Subgroups Ib Research Articles

A Histological Study on the Effect of Whey Protein on Liver and Skeletal Muscle with or without Exercise in Adult Male Albino Rats

Abstract Introduction Whey protein provides a rapid source of amino acids that the muscles can utilize. Whey protein is frequently used by people to increase their strength and improve sports performance. However, other people use whey protein as a dietary supplement because of its beneficial effects without performing any exercise. Aim of the Work to evaluate the effect of whey protein with/or without exercise on the histological structure of the liver and skeletal muscle in adult male albino rats. Materials and Methods Twenty adult male albino rats with weight ranged from 150 to 200 grams were used in this study, rats were randomly divided into two main groups: Group I (Standard diet group): subdivided into two subgroups. Subgroup IA (Standard diet, sedentary): left without intervention. Subgroup IB (Standard diet, exercise-trained): subjected to exercise training. Group II (Whey protein group): received high dose of whey protein daily (6 gram/kilogram) by oral gavage and were further subdivided into two subgroups. Subgroup IIA (Whey protein, sedentary). Subgroup IIB (Whey protein, exercise-trained): received whey protein within 30 minutes after exercise training. Rats of subgroups IB and IIB were subjected to swimming exercise training in swimming basin for four weeks, five days per week, in which the exercise time was increased gradually throughout the four weeks of the study. Liver and gastrocnemius muscle were subjected to microscopic examination, morphometric and statistical studies. Results Histological, morphometric, and statistical studies of liver of subgroup IB were nearly similar to that of subgroup IA. Histological examination of liver of subgroup IIA showed congestion of central vein and portal vein with surrounding mononuclear cellular infiltration and increased mean collagen percentage as compared to other subgroups. It also showed vacuolated hepatocytes with shrunken, irregular, and heterochromatic nuclei. Meanwhile, subgroup IIB showed improved hepatic architecture than subgroup IIA. Histological examination of gastrocnemius muscle of exercise-trained subgroups IB and IIB showed increase in mitochondrial content, mean glycogen optical density, and mean muscle fiber diameter with appearance of splitting and central nuclei, which were more pronounced in subgroup IIB as compared to subgroup IA. Meanwhile, subgroup IIA showed significant decrease in mean muscle diameter as compared to subgroup IIB, however it showed nonsignificant increase in mean diameter when compared to subgroup IA. Conclusion High intake of whey protein without physical exercise has its degenerative effects on liver, also it showed non-significant increase in mean diameter of skeletal muscle as compared to rats fed standard diet. Thus, whey protein should be taken within its recommended dose and accompanied by physical exercise.

Codon Usage Analysis Reveals Distinct Evolutionary Patterns and Host Adaptation Strategies in Duck Hepatitis Virus 1 (DHV-1) Phylogroups.

Duck hepatitis virus 1 (DHV-1) is a major threat to the global poultry industry, causing significant economic losses due to high mortality rates in young ducklings. To better understand the evolution and host adaptation strategies of DHV-1, we conducted a comprehensive codon usage analysis of DHV-1 genomes. Our phylogenetic analysis revealed three well-supported DHV-1 phylogroups (Ia, Ib, and II) with distinct genetic diversity patterns. Comparative analyses of the codon usage bias and dinucleotide abundance uncovered a strong preference for A/U-ended codons and a biased pattern of dinucleotide usage in the DHV-1 genome, with CG dinucleotides being extremely underrepresented. Effective number of codons (ENC) analysis indicated a low codon usage bias in the DHV-1 ORF sequences, suggesting adaptation to host codon usage preferences. PR2 bias, ENC plot, and neutrality analyses revealed that both mutation pressure and natural selection influence the codon usage patterns of DHV-1. Notably, the three DHV-1 phylogroups exhibited distinct evolutionary trends, with phylogroups Ia and Ib showing evidence of neutral evolution accompanied by selective pressure, while the phylogroup II evolution was primarily driven by random genetic drift. Comparative analysis of the codon usage indices (CAI, RCDI, and SiD) among the phylogroups highlighted significant differences between subgroups Ia and Ib, suggesting distinct evolutionary pressures or adaptations influencing their codon usage. These findings contribute to our understanding of DHV-1 evolution and host adaptation, with potential implications for the development of effective control measures and vaccines.

