Patients In Study Group Research Articles

Is Osteopontin a Reliable Biomarker for Endometriosis?

This study aimed to evaluate the concentration of osteopontin in peritoneal fluid and plasma as potential biomarkers for diagnosing endometriosis. Osteopontin levels were measured using surface plasmon resonance imaging (SPRI) biosensors in patients suspected of having endometriosis. Plasma samples were collected from 120 patients, and peritoneal fluid was collected from 86 patients. Based on the detection of endometriosis lesions during laparoscopy, participants were divided into a study group (patients with endometriosis) and a control group (patients without endometriosis). The results showed no significant differences in plasma osteopontin levels between women with endometriosis and the control group (19.86 ± 6.72 ng/mL vs. 18.39 ± 4.46 ng/mL, p = 0.15). Similarly, peritoneal fluid osteopontin concentrations did not differ significantly between patients with and without endometriosis (19.04 ± 5.37 ng/mL vs. 17.87 ± 5.13 ng/mL, p = 0.29). Furthermore, osteopontin levels in both plasma and peritoneal fluid were not significantly associated with the stage of endometriosis, the presence of endometrioma, or the menstrual cycle phase. The findings of this study do not support osteopontin concentration as a reliable biomarker for endometriosis. However, further research is necessary to explore osteopontin’s potential role in the disease.

Impact of perioperative high-protein nutritional support on the quality of life of patients with primary lung cancer: a Russian prospective multicenter comparative study (NUTRILUNC study)

BACKGROUND: Individuals over the age of 70 comprise over half of operable patients with stage 0–IIIA lung cancer. In the early postoperative period of this cohort, pain, fatigue, insomnia, and/or mood disturbances are the four most common symptoms, which can significantly diminish quality of life and functional status. Perioperative nutritional support in such patients, which enhances exercise tolerance, can have a positive impact on their quality of life and socialization. AIM: To assess the effect of perioperative nutritional support using high-protein oral nutrition supplements on the general health and quality of life of non-small cell lung cancer patients during the postoperative period. MATERIALS AND METHODS: Patients with primary non-small cell lung cancer (n=112, 69 males), aged 57.2±8.2, who were awaiting lung surgery and at risk of malnutrition (Nutritional Risk Screening Assessment 2002 score ≥3) were randomly assigned into two groups. Oral nutritional support (Nutridrink Compact Protein, Nutricia LLC) was administered to the study group (n=55) at a rate of 250 ml/d (36 g of protein, 612 kcal) for 14 days prior to and 14 days following the surgery, in addition to the standard diet. Control group patients (n=57) were provided a standard diet. The quality of life was assessed using the Quality of Life Questionnaire Core-30. Results are presented as mean ± standard deviation. Differences were considered significant at p ≤0.05. RESULTS: Throughout the entire observation period, the study group exhibited superior growth indicators in terms of general health status, physical, and role functioning than the control group (p 0.05). The study group patients exhibited a propensity toward improved emotional functioning, and by the end of the study, weakness and insomnia were less pronounced (p 0.05). Other indicators did not exhibit any significant variations. CONCLUSION: Нigh-protein perioperative oral nutrition supplements exert a positive impact on the quality of life of non-small cell lung cancer patients.

Endogenous reactivation cases identified by whole genome sequencing of Mycobacterium tuberculosis: Exploration of possible causes in Latvian tuberculosis patients

BackgroundThe recurrence of tuberculosis (TB) continues to place a significant burden on patients and TB programs worldwide. Repeated TB episodes can develop either due to endogenous reactivation of previously treated TB or exogenous reinfection with a distinct strain of Mycobacterium tuberculosis (Mtb). Determining the precise cause of the recurrent TB episodes and identifying reasons for endogenous reactivation of previously successfully treated patients is crucial for introducing effective TB control measures. MethodsHere, we aimed to provide a retrospective individual analysis of the clinical data of pulmonary TB patients with assumed endogenous infection reactivation based on WGS results to identify the reasons for reactivation. Patient medical files were reviewed to describe the provoking factors for endogenous reactivation. ResultsIn total, 25 patients with assumed endogenous TB reactivation were included in the study group, and 30 patients with one TB episode during the study period were included in the control group. There were no statistically significant differences identified between studied patient groups in patients age (t(53) = −1.53, p = 0.13), body mass index (t(53) = 0.82, p = 0.42), area of residency (χ2(1;55) = 0.015, p = 0.9), employment status (χ2(1;55) = 0.076, p = 0.78) and presence of comorbidities (χ2(1;55) = 3.67, p = 0.78). Study group patients had statistically significantly more frequently positive sputum smear microscopy results (χ2(1;55) = 8.72, p = 0.0031), longer time to sputum smear (t(31) = −2.2, p = 0.036) and sputum culture conversion (W (55) = 198.5, p = 0.0029). Smoking was statistically significantly (χ2(1;55) = 5.77, p = 0.016) more frequently represented among study group patients. The median treatment duration for drug susceptible TB was 6 months in both in the control group (IQR 6–6) and among study group patients (IQR 6–7.75). The median treatment duration for multidrug-resistant TB was 20 months (IQR 17–23) in the control group and 19 months (IQR 16–19) in the study group patients. ConclusionPositive SSM for acid-fast bacteria, delayed time to sputum smear and sputum culture conversion, smoking, and incomplete therapy in the study group patients with multidrug-resistant TB should be considered as potential reasons for reactivation in recurrent TB patient group in our study.

