European Journal of Medicine

12-18

Authors: Athena Myrou, Theodoros Aslanidis, Triantafyllos Didangelos, Georgia Kaiafa, Andreas Theodoridis, Christos Savopoulos

Though continuous glucose monitoring systems (CGMS) have proven their benefits in type 1 diabetes mellitus, research about their use in type 2 diabetes mellitus (Τ2D) are still in progress. The current study aimed to evaluate the use of such systems in patients with T2D in comparison with the standard periodic capillary measurements. Twenty-five patients with T2D under insulin or combination of insulin and oral medication participated in a prospective 7-day observational study. American Diabetes Association 2021 targets for good euglycemic control were used as primary goals for the two groups (CGMS over capillary measurements). Seventy two percent of the participant achieved maintenance of blood glucose within therapy target guidelines. Moreover, 64 % of the participants achieved glycohemoglobin HbA1c < 6.5 %. Glucose values with both methods display high level of correlation ((r = 0.901, p < 0.001) and the same is also valid for HbA1c and estimated HbA1c ((r = 0.939, p < 0.001). Thus, CGMS can achieve both better glycemic control and decrease of HbA1c in patients with T2D. Though the present findings are in accordance with the available literature, further studies in larger populations with more deeper analyses are still needed to confirm the usefulness of CGMS in T2D.

24-27

Authors: Sulaiman Hafizah Sani

The acceptance of COVID-19 vaccine and hesitancy among Health care workers besides doctors in ATBUTH was examined with in order to determine the level of COVID-19 vaccine acceptance among health care workers in ATBUTH and to assess the factors of COVID-19 vaccine non-acceptance/hesitancy among health care workers in ATBUTH. A cross-sectional study was carried out using questionnaires administered to health care workers of ATBUTH. Current studies showed that 70 % of respondents were vaccinated while 40 % were not, reasons given by respondents for accepting the vaccine were: 37 % to avoid travel restrictions, 15 % mandatory by employer, 45 % for protection, while 9 % gave other reasons, those that were hesitant in receiving the vaccine did so for fear of side effects, 35 %, lack of adequate information, 30 %, religious belief, 17 %, while 12 % gave a collection of other reasons. Fear of side effects and limited knowledge about the vaccine appear to be the main reasons for vaccine hesitancy among health care workers in ATBUTH.

37-43

Authors: Igor R. Trutyak, Oleg V. Obaranets

Transcondylar and supracondylar fractures of the humerus in children are one of the most pressing and still not completely solved problems of modern pediatric traumatology. In the problem of condylar and supraorbital fractures of the humerus, the issues of diagnosis, choice of indications for surgical revision of the vascular-nervous bundle of the elbow area in this pathology are insufficiently covered. To solve the problems of the study, we analyzed the treatment of 313 victims with transcondylar and supracondylar fractures of the humerus, which were treated at the City Children's Clinical Hospital in Lviv in the period from 2013 to 2018. The structure of the distribution of arrays on the basis of rotational displacement in condylar fractures of the humerus is dominated by displacement up to 30 °, which in the first group was found in 61.8 % of cases, and in the second group – 69.2 % of cases. The share of severe rotational displacements in the structure of group arrays is almost the same in both observation groups: 29.1 % in the first group and 29.5 % in the second group. Analysis of the proportion of extremely severe rotational displacements up to 90 ° in the structure of group arrays revealed that such victims were 7 times more among the victims of the first group than among the victims of the second group, due to the use of the proposed unified protocol scheme for diagnosis and treatment humeral fractures in pediatric patients, which avoids or reduces the difference in the occurrence of secondary displacements.

