Georgian medical news最新文献

The characteristics of spontaneous electrical activity forming bursts of action potentials in the main rhythmogenic areas of the myometrium (ovarian area, cervical area, uterine corpus) were investigated. The results were analyzed by determining the values of the following parameters of action potentials: amplitude (A), mean rise-rate (V), rise-time (T/2), and half-width (t). The obtained data indicate that the ovarian horn area represents a distinct rhythmogenic site, characterized by generation of bursts of discharges with properties unique to this area, in contrast to the activity patterns observed in the cervical horn area and uterine corpus. Oxytocin, through its excitatory action, induces a synchronous increase in the measured parameters across the studied areas to the same extent. Comparable alterations in the main activity characteristics were observed under conditions of complete isolation of each uterine horn locus. Administration of oxytocin following isolation of loci resulted in a marked increase in spike amplitude and rise rate of action potentials in the ovarian area, approaching values observed in norm. Thus, these findings indicate that the ovarian horn area serves as a leading rhythmogenic site. Morphochemical results demonstrated the presence of different "functional" states in the examined myometrial areas, which is consistent with the presented electrophysiological data.

Acute respiratory distress syndrome (ARDS) is a severe complication of COVID-19. During the pathogenesis of ARDS, a deficiency of alveolar surfactant could lead to severe hypoxemia. This report demonstrates that exogenous surfactant administration improves the overall clinical condition, reduces severe hypoxemia, and enhances the P/F ratio, thereby preventing the multiple organ dysfunction syndrome (MODS) that usually follows hypoxemia. In our experience, inhalational administration of surfactant preparations for one week was the key to successful treatment and recovery of extremely severe patients who would otherwise have had an unfavorable prognosis.

The Covid-19 pandemic represented a profound disruption to the stability of Armenian society. Key areas of public life and social relations were significantly affected. The daily lives of citizens were critically disrupted, and Armenia's healthcare system was burdened with the unforeseen effects of the pandemic. The disease imposed significant challenges on hospitals and medical staff. The crisis environment facilitated the emergence and intensification of conflicts, exacerbating an already difficult situation. Our goal is to identify the root causes, aspects, process, and practices applied in overcoming conflicts within medical institutions of Armenia during the pandemic. In-depth interviews were conducted with chief physicians of Armenian hospitals. The collected material was subjected to thematic analysis. The causes of conflicts have been identified as work and emotional overload, insufficient resources, insufficient reward, organizational contradictions, medical and sanitary norms, parties to conflicts: patients, relatives of patients, other structures, higher instances and coping practices - informal anti-conflict communications adopted by self-organization, adaptation.

Background: Dyslipidemia, characterized by elevated low-density lipoprotein (LDL) cholesterol and triglycerides (TG) and low high-density lipoprotein (HDL) cholesterol, is one of the causes of acute coronary syndrome (ACS) and its complications. The interactions of lipid-abnormalities with established traditional cardiovascular risk factors guide prevention and management efforts. This article aims to estimate the presence of lipid profile abnormalities on patients with ACS and their relationship with demographic, clinical, and metabolic risk variables.

Methods: A hospital-based cross-sectional study was conducted at Madani Heart Center, Sudan. The study included 231 patients diagnosed with ACS based on clinical and laboratory findings. Data on demographic characteristics, cardiovascular risk factors (smoking, hypertension, diabetes mellitus), and biochemical markers (LDL, HDL, total cholesterol, TG, glycated hemoglobin, and random blood glucose) were collected. Statistical analysis included descriptive statistics, ANOVA, Chi-square tests, and bivariate correlations, with statistical significance set at p≤0.05.

Results: The mean age of participants was 60.6±12.3 years. LDL cholesterol showed no significant association with smoking, hypertension, or diabetes. Triglycerides (TG) demonstrated positive correlations with glycated hemoglobin (r=0.180, p=0.006) and random blood glucose (r=0.163, p=0.013), indicating a strong link between dyslipidemia and glycemic control. HDL cholesterol correlated positively with body weight (r=0.149, p=0.024). Both TG and LDL levels showed insignificant association with ACS types, smoking and hypertension (p-values>0.05).

Conclusion: Triglycerides showed significant associations with markers of impaired glycemic control in patients with ACS indicating the importance of triglyceride management, especially among diabetic individuals.

Objective: This study aimed to identify factors influencing learning attitudes and study engagement among vocational medical students and to further analyze the impact of learning attitude on study engagement.