Factors affecting the outcomes of in vitro fertilization in women with endometriosis: Preliminary data from Vietnam

Objectives: This study aimed to assess the efficacy of in vitro fertilization (IVF) in patients with endometriosis and identify related factors that may influence treatment outcomes. Methods: This retrospective descriptive study was conducted between November 2018 and November 2022. The study group comprised individuals who were diagnosed with endometriosis (endometrioma and/or adenomyosis) indicated for in vitro fertilization. The control group (129 patients with 249 cycles), which included patients without endometriosis and had an equivalent mean age as the study group patients. Results: In the endometriosis group, the quantities of retrieved oocytes and Anti-Müllerian Hormone (AMH) were reduced compared to the control group. The overall dose of gonadotropin and the duration of ovarian stimulation were significantly higher than the control group. The endometriosis group exhibited a Metaphase II (MII) oocyte rate of 82.3% and an oocyte fertilization rate of 82.2%. However, in patients with endometriosis, the rates of implantation, clinical pregnancy, and ongoing pregnancy were significantly lower than in patients without endometriosis. Besides, the clinical pregnancy rate of women with endometriosis was remarkably higher in the groups with maternal age ⩽35 years, a ratio of Follicle-stimulating Hormone to Luteinizing Hormone (FSH/LH) ⩽1.5, and over 10 retrieved oocytes. Conclusion: Endometriosis was associated with a decreased rate of implantation, clinical pregnancy, and ongoing pregnancy after in vitro fertilization treatment compared with patients without endometriosis. In vitro fertilization outcomes in patients with endometriosis were influenced by maternal age ⩽35 years, FSH/LH ratio ⩽1.5, and number of retrieved oocytes over 10.

Evaluation of Comparative Efficacy of Kutaki (Picrorhiza kurroa Royle ex. Benth) versus Atorvastatin in the Management of Dyslipidemia - A Randomised Controlled Trial

Introduction: Dyslipidemia is a lipoprotein metabolism condition marked by elevated blood levels of triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol as well as decreased levels of high-density lipoprotein (HDL) cholesterol. It can be correlated with (Medoroga) Medodushti Aim and objectives: To evaluate comparative effectiveness of Kutaki (Picrorhiza kurroa Royle ex. Benth) and Atorvastatin in the management of Dyslipidemia. Methodology: Total 160 patients were randomly divided into two equal groups. Patients in Study Group A were treated with Kutaki Vati and patients in Control Group B were treated with Atorvastatin for 60 days. Data was collected by assessment of Objective parameters like body weight, BMI, lipid levels (TCH-Total serum cholesterol , HDL-High-density lipoproteins, LDL-Low-density lipoproteins, TG- Serum Triglycerides, VLDL-Serum Very Low-density lipoproteins, AST, ALT, S.Urea, S.Creatinine, Fasting blood sugar on the day 0, 30 and 60. The analysis was done with the help of inferential and descriptive statistics. Observation and Result-Kutaki and Atorvastatin both showed significant improvement in lipid levels but Kutaki showed reduction in body weight and BMI with correction in deranged Agni and bowel habit( constipation) which was not seen in Atorvastatin group. Kutaki showed no rise in AST, ALT, S Creatinin and S.urea indicating its hepatoprotective and nephroprotective properties. Conclusion-Both groups are equally effective in the management of Dyslipidemia (Medoroga).But Kutaki is effective in reducing bodyweight and BMI and safe as it showed no rise in AST, ALT, S Creatinin and S.urea.

Evaluation of the effect of vitreomacular interface disorders on anti-VEGF treatment in patients with diabetic macular edema in real life: MARMASIA study group report No. 10.

