Treatment Methods Research Articles

Spatial specificity of radical scavenging ability in Moringa oleifera varieties from selected countries

Moringa oleifera (MO) is widely recognized for its rich content of bioactive compounds, which possess significant antioxidant and anti-inflammatory properties. However, variations in the phytochemical composition of MO seeds, influenced by geographical origin and processing methods, have not been fully explored. This study investigates the radical scavenging abilities of MO seeds from Nigeria, Ghana, Haiti, and India, all grown under controlled conditions at the Winfred Thomas Agricultural Research Station (WTARS) at Alabama A and M University. The primary objective of this study was to assess the variation in radical scavenging abilities, specifically DPPH (1,1-diphenyl-2-picrylhydrazyl) activity, across different MO seed varieties and processing methods. This was done to determine if spatially specific dose-response behaviors exist and to identify which combinations of seed origin and preparation yield the highest antioxidant activity. MO seeds were collected from four countries: Nigeria, Ghana, Haiti, and India, and subjected to three different processing methods—raw, boiled, and fermented. The seeds were then extracted using two solvents, 70% ethanol and 80% methanol. The DPPH radical scavenging activity was measured using the Brand-Williams method with slight modifications, and the results were expressed as micromoles of Trolox Equivalent (TE) per gram of sample. The study revealed significant variability in the antioxidant activity of MO seeds based on their geographical origin and processing methods. Among the four countries, MO seeds from India exhibited the highest average DPPH value (8018.87 µmol/g), followed by Haiti (6741.10 µmol/g), Nigeria (6349.98 µmol/g), and Ghana (6068.87 µmol/g). Raw seeds consistently showed the highest radical scavenging ability across all locations and solvents, with the highest recorded value in Haitian raw seeds extracted with 70% ethanol (9720 µmol/g). In contrast, fermented seeds exhibited the lowest antioxidant activity, with the least value observed in Ghanaian seeds extracted with 80% methanol (306.33 µmol/g). The choice of solvent also played a crucial role, with 70% ethanol outperforming 80% methanol in preserving or extracting antioxidants, particularly in raw and boiled seeds. The study also found significant dose-response relationships, with raw seeds showing the steepest increase in DPPH activity with higher extract concentrations. In contrast, fermented seeds demonstrated a weaker dose-response, indicating diminished radical scavenging ability after fermentation. The ANOVA results further highlighted the significant effects of the country of origin, treatment method, and their interaction on antioxidant activity. The interaction between geographical origin and processing methods was particularly noteworthy, suggesting that the optimal method for maximizing antioxidant activity varies depending on the seed's origin. The findings underscore the importance of considering both the geographical origin and the processing method when evaluating the antioxidant properties of MO seeds. Indian and Haitian MO seeds, particularly in their raw form and extracted with 70% ethanol, offer the highest antioxidant potential. The study also demonstrates that minimal processing is crucial for preserving the radical scavenging ability of MO seeds. Further research should focus on the specific phytochemical compounds responsible for the antioxidant activity in MO seeds from different regions. Additionally, farmers and producers should optimize cultivation and processing methods based on local environmental conditions to maximize the nutritional and medicinal benefits of MO seeds. Finally, public awareness programs should be initiated to promote the health benefits of MO seeds, particularly those with high antioxidant activity.

Development of technology for obtaining tablets by double granulation method with Pipsissewa (Chimaphila Umbellata) extract

