Search

Fungal corneal ulcers are an uncommon, yet challenging, cause of vision loss. In the United States, geographic location appears to dictate not only the incidence of fungal ulcers, but also the fungal genera most encountered. These patterns of infection can be linked to environmental factors and individual characteristics of fungal organisms. Successful management of fungal ulcers is dependent on an early diagnosis. New diagnostic modalities like confocal microscopy and polymerase chain reaction (PCR) are being increasingly used to detect and identify infectious organisms. Several novel therapies, including crosslinking and light therapy, are currently being tested as alternatives to conventional antifungal medications. We explore the biology of Candida, Fusarium, and Aspergillus, the three most common genera of fungi causing corneal ulcers in the United States and discuss current treatment regimens for the management of fungal keratitis.

Hemophilia is a hemorrhagic disorder with a sex-linked inherited pattern, characterized by an inability to amplify coagulation due to a deficiency in coagulation factor VIII (hemophilia A or classic) or factor IX (hemophilia B). Sequencing of the genes involved in hemophilia has provided a description and record of the main mutations, as well as a correlation with the various degrees of severity. Hemorrhagic manifestations are related to levels of circulating factor, mainly affecting the musculoskeletal system and specifically the large joints (knees, ankles, and elbows). This document is a review and consensus of the main genetic aspects of hemophilia, from the inheritance pattern to the concept of women carriers, physiopathology and classification of the disorder, the basic and confirmation studies when hemophilia is suspected, the various treatment regimens based on infusion of the deficient coagulation factor as well as innovative factor-free therapies and recommendations for the management of complications associated with treatment (development of inhibitors and/or transfusion-transmitted infections), or secondary to articular hemorrhagic events (hemophilic arthropathy). Finally, relevant reviews of clinical and treatment aspects of hemorrhagic pathology characterized by acquired deficiency of FVIII secondary to neutralized antibodies named acquired hemophilia.

Tuberculosis is still one of the ten leading causes for death worldwide. In spite of the latest medical and health advance gained over a period of time, tuberculosis effectively evades the successful targeting by drugs. The persistence abilities demonstrated by the mycobacteria had surprised the global community, since its discovery and pathogenesis in humans. Emergence and detection of drug resistant mycobacteria (MDR-TB, XDR-TB) had further complicated the treatment regime. Under the aegis of WHO, there is a concerted understanding and effort by the global community to eradicate TB. Towards this goal, novel drug molecules, new vaccine and treatment regime are being developed. Here, our current understanding pertaining to mode of action, molecular mechanisms of novel as well as traditional drug molecules and possible drug resistance mechanism in M. Tuberculosis is reviewed. Recent advances on new vaccination regime are also reviewed as it demonstrated huge potential in containing TB. This knowledge is essential for the development of more effective drug molecules, vaccines and may help in devising new strategy for containing and eradicating TB.

International audience; Invasive growth along white matter (WM) tracts is one of the most prominent clinicopathological features of glioma and is also an important reason for surgical treatment failure in glioma patients. A full understanding of relevant clinical features and mechanisms is of great significance for finding new therapeutic targets and developing new treatment regimens and strategies. Herein, we review the imaging and histological characteristics of glioma patients with WM tracts invasion and summarize the possible molecular mechanism. On this basis, we further discuss the correlation between glioma molecular typing, radiotherapy and tumor treating fields (TTFields) and the invasion of glioma along WM tracts.

Під нашим спостереженням перебували 27 дітей віком від 10 міс. до 10 років, хворих на гострі респіраторні інфекції, з яких 14 пацієнтам введено до харчового раціону функціональний харчовий продукт із рослинної сировини «Пилок квітковий з розчинною клітковиною» та продукти для спеціального харчування «Олія вівса, ліпофільний комплекс», «Олія чорного кмину, ліпофільний комплекс». Проведений аналіз клінічної симптоматики показав відсутність відмінностей у перебігу захворювання, тривалості симптомів гострих респіраторних інфекцій та терапії при обох способах лікування за дуже подібної клінічної картини на старті хвороби. Обсяг лікувального комплексу в другій групі (13 хворих) був вірогідно більшим за кількістю застосованих препаратів, а вартість — суттєво вищою, ніж у групі порівняння. Тому запропонована схема лікування з корекцією харчування функціональними харчовими продуктами з рослинної сировини може бути рекомендована для практичного застосування.

Background. In recent years, the prevalence of allergic diseases of the anterior chamber of the eye has increased. They are often accompanied by the development of dry eye syndrome, which can complicate their course. Therefore, it is important to take a comprehensive approach to their diagnosis and treatment. The purpose was to study the effectiveness of 0.4% sodium hyaluronate (Gilays) in children with dry eye syndrome on the background of allergic diseases of the conjunctiva. Materials and methods. The study involved 42 patients (84 eyes) aged 3 to 18 years, who were examined and treated on the basis of Regional Eye Clinic. Patients were treated with local H-1 histamine blockers twice a day for 14 days, f necessary — with topical glucocorticoids by the scheme for 12 days. In the first group (21 patients, 42 eyes), the main treatment was added with the drugs containing 0.2% sodium hyaluronate, used topically 4 times a day for 14 days. In the second group (21 patients/42 eyes), 0.4% sodium hyaluronate (Gilays) was added to the treatment regimen. H-1 histamine blockers were not used systemically. Before starting therapy and 2 weeks later, the following values were evaluated: the changes in the anterior chamber of the eye using biomicroscopy, determination of lacrimal film rupture time, Schirmer 1 test, questionnaire. Conclusions. The use of sodium hyaluronate in the complex therapy of dry eye syndrome in allergic eye diseases is quite effective. The use of 0.4% sodium hyaluronate was more effective compared to the control group. It is advisable to use a questionnaire to communicate with the child, but it is necessary to refine the form of questions to eliminate as much as possible the subjectivity of the data.

The article is devoted to the problem of effective ma­nagement of chronic pain. A review of the known mechanisms of development and maintenance of chronic pain and possible me­thods of influence is given. One of the reasons for the lack of chro­nic pain treatment effectiveness in some patients is the use of treatment regimens with drugs acting exclusively on the targets loca­ted in the nerve structures. Today an important role of micro­glia and mast cells in the development and maintenance of chronic pain conditions is well acknowledged. A new class of drugs from the group of acylethanolamides is described. One of the representatives of this group is palmitoylethanolamide. This drug may mo­dulate the activity of microglia and mast cells, thus increasing the pain threshold and the effectiveness of therapy. The use of palmitoylethanolamide in patients with chronic pain can increase the effectiveness of therapy., Стаття присвячена проблемі ефективного управління хронічним болем. Наводиться огляд відомих на сьогодні механізмів розвитку й підтримки хронічного болю й можливих методів впливу на них. Однією з причин недостатньої ефективності лікування хронічного болю в деяких пацієнтів є використання схем лікування препаратами, що діють виключно на мішені, розташовані в нервових структурах, тоді як на сьогодні встановлена важлива роль мікроглії й тучних клітин у процесах розвитку та підтримки хронічних больових станів. Наводиться опис нового класу препаратів групи ацилетаноламідів, представником якого є пальмітоїлетаноламід. Пальмітоїлетаноламід здатний модулювати активність мікроглії й тучних клітин, підвищуючи таким чином поріг болю й ефективність комплексної терапії. Застосування пальмітоїлетаноламіду в пацієнтів із хронічним болем може підвищити ефективність терапії.

