Pub Date : 2023-03-03DOI: 10.11603/ijmmr.2413-6077.2022.2.13123
O. Venger, A. M. Koval, M. Shved, T. Ivanitska
Background. COVID-19 pandemic has negatively affected people’s mental health and created new barriers for those who have already suffered from mental illnesses. Objective. The aim of the study was to compare the symptoms of mental disorders in neurotic and affective patients, who recovered from COVID-19. Methods. The features of disorders during the pandemic in 35 neurotic and 31 affective patients were analysed. The Hamilton anxiety and depression scales (HAM-A, HAM-D), Insomnia Severity Index (ISI), Schulte tables, Jacobson short-term memory study were used. Results. Moderate and severe anxiety was more likely to develop in neurotic patients (34.29% and 37.14%, respectively), mild and moderate – in affective ones (38.71% and 32.26%). Neurotic patients had a higher level of depression (moderate – by 31.42%, severe – by 48.57%) than affective patients (mild – by 32.26%, severe – by 35.48%). The degree of memory loss was higher in affective patients (51.62% – low, 35.48% – very low) than in neurotic ones (41.94% – low, 20.00% – very low). Most of patients had reduced attention. Insomnia severity was higher in patients with neurotic disorders (25.72% – subthreshold, 45.71% – moderate) than in affective patients (38.71% – subthreshold, 22.58% – moderate). A higher level of anxiety and depression severity was observed in patients who had COVID-19 in 2021 than in those who had it in 2020, while the severity of insomnia and memory impairment – vice versa. Conclusion. Anxiety, depression, insomnia, memory and attention loss were detected. Anxiety and depression were more severe in neurotic patients but the degree of memory loss was higher in affective patients.
{"title":"COMPARATIVE CHARACTERISTICS OF SYMPTOMS IN NEUROTIC AND AFFECTIVE PATIENTS AFTER COVID-19","authors":"O. Venger, A. M. Koval, M. Shved, T. Ivanitska","doi":"10.11603/ijmmr.2413-6077.2022.2.13123","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13123","url":null,"abstract":"Background. COVID-19 pandemic has negatively affected people’s mental health and created new barriers for those who have already suffered from mental illnesses. \u0000Objective. The aim of the study was to compare the symptoms of mental disorders in neurotic and affective patients, who recovered from COVID-19. \u0000Methods. The features of disorders during the pandemic in 35 neurotic and 31 affective patients were analysed. The Hamilton anxiety and depression scales (HAM-A, HAM-D), Insomnia Severity Index (ISI), Schulte tables, Jacobson short-term memory study were used.\u0000Results. Moderate and severe anxiety was more likely to develop in neurotic patients (34.29% and 37.14%, respectively), mild and moderate – in affective ones (38.71% and 32.26%). Neurotic patients had a higher level of depression (moderate – by 31.42%, severe – by 48.57%) than affective patients (mild – by 32.26%, severe – by 35.48%). The degree of memory loss was higher in affective patients (51.62% – low, 35.48% – very low) than in neurotic ones (41.94% – low, 20.00% – very low). Most of patients had reduced attention. Insomnia severity was higher in patients with neurotic disorders (25.72% – subthreshold, 45.71% – moderate) than in affective patients (38.71% – subthreshold, 22.58% – moderate). A higher level of anxiety and depression severity was observed in patients who had COVID-19 in 2021 than in those who had it in 2020, while the severity of insomnia and memory impairment – vice versa.\u0000Conclusion. Anxiety, depression, insomnia, memory and attention loss were detected. Anxiety and depression were more severe in neurotic patients but the degree of memory loss was higher in affective patients.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42581869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.12934
J. S. Randhawa, N. Rajendran, J. Husain, R. Shankaran, V. Nair, S. Dorai B.
Background. Hydronephrosis is the most common urinary tract pathology detected on antenatal screening by Ultrasound. The detection of fetal hydronephrosis by ultrasound presents a treatment dilemma to the treating surgeon and parental anxiety. Objective. This study aims to examine the role of serial ultrasounds in antenatally detected fetal hydronephrosis to know the disease progression, and to assess indications and timing of surgery in these patients to preserve renal function. Methods. This is an observational study of 30 cases of foetal hydronephrosis conducted at a tertiary care paediatric surgery centre. A foetal renal pelvic Antero-posterior diameter (APD) >7 mm at 32 weeks of gestation is considered to indicate Foetal hydronephrosis. These patients are followed up for a period of two years from 2018 to 2020. Progression of disease and need for surgical intervention is noted. Results. The study comprised 30 cases of antenatal foetal hydronephrosis (42 renal units). Of 26 renal units with mild hydronephrosis, all are resolved in the post-natal period. Of 10 renal units with moderate hydronephrosis, 3 (30%) resolved and 7 (70%) worsened and required surgical intervention. Of 6 renal units with severe hydronephrosis, all required surgical intervention and underwent surgery between 12 to 18 months of age. Conclusions. These results suggest a grading system with antero-posterior diameter of renal pelvis distinguishes those cases with moderate and severe degrees of hydronephrosis that are at higher risk of surgery.
