Nvpubhouse Library for International Journal of Medical Science and Public Health Research

Dynamics Of Osteoporosis Development In Perimenopausal Women

2026-02-11T12:46:26+00:00

Osteoporosis is one of the most common diseases, which occupies a leading place in the structure of morbidity and mortality of the population. According to the WHO, osteoporosis is the fourth leading cause of disability and mortality among patients with bone fractures (only 25% of patients fully recover from a hip fracture, 50% remain disabled, and 25% die from complications). The perimenopausal period is known to be a risk factor for bone disease. We assessed the skeletal health of 62 perimenopausal women, including their complaints, clinical symptoms of menopause, hormonal status, calcium and vitamin D metabolism, and use of the transdermal gel Estrogel. Based on the data obtained, we developed a scale for assessing the clinical signs of osteoporosis in menopause. A point-based assessment of the 10 parameters studied allows us to create risk groups for bone fractures in perimenopause.

Combined Effect Of COL1A1 And EDN1 Gene Polymorphisms On The Risk Of Developing Cardiological Complications

2026-01-31T10:42:11+00:00

Background: Cardiological complications are a leading cause of adverse outcomes in patients with systemic diseases. Genetic factors, particularly those influencing myocardial structure and vascular regulation, play a significant role in individual susceptibility. Polymorphisms in the COL1A1 gene are associated with myocardial fibrosis and remodeling, while variations in the EDN1 gene are linked to endothelial dysfunction and vasoconstriction. However, the combined effect of these polymorphisms on cardiovascular risk remains underexplored.

Objective: To assess the association of COL1A1 and EDN1 gene polymorphisms with the risk of developing cardiological complications and to evaluate their combined effect on structural and vascular abnormalities.

Materials and Methods: An observational case-control study included 199 participants: 102 patients with an underlying disease (subdivided into 64 with and 38 without cardiological complications) and 97 healthy controls. Cardiological complications were diagnosed based on clinical, ECG, echocardiographic, and laboratory criteria. Genotyping of COL1A1 and EDN1 polymorphisms was performed using PCR. Statistical analysis included allele frequency comparison, odds ratios (OR), and risk stratification.

Results: Carriers of the minor A allele of COL1A1 and the Asn allele of EDN1 showed a trend toward increased risk of complications (OR=1.22, 95% CI: 0.67–2.22 and OR=1.36, 95% CI: 0.70–2.64, respectively). Combined carriage of both unfavorable alleles was associated with a higher frequency of complications and demonstrated an additive risk increase compared to isolated variants.

Conclusion: Polymorphisms in COL1A1 and EDN1 are associated with an elevated risk of cardiological complications, with combined carriage resulting in additive risk. These findings support an integrated genetic approach to cardiovascular risk prediction and may inform personalized prevention strategies.

Medical And Social Significance Of Obesity In Obstetric Practice

2026-02-11T12:46:26+00:00

The prevalence of overweight and obesity among women of reproductive age has increased significantly over recent decades and is now recognized as a global public health problem. Obesity during the pre-pregnancy period and gestation is associated with a wide range of obstetric, metabolic, and cardiovascular complications that adversely affect maternal and fetal outcomes. Excess adipose tissue contributes to insulin resistance, chronic low-grade inflammation, endothelial dysfunction, and hormonal imbalance, which increase the risk of miscarriage, gestational diabetes mellitus, hypertensive disorders of pregnancy, preeclampsia, thromboembolic events, and operative delivery. In addition, maternal obesity alters fetal metabolic programming through dysregulation of glucose, lipid, insulin, and leptin metabolism, leading to fetal macrosomia and an increased risk of obesity and metabolic syndrome in offspring later in life. Despite advances in antenatal care, the incidence of pregnancy complications associated with obesity remains high. Current evidence highlights the importance of preconception counseling, weight management, and multidisciplinary monitoring throughout pregnancy to reduce perinatal morbidity and mortality. Further studies focusing on metabolic and endothelial changes in overweight pregnant women are required to optimize preventive and therapeutic strategies.

