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Culture-dependent evaluation of the respiratory microbiome in children with cystic fibrosis
Get PDFThe study aimed to assess the regional peculiarities of the respiratory profile of children with cystic fibrosis (CF) in the Dnipro region (Ukraine).
Methods. Children living in the Dnipro region and aged younger than 18 years old with molecular-genetic confirmation of CF were enrolled in the study. Lung colonization was evaluated using a culture-dependent method. Sputum, mucus from the posterior pharyngeal wall and bronchoalveolar lavage fluid (BALF) were utilized.
Results. The Firmicutes phylum was the most common and occupied 54.00 % of the general proportion. On the other hand, the Proteobacteria phylum demonstrated overexpression in CF airways and kept the second rank with 28.87 %.
Sorensen's species similarity coefficient showed an allied affinity between the microbial burden of oropharyngeal samples with nasopharyngeal and sputum, QS = 0.61 and 0.91, respectively. However, the species composition within the nasal cavity was distinct from sputum and BALF (QS=0.47).
The primary pathogens in childhood were S. aureus, H. influenza, P. aeruginosa and A. fumigatus. In contrast to gram-negative non-fermenters (GNNF), the prevalence of S. aureus isolates by age had a non-linear character. The commensal microbiota changed negatively with age. Among children under 12 years, the Streptococcus genus was identified in 23.08 % of the samples, but among the age category older than 15 – only in 9.22 %.
11.06 % of S. aureus had small colony variants (SCVs) morphotypes. Isolates of P. aeruginosa with the properties of SCVs were also found in children who underwent prolonged antimicrobial treatment. However, the most prominent was the mucoid phenotype – 34.31 % of isolates.
Conclusions. Along with conventional microbiological properties, obligate pathobionts in children with CF exhibited changes, resulting in difficulties in identification. These included auxotrophic modification into SCVs and mucoid transformation.
The culture-dependent technique gives crucial data about the profile of pathogens usually associated with CF, although it is sufficiently limite
Modern concepts of teeth whitening – a narrative review
Get PDFWhitening has been known since Biblical times. Nowadays, in the developed world, patients are placing a stronger interest in the aesthetic appearance of their teeth. As a result, public demand for aesthetic dentistry, including tooth whitening, has recently increased. Aesthetics of the teeth is of great importance to many patients.
The aim is to summarise and discuss the teeth whitening procedure, tools, materials, and methods, as well as its efficacy and safety. In addition, the paper aims to provide full and comprehensive information for dentists and their patients about the merits and perils of whitening.
Methods. Relevant literature from Scopus published in English was selected using the following search criteria "tooth OR teeth AND whitening OR bleaching" by 2022. In total, there were found 3840 papers. Then, we applied the inclusion and exclusion criteria to the selected scientific papers to choose the relevant ones.
Results. A comprehensive study of the available information related to means and products for teeth whitening was carried out. Whitening may be accomplished by the physical removal of the stain or a chemical reaction to lighten the tooth colour. The indications for appropriate use of tooth-whitening methods and products depend on the correct diagnosis of the discolouration. When used appropriately, tooth-whitening methods are safe and effective.
Conclusions. Tooth whitening is a form of dental treatment and should be completed as part of a comprehensive treatment plan developed by a dentist after an oral examination
Cross-sectional study to evaluate various cardiovascular manifestations in pregnant women with preeclampsia using 2d echocardiogram
Get PDFPreeclampsia is one of the most frequent complications found in pregnancy. Preeclampsia was initially thought to cause poor long-term cardiovascular outcomes, but recent studies have shown its effect to be more early and severe.
Aims: To reduce the morbidity and mortality for all patients with hypertension in pregnancy through any cardiovascular problem that is directly caused by hypertension in pregnancy
Methods: it is a cross-sectional and observational study of pregnant women with preeclampsia in the reproductive age group (15–44 years) diagnosed with preeclampsia in the antenatal ward/HDU/MICU at Niloufer hospital were evaluated with 2d echo on diagnosis and a follow up 2d echo after delivery was done and changes in 2d echo were noted, patients with prior changes in 2d echo have been excluded from the study. About 113 preeclamptic patients were studied and further classified as non-severe and severe preeclampsia, and their results were compared.
Results: This study shows significant cardiovascular dynamics changes in subjects with preeclampsia (both severe and non-severe) which can be studied by 2 D echo. Non-severe preeclampsia was associated with more normal birth weight. This was found statistically significant in our study. IUD and early neonatal death were more associated with severe preeclampsia when compared to non-severe preeclampsia, which was found statistically significant.