Nontuberculous mycobacterial (NTM) infections are an emerging problem. Common organisms include Mycobacterium avium, M. intracellulare, and M. kansasii, along with the M. avium intracellulare complex (MAC), which includes both M. avium and M. intracellulare. Typically, NTM infections affect the lungs and subsequently demonstrate a chronic course. Therefore, persistent respiratory symptoms generally indicate of the presence of pulmonary NTM diseases, and chest radiography, along with a sputum examination, are essential for its diagnosis. Because NTM are ubiquitous environmental organisms, a positive culture from a minimum of two separate expectorated sputum samples are required to make a diagnosis. The repertoire of effective drugs for treatment is considerably limited, indicating the need for long-term management with multiple drugs. Establishing a treatment regimen with high therapeutic efficacy and safety is an important issue for the future.

Introduction: Pyrazinamide (PZA) susceptibility testing plays a critical role in determining the appropriate treatment regimens for multidrug-resistant tuberculosis. We conducted a systematic revie...

Russian forms of electrical stimulation became popular to a large extent as a result of the activities of Kots, who claimed force gains of up to 40% in elite athletes as a result of what was then a new form of stimulation. He did not provide details of his published work, nor did he give references. Russian electrical stimulation became popular despite the lack of research in the English-language literature. No studies published in English examined whether the “10/50/10” treatment regimen (10 seconds of stimulation followed by 50 seconds rest, repeated for 10 minutes) advocated by Kots is optimal, and only one study addressed whether maximum muscle torque was produced at an alternating current frequency of 2.5 kHz. The few studies that compared low-frequency monophasic pulsed current and Russian electrical stimulation are inconclusive. This article reviews and provides details of the original studies by Kots and co-workers. The authors contend that these studies laid the foundations for the use of Russian forms of electrical stimulation in physical therapy. The authors conclude that there are data in the Russian-language literature that support the use of Russian electrical stimulation but that some questions remain unanswered.

Introduction Partial flap necrosis is a common complication after surgery. McFarlane flap model has been used for assessment of various agents' effects on random flap survival. The aim of this study was to review the methodology of studies using this flap model and reveal the most successful agents. Materials and methods PubMed, Scopus, and Web of Science databases were screened for words "McFarlane flap," "flap survival," and ("flap" and "rat") by using time limits between 1965 and 2019. A total of 71 original articles were reviewed. Dimensions and base (cranial/caudal) of the flap, treatment protocol, follow-up period, and survival rates were extracted. Modified survival rates were calculated. Coefficients of variation of cranial/caudally based control group flaps and most commonly used flap models were calculated to assess interstudy variability. Results A total of 165 different treatment regimens were studied. One-hundred twelve regimens (67.9%) were found to increase flap survival. Most common flap dimensions were 9 cm × 3 cm, followed by 10 cm × 3 cm, 8 cm × 2 cm and 6 cm × 2 cm. Studies using caudally based flaps showed less interstudy variability, but survival rates were similar. Pentoxifylline, sildenafil, chlorpromazine, phenoxybenzamine, and phentolamine were reported to be successful in multiple studies. Conclusions There are numerous agents found to be effective for treatment of partial flap necrosis, but further clinical research is needed. To overcome standardization problems, use of commonly used flap dimensions with a caudal base and interpretation of results after 7 days of follow-up seems appropriate.

Facial paralysis is a complex condition requiring a multidisciplinary and systematic approach to develop a comprehensive treatment regimen that will result in optimal outcomes. A multitude of surgical and non-surgical options are available. The time from onset of facial paralysis, type of paralysis (flaccid versus non-flaccid), continuity of facial nerve, and viability of the facial musculature are important factors to consider in the selection of treatment options. Other considerations include underlying etiology, patient preferences and comorbidities, degree of injury, involved facial zones, and laterality (unilateral versus bilateral). The reconstructive surgeon should be familiar with management options for both flaccid and non-flaccid facial paralysis. A wide array of dynamic and static surgical options is available for both early and delayed reanimation. In most cases, patients receive a combination of both dynamic and static treatments. In this article, we aim to discuss the evaluation of the patient with facial paralysis and provide a framework for decision making in treatment selection.

Objective: To evaluate and compare the effectiveness of zinc and B-Complex supplementation to prevent the recurrence of nephrotic syndrome in the cases priory responsive to corticosteroid therapy. Methodology It is a randomized controlled trial conducted at OPD Pediatric medicine, Shaheed Zulfiqar Ali Bhutto University, PIMS Children Hospital Islamabad from October 3, 2016 to April 2, 2017. 192 patients (96 in each group) were included in the study after obtaining informed consent from parents or guardians taken before determining the population. Patients were randomly assigned to two groups (Group 1: Zinc and Group 2: B-Complex) to receive oral zinc sulphate (10 mg / day) or B-Complex using a random number table. The patients were followed up after 4 months. All data were collected by the researchers themselves in a structured form. Results: The age of 192 participants of the trial averaged 6.38±3.42 years of age ranging from 1-12 years. There were 88 (45.8%) men and 104 (54.2%) women cases. In group 1, there were 22 (22.9%) and in group 2, there were 47 (49%) cases that had been pardoned. The recurrence of nephrotic syndrome was significantly higher in group 1 than group 2 (p =

INTRODUCTION: The study aims as a pilot study to evaluate the effect of different treatment regimen and different types of endodontic sealers on pain and periapical radiographic changes was studied. MATERIALS AND METHODS: Forty patients in need of an endodontic root canal treatment on anterior teeth were selected and divided into two groups (20 patients each), according to the endodontic treatment protocol (single or multiple visits). Then, each group was subdivided into two subgroups according to sealer used 10 each (AH Plus Jet resin sealer, Total Fill Bioceramic Sealer). To record pain intensity of the patients at different intervals: 1, 2, 3, 7 days, a visual analog scale was used. Furthermore, patients were recalled after 1, 3, 6, 9 months to evaluate periapical radiographic changes. RESULTS: Showed that as regard pain assessment both tested endodontic sealers, as well as single or multiple visits have no statistically significant difference between pain values of patients during all the observation period from immediately post-operative, after 4, 12, 24, 48, 72 h as well as after 7 days (p > 0.05). As regard lamina dura thickness, results showed that with both tested endodontic sealers as well as single or multiple visits, there was no statistically significant difference between lamina dura thickness of patients after 1 month, 3, 6 as well as after 9 months. CONCLUSIONS: Neither number of visits of endodontic treatment nor type of sealer used for obturation affects post-operative pain and thickness of lamina dura.

Thinning is a necessary and complex forestry activity. The complexity increases due to theoretical disagreements, contradictory recommendations, and errors of modern practice, which require confirmation through long-time experiments. This article presents a summary of experimental results from plantations established 20–30 years ago and explains concepts of the theory, methods, and regime of thinning in permanent sample plots of pine stands in Gatchinsky forest of the Leningrad region. The research results allow for the clarification of growth patterns and age dynamics of pine stands subject to heavy, low thinning, as well as the results of applying the crown (high) thinning technique and a mixed treatment. A combined thinning and fertilization could improve wood quality and yield compared to conventional methods. Of particular scientific importance is the analysis of change in tree diameter classes during growth and after thinning. The research results allow for optimizing the treatment regime in pine plantations and reducing labor intensity by increasing the intensity of thinning and reducing the number of techniques.

