Standard Examination Research Articles

Evaluation of tubal patency based on peak injection pressure in four-dimensional hysterosalpingo-contrast sonography among infertile females: a preliminary study.

Although the application of four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) has relatively good diagnostic accuracy for assessing the patency of the fallopian tubes, the evaluation process mainly relies on morphological findings of the fallopian tubes and pelvic cavity. The purpose of this study was to explore the relationship of peak injection pressure during 4D-HyCoSy and tubal patency to provide a quantitative indicator for the evaluation of fallopian tube patency. This study included infertile patients who underwent 4D-HyCoSy and laparoscopic chromopertubation (LC) between 2020 and 2022, with LC serving as the reference test for assessing tubal patency. For the HyCoSy procedure, the ultrasound contrast agent was injected automatically using a liquid injection machine, and real-time pressure values were recorded. Patients were classified based on tubal patency status in LC as bilaterally patent, unilaterally patent, or bilaterally nonpatent. The average peak injection pressure and contrast agent volume of different groups were compared. Receiver operating characteristic (ROC) curve analysis was employed to determine the cutoff value. A total of 268 infertile patients were enrolled in the study. With LC as the standard examination, the sensitivity and specificity of 4D-HyCoSy in diagnosing nonpatent fallopian tubes were 91.1% and 95.1%, respectively. In general, peak injection pressure was observed to gradually increase as tubal patency decreased (P<0.001), with average peak injection pressures of 233.5±66.3, 338.8±99.8, and 469.6±63.1 mmHg in the bilaterally patent, unilaterally patent, and bilaterally nonpatent groups, respectively. The volume of contrast agent used in patients in the bilaterally nonpatent group was significantly lower than that in the other two groups (P<0.01), with average volumes of 22.7±6.3, 24.3±9.3, and 18.9±9.2 mL, respectively. When one fallopian tube was patent, the area under the curve (AUC) for distinguishing obstruction from patency of the other fallopian tube was 0.827, with a sensitivity of 79.8% and a specificity of 74.3% (cutoff value: 254.3 mmHg). Similarly, when one fallopian tube was nonpatent, the AUC was 0.866, with a sensitivity of 90.6% and a specificity of 78.3% (cutoff value: 401.3 mmHg). Peak injection pressure during 4D-HyCoSy demonstrates promising diagnostic performance in evaluating fallopian tube patency in infertile patients.

RIGHT VENTRICLE IN PATIENTS WITH ARTERIAL HYPERTENSION AND B STAGE HEART FAILURE

Objective: According to ACC/AHA Heart failure (HF) classification the A stage of HF is a high risk for HF but without structural heart disease or symptoms; B stage is a structural heart disease but without signs or symptoms of HF. One of the most important risk factors of HF is Arterial Hypertension (AH). There is no information about Right Ventricular (RV) structure and function, in patients with stage A and B of HF. The aim of our research was to study RV structure and function in patients with AH and stage A or B HF. Design and method: We studied 163 patients with AH (female-76, male 87). 45 in stage A and 118 in stage B HF. All patients undergone standard EchoCG examination. RV outflow tract (RVout) was examined by M-mode from parasternal short axis and PW TDI from subcostal position (RVoutTDI). The shape of RWoutTDI was different from the Tricuspid anulus TDI. It consists from positive isometric contraction (ICTs), isotonic contraction (s), negative early diastolic (e) late (a) diastolic waves velocities, two negative (e1) positive (e2) isometric relaxation waves. We measured the pick velocities of these waves in cm/sec and isometric contraction (ICT), ejection (RVET) and isometric relaxation time (IRT) intervals in msec. On M-mode EcoCG of RVoutRV we measured Diastolic Diameter (Dd) systolic diameter (Ds), fractional shortening (RWoutFS) and RW wall systolic excursion (RWexc). Results: We did not find any significant differences between in RV EcoCG, RVout, RVoutTRI and Tricuspid annulus TDI parameters between the A and B Heart Failure groups in patients wit Arterial Hypertension. Conclusions: There is no difference in EchoCG parameters between A and B Heart Failure groups in patients with Arterial Hypertension.