Conclusions: Early identification of preeclamptic patients at higher risk of developing cardiovascular complications later in life by undergoing timely echocardiography
Study the difference between the measurement of the radiation dose of MRI and CT scan
Get PDFRadiation dose or absorbed dose means that the amount of energy absorbed by human tissue, and accurately is the concentration of energy deposited in tissue, when exposure to ionizing radiation, effective dose is the dose that will achieve the desired effect its unit is (millisievert or mSv). Ionizing radiation used in computed tomography (CT) scans as well as the associated health risks are an ongoing and growing concern.
The aim of this study is to prove the use of X-rays and computed tomography with a small dose of ionizing radiation to produce images for medical examination.
An MRI scan uses powerful magnets and radio waves to create images instead of ionizing radiation. Therefore, you are not exposed to radiation when you have an MRI scan, unlike a CT scan or X-ray. In addition to reducing the examination time and cost.
Material and methods show that individual doses measured for a routine whole-body CT protocol are less than 20 mGy for all parts of the body. Thus, we conclude that the measured doses of the external organs are higher than those in the internal organs under the same conditions that are exposed to radiation Knowing that MRI does not use radiation (such as X-rays or CT scans) there are more MRI machines being produced from several companies around the world.
Knowing that MRI does not use radiation (such as X-rays or CT scans) there are more MRI machines being produced from several companies around the world.
Result in this study, it was done evaluate the benefits of MRI and CT in diagnoses and treatment as well as for their side effects, at present and in the future.Conclusions. We have also concluded that CT is specific in certain areas of the human body such as the lungs and abdominal area and identify the areas of bone fractures, and magnetic resonance (MRI) gives us excellent image of high-definition of the spinal cord, brain and membranes, and the areas of the joints with animated images and a three - dimensional and in a record time of 15-30 minutes.
Where the diagnosis could be re-diagnosed during the procedure and after the occurrence of any side effects, unlike the tomography, which is specified in certain cases mentioned earlier, and a period of time of 5-10 minutes and cannot be returned except in special cases forced to have the effect of radiation. The final conclusion of our work, which is not only important in diagnosing, is that in the case of CT, there are no disturbing sounds and the presence of an area in which the patient can settle, unlike magnetic resonance imaging, Where the annoying resonance sounds are added to the narrowness and smallness of the place where the patient is located, but they are not considered to be of medical importance
Features of the clinical course of acute otitis media in patients with impaired carbohydrate metabolism
Get PDFThe aim of the research: study of the features of the clinical course of acute otitis media (AOM) in patients with impaired carbohydrate metabolism.
Materials and methods. We examined 140 patients with AOM aged 19 to 72 years, of which 75 patients with impaired carbohydrate metabolism constituted the main group and 65 patients were included in the comparison group. Taking into account the peculiarities of the pathogenesis of AOM and disorders of carbohydrate metabolism, patients were randomized into 4 groups: 1 – patients with AOM (36), 2 – patients with AOM on the background of sinusitis (29), 3 – patients with AOM on the background of non-insulin-dependent diabetes mellitus (DM type II) (37), 4 – AOM patients with impaired glucose metabolism (38). The patients underwent a general clinical examination, determination of glycosylated hemoglobin, leukocyte indices of intoxication, audiometry, computed tomography (CT) of the temporal bones (if indicated).
Results. The proportion of patients with impaired carbohydrate metabolism in 2020 was 32.6 %, of which DM type II was diagnosed in 49.3 % earlier. It was shown that a feature of the clinical course of AOM against the background of impaired carbohydrate metabolism is the discrepancy between the duration of the disease history, complaints and objective data to the state of the cellular structure of the mastoid process according to CT data and impaired auditory function mainly by the type of sound perception, which indicates the formation of latent mastoiditis. Clinically significant complaints and objective data for the differential diagnosis of latent mastoiditis in these patients were determined. The absence of statistical significance of differences in indicators in patients with DM type II and against the background of transient hyperglycemia was revealed, and the concept of the latter was characterized. A direct correlation between blood glucose levels and glycated hemoglobin levels was established in patients with DM type II and AOM.
Conclusions. DM type II creates a favorable background for the formation of the clinical course of AOM complicated by latent mastoiditis.
From the general contingent of patients with AOM, patients should be distinguished not only with DM type II, but also with transient hyperglycemia for its timely diagnosis. Significant symptoms: pain and a feeling of “heaviness” in the behind-the-ear region in the absence of reactive phenomena, a feeling of “pulsation” in the ear, dizziness, a cloudy eardrum with a protrusion or perforation in the posterior or posterior-upper section, an asymmetric increase in sound perception thresholds above 25 dB. Such patients should be observed with “early” CT scan of the temporal bones
Relationship between maternal abo blood group and rh typing with maternal and perinatal outcome
Get PDFThe ABO blood group type has been considered an independent risk factor in pregnancy-related complications leading to significant morbidity and mortality in pregnant mothers and neonates.
