Combined Treatment Method Research Articles

Organ preservation treatment of patients with atypical hyperplasia and endometrial cancer: current trends

The high prevalence and steady increase in the incidence of endometrial cancer dictate the need to prevent and improve the effectiveness of treatment of this disease. The solution of these issues is possible either by expanding the indications for surgical treatment in endometrial proliferative processes, or by improving conservative methods of therapy, which is of priority importance, since some patients often have the question of preserving reproductive function.Leading oncogynecological communities have come to a consensus: conservative treatment with preservation of fertility is possible and safe for young patients with endometrioid endometrial cancer of a high degree of differentiation, limited to endometrial damage only. According to published studies, the use of progestins gives a high frequency response to treatment in patients with atypical hyperplasia and early endometrial cancer. Combined treatment methods, including the use of metformin or hysteroscopic resection after drug therapy, can reduce the frequency of relapses.In the absence of larger prospective studies, it is very important to consider a woman's overall health and fertility potential before recommending conservative treatment for early endometrial cancer. It is necessary to conduct further randomized controlled trials in order to provide more convincing evidence of the benefits of a particular technique.

Anti-tumor Effects of Cisplatin Synergist in Combined Treatment with Clostridium novyi-NT Spores Against Hypoxic Microenvironments in a Mouse Model of Cervical Cancer Caused by TC-1 Cell Line.

Despite the development of anti-human papillomavirus (HPV) vaccines, cervical cancer is still a common disease in women, especially in developing countries. The presence of a hypoxic microenvironment causes traditional treatments to fail. In this study, we presented a combined treatment method based on the chemotherapeutic agent cisplatin and Clostridium novyi-NT spores to treat normoxic and hypoxic areas of the tumor. TC-1 Cell line capable of expressing HPV-16 E6/7 oncoproteins was subcutaneously transplanted into female 6-8 week old C57/BL6 mice. The tumor-bearing mice were randomly divided into four groups and treated with different methods after selecting a control group. Group 1: Control without treatment (0.1 mL sterile PBS intratumorally), Group: C. novyi-NT (107 C. novyi-NT). Group 3: Receives cisplatin intraperitoneally (10 mg/kg). Fourth group: Intratumoral administration of C. novyi-NT spores + intraperitoneal cisplatin. Western blot analysis was used to examine the effects of anti-hypoxia treatment and expression of hypoxia-inducible factor 1 (HIF-1) and vascular endothelial growth factor (VEGF) proteins. The results clearly showed that combined treatment based on C. novyi-NT and cisplatin significantly reduced the expression of HIF-1 alpha and VEGF proteins compared to cisplatin alone. At the same time, the amount of necrosis of tumor cells in the combined treatment increased significantly compared to the single treatment and the control. At the same time, the mitotic count decreased significantly. Our research showed that developing a combined treatment method based on C. novyi-NT and cisplatin against HPV-positive cervical cancer could overcome the treatment limitations caused by the existence of hypoxic areas of the tumor.

Effectiveness of combined methods of treatment of atrophic scars of skin

Atrophic post-acne scars are severe manifestations of the post-acne symptom complex, which occur as a result of inflammation due to the loss of collagen fibers and subcutaneous fat during the healing of inflammatory acne elements. The incidence of post-acne scars has been little studied, but according to some authors, about 90 % of patients with severe and moderate acne suffer from them. The aim of the study was to study the effect of the combined use of IPL- and PRP-therapy, fractional microneedle radiofrequency therapy and PRP-therapy, as well as microneedling of autologous plasma with cells on the clinical symptoms of atrophic skin scars, taking into account the duration of the pathological process, based on the dynamics of the indicators of the Manchester Assessment Scale of Scar Deformations. Complex methods showed higher efficiency than the use of hardware techniques in relation to all clinical signs of atrophic scars.

