Therapeutic efficacy of the drug Simparica® for demodicosis in dogs in the Kamianets-Podilskyi, Ukraine

The purpose of our research was to test the therapeutic efficacy of the acaricide «Simparica®» in combination with the biostimulator «Catosal» and the hepatoprotector «Tioprotectin» for demodicosis in dogs in the conditions of veterinary clinics in the Kamianets-Podilskyi, Ukraine. The study has been performed on dogs of different genders, ages and breeds that had a generalized form of demodicosis (affected at least 6 areas on the body of animals), to test the effectiveness of this drug in different treatment schemes. Acarological studies of scrapings from the skin of experimental animals for the presence of live or dead mites Demodex canis or their eggs have been carried out by the vital method according to D.O. Pryselkova. As a result of the conducted researches the choice of acaricidal drugs and development of complex therapeutic measures for demodicosis of dogs has been experimentally substantiated. The drug «Simparica®» has proved to be quite effective against demodicosis of dogs, even with a single use. The dependence of the effectiveness of the use of prolonged acaricide «Simparica®» on clinical forms of demodicosis has been shown. The absolute therapeutic effect of acaricide is obtained in the scaly form of demodicosis. However, in pustular and mixed clinical forms of demodicosis, its effectiveness decreased to 71.4 and 57.1%, respectively. In combination with the drug of pathogenetic therapy «Catosal» for pustular and mixed forms of demodicosis, the therapeutic efficacy of the drug «Simparica®» increases to 85.7%. When added to the scheme of hepatoprotector “Thioprotectin”, it is possible to achieve 100% therapeutic effect in pustular forms of demodicosis. However, in severe mixed form of demodicosis, the effectiveness was not absolute and was only 85.7%. In case of generalized demodicosis of dogs, regardless of clinical forms, it is recommended to use the acaricide «Simparica®» in combination with the drug «Catosal» and in the combination of «Catosal» and «Thioprotectin».

A critical analysis of the ten-year experience of using endoscopic transpapillary interventions in an urgent surgical hospital

The aim of this work was to provide a critical analysis of the ten-year experience of using transpapillary interventions in an urgent surgical hospital with a detailed study of all groups of registered complications.Material and methods. In the period from 2008 to 2018, 1188 retrograde endoscopic transpapillary grafts were performed on the bile ducts with dissection of the major duodenal papilla in a typical and atypical way on the basis of our clinic. The group of observed patients included 1188 patients with endoscopic papillosphincterotomy, including 839 women (70.6%) and 349 men (29.4%). The average age was 63.2 ± 1.25.Results. During the period, 25 complications (2.1%) were revealed when performing transpapillary interventions with dissection of the major duodenal papilla: acute pancreatitis — 10 patients (0.8%); bleeding from the opening of the major duodenal papilla — 4 (0.33%), perforation 12p. intestines — 4 (0.33%), breakage of the basket cable with wedging — 1 (0.08%), cholangitis — 1 (0.08%), overlapping with a stent of the lobar duct — 1 (0.08%). The overall mortality associated with complications is 0.25%. Based on the analyzed material, the iatrogenic index was calculated. It was 0.044. After the analysis of complications, on the basis of the data obtained, we proposed an algorithm of actions when performing transpapillary interventions.Conclusion. Based on the study, we come to the conclusion that it will not be possible to completely level the risk and avoid possible papillotomic-induced complications. In this regard, the early, preferably intraoperative diagnosis of the latter and the prompt implementation of correlating therapeutic measures are of great importance, which will undoubtedly improve the treatment results and have a positive eff ect on the outcome of the disease.

Possibilities of conservative treatment of patients with lymphedema of the extremities (literature review)

The literature review describes various methods for treating patients with lymphedema of the extremities. Statistics show an increase in the incidence and disability of patients with this pathology. However, the possibilities of therapeutic measures in lymphedema are far from perfect.The analysis of literature data showed that the basis of treatment for lymphedema of the extremities is comprehensive conservative therapy with the use of pathogenetically grounded physical, mechanical, and medical methods. In complex schemes of conservative treatment for lymphedema, physiotherapy methods occupy a prominent place. The most common technique among them is regular combined decongestive therapy. This method is recognized by leading experts as the main one in treating patients with lower extremity lymphedema. Commitment of patients to treatment and their social and psychological counseling are of great importance. The choice of the volume and method of surgical intervention requires a difficult and individual assessment of pathological changes developing throughout the course of the disease.Despite certain improvements in treatment methods, lower extremity lymphedema is still an unsolved issue. The experience of most specialists involved in lymphedema treatment demonstrates a reasonable balance between basic conservative and surgical treatment methods. Undoubtedly, results of evaluation of these methods will improve the choice of an optimal technique for treating patients with lymphedema of the extremities.

