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ВПЛИВ ФІЗИЧНОЇ ТЕРАПІЇ ТА ХОЛІНЕРГІЧНИХ ПРЕПАРАТІВ НА ПОКАЗНИКИ ЯКОСТІ ЖИТТЯ У ПАЦІЄНТІВ З ПОРУШЕННЯМ МОТОРИКИ РУКИ ПІСЛЯ ПЕРЕНЕСЕНОГО ІШЕМІЧНОГО ІНСУЛЬТУ
No full textMotor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients.
The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke.
Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy.
Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively.
The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05).
Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.Порушення моторики найбільшою мірою забезпечують функціональну незалежність пацієнтів та мають значний вплив на якість життя (ЯЖ) пацієнтів після перенесеного інсульту.
Мета: оцінити вплив різних підходів фізичної терапії та холіну альфосцерату на функціональну незалежність та якість життя пацієнтів через 1 рік після перенесеного ішемічного інсульту.
Матеріали і методи. Обстежено 104 хворих через1 рік після першого ішемічного інсульту в каротидному басейні. Неврологічний статус, функціональну незалежність та ЯЖ оцінювали за шкалою Національного інституту охорони здоров’я (NIHSS), модифікованою шкалою Ренкіна (mRS), оцінкою функціональної незалежності (FIM) та шкалою якості життя після інсульту (SS-QOL). Пацієнти 1 групи отримували терапію для вторинної профілактики інсульту та протягом 2 місяців виконували комплекс вправ для покращення загальноруховоїфункції; пацієнти 2 групи також впродовж 2 місяців виконували комплекс вправ для покращення моторики кисті; пацієнти 3 групи отримували холіну альфосцерат 400 мг двічі на день в протягом 2місяців додатково до вищезазначеної фізичної терапії.
Результати. Через2 місяці фізичної терапії в групі 1 спостерігали збільшення оцінки в субтесті «Переміщення» та субтотального балу моторики. Значне збільшення рівня балу за субтестами «Самообслуговування», «Переміщення»і відповідносубтотального балу моторики та загальної оцінки спостерігалося у пацієнтів 2 та 3 групи; субтотальний бал моторики та загальна оцінкав 3групі були відповідно на 11,4% та 11,6% вищими за аналогічні показники в 1 групі.
Найбільш суттєве покращення показників ЯЖ спостерігалось у пацієнтів 3 групи, загальний бал яких збільшився на 36,8% від вихідного рівня (р<0,05) та перевищив аналогічний показник 1 групи на 17,1% (р<0,05).
Висновок. Включення вправ для моторики кисті у комплексфізичної терапії пацієнтів після інсульту сприяє покращенню рухової функції верхньої рухової кінцівки і, таким чином, функціональної незалежності хворих. Стимуляція холінергічної нейротрансмісії за допомогою холіну альфосцерату також може підвищити ефективність фізичної терапії та сприяти покращенню загальнорухової функції, моторики верхньої кінцівки та ЯЖ пацієнтів
The Structural-Functional Peculiarities of Heart in Patients with Acute Coronary Syndrome
Get PDFAcute coronary syndrome (ACS) is associated with very high morbidity and mortality. The American Heart Association estimates – approximately every 40 seconds an American has a myocardial infarction. The aim of this study was to evaluate the structural-functional peculiarities of heart remodeling in patients with acute coronary syndrome.
Material and Methods. In this observational cohort trial there were observed 184 patients with ACS. Coronary angiography was performed at admission, and lesions that reduced the lumen area at 50% or more were considered angiographically significant. Transthoracic echocardiography was performed in accordance with recommendations of the American Society of Echocardiography.
Results. The mean age of all observed patients with ACS was 64.6±11.9 years; 93 (50.5%) were males. ACS with persistent ST segment elevation more often was presented as the anterior-lateral myocardial infarction with persistent ST segment elevation (STEMI) – in 70 (50.0%) cases. Among patients with STEMI the left anterior descending coronary artery (LAD) was mostly affected as infarction-related artery (IRA): in 74 (52.9%) cases at initial urgent coronary angiography. Multivessel disease (MVD) was identified in 22 (15.7%) patients with STEMI. The most significant variations of EchoCG parameters were observed in STEMI patients with MVD on coronary angiography (Table 2): dilatation of left atrium and left ventricle (increased of End-diastolic volume (EDV), End-systolic volume (ESV), End-diastolic diameter (EDD) and End-systolic diameter (ESD)) and low ejection fraction (EF) of left ventricle. Low EF of left ventricle was observed in 6 patients with culprit of LAD, 3 patients with culprit of LCx and in 6 patients with MVD (φ=0.244; p<0.05).
