Therapy In Patients Research Articles

Bioengineering stimuli-responsive organic-inorganic nanoarchitetures based on carboxymethylcellulose-poly-l-lysine nanoplexes: Unlocking the potential for bioimaging and multimodal chemodynamic-magnetothermal therapy of brain cancer cells.

Regrettably, glioblastoma multiforme (GBM) remains the deadliest form of brain cancer, where the early diagnosis plays a pivotal role in the patient's therapy and prognosis. Hence, we report for the first time the design, synthesis, and characterization of new hybrid organic-inorganic stimuli-responsive nanoplexes (NPX) for bioimaging and killing brain cancer cells (GBM, U-87). These nanoplexes were built through coupling two nanoconjugates, produced using a facile, sustainable, green aqueous colloidal process ("bottom-up"). One nanocomponent was based on cationic epsilon-poly-l-lysine polypeptide (εPL) conjugated with ZnS quantum dots (QDs) acting as chemical ligand and cell-penetrating peptide (CPP) for bioimaging of cancer cells (QD@εPL). The second nanocomponent was based on anionic carboxymethylcellulose (CMC) polysaccharide surrounding superparamagnetic magnetite "nanozymes" (MNZ) behaving as a capping macromolecular shell (MNZ@CMC) for killing cancer cells through chemodynamic therapy (CDT) and magnetohyperthermia (MHT). The results demonstrated the effective production of supramolecular aqueous colloidal nanoplexes (QD@εPL_MNZ@CMC, NPX) integrated into single nanoplatforms, mainly electrostatically stabilized by εPL/CMC biomolecules with anticancer activity against U-87 cells using 2D and 3D spheroid models. They displayed nanotheranostics (i.e., diagnosis and therapy) behavior credited to the photonic activity of QD@εPL with luminescent intracellular bioimaging, amalgamated with a dual-mode killing effect of GBM cancer cells through CDT by nanozyme-induced biocatalysis and as "nanoheaters" by magnetically-responsive hyperthermia therapy.

Clinical Meaningfulness of an Algorithm-Based Service for Analyzing Treatment Response in Patients with Metastatic Cancer Using FDG PET/CT.

Background/Objectives: Determining how a patient with metastatic cancer is responding to therapy can be difficult for medical oncologists, especially with text-only radiology reports. In this investigation, we assess the clinical usefulness of a new algorithm-based analysis that provides spatial location and quantification for each detected lesion region of interest (ROI) and compare it to information included in radiology reports in the United States. Methods: Treatment response radiology reports for FDG PET/CT scans were retrospectively gathered from 228 patients with metastatic cancers. Each radiology report was assessed for the presence of both qualitative and quantitative information. A subset of patients (N = 103) was further analyzed using an algorithm-based service that provides the clinician with comprehensive quantitative information, including change over time, of all detected ROI with visualization of anatomical location. For each patient, three medical oncologists from different practices independently rated the usefulness of the additional analysis overall and in four subcategories. Results: In the 228 radiology reports, quantitative information of size and uptake was provided for at least one lesion at one time point in 78% (size) and 95% (uptake) of patients. This information was reported for both analyzed time points (current scan and previous comparator) in 52% (size) and 66% (uptake) of patients. Only 7% of reports quantified the total number of lesions, and none of the reports quantified changes in all lesions for patients with more than a few lesions. In the assessment of the augmentative algorithm-based analysis, the majority of oncologists rated it as overall useful for 98% of patients (101/103). Within specific categories of use, the majority of oncologists voted to use it for making decisions regarding systemic therapy in 97% of patients, for targeted therapy decisions in 72% of patients, for spatial location information in 96% of patients, and for patient education purposes in 93% of patients. Conclusions: For patients with metastatic cancer, the algorithm-based analysis of all ROI would allow oncologists to better understand treatment response and support their work to more precisely optimize the patient's therapy.

Opportunities for digitally-enabled personalization and decision support for pediatric growth hormone therapy.

