Sanamed

ASSESSMENT OF THE RELATIONSHIP BETWEEN SERUM TWEAK LEVELS AND THE DEGREE OF VASCULAR INVOLVEMENT IN PATIENTS WITH STABLE ANGINA PECTORIS

2024-04-28T23:09:03+02:00

Introduction: This study investigates the relationship between serum TWEAK levels and the degree of vascular involvement in patients with stable angina pectoris, offering insights beyond conventional cardiovascular risk factors.

Materials and Methods: This study involved 88 patients (33 women, 55 men) diagnosed with stable angina pectoris. Patients were classified based on angiographic findings. Comprehensive demographic and medical history data were collected, and morning blood samples were analyzed, focusing on TWEAK and IL-6 levels. To assess the severity of coronary artery lesions, a modified version of the Gensini scoring system was employed.

Results: Analyses revealed no significant correlation between TWEAK levels and the severity of coronary artery disease. Although some variations in biochemical markers were observed based on gender and diabetic status, these differences did not exhibit a statistically significant relationship with the degree of vascular involvement.

Conclusion: The findings indicate that serum TWEAK levels do not have a significant association with the severity of vascular involvement in patients with stable angina pectoris. These results highlight the limited efficacy of TWEAK as a sole biomarker in assessing the severity of coronary artery disease, emphasizing the complexity of its role.

APPLICATION OF TRANSANAL TUBE AFTER ANTERIOR RECTAL RESECTION: IMPACT ON PREVENTION OF "ACHILLES HEEL" IN COLORECTAL SURGERY

2024-04-28T23:09:50+02:00

Aim: The aim of our study was to investigate the potential reduction in the likelihood of anastomotic leakage occurrence in patients undergoing open anterior resection of the rectum without a protective stoma for stage III adenocarcinoma, by employing a transanal tube after performing stapled colorectal anastomosis.

Results: Considering the influence of all included risk factors, male gender (p=0.032; OR=2.873) and patients with type 2 diabetes mellitus (p=0.033; OR=2.873) demonstrated an increased likelihood of anastomotic leakage, while the presence of a transanal tube (p=0.043; OR=0.349; 95% CI: 0.126, 0.966) was associated with a statistically significant reduction in the likelihood of anastomotic leakage. T-test revealed that patients with anastomotic leakage without a placed tube had a statistically significantly longer mean postoperative hospitalization (20.94 days) compared to those with a transanal tube (19.43 days) (t=2.375; p=0.025). Kaplan-Meier analysis didn’t show a statistically significant difference in the average estimated time to the occurrence of anastomotic leakage between patients without (3.86 days) and with a transanal tube (4.58 days) (p=0.057).

Conclusion: Our study found that the placement of a transanal tube after colorectal anastomosis may be associated with a reduced likelihood of anastomotic leakage and shorter hospitalization in case leakage occurs. Additionally, although no statistically significant difference was found in the effect of the tube on the occurrence of anastomotic leakage depending on the presence of type 2 diabetes mellitus, the indication for its use in patients with type 2 diabetes mellitus may be of particular benefit.

CORRELATION BETWEEN TBARS VALUE IN SERUM AND TISSUE AS OXIDATIVE STRESS MARKERS IN PREMALIGNANT AND MALIGNANT CERVICAL LESIONS

2024-05-21T16:57:06+02:00

Introduction: Numerous risk factors affect the development of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC), with high-risk subtypes of the human papillomavirus (HPV) being the most significant. Oxidative stress (OS) plays an important role in the pathogenesis of CC and CIN as a risk factor. A commonly used marker of OS, which measures lipid peroxidation products in cells, tissues, and body fluids, is thiobarbituric acid reactive substances (TBARS). This study aimed to determine the correlation between TBARS levels in tissue and serum and evaluate their diagnostic significance in patients with cervical lesions.

Patients and methods: The research was conducted at the Clinical Center of the University of Sarajevo. The experimental group consisted of 200 female patients with biopsy-confirmed changes consistent with CIN, carcinoma in situ (CIS), and CC. The control group (N=40) had biopsy-confirmed non-pathological findings. The concentration of TBARS was determined for all subjects from biopsy samples and serum according to standard laboratory practice.