Antenatal Care Utilization, Maternal Knowledge, And Adverse Birth Outcomes: A Comprehensive Multilevel Analysis Of Determinants, Pathways, And Implications In Low- And Middle-Income Contexts

2026-01-31T10:42:12+00:00

Antenatal care (ANC) remains one of the most critical pillars of maternal and child health, serving as a primary preventive and promotive intervention to reduce adverse birth outcomes and maternal mortality. Despite global progress in improving maternal health indicators, delayed initiation, irregular attendance, and suboptimal quality of antenatal care persist across low- and middle-income countries, particularly in Sub-Saharan Africa and parts of South and Southeast Asia. This research article provides a comprehensive, theory-driven synthesis and original analytical interpretation of existing empirical evidence on antenatal care utilization, maternal knowledge of pregnancy danger signs, socio-demographic determinants, and their relationship with adverse birth outcomes. Drawing strictly on the provided references, this study integrates findings from cross-sectional studies, systematic reviews, meta-analyses, demographic health surveys, and institutional health profiles to construct a multilayered explanatory framework. The article explores how structural factors such as food security, health system accessibility, urban–rural disparities, and policy environments interact with individual-level determinants including maternal education, pregnancy intention, spousal support, and exposure to mass media. Furthermore, it examines the mediating role of maternal knowledge, early risk detection, and continuity of care in shaping maternal and neonatal outcomes. By moving beyond descriptive summaries, this paper elaborates on causal pathways, theoretical implications, contextual variations, and countervailing explanations. The findings underscore that antenatal care utilization is not merely a behavioral choice but a socially embedded practice shaped by intersecting economic, cultural, informational, and institutional forces. The article concludes with a critical discussion of methodological limitations in existing studies and proposes future research and policy directions aimed at strengthening equitable, timely, and effective antenatal care systems.

A Comprehensive Clinical And Surgical Approach To The Treatment Of Complex Hand Syndactyly In Children With Apert Syndrome

2026-02-11T12:46:27+00:00

Background: Apert syndrome is a rare congenital condition caused by mutations in the FGFR2 gene and is characterized by craniosynostosis, craniofacial deformities, and complex syndactyly of the hands and feet. Severe hand deformities lead to early functional impairment, limitation of self-care skills, and social adaptation difficulties in affected children. Aim. To evaluate the clinical and functional effectiveness of a comprehensive clinical and surgical approach in the treatment of complex hand syndactyly in children with Apert syndrome. Materials and Methods. Patients diagnosed with Apert syndrome and complex hand syndactyly underwent clinical observation. Evaluation included clinical examination to assess the severity of deformity, functional assessment of grasp and range of motion, and radiological examination. Treatment was carried out using a multidisciplinary approach. Surgical management was planned in a staged manner, taking into account skin deficiency, with the application of combined skin grafting techniques. Postoperative follow-up and rehabilitation were integral components of the treatment strategy. Results. Primary wound healing was achieved in the postoperative period. Adequate interdigital separation was obtained, and a significant improvement in hand mobility and grasping function was observed. The comprehensive clinical and surgical approach reduced the risk of postoperative complications, including skin necrosis, contracture formation, and recurrence of syndactyly. Literature analysis supports the effectiveness of early and staged surgical intervention in improving functional outcomes in patients with Apert syndrome. Conclusion. A comprehensive clinical and surgical approach to the treatment of complex hand syndactyly in children with Apert syndrome provides favorable clinical and functional outcomes. Individualized surgical planning combined with postoperative rehabilitation significantly improves hand function and enhances the quality of life of affected children.

Serotonergic Mechanisms Of Central Nervous System Dysfunction In Eating Disorders In School-Aged Children

2026-01-31T10:42:11+00:00

Eating disorders in school-aged children represent a significant medical and social problem due to their close association with neuropsychiatric dysfunctions and long-term consequences for physical and mental development. Increasing evidence indicates that serotonergic neurotransmission plays a key role in the regulation of appetite, emotional stability, cognitive functions, and stress responsiveness. Disruption of serotonin metabolism, receptor sensitivity, and synaptic signaling may contribute to the development and persistence of maladaptive eating behaviors in childhood. This abstract highlights the serotonergic mechanisms underlying central nervous system dysfunction in children with eating disorders. Alterations in central serotonin levels are associated with impaired hypothalamic regulation of hunger and satiety, dysregulation of limbic structures involved in anxiety and mood control, and reduced cortical modulation of impulse control and decision-making. Neurochemical imbalance within serotonergic pathways may lead to heightened anxiety, obsessive behaviors, emotional lability, and disturbed reward processing, which together form a neurobiological basis for restrictive, compulsive, or dysregulated eating patterns.