{"title":"SHORT TERM STUDY ON CLINICAL RELEVANCE AND OUTCOMES OF FOETAL HYDRONEPHROSIS","authors":"J. S. Randhawa, N. Rajendran, J. Husain, R. Shankaran, V. Nair, S. Dorai B.","doi":"10.11603/ijmmr.2413-6077.2022.1.12934","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.12934","url":null,"abstract":"Background. Hydronephrosis is the most common urinary tract pathology detected on antenatal screening by Ultrasound. The detection of fetal hydronephrosis by ultrasound presents a treatment dilemma to the treating surgeon and parental anxiety. \u0000Objective. This study aims to examine the role of serial ultrasounds in antenatally detected fetal hydronephrosis to know the disease progression, and to assess indications and timing of surgery in these patients to preserve renal function. \u0000Methods. This is an observational study of 30 cases of foetal hydronephrosis conducted at a tertiary care paediatric surgery centre. A foetal renal pelvic Antero-posterior diameter (APD) >7 mm at 32 weeks of gestation is considered to indicate Foetal hydronephrosis. These patients are followed up for a period of two years from 2018 to 2020. Progression of disease and need for surgical intervention is noted.\u0000Results. The study comprised 30 cases of antenatal foetal hydronephrosis (42 renal units). Of 26 renal units with mild hydronephrosis, all are resolved in the post-natal period. Of 10 renal units with moderate hydronephrosis, 3 (30%) resolved and 7 (70%) worsened and required surgical intervention. Of 6 renal units with severe hydronephrosis, all required surgical intervention and underwent surgery between 12 to 18 months of age.\u0000Conclusions. These results suggest a grading system with antero-posterior diameter of renal pelvis distinguishes those cases with moderate and severe degrees of hydronephrosis that are at higher risk of surgery.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44822584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.12903
M. Marushchak, O. Mialiuk, M. Kaskiv, M. Demjanchuk, I. Krynytska
Background. In cases of severe trauma, fractures of long bones are the most often combined with trauma of the chest, head, and abdomen, as well as development of hemorrhagic shock. Therefore, it is reasonable to study the combined trauma of the chest and lower extremities in details, as well as the post-traumatic multiple organ dysfunction especially in early manifestation stage. Objective. The aim of the study was to identify the features of structural organization of the lungs, heart and liver with underlying combined trauma of the chest and both thighs on the 7th day of the post-traumatic period. Methods. The experimental study involved 22 adult nonlinear white male rats with body mass of 200-210 g, kept on a standard diet at animal facility with food and drinking regimes recommended by the standards for laboratory animals. All animals were divided into 2 groups: the control group (1st, n=10), the experimental group (the 2nd) chest trauma and both thighs trauma, observation for 7 days (n=12). The animals of the experimental group were simulated for right-sided closed pneumothorax with a rib fracture by a trocar under thiopental-sodium anesthesia (40 mg/kg of body weight of the rat, intraperitoneally); it was combined with a fracture of the left and right femurs. Skeletal injury was modeled on each thigh that caused a closed fracture by a single dosed blow with a specially designed device. The blow energy was 0.375 J that corresponds to a severe injury. The associated injury was simulated by successive infliction of both injuries. Results. Examination of the liver of animals on the 7th day of the experiment revealed a rapid growth of lesions in their parenchyma. The central veins were poorly visible and contained single erythrocytes; the vessels of medium caliber of myocardial stroma were dilated and blood-filled, which was manifested by the development of perivascular oedema. In the lungs of experimental animals, a moderate decrease of interstitial tissue oedema of the interalveolar septa was present, while cellular infiltration of mast cells, macrophages and lymphocytes also decreased significantly. Conclusions. Multiple organ injuries, which are characterized by structural changes in the liver, heart and lungs in the combined trauma of the thorax and thighs on the 7th day of experiment were evidenced.
