5th Day Of Treatment Research Articles

Richness of sputum microbiome in acute exacerbations of eosinophilic chronic obstructive pulmonary disease.

Background:The eosinophilic chronic obstructive pulmonary disease (COPD) is known to be more sensitive to corticosteroid. The sputum microbiome has been shown to affect COPD prognosis, but its role in acute exacerbations of eosinophilic COPD is unclear. This study aimed to investigate the dynamic changes of the airway microbiome in patients with acute exacerbations of eosinophilic COPD.Methods:Fifty-seven patients with acute exacerbations of COPD from the First Affiliated Hospital of Guangxi Medical University between June 2017 and June 2018 were divided into two groups. Patients with eosinophils ≥300 cells/μL in the peripheral venous blood were assigned to the eosinophilic group (Eos) and the rest to the non-eosinophilic group (Noneos). All patients received similar treatment including inhaled budesonide according to the guidelines. The induced sputum microbiome was analyzed on the 1st and 7th day of treatment using the 16S ribosomal RNA (rRNA) method. The levels of interleukin (IL)-6 and IL-8 were measured in the plasma and the sensitivity to corticosteroids was determined in isolated peripheral blood mononuclear cells. Quantitative data were compared between the two groups using the independent samples t test or Mann-Whitney U test. Categorical data were evaluated using Chi-squared test or Fisher's exact test.Results:Twenty-six patients were classified into Eos group and 31 patients were classified into Noneos group. Prior to treatment, the alpha diversity (Shannon index) (2.65 ± 0.63 vs. 2.56 ± 0.54, t = 0.328, P = 0.747) and the structure of the sputum microbiome were similar in the Eos group and the Noneos group. After 7 days of treatment, alpha diversity increased in both groups, while the microbiome richness (Ace index) was significantly lower in the Eos group (561.87 ± 109.13 vs. 767.88 ± 148.48, t = −3.535, P = 0.002). At the same time, IL-6 (12.09 ± 2.85 pg/mL vs. 15.54 ± 2.45 pg/mL, t = −4.913, P < 0.001) and IL-8 (63.64 ± 21.69 pg/mL vs. 78.97 ± 17.13 pg/mL, t = −2.981, P = 0.004) decreased more significantly in the Eos group, and the percentages of inhibition of IL-8 at dexamethasone concentrations 10−8 to 10−6 mol/L were significantly higher in the Eos group than those in the Noneos group (all P < 0.05).Conclusions:The induced sputum microbiome richness decreased more significantly following treatment in the Eos patients compared to the Noneos patients. The lower plasma inflammatory factor levels and the higher percentage of inhibition of IL-8 might be due to higher corticosteroid sensitivity in Eos patients.

Effect of Terebinthus atlanticus on Glucose Metabolism in Diabetic Rats.

Background: Terebinthus atlanticus (Anacardiaceae) is an important source of essential oil and phenolic compounds justifying its use in traditional medicine.Objective: The present work aimed to evaluate the antidiabetic and the antioxidant activities of the aqueous extract of the leaves of Terebinthus atlanticus (T. atlanticus).Methods: The current study evaluated the effect of a single and repeated (15 days of treatment) oral administration of the aqueous extract of the leaves of T. atlanticus (PALAE) on blood glucose levels in normal and streptozotocin(STZ)-induced diabetic rats. Furthermore, the effect of PALAE on glucose tolerance and histopathological examination of the liver was carried out.Results: A single oral administration of PALAE reduced blood glucose levels in normal (p<0.05), and STZ diabetic rats (p<0.0001), 6 and 4 hours after administration, respectively. Furthermore, this extract had an optimal effect (p<0.0001) in both normal and STZ diabetic rats at the 15th and 7th day of treatment. This extract was also shown to prevent significantly the increase on blood glucose levels 120 min after glucose administration, in both normal (p<0.05), and diabetic (p<0.01) treated rats when compared to the control group. In addition, the histopathological analysis highlighted the positive effect of T. atlanticus on pancreas and liver.Conclusion: The study demonstrates the antihyperglycemic effect of the aqueous T. atlanticus extracts in diabetic rats which should be mediated through the amelioration of the oxidative stress as well as an improvement in liver histology.