A survey of ictal physical examination during VEEG monitoring in a tertiary epilepsy center

BackgroundIctal examination based on video-based electroencephalography (EEG) is crucial for locating and lateralizing seizures. In this study, we aimed to evaluate the quality of ictal examination in the Comprehensive Epilepsy Center of West China Hospital, Sichuan University, in order to provide information for quality improvement in daily clinical practice.MethodsVideo recordings of 100 patients with epilepsy were retrospectively reviewed. The performance of the ictal examination was independently reviewed by two epileptologists using an ictal examination protocol.ResultsIn this retrospective analysis, 589 seizure episodes from 100 patients with epilepsy were reviewed. The ages of the patients ranged from 3 to 77 years, with a mean age of 25.8 ± 12.8 years. Among the 589 seizure episodes, a majority (93.7%) were focal seizures. For 226 (38.4%) seizures, the medical staff arrived at the bedside. Among them, 153 (153/226, 64.7%) seizure episodes, the medical staff arrival at the bedside within 30 s of onset, and 120 (120/226, 53.1%) seizures were tested by the medical staff. The compliance rates for "safety” and "visibility" reached 80% or higher while “naming”, “retelling”, and “memory testing” only reach less than 3%.ConclusionsOur survey identified the main problems in ictal assessments. It is challenging to complete a standardized examination for new trainees at Epilepsy Monitoring Units. Regularly strengthening training in ictal examination and understanding of semiology may improve patients’ examination ability. However, further study of the implementation of training is necessary.

THE RELATIONSHIP BETWEEN PREGNANT WOMEN'S ATTITUDES AND COMPLIANCE WITH INTEGRATED ANTENATAL CARE VISITS AT SINGOSARI HEALTH CENTER, MALANG REGENCY

Background: Integrated Antenatal Care is a 10 T standardized pregnancy examination to facilitate the development of mother and baby and detect complications. The purpose of this study was to analyze the relationship between attitude and compliance of pregnant women to conduct Integrated Antenatal Care visits. Methods: The research design was correlation analytic with cross sectional approach. The population was all pregnant women who made Integrated Antenatal Care visits in July 2023, using purposive sampling technique obtained a sample of 44 respondents. The instrument used was a questionnaire of the attitude of pregnant women and a checklist of pregnant women's data from the Maternal &amp; Child Health book and cohort. Chi Square test is used to analyze the relationship between variables. Research results: Most of the 59% of pregnant women have a negative attitude towards Integrated Antenatal Care and 61% of pregnant women are not compliant with Integrated Antenatal Care . The results of chi square analysis of the relationship between the attitude of pregnant women with compliance with Integrated Antenatal Care visits obtained the result of p = 0.000 (α &lt; 0.05). Conclusion: There is a relationship between the attitude of pregnant women and compliance with Integrated Antenatal Care at Singosari Health Center, Malang Regency. The results of the study can be used as a basis for developing or comparing other factors that affect the compliance of pregnant women to conduct Integrated Antenatal Care visits.

Eating Disorders and Disordered Eating Behaviors Among Undergraduate Students in Pakistan as Measured by Eating Disorder Examination Questionnaire (EDE-Q).