Continuous glucose monitoring system is a convenient wearable device that provides glucose readings from the interstitial fluid every few minutes. Continuous glucose monitoring has revolutionized diabetes care. Patients with type 1 diabetes mellitus and type 2 diabetes mellitus, regardless of the type of treatment regimen, can benefit from continuous glucose monitoring. Continuous glucose monitoring systems provide patients with diabetes and their providers with an ambulatory glucose report that summarizes and also gives graphical representations of the glucose data. This wealth of information helps to better understand patients' glycemic patterns, and thereby reduces hemoglobin A1c and hypoglycemia.

Hook of hamate fractures are uncommon injuries with unclear prevalence. Classic presenting symptoms include volar-ulnar hand/wrist pain and weakness in grip, with possible ulnar nerve paresthesias. Patient factors, such as activity level and desired return to work/sport, shape the most appropriate treatment regimen although excision of the hook has been adopted by most surgeons. Overall, once patients receive the correct diagnosis and are treated, good outcomes with high satisfaction rates are expected.

The 4C Deterioration model was developed and validated on data collected in UK hospitals until August 26, 2020, but has not yet been validated in the presence of SARS-CoV-2 variants and novel treatment regimens that have emerged subsequently. In this first validation study of the 4C Deterioration model on patients admitted between August 27, 2020 and April 16, 2021 we found, despite a slightly overestimation of risk, that the discrimination (area under the curve 0.75, 95% CI 0.71-0.78) and calibration of the model remained consistent with the development study, strengthening the evidence for adopting this model into clinical practice.

Human African and American trypanosomiasis are the vector-borne parasitic diseases that have killed millions of people early, and many people are yet suffering from these neglected diseases. The causative agents of these infections are parasitic protozoans of the genus Trypanosoma. Current treatment regimens against these endemic diseases have several limitations in terms of safety, efficacy, route of administration, and some of them have lost efficacy due to the emergence of resistance in their respective parasites. In this review, the most promising compounds identified by different strategies of drug development against these neglected diseases including target-based approach, the phenotypic high-throughput screening, the drug repurposing approach and combination therapy are emphasized. The potent heterocyclic compounds currently undergoing pre-clinical or clinical studies have also been assessed to ascertain an effective class of organic compounds having significant therapeutic potential against these tropical diseases. The molecular hybridization of outlined motifs may result in more active compounds and circumvent the development of resistance by specific targets in future.

Background: Hospitalization is a completely new experience to infants and young children. Some parents know the illness about their child but some have not but most of them don’t know the treatment regimen on illness of child through which he/ she is going through. When the child is admitted in patient department he or she has go through. As they don’t know about the procedures through which their child undergone; that responsible for the increase in anxiety level of father and mother both. Various questions are there in their mind; about which kind of procedure is this, my child is bearing or not? How painful it is? Is my child crying? All these questions are arises. As they don’t know about the procedures so these questions are increasing the stress level and anxiety level of parents. Objective: To assess the level of anxiety of parents regarding invasive procedures among hospitalized children 2. To compare the level of anxiety of mother and father regarding invasive procedures among hospitalized children 3. To associate the level of anxiety of parents regarding invasive procedures with selected demographic variables. Methods and Materials: Descriptive survey method. Tool: Standardized and validated STAI anxiety tool. Research Approach: Descriptive approach. Sample Size: 100. Sampling technique: Non convenient sampling technique Sample: Parents of hospitalized child. Setting: Selected hospital. Results: In these study the level of anxiety were seen into 4 categories; no anxiety, mild, moderate and severe anxiety. No anxiety had been seen in parents having score range (0 - 25%), mild anxiety is assessed in 15 parents having anxiety score (26 – 50%) while in 80 parents an moderate anxiety is assessed having score range in between (51 – 75%) and severe anxiety was assessed in 5 parents of an hospitalized child who were undergoing selected invasive procedures and having anxiety score in between (76 – 100%) on Comparison of level of anxiety of mother and father regarding invasive procedures in hospitalized children shows that mother had more anxiety level than father. Conclusion: In the study, moderate anxiety is assessed in 80% of parents while shown an association in between anxiety level and knowledge of a parents as well as the age of hospitalized child.

BACKGROUND Sputum smear conversion is the negative conversion of the sputum smear at the end of the second month of treatment regimen under the National Tuberculosis Elimination Program (NTEP). When the acid-fast bacillus (AFB) smear comes negative at the end of an intensive phase, the treatment regimen can shift to the continuation phase that indicates bacillary load is a minimum. Although some authors consider the conversion of cultures when the AFB smear is negative, two potent drugs in the continuation phase are sufficient to kill the remaining bacilli. The drug that can kill bacteria in the first 2 days of treatment is called early bactericidal activity (EBA). This can be assessed by the percentage of negative conversion of cultures at the end of the intensive phase of the treatment regimen. EBA is very essential because it reduces the transmission in the community and chances of patient death. When the purpose is to kill as many bacilli as possible in the first few days and weeks of treatment, it is very important to include bactericidal drugs in the treatment regimen so that it reduces the chances of patient death and infectiousness and the negative conversion of the cultures after 2-month treatment regimen is an indication of the bactericidal capacity of the drug. The purpose of this study was to compare sputum smear conversion in daily versus intermittent treatment regimens in diagnosed cases of new sputum smear-positive pulmonary tuberculosis patients. METHODS This retrospective observational study was carried out in the Department of Respiratory medicine and nodal drug resistance tuberculosis centre (DR-TB) at the Government medical college and hospital, Akola. In this study, a total of 120 new patients were taken. 60 patients were given daily and intermittent regimens respectively under NTEP. RESULTS Out of 120 patients, 56 (93.33 %) patients in intermittent and 53 (88.33 %) patients in daily regimen were sputum smear-negative at the end of 2nd month (intensive phase) and at the end of 6th month (continuation phase). 1 patient (1.6 %) remained sputum smear-positive after the intensive phase. That patient was given 1 month of extension of anti-tuberculosis treatment (AKT) in the intensive phase and the patient became sputum negative after 1 month of extension. CONCLUSIONS It was concluded in this study, daily regimens and intermittent regimens were equally effective in negative conversion of the sputum smear at the end of the intensive phase and the end of the continuation phase. Negative conversion of the sputum smear is quite important because the bacillary load will be so low at the end of 2nd month that reduces the chances of patient death and transmission in the community. KEY WORDS Pulmonary Tuberculosis (PTB), Drug-Resistant TB (DR-TB), National Tuberculosis Programme (NTP), Revised National TB Control Program (RNTCP), Intensive Phase (IP), continuation Phase (CP), National Tuberculosis Elimination Program (NTEP).