Conclusion. Acute STEMI is caused by significant left ventricle remodeling (dilatation and ejection fraction decrease) in case of multivessel disease in coronary angiography
Assesment of Iodine Deficiency in Patients with Nodular Goiter Living in the Precarpatian Region
No full textThe objective of the research was to assess the state of iodine supply of patients with nodular goiter living in the Precarpathian region.
Materials and methods: 56 patients with nodular goiter were examined (38 women and 18 men), the average age of patients was 48 years. WHO / UNICEF / ICCIDD guidelines were used to assess the severity of iodine deficiency: goiter frequency according to palpation and ultrasound examinations, median of iodine excretion in urine, thyroid-stimulating hormone (TSH) and thyroglobulin levels. Determination of iodine concentration in urine was conducted by the method of “blind”, closed randomized study in single portions of urine according to the Sandell-Kolthoff reaction by the method of Dunn et al. in the laboratory of epidemiology of endocrine diseases at the State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism” (supervisor – Professor VI Kravchenko).
Results. According to the results of the study of iodine in the urine, the data with an average value of 85.9 μg/l were obtained. The median of thyroglobulin serum was in the range of 12.27 ng/L. Levels of thyroid-stimulating hormone were average in patients with nodular goiter of I and II grades constituting 3.13 mU/l (table 2). The level of thyroglobulin median was noted to be the highest in patients with thyroid size corresponding to grade II.
Conclusions. The results of the study of iodine in the urine of patients with nodular goiter of grades I and II living in the Precarpathian region indicated a mild level of iodine deficiency. The presence of iodine deficiency necessitated both mass (the use of iodized salt by the population) and individual iodine prevention (prescribing potassium iodide)
Age features of morphological changes of vessels of testicular hemomicrocirculatory flow in streptozotocin diabetes mellitus
No full textMedico-social problem of diabetes is caused by early disability and mortality of patients due to specific complications of micro- and macroangiopathies. Therefore, the aim of our study was to establish morphological changes in vessels of the hemomicrocirculatory flow of the testes of immature rats with experimental streptozotocin diabetes mellitus (SDM). The material for the study were the testicles of 20 two-month-old immature (weighing 65-95 g) white outbred male rats, which were divided equally into 2 groups: experimental and control ones. SDM in animals of the experimental group was simulated by a single intraperitoneal injection of streptozotocin (dissolved in 0.1 M citrate buffer solution with a pH of 4.5) at a dose of 7 mg per 100 g of mass. The control group of animals received intraperitoneally an equivalent dose of 0.1 M citrate buffer. Histological, electron microscopic, biochemical, morphometric and statistical research methods were used.
It was found that in the early stages of SDM (14th day) on the background of hyperglycemia in the hemomicrocirculatory flow of the testes there is a spasm of the vessels of the afferent link, which is confirmed by a decrease in the area of arterioles lumen and an increase in their VI.
On the 56th day of SDM, on the background of elevated levels of glucose and glycosylated hemoglobin in the links of the hemorrhagic circulatory flow of the testes there are initial signs of diabetic microangiopathy, manifested by: hemorheological disorders in micro-hemo-vessels (erythrocyte sludges, adhesion of erythrocytes and platelets, microclasmatosis), decreased capacity of arterioles and capillaries (increase in VI, respectively by 1.2 and 1.9 times), microclasmatosis, thickening and proliferation of the basement membrane of capillaries.
Thus, on the 56th day of SDM in the hemomicrocirculatory flow of the testes, the development of diabetic microangiopathy is observed, which leads to the disruption of the blood-testis barrier, and as a consequence, to a violation of spermatogenesis
The Radicular Cyst in a Child: Case Report
Get PDFThe most commonly occurring odontogenic cysts of the jaws are radicular cysts.
Causes of jaw cysts are different, numerous and depend on the type of cyst. The basic precondition for the occurrence of a cystic lesion is the previous presence of epithelial tissue at the site of future development of the cystic formation.
Radicular cysts are one of the most common odontogenic cysts and arise from epithelial so-called Malassez - these residues in the periodontal tissue, as a consequence of inflammation of the pulp. They can occur at any age, and are equally prevalent in both sexes. The aim of this paper is to present the clinical symptoms and treatment of a radicular cyst in a 12-year-old child.