Aim: To study the relationship between maternal ABO blood group and Rh typing with maternal and perinatal outcomes.
Materials and methods: Prospective Observational study was carried out for 24 months from November among 1000 pregnant women attending outpatient for ABO blood group and Rh typing with maternal and perinatal outcome.
Results: Among 1000 subjects, 43.5 % belonged to blood group O, followed by 30 % in blood group B. 20.7 % had blood group A, and 5.8 % had AB blood group. In the present study, 95.4 % had Rh+ve, and 4.6 % had Rh-ve typing. The incidence of preterm labour was high at 6.3 % in the O+ve blood group, followed by 1.8 % in the AB +ve, 0.6 % in the A+ve and 0.3 % in the B+ve blood group. A statistically significant association was found between blood grouping and preeclampsia with high incidence among the A+ve blood group. A statistically significant association was found between blood grouping and imminent eclampsia with high incidence among the AB+ve blood group. There was a statistically significant association found between blood grouping and intrauterine death.
Conclusion: The findings in the present study will help clinicians to identify the patients at risk of developing adverse pregnancy outcomes like preeclampsia and imminent eclampsia; hence, the timely intervention will help to improve maternal and perinatal outcome and also helps to reduce the complications of preeclampsia and imminent eclampsia
The relationship between physical activity and polypharmacy with Ikigai in a population
Get PDFThe aim: The Japanese word “ikigai” indicates “something to live for” and “having a purpose in life”. Ikigai or well-being, has been associated with many positive outcomes in the physical and mental health of elderly people. In this study, the relationship between ikigai and level of physical activity and polypharmacy was examined in a Turkish population.
Material and methods: Both telephonic interviews and face-to-face interviews were conducted with 307 participants (59.2 % women) who completed the Ikigai-9 Turkey Scale and provided demographic information.
Results: Correlations between groups (polypharmacy vs. non-polypharmacy) were analyzed with an independent t-test and analysis of variance. The means of the ikigai scores were statistically significant in the polypharmacy (24.04±8.72) and non-polypharmacy 32.64±7.53) groups (p<0.05). The number of drugs used was negatively correlated with duration of exercise per week (1.32±1.82, correlation coefficient = 0.538, p<0.05).
Conclusions: The level of ikigai was negatively correlated with polypharmacy and positively correlated with duration of physical activity. An individual’s ikigai should be assessed by healthcare providers to maximize positive outcomes later in lif
Prevention of perinatal mental disorders in women of advanced maternal age with pregnancy resulted from assisted reproduction
Get PDFWomen of advanced maternal age (AMA) with pregnancies resulting from assisted reproductive technology (ART) have a high risk of the onset and progression of anxious and depressive disorders, associated with adverse obstetric and perinatal outcomes.
The aim. To improve the mental well-being of pregnant AMA women after ART using the developed algorithm of preventive psychological support.
Materials and methods. The prospective study comprised 150 patients divided into three equal groups of 50 nulliparous women aged 35–45 years with a singleton pregnancy in the cephalic presentation: the main group consolidated of pregnant women after ART who have got routine psychological support; patients with a pregnancy after ART included to the comparison group and patients with a spontaneous pregnancy from the control group were not consulted routinely.
To estimate the psychological condition of the patients the level of maternal anxiety using the Spielberg State-Trait Anxiety Inventory (STAI); sleep quality using Pittsburgh Sleep Quality Index (PSQI); the presence of depressive manifestations using Edinburgh Postnatal Depression Scale (EPDS) were assessed.
Results. We did not observe a significant difference in trait (TA) and state anxiety (SA) levels between the main and comparison groups at terms of 22–24 weeks of gestation; however, these values were significantly lower in the control group. The numbers of patients with high TA and SA levels in the main and comparison groups were also significantly higher than in the control group (p<0.05). We observed no significant increase in TA and SA levels in the main group at gestational terms of 35–37 weeks, in contrast to the comparison and control group. The number of patients with high TA and SA levels in the main group remained significantly lower than in the comparison group. A gradual decrease in TA and SA levels in all groups was observed in the postpartum period, but the differences between the groups remained consistent.
We did not observe a significant difference in sleep quality score between the study groups at terms of 22–24 weeks of gestation. Patients of all study groups reported sleep disturbance with the pregnancy progression, but average PSQI values at terms of 35–37 weeks of gestation and 6-8 weeks after delivery were significantly lower in the main group compared to the comparison group.
The incidence and severity of postnatal depressive symptoms, along with the number of patients at high risk of developing depression in the postpartum, were significantly lower in the main group than in the comparison group.