The aim of this study is to investigate the effect of vitreomacular interface disorders (VMID) on treatment response in patients treated with anti-vascular endothelial growth factor (anti-VEGF) due to diabetic macular edema (DME). Three hundred seventy-seven eyes of 239 patients in the MARMASIA Study Group who received intravitreal anti-VEGF treatment (IVT) due to DME were included in the study. The group 1 consisted of 44 eyes of the patients who had not received any treatment before, were followed up regularly for 24months after at least a 3-month loading dose, and suffered from VMID such as epiretinal membrane, vitreomacular adhesion or traction, and lamellar hole. The group 2 consisted of 333 eyes of the patients without VMID. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) of the patients at baseline, 3rd month, 6th month, 1st year and 2nd year follow-ups were measured. The mean age of the Groups 1 and 2 was 67.1 ± 11.3 and 61.9 ± 10.2 years, respectively. 61.3% of the group 1 and 58.8% of the group 2 were female (p > 0.05). The duration of diabetes was 19.2 ± 3.7 and 15.8 ± 3.2 years, respectively, and the number of follow-ups was 16.09 ± 4.68 and 12.06 ± 4.58, respectively in the groups (p < 0.001, 0.001, respectively). The number of IVT was 7.13 ± 2.71 and 7.20 ± 2.22, respectively in the groups 1 and 2 and no statistically significant difference was observed between them (p = 0.860). According to logMAR, BCVA values at baseline were 0.63 ± 0.24 and 0.59 ± 0.26 (p = 0.29), respectively, in the groups and the amount of change in BCVA at the end of the 2nd year was -0.02 ± 0.48 in the group 1 and -0.12 ± 0.48 in the group 2. It was observed as 0.48 (p = 0.13). Although the increase in BCVA was greater at all follow-ups in the group 2 compared to their initial examination, no significant difference was observed between the groups in terms of BCVA change. The CMT values of the groups at baseline were 442.5 ± 131.3µm and 590.9 ± 170.6µm, respectively (p = 0.03) The decrease in CMT after IVT was significantly greater in the group 2 at all follow-ups when compared to the first group (p < 0.05). While the presence of VMID in DME patients receiving IVT did not affect visual results, it negatively affected the anatomical response and macular edema morphology. The presence of VMID at baseline affected the success of IVT. It should be taken into consideration that VMID may resolve spontaneously or with IVT, and new cases of VMID may occur in patients during the treatment process.

The effect of vibroacoustic therapy on the structural integrity of erythrocytes and platelets in patients with acute exogenous poisoning

Background. Vibroacoustic therapy is used as a non-drug method of correcting respiratory disorders in various diseases, including acute poisoning. The effect of vibroacoustic therapy on blood cells currently remains unexplored.Objective. To evaluate the impact of vibroacoustic therapy on the morphofunctional rate of erythrocytes and platelets in patients with acute poisoning in patients with acute poisoning.Material and methods. Thirty eight patients with complicated acute poisoning transferred to the Toxicology Department of the N.V. Sklifosovsky Research Institute for Emergency Medicine were examined. In 19 patients, along with the standard therapy, a vibroacoustic therapy was performed using a VibroLUNG device (the main study group); the other 19 patients received only standard therapy (the comparison group). Vibroacoustic therapy began on the 2nd day after the patient admission to the Toxicology Department. The course of vibroacoustic therapy consisted of 2–9 procedures. Morphofunctional analysis of erythrocytes and platelets in all cases was performed before the start of the vibroacoustic therapy (before treatment) and before discharge from the hospital (1–2 days after completing the vibroacoustic therapy course).Results. In both groups, before treatment, we noted normal morphofunctional rate of erythrocytes and normal level of platelets with granules in the circulating blood. The level of severely damaged or altered platelets was only slightly higher than normal and did not differ between the groups. Meanwhile, in 50% of patients, platelets had a tendency to spontaneous activation and hyperactivation. Before discharge, the morph functional parameters of erythrocytes and platelets did not significantly change in both groups, while treatment with vibroacoustic therapy allowed to eliminate or reduce spontaneous platelet activation in 7 of 9 patients in the main study group. In the comparison group spontaneous platelet activation was absent in only 3 of 10 patients. In parallel, the time till pneumonia resolution turned statistically significantly reduced, by 1.5 times.Conclusions. In acute exogenous poisoning with complicated course, the risk of spontaneous platelet activation and hyperactivation increases. Vibroacoustic therapy does not violate the structural integrity of circulating erythrocytes and platelets. Vibroacoustic therapy, using the VibroLUNG device, reduces the tendency of platelets to spontaneous activation and hyperactivation, reduces the time for resolving pneumonia.

