Pub Date : 2021-11-22DOI: 10.11603/ijmmr.2413-6077.2021.1.12258
M. Ali, B. Banavalikar, M. Ghadei, A. Kottayan, D. Padmanabhan, J. Shenthar
Background. Radiofrequency catheter ablation (CA) has been the treatment of choice in patients with accessory pathway (AP)-mediated tachycardias. Most of these procedures are done under fluoroscopic guidance, leading to significant radiation exposure to the patient and the laboratory personnel. In this analysis, we have looked at the amount of radiation exposure in AP CA procedures performed without the support of a three-dimensional electroanatomic mapping system. We have analyzed changes in exposure indices over the study period and the impact of change in fluoroscopy frame rate (FFR). Objectives. The objectives of this study are to quantify radiation exposure in accessory pathway ablation procedures; to analyze the radiation exposure trend over time; and to evaluate the effect of fluoroscopy frame rate reduction on the radiation exposure indices in these procedures. Methods. All the AP ablation procedures performed at our institute from January 2016 to December 2019 were retrospectively analyzed. The collected data were age, sex, location of APs based on successful site of ablation on fluoroscopy, procedure time, fluoroscopy time, and dose-area product (DAP). Effective dose (ED) was estimated from DAP. The data of procedures performed before January 2018 (“pre” group) were compared with those of the procedures performed after that date (“post” group). Pre-group procedures were performed at an FFR of 7.5 frames per second (fps), and post-group procedures – at an FFR of 3.75 fps. Results. The total number of procedures included in the analysis was 635. The mean age of the patients was 39±14 years, and 401 of them (63%) were males. The most common location of the APs was left lateral (38%). Procedure time and radiation indices showed a significant decrease over the study period (p < 0.001). Post group procedures had significantly shorter procedure time and lower radiation exposure than pre group procedures. Conclusions. A decrease in the FFR was associated with a significant reduction in radiation exposure in AP ablation procedures
{"title":"RADIATION EXPOSURE IN ACCESSORY PATHWAY ABLATION PROCEDURES IN CARDIAC ELECTROPHYSIOLOGY: A RETROSPECTIVE ANALYSIS","authors":"M. Ali, B. Banavalikar, M. Ghadei, A. Kottayan, D. Padmanabhan, J. Shenthar","doi":"10.11603/ijmmr.2413-6077.2021.1.12258","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2021.1.12258","url":null,"abstract":"Background. Radiofrequency catheter ablation (CA) has been the treatment of choice in patients with accessory pathway (AP)-mediated tachycardias. Most of these procedures are done under fluoroscopic guidance, leading to significant radiation exposure to the patient and the laboratory personnel. In this analysis, we have looked at the amount of radiation exposure in AP CA procedures performed without the support of a three-dimensional electroanatomic mapping system. We have analyzed changes in exposure indices over the study period and the impact of change in fluoroscopy frame rate (FFR).\u0000Objectives. The objectives of this study are to quantify radiation exposure in accessory pathway ablation procedures; to analyze the radiation exposure trend over time; and to evaluate the effect of fluoroscopy frame rate reduction on the radiation exposure indices in these procedures.\u0000Methods. All the AP ablation procedures performed at our institute from January 2016 to December 2019 were retrospectively analyzed. The collected data were age, sex, location of APs based on successful site of ablation on fluoroscopy, procedure time, fluoroscopy time, and dose-area product (DAP). Effective dose (ED) was estimated from DAP. The data of procedures performed before January 2018 (“pre” group) were compared with those of the procedures performed after that date (“post” group). Pre-group procedures were performed at an FFR of 7.5 frames per second (fps), and post-group procedures – at an FFR of 3.75 fps.\u0000Results. The total number of procedures included in the analysis was 635. The mean age of the patients was 39±14 years, and 401 of them (63%) were males. The most common location of the APs was left lateral (38%). Procedure time and radiation indices showed a significant decrease over the study period (p < 0.001). Post group procedures had significantly shorter procedure time and lower radiation exposure than pre group procedures. \u0000Conclusions. A decrease in the FFR was associated with a significant reduction in radiation exposure in AP ablation procedures","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49015906","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 : 2021-05-18DOI: 10.11603/ijmmr.2413-6077.2020.2.12011
I. Kulyk, S. Khmil
