Навчально-науковий медичний інститут (НН МІ)
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Item PWE-50 Dependence of BMI on c677t and a1298c polymorphisms of methyl entrahydrafolatreductase-gene in patients with non-alcoholic-fatty-liver-disease(BMJ Publishing Group Ltd, 2021) Abdul-Rahman, T.; Wireko, A.A.; Кучма, Наталія Григорівна; Kuchma, Nataliia Hryhorivna; Obinna, S.A.Introduction Non-alcoholic fatty liver disease (NAFLD) occurs in almost 50% of the adult population and is the cause of liver dysfunction in developed countries. The widespread use of overweight makes the problem of NAFLD relevant among both adults and children. The vast majority of patients with NAFLD are overweight and obese, which increases the risk of developing atherosclerosis, hypertension and type 2 diabetes and accelerates the progression of pathological changes in the liver. Genes associated with the onset and progression of liver disease and obesity are widely studied today. There is evidence that the methylenetetrahydrofolate reductase (MTHFR) gene affects the development and progression of NAFLD and hyperhomocysteinemia, associated with allelic polymorphism of this gene affects the development of pathological changes in the liver and in the body as a whole. Aim The aim of our study was to investigate the dependence of BMI on C677T and A1298C polymorphisms of the MTGFR gene in patients with NAFLD. Method We monitored 110 patients with NAFLD. The diagnosis of NAFLD was made on the basis of laboratory and instrumental methods of examination. The calculation of BMI was performed according to the formula Kettle - weight (kg)/height (m)2. Determination of allelic polymorphism was performed by PCR with detection of results by hybridization-fluorescence method in real time. Results As a result of our studies, we found that carriers of genotypes C677C, C677T and T677T of the MTGFR gene had BMI values of 34.7 ± 3.6, 37.9 ± 3.8 and 39.7 ± 3.2 kg/m2. We found that patients carrying the T-allele (C/T and T/T genotypes) had significantly higher BMIs compared to homozygotes for the main C-allele (C/C genotype). Studying the frequency of genotypes by A1298C polymorphism of the MTGFR gene depending on BMI, it was found that carriers of genotypes A1298A, A1298C and C1298C had BMI values of 37.1 ± 4.1, 36.6 ± 4.2 and 36.9 ± 3.8 kg/m2 in accordance. We did not find a significant difference in the frequency distribution of genotypes by A1298C polymorphism depending on BMI. Conclusions BMIs are favorably associated with the frequency of genotypes by the C677T polymorphism of the MTGFR gene and do not have such an association with the frequency of genotypes by the A1298C polymorphism of the MTGFR gene.Item Elective surgeries during and after the COVID-19 pandemic: Case burden and physician shortage concerns(Wolters Kluwer, 2022) Mehta, A.; Awuah, W.A.; Ng, J.C.; Kundu, M.; Yarlagadda, R.; Sen, M.; Nansubuga, E.P.; Abdul-Rahman, T.; Hasan, M.M.The COVID-19 pandemic had a significant impact on several aspects of global healthcare systems, particularly surgical services. New guidelines, resource scarcity, and an ever-increasing demand for care have posed challenges to healthcare professionals, resulting in the cancellation of many surgeries, with short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides and the healthcare system attempts to reestablish a sense of normalcy, surgical recommendations and advisories will shift. These changes, combined with a growing case backlog (postponed surgeries + regularly scheduled surgeries) and a physician shortage, can have serious consequences for physician health and, as a result, surgical care. Several initiatives are already being implemented by governments to ensure a smooth transition as surgeries resume. Newer and more efficient steps aimed at providing adequate surgical care while preventing physician burnout, on the other hand, necessitate a collaborative effort from governments, national medical boards, institutions, and healthcare professionals. This perspective aims to highlight alterations in surgical recommendations over the course of the pandemic and how these changes continue to influence surgical care and patient outcomes as the pandemic begins to soften its grip.Item Investigating discrepancies in demand and access for bariatric surgery across different demographics in the COVID-19 era(Wolters Kluwer, 2022) Mehta, A.; Awuah, W.A.; Kalmanovich, J.; Huang, H.; Tanna, R.; Iqbal, D.J.; Garg, T.; Bulut, H.I.; Abdul-Rahman, T.; Hasan, M.M.Obesity affects over 650 million adults worldwide and increases the risk of cardiovascular events, diabetes, and hypertension. While lifestyle recommendations are popular management options, bariatric surgery has emerged as a standard of care in refractory cases, reported to cause at least a 30% reduction in mortality. In addition, it mitigates obesity-related complications leading to a significant improvement in the quality of life for morbidly obese patients (BMI >40). Despite the numerous benefits, demand and access to bariatric surgery vary across different demographics such as age, gender, and socioeconomic status. This demand and access were further reduced due to the COVID-19 pandemic. This has resulted