Objective Signs Research Articles

The Contribution of the Face-Name Associative Recognition Test to Objectifying the Impairment of Associative Memory in Subjective Cognitive Decline

Objective: Subjective cognitive decline (SCD) is defined as a self-reported perception of cognitive decline that occurs without clear objective signs of cognitive impairment. There is still uncertainty in the literature about the reliability of SCD as an accurate indicator of the early stages of major neurocognitive disorders. Furthermore, objectifying cognitive impairment in SCD is difficult, mainly due to the insensitivity of the assessment instruments. The main objective of this study was to investigate the potential contribution of the face-name associative recognition test (FNART) to the objective identification of memory impairment in SCD. Method: A research sample of 69 adults with SCD and 69 healthy controls (HCs) recruited in the community were administered in the FNART, which included 32 photographs of neutral faces associated with 32 first names. Results: The total score of the HC group in the FNART was significantly better than that of the SCD group. Moreover, analyses based on the serial position of the stimuli showed that the SCD group performed significantly worse than the HC group only for the middle items (stimuli placed at the beginning or end of learning lists are more likely to be recalled than those presented in the middle), while no primacy and recency effects were found in the HCs. Conclusions: These findings indicate that associative episodic memory is more vulnerable in individuals with subjective cognitive decline (SCD) compared to those without cognitive complaints. Additionally, they suggest that the FNART may be effective in identifying cognitive decline in the preclinical stage of Alzheimer’s disease.

Assessment of the disease course, diagnosis, and treatment of the new coronavirus infection in a Stavropol multidisciplinary hospital during the COVID-19 pandemic

Aim. To evaluate the disease course, laboratory diagnosis, and treatment results of COVID-19 patients. Materials and methods. In the period from January to December 2021, the moderate and severe COVID-19 forms complicated by polysegmental community-acquired pneumonia were monitored in 861 patients admitted to Stavropol Clinical City Hospital No. 3. Patients were assessed according to laboratory data, body mass index, concomitant diseases, gender, age, duration of inpatient treatment, and disease outcome. Results. More than half of the COVID-19 patients were overweight and had concomitant diseases at the time of admission, which significantly worsened the course and prognosis of the disease. The inflammation predictors (C-reactive protein, procalcitonin, fibrinogen, D-dimer, lactate dehydrogenase) were found to have an important role, with their indicators correlating significantly with the severity of the patient’s condition. Dynamic monitoring of these laboratory parameters served as a marker of the adequacy of the therapy; however, these were not always a criterion for prescribing antibacterial therapy. Bacteriological diagnostics was applied only in 9.4% of cases. Conclusion. Although the COVID-19 severity was not associated with gender, it correlated significantly with age and the presence of comorbid cardiovascular, bronchopulmonary, and endocrine diseases. A retrospective analysis revealed characteristic laboratory markers of the severity of COVID-19 infection. It was revealed that the initial empirical ABT was initiated in 94% of cases in the absence of reliable objective signs of bacterial infection.

Model-Informed Drug Development-Based Approval of Intravenous Secukinumab for the Treatment of Adult Patients with Active Psoriatic Arthritis, Active Ankylosing Spondylitis, and Active Non-Radiographic Axial Spondyloarthritis.

On October 6, 2023, the US Food and Drug Administration (FDA) approved an intravenous (IV) formulation and dosage of Cosentyx® (secukinumab), for the treatment of adult patients with active psoriatic arthritis (PsA), active ankylosing spondylitis (AS), and active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation. Clinical pharmacokinetics (PK), efficacy, and short-term placebo-controlled safety data were available from clinical studies (NCT04156620 and NCT04209205) with the to-be-marketed IV formulation using a maintenance dosage 3 mg/kg every 4 weeks (q4w), which was different from the dose approved (1.75 mg/kg q4w). The IV dosage of 3 mg/kg utilized in these two trials resulted in exposures (Cmax,ss) significantly higher than those for the approved subcutaneous (SC) regimens. Further, there is limited long-term safety information available for this 3 mg/kg q4w IV dose. To address this important limitation, a model-informed drug development (MIDD) approach was employed to leverage available clinical PK, efficacy, and safety data from the secukinumab development program to identify a maintenance IV dosing regimen, 1.75 mg/kg IV q4w, that better approximated the relevant SC secukinumab exposures for which efficacy and safety have been established. The MIDD analyses were used to support approval of this IV dosing regimen not directly studied in the indications sought for licensure, PsA, AS, and nr-AxSpA.