Effect of various extracts of Justicia gendarussa leaves on neuropharmacological behavior activity in MPTP induced mice model

The present research work is assessment of various extracts of Justicia gendarussa (JG) leaves on neuropharmacological behavior studies in MPTP induced mice model. Animals were administered with Ethanol, Ethyl acetate, Aqueous and n-hexane extracts at dose 200 and 400mg/kg orally along with MPTP (20mg/kg I.P) 4 injections on day 1 and L-DOPA(100mg/kg I.P) was used as standard. Treatment was continued for 7 days and behavioral assessment was made by spontaneous motor activity, number of head dippings (alertness), rota rod test(grip strength) and immobility time by Tail suspension test (TST) and Forced swimming test(FST) on 1st, 4th and 7th day of treatment. The results of the present study showed that spontaneous motor activity, retention time on rota rod and number of head dipping were decreased (P<0.001) whereas, immobility time in TST and FST were increased (P<0.01) in MPTP induced animals. While the motor scores, alertness and retention time (P<0.001) were increased and immobility time in TST and FST(P<0.01) were decreased significantly and dose dependently with ethanol, ethyl acetate and aqueous extracts on 4th and 7th day of treatment as compared with MPTP, L-dopa and normal control, where as n-hexane extract showed slight activity. Preliminary phytochemical analysis of all the extracts showed presence of flavonoids, poly phenols, amino acids, proteins, terpenoids, carbohydrates, tannins and alkaloids. It was observed that ethanol extract of JG at a dose of 400mg/kg on 7th day exhibited maximum increase in spontaneous motor activity, retention time and number of head dipping and decrease in immobility time in TST and FST as compared to Control, MPTP and L-Dopa treated animals. Evidence of above observations, Justicia gendarussa leaves may be suggested as a potential source for CNS stimulant activity with neuroprotective effect. The effect may be due to presence of L-dopa like compounds, terpenoids, flavonoids -polyphenols (Naringenin), amino acids like tyrosine and proteins.

A neglected cause of recurrent rhabdomyolysis, LPIN1 gene defect: a rare case from Turkey

Rhabdomyolysis; can occur due to toxic, infectious, metabolic, and genetic causes. Severe rhabdomyolysis may progress to several clinical manifestations such as cardiac arrest and may pose a risk of mortality if it is not treated timely. In this article, we presented a 26-month-old patient who was admitted with an acute rhabdomyolysis attack and a venovenous hemodiafiltration (CVVHDF) was initiated on the 5th hour of hospitalization. Creatine kinase (CK) levels of the patient continued to increase (max: 943 452 IU/L) until the 5th day of treatment and hereafter began to decrease. As the common causes of rhabdomyolysis were excluded and the CK levels were the highest values reported in the literature, although, LPIN1 deficiency was the most suspected diagnosis, to facilitate the diagnostic procedures a whole-exome sequencing was performed. A homozygous [c.1696G > C p. (Asp566His)] mutation was detected on LPIN1 gene. This variant has not been described previously, however, when examined with programs such as SIFT and Mutation taster, it has been considered as pathogenic. In the pediatric age group, especially in infants presenting with severe rhabdomyolysis, LPIN1 deficiency should also be considered; as early diagnosis and appropriate treatment may reduce mortality.

Quercetin a major biomarker of Psidium guajava L. inhibits SepA protease activity of Shigella flexneri in treatment of infectious diarrhoea