Antioxidant status in children and adolescents with COVID-19

Background. The COVID-19 pandemic has raised the importance of this problem to the first stage and has affected healthcare system around the world. Despite the more favorable COVID-19 course, the child population should be at focus of special attention, due to the active participation in its distribution. The course of COVID-19 includes a cascade of pathological processes accompanied by the generation of reactive oxygen species, which can have extremely negative consequences for the developing organism. The research of these processes in children is vital and will improve the effectiveness of preventive and therapeutic measures. The aim: to analyze changes in enzymatic and non-enzymatic links in the antioxidant defense in children and adolescents with diagnosed COVID-19 infection.Materials and methods. 17 children and adolescents (average age – 12.35 ± 4.01 years) were examined, including 8 boys (47 %) and 9 girls (53 %) with COVID-19 infection. The control group of children and adolescents (practically healthy) according to the «copy-pair» principle was selected. We used spectrophotometric methods.Results. In the group of children and adolescents with diagnosed COVID-19 infection, there were lower levels of total antioxidant activity (p < 0.0001), superoxide dismutase activity (p < 0.0001), content of reduced glutathione (p = 0.048) and retinol (p = 0.015), increase in glutathione reductase activity (p = 0.015) relative to the control.Conclusion. The obtained data indicate the insufficiency of antioxidant system components number in children and adolescents with diagnosed COVID-19 infection and indicate the advisability of antioxidant therapy using to stabilize these indicators.

Comparative characteristics of different methods of treatment of microsporia

Microsporia is the most common disease of fungal etiology, most often caused by the pathogen Microsporum canis. Treatment of this disease requires a comprehensive approach, because the disease is dangerous to humans. Therefore, in the treatment of microspores, it is important not only to carry out therapeutic measures, but also to prevent the spread of the pathogen of the fungus in the environment and increase the immune status of the organism in the fight against infection. The main source of infection is cats. In order to determine the effectiveness of treatment of microsporia by various methods, studied of the blood and skin of guinea pigs infected with the pathogen M. canis. Sick animals were divided into three groups. The first group was treated with the systemic antifungal itraconazole and topical treatment with a solution of clotrimazole. Treatment of the second group was performed with a topical antifungal agent (1% solution of clotrimazole) with vaccination with the antifungal vaccine “Vakderm”. For the third group, the developed drugs were used – antifungal agent “Micromar” and immunostimulant “Biogluk”. During treatment, hematological and immunological blood researches and histological skin examinations were performed. During treatment with antifungal drugs (itraconazole and clotrimazole) the number of leukocytes decreases from 11.13 ± 0.72 to 7.13 ± 0.22, rod-shaped neutrophils from 15.76 ± 1.29 to 5.50 ± 0.76, and segmental increases from 12.17 ± 1.47 to 24.17 ± 2.27, decreases ESR from 5.67 ± 0.67 to 2.33 ± 0.42, which occurs when inhibiting the inflammatory response of the organism to infection. Thrombocytopenia (from 231.17 ± 7.60 to 184.33 ± 7.65) and eosinophilia (from 2.70 ± 0.73 to 7.33 ± 1.33) are also noted. There is a slight increase in T-helpers and a decrease in T-suppressors. Histologically, the infiltration of the dermis by histiocytes and eosinophils under skin persists. In the treatment of microsporia by treatment with 1 % solution of clotrimazole and vaccination with the vaccine “Vakderm” the results of studies showed that the number of leukocytes decreases from 11.13 ± 0.72 to 5.35 ± 0.31 (P < 0.01), rod-shaped neutrophils from 15.76 ± 1.29 to 7.67 ± 0.56, and segmental increases from 12.17 ± 1.47 to 22.17 ± 0.91 (P < 0.001), decreases). The number of T-helpers is increasing. The histological picture on day 7 is characterized by hyperkeratosis, and on day 14 the hyperemia of the basal layer of the epidermis persists. When using the antifungal drug “Micromar” and immunostimulant “Biogluk” the results of studies showed that the number of leukocytes decreases from 11.13 ± 0.72 to 6.95 ± 0.10, rod-shaped neutrophils from 15.76 ± 1.29 to 6.17 ± 0.65, and segmental increases from 12.17 ± 1.47 to 22.00 ± 0.86, decreases ESR from 5.67 ± 0.67 to 2.17 ± 0.31. Increases the number of T-helpers and the number of natural killers and T-suppressors is gradually decreasing. Histological changes are presented in the form of dilation of blood vessels and visualization of single erythrocytes in the dermis on day 14 of treatment.