Pleuropneumonectomy for the treatment of tuberculosis

The OBJECTIVE was to reduce the risk of complications and mortality after pleuropneumonectomy in patients with pulmonary tuberculosis complicated by pleural empyema.METODS AND MATERIALS. The immediate and long-term results of surgical treatment were analyzed in 910 patients who underwent pneumonectomy between 1984 and 2021. Among these, 342 patients (37.6 %) underwent pleuropneu- monectomy (Group I), while 568 patients (62.4 %) underwent pneumonectomy (Group II). Group I was further divided into two subgroups. Subgroup Ia consisted of 278 patients (main group) who received stump-free suturing of the main bronchus according to D. B. Giller’s method, long-term drainage management of the pleural cavity using an original technique, and the proposed staged surgical tactics. Subgroup Ib comprised 64 patients who were treated using traditional methods for the main bronchus and puncture management of the pleural cavity.RESULTS. Postoperative complications were more frequent after pleuropneumonectomy (PPE); however, the mortality rate in Subgroup Ia and Group II did not significantly differ. In contrast, the hospital mortality rate in Subgroup Ib, which utilized traditional approaches for the treatment of the main bronchus and puncture management of the pleural cavity, was 2.3 times higher than the mortality rate after pneumonectomy (PE). The incidence of complications, mortality, recurrence of tuberculosis, and empyema differed significantly between Subgroups Ia and Ib, with the best outcomes observed in Subgroup Ia. These results are attributed to the applied method of treating the main bronchus, pleural cavity management, and differentiated surgical tactics.

The Potential Role of Bone Marrow Mesenchymal Stem Cells Derived Exosomes on Experimentally Induced Osteoarthritis of Knee Joint in Male Albino Rats. Histological and Immunohistochemical Study

Abstract Introduction Osteoarthritis (OA) is the most common joint disorder worldwide characterized by progressive loss of articular cartilage. This study was conducted to evaluate the role of bone marrow mesenchymal stem cells (BMSCs) derived Exosomes as a promising therapy for treating osteoarthritis. Aim of the Work to study the healing potential of BMSCs derived exosomes on experimentally induced knee osteoarthritis. Materials and Methods Forty adult male albino rats, weighing 200-250 gm, were used in this study, five rats used as a source of BM-MSCs derived exosomes. The other thirty-five rats were randomly divided into three main groups Group I: The control group (20 rats) in which rats were subdivided into four subgroups. Subgroups IA and IB were sacrificed 2 and 6 weeks after the beginning of the experiment. Subgroup IC left for 2 weeks then were received intra-articular injection of 0.1ml Phosphate buffer saline (PBS) in right knee joint once weekly for 4 weeks Subgroup ID: left for 2 weeks then given intra-articular injection of purified exosome concentrate in the right knee joint once weekly for 4 weeks then the animals were sacrificed Group II:(15 rats) in which OA was induced by intra-articular injection of 2% formaldehyde solution in the right knee joints. The rats of group II were subdivided into two subgroups. Subgroups IIA and IIB were sacrificed 2 and 6 weeks after induction of OA respectively. Group III (5 rats), Osteoarthritis induced, as in group II and animals left for 2 weeks then treated by intra-articular injection of purified exosome concentrate in right knee joint once weekly for 4 weeks. The right joints from all groups were collected, decalcified and processed for histological studies. Morphometric and statistical measurements were done. Results Histological examination of the right knee joints of OA group (subgroups IIA and IIB) showed surface erosions, decrease cartilage thickness, chondrocytes with pyknotic nuclei and areas of chondrocytes loss with longitudinal clefts reaching the deep zone. Synovial membrane of group II showed increased thickness of the intima, mononuclear cellular infiltration with abundant collagen fibres deposition and dilated congested blood vessels in subintima, apparent increase in the number of iNOS positive intimal synovial cells. Meanwhile, group III showed smooth articular surface, with multiple colonies of chondrocytes and multiple cell nests, significant increase in the mean area percentage of PCNA positive chondrocytes in animals of group Ш when compared to all the other groups. Conclusion BMSCs derived exosomes improved OA induced damage of articular cartilage and synovial membrane. Therefore, it offers a cell-free treatment of OA and joint damage.

Внутрішньовенна інфузія лідокаїну для попередження хронічного післяопераційного болю в дітей після різних видів оперативних втручань

Chronic postoperative pain is a serious postoperative complication. Inadequate pain management in the early postoperative period can contribute to the development of hyperalgesia. Aim - to evaluate the effectiveness of intravenous infusion of lidocaine in the prevention of chronic postoperative pain after various types of surgical intervention in children and adolescents. Materials and methods. 150 children who underwent under general multicomponent anesthesia surgical interventions due to traumatic pathology (I group, n=40), abdominal (II group, n=48) and urological (III group, n=62) surgical interventions were examined. Each of these groups was divided into two subgroups: in the subgroups Ib (n=17), IIb (n=19) and IIIb (n=24) children received intravenous lidocaine (according to the instructions) as a component of multimodal analgesia in the perioperative period, in the control subgroups Ia (n=23), IIa (n=29) and IIIa (n=38) children did not receive lidocaine. The presence of chronic postoperative pain 6 and 12 months after the operation, its frequency, localization, intensity according, the impact on the child’s daily activity were analyzed. Data analysis was performed using the statistical package «SPSS 20» (SPSS Inc.) version 21.0.0. Results. Perioperative use of intravenous lidocaine infusion inpediatric patients was associated with a lower incidence of chronic pain 6 and 12 months after trauma surgery (odds ratio (OR): 5.13; 95% confidence interval (95% CI): 1.13-23.3 and OR: 4.24; 95% CI: 1.01-93.48, respectively) and after abdominal surgery (OR: 5.19; 95% CI: 1.02-26.94), as well as a higher level of functional activity after trauma (OR: 5.52; 95% CI: 1.08-28.2; p=0.028) and abdominal surgery (OR: 8.1; 95% CI: 1.01-70.36; p=0.032), but not after urological operations. Conclusions. This study demonstrated the efficacy of intravenous infusion of lidocaine to prevent of chronic pain after trauma and abdominal surgery in pediatric patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Morphometric, biochemical and histopathological effects of sofosbuvir (sovaldi) on testes of adult male albino rats