The leaves of the plant Psidium guajava L. (Myrtaceae) has been traditionally used in treatment of various gastrointestinal disorders including diarrhoea and have also been reported for its potent antidiarrhoeal activity on various chemical induced diarrhoea models. The objective of our present study was to evaluate the potency of the leaf extract of the plant Psidium guajava (PGE) along with its major biomarker quercetin against Shigella flexneri-induced sub chronic model of infectious diarrhoea. PGE at 100, 200 and 400 mg/kg, p.o. and quercetin at 50 mg/kg, p.o. were administered to Shigella flexneri-induced diarrhoeal rats for five days and various behavioural parameters were evaluated on 1st, 3rd and 5th day of treatment. This was followed by assessment of stool water content, density of Shigella flexneri in stools and blood parameters examination. After treatment, colon and small intestine of rats was dissected and subjected to biochemical estimations, cytokine profiling, antioxidant evaluations, ion concentration determination, Na+/K+–ATPase activity and histopathology. Molecular docking studies on crystal structure of Secreted Extracellular Protein A (SepA) from Shigella flexneri with biomarker quercetin was also performed. PGE at 200 mg/kg followed by quercetin depicted maximum antidiarrhoeal potential, which was confirmed through diarrhoea score and % protection, while PGE at 400 mg/kg showed similar effect to PGE 200 mg/kg thus, the later may have ceiling effect. PGE and quercetin also significantly reduced the density of Shigella flexneri in stools, water content of stools and restored the alterations observed in blood parameters, antioxidant status and pro-inflammatory cytokines (IL-6 and TNF-α) expression. These parameters contributed in normalization of electrolyte balance, reactivation of Na+/K+–ATPase activity and repairing of epithelial tissue damage, confirmed through histopathology. Docking simulation studies revealed the role of quercetin in inactivating the protease activity of SepA, a protein secreted by Shigella, which disrupts epithelial barrier integrity during infection and also manages its signal production. Thus, the overall results confirmed the role of quercetin as a major biomarker for the observed antidiarrhoeal potential of P. guajava against Shigella flexneri induced infectious diarrhoea.

Atopic dermatitis and eczema: emergency care and effective treatment

Objective — to study the effectiveness and safety of the use of combined topical agents with a triple mechanism of action (anti­inflammatory, antibacterial and antimycotic) in the treatment of patients with eczema and atopic dermatitis.Materials and methods. The study included 65 patients with various forms of eczema and atopic dermatitis. The control group consisted of 150 healthy individuals. The severity of allergic dermatosis was assessed according to the SCORAD scale, and the severity of itching — according to the ten­point numerical rating scale. The study of the skin microbiocenosis was carried out by the method of its direct qualitative and collective assessment. The quality of life assessment was carried out according to an authorized Ukrainian translation of DLQI.Results and discussion. The course of atopic dermatitis and eczema of various forms is accompanied by violations of the skin microbiocenosis with an increase in the total number of bacteria and fungi in the affected areas, which requires appropriate treatment. The advantages of the drug Triacutan were established over monocomponent topical corticosteroids for the treatment of patients with atopic dermatitis and various forms of eczema. During the first 3 days of treatment with the use of the Triacutan, the severity of erythema, edema, papule formation, and excoriation decreased. On the 5th day of treatment, the SCORAD index decreased by 13 times compared with the corresponding indicators before treatment. At the end of treatment, lower indices of SCORAD (by 3.8 times), DLQI (by 1.98 times), itching (by 1.75 times) were noted. At the end of the therapeutic course, normalization of the skin microbiocenosis was registered in patients who used the drug Triacutan.Conclusions. Complex therapy of allergic dermatoses using Triacutan cream or ointment is pathogenetically justified and provides a rapid clinical effect which is manifested by a decrease in the SCORAD and DLQI indexes, a pronounced decrease in itching and its objective signs, and normalization of the skin microbiocenosis. The use of Triacutan cream or ointment in the complex treatment of various forms of eczema and atopic dermatitis is safe.

