Effectiveness of diabetes mellitus management program at primary health care level

FRUCTOSAMINE VALUES IN MONITORING COMPENSATION AND EFFICACY OF DIABETES MELLITUS TREATMENT

OBJECTIVE

Aim: The relevance of the study is determined by the objective of finding an optimal type of diagnostics of carbohydrate metabolism, that would assess the condition of a diabetic patient undergoing treatment. The purpose of the study is to create a model for monitoring the efficacy of diabetes mellitus treatment by determining the fructosamine levels.

PATIENTS AND METHODS

Materials and Methods: The methods for investigating the highlighted issue are clinical examination and laboratory diagnosis of diabetic patients to measure the state of carbon metabolism using ion-exchange chromatography to determine glycated haemoglobin levels and an automatic colorimetric method to determine fructosamine levels.

RESULTS

Results: The study presents certain values of fructosamine over the level of changes in the state of patients with diabetes mellitus, reflecting the progress from the treatment in the compensation of carbohydrate metabolism, which allows creating a model of diagnostic values of the fructosamine levels, according to which the efficacy of treatment of diabetes mellitus, the state of progress of the disease in its compensation or decompensation are determined at a qualitative level.

CONCLUSION

Conclusions: This allows for the timely adaptive corrective therapeutic and preventive measures to be carried out by medical personnel, who, using values, will monitor the efficacy of treatment in each patient once every three weeks, as this will determine the influence of the type of conducted treatment or other factors aimed at compensating for pathogenetic and clinical manifestations of the disease, which makes the identified fructosamine criteria an important component in the treatment of diabetes mellitus, and indirectly allows to improve the life quality of this patient population, thus bringing a practical solution to the challenge facing the healthcare sector.

Effects of metformin on lymphocyte DNA damage in obese individuals among Kazakh population

BACKGROUND AND AIMS

The global obesity epidemic is growing worldwide and its further growth is expected in the future. In obesity, the formation of reactive oxygen species (ROS) and cytokines is normally observed, which damage the genetic material. The purpose of this study was to assess lymphocyte DNA damage before and after metformin use in obese individuals.

NOVELTY

The novelty of the article is that for the first time DNA damage in lymphocytes before and after the use of metformin in obese individuals among Kazakh population was studied.

METHODS

Indirect immunofluorescence analysis using the AKLIDES apparatus was used for the quantitative determination of phosphorylated γ-H2AX (Ser 139) and 53BP1 in order to analyze DNA breaks in the lymphocytes.

RESULTS

The data indicating premature cell aging in the visceral adipose tissue in obese individuals were obtained. An increased hypoxia was observed in combination with an increase in γ-H2AX foci. DNA damage monitoring may become an important part of clinical studies of obesity. Advanced methods to diagnose obesity with early detection of precancerous changes imply a personalized approach, which is ineffective without data from genomic studies.

CONCLUSION

This study showed that metformin at a dose of 850 mg/day for 3 months for the treatment of obesity (BMI more than 30 kg/m²) resulted in a decrease in DNA breaks in the lymphocytes.

Optimization of urolithiasis treatment and diagnosis in the Turkestan region

The article aims to identify the main problems in treating urological pathologies by analyzing scientific literature from this field and developing recommendations. The quantitative excretion of uric acid, urine volume, and pH are essential in the formation of uric acid stones. The most important risk factor for uric acid nephrolithiasis is the acidic reaction of urine, which is a prerequisite for the formation of urinary stones. When urine is alkalized, the pH should be 6-6.5. Drugs alkalize urine, and one should titrate using urine pH indicator paper until the level is stable. This study found that the spread of genitourinary diseases is increasing. This situation can be improved by monitoring and assessing epidemiological processes, preventing urological pathology, and optimizing medical care organization in the context of health care reform.

Improving of long-term follow-up after cystocele repair

INTRODUCTION

The anterior vaginal wall is the most common site of repair compared with apex and posterior vaginal wall, and is also the site with the highest recurrence rate after surgery. The aim of this study was to evaluate the anatomical location of apex in patients with cystocele staged 2-3 (POP-Q), to correct all anatomical defects and to improve cystocele repair results.

MATERIALS AND METHODS

This was a single-center prospective study of women with cystocele of stage 2-3 with and without apical prolapse who underwent combined surgical treatment. The authors performed combined surgical procedures in women with apical prolapse, including pectopexy. Clinical and anatomical follow-ups were carried out at least in 12 months.

RESULTS

All patients revealed good to excellent results, with a high rate of satisfaction. There were no significant differences in recurrence among women with and without apical prolapse. Of the 22 women after pectopexy, the only one had apical prolapse of grade 1. The median cystocele recurrence rate was 3.8% in group without apical prolapse (grade 1), and 4.5% (grade 1) in pectopexy group. Sexual matters, incontinence score and QoL were significantly improved in both groups. The main reason for cystocele low recurrence rate is defect-oriented multicompartment strategy in all cases including patients with and without apical defect.

CONCLUSION

Pectopexy can be a good choice for prolapse surgery, including the positive effect in cases of lateral anterior wall defect. Using this strategy, it becomes possible to perform native tissue vaginal repair with encouraged long-term follow-ups.