Objectives Eating disorders (ED) are an emerging public health issue globally, especially in young adults studying at the undergraduate level. This study aims to assess the frequency of eating disorders, their types, and disordered eating behaviors among such students. Moreover, it aims to identify factors like weight concern, shape concern, eating concern, and restraint, along with assessing the shifting trend of BMI impact on eating disorders using a standardized Eating Disorder Examination Questionnaire (EDE-Q). Methods In this cross-sectional study, 400 undergraduate students (aged 18-25) from four public universities participated from July 2022 to November 2023. Data was collected using the Eating Disorder Examination Questionnaire (EDE-Q). The frequency of eating disorders was computed using SPSS version 27. Results Among the participants, 21.75% (n=84) were identified as having a score surpassing the clinical cut-off. This group comprised 5.5% males (n=22) and 16% females (n=64). The highest prevalence among the four subscales was observed in the Shape Concern subscale (10.5%). Objective binge episodes (19.3%) emerged as the most notable disordered eating attitude. Atypical anorexia nervosa accounted for 13.8% of different eating disorders, while disordered eating was noted in 19.5% (n=78) of individuals. Discussion This study offers critical insights into eating disorders among Pakistanundergraduate students, utilizing the EDE-Q 6.0. Disordered eating behaviors, particularly shape concern and objective binge eating, exhibit significant correlations with these disorders. Weight dissatisfaction emerges as a prominent predictor, suggesting societal influence. The study also reveals a moderate correlation between BMI and eating disorders, challenging conventional assumptions. Furthermore, a changing trend in the prevalence of eating disorders is observed among the male population.

Digital image characteristics for enhanced interpretation in child sexual violence case examinations

BACKGROUND Photography is an integrated part of standard forensic examination procedures, acting as a guide and the evidence itself. Despite its potential, no research has yet explored the use of 35mm format cameras (digital single-lens reflex [DSLR]) in sexual violence cases. This study aimed to assess the impact of DSLR camera image characteristics on the interpretation of child sexual abuse cases. METHODS This cross-sectional study used 55 digital photos selected through a convenience sampling. The samples were interpreted by two independent forensic experts who were not affiliated with this research and were compared with the results of the doctor’s examination from the medical records. RESULTS The metadata extraction results (EXIF data) indicated that all characteristic values had an abnormal distribution. The digital photos’ characteristics were associated with the use of a 50mm focal length (p = 0.011). A range of lens opening values (aperture = f7.1–f8.0), shutter speed (1/100–1/125 sec), and sensor sensitivity (ISO = 800–1600) were not associated with the experts’ interpretation conformity. Additionally, the conformity index for the overall interpretation by the two forensic experts differed in each area. CONCLUSIONS Focal length of 50mm was significantly related to interpretation conformity. The exposure triangle settings, including aperture (f7.1–f8.0), shutter speed (1/100–1/125 sec), and ISO (800–1600), can serve as fundamental guidelines for digital camera settings in examining child sexual violence cases.

Refining glaucoma diagnosis and treatment in cataract surgery candidates: contribution of preoperative OCT retinal nerve fiber layer.

To evaluate the clinical significance of preoperative spectral domain optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL) thickness in identifying glaucoma and better managing patients scheduled for routine cataract surgery. Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. Retrospective cohort study. Consecutive patients scheduled for cataract surgery were enrolled from February 2022 to August 2022. Participants underwent routine OCT RNFL studies which were evaluated by a glaucoma specialist. Findings were compared with those of preoperative fundus biomicroscopic examinations conducted by the referring ophthalmologist. The main outcomes were the incidence of newly detected glaucoma based on OCT RNFL findings and the consequent changes in patient management. In total, 486 patients met the inclusion criteria of whom 112 (23%) had abnormal RNFL. 31 patients (6.4%) had abnormal OCT RNFL findings attributed to comorbidities other than glaucoma, and 81 patients (16.7%) were suspected to have glaucoma based on their OCT RNFL findings, from which 44 patients (9%) were newly diagnosed with glaucoma or as glaucoma suspects, resulting in management modifications that included routine glaucoma follow-up (25 patients, 5.1%), initiation of intraocular pressure-lowering treatment (12 patients, 2.5%), and conversion to combined cataract-glaucoma surgery (7 patients, 1.4%). OCT RNFL for cataract surgery candidates proved valuable in detecting glaucoma that had not been revealed by standard fundus biomicroscopic examination. The additional information provided by OCT RNFL can potentially enhance patient management and optimize outcomes.

