ScienceRise: Medical Science <p><em>«ScienceRise: Medical Science» – </em>scientific peer-reviewed journal, published 6 times a year, included in category “B” «List of scientific professional editions of Ukraine» (Сertificated by order of Ministry of Education and Science of Ukraine No. 612 from 07.05.2019).</p><p>The aim of «ScienceRise: Medical Science» is to publish high-quality articles on all aspects of fundamental and clinical studies in all areas of medicine, with a focus on issues of global interest, advances in medicine and research. «ScienceRise: Medical Science» also welcomes publication of studies related to interdisciplinary medical fields as part of a common approach that will combine clinical research with preclinical work on the discovery of new mechanisms of treatment.</p><p>The journal «ScienceRise: Medical Science» primarily publishes original research and clinical cases, but it also accepts quality literature reviews and meta-analyzes. The journal does not publish short reports, brief reviews, reports and messages.</p> <a href="">ISSN 2519-478X </a> (print), <a href="">ISSN 2519-4798 </a>(on-line) <br /><br />Drawing up the items of the publication ethics policy of the journal «ScienceRise: Medical Science» Editors followed the recommendations of Committee on Publication Ethics <a href="">(COPE)</a>. РС ТЕСHNOLOGY СЕNTЕR en-US ScienceRise: Medical Science 2519-478X <p>Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.</p> <p>Authors, who are published in this journal, agree to the following conditions:</p> <p>1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.</p> <p> 2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.</p> Evaluation of the efficacy of paravertebral blockade as a component of combined anesthesia in the surgical treatment of pulmonary cancer <p>The aim. The paper evaluates the effectiveness of implemented combined anaesthesia (inhalation with paravertebral blockade) in comparison with inhalation anaesthesia (IA) and total intravenous anaesthesia (TVA) at the stages of surgery and the early postoperative period in the surgical treatment of cancer lungs.</p> <p>Methods. The study involved 60 patients with an average age of 55±5.6 years, physical status ASA II–III, who underwent open surgical interventions in the scope of frontal or pneumonectomy or resection of part of the lung. Patients were divided into 3 groups depending on the method of anaesthetic support at the stage of anaesthesia maintenance: I (n=20) – combined anaesthesia was used; II (n=20) – IA with sevoflurane; III (n=20) – TVA. In addition, the leading indicators of central hemodynamics were studied; oxygen saturation (SaO<sub>2</sub>), CO<sub>2</sub> ET (concentration of CO<sub>2</sub> in exhaled air), cortisol level, and indicators of acid-base status were determined. The effectiveness of analgesia in the early postoperative period was assessed using a visual analogue scale (VAS) at 10 control stages. Fasting intensity was recorded after waking up, after extubation, after 1 h. after surgery, on the first day after surgery every 3 h. and once a day from the 2nd day for 5-6 days.</p> <p>Results. The studied clinical and laboratory indicators indicated an adequate course of the applied type of anaesthesia. In the dynamics of pain syndrome (PS) in the postoperative period, a gradual subjective increase of pain syndrome was noted until the 3rd day, including a decrease in pain on the 4th - 6th day. It was established that when using combined anaesthesia, a less significant level of PS, according to VAS, was noted compared to inhalation anaesthesia and the use of TVA.</p> <p>Conclusions. Combined anaesthesia (inhalation with PVB) can more effectively prevent the development of post-thoracotomy pain syndrome (PTPS) compared to TVA and IA in the surgical treatment of lung cancer</p> Andrey Suprun Victor Lysenko Copyright (c) 2022 Andrey Suprun, Victor Lysenko 2022-09-30 2022-09-30 5 (50) 4 7 10.15587/2519-4798.2022.265238 Optimisation of acute pain treatment in children in abdominal surgery at the stages of the perioperative period <p><strong>The aim of the study.</strong> To improve the quality of perioperative analgesia by combined multimodal use of paracetamol and ketorolac tromethamine in children after abdominal surgery.</p> <p><strong>Materials and methods.