Subgroups IIB Research Articles

Chemical Variability of the Leaf Essential Oil of Two Subspecies of Juniperus oxycedrus L. from Northwestern Algeria.

Thirty-seven essential oil samples have been isolated from leaves of individual plants of Juniperus oxycedrus (subspecies oxycedrus and macrocarpa) growing wild in Tlemcen and Aïn Témouchent provinces (Northwestern Algeria). Analysis of eight selected oil samples by GC(RI), GC/MS and 13C NMR, allowed the identification of 88 components that accounted for 84.4-99.5% of the whole compositions. The 37 compositions were subjected to statistical analysis which suggested the existence of groups and sub-groups I, IIA and IIB. Group I, the most important group with 24 oil samples out of 37, differed from sub-groups IIA and IIB, essentially by the high content of α-pinene (mean value, 69.2%; SD 6.24). Sub-groups IIA and IIB were differentiated by their content of α-pinene (Mean values, 49.7% and 27.3%, respectively) as well as δ-3-carene (10.3%, sub-group IIA), sabinene and (Z)-6-pentadecen-2-one (8.7% and 4.9%, respectively, sub-group IIB).

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.

Histological study of the effect of curcumin on indomethacin-induced ileitis in adult male albino rats

Background Ileitis induced by indomethacin represents a well-standardized model in the study of acute and chronic inflammation of the intestine. Curcumin is an orange-yellow component of the herb turmeric. It has potent anti-inflammatory, antioxidant, antimicrobial, and anticancer effects. Aim This work was performed to show the effect of curcumin on indomethacin-induced ileitis in rats using H&E stain. Materials and methods Thirty-six mature male albino rats (160–200 g) were used in this study. They were separated into four formain groups; control group: 8 rats, group I: 8 rats that received oral aqueous suspension of curcumin 100 mg/kg daily; group II: 10 rats included subgroups (IIA & IIB): ileitis was induced by subcutaneous injection of two doses of indomethacin; each dose was 7.5 mg/kg separated by 24 hours, the rats were then killed on the 3rd and the 18th day, respectively, and group III: 10 rats included subgroups (IIIA& IIIB): the ileitis group was treated with an oral aqueous suspension of curcumin 100 mg/kg daily and then the rats were killed on the 3rd and 18th day respectively. Results Subgroups IIA and IIB revealed sloughing of surface epithelium in the lumen of the intestine, ulceration, a significant decrease of villus height at H&E sections, and inflammatory cellular infiltration. Subgroups IIIA and IIIB showed marked improvement in the pathological changes of induced ileitis. Conclusion Curcumin could decrease ileitis induced by indomethacin in rats. So, it could be useful for the treatment of intestinal injury.

Application of Sonographic Assessments of the Rate of Proximal Progression to Monitor Protobothrops mucrosquamatus Bite-Related Local Envenomation: A Prospective Observational Study.

Patients bitten by Protobothrops mucrosquamatus typically experience significant pain, substantial swelling, and potentially blister formation. The appropriate dosage and efficacy of FHAV for alleviating local tissue injury remain uncertain. Between 2017 and 2022, 29 snakebite patients were identified as being bitten by P. mucrosquamatus. These patients underwent point-of-care ultrasound (POCUS) assessments at hourly intervals to measure the extent of edema and evaluate the rate of proximal progression (RPP, cm/hour). Based on Blaylock's classification, seven patients (24%) were classified as Group I (minimal), while 22 (76%) were classified as Group II (mild to severe). In comparison to Group I patients, Group II patients received more FHAV (median of 9.5 vials vs. two vials, p-value < 0.0001) and experienced longer median complete remission times (10 days vs. 2 days, p-value < 0.001). We divided the Group II patients into two subgroups based on their clinical management. Clinicians opted not to administer antivenom treatment to patients in Group IIA if their RPP decelerated. In contrast, for patients in Group IIB, clinicians increased the volume of antivenom in the hope of reducing the severity of swelling or blister formation. Patients in Group IIB received a significantly higher median volume of antivenom (12 vials vs. six vials; p-value < 0.001) than those in Group IIA. However, there was no significant difference in outcomes (disposition, wound necrosis, and complete remission times) between subgroups IIA and IIB. Our study found that FHAV does not appear to prevent local tissue injuries, such as swelling progression and blister formation, immediately after administration. When administering FHAV to patients bitten by P. mucrosquamatus, the deceleration of RPP may serve as an objective parameter to help clinicians decide whether to withhold FHAV administration.

Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study.