CLINICAL EVALUATION OF MEDADUSTI IN PRAMEHA W.S.R. TO ITS THERAPEUTIC MEASURES WITH MUSTAK

Introduction: Agni (digestive and metabolic energy) is the main factor for digestion and metabolism. Meda (a type of body tissue i.e., fats) is formed from the Mamsa (a type of body tissue i.e., muscle) with its own Ushma (heat) in addition to the Snigdhatva (unctuousness) & Dravadtva Guna (liquidity) of Apa Mahabhuta (one of the fundamental components of this universe i.e., water). Due to impairment of Dhatvagni (metabolic energy), Medadusti (impair- ment of fats) takes place and in turn may result in Prameha (diabetes mellitus), Sthaulya (obesity) etc. Prameha is one of the leading diseases in the present era. The aggravated Kapha afflicts Meda, Mamsa and Kleda (moisture elements of the body) and in due course of time, Kaphaja Meha (a type of Prameha) is converted into Pittaja Meha (a type of Prameha), followed by Vataja Meha (another type of Prameha) if not treated properly. Aim: The present study was carried out to evaluate the concept of Meda and the role of Medadusti in the pathogenesis of Prameha along with the efficacy of the selected drug Mustak (Cyperus rotundus Linn.) to combat the situation. Material & Methods: In selected 35 patients of Prameha having the Medadusti Lakshan based on inclusion and exclusion criteria, Mustak (Cyprus rotundus Linn.) was administered in stipulated dose (12 grams in two divided doses with plain warm water) for two months. Result: The subjective parameters for Medadusti is clinically present in a max- imum number of Prameha patients. The result also reveals the significant efficacy of Mustak on relevant subjective and objective parameters with a 'p-value <0.001 in all subjective and objective parameters. Conclusion: The Nidan (aetiology) of Medadusti has a definite role to cause Prameha. In all the patients of Prameha, Medadusti Lakshan (features of impaired fatty tissue) is clinically present. The patients suffering from Prameha can be treated with the drug response to arrest the Medadusti like Mustak. Keywords: Medadusti, Mustak, Prameha

STRENTHENING BY DIVIDING: TREATMENT OF GRADE III FURCATION INVOLVEMENT WITH PLATELET RICH FIBRIN

The modern dentistry has provided opportunity to the patient to increase the longevity of functional dentition. Therapeutic measures may vary in the complexity of the teeth. The treatment may involve combination of restorative dentistry, endodontics, and periodontics

Therapeutic physical factors in restorative treatment of patients with nonalcoholic steatohepatitis combined with biliary sludge

Purpose of the study. To study the effectiveness of restorative treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge at the inpatient stage when low-mineralized mineral water and preformed peloid therapy are included in the basic scheme. Material and methods. A total of 119 patients with nonalcoholic steatohepatitis in combination with biliary sludge were observed and distributed into 3 randomized groups: in the main group, 39 patients received basic drug therapy in accordance with the Federal Clinical Recommendations, «Sernovodskaya» mineral water for ingestion and in the form of gallbladder cleanse, and preformed application peloid therapy; in the comparison group, 40people received only pharmacotherapy and balneotherapy, in the control group — pharmacotherapy. The control of the effectiveness of the treatment was carried out according to the dynamics of clinical, biochemical and functional studies. Results. The inclusion of medium-mineralized mineral water «Sernovodskaya» in the form of drinking treatment and cleanse and preformed peloid therapy in the complex of therapeutic measures for patients provides a significant decrease in the intensity of clinical manifestations by 54.4% versus 40% with the use of pharmaco- and balneotherapy and 28,8% — with only drug therapy; cytolysis and cholestasis syndromes — by 46,2; 39,8 and 28.9%, respectively. Restoration of the contractile function of the gallbladder is observed in 78,8% of cases versus 65.6% when using only pharmacotherapy. The duration of hospitalization in the main group was reduced by 3 days, and in the comparison group — by 1,5 days, compared with the indicators in the control group. Conclusion. The developed new medical technology for the treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge with the combined use of mineral waters and preformed peloid preparations against the background of basic pharmacotherapy at the inpatient stage provides a significant increase in the efficiency of therapeutic measures.

