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“A Study of Magnesium and Potassium Supplements selection and Usage Reasons in Kaunas city”
No full textAim: To determine supplements, which contains magnesium and/or patassium selection and usage causes in Kaunas. Objectives: 1. Investigate, what reasons makes people chose using supplements which contains potassium and/or magnesium; 2. To determine which supplements of potassium and/or magnesium patients choose to use most frequency and how inducated concentration of the supplement influences the choice; 3. Find out people’s knowledge of the necessity for macronutrients before choosing them; 4. To determine whether patients are inclined to consult medical professionals about potassium and magnesium effects for organism, and usage of recommendations. Methods: During the study the questionnaire was completed by 399 respondents older than 18 years which visited pharmacy. Descriptive and comparative analysis has been performed to analyse the data, the results are presented in figures and percentages. Statistical significance of the data was checked using the Chi square criterion, statistically significant results when p <0.05. Results: Respondents claimed, that the most important macronutrient was calcium (80.7%). It was found that 41.8% of respondents choose to take potassium and/or magnesium supplements and most often mentioned that potassium and magnesium are needed to improve heart function (54.3%). The most common reason for using and choosing these supplements was a health care professional (24%). 43.1%. respondents heard about the excess of macronutrients in the body. The most common symptom reported for hypermagnesemia is nausea (40.2%) and abnormal heart rhythm for hyperkalaemia (55.2%). For the majority of respondents, which are taking potassium and/or magnesium (79.7%), the pharmacist or his assistant helped to choose the right preparation, and the most common information mentioned by the pharmacist was the time and frequency of usage. A very small prart of respondents (3.2%) claimed that the pharmacist did not provide information on the chosen supplement at all. Conclusions: Potassium and/or magnesium supplements common used to improve heart function. Most of the respondents decided to take potassium and/or magnesium supplements by themselves, while the rest uses recommendations of health care professionals. A small part of those taking these supplements have had a test for deficiency of one or both macronutrients, which was not positive for everyone. The majority of respondents have lack of information about the effects of an excess of these macronutrients in the body. The majority of respondents turn to pharmacist for consultation about purchasable product and uses their recommendations
CYP2C19, CYP2C9 and CYP2D6 enzyme allelic variants and its’ effect on drug metabolism
No full textAim: To evaluate the influence of genetic polymorphism of cytochrome P450 enzymes on drug metabolism. Methods: A literature search of „Science Direct“, „Pubmed“, „The University of Washington Metabolism and Transport Drug Interaction Database“ up to 2020 May 1st was performed using the keywords "Drugs metabolized by CYP2C19", "Drugs metabolized by CYP2D6", "Drugs metabolized by CYP2C9", "CYP2C19 pharmacogenetics", "CYP2D6 pharmacogenetics", "CYP2C9 pharmacogenetics", "drug interactions" to identify the drugs most affected by genetic polymorphisms. A total of 50 scientific publications meeting our inclusion criteria were identified. From 2017 to 2018, 54 pharmacogenetic tests were performed using the AutoGenomics Infiniti™ system in the Department of Genetics and Molecular Medicine of Kaunas Clinics. Based on the expression of allelic variants and metabolic phenotypes of the enzymes CYP2C19, CYP2D6 and CYP2C9, patients were divided into five groups according to the guidelines of the Clinical Pharmacogenetics Implementation Consortium (CPIC): normal metabolizers, intermediate metabolizers, rapid metabolizers, ultrarapid metabolizers and poor metabolizers. The calculations were performed using „Microsoft Office Excel 2013“. Results: Distribution of allelic variants and metabolic phenotypes of the CYP2C19 enzyme: *1/*1 allelic variant determining normal enzyme activity (Normal metabolizers) was detected in 18 patients (33,33%); 14 patients (25,93%) had *1/*2 and *2/*17 allelic variants, resulting in slower than normal (intermediate metabolizers) enzymatic activity; *1/*17 allelic variant and rapid enzymatic activity (rapid metabolizers) were detected in 15 patients (27,78%); 4 patients (7,4%) had the *17/*17 