ABSTRACT Sofosbuvir treatment regimens for chronic HCV infection have recently been linked to extra hepatic side effects. This study aimed to show how sofosbuvir affected the adult male albino rat testis. Forty adult male albino rats were used. The rats were equally split into two main groups (I and II), then each group subdivided into two subgroups (A and B). Each rat in group I (control) received 0.5 ml of distilled water every day for four weeks. Each rat in group II (sofosbuvir-treated) received 0.5 ml of distilled water containing 7.2 mg of sofosbuvir every day for four weeks. After four weeks (subgroups IA and IIA) and eight weeks (subgroups IB and IIB) of treatment, the rats were sacrificed. Histological, biochemical, and morphometric studies on the testes were conducted. The data were analyzed. Examination of testes of sovaldi treated group revealed histopathological changes. Biochemical and morphometric analysis showed reduced levels of reduced glutathione and seminiferous tubule epithelial height respectively. Following a 4-week drug withdrawal period, the testes only partially recovered. We concluded that sofosbuvir induced deteriorating changes in the adult male albino rats’ testes. These changes were proved by histological and biochemical studies. These changes were incompletely reversible after cession of treatment. Researches investigating the effect of adding drugs that have antioxidant properties during sofosbuvir therapy are recommended.

Correlation of mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with different growth pattern.

To evaluate, compare, and correlate the mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with skeletal class II malocclusion and different growth pattern. A total of 250 patients (age >18 yrs) having skeletal class II malocclusion (based on YEN angle and WITS appraisal) were divided into two groups. Both the groups (Group I with erupted mandibular third molars {N = 150} and Group II with impacted mandibular third molars {N = 100}) were subdivided into subgroups IA (n = 71), IB (n = 19), IC (n = 71) and Group IIA (n = 54), IIB (n = 30) and IIC (n = 16) for normo-, hypo- and hyperdivergent growth patterns, respectively (based on Jarabak ratio and Sn-Go-Gn angle). Four parameters, that is, retromolar space, width of third molar, third molar angulation, and mandibular incisor angulation were measured on orthopantomogram whereas arch length discrepancy was calculated with the help of lateral cephalogram and study model. Intragroup, intergroup comparisons (using unpaired Student's 't' test), and Pearson's correlation coefficient for assessed parameters were obtained. Third molar angulation and retromolar space were significantly higher in Group I than in Group II (hyperdivergent pattern of Group II had highest value). The width of third molar was less than retromolar space in Group II and vice versa for Group I. Mandibular incisor angulation and arch length discrepancy were more in Group II than in Group I, but difference was statistically nonsignificant. Strong positive correlation was observed for mandibular third molar angulation and available retromolar space in normo- and hyperdivergent growth patterns. Lack of retromolar space along with increased amount of arch length discrepancy and mandibular incisor angulation is responsible for increased chances of third molar impaction in some subjects with class II malocclusion.

Correlation between the response of maize lines to CMS and their origin

Transferring maize hybrids to a sterile basis is the most important condition for their introduction into production. In this regard, it is important to study the behavior of the initial forms of hybrids, namely self-pollinated lines, in the sterile cytoplasm. The purpose of the current study was to estimate the response of new self-pollinated maize lines, depending on their origin, to the “M” and “C” types of CMS, to identify natural restoring agents and complete sterility fixatives. The study was carried out at the FSBSI “ARC “Donskoy” in 2021–2023. The subjects of the study were 20 new self-pollinated maize lines of various origins, 6 sources of sterility, 120 testcross maize hybrids. There was found that the response of maize lines depended on their origin. Lines belonging to the same group (by origin) usually had the same reaction to the Moldovan (“M”) and Bolivian (“C”) types of cytoplasmic male sterility (CMS). The closer the lines are related, the smaller the differences. The new self-pollinated lines of the first group ‘SL 171’, ‘SL 172’, ‘SL 174’, ‘SL 175’, ‘SL 176’ and ‘SL 177’ were characterized by complete consolidation of the type “M” of CMS (class 0). Lines of subgroup Ia were fixed, but subgroups Ib did not completely restore the type “C” of sterility. In the second group there were identified the complete ‘SL 181’, ‘SL 182’ (class 4, 5) and incomplete ‘SL 183’, ‘SL 184’ (class 2–5) reducing agents of the type “M” of sterility. There was determined that all lines of the second group perpetuated sterility of the Bolivian type (class 0). There have been identified the lines of the third group ‘SL 191’, ‘SL 192’, ‘SL 193’, ‘SL 194’, as full reducing agents of the type “M” of CMS, two of them ‘SL 191’ and ‘SL 193’ are also complete reducing agents of the type “C” of CMS (class 4, 5). All lines of the fourth group could be classified as complete fixatives (class 0, 1) of the studied types of CMS. The results obtained will improve the efficiency of work on transferring maize hybrids to a sterile basis.

