First- and Second-generation Health Condition Affected by Radiation

Research relevance: article presents the incidence of children and grandchildren for 2018–2019 of liquidator workers who took part in cleaning up the contaminated area around the Chernobyl nuclear power plant, as well as residents evacuated from the city of Pripyat and other settlements within a radius of 70 km from the station. The consequences of radiation exposure of Chernobyl accident remain a topical issue. Research objectives: in order to study health status of children and grandchildren of liquidators, outpatient cards and reporting forms no. 15-zdrav “On medical care for people affected by radiation and included in the Kyrgyz State Medical and Dosimetric Register” examined. Research materials and methods: diseases of the endocrine and nervous systems, nutritional disorders, metabolic disorders, mental disorders, diseases of the eye and its adnexa, ear diseases of and mastoid process were studied. Circulatory and respiratory system diseases were analyzed. Research results: animal and cell culture studies show that high doses of ionizing radiation can lead to mutations in offspring. However, there have not been sufficiently large-scale studies on humans that would allow assessing the effect of radiation on the health of offspring. The exposure provokes mutations and incurable diseases, but it is still unclear how it might affect the children affected. It is known that exposure to ionizing radiation increases DNA mutagenesis compared to background values. Conclusions: obtained data substantiate the need for further monitoring of their health, organization of differentiated dispensary observation of this contingent and timely implementation of medical, rehabilitation and preventive measures in order to preserve health of “children and grandchildren of Chernobyl” at all subsequent stages of their life.

Analysis of Disability Due to Ear and Mastoid Diseases in Kyrgyzstan

One of the main medical and social problems is disability, which causes economic losses, both for citizens and for the state. This article presents an analysis of the indicators of disability and disability due to diseases of the ear and mastoid process in Kyrgyzstan for the period 2014–2019. In the republic in general and in the Osh region in particular, there is a slight increase in persons with disabilities among the adult category of the population in all classes of diseases under medical supervision in health organizations from 2014 until 2019 and a slight decrease in 2019. With the regional distribution of the frequency of the first recognized by persons with disabilities by diseases of the ear and mastoid process among the adult population, the Osh region ranks third, among children under 18 years old - seventh in rank. In the republic, against the background of the trend of a stable decrease in the number of adults with disabilities for diseases of the ear and mastoid process registered, an increase was observed among children under 18 years old only in 2018. Against the background of a decrease in the frequency of primarily recognized persons with disabilities for diseases of the ear and mastoid process among the category of adult population of the republic, children under 18 years old showed an increase in 2017 and 2018. In the Osh region, among adults, an increase was revealed in 2015 and 2016, and among children under 18 years old, against the background of a stable indicator for four years, a sharp increase in the indicator was in 2018. There is a need for a unified and integrated approach to disability-specific rehabilitation, as well as for individual rehabilitation and habilitation programs for persons with disabilities, with close inter-agency cooperation.

Quantitative Prediction of the Location of Carotid Bifurcation and Neurovascular Structures in the Carotid Region: A Cross-Sectional Cadaveric Study

Introduction. The carotid region is encountered in vascular and neurological surgery and carries a potential for vascular and cranial nerve trauma. The carotid bifurcation is an especially important landmark and difficult to predict based on currently established landmarks. This study is a detailed analysis of the carotid region and proposes a novel methodology to predict the height of the bifurcation. Materials and Methods. Superficial and deep dissections were performed on the anterior triangle of the neck to expose the carotid region in twenty-one formalin-fixed donor cadavers. Musculoskeletal and neurovascular structures were assessed in relation to the carotid bifurcation and the medial border of the clavicle (MBC). Results. The carotid bifurcation occurred, on average, 11.4 mm higher on the left ( p < 0.001 ; 95% CI: 9.28, 13.54). The superior thyroid artery ( p < 0.001 ), facial vein ( p < 0.001 ), and cranial nerve XII ( p < 0.001 ) were all more distal on the left side when measured from the MBC while the angle of the mandible and stylohyoid muscle remained symmetric. Left- and right-sided vascular structures were symmetric when measured from the carotid bifurcation. Conclusions. Neurovascular structures within the carotid region are likely to be anatomically superior on the left side while vessels are likely to remain symmetric in relation to the carotid bifurcation. When measured from the MBC, the bifurcation height can be predicted by multiplying the distance between the MBC and mastoid process by 0.65 (right side) or 0.74 (left side). This novel methodological estimation may be easily learned and directly implemented in clinical practice.