The potential role of Helicobacter pylori in chronic rhinosinusitis with or without nasal polyposis

BackgroundCertain gastrointestinal and extra-intestinal diseases are caused by the gram-negative bacterium Helicobacter pylori (H. pylori). We aimed to determine the potential H. pylori role in chronic rhinosinusitis (CRS) with or without nasal polyposis. This cross-sectional study was conducted on 80 subjects of any age and sex diagnosed with CRS (CRSWNP and CRSSNP) who had failed medical treatment and scheduled for surgery. Patients were further categorised into two equal groups: study group (n = 40) were diagnosed with CRS with or without nasal polyposis (CRSWNP and CRSSNP) who had failed medical treatment and scheduled for surgery, and control group (40 patients) were admitted for septoplasty. All patients had clinical assessment, physical assessment, diagnosis of rhinosinusitis (according to EPOS), based on symptoms, rhinoscopic/endoscopic findings, CT scan findings, questionnaire for gastroesophageal reflux disease (GERD), and questionnaire for laryngopharyngeal reflux (LPR). Samples were collected in the operating room during surgery from both groups and PCR tissue was done.ResultsThe study group patients demonstrated significantly higher history of GERD, LPR, and H. pylori. H. pylori patients had significantly lower ages than those without (P = 0.03). Patients with H. pylori revealed significantly higher GERD history (P < 0.001) and LPR (P = 0.002) than those without H. pylori. History of GERD (P = 0.003), LPR (P = 0.043), and H. pylori presence (P = 0.028) were significant predictors, controlling for the abovementioned variables.ConclusionsWe concluded that a significant correlation was observed between the H. pylori presence in the sinonasal mucosa and nasal polyps and the development of chronic rhinosinusitis with or without nasal polyps.

Clinical significance of normohydration state in peritoneal dialysis patients

Introduction: Assessing the fluid status of dialysis patients is crucial, as overhydration can lead to hypertension and left ventricular hypertrophy. Objectives: We aimed to determine the hydration of peritoneal dialysis (PD) patients by using a bioimpedance device and performing concomitant echocardiographic measurements. Patients and Methods: In our cohort, we enrolled PD patients in the study group and kidney transplantation waitlisted patients on hemodialysis (HD) or with stage 4-5 chronic kidney disease (CKD) in the control group. Fluid status was measured with a Fresenius Body Composition Monitor (BCM), and we performed an echocardiography examination. For statistical analysis, we used the Fisher’s exact test for categorical variables and the Kruskal-Wallis test for continuous variables to compare groups. Results: The patients’ average age was 47 (SD 9.45), with a mild female predominance (54.3%). Overhydration was only found in 8 (12%) patients and was related to non-significantly lower ejection fraction (EF). Follow-up found that preserved EF was a non-significantly better outcome (HR: 0.881, 95% CI interval: 0.776; 1.001, P=0.0514). PD patients had significantly lower potassium levels (P=0.0006) and more angiotensin-converting-enzyme inhibitors (ACEis) (46%) and mineralocorticoid receptor antagonists (MRAs) (26%). Conclusion: Lower potassium levels in continuous ambulatory peritoneal dialysis (CAPD) patients allow for the administration of drugs to treat cardiac remodeling and volume overload, which can help reduce patient mortality. The possible usage of MRAs in CKD could reduce cardiovascular mortality effectively.

Three-dimensional analysis of posttreatment tooth movements despite bonded retainers: partI-upper jaw.

Adverse side effects of fixed retainers in terms of unwanted tooth movements have been described for both the upper and lower jaw, but data about the extent and movement patterns for the maxilla are scarce. The purpose of the present retrospective case-control study was to analyze the amount and direction of unwanted tooth movements despite upper bonded retainers as well as to analyze possible predisposing pretreatment- and treatment-related factors. Plaster casts of 1026 patients who completed orthodontic treatment and asubsequent retention phase of 2years were screened for unintentional tooth movements. The study group comprised 57patients with visually obvious tooth movements in the upper jaw, while 57randomly selected patients without visible tooth movements served as control group. For all patients, plaster casts after debonding of multibracket appliance (T1) and after supervised retention (T2) were digitized, and superimposed digitally using astable palatal reference area. Thereafter, translational and rotational movements were measured in all three planes of space. Pretreatment- and treatment-related factors of the study and control groups were compared by χ2 test, exact Fisher test, Mann-Whitney U test, and the T‑test for independent samples. The mean translational movements ranged between 0 and 0.6 mm and the average rotational movements between 0 and 1.3°. Large individual movements up to 2.7 mm translation and 15.9° rotation were seen. Amovement pattern around the Y‑ and Z‑axis with an opposite rotational peak at the canines ("upper twist effect") was identified. Compared to the control group, patients of the study group showed asignificantly smaller intercanine width pretreatment. Also, study group patients presented alarger intercanine expansion and aslightly larger overjet reduction during treatment, and were more often affected by retainer bonding site detachments and wire fractures, but without reaching statistically significance. Upper bonded retainers show asimilar unwanted movement pattern ("twist effect") like the one described for mandibular retainers.