allelic variant resulting in very rapid enzymatic activity (Ultrarapid metabolizers); *2/*2 allelic variant leading to slow enzymatic activity (Poor metabolizers) was detected in 3 patients (5,56%). Distribution of CYP2D6: 26 patients (48,15%) had *1/*1,*2/*2,*1/*2,*1/*41,*2/*41 allelic variants, showed normal enzymatic activity (Normal metabolizers); 21 patients (38,89%) had *1/*5, *2/*4,*10/*41,*1/*4,*1/*3,*2/*5,*2/*4,*2/*6 allelic variants and slower than normal enzymatic activity (Intermediate metabolizers); *2xN allelic variant and very rapid enzyme activity (Ultrarapid metabolizers) were detected in 2 patients. In all 5 patients (9,26%), *4/*5,*4/*10,*4/*9,*4/* 41 allelic variants resulting in slow enzymatic activity (Poor metabolizers) were identified. Distribution of CYP2C9 enzyme: 44 patients (81,48%) were identified with the *1/*1 allelic variant leading to normal 8 enzymatic activity (Normal metabolizers); *1/*2;*1/*3 allelic variants and slower than normal enzymatic activity (Intermediate metabolizers) were detected in 10 patients (18,52%). Deviations from normal enzymatic activity were observed in all three patients after separate evaluation of the pharmacogenetic studies of the three patients with the administered drugs, doses and allelic variants. Patient no.1 showed very rapid activity of the enzyme CYP2D6 (Ultrarapid metabolizers). Patient no.2 had a slower than normal enzymatic activity of CYP2C19 (Intermediate metabolizers). Patient no.2 had a slower than normal enzyme activity of CYP2C19 (Intermediate metabolizers) and a slow activity of CYP2D6 (Poor metabolizers). Thus, treatment of these patients with standard doses may result in adverse reactions. Conclusions: Given the clinical importance of CYP2C19, CYP2D6 and CYP2C9 enzymes, it is essential that combined pharmacogenetic testing of CYP2D6, CYP2C9 and CYP2C19 enzymes be promoted as the most advanced patient testing method, as drugs such as analgesics, antihypertensives and antidepressants are commonly used in clinical practice are metabolized by isoforms of different enzymes of the CYP450 family. The results of our research correlate with the results of research conducted by authors from other EU countries and show that Lithuanian people are characterized by deviations from normal enzymatic activity. Respectively, CYP2C19 accounted for 66,67%, CYP2D6-57,85%. And CYP2C9 – 18,52% of patients had different than normal enzymatic activity (had fast, very fast, slow or slower than usual). Pharmacogenetic research is very important aspect of precision medicine or pharmacogenetically based prescribing methodologies, it is a precision medicine initiative that can help the patient and the doctor to achieve the best possible treatment result. Practical recommendations: According to the approved guidelines of the CPIC (Clinical Pharmacogenetics Implementation Consortium), the methodology for prescribing drugs based on pharmacogenetic studies should be increasingly applied in clinical practice. Healthcare professionals should promote interdisciplinary collaboration in the application of precision medicine techniques in order to ensure the most effective possible treatment for the patient. The application of pharmacogenetic studies is particularly important in the case of drugs for which it is difficult to assess the clinical effect or for which the clinical effect occurs only after a certain period of time, for example for the treatment of depression or for inhibiting platelet aggregation. Further studies in a larger population, summarizing pharmacogenetic studies and changes in drug concentrations, are needed to better understand the impact of pharmacogenetics on treatment efficacy
Pagalbinių medžiagų įtaka kietųjų kapsulių su resveratroliu kokybei
No full textMaster thesis of Agnė Mikolainytė: „Impact of additive substances to quality of hard-shelled resveratrol capsules“/ scientific manager Prof. Jurga Bernatonienė; Lithuanian University of Health Sciences, Academy of medicine, Pharmacy faculty, Institute of pharmaceutical technologies. – Kaunas. In recent years resveratrol came to attention among the polyphenols due to its diverse biological properties, ranging from antibacterial and antifungal to cardio- and neuroprotective, as well as anti-cancer. Studies have also shown the benfits of resveratrol of improving lifespan and fold-age related problems. The practical use of resveratrol is, however, limited due to its poor water solubility, high chemical instability and low bioavailability. In order to overcome these caveats, it is important to find appropriate additive substances, which