The optimal way to use geoinformation systems with graphical elements of symbols of veterinary significant objects in vector format

A significant problem in the field of standardization in the monitoring of infectious animal diseases is the lack of a system of conventional symbols of veterinary significant objects used in geoinformation technologies, in particular in digital and electronic cartography. The object of the study is the conventional signs of veterinary significant objects, which in the context of display on digital maps can be defined as "non–scalable", marked with corresponding pictograms. A systematic approach has been applied as a methodological basis for the epizootological research method. The basic graphic format of the proposed SVG symbols is used – (Scalable Vector Graphics), which is a modern generally accepted vector format. This article presents the results of cartographic display of pictograms of one of the three sets of symbols for the database – veterinary facilities for various purposes – for which the method of selecting basic signs is used. An algorithm for fixing elements of symbols of veterinary significant objects in the vector format of the SVG geoinformation system with maximum use of free software and secure information technologies is presented. Images in SVG format can be directly represented in current GIS and converted to almost any vector and raster formats without loss of image quality. The algorithm for developing a system of symbols for veterinary significant objects will be used in the Draft of the preliminary national standard in the future.

Difficult-to-Treat Axial Spondyloarthritis: A New Challenge.

Axial spondyloarthritis is a common form of chronic inflammatory rheumatic disease in adults, the treatment of which is based on non-pharmacological elements on the one hand, and pharmacological options on the other, such as non-steroidal anti-inflammatory drugs in the first line, followed by biological or targeted synthetic treatments. The therapeutic objective is remission or a low level of disease activity; if this objective is not achieved, the treatment is rotated or changed. Multiple changes is one factor illustrating the inability to achieve disease control and may lead to the notion of a difficult-to-treat disease (D2T). This requires a consensual definition including, beyond the number or therapeutic changes, the assessment of all the dimensions of the disease (objective signs of inflammation, residual pain, degenerative changes, psychosocial context). Recognising D2T patients will enable us to identify a particular population and the factors associated with this condition. When faced with a D2T disease, we need to analyse the causes of treatment failure and take into account the different components of the disease and the patient. In the absence of any prospect of new therapeutic targets in the short term for this disease, patient management may involve intensification of non-pharmacological means and evaluation of new therapeutic strategies such as combinations of targeted treatments.

Integrasi Dan Penerapan Teori Signiant-Signified Saussure Dalam Pembelajaran Mufradāt

Learning Arabic mufradat, strategies, methods, and approaches are often less meaningful and only a formality for students. This research describes integrating Saussure's signifier-signified theory into Arabic vocabulary learning. The process in this research uses library research, which is a method of collecting data then understanding the data and studying theories from various sources of articles, and books by the research. The results of this study show that Saussure's signifiant-signified theory in the application of the principles of the relationship between the signifier and signified includes four aspects, including a) written sign (sign in the form of writing, b) oral-audio sign (sign in the form of sound), c) visual sign (sign in the form of pictures), d) object sign (a sign of a concrete object). Implementation in learning should be done sequentially, starting from the written sign as an introduction to the vocabulary and its meaning, oral-audio sign as an improvement of pronunciation, visual sign as strengthening mastery of mufradat, and object sign as contextual use of mufradat.