Genitourinary syndrome of menopause and intestinal microbiota.

Genitourinary syndrome of menopause (GSM) is one of the pathological symptoms of menopause, which causes significant physical, psycho-emotional, and sexual discomfort to a woman. The study describes an examination of 65 middle-aged women, who were divided into 2 groups. Group I included 39 patients with GSM, who, depending on the duration of symptoms (3-5 years, more than 7 years), were divided into subgroups Ia and Ib. Group II included 26 patients who did not have clinical manifestations of GSM. All patients underwent general clinical studies. Bacteriological examination of faeces was used to assess the state of the intestinal microbiota. It was found that menopause occurred in women with GSM earlier, compared with patients without manifestations of urogenital disorders. Also, the women with GSM were more likely to be diagnosed with type 2 diabetes mellitus, metabolic syndrome, overweight, and iron deficiency anaemia. When analysing the results of a bacteriological study in this group of patients, a statistically significant decrease in the colonization of Bifidobacterium and Lactobacillus, as well as excessive bacterial growth of such conditionally pathogenic bacteria as Escherichia coli with reduced enzymatic activity, and Klebsiella and Streptococcus was revealed. Conclusions: Conducting a fundamental study on the characteristics of the intestinal microbiota in menopausal disorders will be an important step towards understanding the pathogenetic mechanisms of their formation, and correction of intestinal metabolism can become an important condition for effective prevention and treatment.

New insights into molecular features of the genome-wide AOX family and their responses to various stresses in common wheat (Triticum aestivum L.)

Alternative oxidase (AOX) is an important terminal oxidase involved in the alternative oxidation pathway in plants, which is closely related to various biotic and abiotic stress responses. However, a comprehensive research on AOX gene family of wheat is still lacking. In this study, the members of wheat AOX (TaAOX) family were identified, and their molecular characteristics and gene expression patterns were systematically investigated. Seventeen TaAOX genes were identified from Chinese Spring (CS) genome, which were mapped on 7 chromosomes and mainly clustered on the long arm's distal end of the second homologous groups. Phylogenetic analysis showed that TaAOX genes were classified into four subgroups (Ia, Ib, Ic, and Id), and the Ia subgroup possessed the most members. Tandem duplication and segmental duplication events were found during the evolution of TaAOX genes and they were affected by purifying selection demonstrated by Ka/Ks analysis. The exon numbers of this family gene varied greatly from 1 to 9. Except for Ta3BSAOX14, all the proteins encoded by the other 16 TaAOX genes contained the amino acid residues of the key active sites in the AOX domain (cd01053). The expression patterns of TaAOX genes in various tissues and under abiotic and biotic stresses were analyzed using public transcriptome data, furthermore, qRT-PCR analysis was performed for some selected TaAOX genes, and the results suggested that most members of this gene family play an important role in response to different stresses in common wheat. Our results provide basic information and valuable reference for further exploring the gene function of TaAOX family by using gene editing, RNAi, VIGS, and other technologies.

Incidence of venous thromboembolism with immune checkpoint inhibitors in a community setting: A single-center retrospective study.

e14681 Background: Immune activation and inflammation caused by immune checkpoint inhibitors (ICIs) are critical pathobiological drivers for venous thromboembolism (VTE). There is a paucity of data about VTE risk in cancer patients receiving ICI. We aimed to describe the incidence of VTE in cancer patients receiving ICI in a community setting. Methods: We conducted a single center, retrospective cohort study at Saint Vincent Hospital. The study cohort was created using our center's pharmacy database of patients who received any of the five ICIs (ipilimumab, nivolumab, pembrolizumab, atezolizumab, or durvalumab) between Jan 2017 and Dec 2022. VTE events including deep venous thrombosis, splanchnic vein thrombosis, and pulmonary embolism, were identified by chart review. We used a self-controlled risk-interval design, with "control period" and "at-risk period" being 6 months before and after the initiation of ICI treatment respectively. VTE events were also analyzed for subgroups: Single-agent ICI therapy (IA), Dual ICI therapy (IB), and ICI + chemotherapy (IC). Descriptive statistics and cox regression were used for statistical analysis. Results: Study population included 170 patients, with 75, 14, and 81 patients in subgroups IA, IB, and IC respectively. The mean age of the patients was 69.51 ± 10.05 years with a majority being males (62.4%). The most common cancer observed was non-small cell lung cancer (43.5%) followed by small cell lung cancer (6.9%), and malignant melanoma (5.7%). Pembrolizumab (55.3%) was the most common ICI used and nivolumab + ipilimumab (7.64%) was the most common dual ICI used. We noted a 1.25-fold higher incidence of VTE post-ICI use (Incidence rate ratio [IRR]: 11.76 per 100 person-year) compared to pre-ICI use (IRR: 9.41 per 100 person-year) at 6 months. On subgroup analysis, Group IB had the highest risk for VTE at 6 months (IRR: 28.57 per 100 person-year), followed by group IC and IA (IRR: 14.12 and 8.0 per 100 person-year respectively). IRR decreased to 6.62 per 100 person-year at 12-month interval indicating increased VTE risk in the first 6 months of ICI exposure. Type of ICI, adjuvant chemotherapy or type of cancer was not able to predict VTE risk on multivariate analysis. Conclusions: ICI treatment was associated with an increased incidence of VTE in our study cohort with the highest risk among patients on dual ICI followed by ICI + chemotherapy and ICI monotherapy. Future prospective studies are needed to identify risk factors and biomarkers to improve risk stratification and risk-adapted thromboprophylaxis.[Table: see text]