Strategy optimization in the acute pancreatitis treatment

The aim — to analyze the efficacy of ethyl methylhydroxypyridine succinate (Lodixem) and the combination of ethylmethylhydroxypyridine succinate and pentoxifylline in a Ringer Lactate solution (Lodixem + Latren) in the treatment of patients with acute pancreatitis.Materials and methods. The treatment results analysis in 120 patients with acute pancreatitis was performed. Men were 67 (55.8 %), women — 53 (44.2 %). The patients’ age was from 19 to 82 years (average age — 44.23 ± 2.51 years). Patients receiving standard therapy were divided into two groups: group 1A — 30 patients who received ethylmethylhydroxypyridine succinate in addition to standard therapy, group 1B — 30 patients who received ethylmethylhydroxypyridine succinate and pentoxyphylline in Ringer’s lactate solution in addition to standard therapy. The treatment results of 60 patients with acute pancreatitis treated in the surgical department in the period from 2016 to 2018 (the control group) were retrospectively analyzed. The criterion for inclusion in the study was the presence of acute pancreatitis (Atlanta, 2013), the early stage of the disease, the exclusion criteria — severe acute hepatic or renal failure, hypersensitivity to Latren or Lodiksem in anamnesis, childhood, pregnancy, breastfeeding period. The following clinical and laboratory indicators were evaluated: peripheral blood reaction, basic biochemical parameters, electrolytes in the blood, general state on integral scales to determine the diagnostic criteria for the course of acute pancreatitis on admission to hospital (day 0) and on the 1st, 3rd and 5th day of treatment,.Results and discussion. A statistically significant decrease in leukocyte levels, leukocyte intoxication index, intoxication index and C‑reactive protein content was noted in all groups, however, the rate of decline was more pronounced in groups 1A and 1B. Ranson, Simplified Acute Physiology Score II, Acute Sepsis Severity Evaluation Scale score of patients was assessed by a statistically significant reduction in patient groups treated with ethylmethylhydroxypyridine succinate and a combination of the latter with pentoxyphylline in Ringer’s lactate solution.Conclusions. The ethyl methylhydroxypyridine succinate in combination with pentoxifylline in a Ringer’s solution of lactate reduces the appearance of intoxication and stimulates reparative processes in the acute pancreatitis treatment. At the 5th day there was a significant decrease in the ASSES scale marks (up to 6.11 ± 0.37) and on the Ranson scale ones (up to 1.8 ± 0.9 points) in patients with the proposed treatment regimen. This treatment scheme can be recommended for inclusion into the treatment protocols for patients with pancreatic inflammation.

BIOCHEMICAL MARKERS OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ACUTE INFLAMMATORY DISEASES OF THE ORGANISM OF THE PELVIC ORGANS AGAINST THE BACKGROUND OF DIFFERENT TREATMENT OPTIONS

Inflammatory diseases of the pelvic organs (IDPO) remain one of the most pressing and debatable problems of modern gynecology. Currently, IDPO acquired an erased course due to immune and vascular changes at the local and systemic level, leading to endothelial dysfunction, which, in the absence of acomprehensive, step-by-step treatment, causes chronicity and disrupts the fertility of women. We examined 184 patients with acute episodes of IDPO divided into 2 groups: the main group included 94 patients and the comparison group consisted of 90 patients. All patients started comprehensive drug anti-inflammatory therapy. Patients of the main group additionally received a vaginal laser-magnetopuncture from the 2nd to the 7th day of treatment. To assess the state of endothelial function, the enzyme-linked immunosorbent assay (ELISA) in the serum was used to determine the level of a metabolite of nitric oxide (NO) iNOS - inhibited endothelial NO synthase and endothelin-1. Similar markers were determined in the blood serum of 20 healthy women volunteers of the reproductive age. As a result of the study, in the acute phase of inflammation there was found an increase in both the vasodilator NO and the vasoconstrictor - endothelin-1, which was 2.5 times higher than in healthy women, which confirms the presence of endothelial dysfunction in IDPO patients, which cannot be stopped when carrying out traditional therapy. The use of improved complex treatment with the inclusion of preformed exposure factors contributed to the reduction in the production of NO and endothelin-1, the normalization of epithelial cells and the restoration of the vasomotor function of the endothelium. The use of laser-magnetic vaginal exposure in the early period of treatment and rehabilitation of IDPO patients may help prevent chronic inflammation and normalize the specific functions of the female body.

The Importance of RET-He in the Diagnosis of Iron Deficiency and Iron Deficiency Anemia and the Evaluation of Response to Oral Iron Therapy.

SummaryBackgroundThe purpose of this study is to investigate whether or not reticulocyte hemoglobin equivalent (RET-He) is a superior indicator of blood count and other iron parameters in terms of diagnosing iron deficiency (ID) and iron deficiency anemia (IDA), and thus evaluating a patient’s response to oral iron treatment.MethodsThe research population consisted of 217 participants in total: 54 control, 53 ID, 58 non-ID anemia, and 52 IDA patients. A hemoglobin (Hb) value of < 130.0 g/L was defined as indicating anemia for men, while an Hb value of < 120.0 g/L was defined as indicating anemia for women. All patients were administered 270 mg oral elemental iron sulphate daily.ResultsThe RET-He was significantly lower in the IDA group, compared to other groups (IDA: 21.0 ± 4.1, ID: 26.0 ± 4.9, non-ID anemia: 32.1 ± 6.8, control: 36.6 ± 7.0; < 0.001). The ID group had a lower RET-He compared to the non-ID anemia group and the control group. On the 5th day of treatment, the ID and IDA group showed no significant differences in terms of Hb while the RET-He level demonstrated a significant increase. The increase in the RET-He level observed in the IDA group on the 5th day was significantly higher compared to the increase observed in the ID group. A RET-He value of 25.4 pg and below predicted ID diagnosis with 90.4% sensitivity and 49.1% specificity in IDA patients, compared to the ID group.ConclusionsThe results of our study, therefore, suggest that RET-He may be a clinically useful marker in the diagnosis of ID and IDA.

