Georgian medical news最新文献

Purpose: The objective of this prospective case-control study was to perform translation, cross-cultural adaptation, and validation of the Sino-nasal outcome test 22 (SNOT-22) into the Georgian language.

Methods: The translation and validation of the SNOT -22 questionnaire was performed using the forward-backward translation technique. After proper translation, the translated questionnaire was completed by chronic rhinosinusitis (CRS) patients before and after functional endoscopic sinus surgery (FESS) and by healthy individuals as controls.

Results: SNOT22 was translated into the Georgian language; the pilot study involved 34 patients, the test-retest group consisted of 30 patients with CRS and the control group of 71 patients without CRS complaints; 34 patients were evaluated before surgery and 3 months after surgery. The results showed a good internal correlation with Cronbach's alpha - 0.88 at the initial examination, and 0.93 at the retest examination; both values suggest good internal consistency within SNOT-22. Pearson's correlation coefficient was 0.72 (p<0.001), revealing a good correlation between initial scores and retest scores. Our sample of healthy individuals had a median score of 10,11 points and the instrument was able to differentiate between the healthy and the patient group, demonstrating its validity (p<0.0001).

Conclusions: The Georgian version of the SNOT-22 questionnaire is a valid outcome measure for patients with CRS.

Primary hyperparathyroidism is an endocrine disorder caused by excessive secretion of parathyroid hormone due to primary pathology of the parathyroid glands. The main manifestations are hypercalcaemia and multiple organ disorders, leading to a reduced quality of life and disability in patients. In rare cases, primary hyperparathyroidism debuts with a hypercalcaemic crisis, a life-threatening condition with high mortality. The article presents a clinical case of primary hyperparathyroidism manifested by a hypercalcaemic crisis in a 58-year-old woman, emphasising the importance of timely diagnosis of the disease.

Objective: This study aims to assess childhood immunisation coverage in Kazakhstan, identify the main factors contributing to parental vaccine refusal, and examine the influence of social media and parental beliefs on immunisation decisions.

Materials and methods: A comprehensive literature review was conducted using databases such as PubMed, Scopus, and DOAJ. Keywords included «Immunisation», «Vaccination Refusal», «Health Knowledge», «Kazakhstan», and «Public Health». Studies in English involving qualitative, quantitative, or mixed methods were included, while case reports and non-English publications were excluded.

Results: Despite free access to vaccines, Kazakhstan has seen a decline in immunisation coverage since 2018, with measles outbreaks re-emerging in 2023. Parental vaccine hesitancy is influenced by safety concerns, misinformation, cultural beliefs, and limited trust in healthcare providers. Social media plays a dual role-while it can spread misinformation, it also offers an opportunity to increase awareness through targeted communication strategies. Key barriers include lack of healthcare access, socio-economic factors, and insufficient provider communication.

Conclusion: Improving vaccination coverage in Kazakhstan requires a multidisciplinary approach involving healthcare professionals, educators, policymakers, and the media. Efforts should focus on strengthening public trust, addressing misinformation, and adapting strategies to the local cultural and social context. Strengthening training for medical professionals and leveraging social media for evidence-based communication are essential steps to improve vaccine acceptance.

Background: An enduring soft tissue barrier with adequate keratinized mucosa and crestal bone height is critical to the functional lifespan of the implant. This study aims to investigate the impact of PRF membrane layers on the peri-implant tissue phenotype.

Methods: This prospective clinical trial evaluated the effects of single versus multiple layers of platelet-rich fibrin membranes on peri-implant soft tissue healing compared to a control group. Fifteen participants per group (n=45) were sequentially assigned to one of three groups: single PRF membrane group, multiple PRF membrane group, and control group. The outcomes included the estimation of radiographic soft tissue thickness (RSTT) and bone height (BH) using standardized bitewing radiographs before the procedure, immediately after it, at 6 and 12 weeks postoperatively. The data was analyzed using one way ANOVA analysis, significance level was set at 0.05.

Results: Both the single PRF and multiple PRF groups had an increase in soft tissue thickness radiographically at the postoperative, six-week, and twelve-week intervals when compared to the control group. The multiple PRF group demonstrated the best retention of vertical bone levels in comparison to the control group.

Conclusion: PRF application, particularly with multiple layers, significantly enhanced bone height preservation and crestal tissue thickness.

Aim of the study: To systematically evaluate preclinical evidence on the protective effects of herbal interventions against toxicant-induced genetic and epigenetic alterations in animal models.

Materials and methods: A systematic review (2015-2025) across PubMed, Scopus, Web of Science, Cochrane, and Google Scholar identified six animal studies on herbal protection against toxicant-induced mutations. SYRCLE's tool showed generally robust designs.

Results and discussion: Six rodent studies investigated exposures such as BPA, busulfan, testosterone propionate, OVA, and prenatal stress. Herbal treatments (carob, ginger, ASHMI, BSTJF, Cuscuta flavonoids) were administered via diverse routes and durations. All studies reported significant improvements (P < 0.05 to P < 0.001) in genetic and epigenetic outcomes, including enhanced sperm DNA integrity, reduced inflammation, improved neurobehavior, hormonal regulation, and restored DNA methylation patterns. Transgenerational assessments consistently supported the potential of herbal therapies to mitigate inheritable mutation risks. Herbal medicines show protective effects against toxicant-induced genetic and epigenetic changes in animal models, suggesting potential preventive strategies, while long-term and mechanistic studies are needed to confirm human applicability.

