Georgian medical news最新文献

Leptospirosis is classified as an infection subject to mandatory notification; however, surveillance effectiveness varies across regions in Georgia. The aim of the present study was to assess the impact of the COVID-19 pandemic on the leptospirosis epidemiological surveillance system in the Adjara region during 2020-2024. A mixed-methods assessment was conducted following the CDC Updated Guidelines for Evaluating Public Health Surveillance Systems (MMWR, 2001) and national NCDC regulations. Data quality was high within the evaluated subset of cases (86.1%); however, overall system-wide data completeness was low (46.1%), reflecting substantial limitations in routine surveillance data quality. Timeliness significantly declined during 2020-2021 due to COVID-19-related system overload and laboratory delays. Case detection was uneven across municipalities, and field findings revealed gaps in case identification, diagnostic access, and accurate completion of mandatory reporting forms. The Adjara leptospirosis surveillance system demonstrated moderate performance but notable vulnerabilities amplified by the COVID-19 pandemic.

Objective: This study aimed to evaluate the clinical efficacy and safety of facial proprioceptive neuromuscular facilitation (PNF) combined with mirror therapy (MT) in the treatment of acute peripheral facial paralysis (PFP).

Methods: A single-center, randomized controlled trial (RCT) was conducted between December 2022 and June 2024 at Ziyang Central Hospital. A total of 34 patients with acute PFP (disease duration ≤7 days) were randomly assigned to the experimental group (n=17) or the control group (n=17) in a 1:1 ratio. Both groups received standardized conventional treatment (pharmacotherapy + acupuncture + intermediate-frequency pulse electrical stimulation + ultrashort wave therapy) and facial PNF training. The key of drug treatment is to use intravenous dexamethasone 10 mg as early as possible, once a day, and gradually reduce the dose after 5 days of continuous use, and then stop the drug, with a total course of 10 days. Additionally, the experimental group underwent mirror therapy synchronously. The primary outcome was the Facial Clinimetric Evaluation (FaCE) scale score at 4 weeks post-treatment. Secondary outcomes included House-Brackmann (HB) grading (assessed at baseline, 2 weeks, 4 weeks, and full recovery) and Clinical Recovery Time.

Results: Baseline characteristics were well-balanced between the two groups (all P>0.05). At 4 weeks, the median (IQR) FaCE score in the experimental group [67 (62, 71)] was significantly higher than that in the control group [39 (30, 47)] (W=249.50, P<0.001). The experimental group also achieved a significantly shorter mean ± SD Clinical Recovery Time (32±8 days vs. 47±8 days, t=-5.19, P<0.001) and a higher proportion of HB Grade I (normal function) at 4 weeks (52.94% vs. 5.88%, P=0.015) compared with the control group. At full recovery, the experimental group maintained a higher FaCE score (P=0.015) and a trend toward more patients achieving HB Grade I (64.71% vs. 35.29%, P=0.086). No adverse events were reported in either group.

Conclusion: Facial PNF combined with mirror therapy significantly improves facial function, shortens recovery time, and exhibits good safety in patients with acute PFP, making it a promising rehabilitation strategy.

Infertility treatment requires a high-quality service. Initial evaluation of tubal patency and uterine pathology in a cost-effective manner was required to improve treatment success. This study was conducted to evaluates the benefit of saline infusion sonography (SIS) compared to hysterosalpingography (HSG) during assessment of tubal patency and uterine pathology in subfertile women. Prospective interventional clinical trials were applied to 200 (18-35 years of age) women during their infertility evaluation. A questionnaire was used to gather data. SIS performed at cycle day 6-9, checking for tubal patency and uterine endometrial pathology, such as the presence of polyps, fibroids, and congenital uterine anomalies. SIS diagnosed bilateral tubal closure in (7.5%), while previously tried HSG had a higher rate of tubal closure (9.5%), with an extra number of cases was due to false positive as a result of tubal spasm (p 0.371). SIS predict tubal closure with agreement rate of 78.9%, discordance rate of 99.4%, the positive percent agreement value was 93.7%, and the negative percent agreement value was 97.2%. SIS provided more accurate results in diagnosing tubal closure and endometrial pathology than HSG, as SIS had fewer false diagnoses of tubal closure and was more accurate in detecting polyps and fibroids that had been missed by HSG.

Objective: To report the surgical technique and short-term anatomical outcomes of foldable capsular vitreous body (FCVB) implantation in a pre-phthisical eye with chronic retinal and uveal detachment.