Hearing recovery prediction and prognostic factors of idiopathic sudden sensorineural hearing loss: a retrospective analysis with a deep neural network model

ObjectiveIdiopathic Sudden Sensorineural Hearing Loss (ISSHL) is an otologic emergency, and an early prediction of prognosis may facilitate proper treatment. Therefore, we investigated the prognostic factors for predicting the recovery in patients with ISSHL treated with combined treatment method using machine learning models. MethodsWe retrospectively reviewed the medical records of 298 patients with ISSHL at a tertiary medical institution between January 2015 and September 2020. Fifty-two variables were analyzed to predict hearing recovery. Recovery was defined using Siegel’s criteria, and the patients were categorized into recovery and non-recovery groups. Recovery was predicted by various machine learning models. In addition, the prognostic factors were analyzed using the difference in the loss function. ResultsThere were significant differences in variables including age, hypertension, previous hearing loss, ear fullness, duration of hospital admission, initial hearing level of the affected and unaffected ears, and post-treatment hearing level between recovery and non-recovery groups. The deep neural network model showed the highest predictive performance (accuracy, 88.81%; area under the receiver operating characteristic curve, 0.9448). In addition, initial hearing level of affected and non-affected ear, post-treatment (2-weeks) hearing level of affected ear were significant factors for predicting the prognosis. ConclusionThe deep neural network model showed the highest predictive performance for recovery in patients with ISSHL. Some factors with prognostic value were identified. Further studies using a larger patient population are warranted. Level of evidenceLevel 4.

Возможность применения крема дозированного Ацилакт Дуо при бактериальном вагинозе

Bacterial vaginosis is a clinical condition in which the normal vaginal microflora, predominantly lactobacilli, is replaced by other microorganisms, mainly anaerobes. The goal of treating bacterial vaginosis is to restore the normal microflora of the vagina, to delay the growth of microorganisms that are not characteristic of this vaginal microcenosis. The purpose of the study was to evaluate the effectiveness of various methods of combined two-stage treatment of bacterial vaginosis in women of reproductive age. Material and methods. The study included 50 patients aged 18 to 45 years (mean age 29.6 ± 4.5 years) with bacterial vaginosis. The first group consisted of 25 patients who received Clindamycin 2% cream for 7 days, dose vaginally at night. For the second stage of therapy in this 1 group, acidophilus bacteria + vitamin-mineral-protein-peptide complex Superlimfly (Acylact Duo) were used, suppository time per day at night intravaginally for 10 days. The second group consisted of 25 patients who received Clindacimin cream for 7 days, dose vaginally at night. For the second stage of therapy, a preparation containing a lyophilized culture of lactobacilli L. casei rhamnosus Doderleini was used, at least 1 × 108 CFU, capsule in the vagina at night for 14 days. Results. The effectiveness of BV therapy was 49% (n = 46). The duration of remission was 24.1 ± 2.1 days (n = 24) in the group of women receiving adjuvant therapy with Acilact Duo dosed cream, and 19.9 ± 2 3. days (n = 22) in the comparison group. In all patients, the average vaginal pH before therapy was 5.5 ± 0.4. In group1 participants, after therapy, the pH was 4.54 ± 0.143 , in group 2 patients, the average vaginal pH was 4.976 ± 0.241. Among the patients of both groups, vaginal dysbiosis of varying severity was detected before treatment (normocenosis was not detected). After therapy, in patients of group, normocenosis of the vagina was achieved in 88% (22/25), in participants of group 2, normocenosis was noted in 72% (18/25). At visit (in 45 days) in women of the group 1 84% (21/25), in the participants of the group 2 – normocenosis was noted in 64% (16/25). Conclusions. Acidophilic bacteria + vitamin-mineral-protein-peptide complex Superlymfly (in which dosed Acylact Duo) quickly restores the optimal acidity of the vagina (pH value) and promotes the growth of the number of beneficial lactobacilli, as a result of which it creates an optimal and natural microflora that prevents the appearance of dysbiosis in patients of reproductive age

The combined magnetic-vibration stress relief

This study proposes a new method of residual stress reduction. In addition, through a series of devices and technologies, it investigates the evolution of the residual stress, strength, and microstructure in the stress relief process. The experiment results show that the combined magnetic–vibration treatment is efficient in reducing the residual stress. Moreover, the measurement and the analysis results of the macro size and roughness of the material show that a local small amount of plastic deformation occurs in the process of residual stress reduction by the combined magnetic–vibration treatment. After the combined magnetic–vibration treatment, the grain size of the silicon steel and the energy of Goss texture slightly increase, the grain boundary narrows, and the dislocation density increases, which may be an important reason for the change of the mechanical properties of the materials. Furthermore, the combined magnetic–vibration treatment can significantly increase the number of parallel domains and decrease the number of labyrinth domains. The application effect of the combined magnetic-vibration treatment method and its mechanism are also revealed. The results show that the proposed combined magnetic–vibration treatment method is accurate and has a high performance.