Campylobacteriosis is one of the most common bacterial intestinal infections with a high risk of severe course in childhood. The treatment of children with campylobacteriosis is complex and requires further study. Objective of the study: to study the clinical efficacy of various drug therapy regimens for campylobacteriosis and their effect on intestinal microbiocenosis in young children. Materials and methods of research: From 2018 to 2020 in the Pediatric Research and Clinical Center for Infectious Diseases of the Russian Federal Biomedical Agency, a comprehensive singlecenter prospective dynamic open observational study of 84 children aged 6 to 18 months with campylobacteriosis was carried out (41 boys, 43 girls, mean age 12,7±4,7 months). A comparison was made between patients who did not receive an antibacterial drug (n=30), received azithromycin (n=30), and received several antibacterial agents (n=24). Clinical and laboratory parameters and indices of the intestinal microbiocenosis composition were assessed by real-time PCR. Results: antibacterial drugs of the macrolide group are most effective in the etiotropic therapy of severe and moderate forms of campylobacteriosis in infants. The appointment of antibacterial drugs of the cephalosporin group for campylobacteriosis leads to a slowdown in the recovery process (an increase in the duration of diarrhea, fever and abdominal pain), accompanied by significant damage to the intestinal microbiocenosis (a decrease in the symbiotic Lactobacillus spp. and Bifidobacterium spp.). The combination of these factors predisposes to more frequent re-isolation of the pathogen observed in this group of patients. For children who are on mixed or artificial feeding, the inclusion of nutritional mixtures with probiotics in the complex of therapeutic measures has a pronounced therapeutic effect and can be used as one of the main means of rehabilitation of campylobacteriosis convalescents.

The management of aggressive breast cancer, particularly, triple negative breast cancer (TNBC) remains a formidable challenge, despite treatment advancement. Although newer therapies such as atezolizumab, olaparib, and sacituzumab can tackle the breast cancer prognosis and/or progression, but achieved limited survival benefit(s). The current research efforts are aimed to develop and implement strategies for improved bioavailability, targetability, reduce systemic toxicity, and enhance therapeutic outcome of FDA-approved treatment regimen. This review presents various nanoparticle technology mediated delivery of chemotherapeutic agent(s) for breast cancer treatment. This article also documents novel strategies to employ cellular and cell membrane cloaked (biomimetic) nanoparticles for effective clinical translation. These technologies offer a safe and active targeting nanomedicine for effective management of breast cancer, especially TNBC., Graphical abstract Image 1, Highlights • The management of aggressive breast cancer remains challenge. • Various nanoparticle technology mediated delivery of chemotherapeutic agent(s) for breast cancer treatment. • Novel strategies to employ cellular and cell membrane cloaked nanoparticles for effective clinical translation.

Psoriasis affects from age group of 11 to 60. This is autoimmune diseases. Psoriasis affects mainly the skin and nails, but in six per cent of cases it is accompanied by inflammation of joints, affecting mainly fingers, toes and the spine and is called psoriatic arthritis. In about 78% cases this problem due to stress. These conditions can be triggers as per the management of stress, emotions and fillings of patient. Based on the type of psoriasis, its location, extent and severity there are various treatment regimens available for psoriasis such as topical agents, phototherapy, systemic agents, and homeopathic approach which can help to control the symptoms. This review aims to cover each and every aspect of the disorder Psoriasis and details of particularly plaque psoriasis as about 80% of people who develop psoriasis have plaque psoriasis.

BACKGROUND: South Africa´s diagnostic algorithm for TB diagnosis from 2011 to 2017 employed the Xpert® MTB/RIF assay as the initial screening test for TB diagnosis and rifampicin (RIF) susceptibility, followed by submission of a specimen for GenoType® MTBDRplus. This study aimed to determine the concordance between the two assays in terms of RIF susceptibility and explore reasons for discordance.METHODS: This was a retrospective laboratory-based study that included all MTBDRplus results of tests performed at the Braamfontein Mycobacteriology Referral Laboratory between 1 September 2014 and 31 August 2015. The patient´s Xpert RIF result was linked with the MTBDRplus result.RESULTS: The overall concordance between RIF susceptibility results was 96.4%. There were 68 discordant RIF results. The most common reasons for discordance identified were possible false Xpert RIF-resistant results (22%), mixed infection/heteroresistance (16%), transcription errors (7%) and erroneous manual interpretation of the MTBDRplus strip (7%). Xpert RIF resistance detected using delayed hybridisation was associated with discordance.CONCLUSIONS: The overall concordance between the MTBDRplus and Xpert RIF results were very good. Management of discordance should include repeat specimens for Xpert and MTBDRplus and rpoB sequencing. All variables should then be considered before treatment regimens are altered.

Actinic keratoses (AK) are lesions with potential to transform into nonmelanoma skin cancers. Numerous methods are available for treatment of AK. Here, we review clinical trial data on the use of photodynamic treatment combined with the sensitizing agent aminolevulinic acid 20% solution (ALA-PDT) for AK management. Although treatment guidelines for AK vary in their specific recommendations, efficacy of ALA-PDT is considered comparable or better relative to other FDA-approved treatments for AK. It is generally well tolerated and has a very acceptable long-term safety profile. ALA-PDT is typically recommended for patients who have multiple AKs and is associated with improved cosmetic outcomes compared with cryotherapy. Patients who undergo treatment with ALA-PDT should receive thorough education regarding the risks and benefits of treatment, the treatment regimen and the importance of adhering to it, how to manage local reactions, and signs and symptoms that warrant further evaluation. J Drugs Dermatol. 2021;20(11):1239-1244. doi:10.36849/JDD.6166.

Objective — to investigate immuno-metabolic homeostasis in patients with new and recurrent cases of destructive forms of multidrug-resistant pulmonary tuberculosis (MDR-PTB) after treatment with bedaquiline and linezolid. Materials and methods. A clinical and laboratory examination of 175 people with MDR-PTB (89 patients with new cases and 86 patients with recurrent cases of destructive forms of MDR-PTB). The study was performed before and after treatment with bedaquiline and linezolid. The total leukocytes count (L), the leukocyte differential count (leukocyte formula), was determined in all subjects, The content of populations and subpopulations of lymphocytes were calculated using monoclonal antibodies to CD3+, CD4+, CD8+, CD19+, CD23+, CD56+ lymphocytes antigen in the reaction of indirect immunofluorescence. Quantitative determination of serum immunoglobulins was performed by Manchini radial immunodif­fusion in a gel. The level of circulating immune complexes (CIC) was determined by the spectrophoto­metric method by precipitation in polyethylene glycol. Results and discussion. In patients with new cases of destructive forms of MDR-PTB to treatment revealed hypersensitivity reactions of the first and the fourth type. Expressed activation of humoral and killer parts of immunity detected. In patients with recurrent cases of destructive forms of MDR-PTB before treatment, there are pronounced hypersensitivity reactions of the fourth type and activation of the humoral and killer parts of the immune system.Patients with new cases of destructive forms of MDR-PTB after application of treatment regimens with bedaquiline and linezolid have hypersensitivity reactions of the first and fourth types. Activation of humo­ral and killer parts of immunity detected. In patients with recurrent cases of destructive forms of MDR-PTB after the application of treatment regimens with bedaquiline and linezolid revealed a pronounced hypersensitivity reaction of the first type and activation of the killer and humoral parts of the immune system. Conclusions. In patients with new cases of destructive forms of MDR-PTB before treatment revealed T-cell immunodeficiency, which is expressed by a decrease in the level of T-lymphocytes (1.7 times relative to normal) and T-helpers (twice below normal). In patients with recurrent cases of destructive forms of MDR-PTB before treatment revealed T-cell immunodeficiency with a marked decrease in the level of T-lymphocytes (1.8 times normal) and T-helpers (1.8 times below normal). In patients with new cases of destructive forms of MDR-PTB after the application of treatment regimens with bedaquiline and linezolid revealed activation of the T-cell immune system due to increased levels of T-suppressors. In patients with recurrent cases of destructive forms of MDR-PTB after the application of treatment regimens with bedaquiline and linezolid revealed T-cell immunodeficiency due to the reduced content of T-lymphocytes (1.5 times below normal), namely T-helpers (1.9 times lower than normal).