Smart technologies and connected health are providing opportunities for improved healthcare for chronic conditions. Acceptance by healthcare professionals (HCPs) and patients is crucial for successful implementation. Evidence-based standards, technological infrastructure and regulatory processes are needed to integrate digital tools into clinical practice. Personal health records provide continuity and aid decision-making, while machine-learning algorithms may help in optimizing therapies and improving outcomes. Digital healthcare can negate geographical barriers, enabling patients in remote areas to access specialist endocrine expertise. We review available and developing digital tools to manage care for patients requiring growth hormone (GH) therapy for growth failure conditions. GH is most often administered via daily injections over several years; continuous adherence is necessary but may become insufficient. Future development and integration of electronic platforms for GH therapy requires involvement of all stakeholders in design-thinking approaches and human-factor testing. Growzen Connect is an innovative digital ecosystem designed to increase the management and monitoring of GH therapy, comprising the easypod device and connected mobile apps. It provides a real-time overview of a patient's therapy, including adherence and growth response, which aids decision-making by HCPs and empowers patients to engage in their therapy journey. Incorporating prediction models for adherence and growth in the ecosystem helps patients build treatment habits and allows issues to be addressed in a timely fashion. A connected ecosystem for GH therapy can enhance outcomes and empower patients, fostering a collaborative and patient-centered approach that is more proactive, beyond the traditional clinic-based approach.

Automated system utilizing non-invasive technique mammograms for breast cancer detection

In order to increase the likelihood of obtaining treatment and achieving a complete recovery, early illness identification and diagnosis are crucial. Artificial intelligence is helpful with this process by allowing us to rapidly start the necessary protocol for treatment in the early stages of disease development. Artificial intelligence is a major contributor to the improvement of medical treatment for patients. In order to prevent and foresee this problem on the individual, family, and generational levels, Monitoring the patient's therapy and recovery is crucial. This study's objective is to outline a non-invasive method for using mammograms to detect breast abnormalities, classify breast disorders, and identify cancerous or benign tumor tissue in the breast. We used classification models on a dataset that has been pre-processed so that the number of samples is balanced, unlike previous work on the same dataset. Identifying cancerous or benign breast tissue requires the use of supervised learning techniques and algorithms, such as random forest (RF) and decision tree (DT) classifiers, to examine up to thirty features, such as breast size, mass, diameter, circumference, and the nature of the tumor (solid or cystic). To ascertain if the tissue is malignant or benign, the examination's findings are employed. These features are mostly what determines how effectively anything may be categorized. The DT classifier was able to get a score of 95.32%, while the RF satisfied a far higher 98.83 percent.

Lymph node metastasis in early invasive lung adenocarcinoma: Prediction model establishment and validation based on genomic profiling and clinicopathologic characteristics.

The presence of lymph node (LN) metastasis directly affects the treatment strategy for lung adenocarcinoma (LUAD). Next-generation sequencing (NGS) has been widely used in patients with advanced LUAD to identify targeted genes, while early detection of pathologic LN metastasis using NGS has not been assessed. Clinicopathologic features and molecular characteristics of 224 patients from Ruijin Hospital were analyzed to detect factors associated with LN metastases. Another 140 patients from Huashan Hospital were set as a test cohort. Twenty-four out of 224 patients were found to have lymph node metastases (10.7%). Pathologic LN-positive tumors showed higher mutant allele tumor heterogeneity (p < 0.05), higher tumor mutation burden (p < 0.001), as well as more frequent KEAP1 (p = 0.001), STK11 (p = 0.004), KRAS (p = 0.007), CTNNB1 (p = 0.017), TP53, and ARID2 mutations (both p = 0.02); whereas low frequency of EGFR mutation (p = 0.005). A predictive nomogram involving male sex, solid tumor morphology, higher T stage, EGFR wild-type, and TP53, STK11, CDKN2A, KEAP1, ARID2, KRAS, SDHA, SPEN, CTNNB1, DICER1 mutations showed outstanding efficiency in both the training cohort (AUC = 0.819) and the test cohort (AUC = 0.780). This study suggests that the integration of genomic profiling and clinical features identifies early-invasive LUAD patients at higher risk of LN metastasis. Improved identification of LN metastasis is beneficial for the optimization of the patient's therapy decisions.