Results: We found a significant difference in serum/tissue TBARS levels between study groups. Serum/tissue levels of TBARS in patients with CIS were significantly higher compared to the control group, patients with CIN 1, CIN 2, CIN 3, and patients with CC (p<0.05 for all). There was a significant positive correlation between TBARS levels in serum (µM) and TBARS levels in tissue (µM) (Pearson's r=0.494, p<0.001). Tissue and serum TBARS levels are major differentiation markers between CIS patients and the control group, as well as patients with CIN 1, CIN 2, CIN 3, and CC.

Conclusion: Patients with CIN and CC exhibit increased oxidative stress, indicated by higher levels of TBARS in their tissue and serum compared to healthy controls. TBARS levels in tissue are positively correlated with levels in serum. Tissue and serum TBARS levels are significant markers for differentiating the clinical stages of the disease.

RIBONUCLEIC ACID ISOLATION FROM HUMAN MONONUCLEAR CELL CULTURE WITH MAGNETIC BEADS PRE-ENRICHMENT FOR MOLECULAR ANALYSIS

2024-05-24T11:11:16+02:00

Introduction: In order to develop immunotherapies and therapeutic humoral molecules, ribonucleic acid (RNA) from cultured mononuclear cells (MNCs) is needed. However, it is not possible to isolate RNA using the standard mini column method from older MNC cultures. Therefore, the aim of this study was to develop a method to isolate RNA from MNC cultures, particularly older ones.

Materials and Methods: MNC cultures were grown from human buffy coats. The media from the cell culture was centrifuged to generate a pellet, to which CD45-specific magnetic beads were added. RNA was then isolated using the mini column method. The housekeeping gene beta-actin was used to confirm the success of RNA isolation through both real-time and conventional PCR tests.

Results: RNA was successfully isolated from MNC cultures, especially those that were a few months old, after pre-enrichment with magnetic beads. Without the magnetic bead pre-enrichment step, RNA isolation was not achieved. The results of the housekeeping gene tests indicated successful RNA isolation in all cases through both real-time and conventional PCR. Additionally, spectrophotometric values of the isolated RNA confirmed successful isolation.

Conclusion: This study is the first to demonstrate that it is possible to isolate RNA from human MNC cultures, particularly older ones, using specific magnetic beads. This method opens new opportunities for conducting genetic analyses, biomarker confirmation, and the development of antibodies.

PATIENT SATISFACTION WITH DENTAL HEALTH CARE DURING THE COVID-19 OUTBREAK IN SERBIA

2024-05-28T09:31:17+02:00

Introduction: The COVID-19 virus belongs to the group of respiratory viruses. Due to the nature of their work, dentists are at greater risk of contracting the new coronavirus during dental interventions. Knowing the path of transmission of the virus is of great importance in preventing and suppressing the development of infection. Patients' fear of infection during the coronavirus pandemic was significant, and because of this, visits to the dentist for standard dental services were postponed, and patients came only for emergencies. Adherence to protective measures directly affected patients' satisfaction with dental services.

The aim of this work was to examine patient satisfaction with dental services during the coronavirus pandemic.

Materials and Methods: The study was designed as a cross-sectional study using an epidemiological questionnaire. A total of 120 patients were surveyed, 60 from private practice and 60 from the state sector. The questionnaire was anonymous and contained sociodemographic questions and questions related to knowledge of protocols and satisfaction with dental services. The data were processed in the SPSS 11.5 program.

Results: Out of 120 respondents with an average age of 38.92 ± 13.08 years, 98% were familiar with the protocol for protection against the coronavirus. There were no dissatisfied people in either private practice or the public sector; the only difference was in the degree of satisfaction. In private practice, more respondents were very satisfied as the highest level of satisfaction, while in the public sector, it was very satisfied.

Conclusion: A good knowledge of the protocol for protection and prevention of the spread of the virus raises awareness among dentists and patients. By following these measures, infection with the virus is reduced to a minimum, and therefore patient satisfaction with dental services is at a higher level.

COULD WEARING FACE MASKS DURING THE PANDEMIC HAVE CREATED AN ENVIRONMENT FOR DEMODEX MITES?

2024-06-24T11:18:59+02:00

Background: During the COVID-19 pandemic, wearing face masks became mandatory in our country to prevent the spread of the virus, as in many other countries.

Objective: We aimed to examine whether wearing face masks during the pandemic created a microenvironment for Demodex mites.

