COMPARISON OF THE EFFECT OF DEXAMETHASONE ON THE BLOOD GLUCOSE LEVEL IN PREGNANT AND NON-PREGNANT WOMEN UNDER GENERAL ANESTHESIA

The aim: To compared blood glucose concentrations after intravenous injection of dexamethasone in the pregnant and non-pregnant women under general anesthesia. Materials and methods: Eighty patients aged 18-50 years took part in the study (ASA class 1 and 2). Forty of patients were undergoing elective cesarean section under G/A and the other forty undergoing elective laparoscopic Cholecystectomy under G/A. Anesthesia was induced using IV anesthetic drugs (0.5mg/kg ketamine, sleeping dose of propofol up to 2mg/kg, muscle relaxant was 0.6 mg/kg rocuronium and maintained with isoflurane). All of patients have been injected with 0,1mg/kg dexamethasone intravenously, at induction of anesthesia, Blood glucose concentrations were measured at induction and then in 60min, 180min and in 360 min after injection of dexamethasone and results were compared between the groups; IV fluid added was normal saline (0.9%) during the study. Results: Regarding to blood glucose levels, we noticed that its level significantly increased over time and peaked in 180min after dexamethasone injection in both groups. The difference percentage between the lower reading (pre injection) and the upper reading (in 180min after) was 33.5% in pregnant woman and 46.2%for non-pregnant women, this difference was statistically significant relative to the pre injection, as this difference was lower in the pregnant women. In 360min after blood glucose level began to drop in both groups. After giving 0.1 mg/kg of dexamethasone, blood glucose level increased in both groups, but it was lower in pregnant women.

FEASIBILITY OF CYSTATIN C DETERMINATION FOR EARLY DIAGNOSIS OF KIDNEY DAMAGE IN PATIENTS WITH TYPE 2 DIABETES COMBINED WITH NONALCOHOLIC FATTY LIVER DISEASE AND OBESITY EXPOSED TO COVID-19 INFECTION IN THE PAST

The aim: To examine the diagnostic possibilities of determining the level of cystatin C in the blood serum in order to ascertain the functional status of the kidneys in patients with type 2 diabetes (those who recovered from COVID-19 infection) depending on the presence or absence of non-alcoholic fatty liver disease (further – NAFLD) and malnutrition. Materials and methods: We investigated 18 patients with type 2 DM, who were included in the first group of the patients examined; group 2 consisted of 20 patients with type 2 DM and non-alcoholic fatty liver disease (NAFLD), namely with non-alcoholic steatohepatitis; and group 3 of the patients examined consisted of 30 patients with type 2 DM and obesity. Results: Renal damage in patients with metabolically associated diseases in the background of respiratory disease due to COVID-19 infection was also indicated by changes in urine test indicators, and namely – proteinuria and erythrocyturia, leukocyturia in urine sediment. The examination of cystatin C (Cys C) level indicates its statistically significant increase in patients of all examined groups, with the highest levels established in group 3 patients (with its increase up to 2.58 ± 0.11 mg/L, compared with the norm of 0.75 ± 0.04 mg/L in the control group – p < 0.01). The examination of GFR by calculation, where the Cys C index in serum was used, revealed a significant decrease in this parameter in all the examined groups of patients. At the same time, the maximum values were found in group 1 patients (65.7 ± 1.4 ml/min per 1.73 m2 of the body surface), and the minimum values – in group 3 patients (48.3 ± 2.7 ml/min per 1.73 m2 of the body surface). Conclusions: An increase in serum cystatin C levels was determined in type 2 diabetes patients, with the lowest level in group 1 patients (1.24 ± 0.07 mg/L – p < 0.05), and the highest level in patients suffering from type 2 diabetes combined with NAFLD and obesity (2.58 ± 0.11 mg/L – p < 0.01). A moderate to severe course of COVID-19 infection in patients with type 2 diabetes as well as with its combination with NAFLD and obesity contributes to the development of renal functional disorders in these patients. Moreover, an increase in serum Cys C levels is a more sensitive and earlier marker of renal damage development in comorbid pathology.

IMPACT OF INFECTIOUS DISEASES ON PUBERTAL TIMING IN UKRAINIAN GIRLS: RESULTS A MULTICENTER STUDY

The aim: To determine current age at the initiation of puberty for Ukrainian school-aged girls and infections impact to puberty. Materias and methods: We performed a multicentre cohort study. The analyses are based on data that were collected and evaluated biannually on Ukrainian school girls aged 6-17 years from 5 regions of Ukraine. Pubertal development was classified according to the Marshall and Tanner criteria. Results: Overall, 2,784 girls have been included in the study. Mean age of onset of puberty in Ukrainian girls was 10.1±1.0 yrs. Age of onset of pubic hair was 11.0±1.0 yrs and that of axillary hair was 11.6±1.0 yrs. Mean age in girls of menarche was 12.2±0.9 yrs. There were no significant correlations between age at onset of puberty and body mass index, final height, total peak height velocity, duration of puberty, and peak height velocity. A total of 2,420 infectious diseases were diagnosted. Of these, 64.8% were viral and 35.2% bacterial infections, respectively. Ukrainian girls with infectious diseases (especially viral infections) had older age at pubertal onset and positive association of infections in childhood with late age of menarche. Conclusions: Infectious morbidity (especially viral infections) in girls may be associated with later puberty. The lowering of the number of infections in childhood could be an additional factor that contributes to earlier puberty. To reduce infectious diseases, more attention should be paid to the vaccination of children.