</strong> 48 children (6-17 years old) with choledochal, pancreatic cysts, hepatic echinococcosis, and abdominal trauma. The study period was from January 2021 to January 2022. Group 1 (main group, n=28): baseline analgesia - 15 min before surgery, intravenous paracetamol administration at 25-30 mg/kg. In order to prevent postoperative pain syndrome 15 minutes before the end of the surgery, we administered ketorolac and tromethamine in a dose of 0.5 mg/kg. Pain relief was repeated 6-8 h later with ketorolac at a dose of 0.5 mg/kg. Group 2 (comparison, n=20), who received 0.2 – 0.3 mg/kg promedol (<u>trimeperidin)</u> in the postoperative period. Both groups received standard endotracheal anaesthesia (propofol + fentanyl + arduan against the background of Low-flow anaesthesia with sevoflurane MAK=1). Systemic haemodynamics, C-reactive protein, and glucose were investigated, and a visual analogue scale was applied at the main stages of the study.</p> <p><strong>Results: </strong>Analysis of the parameters of central hemodynamics, parameters of the operational stress response and clinical data showed that in the postoperative period, sufficient analgesic effect was established only in children in group 1 with the preventive combined administration of paracetamol and ketorolac on the operating table, which allows recommending them in the practice of perioperative analgesia during abdominal surgical interventions.</p> <p><strong>Conclusions.</strong> Optimised method of preventive (preoperative) use of paracetamol in children at a dose of 25-30 mg/kg during abdominal surgery followed by administration of ketorolac tromethamine (15 minutes before the end of the surgery) increases the degree of nociceptive protection. It ensures high efficiency of postoperative pain relief, which allows to recommend it in the practice of perioperative analgesia for the above abdominal surgical interventions in children</p> Elmira Satvaldieva Eldor Turgun ugli Kuralov Copyright (c) 2022 Elmira Satvaldieva, Eldor Turgun ugli Kuralov 2022-09-30 2022-09-30 5 (50) 8 15 10.15587/2519-4798.2022.265222 Prevalence of overt and subclinical thyroid dysfunction in pregnant women and outcome in a tertiary care centre <p><strong>Aim: </strong>To know the prevalence of overt and subclinical thyroid disorders in Indian pregnant women and to know the effect of overt and subclinical thyroid dysfunction on maternal and fetal outcome.</p> <p><strong>Materials and methods:</strong> This study was conducted at the Government Maternity Hospital, sultan bazaar, Osmania medical college, Hyderabad over a period of 15 months from august 2016 to October 2017. 1000 pregnant women who attended the antenatal clinic were screened for the thyroid dysfunction. Serum TSH level estimated. fT<sub>3, </sub>fT<sub>4 </sub>and anti TPO Ab levels were estimated if the TSH level was abnormal. Patients were managed accordingly and followed till the delivery. Maternal and fetal outcome recorded.</p> <p><strong>Results</strong>: It was a prospective study done on 1000 antenatal women. Prevalence of thyroid disorder in this study was 11.3%. Prevalence of subclinical, overt hypothyroidism, subclinical and overt hyperthyroidism was 9.4%, 1.4%, 0.4% and 0.1% respectively. Subclinical hypothyroidism was associated with complications like preeclampsia (13.8%), Anaemia (15.95%), preterm delivery (6.38%), Intrauterine growth restriction (4.25%), low birth weight (12.76%) and Intrauterine fetal death)(2.12%). Overt hypothyroidism was associated with complications like Preeclampsia (14.28%), anaemia (21.4%), Preterm delivery (14.28%), intrauterine growth restriction (14.28%), low birth weight (21.4%) and Intrauterine fetal death (7.14%). Incidence of CD was 18.05% in women with hypothyroidism. Subclinical hyperthyroidism was associated with complications like Preeclampsia, Preterm delivery, Intrauterine growth restriction, Intrauterine fetal death.</p> <p><strong>Conclusion: </strong>Thyroid disorders in pregnancy are significantly associated with both maternal and fetal complications and adversely affect the outcome of pregnancy. Hence, early identification of thyroid disorders and timely initiation of treatment is essential</p> Lakshmi Aravelli Amritha Aurora Meduri Swathi Rallabhandi Kundena Srilakshmi Copyright (c) 2022 Lakshmi Aravelli, Amritha Aurora Meduri, Swathi Rallabhandi, Kundena Srilakshmi 2022-09-30 2022-09-30 5 (50) 16 23 10.15587/2519-4798.2022.265721 Study of histopathology of tumors of the central nervous system in a teaching hospital <p>Primary central nervous system (CNS) tumours are rare, but they are the second most common in childhood after the most common malignancy, leukaemia. They are considered the most notorious of all cancers. They represent characteristics of a unique, heterogeneous population of neoplasms with benign and malignant tumours and are reported to be less than 2 % of all malignant neoplasms.