in cancellations of elective surgeries such as weight loss procedures and promotes a sedentary lifestyle which has short-term and long-term detrimental consequences on the health of obese patients. In the context of the prevalent epidemiological trends, this reduction in bariatric services will disproportionately affect the elderly, males, low SES, and African Americans. This editorial highlights the prevalent discrepancies in demand and access to bariatric surgery amidst the COVID-19 pandemic, and possible recommendations to improve overall access and utilization of bariatric services in morbidly obese patients belonging to all demographics.Item Vulnerable in silence: Paediatric health in the Ukrainian crisis(Wolters Kluwer, 2022) Awuah, W.A.; Ng, J.C.; Mehta, A.; Yarlagadda, R.; Khor, K.S.; Abdul-Rahman, T.; Hussain, A.; Kundu, M.; Sen, M.; Hasan, M.M.The Russian invasion of Ukraine is a humanitarian disaster. It has a wide-ranging impact on the livelihood and the health of those affected by the war. In the midst of constant shelling and casualties, children are more vulnerable to injuries, infections, malnutrition, and trauma, all of which can have serious consequences for their physical and mental health. Children, unlike adults, are simply subjected to the horrors of war with no pre-existing ability to deal with the consequences. We hope to highlight the effects of the current Ukrainian war on the health of the paediatric population, with a particular emphasis on surgical care, cancer care, infectious disease, to name a few. We hope to help contextualize future data and encourage the development of a system to protect and serve the war's most vulnerable population.Item Embracing robotic surgery in low- and middle-income countries: Potential benefits, challenges, and scope in the future(Wolters Kluwer, 2022) Mehta, A.; Ng, J.C.; Awuah, W.A.; Huang, H.; Kalmanovich, J.; Agrawal, A.; Abdul-Rahman, T.; Hasan, M.M.; Сікора, Владислав Володимирович; Sikora, Vladyslav Volodymyrovych; Isik, A.Robotic surgery has applications in many medical specialties, including urology, general surgery, and surgical oncology. In the context of a widespread resource and personnel shortage in Low- and Middle-Income Countries (LMICs), the use of robotics in surgery may help to reduce physician burnout, surgical site infections, and hospital stays. However, a lack of haptic feedback and potential socioeconomic factors such as high implementation costs and a lack of trained personnel may limit its accessibility and application. Specific improvements focused on improved financial and technical support to LMICs can help improve access and have the potential to transform the surgical experience for both surgeons and patients in LMICs. This review focuses on the evolution of robotic surgery, with an emphasis on challenges and recommendations to facilitate wider implementation and improved patient outcomes.Item The paradoxical role of cytokines and chemokines at the tumor microenvironment: a comprehensive review(Springer Nature, 2024) Abdul-Rahman, T.; Ghosh, S.; Badar, S.M.; Nazir, A.; Bamigbade, G.B.; Aji, N.; Roy, P.; Kachani, H.; Garg, N.; Lawal, L.; Bliss, Z.S.B.; Wireko, A.A.; Atallah, O.; Adebusoye, F.T.; Теслик, Тетяна Петрівна; Teslyk, Tetiana Petrivna; Сікора, Катерина Олексіївна; Sikora, Kateryna Oleksiivna; Горбась, Вікторія Анатоліївна; Horbas, Viktoriia AnatoliivnaДана стаття представляє комплексний огляд щодо ролі цитокінів і хемокінів у мікрооточенні пухлини. Для онкологів, терапевтів, імунологів, сімейних лікарів, імунологів. Прогресування та ліквідація пухлини вже давно викликають інтерес наукової спільноти. Нещодавні відкриття про роль хемокінів і цитокінів у цих процесах викликали новий інтерес до відповідних досліджень. Ці ролі часто розглядаються як спірні через їхню здатність як пригнічувати, так і сприяти прогресуванню раку. Як наслідок, у цьому огляді критично оцінено наявну літературу для обговорення унікальної ролі цитокінів і хемокінів у мікрооточенні пухлини, а також існуючих проблем і майбутніх можливостей використання цих ролей для розробки нових цільових методів лікування. Хоча ці модулюючі молекули відіграють важливу роль у пригніченні пухлини за допомогою посиленої ідентифікації ракових клітин цитотоксичними ефекторними клітинами та безпосереднього рекрутування імунологічних ефекторних клітин і стромальних клітин у ТМЕ, ми спостерігали, що вони також сприяють проліферації пухлини. Багато цитокінів, у тому числі GM-CSF, IL-7, IL-12, IL-15, IL-18 та IL-21, почали клінічні випробування для людей із пізніми стадіями раку, тоді як FDA схвалило інтерферон-альфа та IL- 2. Тим не менш, низька ефективність і токсичність, що обмежує дозу, обмежують повний потенціал цих агентів. І навпаки, хемокіни мають величезний потенціал для збільшення проникнення ракових імунних клітин у мікрооточення пухлини та сприяння корисним імунологічним взаємодіям. Коли хемокіни поєднуються з цитокінами, вони активують лімфоцити, виробляючи IL-2, CD80 та IL-12, усі з яких мають сильний протипухлинний ефект. Це явище відкриває двері для розробки ефективних протипухлинних комбінованих терапій, таких як терапія, яка може повернути назад розвиток раку, і хемотаксис імуносупресивних клітин.Item