EVALUATION OF PARAMETERS OF ACTUAL TYPICAL PATHOGENETIC SYNDROMES IN COMORBIDITY OF TYPE 2 DIABETES MELLITUS AND CHRONIC PANCREATITIS

The aim: To assess the state of typical pathogenetic syndromes (inflammation, endotoxicosis, liperoxidation, enzymatic and non-enzymatic antioxidant deficiency) in the comorbidity of type 2 diabetes mellitus (DM2) and chronic pancreatitis (CP). Materials and methods: We examined 137 patients (112 patients with comorbidity of CP and DM2 and 25 patients with isolated CP. Typical pathogenetic syndromes (inflammation, endotoxicosis, liperoxidation, enzymatic and non-enzymatic antioxidant deficiency) were determined. Results: It was proved that patients with CP even in the remission phase of the active course of EI and LPO, which was significantly more significant in comorbidity with DM2. Statistically significant more significant changes in the parameters of antioxidant protection in the comorbidity of CP and DM2 in relation to those in isolated CP. Conclusions: Treatment of CP and DM2 is a difficult task and should take into account the impact on the studied common typical pathogenetic syndromes – inflammation, endotoxicosis, lipid peroxidation, and enzyme and non-enzymatic antioxidant protection – to address short-term and prevent long-term complications.

BIOMECHANICAL FACTORS IN RESIDUAL LIMB FORMATION AFTER AMPUTATION

The aim: To study the influence of biomechanical factors on the character of morphological disorders in the process of reparative regeneration at the end of the residual limb after amputation. Materials and methods: 10 series of experiments on 144 rabbits were conducted. We used myodesis with normal, insufficient and excessive muscle tension, their electrical stimulation, tight and leaky closure of the bone marrow canal. Terms of observation 1, 3, 6 months. The method of research – histological with the filling of vessels with inkgelatin mixture. Results: Dense closure of the meduallary cavity and uniform muscle tension during plasty in the first three series of experiments allow to obtain a cylindrical residual limb with preservation of the cortical diaphyseal plate, formation of the bone closing plate, normalization of intraosseous microcirculation, completion of the reparative process. In the majority of observations of the IV-X series there was a reparative regeneration disorder connected with the incorrect tension of muscles and the absence of normalization of intraosseous circulation, the reparative process was not observed to be complete, which led to the pathological reorganization of bone tissue with the formation of stumps of various shapes. Conclusions: Uneven muscle tension and lack of closure of the intramedually canal except for microcirculation disorders leads to increased periosteum bone formation, formation of periosteum cartilage exostases, clavate stumps, resorption and fractures of the cortical diaphyseal plate with curvature and stump axis disorders, formation of a conical stump.

ASSOCIATION BETWEEN APE1 GENE AND LUNG CANCER IN IRAQI POPULATION

The aim: To find association between ape1 gene and lung cancer in Iraqi population. Materials and methods: This study included forty patients with lung cancer and forty people of control group, ranging in age from 40 to 65 years old. Results: The results of (Asp/Glu) genotype showed a significant (p=<0.01) higher frequency in patients than in control group carrying the (Asp/Asp). Conclusions: APE1 Asp148Glu polymorphism may bear a risk for development of the lung cancer in Iraqi patients, and the Asp/Glu genotype contributed to more often predisposal of the disease by playing an important role as increased activity of gene as a result of APE1 Asp148Glu (rs1130409) polymorphism, while Asp/Asp genotype may have a protective action against this disease.

CLINICAL AND IMMUNOLOGICAL ASPECTS OF VERIFICATION OF LATENT AUTOIMMUNE DIABETES IN ADULTS AT EARLY STAGES OF DISEASE MANIFESTATION

The aim: To establish diagnostic markers of LADA at the stage of manifestation based on the analysis of clinical and anamnestic data, the results of immunological examination of patients with different types of DM. Materials and methods: Study included 121 patients with LADA (1st (main) group), 60 patients with type 1 DM (2nd group), 81 patients with type 2 DM (3d group). The examination included analysis of complaints, medical history, determination of anthropometric data, studies of the level of antibodies to glutamic acid decarboxylase (GAD ab), cytoplasmic antigen (ICA ab), tyrosine phosphatase (IA-2 ab). Results: Criteria of LADA diagnosis included slow nature of DM course, the average age of the disease onset (45,02±9,96) years, combination of diabetic complaints with gradual weight loss, frequent detection of DM (64,46%) on request, fairly high level of glycemia at diagnosis ((14,12±4,57) mmol/l)), the possibility of ketonuria episodes in a certain amount (23,14%) of cases in the absence of acute ketoacidotic states. The presence of excess body weight and even obesity is not a criterion for excluding LADA. Conclusions: To verify the diagnosis of LADA it is necessary to study of at least two types of antibodies. The most conclusive is the determination of GAD ab and IA-2 ab.