The use of the therapeutic potential of medicinal plants is currently considered a physiological method of prevention and treatment, which affects the normalization of metabolic processes and the restoration of the body's functional capabilities. Medicinal products created based on plants can be used for a longer period, including in the treatment of chronic diseases. The aim of the work is to select a technology to produce tablets containing wintergreen umbrella herb liquid extract, considering the pharmaco-technological properties of the resulting dosage form. Materials and methods. The objects of the study were pipsissewa herb liquid extract and experimental model samples of mixtures of this plant substance with excipients permitted for medical use. The research on the analysis of the liquid extract and pharmaco-technological indicators of test samples of tablet mass and tablets was carried out according to the methods of the State Pharmacopoeia of Ukraine (SPhU). Determination of the optimal technology for obtaining and quantitative composition of excipients of tablets from pipsissewa herb liquid extract was carried out using mathematical design of experiments (MDE) by the method of a four-factor experiment based on the Greco-Latin square. Results. The analysis of the liquid extract of pipsissewa showed the presence of 47.0±1.0 % of extractive (dry residue) substances. It was determined that the use of Liquid-Solid technology in the technology of obtaining tablets with plant extract based on the amorphous form of magnesium aluminometasilicate (Neusilin US2) requires the use of a combined approach that will ensure the quality of the finished product. During experimental studies, the use of three interrelated production strategies was proposed. In the process of applying the proposed strategy, it was determined that microcrystalline cellulose effectively performs the function of an adsorbent and filler; the consistency of the mixtures significantly depends on the ratio of MCC 101:extract. It was investigated that the use of double granulation will allow for the increase of the amount of active ingredient in the granulate without changing the volume of MCC 101, which will allow for the achievement of a higher extract content in the finished tablets. The use of double granulation technology can also ensure uniform distribution of the active ingredient and maintain the necessary flowability of the mixture for subsequent tabletting. The use of mathematical, experimental planning in the development of double granulation (drying) technology and the composition of excipients based on studies of the fluidity of the tabletting mass; attrition, disintegration, resistance of tablets to crushing, and organoleptic indicators became the basis for the development of the composition of the medicinal product in the form of tablets containing pipsissewa liquid extract. Conclusions. The adsorption property and its influence on the tabletting process of the synthetic amorphous form of magnesium aluminometasilicate (Neusilin US2) and microcrystalline cellulose 101 (MCC 101) were determined when using these substances as a carrier for pipsissewa grass liquid extract. The possibility of conducting a double granulation process using microcrystalline cellulose 101 (MCC 101) according to a given amount of liquid extract was proven. Using mathematical planning of the experiment, the drying conditions of the granulate and the quantitative composition of excipients were selected

A business model canvas for construction waste resource use under dual carbon targets

For several years, as China's urbanization efforts have continued to advance, construction waste treatment has been a priority issue. Many treatment modes focused on sustainability have been researched, while the current method of construction waste treatment in China remains stuck in the linear economic mode. The circular economy mode is developing slowly, the construction waste resourcing and treatment industry is underdeveloped, and the business model is insufficiently mature. This paper analyzes the main elements in the economic, environmental, and social layers; suggests improvements based on the existing business model canvas; constructs a more targeted business model canvas for construction waste treatment resourcing; and explores the relationship between environmental, social, and economic values. It concludes that the government should guide the promotion of stakeholder cooperation and consider the sustainable use of building materials from the perspective of the whole life cycle and the interrelationship based on stakeholders to promote the application of the circular economy in construction waste resourcing. The economic value of the construction waste recycling industry requires the government's support and encouragement to attract more enterprises to participate in and realize the value of construction waste recycling, create more jobs, and thereby reduce carbon emissions.

Varicella cellulitis in children (personal experience)

Annotation. The frequency of complications with varicella is 5-30%, and their level is much higher in patients with immunodeficiencies. In 8-50% of hospitalized children with varicella virus infection develop skin and soft tissue complications such as cellulitis, lymphadenitis, abscess, hysteria, toxicoderma. They are located on vulnerable parts of the body against the background of a state of anergy in a sick child, which is caused by the varicella virus. The aim is highlight clinical and diagnostic features and methods of treatment of varicella virus cellulitis in children based on own experience and according to literature sources. The high frequency of complications is associated with untimely detection of signs of inflammation and untimely treatment in case of secondary flora joining. The main etiological factors of superinfection are β-hemolytic streptococcus group A and staphylococcus aureus. Recently, cellulitis of the subcutaneous tissue is one of the most serious complications in patients with varicella virus infection. The clinical picture of this complication includes local and general manifestations. Local symptoms are accompanied by pronounced redness in the affected area, a significant increase in tissue volume due to swelling, intense, throbbing pain that worsens with touch or movement, the presence of purulent secretions from the affected area, compaction or softening of tissues at the site of the lesion, local hyperthermia. Treatment of varicella cellulitis involves a wide range of measures, which include: antibiotic therapy, drainage of purulent foci, symptomatic treatment, local treatment, supportive therapy, physiotherapy, observation and control. Before determining the optimal antibiotic, it is important to take into account the regional characteristics of the resistance of microorganisms and information about the typical causative agents of varicella cellulitis. Broad-spectrum antibiotics such as amoxicillin with clavulanic acid, ceftriaxone, clindamycin, or vancomycin are usually used for treatment. So, the main etiological factors causing complications in the form of necrotic cellulitis on the background of varicella virus are β-hemolytic streptococcus group A and Staphylococcus aureus. Diagnosis of varicella cellulitis includes a set of examination methods to confirm the diagnosis: daily examination of the child's body surface for inflammatory foci. The optimal treatment tactic is combined therapy (surgical and conservative treatment). Vaccination is recommended for children who are in risk groups – patients with oncology who receive cytostatics, corticosteroids; children with congenital and acquired immunodeficiencies.