Stress and Mental Health Detection using Machine Learning

Abstract: The precise determination of psychological health and stress levels substantial involvement in the course of a patient's therapy, Especially during the initial phases of the condition, it's crucial to remain vigilant as there's a potential for health risks to emerge for the patient. Deep Learning (DL) has emerged as a prevalent technique utilized to detect stress and mental health conditions, aiding in their identification. in a timely manner. Here, we provide mental health prediction utilizing KNN, Random Forest, and Logistic Regression whereas CNN for stress detection to aid in the timely identification of the illness. The website we created compiles the patient/person dataset. It aids When forecasting the outcome of the event, patient's or person's mental health and stress levels once the necessary training procedures have been completed.

Development and validation of a prediction score to assess the risk of incurring in COPD-related exacerbations: a population-based study in primary care

BackgroundChronic obstructive pulmonary disease (COPD) is the fourth most important cause of death in high-income countries. Inappropriate use of COPD inhaled therapy, including the low adherence (only 10 %–40 % of patients reporting an adequate compliance) may shrink or even nullify the proven benefits of these medications. As such, an accurate prediction algorithm to assess at national level the risk of COPD exacerbation might be relevant for general practictioners (GPs) to improve patient's therapy. MethodsWe formed a cohort of patients aged 45 years or older being diagnosed with COPD in the period between January 2013 to December 2021. Each patient was followed until occurrence of COPD exacerbation up to the end of 2021. Sixteen determinants were adopted to assemble the CopdEX(CEX)-Health Search(HS)core, which was therefore developed and validated through the related two sub-cohorts. ResultsWe idenfied 63763 patients aged 45 years or older being diagnosed with COPD (mean age: 67.8 (SD:11.7); 57.7 % males).When the risk of COPD exacerbation was estimated via CEX-HScore, its predicted value was equal to 14.22 % over a 6-month event horizon. Discrimination accuracy and explained variation were equal to 66 % (95 % CI: 65–67 %) and 10 % (95 % CI: 9–11 %), respectively. The calibration slope did not significantly differ from the unit (p = 0.514). ConclusionsThe CEX-HScore was featured by fair accuracy for prediction of COPD-related exacerbations over a 6-month follow-up. Such a tool might therefore support GPs to enhance COPD patients’ care, and improve their outcomes by facilitating personalized approaches through a score-based decision support system.

Lijekovima uzrokovana imuna trombocitopenija – prikaz bolesnice

Thrombocytopenia is defined as a reduced platelet count. Drug-induced immune thrombocytopenia (DITP) is a condition mediated by antibodies developed following the ingestion of a certain medication. A sudden drop in platelet count accompanied by ecchymosis, petechiae, and mucosal bleeding following the introduction of a new medication should raise suspicion for DITP. This case report describes the case of a 76-year-old female patient who first appeared at the Emergency Department (ED) with symptoms related to heart failure and atrial fibrillation. The patient was taking warfarin as an anticoagulant therapy when she presented herself to the ED. Following a short hospitalization at the Cardiology Department, the patient was discharged home with dabigatran instead of warfarin as the anticoagulant therapy. After several days of taking dabigatran, the patient came to the ED with a chief complaint of dark-colored urine. Her platelet count (measured using a machine and manually counted) was 13×109/L, and the urinalysis was positive for microhematuria. Dabigatran was excluded from the patient’s medication list. At a later date, following the patient’s request, she started with rivaroxaban prescribed by her general practitioner. The test for anti-platelet IgG antibodies (performed while the patient was taking dabigatran and later rivaroxaban) was positive. Therefore, rivaroxaban was also excluded from the patient’s medication list. After the platelet count normalized, warfarin was reinstituted into the patient's therapy. Due to the diagnosis of DITP being most often empirical, clinicians should suspect DITP if there is a sudden drop in the platelet count accompanied by signs of bleeding following the introduction of a new medication in the patient’s therapy. Additional laboratory workup for transfusion reactions should be conducted, while the culprit medication should be excluded from the patient’s medication list without delay.