6928 Vitamin D excess in a patient with hypoparathyroidism after parathyroidectomy

Abstract Disclosure: Z. Zavgorodneva: None. A. Barsegian: None. F. Zhang: None. Introduction. We describe a case of a patient with mild persistent hypoparathyroidism after parathyroidectomy with autotransplantation, which was indicated for ESRD-related secondary hyperparathyroidism. The patient presented with nonspecific complaints and was found to have a high Vitamin D level after long-term moderate-dose Vitamin D supplementation. Case report. A 71-year-old male with a past medical history of end-stage renal disease (ESRD) undergoing hemodialysis for the past 18 years, as well as a history of parathyroidectomy with autoimplantation of parathyroid glands in the forearm in 2010 due to severe secondary hyperparathyroidism, presented to the hospital complaining of generalized weakness and lower extremity cramps that had been ongoing for a few weeks. Further investigations did not reveal evidence of infectious processes. A review of medications indicated the absence of statins among his outpatient medications. No focal neurological deficits or objective signs of muscle weakness were identified. Laboratory findings showed no significant metabolic derangements or haematological abnormalities. Inflammatory markers and creatine phosphokinase were within normal ranges. As part of the workup for generalized subjective weakness and ESRD, Vitamin D levels were checked, revealing a result of of120 ng/mL. The patient reported taking over-the-counter 2000 IU of Vitamin D twice daily for the past six years despite having a normal level of Vitamin D checked five years prior to admission. Calcium supplements were initiated in the postoperative period and continue to be administered at a dose of 600 mg daily. Analysis of the PTH-calcium axis demonstrated persistent mild hypoparathyroidism with hypocalcemia since the time of the surgery. However, there was an observed tendency for calcium levels to improve, especially in the last six years. Vitamin D supplement was discontinued, and the patient was subsequently discharged home with the continuation of physical therapy. Discussion. Explaining the origin of the high level of Vitamin D in this patient poses a challenge. There is limited data in the literature regarding the long-term effects of vitamin D use when the initial Vitamin D levels are normal. Additionally, there are numerous abstracts suggesting significantly higher doses of Vitamin D received for up to 6 years without any evident biochemical or clinical consequences. Moreover, the typical consequences of Vitamin D toxicity, such as hypercalcemia, can not be present in patients who underwent parathyroidectomy. Therefore, it is possible to consider that the severe generalized subjective weakness may be a sign of Vitamin D toxicity itself. Presentation: 6/1/2024

Evaluation of the effectiveness of topical use of sertaconazole in dermatophytosis

Objective — to evaluate the effectiveness of a cream containing sertaconazole nitrate 2 % (Onabet 2 % cream) in patients with various forms of dermatophytosis. Materials and methods. 32 patients aged 21—50 were under outpatient observation. The duration of dermatophytosis varied from several weeks to 3 months. Tinea corporis was diagnosed in 25.0 % of patients, foot mycosis in 43.8 %, and axillary mycosis in 31.2 %. The diagnosis was based on the clinical manifestations of the disease and the results of microscopic examination with potassium hydroxide (PH). The clinical picture was evaluated based on the presence of subjective and objective signs (itching, erythema, scaling, vesicles/maceration, pustules) and their intensity according to the scale: 0 points — absence, 1 point — mild, 2 points — moderate, 3 points — severe. The area of skin damage was determined using the «rule of the palm» in patients. The final score of clinical manifestations was calculated by adding the individual scores of each symptom and the value of the area of the affected skin. Onabet 2 % cream was applied by patients twice a day to the affected area of the skin for 4 weeks. Results and discussion. As a result of topical treatment, positive dynamics regarding the clinical manifestations of dermatophytosis were noted in all patients. The regression of inflammatory symptoms (itching, erythema, wetting in 65.5, 40.6 and 71.4 % of patients, respectively) by the end of the 1st week of treatment serves as evidence of anti-fungal, anti-inflammatory and anti-pruritic effects. The terms of regression of clinical manifestations of dermatophytosis depended on the clinical form of the infection. Clinical remission by the end of the 1st week of therapy in 34.4 % of patients, clinical remission and mycological negativity by the end of the 2nd week in 81.3 % of patients testify to the rapid effect of the drug. At the end of the 6th week, clinical success was achieved in 93.7 %, mycological (pathogen eradication) in 100.0 % of patients. Remote observation results within 3 months showed no disease recurrence in all patients. Side effects during treatment were not registered. Conclusions. Onabet cream 2 % is a modern topical antimycotic with a wide spectrum of action; its use twice a day for 1 month allows for achieving clinical cure in 93.7 %, etiological cure in 100 % of patients with dermatophytes (tinea corporis, tinea pedis, and tinea cruris). The high effectiveness and safety of Onabet cream in treating dermatophytosis allow us to recommend this topical agent for treating patients with dermatophytosis.

