831 deaths in 2020. We conducted a retrospective, observational cohort study using clinical data to verify the influence of HPV vaccine (Gardasil, Merck&CO) on fertility function in women, vaccinated in RA since 2017 year in the limits of anti-HPV vaccination Program (included in National Vaccination Calendar).

Materials and methods: For the study, we analyzed data received from Armenian-American Wellness Center (Yerevan, Armenia). 98 female volunteers vaccinated with the 4vHPV who attended AAWC and were examined for reproductive function. The subjects were divided into 3 age groups - 1st group - 15 years -24 years 11 months, 2nd group - 25 years -34 years 11 months, 3rd group - 35 -40 years. Each control group was composed of randomly selected 30 healthy women in age identical to the main group who applied AAWC for regular checkup in the same time frame and have never been exposed to anti HPV vaccine.

Results: The current research is aimed to reveal any negative impact of 4vHPV vaccine on fertility indicators in Armenian cohort. The performed comparative statistical analysis of the assessed indicators has revealed the ORs<1 for POI, late fertilization disorders of menstrual cycle and anovulation prevalence indicators. The chance of investigated disorders' development in 4vHPV vaccine exposed cohort did not exaggerate that in non-exposed sample cohort. The significant difference was not observed in Anti-Mullerian Hormone, FSH basal levels, as well as in mean ovarian volume and number of antral follicles indicators between clinical and respective control groups (p<.05).

Conclusion: The data obtained make us to conclude about absence of any negative impact of 4vHPV vaccine on fertility function indicators in 4vHPV vaccinated cohort in RA. The study results contribute to perception of the 4vHPV vaccine safety concept, what in its turn can trigger increase of vaccination coverage leading to CC control efficiency.

Background: To evaluate the treatment outcomes of lateral interbody bone graft surgery and posterior percutaneous screws for lumbar spinal stenosis Methods: This is a cross-sectional descriptive study. There were 27 patients with 30 segments of surgery diagnosed with lumbar spinal stenosis that were surgically treated with the XLIF method. Clinical outcomes measured included VAS scores for lower back pain and leg pain, ODI, and JOA scores. Magnetic resonance imaging of the lumbar spine after surgery was used to evaluate indirect decompression. X-ray or CT scan to evaluate bone fusion after 6 months of surgery. Differences were determined by independent T-test.

Results: There were 27 patients with 30 segments of surgery. They were 12 males and 15 females with an average age of 58.81±8.1. There was significant improvement in VAS for lower back pain from 7.11±1.31 to 3.67±1.3, VAS for leg pain from 6.81±2.19 to 1.59±1.89, ODI from 26.41±8.95 to 13.69±8.34, and JOA score from 7.63±2.87 to 13.5±1.73. A-P diameter increased 134%, lateral diameter increased 120%, lateral recess depth increased 166%, disc height increased 126%, foraminal height increased 124%, spinal canal area increased 30%. The p-values were all <0.001. The average hospital stay was 6.79±3.01 days. Complications included 1 pedicle screw malformation, 1 ALL avulsion fracture, 1 abdominal herniation, 1 venous damage, 1 failure.

Conclusion: XLIF surgery presents a favorable option for patients with lumbar spinal stenosis. This is a minimally invasive surgical method that reduces pain, reduces bleeding, and is effective in indirectly decompressing the spinal canal both clinal and imaging.