Three-dimensional analysis of posttreatment tooth movements despite bonded retainers: partII-lower jaw.

Complications of bonded lingual retainers in terms of unexpected tooth movements have been reported with increasing frequency during the last decade, but the vast majority of the literature comprises case reports. The purpose of the present retrospective case-control study was to analyze the amount and direction of unwanted tooth movements despite lower bonded retainers, to analyze possible predisposing pretreatment- and treatment-related factors, and to seek for movement thresholds which could enhance the rapid and objective identification of critical cases. Plaster casts of 1026 patients who completed orthodontic treatment and asubsequent retention phase of 2years were screened for unintentional tooth movements. The study group comprised 39patients with tooth movements in the lower jaw, while 39randomly selected patients without visible tooth movements served as the control group. For all patients, plaster casts after debonding of multibracket appliances (T1) and after supervised retention (T2) were digitized, and athree-dimensional (3D) digital superimposition based on the best fit of premolars and molars was undertaken. Thereafter, translational as well as rotational movements were measured in all three planes of space. Pretreatment- and treatment-related factors of the study and control groups were compared. Aseverity classification based on rotational movement thresholds was applied to seek acritical amount of translational movements. The mean translational movements ranged between 0 and 0.4 mm and the average rotational movements between 0 and 1.6°. Large individual movements up to 1.9 mm translation and 16° rotation were seen. Atwist-effect with opposite movements of the canines along the Y‑axis could be confirmed. Compared to the control group, patients of the study group had asmaller intercanine distance at all timepoints. In addition, study group patients presented aslightly larger intercanine expansion during treatment and were more often affected by retainer bonding site detachments. Applying the severity classification based on rotational thresholds, translational movements of 0.5-1.0 mm along the X‑ and Y‑axis could serve as acritical threshold. It can be assumed that extrusive translational movements along the Z‑axis seem to be of specific nature and perhaps do not reflect aretainer complication in terms of unwanted tooth movements. Patients with alarger intercanine distance after active treatment and those with more frequent retainer bonding site detachments could be at higher risk for unwanted tooth movements during fixed retention. Sagittal and transverse movements of 0.5-1.0 mm should sensitize the practitioner for further measures.

Bile acid diarrhoea and metabolic changes after cholecystectomy: a prospective case-control study

IntroductionBile acid diarrhoea (BAD) can occur due to disruption to the enterohepatic circulation such as following cholecystectomy. However, the mechanism behind this is as yet unknown. The aim of this study was to determine the rate of post-cholecystectomy diarrhoea and to assess whether FGF19 within the gallbladder was associated with the development of BAD.MethodsThis was a prospective case-control study in which patients were assessed pre- and post- cholecystectomy (study group) and compared with patients also having laparoscopic surgery but not cholecystectomy (control group). Their bowel habits and a GIQLI questionnaire was performed to compare the pre- and post-operative condition of the two groups. Gallbladder tissue sample was tested for FGF19 and PPARα in the study group patients. A subset had serum lipid levels, FGF19 and C4 measurements.ResultsGallbladder PPAR α was found to have a significant correlation with stool consistency, with the lower the PPARα concentration the higher the Bristol stool chart number (i.e. looser stool). There were no significant correlation when assessing the effect of gallbladder FGF19 concentration on bowel habit, stool consistency, lipid levels, BMI or smoking. The study group showed a significant increase in triglycerides post-operatively, however there were no changes in cholesterol, HDL and LDL levels. Correlation of the increased triglyceride levels with stool consistency and frequency showed no significant resultsDiscussion and conclusionWe did not find any direct evidence that FGF19 levels within the gallbladder impact the development of post-cholecystectomy diarrhoea. There was however a significant increase in triglycerides postoperatively. There was also no correlation of bowel habits with PPARα suggesting the observed rise is independent of this pathway. Further work is required particularly relating to the gut microbiome to further investigate this condition.