Background. Endometriosis-associated infertility (EAI) has a number of specific features, which are crucial in the choice of medical treatment. Objective. The aim of the study is to analyze endocrine profile in women with EAI before and after sclerotherapy and pregravid preparation (PP), which includes a vitamin complex FT 500 plus with inositol and vitamin D3. Methods. The study involved 70 women aged 21-40 years with endometriosis-associated infertility. The comparison group included 30 women with tuboperitoneal infertility. ELISA was used to determine concentrations of Anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone and estradiol in blood serum using a standard kit by Diagnostic Systems Laboratories, Inc (USA). During two menstrual cycles the FT 500 plus was prescribed once a day from the 2nd/3rd day of the cycle, vitamin D3 was prescribed at the dose of 2,000 IU for women without its deficiency and in therapeutic doses in case of hypovitaminosis. The sclerotherapy with 95% ethanol solution was performed on the 6th-8th day of menstrual cycle. Results. It was established that in women with EAI undergoing PP and sclerotherapy the level of AMH was lower (by 12.90%) as well as progesterone (by 9.84%), while FSH (by 14.47%), LH (by 21.14%) and estradiol (by 35.55%) was higher compare to the comparison group. At the same time, FSH (by 21.98%), LH (by 32.89%) and estradiol (by 32.23%) concentrations were significantly lower compare to their primary indices before sclerotherapy. Conclusions. Sclerotherapy and PP with a vitamin complex, inositol and vitamin D3 has a positive effect on endocrine profile in women with endometriosis-associated infertility
{"title":"ENDOMETRIOSIS-ASSOCIATED INFERTILITY: THE ROLE OF HORMONES AND ITS CORRECTION","authors":"I. Kulyk, S. Khmil","doi":"10.11603/ijmmr.2413-6077.2020.2.12011","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.2.12011","url":null,"abstract":"Background. Endometriosis-associated infertility (EAI) has a number of specific features, which are crucial in the choice of medical treatment. \u0000Objective. The aim of the study is to analyze endocrine profile in women with EAI before and after sclerotherapy and pregravid preparation (PP), which includes a vitamin complex FT 500 plus with inositol and vitamin D3. \u0000Methods. The study involved 70 women aged 21-40 years with endometriosis-associated infertility. The comparison group included 30 women with tuboperitoneal infertility. ELISA was used to determine concentrations of Anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone and estradiol in blood serum using a standard kit by Diagnostic Systems Laboratories, Inc (USA). During two menstrual cycles the FT 500 plus was prescribed once a day from the 2nd/3rd day of the cycle, vitamin D3 was prescribed at the dose of 2,000 IU for women without its deficiency and in therapeutic doses in case of hypovitaminosis. The sclerotherapy with 95% ethanol solution was performed on the 6th-8th day of menstrual cycle. \u0000Results. It was established that in women with EAI undergoing PP and sclerotherapy the level of AMH was lower (by 12.90%) as well as progesterone (by 9.84%), while FSH (by 14.47%), LH (by 21.14%) and estradiol (by 35.55%) was higher compare to the comparison group. At the same time, FSH (by 21.98%), LH (by 32.89%) and estradiol (by 32.23%) concentrations were significantly lower compare to their primary indices before sclerotherapy. \u0000Conclusions. Sclerotherapy and PP with a vitamin complex, inositol and vitamin D3 has a positive effect on endocrine profile in women with endometriosis-associated infertility","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42795438","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 : 2021-05-18DOI: 10.11603/ijmmr.2413-6077.2020.2.11485
Muzamil Latief, O. Shafi, Z. Hassan, F. Abbas
Background. The clinical presentation of Coronavirus disease 19 (COVID-19) varies from mild symptoms to severe illness including multiorgan dysfunction. Favipiravir is an antiviral agent which has been previously used for treatment of influenza and was recently approved for treatment of mild to moderate COVID-19 in India. Objective. The Objective of this study was to assess the role of Favipiravir and Dexamethasone in patients with COVID-19. Methods. A total of 17 patients were included in this observational study. The included patients were RT-PCR for SARS-Cov-2 positive with increased inflammatory markers. All patients received Antiviral therapy, Anticoagulation (Enoxaparin 0.4mg subcutaneous twice daily), Steroids (Dexamethasone 8mg daily for 5days and 4mg daily for 5 days). Viral clearance (time to RT-PCR negative), time to defervescence after antiviral therapy, time to become independent of Oxygen support was studied. Results. Fever, myalgias, dry cough and dyspnea were the commonest presentation of COVID-19. All of our patients had lymphopenia. In our study 11 (64.7%) patients had bilateral ground glass opacities on CT chest while 6 had consolidation in addition to ground glass opacities. In two patients, who required non-invasive ventilation, Favipiravir was stopped and these patients received Remdesivir for a total of 5 days. In patients who received Favipiravir only, the Median time to RT-PCR negative, defervescence and oxygen independence was 8,3 and 6 days respectively. Conclusion. Our observational study demonstrated improvement in the majority of patients with COVID-19 with use of Favipiravir. Additional studies are needed to compare the efficiency of Favipiravir with Remdesivir.