Treatment of Knee Osteoarthritis with Transcutaneous Electrical Nerve Stimulation

In China, the majority of osteoarthritis patients have the disease in the knee. Clinically, knee osteoarthritis (KOA) often has joint swelling, pain, stiffness, dysfunction and other symptoms, which reduce the patients’ quality of life. There is a trend that osteoarthritis affects more and more young people in China, so it is much more important to treat KOA. Being a cheap and non-surgical option, the transcutaneous electrical nerve stimulation (TENS) has unique advantages in dealing with the pain caused by KOA. This article presents the pathogenesis and pain mechanism of KOA, describes the mechanism of TENS in KOA treatment, discusses the advantages and disadvantages, and proposes some combined treatment methods. Some studies have shown that the pathogenesis of KOA is related to the theory of unequal settlement of knee joints, and the pain comes from cartilage, subchondral bone and synovial membrane lesions. The gate control theory, endogenous opioid peptide release theory and diffuse noxious inhibitory controls theory are considered as the theoretical basis for TENS to inhibit pain. Its effectiveness, adaptability and incidence of adverse reactions are better than using drugs, but it cannot improve walking ability and the range of motion of the joints. Combination therapies of TENS are currently effective for treating KOA, including TENS combined with ultrasound, sodium hyaluronate, massage, functional training and other treatment options.

MicroRNAs in the Diagnosis of Malignancy of Supratentorial Brain Gliomas and Prognosis of Disease Progression.

The study of brain tumors has shown that microRNAs can act as both oncogenes and tumor suppressors and, consequently, can be used as biomarkers for the diagnosis and prognosis of such tumors. Thus, big interest arises in the role of microRNA and its part in oncogenesis in the human brain to find key molecules that can act as tumor markers for diagnostic and prognostic purposes, as well as potential therapeutic agents. The sim of this study was to assess histological, molecular, and genetic metrics in patients with supratentorial gliomas, and indicate diagnostic and prognostic abilities of microRNA usage as biomarkers of the grade of malignancy of the tumor. Clinical and genetic studies were performed in 107 operated patients with supratentorial gliomas of different malignancies. The expression levels of 10 microRNAs (-16, -21¸ -31, -124, - 125b, -181b, -191, -221, -223, and -451) were analyzed using real-time polymerase chain reaction (PCR). The results were analyzed statistically using Statistica 12.0 (Statistica, Hamburg, Germany) and GraphPad Prism 9 software (GraphPad Software Inc., Boston, Massachusetts, United States). Based on a comprehensive statistical analysis involving the database of the clinical results of treatment of all 107 patients (combined treatment methods, quality of life, and survival) and microRNA expression levels, specific profiles of microRNA expression typical of different histotypes of gliomas of different malignancy were identified, the prognostic significance of the studied microRNAs as potential predictors of survival in patients with brain gliomas was determined, and microRNAs with the highest prognostic value were identified among them.

Study on the effect of Huayu Changshen Formula combined with ideological and political psychological intervention on students with anxiety disorder