Hyperlipoproteinemia(a): the role of antisense­­oligonucleotides in reduction of lipoprotein(a) level. Literature review

The literature review is devoted to a relevant problem of correction of elevated level of lipoprotein(a) (LP(a)) which is a risk factor (RF) for atherosclerotic cardiovascular diseases (ACVD) and demonstrates a stability to action of existing lipid‑lowering drugs (LLD) due to genetic determination of apolipoprotein(a) (apo(a)), a structural component of LP(a) molecule. Since human lipid metabolism is regulated by many genes, the majority of them, in particular, apo(a) gene can be potential targets for innovative antisense therapy, a method of treatment based on reduction of synthesis of LP(a) involved in the development of ACVD through inhibition of apo(a) matrix ribonucleic acid (mRNA) translation due to connection with complementary short sequences called antisense oligonucleotides (ASO). Update insights into the structure and pathophysiological role of LP(a) in atherothrombosis, a necessity of hyperlipoproteinemia(a) correction caused by its proatherosclerotic and prothrombotic effects are given. A focus was made on innovative LLD with high potential in treatment of ACVD and correction of their risk factors, particularly on ASO capable of blocking a translation of apo(a) mRNA. Principal mechanisms of ASO action, the ways of their delivery to mRNA targets are presented. The data of studies on LP(a) reduction with mipomersen, pelacarsen, SLN360 agent, olpasiran and lepodisiran are presented. It is emphasized that despite the efficacy of enumerated ASO in LP(a) reduction, there are unknown long­­term consequences of its intensive reduction, particularly an influence on cardiovascular events and the functional state of organs and their systems in different diseases. The only ASO drug approved by the US Food and Drug Administration is mipomersen recommended for correction of low­­density lipoprotein cholesterol and LP(a) levels due to its ability to block apolipoprotein B­­100 synthesis. In Europe mipomersen was not registered because of its unfavorable safety profile. Thus, despite the prospects for developing new drugs based on antisense technologies, many questions remain about their efficacy and safety, especially for LLD intended for long­­term use.

The place of dental implantation in the rehabilitation of patients with loss of teeth due to liver pathology

Annotation. Dental implantation is a modern and effective method of treatment of complete or partial adentia, both on the upper and lower jaws. The process of dental implantation involves the installation of artificial structures in the place of lost teeth, in the jawbone, to which dental crowns or prostheses are then fixed. Dental implants allow you to get a permanent structure to restore lost teeth. Dental implantology has become one of the most widespread and popular fields in dentistry due to its effectiveness and durability. Every year, the number of patients who choose dental implants as a way to restore lost teeth is increasing, which is due to the awareness of their advantages compared to other methods. The development of new technologies and materials, such as biocompatible titanium alloys and digital planning, has made dental implantation more affordable and reliable, contributing to its growing popularity. Many dental clinics and medical institutions offer specialized courses and training in implantology for dentists, which increases the number of qualified specialists in this field. Implants provide a high quality of life, restoring the chewing function and the aesthetic appearance of the teeth, which contributes to their popularity among patients who are looking for a durable and comfortable solution. The increase in the number of clinics specializing in implantology, as well as the decrease in the cost of procedures thanks to competition and technological advances, make implants more accessible to a wide range of patients. The large number of patients who have had a positive experience with dental implants helps to spread information about this technique and increase its popularity through recommendations and reviews. Thus, dental implantology continues to develop and gain popularity in the dental market due to its many advantages, technological innovations and growing demand from patients.

Cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus. Review

According to the data, obtained in 2024, type 2 diabetes mellitus affects 8% of the global population, totaling 400 million patients worldwide. Cardiovascular autonomic neuropathy is a very common but underestimated complication of type 2 diabetes, occurring in 60% of cases. It causes various cardiovascular diseases, which are the cause of 50­80% of deaths among patients with type 2 diabetes mellitus. The pathogenesis of cardiovascular autonomic neuropathy involves the disruption of insulin’s trophic effects and the toxic effects of hyperglycemia. These disorders cause systemic inflammation and oxidative stress, reduce the synthesis and bioavailability of the vasodilator, anti­­inflammatory, and antiplatelet agent nitric oxide, inhibit the parasympathetic nervous system, and increase the activity of the sympathoadrenal and renin­­angiotensin­­aldosterone systems. Poor glycemic control, insulin resistance, a duration of diabetes of more than 15 years, visceral obesity, smoking, excessive alcohol consumption, arterial hypertension, dyslipidemia, and advanced age are the most significant factors in the development and progression of cardiovascular autonomic neuropathy. Early intensive multifactorial intervention to control all risk factors leads to a more than 50% reduction in the risk of this pathological condition. The main measures for the prevention and treatment of cardiovascular autonomic neuropathy are lifestyle modification and pathogenetic pharmacotherapy, which includes the use of glucagon­­like peptide­­1 receptor agonists, sodium­­dependent glucose cotransporter type 2 inhibitors, metformin, cardioselective β­blockers, blockers of the renin­­angiotensin­­aldosterone system, and combinations of sacubitril and valsartan. The article provides current evidence regarding the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications, and current methods of treatment of cardiovascular autonomic neuropathy.

