Modern Diagnostic Techniques Research Articles

A Review of Shaped Charge Variables for its Optimum Performance

Shaped charge is a device for focusing the chemical energy of explosives to a particular point or line for penetration or cutting purpose respectively. They are used for the penetration or cutting of various types of targets on land, water, underground, underwater, or air. Their shape is either conical or linear and consists of explosive, casing and liner. The liner is bent towards the central axis producing a thin hypervelocity jet by the energy released as a result of the explosive detonation. This jet is utilized against the target. Shaped charges can perforate or penetrate targets like aircrafts, ships, submarines, armored vehicles, battle tanks, and bunkers. This paper presents a detailed review of analytical works, computer simulations, and experimental results related to the liner. Among modern diagnostic techniques flash x-rays, radiography is most used in the experiments performed in the last 40 years. Powder metallurgy, which started in the late twentieth century raised the efficiency of shaped charges to new altitudes. The efficiency of the shaped charge depends on numerous factors such as explosive’s type, liner’s material, geometry and metallurgy, manufacturing technique, and casing thickness. Factors concerning the liner’s material, metallurgical advancements, and geometry are discussed chronologically and in detail.

Type Va extrahepatic bile duct duplication: a case report

BackgroundExtrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety.Case presentationThis case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy.ConclusionA rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.

2848 Treatment of Adenomyosis by Hysteroscope

Video Objective To demonstrate a novel hysteroscopic surgery for adenomyosis. Setting The benign gynecology department at a university hospital. Interventions We performed a hysteroscopic minimally operation to treat symptomatic myometrial adenomyosis. The operations were performed under transabdominal ultrasound-guide. We used a cutting loop to resect the lesions repeatedly and progressively with the standard electroresection. The operation was considered complete when the pink fasciculate structure of the myometrium appeared. This study was approved by the institutional ethics committee of the International Peace Maternity and Child Health Hospital in Shanghai, China, on 19 April 2016. The approval number is GLW (2015) 19.Following-up were performed for 2 times at 3-months interval. The patient menstruated regularly. The postoperative VAS scores of dysmenorrhea and menstrual blood volume declined significantly after operation. 6 months after the operation the uterine volume evaluated by magnetic resonance imaging (MRI) reduced by about 33%. Conclusion Traditionally, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies and/or percutaneous ultrasound-based biopsies. The modern diagnostic imaging techniques, such as (MRI), contributing to improving accuracy in the identification of this pathology, results in that the conservative uterine-sparing treatments of adenomyosis appear to be feasible and efficacious. Hysteroscopic excision of uterine adenomyosis has the following benefits: the uterine is reserved and the symptoms of adenomyosis get improvement; the minimally invasive operation is short-time taking and the patients recovers quickly. Therefore, hysteroscopic excision provides an effective and optional conservative technique for the treatment of adenomyosis.

Peripheral nerve injury and myelination: Potential therapeutic strategies.

Traumatic peripheral nerve injury represents a major clinical and public health problem that often leads to significant functional impairment and permanent disability. Despite modern diagnostic procedures and advanced microsurgical techniques, functional recovery after peripheral nerve repair is often unsatisfactory. Therefore, there is an unmet need for new therapeutic or adjunctive strategies to promote the functional recovery in nerve injury patients. In contrast to the central nervous system, Schwann cells in the peripheral nervous system play a pivotal role in several aspects of nerve repair such as degeneration, remyelination, and axonal growth. Several non-surgical approaches, including pharmacological, electrical, cell-based, and laser therapies, have been employed to promote myelination and enhance functional recovery after peripheral nerve injury. This review will succinctly discuss the potential therapeutic strategies in the context of myelination following peripheral neurotrauma.

Investigation Of Reducing Omniscan Toxicity Using Intracellular And Targeted N-Acetylcysteine Lysine Complex