Features of depressive disorders in patients with multiple sclerosis

Depressive disorders are the most common manifestations of multiple sclerosis. The severity of depressive symptoms depends on many factors: fear of a disabling disease, dependence on loved ones, the frequency of exacerbations. Early diagnosis of affective conditions helps to prescribe therapy in a timely manner, thereby improving the quality of life of patients with multiple sclerosis. The purpose of this study is to investigate the features and manifestations of depressive disorders in patients with multiple sclerosis. Patients and methods: The study involved patients with relapsing-remitting multiple sclerosis who were diagnosed with depressive disorders — the study group, and patients with depressive disorders — the comparison group. At the time of examination, the age of the patients in the study group (113 participants) ranged from 15 to 60 years, with the mean age of 39.7±10.91 years. The duration of the disease was 9.84±0.73 years, while the disability rate by the EDSS was 2.89±0.16 points. The comparison group was represented by patients with disorders of the depressive spectrum (70 patients). The mean age of the patients was 32.81±13.57 years. The age of onset of the disease in patients with depressive disorders was within 22.09±2.09 years, and the duration of the disease with depression was 4.6±3.86 years. Results and discussion: In the study group patients with depressive disorders, the initial manifestations are not pronounced and are within the limits of the average degree of depression. The analysis revealed the dynamics of symptoms depending on the level of depression: with mild depression p&lt;0.001, «loss of appetite» appears more often, with moderate depression p&lt;0.001, the symptoms of «dissatisfaction», «feelings of guilt», and «preoccupation with bodily sensations» appeared, and with severe depression p&lt;0.001, «ideas of self-blame», increased «tearfulness», and changes in «body image» became significant. Meanwhile, in the patients in the comparison group, symptoms of low mood and dissatisfaction, which were often accompanied by feelings of guilt and ideas of self-blame, came to the fore. Conclusion: The symptoms of depressive manifestations in patients with multiple sclerosis differ from those in patients with depressive disorders. When selecting the basic therapy for the treatment of multiple sclerosis with disease modifying drugs, it is necessary to take into account the emotional background of patients, since interferons affect the emotional sphere of multiple sclerosis patients and can cause or intensify depressive experiences.

Evaluation of the effect of dextrose prolotherapy versus deep dry needling therapy for the treatment of temporomandibular joint anterior disc displacement with reduction: (a randomized controlled trial)

Objectiveto compare the combined effect of Prolotherapy and Deep Dry Needling (DDN) versus DDN effect on relieving the symptoms of Temporomandibular joint (TMJ) anterior disc displacement.Patients and methodsThe clinical trial randomly allocated forty patients. The (control group) patients received four intraarticular and masseteric DDN sessions, while the (study group) patients were subjected to the exact technique followed by Prolosolution injection. The baseline preoperative measurements included Maximal interincisal opening (MIO), auscultation of the presence of clicking, and Visual Analogue Scale (VAS), which were repeated for postoperative measurements after one, two, five, and eight months.ResultsBy the end of the study, all patients expressed apparent improvement in pain MIO and clicking. The inter- and intragroup comparison revealed that the pain score values of the control group after five and eight months were significantly higher than those of the study group. The study group demonstrated more significant MIO calibration than the control group, with insignificant differences between both groups regarding the presence of clicking at any time interval. The associations between clicking and VAS values, between clicking and MIO, and between VAS values and increased MIO were positive in the test group and negative in the control group.ConclusionsDextrose Prolotherapy and DDN were beneficial. However, Prolotherapy demonstrated more significant, sustained, and correlated long-term alleviation of symptoms and increased MIO.Clinical relevanceThe study assesses the sole effect of dextrose prolotherapy on relieving the signs of TMJ anterior disc displacement apart from the impact of the penetrating needle.Clinical trial registrationThe study was registered on www.clinicaltrials.gov (#: NCT05821985) by Ahmed Nagi Alghandour.