Facial expressions to identify post-stroke: A pilot study

Background and Objective:Timely stroke treatment can limit brain damage and improve outcomes, which depends on early recognition of the symptoms. However, stroke cases are often missed by the first respondent paramedics. One of the earliest external symptoms of stroke is based on facial expressions. Methods:We propose a computerized analysis of facial expressions using action units to distinguish between Post-Stroke and healthy people. Action units enable analysis of subtle and specific facial movements and are interpretable to the facial expressions. The RGB videos from the Toronto Neuroface Dataset, which were recorded during standard orofacial examinations of 14 people with post-stroke (PS) and 11 healthy controls (HC) were used in this study. Action units were computed using XGBoost which was trained using HC, and classified using regression analysis for each of the nine facial expressions. The analysis was performed without manual intervention. Results:The results were evaluated using leave-one-our validation. The accuracy was 82% for Kiss and Spread, with the best sensitivity of 91% in the differentiation of PS and HC. The features corresponding to mouth muscles were most suitable. Conclusions:This pilot study has shown that our method can detect PS based on two simple facial expressions. However, this needs to be tested in real-world conditions, with people of different ethnicities and smartphone use. The method has the potential for a computerized assessment of the videos for use by the first respondents using a smartphone to perform screening tests, which can facilitate the timely start of the treatment.

Precision and accuracy of transcutaneous CO2 monitoring in infants born at 32-36 weeks of pregnancy on respiratory support

Background Respiratory disorders in premature neonates often require respiratory support. Continous transcutaneous monitoring is an available non-invasive option to monitor CO2 pressure, substituting the need for blood gas analysis as the gold standard evaluation in practice. Most studies have been conducted on very and extremely preterm neonates, but rarely in late and moderately preterm neonates. Objective To determine the precision and accuracy of transcutaneous CO2 pressure measuring devices compared to arterial blood gas analysis in neonates of 32-36 weeks gestational age who received respiratory support. Methods This diagnostic, cross-sectional study was conducted on 35 late and moderately preterm neonates of 32–36 weeks gestation who received cardiopulmonary resuscitation (CPR) in the Neonatology Unit at Rumah Sakit Cipto Mangunkusumo, Jakarta. Subjects were monitored with a transcutaneous CO2 monitor and blood gas analysis (BGA). CO2 pressure measurements were made three times from the two devices. Data were analyzed using Spearman’s correlation and Bland-Altman tests to determine the precision and accuracy of transcutaneous monitoring by comparing its mean difference (MD) to BGA as the gold standard measurement. Results Spearman’s analysis revealed a significant positive correlation between BGA and transcutaneous CO2 monitoring (P&lt;0.001). However, the Bland - Altman test revealed a level of agreement between measuring devices was -14.46 to 6.9, with mean difference of -3.78; indicating poor precision of the transcutaneous evaluation regardless its high accuracy compared to its gold standard. Conclusion The transcutaneous CO2 monitoring device has low precision, but a strong positive correlation to BGA; underlining its high accuracy in practice. Transcutaneous CO2 monitoring cannot replace BGA, the gold standard examination.

Endoscopic Ultrasound-based Shear Wave Elastography for Detection of Advanced Liver Disease.

Endoscopic ultrasound shear wave elastography (EUS-SWE) is a novel modality for liver stiffness measurement. The aims of this study are to evaluate the performance and reliability of EUS-SWE for detecting advanced liver disease in a prospective cohort. EUS-SWE measurements were prospectively obtained from patients undergoing EUS between August 2020 and March 2023. Liver stiffness measurements were compared between patients with and without advanced liver disease (ALD), defined as stage ≥3, to determine diagnostic accuracy for advanced fibrosis and portal hypertension. Logistic regression was performed to identify variables that impact the reliability of EUS-SWE readings. Select patients underwent paired magnetic resonance elastography (MRE) for liver fibrosis correlation. Patients with ALD demonstrated higher liver stiffness compared to healthy controls (left lobe: 17.6 vs. 12.7 kPa, P<0.001; median right lobe: 24.8 vs. 11.0 kPa, P<0.001). The area under the receiver operator characteristic (AUROC) for the detection of ALD was 0.73 and 0.80 for left and right lobe measurements, respectively. General anesthesia was associated with reliable EUS-SWE liver readings (odds ratio: 2.73, 95% CI: 1.07-7.39, P=0.040). Left lobe measurements correlated significantly with MRE with an increase of 0.11 kPa (95% CI: 0.05-0.17 kPA) for every 1 kPa increase on EUS-SWE. D. SWE is a promising technology that can readily be incorporated into standard EUS examinations for the assessment of ALD.