{"title":"STRUCTURAL ORGANIZATION OF RAT TISSUES IN EXPERIMENTAL COMBINED TRAUMA OF THE CHEST AND BOTH THIGHS","authors":"M. Marushchak, O. Mialiuk, M. Kaskiv, M. Demjanchuk, I. Krynytska","doi":"10.11603/ijmmr.2413-6077.2022.1.12903","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.12903","url":null,"abstract":"Background. In cases of severe trauma, fractures of long bones are the most often combined with trauma of the chest, head, and abdomen, as well as development of hemorrhagic shock. Therefore, it is reasonable to study the combined trauma of the chest and lower extremities in details, as well as the post-traumatic multiple organ dysfunction especially in early manifestation stage. \u0000Objective. The aim of the study was to identify the features of structural organization of the lungs, heart and liver with underlying combined trauma of the chest and both thighs on the 7th day of the post-traumatic period.\u0000Methods. The experimental study involved 22 adult nonlinear white male rats with body mass of 200-210 g, kept on a standard diet at animal facility with food and drinking regimes recommended by the standards for laboratory animals. All animals were divided into 2 groups: the control group (1st, n=10), the experimental group (the 2nd) chest trauma and both thighs trauma, observation for 7 days (n=12). The animals of the experimental group were simulated for right-sided closed pneumothorax with a rib fracture by a trocar under thiopental-sodium anesthesia (40 mg/kg of body weight of the rat, intraperitoneally); it was combined with a fracture of the left and right femurs. Skeletal injury was modeled on each thigh that caused a closed fracture by a single dosed blow with a specially designed device. The blow energy was 0.375 J that corresponds to a severe injury. The associated injury was simulated by successive infliction of both injuries. \u0000Results. Examination of the liver of animals on the 7th day of the experiment revealed a rapid growth of lesions in their parenchyma. The central veins were poorly visible and contained single erythrocytes; the vessels of medium caliber of myocardial stroma were dilated and blood-filled, which was manifested by the development of perivascular oedema. In the lungs of experimental animals, a moderate decrease of interstitial tissue oedema of the interalveolar septa was present, while cellular infiltration of mast cells, macrophages and lymphocytes also decreased significantly. \u0000Conclusions. Multiple organ injuries, which are characterized by structural changes in the liver, heart and lungs in the combined trauma of the thorax and thighs on the 7th day of experiment were evidenced.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48665765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13090
R. Jahagirdar
Background. Psychiatry is a medical subject; many medical students ignore its importance in medicine. Regarding mental illness, many medical professionals and students are less aware as mental illness is very important in affecting the quality of care the patient receives and in choosing psychiatry as a career. This study specializes in psychiatry based on many factors, however undergraduate students’ attitude towards career choice is the most important. Objective. This study aims to explore attitude towards psychiatry subject among undergraduate medical students. Methods. This is a Descriptive cross-sectional study done at Vikhe Patil Medical College, Ahmednagar. The total of 295 volunteer students from all phases of MBBS (Bachelor of Medicine and Bachelor of Surgery) were enrolled by purposive sampling, a 30-item self-administered questionnaire, ATP-30 (Attitude towards Psychiatry) was used to measure the attitude of medical students. Data collected was analysed using SPSS version 24. The results were reported as percentage and frequencies. Results. In the study, 47.4% of the respondents were males and 52.6% were females. Out of total study participants 52.3% of our study respondents strongly agreed that psychiatry was a respected branch of medicine; 56.7% strongly agreed that psychiatry should be an important part of medical curriculum; 19.4% of study respondents considered it in the list of the career choice while the majority did not think that it should be in their career list options. Conclusions. In the study, the students from the later phases of MBBS showed positive attitude than that of the initial phases. Many students found it as respected subject and essential field of medicine for their choice of profession. However, shortcoming knowledge and awareness was observed in the responses pertaining to present available treatment and recent trends in the field.
{"title":"ATTITUDE TOWARDS PSYCHIATRY AND PSYCHIATRISTS AMONG MEDICAL STUDENTS IN TERTIARY HEALTH CARE HOSPITAL","authors":"R. Jahagirdar","doi":"10.11603/ijmmr.2413-6077.2022.1.13090","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13090","url":null,"abstract":"Background. Psychiatry is a medical subject; many medical students ignore its importance in medicine. Regarding mental illness, many medical professionals and students are less aware as mental illness is very important in affecting the quality of care the patient receives and in choosing psychiatry as a career. This study specializes in psychiatry based on many factors, however undergraduate students’ attitude towards career choice is the most important.\u0000Objective. This study aims to explore attitude towards psychiatry subject among undergraduate medical students.\u0000Methods. This is a Descriptive cross-sectional study done at Vikhe Patil Medical College, Ahmednagar. The total of 295 volunteer students from all phases of MBBS (Bachelor of Medicine and Bachelor of Surgery) were enrolled by purposive sampling, a 30-item self-administered questionnaire, ATP-30 (Attitude towards Psychiatry) was used to measure the attitude of medical students. Data collected was analysed using SPSS version 24. The results were reported as percentage and frequencies.\u0000Results. In the study, 47.4% of the respondents were males and 52.6% were females. Out of total study participants 52.3% of our study respondents strongly agreed that psychiatry was a respected branch of medicine; 56.7% strongly agreed that psychiatry should be an important part of medical curriculum; 19.4% of study respondents considered it in the list of the career choice while the majority did not think that it should be in their career list options.\u0000Conclusions. In the study, the students from the later phases of MBBS showed positive attitude than that of the initial phases. Many students found it as respected subject and essential field of medicine for their choice of profession. However, shortcoming knowledge and awareness was observed in the responses pertaining to present available treatment and recent trends in the field.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42984578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.12924