Background. Coronavirus disease (COVID-19) is the biggest challenge the whole modern world has faced. Physicians and scientists are trying to find a solution to this problem. That is why many guidelines for the management of patients with ­COVID-19 have been created recently and they are constantly updating because of new results of the latest studies. But it is noticeable that there is a lack of protocols for certain special groups of the population the management of which differs from the treatment of the general population. Such groups include children, pregnant and postpartum women, the elderly, and patients who need surgery. The purpose of our study is to evaluate the management of pregnant and postpartum women in the Municipal Non-Profit Enterprise “Lviv Clinical Emergency Care Hospital”. Materials and methods. From September 2020, at the premises of the Municipal Non-Profit Enterprise “Lviv Clinical Emergency Care Hospital”, treatment has been carried out for pregnant and postpartum women with ­COVID-19; three case reports are presented. Results. Unfortunately, the treatment does not always lead to positive outcomes, sometimes it can be fatal, as the course is often accompanied by bacterial complications on the background of immunosuppression. However, it was found that the best treatment regimen is still a combination of antibiotics, anticoagulants and hormones and excludes the widespread use of antiviral or antimalarial drugs. Continuous monitoring of vital functions and assessment of liver, kidney, and heart function is essential to prevent complications or detect them at an early stage. Conclusions. During treatment of pregnant women in the intensive care units, it is important to choose the right empirical therapy, think about delivery done in time and oxygen therapy, based on theoretical and practical principles of ventilation., Актуальність. COVID-19 — це найбільший виклик, з яким зіткнувся увесь сучасний світ. Медики та науковці намагаються відшукати вирішення цієї актуальної проблеми. Саме тому останнім часом створено багато гайдлайнів для ведення пацієнтів з COVID-19, які постійно оновлюються з урахуванням результатів останніх досліджень для того, аби забезпечити пацієнтів найкращою допомогою. Але помітно, що існує нестача протоколів для певних особливих груп населення, ведення яких відрізняється від лікування загальної популяції. До таких груп належать діти, вагітні та породіллі, люди похилого віку, пацієнти, які потребують хірургічного втручання. Мета. Оцінювання допомоги вагітним та породіллям в умовах комунального некомерційного підприємства «Клінічна лікарня швидкої медичної допомоги міста Львова» (КНП «КЛШМД м. Львова»). Матеріали та методи. Із вересня 2020 року на базі КНП «КЛШМД м. Львова» проводилося лікування вагітних та породіль з COVID-19, три випадки з яких подано вашій увазі. Результати. На жаль, проведене лікування не завжди веде до позитивних наслідків і може закінчитися летально, оскільки перебіг часто супроводжується бактерійними ускладненнями, картина яких особливо яскраво проявляється на фоні імуносупресії. Проте визначено, що найкращою схемою лікування залишається поєднання застосування антибіотиків, антикоагулянтів та гормонів і виключає широке застосування противірусних або протималярійних препаратів. Визначальним чинником також залишається постійний моніторинг вітальних функцій та оцінка функціонування печінки, нирок, серця з метою запобігання розвитку ускладнень чи виявлення їх на ранній стадії. Висновки. При лікуванні вагітних у відділенні анестезіології та інтенсивної терапії важливо правильно підібрати емпіричну терапію, вчасно провести розродження та здійснювати кисневу терапію, ґрунтуючись на теоретичних і практичних принципах штучної вентиляції легень.

Introduction: Approximately 3% of all pediatric TB cases develop MDR-TB, with only 3–4% of such children receiving MDR-TB treatment. In Tajikistan, children as a proportion of all DR-TB in the country increased from 4.3 to 7.5% during 2013-2018. Despite limited evidence on the use of new anti-TB drugs in children, WHO has updated its guidelines for DR-TB treatment for children, and Tajikistan did so in 2013 and 2017. Novel and adapted regimens included individual regimens for RR/MDR, XDR (with and without Bedaquiline and Delamanid) and short treatment regimens with and without injectables. It is important to document the outcomes of the treatment regimens. Therefore, the aim of this study was to describe characteristics of children receiving different treatment regimens for DR-TB, the culture conversion and treatment outcomes. Methodology: Cohort study of children enrolled in DR-TB treatment by the National Tuberculosis Program in Dushanbe, Tajikistan, January 2013 to July 2019. Results: The study included 60 DR-TB children. The male to female ratio was 1:2 and mean age 13.6 years. Median time to culture conversion was 66 days [IQR:31-103; Range:2-232]. In children with treatment outcomes (N = 58), 93% had favorable outcomes. There were four children (7%) with unfavorable treatment outcomes, all of whom were female 15-17 years, on standard (RR/MDR) treatment during 2013-2015. Favorable outcomes by DR-TB type were 91%, 90%, and 100% in RR/MDR, PreXDR, and XDR-TB patients, respectively. Conclusions: All children enrolled after the introduction of modified guidelines for novel and adapted regimens for DR-TB showed positive TB treatment outcomes.

The aim of our study was to investigate the interrelations of symptoms, clinical outcomes and treatment regimens in pregnant women, diagnosed with myasthenia gravis and superimposed COVID-19 infection.We conducted an observational retrospective study between August, 2020 and July, 2021. Five patients with preexisting MG and superimposed COVID- infection were included in our study. We investigated the duration of MG, the antibody patient status, any present comorbidities, MG baseline treatment and MG severity class prior to the COVID-19 infection, MG severity class and treatment during the COVID-infection, and last but not least, the maternal and fetal clinical outcome.None of the participants were hospitalized as they were treated under quarantine at their homes. The most frequently reported complaints were anosmia, headache and fever, which were observed in 3 out of 5 patients. The MG severity was evaluated twice - before and after the quarantine period. Progression to a more advanced stage was found in 2 of our 5 patients. Three of the patients did not require any changes in the prescribed baseline MG treatment. In 2 patients the pyridostigmine dosage had to be increased. One patient received azithromycin and 4 patients were given LMWH (nadroparin) as specific anti-COVID measures. All patients fully recovered and gave birth to healthy newborns.To our knowledge, this is the first study on pregnant MG patients with superimposed COVID-19 infection. Based on our observations in this study it would seem that the coexistence of MG and COVID-19 infection in pregnancy does not elicit exacerbation in neither of those conditions. Further research is needed to confirm or challenge these findings, especially with the prospects of new virus variants emerging in the future.