</p> <p><strong>The aim of the study</strong>: To study various tumours of the central nervous system (CNS)</p> <p><strong>Methods:</strong> A prospective study on CNS tumours was conducted in the department of Pathology, Guntur Medical College, Guntur, for two years, from June 2011 to May 2013. The data necessary for the study has been retrieved from the histopathology records at the department. 104 cases of CNS tumours were studied in detail, correlating the clinical, radiological and histopathological findings. The department of neurosurgery has provided the biopsy material. The applied nomenclature is that adopted by the 2007 WHO classification.</p> <p><strong>Results:</strong> The tumours have been encountered in all age groups, from infants to 80yr elderly persons. The highest frequency is seen in the age group of 41 to 50 years (27 %), followed by 51 to 60 years age group (19 %). The most common tumour reported was astrocytomas constituting 21.1 % (22/104), followed by schwannomas constituting 19.2 % (20/104). least reported was plasmacytoma astrobalstoma 0.9 % (1/104).</p> <p><strong>Conclusion:</strong> Adequate imaging by CT/MRI is an essential aid in the diagnosis. Although H&amp;E staining is the mainstay for histopathological diagnosis, immunohistochemistry has played a significant role in diagnostic accuracy. In addition, the judicious use of a panel of selected antibodies is helpful in diagnostically challenging cases</p> Katakonda Sunitha Mulukutla Partha Akarsh Geetha Vani Panchakarla Copyright (c) 2022 Katakonda Sunitha, Mulukutla Partha Akarsh, Geetha Vani Panchakarla 2022-09-30 2022-09-30 5 (50) 24 31 10.15587/2519-4798.2022.265313 Dosimetric evaluation of cardiac and left anterior descending artery dose in patients with left-sided breast cancer treated by different techniques of hypofractionated adjuvant radiotherapy after breast conservative surgery <p><strong>The aims:</strong> to dosimetrically evaluate the dose to the heart and left anterior descending artery in left-sided early breast cases using different techniques.</p> <p><strong>Materials and methods: </strong>Prospective observational/analytical study done in cases of left-sided BCS referred for adjuvant RT in 54 patients. Patients who underwent left-sided BCS (breast conservative surgery), patients aged between 18- and 75 years performance status ECOG 0-2, histological confirmed DCIS, Invasive Breast Cancer-Stage 1, 2, 3, patients without any evidence of metastatic disease Irrespective of hormonal receptor and HER-2 neu status are included in the study.</p> <p><strong>Results</strong>: All the 3 parameters for LAD showed the highest doses with 3DCRT and lowest with VMAT. Thus our study favoured VMAT (p&lt;0.01) as the planning technique to achieve the least doses of LAD. However, for the heart, there was no statistically significant difference between 3DCRT and IMRT (p=0.349) for the average mean dose (Gy). On the other hand, there was a statistically significant difference between 3DCRT Vs VMAT and IMRT Vs VMAT (95 % CI, p&lt;0.01), again favouring VMAT as the choice of planning technique. The average heart max dose(Gy) and average heart V20(%) showed statistically significant benefits with VMAT (p&lt;0.01). There was a statistically significant benefit (p&lt;0.000) with VMAT for both LV parameters. At the same time, there was a statistically significant benefit in terms of ipsilateral lung dose with VMAT(p&lt;0.000), the dose to the right lung, right breast and favoured 3DCRT (p&lt;0.01). PTV95 % (Gy) by 3DCRT, IMRT, and VMAT in our study is 41.01, 41.96, and 41.76, respectively. Though the difference between the 3 techniques seems meagre, there was a statistically significant difference (p&lt;0.012) favouring IMRT.