М. В. Данчишин, О. В. Лотоцька
Вступ. Проблема забруднення довкілля нітратами за своїми масштабами та наслідками вийшла на глобальний рівень. Приблизно в одній третині підземних водних об’єктів, щодо яких наразі доступна інформація, перевищено гранично допустимі концентрації вмісту нітратів у питній воді. Мeтою цієї роботи стало вивчення особливості антиоксидантного захисту в організмі білих щурів на тлі вживання питної води з понаднормативною концентрацією нітратів впродовж 30 днів в залежності від віку. Матеріали. Експеримент проводили на 2 групах безпородних білих самок-щурів різного віку (статевозрілих та статевонезрілих) по 30 особин у кожній, розділених на 5 підгруп, які відрізнялися за якістю питної води, яку вони споживали самостійно. У 30-денному дослідженні нітрати давали щурам у питній воді в дозі 50, 150, 250, 500 мг нітрату натрію на літр. Тварини контрольної групи пили воду з міського водопроводу. Оцінювали вплив нітратів на активність супероксиддисмутази (СОД), каталази та церулоплазміну (СР) в сироватці крові щурів. Результати. У результаті досліджень виявлено підвищену активність СОД, каталази та СР у сироватці крові на тлі вживання питної води з концентрацією нітратів від 150 до 500 мг/л у піддослідних групах обох вікових категорій. Встановлено, що найбільш виражені зміни показників викликає вживання питної води з нітратами у концентрації 500 мг/л. Більш виражені зміни були у статево незрілих тварин. Висновки. Присутність нітратів у питній воді у понаднормативних концентраціях негативно впливає на організм піддослідних тварин, викликаючи активацію досліджуваних показників антиоксидантної системи.
{"title":"ОСОБЛИВОСТІ АНТИОКСИДАНТНОГО ЗАХИСТУ В ОРГАНІЗМІ БІЛИХ ЩУРІВ НА ТЛІ ВЖИВАННЯ ПИТНОЇ ВОДИ З ПОНАДНОРМАТИВНОЮ КОНЦЕНТРАЦІЄЮ НІТРАТІВ","authors":"М. В. Данчишин, О. В. Лотоцька","doi":"10.11603/ijmmr.2413-6077.2022.1.12924","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.12924","url":null,"abstract":"Вступ. Проблема забруднення довкілля нітратами за своїми масштабами та наслідками вийшла на глобальний рівень. Приблизно в одній третині підземних водних об’єктів, щодо яких наразі доступна інформація, перевищено гранично допустимі концентрації вмісту нітратів у питній воді.\u0000Мeтою цієї роботи стало вивчення особливості антиоксидантного захисту в організмі білих щурів на тлі вживання питної води з понаднормативною концентрацією нітратів впродовж 30 днів в залежності від віку.\u0000Матеріали. Експеримент проводили на 2 групах безпородних білих самок-щурів різного віку (статевозрілих та статевонезрілих) по 30 особин у кожній, розділених на 5 підгруп, які відрізнялися за якістю питної води, яку вони споживали самостійно. У 30-денному дослідженні нітрати давали щурам у питній воді в дозі 50, 150, 250, 500 мг нітрату натрію на літр. Тварини контрольної групи пили воду з міського водопроводу. Оцінювали вплив нітратів на активність супероксиддисмутази (СОД), каталази та церулоплазміну (СР) в сироватці крові щурів.\u0000Результати. У результаті досліджень виявлено підвищену активність СОД, каталази та СР у сироватці крові на тлі вживання питної води з концентрацією нітратів від 150 до 500 мг/л у піддослідних групах обох вікових категорій. Встановлено, що найбільш виражені зміни показників викликає вживання питної води з нітратами у концентрації 500 мг/л. Більш виражені зміни були у статево незрілих тварин.\u0000Висновки. Присутність нітратів у питній воді у понаднормативних концентраціях негативно впливає на організм піддослідних тварин, викликаючи активацію досліджуваних показників антиоксидантної системи.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45269188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13043
I. Y. Dzyubanovskyy, A. Bedeniuk, S. Grytsenko
Background. Reversal of Hartmann’s procedure (HP) is one of the most complex surgical interventions in abdominal surgery with high morbidity rates of up to 58% in the patients after HP and mortality of up to 3.6%. Objective. This was a retrospective observational study to analyze the Hartmann’s reversal (HR) outcomes. Methods. The study involved 31 patients (16 males and 15 females), average age 59.6±10.31 (range 26-80), who underwent HR at Ternopil Regional Hospital in 2010 - 2021. The reasons for the HP were: cancer in 20 (64.5%) cases, perforation of the diverticulum – 6 (19.3%), traumatic rupture – 3 (9.7%) and Crohn’s disease - 2 (6.4%) cases. Results. Median time from Hartmann’s procedure to reversal was 11.13±9.24 months (interval 3-38). Intraoperative time was 210.33±56.91 minutes (range 120-330). HR was performed in 30 (96.8 %) patients. Dense pelvic adhesions of the stump of the rectum was diagnosed in 13 (41.9%) patients. Hand-sewn anastomosis was performed for 22 (71%) patients, stapler anastomosis – 4 (12.9%), pull-through technique – 3 (9.7%) patients. AL occurred in 3 (9.7%) patients on the 15th, 23rd and 35th postoperative days. pseudomembranous colitis was diagnosed in 2 (6.4%) patients with AL. The mortality rate was 1 (3.3%) as a result of septic complications due to AL; this case was not operated by a colorectal surgeon due to administrative issue in the hospital. Conclusions. Hartmann’s reversal is still one of the most difficult operations in colorectal surgery with high incidence of postoperative complications. Sound selection of patients with low comorbidity and in suitable time period is crucial for successful HR.
