bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disorders of carbohydrate metabolism in critical conditions
Authors: Nedashkivsky S.M. , Halushko O.A. 
Published: October 2020

Objective. To characterize the features of the occurrence and treatment of disorders of carbohydrate metabolism in critical conditions.
Materials and methods. The search of publications was conducted using the engines PubMed and Google Scholar and analyzed the available domestic literature sources on the topics: carbohydrate metabolism disorders and critical conditions.
Results and discussion. In critical conditions, the following disorders of carbohydrate metabolism develop: diabetic and non-diabetic ketoacidosis, hyperosmolar syndrome, hypoglycemia and lactic acidosis. Carbohydrate disorders in critical conditions develop against the background of the underlying disease, masked by it and worsen the patient’s condition. To diagnose these conditions, a nitroprusside ketonuria test is often used, which does not reflect the actual level of ketonuria (β-oxybutyric acid) and responds to their level in a delayed manner, so most ketosis is diagnosed late – in a decompensated state. Therefore, it is necessary to be guided first of all by a condition of the patient and clinical signs of existence of ketoacidosis. Xylitol (Xylat) solutions are used to treat these conditions. It is believed that xylitol has the greatest antiketogenic effect among all known substances. In particular, Xylat reduces the amount of free fatty acids; increasing of the formation of pyruvic acid, which promotes the oxidation of acetyl-coenzyme A in the Krebs cycle; enhances glycogen production in the liver; stimulates insulin secretion. Do not wait for the appearance of “4+” acetone in the urine analysis. If the patient has nausea, vomiting, dizziness, drowsiness, dry skin and dry mouth, deep noisy breathing and frequent urination on the background of hyperglycemia (>13.9 mmol/l) – should use xylitol-containing drug (Xylat) at a dose of 6-10 ml/kg intravenously.
Clinical case. Patient M., 67 years old, was admitted to the trauma department with a hip fracture. He was treated conservatively (skeletal traction) for 3 weeks. Sudden deterioration of state of health is registered: periodically non-contact, loses consciousness. Blood pressure is not determined, heart rate cannot be calculated due to high frequency. On ECG – ventricular tachycardia. Bolus administration of amiodarone had no effect. Carefully analyzed history (diabetes does not get sick, but 3 weeks did not eat enough, almost starved). The level of glycemia is 5.2 mmol/l, ketonemia is 8.4 mmol/l (N=1.7 mmol/l). Diagnosed with non-diabetic ketoacidosis. Xylat infusion (7.5 ml/kg) was performed and amiodarone was reintroduced. As a result, sinus rhythm was restored, the patient regained consciousness.
Conclusions. With the development of critical conditions, patients often have disorders of carbohydrate metabolism, which are often stopped by the introduction of xylitol (Xylat).
Infusion intravenous IgG replacement therapy for hypogammaglobulinemia after anti-CD20 monoclonal antibodies at patients with non-hodgkin’s malignant lymphomas
Authors: Savchenko Ya.B. , Guseva S.A. 
Published: October 2020

Objective. Determining the risk of infectious complications in patients with non-hodgkin’s lymphomas (NМL) who received anti-CD20 monoclonal therapy and the effectiveness of intravenous immunoglobulin G (IgG) replacement therapy.
Materials and methods. A prospective analysis of data of 37 persons with NML who were treated in the hematology clinic of the National Military Medical Clinical Center “Main Military Clinical Hospital” from January to December 2019. Statistical data processing was performed using computer programs Microsoft Office Excel (2007) and statistical processing package Statistica 6.0 using the procedure 2×2 Tables (YI/VI/Phil, McNemar, Fisher Exact) module Nonparametric Statistics, which uses the analysis of a four-cell conjugation table.
Results and discussion. The mean age of patients was 56.5±1.4 years; 12 (32.43 %) were female patients. Baseline IgG levels before anti-CD20 monoclonal therapy were not determined in 17 (45.94 %) patients. Hypogammaglobulinemia was detected in 20 (54.05 %) subjects who were tested for IgG levels prior to anti-CD20 therapy. After administration of anti-CD20 monoclonal therapy, hypogammaglobulinemia worsened. There was an increase in severe infections after anti-CD20 therapy (from 9.4 to 40.7 %; p<0,001). An analysis of patient survival within 6 months of starting anti-CD20 monoclonal therapy revealed an increased mortality associated with an increase in age (hazard ratio (HR) 1.05; 95 % confidence interval (CI) 1.00-1.02; p<0.005), male (HR 1.12; 95 % CI 1.01-1.18; p<0.005), severe infectious complications (HR 5.18; 95 % CI 3.16-4,72; p<0.001). Only 10 (27.02 %) patients received IgG replacement therapy after anti-CD20 monoclonal therapy. Among these patients, a higher cumulative dose of immunoglobulin replacement therapy was associated with a reduced risk of serious infectious complications (HR 1.00; 95 % CI 0.98-1.02; p<0.005).
Conclusions. Monitoring of IgG levels both before and after rituximab therapy may allow for earlier identification of risk for developing significant infection and identify patients who may benefit from IgG replacement, which may in turn help to avoid excess morbidity and mortality.
Applications of infusion therapy in the difficult form of tuberculosis
Authors: Todoriko L.D. , Pidverbetska О.V. , Semianiv І.О. , Yeremenchuk І.V. , Kuzhko М.М. 
Published: October 2020