Understanding serotonergic dysfunction in the context of eating disorders provides important insights into the pathogenesis of these conditions and supports the development of targeted diagnostic and therapeutic strategies. Early identification of serotonergic imbalance may improve prognostic assessment and enable personalized interventions aimed at restoring neurochemical homeostasis, optimizing cognitive-emotional regulation, and improving long-term outcomes in school-aged children with eating disorders.

The Use Of Nanochitosan For Local Prophylaxis Of Postoperative Infections In Hip Arthroplasty: An Experimental Study

2026-02-11T12:46:26+00:00

This experimental study evaluates the effectiveness of nanochitosan as a local prophylactic agent against postoperative infections following hip arthroplasty. The investigation included assessment of inflammatory and immunological biomarkers such as C-reactive protein (CRP), procalcitonin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), ferritin, and white blood cell counts in animal models. Results demonstrate that nanochitosan significantly reduces markers of systemic inflammation and infection compared to traditional prophylactic methods. The findings suggest that nanochitosan coatings on implants may provide a promising strategy for preventing periprosthetic joint infections, thereby improving postoperative outcomes and reducing complications.

Perforated Colonic Peritonitis As A Source Of Surgical Sepsis

2026-01-31T10:42:11+00:00

Background. Perforated colonic peritonitis remains one of the most severe conditions in emergency abdominal surgery and is frequently complicated by surgical sepsis. Despite radical elimination of the perforation source, systemic deterioration may develop rapidly or follow a subacute course, particularly in patients with significant comorbidity.

Methods. A retrospective cohort study included 118 patients operated on for perforated colonic peritonitis of malignant and non-malignant etiology. Surgical sepsis was defined according to Sepsis-3 criteria. Clinical course, comorbid conditions, surgical strategy, need for intensive care, progression to septic shock and multiple organ failure, and in-hospital mortality were analyzed.

Results. Surgical sepsis was identified in a substantial proportion of patients either at admission or during early postoperative period. Patients with pronounced comorbidity more often demonstrated fulminant septic progression with early development of septic shock, multiple organ failure, and high mortality, despite radical surgical source control. In patients without severe comorbidities, septic complications frequently evolved in a subacute manner, with transient postoperative stabilization that could mask ongoing systemic infection. Requirement for intensive care treatment and progression to septic shock were strongly associated with adverse outcomes.

Conclusion. Perforated colonic peritonitis should be regarded as a condition with an inherent risk of surgical sepsis regardless of the apparent adequacy of operative management. Apparent postoperative stabilization does not exclude systemic progression. Continuous assessment for septic manifestations and timely escalation of anti-septic therapy are essential to improve outcomes in this high-risk patient population.

Clinical Significance Of The C-786t Polymorphism Of The Nos3 Gene In Purulent-Necrotic Lesions Of The Lower Extremities Associated With Diabetes Mellitus

2026-02-11T12:46:26+00:00

Purulent-necrotic lesions of the lower extremities developing against the background of diabetes mellitus are currently considered one of the most pressing problems of modern medicine. These complications are characterized by high rates of disability and limb amputation. In recent years, the role of genetic factors in the development of this pathology has gained particular importance.

In the present study, a comparative analysis of the genotype frequency distribution of the C-786T polymorphism of the NOS3 gene was conducted among patients with diabetes-associated purulent-necrotic foot lesions who underwent surgical or conservative treatment. The results demonstrated that the unfavorable C/C genotype of the NOS3 gene was more frequently observed in patients who required surgical treatment, whereas the wild-type T/T genotype may be associated with a milder course of the disease and better effectiveness of conservative therapy. The C-786T polymorphism of the NOS3 gene may serve as a significant genetic marker for predicting purulent-necrotic complications developing in patients with diabetes mellitus.

Prognostic Significance Of The Immune-Stress Index In Assessing Dental Risk In Children With Hearing Impairment

2026-02-11T12:46:26+00:00

Significant correlations were identified between the Immune-Stress Index (ISI) and the OHI-S, PLI, PMA, and SBI indices (rₛ = 0.59–0.67; p < 0.001), as well as with the level of dental anxiety and negative behavior (rₛ= 0.62–0.66; p < 0.001). At high ISI values, the risk of unfavorable dental outcomes increased by 3.9–5.6 times. ROC analysis confirmed the high prognostic value of ISI (AUC = 0.86). The findings allow ISI to be considered an integral marker for predicting the risk of developing an unfavorable dental status in children with hearing impairment.