{"title":"FAVIPIRAVIR AND DEXAMETHASONE IN MANAGEMENT OF SARS-COV2 INFECTION","authors":"Muzamil Latief, O. Shafi, Z. Hassan, F. Abbas","doi":"10.11603/ijmmr.2413-6077.2020.2.11485","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.2.11485","url":null,"abstract":"Background. The clinical presentation of Coronavirus disease 19 (COVID-19) varies from mild symptoms to severe illness including multiorgan dysfunction. Favipiravir is an antiviral agent which has been previously used for treatment of influenza and was recently approved for treatment of mild to moderate COVID-19 in India.\u0000Objective. The Objective of this study was to assess the role of Favipiravir and Dexamethasone in patients with COVID-19.\u0000Methods. A total of 17 patients were included in this observational study. The included patients were RT-PCR for SARS-Cov-2 positive with increased inflammatory markers. All patients received Antiviral therapy, Anticoagulation (Enoxaparin 0.4mg subcutaneous twice daily), Steroids (Dexamethasone 8mg daily for 5days and 4mg daily for 5 days). Viral clearance (time to RT-PCR negative), time to defervescence after antiviral therapy, time to become independent of Oxygen support was studied.\u0000Results. Fever, myalgias, dry cough and dyspnea were the commonest presentation of COVID-19. All of our patients had lymphopenia. In our study 11 (64.7%) patients had bilateral ground glass opacities on CT chest while 6 had consolidation in addition to ground glass opacities. In two patients, who required non-invasive ventilation, Favipiravir was stopped and these patients received Remdesivir for a total of 5 days. In patients who received Favipiravir only, the Median time to RT-PCR negative, defervescence and oxygen independence was 8,3 and 6 days respectively. \u0000Conclusion. Our observational study demonstrated improvement in the majority of patients with COVID-19 with use of Favipiravir. Additional studies are needed to compare the efficiency of Favipiravir with Remdesivir.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46395048","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 : 2021-05-18DOI: 10.11603/ijmmr.2413-6077.2020.2.11600
H. Rathi, M. Biyani, M. Malik, P. Rathi
Background. On March 24, 2020, a nationwide Lockdown for 21 days was ordered by the Government of India which was then extended till May 31, 2020. Researchers have predicted lockdown is a necessary step to prevent COVID-19 spread. However, others have also stated that it could cause serious damage to the economic, mental, social, and physical well-being of the people. Objective. The aim of the study is to evaluate the impact of lockdown on the quality of life and well-being of the Indians. Methods. It is a cross sectional prospective web-based questionnaire study. A link (https://forms.gle/pX25VuahP5NxT88QA) was created. Total 426 responses were received via that link and the data was included in the statistical analysis. Results. Our study revealed that during the lockdown 61.5% of the respondents were performing physical activities lesser than before. More than half responded they had a reduced financial satisfaction. Most answers on emotional well-being and social-family wellbeing were also positive, but some responses showed disturbing too, like 22% felt anxious and nervous over half of the days. It was found in the study that physical, financial, emotional, mental, social and family wellbeing were disturbed during the lockdown and quality of life was also hampered. Conclusion. Though, may be Nationwide Lockdown was the most required action at that point of time to prevent virus spread, but our study revealed that uncertainty regarding its cure and management guidelines like lockdown and social distancing has badly affected quality of life and wellbeing of the population.
{"title":"QUALITY OF LIFE AND WELL-BEING OF POPULATION AT THE END OF THIRD PHASE OF LOCKDOWN IN INDIA AGAINST THE COVID-19 PANDEMIC","authors":"H. Rathi, M. Biyani, M. Malik, P. Rathi","doi":"10.11603/ijmmr.2413-6077.2020.2.11600","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.2.11600","url":null,"abstract":"Background. On March 24, 2020, a nationwide Lockdown for 21 days was ordered by the Government of India which was then extended till May 31, 2020. Researchers have predicted lockdown is a necessary step to prevent COVID-19 spread. However, others have also stated that it could cause serious damage to the economic, mental, social, and physical well-being of the people.\u0000Objective. The aim of the study is to evaluate the impact of lockdown on the quality of life and well-being of the Indians.\u0000Methods. It is a cross sectional prospective web-based questionnaire study. A link (https://forms.gle/pX25VuahP5NxT88QA) was created. Total 426 responses were received via that link and the data was included in the statistical analysis.\u0000Results. Our study revealed that during the lockdown 61.5% of the respondents were performing physical activities lesser than before. More than half responded they had a reduced financial satisfaction. Most answers on emotional well-being and social-family wellbeing were also positive, but some responses showed disturbing too, like 22% felt anxious and nervous over half of the days. It was found in the study that physical, financial, emotional, mental, social and family wellbeing were disturbed during the lockdown and quality of life was also hampered.\u0000Conclusion. Though, may be Nationwide Lockdown was the most required action at that point of time to prevent virus spread, but our study revealed that uncertainty regarding its cure and management guidelines like lockdown and social distancing has badly affected quality of life and wellbeing of the population.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44174275","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 : 2020-11-11DOI: 10.11603/ijmmr.2413-6077.2020.1.11503
O. Kachur, L. Fira, P. Lykhatskyi