The treatment of radicular cysts in most cases is surgical. The possibilities for such treatment and the choice of surgical method depend on the size of the cyst, its location, and the pathological formation.
The present article reported a case of a 12-year-old male with the chief complaint of pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border between mandibular central incisive. The case was managed by complete enucleation under local anesthesia without extraction of any teeth.
We chose enucleation (cystectomy) as a surgical procedure as the method of choice, because postoperative complications are the rarest, and the best healing is also provided. Аfter one month of surgery treatment, complete wound healing was recorded at the clinical control at the Department for oral surgery
Examination of Affiliate Stigma, Hopelessness and Life Satisfaction in Parents of Children with Intellectual Disabilty
Get PDFIntroduction. While expecting a healthy child, having a child with a disability can be quite traumatic for all family members, especially parents.
The objective of the research was to evaluate affiliate stigma, hopelessness, and life satisfaction in parents of children with intellectual disability.
Materials and Methods. The descriptive research included 203 parents of children with intellectual disabilities, who met the research inclusion criteria and agreed to participate in the study. The data were collected using the Personal Information Form, the Affiliate Stigma Scale, the Beck Hopelessness Scale, and the Satisfaction with Life Scale.
Results. The mean age of parents included in the study was 40.74 ± 7.22 years, with 67.5% of caregiving mothers. The levels of affiliate stigma and hopelessness among parents were low, and they were satisfied with their lives. In case of increasing parental affiliate stigma, their hopelessness was found to increase, while life satisfaction was found to decrease.
Conclusions. In order to increase public acceptance of people with disabilities by society, it is recommended to provide trainings and raise awareness against individuals with disabilities and their families
Blood Plasma Serotonin and von Willebrand Factor as Biomarkers of Unstable Angina Progression Toward Myocardial Infarction
Get PDFAim: To investigate the serotonin and von Willebrand factor (vWF) concentrations among unstable angina (UA) patients without and with progression toward myocardial infarction (outcome) and to assess the utility of both as prognostic markers of UA complications.
Materials and methods: In observational cohort study, we recruited 103 patients with ischemic heart disease (the median age 65.0 (59.0-69.0) years, 45 females (43.7%)). After full set of investigations including high sensitive Troponin I test and 28-day follow-up period, we defined three groups: Group 1 - stable angina patients (n=22) as control, Group 2 - UA patients without outcome (n=71), Group 3 - UA patients with outcome (n=10). We analyzed the blood plasma serotonin content by the ion-exchange chromatography with measurement of serotonin on fluorescence spectrophotometer. VWF concentration was determined by ELISA. We compared the concentrations of observed parameters among the groups with the Kruskal-Wallis test (with post-hoc Mann-Whitney test with Bonferroni-Holm correction). We assessed binary logistic models, receiver operating characteristic curves, calculated sensitivity (Se), specificity (Sp), and positive likelihood ratio (LR+) for each indicator.
Results: We registered elevation in serotonin concentration and decline in vWF concentration in Group 3 in comparison with Group 2 (22.670 (20.687-24.927) μg/ml vs 11.980 (8.120-15.000) μg/ml, p< 0.001, and 0.117 (0.109-0.120) rel.units/ml vs 0.134 (0.127-0.143) rel.units/ml, p < 0.001) and Group 1 (12.340 (10.052-13.619) μg/ml, p < 0.001, and 0.137 (0.127-0.156) rel.units/ml, p < 0.001), respectively. No significant differences in serotonin and vWF concentrations between Group 1 and Group 2 were detected (p=0.81 and p=0.36, respectively). The probability of outcome increased significantly (by 60.7% and 59.7%, LR+ 19.0 [6.0, 60.0] and 18.0 [3.9, 80.0]) if serotonin concentration was above 21.575 μg/ml (Se=80.0%, Sp=95.8%, AUC=0.975) and vWF concentration was below 0.114 rel.units/ml (Se=50.0%, Sp=97.2%, AUC=0.973), respectively.
Conclusions: Serotonin and vWF as biomarkers are demonstrated promising results for rule-in the patients with risk of short-term UA progression toward myocardial infarction
The Relationship Between Perceived Parental Attitude and Life Satisfaction Among University Students
Get PDFIntroduction. The effect of parental attitudes and behaviors in raising their children on the individual’s life has been the subject of numerous studies for many years. There is a strong correlation between parental attitudes and the child’s ability to be satisfied with life.