Гипертонический раствор морской воды как альтернатива топическим деконгестантам

The authors performed a comparative study of the efficacy and safety of irrigation elimination therapy (IET) a hypertonic solution of sea water (and other means-Forte) and a topical decongestant 0.1% solution of Xylometazoline (0.1% Glycine Ksilo) in the treatment of children with acute infectious rhinosinusitis. The article presents the results of evaluation of the dynamic clinical picture and the data of objective study of anterior active rhinomanometry (PARM) using the rhinomanometer ATMOS 300 from the moment of entering the study to the 7th day of treatment. Obtained by the authors of the subjective (clinical) and objective (results of PARM) data to prove the comparative efficacy and high safety of the IEP of hypertonic saline solution in comparison with the use of topical vasoconstrictor for acute infectious rhinosinusitis in children.

Efficacy of Alginate-Antacid Medication in the Treatment of Patients with Gastroesophageal Reflux Disease

Efficacy of Alginate-Antacid Medication in the Treatment of Patients with Gastroesophageal Reflux Disease

Hematemesis on Hepatic Cirrhosis Patients in Area with Limited Facilities

Esophageal variceal haemorrhage is one of the more dangerous complications of hepatic cirrhosis. Initial treatment can determine patient mortality and morbidity. But not all hospitals have adequate facilities and medicines to handle it. The 53-year-old woman came with a diagnosis of ascites and hematemesis. At the initial examination found hypotension. Laboratory results show anemia, thrombocytopenia, and leukocytosis. The next morning the patient's condition worsened and was transferred to ICU. During the ICU patients receive 10 lpm oxygen support, cefobactam, pantoprazole, PRC transfusion, and dopamine. Patients begin conscious on the 5th day of treatment. Then the patient started getting diuretics on day 6 and propranolol on day 9. On day 13 the patient's condition improved and the patient was discharged for outpatient treatment. Limitations of the endoscopic tool cause not every hospital in Indonesia can perform emergency endoscopy for therapy. However, with rapid and appropriate pharmacological therapy, patients can be helped not to fall into mortality and prevent recurrent bleeding.