A Study on the Backwash Effect of International Talent English Exam on Students' English Learning—Teaching Based Backlash Promotes Student Learning Strategy Adjustment

With the acceleration of globalization, English has become the main language for international communication, and various English exams have also emerged. The International Talent English Examination (ETIC), also known as the National Talent Examination, is a standardized examination that evaluates students' English proficiency. Its implementation has a direct impact on their English learning. On the basis of literature review, questionnaire survey, interview, and classroom observation, this study comprehensively adopts a data analysis method combining descriptive statistics and qualitative analysis to explore the backlash effect of the National Talent Examination on student English learning, that is, to clarify the impact of ETIC on student English learning, and how to promote student learning through exam feedback.

The right to health care in the system of social human rights

In the current academic literature, the right to health is considered in the context of a wide range of disciplines, including medical law, international law and social sciences. An important step in the formation of the legal framework for the right to health was the adoption of the WHO Constitution in 1946, which proclaimed that «the enjoyment of the highest attainable standard of health is a fundamental right of every human being». This declaration became the basis for the further development of international health standards, including the 1966 International Covenant on Economic, Social and Cultural Rights, which in Article 12 recognises the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.&#x0D; Research and scholarship on the right to health covers various aspects of this issue, including analyses of national health systems, examination of international standards and their impact on national legislation, and development of recommendations to ensure equal access to health services. Despite the significant achievements in the development of international norms and standards, there are challenges related to their implementation at the national level, including the need to adapt national legislative and institutional frameworks to international obligations.&#x0D; Ukraine, like many other countries, is striving to meet international standards in the field of the right to health, while facing a number of challenges that require a comprehensive approach to reforming the national healthcare system. Scientific research plays an important role in this process, helping to identify gaps in legislation and practice, as well as to develop sound recommendations for their elimination.&#x0D; Given these aspects, this article aims not only to analyse the theoretical foundations of the right to healthcare, but also to highlight the practical steps and challenges that Ukraine faces on the way to its full implementation.

Comparison of Elva Diagnostic SARS-CoV-2 Saliva Nucleic Acid Test Kit with RT-qPCR and Rapid Antigen Tests in COVID-19 Patients

The practical application of the reverse transcription loop-mediated isothermal amplification (RT-LAMP) technique has been confirmed in diagnosing different viral infections. Nevertheless, its accuracy in identifying SARS-CoV-2, particularly in practical clinical situations, has not been thoroughly investigated. This study aims to investigate the sensitivity and specificity of the Elva Diagnostic SARS-CoV-2 Saliva Nucleic Acid Test Kit, utilizing the RT-LAMP and Rapid Antigen Test (RAT) methods for in vitro diagnostic testing, compared to the real-time quantitative polymerase chain reaction (RT-qPCR) method throughout the progression of COVID-19. Method: This study employed an analytical observational diagnostic test at Dr. Soetomo Regional Public Hospital, Surabaya, from March 2022 to May 2022. This research involved 54 samples of saliva and nasopharyngeal swabs obtained from 36 patients confirmed positive for COVID-19 and 18 samples from subjects not confirmed to have COVID-19, tested using the RT-qPCR method. The diagnostic performance of both the RT-LAMP and RAT methods was assessed by calculating their sensitivity and specificity in comparison to RT-qPCR, beginning from the time the patient was confirmed positive for COVID-19. The suitability of each method was analyzed using Cohen’s kappa. The nucleocapsid (N) protein gene from SARS-CoV-2 RNA was detected with RT-LAMP and RAT test kits which showed incompatibilities with the RT-qPCR method (p value 0.308). The positive and negative results with the RT-LAMP and RAT method examinations were similar in number compared to the RT-qPCR method, where the positive results in the RT-LAMP and RAT methods were 2 subjects and the negative results were 52 subjects. Based on the results, only 2 confirmed cases had positive results with RT-LAMP and RAT, which means the sensitivity of both tests is only 5.5% and both are poor screening tests for patients suspected of having COVID-19. In addition, the specificity of RT-qPCR as the gold standard examination method for diagnosing COVID-19 cannot be replaced by the RT-LAMP and RAT methods.