KlasJakub, Kluz Natalia,MakaryczewMikołaj, Piwowar Klaudia. Treatment of schizophrenia and bipolar disorder (ChAD) - a review of the literature. Journal of Education, Health and Sport. 2021;11(9):473-483. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.061 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.061 https://zenodo.org/record/5524184 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 23.09.2021. Treatment of schizophrenia and bipolar disorder (ChAD) - a review of the literature Jakub Klas1, Natalia Kluz1, Mikołaj Makaryczew1, Klaudia Piwowar1 1Medical University of Lublin ORCID ID and E-mail: Jakub Klas https://orcid.org/0000-0002-4795-1909jakubklas99@gmail.com Natalia Kluz https://orcid.org/0000-0002-5801-5913nataliakluz99@gmail.com Mikołaj Makaryczew https://orcid.org/0000-0003-4735-8221mo7655010@gmail.com Klaudia Piwowar https://orcid.org/0000-0001-8232-003Xklaudiaklaudia66@gmail.com ABSTRACT Introduction and aims of the study: The aim of this study is to present recent reports on the treatment and therapy of schizophrenia and bipolar disorder (ChAD). The current treatment of patients affected by these diseases is difficult and unsatisfactory, therefore it is necessary to find new therapeutic options that will improve the effectiveness of treatment For the purpose of this study, scientific papers were reviewed using the Google Scholar search engine covering studies from 2016 to 2021. A dozen papers covering the scope of the publication were selected. Results: In the treatment of schizophrenia, the use of cannabinoids is of greatest interest due to the action of the preparations on the endocannabinoid system. In the treatment of ChaD, promising reports have been published on the therapy with aripiprazole and the need to improve its use in the treatment of both akathisia and agitation. Furthermore, from the fact that abnormalities of calcium signalling are considered a possible pathophysiological process in ChAD, it has been suggested that calcium channel L antagonists may be potential therapeutic agents in bipolar affective disorder. One study also demonstrated the potential use of vortioxetine in the treatment of patients with a depressive episode. Conclusions: The results of recent studies on the treatment of schizophrenia and ChAD cited in this paper offer the prospect of creating treatment regimens that are more effective and targeted in the aforementioned diseases. However, further randomised trials are needed to confirm the effective use of the cited drugs in the treatment of these diseases. Keywords: schizophrenia, ChAD, bipolar disorder

Survival of children with acute lymphoblastic leukemia (ALL) has improved from 10% to 90% over the last six decades. Survival gains in adult ALL have been more modest and confined to the adolescent and young adult population. Age is an important factor in determining outcomes in ALL. Additional factors like adverse biology, less intense treatment regimens, and poorer tolerance to therapy contribute to inferior survival among adults. Indian physicians face unique challenges while managing these patients. These are high infection rates, limited access to high-end investigations, and newer drugs. In this context, the management decisions in an individual patient are highly nuanced. Through a case-based review, we discuss representative scenarios in adult ALL where we detail our current approach to treatment in the context of available evidence.

Recently, there has been a significant growth in parasitic invasions among young children. At a younger age, parasitic infestations most often occur “under the mask” of gastroenterological pathology. At this age range, according to the domestic and world literature, functional diseases prevail. In May 2016, at the week of American gastroenterology, the Rome criteria IV were adopted. According to the the Rome criteria IV, as well as in the previous editions, it is suggested to prescribe therapy on the basis of the predominant symptom principle, giving preference to so-called complementary and alternative medicine, and, in particular, phytotherapy as additional therapy for the disease, but all also from the standpoint of evidence. The first such combined phytocomplex, which attracted interest from clinical researchers and patients, is Vormil Phyto — a mix of extracts of thirteen plants. The purpose of our research was the improvement of therapeutic approaches to the correction of the combined functional pathology of the biliary tract and parasitic invasion, as well as unassociated pathology of the biliary tract using phytocomplex Vormil Phyto in the main treatment regimens. Sixty children were divided into three groups: the first group with combined functional disorder of the biliary tract and parasitic infestation; the second group with a functional biliary tract disorder, received the phytocomplex Vormil Phyto; the third group with a functional biliary tract disorder, received traditional therapy. In the course of the research, data were obtained that indicate the effectiveness of the phytocomplex Vormil Phyto, which has not only an antihelmintic effect, but also normalizes the kinetics of the biliary tract that improves appetite rapidly and does not induce dyspeptic symptoms at earlier terms.

Objectives Previous studies suggest that exposure to inflammation in infancy may increase the risk for attention-deficit and hyperactivity disorder (ADHD). We studied the ADHD manifestations among 124 familial Mediterranean fever (FMF) patients and examined the relationship between FMF patient characteristics and ADHD. Methods Clinical, demographic, and genetic data were abstracted from patients’ medical records and supplemented by information obtained during clinic visits. ADHD manifestations were assessed using the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) questionnaire. Results ADHD was diagnosed in 42 (32.8%) FMF patients, a rate significantly higher than in unselected populations (∼8%). A majority (n = 27, 64.3%) had combined inattentive, hyperactive-impulsive manifestations. Eight (19%) had predominantly hyperactive-impulsive, and seven (16.6%) had predominantly inattentive symptoms. FMF patients with severe manifestations reported more ADHD symptoms. FMF patients with ADHD symptoms were less adherent to their treatment regimen, with only 61.9% of the patients with ADHD symptoms adhering to colchicine therapy compared to 92.7% of the patients without ADHD symptoms. Conclusion The high prevalence of ADHD characteristics in children with FMF may support the neuroimmune hypothesis that chronic inflammation increases the risk for ADHD. Children with FMF should be screened for ADHD as its presence may adversely affect adherence to treatment.

Background Beyond submental fat reduction, injectable deoxycholic acid (DCA) has gained popularity in recent years for various minimally invasive lipolysis applications. Objective To summarize and evaluate the evidence of off-label uses of injectable DCA. Methods MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL were searched. The outcomes measured included applications of DCA, treatment regimen, and its efficacy. An overall success rate for each condition was calculated based on the improvement defined in the included studies. Results Eleven studies evaluated the cosmetic use of DCA for excess adipose tissue on various anatomical locations. The outcomes were evaluated at time points ranging from 1 to 21 months post-treatment, with overall success rates over 85%. Eight case reports and series reported the success of using DCA treating lipomas, xanthelasmas, paradoxical adipose hyperplasia, fibrofatty residue of infantile hemangioma, piezogenic pedal papules, and HIV-associated lipohypertrophy. Although the preliminary efficacies were high, the overall recommendations for off-label uses are weak because of the lack of high-level studies. Conclusion The review emphasizes the diversity of injectable DCA as a minimally invasive technique for lipolysis. Further high-level studies demonstrating consistent treatment regimens and methods of evaluation are warranted to make more definitive recommendations regarding off-label DCA use.

