Risk of Infection from Application of Two Types of Pharmaceutical Creams

Introduction: Infection risk from the misuse of multi-dose medicinal products is a seriousproblem which affects final consumer health and may impact on thereputation of pharmaceutical companies adversely.Objectives:The current study aimed to trace the most important contributing factors in the infection transfer through the application of two selected types of medicinal topical creamsfor the treatment of skin disease conditions.Methods: One type of the product that was subjected to the present study is anti-psoriatic while the other is steroidal anti-inflammatory antimicrobial creams that were packed in Aluminum tubes with orifice diameter of 0.173 cm2, approximately. The simulation study – conducted on these topical creams - integrated preservative efficacy test (PET) with dose-response model of infection to demonstrate the probability of infection that could occur due to unintentional transmission of pathogenic bacteria to damaged or injured skin of the patient.Results:The studied model showed that although both products possessed antimicrobial power activity against standard strain microorganisms, yet the critical factor is the hygienic control of hands and fingers during application of the cream on the affected area.Conclusion:The medicinal products itself were little affected by microbial contamination when they were enclosed in their primary packaging materials as was observed by the in-use study. However, the most important part was that portion of the product that was transferred to the patient skin. From the simulation study, it was expected that the situation could be aggravated if the hyiegenic practice was underestimated by hospital staff.

Vitamin D status and its correlation with blood pressure in premenopausal Saudi women: a cross-sectional study.

Vitamin D deficiency is a major health problem in the Saudi population. A negative association between blood pressure and vitamin D level has been suggested in several clinical and epidemiological studies and evidence for an effect of vitamin D in lowering blood pressure was reported. These findings indicate that 1,25(OH)2D3 deficiency may play a role in the pathogenesis of hypertension through its effect on the renin-angiotensin system. We are the first to investigate the correlation between blood pressure or renin concentration and vitamin D status in the Saudi population METHODS: we included 201 healthy Saudi premenopausal females (20-45 years old). Blood pressure was measured by a standardized method using an automated blood pressure monitor (BPTru). Fasting blood samples were collected from each participant after 20 minutes of rest in the seated position. Serum cholicalciferol, PTH and renin concentration were measured by sandwich chemiluminescence immunoassaymethod (DiaSorin, Italy). RESULTS: The analysis included 192 subjects who were normotensive (blood pressure <140/90 mmHg). A total of 34% of women had a severe deficiency (vitamin D ≤ 12.5 nmol/L); 41% had moderate deficiency (vitamin D levels between 12.5 - 25 nmol/L); 23% had mild deficiency (vitamin D level ≥ 25 - < 50 nmol/L); and 2% had insufficiency (vitamin D level ≥ 50 - ≤ 75 nmol/L). None had a sufficient level of ≥75 nmol/L. The systolic blood pressure ranged from 79-130.5mmHg and the diastolic from 48.5-85.5 mmHg. Both systolic and diastolic blood pressures were significantly higher in women that were in the lower 2 quartiles of vitamin D. However, linear regression analysis adjusting for potential confounders showed that 25(OH)D level was not a predictor of either systolic or diastolic blood pressures. A negative correlation (although not significant) was found between vitamin D level and plasma renin concentration in this study group. CONCLUSION: Vitamin D deficiency was highly prevalent among the study group. Vitamin D was a not a predictor of either systolic or diastolic blood pressure. There was a negative correlation between vitamin D level and renin concentration although not statically significant. It is possible that any underlying relationship was obscured by the relatively young age group or due to the narrow blood pressure range of the studied population. A larger sample size including hypertensive subjects may be needed.

The potential crosstalk between the brain and adipose tissue in Obesity

Obesity is a major health problem that is increasing in an alarming rate and is associated with an increased prevalence of cardiovascular morbidity and mortality. New strategies to combat obesity epidemic are urgently needed, but gaps in understanding of obesity pathogenesis continue to limit progress in this goal. This review aims at discussing the neural aspects of obesity and the brain potential role in energy balance ,also to contribute in the complex solution of obesity puzzle on neurological basis. The hypothalamic region of the brain is the center that plays an important role in the control of feeding and its related behaviors. A better understanding of its role and how it is affected by neuroendocrine and adipokines signaling might be helpful in developing new pharmacological therapy for obesity. Also, this article highlights different mechanisms by which altered brain signaling and hypothalamic inflammation predispose to diet –induced obesity.

EVALUATING THE EFFECTIVENESS OF FRUCTOSE-1,6-DIPHOSPHATE IN TREATING OF OCULAR ISCHEMIC SYNDROME

The purpose of this study was to evaluate the efficacy and safety of FDP in patients with ocular ischemic syndrome.Material and methods. The material for this study is based on results of a comprehensive examination and treatment of 53 patients with a diagnosis OIS. The average age of the patients was 57,8 ± 6,82 year. 19 of them women, 34 men. 27 patients entered to the main group (1) which received standard therapy in combination with intravenous FDP (fructose 1,6-bisphosphate). 26 patients in the control group (2) received standard treatment.Results. In applying the FDP combined with comprehensive therapy in the main group resulted in increased of visual acuity by 32.8%, parameters of retinal sensitivity by 17.8%, reducing the area of scotomas compared with patients of the control group. Optical coherence tomography registered significant changes in the dynamics in patients of the main group - reducing the edema and restoration of RNFL and ONH. Recovery of visual function may have contributed neuroprotective activity of the drug FDP by a protective effect on nerve tissue, reducing the effects of hypoxic stress.Conclusions. The use of standard therapy in combination with FDP in the treatment of ocular ischemic syndrome has a positive effect on the course of the disease, thereby, increase of visual acuity, a decrease in sectoral loss in vision fields, the positive dynamics OCT parameters, improving hemodynamic parameters at Doppler imaging in dynamics.