Multiple Myeloma and Solid Tumors – a Frequent Rarity –

Objective: Multiple Myeloma is defined by the proliferation of monoclonal B leukocytes (plasmacytes) in the bone marrow, which results in the production of monoclonal proteins into the urine or blood. With the development of novel therapies, the management of multiple myeloma has improved over time. However, an increasing number of patients now present with a history of solid tumors related to myeloma, which may be observed during the course of the patient's therapy. Case presentation: We present the case of a 53-year-old man who was referred to our department for additional testing to distinguish between multiple myeloma and bone metastases. The patient had a personal history of colonic cancer, which was diagnosed 5 months prior, and osteolytic lesions discovered on the abdominal CT scan. Increased atypical plasmocytic cells were observed in the bone marrow biopsy, and serum IgG kappa monoclonal protein were also positive. Conclusion: The case highlights the potential for concurrent hematologic and solid cancer coexistence.

A rare case presentation of neurofibromatosis type 1 with multiple gastrointestinal stromal tumors: a case report

Neurofibromatosis type 1 (NF1), a hereditary cancer predisposing syndrome is an autosomal dominant disorder. Gastrointestinal stromal tumor (GIST) is the most prevalent non-neurological tumor in these individuals. In NF1-associated GIST, KIT and platelet-derived growth factor receptor α (PDGFRA) mutations might not be present, and Imatinib may not be effective. Surgical resection is the first-line treatment. The primary aim was to include the possibility of rare tumors including GIST in neurofibromatosis patients in the differential diagnosis of GIT pathology/presentation. A 50-year-old male with neurofibromatosis came with complaints of dull aching abdominal pain and on further investigation was found to have lesions in the distal small bowel, suspicious of nerve sheath tumors, in abdominal computed tomography. A laparotomy was performed and the jejunum containing nodular lesions was resected and pathologically diagnosed as GIST. The patient was then started on Imatinib. At the 6-month follow-up, no tumor recurrence was visible. The rare and unusual location of multiple GIST in neurofibromatosis patients underscores its importance in differential diagnosis, and our case report on the patient's therapy and the clinical outcome could aid in patient care.

Clinical evaluation of a patient participation assessment system for upper extremity rehabilitation exercises.

In conventional and robotic rehabilitation, the patient's active participation in exercises is essential for the maximum functional output to be received from therapy. In rehabilitation exercises performed with robotic devices, the difficulty levels of therapy tasks and the device assistance are adjusted based on the patient's therapy performance to improve active participation. However, the existing therapy performance evaluation methods are based on either some specific device designs or certain therapy tasks, which limits their widespread use. In this paper, the effectiveness of a participation assessment system, which can evaluate patients' therapy performance, tiredness, and slacking independent of any device design and therapy exercise, was clinically tested on ten patients diagnosed with frozen shoulder syndrome. The patients performed exercises using the system once a week throughout their 4-week treatment period. Multiple clinical measurements and scales were employed during the clinical study to assess patients' progress and status, such as tiredness throughout the therapy process. The clinical data, along with the patient findings obtained from the participation assessment system, were statistically analyzed and compared. The findings revealed that the patients' improvements and progress during the therapy process clinically coincide with the variations in the performance evaluation results of the system, and the implemented method successfully assesses the patients' participation during the rehabilitation exercises.

Congenital chest wall spindle cell rhabdomyosarcoma in a one-month-old patient

This article presents a rare clinical case of an infant with congenital spindle-cell rhabdomyosarcoma, demonstrates a combined approach to the patient's therapy, describes in detail the performed reconstructive plastic surgery, analyzes the short-term and long-term results of the treatment with an emphasis on late orthopedic complications, provides a detailed literary review on the topic of the publication. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.