BackgroundWith the increasing academic pressure on students, students have become a large group of anxiety patients. Some studies have shown that Huayu Changshen Formula can relieve the stagnation of liver qi in patients, and has high application value in the clinical treatment of anxiety disorders. In order to improve its treatment effect on students with anxiety disorder, the study proposed a combined treatment method of Huayu Changshen Formula and ideological and political psychological intervention to improve the diagnosis and treatment level of students with anxiety disorder.Subjects and MethodsA total of 86 students with anxiety disorders from February 2020 to November 2020 were retrospectively analyzed. All patients were randomly divided into the experimental group and the control group. The patients in the experimental group were treated with the combination of Huayu Changshen Formula and ideological and political psychological intervention, and the patients in the control group were treated with paroxetine. The treatment lasted for 10 weeks. Before and after the treatment, Hamilton Anxiety Scale (HAHA) was used for scoring to understand the anxiety level of patients. The symptom scale of liver qi stagnation syndrome was used to score the patient’s condition. All data were analyzed by SPSS24.0 software.ResultsBefore treatment, there was no significant difference in HAHA score and Traditional Chinese Medica (TCM) symptom score between the two groups; After treatment, the HAHA scores of the patients in the experimental group and the control group decreased to about 7.88 and 12.39 respectively, and the TCM symptom scores of the patients in the experimental group decreased by about 4.86 points compared with the control group. The difference between the two groups of patients was statistically significant (P < 0.05). The observation of the overall efficacy of the two groups of patients showed that the recovery rate of the experimental group patients reached 28.78%, which was 24% higher than that of the control group. The overall efficacy difference between the two groups was statistically significant (P < 0.05).ConclusionsThe combined treatment of Huayu Changshen Formula and ideological and political psychological intervention has improved the overall treatment level of anxiety disorder, and its therapeutic effect is far better than that of paroxetine, which can significantly improve students’ anxiety disorder, and can be popularized in the clinical treatment of anxiety disorder.Table 1.Changes in patients’ HAHA score and TCM symptom score before and after the treatmentProjectHAHATCM symptomBefore treatmentAfter treatmentBefore treatmentAfter treatmentExperimental group21.57±1.257.88±0.1413.68±1.172.86±1.48Control group20.69±2.1413.29±2.6914.55±0.097.72±3.09t3.554.212.152.48P0.1350.0010.1430.001AcknowledgementThe research is supported by: Jiangsu Postgraduate Research and Practice Innovation Program: Marx’s Thought of Civil Society and Its Contemporary Value (No. KYCX22_1694).

USE OF SURGICAL METHODS OF TREATMENT FOR THROMBOSIS OF THE INFERIOR VENA CAVA SYSTEM

Objective. Develop surgical tactics in the treatment of acute deep venous thrombosis (DVT) of the inferior vena cava system.Materials and methods. We analyzed the results of the surgical treatment of 181 patients with DVT for the period from 2001 to 2014. Among the patients with DVT in our study, 37 (20.4%) patients had thrombosis of the inferior vena cava (IVC). Separately, we selected a group of 44 patients with floating DVT. During the treatment, catheter-directed thrombolysis (CDT) was used in 60 (33.1%) patients, systemic thrombolysis in 30 (16.5%), thrombectomy was performed in 44 (24.3%) patients, and anticoagulants were used in 47 (25.9%) patients. Catheter-directed thrombolysis was performed according to the developed method in 30 patients. Results. In the general assessment of the efficiency of the methods, we found that the efficiency of the patented method is 20.5% greater than the efficiency of thrombolysis in the back vein of the foot and 39% greater than the efficiency of systemic thrombolysis (p<0.001). In our study, out of 60 cases of CDT, hemorrhagic complications occurred in 2 (3.3%) cases. In the treatment of patients with floating DVT, we used active surgical tactics when the length of the floating part was more than 4 cm. In the treatment of occlusive thrombosis of the IVC, catheter-directed thrombolysis was used in 9 patients, systemic thrombolysis in 4 patients, and thrombolysis for pulmonary embolism (PE) in 1 patient. 1 patient with thrombosis of the vena cava inferior died of massive PE during anticoagulant therapy. The use of combined methods of DVT treatment of the IVC system made it possible to obtain good and satisfactory results in the immediate period in 166 (92%) patients and in the long-term period in 90 (49.7%) patients.Conclusions. Treatment tactics for thrombosis of IVC system requires an individual approach in each specific case, taking into account the etiological factors of the disease, anatomical features of the structure of IVC system, terms from the onset of the disease, the risk of pulmonary embolism (PE), the presence of concomitant pathology.

New approach to pathogenesis and treatment of trophycal ulcers

Introduction. Trophic ulcers are one of the most common medical ailments worldwide. Treatment of patients with trophic ulcers is difficult not only because they often recur, but also because they are difficult to treat. Purpose. Study the clinical features and present our own results of combined methods of treatment of trophic ulcers of venous etiology. Materials and methods. The study involved 100 patients with trophic ulcers of the lower extremities of venous, diabetic and atherosclerotic etiology, who had a history and were treated for varicose veins of the lower extremities and post-thrombotic disease. Examination of patients included questionnaires, clarification of complaints, anamnesis data, causes of development, examination and ultrasound diagnostics (duplex examination). The examination of the ulcer included determining the location, size, appearance, base of the wound, the level of exudation and assessment of the condition of the skin around the defect. Results. The etiological factors in the development of trophic ulcers were: varicose disease with chronic venous insufficiency – 25 patients, post-thrombotic disease – 55 patients. All patients underwent only conservative treatment of trophic venous ulcers with the appointment of a placenta compositum. After the treatment of a group of patients, out of 100 patients with venous trophic ulcers, 89% were cured within 4 months, 8% were cured within 2 years, and in 3 % ulcers did not heal for more than two years. The average duration of the course of ulcers was 12 months. The average size of trophic ulcers based on the results of the analysis was 8 cm2. Complete healing of venous ulcers was most often observed in the age group 61–73 years in 30% patients. Conclusion. The use of the compositum placenta contributed to the acceleration of wound healing, which made it possible to obtain more effective results.