SIMULTANEOUS LAPAROSCOPIC SURGERY IN GYNECOLOGY AND SURGERY

The presence of many patients with combined pathology, which according to the WHO is 30-40%, confronts surgeons and gynecologists the problem of possibility of simultaneous correction of this pathology. Relevant is the question of the necessity and safety of invasive techniques, both classic and minimally invasive, using the endosurgical techniques.

CREATION OF THE INFORMATIONAL MODEL OF TOXIC MYOCARDITIS OCCURRED UNDER THE INFLUENCE OF PESTICIDES

Creation of productive knowledge is important whereas on the base of this knowledge we can diagnose morphologic and morphometric properties of vascular stromal tissues of myocardium under toxic myocarditis on the bases of clinical symptoms. Consequence of this is a proper therapeutic strategy that will have a life importance for the patients.

TREATMENT OF DIAPHYSEAL FRACTURES OF THE METACARPAL BONES

Presented the experience of the application of stable osteosynthesisby three Kirschner wires on diaphyseal fractures of the metacarpal bones at 74 patients.Indications for osteosynthesiswas opened (6%), closed (94%), non-united, mal-unitedfractures and false joints of metacarpal bonesdiaphysis. Patients were performed intraosseous anesthesia atdistal epimetaphysisarea of radial bone.Describeda method of operation extramedullaryosteosynthesis using three Kirschner wires. Also,describedmethod of wedge osteotomy for full recovery of hand function. Good results were obtained in 83.1% of patients, satisfactory at 13.6%, and unsatisfactory results in 3.4% of patients

Positive predictive value of CEA and Ca19-9 as tumor markers for recurrent colorectal cancer in cases where conventional work-up fail to localize disease.

Introduction: Routine surveillance of colorectal cancer includes serial measurements of CEA levels. Although not routinely indicated Ca 19-9 is also a tool for recurrence. When any of these serum markers is elevated during follow up, this could represent a recurrence. The management of elevated tumor marker levels include clinical exams, endoscopy and conventional imaging –ultrasound, CT, MRI.Objective: To evaluate the positive predictive value of CEA and Ca19-9 as tumor markers for recurrent colorectal cancer in cases where conventional imaging and endoscopic studies fail to localize disease.Materials and methods: A total of 75 patients with elevated CEA and/or Ca19-9 serum levels and negative endoscopic exam as well as negative abdominal CT and Chest X-ray were included in the study. CEA levels were tested in 50 patients. Ca 19-9 was tested in 65 patients. 34 of the patients had both markers tested. All patients underwent whole body 18F-FDG PET/CT. Patients with negative of equivocal PET scan were further followed up (10 to 24 months).Results: Based on the reference standard – the results from PET/CT, if positive and the results from follow-up in cases of negative or equivocal scans, the positive predictive value of Ca 19-9 was 84% and that of CEA -83%. There was no significant difference in the PPV of Ca19-9 and CEA.Conclusion: Elevated CEA and Ca 19-9 levels in patients under active surveillance after operation for colorectal cancer have high positive predictive value for recurrence, even in cases where conventional work-up – endoscopy and CT don’t localize disease.

THE ROLE OF PATIENTS IN THE MANAGEMENT OF CHRONIC DISEASES: RESULTS OF THE FOCUS-GROUP STUDY

The management of chronic diseases shall be considered a priority in the work of the global international institutions, which are related to health policies. In the search for effective and efficient solutions for the treatment of chronic diseases, scientists are developing different programs. In Bulgaria the continuous monitoring of chronically ill people is defined with the term dispensarization. The objective of the research is to analyze the place and the role of patients in the monitoring of their chronic diseases and how the concept of quality of life relates to this process.Method The research in focus groups is planned within a research project on the monitoring of chronic diseases. Five group discussions were held. The number of participants in all focus groups was sixty.Results The two discussed directions - the active role of the patient and the focus on the results are weak links in the current organization of the care for the chronically ill people. The topic of creating and adopting an Act of the patient was also presented, in which to be paid attention to the evaluation of the quality of life. In general was brought the need for a clear delineation of the roles and the competencies of everyone involved in the monitoring process of chronic diseases. The chronic disease cannot be defined only as a medical problem, as there are economic and social, including political consequences.Conclusions The management of the chronic disease requires coordination of doctor-patient interaction, a model of partnership and trust in the relations, self-management of the condition by the patients and their inclusion in the health team. The most important step to achieve this goal is the education of the patients, increasing their knowledge and motivation, psycho-emotional support, instilling hope and faith in the capacity of the patients.

Psychometric evaluation of Arabic version of Self- Esteem, Psychological Well-being and Impact of weight on Quality of life questionnaire (IWQOL-Lite) in female student sample of PNU

Purpose: Usually any research survey can produce better results if it is utilized in local language. The study aimed to measure the inter-consistency, reliability and validity of three measures in Arabic language. Current study is phase I of research project to validate the measures in Arabic language.Material and Method: These three valuable and most widely used scales, Rosenberg self-esteem scale, brief psychological well-being scale and impact of weight on quality of life questionnaire were translated in Arabic language by adapting standard procedure of translation. Data was gathered from female students (N=500) enrolled in bachelors program during the period of November 2014-October 2015.Results: Reliability of the scale was calculated using Cronbach alpha. Psychological well-being scale was found having high reliability of 0.92, whereas, Rosenberg self-esteem scale and Impact of weight on quality of life questionnaire was found having acceptable range of reliability (0.72). All the sub scales of IWQOL-Lite reliability ranges from 0.87-0.95. Three of the scales were found having good content and construct validity.Conclusion: Findings shows that these scales being employed in this study is reliable instrument for measurement of the constructs of interest in Arabic version.