20-25

Authors: Оleg V. Voennov, Кonstantin V. Моkrov, Valery I. Zаgrekоv, Sergey А. Аbramov, Danyil S. Chumanov, Olesya N. Gunderchuk

An observational prospective study was conducted, during which 50 patients of both sexes with severe COVID-19 and moderate manifestations of acute respiratory failure were examined. The study included patients who showed a decrease in transcutaneous saturation of less than 93 %, with a respiratory rate of no more than 25 per minute, who did not have complaints of dyspnea and impaired consciousness, but required, according to temporary clinical recommendations for the treatment of patients with COVID-19, correction of respiratory disorders. We determined the values of transcutaneous saturation using pulse oximetry, studied the acid-base state and gas composition of arterial and venous blood, and also took into account complaints of respiratory disorders, respiratory rate, the presence of forced breathing, heart rate, the "white spot" symptom and blood lactate level. The selected methods of treatment of respiratory disorders, necessary for the correction of acute respiratory failure, and the results of hospitalization were also taken into account. Based on the data obtained, it was concluded that in patients with COVID-19 "silent hypoxia" is associated with the development of moderate compensated arterial hypoxemia without the development of hypercapnia, tissue hypoxia and acidosis. Arterial hypoxemia in patients with "silent hypoxia" is compensated by known compensatory mechanisms – an increase in the delivery and utilization of oxygen to the tissues and an increase in the alkaline reserve. Moderate arterial hypoxemia without tissue hypoxia is corrected by pron-position and oxygen therapy, and does not require conversion to artificial ventilation.

47-55

Authors: Mousa Qasim Hussein, Omar S. Hamad, Noor Hamza Abdulkhdhur Al-khuzaie

The coronary artery disease is the leading cause of mortality and morbidity globally and acute myocardial infarction is the commonest mode of presentation. The tissue Doppler imaging shows myocardial motion (measured as tissue velocity) at specific locations in the heart. Tissue velocity indicates the rate at which a particular point in the myocardium moves toward or away from the transducer. Integration of velocity over time yields displacement or the absolute distance moved by that point. The most common method for determining ventricular volumes is the Simpson rule, or the "rule of disks.” This technique requires recording an apical, four- and/or two-chamber view from which the endocardial border is outlined in end-diastole and end-systole. A cross-sectional study carried out in The AL-Kindey Teaching Hospital (November 2017 – July 2018), 60 patients, 39 (65 %) males and 21(35 %) females with acute myocardial infarction of first time admitted to CCU. All patient were admitted to Coronary Care Unit and Left Ventricular systolic function had been evaluated by measuring Systolic myocardial velocity (sm) by Pulse Wave tissue Doppler imaging and Ejection Fraction by Simpson’s method. Results revealed that 25 patients (41.7 %) of them presented with anterior Myocardial infarction, inferior Myocardial infarction in 17 patients (28.3 %), lateral Myocardial infarction in 11 patients (18.3 %), and septal Myocardial infarction in 7 patients (11.7 %). (60.6 %) of anterior Myocardial infarction, (24.2 %) of inferior Myocardial infarction, (9.1 %) of lateral Myocardial infarction, and (6.1) of septal Myocardial infarction were associated with Ejection Fraction <55. There were significant differences between means of 4 mitral annular sites Sm by ejection fraction for patients with anterior, lateral Myocardial infarction, and septal Myocardial infarction.

62-66

Authors: Priyanka Shukla, Jyoti Singh, Sudhakar Dwivedi, Sanjay Kumar Pandey

When microcytosis occur with severe acute malnutrition it is characterized by body’s tissues thus organs do not get enough oxygen as the red blood cells becomes smaller in size and carries less oxygen which causes sudden major weight loss requiring a quick nutritional and medical intervention. SAM was diagnosed by WHO – MUAC method. Complete blood count and red cell indices were measured by automated 5-part hematoanalyzer and microcytosis was determined by peripheral smear method.Among all SAM infants with microcytic anemia; WBC was elevated and comparative mean value of RBC, MCV and MCH were statistically significant. Xeropthalmic stage and eyes puffiness was associated clinical symptoms of SAM infants with microcytosis. The result of the study emphasizes the importance of identifying the co-morbidities of microcytic anemia in SAM infants.