would improve the pharmacological effects and bioavailability of resveratrol [1]. The aim of research: to evaluate the impact of additive substances to the quality of resveratrol capsules. Objectives of research: evaluate the physico-chemical (shrinkage, solubility) and technological (brittleness, particle size) properties; determine the effect of additive substances to powdered capsulated compounds with resveratrol; manufacture the hard-shelled capsules and evaluate the effects of additive substances to their quality; determine the properties of different additive substances to release and quality of resveratrol capsules . Object of the research: resveratrol and manufactured resveratrol-gelatine capsules. Applied research methods: Analysis of literature for the description of the topic, technological analysis of the powdered substances (Carr index, Hausner coefficient, cone angle), tests of the capsule mass uniformity, disintegration and solubility. Results of research: during the course of the study 4 different compositions of resveratrolcapsules with different additive substances were manufactured. Solubility tests showed, which compositions were in accordance with European Pharmacopoeia and show the optimal properties. Conclusions: the study data confirms that the additive substances in resveratrol-capsules, as well as the ratio of resveratrol to additive substances influence the pharmacological qualities. The performed solubility tests showed, which additive substances ensure the optimal pharmaceutical qualities of resveratrol
Body Composition and Metabolism in Women with a History of Gestational Diabetes Mellitus
No full textAim: To evaluate body composition, metabolism, and lifestyle of women with gestational diabetes mellitus diagnosed 15 and more years ago. Objectives: To evaluate body composition (weight, body mass index, lean body mass, fat mass) of women with a history of gestational diabetes mellitus. To evaluate metabolism of carbohydrates and lipids in women with a history of gestational diabetes mellitus. To evaluate dietary habits and physical activity of women with a history of gestational diabetes mellitus. Methods and participants: The retrospective study included 149 women who were diagnosed with gestational diabetes mellitus 15 and more years ago. The patients were interviewed using the questionnaire about their eating habits and physical activity. Anthropometric measurements, bioelectrical impedance analysis, arterial blood pressure measurement, carbohydrates and lipids metabolism tests results were also collected. Results: 123 (82,6 %) patients’ fat mass exceeds the limits. The percentage of fat mass in the normoglycemia group was 34,3 %, in impaired fasting glycemia group was 36,43 %, in impaired glucose tolerance – 37,58 %, in diabetes mellitus – 38,78 %. The percentage of lean body mass in the normoglycemia group was 65,62 %, in impaired fasting glycemia group was 63,57 %, in impaired glucose tolerance - 61,99 %, in diabetes mellitus – 61,22 %. Grade I obesity was found in 27 (18,1 %) of subjects, grade II in 23 (15,4 %), grade III in 21 (14,1 %). Normoglycemia was found in 65 (43,6 %) of women, impaired fasting glycemia was diagnosed in 11 (8,7 %), impaired glucose tolerance in 13 (7,4 %), and diabetes mellitus in 60 (40,3 %). Dyslipidemia was detected in 135 (95,1 %) of subjects. 62 (80,52 %) of women with carbohydrate metabolic disorders consume fast food very rarely, 34 (60,7 %) of women with type 2 diabetes mellitus rarely eat sweets. Other lifestyle habits differed insignificantly between the different groups. Conclusions: Most women who were diagnosed with gestational diabetes mellitus fat mass was too high. The mean percentage of lean body mass in all women in the different carbohydrate metabolism groups was too low. Almost half of the subjects were diagnosed with obesity. Most women with a history of gestational diabetes mellitus had impaired carbohydrate metabolism and dyslipidemia. A quarter was diagnosed with diabetes mellitus. Women diagnosed with diabetes mellitus rarely consume fast food and sweets. Other dietary characteristics and physical activity did not differ between body mass index and carbohydrate metabolism groups. Recommendations: To carry out an active monitoring of women for possible remote complications, to reduce body weight, to inform about possible complications, its symptoms, prevention, and control
The evaluation of the attitudes of the medical staff of the perinatal center N regarding teamwork