Background:The main issue is finding the most efficient method in the treatment of cancer in terms of early and accurate diagnostic. One of the most modern diagnostic techniques is imaging methods. The accuracy and detection speed of MRI and CT SCAN are high.Methods:The most important complication of iodinated contrast agents in medical imaging is severe renal toxicity Nephrogenic Systemic Fibrosis (NSF). In order to reduce the cytotoxicity of kidney cells caused by the usage of iodized contrast agents a complex agent should be designed. The two drugs which have been used for the synthesis of this compound are L -lysine amino acid and NAcetyl- Cysteine (NAC).Results:The synthesis of this complex due to two dimer molecules with each other and NAC greatly a helper for an antioxidant activity and L-lysine amino acid helps in drug entry into the cells. However, helping for an antioxidant activity heavily reinforce and eventually will successfully reduce the cytotoxicity. When its exposure to HEK 293 cell line (P<0.05). The reduction in toxicity at the dosage of 100 µM has been showed as the greatest reduction. The amount of renal toxicity was reported 40% in Omniscan.Conclusion:Omniscan was tested when iodinated contrast medium was combined with the synthesized 2NAC-LYS-OMNISCAN complex and the human embryonic kidney 293 (HEK293) cell line. Then, the cytotoxicity was reduced to 10 %. On the other hand, the viability increased from 60 % to 90 %, or in other words, the cytotoxicity was reduced from 40 % to 10 %.

Cancer du poumon et irradiation ganglionnaire prophylactique : un débat clos ?

Lung cancer treatment is a heavy workload for radiation oncologist and that field showed many evolutions over the last two decades. The issue about target volume was raised when treatment delivery became more precise with the development of three-dimensional conformal radiotherapy. Initially based upon surgical series, numerous retrospective and prospective studies aimed to evaluate the risk of elective nodal failure of involved-field radiotherapy compared to standard large field elective nodal irradiation. In every setting, locally advanced non-small cell lung cancer, localized non-small cell lung cancer, localized small cell lung cancer, exclusive chemoradiation or postoperative radiotherapy, most of the studies showed no significant difference between involved-field radiotherapy or elective nodal irradiation with elective nodal failure rate under 5% at 2 years, provided staging had been done with modern imaging and diagnostic techniques (positron emission tomography scan, endoscopy, etc.). Moreover, if reducing irradiated volumes are safe regarding recurrences, involved-field radiotherapy allowed dose escalation while reducing acute and late oesophageal, cardiac and pulmonary toxicities. Consequently, major clinical trials involving radiotherapy initiated in the last two decades and international clinical guidelines recommended omission of elective nodal irradiation in favour of in-field radiotherapy.

Macroalgal Polysaccharides in Biomimetic Nanodelivery Systems.

Imitating nature in the design of bio-inspired drug delivery systems resulted in several success stories. However, the practical application of biomimicry is still largely unrealized owing to the fact that we tend to copy the shape more often than the whole biology. Interesting chemistry of polysaccharides provides endless possibilities for drug complex formation and creation of delivery systems with diverse morphological and surface properties. However, the type of biological response, which may be induced by these systems, remains largely unexploited. Considering the most current research for the given topic, in this review, we will try to present the integrative approaches for the design of biomimetic DDS's with improved therapeutic or theranostic effects based on different algal polysaccharides that exert multiple biological functions. Algal polysaccharides may provide building blocks for bioinspired drug delivery systems capable of supporting the mechanical properties of nanomedicines and mimicking various biological processes by molecular interactions at the nanoscale. Numerous research studies demonstrate the efficacy and safety of multifunctional nanoparticles integrating several functions in one delivery system, composed of alginate, carrageenan, ulvan, fucoidan and their derivatives, intended to be used as bioartificial microenvironment or for diagnosis and therapy of different diseases. Nanodimensional structure of polysaccharide DDS's shows substantial influence on the bioactive motifs potential availability for interaction with a variety of biomolecules and cells. Evaluation of the nano dimensional structure-activity relationship is crucial for unlocking the full potential of the future application of polysaccharide bio-mimicking DDS in modern diagnostic and therapeutic procedures.

Abdominal Physical Signs and Medical Eponyms: Part II. Percussion and Auscultation, 1924-1980.

Percussion and auscultation are derived from the Latin words to touch and hear, respectively. Covered are abdominal percussion signs and ausculatory signs discovered from 1924 to 1980. Signs ascribed as medical eponyms pay homage to these physicians who provided new and unique insights into disease. PubMed, Medline, online Internet word searches, textbooks, and references from other source text. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign. Many of these signs have been discarded because of modern imaging and diagnostic techniques. When combined with a high clinical suspicion, positive results using percussion combined with palpation is a useful bedside technique in detecting splenic enlargement. Thus, some of these maneuvers remain important bedside techniques that skilled practitioners should master, and along with a meaningful history, provide relevant information to diagnosis. It is through learning about these signs that we gain a sense of humility on the difficulty physicians faced prior to the advent of techniques that now allow us an easier way to visualize and diagnose the underlying disease processes.