EPIDEMIOLOGICAL ANALIYSIS OF PERTUSSIS MORBIDITY IN UKRAINE

The aim: To improve epidemiological monitoring of pertussis by analyzing the disease morbidity during 1995-2017 in Ukraine, to make a prognosis. Materials and methods: Analysis of the pertussis morbidity during 1995-2017 using the data of the Ministry of Health of Ukraine. The cyclicity was determined by Fourier spectral analysis. The models of prognosis were constructed using polyharmonic regression and an exponential smoothing algorithm. Cartographic analysis and integrated indicators (multiyear index of the prevalence rate, mean square deviation, mean the multiyear pace of the gain in the prevalence rate) were used to determine the areas of risk. Summarized data were used to calculate the generalized coefficient. Results: The pertussis morbidity cycle has 5 years intervals in Ukraine. The prognosis is for increasing the pertussis morbidity from 4.91-5.54 to 5.48-7.06 per 100.000 people. The generalized coefficient was significantly higher in western part (83.3%) than in central (50.0%) and eastern (16.6%) parts. The study showed that population reproduction rates, natural population increase, and the proportion of people against vaccination were higher in the western part than in other parts of the country. Conclusions: The pertussis cyclicity depends on the internal mechanisms of interaction in the ecological system. There is a prognosis of worsening the epidemic situation of pertussis spreading. The risk area is the western part of Ukraine, which is characterized by active demographic processes and a greater number of people who are negative about vaccination.

MATHEMATICAL MODELING OF TELEROENTGENOGRAPHIC PARAMETERS ACCORDING TO THE METHOD OF SCHWARZ A. M. DEPENDING ON THE BASIC CEPHALOMETRIC PARAMETERS IN UKRAINIAN YOUNG MEN AND YOUNG WOMEN WITH DIFFERENT FACE TYPES

The aim: Is development and analysis of regression models of teleroentgenographic indices according to Schwarz A. M., which can be adjusted during surgery depending on the parameters that usually do not change in Ukrainian young men and young women with with normal occlusion close to orthognathic occlusion and different facial types. Materials and methods: Teleroentgenographic indices were obtained using a dental cone-beam tomograph Veraviewepocs 3D Morita and studied in 49 young men and 76 young women with normal occlusion close to orthognathic. Persons were divided into groups with different face types according to the recommendations of Schwarz A. M. In the license package “Statistica 6.0”, regression models of teleroentgenographic indices were built according to Schwarz A. M. Results: For young men with orthognathic occlusion and with different types of faces according to Schwarz A. M. constructed 10 of 27 possible reliable regression models of the group of teleroentgenographic indicators, which can be corrected during surgical, orthopedic interventions in dentistry depending on the group of basic, invariable cephalometric indicators greater than 0.6 (R2 = from 0.609 to 0.996); and in young women with different face types, 8 of the 27 possible reliable regression models in which the coefficient of determination is greater than 0.6 (R2 = from 0.642 to 0.986). Conclusions: The developed regression models provide the most individualized approach in determining the method and scope of the required dental intervention.

ASSOCIATION ANALYSIS OF PIOGLITAZONE EFFECTIVENESS IN TREATMENT OF NAFLD PATIENTS WITH OBESITY AND PPARG RS1801282 (PRO12ALA) GENOTYPE

The aim: To study the association between the effectiveness of treatment with pioglitazone non-alcoholic fatty liver disease (NAFLD) in patients with obesity and PPARG rs1801282 (Pro12Ala)-polymorphism in Ukrainians. Materials and methods: 123 patients with NAFLD in combination with obesity 1, 2, 3 classes were included in comprehensive weight loss program (5 visits, 12-weeks). The case group was treated with pioglitazone 15 mg / day, while the control group received only program. Ultrasound (US) steatometry and genetic testing rs1801282 polymorphism in PPARG gene were performed. Results: Pioglitazone, PPARG rs1801282 genotype, CAP before treatment, previous weight loss attempts, and duration of obesity were associated with the change in controlled attenuation parameter (CAP) during treatment. There was a significant association between the target CAP reduction achievement and pioglitazone treatment (adjusted odds ratio 0.23, 95% CI 0.07–0.73; p = 0.01) with the CC genotype of PPARG gene (adjusted odds ratio 92.9, 95% CI 7.4–1159; p < 0.001) compared to patients with the CG genotype. Conclusions: Pioglitazone and PPARG rs1801282 polymorphism could influence on dynamics of CAP reduction during treatment.