No full textThe study was conducted in VUL Santaros clinics from February of 2020 till March of 2020. The participants were selected using non – probability convenience sampling method. A total of 160 questionnaires were given out throughout the study, with 101 returned. Total response rate was 63,1%. The majority of respondents – 92,1 % indicated that teamwork significantly improves the quality of treatment for patients. Regarding the success of teamwork, respondents' opinions, the definition of easy-to-understand goals and compatible tasks (94,1%). Respondents who assessed friendly relations in a team statistically significantly more often stated that they always and often receive help (p <0,05). The majority of respondents – 54,5% specified that they usually know their role in their team. The most important motive in team work according to the respondents is patient orientation (81.2%). The majority of respondents rated their teamwork skills as average ( 67.3%). 84.2% of the responders would like to improve their teamwork qualifications. respondents. The medical staff of the N perinatology center stated that they wanted to improve their teamwork skills, preferring practical sessions and simulations (63,4%)
Technology development and evaluation of medicinal syrups with liquid extracts of small – leaved linden and raspberry
No full textThe aim of this study is to produce medicinal syrups, containing liquid ethanolic extracts of small – leaved linden flowers and raspberry leaves and to evaluate how the concentration of extraction solvent determines the quality and stability of the prepared preparations. Tasks: 1. To find the right composition of raw material and extractive solvent for producing small – leaved linden flowers and raspberry leaves liquid extracts, based on the references from scientific literature 2. To determine the impact of ethanol concentration for quality of the liquid extracts by assessing dry residue level, amount of phenolic compounds and antioxidant activity. 3. To select the optimal composition of medicinal syrup with liquid extracts of small-leaved linden and raspberry as well as develop the technology. 4. To determine the characteristics of the syrup using analytical methods. 5. Evaluate the stability of the produced syrups. Objects of the study: liquid ethanol extracts of small-leaved linden flowers and raspberry leaves as well as syrups that contains them. Study methods: Liquid extracts were analyzed using gravimetric dry residue method. The total phenol content in extracts and syrups were determined by applying the Folin‐Ciocalteau colorimetric method. Antioxidant activity was evaluated using spectrophotometric DPPH radical scavenging method. The viscosity of syrups was determined using a viscometer. Stability studies for the obtained extracts and syrups were performed by observing the changes in the results of the selected indicators over time. The results were analyzed using “MS Excel 2016” and “SPSS 20”. Results and Conclusions: It was found that the most appropriate concentrations of ethanol for producing linden flowers and raspberry leaves liquid extracts were 20 %, 30 %, 40 %. The compositions of the syrups were designed using the prepared liquid extracts. After preparing the syrups with the obtained extracts and evaluating the results of antioxidant activity and total phenol content, it was found that properties of the syrup depends on the extracts included in it. The optimal antioxidant activity - 71,34 ± 1,73 % and the highest total phenol content - 4,33 ± 0,31 mg GAE /ml was found in 1A syrup when the concentration of ethanol stood at 20 %. The dynamic viscosity results of the different series of syrups (1A-4A and 1B-4B) showed, that a slightly higher viscosity was obtained when joint plant extracts were used in the syrups. Summarizing the results of the stability studies of liquid extracts, it was found that the prepared extracts remained stable for 12 months. Evaluating the results of the stability studies of syrups, it was found that the prepared formulations remained stable at + 2-8 ± °C temperature (in refrigerator) throughout the study
Caffeine Associations with Manifestation of Ocular Diseases