Conclusions. AMA patients after ART formed a high-risk group for developing anxious and depressive disorders during the pregnancy and postpartum. High anxiety levels compromised sleep patterns have leaded to poorer quality of life of women. Preventive psychological support for patients during the pregnancy and postpartum enabled early detection and correction of depressive symptoms; validly reduced anxiety levels, improved sleep quality and consequently improved the quality of life of women and prevented adverse obstetric, perinatal, and psychiatric outcome
Features of retrochoir hematomas and their effect on the course of pregnancy
Get PDFThe aim. Study of the features of retrochoir hematomas (RHG) and their influence on the formation of the placenta, the course of pregnancy, as well as the occurrence of premature birth.
Materials and methods. 2 groups of pregnant women were selected depending on the frequency of RHG formation: 1 group – 60 pregnant women with recurrent RHG, group 2 – 50 pregnant women with RHG, which was detected only in the early stages of pregnancy. extragenital and genital pathology did not differ reliably. All the women studied were anamnesis, examined, and ultrasound and dopplerometry were performed.
Statistical methods included an assessment of statistical significance using Student's t-criterion and criterion X2 and were considered significant at p<0.05.
Results. Supracervical localization of hematomas prevailed in the studied pregnant women, namely: in group 1 – 51.7 % (in 31 pregnant women) and 68 % (in 34 women) in group 2. The same pattern was observed regarding the involution of hematomas.
Changes in the yolk sac were found in both groups with RHG (in 6.7 % of women (i.e., in 4 pregnant women) of group 1 and 4 % (in 2 pregnant women) of group 1.
Mean values of the pulsation index (PI) of blood flow velocity curves in the uterine arteries (UA) and umbilical cord artery (UCA) in pregnant women with RHG were higher than the standard average for gestational age.
In pregnant RHGs, a history of various types of fetal growth retardation (FGR) is detected. The number of early forms of URP was higher in group 1 (16.7 %, i.e. in 10 pregnant women) as opposed to group 2 (2.0 %, i.e. 1 case). The late form was approximately the same amount in both groups. Also, group 1 was characterized by a significantly larger number of FGR of 2-3 centuries.
In addition, in both groups with RHG, such pathological conditions were identified during pregnancy as the threat of premature birth, premature placental maturation, placental hypoplasia, oligohydramnios, and hydramnios.
Conclusions. Pregnant women with recurrent RHG compared to pregnant women with sporadic RHGs have a greater number of complications during pregnancy, including the threat of preterm labour, premature placental maturation, placental hypoplasia, oligohydramnios, hydramnios, FGR, impaired uterine-placental and placental-fetal blood flow
A comparative study of second trimester termination of pregnancy with mifepristone and misoprostol vs misoprostol alone in 50 cases
Get PDFThe aim: To study the efficacy and safety of combined mifepristone and misoprostol used in second-trimester abortion(≥ 12 and ≤ 20 weeks) in comparison with only vaginal misoprostol.
Materials and methods: This study was a prospective comparative randomised clinical study in women attending hospitals in need of a second-trimester abortion, i.e., 12–20 weeks of pregnancy were taken up and divided as Group A – 50 women with mifeprisptone and misoprostol, Group B – 50 women with misoprostol alone Results were analysed according to age, parity, gestational age, average dose of misoprostol required for complete abortion, Induction abortion interval, completeness of abortion, side effects and mean days of hospital stay.
Results: Demographic details are comparable and insignificant in the comparison. The average dose of misoprostol (mcg) required for the completeness of abortion in group A is 596±28.28 mcg, and in group B, it is 1148±160.66 mcg (p<0.001) which is statistically significant. In the present study, the induction abortion interval is significantly less in group A compared to group B, with p<0.001. In addition, 10 out of 50 patients in group A aborted within 7 hours, whereas none in group B. Mean duration of hospital stay in group A is 24 hours. In group B, it is 34.82 hours which is statistically significant with a p-value of <0.001. 12 patients in group A and 26 in group B had side effects like nausea, vomiting, fever, headache and diarrhoea. 8 % of group A and 20 % of group B had a fever. These patients were treated with antipyretics. 6 % in group A and 14 % in group B had nausea and vomiting and were treated with antiemetics. 4 % in group A and 8 % in group B had diarrhoea and were treated with antimotility drugs. 6 % in group A and 10 % in group B had a headache; these patients were treated with NSAIDs.
Conclusions: The combination of mifepristone and misoprostol is a highly effective and safe method for second-trimester termination of pregnancy. The amount of misoprostol needed to accomplish the abortion, and the severity of the adverse effects are lower in the mifepristone-primed group than in the misoprostol-alone group. Since there are fewer difficulties, this approach can be employed in hospitals with high patient density