To evaluate the effect of antioxidants on the shear bond strength of composite resin to bleached enamel. A total of 120 extracted permanent anterior teeth were split into four major groups, one among them being a control group. Group I (bleaching + without antioxidant), group II (bleaching + 10% sodium ascorbate), group III (bleaching + 5% grape seed extract), and group IV (bleaching + 5% pine bark extract). All of the groups were bleached using a gel containing 35% carbamide peroxide, and then they were divided into two subgroups depending on when the bonding operation was to be completed-subgroup A was done in 24 hours, while subgroup B took 3 weeks. The universal testing machine was used to measure the shear bond strength. Subgroup IA showed poor shear bond strength than other groups, there was no statistically significant difference between subgroup IB, IIA, and IVA. Subgroup IIIA showed the highest shear bond strength than the remaining groups. Between subgroups IIA and IIB, IIIA and IIIB, and IVA and IVB there was no statistically significant difference. This shows that delaying the bonding procedure for 3 weeks shows similar shear bond strength when compared to groups that were immediately bonded after antioxidant applying groups. All the antioxidants' immediate application could reverse compromised bond strength. Among them, 5% grape seed extract shows the highest increase in shear bond strength. Maddula DC, Vasepalli M, Martha S, et al. Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):87-92.

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.

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.

Variant anatomy of the renal arteries with anastomosis variants in kidney transplantation

Abstract Funding Acknowledgements Type of funding sources: None. One of the most important tasks of morphology as an integral part of practical medicine is comprehensive development of theoretical knowledge pertaining to the variants and anomalies of the renal arteries anatomy. One of the main conditions required for the normal functioning and viability of the renal transplant is its adequate perfusion. Due to the variant anatomy of the renal arteries and the presence of several adjacent vessels with which anastomosis can be performed, there are many strategies for arterial allograft anastomosis. The goal of the study was to identify patterns of variant topography and anatomy of the human renal arteries according to CT angiography with three-dimensional modeling which would be further used to optimize the technique of forming vascular anastomosis during kidney transplantation. Materials and methods. The study included an assessment of computed tomograms of the abdominal organs of 130 patients, which were used to build three-dimensional models. Morphometry was carried out using the Autoplan and Luch-S programs. Based on the results of the CT scans of the kidneys and renal arteries in patients who underwent kidney transplantation, computer 3D models of the renal artery and arterial renal bed were constructed when anastomoses of the renal artery were performed with: the external iliac (group I), the internal iliac (group II) and common iliac (group III) arteries, and in the cases of multiple arteries - during the formation of a common trunk (IIa subgroup) or separate anastomosis with the common iliac artery (IIb). Afterwards, using the Abaqus program, analysis of hemodynamic parameters of intravascular blood flow was conducted, namely: volumetric blood flow rate, partial renal blood flow (the ratio of volumetric blood flow rate to graft weight), visual assessment of the blood flow turbulence. Results volumetric renal blood flow in group II (594 cm3/min) and group III (610 cm3/min) was greater than in group I (550 cm3/min); specific renal blood flow in group III exceeded groups I and II by 0.34 cm3/min/g; high turbulence was observed in the anastomosis angle region in groups I and III. The volumetric renal blood flow in subgroups IIa and IIb was 615 and 585 cm3/min respectively, and in the presence of an extra artery extending from the lower pole, a decrease in the linear blood flow velocity in the inferior polar segmental artery was visually assessed. Based on the results of the study, we can conclude that in the presence of a single renal artery, the best perfusion outcome is achieved when performing anastomosis with the common and internal iliac arteries. With multiple kidney arteries, the best perfusion option is obtained when a single renal artery fistula is formed.

The effectiveness of extracorporeal shock wave lithotripsy for lower calyx stones in children

Introduction. According to current clinical guidelines, the use of extracorporeal shock wave lithotripsy (ESWL) for lower calyx stones is indicated when their size is less than 1 cm. This is due to the low efficiency and high frequency of repeated procedures for larger stones.Purpose of the study. To examine the results of ESWL usage in the treatment of children with lower calyx stones of various sizes.Materials and methods. ESWL was performed on 33 children with lower calyx stones during 2013 - 2018 yrs. Patients were divided into 2 groups: Group I - 24 (72.7%) patients with primary stones, Group II - 9 (27.3%) patients after ESWL of kidney pelvis stones that migrated to the lower calyx. Both groups are divided into subgroups: a - children with stones less than 1 cm and b - with stones more than 1 cm. ESWL was performed under general anesthesia and ultrasound guidance. In all patients after ESWL we used the inversion technique. The result was considered positive in case of the complete elimination of stones was achieved.Results. After the first ESWL session, stone-free status was achieved in 21/33 (63.6%) patients of all groups, after the second ESWL session in 26/33 (78.8%), after 3 sessions - 30/33 (90.9%). In subgroups Ia and IIa, there were 14/22 (63.6%) children after the first ESWL with complete elimination of calculi, and after subsequent sessions, the success rate was 90.9% (20/22 calculi). After the first ESWL session in subgroups Ib and IIb, complete elimination of stones was achieved in 7/11 (63.6%) children, after repeated sessions in 10/11 (90.9%) children.Conclusions. ESWL demonstrates a high efficiency in the treatment of lower calyx stones less and more than 1 cm, both after the first and third sessions, and in the treatment of primary and residual (migrated) stones.