Background. The increasing incidence of colon malignant tumors is one of the most urgent matters of contemporary medicine. In the study of carcinogenesis of the colon the attention is paid to the state of the body’s immune system and activation of inflammatory processes in experimental animals. Objective. The aim of the study was to estimate the level of markers of inflammation in the serum of experimental animals with chemically induced carcinogenesis and their dynamics in case of administration of the cytostatic Vincristine secondary to AUT-M carbon enterosorbent. Methods. The study was performed on white male rats. Animals were modeled for colon cancer by administration of 1.2-dimethylhydrazine hydrochloride at a dose of 7.2 mg/kg body weight for 30 weeks. AUT-M enterosorbent was administered intragastrically daily during 7 and 21 days after modeling of carcinogenesis at a dose of 1 ml of suspension (corresponding to 0.2 g of drug weight) per 100 g of animal body weight. The antitumor drug was administered to the animals with induced carcinogenesis intragastrically daily during 14 days at a dose of 0.23 mg/kg of body weight after a 21-day detoxification therapy. The activity of inflammatory processes was evaluated by the content of pro-inflammatory interleukin 6 and anti-inflammatory interleukin 4, C-reactive protein in the serum of experimental animals. Results. It was established that introduction of 1.2-dimethylhydrazine hydrochloride in the rats caused changes in the cytokine profile and the content of C-reactive protein. In the affected animals an increase in the content of pro-inflammatory interleukin 6, C-reactive protein, as well as a decrease in the content of antiinflammatory interleukin 4 was evidenced in all periods of the study. AUT-M enterosorbent contributed to normalization of these parameters. The cytostatic Vincristine had a negligible effect on development of inflammatory processes in the studied animals. Conclusions. In cases of induced carcinogenesis, an imbalance in the content of proand anti-inflammatory cytokines, an increase in the content of acute-phase C-reactive protein was established. The positive effect of the cytostatic Vincristine secondary to a previous detoxification therapy with AUТ-M sorbent during a progressive development of inflammatory processes in the presence of modeled carcinogenesis was evidenced.
{"title":"INFLAMMATION AND IMPACT OF VINCRISTINE AND ENTEROSORPTION USE IN CHEMICALLY INDUCED COLON CARCER IN RATS","authors":"O. Kachur, L. Fira, P. Lykhatskyi","doi":"10.11603/ijmmr.2413-6077.2020.1.11503","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.1.11503","url":null,"abstract":"Background. The increasing incidence of colon malignant tumors is one of the most urgent matters of contemporary medicine. In the study of carcinogenesis of the colon the attention is paid to the state of the body’s immune system and activation of inflammatory processes in experimental animals. Objective. The aim of the study was to estimate the level of markers of inflammation in the serum of experimental animals with chemically induced carcinogenesis and their dynamics in case of administration of the cytostatic Vincristine secondary to AUT-M carbon enterosorbent. Methods. The study was performed on white male rats. Animals were modeled for colon cancer by administration of 1.2-dimethylhydrazine hydrochloride at a dose of 7.2 mg/kg body weight for 30 weeks. AUT-M enterosorbent was administered intragastrically daily during 7 and 21 days after modeling of carcinogenesis at a dose of 1 ml of suspension (corresponding to 0.2 g of drug weight) per 100 g of animal body weight. The antitumor drug was administered to the animals with induced carcinogenesis intragastrically daily during 14 days at a dose of 0.23 mg/kg of body weight after a 21-day detoxification therapy. The activity of inflammatory processes was evaluated by the content of pro-inflammatory interleukin 6 and anti-inflammatory interleukin 4, C-reactive protein in the serum of experimental animals. Results. It was established that introduction of 1.2-dimethylhydrazine hydrochloride in the rats caused changes in the cytokine profile and the content of C-reactive protein. In the affected animals an increase in the content of pro-inflammatory interleukin 6, C-reactive protein, as well as a decrease in the content of antiinflammatory interleukin 4 was evidenced in all periods of the study. AUT-M enterosorbent contributed to normalization of these parameters. The cytostatic Vincristine had a negligible effect on development of inflammatory processes in the studied animals. Conclusions. In cases of induced carcinogenesis, an imbalance in the content of proand anti-inflammatory cytokines, an increase in the content of acute-phase C-reactive protein was established. The positive effect of the cytostatic Vincristine secondary to a previous detoxification therapy with AUТ-M sorbent during a progressive development of inflammatory processes in the presence of modeled carcinogenesis was evidenced.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45520215","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 : 2020-11-11DOI: 10.11603/ijmmr.2413-6077.2020.1.11504
Z. Bokhua, K. Chelidze, K. Ebralidze
Background. New challenges of permanently changing context of healthcare system requires new methods of medical education and new assessment tools, as well. Competency-based Medical Education (CBME), framework which has been adopted as a new approach in medical education, needs appropriate assessment tool such as portfolio. Portfolio is learner-centered assessment instrument which evaluates learner’s progression towards outcomes and enables both residents and teachers to engage in a process of learning through assessment. Objective. In this paper we aim to share our successful experience of an effective use of web-based 5-Dimensional Electronic Portfolio (5DeP) as an assessment tool in the Pilot Group. Methods. Pilot Group of sixteen residents (six first year residents of Obstetrics/Gynecology and ten first year residents of Internal Medicine. Tbilisi State Medical University Institute of Postgraduate Medical Education and Continuous Professional Development) and twelve mentors (four Obstetrics/Gynecology mentor and eight Internal Medicine mentors) reported some feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool. Results. Feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool from mentors and students demonstrated efficiency of the program. It enables assessment within a framework of transparent and declared criteria and learning objectives; provides a model for lifelong learning and continuing professional development; increases competence in a wider context with benefits to both professional and personal roles; improves organizing skills. Conclusions. 5DeP have been recognized as an extremely effective assessment tool.