Effectiveness of cyclosporine nanoemulsion eye drops in patients with mild-to-moderate dry eyes: objective and subjective evaluation

BackgroundTo compare and evaluate objective and subjective clinical parameters between 0.05% cyclosporine nanoemulsion (CsN) and 0.15% hyaluronic acid (HA) administration in patients with mild-to-moderate dry eyes.MethodsIn this prospective, randomized, double-masked, single-center, and placebo-controlled parallel study, patients with mild-to-moderate dry eyes were randomly allocated to be treated with 0.05% CsN or 0.15% HA twice daily. Patients were followed-up at 4, 8, and 12 weeks. Objective and subjective parameters were evaluated during each visit.ResultsA total of 35 patients were enrolled in this study. Compared with baseline, tear film break-up time and fluorescein staining scores at 4, 8, and 12 weeks significantly improved in the CsN group. However, the Schirmer I test showed no statistically significant change until week 12. Using the Symptom Assessment in Dry Eye (SANDE) score, both groups gradually showed significant improvement compared with baseline values. However, the Dry Eye-Related Quality-of-life Score Questionnaire (DEQS) showed no statistically significant change during the treatment period.ConclusionsBoth 0.05% CsN and 0.15% HA administration twice a day effectively improved the objective signs and subjective symptoms of patients with mild-to-moderate dry eyes. However, patients treated with 0.05% CsN experienced greater and faster improvement.

5-Aminolevulinic acid photodynamic therapy is a safe and effective treatment for female patients with intractable vulvar lichen sclerosus

BackgroundFemale vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disease of the vulva and its etiology is unknown. The main clinical symptoms are itching, burning and dyspareunia, and there is a lack of effective treatment. MethodsClinical and follow-up data of women with VLS who underwent 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) from January 2023 to December 2023 in the department of obstetrics and gynecology, Qilu Hospital of Shandong University, were retrospectively analyzed. According to the inclusion and exclusion criteria, 36 patients with VLS who received ineffective conventional treatment (intractable VLS) were enrolled. Objective signs and subjective symptoms of vulvar lesions were recorded before treatment and 6 months after the end of treatment according to corresponding scoring criteria. Quality of life was evaluated using the Dermatology Life Quality Index (DLQI). ResultsAll patients received six sessions of ALA-PDT treatment and follow-up visits. After ALA-PDT treatment, 24 of 36 (66.67 %) patients' itching symptoms completely disappeared, 10 of 36 (27.78 %) patients' itching symptoms were relieved from severe to mild, and only 2 of 36 (5.56 %) patients' symptoms were not significantly relieved. 16 of 36 (44.4 %) patients' itching symptoms completely disappeared, 9 of 36 (25 %) patients' itching symptoms were relieved from severe to mild, and only 2 of 36 (5.56 %) patients still had severe pain. Compared to 22 patients with dyspareunia before treatment, only 9 patients still had dyspareunia with varying degrees of dyspareunia relief after treatment. Clinical signs improved significantly in the patients after ALA-PDT treatment. The total scores of clinical signs were (5.31 ± 1.67 vs 3.67 ± 1.71) before and after treatment. All patients showed improvement in DLQI after treatment. The main side effects of ALA-PDT were pain, erythema and swelling which were transient and tolerable. All patients were “satisfied” or “very satisfied” with the results of the treatment. ConclusionsALA-PDT is a safe and effective treatment for women with intractable vulva lichen sclerosus.