Methods: A total of 243 first-year students enrolled in the Medical Statistics course at our institution participated in the study. They were assessed using the Chinese versions of the Statistical Attitudes Towards Teaching Survey (SATS-36) and the Utrecht Work Engagement Scale for Students (UWES-S). Linear regression analysis was employed to examine the effect of learning attitude on study engagement.

Results: Significant differences were observed in both the total learning attitude scores and overall study engagement scores based on students' perceptions of course interest, practicality, and teaching quality (all P<0.05). A significant difference was also found in the vigor dimension of study engagement between only children and non-only children (P=0.036). Multivariate linear regression analysis indicated that mean scores for the cognitive component, interest, and effort in learning attitude had a significant positive effect on total study engagement scores, whereas the mean score for perceived difficulty had a significant negative effect.

Conclusion: The overall levels of learning attitude and study engagement among the vocational students were moderate. Cultivating positive learning attitudes may help enhance students' study engagement.

Background: Children diagnosed with autism spectrum disorder (ASD) are often more sensitive to environmental stimuli, particularly light, sound, and touch, which can provoke significant anxiety and behavioral resistance during dental visits, thereby contributing to poor oral health.

Objective: To assess the efficacy of sensory adapted dental environments (SADEs) and related interventions to reduce dental anxiety by improving behavioral cooperation of children with ASD based on peer-reviewed evidence.

Methods: English language studies published between January 2010 and June 2025 were retrieved from the PubMed, ScienceDirect, and Google Scholar databases using the keywords "autism spectrum disorder," "sensory adapted dental environment," "multisensory," "dental anxiety," and "occupational therapy." Reports were limited to randomized controlled trials, quasi experimental studies, observational research, and systematic reviews involving children with ASD or other developmental disabilities. Data were assessed qualitatively.

Results: Evidence indicates that SADEs consistently reduced physiological and behavioral signs of dental anxiety. A large crossover trial involving 162 autistic children reported that visual, auditory, and tactile adaptations significantly reduced stress during dental cleanings. Modifications (dimmed lighting, nature sounds, slow motion projections, and deep pressure wraps) were effective. A 2024 study involving neurotypical children found improved behavior and reduced anxiety in the SADE group, along with lower heart rates and higher oxygen saturation. A randomized trial of children with Down syndrome demonstrated that a multisensory waiting room significantly reduced heart rate and anxiety scores. While the primary focus was ASD, some comparative studies involving neurotypical children and children with Down syndrome were reviewed due to their relevance to sensory-processing mechanisms Meta-analyses of five studies found that SADEs significantly lowered psychophysiological markers of anxiety Conclusion: Current evidence supports the efficacy of SADEs to reduce anxiety and enhance cooperation of children with ASD. These interventions are cost-effective, feasible, and easily tailored to individual sensory profiles. Future research is recommended to examine long-term outcomes, implementation in community settings, and integration with behavioral approaches.

Ulcerative colitis (UC) is a chronic somatic disease requiring long-term treatment and associated with unfavorable outcomes. While global incidence and prevalence of UC are reported to be increasing, epidemiological data for Kazakhstan, particularly for the central city of the Semey region (Abai Region), remain scarce.

Objective: To determine the trends in prevalence and other epidemiological characteristics of ulcerative colitis in the central city of the Semey region - Abai Region.

Materials and methods: A cross-sectional study was conducted using primary medical records (inpatient, outpatient, and electronic medical records from Integrated medical information system) collected between 2014 and 2023. Data on incidence, prevalence, patient loss to follow-up, disease exacerbations, severity, activity level, age, and gender structure were analyzed. A total of 1,539 primary medical records were reviewed. Statistical analysis involved Pearson's chi-square test and Fisher's exact two-tailed test, with a significance level set at p<0.05.

Results: The study revealed an overall increasing trend in the average annual number of registered UC patients per 100,000 population, rising from 23.7 in 2014 to 45.4 in 2023 (trend magnitude: 9.0% per year). Newly diagnosed cases showed a general increase, but with a noticeable decrease during the COVID-19 pandemic. The disease structure was dominated by patients with moderate severity (Grade 2) (58.5% average) and Grade 2 activity (57.5% average). A significant finding was the consistent upward trend in the proportion of patients with Grade 1 activity (4.7% per year increase), likely due to improved diagnosis. The age distribution showed two peaks, in the 31-40 years and 51-60 years categories. Females moderately predominated throughout the study period, accounting for 54.9% to 58.1% of the cohort.