The method of treatment of chronic pancreatitis, complicated by a complete pancreatic fistula with obstruction of the proximal part of the main pancreatic duct, under conditions of preservation of the left anatomical segment

Annotation. Chronic pancreatitis (CP) is a long-term disease that causes associated complications of the gastrointestinal tract. Pancreatic fistula (PF) is one of the complications of various diseases and pathology of the pancreas, as well as surgical interventions performed by various methods depending on the indications and the reason for their use. Not infrequently, this pathology is complicated by peritonitis with subsequent development of sepsis, which quite often results in the death of the patient. External PF, depending on its flow rate, is dangerous for the exhaustion of the patient, the formation of maldigestion syndrome, malabsorption, and hypoproteinemia. During 2016-2023, operations for PA and pleurisy were performed in 35 patients. In 5 (14.3%) of them, we performed our proposed surgical intervention in patients with complicated CP, for which the copyright was obtained for the work “Method of treatment of chronic pancreatitis complicated by a complete pancreatic fistula with obstruction of the proximal part of the Wirsung duct, under the conditions preservation of the left anatomical segment” No. 120597 dated July 18, 2023. The basis of a useful model is the task of creating such a method of treatment of CP, complicated by virsungolithiasis, a complete fistula of the PP and obstruction of the proximal part of the duct of the pancreas, which would allow, in addition to the removal of the pancreatic fistula, to remove the block in the head area in the simplest way, thus restoring the integrity of the tract while being more physiological and less traumatic with preservation of the tail of the pancreas and, accordingly, endocrine function.

Perforation of Meckel’s diverticulum complicated with suspected acute appendicitis successfully treated by laparoscopic surgery

Some diseases have clinical symptoms similar to acute appendicitis, making preoperative diagnosis difficult, including Meckel’s diverticulum. We report a case with a preoperative diagnosis of suspected acute appendicitis, but a perforated Meckel diverticulum caused by a bamboo toothpick was discovered intraoperatively. A male patient, 32 years old, was admitted to the hospital for right iliac fossa pain 1 day before admission. Preoperative diagnosis of suspected acute appendicitis, emergency surgery indicated. During surgery, the appendix has no inflammation. Examining the entire abdomen, the ileum was found 50 cm from the ileocecal valve with a Meckel’s diverticulum perforated by a bamboo toothpick. The patient was successfully treated with laparoscopic surgery. Perforation of Meckel’s diverticulum is a rare complication. Preoperative diagnosing complications of Meckel’s diverticulum is challenging, especially in children. Most imaging investigations are unrecognizable, requiring laparoscopic exploration. Laparoscopic surgery is the preferred method of treatment. Taking a history of ingesting foreign bodies or having a habit of using toothpicks helps identify risk factors. During surgery, it is necessary to carefully examine the abdominal organs, especially when damage to the appendix is disproportionate to clinical symptoms.

Herbicide application in maize and cassava crops, impact on environment and population health in the department of Vavoua (Côte d’Ivoire)

The present study analyses Vavoua department agricultural producer’s knowledge, practices and attitudes regarding herbicide application and their impact on human health and the environment. It covered nine (9) selected agricultural sites including Brouafla-Nattis, Bénoufla, Vavoua, Koudougou PK8, Koudougou PK5, Bidiafla, Bahiri (Bafla), Brouafla Kouya and Bonoufla, for a structured quantitative survey involving 72 producers. More than 95% of the surveyed producers systematically use phytosanitary products including glyphosate-based herbicides. The majority of producers (95%) have not received any training on the use of plant protection products and do not have a good knowledge of application rates and treatment frequencies. The diversity of phytosanitary treatment methods is explained by the lack of training and especially by the lack of supervision of producers that could have mitigated the harmful effects on human such as dizziness, nasal congestion, colds, redness of the eyes, nausea and vomiting, etc., and on the physical environment.

