International Journal of Medicine and Medical Research

3

Authors: S. V. Kalinichenko, O. O. Korotkykh, S. I. Pokhil, M. G. Bakumenko

Background. Lactobacilli are very important for the formation of colonization resistance and have pro- nounced antagonistic effect against a wide range of microorganisms. That is why the lactobacilli have extensive use as a component of classic probiotic agents that are widely used to prevent and treat dysbiotic conditions of digestive and genital systems of people. Objective. The aim of the research was to study the effect of lactobacilli on anti-infectious resistance of mucous membranes of upper respiratory tract. Methods. The colonization degree (lg CFU / g) of nasal mucosal membranes by Lactobacillus spp. and S. aureus was determined in all carriers before the experiment. Also, the level of lysozyme and secretory immuno- globulin A (sIgA) in nasal secretions cavities was identi ed. Results. It was established a clear dysfunction of anti-infectious resistance in carriers of Staphylococcus aureus - a decrease of colonization resistance and local immunity of mucous membranes of upper respiratory tract. As for the anti-infectious resistance of nasal mucosal of S. aureus carriers, the level of lysozyme and secre- tory immunoglobulin A gradually increased after the application of probiotic strain L. rhamnosus GG, and in 21 days it reached rates of healthy individuals. Conclusions. It was found out that probiotics for nasal passages sanitation in Staphylococcus aureus car- riers lead to gradual eradication of the pathogen (S. aureus) with restoration of colonization and anti-infectious resistance, mucous membranes and upper respiratory tract.

4

Authors: A. V. Kedyk, M. V. Rishko, O. O. Kutsyn

Background. The lipid pro les of patients with overweight, obesity and healthy individuals, the citizens of Transcarpathia valley regions were analysed. Objective. The study was aimed at evaluation of dyslipidaemia frequency in patients with overweight and obesity, determination of expedience of statins prescription. Methods. All patients were divided into 2 groups: group 1 – patients with overweight; group 2 – patients with obesity of I and II degree. Estimation of lipid pro le parameters was conducted by means of spectrophotometric device SIEMENS Dimension RxL Max. Statistical analysis of the data was conducted using Microsoft Excel 2007. Results. The patients with obesity had higher level of total cholesterol (6.03±0.53 mmol/l), lower HDL-C (1.15±0.07 mmol/l) and higher level of LDL-C (4.19±0.46 mmol/l) compare with overweight patients. In 46% of patients with overweight, dyslipidaemia was evidenced and required correction, 27% of them had high CVR and needed statin therapy, 19% of people with obesity had moderate CVR and didn’t need statins. 77% of obese patients needed lipid correction, 54% of them with very high and averagely high level of CVR required statin therapy; 23% of people with obesity had moderate CVR and did not need statins. Conclusions. In the studied overweight and obese patients, atherogenic dyslipidaemia was established in 46% and 77% of cases respectively. Correction of dyslipidaemia with statin was compulsory for 27% of patients with overweight and for 54% with obesity.

4

Authors: L. P. Melnyk, L. A. Hryshchuk, M. Koziol–Montewka, P. S. Tabas, R. O. Klos

Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epi- demiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ter- nopil region is endemic with Lyme borreliosis. Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary. Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the ques- tions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites. Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculo- sis (TB) and exudative pleurisy, respectively. Conclusions. The absence of appeals for medical care, lack of su cient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB) among this category of population. 24 (82.7%) of 29 respondents did not remember the tick bite. The symptoms of (LB) are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin), and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato.