Osteopathic Considerations in the Medical Treatment of a Patient with COVID-Related Respiratory Distress

Abstract We present a case of a woman hospitalized for acute hypoxic respiratory failure secondary to suspected post coronavirus disease 19 (COVID-19) pneumonitis who clinically improved after addition of sequenced Osteopathic Manipulative Treatment (OMT) to her medical management. Objective signs (such as oxygen saturation, SPO2) improved, resulting in decreased oxygen volume requirements by 75% after 1 treatment of OMT, and by 97.5% over her remaining hospitalization. Subjective symptoms of dyspnea, chest tightness, fatigue and mental health also improved. Her most significant somatic dysfunctions (SD), which were primarily in her thoracic, ribcage and cervical regions, were correlated with her clinical presentation and disease process. This suggests that SD was likely a modifiable risk factor impairing her normal adaptive physiologic processes and therefore treating SD with sequenced OMT may have contributed to her realizing a higher health potential when combined with standard medical care.

Efficacy and safety of the disposable eyelid warming masks in the treatment of dry eye disease due to Meibomian gland dysfunction

BackgroundWarm compresses are the routine treatment for Meibomian gland dysfunction (MGD) in daily life, but in order to achieve satisfactory efficacy, the treatment needs to be sustained over a long time, which can have an impact on the patient compliance. A more convenient warm compresses will help improve the patient compliance. Therefore, the purpose of the study is to investigate the efficacy and safety of the disposable eyelid warming masks for treatment of dry eye disease (DED) due to MGD.MethodsThis was a randomized, controlled, non-masked, two-center clinical trial. One hundred and forty-four patients were treated by the masks or the hot towel twice daily for 12 weeks. Patients were evaluated at baseline, 4-week and 12-week visits for subjective symptoms, objective signs and safety assessments, including ocular symptom scores, ocular surface disease index (OSDI), tear break-up time (BUT), corneal fluorescein staining (CFS), Schirmer I test (SIT), meibum quality, meibum expressibility, and adverse events (AEs).ResultsA totle of 134 patients were followed in the study. The mean age of the masks group (14 males and 52 females) and the hot towel group (20 males and 48 females) was 43.7 ± 13.5 years and 39.5 ± 13.9 years, respectively. At 4-week visit, there were significant statistical differences in ocular symptom scores, OSDI and CFS between two groups (P < 0.05). Except for SIT, the treatment group showed a greater improvement in subjective symptoms and objective signs than the control group at 12-week visit. (P < 0.05). In addition, 40 AEs occurred in 27 patients (37.5%) in the treatment group, and 34 AEs occurred in 21 patients (29.17%) in the control group. No serious AEs were reported.ConclusionsThe masks had a good efficacy and safety in the treatment of DED due to MGD, and might offer an attractive treatment option for some patients.Trial registrationThe study was registered at Chinese Clinical Trial Registry (ChiCTR1900025443) on August 26, 2019.

A translationally informed approach to vital signs for psychiatry: a preliminary proof of concept

The nature of data obtainable from the commercial smartphone – bolstered by a translational model emphasizing the impact of social and physical zeitgebers on circadian rhythms and mood – offers the possibility of scalable and objective vital signs for major depression. Our objective was to explore associations between passively sensed behavioral smartphone data and repeatedly measured depressive symptoms to suggest which features could eventually lead towards vital signs for depression. We collected continuous behavioral data and bi-weekly depressive symptoms (PHQ-8) from 131 psychiatric outpatients with a lifetime DSM-5 diagnosis of depression and/or anxiety over a 16-week period. Using linear mixed-effects models, we related depressive symptoms to concurrent passively sensed behavioral summary features (mean and variability of sleep, activity, and social engagement metrics), considering both between- and within-person associations. Individuals with more variable wake-up times across the study reported higher depressive symptoms relative to individuals with less variable wake-up times (B [95% CI] = 1.53 [0.13, 2.93]). On a given week, having a lower step count (−0.16 [−0.32, −0.01]), slower walking rate (−1.46 [−2.60, −0.32]), lower normalized location entropy (−3.01 [−5.51, −0.52]), more time at home (0.05 [0.00, 0.10]), and lower distances traveled (−0.97 [−1.72, −0.22]), relative to one’s own typical levels, were each associated with higher depressive symptoms. With replication in larger samples and a clear understanding of how these components are best combined, a behavioral composite measure of depression could potentially offer the kinds of vital signs for psychiatric medicine that have proven invaluable to assessment and decision-making in physical medicine. Clinical Trials Registration: The data that form the basis of this report were collected as part of clinical trial number NCT03152864.