A combined precipitation-adsorption method for harmless treatment of glyphosate mother liquor

A large amount of glyphosate mother liquor containing high concentrations of several phosphorous-based compounds, namely glyphosate, phosphorous acid, and glyphosine at a concentration of 34 g/L, is generated in the production of the most widely used organophosphorus herbicide and poses a grave threat to the environment. In this study, a combined method of precipitation and resin adsorption was used for the harmless treatment of the mother liquor. Firstly, most of the phosphorous-based compounds in the mother liquid were precipitated by metal ions of Ca2+, and then the excess metal ions and the remained phosphorous compounds in the supernatant were removed by using 001*7 and D301 resin, respectively. Results showed that 98.9% of the phosphorous compounds could be precipitated by Ca2+, and the residual concentration of Ca2+ and total phosphorus were 1.2 and 0.4 g/L, respectively, after this treatment. Adsorption experiment results showed that the 001*7 resin had the high adsorption capacity of 52.9 mg/g for Ca2+, and it almost did not absorb glyphosate, phosphorous acid, and glyphosine (adsorption capacity of them all <0.1 mg/g) in the investigated pH range from 1.0 to 8.0. The D301 resin performed well under dynamic adsorption conditions, with adsorption capacities of 233.3, 90.3, and 89.6 mg/g for glyphosine, phosphorous acid, and glyphosate, respectively, at a flow rate of 7.2 mL/min. When using tandem columns fixed with 001*7 and D301 resins to treat the supernatant from the precipitation step, the concentrations of Ca2+ and total phosphorus decreased significantly to 1.5 and 0.5 mg/L, respectively, and reached the discharge standards for industrial wastewater. The technology proposed in this study has great application potential in the glyphosate production industry.

CLINICAL PATHOGENETIC SUBSTANTIATION OF THE REGENERATIVE TREATMENT OF PARTURIENTS WHO SUFFERED FROM OBSTETRICAL HAEMORRHAGES

The publication is devoted to an urgent problem of modern obstetrics – the study of pathophysiological changes in the organism of parturients after obstetrical haemorrhages, improvement of restorative treatment, as well as reduction of complications in the puerperium and prevention of their occurrence. The aim of the study: to increase the effectiveness of restorative treatment of women in labor who suffered obstetric bleeding by studying the features of the clinical course, mechanisms of pathogenetic disorders, and their correction using ozone therapy. Materials and methods. A comprehensive clinical and laboratory examination of 150 women in labor was carried out, including 120 women (the main group) who suffered bleeding during childbirth and the early postpartum period. The control group consisted of 30 women with the physiological course of labor, childbirth and the early postpartum period. The state of lipid peroxidation (LPO) in parturient women was evaluated by the content of primary lipid products in the blood plasma – diene conjugates (DK) according to the method of B.V. Gavrilov (1983) and secondary molecular products – malondialdehyde (MDA) using the reaction with 2 thiobarbituric acid. The activity of the enzymatic link of the antioxidant system (AOS) was determined by the content of catalase in peripheral blood erythrocytes using the substrate hydrogen peroxide and glutathione peroxidase (GPO) using the P phenylenediamine substrate. The Spielberg–Hanin scale of state and trait anxiety was used to study the state of the psycho-emotional sphere in parturient women. Morphological examination of preparations of placentas and surgically removed uteri was carried out with staining of sections with hematoxylin and eosin, picrofuchsin according to Van Gieson. Results. Basic etiopathogenetic factors of the development of obstetric haemorrhages were examined, changes in the psychoemotional status of the patients were detected, haematological and metabolic indices, parameters of oxidation-antioxidation homeostasis and endogenic intoxication were studied, as well as morphofunctional disorders in placentas and uteruses. The efficacy of the restorative treatment of the parturients, who had moderate and massive haemorrhages during delivery, with the use of medical ozone in combined treatment versus traditional methods of treatment was studied. Conclusion. From the first day of the puerperium, free-radical lipid peroxidation increases, the activity of the enzymatic and non-enzymatic links of the antioxidant system increases, endogenous intoxication increases, and lactate and pyruvate levels increase. In the placentas of women in labor who suffered bleeding during labor, there is a violation of the synthesis of type IV collagen in the basal membranes of vessels and the phenomenon of endothelial dysfunction in the form of increased expression of endothelin by the endotheliocytes of the vessels of the decidual membrane (53.8 ± 2.9 µa) and the villous chorion (46.0 ± 2.6 μa). In the uterus, an increase in the expression of endothelin by endotheliocytes of the spiral arteries of the uterus (57.8 ± 8.56 µa) was detected, in combination with a violation of the synthesis of stromal collagen of type I and III and type IV in the basal membranes of vessels.