{"title":"CLINICAL OUTCOMES OF REVERSAL OF HARTMANN’S PROCEDURE","authors":"I. Y. Dzyubanovskyy, A. Bedeniuk, S. Grytsenko","doi":"10.11603/ijmmr.2413-6077.2022.1.13043","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13043","url":null,"abstract":"Background. Reversal of Hartmann’s procedure (HP) is one of the most complex surgical interventions in abdominal surgery with high morbidity rates of up to 58% in the patients after HP and mortality of up to 3.6%.\u0000Objective. This was a retrospective observational study to analyze the Hartmann’s reversal (HR) outcomes.\u0000Methods. The study involved 31 patients (16 males and 15 females), average age 59.6±10.31 (range 26-80), who underwent HR at Ternopil Regional Hospital in 2010 - 2021. The reasons for the HP were: cancer in 20 (64.5%) cases, perforation of the diverticulum – 6 (19.3%), traumatic rupture – 3 (9.7%) and Crohn’s disease - 2 (6.4%) cases.\u0000Results. Median time from Hartmann’s procedure to reversal was 11.13±9.24 months (interval 3-38). Intraoperative time was 210.33±56.91 minutes (range 120-330). HR was performed in 30 (96.8 %) patients. Dense pelvic adhesions of the stump of the rectum was diagnosed in 13 (41.9%) patients. Hand-sewn anastomosis was performed for 22 (71%) patients, stapler anastomosis – 4 (12.9%), pull-through technique – 3 (9.7%) patients. AL occurred in 3 (9.7%) patients on the 15th, 23rd and 35th postoperative days. pseudomembranous colitis was diagnosed in 2 (6.4%) patients with AL. The mortality rate was 1 (3.3%) as a result of septic complications due to AL; this case was not operated by a colorectal surgeon due to administrative issue in the hospital.\u0000Conclusions. Hartmann’s reversal is still one of the most difficult operations in colorectal surgery with high incidence of postoperative complications. Sound selection of patients with low comorbidity and in suitable time period is crucial for successful HR.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43746815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13083
T. Singh, R. Kumar, A. Nigam, T. R. Devi
Background. Diagnosing acute appendicitis correctly in a female patient is a challenge for a practicing surgeon. Rate of misdiagnosis of acute appendicitis is very high among female patients. There are many studies carried out to find incidence of acute appendicitis as per various phases of menstruation cycle but the results were conflicting. Objective. The study was conducted to find the relationship of acute appendicitis with the different phases of the menstruation cycle. Methods. This research was an observational study carried out in two regional hospitals in northern and north-eastern part of India. Duration of study was 24 months between 01 June 2019 and 31 May 2021. Inclusion Criteria were for all female patients, non-pregnant and menstruating, who were histopathologically confirmed as acute appendicitis. All pathologically proven negative appendectomy patients were excluded from this study. All female patients taking oral contraceptive pills (OCP) were excluded from the study. Results. A total of 96 females were hospitalized in both hospitals during the study period; 12 of them did not attain menarche (12.5%), 6 had menopause (6.3%) and 78 were menstruating (81.25%). Of those 78 patients, who had physiological menstrual cycles, 6 were in menstrual phase (7.6%), 18 were in proliferative phase (23%), and 54 in luteal phase (69.2%). In our study, there were only 6 cases of acute appendicitis during menstruation. therefore, the expected ratio of cases was 6/14=0.42. The corresponding expected rate for the proliferative phase was 2.78×9=25 cases, whereas for the luteal phase it was 2.78×14=38.92. The expected ratio was 18/25=0.72 for the proliferative phase and 54/39=1.38 for the luteal phase. There was a significant increase in number of cases of acute appendicitis among the menstruating women in luteal phase with p value <0.05. Mean age of the study participants was 28.31±9.56. Conclusions. According to the result of the study, the incidence of acute appendicitis significantly differs in different phases of menstruation cycle with highest incidence in luteal phase. Hence, female hormones (estrogen and progesterone) are significant in causing acute appendicitis.