Antibacterial Efficacy of Irrigants with Varying Osmolarity on E. faecalis Biofilm: An In Vitro Study.

To evaluate the role of the addition of different concentrations of sodium chloride salt to conventional intracanal irrigants to vary their osmotic values and thereby compare their antibacterial efficacy. In an active attachment biofilm model, Enterococcus faecalis (ATCC 29212) biofilms were grown. Sodium chloride salts were added to 100 mL of distilled water to make 6M (hyperosmotic), 0.5M, and 0.25M (hypoosmotic) sodium chloride solutions, respectively. The experimental groups were divided into three groups: Group I: 5.25% sodium hypochlorite, group II: 2% chlorhexidine, and group III: 2% povidone iodine, and four subgroups within these three groups, such as subgroup A (without salt solution), subgroup B (with 6M of hyperosmotic salt solution), subgroup C (with 0.5M of hypoosmotic salt solution), and subgroup D (with 0.25M of hypoosmotic salt solution), respectively. Biofilms were treated with all the subgroups for a contact time of 15 min. A crystal violet assay was done to estimate the bacterial cell biomass. The results revealed that subgroups IIIB, IB, and IID, ID had a statistical reduction in bacterial biomass at p < 0.05. There were no significant differences between subgroups IC, IIC, and IIIC and subgroups IA, IIA, and IIIA. The antibacterial efficacy of all three irrigants was significantly affected by varying the osmolarities. The results prove that the hyperosmotic and hypoosmotic salt solutions, along with irrigants, have enhanced antibacterial efficacy on E. faecalis biofilm due to its ability to vary the turgor pressure of cell wall, as well as the inherent properties of the irrigants such as hypochlorous acid formation, ionic interaction, and free radical interactions.

Можливості використання декаметоксину у пацієнтів з хронічними захворюваннями нижніх дихальних шляхів при гострих респіраторних вірусних інфекціях

The annual increase in the number of patients with chronic respiratory diseases and a significant increase in the level of antibiotic resistance in Ukraine and in the world has set modern scientists an extremely important task - the search for new effective ways of combating infectious agents of viral and bacterial exacerbations of pathologies of the tracheobronchial tree. The aim: to assess the efficacy and safety of decamethoxine in patients with exacerbations of chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB). Materials and methods: clinical symptoms were evaluated in 19 patients with COPD (group I) and 38 patients with COPD (group II) with signs of acute respiratory viral infection (ARVI) at three visits: the initial visit (at the time of the initial visit to the family doctor ), the second visit (on days 3-5 after the initial application) and the third visit (on days 7-10 after the initial application). Subgroups were divided depending on the prescribed anti-infective therapy: subgroups Ib and IIb received symptomatic therapy, and subgroups Ia and IIa additionally received decamethoxine. The results. One of the most frequent symptoms at the initial visit was cough for the patients of both groups. Decamethoxine contributed to a decrease in the frequency of cough on the 7-10th day of treatment by two times in subgroup Ia (p &lt; 0.05) and by almost 5 times in subgroup IIa (p &lt; 0.001). The dynamics of dyspnea in patients with COPD who did not receive additional therapy with decame thoxine was not variable during the entire study period. Patients with CB extremely rare had such a symptom as shortness of breath. In both subgroups of patients treated with decamethoxine, a certain tendency to an increase in cases of purulent sputum was observed only at visit 2, however, at the third visit, the number of such patients decreased and clearly coincided with the appointment of antibacterial drugs. Manifestations of the intoxication syndrome decreased over time in all subgroups, and at the third visit were less pronounced compared to the first two visits in most patients and practically did not depend on the additional intake of decamethoxine. There was no significant difference in the reduction of symptoms of nasopharyngoconjunctival syndrome. The conducted analysis of the frequency of hospitalization showed that only 1 patient from subgroups Ia and IIa continued treatment in hospital conditions at visit 3, and in patients with standard basic therapy by the time of visit 3, hospitalization was required for 2 patients of subgroup Ib and two from IIb. Conclusions. The inclusion of decamethoxin solution in the complex treatment of ARVI in patients with chronic diseases of the lower respiratory tract allows to reduce the duration of cough, shortness of breath, producing of purulent sputum, manifestations of nasopharyngeal syndrome by 1.5-3 times. Additional inhalation use of 0.02 % decamethoxine solution reduces the need to prescribe antibacterial drugs and the risk of hospitalization by 2.2 times among patients with COPD. Patients with CB who received inhalation nebulizer therapy with a sterile solution of decamethoxine used antibiotics 2.2 times less often, and none of them were hospitalized.