Combined method of treatment of synechiae of the nasal cavity

Diseases of the nasal cavity and paranasal sinuses lead to the development of clinical symptoms, among which difficulty in nasal breathing is among the most common complaints of patients in the practice of otorhinolaryngologists. To prevent the development of synechiae of the nasal cavity in surgery, the following principles are defined: 1) to reduce tissue injury, which is achieved by using modern equipment (endoscopic, laser, radio frequency, etc.); 2) to create a barrier between nearby areas of the nasal mucosa by introducing various intranasal splints; 3) to improve the process of tissue regeneration with the help of medicines (regenerants, reparants, etc.). Currently, there is no single approach to the surgical treatment of synechiae of the nasal cavity. The high frequency of postoperative relapses indicates the need to develop effective methods for the prevention of synechiae of the nasal cavity. The choice of surgical tactics is usually carried out taking into account the localization and extent of synechiae of the nasal cavity. All known methods of surgical treatment, depending on the instruments used for excision of synechiae of the nasal cavity, can be conditionally divided into cold and hot. The Sverzhevsky Research Clinical Institute of Otorhinolaryngology has developed a method of complex treatment and prevention of synechiae of the nasal cavity using laser technologies, silicone splints and a hydrogel material based on sodium alginate with derinate.

Застосування фототерапії та клітинних технологій у комплексній терапії хворих на вітиліго. Власний досвід

Vitiligo is a chronic acquired disorder of skin pigmentation, characterized by the presence of sharply limited depigmented areas of the skin as a result of the progressive loss of melanocytes. The purpose of the work: increasing the effectiveness of treatment of patients with vitiligo by shortening the treatment period, ensuring the stability of results and reducing the number of complications with combined methods of treatment of a stable form of vitiligo with the use of cultured melanocytes and keratinocytes compared to methods approved by European standards and domestic orders. Study object and methods: 107 vitiligo patients aged 19 to 65 were under our observation. Depending on the method of treatment, the patients were randomly selected into two representative groups: the main group, which received treatment according to the developed method, and the comparison group, which received traditional treatment. When evaluating the results of treatment in examined patients 8 and 16 weeks after the start of therapy, more pronounced positive dynamics were found in patients of the main group, whose complex therapy included melanocyte-keratinocyte suspension (MCS) and automesoconcentrate (AMK). Conclusions: the analysis of the results of treatment of patients with vitiligo proved not only good tolerance, but also high efficiency of treatment when using, along with traditional therapy, cellular technologies.

Применение бета-адреноблокаторов и лазерной коагуляции сосудов при лечении гемангиомы у детей

The most severe course of hemangioma with irreversible complications is represented by complex infantile forms. The aim of this work to study the results of a combined method of treating infantile hemangiomas using beta-blockers and laser coagulation of blood vessels. Methods of the study were the results of treatment of 128 children with vascular pathology under 18 from socially vulnerable groups in the period from 4 to 8 months. The results of the treatment proved that the use of yellow spectrum laser radiation with a wavelength of 577 nm in the treatment of infantile hemangiomas allows obtaining good cosmetic results without the formation of scar tissue in 100% of cases. Conclusion. Thus, the use of a combined method of treatment with the use of drug treatment and laser coagulation of blood vessels reduces the duration of the course of treatment by an average of 2.5 months.The discussion revealed the need to introduce modern methods of treatment using laser technologies in order to prevent complications and disability.