{"title":"AN OBSERVATIONAL STUDY TO FIND RELATIONSHIP OF ACUTE APPENDICITIS TO MENSTRUATION CYCLE IN NORTHERN AND NORTHEASTERN PART OF INDIA","authors":"T. Singh, R. Kumar, A. Nigam, T. R. Devi","doi":"10.11603/ijmmr.2413-6077.2022.1.13083","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13083","url":null,"abstract":"Background. Diagnosing acute appendicitis correctly in a female patient is a challenge for a practicing surgeon. Rate of misdiagnosis of acute appendicitis is very high among female patients. There are many studies carried out to find incidence of acute appendicitis as per various phases of menstruation cycle but the results were conflicting. \u0000Objective. The study was conducted to find the relationship of acute appendicitis with the different phases of the menstruation cycle. \u0000Methods. This research was an observational study carried out in two regional hospitals in northern and north-eastern part of India. Duration of study was 24 months between 01 June 2019 and 31 May 2021. Inclusion Criteria were for all female patients, non-pregnant and menstruating, who were histopathologically confirmed as acute appendicitis. All pathologically proven negative appendectomy patients were excluded from this study. All female patients taking oral contraceptive pills (OCP) were excluded from the study.\u0000Results. A total of 96 females were hospitalized in both hospitals during the study period; 12 of them did not attain menarche (12.5%), 6 had menopause (6.3%) and 78 were menstruating (81.25%). Of those 78 patients, who had physiological menstrual cycles, 6 were in menstrual phase (7.6%), 18 were in proliferative phase (23%), and 54 in luteal phase (69.2%). In our study, there were only 6 cases of acute appendicitis during menstruation. therefore, the expected ratio of cases was 6/14=0.42. The corresponding expected rate for the proliferative phase was 2.78×9=25 cases, whereas for the luteal phase it was 2.78×14=38.92. The expected ratio was 18/25=0.72 for the proliferative phase and 54/39=1.38 for the luteal phase. There was a significant increase in number of cases of acute appendicitis among the menstruating women in luteal phase with p value <0.05. Mean age of the study participants was 28.31±9.56. \u0000Conclusions. According to the result of the study, the incidence of acute appendicitis significantly differs in different phases of menstruation cycle with highest incidence in luteal phase. Hence, female hormones (estrogen and progesterone) are significant in causing acute appendicitis.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42558163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13095
I. Galaychuk
Background. According to the existing recommendations of the NCCN, 2-cm margins are optimal for surgical excision of skin melanoma (SM). Objective. A method of cone-shaped oncoplastic surgery of SM in sites with limited skin-plastic resources is presented. Methods. In the study 30 patients (11 men, 19 women) underwent cone-shaped removal of primary SM on arm and shin, epigastria and subclavicular sites. Oncosurgical approach involves the following: primary SM is excised with 2 cm margins around with transforming this round wound into conical using additional incisions; then conical wound is closed by transverse displacement of lateral skin-fatted flap. The postoperative seam looks like hook-shaped line. SM thickness is measured by sonography before surgery. Morphological verification is obtained by cytological examination of smears after superficial scraping biopsy. Results. Postoperative histology confirmed melanomas in all cases with “clear margins” in all surgical specimens, and postoperative staging was as follows: pT2bN0M0 – in 3 patients, pT2bN1-2M0 – 4 patients, pT3bN0M0 – 9 patients, pT4bN0M0 – 7 patients, and pT4bN1-2M0 – in 7 patients. Partial marginal necrosis of displaced flaps was of 4 patients (13.3%). There were no recurrences of melanoma at site of postoperative scar. 3-years disease free survival (DFS) rate was 76.6%, and 5 years DFS rate – 60.0%. Conclusions. Cone-shaped radical excision of primary melanoma is an appropriate surgery for patients with SM on the forearms, shoulders, epigastria and subclavicular sites and legs. The one-step oncoplastic radical surgery without intermediate biopsy prevents local recurrence in site of surgery as well as iatrogenic metastasis to regional lymph nodes.