A novel and alternative treatment method for moderate diabetic foot ulcer: tibial periosteal distraction

ObjectiveResearchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.MethodsWe provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department. The demographic information had been collected at the time of their admission. The patients were followed up at 3, 6, and 12 months after the operation with the ulcer area, skin temperature of the medial malleolus, transcutaneous oxygen pressure of the medial malleolus, ankle brachial index, dorsalis pedis artery pulsation, 12 item short form survey quality of life scale score, and visual analogue scale.ResultsA total of 35 patients with type 2 diabetes were included in this study, including 19 males and 16 females, with an average age of 62.49 ± 10.34 years and a maximum age of 87 years. The ulcers of all patients were cured, and the average healing time of ulcers was 8.09 ± 2.28 weeks, with no associated complications. The microcirculation indexes of the affected foot were significantly improved (p < 0.05). Three cases showed new vessels regeneration in the affected limbs according to their computed tomography angiography (CTA) results.ConclusionTPD surgery technique is a simple procedure that significantly increases the efficacy and reduces the complications of moderate diabetic foot ulcer patients, which could accelerate the formation of collateral circulation.

Assessment of skin microcirculation in different morphotypes of face and neck aging

Annotation. Objective – to establish the relationship between facial aging morphotypes and skin microcirculation indicators, which may form the basis for improving diagnostic and treatment methods for age-related changes. The study included 52 female patients aged 50 and older. Among the examined patients, the following facial aging morphotypes were identified: gravitational (28.8%), fine-wrinkled (15.4%), deformational (34.6%), and combined (21.2%). The microcirculation of the face was studied by the method of laser Doppler flowmetry. To obtain statistical data, we calculated the average arithmetic value (M), the probability of differences in the results of the study (p) relative to the indicators of different groups. The results were considered statistical when the probability ratio was less than or equal to 0.05. The microcirculation index in patients with the fine-wrinkled morphotype was significantly lower than that in individuals with the deformational morphotype by 1.5 times (p=0.005). There was also a significant difference between the microcirculation index in patients with gravitational and fine-wrinkled morphotypes (p=0.03), gravitational and combined morphotypes (p=0.04), and fine-wrinkled and combined morphotypes (p=0.002). So the best facial microcirculation indicators were found in patients with deformational and combined aging morphotypes, while the lowest were observed in patients with gravitational and fine-wrinkled morphotypes. Future research should focus on studying the relationship between microcirculatory disorders and morphological changes in the skin across different aging types, which may contribute to the development of new methods for preventing and treating age-related skin changes.

"LiquiPerfPro" reagent for increasing the permeability of the well bottom hole zone

The purpose of the technology's development is to reduce the skin effect and restore the permeability of wells, which have experienced a significant reduction in permeability for various reasons, including contamination of the filter zone by oil-based drilling fluids during drilling. The developed alkaline-based new chemical composition, "LiquiPerfPro", reduces the interfacial surface tension on the rock surfaces contaminated by oil-based drilling fluid in the near-wellbore zone, altering the wetting angle in favor of oil and creating a hydrophilic surface. Additionally, it removes the oil screen formed on the weighting components present in the drilling fluid and reduces adhesion forces. After reacting with the oil-based component, the weighting components undergo segregation, increasing their ability to migrate and enabling them to be easily displaced from the pores. Furthermore, after the weighting particles are cleaned from the oil screen, their surfaces become open to other solvents, allowing the application of other traditional methods for deeper cleaning of contamination. Moreover, the "LiquiPerfPro" reagent, due to its physico-chemical properties, has the ability to penetrate a significant distance from the wellbore into the drainage area. The application of the "LiquiPerfPro" reagent is also favorable for lithologically weakly cemented rocks, as it does not create the risk of formation collapse, unlike traditional acid treatment methods, and does not damage the matrix. The reagent can be applied to both production and injection wells. Keywords: Alkali; acid; permeability; reservoir model; wellbore zone; new chemical composition; surfactant; organic solvent; oil-based drilling mud.

Developments in Radiofrequency Processing Applications on Food of Animal Origin

Radio frequency (RF) treatment is one of the novel dielectric heating techniques for foods. It is an indirect process whereby electrical energy is initially transformed into electromagnetic radiation, which then generates heat within the food. Radiofrequency heating has been found some advantages like rapid heating or deep penetration into food compare to conventional methods. Traditional heat treatments applied to animal products can lead to quality losses, color and texture changes, overheating problems and other undesirable side effects. RF treatment has the potential to minimize these problems, improve organoleptic quality, reduce process time and save energy. Recently, the most investigated methods for animal origin foods are RF pasteurization/sterilization, RF-supported thawing methods, RF heating or cooking and the results obtained are promising. Radiofrequency technique is also investigated for following purposes; blanching, post-bake drying, roasting and disinfection. The new generation of RF studies explore other aspects, including the discovery of dielectric properties of foods, the evaluation of efficiency and quality effects, environmental sustainability of RF technologies and the improvement of RF system performance. Also combined systems are investigated such as radiofrequency-assisted cryogenic freezing. This paper reviewed principles of RF, overview situation of RF treatment methods and recent literature on RF applications on food of animal origin.