Objective. Analysis of the prevalence of the difficult cases of tuberculosis (TB) and assessment of the effectiveness of the treatment when using infusion anti-TB drugs in standard regimens.
Materials and methods. A retrospective analysis was carried out for 2017-2019 of the electronic database the register of patients and the inpatient case history KU “Chernivtsi Regional Clinical TB Dispensary”.
Results and discussion. From 16 to 46 % of patients with TB infection have concomitant signs of diabetes mellitus. In 58.9 % of patients with sensitive TB, the absorption capacity of the small intestine significantly decreases with a predominant decrease in the intestinal permeability index from 3.1 to 6 (in 21.9 % of cases). At multiple-drug resistance TB decrease the absorptive function of intestines is observed in 76,1 % of cases with the prevalence of severe degree of disturbance (in 42,3 % of patients). The proportion of severe forms of sensitive TB is more than 42 % of cases, of which 69.6±1.6 % were diagnosed with destruction. The share of common forms of TB among all cases of drug-resistant TB (DRTB) treated in 4th categories is 47 %, of which with destructive forms – 78.5±3.6 %. The frequency of adverse reactions increases in severe forms of DRTB and amounts to 38 % of all analyzed cases.
Conclusions. Early detection of patients with severe forms of TB, especially in the presence of concomitant pathology, and their allocation into a separate category of “severe patients with TB” using parenteral forms of anti-TB drugs, especially in the early stages of treatment (during the intensive phase, which is the most critical period), it facilitates to reduce the unfavorable prognosis of the course of the underlying disease.
Optimization of therapy in patients with renal hypertension by stabilizing hemovascular hemostasis
Authors: Bobieva N.Kh. , Gadoev S.Kh. , Rashidov I.M. 
Published: October 2020

Objective. To study the aggregation activity of platelets in patients with renal hypertension.
Materials and methods. The research work was carried out on the basis of the nephrological department of the State Institution NMC RT “Shifobakhsh”. The study included 46 patients aged 25 to 60 years with chronic pyelo- and glomerulonephritis. The patients were divided into two equal groups: first, the control group received standard therapy in accordance with the clinical protocol of the Tajik Association of Nephrologists; second, the main group, along with complex pathogenetic therapy in order to stabilize the hemostasis system and improve endothelial dysfunction, used the drugs Tivortin (intravenously drip and then long-term per os Tivortin aspartate) and Rheosorbilact intravenously drip. In addition to the generally accepted studies of patients with kidney pathology, emphasis was placed on the criteria for platelet quality (number, mean platelet volume, platelet distribution index, thrombocyte and large erythrocyte ratio) and studies of the hemostasis system (fibrinogen, prothrombin time, activated partial thromboplastin time, prothrombin relation).
Results. There were found the hemostasis in microvessels, increases of the blood viscosity, the activation of systemic thrombus formation, and the progression of endothelial dysfunction in patients with renal hypertension. The results of observation of the dynamics of platelet aggregation activity under the influence of the combination of the studied drugs in this category of patients prove an effective decrease in its level. It is also necessary to emphasize the antiplatelet effect of this combination in relation to the prevention of microthrombosis and the pronounced endothelioprotective effect in patients with renal pathology.
Conclusions. The complex therapy of patients with renal hypertension with Tivortin and Rheosorbilact is an effective way to stabilize hemovascular hemostasis. The effects of this therapy contributed to the improvement of the clinical condition of the patients, and during repeated examinations, there was a stable preservation of the decrease in the level of platelet aggregation activity.
Influence of Rhesorbilact on rheological properties of blood in patients with acute peritonitis
Authors: Khamidov D.B. , Kosimov Z.K. , Boboev B.R. , Khalifaev U.R. , Kholnazarov Sh.E. 
Published: October 2020