Methods: A 35-year-old male with a blind eye secondary to long-standing total retinal detachment was evaluated. The eye had no light perception, sensory exotropia, and severe hypotony. Although the patient did not report significant ocular pain, progressive hypotony, uveal detachment, and early pre-phthisical changes raised concern for future ocular atrophy and cosmetic deformity. A 23-gauge chandelier-assisted pars plana vitrectomy with 360° retinectomy was performed, followed by implantation of a foldable capsular vitreous body filled with silicone oil.

Results: At six-month follow-up, B-scan ultrasonography and ultrasound biomicroscopy demonstrated reattachment of the choroid and ciliary body. Intraocular pressure stabilized between 9-10 mmHg. The FCVB remained well positioned, with no evidence of inflammation, extrusion, or device-related complications.

Conclusion: This preliminary short-term report suggests that FCVB implantation may serve as a globe-preserving option in selected pre-phthisical eyes lacking visual potential. Longer follow-up and larger studies are required to assess long-term safety and durability.

Background and objectives: Vascular structures may be damaged during laparoscopic surgery for colorectal cancer. One of the major reasons is the variant anatomy of the inferior mesenteric artery. It could lead to intraoperative massive bleeding and also postoperative intestinal ischemia. Thus, preoperative study of the inferior mesenteric artery variant anatomy is very important.

Aim: Our aim is to develop a clinical - based and useful classification of inferior mesenteric artery variability for healthcare practitioners.

Materials and methods: From December 2019 to March 2023, 214 abdominal computed tomograms (CT) with contrast were analyzed. We studied the inferior mesenteric artery variant anatomy.

Results: The 15 inferior mesenteric artery anatomical types were identified in previous studies. But due to the complexity of using this in practice - new classification of inferior mesenteric artery anatomy and its branches was developed: type I - several colonic branches by separate trunks (54.2%); type II - all colonic branches from one point in the form of a "crow's foot" (25.2%); type III - a single trunk which is divided into colonic branches throughout its length (20.6%).

Conclusions: The new inferior mesenteric artery classification is developed and been induced in practice. By using this classification and CT angiography with 3D reconstruction surgeons could perform operations on colorectal region with minimal risk of complications.

Breast cancer is a leading cause of cancer morbidity and mortality among women, with an increasing proportion of older patients. This population exhibits significant heterogeneity in health status, complicating treatment decisions. Surgical intervention remains a cornerstone of multimodal therapy for localized disease. This narrative review aims to clarify its role in older patients by synthesizing and discussing key contemporary evidence from the literature (2015-2025). Findings indicate that chronological age alone is not a contraindication to surgery. With careful patient selection, including comprehensive geriatric assessment (CGA), surgical treatment can be performed safely with acceptable outcomes. For biologically favorable tumors, de-escalation strategies (e.g., breast-conserving surgery, limited axillary procedures) are viable. Conversely, unjustified omission of surgery in aggressive disease worsens survival. Thus, treatment must be individualized, integrating CGA, comorbidity burden, functional status, and tumor biology rather than relying on age.

Purpose: To evaluate the efficacy and safety of radiofrequency-assisted endonasal endoscopic dacryocystorhinostomy (RF-EE-DCR) in patients with chronic abscessed dacryocystitis.

Methods: A prospective single-arm study included 35 patients, all presenting with a lacrimal sac abscess. Outcomes included anatomical and functional success, intraoperative blood loss, operative time, pain score (VAS), and complications. Surgical success required endoscopic patency and complete symptom resolution. The study adhered to the Declaration of Helsinki, ensuring full protection of patient rights. Ethical approval was obtained (IRB No. 5). Informed consent was obtained from all participants.

Results: Mean operative time was 20-40 minutes, and intraoperative blood loss 10-30 mL. No complications were reported (0%). Anatomical and functional success rates at 12 months were 100%. All abscesses resolved completely by 2 months. Postoperative pain decreased from VAS 4/10 on day 1 to 0/10 by week 1.

Conclusion: RF-EE-DCR is a highly effective and safe method for treating chronic abscessed dacryocystitis, demonstrating minimal invasiveness, excellent hemostasis, rapid recovery, and 100% long-term success.

Aim of the study: To provide a comprehensive assessment of cardiometabolic biomarkers in patients with arterial hypertension and to analyze their relationship with the presence of coronary artery disease and atherosclerosis, as well as to outline directions for further research.