Intravitreal methotrexate infusion for prophylaxis of proliferative vitreoretinopathy after pars plana vitrectomy for rhegmatogenous retinal detachment.

Proliferative vitreoretinopathy (PVR) is the leading cause of recurrent retinal detachment after surgical repair of rhegmatogenous retinal detachment (RRD). Our study aimed to assess the efficacy and safety of intravitreal methotrexate infusion (IMI) for the prevention of PVR after pars plana vitrectomy (PPV) in eyes with RRD. This prospective comparative interventional study was conducted from September 2020 to November 2021 at Ain Shams University Hospitals, Egypt. We recruited a consecutive, non-randomized sample of 47 eyes of 47 patients with RRD undergoing PPV. Participants were allocated to a control group or an intervention group that received IMI during surgery. Each group was subdivided into subgroups of eyes at high-risk of developing PVR and eyes with established preoperative PVR grade C. Outcome measures at the 3-month postoperative follow-up were the rate of retinal attachment, incidence of PVR, reoperation rate to flatten the retina, and changes in the retina and/or optic nerve function as assessed by full-field electroretinogram and flash visual evoked potential. Data from 47 eyes (23 and 24 eyes in the intervention and control groups, respectively) were evaluated. Subgroups IA, IB, and IIB each included 12 eyes, subgroup IIA included 11 eyes, and all subgroups had comparable sex ratios and age distributions. Postoperative PVR at 1 month and between 1 and 3 months was present in 13% and 4% of eyes in the intervention group, respectively. Reoperation to flatten the retina was required in 2 (9%) eyes in the intervention group, while 22 eyes (96%) had complete flattening of the retina at 3 months. No significant differences were found between the study groups and the corresponding subgroups regarding the outcome measures (all P > 0.05). No adverse events attributable to IMI were detected up to 3 months postoperatively. Although IMI was safe for intraocular use in eyes with RRD and PVR grade C or a high risk of developing PVR, it did not affect the anatomical success rate or development of PVR up to 3 months after PPV. Further multicenter randomized clinical trials with longer follow-up periods and larger sample sizes are needed to verify these preliminary outcomes.

Efficacy of using bedaquiline in treatment of tuberculosis patients with multiple and extensive drug resistance

The objective: to compare treatment efficacy of pulmonary tuberculosis patients with multiple (MDR) and extensive drug resistance (XDR) using a standard chemotherapy regimen and the regimen containing bedaquiline.Subjects and Methods. A retrospective study was conducted to analyze treatment outcomes in 219 patients with pulmonary tuberculosis and MDR/XDR of Mycobacterium tuberculosis (MTB) aged 18-75 years old who were treated in in-patient and out-patient facilities of St. Petersburg from 2016 to 2019. Treatment outcomes were analyzed by subgroups formed taking into account resistance patterns and addition of bedaquiline to the treatment regimens: Ia – n = 94 (MDR TB; Bq-) and IIa ‒ n = 80 (XDR TB; Bq-); Ib ‒ n = 22 (MDR TB; Bq+) and IIb ‒ n = 23 (XDR TB; Bq+). Clinical and laboratory parameters of patients, the severity of comorbidity were assessed before the start of treatment, after 3, 6, 12-14 and 18-24 months of therapy, as well as after therapy completion and during the follow-up period. Statistical analysis was carried out using Statistica 10.0 and methods of parametric and nonparametric statistics and the SPSS 16.0 software, where p ≤ 0.05 was considered significant.Results. XDR TB patients in Subgroup IIb were significantly more likely to have a high level of comorbidity according to Charlson index (from 5 to 6 points) – in 34.7% of cases versus 5.0% in Subgroup IIa. At all stages of treatment in MDR TB patients with Bq+ (Ib), sputum conversion was recorded significantly more often versus patients of Subgroup Ia with Bq- when examined at all stages, with maximum effectiveness achieved by 18-24 months of treatment (90.9%). Treatment efficacy of XDR TB patients (IIb, Bq+) was also significantly higher versus treatment regimen containing no bedaquiline (60.8% (IIb, Bq+) versus 25.0% (IIa, Bq-), χ2 = 4.61, p &lt; 0.05).Conclusions. Achieved high efficacy of therapy in Subgroups Ib and IIb containing Bq provided a positive impact on treatment default rates, that were recorded in a low percentage of cases in those subgroups. An ineffective course of treatment in MDR TB patients treated with regimens containing no Bq was observed in 42.5% in Subgroup Ia, while this rate made only 0.09% in Subgroup Ib. Treatment effectiveness was the highest in XDR TB patients of Subgroup IIb when Bq was added to the treatment regimen.