{"title":"WEB-BASED 5-DIMENSIONAL ELECTRONIC PORTFOLIO (5DEP) AS A COMPETENCY-BASED ASSESSMENT TOOL IN POST-GRADUATE MEDICAL TRAINING","authors":"Z. Bokhua, K. Chelidze, K. Ebralidze","doi":"10.11603/ijmmr.2413-6077.2020.1.11504","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.1.11504","url":null,"abstract":"Background. New challenges of permanently changing context of healthcare system requires new methods of medical education and new assessment tools, as well. Competency-based Medical Education (CBME), framework which has been adopted as a new approach in medical education, needs appropriate assessment tool such as portfolio. Portfolio is learner-centered assessment instrument which evaluates learner’s progression towards outcomes and enables both residents and teachers to engage in a process of learning through assessment. Objective. In this paper we aim to share our successful experience of an effective use of web-based 5-Dimensional Electronic Portfolio (5DeP) as an assessment tool in the Pilot Group. Methods. Pilot Group of sixteen residents (six first year residents of Obstetrics/Gynecology and ten first year residents of Internal Medicine. Tbilisi State Medical University Institute of Postgraduate Medical Education and Continuous Professional Development) and twelve mentors (four Obstetrics/Gynecology mentor and eight Internal Medicine mentors) reported some feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool. Results. Feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool from mentors and students demonstrated efficiency of the program. It enables assessment within a framework of transparent and declared criteria and learning objectives; provides a model for lifelong learning and continuing professional development; increases competence in a wider context with benefits to both professional and personal roles; improves organizing skills. Conclusions. 5DeP have been recognized as an extremely effective assessment tool.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49354108","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 : 2020-11-11DOI: 10.11603/ijmmr.2413-6077.2020.1.11502
M. Hnatiuk, S. Konovalenko, L. Tatarchuk, О. B. Yasinovsky
Background. Over the last 20 years, the quality of men’s sperm around the world has deteriorated twice. The causes are poor environment, stress, sedentary lifestyle, prevalence of sexually transmitted infections, obesity, alcohol abuse and various stimulants. The structure and function of the testes, when exposed to various drugs and chemicals, attracts the attention of present researchers. Objectives. The aim of the research was to study the structural changes of the spermatogenic epithelium in testicular damage caused by rubomycin hydrochloride. Methods. The spermatogenic epithelium of the testes of 30 white adult white male rats, which were divided into 2 groups, was morphometrically examined. The 1st group comprised 15 experimental intact animals, the 2nd – 15 rats, in which testicular damage with rubomycin hydrochloride was simulated. Euthanasia of rats was performed by bloodletting under thiopental anesthesia one month after the experiment beginning. Quantitative morphological parameters were statistically processed. In spermatocytes of the 1st P-order, spermatogonia and spermatids of testes, their height, diameter of nuclei, nuclear-cytoplasmic ratio and relative volumes of damaged cells of spermatogenic epithelium were evaluated. Results. It was established that spermatogenic epithelial cells were damaged in the simulated experimental conditions, which was morphometrically confirmed by changes in nuclear-cytoplasmic relations in the 1st, 2nd order spermatocytes, spermatogonia and spermatids. The relative volumes of damaged spermatogenic epithelial cells also increased significantly. The most significant morphometric parameters were altered in spermatids. Thus, the nuclear-cytoplasmic ratio in the studied cells was statistically significantly (p <0.001) increased by 7.4% compared with the similar control morphometric parameter. The relative volume of damaged spermatids in these experimental conditions reached (32.50±0.18) %, which with a high statistically significant difference (p<0.001) exceeded the same control value in almost 15.8 times. Optically, histological preparations of the testes showed severe vascular disorders, characterized by dilation and plethora mostly of venous vessels, which pointed to violation of venous drainage of the studied organs. Conclusions. According to the attained research results it has been established that nuclear-cytoplasmic relations are an objective and valuable informative indicator of a functional condition of cells and their structural changes in pathological conditions. When rubomycin hydrochloride is exposed to experimental animals, the most significant changes in nuclear-cytoplasmic relations are found in spermatic spermatozoa.