Material and Methods: The study included three groups: (i) those who wore N95/FFP2 masks, (ii) those who wore a 3-ply surgical mask, and (iii) a control group (who rarely wore masks). The age, gender, occupation, smoking status, alcohol consumption, past medical history, and face-washing habits were questioned, and dermatological examination was performed. The presence of Demodex mites was detected by the standard superficial skin biopsy (SSSB) from three regions of the face.

Results: Sociodemographic characteristics and the findings of dermatological examination of the three groups were similar (p > 0.05). There was no significant difference across the groups concerning the presence of Demodex mites in corresponding regions (the right cheek, nose, forehead) and corresponding numbers of Demodex mites (>5 D/cm²⁾; the total number of Demodex mites in each region; presence of Demodex mites in any area on the face, number of Demodex mites in any region >5 D/cm²on the face, the total number of Demodex mites found on the face, and the presence of Demodex mites in the areas under the mask (the nose and the right cheek together) (p> 0.05).

Conclusion: We can conclude that wearing masks by healthy adults with no known skin diseases during the pandemic does not create a proper microenvironment for the lives of Demodex mites.

ITEM ANALYSIS OF MULTIPLE-CHOICE QUESTIONS IN AN UNDERGRADUATE SURGERY COURSE-AN ASSESSMENT OF AN ASSESSMENT TOOL

2024-06-24T11:22:07+02:00

Introduction: In the field of medical education, multiple-choice questions (MCQs) represent the most commonly utilized method of assessment. It is necessary to analyze the assessment results through item analysis to ensure the quality is appropriate. This study evaluated the quality of the MCQs utilized for summative evaluation of the students in the General Surgery Course conducted in the year 2023-24, at the College of Medicine (Unaizah), Qassim University, Saudi Arabia.

Methods: Using a number of established parameters for item analysis, the study evaluated the multiple-choice questions for difficulty, discrimination power, and quality of distractors.

Results: The quality of the questions varied. The means of the facility index, discrimination index, discriminative efficiency, and distractor efficiency were, in order, 76.31%, 0.28, -0.7743, and 32%.

Conclusion: Item analysis is a crucial technique for evaluating the quality of MCQs. There were multiple defects in the MCQs used in summative assessments, revealing the scope for further improvement in future courses. It is important to plan faculty development events often to impart knowledge and skills related to creating MCQs that are valid, reliable, and of high quality.

SOFT LINING OF IMMEDIATE COMPLETE DENTURES: CASE REPORT

2024-04-28T23:07:58+02:00

Introduction: With the placement of dental implants in edentulous patients, creating and adapting immediate dentures is crucial to allow patients to perform basic physiological functions during the osseointegration period without affecting implant healing. This report presents a case of direct soft lining of immediate complete dentures following implant placement.

Case Report: Six dental implants were inserted in the upper jaw, while the patient retained natural teeth in the lower jaw. An immediate complete denture was fabricated and adjusted for the upper jaw. The prosthesis base was prepared and processed to accommodate soft lining material. Adhesive was applied to the prepared base, followed by silicone application for soft fitting onto the prosthesis base, which was then inserted into the patient's mouth. After three minutes, the denture was removed, and soft lining treatment of the immediate complete denture was completed.

Conclusion: Direct soft lining facilitated patient adaptation to the immediate prosthesis and supported safer healing and osseointegration until definitive work could be completed. The addition of a soft silicone layer reduced pressure on the residual alveolar ridge and improved adhesion of the immediate prosthesis.

TREATMENT OF OPEN EXTRUDED FRACTURE NECK OF THE TALUS USING THE COMBINED METHOD OF EXTERNAL FIXATION MODIFIED FOR DYNAMIC ANKLE JOINT FIXATION AND KIRSCHNER WIRES

2024-06-24T11:20:44+02:00

Introduction: Open extruded fractures of the talus occur in 2% of talar fractures. These fractures are challenging for surgeons due to complications such as infection, nonunion, and arthritis. The most common treatment method is talus reimplantation and osteosynthesis.

Case report: A 19-year-old presented with an open extruded fracture of the talus, classified as Hawkins II, following a fall from a height. Emergency surgery involved wound debridement, talus reimplantation, osteosynthesis with modified external fixation for dynamic ankle joint fixation (Mitkovic-type), and two Kirschner wires. Fragments were repositioned under C-Arm fluoroscopy. The patient received a 14-day antibiotic regimen (Cephalosporins, Aminoglycoside, Metronidazole) and thromboembolic prophylaxis for 35 days. After 6 weeks we allowed movements in the ankle joint with physical therapy. Gradual weight-bearing was allowed after 8 weeks. The osteosynthetic material was removed after 18 weeks, with full weight-bearing achieved after 6 months. Radiographic follow-up was conducted up to 24 months postoperatively, showing excellent healing with minimal dorsiflexion restriction.