No full textAim of the study: To analyse the effects of caffeine on cataract, glaucoma and dry eye disease in selected scientific literature. Objectives: To theoretically determine whether antioxidant properties of caffeine can prevent cataract formation. To elucidate the effect of caffeine on the course of glaucoma and the relationship between caffeine and the risk of glaucoma. To evaluate the links between caffeine consumption and dry eye disease. Methods: This systematic literature review was written by following the requirements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement). [1] The research was conducted on "PubMed" database, using following keywords: ((caffeine OR coffee OR coffee brew)) AND (cataract OR lens opacities OR glaucoma OR intraocular pressure OR dry eye OR cornea OR retina). Inclusion and exclusion criteria were determined based on PRISMA recommendations, publications were evaluated according to objectives of this review and PICO (population, interventions, comparative, results) system. An analysis of included publications was performed. Results: A total of 142 publications were found using selected keywords. After excluding studies that did not meet the criteria, 14 scientific publications were included in this review. In four of them the effect of caffeine on development of cataracts was studied (three experiments on animals and one on human lens structures); two studies were focused on effects of caffeine on people with primary open-angle glaucoma. There were also eight studies on healthy participants, exploring changes that caffeine causes in eyes and determining the risk of glaucoma and dry eye disease. Conclusions: Caffeine consumption effectively reduces oxidative stress caused by ultraviolet rays, galactose, type 1 diabetes, and increases the concentration of antioxidant components in lenses of experimental animals. In human lenses, caffeine levels increase significantly after oral administration, but it is not entirely clear whether this is enough for cataract prevention in clinical practice. Caffeine has been associated with an increased risk of pseudoexfoliative glaucoma. Data on effects of caffeine on intraocular pressure, anterior chamber parameters and ocular perfusion pressure are contradictory, but a slight increase in values of these indicators after consuming caffeinated beverages may be related to a negative impact on the course of glaucoma. Caffeine has been shown to promote tear secretion, but no statistically significant association was observed between the risk of dry eye disease and coffee consumption in a healthy population. Recommendations: Clinical trials are needed to evaluate the impact of caffeine to the course of glaucoma, its preventive and therapeutic effects on cataract, dry eye disease
Analysis of Diagnosis and Treatment of Adolescents with PCOS.
No full textAnalysis of diagnosis and treatment of adolescents with PCOS. Author: Eglė Valužytė The Tutor for Research: Doc. Dr. Kristina Jarienė Aim: To analyze diagnostic criteria and treatment options in adolescents with PCOS. Objectives: 1. To analyze PCOS etiopathogenesis and risk factors. 2. To identify PCOS clinical outcomes 3. To conclude diagnostic laboratory and instrumental research methods. 4. To analyze treatment options in adolescents with PCOS. Material and the methods: A systematic review of the literature was conducted using the electronic medical database „PubMed" (MEDLINE), selecting publications which analyze treatment and diagnosis of PCOS. Combination of the key terms „polycystic ovary syndrome”, „adolescents”, „guidelines”, ,,treatment”, ,,pathogenesis”, ,,Rotterdam criteria”, ,,hyperandrogenism” was used. Also filters were applied: language „english” and publication date „10 years”. UptoDate medical database was also used to find publications in englisch language, with publication date 10 years and using key words: „polycystic ovary syndrome’’, „adolescents”. Lithuanian language publications were used as additional publications, which were released no later than 10 ago, and matched key words: „polycystic ovary syndrome”, ,,diagnosis”, ,,treatment”. Results: Systematic review of the literature was conducted and 589 studies were found using compelling keywords. Out of these 50 met the chosen criteria of inclusion and were further analysed. 7 studies were found in UptoDate medical database, and 3 of them used. Also 3 lithuanian language studies were used. Other articles were not included because they did not answer the objectives of this review. Conclusions: 1. PCOS etiopathogenesis is not clear. This syndrome may develop because of hyperandrogenism of the ovaries, luteinizing hormone hypersecretion, hyperinsulinemia or anti-Müllerian hormone-dependent disruption of folliculogenesis in ovaries. PCOS might be also inherited genetically. 2. In early adolescence PCOS may clinically present as menstrual cycle irregularities, acne vulgaris and hirsutism. In many cases, adolescents with PCOS have higher BMI and tend to obese during the years. 3. In order to diagnose PCOS it is essential to measure serum testosterone levels, serum LH and FSH levels, to count LH/FSH ratio, free androgen index. Measure free thyroxine, thyroid-stimulating hormone and to perform ovarian ultrasonography. 4. Combined hormonal estrogen-progestin oral contraceptives are considered to be first-line agents for treating PCOS. When the patient is obese or has hyperinsulinemia first-line treatment is to lose weight. For better results metformin might be prescribed