Central Nervous System Opportunistic Infections.

Opportunistic infections of the central nervous system are classically associated with immunosuppression arising from infection with human immunodeficiency virus and with various hematologic malignancies. However, over the past few years, they are increasingly associated with transplantation and various immunosuppressive treatments used to treat autoimmune diseases. They cause significant morbidity and mortality and remain a diagnostic challenge due to the absence of typical signs and symptoms of infection and mimicry by various noninfectious causes. The pathogens associated with these infections are often commonly found pathogens of low virulence in immunocompetent hosts and include various bacteria, parasites, fungi, or viruses. These infections can present as various clinical syndromes, including meningitis, encephalitis, space-occupying lesions, stroke-like presentations, or even neoplastic manifestations. Progressive multifocal leukoencephalopathy can be seen in patients with multiple sclerosis on various new immunomodulatory drugs in addition to patients with human immunodeficiency virus, transplantation, or hematologic malignancies, and is characterized by multifocal white matter lesions. Human herpesvirus-6 causes severe encephalitis in transplant recipients, known as posttransplantation acute limbic encephalitis. Neoplastic manifestations like Epstein-Barr virus-associated primary central nervous system lymphoma and posttransplantation lymphoproliferative disorders are particularly challenging to diagnose and manage. Modern diagnostic techniques, including advanced imaging techniques like magnetic resonance spectroscopy, use of polymerase chain reaction, and metagenomic sequencing, can be helpful in early recognition of pathogens. Treatment of most of these involves lowering of immunosuppression when possible and use of specific antimicrobial agents when available. Improved outcomes can be seen when early diagnosis is made.

The Clinical Anatomy and Imaging Laboratory: Vertical Integration in the Preclerkship Curriculum.

As medical schools implement integrated curricula, anatomy education especially has experienced increased pressure to make foundational content clinically relevant. We designed a novel type of integrative anatomy laboratory experience where students could use foundational anatomy concepts in concert with modern imaging/diagnostic techniques to enhance important clinical concepts. We selected a process called Lesson Study to develop the multidisciplinary Clinical Anatomy and Imaging Laboratory (CAIL) in the cardiovascular and gastrointestinal systems. We utilized soft-embalmed cadavers extensively for their highly realistic tissue appearance and texture, which allowed instructors and students to perform a wide array of procedures in case-based scenarios similar to practicing clinicians. We conducted field observations of participating students, focus-group discussions, and knowledge-based exams to examine efficacy of the CAIL. Approximately 150 first- and second-year students participated in each of the CAIL activities on an annual basis. Most focus-group participants felt the CAIL was a great learning experience. They commented on how the lab provided relevance to anatomy knowledge and helped integrate prior classroom learning more deeply. Instructors noted that students asked more advanced, clinically relevant questions than in a typical anatomy lab. Knowledge improved significantly after the CAIL, although it is unclear if this translates to summative exams. The CAIL creates a unique learning experience where students use prior foundational anatomy knowledge in conjunction with modern imaging and diagnostic techniques to reinforce important clinical concepts. We have continued to integrate CAIL experiences into more clinical systems in our medical school curriculum.

DISORDERS OF COAGULATION STATUS AND HAEMOSTASIS AS PROGNOSTIC PARAMETERS OF IMMEDIATE AND EARLY RESULTS AFTER SURGICAL MYOCARDIAL REVASCULARISATION