EFFICIENT IMPROVEMENTS OF HERPEX SIMPLEX LABIALIS TREATMENT USING DIODE LASER AND “TEBODONT” GEL

The introduction of laser systems into the dental practice takes an important place in the development of methods for accelerated and effective treatment of viral diseases. As a matter of fact, laser radiation blocks the inflammatory process, suppresses the pathogenicity of the virus, improves the processes of microcirculation. The use of tea tree oil-based preparations promotes regeneration and restoration of the tunica mucosa of mouth.&#x0D; The aim of this study is to assess the therapeutic efficacy of combined use of laser radiation with “Tebodont” gel based on tea tree oil in the treatment of recurrent Herpes simplex Labialis. Clinical observation of 44 patients was conducted on the basis of Pyrohov Memorial Vinnytsia National Medical University at the age from 17 to 22 years old. Among them there were 26 women and 18 men with a prolonged history of the disease within 6 years or more: light severity. Diagnosis of the disease was performed on the basis of complaints of patients, results of objective examination and molecular-biological method of polymerase chain reaction (PCR).&#x0D; To assess the treatment efficiency, patients were divided into three levels according to the number of group: I, II and control. All patients were prescribed a commonly agreed treatment regimen, which included the local application of antiviral “Herpevir” ointment for the first 3 days, anaesthetic gel “Kamistad”, and keratoplastic agents to stimulate the epithelization. Patients of I group, with the exception of “Herpevir” ointment, during the first 3 days of the disease received a daily two-time application of “Tebodont” gel on the affected lip area until the final epithelization.&#x0D; Patients of II main group underwent laser contactless irradiation of the affected lip area with diode laser Picasso made by the company “AMD Lasers” (USA) in a continuous mode with the power range of 0.5 Watt using non-activated fibre and “Program 4”. Exposition – 2 minutes on the area, number – 5 procedures and daily two-time application of “Tebodont” gel on the affected lip area until the final epithelization.&#x0D; The efficiency was being assessed within two weeks from the starting date of treatment based on subjective data and clinical examination results. Patients of I main group began to recover on 3-4 days of examination. Full epithelization of the affected area occurred on the 5-6 days of treatment. All patients of II main group showed an improvement in the clinical picture already on the second day after the treatment. They noted a decrease in pain, edema, and hyperaemia. Complete epithelization of erosive defects in patients was observed on the 3-4 days of the examination. Patients of the control group noted an improvement in the clinical picture of the disease – decrease of discomfort, pain, only on the fifth day of treatment. Initial manifestations of epithelization of the affected area were observed in the patients of this group only on the 7-8 days. High efficiency of treatment in the main groups was observed already on the 5th day of treatment and constituted 100% in II and 79% in the I group. In the control group, complete healing occurred only on the 10-12 days of treatment.&#x0D; Obtained results of the study certify that the use of laser radiation in combination with tea tree oil-based “Tebodont” gel in the treatment of recurrent Herpes simplex Labialis, in terms of therapeutic efficiency, exceeds conventional medical treatment.&#x0D; The prospect of further research is to develop and introduce modern methods for the treatment of diseases of the tunica mucosa of mouth into the dental practice with the usage of laser radiation and preparations based on tea tree oil.

Diagnosis and treatment of neurogenic dysphagia after acute ischemic stroke

To determine the efficacy of post-stroke dysphagia treatment by choline alfoscerate (ChA), succinate combination (SC), and their combination with sip, larynx, and swallowing exercises. Four groups of primary ischemic stroke (IS) patients (n=80; 62±0.2 y.o., verified by MRI), including controls, admitted to Stroke Unit 24 h after stroke in the area of RAM (29.5%), and LAM (70.5%), were studied. Basic therapy was provided according to National Stroke Treatment Recommendations, treated groups received ChA 14 mg/kg (2st gr.), SC 0.5 mg/kg (3nd gr.), combination of two compounds (3d gr.). Controls (4th gr.) received placebo. Pharmacological treatment was provided for 10 days with continuation by oral administration. Dysphagia was measured semi-quantitively by MASA scale, three scale determinants were measured on admission, on 5 and 13 days of stay in the hospital. The differences were significant and observed on the 5th day of treatment. ChA mostly improved sip control, and larynx movements (38% above controls; p<0.01), while SC improved the closure of vocal cords (55% above controls; p<0.01). This may reflect the differences in synaptic control of these functions. Combined treatment was more effective than monotherapy: 15% above ChA, and 21% above SC for swallowing function (p=0.01); 33 and 22% for vocal closure, 37% (p=0.05) and 76% (p=0.01) for larynx movement, which may be due to synergism between two medications. Therefore, sip, larynx, and swallowing exercises with pharmacological support of ChA and SC ameliorated dysphagia after IS.

The treatment of the patients suffering from acute bacterial external otitis with the use of intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm

The prevalence of allergic reactions to the pharmaceutical products and the development of antibiotic resistance limit the provision of the high-quality medical care to the patients presenting with acute bacterial external otitis media (ABEO). The objective of the present study was to evaluate the effectiveness of the treatment of the patients suffering from ABEO with the application of the new technique based on intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm (ILBI-445). This open comparative clinical study was carried out from April 2017 till June 2017 and included the patients with ABEO who were divided into two groups. The patients of the main group underwent the standard treatment in the combination with low-intensity laser radiation at a wavelength of 445 nm. Those comprising the control group were given the conventional treatment alone. The end point of the study was the complete disappearance of local inflammatory signs in the region of the external auditory canal (EAC) and auricle, the restoration of the volume of the EAC, the absence of complaints estimated based on the visual analogue scale (VAS), and the complete disappearance of symptoms of intoxication. The local signs of inflammation in the region of the EAC and auricle were assessed from the otoscopic picture. The measurement of the volume of the external auditory canal were carried out by filling it with a furacilin solution at a temperature of 360C using a 2 ml syringe. The character of the inflammatory changes in the external auditory canal, the intensity of pain and itching, as well as the degree of hearing loss were estimated at 10 points based on the 10-point visual analogue scale (with 0 points standing for the absence of complaints and 10 points denoting the maximum severity of the complaints). The symptoms of intoxication were determined from the measurements of body temperature. The combined treatment of the patients with ABEO using ILBI-445 resulted in their earlier recovery in comparison with that achieved by means of the standard therapy. The differences were especially pronounced on the 5th day of treatment. Complaints of pain and the loss of hearing were documented only in the patients of the control group. Itching was a significantly less serious trouble in the patients of the main group than it was in those comprising the control group. The volume of the external auditory canal in the patients of the main group on the 5th day after the onset of the treatment was more than 16.7% greater than in the control one. The high therapeutic effectiveness and simplicity of the approach employed in the present study taken together with a minimum of contraindications for its application give reason to recommend intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm for the treatment of the patients suffering from acute bacterial external otitis.