Cancer is one of the major causes of human mortality worldwide. A number of approved antineoplastic medications and treatment regimens are already working in the field, and several new compounds are in different phases of clinical trials. An extensive series of anticancer drugs exist in the market, and studies explained that these molecules are associated with different types of adverse side effects. The reduction of the cytotoxicity of drugs to normal cells is a major problem in anticancer therapy. Therefore, researchers around the globe are involved in the development of more efficient and safer anticancer drugs. An interesting output of extensive research is that the quinazoline scaffold and its various derivatives can be explored further as a significant class of cancer chemotherapeutic agents that has already shown promising activities against different tumors. In general, quinazoline derivatives have already occupied a crucial place in modern medicinal chemistry. Quinazoline is one of the most studied moieties in medicinal chemistry due to the wide range of biological properties such as the anticancer, antibacterial, anti-inflammatory, antimalarial and antihypertensive activities. The anticancer activity of this scaffold has been well established.

New data on several COVID-19 infection parameters are slowly beginning to emerge which include the relative frequencies of symptomatic versus asymptomatic individuals positive for COVID-19, individual variation in response to re-purposed drug treatments, prognostic factors for developing severe COVID-19 and genetic risk factors for COVID-19 susceptibility and severity. From a larger perspective, it is our view that these parameters endorse the call for greater efforts in personalised medicine, especially when specific pharmacological interventions (i.e. vaccines or drugs to COVID-19 and other zoonotic diseases) are yet to be developed. Here, the aim of personalised medicine would be to rapidly identify vulnerable individuals and subsequently to design better treatment regimens for them, should COVID-19 or other pandemics appear in future. Application of genomic technology also will continue to be of importance to gain knowledge about the biology of the virus and will facilitate vaccine development and predict markers of resistance and/or susceptibility. © 2021. Penerbit UMT

Objective: to review the data on the efficacy and consumption of octocog alfa and rurioctoctog alfa pegol in standard prophylaxis and individualized prophylaxis in hemophilia A patients based on published international data.Material and methods: a systematic literature search and review were performed. Among 25 sources identified within the systematic search 7 relevant sources describing the comparison of treatment with octocog alfa and rurioctocog alfa pegol in adult and pediatric patients with severe and moderate hemophilia A based on personalized assessment of the pharmacokinetic curve using the interactive tool myPKFit versus the standard (non-personalized) dosage regimen were selected. Data on individual patients, as well as data from secondary subgroups defined by age, bleeding rate, risk of bleeding associated with the daily physical activity were combined and analyzed.Results. In observational studies, adjustments of the dose and administration of octocog alfa in patients with severe hemophilia based on personalized assessment of the pharmacokinetic curve using myPKFit resulted in the reduced consumption and/or increased efficacy of prophylaxis — a reduced annual bleeding rate. In an extended controlled study of rurioctocog alpha pegol a trend toward reduced bleeding rate and increased mean annual consumption of the drug was reported in patients who received myPKFit guided prophylaxis compared to a non-personalized treatment regimen. In the single-cut studies, myPKFiT use resulted in the regimen revisions in less than a quarter of patients.Summary. Personalized dosing for octocog alpha and rurioctocog alpha pegol based on pharmacokinetic curve built using pharmacokinetic population model enables reasonable dose adjustments and improves outcomes.

Background: Helicobacter pylori (H. pylori) infection is the most common cause of peptic ulcer disease and it can be associated with many complications, including malignancies. In clinical practice, some clinicians may use Clavulanic Acid (CA) in combination with amoxicillin or other beta-lactams as an addition to the standard treatment regimens. This practice may be done by habitual mistake, non-evidence based hypothetical assumptions, or by prescribing it as an alternative treatment. This review aims to expose the effect of CA against H. pylori infection and to review the possible mechanisms that may contribute to that effect. Methods: A PubMed and Google Scholar literature search was obtained on both pre-clinical and clinical studies related to CA and H.pylori infection. Results: Available clinical studies showed improvement in the eradication of H. pylori by about 10- 20% when CA was added to the treatment regimens. This effect for CA could be related to several mechanisms including inhibition of H. pylori growth by binding to Penicillin-Binding Proteins (PBPs), the transformation of H. pylori from the active filamentous form into coccoidal form, induction of the release of dopamine, modulation of immunological response towards H. pylori infection and its relationship with other microbiota. Randomized-controlled studies on patients with resistance to H. pylori are needed. Moreover, in vitro studies to evaluate the mechanisms by which CA may influence H. pylori are warranted. Conclusion: The presented literature suggests potential avenues for the use of CA in the management of peptic ulcer disease and H.pylori infection.

Proliferation of cells that have managed to evade central endogenous control mechanisms is a hallmark of cancer. Cancers are classified not only by their organ or tissue of origin, but also by the molecular characteristics of the cancer cells themselves. Because of recent scientific advancements, it is now possible to examine the genetic structure of various cancer types in great detail in a limited amount of time, the growing body of information about cancer's development and progression can be used to develop more accurate diagnostics and/or less toxic cancer treatments. In the long run, the aim is to provide each cancer patient with a treatment regimen that is optimally adapted to his or her condition and circumstance.

Family medicine and family physicians have exerted significant efforts in reducing the impact of the deteriorated socioeconomic factors in some communities. They attempt to enhance the quality of care for individuals. Continued research and dedicated levels in this field can also be associated with clear and innovative approaches to enhance the management of certain diseases and to improve the quality of care to reduce patients’ negligence related to potential management plans. it has been reported that family physicians have major roles in elevating the quality of care, achieving better disease management, and enhancing the quality of care for the corresponding patients because they have direct involvement with the individuals’ community and patients, In this literature review, the aim to discuss the impact of socioeconomic status on healthcare and the role that family medicine plays to enhance the quality of care for corresponding individuals’ community. The continued care of family physicians towards the health care of patients can significantly enhance the quality of life and have related health outcomes. Setting priorities and prescribing suitable treatment regimens are two important factors that might solve the problem of negligence to treatment regimens in low socioeconomic communities. Local authorities should also provide suitable environments for patients to enhance the nationwide outcomes and to reduce the burdens over the healthcare facilities by calling for integrated social, providing medical efforts, and enhancing the quality of care for patients.

Introduction The search for biomarkers in juvenile idiopathic arthritis (JIA) is a promising and rapidly expanding field of investigation. The biomarkers identified so far may help to dissect the clinical heterogeneity of the illness, measure the level of disease activity, predict clinical remission, relapse, response to medications, course over time, complications, and forestall disease flares. Areas covered We provide a summary of the most recent advances in the development and application of biomarkers in JIA. We performed a PubMed search for significant articles combining predetermined keywords related to biomarkers in non-systemic and systemic JIA, chronic uveitis, and macrophage activation syndrome (MAS).The biomarkers available or under study are presented and discussed separately for non-systemic and systemic subtypes and for the two main disease complications, uveitis and MAS. Expert opinion The incorporation of valid and reliable biomarkers in standard clinical care may help to design better patient-tailored treatment regimens and to improve the therapeutic strategies based on the treat-to-target approach. The establishment of biomarkers that predict the risk of disease flare may lead to define the optimal modalities for treatment discontinuation after the achievement of clinical remission.