Production of Anti-Recombinant Human Insulin Antibody and Validation by Indirect ELISA

Human insulin potential has become an interest and is important in maintaining the success of therapyin patients with the availability of chemical-based analytical methods, however, only a few have beenusing immunoassays. This study aimed to produce IgG polyclonal antibodies from rabbits immunizedwith 1 mg/mL rhINS subcutaneously and validated by indirect ELISA. Antibody was precipitated andfractioned on a HiTrap® Protein A HP column before being quantified with a UV spectrophotometerat λ 280 nm. The characterization was conducted by Dot Blot test on a BCIP-NBT substrate, as well asSDS-PAGE and Western Blot with polyacrylamide gel concentrations of 7.5% and 17.5%. Validationwas performed using solutions containing glycerol and m-cresol as matrices spiked with rhINS. Thelinearity test in the rhINS concentration range of 80.11-200.28 μg/mL (r = 0.99) showed the linearresult. The accuracy and precision obtained an average of 99.11%±5.01 and 3.91%, while the LODand LOQ were 22.05 μg/mL and 73.51 μg/mL, respectively. Human insulin was stable at 2-8oC for 24hours (α: 0.05, ANOVA). In conclusion, in-house produced IgG polyclonal antibodies and goat anti-IgG peroxidase conjugate can be used for routine testing of human insulin.

Physical activity of patients with chronic kidney disease

Introduction: The main causes of chronic kidney disease (CKD) are diabetic and hypertensive nephropathy. The incidence of civilization diseases is increasing, which also indirectly affects the increase in the incidence of CKD. The patient's therapy after the diagnosis should include the care of a multi-specialist therapeutic team that will remove as many restrictions as possible in everyday functioning and ensure a high quality of life. In addition to the selection of individual renal replacement therapy, i.a. physical rehabilitation. Despite the fact that in the course of chronic kidney disease physical activity is impaired by numerous pathophysiological processes, the patient should be encouraged to undertake physical activity in order to reduce the risk of death due to cardiovascular diseases, as well as to eliminate many other adverse health effects of the disease. The following paper aims to analyze the impact of physical activity on CKD patients and the pathophysiological causes of low physical activity in this group of patients and the possibility of implementing rehabilitation as an element of comprehensive therapy.&#x0D; Aim of the study: To review the current literature on the physical activity of patients with chronic kidney disease&#x0D; Materials and Methods: A review of the publications available in PubMed, using the key words „chronic kidney disease”, „psychical activity in chronic kidney disease”, physical activity”, „kidney failure”, „dialysis”, „renal rehabilitation”, „quality of life”

PRIMARY DIFFUSE MENINGEAL MELANOMATOSIS – CASE REPORT

Background: The diffuse meningeal melanomatosis (MM) is part of a group of rare melanocytic diseases. Aiming to emphasize aspects of the natural history, diagnosis and treatment of this rare disease we decide to report the present case. Cade Description: A 17 years-old girl presenting with headache for the last 45 days, followed by episodes of agitation and hallucinations. CT scan revealed mild meningeal enhancement on the right hemisphere. MRi revealed significant diffuse dura--mater thickening, invading cerebral cortex and white matter, including the brain stem. The study of cerebrospinal fluid showed the presence of neoplastic cells, cytology confirmed melanocytes. The histological study, carried out from the brain biopsy, showed diffuse melanocytes infiltrating the meninges, at the subarachnoid space and cerebral cortex. The histological diagnosis was diffuse MM. Conclusions: In conclusion, diffuse MM is a rare condition of malignant characteristics and usually has a poor prognosis. Early diagnosis is essential to determine and expand the patient's therapy.

Kajian Interaksi Obat pada Pasien Gagal Ginjal Rawat Inap di RSUD Panglima Sebaya Tanah Grogot

Patients with acute and chronic kidney failure generally have accompanying diseases so many drugs are often prescribed. The increasing complexity of the drugs used will lead to an increased risk of drug interaction events, potentially affecting the success of the patient's therapy. This study aims determine the potential of drug interactions of patients with kidney failure inpatient of Panglima Sebaya Hospital. This research is a descriptive study retrospectively with purposive sampling techniques. The results of the study of 64 medical records of patients who qualified for inclusion showed that the characteristics of the most patients were men as many as 34 patients (53.13%), ages ranging from 46-55 years (early elderly) as many as 19 patients (29.69%), with the number of diseases accompanying 1-2 diseases as many as 50 patients (78.13%) such as anemia as many as 27 patients (28.13%). The total use of 6-10 drugs was mostly given to 31 patients (48.44%) in the form of cardiovascular system drugs which is 149 prescribing (31.17%). The potential drug interactions found were 12% minor, 80% moderate, and 8% major.