Coexistence of Bronchiectasis Related with Rheumatoid Arthritis and Posttuberculosis Lung Disease - An Everpresent Issue

Abstract The lung is a common site of involvement both in TB and rheumatoid arthritis (RA) disease, caused by disease itself or therapy. After completion of antiTB treatment, post TB lung disease (PTLD) residual changes persist and affect heath, survival and quality of life, mainly in patients with associated collagen diseases, as RA. Bronchiectasis are described in both RA and PTLD. The purpose of this prevalence study of bronchiectasis, performed among 92 RA hospitalized patients, from June 2017 to June 2019, consists in a pictorial assessment of the lung involvement changes, noticed on chest radiography and/or computed tomography, described in relation with TB sequelae, severity and duration of RA disease. Results. A high prevalence of imagistic abnormalities was found in 77.2% of cases (n=71/92). Bronchiectasis was a frequent imagistic chest finding (24/71; 33.8%), having a lower frequency among all study group patients (n=24/92; 26%), mostly older nonsmoker females. Conclusions. In a high TB burden, as Romania, the prevalence of bronchiectasis is related with advanced RA disease, being strongly correlated with persistent respiratory symptoms (p=0.009), and coexisting PTLD calcified nodular lung sequelae (p=0.001).

Evaluation of Sociodemographic Characteristics and Effects of Sensory Stimulation for Management of Acute Stroke Syndrome in Children

Introduction with Objective: In this study our main goal is to assess the sociodemographic characteristics of acute stroke syndrome in children and effect of sensory stimulation for management of acute stroke. Materials and Methods: This randomized control trial study conducted at Magura Medical College Hospital, Magura from January 2021 to December 2023. During experiment, in study group was 43 patients &amp; 42 patients in control group. Children in study group were given sensory stimulation therapy while those in control group received no sensory stimulation. Result: during the study, highest number of the patients in study and control group belong to 2 months to 1 year’s age group, (n=24) and (n=27). 57% patients from urban and 43% from rural. 76% patients had ischemic stroke and 24% had hemorrhagic stroke. Also, GCS score improved significantly after two weeks of sensory stimulation in study group. Conclusion: From our study we can conclude that, early sensory stimulation has been shown to have significant effects, both beneficial and detrimental, on stroke size and functional outcome. Further study is needed for better outcome. Medicine Today 2024, Vol.36 (2): 124-126

Variability of changes in proand antiinflammatory cytokines due to IFNα and IFNγ deficiency in patients with post-covid syndrome associated with activation of chronic herpes viral infections

Post-COVID syndrome (PCS) is characterized by long-term complications and conditions accompanied by neuroimmunoinflammation, and includes chronic fatigue syndrome (CFS) and cognitive disorders (CD), which are often associated with activation of chronic herpesvirus infections (HVI). Timely detection of symptoms and immunodiagnosis of PCS are a priority and are of undoubted interest. Objective: to clarify the levels of serum proand anti-inflammatory cytokines, alpha and gamma interferons in patients with post-COVID syndrome associated with confirmed activation of chronic herpesvirus infections. Patients (n = 60) aged from 18 to 65 years with complaints of manifestations of PCS associated with HVI were studied — the study group (SG). A survey was conducted using a modified scale-questionnaire to assess the severity of PCS symptoms in points from 0 to 4, real-time PCR of HVI (EBV, HSV1/2, VCH6, VCH8, CMV) in saliva and scrapings from the tonsils, determination of the level of IFNα and IFNγ, pro- (TNFα, IL-18, IL-1β, IL-6, IL-17A, IL-8) and anti-inflammatory (IL-4 and IL-10) cytokines in blood serum. Comparison group (CG) — 60 apparently healthy individuals. SG patients with mixed HVI with EBV dominance noted the most pronounced and persistent clinical manifestations of PCS, among which the leading place was occupied by longterm sensations of CFS and CD. A persistent multisystem inflammatory response was identified, confirmed by elevated levels of IL-6 and IL-17A, which caused severe PCS. In post-COVID period, hyperproduction of IL-1β was detected, which was accompanied by clinical manifestations of persistent neuroimmunoinflammation. At the same time, the identified deficiency of IFNα, IFNγ and dysregulatory disorders in the antiviral defense of the immune system in patients with PCS contributed to the activation of HVI. Data on the imbalance of proand anti-inflammatory cytokines in the SG were obtained, which confirms the presence of a persistent multisystem inflammatory reaction with dominance of persistent neuroimmunoinflammation, which causes severe PCS. An imbalance of the cytokine system with IFNα and IFNγ deficiency, associated with the activation of chronic HVI with EBV dominance in the post-COVID period, contributes to the development of neuroimmunoinflammation, which is accompanied by the leading clinical signs of PCS: CFS and CD.