{"title":"ONCOPLASTIC CONE-SHAPED REMOVAL OF MELANOMA IN SITES WITH LIMITED SKIN RESOURCES","authors":"I. Galaychuk","doi":"10.11603/ijmmr.2413-6077.2022.1.13095","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13095","url":null,"abstract":"Background. According to the existing recommendations of the NCCN, 2-cm margins are optimal for surgical excision of skin melanoma (SM).\u0000Objective. A method of cone-shaped oncoplastic surgery of SM in sites with limited skin-plastic resources is presented. \u0000Methods. In the study 30 patients (11 men, 19 women) underwent cone-shaped removal of primary SM on arm and shin, epigastria and subclavicular sites. Oncosurgical approach involves the following: primary SM is excised with 2 cm margins around with transforming this round wound into conical using additional incisions; then conical wound is closed by transverse displacement of lateral skin-fatted flap. The postoperative seam looks like hook-shaped line. SM thickness is measured by sonography before surgery. Morphological verification is obtained by cytological examination of smears after superficial scraping biopsy.\u0000Results. Postoperative histology confirmed melanomas in all cases with “clear margins” in all surgical specimens, and postoperative staging was as follows: pT2bN0M0 – in 3 patients, pT2bN1-2M0 – 4 patients, pT3bN0M0 – 9 patients, pT4bN0M0 – 7 patients, and pT4bN1-2M0 – in 7 patients. Partial marginal necrosis of displaced flaps was of 4 patients (13.3%). There were no recurrences of melanoma at site of postoperative scar. 3-years disease free survival (DFS) rate was 76.6%, and 5 years DFS rate – 60.0%. \u0000Conclusions. Cone-shaped radical excision of primary melanoma is an appropriate surgery for patients with SM on the forearms, shoulders, epigastria and subclavicular sites and legs. The one-step oncoplastic radical surgery without intermediate biopsy prevents local recurrence in site of surgery as well as iatrogenic metastasis to regional lymph nodes.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42788469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13157
I. Venher, S. Kostiv, B. Selskyi, D. Khvalyboha, M. Orlov, I. Faryna, N. Tsiupryk
Background. Occlusive-stenotic lesions of the lower extremity arteries are the second in the structure of cardiovascular diseases, after only coronary heart disease. Surgical treatment of patients with infrainguinal atherosclerotic lesions of the arterial segment is challenging in a number of cases. At the same time, revascularizing surgical interventions on the femoral-distal artery and especially on the tibial arteries in chronic critical ischemia is the only chance to avoid amputation of the lower limb. In this regard, the search and study of optimal methods of revascularizing surgery on the infrainguinal artery for stenotic-occlusive lesions of the arteries of the tibial segment is urgent. Objective. This study is aimed at promotion of endovascular and hybrid technology in cases of stenotic-occlusive process of the tibial arteries and choosing the optimal surgical treatment tactics in this case. Methods. Endovascular interventions of the femoral-distal arterial bed in cases of stenotic-occlusive process of the tibial arteries performed for 135 patients at the Department of Vascular and Cardiac Surgery of Ternopil Regional Clinical Hospital have been analysed. Results. In most cases, endovascular angioplasty of two tibial arteries in hybrid and endovascular methods of revascularization of multilevel atherosclerotic process of the femoral-distal arterial segment of the lower extremity prevents development of thrombosis in tibial segment and allows maintaining the patency of the reconstruction segment and preservation of the lower extremity in 97.57% and 93.44% of cases, respectively. Conclusions. Endovascular angioplasty of two tibial arteries provides a better result than angioplasty of one isolated tibial artery and allows maintaining the patency of the reconstructed segment for more than 90 percent compare to one isolated angioplasty.
{"title":"ENDOVASCULAR ANGIOPLASTY FOR MULTI-LEVEL STENOTIC-OCCLUSIVE LESIONS OF THE FEMORAL-DISTAL ARTERIAL BED IN CASES OF STENOTIC-OCCLUSIVE PROCESS OF THE TIBIAL ARTERIES","authors":"I. Venher, S. Kostiv, B. Selskyi, D. Khvalyboha, M. Orlov, I. Faryna, N. Tsiupryk","doi":"10.11603/ijmmr.2413-6077.2022.1.13157","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13157","url":null,"abstract":"Background. Occlusive-stenotic lesions of the lower extremity arteries are the second in the structure of cardiovascular diseases, after only coronary heart disease. Surgical treatment of patients with infrainguinal atherosclerotic lesions of the arterial segment is challenging in a number of cases. At the same time, revascularizing surgical interventions on the femoral-distal artery and especially on the tibial arteries in chronic critical ischemia is the only chance to avoid amputation of the lower limb. In this regard, the search and study of optimal methods of revascularizing surgery on the infrainguinal artery for stenotic-occlusive lesions of the arteries of the tibial segment is urgent. \u0000Objective. This study is aimed at promotion of endovascular and hybrid technology in cases of stenotic-occlusive process of the tibial arteries and choosing the optimal surgical treatment tactics in this case. \u0000Methods. Endovascular interventions of the femoral-distal arterial bed in cases of stenotic-occlusive process of the tibial arteries performed for 135 patients at the Department of Vascular and Cardiac Surgery of Ternopil Regional Clinical Hospital have been analysed. \u0000Results. In most cases, endovascular angioplasty of two tibial arteries in hybrid and endovascular methods of revascularization of multilevel atherosclerotic process of the femoral-distal arterial segment of the lower extremity prevents development of thrombosis in tibial segment and allows maintaining the patency of the reconstruction segment and preservation of the lower extremity in 97.57% and 93.44% of cases, respectively. \u0000Conclusions. Endovascular angioplasty of two tibial arteries provides a better result than angioplasty of one isolated tibial artery and allows maintaining the patency of the reconstructed segment for more than 90 percent compare to one isolated angioplasty.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45635714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.11603/ijmmr.2413-6077.2022.1.13098