Materials and methods: A pilot sample of 31 patients with established arterial hypertension was analyzed. Anthropometric indicators, lipid parameters, and inflammatory biomarkers were assessed in relation to documented coronary artery disease and atherosclerosis.

Results: The strongest associations with coronary artery disease and atherosclerosis were observed for waist circumference, BMI, LDL-C, total cholesterol, triglycerides, and systolic blood pressure. Elevated lipoprotein(a) levels were noted in several patients without confirmed disease, suggesting possible early subclinical vascular involvement. These trends are consistent with previously described cardiometabolic patterns in the Kazakhstani population.

Conclusion: Comprehensive assessment of anthropometric and biochemical biomarkers may be useful for early cardiovascular risk stratification in patients with arterial hypertension in Kazakhstan. The observed tendencies highlight potential region-specific features of cardiometabolic risk, warranting further investigation in larger cohorts.

Background: Saudi Arabia's Vision 2030 has introduced substantial reforms aimed at transforming the healthcare sector, including the expansion of advanced clinical roles, digital health integration, and workforce localization. Understanding how these reforms influence pharmacy students' career outlooks and specialization choices is essential for aligning pharmacy education with national workforce priorities.

Objective: This study aimed to examine pharmacy students' career outlooks and specialization preferences in Saudi Arabia, with a particular focus on the perceived influence of Vision 2030 on their professional decision-making.

Methods: A descriptive cross-sectional survey was conducted among pharmacy students enrolled in public and private universities across Saudi Arabia. A structured bilingual (English-Arabic) questionnaire collected data on demographics, awareness of Vision 2030, career preferences, and perceived influence of Vision 2030 using Likert-scale items, along with open-ended qualitative reflections. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative responses underwent thematic content analysis.

Results: A total of 440 pharmacy students participated. Nearly all respondents (97.7%) reported familiarity with Vision 2030. Clinical pharmacy (24.1%) and hospital pharmacy (21.4%) were the most preferred career pathways, while 4.5% expressed interest in health informatics or digital health. Most students (73.6%) planned to pursue specialization after graduation. Although Vision 2030 was less frequently identified as a direct factor influencing career choice (13.6%), Likert-scale findings indicated a moderate perceived influence on career thinking and preparedness. Qualitative analysis revealed three major themes: perceived expansion of professional opportunities under Vision 2030, opportunities and challenges related to technological advancement (including concerns about artificial intelligence), and the need for curriculum modernization emphasizing practical training and digital competencies.

Conclusion: Pharmacy students in Saudi Arabia perceive Vision 2030 as an important contextual framework shaping the future of pharmacy practice and career opportunities, primarily through system-level changes rather than as a direct personal motivator. These findings highlight the need for continued curriculum reform, expanded postgraduate training pathways, and structured career guidance to ensure alignment between pharmacy education, student aspirations, and national health sector transformation goals.

Introduction: Nail diseases in children have a specificity and course that differ from those in adults. They include both infection-associated and inflammatory processes. Pediatric nail disorders may be the first sign of a specific syndrome or systemic disorder. Some types of onychodystrophies may represent a later complication of previous infections.

The aim: Identification of the causes, course and clinical specificity of acquired onychodystrophies in children.

Material and methods: Data on 47 patients aged 3-12 years referred to the National Center of Dermatology and Venereology were processed. Microscopic and cultural examinations were used to identify the etiological cause; Structural changes and specific abnormalities of the nails were fully evaluated using a digital dermoscope.

Results: The diagnoses of the examined patients were divided into the following groups: trachyonychia (9/19.1%), onychomadesis (11/23.4%), Beau's line (4/8.5%), onychoschizia (2/4.3%), onychomycosis (6/12.8%), and nail disorders associated with paronychia (15/31.9%). Multiple nail disorders were detected in 33 (70.2%) cases; single nail disorders in 14 (29.8%) patients; Dystrophies of the fingernails were detected in 31 (66%) patients; dystrophies of the toenails in 5 (10.6%) cases; dystrophies of the fingernails and toenails in 11 (23.4%) cases.

Conclusion: The clinical features of pediatric onychodystrophies are predominantly determined by pathological changes in the matrix. The majority of pathologies manifest as multiple nail disorders, with predominant damage to the fingernails and are characterized by a benign course. The late hand, foot, and mouth disease complications (onychomadesis; Beau's line) are self-limited and do not require specific treatment. In the case of disorders associated with infections, management is based on the treatment of the underlying pathology and the prognosis is also favorable.