Objective. Study of the effect of Rheosorbilact on the rheological properties of blood in patients with acute peritonitis.
Materials and methods. 62 patients with acute peritonitis at the age from 20 to 87 years were examined. The patients were divided into two groups depending on the inclusion of Rheosorbilact solution in the infusion therapy program. The first group (control) included 30 patients with the infusion therapy program consisted of conventional crystalloid and colloidal infusions. The second (main) group included 32 patients with the treatment of Rheosorbilact infusion therapy program at an average dose of 5.7-6.6 ml/kg (400 ml per day). The rheological properties of blood were studied by determining the relative blood viscosity with a VK-4 viscometer, hematocrit, fibrinogen and ESR according to generally accepted methods.
Results. In patients with acute peritonitis, when Rheosorbilact (main group) is included in the infusion therapy program, there is a significant improvement in the rheological properties of blood compared with the results of the control group who received crystalloids and colloids. After treatment in patients of the control group, the indicators of the rheological properties of blood were characterized by a decrease in hematocrit – by 16.5 %, blood viscosity – by 11.6 %, fibrinogen content – by 15.2 %, ESR – by 18.2 % compared to the initial data. In patients of the main group who received Rheosorbilact in the infusion therapy program, the rheological properties of the blood significantly improved and amounted to 24.0 % in comparison with the initial data on hematocrit, 18.7 % in blood viscosity, 21.0 % in fibrinogen, and 23.4 % in ESR.
Conclusions. In patients with acute peritonitis, a significant violation of the rheological properties of blood is observed. The inclusion of Rheosorbilact in the infusion therapy program contributes to the correction of impaired blood.
Heat-sensitive poly-acrylamide nanoparticle for cancer treatment
Authors: d'Amora Marta , Colucci Patrizia , Usai Alice , Landi Elena , Deleye Lieselot , Dente Luciana , De Angelis Francesco , Raffa Vittoria , Tantussi Francesco 
Published: October 2020

<img src=” https://s3.amazonaws.com/production.scholastica/article/17629/large/prnano_552020_ga.jpg?1602866898”> Several nanomedicine-based platforms, including polymeric micelles, dendrimers, and liposomes, have been developed and explored for targeted delivery of therapeutics in cancer. These nanoparticles are capable of delivering selectively antineoplastic agents to the tumor, reduce the untoward toxicity, and improve the therapeutic effect. In the present study, we propose new thermosensitive polyacrylamide-based nanoparticles as polymer-based drug carriers. Polyacrylamide has a controllable swelling temperature, which enables a rapid release of an encapsulated drug above certain temperatures. PAA-NP was synthesized then functionalized with folic acid to improve selective targeting. Then doxorubicin, an antineoplastic agent, was encapsulated inside of the polymeric core. Our data show that these nanoparticles have a sol-gel transition temperature of 41°C. We investigated the effects of the folic acid functionalized PAA nanoparticles on HeLa cells both in vitro and in vivo, and on zebrafish larvae xenografted with human pancreatic cancer cell line Mia Paca-2. Functionalized NPs were internalized in a short time by the cancer cells, mainly localizing in the lysosomes. In vitro and in vivo cytotoxicity studies indicated high viability of cells treated with functionalized nanoparticles encapsulating doxorubicin by signaling a minor release of doxorubicin at physiological temperatures. Conversely, at the temperature of 41 °C, they trigger apoptosis of the xenografted cells, resulting in a strong arrest of the increase of the tumor area. Our results suggest that the heat-activated DOX:PAA-NP-FA could be used to implement combined therapies for the local treatment of solid cancers.
Glucose-6-Phosphate Dehydrogenase Status in the Term Newborns and Their Clinical and Other Laboratory Correlates
Authors: Dey Sanjoy Kumer , Jahan Ismat , Mkh Shabuj , Shaha Chandan Kumar , Chowdhury Suparna , Naznin Lubna , Rahman Kazi Monisur , M Shahidullah 
Published: October 2020