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

Pleural Pressure Targeted Positive Airway Pressure Improves Cardiopulmonary Function in Spontaneously Breathing Patients With Obesity

Increased pleural pressure affects the mechanics of breathing of people with class III obesity (BMI > 40kg/m2). What are the acute effects of CPAP titrated to match pleural pressure on cardiopulmonary function in spontaneously breathing patients with class III obesity? We enrolled six participants with BMI within normal range (control participants, group I) and 12 patients with class III obesity (group II) divided into subgroups: IIa, BMI of 40 to 50kg/m2; and IIb, BMI of≥ 50kg/m2. The study was performed in two phases: in phase 1, participants were supine and breathing spontaneously at atmospheric pressure, and in phase 2, participants were supine and breathing with CPAP titrated to match their end-expiratory esophageal pressure in the absence of CPAP. Respiratory mechanics, esophageal pressure, and hemodynamic data were collected, and right heart function was evaluated by transthoracic echocardiography. The levels of CPAP titrated to match pleural pressure in group I, subgroup IIa, and subgroup IIb were 6 ± 2cmH2O, 12 ± 3cmH2O, and 18 ± 4cmH2O, respectively. In both subgroups IIa and IIb, CPAP titrated to match pleural pressure decreased minute ventilation (IIa, P= .03; IIb, P= .03), improved peripheral oxygen saturation (IIa, P= .04; IIb, P= .02), improved homogeneity of tidal volume distribution between ventral and dorsal lung regions (IIa, P= .22; IIb, P= .03), and decreased work of breathing (IIa, P< .001; IIb, P= .003) with a reduction in both the work spent to initiate inspiratory flow as well as tidal ventilation. In five hypertensive participants with obesity, BP decreased to normal range, without impairment of right heart function. In ambulatory patients with class III obesity, CPAP titrated to match pleural pressure decreased work of breathing and improved respiratory mechanics while maintaining hemodynamic stability, without impairing right heart function. ClinicalTrials.gov; No.: NCT02523352; URL: www.clinicaltrials.gov.

EFFECT OF CHOLECALCIFEROL ON PULSE WAVE VELOCITY IN WOMEN WITH ARTERIAL HYPERTENSION IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL PERIODS

Abstract Objective: Aim: To assess effect of cholecalciferol on pulse wave velocity (PWV) in women with arterial hypertension (AH) in premenopausal and early postmenopausal periods who received 25 (OH)D supplementation. Design and method: Materials and methods: 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 PWV was determined by assessing the elastic properties of blood vessels using computer rheovasography. Statistical analysis was performed by means of «STATISTICA 10.0». Results: 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, IIA and IIB did not differ (p &gt; 0,05) by PWV. Following the therapy PWV decreased (p &lt; 0,01) in all groups. However, the PWV was significantly lower (p &lt; 0,05) in subgroups IB (3,7 (3,1;4,3) m/s) and IIB (4,1 (3,6; 4,5) m/s) than in the comparable subgroups IA (4,2 (3,6; 5,2)m/s) and IIA (4,8 (4,0;5,6) m/s), correspondingly. Conclusions: Conclusion: Correction of 25 (OH)D level by intake of cholecalciferol 2000 IU/day for 3 months leads to reduction of PWV in women with AH.

Efficacy of Multiple Rotary File Systems in Retreatment of Oval-shaped Root Canals in Mandibular Molars: A Cone-Beam Computed Tomography Study

Aim: To evaluate effectiveness of multiple rotary file systems on removal of the filling materials during retreatment of oval-shaped root canals. Methods: 40 oval root canals were instrumented with ProTaper Next to size X4. The canals were allocated into two equal groups according to the final rinse, Group I: with Biopure MTAD, and Group II: with 17% EDTA. All the canals were obturated with bioceramic based root canal sealer and gutta-percha using lateral compaction technique. According to the used retreatment rotary system, each group were further subdivided into two equal subgroups including subgroups Ia & IIa using D-Race (DR1) + XP-endo Shaper (XPS) + XP-endo Finisher R (XPFR), and subgroups Ib & IIb using R-Endo retreatment files up to R3 + Revo-S rotary files up to (40/.06). CBCT scans were used to calculate the remaining amount of root filling materials at the pre scan (after obturation), and that of air at the post scan (after retreatment). The dentin volumes were also recorded at both scans to analyze the amount of remaining filling materials. Results: No significant differences were recorded regarding the amount of residual filling material with the tested systems (p > 0.05). Intra subgroups assessments showed more filling material removed when using a larger sized final instrument (p < 0.001). Conclusions: Tested file systems were evenly efficient in removing filling materials from oval-shaped root canals of extracted molars. Types of chelators used and bioceramic based sealer had no significant validity on effectiveness of removal of root canal filling material.