The effectiveness of the combined treatment package based on acceptance and commitment and positive treatment and on the control of emotions and perseverance of female managers

Aim: The present study was conducted with the aim of investigating the effectiveness of the combined therapy package based on acceptance and commitment and positive therapy on emotional control and perseverance of female managers. Methods: The research method was a quasi-experimental pre-test-post-test type with a control group with a follow-up period of two months. The statistical population of the research included all female managers of Bahar Zeit, Barsa and Hamon Naizeh institutions and organizations in 2021. The selection of samples was available in the form of sampling method and the sample size in this section was also based on the type of research in two groups of 32 people. The research tools included Duckworth et al.'s persistence questionnaire (2007), and Williams et al.'s (1997) emotion control scale. The results of the qualitative part of the research led to the development of an 18-session combined therapy package based on acceptance and commitment and researcher-made positivity. Data analysis was done with SPSS version 16 software and analysis of variance test with repeated measurement between groups at a significance level of α=0.05. Results: The results of data analysis showed that the combined treatment method of acceptance and commitment and positivity on anger control scores (F=7.72, P=0.010), depressed mood control (F=20.37, P=0.001), anxiety control (F=4.31, P=0.040), perseverance and self-efficacy (F=3.96, P=0.040), and this effect is also in the follow-up stage compared to the pre-test. It was meaningful. Conclusion: Considering that the combined training of positive psychology and the psychology of acceptance and commitment increased the control of emotions (anger, anxiety, depression and positive emotions) and the perseverance of managers, it is suggested that organizations and companies, both in the private and public sectors, Use this training and treatment package intervention for their organizational growth and improvement.

A novel hybrid treatment for pharmaceutical wastewater implying electroflocculation, catalytic ozonation with Ni-Co Zeolite 5A° catalyst followed by ceramic membrane filtration

The removal of veterinary antibiotics in pharmaceutical wastewaters become more challenging with modern-day technologies due to their persistent nature. In a sequence, the release of veterinary antibiotics containing wastewater such as Enrofloxacin (EFC) and Tylosin Tartrate (TT) in water bodies has increased the chance for bacteria to attain the antibiotic resistance genes and also moved to others via horizontal gene movement. As a result, the microbes become more resistant even to conventional antibiotics due to the growth of antibiotic resistance genes in microbes. Consequently, conventional treatment technologies just partially remove the pharmaceuticals from the wastewater and are not fully effective because they are not premeditated to remove antibiotics drugs. This alarming situation seriously threatens human well-being and aquatic life. Therefore, it is indeed important to develop an economical advanced oxidation treatment method for the efficacious treatment of pharmaceutical wastewater (PhWW). In the current study, a novel approach was adopted by implying Electroflocculation (EF), Catalytic ozonation (CO) in combination with novel catalyst Ni-Co-Zeolite 5A° followed by Ceramic membrane filtration (CMF). For the first time, in the current investigation, the studied hybrid process (EF + CO–CMF) using Zeolite 5A° coated with double metal salts of Nickel and Cobalt was applied as a catalyst in ozonation (O3) for the treatment of PhWW. Moreover, the removal of COD, BOD5, and turbidity was also studied and compared with national and international effluent quantity discharge standards. The obtained results exhibited that the combined EF + CO process has achieved removal efficiencies of 33 %, 93 %, 78 %, 45 %, and 60 % for EFC, TT, COD, BOD5, and turbidity respectively. Furthermore, the integration of CMF after EF + CO has enhanced the removal of pollutants up to the mark. It was revealed that the novel combined treatment method EF + Ni-Co Zeolite 5A°/O3–CMF has removed the EFC, TT, COD, BOD5, and turbidity of 97 %, 98 %, 90 %, 86 %, and 93 % respectively at optimum conditions (pH = 7.1 ± 0.2; treatment time = 30 min; EF voltage = 10 V; catalyst dose = 10 g/L; O3 = 1.1 mg/min). Additionally, it was observed that biodegradability (BOD5/COD ratios) enhanced from 0.48 to 0.60, and become easily biodegradable for further treatment. Henceforth, EF + Ni-Co Zeolite 5A°/O3–CMF treated wastewater has also complied with the Punjab Environmental Quality Standards (PEQS). Therefore, this novel hybrid treatment process may efficaciously apply at an industrial scale for the treatment of veterinary antibiotics containing PhWW.