Classification and Morphometric Features of Pterion in Thai Population with Potential Sex Prediction

Background and Objectives: The landmark for neurosurgical approaches to access brain lesion is the pterion. The aim of the present study is to classify and examine the prevalence of all types of pterion variations and perform morphometric measurements from previously defined anthropological landmarks. Materials and methods: One-hundred and twenty-four Thai dried skulls were investigated. Classification and morphometric measurement of the pterion was performed. Machine learning models were also used to interpret the morphometric findings with respect to sex and age estimation. Results: Spheno-parietal type was the most common type (62.1%), followed by epipteric (11.7%), fronto-temporal (5.2%) and stellate (1.2%). Complete synostosis of the pterion suture was present in 18.5% and was only present in males. While most morphometric measurements were similar between males and females, the distances from the pterion center to the mastoid process and to the external occipital protuberance were longer in males. Random forest algorithm could predict sex with 80.7% accuracy (root mean square error = 0.38) when the pterion morphometric data were provided. Correlational analysis indicated that the distances from the pterion center to the anterior aspect of the frontozygomatic suture and to the zygomatic angle were positively correlated with age, which may serve as basis for age estimation in the future. Conclusions: Further studies are needed to explore the use of machine learning in anatomical studies and morphometry-based sex and age estimation. Thorough understanding of the anatomy of the pterion is clinically useful when planning pterional craniotomy, particularly when the position of the pterion may change with age.

Facial nerve paresis in the course of masked mastoiditis as a revelator of GPA

Purpose The aim of this study was to present a series of 6 patients with facial nerve palsy and masked mastoiditis which constituted as revelators of localized granulomatosis with polyangiitis (GPA) and to evaluate the utility of the ACR/EULAR 2017 provisional classification criteria for GPA in such cases. Methods Study group included 58 patients with GPA. Cases with facial nerve palsy and masked mastoiditis were thoroughly analyzed. Results The mean age of patients was 37 years. All manifested unilateral facial nerve palsy and hearing loss, while only 2 reported aural complaints suggesting inflammatory cause of the disease. All cases were qualified for surgical intervention. Intraoperative findings were similar: granulation tissue in tympanic cavity and/or pneumatic spaces of the mastoid process. Only 50% of histopathological results suggested vasculitis. In all cases, elevated levels of antineutrophil cytoplasmic antibodies (ANCA) against peroxidase 3 (PR3-ANCA) were determined. Two patients presented rapid progression of the disease and died within 1 week and 2 months, respectively. Four other patients manifested gradual improvement of hearing and facial nerve function after treatment. Conclusion GPA should be included into differential diagnosis in all cases of persistent facial nerve palsy especially when otological symptoms coexist. Even localized GPA could be very aggressive, revelating generalized form of the disease. Rapid systemic treatment of GPA can protect hearing and facial nerve from permanent severe dysfunction. The ACR/EULAR 2017 provisional classification criteria for GPA seem to be valuable tool in diagnosing ENT patients with localized otological form of the disease.

Assessment of Sexual Dimorphism from the Mastoid Triangle Using 3d CT scan in Nepalese Population

Introduction: Skull plays an important role, second only next to pelvis for sex determination. In skull, mastoid and occipital region due to its anatomical location is the most protected region, offering high resistance to decomposition and any form of tempering. With the intension of studying sexual dimorphism in the mastoid region involving mastoid process, we initiated this study. The technique we adopted was first introduced by Paiva and Segre, i.e. measuring the distance between three cranio-metric land mark (Porion, Mastoidale, and Asterion) and calculating the area of the triangle to study sexual dimorphism. Objective: The objective of this study is to determine sex based on mastoid triangle dimensions measured in 3D reconstructed computed tomography of the skull. Methodology: The study included 196, 3D reconstructed CT scan images of skull, 98 of which were males and 98 of which were females. The three craniometric points were marked to demarcate the mastoid triangle on both side (mention the software used).Heron’s formula was used for measurement of mastoid triangle areas. Result: Descriptive statistics and the student t-test revealed that males have larger mastoid triangle dimensions in all measurements than females, with a significant difference (p<0.000) between them. The paired t-test revealed no statistically significant difference (p<0.05) between the right and left sides. Apart from angle asterion (p<0.05) on the right side, no other mastoid triangle angles on either side showed a significant difference. The predictability of mastoid triangle measurements and areas was determined using a discriminant function and ROC curve analysis. The calculated mastoid triangle measurements and areas were 72.5 % of Asterion to Porion, 74.5 % of Asterion to Mastoidale, 86.3 % of Mastoidale to Porion, and 88.2 % of areas, respectively. Conclusion: The study findings suggest that mastoid triangle could be used to determine gender in the case of fragmentary skull remains by the forensic experts in the course of investigation. In order to generalize the data nationally, an autopsy-based, large sample size study on different age groups should be conducted.

Tuberculosis otitis media: problem relevance

Aim: currently clarification of the course characteristics, diagnosis and treatment principles of tuberculosis otitis media. Materials and methods: The study included 6 cases (8 ears) of tuberculosis otitis media and mastoid process from 2015 to 2020. Clinical, radiological, bacteriological, pathomorphological studies were used for diagnostics. Results: Primary localization of tuberculosis in the middle ear was found in 2 patients. In 4 patients tuberculosis middle otitis associated with lung affection. The disease manifested in the form of purulent perforated otitis media with a polymorphic otoscopic picture in all examined patients. The terms of the diagnosis were from 6 months to 1.5 years since the onset of the disease. This indicates the complexity of diagnosing the tuberculous etiology of the middle ear disease.