Prevention of Postoperative Nausea and Vomiting (PONV) in Laparoscopic Gastric Reduction Surgery
No full textAim: To evaluate the effectiveness of double (dexamethasone and ondansetron) and triple (dexamethasone, ondansetron and haloperidol) antiemetic prophylaxis of PONV in laparoscopic gastric reduction surgery. Objectives: 1. To identify factors associated with an increased risk of PONV among obese patients undergoing gastric volume reduction operations. 2. To evaluate PONV frequency, intensity, time of onset of the first episode in the experimental and control group . 3. To assess the need for additional antiemetic therapy in the experimental and control groups. 4. To evaluate and compare patient satisfaction with obtained PONV prevention and treatment in both study groups. Methods: A prospective randomized, double-blind study. Group V2 patients received 8 mg dexamethasone during i.v. induction of anesthesia and 8 mg ondansetron at the end of surgery, while group V3 patients to this prophylaxis additionally received 1 mg of haloperidol iv. at the end of the operation. PONV frequency, intensity, time of onset of the first episode and the need of additional anti-emetic therapy were evaluated in PACU (postnesthesia care unit) and general ward during the 24 h period after surgery. The comparison of the applied PONV prophylaxis was also assessed taking into account the patient's satisfaction with the given PONV prophylaxis. Results: The study included 43 (79.6%) women and 11 (20.3%) men with moderate risk for PONV (2.31 ± 0.947 factors in Apfel’s score. 31(57.4%) patients received double (V2) and 23 (42.6%) patients received triple(V3) PONV prophylaxis. Although patients in group V3 were more likely not to experience PONV or it was mild to moderate (p = 0.007), they were more poorly protected from severe nausea and gnawing (p = 0.014). The need for additional anti-emetics in PACU and general ward did not differ between groups (p <0.05). 47 (87%) patients tend to recommended and 43 (79.6%) patients would repeat their POPV prophylaxis. Satisfaction with POPV prophylaxis did not differ significantly between our study groups (p <0.005). Conclusion: Triple PONV prophylaxis was not superior to double among bariatric patients. Recommendations: Due to high PONV prevalence anti-emetic prophylaxis is necessary for bariatric patients
Parafunction prevalence between preschool and school aged children in Kaunas city
No full textRelevance of the problem and the aim of this study Numerous articles evaluate the influence of parafunctions at an early age and its significance in malocclusion development. In recent years, parafunction prevalence has increased in children, leading to an increase in preventable malocclusion problems such as an open bite due to digit finger sucking. The aim is to find the parafunction prevalence amongst preschool and school age children in Kaunas city. Materials and methods Research group consisted of individuals living in Kaunas, who has preschool and school age children. The parents received an anonymous, online questionnaire through Facebook platform. Participants were given a consent form. The study group consisted of 412 participants. Data collected: child's sex, age, nutritional history, nutrition type for up to 6 months and up to 1 year, parafunction history, parafunction family history, current parafunction data, parental education data, their opinion of parafunctions and need for treatment. Results The group consisted of 224 (54,4%) girls and 188 (45,6%) boys. The prevalence of parafunctions is 60,6 percent. Most occurring is nail, lip, pencil biting (36,4%), least is tongue thrusting (1,4%). Parafunctions are most prevalent in the 3 to 5-year age group (61,9%), least is in the older than 12-year age group (11,4%). 4 out of 5 dysfunctions were more commonly seen in the girl group. 57% of children with one or more parafunctions has been bottle fed exclusively from 6 months up. Conclusions The parafunctions are most prevalent in the preschool aged girl group. Most prevalent parafunction is nail, lip and pencil biting. Parafunctions occurred more frequently in children that were bottle fed exclusively from 6 months