CLINIC, DIAGNOSIS AND EFFICIENCY OF NONINVASIVE METHOD OF TREATMENT YOUNG CHILDREN WITH HAEMORRHOIDS

Hemorrhoids have been known since ancient times. They have always been considered the prerogative of adult patients. Methods of conservative and surgical treatment of hemorrhoids in adults are still used in children and often have negative results. Pediatric surgical practice has not optimized methods of diagnosis and treatment of hemorrhoids in infants and preschool children. Materials and methods. The work was based on retrospective and prospective analysis of medical records and case histories of 112 children with hemorrhoids treated in the last 11 years. The number of patients under 1 year of age was 4 (0.4%); 1-3 years - 30 (26.4%); 3-6 years - 50 (44.6%); 7-12 years - 16 (14.2%); 13-18 years - 12 (10.7%). External hemorrhoids were found in 107 (95.5%), internal hemorrhoids in 4 (3.8%) and combined hemorrhoids in 1 (0.9%) patient. There were 70 (62.5%) boys and 42 (37.5%) girls. All cases underwent general clinical and laboratory examination, orthostatic exercise (squatting), rectal palpation, anoscopy and rectoscopy. Statistical processing of the research materials was carried out using the method of variance statistics. All values in the work are presented in the form of arithmetic mean with calculation of standard deviation within the confidence interval. For all compared values the achieved level of significance (p) was considered statistically reliable - &lt; 0.05. Student's t-distribution was used to compare data with normal distribution of means. When comparing 2 related groups, calculations were performed using Student's paired t-criterion. Microsoft Excel and Statistica computer programs were used for statistical data processing. Results and discussion. This paper presents clinical material from the examination and treatment of 112 children with hemorrhoids over the past 11 years. The authors compare the characteristics of the etiopathogenesis of hemorrhoids in children from the literature and their own research data. The proposed non-invasive compression methods in the complex treatment of hemorrhoids in children are more effective in children of early and preschool age. A study of long-term results of complex conservative treatment of 84 patients of young age with hemorrhoids showed good results in 86,9%, satisfactory - in 9,5% and unsatisfactory (recurrence) - in 3,6% of patients. Surgical treatment of hemorrhoids in children was used only when conservative treatment was unsuccessful in 11 (12.6%) patients, with good long-term results in all cases. Indications for hemorrhoidectomy were: frequent prolapse of hemorrhoids (HU). After surgical treatment, good results were obtained in all cases; no recurrence was observed. The optimization of conservative and surgical treatment, respecting the age characteristics of children, led to good results. Conclusions: 1. Examination of children with GU enlargement with the use of additional methods (ultrasound, RRS, FACS, PCI) of research allows to reveal and treat concomitant intestinal pathologies, which are the causes of secondary transient hemorrhoids development. For children of preschool age the most effective non-invasive method of treatment is rectal balonocompression. 3. After complex conservative treatment with rectal balonocompression of children with hemorrhoids good results were observed in 86,9% of children, satisfactory - in 9,5% and unsatisfactory - in 3,6%.

EFFECTIVENESS OF DISTRACTION AND ORTHOGNATHIC INTERVENTION IN THE TREATMENT OF MESIAL OCCLUSION IN PATIENTS WITH MAXILLARY UNDERDEVELOPMENT

Mesial occlusion is a complex orthodontic pathology that adversely affects facial aesthetics, masticatory function, and patient quality of life, making timely treatment critical. One of the modern methods of correction is distraction osteogenesis, which allows gradual expansion of bone structures while minimizing the risk of relapse. The choice of treatment is based on the patient's clinical presentation, with distraction being a priority in cases where traditional surgery is contraindicated. Aim of the study was a detailed analysis of the effectiveness and safety of various treatment methods for mesial occlusion in adult patients with maxillary underdevelopment. Material and methods. The study included 15 adolescent patients between the ages of 19 and 23 with skeletal mesial occlusion. Baseline diagnostic data were obtained for each patient, and the volume of bone tissue in the vestibulo-oral direction at the site of planned implant placement was assessed during preparation for implant placement. Statistically significant differences between alternative quantitative characteristics with normal distributions were evaluated using Student's t-test. A difference was considered statistically significant at p&lt;0.01. The study was carried out in compliance with the main provisions of the Council of Europe Convention on Human Rights and Biomedicine (4 April 1997), the World Medical Association Declaration of Helsinki on the Ethical Principles for Scientific Medical Research Involving Human Subjects (1964-2013), ICH GCP (1996), orders of the Ministry of Health of Ukraine No. 690 of 23.09.2009, No. 944 of 14.12.2009, No. 616 of 03.08.2012. The work is a fragment of the research project “Correction of violations of osteogenesis processes in the treatment and prevention of complications of dental diseases wartime” state registration No. 0123U103247. Results. The results of the study showed that in adult patients, orthognathic surgery ensures favorable skeletal outcomes for maxillary mesialization. However, when the replacement of lateral incisors with canines is feasible, this treatment approach may reduce the number of rehabilitation stages while achieving dentoalveolar relationships that conform to normal standards. The use of distraction osteogenesis in adult patients has yielded good results and may be justified in cases of critical reduction of maxillary body dimensions or contraindications to conventional orthognathic surgery. Conclusion. Distraction osteogenesis and orthognathic procedures effectively correct mesial occlusion, ensuring a stable increase in the sagittal dimension of the maxilla and improving occlusion. Replacement of lateral incisors with canines minimizes the need for additional surgery in cases of agenesis. The choice of treatment method should be based on individual clinical indications and risk assessment for each patient.