A Case Report of Psychogenic Erectile Dysfunction with Ego Dystonic Sexual Disorientation: Is Still Relevant to Treat?

Background: Converting Ego-dystonic homosexual to heterosexual is still controversial. homosexuals are encouraged to be accepted and do not require conversion. Currently, many cases of homosexuals are required to accept their identity and do not require conversion. However, there are times when patients want to be heterosexual and experience sexual dysfunction because of this orientation. Then, how a medical professional deal with such a case especially in the era of ease of information and technology? Choose to demand that the patient accept their sexual orientation or help the patient to become heterosexual. Objective: Here we present the case of a man, 44 years old, with a psychogenic erection with ego-dystonic homosexual disorientation, along with a review of the literature related to the case. Method: A case report with literature review Case/Result: We report 44-year-old man who has been married for six years complains of difficulty and decreased erection for 5.5 years. This man had a history of sexual intercourse with men during college but decided to become a heterosexual man and married his current wife. For the first six months, the patient performed oral sex with his wife. Then afterwards, the patient has difficulty getting an erection and even fails. The patient feels guilty toward his wife until their relationship becomes a crisis. The patient wants to commit to being a heterosexual man. So, the patient came to the andrology clinic for therapy. We applied intersystemic assessment approach to the patient. There is progress in the patient’s condition until now. Conclusion: Many experts say that homosexuality should be accepted and should not be converted. But in the end, the choice is returned to the patient, whether to choose to convert or not. Physicians only need to support the patient's therapy and choices so that he does not experience any mental disorders that ultimately endanger his life. Keywords: , , , ,

A RETROSPECTIVE REVIEW OF THE THERAPEUTIC CHALLENGES OF 16 FITBONE INTRAMEDULLARY FEMORAL LENGTHENINGS COMPLETED AT SHEFFIELD CHILDREN'S HOSPITAL BETWEEN 2021 AND 2022

IntroductionAt Sheffield Children's Hospital, treatment of leg length discrepancy is a common procedure. Historically, this has been done with external fixators. With the development in intramedullary technology, internal nails have become the preferred modality for long bone lengthening in the adolescent population. However, it is important to review whether this technology practically reduces the known challenges seen and if it brings any new issues. Therefore, the aim of this review is to retrospectively evaluate the therapeutic challenges of 16 fit-bone intramedullary femoral lengthening's at Sheffield Children's Hospital between 2021–2022.Materials &amp; MethodsThe international classification of function (ICF) framework was used to differentiate outcomes. The patient's therapy notes were retrospectively reviewed for themes around structural, activity and participation limitation. The findings were grouped for analysis and the main themes presented.ResultsThere were 8 males, mean age 17.4 years (range 17–18) and 8 females, mean age 15.9 years (range 14–18). 5 right and 11 left femurs were lengthened. Underlying pathology varied amongst the 16 patients. All patients went into a hinged knee brace post operatively. Structural limitations included: pain, fixed flexion deformity of the knee, loss of knee flexion, quadriceps muscle lag, muscle spasms and gluteal weakness. The primary activity limitation was reduced weight bearing with altered gait pattern. Participation limitations included reduced school attendance and involvement in activities with peers. Access to Physiotherapy from local services varied dramatically. Five of the cohort have completed treatment.ConclusionsAnecdotally, intramedullary femoral lengthening nails have perceived benefits for families compared to external fixators in the adolescent population. However, there remain musculoskeletal and psychosocial outcomes requiring therapeutic management throughout the lengthening process and beyond. Therefore, quantifying these outcomes is essential for measuring the impact on each patient for comparison. To interpret these themes, we need to evaluate the outcomes objectively, this was not done consistently in this review. Future research should look at outcome measures that are sensitive to all aspects of the ICF. With an aim of improving the therapeutic treatment provided and the overall outcome for the children treated.