EFFECT OF CHOLECALCIFEROL ON RATE OF MORNING BLOOD PRESSURE RISE IN WOMEN WITH ARTERIAL HYPERTENSION IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL PERIODS

Objective: To assess effect of cholecalciferol on rate of morning blood pressure (BP) rise in women with arterial hypertension (AH) in premenopausal and early postmenopausal periods. Design and method: We investigated 102 women with AH stage II risk 3 aged 50 (48; 53) years: 50 females in premenopausal period – group I and 52 females in early postmenopausal period – group II. Serum level of 25(OH)D was determined by the immunoenzymatic assay. In groups I and II we identified subgroups with the level of 25(OH)D&lt; 30ng/ml: subgroup IB (n = 25) and subgroup IIB (n = 21) respectively, in which antihypertensive therapy was supplemented with cholecalciferol 2,000 IU/day for 3 months. In subgroups IA (n = 25) and IIA (n = 31) cholecalciferol was not administered. The rate of morning BP rise was calculated by the ratio of the BP rise value to its time using daily monitoring of BP. Results: At baseline the level of 25(OH)D was lower (p &lt; 0,05) in subgroups IB (19,3 ± 8,5ng/ml) and IIB (18,2 ± 9,5ng/ml) than in the comparable subgroups IA (26,7 ± 11,5ng/ml) and IIA (27,4 ± 10,5ng/ml). After supplementation the level of 25(OH)D increased (p &lt; 0,001) in subgroup IB (37,28 ± 11,97ng/ml) and in subgroup IIB (36,4 ± 10,0ng/ml), and became higher (p &lt; 0,001) than in the comparable subgroups I and IIA. At baseline, subgroups IA and IB did not differ (p &gt; 0,05) by rate of morning SBP/DBP rise. In subgroup IIB rate of morning DBP rise was higher (p = 0,04) than in subgroup IIA. After therapy in subgroup IB there was a decrease rate of morning SBP/DBP rise (p &lt; 0,05); in subgroup IA, rate of morning SBP/DBP rise did not change (p &gt; 0,05). In subgroup IIA, there was no decrease (p = 0.62) rate of morning DBP rise, while in subgroup IIB, rate of morning DBP rise in the decreased (p &lt; 0,05) compared to the baseline and in comparison with rate of morning DBP rise in subgroup IIA after therapy (p = 0,04). The contribution of cholecalciferol to the dynamics of rate of morning DBP rise was established: F = 4,33, p = 0,04. Conclusions: Correction of 25(OH)D level by intake of cholecalciferol 2000 IU/day for 3 months leads to reduction of rate of morning BP rise in women with AH.

What Is Most Suitable for Children With Cystic Fibrosis-The Relationship Between Spirometry, Oscillometry, and Multiple Breath Nitrogen Washout.

IntroductionIn cystic fibrosis (CF), pathological lung changes begin early in life. The technological progress currently gives many diagnostic possibilities. However, pulmonary function testing in children remains problematic.ObjectivesOur study aimed to correlate the results of impulse oscillometry (IOS) with those of multiple breath nitrogen washout (MBNW) in our pediatric CF population. We also compared those parameters between the groups with and without spirometric features of obturation.MethodsWe collected 150 pulmonary function test sets, including spirometry, IOS, and MBNW in patients with CF aged 12.08 ± 3.85 years [6–18]. The study group was divided into two subgroups: IA (without obturation) and IB (with obturation). We also compared Sacin, Scond, and oscillometry parameters of 20 patients aged 14–18 years who reached the appropriate tidal volume (VT) during MBNW.ResultsStatistical analysis showed a negative correlation between lung clearance index (LCI) and spimoetric parameters. Comparison of subgroups IA (n = 102) and IB (n = 48) indicated a statistically significant difference in LCI (p < 0.001) and FEV1z-score (p < 0.001), FEV1% pred (p < 0.001), MEF25z-score (p < 0.001), MEF50 z-score (p < 0.001), MEF75 z-score (p < 0.001), R5% pred (p < 0.05), and R20% pred (p < 0.01). LCI higher than 7.91 was found in 75.33% of the study group, in subgroup IB—91.67%, and IA−67.6%.ConclusionsLCI derived from MBNW may be a better tool than IOS for assessing pulmonary function in patients with CF, particularly those who cannot perform spirometry.