COMBINED METHOD OF WASTEWATER TREATMENT OF A SMALL-CAPACITY BREWERY

With the help of the proposed circuit of EMT, the method of simultaneous measurements of the static characteristics of the magnetic fluid: specific electrical conductivity χt, magnetic susceptibility kt and temperature t of the magnetic fluid, which is recommended to be used for wastewater treatment of breweries, was investigated. A combined method of cleaning has been developed and the appropriate technological scheme has been improved, which provides, together with the use of mechanical cleaning devices, the use of an additional filter for magnetizing wastewater samples, which includes a special zone for the introduction of a pre-calculated magnetic liquid. Thus, in the process of wastewater treatment, mini-breweries using the proposed combined method, after applying methods of pre mechanical cleaning, use the wastewater interaction and the magnetic fluid: after intensive stirring of the mixture, the droplets of magnetic fluid dissolve in impurities and a weakly magnetic fluid is formed, which enters the magnetic separator for further cleaning. A rational ratio of wastewater: magnetic fluid (WW:MF), WW:MF = 8,7‧10-3: 1 was found. A comparison of the data obtained using informative methods with the data given in the regulatory documents witness the effectiveness of the proposed combined method of beer wastewater treatment in relation to the norms of water discharge into the city sewer, namely, the hydrogen pH indicator decreases as a result of the treatment by 34.6%, COD by 7.14 times, BOD5 by 1.52 times, suspended substances by 1.52 times, calcium cations Ca2+ by 1.53 times, magnesium cations Mg2+ by 1.51 times, total hardness dH by 1.64 times, carbonate hardness KH by 1, 86 times.

Integrated Approach to the Diagnosis and Treatment of Endo-Periodontal Lesions

The purpose of the study was to increase the effectiveness of diagnosis and treatment of patients with endo-periodontal lesions. Materials and methods. The study was conducted from 2019 to 2022 on the basis of the Department of Therapeutic Dentistry of the Azerbaijan Medical University. 41 patients with endo-periodontal lesions who were not burdened with somatic pathology with combined endodontic and periodontal lesions were examined. Radiation diagnostic methods, in particular orthopantomography and intraoral targeted radiographs, were carried out in both groups and in all patients in these groups before the start of therapeutic measures and 6 and 12 months after their completion. The selected groups of patients were practically comparable in gender and age composition (p&gt;0.05). All persons with the same diagnosis, depending on the therapeutic method or treatment algorithm, were divided into two groups: I – with the diagnosis of endo-periodontal lesions – 20 patients of the main group, who, along with standard treatment, were additionally treated with decontamination of root canal and laser curettage with a dental diode laser (Picasso Life); II – with a diagnosis of endo-periodontal lesions – 21 patients of the control group. Root canal treatment: mechanical expansion with endodontic instruments, antiseptic treatment with 3% sodium hypochlorite solution, 17% EDTA solution. To remove dental deposits in the control group, scaling, curettage with Gracie curettes were performed, and an ultrasound device "Piezon Master 600" ™ EMS was used. Cleaning and polishing of the teeth surface was carried out with an abrasive paste. Patients of the main group were additionally treated with a diode laser. Patients of the control group did not undergo such a procedure. Results and discussion. According to the results of the behavioral study, the values of the hygienic index, the gingivitis index and the periapical index before the start of the course of basic therapy for endo-periodontal complications were comparable in both study groups. In terms of follow-up, statistically significant differences were clearly expressed 12 months after treatment. The high frequency of occurrence of combined periodontal and endodontic tissue diseases in male and female individuals, as well as the increase in their prevalence with age, certain difficulties in the diagnosis and treatment of endo-periodontal lesions, causes constant and increased interest in this problem. The results of the index evaluation showed pronounced anti-inflammatory and stimulating bone tissue repair properties of laser therapy. Conclusion. The method of treatment of endo-periodontal complications with the use of a diode laser made it possible to significantly reduce the focus of destruction of bone tissue in the periapical region; contributed to improving oral hygiene and the condition of periodontal tissues. The high efficiency of the proposed combined method of endo-periodontal lesions treatment allows us to recommend it for wide application in practical dentistry