Conclusions: Treating this injury is a significant challenge. External fixation can be a viable method for managing open luxation fractures of the talus.

IMPACT OF VITAMIN E ON DIFFERENT ORGAN SYSTEMS

2024-04-26T07:58:46+02:00

Vitamin E, present in both plant and animal-based foods, is a lipophilic compound with multifaceted biochemical functions. Its deficiency can lead to severe health consequences, while excessive intake may result in hypervitaminosis. Among tocopherols, Alpha-tocopherol stands out for its pharmacokinetic properties and potent antioxidant effects. It exerts significant influence on the immune, nervous, and cardiovascular systems, as well as on skin health. Notably, it plays a crucial role in preventing carcinogenesis. While Alpha-tocopherol garners attention, other tocopherol group members should not be overlooked, as advancements in science uncover their diverse biological impacts. In recent years, tocotrienols have emerged with distinct biochemical properties that profoundly affect human health.

DIABETIC KETOACIDOSIS IN PREGNANCY

2024-05-28T09:32:08+02:00

Diabetic ketoacidosis (DKA) is one of the most serious and life-threatening complications of diabetes mellitus (DM), especially when it occurs during pregnancy, with a prevalence ranging from 0.5% to 3%. Pregnancy is considered a susceptible environment for the development of this type of metabolic imbalance due to its inherent physiological changes. Unspecific symptoms (vomiting, diarrhea, abdominal pain, etc.), especially in pregnant women, and the fact that ketoacidosis can develop even with normal glucose values (defined as euglycemic ketoacidosis), often lead to a delayed diagnosis. Evidence suggests that timely diagnosis and appropriate management of ketoacidosis are crucial in preventing adverse outcomes for both the mother and the fetus. Fetal outcomes are often dichotomous, resulting in either fetal demise (miscarriage/stillbirth) with a prevalence of 10% to 35%, or the birth of a healthy baby, with possible complications primarily related to diabetes mellitus itself. Additionally, case reports of ketoacidosis developing even in non-diabetic women due to other diseases (such as acute pancreatitis, appendicitis), as well as in those with gestational diabetes mellitus (GDM), further emphasize the importance of considering this condition in everyday clinical practice. The aim of this paper is to further elucidate the causes and course of this complication, as well as the outcomes for both mother and fetus, to contribute to a better overall understanding.

COMPARISON OF CONVENTIONAL PAP SMEAR AND LIQUID-BASED CYTOLOGY IN DETECTING CERVICAL ABNORMALITIES

2024-06-21T17:29:32+02:00

Cervical cancer represents one of the most common types of cancer in women, requiring early diagnosis to reduce prevalence and mortality rates. The Pap smear plays a crucial role in the early diagnosis of precancerous lesions. While the conventional Pap smear has been the standard method for lesion detection, liquid-based cytology (LBC) is emerging as an alternative with potential advantages.

Research comparing the conventional Pap smear to LBC has shown that LBC yields a higher percentage of satisfactory samples and demonstrates greater sensitivity and specificity in identifying various cervical abnormalities. Similar findings have been reported in Japanese research. However, some studies have shown conflicting results, emphasizing the specificity of the conventional method. While some studies suggest that the conventional Pap smear is better at detecting ASC-US, others show similar or favorable results for the LBC method.

The LBC method stands out for its higher diagnostic sensitivity, especially in detecting various types of cervical abnormalities, while the conventional Pap smear method maintains its specificity, particularly in diagnosing LSIL. The LBC method has the advantage of better sample representativeness and fewer unsatisfactory samples.

HOW TO PREPARE FOR AN AVIAN INFLUENZA H5N1 PANDEMIC OUTBREAK:LESSONS LEARNED FROM THE INFLUENZA H1N1 PANDEMIC OF 1918

2024-07-13T21:23:30+02:00

In this paper, we highlight the significant challenges encountered during the influenza H1N1 pandemic of 1918. These lessons are being utilized to prepare for potential avian influenza H5N1 pandemic outbreaks, as this virus will impact both humans and food-serving animals. Preparation for this threat is crucial because H5N1 infections are already affecting the United States and many other countries.