ScienceRise: Medical Science

Changes in metabolic parameters in ischemic heart disease against the background of metabolic syndrome

2023-08-04T16:32:03+03:00

For many years, and to this day, cardiovascular disease has been and remains the leading cause of death worldwide. Cardiovascular diseases mainly affect people in countries with middle and low living standards.

The aim of the study was to find out the peculiarities of lipid, carbohydrate, and hormonal changes in patients with coronary heart disease against the background of metabolic syndrome.

Materials and methods: 120 patients with verified coronary heart disease were examined, including 60 patients with coronary heart disease without metabolic syndrome and 60 patients with coronary heart disease with metabolic syndrome. The control group consisted of 30 practically healthy individuals of appropriate age and sex. The content of HbA1c, glucositol C-peptide, triacylglycerols, total cholesterol, leptin, HDL-cholesterol, and LDL-cholesterol in blood serum was determined by modern methods.

Results: The analysis of the results of laboratory tests of patients' blood revealed more pronounced changes in carbohydrate and lipid metabolism in patients with coronary artery disease against the background of metabolic syndrome, which indicates the severity of the clinical course in such patients. The results obtained indicate that in coronary heart disease with metabolic syndrome, there are more pronounced dysmetabolic changes: hyperleptinemia, glucosemia, elevated HbA1c, and decreased C-peptide content. Studies have shown that obesity is accompanied by high levels of leptin, which exacerbates insulin resistance and is a trigger for the development of coronary heart disease.

Conclusions: 1. Leptin resistance is a potential cause of insulin resistance and, consequently, obesity, which ultimately leads to metabolic syndrome and the development of coronary heart disease. The data obtained indicate a greater tendency to obesity in women with coronary heart disease complicated by metabolic syndrome.

The data obtained may indicate a latent disorder of carbohydrate metabolism in patients with coronary artery disease without metabolic syndrome.
The detected deviations in lipid metabolism indicate the presence of type II dyslipoproteinemia in patients of group 1 and type IV dyslipoproteinemia in patients of group 2

Epidemiological characteristics of hereditary motor and sensory neuropathy in the Sumy region

2023-07-26T12:53:33+03:00

The aim of the study was to investigate the characteristics of the spread of hereditary motor and sensory neuropathy type 1A in the Sumy region, in terms of administrative units and specific ethnic groups of the population.

Materials and methods. An epidemiological study of hereditary motor and sensory neuropathy (HMSN) type 1A in the Sumy region was conducted based on patient referrals to various healthcare facilities from 2014 to 2017. The prevalence of HMSN in the Sumy region was studied using an epidemiological approach. The prevalence rate of HMSN was calculated for different administrative units of the Sumy region, as well as for specific ethnic groups of the population.

Results. The study registered 67 patients with hereditary motor and sensory neuropathy type 1A in the Sumy region. The prevalence rate of hereditary motor and sensory neuropathy type 1A in the Sumy region was 5.96 per 100,000 population. Of the HMSN patients, 47.8 % (32 individuals) resided in urban areas, while 52.2 % (35 individuals) lived in rural areas. In terms of gender distribution, 59.7 % (40 individuals) were female, and 40.3 % (27 individuals) were male. Most patients were of Ukrainian ethnicity (77.6 %), followed by Russians (20.9 %). Belarusians accounted for 1.5 % of HMSN patients in the Sumy region. Among other ethnic groups present in the Sumy region, HMSN type 1A was not detected.

Conclusions. Hereditary motor and sensory neuropathy type 1A is unevenly distributed in the Sumy region. The heterogeneous distribution of the disease is primarily attributed to the characteristics of settlement in specific geographic regions, which have led to the formation of territorial, national, and religious isolates with the accumulation of genetically heterogeneous types in these populations, resulting in an increased genetic burden

Surgical treatment of elderly and senile patients with transtrochanteric fractures of the femur

2023-08-07T12:41:26+03:00

The aim of the work was to analyze the functional results of surgical treatment in elderly and senile patients with transcavitary fractures depending on the method of osteosynthesis.

Materials and methods. 134 elderly and senile patients with transtrochanteric fractures of the femur type 31A1.1-A1.3 according to AO/ASIF were examined (average age - 72.4±9.3 years). The patient underwent osteosynthesis with a DHS fixator, a PFNA rod and a Gamma nail according to indications. The functional result of the treatment was determined by radiographic signs of fusion, the Harris scale, and complications detected during the period of 1, 3, 6, and 12 months of examination.

Results and their discussion. The functional result according to the Harris scale dramatically prevailed in the first six months after surgical treatment with intramedullary osteosynthesis. For the DHS fixator, the indicator improved from 29.8 points in the first month to 57.7 at the sixth month, for the PFNA rod - from 50.7 points to 76.9, and for the Gamma nail from 50.1 to 76.7, respectively.

Consolidation of a transtrochanteric fracture in treated elderly and senile patients was observed in 83.33 % of cases after extramedullary osteosynthesis, and in 90.22 % of cases after intramedullary osteosynthesis. Complications of extramedullary osteosynthesis included instability of the fixator with migration and fracture of the fixator, during intramedullary osteosynthesis – migration of the cervical blade "cut-out" and fracture of the rod.

Conclusions. The functional result in elderly and senile patients with transtrochanteric fractures after intramedullary osteosynthesis has advantages over extramedullary osteosynthesis. The results of the calculation of the Harris scale indicators, among which the evaluation of the restoration of gait, movements and resistance of the injured limb were decisive, are significantly higher in osteosynthesis with a Gamma nail and a PFNA rod in comparison with a DHS fixator. Complications that occurred in the three groups of the study coincide with the average international indicators and are not significantly low with intramedullary osteosynthesis. Improvement of surgical treatment methods is urgent and requires the search for complex treatment approaches in elderly and senile patients with transtrochanteric fractures

Effect of labetalol and lignocaine on hemodynamic response to laryngoscopy and endotracheal intubation

2023-08-07T12:06:29+03:00

Direct laryngoscopy and endotracheal intubation is a noxious stimuli and induce sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life-threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients.