92-98

Authors: Ignat Ignatov, Christos Drossinakis, Reneta Toshkova, Elisaveta Zvetkova, Iliana Yaneva, Georgi Gluhchev

Studies were conducted with model systems of bio influence (Drossinakis’ method) with electromagnetic (e.m.) fields and infrared thermal field (ITF) (Ignatov et al., 2013). The purpose of research is to analyze effects over DNA. Analysis of effects over water and physiological saline is carried out in the report. Results are achieved with blood serum of hamsters and physiological processes in hamsters with tumors. The water analyses have been conducted with Nonequilibrium Energy Spectrum (NES) and Differential Nonequilibrium Energy Spectrum (DNES) methods (Antonov, 1992; Ignatov, 1998). Experiments were carried out about the influence on tumor cells of mice in water. Reduction of DNES spectrum according to the control sample of cells in healthy animals was observed. (Antonov, 1992). Reduction is also observed in DNES spectrum in blood serum of people having oncological diseases, compared to the one of healthy people (Ignatov, 2012). Such a reduction is most prevalent in (-0.1387 eV; 8.95 µm; 1117 cm-1). In research of the effects of e.m. fields in water and blood serum from hamsters the range is (-0.08 – -0.14 eV) (8.9 –15.5µm) (645–1129 cm-1). Research is conducted for the effects over Graffi tumor that was implanted in hamsters (Toshkova et al., 2019). Studies are conducted with pH and oxidation redox potential (ORP) effects of e.m. fields over physiological saline (Gluhchev et al., 2019).

106-113

Authors: Naina Mohamed Pakkir Maideen

Dihydropyridine Calcium Channel Blockers (CCBs) are widely used as first-line agents to treat hypertension in black patients and in patients aged more than 55 years. They have been identified as the substrates of intestinal and hepatic CYP3A4 enzymes and this review focuses on possible drug-drug interactions of dihydropyridine CCBs involving CYP3A4 enzymes. As object drugs, the dihydropyridine CCBs involved in drug-drug interactions with drugs such as Macrolide antibiotics, Azole antifungals, Protease inhibitors and fruit juices like Grapefruit juice and Seville orange juice and increase the plasma concentrations of dihydropyridine CCBs resulting in enhanced adverse effects. In addition, the drugs like Rifampicin, Phenytoin, and other antiepileptics including Carbamazepine and Phenobarbital decrease the bioavailability of dihydropyridine CCBs. Moreover, as precipitant drugs dihydropyridine CCBs increase the plasma concentrations of Statins and Cyclosporine and decrease the therapeutic efficacy of Clopidogrel. The prescribers and pharmacists are required to be aware of the adverse drug interactions of dihydropyridine CCBs to prevent adverse outcomes.

120-130

Authors: Nedyalka Valcheva

Defined are the physicochemical properties of healing thermal spring waters in the area of Burgas District. It is shown that according to 18 controlled parameters included in the research, the thermal healing spring water village of Shivarovo, thermal healing spring water village of Polyanovo, fulfill the required conditions for drinking water. The spring waters from the given four water sources are characterized by microbiological indicators, as the pathogenic micro-organisms are defined by the membrane method. It is established that thermal healing spring water Burgas Mineral baths, thermal healing spring water village of Shivarovo, thermal healing spring water of village of Polyanovo, fulfill the standard requirements. The healing water of village Judge, District ofBurgas does not conform to the physicochemical indicators given for fluorides, and microbiological indicators with regards to coliform bacteria, Escherichia coli and enterococci. Defined are the physicochemical properties of healing thermal and non-thermal spring waters in the area of Varna District. It is shown that according to 18 controlled parameters included in the research, the thermal healing spring water drilling №Р-83хКК “Saints Constantine and Helena”, thermal healing spring water Р-1х “Aquarium”, thermal healing spring water Р-106 х “Dom Mladost”, thermal healing spring water Р-161х Varna at “Primorski” swimming pool, fulfill the required conditions for drinking water. The spring waters from the given four water sources are characterized by microbiological indicators, as the pathogenic micro-organisms are defined by the membrane method. It is established that thermal healing spring water drilling №Р-83хКК “Saints Constantine and Helena”, thermal healing spring water Р-1х “Aquarium”, thermal healing spring water Р-106 х “Dom Mladost”, thermal healing spring water Р-161х Varna at “Primorski” swimming pool, fulfill the standard requirements. “The healing water” of village Goren Chiflik, District of Varna does not conform with the physicochemical indicators given for nitrates, and microbiological indicators with regards to coliform bacteria and enterococci.