Nasal airway resistance in patients with different degrees of operated unilateral cleft lip: Evaluation of ventilation in 112 patients

ObjectiveThe aim of this study was to compare the nasal airway resistance between the cleft and non-cleft sides in operated unilateral cleft lip (UCL) patients with varying severities at birth, as well as to assess the differences in nasal airway resistance between UCL patients and healthy individuals. MethodsThis retrospective study was conducted on 112 UCL patients who have undergone primary lip reconstructions but not advanced surgeries as the study group and 20 healthy participants as the control group between February 2023 to March 2024. The study group patients were grouped based on the severity of their cleft lip at birth, divided into occult cleft lip group, incomplete cleft lip group, and complete cleft lip group. The anterior rhinomanometry was used to evaluate nasal resistance, including unilateral effective resistances during inspiration (Reffin), expiration (Reffex), and the entire breath (ReffT), as well as unilateral vertex resistance during inspiration (VRin) and expiration (VRex). The Kolmogorov-Smirnov test was used to assess normality. Paired t-tests were utilized to analyze the differences in nasal resistance between the healthy and affected sides within the same group of patients. Student's t-test was used to analyze the differences in nasal resistance among patients with different degrees of cleft lip. A p-value of <0.05 was considered statistically significant. ResultsThe nasal resistances of the occult cleft and incomplete cleft lip groups showed no significant differences between the cleft and non-cleft sides, and were similar to the control group. However, in the complete cleft lip group, the cleft side nasal resistance was significantly higher than the non-cleft side and control group. Among the groups, the complete cleft lip group had significantly higher nasal resistances on the cleft side for Reffin, VRin, and ReffT compared to the occult cleft group. ConclusionUnderstanding the nasal resistance of different degrees of operated UCL patients can benefit clinical diagnosis and treatment. Patients with complete cleft lip have more severe nasal obstruction on the cleft side, with greater impact on inhalation than exhalation. For these patients, treatment by an otolaryngologist is recommended to improve nasal airflow.

Impact of musculoskeletal disorders in patients using orthopedic equipment on sternotomy wound healing after cardiac surgery - preliminary report.

The presence of locomotive disorders may negatively impact the outcome of cardiac surgeries. This retrospective study aimed to assess the effect of preoperative diagnosis of locomotive disorders requiring the continuous use of orthopedic devices on postoperative rehabilitation and stable sternum adhesion. The study included 122 patients who underwent cardiac surgery, with 68 patients in the study group having a musculoskeletal disorder and 54 patients in the control group without such disorders. Preoperative demographic, clinical, and laboratory data as well as postoperative rehabilitation and sternum adhesion were evaluated. The results showed that patients in the study group had lower levels of calcium (p < 0.001), vitamin D (p < 0.001), and creatine kinase (p = 0.022) prior to the surgery. In the early postoperative period, 8 patients from the study group and 4 from the control group required reoperation due to sternal instability (p = ns). In the late postoperative period, sternal instability was present in 2 patients from the study group and 3 from the control group (p = ns). The survey study revealed a significantly better (p = 0.029) evaluation of postoperative rehabilitation among the study group patients. Overall, the results indicated that a preoperative locomotive disorder has no significant impact on sternal instability in the early or late postoperative periods. However, patients with such disorders have a better understanding of the importance, purpose, and course of rehabilitation after cardiac surgery and exhibit lower levels of calcium, vitamin D, and creatinine.

3Dimensional sonography for the diagnosis of congenital uterine anomalies in women with eccentric pregnancy implantation: a novel approach.

The eccentric implantation of pregnancies in the upper lateral aspect of the uterine cavity is poorly defined clinically. The aim of the current study was to investigate whether differentiating between uterine anomalies that can lead to cavitary distortion has implications for the management of these pregnancies. Eight cases of first-trimester eccentric pregnancy implantation within the endometrial cavity (study group) were retrospectively identified. For each woman in the study group, 10 women identified as having a first-trimester concentric pregnancy implantation during the first-trimester US examination were retrieved from our database (control group). After delivery or pregnancy demise, the presence of uterine anomalies was assessed by a 3D-US examination in all patients. In the study group patients, an increased incidence of uterine anomalies (50.0% vs. 8.8%, p = 0.007) was found, compared to the controls. In the study group, the eccentric location persisted in half of the pregnancies (n = 4; 50%), whereas the other half migrated to a more centric location within the endometrial cavity (n = 4; 50%). The follow-up examination showed that all the early pregnancy demises occurred in cases where the pregnancy persisted at the eccentric location. Uterine malformations were also detected in all these cases. The data point to a significantly higher incidence of uterine anomalies in patients diagnosed with eccentric pregnancy implantation within the endometrial cavity. These results advocate for the value of differentiating between eccentric pregnancies in non-anomalous versus anomalous uteri.