{"title":"MORPHOMETRIC EVALUATION OF SPERMATOGENIC EPITHELIOCYTES STRUCTURE UNDER THE RUBOMYCIN INFLUENCE IN RATS","authors":"M. Hnatiuk, S. Konovalenko, L. Tatarchuk, О. B. Yasinovsky","doi":"10.11603/ijmmr.2413-6077.2020.1.11502","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.1.11502","url":null,"abstract":"Background. Over the last 20 years, the quality of men’s sperm around the world has deteriorated twice. The causes are poor environment, stress, sedentary lifestyle, prevalence of sexually transmitted infections, obesity, alcohol abuse and various stimulants. The structure and function of the testes, when exposed to various drugs and chemicals, attracts the attention of present researchers. Objectives. The aim of the research was to study the structural changes of the spermatogenic epithelium in testicular damage caused by rubomycin hydrochloride. Methods. The spermatogenic epithelium of the testes of 30 white adult white male rats, which were divided into 2 groups, was morphometrically examined. The 1st group comprised 15 experimental intact animals, the 2nd – 15 rats, in which testicular damage with rubomycin hydrochloride was simulated. Euthanasia of rats was performed by bloodletting under thiopental anesthesia one month after the experiment beginning. Quantitative morphological parameters were statistically processed. In spermatocytes of the 1st P-order, spermatogonia and spermatids of testes, their height, diameter of nuclei, nuclear-cytoplasmic ratio and relative volumes of damaged cells of spermatogenic epithelium were evaluated. Results. It was established that spermatogenic epithelial cells were damaged in the simulated experimental conditions, which was morphometrically confirmed by changes in nuclear-cytoplasmic relations in the 1st, 2nd order spermatocytes, spermatogonia and spermatids. The relative volumes of damaged spermatogenic epithelial cells also increased significantly. The most significant morphometric parameters were altered in spermatids. Thus, the nuclear-cytoplasmic ratio in the studied cells was statistically significantly (p <0.001) increased by 7.4% compared with the similar control morphometric parameter. The relative volume of damaged spermatids in these experimental conditions reached (32.50±0.18) %, which with a high statistically significant difference (p<0.001) exceeded the same control value in almost 15.8 times. Optically, histological preparations of the testes showed severe vascular disorders, characterized by dilation and plethora mostly of venous vessels, which pointed to violation of venous drainage of the studied organs. Conclusions. According to the attained research results it has been established that nuclear-cytoplasmic relations are an objective and valuable informative indicator of a functional condition of cells and their structural changes in pathological conditions. When rubomycin hydrochloride is exposed to experimental animals, the most significant changes in nuclear-cytoplasmic relations are found in spermatic spermatozoa.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46909795","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 : 2020-11-10DOI: 10.11603/ijmmr.2413-6077.2020.1.11103
M. Raza, B. Das, V. Goyal, R. Lodha, R. Chaudhry, S. Sood, V. Sreenivas, D. Nair, S. Mohapatra, H. Gautam, A. Kapil
Background. Acute bacterial meningitis is one of the significant infectious diseases that add an immense burden to the health system. Proper management of meningitis is an invincible need to overcome the severe consequences. Objectives. The aim of the study is detection of the etiological agents of acute bacterial meningitis by PCR. Methods. Total 267 CSF samples collected from suspected bacterial meningitis cases were processed for the detection of S. pneumoniae, H. influenzae, N. meningitidis, E. coli and Group B streptococci by conventional and molecular diagnosis method. CSF was inoculated on Blood, chocolate and MacConkey agar plates and incubated at 37 °C for 24-48 hrs. Bacteria grown were identified by Matrix assisted laser desorption/ionization time of flight (MALDI-TOF). Multiplex PCR of the enlisted bacteria was performed using DNA extracted from CSF by DNA extraction kit (Qiagen, USA). Results. 5 (1.87%) out of the total 267 CSF samples were culture positive (3 S. pneumoniae and 2 E. coli) and 28 (10.49%) had detectable DNA by conventional PCR. Out of these 28 samples, 20 (71.43%) were S. pneumoniae and 8 (28.57%) were E. coli. 15 (53.57%) out of total S. pneumoniae were present in children below 5 years of age. Similarly, E. coli was predominant in neonates. Sensitivity and specificity of the PCR was 100% and 95-98% respectively. Conclusions. Streptococcus pneumoniae is the commonest cause of community acquired bacterial meningitis in children below five years of age. Hence, for the promising outcome, PCR should be implemented for the diagnosis of acute bacterial meningitis.