Recurrent bacterial vaginosis: possible ways of correction

Research objective: to increase the effectiveness of bacterial vaginosis (BV) treatment in women of reproductive age.Materials and methods. The study involved 64 women of reproductive age with BV. After a course of local antibiotic therapy participants were divided into 2 groups: patients of group I were not prescribed local remedies to restore the vaginal microflora, patients of group II were prescribed vaginal prebiotic suppositories Folial № 10. No additional drugs were used in subgroups IA and IIA, while oral probiotic Maxibalance was prescribed in subgroups IB and IIB. The effectiveness of BV treatment was evaluated at the first, third and sixth months of the observation period according to the results of clinical examination and vaginal pH evaluation by litmus strips.Results. The course of BV in subgroup IA was characterized by prevailing number of relapses and their early appearance. 1 case of BV recurrence was found among patients of subgroup IA at the 1st month of follow-up, 6 and 8 BV episodes were found at 3 and 6 months of follow-up respectively. Sequential treatment with antibiotics and oral probiotics (subgroup IIB) was associated with the onset of 3 BV relapses on 4–5 months from baseline. Local prebiotic (subgroup IIA) after the vaginal sanation was associated with BV reoccurrence in only one patient at the end of the study. No relapses of BV were detected in subgroup IIB during the study.Conclusions. Permanent imbalance of vaginal normocenosis creates optimal conditions for chronic and recurrent diseases of dysbiosis nature, especially BV. Despite the sensitivity of the anaerobic flora to the recommended antibacterial medications, their use as monotherapy in BV treatment is often insufficient. The results of the study demonstrate a significant anti-relapse efficiency of consecutive treatment by antibacterial drugs and a complex of probiotic + prebiotic. This effect is probably based on the restoration of vaginal immunity and metabolism by stable colonization of the vaginal mucosa with live lactobacilli of eubiotic origin.

ROLE OF TLR2, TLR4 GENE POLYMORPHISM IN DEVELOPING MICROVASCULAR COMPLICATIONS IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

Long-term complications of type 1 diabetes mellitus (T1DM) in children and adolescents are an important problem in modern medicine. Recently, the role of immune mechanisms, in particular, chronic inflammation, in the development of both T1DM and its microvascular complications has been actively discussed. Activation of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) leads to hyperproduction of proinflammatory cytokines, chemokines, adhesion molecules involved in the formation of diabetic microvascular complications. At the same time, TLR2 and TLR4 gene polymorphism alters the immune susceptibility to the endogenous ligands, which may increase the risk of diabetic microangiopathies. The aim of this study is to evaluate the frequency of genotypes and alleles of TLR2 and TLR4 genes distribution and to determine the content of TNFα, IL-1, VCAM-1, fractalkine, endothelin-1 in adolescents with T1DM with microvascular complications. We examined 139 adolescents with T1DM from 14 to 18 years old and 56 healthy teenagers. Patients with T1DM were divided into two groups: Group I – patients with poor glycemic control (HbA1C &gt; 9.0%), (n = 64); Group II – patients with satisfactory glycemic control of T1DM (HbA1C ≤ 9.0%), (n = 75), including adolescents with optimal (HbA1C &lt; 7.5%) and suboptimal glycemic control (7.5% ≤ HbA1C ≤ 9.0%) (ISPAD clinical practice consensus guidelines 2014). According to the presence of microvascular complications, the groups were subdivided into subgroups: Iа (n = 49), IIа (n = 38) – adolescents with verified microvascular disorders: diabetic retinopathy, nephropathy and neuropathy; Ib (n = 15), IIb (n = 37) – without microvascular complications. Allelic variants of TLR genes were determined using test systems GosNII genetics (Moscow). The content of cytokines in blood serum was carried out by the method of enzyme-linked immunosorbent assay “BIOSCIENCE”. Data were analyzed using software packages Statistica version 6.0. The assessment of TLR2 (Arg753Gln) and TLR4 (Thr399Ile) polymorphism distribution did not reveal significant differences between the observed subgroups and the control. In Ia and IIa subgroups (with complications) Asp299Gly variant was noted to be significantly less common when compared to subgroups Ib, IIb and controls. The presence of Gly allele in TLR4 gene was found to disrupt the expression of TNFα and VCAM-1 and can be considered protective for the development of microvascular complications.

Histological and biochemical studies on effect of Sofosbuvir (Sovaldi) on adult male albino rat kidney

ABSTRACT Sofosbuvir (sovaldi) is the backbone of many anti‐HCV drugs. We aimed to demonstrate the effect of sofosbuvir on the adult male albino rat kidney. Sixty adult male albino rats were used. The animals were divided equally into 2 main groups (I and II), and each group was divided equally into 3 subgroups (A, B, and C). In group I (control group), each rat was gavaged 0.5 ml distilled water daily for 4 weeks. In group II (sofosbuvir treated group), each albino rat was gavaged 0.5 ml distilled water containing 7.2 mg sofosbuvir daily for 4 weeks. The rats were sacrificed at the end of the 4th week (subgroups IA and IIA), 6th week (subgroups IB and IIB), and 8th week (subgroups IC and IIC) from the start of the treatment. The kidneys were used for histological study while blood samples were used for biochemical study. The obtained data were statistically analyzed. Sofosbuvir (sovaldi) induced pathological changes that gave the criteria of acute Kidney injury in the adult male albino rats. The pathological changes were confirmed by elevation of serum level of urea and creatinine. After 2 and 4 weeks of drug withdrawal, the kidney incompletely recovered. We concluded that sofosbuvir induced criteria of acute tubular injury in the kidney of the adult male albino rats. This renal injury was proved by histological and biochemical studies. These insults were incompletely reversible after the end the treatment.