The objective of the research was to determine the relationships between perceived parental attitudes (overprotection, rejection, emotional warmth) and life satisfaction among university students. We investigated whether parental attitudes play a role in predicting life satisfaction among university students, and what role they play.
Materials and Methods. The study was conducted from June 2020 to September 2020. Data were collected using Google Forms. Each person consented to anonymously participate in the study and was informed about the objectives of the study being a descriptive one. The population of the study consisted of nursing students enrolled in the Faculty of Health Sciences. For this purpose, 220 students at the age of 20 to 30 years participated in the study. The assessment battery consisted of Student Demographic Form, the Short-Egna Minnen Beträffande Uppfostran (Own Memories of Upbringing), and the Life Satisfaction Scale.
Results. There was a significant negative correlation between maternal rejection and life satisfaction among the students. Male students were more likely to perceive their fathers as being disapproving than female students did. These findings were discussed in line with the studies in the related literature.
Conclusions. High life satisfaction is a variable that protects young people from risk factors. Therefore, a focus should be placed on increasing life satisfaction among students. Parental attitude is an effective factor for life satisfaction among students. For this reason, it can be said that it would be beneficial to inform families about appropriate parental attitudes to increase their children’s life satisfaction
Multidetector Computed Tomography Evaluation of Uncommon Acute Post-Caesarean Section Complications
Get PDFIntroduction. The most common major abdominal surgery in women is caesarean section. Despite being a safe procedure, a variety of complications, both acute and chronic, can occur. About 14.5% of caesarean sections result in complications. Infection followed by postpartum haemorrhage is the most frequent complication. Imaging modalities such as ultrasonography and multidetector computed tomography are often used in the evaluation of suspected uncommon post-caesarean complications. Computed tomography has been found to be a good initial modality for assessing acute postoperative complications after caesarean delivery.
The objective of the research was to evaluate the imaging findings and the characteristic visual manifestations of atypical acute complications of caesarean section, other than common complications such as postpartum haemorrhage, wound infection, etc.
Materials and Methods. This prospective study was carried out at the Department of Radiodiagnosis and Imaging, Government Medical College, Srinagar from June 2019 to February 2020 in collaboration with the Department of General Surgery and Gynaecology and Obstetrics of the Sher-i-Kashmir Institute of Medical Sciences. All patients with suspected complication in the immediate post-caesarean period were evaluated with contrast-enhanced multidetector computed tomography.
Results. Out of 427 patients who underwent caesarean section, 25 patients were suspected of having uncommon acute complications. Out of 25 patients evaluated for suspected immediate post-caesarean complication, only 5 patients had bladder flap hematoma, 8 patients were diagnosed with uterine dehiscence, 6 patients had uterine rupture, 3 patients suffered from ureteral injury, 1 patient had gossypiboma, 2 patients developed pelvic sepsis.
Conclusions. Multidetector computed tomography plays an important role in detection and confirmation of multiple acute complications after caesarean delivery and can also help in guiding the management of complications as well
Evaluation of Quality of Life and Self-Care Among Individuals with Heart Failure
Get PDFThe objective of the research was to evaluate quality of life and self-care agency among individuals with heart failure.
Materials and Methods. The study sample consisted of 61 patients who were diagnosed with heart failure that occurred at least six months before we started our research, had no communication problems, were over 18 years old and were selected by random sampling method. The data were collected by the researcher using a face-to-face interview technique, a descriptive information form, the Short Form-36 Quality of Life Scale, and the Self-Care Agency Scale. In the analysis of the data, numbers, percentiles, means, the Kruskal-Wallis test, the Mann-Whitney U test, and the Pearson correlation coefficient were used.
Results. The patients’ average self-care agency score was 71.75 ± 33.66. The patients received the highest score on the subscale of bodily pain (46.76 ± 31.02) and the lowest score on the subscale of role limitations due to physical health problems (19.26 ± 32.40). The patients’ age and disease duration were found to affect their self-care. Some quality-of-life subscales were affected by the educational, occupational and socioeconomic status, age, disease duration.
Conclusions. Patients’ quality of life was found to be low, and the level of self-care agency was found to be moderate. Patients’ quality of life can be improved by increasing the frequency of self-care trainings given to patients