</p> <p><strong>Conclusion</strong>: We conclude that using the VMAT technique in radiotherapy for left-sided breast cancer can significantly reduce radiation doses to the heart and LAD, potentially reducing cardiac risk. For all patients, the cardiac doses are considerably decreased for all dose levels without compromising the dose coverage to PTV, which is an advantage over IMRT and 3DCRT</p> Nindra Armugam Zoha Mohd Saleem Chandipriya Veluru Erukula Ramanjaneyulu Copyright (c) 2022 Nindra Armugam, Zoha Mohd Saleem, Chandipriya Veluru, Erukula Ramanjaneyulu 2022-09-30 2022-09-30 5 (50) 32 40 10.15587/2519-4798.2022.265543 The results analysis of cytological examination of vulvar intraepithelial neoplasia compared to histology report <p>Timely diagnosis and effective treatment of precancerous diseases of the female genital organs prevent the development of oncogynecological diseases. Vulvar intraepithelial neoplasia is a precancerous disease characterized by lesions of the stratified squamous epithelium with impaired maturation and normal keratinization of cells, but without inclusion of the basement membrane in the pathological process. The main methods of diagnosis of vulvar intraepithelial neoplasia are vulvoscopy, cytological and histological examination.</p> <p><strong>The aim</strong> of this study was to assess the clinical significance and effectiveness of different sampling methods for cytological examination in comparison with histological report.</p> <p><strong>Materials and methods.</strong> The study involved 235 women aged 35-79 years, with a mean age of 57±11,3 years with complaints of pain, burning, discomfort and itching in the vulva. All patients underwent a simple vulvoscopy, where atrophy of the mucosa, partial or complete loss of the clitoris and / or labia minora, fissures, ecchymoses (haemorrhages), eroded surfaces, exophytic growths from 1 to 5 cm were detected. Material sampling was performed by various cytological methods.</p> <p><strong>Results.</strong> According to the results of the study, no significant differences between the methods of cytological sampling were observed. The cytological report was compared to the result of histological examination of biopsies. According to the results of cytological examination, squamous cell carcinoma of the vulva was detected in 12 patients, atrophy was identified in 5 women and squamous epithelial scales cytologically detected in the remaining 218 women.</p> <p><strong>Conclusions.</strong> The sensitivity and specificity of cytological examination methods were high in the presence of eroded surfaces and exophytic lesions. It was found that cytological research methods were not informative enough to detect vulvar cancer, which is in the stratum of hyperkeratosis, and was diagnosed in 5.1 % of patients. Therefore, for the reliability of the results and confirmation of the diagnosis it is necessary to conduct histological examination, with the help of which 14.9 % of patients were diagnosed with squamous cell carcinoma</p> Viktoriia Dunaevskaya Evgenia Loginova Pavlina Botsuin Nataliia Bohonis Copyright (c) 2022 Viktoriia Dunaevskaya, Evgenia Loginova, Pavlina Botsuin, Nataliia Bohonis 2022-09-30 2022-09-30 5 (50) 41 46 10.15587/2519-4798.2022.263490 Role of fibroscan in assessing the extent of liver involvement among chronic hepatitis B and C cases <p>Chronic liver diseases (CLD) cause significant morbidity and mortality worldwide, accounting for approximately 2 million deaths annually. The majority of CLDs include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Of these, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases which is responsible for liver damage ranging from minor disorders to liver cirrhosis and hepatocellular carcinoma (HCC). Fibroscan is a novel non-invasive method for assessing hepatic fibrosis by measuring liver stiffness.</p> <p><strong>The aim.</strong> The present study was conducted to know the prevalence of blood-born viral pathogens (HBV, HCV) among patients with chronic liver diseases (CLD) and also to assess the role of Fibroscan and liver function tests (LFT) in evaluating the extent of chronic liver disease.</p> <p><strong>Material and methods: </strong>The present study comprised 100 chronic liver disease patients attending the gastroenterology department. All the chronic liver disease cases were tested for Hepatitis B and Hepatitis C viral infections using a rapid Immunochromatography assay. Simultaneously they were subjected to liver function tests and fibroscan to assess the extent of fibrosis by staging from F0 to F4.</p> <p><strong>Results: </strong>When screened for bloodborne viral pathogens, 46 % were HBV positive, 10 % were HCV, and none were HIV positive. No co-infection was detected. HBV was identified as the most typical cause of CLD in about 46 %, followed by non-viral/non-infectious (alcoholic, metabolic, autoimmune) cause in 44 % and 10 %, the cause for CLD was HCV. As per fibroscan results, 80 % of HCV and 39 % of HBV patients were in the stage of cirrhosis/advanced fibrosis.