Conclusion: The burden of UC on the healthcare system in the Semey region is growing, driven by both increasing incidence and improved diagnostic efficiency. The identified epidemiological characteristics, including the dual age peaks and moderate female predominance, largely align with international findings. Data collection during the COVID-19 pandemic suggests a potential issue with case detection during healthcare restrictions, hypothesizing increased mortality requiring further verification. These data are crucial for forecasting future trends and planning necessary healthcare resources for UC management in Kazakhstan.

Background: Corticobasal syndrome (CBS) is a rare, clinically heterogeneous neurodegenerative syndrome most commonly associated with corticobasal degeneration (CBD), a 4-repeat tauopathy. CBS presents with asymmetric motor and cortical features, but diagnosis remains challenging, as clinicopathologic concordance is imperfect and other conditions such as Alzheimer's disease (AD), progressive supranuclear palsy (PSP), and frontotemporal lobar degeneration (FTLD) can present with similar phenotypes.

Case presentation: We report the case of a 55-year-old woman with a four-year history of progressive, right-sided spastic hemiparesis and rigidity. Electroneuromyography (ENMG) revealed isolated upper motor neuron (UMN) findings with no lower motor neuron (LMN) involvement. Brain MRI demonstrated cortical atrophy in perirolandic regions, and dopamine transporter (DaT) SPECT imaging revealed a marked, unilateral presynaptic dopaminergic deficit. No sensory, cerebellar, or autonomic features were observed, and levodopa challenge test yielded no benefit. FDG-PET and tau-PET imaging were not performed due to unavailability at our center.

Discussion: The marked clinical asymmetry, dopaminergic deficit strongly support a diagnosis of CBS. While CBD remains the most probable underlying pathology, differential diagnoses include PSP, AD, multiple system atrophy (MSA), idiopathic Parkinson's disease (PD), and, less likely, Mills syndrome or other UMN syndromes. Mills syndrome was considered due to asymmetric UMN findings but was excluded due to parkinsonism, cortical atrophy, and presynaptic dopaminergic loss. This case underscores the diagnostic complexity of CBS, particularly in resource-limited settings where advanced imaging tools are unavailable.

Conclusion: CBS should be considered a leading diagnosis in patients presenting with asymmetric parkinsonism, UMN findings, especially when supported by DaT-SPECT abnormalities. This case highlights the importance of comprehensive clinical evaluation and multimodal imaging in differentiating CBS from other neurodegenerative syndromes.

Background: Objective, reproducible appraisal of primary healthcare (PHC) organizational maturity is essential for steering quality, safety, and sustainability. Existing approaches (e.g., accreditation, compliance audits, single-dimension scorecards) seldom provide an integrated, development-oriented view tailored to outpatient settings.

Aim: To develop a Multilevel System for Competency Development in primary healthcare organizations (MSRK PMSP) based on the Indicator Model For Outpatient Clinic Development (IMORP) model and to assess its feasibility and applicability in urban polyclinics.

Material and methods: The IMORP model was built on aggregated data from a six-year monitoring programme (2020-2025) covering eight urban polyclinics. The framework was designed by four public-health experts and underwent external content review by two independent experts. IMORP structures organizational maturity across seven domains (workforce, quality of care, infrastructure, innovation, digitalization, finance, managerial responsiveness) with a maximum of 155 points and four maturity tiers (basic, intermediate, advanced, expert). Descriptive statistics (mean, SD, min-max) were computed. Group comparisons used the Kruskal-Wallis test with Dunn-Bonferroni post hoc procedures where applicable (α=0.05). Temporal changes within each PHC organization were evaluated using Repeated Measures ANOVA or the Friedman test, depending on data distribution.

Results: The model demonstrated clear managerial interpretability and domain-level diagnostic resolution. Clinic-level mean IMORP totals differed significantly (Kruskal-Wallis p<0.001), with representative ranges from approximately 60.0±3.3 to 105.3±8.1 points across facilities; domain-specific means typically fell within narrow bands (e.g., digitalization ≈14-15 points, SD minimal), whereas innovation remained uniformly low. Despite statistically significant between-clinic differences in total scores, all eight facilities were classified within the same maturity tier (Intermediate) according to predefined cut-offs, indicating structural heterogeneity without cross-tier transitions in the pilot phase.

Conclusions: MSRK PMSP (IMORP) offers a practical, multi-domain, maturity-levelled instrument for PHC organizations, simultaneously supporting diagnostic profiling and targeted improvement planning. A full psychometric validation is planned on a larger sample (≥35 polyclinics) to establish internal consistency, inter-rater/test-retest reliability, factor structure, and predictive validity versus clinical-economic and patient-engagement outcomes.