Prevalence, outcome and complications of Intertrochanteric Femur Fracture In Patients Admitted to AL Sammad General Hospital-from MAY 2020 to MAY 2022 Amran-Yemen

Background: Intertrochanteric fractures are common injuries, especially in elderly, and require effective management to minimize complications. This study aimed to evaluate the demographic characteristics, treatment modalities, and early postoperative complications of patients with intertrochanteric fractures admitted to the Al Sammad General Hospital, Amran, Yemen, from May 2020 to May 2022. Methods: A retrospective analysis was conducted on 90 patients diagnosed with intertrochanteric fractures during the study period. Data on age, sex, mechanism of injury, fracture type, treatment methods, and postoperative complications were collected and analyzed. Results: Among the 90 patients, 51% were male and 49% female, with the highest incidence in those aged &gt; 60 years (46.7%). The primary mechanism of injury was falling from a standing height (73.4%). Fracture classifications included 46.7% stable , 44.4% unstable , and 8.8% reverse oblique. Surgical treatment was performed in 96.7% of the cases, predominantly using dynamic hip screws (53.3%). Early postoperative complications were noted in 9.9% of the patients, with deep vein thrombosis (DVT) being the most common (3.3%). Conclusion: Intertrochanteric fractures are more common in males aged &gt; 60 years, with falls from standing height being the leading cause. Surgical treatment is preferred, and the complication rate is relatively low. Continued efforts to improve surgical outcomes and manage complications are vital to enhance patient recovery.