</p> <p><strong>Conclusion:</strong> HBV was the predominant cause of CLD. Liver stiffness has recently been shown to be a good predictor of clinical outcomes. A fibroscan will help in the decision-making process in staging the disease and choice of treatment in viral hepatitis cases</p> Pendyala Jyothi Dasari Vanisree Durbha Satyanarayana Murty Kolli Prasanthi Copyright (c) 2022 Pendyala Jyothi, Dasari Vanisree, Durbha Satyanarayana Murty, Kolli Prasanthi 2022-09-30 2022-09-30 5 (50) 47 51 10.15587/2519-4798.2022.265104 Diagnostic approach to chronic bowel diseases in children <p>Diagnosing inflammatory bowel diseases in children and differentiating them from functional disorders is complicated based on clinical assessment, laboratory data, and radiological, endoscopic, and histological signs. Therefore, in paediatrics, substantial attention has been given to standard invasive evaluation methods. Recently, research efforts have been directed towards using faecal calprotectin as a sensitive non-invasive stool test.</p> <p><strong>The aim </strong>of the research was to study the diagnostic value of faecal calprotectin in pediatric chronic inflammatory bowel diseases. The paper discusses faecal calprotectin's diagnostic and monitoring role in 35 children aged 3 to 17 years with ulcerative colitis, non-specific non-ulcerative colitis, and irritable bowel syndrome. The concentration of the faecal calprotectin level was examined by ELISA using monoclonal antibodies.</p> <p><strong>Results.</strong> The study shows that in patients with non-specific ulcerative and non-ulcerative colitis, the faecal calprotectin level exceeds the normal ranges 2-5 times, corresponding to clinical and morphological manifestations of the diseases and the level of inflammatory markers. However, this biological marker does not exceed the average values in children with irritable bowel syndrome.</p> <p><strong>Conclusions.</strong> The faecal calprotectin test allows us to differentiate organic and functional intestinal diseases, monitor chronic inflammatory bowel disease activity dynamics, and estimate treatment effectiveness. Applying the faecal calprotectin test within the framework of primary medical care can decrease the number of referrals for invasive endoscopic, laboratory, and radiologic examinations in pediatric patients with inflammatory bowel diseases</p> Tetiana Yaroshevska Kateryna Skriabina Copyright (c) 2022 Tetiana Yaroshevska, Kateryna Skriabina 2022-09-30 2022-09-30 5 (50) 52 56 10.15587/2519-4798.2022.265388 A cross-sectional study of psychopathology, quality of life and caregiver burden in caregivers of cancer patients <p>Caregivers of cancer patients were prone to deterioration of their QOL due to the caregiving burden. A high caregiving burden and low QOL were common among CG. In India, only a few studies were done on the caregivers of cancer patients. Hence this study was undertaken.</p> <p><strong>The aim</strong>: To study psychopathology, quality of life and burden in caregivers of cancer patients</p> <p><strong>Materials and methods:</strong> The study was done on 100 caregivers of cancer patients attending after fulfilling the inclusion criteria. A semi-structured Proforma was administrated to collect the socio-demographic details. Following by Mini International Neuropsychiatric Interview (MINI), WHO-QOL and Burden assessment scale was administered to the caregivers. Data were analysed using SPSS. Descriptive statistics, Pearson and Spearman Correlations and ANOVA were used.</p> <p><strong>Results: </strong>31 % of caregivers suffer from generalised anxiety disorders (15 %) and depression (16 %). The environmental domain of QOL (mean-18.2, SD-15.4) was the most affected. 83 % of caregivers experienced a moderate burden, and 17 % had a severe burden. These variables are significantly associated with caregiver relation with patient and socio-economic status (&lt;0.05). A significant correlation was found between Psychiatric morbidity, QOL and Burden in caregivers.</p> <p><strong>Conclusion</strong>: psychiatric morbidity, quality of life and burden in CGs influence one another. The least attention was paid to caregivers' mental health, many of them left unidentified and untreated. These results highlight the need to educate them about mental health and counsel and treat them for their psychiatric problems</p> Gangaraboina Sanjeevani Paniharam Ramakanth Adhi Chaitanya Copyright (c) 2022 Gangaraboina Sanjeevani, Paniharam Ramakanth, Adhi Chaitanya 2022-09-30 2022-09-30 5 (50) 57 64 10.15587/2519-4798.2022.265395