Analysis of the Clinical Value of Laparoscopic Sacrocolpopexy to Support the Posterior Compartment in Women with Multicompartment Prolapse Including Rectocele.

Background/Objectives: Laparoscopic sacrocolpopexy is regarded as the gold standard treatment for apical or multicompartment prolapse, predominantly with anterior compartment descent. However, the optimal surgical approach for concurrent rectocele is still debated. The aim of this study was to evaluate the effectiveness of nerve-sparing laparoscopic sacrocolpopexy in managing multicompartment prolapse with concurrent rectocele (≥stage II), analyzing the anatomical outcomes, the necessity for concomitant or subsequent posterior repair, and the impact on bowel function in women undergoing surgery. Methods: Data from all women who underwent laparoscopic sacrocolpopexy with or without posterior repair between 01/2017 and 07/2022 for symptomatic multicompartment prolapse, including apical and posterior compartment descent ≥ stage II, were retrospectively evaluated. All women underwent a standardized urogynecological examination, including assessment of genital prolapse using the POP-Q quantification system, and completed the German-validated Australian Pelvic Floor Questionnaire before and after surgery (6-12 weeks). Preoperative anatomic support and bowel symptoms were compared with postoperative values. Results: In total, 112 women met the criteria for surgical correction. The majority (87%) had stage II posterior descent, with only 10% undergoing concurrent posterior repair during laparoscopic sacrocolpopexy. Significant (p < 0.001) objective improvement was seen for all compartments post- compared with preoperatively (Ba: 0 (-1/2) vs. -3 (-3/-2), C: -1 (-2/0) vs. -8 (-12/-7), Bp: 0 (-1/0) vs. -3 (-2/-2); (median (25%/75% quartiles)). Subsequent surgery for persistent rectocele and/or stool outlet symptoms was required in 4% of cases. Most bowel-specific questions in the German-validated Australian Pelvic Floor Questionnaire showed significant improvement (p < 0.001). Conclusions: Nerve-sparing sacrocolpopexy alone appears to be a suitable surgical approach to correct multicompartment prolapse, including a rectocele ≥ stage II, and results in a reduction of objective signs and symptoms of pelvic organ prolapse.

ОБЪЕКТИВНЫЕ ПРИЗНАКИ ЗЛОУПОТРЕБЛЕНИЯ ДОЛЖНОСТНЫМИ ПОЛНОМОЧИЯМИ В ФИНАНСОВО-БЮДЖЕТНОЙ СФЕРЕ

The article substantiates the thesis about the high nature and degree of public danger of abuse of office in the financial and budgetary sphere. The author's vision of the direct object of abuse of office in the financial and budgetary sphere has been formulated, signs of the objective side of the criminal encroachment have been identified, recommendations have been developed on the qualification of abuse of office on objective signs of corpus delicti. The conclusion is formulated that when qualifying an action that goes beyond the authority of an official, first of all, it is necessary to establish the rights and obligations granted to the person within the limits of the job competence established by law and regulatory legal acts (decree, order, job regulations and instructions, etc).

The role of vitamin D in amelioration of oral lichen planus and its effect on salivary and tissue IFN-γ level: a randomized clinical trial