Cytokine Dysregulation As A Key Mechanism Of Dic Syndrome Formation In Children With Severe Pneumonia: Clinical And Immunological Analysis

2026-01-31T10:42:12+00:00

The aim of the study: To determine the clinical and immunological characteristics and elucidate the role of cytokine dysregulation in the development of DIC syndrome in children aged 1–3 years with severe pneumonia in order to improve early diagnosis and prognosis of complications.

Materials and methods. The study was conducted in 2024–2025 at the Intensive Care and Pediatric Pulmonology Department of the Multidisciplinary Clinic of TSMU. Thirty-nine children aged 1–3 years diagnosed with severe pneumonia were observed. To elucidate the role of cytokine dysregulation in the development of DIC syndrome, the patients were divided into two groups. The first group consisted of 17 children (43.6%) who developed DIC syndrome against a background of severe pneumonia. Among them, there were 10 boys (58.8%) and 7 girls (41.2%). The second group consisted of 22 children (56.4%) who did not have hemostasis disorders. Of these, 12 were boys (54.5%) and 10 were girls (45.5%).

Results and discussion. The analysis of the examined children revealed significant differences in clinical and laboratory parameters between the group with DIC and patients without coagulopathic complications. Already at admission, children with DIC demonstrated a more pronounced inflammatory response: their C-reactive protein levels averaged 118.4 mg/L (95% CI: 103–132 mg/L), which was statistically significantly higher than those in the second group, where the average values were 62.7 mg/L (95% CI: 52–73 mg/L; p < 0.01).

Conclusions. In children aged 1–3 years with severe pneumonia, the development of DIC syndrome is accompanied by more pronounced systemic inflammation, as evidenced by significantly elevated levels of C-reactive protein and procalcitonin compared to patients without DIC. The development of DIC is associated with pronounced cytokine dysregulation: IL-6 concentrations in children with DIC were more than twice as high, while IL-10 levels were significantly lower, indicating an insufficient anti-inflammatory response.

Result Of Treatment And Rehabilitation After A Hip Fracture

2026-02-11T12:46:27+00:00

Treatment of femoral neck fractures is an urgent problem in traumatology and orthopedics. We observed 62 patients from 20-24 to 2025, aged 60-70 years in 26 patients, 71-80 years in 31 patients, and 81 years or more in 5 patients. Men – 22 , women – 40 . When studying the causes of hip fracture, we found that 15 patients had careless walking, 37 patients had instability and falls, and 10 patients had traffic accidents. The patients were divided into two groups: the main group consisted of 32 patients who received our developed treatment after surgery. The control group consisted of 30 patients who received traditional treatment after surgery. We studied the results of treatment. Good and excellent results were obtained in 52 (83.8%) patients after 3 months, satisfactory results were obtained in 8 (12.9%) patients, and unsatisfactory results were obtained in 2 (3.22%) patients. After 6 months, good and excellent results were obtained in 57 (92%) patients, satisfactory results were obtained in 4 (6.4%) patients, and unsatisfactory results were obtained in 1 (1.6%) patient.

Early Diagnosis Of Oral Leukoplakia As A Key Factor In The Prevention Of Malignant Transformation

2026-01-31T10:42:11+00:00

Oral leukoplakia is recognized as the most common potentially malignant disorder of the oral cavity and remains a major concern in preventive dentistry and oral medicine. Despite its often asymptomatic nature, oral leukoplakia carries a significant risk of malignant transformation into oral squamous cell carcinoma, particularly when diagnosis is delayed or clinical monitoring is insufficient. Early diagnosis plays a decisive role in reducing this risk, enabling timely intervention, elimination of etiological factors, and appropriate clinical management. This paper explores the importance of early detection of oral leukoplakia as a preventive strategy against malignant transformation. Emphasis is placed on epidemiological relevance, etiological factors, clinical and histopathological characteristics, diagnostic approaches, and the prognostic value of early identification. The paper also discusses the role of dental practitioners in screening, patient education, and long-term follow-up. By integrating clinical vigilance with modern diagnostic tools, early diagnosis can significantly reduce morbidity and mortality associated with oral cancer. Strengthening early detection strategies is therefore essential for improving patient outcomes and advancing oral cancer prevention.