5

Authors: O. D. Boiagina

ackground. It is established that there is an anatomical relationship between the corpus callosum and longitudinal strips. These formations must correlate to the common commissural system of the corpus callosum conductors. At present this issue in such a formulation is not considered in literature on Neuromorphology. Objective. The study was aimed to determine the commutations between the longitudinal strips and commissural conductors of the corpus callosum. Methods. The corpus callosum of people aged from 36 to 60 was studied. Some slices of the corpus callosum stem were used for impregnation and then inserted in para n blocks. Another part of these slices was subjected to plastination in epoxy resin. Results. Lateral longitudinal strips contain signi cantly greater mass of nerve conductors. Most of them compactly pass along limbic ring, while the other part is combined to nerve bres of the corpus callosum commissural cords. The longitudinal strips are coated with an outer limiting glial membrane (grey coating). Conclusions. By means of the corpus callosum the connections between conscious and subconscious brain areas are structurally xed. It can be assumed that longitudinal strips have relation to hippocampal area, related to the ancient formation of the pallium. This does not exclude the fact that the nerve bres, found within longitudinal strips may have projections on the cortical cells of vaulted gyrus, which is considered to be paleopallium sphere. So, this interaction between the ancient and the old cortex should presumably be carried out by means of lateral longitudinal strips.

5

Authors: P. H. Lykhatskyi, L. S. Fira

Background. Due to the wide use of nitrate fertilizers in agriculture and their migration into groundwater and food, the spreading of nitrate poisoning has become epidemic. However, people in the process of life get into bad habits: smoking, alcohol, drugs abuse. All these factors affect health and can cause fatal outcome. In real life, people are often exposed to more toxic factors that lead to general poisoning of the body and damage of many organs. Objective. The research was aimed to study the activity of free radicals and in ammation in rats of different age in cases of sodium nitrite affection with underlying 45-day tobacco intoxication. Methods. The content of nitrite ion (NO2-) was evaluated by Gris reaction. The level of pro-in ammatory (interleukin 6 (IL-6) and anti-in ammatory (interleukin 4 (IL-4) cytokines was determined in serum by ELISA method using test kits. Results. It was proved that in rats of different age affected by sodium nitrite with underlying 45-day tobacco smoke intoxication, the content of nitrite ion in serum, liver, lungs and myocardium is increased. After poisoning the animals with the studied toxicants, in ammation was activated in the body that was evidenced by the increased pro-in ammatory cytokine IL-6 and decreased in ammatory cytokine IL-4 in serum. Conclusions. The nitrite ion content in organs was the most signi cant and in ammation was manifested in the immature rats. In these animals the content of anti-in ammatory cytokines was the lowest.

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Authors: O. P. Venger, Y. I. Mysula, L. V. Shkrobot

Background. Social and clinical relevance of emigration and re-emigration is determined by a signi cant amount of Ukrainians that emigrate and re-emigrate. Clinical features of depressive disorders have not been studied;as well as risk factors and antiriscs of various forms of depression have not been established yet. Development of comprehensive approaches to the treatment and rehabilitation of these patients is an effective way of resolving of this problem and is of signi cant scienti c, practical, medical and social importance. Objective. The development of measures for treatment of depressive disorders in emigrants and re-emigrants is based on investigation and analysis of clinical-psychopathological phenomenology of depression. Methods. We examined 196 emigrants, 191 re-emigrants and 198 not emmigrants with nal clinical diagnosis of depressive disorder according to ICD-10 criteria. Examination was conducted by means of depression rate according to M. Hamilton, the Montgomery-Asberg and Symptom Checklist-90-Revised and the scale of life quality by WHO QOL-26. Statistical analysis of the results was performed using nonparametric methods: Mann-Whitney test, Wilcoxon criterion of signs. Results. It was found that the maximum content of organic acids is accumulated in grass Hyssopus o cinalis L. (Lamiaceae), and the minimal is in the leaves of Chrysánthemum xhortorum L. variety Apro (Asteraceae). The dominance of aliphatic acids was determined by means of gas chromatography. Benzoic is predominant among aromatic acids. Conclusions. The suggested therapy schemes proved higher effectiveness compared with the traditional one, and also allowed to improve the life quality of emigrants and re-emigrants.