Background and objectivesOral lichen planus (OLP) is a common, prevalent, immune-mediated, inflammatory disease affecting both the skin and oral mucosa and is considered one of the potentially malignant diseases. Since OLP is regarded as an immunologically mediated disease, some studies suggest the use of vitamin D (VD) for its management as it exhibits immune-modulatory, anti-inflammatory, and antimicrobial properties, as well as anti-proliferative, pro-differentiative, and anti-angiogenic effects. VD has demonstrated a suppressive effect on TH1 pro-inflammatory cytokines, including IFN-γ while augmenting the secretion of anti-inflammatory cytokines. At the same time, VD deficiency is a prevalent public issue. Therefore, the present study aimed to investigate the role of VD as an adjunct to steroids in the management of VD-deficient OLP patients as well as its inhibitory effect on IFN-γ through measurement of salivary and tissue IFN-γ levels in OLP patients.MethodsA total of 40 patients with ulcerative or erythematous OLP, diagnosed according to the World Health Organization’s (WHO) modified criteria for OLP, were randomly allocated into one of the two study groups to receive either systemic steroids in addition to VD supplements (Group A) or systemic steroids only (Group B). Blood samples were collected for the measurement of serum VD level (SVDL) using the enzyme-linked immunosorbent assay (ELISA) to involve only patients with VD deficiency or insufficiency (≤ 30 ng/ml). Clinical evaluation of the lesion involved objective signs and subjective symptoms. Also, changes in salivary and tissue INF-γ levels (in pg/mL and pg/mg, respectively) were determined using the ELISA technique. All parameters were measured at baseline and after 4 weeks of treatment. The clinical pharmacy team devised a checklist to record all team interventions. The interventions were categorized into six domains, including drug interactions and/or adverse reactions, medication dose issues, drug selection issues, support with medication history, patient-related concerns, and suggestions for dental medication.ResultsAfter one month of treatment, a significantly greater number of patients in group A showed complete pain relief and resolution of clinical lesions, as well as a greater number of patients showing a reduction in the clinical severity of lesions than in group B (P = 0.005). Also, there was a statistically significant reduction in average VAS pain scores and clinical scores in group A compared to group B after 1 month of treatment (P = 0.001 and 0.002, respectively). Furthermore, there was a statistically significant greater reduction in salivary and tissue IFN-γ levels in group A than in group B (P ≤ 0.001 and 0.029, respectively) after 1 month of treatment.ConclusionCurrent evidence suggests a significant preventive and therapeutic role for VD as an adjunct to standard therapies indicated for OLP lesions. These protective and therapeutic functions are achieved through the suppressive effect of VD on pro-inflammatory cytokines, particularly IFN-γ. Also, salivary IFN-γ appears to be a valuable prognostic marker for monitoring the progression of OLP. In addition, the inter-professional collaboration between dentists and clinical pharmacists helped to deliver complete, patient-centered primary care and ensured the quality of the medications included in patient kits, thus improving patient treatment and management. Nevertheless, further studies with larger sample sizes, longer follow-ups, and standardized designs may still be needed.

Objective Signs versus Subjective Disease Index in Dry Eye Disease.

To compare the ocular surface disease index (OSDI) questionnaire with objective tests in dry eye disease. A prospective observational study. Place and Duration of the Study: Department of Ophthalmology, Nigde Omer Halisdemir University, Nigde, Turkiye, from 9th June to 31st December 2022. All clinically diagnosed 323 eyes of patients with dry eye disease (DED) were included. The subjects were evaluated by the Oxford classification of corneal and conjunctival fluorescein staining, Schirmer I test, and fluorescein tear breakup time (TBUT). Symptoms of the patients were interpreted with OSDI and correlations of symptoms and objective markers were analysed. There was no significant association between any objective signs (Schirmer I, TBUT, and Oxford), and OSDI (p = 0.26, 0.52, 0.18, and respectively). Schirmer I score showed a significant positive correlation with TBUT (p <0.001, r = 0.21) and a significant negative correlation with Oxford scale (p <0.001, r = -0.19). There was a statistically negative correlation between TBUT and Oxford scale (p <0.001, r = -0.37). Except for the Schirmer test, TBUT and Oxford scale are effective tools in the diagnosis of DED. Symptom markers, such as OSDI may have lower reliability in diagnosing DED and determining its severity. Diagnostic tests are important in the detection of asymptomatic or less severe dry eye disease that can be ignored. Dry eye disease, Diagnosis, Ocular surface disease index (OSDI), Tear breakup time (TBUT), Oxford grading scale, Schirmer I test.