EFFICIENCY OF INHALATION AND PARENTAL THERAPY OF ACUTE BRONCHIAL OBSTRUCTION SYNDROME BY INFECTIOUS OR ALLERGIC GENESIS IN CHILDREN. PRINCIPLES AND TECHNIQUE OF INHALATIONS

Relevance. Diseases of the respiratory organs occupy the first ranked place in the structure of the incidence of children, reaching 50-75 % in the regions of Ukraine. The prevalence of the syndrome of bronchial hyperactivity increases . Objective: to study the effectiveness of nebulizer therapy for relief of acute bronchial obstruction syndrome in children with exacerbation of recurrent bronchitis or bronchial asthma. Materials and methods. 52 children of school age with acute bronchial hyperactivity (recurrent bronchitis – 28, bronchial asthma – 24) were examined. Two groups were formed by randomization: the main group (27 children) and the control group (25 children). Both groups were representative by sex, age, nosological diagnosis and severity of the disease. All children received basic therapy with topical glucocorticosteroids by nebulization. Children of the main group received intensive treatment by salbutamol inhalation during the first treatment day, and on 2–5 days as in the control group only 3 times a day. Children of the control group received inhalations together with intravenous drip infusions of euphyllin and dexamethasone. Results. In both groups, there was a dynamic regression of cough and sputum excretion, but in the main group, the rate of disappearance of cough by the 5th day of treatment was 3 times, and by the 10th day – 2,3 times higher, than in the control (p &lt; 0.05); the rate of disappearance of sputum within 10 days is 1,7 times higher, respectively (p &lt;0.05). Positive changes were confirmed by an auscultative pattern, the normalization of which occurred earlier for 1 week in patients receiving intensive nebulization bronchodilator therapy during the first day of the treatment. Conclusions. Competent use of nebulizers allows to increase the effectiveness of treatment of children with acute bronchial obstructive syndrome. Early relief of bronchospasm promotes faster normalization of inspiratory flow and respiration recovery. As a result, the terms of recovery and length of stay of children in the hospital are shortened.

Clinicopathological Findings and Therapeutic Management of Secondary Photosensitization Caused by &lt;I&gt;Lantana camara&lt;/I&gt; in Deccani Sheep Flock

A flock of twenty Deccani sheep was admitted to clinics with the history of swellings over face, ears, tail base, head shaking, rubbing head against hard objects, recumbency and death in three female sheep. Clinical examination of ailing flock revealed anorexia, increased rectal temperature and respiratory rate, tachycardia, swellings and crests formation or loss of hairs over ears, around eyes, submandibular area and tail base along with inco-ordination,intense itching and passing yellow to amber coloured urine. Haematological analysis revealed granulocytic leucocytosis. On post-mortem examination of dead animals, yellowish discolouration of conjunctival mucous membranes, sclera, subcutaneous tissue or fat and various organs including heart, liver and kidney was observed. Affected sheep were treated with tentative diagnosis of Lantana camara induced photosensitization and complete clinical recovery was observed in all affected sheep on 5th day of treatment. On the basis of history, clinical signs, haematological changes, post-mortem lesions and therapeutic response, the ailing flock was diagnosed for secondary photosensitization due to ingestion of Lantana camara .

Effects of inflammatory factors including plasma tumor necrosis factor-α in the clinical treatment of acute respiratory distress syndrome.