{"title":"IMPACT OF MOLECULAR METHOD FOR THE DIAGNOSIS OF ACUTE BACTERIAL MENINGITIS IN A TERTIARY HEALTH CARE CENTRE IN NORTH INDIA","authors":"M. Raza, B. Das, V. Goyal, R. Lodha, R. Chaudhry, S. Sood, V. Sreenivas, D. Nair, S. Mohapatra, H. Gautam, A. Kapil","doi":"10.11603/ijmmr.2413-6077.2020.1.11103","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.1.11103","url":null,"abstract":"Background. Acute bacterial meningitis is one of the significant infectious diseases that add an immense burden to the health system. Proper management of meningitis is an invincible need to overcome the severe consequences. Objectives. The aim of the study is detection of the etiological agents of acute bacterial meningitis by PCR. Methods. Total 267 CSF samples collected from suspected bacterial meningitis cases were processed for the detection of S. pneumoniae, H. influenzae, N. meningitidis, E. coli and Group B streptococci by conventional and molecular diagnosis method. CSF was inoculated on Blood, chocolate and MacConkey agar plates and incubated at 37 °C for 24-48 hrs. Bacteria grown were identified by Matrix assisted laser desorption/ionization time of flight (MALDI-TOF). Multiplex PCR of the enlisted bacteria was performed using DNA extracted from CSF by DNA extraction kit (Qiagen, USA). Results. 5 (1.87%) out of the total 267 CSF samples were culture positive (3 S. pneumoniae and 2 E. coli) and 28 (10.49%) had detectable DNA by conventional PCR. Out of these 28 samples, 20 (71.43%) were S. pneumoniae and 8 (28.57%) were E. coli. 15 (53.57%) out of total S. pneumoniae were present in children below 5 years of age. Similarly, E. coli was predominant in neonates. Sensitivity and specificity of the PCR was 100% and 95-98% respectively. Conclusions. Streptococcus pneumoniae is the commonest cause of community acquired bacterial meningitis in children below five years of age. Hence, for the promising outcome, PCR should be implemented for the diagnosis of acute bacterial meningitis.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48079050","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 : 2020-11-10DOI: 10.11603/IJMMR.2413-6077.2020.1.11268
Z. Lominadze, K. Chelidze, L. Chelidze, E. Lominadze
Background. Oxidative stress is crucial in developing broad spectrum of diseases, including atherosclerosis and related life-threatening conditions, such as acute coronary syndrome (ACS) mainly caused by atherosclerotic plaque vulnerability. Objective. To clarify the relation between oxidative stress and plaque instability we decided to compare oxidative profiles of patients with acute coronary syndrome (ACS) and with chronic coronary syndrome (CCS), evaluated at admission to the coronary care unit (CCU) of LTD Clinic-LJ (Kutaisi, Georgia) in April 2018 June 2019, who underwent successful primary percutaneous coronary intervention (PCI). Methods. 191 patients were enrolled (100 patients with ACS in Group 1 and 91 patients with CCS in Group 2) into the study. Using the CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) – Callegari Point of Care instrument we evaluated free oxygen radical test (FORT), free oxygen radicals defense (FORD), calculated REDOX Index and the overall Profile of oxidative stress. Results. The mean/median concentration of Free Oxygen Radicals was significantly higher in the patients with ACS (404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p<0.0001). Significant correlation was found between advanced oxidative stress and acute coronary syndrome (OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI (2.31-4.60) with high diagnostic characteristics (sensitivity of 82% and specificity of 92.3%; positive predictive value of 92% and positive likelihood ratio of 11). Conclusion. Oxidative stress is crucial in life-threatening acute coronary events. Measurement of overall oxidative stress profile, as a surrogate of plaque instability and rupture predictor, could help the clinicians in risk stratification and prevention of acute coronary syndrome (ACS).