The aim is to study the effects of intravenous labetalol and lignocaine on haemodynamic responses to laryngoscopy and endotracheal intubation.

Materials and methods: It is a cross-sectional and randomized controlled study with two study groups was planned. 70 patients were randomly assigned to one of two groups: those receiving Labetalol 0.25 mg/kg (n=35) or those receiving lignocaine 1mg/kg (n=35). The parameters assessed are heart rate, systolic BP, diastolic BP and Mean arterial pressure. Baseline parameters were recorded at the time of induction, post-intubation immediately and 1, 3, 5, 10 minutes later.

Results: In the current study, at the time of induction, the mean heart rate was 65.97 ± 5.22 per min in group LB whereas the mean heart rate was 76.66 ± 8.49 per min in group LG which was statistically significant (P value <0.001). There was significantly reduced systolic blood pressure at 1min after intubation, 3min after intubation, 5min after intubation, and 10min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Significantly reduced diastolic blood pressure at 1 min after intubation, 3 min after intubation, 5 min after intubation, and 10 min after intubation in patients of group LB when compared with patients of group LG (P value <0.05).

Conclusions: It was concluded in the present study that intravenous labetalol of dosage 0.25 mg/kg before laryngoscopy and endotracheal intubation was efficient in attenuating the hemodynamic parameters

Chronic viral hepatitis B and C in pediatric patients: possibilities of ultrasound techniques for patients’ management

2023-07-21T13:42:01+03:00

Chronic viral hepatitis B and C have already become one of the medical and social problems of modern hepatology and paediatrics due to their high prevalence and ability to transform liver parenchyma and form additional complications. Nowadays, it is important to assess and examine patients by ultrasound techniques to estimate changes in morphometric, hemodynamic, and echoacoustic characteristics of the liver in patients with viral hepatitis B and C.

The aim: to estimate ultrasound morphometric parameters and hemodynamic indexes, morphological deviations of the liver and spleen in pediatric patients with chronic viral hepatitis B and C by implementing of the system as Y. Davoudi diagnostic scale (2015) and analysis of echo-acoustic patterns.

Materials and methods. 34 children were examined. 19 children with chronic viral hepatitis B and C formed group I, while 15 almost healthy children formed group II. All examined patients underwent collecting of anamnesis, general clinical examination, determination of the degree of liver fibrosis by non-invasive method (Fibrotest or fibroelastometry) and ultrasound examination of the abdominal cavity organs with the possibility of Doppler scanning. Differences at p<0.05 were considered statistically significant.

Results. Obtained data showed that in patients of group, I index of Y. Davoudi grayscale was higher (2,6±0,26 U) compared with patients of group II (1,4±0,32 U) (p<0,01). Systolic blood flow velocities in the portal vein and the splenic vein were decreased in patients of group I (15,59±0,4 cm/s; 15,7±0,8 cm/s) compared with group II (17,68±0,8 cm/s; 17,54±0,42 cm/s) (p<0,05), resistance index in the hepatic artery was increased in patients of group I (0,78±0,02 IU) compared with patients of II group (0,68±0,04 IU) (p<0,05). Histogram indexes of the liver and liver-kidney region were higher in patients of group I (p<0,001).

Сonclusions. Y.Davoudi diagnostic scale, hemodynamics parameters of the portal, splenic and hepatic vessels, echoacoustic patterns and other indexes could be prognostic factors which will indicate liver fibrosis progression in patients with chronic viral hepatitis B and C. The analysis of the obtained data showed that deviations in morphometric, echoacoustic and Doppler indexes of liver and spleen in paediatric patients with chronic viral hepatitis B and C were more clinically significant compared with almost healthy children and could be taken into account as liver fibrosis predictors

Hygienic assessment of palm oil content in dairy products as a measure of health protection

2023-08-07T12:32:20+03:00

Nutrition provides the most important function of the human body, providing it with the energy it needs for an active life and longevity. Experts of the World Health Organization have proven that eating palm oil leads to obesity and the development of chronic diseases on a global scale.

The aim of the study was to examine different types of dairy products of brands popular on the modern Ukrainian market for the content of palm oil.

Materials and methods. To carry out the research, we purchased the following dairy products: pasteurized milk, pasteurized milk-containing drink, sour cream, milk-containing sour cream product, hard cheese and cheese product, processed cheese and processed cheese product, as well as sweet cream butter and vegetable cream product of popular brands. The research was carried out using the methods described in the educational literature on the hygienic examination of milk and dairy products. The choice of methods was based on ease of implementation and reproducibility at home.

Results. As a result of the use of selected research methods, characteristic differences between natural products and those containing palm oil have been established. The conducted research will allow consumers to quickly determine the content of vegetable fats in dairy products under normal conditions and choose natural, healthy and safe products for their nutrition.

Conclusion. After analyzing the milk and milk-containing products of the most popular brands for the presence of palm oil in their composition, we found that no vegetable fats were found in dairy products (milk, cheese, butter, and sour cream). The presence of vegetable fat was detected in milk-containing products, which was indicated on the packaging as part of the products. So, as a result of the conducted research, we came to the conclusion that manufacturers comply with the requirements of current legislation and warn consumers about the presence of fats of vegetable origin in milk-containing products