Prevalence of early childhood caries post covid-19 pandemic in Mumbai among children aged 3-5 years: A cross-sectional pilot study

This cross-sectional pilot study aims to investigate the prevalence of Early Childhood Caries (ECC) among children aged 3 to 5 years in Mumbai City, Maharashtra, following the COVID-19 pandemic. A total of 91 children were included in the study, with ECC prevalence assessed through standardized examinations and dmfs scoring. Simple random sampling was employed, and data were analyzed using descriptive statistics and inferential tests. The study found a high prevalence of ECC (63.74%) among the study population, with no significant gender-based differences observed in ECC occurrence or severity. Despite similar ECC prevalence rates between boys and girls, the overall burden of ECC underscores the urgent need for targeted interventions and preventive measures. The findings highlight the pressing oral health challenge faced by young children in urban settings post-pandemic and emphasize the importance of comprehensive oral health promotion programs and equitable access to preventive oral healthcare. Addressing modifiable risk factors and integrating oral health services into primary healthcare systems are essential steps toward improving oral health outcomes for children in Mumbai and similar urban environments.

RAD6 Overexpression and Ovarian Cancer Chemo-Resistance: Flow Cytometry and Immunohistochemistry

Objective: Ovarian cancer is one of the deadliest women’s cancers in the world. Nearly all the patients have poor prognosis and recurrence after standard therapy because of chemo-resistance. The standard therapy is cytoreductive debulking surgery followed by platinum-based chemotherapy. RAD6 has an important role in chemo-resistance. RAD6 is an E2 Ubiquitin-Conjugating Enzymes (UBE2) enzyme required for DNA repair, cell proliferation, and cell mutagenesis. Increased expression of RAD6 is believed to be associated with chemoresistance, recurrence, and poor prognosis of the disease. We aimed to study RAD6 relationship with ovarian cancer chemo-resistance and its ability to predict chemo-resistance. Methods: This study is an ambispective cohort study of 32 people in each group at the obstetrics-gynecology and pathology Department of Cipto Mangunkusumo, Tarakan, Dharmais, and Fatmawati Hospital. All patients will undergo standard cytoreductive debulking and histopathological examination followed by six series of chemotherapy followed by six months of observation. After the observation, we determine therapy response with the RECIST Criteria (Response Criteria in Solid Tumors). The chemo-resistance and chemo sensitive groups will be analyzed according to the therapy response. Our study is the first study examining RAD6 in ovarian cancer from flow cytometry blood test and directly from ovarian cancer tissue by double immunohistochemistry.

Neurocognitive impairment in Ugandan children with sickle cell anemia compared to sibling controls: a cross-sectional study.

The neurocognitive functions in Ugandan children aged 1-12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings to identify risk factors for disease-associated impairment. This cross-sectional study of the neurocognitive functions in children with SCA (N = 242) and non-SCA siblings (N = 127) used age- and linguistically appropriate standardized tests of cognition, executive function, and attention for children ages 1-4 and 5-12. Test scores were converted to locally derived age-normalized z-scores. The SCA group underwent a standardized stroke examination for prior stroke and transcranial Doppler ultrasound to determine stroke risk by arterial flow velocity. The SCA group was younger than their siblings (mean ages 5.46 ± 3.0 vs. 7.11 ± 3.51 years, respectively; p < 0.001), with a lower hemoglobin concentration (7.32 ± 1.02 vs. 12.06 ± 1.42, p < 0.001). The overall cognitive SCA z-scores were lower, -0.73 ± 0.98, vs. siblings, -0.25 ± 1.12 (p < 0.001), with comparable findings for executive function of -1.09 ± 0.94 vs. -0.84 ± 1.26 (p = 0.045), respectively. The attention z-scores for ages 5-12 for the SCA group and control group were similar: -0.37 ± 1.4 vs. -0.11 ± 0.17 (p = 0.09). The overall differences in SCA status were largely driven by the older age group, as the z-scores in the younger subsample did not differ from controls. Analyses revealed the strongest predictors of poor neurocognitive outcomes among the SCA sample to be the disease, age, and prior stroke (each p < 0.001). The impacts of anemia and SCA were indistinguishable. Neurocognitive testing in children with SCA compared to non-SCA siblings revealed poorer SCA-associated functioning in children older than age 4. The results indicate the need for trials assessing the impact of disease modification on children with SCA.