背景。氧化应激在发展广泛的疾病中是至关重要的，包括动脉粥样硬化和相关的危及生命的疾病，如主要由动脉粥样硬化斑块易感性引起的急性冠状动脉综合征(ACS)。目标。为了阐明氧化应激与斑块不稳定之间的关系，我们决定比较急性冠状动脉综合征(ACS)和慢性冠状动脉综合征(CCS)患者的氧化谱，这些患者于2018年4月至2019年6月在LTD Clinic-LJ (Kutaisi, Georgia)冠状动脉监护室(CCU)入院时进行评估，并成功接受了初级经皮冠状动脉介入治疗(PCI)。方法:191例患者(1组为100例ACS患者，2组为91例CCS患者)纳入研究。使用CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) - Callegari Point of Care仪器评估游离氧自由基测试(FORT)，游离氧自由基防御(FORD)，计算氧化还原指数和氧化应激的总体概况。结果。ACS患者的平均/中位自由基浓度明显高于ACS患者(404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq.， p<0.0001)。晚期氧化应激与急性冠脉综合征有显著相关性(OR 14.42 95% CI (7.08-29.4)， RR 3.26 95% CI(2.31-4.60)，具有较高的诊断特征(敏感性82%，特异性92.3%;阳性预测值92%，阳性似然比为11)。结论。氧化应激在危及生命的急性冠状动脉事件中至关重要。测量整体氧化应激谱，作为斑块不稳定性和破裂预测指标，可以帮助临床医生进行危险分层和预防急性冠脉综合征(ACS)。
{"title":"SYSTEMIC OXIDATIVE STRESS AS A SURROGATE OF CORONARY ATHEROSCLEROTIC PLAQUE INSTABILITY AND RUPTURE PREDICTOR","authors":"Z. Lominadze, K. Chelidze, L. Chelidze, E. Lominadze","doi":"10.11603/IJMMR.2413-6077.2020.1.11268","DOIUrl":"https://doi.org/10.11603/IJMMR.2413-6077.2020.1.11268","url":null,"abstract":"Background. Oxidative stress is crucial in developing broad spectrum of diseases, including atherosclerosis and related life-threatening conditions, such as acute coronary syndrome (ACS) mainly caused by atherosclerotic plaque vulnerability. Objective. To clarify the relation between oxidative stress and plaque instability we decided to compare oxidative profiles of patients with acute coronary syndrome (ACS) and with chronic coronary syndrome (CCS), evaluated at admission to the coronary care unit (CCU) of LTD Clinic-LJ (Kutaisi, Georgia) in April 2018 June 2019, who underwent successful primary percutaneous coronary intervention (PCI). Methods. 191 patients were enrolled (100 patients with ACS in Group 1 and 91 patients with CCS in Group 2) into the study. Using the CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) – Callegari Point of Care instrument we evaluated free oxygen radical test (FORT), free oxygen radicals defense (FORD), calculated REDOX Index and the overall Profile of oxidative stress. Results. The mean/median concentration of Free Oxygen Radicals was significantly higher in the patients with ACS (404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p<0.0001). Significant correlation was found between advanced oxidative stress and acute coronary syndrome (OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI (2.31-4.60) with high diagnostic characteristics (sensitivity of 82% and specificity of 92.3%; positive predictive value of 92% and positive likelihood ratio of 11). Conclusion. Oxidative stress is crucial in life-threatening acute coronary events. Measurement of overall oxidative stress profile, as a surrogate of plaque instability and rupture predictor, could help the clinicians in risk stratification and prevention of acute coronary syndrome (ACS).","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45063427","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 : 2020-11-10DOI: 10.11603/ijmmr.2413-6077.2020.1.11047
I. Venher, N. Herasymiuk, S. Kostiv, I. Loyko, D. Khvalyboha
Background. Important part of orthopedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movement and the support ability of lower limbs. But some complications usually take place; venous thromboembolism is leading among them. Objective. The aim of the study was to investigate endothelial dysfunction and activity of the hemocoagulation system at different levels of VTEC risks and thus to work out the strategy of thromboprophylaxis in patients with osteoarthrosis of the hip joint and femoral neck fracture combined with non-specific dysplasia of the connective tissue. Methods. 219 patients of a mean age of 64.7±3.8 years old underwent surgery. In 137 (62.1%) cases, a total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients underwent total and unipolar cement hip replacement for cervical femoral neck fractures. Results. Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients that was confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) cases. The level of indicators of endothelium status dysfunction was much more significant in the patients in cases of nonspecific dysplasia of connective tissue. Operative intervention on the hip joint in the patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by development of venous thrombosis. In the patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) cases. Conclusions. Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by high levels of endothelial dysfunction and increased activity of the blood-coagulation system.
{"title":"NONSPECIFIC DYSPLASIA OF THE CONNECTIVE TISSUE – A FACTOR OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN ENDOPROSTHETICS OF HIP JOINTS","authors":"I. Venher, N. Herasymiuk, S. Kostiv, I. Loyko, D. Khvalyboha","doi":"10.11603/ijmmr.2413-6077.2020.1.11047","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2020.1.11047","url":null,"abstract":"Background. Important part of orthopedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movement and the support ability of lower limbs. But some complications usually take place; venous thromboembolism is leading among them. Objective. The aim of the study was to investigate endothelial dysfunction and activity of the hemocoagulation system at different levels of VTEC risks and thus to work out the strategy of thromboprophylaxis in patients with osteoarthrosis of the hip joint and femoral neck fracture combined with non-specific dysplasia of the connective tissue. Methods. 219 patients of a mean age of 64.7±3.8 years old underwent surgery. In 137 (62.1%) cases, a total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients underwent total and unipolar cement hip replacement for cervical femoral neck fractures. Results. Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients that was confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) cases. The level of indicators of endothelium status dysfunction was much more significant in the patients in cases of nonspecific dysplasia of connective tissue. Operative intervention on the hip joint in the patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by development of venous thrombosis. In the patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) cases. Conclusions. Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by high levels of endothelial dysfunction and increased activity of the blood-coagulation system.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42798174","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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