Heart failure (HF) remains a major public health issue globally, characterized by high morbidity and mortality rates. The complexity of HF management requires continuous evolution of treatment paradigms to ensure optimal patient outcomes. This comprehensive review focuses on the fundamental role of Guideline-Directed Medical Therapy (GDMT) in enhancing the management of heart failure across various dimensions, and to identify effective strategies and areas for improvement in the management of heart failure. The ultimate goal is to underscore the critical importance of GDMT in elevating the standard of care and improving patient outcomes in heart failure. GDMT, endorsed by leading cardiology societies, provides a comprehensive framework for HF treatment, based on the latest evidence and expert consensus.

Aim of the study: To evaluate immunological markers associated with the risk of severe and complicated forms of varicella zoster virus (VZ) in children in order to determine prognostic criteria for disease severity.

Materials and methods: The study included 120 children with VZ, divided into groups with complicated (n=63) and uncomplicated (n=57) disease. All patients underwent assessment of interferon alpha markers, complement components (C3, C4), antibodies to MAG, TGF, as well as analysis of complete blood count and C-reactive protein (CRP). Statistical analysis included binary logistic regression and 5-fold cross-validation.

Selection criteria: Children aged 0 to 18 years inclusive with a verified diagnosis of varicella Results: The most significant predictors of complicated disease were elevated levels of CRP (OR=10.05; p<0.001), platelets (OR=9.69; p=0.04), and C3 component (OR=2.77; p=0.006), as well as reduced levels of C4 component (OR=0.036; p=0.005). The logistic regression model showed high discriminatory ability (AUC=0.7857).

Conclusion: Immunological parameters such as CRP, C3, C4 and platelets can be used as prognostic markers of complicated varicella in children. Early assessment of immune status contributes to the timely identification of patients at risk and optimization of treatment tactics.

Objective of the study: To assess the prevalence of autism spectrum disorders (ASD) among children in Kazakhstan, the availability of psychiatric and correctional care, and to identify barriers to diagnosis and treatment.

Materials and methods: The data from the statistical collection "Psychiatric Care to the Population of the Republic of Kazakhstan" (2015-2023) and the results of an online survey of 188 parents of children with ASD, conducted in 2021 through public organizations in 29 cities/towns, were analyzed. Descriptive statistics, chi-square test, Mann-Whitney test, and logistic regression were used.

Results: In 2023, the number of psychiatrists was 0.4 per 10,000 population, psychotherapists - 0.01. The contingent of children with ASD increased from 8.6 (2015) to 161.3 per 100 thousand children aged 0-17 years (2023), primary incidence - from 4.3 to 33.6 per 100 thousand (2015-2022). The survey revealed that 81.4% of children receive correction, but ABA therapy is available to only 4.3% of them. The average age of diagnosis is 2.5 years, and 79.8% of parents have low awareness-the main barriers are a shortage of specialists, high cost of services, and stigmatization.

Conclusions: Low detection rates of ASD (compared to the US - 3220 per 100,000, South Korea - 2640) are due to a lack of screening, shortage of specialists, and low awareness. The study highlights the unique challenges of Central Asia, where a lack of data and resources hinders diagnosis and support. A national program of screening, training of specialists, and subsidizing of ABA therapy is needed. The work holds international importance for countries with transition economies, particularly in Central Asia, where similar problems necessitate systemic solutions.

Objectives: This study aimed to assess the diagnostic and prognostic value of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA) patients, focusing on early diagnosis and disease activity.

Methods: Dr. Mohammed Ali Saad Medical Center and Doctors Hospital in Port Sudan, red sea state in Sudan were the sites of an analytical case-control study was conducted, including 166 RA patients, 68 early RA patients, and 166 healthy controls. RF, anti-CCP, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Statistical analyses included chi-square, Kruskal-Wallis, and receiver operating characteristic (ROC) curve studies.

Results: RF and anti-CCP antibody levels were higher in established RA patients than in early RA patients and healthy controls (p < 0.001). Anti-CCP demonstrated superior specificity (98%) compared to RF (79% specificity) for RA diagnosis. In established RA, anti-CCP showed higher sensitivity (79%) than RF (67%). However, the majority of early RA patients (54.5%) tested negative for both markers, indicating that inflammatory markers such as CRP and ESR may be more useful than autoantibodies for early RA detection. The combination of both tests enhanced diagnostic sensitivity in established RA.

Conclusion: It was discovered that anti-CCP antibodies were a very specific indicator of RA, especially when the disease was progressed. Improved diagnostic accuracy is achieved when RF and anti-CCP testing are combined, with anti-CCP testing showing greater sensitivity for early RA identification. This study emphasizes how useful both markers are in clinical practice for RA patient prognosis, disease activity evaluation, and early diagnosis.

Diabetic foot disease remains a leading cause of non-traumatic lower-extremity amputations worldwide, contributing significantly to morbidity, mortality, and healthcare costs. This article synthesizes evidence-based recommendations from the International Working Group on the Diabetic Foot (IWGDF), International Diabetes Federation (IDF), and American Diabetes Association (ADA) to provide a comprehensive approach to prevention, classification, and management. Core principles include early identification of at-risk feet, patient education, biomechanical offloading, restoration of perfusion, infection control, and coordinated multidisciplinary care. Implementation of these strategies has been shown to reduce amputation rates and improve patient outcomes.