Surgical myocardial revascularization is one of the most commonly performed surgical procedures in the world. Over time, with the development of technology and modern diagnostic procedures, as well as the advancement of surgical techniques, the mortality rate for elective uncomplicated cases has fallen to below 2%. Nevertheless, despite the exceptional development of the surgical techiniques, the rate of postoperative complications, that can compromise the patients, is over 10%. The aim of this study was to define a group of patients with an increased risk of postoperative complications depending on the disorders of coagulation status and haemostasis. Twenty eight patients who underwent surgical revascularization of the myocardium were included in this prospective, non-randomized study. The study was conducted at the Clinic for Cardiac Surgery, Clinical Center Nis, from January to April 2017. Preoperatively as well as 3 hours, 24 hours, 48 hours, 3 days, and 5 days postoperatively, the following parameters were determined: blood count, inflammation parameters (C reactive protein, presepsin); coagulation status (prothrombin time (PT), International Normalized Ratio (INR), activated partial thromboplastin time (APTT), fibrinogen, anti-thrombin III, D dimer). The only preoperative independent prognostic parameter for increased postoperative drainage was INR. Activated clothing time (ACT) was an independent postoperative prognostic parameter of increased postoperative drainage, probably due to delayed or prolonged heparin activity. Inflammation parameters showed no association with the onset of postoperative complications. In relation to patients without bleeding, in patients with bleeding, significantly higher values of urea and the difference in APTT values, preoperatively and at the end of the monitoring period, were detected. Multivariate logistic regression analysis, confirmed the difference in APTT values preoperatively and at the end of the monitoring period, as the only factor, significantly associated with the risk of bleeding. Multivariate linear regression analysis, confirmed the value of the urea, as the only factor significantly associated with the change in total allogeneic transfusion value. Increase in urea levels is associated with an increase in the total amount of allogeneic transfusion. Correlation analysis showed that the increased number of days in the intensive care was significantly associated with female gender, number of grafts, prolonged ECC, clamping time, hematocrit (HCT), PT, INR preoperatively and at the end of the follow-up period. Surgical myocardial revascularization is a safe method with a minimal morbidity rate. Using of modern methods for the preoperative monitoring of haemostasis may significantly reduce the risk of postoperative bleeding and the need for transfusion of red blood cells and other blood derivatives.

Genetics of movement disorders-rare but important

Rare genetic movement disorders are aheterogeneous group of diseases. The causes of many of these rare movement disorders could be resolved due to the progress in molecular genetic diagnostics. This led to abetter pathophysiological characterization of rare movement disorders and also to the fact that many phenotypical overlaps could be found between different diseases. The classification of genetic results requires a close cooperation between neurologists and geneticists. Therefore, modern diagnostic procedures cannot replace the clinical classification of genetic movement disorders and the exact patient history. This article provides the reader with an overview of the most important groups of genetic movement disorders. Genetic Parkinson syndromes, dystonia, essential tremor, genetic chorea, cerebellar ataxia and hereditary spastic paraplegia are dealt with in detail. For a better understanding individual genetic terms are explained and differences in molecular genetic diagnostics are presented.

The Tenchini’s collection: a forensic anthropometric legacy of 19th century Parma, Italy

A group of 19th century inmates dead in the prison of Parma are the protagonist of an incredible scientific collection. Lorenzo Tenchini started the creation of this collection and dedicated his work and his studies to its completeness. Anatomist and academic, Lorenzo Tenchini (1852–1906) dedicated his scientific studies to macroscopic anatomy, particularly about central nervous system and its correlation with psychic function. In 1881 he became ordinary professor in Normal Human Anatomy at the University of Parma dedicating himself to the study of the anatomical organization of the brain and psychic and social disturbs. During the study of the skulls and brains of psychotic patients and the deformations of skulls belonging to patients admitted in the Hospital of Brescia, he started a collaboration with Alessandro Cugini (1829–1913), founder of the Institute of Legal Medicine at the University of Parma. Tenchini realized an anatomical collection, preserved today in the Museum of Biomedicine of the University of Parma. This collection represents the masterpiece of his research carried out during his academic activity and still a unicum in the western world, as there are no similar collection assembling such a multidisciplinary information. The peculiarity of this collection is due not only to the scientific interest of the anatomic samples and their full clinical documentation, but also to the methods employed in order to realize it. At the end of the 19th century, as a student of Cesare Lombroso (1835–1909), Tenchini based his work on the study of the face, the skull and brain of each dead inmate of Parma’s prison or Colorno’s mental hospital. These individuals as protagonists of Tenchini’s collection, leave a legacy identifiable as scientific heritage. Their skulls and brains, the reproduction of their faces through ceroplastic and other anatomical samples treated with other techniques, are accompanied by an autoptic and psychiatric full documentation, allowing the collection to be complete with every aspect related to the inmates studied. Through his work, a comparison between different kind of studies, such as psychiatry, psychology, neurology, legal medicine and anthropology, is suitable in scientific research to be realized. Moreover, data come from a forensic context: this allows a comparison with different methodologies employed in modern age by forensic expertise such as the comparison between modern and ancient medical diagnostic technique. This masterpiece represents Tenchini’s neuroanatomical research on behaviour and set a pioneering step in the history of biomedical science allowing further multidisciplinary studies.