Kula Łucja, Kalinowska Julita, Koczor-Rozmus Aleksandra. Endodontic treatment regimens and their application in practice - survey and comparative study.Journal of Education, Health and Sport. 2021;11(7):30-43. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.07.003 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.07.003 https://zenodo.org/record/5076337 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 07.06.2021. Revised: 16.06.2021. Accepted: 06.07.2021. Endodontic treatment regimens and their application in practice - survey and comparative study Łucja Kula¹, Julita Kalinowska¹, Aleksandra Koczor-Rozmus² ¹Student’s Scientfic Society of the Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Faculty of Medical Sciences, Pl. Akademicki 17, 41-902 Bytom, Poland ²Department of Conservative Dentistry with Endodontics, Faculty of Medical Science, Medical University of Silesia, Pl. Akademicki 17, 41-902 Bytom, Poland *Correspondance:akoczor@sum.edu.pl, Phone.: +48602247826 Julita Kalinowska https://orcid.org/0000-0003-1579-8310Phone: +48506-624-601 julita.kalinowska@gmail.com Łucja Kula https://orcid.org/0000-0001-9636-843XPhone: +48662-184-112 lucja.kula@outlook.com Aleksandra Koczor-Rozmus https://orcid.org/0000-0002-1300-2991, Phone: +48602247826 Abstract Introduction: Endodontics is a rapidly developing field of dentistry. Dentists have an increasing selection of techniques, tools and materials to ensure therapeutic success. Aim: The aim of study was to analyzed the endodontic treatment regimens and their application in daily practice of dentist. Material and Methods: A dentist survey was conducted through a Google Doc. The link to the form was placed on online dental groups, sent by e-mail to the offices and the questionnaire was also delivered to the dental offices in a printed form. Results: The majority of respondents always perform endodontic treatment procedures on pregnant women, take three X-rays and use a rubber dam during the treatment. Almost all respondents have the opportunity to take an X-ray in the workplace, and the working length is usually measured by the electronic method. The most commonly used methods of root canal preparation are the traditional and crown-down methods, and the most commonly used root canal filling method - the thermal method. Most of the respondents declared the following rinsing protocol: NaOCl and CA or EDTA. Apex locator, ultrasounds and microscopes are used in most dental offices, and more than half of the dentists responded that they perform procedures like broken tools removal or obliterated canals enlargment. . Conclusions: Polish endodontics has developed over the years. Modern solutions are used more and more often. The canals are filled with the thermal method, and the popularity of performing complex endodontic procedures has increased. However, it is necessary to conduct further studies comparing the effectiveness of the canal preparation methods and the standardization of the root canal irrigation protocol. Key words: endodontics; root canal therapy, survey

The history of Tuberculosis control in India dates back to 1951 with mass vaccination with BCG and it started as a National Programme in 1962. Radical changes in the form of DOTS were incorporated with the start of Revised National Tuberculosis Control Programme (RNTCP) in 1997. Since then, TB control efforts have witnessed many changes in the form of daily DOTS, Injection free regimen for both drug sensitive & drug resistant TB, moving from fixed Categories of treatment regimen to Individualized treatment regimen based on prior Universal Drug susceptibility testing. Flexibility has been incorporated in the programme to accommodate Private practitioners in the form of various incentives. Introduction of Active case finding strategy has helped in early diagnosis leading to prompt treatments. Engagement of Community and leaders from all sectors and various organizations has helped to reach all communities in this fight against TB. India hopes to End TB by 2025 with rechristening the programme to National TB Elimination Programme (NTEP) and bringing in the much needed changes & flexibilities in the programme.

Sandhigatavata is a disease with Shoola (pain), Shotha (swelling) and Hanti Sandhi Gatah Sandhi (impairment of the functions of joints). This can be correlated with osteoarthritis. Osteoarthritis is a degenerative arthritis. While any joint can be affected in osteoarthritis, knee joint is most commonly affected. Vangasena Samhitha mentions Ksheera Vaitarana Vasti as a treatment for Janu Sankocha (stiffness of joint), Kati Prushta Shoola Shotha (swelling and pain in waist, knee and back). Prasarana Akunchanayoh Pravrutthishca Savedana (pain during contraction and extension of limbs) is described as a symptom of Sandhigatavata and stiffness in joint is a symptom of osteoarthritis. Sri Lankan traditional physician family ‘Weerasinghe’ treat Sandhigatavata with Belimul Thippilimul Amu Inguru Kashaya with effective results. Gugguladi Thaila is described in Sri Lankan Ayurveda Pharmacopeia in treatment of Vata Roga. Susruta advises to conduct Snehana in treatment of Vata Roga. Janu Vasti is one method of administering Bhahya Snehana to Janu Sandhi (knee joint). A 65 years old female with an 8 years history of Sandhigatavata Ayurveda treatments for 21 days. Ksheera Vaitarana Vasti was conducted for seven days and from Day 8 to 21, with oral administration of Belimul Thippilimul Amu Inguru Kashaya along with Janu Vasti using Gugguladi Thaila. After completion of treatment, it was observed that swelling, tenderness and pain during contraction and extension of limbs were completely relived. It is concluded that above treatment regimen is effective in treatment of Sandhigatavata (osteoarthritis).

Ocular tuberculosis is a serious disease with a long recurrent course, often leading to a significant decrease in the visual functions and quality of life of patients as well as disability. In recent years, the incidence rate of the ocular tuberculosis in the Russian Federation has been declining: in 2016, according to a number of authors, its incidence amounted to 5.2%.Purpose. To systematize literature data on the topic of ocular tuberculosis.Materials and methods. We reviewed literature available on elibrary.ru, cyberleninka.ru websites and in “Clinical Ophthalmology” journal. Results. We suggested classification of the ocular tuberculosis lesions, analyzed modern diagnostic methods and treatment regimens and evaluated their effectiveness.Conclusions. Literature review revealed that in order to improve the quality of detection, diagnosis and treatment of ocular tuberculosis, joint efforts of ophthalmologists and phthisiologists as well as use of modern methods of tuberculinodiagnosis are essential.

Oxcarbazepine (OXC) is an antiepileptic drug (AED) used in children and adults as initial and adjunctive therapy for focal epilepsy (FE). It has been used in Russia since 2007; however, only a few studies have been published on its use in Russian patients to date.Objective: to assess the effectiveness and tolerability of OXC as initial therapy for FE in adults and adolescents, as well as to study epileptiform activity index (EAI) changes during treatment and its relationship with treatment effectiveness and tolerability.Patients and methods. We evaluated treatment effectiveness and tolerability and EAI in 89 adults with newly diagnosed FE aged 15–75 years for 12 months. Patients were divided into three subgroups according to the OXC treatment regimen. Side Effects of Anti-Epileptic Drugs (SIDAED) scale was used to assess treatment tolerability. Retention rate and seizure frequency changes were used to evaluate treatment effectiveness. EAI changes were assessed with video electroencephalography monitoring (4–24 h) during each visit (baseline, after 1, 3, 6, and 12 months).Results and discussion. The retention rate in patients on OXC monotherapy after 12 months was 71.9%, almost one-half of them (46.1%) achieved sustained remission. More than half of patients (52.9%) were prescribed 1200 mg/day of OXC, 12.3% – Conclusion. OXC, as the initial AED for FE, has demonstrated high treatment effectiveness and tolerability. In addition, total EAI 2.5-fold reduction allows its usage as an additional quantitative marker of OXC treatment effectiveness.

In this study, the influence of ultrasound on the stability of colemanite suspension was first studied without reagents, and the effects of ultrasound power value, treatment regime (batch and conti...