Association of Waist and Hip Ratio with the Angiographicc Severity of Coronary Artery Disease in Patients with Non ST Segment Elevation Myocardial Infarction

Background: Coronary artery disease and obesity cardiomyopathy, and cardiac autonomic neuropathy are the most prevalent types of cardiac involvement in the comorbid. Obesity has a two- to fourfold greater risk of developing coronary artery disease. Stroke and other cerebrovascular occurrences fare poorly for those with obesity and diabetes. Hospital, autopsy, epidemiological, longitudinal research, and other studies have all demonstrated the increasing prevalence of cardiomyopathy in diabetes and obese individuals Objective: the objective of the study is to association of waist and hip ratio with the angiographic severity of coronary artery disease in patients with non-ST segment elevation myocardial infarction Study Design: Cross sectional observational study Study Setting: This study was conducted in the department of Interventional Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi from Ist August 2022 to 31st January 2023. Methodology: Total 120 subjects were enrolled in the study and divided in to two groups. Group I consisted of 60 patients with normal WHR, and group II consisted of 60 patients with elevated WHR. The history and anthropometric measurements were noted using a pre-designed structured form, including demographic data and a profile of potential risk factors. Three universal criteria for diagnosing myocardial infarction were used to confirm the presence of non-ST segment elevation myocardial infarction. Each participant's signed permission was obtained before any data was collected. The patient's waist and hip circumferences were measured the day before the CAG. At least two cardiologists engaged per patient's therapy or the clinical context while evaluating the angiogram results. Visual estimation (in at least two orthogonal views) was used to estimate the vessel and Gensini scores to determine the degree of coronary artery disease on angiograms. The statistical analysis was done by using SPSS version 20. Results: Patients in Group II had a considerably higher mean body mass index and anthropometric status than those in Group I. The average WHR of the participants in the study is listed in order of increasing vascular involvement. For those with normal angiogram results, the average WHR was 0.98. There was a statistically significant difference (p&lt;0.01) in the mean WHRs of those with single-vessel disease and the value of mean is gradually increased in scoring 1, 2 and 3. The WHR positively correlated with the severity of CAD as measured by vessel score (r=0.45). In addition, a positive connection (r=0.63) between WHR and CAD severity, as measured by the Gensini score. Multivariate logistic regression analysis of odds ratio (OR) for subject characteristics likely to cause coronary artery disease severity. Practical implication: In addition, there is only one local study, which provides scant information, and worldwide data is scant and conflicting about the relationship of the ratio of waist to hip with severe coronary artery disease (CAD). The incidence of obesity and coronary artery disease in Pakistan is much higher than in Western countries; thus, this study will offer more information regarding the relationship based on local data. Conclusion: The current study found that in individuals with non-ST-segment elevation myocardial infarction, increasing WHR was substantially correlated with the angiographic severity of coronary artery disease Keyword: WHR, BMI, Waist circumference, Cardiovascular disease

APPLICATION OF MIRROR THERAPY IN PATIENTS WITH STROKE

Purpose. The aim of the study was to investigate the effect of mirror therapy as a method of restoring damaged upper limb function in patients with ischemic stroke treated with venous thrombolysis. Materials. Mirror therapy was administered to 10 thrombolyzed patients with ischemic stroke. The patients were treated in the neurological ward of the Multi-profile Hospital for Active Treatment-Blagoevgrad in the period from 2014-2015. After signing a declaration of informed consent of the patients, a Barthel index test was applied before and after hospitalization. The duration of the procedure is 15-20 minutes for 5 days and is part of the general kinesitherapy program. The Prizm statistical package was used for statistical data processing and graphical presentation. Results. The mean age of the studied contingent was 67±2.8 years. Our new and specialized method of kinesitherapy for the recovery of patients treated with venous thrombolysis confirms a significant positive effect (Wilcoxon, ANOVA). Conclusion. The results of our research show that the application of the author's methodology with mirror therapy creates an opportunity to improve the functions in the damaged upper limb and improves the quality of life.