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Authors: A. R. Vergun, B. M. Parashchuk, M. R. Krasnyy, Z. M. Kit, O. M. Vergun

Background. Conservative treatment of secondary recurrent unguis incarnatus are not very effective and Dupuytren’s method, Emmert-Schmiden surgeries etc. are very traumatic, dis gure nail bone, distort anatomic and functional unity of a nail. Objective. The aim of our research was the optimal sequence of holiatry, surgical moving away of nails, local and system therapy after excision of the staggered nails in case of destructive onychomycosis complicated by secondary ingrown nail for some patients with complicated mycotic defeat of nails. Clinical options of surgical treatment were clari ed; morphologic changes were studied; causes of unsatisfactory outcomes of chronic pathology complex treatment were analyzed for prospective approaches to preventing of relapses. Methods. The analysis justi es the feasibility of establishing of predictive relationships between clinical variants of chronic purulent necrotic infections and combined comorbidity. System therapy by itraconazole before operative treatment (basic onychial defeats sanation) and in a postoperative period was carried out. Types of operative treatment applied may be divided into ve statistic groups. Results. over a ve-year period (2010-2015) 436 unguis incarnates diagnosis (325 cases of incarnated onychomycosis) in 259 men and 177 women aged 12-67 were performed, 38 of them with incarnated onychogryphosis had diabetes mellitus and 24 had metabolic syndrome. Analysis of subonychial scraping allowed stating the prevalence of red trichophytia in 31% of cases with the bacterial ora. Patients with combined pathology got 4-5 ve-day system ‘pulses’ of 400 mg/day itraconazole therapy. In patients with primary advantage of providing low-impact methods of nail excision with access via onycholisation structure a nail extirpation and marginal matricectomy was carried out; dermatophytoms and strati cation on a nail bed were deleted. Conclusions. Type of onychectomy wound cytograms in the study group on the 10th day was de ned as regenerative-in ammatory in 24.81%, regeneratory in 75.19% (p=0.031). The methods of surgical treatment of mycotical recurrent nail incarnation have been improved considering patho- and morphogenetic properties of destructive onychomycosis.

7

Authors: I. D. Khan, B. Asima, Sh. A. Khan

Background. Golden-hour, a time-tested concept for trauma-care, involves a systems approach encompassing healthcare, logistics, geographical, environmental and temporal variables. Golden-hour paradigm in mass- gathering-medicine such as the Hajj-pilgrimage entwines along healthcare availability, accessibility, e ciency and interoperability; expanding from the patient-centric to public-health centric approach. The realm of mass- gathering-medicine invokes an opportunity for incorporating operations-throughput as a determinant of golden- hour for overall capacity-building and interoperability. Methods. Golden-hour was evaluated during the Indian-Medical-Mission operations for Hajj-2016; which established, operated and coordinated a strategic network of round-the-clock medical operations. Throughput was evaluated as deliverables/time, against established Standard-Operating-Procedures for various clinical, investigation, drug-dispensing and patient-transfer algorithms. Patient encounter-time, waiting-time, turnaround- time were assessed throughout echeloned healthcare under a patient-centric healthcare-delivery model. Dynamic evaluation was carried out to cater for variation and heterogeneity. Results. Massive surge of 394 013 patients comprising 225 103 males (57.1%) and 168 910 females (42.9%) overwhelmed the throughput capacities of outpatient attendance, pharmacy, laboratory, imaging, ambulance, referrals and documentation. There was a delay in attendance, suspicion, diagnosis and isolation of patients with communicable infections. The situational-analysis of operations-throughput highlights wasted turnaround-time due to mobilization of medical-team, diverting critical healthcare resources away from emergency situations. Conclusions. Time being a crucial factor in the complexity of medical-care, operations-throughput remains an important determinant towards interoperability of bottlenecks, thereby being a determinant of golden-hour in mass-gathering-medicine. Early transportation of a patient to de nitive-care reduces treatment initiation-time, notwithstanding logistics of communication, evacuation, terrain and weather being deterministic in outcome. Golden-hour needs to be emphasized under a population-based approach targeting the clientele towards administering rst-aid and reaching out to hospital within the golden-hour.