Successful conservative management in cervical Ectopic Pregnancy

Incidence of cervical ectopic pregnancy is 6% of all the ectopic pregnancies. And this percentage is rising since last decade with increased incidence of ectopic pregnancies in general. Assisted reproduction, tubal pathology due to pelvic inflammatory disease or/and adhesions due to surgery are leading causes for increased incidence of ectopic pregnancy. Modern diagnostic techniques and regular follow up in assisted reproduction cases, pick up ectopic pregnancy at an earlier gestation. Previously hysterectomy was the only resort in majority if not all the cases of cervical ectopic pregnancies But now in selective cases like saving fertility in a patient a promising management has emerged It is however emphasized that appropriate treatment option - medical or surgical should be considered according to individual case. This case of ectopic cervical pregnancy at 6 weeks of gestation is managed successfully by conservative management.

Organ injuries due to thoracic trauma : Diagnostics, clinical importance and treatment principles

Thoracic trauma can be alife-threatening condition due tothe involvement of vital organs, such as the heart, lungs, tracheobronchial tree and the great vessels. A coordinated interdisciplinary management is vital for the survival of the injured person. Modern diagnostic procedures provide an essential basis for the surgical treatment of patients. Surgical treatment principles include insertion of chest drainage, emergency thoracotomy, complex bronchoplastic and vascular reconstructive techniques and cardiac surgical maneuvers. For this reason highly complex surgical procedures are available, which can be effectively and specifically integrated into an interdisciplinary concept. In this review, the most frequent and prognostically relevant conditions, the indicated diagnostics and their significance as well as the surgical treatment principles, are comprehensively presented under consideration of the clinical situation.

Computer Aided Optical Disc Detection in Fundus Images: A Review

Colour fundus images of the human retina are increasingly used in the diagnosis and treatment of several eye related pathologies and in ailments such as arteriosclerosis, diabetes, and hypertension. The effectiveness of treatment for many eye related diseases lies in the early detection through regular screenings. But, screening a large number of patients is a significant problem faced by medical practitioners in populous developing countries like India. In addition, there are extensive influences of human blunders and subjectivity on the consequences of assessment by a human master. This opens up the probability of applying propelled image processing techniques in fundus images to support and improve determination in different ways. Thus, automatic detection of pathologies and computer aided analysis in retinal images play a important role in modern diagnostic procedures and screening systems. Reliable and robust extraction of retinal features like optic disc, macula and vasculature is an essential for ensuing retinal image analysis and handling since these are the overwhelming and most stable structures showing up in the retina. However, automatic segmentation of retinal images is a complicated affair since retinal images are often poorly contrasted noisy, and there are a wide variations in orientation. This paper presents a review on algorithms or methods to detect optic disc automatically.

Etiological and pathogenetic aspects of non-specific bacterial vaginosis

The aim of this review was the biological properties analysis of microorganisms known as the main contributors to the non-specific bacterial vaginosis development. The mechanisms of anaerobic vaginal microflora pathogenic action have been found out to be the main cause of non-specific inflammatory processes. Special attention was given to the genera of Mobilunkus spp., Atopobium spp., Prevotella sp. representatives , which were studied as vaginal flora due to the modern diagnostic methods and techniques development. The homeostasis of the vaginal ecosystem results from complex interactions and synergies among the host and different microorganisms that colonize the vaginal mucosa and healthy vaginal microbiota is generally dominated by Lactobacillus spp. Lactobacilli which have been known to be antagonistic toward a variety of microorganisms. In cases of bacterial vaginoses, the proportion of Lactobacilus spp sharply decreases, while the share of anaerobic microorganisms increases: Gardnerella vaginalis, Atopobium sp., Mobiluncus sp., Prevotella sp . The virulence factors of Gardnerella vaginalis pathogenicity are: its ability to form biofilms; the presence of genes responsible for cytotoxicity. The ability of Gardnerella vaginalis, Atopobium sp., Mobiluncus sp., Prevotella sp . to produce short chain volatile fatty acids isomers results in the vaginal mucosa irritation (itching or burning) and discharge with unpleasant odour in BV associated with these microorganisms. Atopobium vaginae , together with Mobiluncus spp . and Prevotella spp ., provoke the accumulation of pro-inflammatory cytokines. The whole mechanism leads to an inflammation worsening in BV and stimulates the chronic process development. Both microorganisms Mobiluncus spp . and A. vaginae are competitive lactobacilli in relation to the glycogen consumption. Conclusions. Analysis of literature shows that pathogens of non-specific bacterial vaginosis have wide range of pathogenicity factors. This provides pathogenesis and clinical signs of the disease.