Modern approaches to the treatment of joint pathology: the value of hyaluronic acid

Патология опорно-двигательного аппарата и остеоартрит в частности остаются частой причиной обращения за медицинской помощью в амбулаторном звене. Среди разных суставов самым страдающим считается коленный – на него приходится до 25% всех поражений опорно-двигательной системы, что связано с его опорной функцией и частым травматическим поражением. Рост популярности активного отдыха, развитие игровых и экстремальных видов спорта приводят к росту частоты травм коленного сустава, связочного аппарата, а также внутрисуставных повреждений. Именно травматизация признается одной из ведущих причин последующего остеоартрита. Статья предлагает краткие алгоритмы диагностики и терапии остеоартрита для применения на амбулаторно-поликлиническом этапе оказания медицинской помощи. Уделено внимание применению препаратов гиалуроновой кислоты, проведен анализ литературных данных, оценены перспективы применения подобной терапии в комплексе лечебных мероприятий. Гиалуроновая кислота является натуральным компонентом синовиальной жидкости, она служит в качестве смазки суставных поверхностей и обеспечивает ряд защитных и регуляторных эффектов. Вводимая извне гиалуроновая кислота берет на себя нагрузку, восполняя недостающие функции синовиальной жидкости, что и позволяет считать такое применение протезированием недостаточной функции сустава. Препараты гиалуроновой кислоты — быстродействующие локальные средства для улучшения функции пораженного сустава и купирования болевого синдрома, что важно для поддержания активности пациентов. Данные эффекты обусловлены реологическими особенностями гиалуроновой кислоты, которые позволяют не только улучшить смазывающие свойства и скольжение в пораженном суставе, но и обеспечивают защиту суставного хряща от ударных нагрузок. Полученная промышленным способом гиалуроновая кислота уже более 30 лет успешно применяется в лечении остеоартрита. Pathology of the musculoskeletal system and osteoarthritis, in particular, remain a frequent reason for seeking outpatient care. Among the various joints, the knee joint is considered the most affected - it accounts for up to 25% of all lesions of the musculoskeletal system, which is associated with its supporting function and frequent traumatic injury. The growing popularity of outdoor activities, the development of playing and extreme sports leads to an increase in the frequency of injuries of the knee joint, ligamentous apparatus, as well as intra-articular injuries. It is traumatization that is recognized as one of the leading causes of subsequent osteoarthritis. The article offers brief algorithms for the diagnosis and treatment of osteoarthritis for use at the outpatient stage of medical care. Attention is paid to the use of hyaluronic acid preparations, an analysis of the literature data is carried out, the prospects for the use of such therapy in a complex of therapeutic measures are assessed. Hyaluronic acid is a natural component of synovial fluid that serves as a lubricant for articular surfaces and provides a range of protective and regulatory effects. Hyaluronic acid introduced from the outside takes on the load, replenishing the missing functions of the synovial fluid, which allows us to consider such use as prosthetics of insufficient joint function. Hyaluronic acid preparations are a fast-acting local remedy to improve the function of the affected joint and relieve pain, which is important to keep patients active. These effects are due to the rheological features of hyaluronic acid, which not only improve lubricating properties and sliding in the affected joint, but also protect the articular cartilage from shock loads. The industrially obtained hyaluronic xylote has been successfully used in the treatment of osteoarthritis for more than 30 years.

Improving the Effectiveness of Therapeutic Measures for Generalized Periodontitis in Patients with Hypertension

The program of standard therapeutic measures in 45 patients with Generalized Chronic Periodontitis (GCP) and background hypertension, group I(a), included hirudotherapy, for comparison, the effectiveness of traditional treatment was evaluated in 40 patients, group I(b), who refused to use medical leeches. In the second comparison group (35 patients), patients with GCP, but normal blood pressure, also received only a set of traditional methods of treatment. The inclusion of hirudotherapy in the program of therapeutic measures in patients with GCP and hypertension makes it possible to optimize the onset of a persistent therapeutic effect, lengthen the period of remission of the pathological process in periodontal disease and significantly improves the quality of life of patients.