Tактика хирургического лечения пациента с непроникающей травмой роговицы после ранее перенесенной операции ФемтоЛАЗИК

Abstract Tactics of surgical treatment of a patient with non-penetrating corneal trauma after previous FemtoLASIK V.A. Breev, E.G. Solodkova, D.D. Sibakin S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd Branch, Volgograd, Russian Federation Purpose. To present the tactics of surgical treatment of the patient with non-penetrating corneal trauma after previously undergone FemtoLasik. Methods. The patient, operated by FemtoLASIK for middle degree myopia, had non-penetrating corneal trauma of the right eye. When applying to the Clinic of Volgograd branch he underwent corneal flap repositioning with removal of multiple corneal foreign bodies. Before and after the operation the patient underwent standard ophthalmologic examination. Results. According to the examination data, the uncorrected visual acuity of the right eye was reduced to 0.3 due to dislocation and linear defect of the corneal flap, multiple corneal foreign bodies, corneal opacity and mixed astigmatism. In 1 month after the surgical treatment there was noted restoration of transparency, correct position and integrity of the corneal flap, absence of corneal foreign bodies and increase of uncorrected visual acuity of the right eye up to 0.5. Conclusion. The correct sequence of surgical actions after trauma against the background of previously performed FemtolASIK provides qualitative corneal flap repositioning and restoration of visual functions. Key words: non-penetrating corneal trauma, corneal flap repositioning, FemtoLASIK For citation: Breev V.A., Solodkova E.G., Sibakin D.D. Tactics of surgical treatment of a patient with non-penetrating corneal trauma after previous FemtoLASIK.

Study of the initial vasculotoxic risk in patients with lymphoproliferative diseases before the start of polychemotherapy

Research objective. To evaluate the levels of CRP, cardio-specific markers, lipids, structural-functional (SF) state of vessels, and their interrelations in patients with lymphoproliterative diseases (LPD) before polychemotherapy (PCT).Materials and methods. The study included patients with newly diagnosed LPD (n = 30), including 16 men (53.3%) and 14 women (46.7%). All patients were divided into two groups: group 1 (n = 15) — patients with low/intermediate cardiovascular toxicity (CVT) risk; group 2 (n = 15) — patients with high/very high CVT risk. CVT risk stratification was performed with the use of specialized scales according to the current European clinical guidelines for cardio-oncology 2022. All patients included in the study underwent standard laboratory and instrumental examinations. Specific laboratory research involved assessing the levels of C-reactive protein (CRP), troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lipid profile. The SF state of vessels was evaluated non-invasively using photoplethysmography (PPG) (Angioscan-01 device, Russia) and computerized videocapillaroscopy (CVC) of the periungual area (Capillaroscan-01 device, Russia).Results. According to the results of PPG and CVC, the occlusion index (OI) in group 2 was significantly lower and amounted to 1.2 [1; 1.3] compared to 1.7 [1.45; 2.1] in group 1 (p &lt; 0.001); capillary density after reactive hyperemia (CDRH) was also significantly lower in group 2 compared to group 1 — 43 [35.5; 45] and 54 [43; 58] cap/mm², respectively (p = 0.033). According to the obtained results, there were no statistically significant diff erences in the levels of CRP, TnI, and NT-proBNP between patients in both groups; the indicators were within the reference values. A moderate inverse statistically signifi cant correlation was found between the level of CRP and the percentage of perfused capillaries (PPC) (rs = –0.545; p = 0.02) and the percentage of capillary recovery (PCR) (r = –0.446; p = 0.013).Conclusion. Patients with LPD have endothelial dysfunction before PCT, primarily due to the presence of cardiovascular risk factors (age, body mass index), and concomitant cardiovascular diseases. At the same time, the SF state of vessels initially does not depend on the stage and course of LPD, lipid levels, and TnI.