Development of zinc deficiency in children with a course of community-acquired pneumonia(Frontiers Media SA, 2022) Abdul-Rahman, T.; Wireko, A.A.; Горбась, Вікторія Анатоліївна; Horbas, Viktoriia AnatoliivnaHealth represents an unconditional value for every child. However, improper nutrition, lack of sleep and unfavorable environmental situation reduces the quality of life contributing to increase in the number of diseases. Zinc (Zn) is the main trace element that regulates activity of the immune system. It also affects the body’s resistance, reproduction processes and death of microor-ganisms, especially during inflammation. The aim is to study the relationship between trace element of Zn content in blood serum and indicators of immune status in children with pneumonia. Blood content among 55 children diagnosed with community-acquired pneu-monia in Sumy Children’s Clinical Hospital were analyzed. Indicators of Zn level in children with pneumonia, regardless of age and severity of the disease, were reduced in both acute and convalescence peri-ods of the disease. Correlative analysis showed that the level of Zn in blood serum during the acute period in children with pneumonia had a negative average correlation with the level of blood leukocytes , and average positive relationship with the number of lymphocytes in peripheral blood. The levels of leukocytes and lymphocytes had a clear dependence on severity of the course of the disease. Higher levels of leukocytosis corresponded to a significant decrease in the absolute number of lymphocytes and increased severity of condition of the children. The impact of impaired Zn metabolism in the body during pneumonia on development of the body’s immune response after antigenic stimulation is of significant importance, which is manifested by significant disintegrating changes in immune homeostasis.Item Inaccessibility and low maintenance of medical data archive in low-middle income countries: Mystery behind public health statistics and measures(Elsevier Ltd, 2023) Abdul-Rahman, T.; Ghosh, S.; Lukman, L.; Bamigbade, G.B.; Oladipo, O.V; Amarachi, O.R.; Olanrewaju, O.F.; Toluwalashe, S.; Awuah, W.A.; Aborode, A.T.; Lizano-Jubert, I.; Audah, K.A.; Теслик, Тетяна Петрівна; Teslyk, Tetiana PetrivnaAfrica bears the largest burden of communicable and non-communicable diseases globally, yet it contributes only about 1 % of global research output, partly because of inaccessibility and low maintenance of medical data. Data is widely recognized as a crucial tool for improvement of population health. Despite the introduction of electronic health data systems in low-and middle-income countries (LMICs) to improve data quality, some LMICs still lack an efficient system to collect and archive data. This study aims to examine the underlying causes of data archive inaccessibility and poor maintenance in LMICS, and to highlight sustainable mitigation measures. Method Authors conducted a comprehensive search on PubMed, Google scholar, organization websites using the search string “data archive” or “medical data” or “public health statistics” AND “challenges” AND “maintenance” AND “Low Middle Income Countries” or “LMIC”. to Identify relevant studies and reports to be included in our review. All articles related data archive in low and middle income countries were considered without restrictions due to scarcity of data. Result Medical data archives in LMICs face challenges impacting data quality. Insufficient training, organizational constraints, and limited infrastructure hinder archive maintenance. To improve, support for public datasets, digital literacy, and technology infrastructure is needed. Standardization, cloud solutions, and advanced technologies can enhance data management, while capacity building and training programs are crucial. Conclusion The creation and maintenance of data archives to facilitate the storage of retrospective datasets is critical to create reliable and consistent data to better equip the development of resilient health systems and surveillance of diseases in LMICs.Item Concern over Nipah virus cases amidst the COVID-19 pandemic in India(Willey, 2022) Aborode, A.T.; Wireko, A.A.; Mehta, A.; Abdul-Rahman, T.; Nansubuga, E.P.; Kundu, M.; Pustake, M.; Mehmood, Q.; Tillewein, H.Nipah virus, a member of the paramyxoviridae family, is classified as a“virus of concern” by the World Health Organization (WHO).1,2 Nipahvirus is usually reported in Southeast Asia due to the geographicalprevalence of its natural host, thePteropusfruit bat.1,3It is a zoonoticinfection transmitted by direct contact with infected animals or viabodily secretions such as bat blood, saliva, and urine. The virus alsodemonstrates human–human transmission.4Nipah virus infectiongenerally affects the central nervous system in human hosts, causinginflammation of brain parenchyma (encephalitis) and can also causerespiratory symptoms.3Initial symptoms include fever, headache, later progressing to drowsiness, altered mental status, coma, andeven death.5As reported by Kenmoe et al. Nipah virus encephalitishas a pooled case fatality rate of 61%.6The current managementincludes symptomatic treatment due to lack of specific pharmaco-logical treatment for Nipah virus.