KLIPPEL-TRENAUNAY SYNDROM IN FIRST AID DOCTOR’S MEDICAL PRACTCE

Aim. To acquaint practical health care doctors with clinical display, modern diagnostic methods and treatment techniques of patients with uncommon genetically determined vascular disease, mainly affecting lower limbs vessels – KlippelTrenaunay syndrome. Materials and methods. The retrospective analyses of anamnesis data, clinical course, laboratory results and instrumental research methods are made, treatment techniques of patients are determined. Results. Klippel-Trenaunay syndrome is a form of systemic genetic phleboangiosis. Anomaly is diagnosed at birth based on clinical symptoms or infant development, when typical symptoms of diseases are visible. Promptly made instrumental research helps to estimate affection severity of bloodstream, to specify concomitant anomaly in order to choose the most effective treatment method (conservative or surgical). Conclusion . Knowledge of clinical display, differential diagnostics and prompt treatment techniques for patients with Klippel-Trenaunay syndrome are performed, these data are important for all levels of medical aid to save life quality.

Оптимізація профілактики септичних ускладнень у роділь з високим інфекційним ризиком

Despite the introduction of modern diagnostic technologies, prophylaxis and treatment techniques in obstetrical practice, the incidence of postpartum purulent-septic complications (PPSC) remains rather high and is an important medical and social problem, as they take one of the leading places in the structure of maternal morbidity and mortality. The objective: to improve the management of parturient womenwith a perineal birth injury in anamnesis, as part of an effective prevention of purulent-septic complications of puerperium. Materials and methods. The study included 77parturient women. Main and comparative groups were formed by women with a violation of the integrity of the perineum in the previous labor and with a high risk of developing infectious complications in puerperium. Women of the main group (n = 24) during each vaginal examination in labor (and an additional injection in 15-30 minutes after the rupture of the membranes) and twice a dayat a dose of 5 ml for 5 days postpartum, an antiseptic agent in the form of a vaginal gel, which consists of: 0.02% decamethoxin (antiseptic component), 0.5% hyaluronic acid (regenerating component) and lactate buffer (regulatory component). The comparison group included 27 women, without using vaginal gel in laborand using traditional wound treatment techniques in the postpartum period. The control group consisted of 26 women with uncomplicated somatic status, physiological course of pregnancy and labor. The evaluation of the effectiveness of the prescribed treatment was based on subjective symptoms (pain, discomfort, burning in the region of the perineal sutures), clinical data (swelling, hyperemia, nature of suturing healing), generally accepted indicators in dynamics (bacterioscopy of vaginal contents, pH-metry of the vaginal environment). Results. At the background of the use of three-component vaginal gel in the main group, the level of injury of soft tissues of the birth canal in these deliveries was lower by 19.9% than in the comparison group, prevalence of the 1st degreeperineumruptures, decreased the need for repeated episio- and perineotomy, which reduced the duration stay at hospital and improved postpartum rehabilitation in relation to the comparison group. On the third day of puerperium, hyperemia and edema of the wound area in women of the main group were observed almost three times less compared with the comparison group. On the fifth day of the puerperium in the main group the complaints were insignificant and appeared on the average 5 times less often, the healing was by the primary tension without infectious complications. The use of vaginal gel reduced the number of leukocytes in wound secretions by shortening the time of wound epithelization (1.5 times faster than in the parous from the comparison group). On the fifth day of using vaginal gel, 2/3 of the patients observed normalization of the vaginal microflora, the restoration of pH was observed. The results indicate the benefits of early onset of prophylactic measures and high effectiveness of topical antiseptic therapy in women with high infectious risk. Conclusions.In order to prevent antibiotic resistance tactics of prevention of PPSC in the group of high-risk septic complications provides one of the elements of anintegrated approach to use local antiseptics. Inclusion of the latter into a complex of prophylactic and treatment measures in the management of a high-riskwomen in puerperium contributes to the reduction of traumatic and infectious complications and provides more favorable course of labor and the postpartum period. Key words: labor traumatism, postpartum purulent-septic complications, local antiseptic.

110. Use of modern diagnostic techniques in Ayurvedic diagnosis – An analysis through case studies

110. Use of modern diagnostic techniques in Ayurvedic diagnosis – An analysis through case studies