ALAGILLE SYNDROME IN THE MODERN VIEW OF A MULTIDISCIPLINARY APPROACH TO THE PROBLEM

Introduction. Alagille syndrome (AS) is a syndrome of a decrease in the number of interlobular cells bile ducts, also known as arteriohepatic dysplasia. AS is a genetic multisystemic autosomal dominant disorder with highly variable manifestations, predominantly affecting the liver, heart, face, skeleton and other anomalies may include. Aim. Literature review and analysis of our own experience to update the current knowledge about AS. To introduce new diagnostic and treatment methods, taking into account the need and importance of a systemic multidisciplinary approach to the management of patients with Alaghil syndrome. Pathogenesis. AS, or Watson-Miller syndrome, is a rare disorder caused by mutation of the Jagged1 (JAG1) gene - AGS type 1, and in 2% of cases by mutation of the NOTCH2 gene - AGS type 2, with autosomal dominant inheritance. Mutations of the JAG1 or NOTCH2 genes cause defects in bile duct morphogenesis and angiogenesis, as well as abnormalities of the skeleton, eyes, cardiovascular system, and kidneys. Diagnostics. Since AS manifests itself in different ways, it can be suspected in all age groups and, depending on the variability of symptoms, can be diagnosed by any specialist - neonatologist, pediatrician, ophthalmologist, surgeon, cardiologist, etc. The main diagnostic criteria are primarily liver pathology. The main diagnostic criteria are primarily attributed to liver pathology, 75-100% of cases are hypoplasia of bile ducts, absence of intralobular bile duct, which is clinically manifested by significant persistent cholestasis. The next strong sign of AS is the combination of cholestasis with cardiovascular abnormalities in 85-95% of cases. The most common is stenosis of the peripheral pulmonary arteries or ventricular septal defect, atrial septal defect, tetralogy of Fallot, pulmonary atresia, etc. Other typical anomalies include skeletal pathologies, which occur in 33-80% of affected children. These are "butterfly" vertebrae, inferiorly formed vertebrae, fusion of vertebrae, spina bifida. In the AS group, the frequency of urinary system abnormalities is 20-70% according to the data, they affect the ureters, bladder and pelvis disorders, renal tubular acidosis, etc. In 55-75% of patients with AS there are ocular changes - pigmentary retinopathy, retinal angle vessels, posterior embryotoxon, optic drusen. In 15-35% of patients there are anomalies of peripheral vessels - aneurysms of cerebral vessels, stenosis of internal carotid artery, Moya-Moya disease, as well as anomalies of vessels of abdominal cavity: coarctation of abdominal aorta, stenosis of renal artery. However, the pathognomonic signs of AS include characteristic facial features - 70-95% of patients have a wide forehead, deep-set eyes, slanting upward slits, protruding ears, a straight nose with a bulbous tip, a pointed chin with the effect of a triangular face. Clinical manifestations. In 80-100% of patients with AS, the first clinical manifestation is liver failure of various stages. In neonates and young patients, cholestasis is present with a clinical picture very similar to that of biliary atresia. Jaundice appears on the 2nd or 3rd day of life, i.e. in normal physiological days jaundice period. About 2/3 of the patients studied by us had "light interval" - a decrease in the intensity of jaundice until the end of the 1-2 weeks of life and the following month its gradual increase and the appearance of a greenish tint. Acholia is the earliest and most constant clinical symptom of the disease. It is characterized by the absence of hepatomegaly at birth, followed by an increase in the size of the liver and a change in its consistency from elastic to dense during the first 2 months of life. At about 1 month of life, the development of a hemorrhagic syndrome is possible (bleeding from the mucous membranes of the gastrointestinal tract, umbilical wound, intracranial hemorrhages), which is due to a deficiency of vitamin K-dependent blood coagulation factors as a result of a violation of the processes of absorption of vitamin K in the intestine, which we observed in 3 patients. By 5 years of age, 15-30% of children with AS develop acute liver failure and portal hypertension. Treatment. The main goal of treating a child with AS is to relieve cholestasis and reduce the debilitating symptoms of pruritus. Ursodeoxycholic acid is used, cholestyramine, rifampicin, ondansetron, naltrexone, etc. may be added. It was absolutely revealing the inclusion of marlioxibat, which acts on the inhibitors of transporters of bile acids in the upper parts of the ileum. Liver transplantation, as a rule, becomes necessary in some patients with AS, which meets end-stage liver failure and severe portal hypertension. Another indication for transplantation is hepatocellular carcinoma. According to our experience and data from other centers, transplantation completely solves these problems and has a successful outcome, as it has been proven that AS does not recur in the transplant.

A Global Systematic Review of Factors Affecting the Biological Treatment of Wastewater Containing Petroleum Substances

Introduction: A variety of treatment methods, including biological remediation, have been employed to address oil-contaminated wastewater. Bioremediation, which involves using microorganisms to mitigate or eliminate pollutants, is recognized as an environmentally friendly, cost-effective, and evolving technique for removing and breaking down various environmental contaminants, including those from oil industry. Materials and Methods: This systematic review not only introduces biological treatment but also explores factors contributing to its success. In this study, a search was performed with keywords including petroleum substances, bioremediation, and biological treatment on Scopus, ScienceDirect, Web of Science, and PubMed, and 1349 studies were obtained, and 61 articles were finally chosen according to exclusion and inclusion criteria. Results: A significant increase was observed in research articles over the past five years, likely reflecting the growing awareness of the need to remediate petroleum pollution in recent years. The nature of petroleum wastewater varies depending on the specific crude oil refining process, and factors that have the greatest effect on biological treatment include temperature, pH, inhibitors, time, oxygen, nutrients, nature, concentration of pollutants, and microorganism type. No single species of microorganism can break down all petroleum compounds. Conclusion: This study allows decision-makers to evaluate these factors before implementing and investing in this method, ensuring its effectiveness in reducing petroleum pollution concentrations.

Disease-specific complaints among multiple myeloma patients treated with chemotherapy, autotransplantation and supportive therapy in Poland: a cross-sectional study

Due to its course, multiple myeloma may negatively affect the functioning of patients. Different treatment methods are also associated with patients’ varying perception of their health condition. The purpose of this study is to determine the disease-specific complaints among multiple myeloma patients during selected treatment methods—chemotherapy, autologous hematopoietic stem cell transplantation, and supportive therapy. The study group included 246 patients (98 in the chemotherapy group, of which 87 in the autologous hematopoietic stem cell transplantation group and 61 in the supportive therapy group). The study was conducted between August 2020 and December 2021 with the EORTC QLQ-MY20 questionnaire. According to the study results, patients treated with chemotherapy had the highest degree of disease symptom severity and side effects of treatment as well as the lowest assessment of their perspectives for the future. Patients who received supportive treatment had the lowest degree of disease symptom severity and side effects of treatment, and also assessed their body image and future perspectives the highest. Women assessed their future perspectives significantly lower than men. The severity of disease symptoms experienced by patients increases with age.