The present study investigated the association between the levels of plasma tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-8, high-sensitivity C-reactive protein and fibrinogen levels of patients with acute respiratory distress syndrome (ARDS) with ARDS treatment outcome and duration of mechanical ventilation, with the aim of improving the efficacy of ARDS therapy. A total of 140 patients with ARDS were randomly divided into groups A and B, with 70 patients in each group. The patients in group A received a combination of conventional treatment and comprehensive treatment (test group) and the patients in group B were treated with conventional therapy only (control group). Elbow venous blood was obtained from each patient in the morning prior to treatment, on the 3rd day of treatment and on the 5th day of treatment. The levels of inflammatory factors, the clinical effects and the duration of mechanical ventilation of the two groups were statistically analyzed. The levels of IL-6, TNF-α and IL-8 in patients from group A were significantly reduced compared with those from group B (P<0.05). Additionally, the oxygenation index and arterial partial oxygen pressure of patients in group A were significantly higher compared with group B patients (P<0.05), the duration of mechanical ventilation of group A was decreased compared with that of group B (P<0.05) and the overall response rate of group A was >90%, whereas group B had a response rate of 80.0%. These results indicate that the treatment administered to patients in group A exhibited an improved clinical efficacy. The combination of comprehensive and conventional therapy may effectively reduce the levels of inflammatory factors and the inflammatory response, and these levels may be important for the effective treatment of ARDS and in reducing treatment duration. Therefore the current study may improve upon current clinical practice.

Effects of thiocolchicoside, a commonly used myorelaxant, on the acoustic reflex.

To determine whether thiocolchicoside, a commonly used myorelaxant, may impair the acoustic reflex. Forty-two patients scheduled to receive thiocolchicoside treatment for different reasons were enrolled in the study. Acoustic reflex thresholds at 500, 1000, 2000 and 4000 Hz were determined and analysed statistically pre-treatment and on the 5th day of treatment. Increases were observed in the mean acoustic reflex thresholds on the 5th day of treatment compared to pre-treatment, at all frequencies, except right contralateral thresholds at 500 and 2000 Hz. These increases were statistically significant for right ipsilateral thresholds at 2000 and 4000 Hz, left ipsilateral thresholds at 500, 1000, 2000 and 4000 Hz, and left contralateral thresholds at 2000 and 4000 Hz (p ≤ 0.05), but not at other frequencies (p > 0.05). Muscle relaxant drugs, especially those affecting the central nervous system, may weaken the stapedial muscle so that the ability of noise to cause acoustic trauma may become evident. For this reason, physicians should advise their patients to avoid loud noises when muscle relaxant therapy is prescribed.

Comparative efficacy of different schemes for the therapy of rotavirus gastroenteritis in children. Case–control study

Objective research : compare the efficacy of different types of therapy for rotavirus gastroenteritis in children. Materials and methods. A study was carried out, the design of which corresponded to the case–control type. The main group is children hospitalized in a hospital with laboratory confirmed rotavirus infection (35 cases), who were prescribed a modern regimen of therapy that included a low-carbohydrate diet, rehydration with low osmolar oral solutions, dioctahedral smectite, probiotic containing Saccharomyces boulardii. For each child of the main group was selected another patient (control), the corresponding sex, age, the period from the onset of the disease to admission to hospital, and the degree of dehydration. Patients of the control group (n=35) were assigned a traditional «old» therapy regimen, including a diet corresponding to Table No. 4 in Pevznur, oral rehydration solutions with osmolality of 282 mOsm/l, anthibacterial therapy (ceftriaxone), dioctahedral smectite and pancreatin at age-dependent doses. The duration of the observation was 5 days. Results : By the 5th day of treatment, the normalization of the stool was recorded in 91.4% [95% CI 82.1–100.7], 32/35 in the main group and 71.4% [95% CI 56.5–86.3], 25/35 children in the control (p &lt;0.05, OR 4.27 [95% CI 1.06–17.2]). The timing of relief of excess meteorism also had statistically significant differences and was shorter in patients receiving a «new» therapy regimen (OR 2.8 [95% CI 1.01–8])). The positive effect of the proposed scheme was also observed when assessing the duration of dehydration symptoms and the timing of hospitalization. Conclusions : The conducted study case–control showed the advantage of modern schemes of therapy of rotavirus infections in children.