S. Zaporozhan, D. Fira, O. Pokryshko
Background. Treatment of burn wound infection is an urgent issue of contemporary medicine, including surgery, combustiology and microbiology. It is established that infectious complications are a challenge for burn patients. In the course of wound reparation, infectious complications may worsen. Along with surgical treatment, mechanical removal of pathogens from burn wounds is also important as well as antimicrobials for patients with severe burns. Objective. The aim of the study was to define the most common pathogens of purulent-inflammatory complications of burn wounds and their susceptibility to antibiotics. Methods. The study involved patients treated at the Center of Thermal Trauma and Plastic Surgery of Lviv I-Territorial Medical Association, the unit of St. Luke Hospital of Lviv. Collection of material from wound secretions of burn wounds was performed with sterile swab. The study was performed before prescription of antibiotics, at the end of the first and second weeks of the disease. The pathogens were isolated and identified. Antibiotic susceptibility was studied using standard research methods. The obtained results were analyzed by means of the software package of the microbiological monitoring system WHONET 5.2 (WHO Collaborating Centre for Surveillance of Antimicrobial Resistance) and the program Microsoft Office Excel 2007. Results. The study of smears from burn wounds proved that 240 strains of gram-positive and gram-negative microorganisms that caused purulent-inflammatory processes were isolated. Among the selected causative agents of a burn wound complicated by a purulent-inflammatory process, gram-negative bacteria predominated (60.8% of all detected microorganisms). Gram-positive flora of S. epidermidis and S. aureus were more common in the wound surface during the first week of the disease. In most patients with severe burns, bacterial associations were isolated from the wound surface (66.3%) in two and three weeks, and in three weeks Candida spp. were isolated. Non-fermenting rods A. baumannii and P. aeruginosa dominated among the gram-negative flora isolated from the wound surface of burns. The analysis of susceptibility of microorganisms isolated from patients with burns to antibiotics showed that almost all of the cultures were polyresistant. Conclusions. Gram-negative microorganisms, strains of non-fermenting bacteria predominated among the pathogens isolated from burn wounds complicated by purulent inflammation; Staphylococcus aureus prevailed among the gram-positive ones. The most significant clinical strains were highly polyresistant to antibiotics.
{"title":"ANTIBACTERIAL THERAPY FOR PATIENTS WITH BURN INJURIES","authors":"S. Zaporozhan, D. Fira, O. Pokryshko","doi":"10.11603/ijmmr.2413-6077.2022.1.13098","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.1.13098","url":null,"abstract":"Background. Treatment of burn wound infection is an urgent issue of contemporary medicine, including surgery, combustiology and microbiology. It is established that infectious complications are a challenge for burn patients. In the course of wound reparation, infectious complications may worsen. Along with surgical treatment, mechanical removal of pathogens from burn wounds is also important as well as antimicrobials for patients with severe burns.\u0000Objective. The aim of the study was to define the most common pathogens of purulent-inflammatory complications of burn wounds and their susceptibility to antibiotics.\u0000Methods. The study involved patients treated at the Center of Thermal Trauma and Plastic Surgery of Lviv I-Territorial Medical Association, the unit of St. Luke Hospital of Lviv. Collection of material from wound secretions of burn wounds was performed with sterile swab. The study was performed before prescription of antibiotics, at the end of the first and second weeks of the disease. The pathogens were isolated and identified. Antibiotic susceptibility was studied using standard research methods. The obtained results were analyzed by means of the software package of the microbiological monitoring system WHONET 5.2 (WHO Collaborating Centre for Surveillance of Antimicrobial Resistance) and the program Microsoft Office Excel 2007.\u0000Results. The study of smears from burn wounds proved that 240 strains of gram-positive and gram-negative microorganisms that caused purulent-inflammatory processes were isolated. Among the selected causative agents of a burn wound complicated by a purulent-inflammatory process, gram-negative bacteria predominated (60.8% of all detected microorganisms). Gram-positive flora of S. epidermidis and S. aureus were more common in the wound surface during the first week of the disease. In most patients with severe burns, bacterial associations were isolated from the wound surface (66.3%) in two and three weeks, and in three weeks Candida spp. were isolated. Non-fermenting rods A. baumannii and P. aeruginosa dominated among the gram-negative flora isolated from the wound surface of burns. The analysis of susceptibility of microorganisms isolated from patients with burns to antibiotics showed that almost all of the cultures were polyresistant.\u0000Conclusions. Gram-negative microorganisms, strains of non-fermenting bacteria predominated among the pathogens isolated from burn wounds complicated by purulent inflammation; Staphylococcus aureus prevailed among the gram-positive ones. The most significant clinical strains were highly polyresistant to antibiotics.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41874030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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