Diagnosis dan Tata Laksana &lt;i&gt;Mild Cognitive Impairment&lt;/i&gt; (MCI)

The number of elderly population in the world is increasing nowadays. In 2020, there were 1.4 billion people in the world aged ≥60 years and it is predicted to double by 2050. Decline in cognitive function and memory is one of the consequences of the aging process that can affect a person’s quality of life. MCI is a pathological condition also preclinical and transitional stage between normal aging and dementia. Early detection and intervention of MCI may delay onset and prevent the progressivity of MCI to dementia. This article aims to provide an overview of MCI which includes risk factors, subjective and objective clinical signs, disease course, diagnosis, and recommendation of MCI management based on existing studies and guidelines.

CHARACTERISTICS OF OBJECTIVE SIGNS OF THE MAIN COMPOSITION OF ILLEGAL LOAN RECEIPT

The author examines the objective signs of the corpus delicti described in Part 1 of Article 176 of the Criminal Code of the Russian Federation. This crime undermines the system of relations between the lender and the borrower in the field of lending, which is based largely on mutual trust. Having similarities with encroachments on property, the illegal receipt of a loan is not such, which led to a special characteristic of the signs of the composition of this crime. When carrying out official qualification, law enforcement officers need to be clear about what the content of the sign of the composition of the specified crime is, which are classified as objective signs. At the same time, it seems that a complete understanding of the properties of these features is possible only with a comprehensive analysis and comparison. In this article, the author draws attention to the ambiguity of perception of some signs of a crime indicated in Part 1 of Article 176 of the Criminal Code of the Russian Federation. This is due to the fact that the disposition of this norm belongs to the category of blanks and therefore implies an appeal to the norms of not only criminal, but also civil and banking legislation of Russia. In general, the scientific article is aimed at employees of investigative and judicial authorities pecializing in the investigation of economic crimes. At the same time, it is of interest to persons engaged in research activities in the field of analysis of economic crimes

Effectiveness and safety of demodecosis blepharitis therapy under dry eye conditions

Purpose: to evaluate the effectiveness and safety of complex therapy in patients with demodex blepharitis and dry eye. Methods. 25 patients with mixed demodex blepharitis and dry eye (50 eyes; 10 men, 15 women; 61.9 ± 5.6 years) were examined before and after treatment with 0.5 % levofloxacin instillation (5 times a day, 5 days); sulfur and metronidazole gel applications (Blefarogel-forte) as part of therapeutic eyelid hygiene (Blepharogel-cleansing, Blepharolotion; starting from day 6, 2 times a day, 45 days); 0.24 % sodium hyaluronate instillation (3 times a day). Therapy effectiveness criteria were as follows: D. folliculorum mite population reduction; positive dynamics of blepharitis objective signs and meibomian gland dysfunction severity (MGD-S, points). Therapy safety criteria included the absence of negative dynamics of OSDI, tear film breakup time (TBUT, s), inferior tear meniscus height (ITMH, µm) and xerosis index (XI, points). Results. As a result of the therapy, statistically significant changes were noted, including mite population reduction (from 9.23 ± 0.81 to 3.54 ± 0.80 imagos); eyelid margins edema intensity decrease (from 3.18 ± 0.39 to 1.30 ± 0.45 points) and hyperemia decrease (from 2.90 ± 0.29 to 0.9 ± 0.3 points); MGD-S decrease (from 2.1 ± 0.3 to 0.95 ± 0.21 points); OSDI decrease (from 43.23 ± 4.70 to 25.10 ± 2.65 points); TBUT increase (from 4.05 ± 0.50 to 5.55 ± 0.50 s); XI decrease (from 5.36 ± 0.49 to 4.04 ± 0.60 points). Conclusion. The treatment of demodex blepharitis and dry eye treatment, including sulfur and metronidazole gel applications, therapeutic eyelid hygiene and 0.5 % levofloxacin and 0.24 % sodium hyaluronate instillation demonstrated a high efficiency and a good safety profile.