Clinical-functional correlation with brain volumetry in severe perinatal asphyxia: a case report

BackgroundHypoxic-ischemic encephalopathy (HIE) appears in neurological conditions where some brain areas are likely to be injured, such as deep grey matter, basal ganglia area, and white matter subcortical periventricular áreas. Moreover, modeling these brain areas in a newborn is challenging due to significant variability in the intensities associated with HIE conditions. This paper aims to evaluate functional measurements and 3D machine learning models of a given HIE case by correlating the affected brain areas with the pathophysiology and clinical neurodevelopmental.Case presentationA comprehensive analysis of a term infant with perinatal asphyxia using longitudinal 3D brain information from Machine Learning Models is presented. The clinical analysis revealed the perinatal asphyxia diagnosis with APGAR <5 at 5 and 10 minutes, umbilical arterial pH of 7.0 BE of -21.2 mmol / L), neonatal seizures, and invasive ventilation mechanics. Therapeutic interventions: physical, occupational, and language neurodevelopmental therapies. Epilepsy treatment: vagus nerve stimulation, levetiracetam, and phenobarbital. Furthermore, the 3D analysis showed how the volume decreases due to age, exhibiting an increasing asymmetry between hemispheres. The results of the basal ganglia area showed that thalamus asymmetry, caudate, and putamen increase over time while globus pallidus decreases. Clinical outcomes: spastic cerebral palsy, microcephaly, treatment-refractory epilepsy.ConclusionsSlight changes in the basal ganglia and cerebellum require 3D volumetry for detection, as standard MRI examinations cannot fully reveal their complex shape variations. Quantifying these subtle neurodevelopmental changes helps in understanding their clinical implications. Besides, neurophysiological evaluations can boost neuroplasticity in children with neurological sequelae by stimulating new neuronal connections.

The Association Between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and the Incidence of Type 2 Diabetes Mellitus in the Japanese Population.

Abstract Aims: To explore whether the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) was independently associated with the risk of incident type 2 diabetes mellitus (T2DM) in a large Japanese cohort. Methods: A secondary analysis was performed using open-access data from a retrospective cohort study. A total of 12,716 eligible participants who had standard medical examinations at the Murakami Memorial Hospital were included in this study. New-onset T2DM was the main outcome during follow-up. The risk of T2DM based on the TG/HDL-C ratio was evaluated using Cox regression analysis and Kaplan-Meier analysis. Subgroup analysis was performed to understand further the significance of the TG/HDL-C ratio in particular populations. To assess the potential of the TG/HDL-C ratio for predicting T2DM, a receiver operating characteristic (ROC) analysis was performed. Results: One hundred fifty new-onset T2DM cases were observed during a median follow-up of 5.39 years. The incidence of T2DM increased with a rise in the TG/HDL-C ratio based on the Kaplan-Meier curves (P < 0.0001). After controlling for potential confounding variables, the TG/HDL-C ratio was positively related to incidence of T2DM (hazard ratio = 1.08, 95% confidence interval: 1.01-1.15, P = 0.0239). In subgroup analysis, those with a body mass index of ≥18.5 and <24 kg/m2 showed a significantly positive relationship. The area under the ROC curve for the TG/HDL-C ratio as a T2DM predictor was 0.684. The optimal TG/HDL-C ratio cutoff value for T2DM was 1.609, with a sensitivity of 54.7% and a specificity of 73.6%. Conclusion: The authors' results showed a significant relationship between the TG/HDL-C ratio and the incidence of T2DM in the Japanese population.