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme defect in man. Though G6PD deficiency affects every cell in the body, its primary effects are hematological.
Objectives: The objectives of the study were to determine the G6PD enzyme concentration and deficiency states among the term newborns, to see the impact of the enzyme status with development of neonatal jaundice and to delineate any correlation of the G6PD with other hematological values.
Materials and Method: Total 100 term newborns were enrolled in the study. Umbilical cord blood sample from the placental end were collected for G6PD enzyme assay, blood counts including reticulocyte count, blood indices and bilirubin estimation. Clinical and other relevant data were collected. Statistical analysis was done by using SPSS 19.0 version.
Results: Overall G6PD activity was detected 9.86 ± 1.68 U/g Hb and no G6PD enzyme deficiency state was identified. There were no statistically significant differences in the hematological parameters and cord blood bilirubin concentration between male and females. But females have significantly higher G6PD enzyme concentration than males (p=0.002). There were no significant differences in the enzyme concentration in different gestational age groups. There was significant negative correlation between G6PD enzyme and hemoglobin levels, G6PD enzyme concentration with HCT and MCV values.
Conclusion: This study could not identify any G6PD deficiency state. So further large scale community-based study is needed to validate this finding and also establish the normal G6PD enzyme concentration in the population of Bangladesh.
Bangladesh J Child Health 2020; VOL 44 (1) :18-23
Efficacy of Nebulized Magnesium Sulphate in the Treatment of Acute Bronchial Asthma Compared to Nebulized Salbutamol: A Randomized Control Trial
Authors: Sarmin Zannat Ul , Anwar Sayeeda , Khan Tafazzal Hossain , Mollah Md Abid Hossain , Khanam Rokeya , Baki Shah Abdullah Al 
Published: October 2020

Background: Nebulized salbutamol is commonly used in treatment of asthma in children. The use of nebulized MgSO4 is one of the different treatment options available during acute exacerbation.
Objective: To compare the efficacy of nebulized MgSO4 with nebulized salbutamol in the treatment of acute asthma in children.
Materials and method: This randomized controlled study was conducted in Dhaka Medical College Hospital between January to December 2016. Children of 7-12 years with acute exacerbation of asthma were randomized into study group-A (MgSO4 group, n=30) and control group-B (Salbutamol group, n=30). Children of both groups were treated with serial nebulization thrice at 20 minute intervals by either 2.4 ml (4% MgSO4, 96 mg) or salbutamol (0.15 mg/kg minimum 2.5 mg) with 2.5 ml of isotonic normal saline.
Results: The mean final PEFR were not different between the two groups (275.0±41.42 L/min in MgS04 group and 263±36.17 L/min in salbutamol group). The increase in PEF was statistically significant and comparable in both groups (by 35.1% in the MgS04 group and by 42.1% in the salbutamol group). Fischl score improvement was comparable and significant in both groups (4.31 to 0.43 in MgS04 group and 4.29 to 0.76 in salbutamol group). Statistically significant increase in oxygen saturation and reduction of heart rate was found in MgS04 group without any side effects. Nebulized MgSO4 was found having significant bronchodilator effect which is comparable to salbutamol.
Conclusion: Nebulized MgS04 was found equally effective as nebulized salbutamol in the treatment of severe acute asthma in children.
Bangladesh J Child Health 2020; VOL 44 (1) :24-29
Platelet Indices As Markers For Remission In ALL During Induction of Remission: An Experience of 52 Cases
Authors: Khan Masuma , Morshed AKM Amirul , Ahmed Taslim Uddin , Khan Hakimul Haque , Ahmed Ashraf Uddin , Roy Sudipta , Kabir ARM Luthful 
Published: October 2020

Background: Platelet indices (plateletcrit, mean platelet volume, platelet distribution width and Platelet count) are potentially useful markers for the early diagnosis and outcome of many diseases. Platelet indices could serve as surrogate marker for remission in patients with ALL.
Objective: To observe change of platelet indices in ALL during induction of remission.
Material & Methods: This observational study was carried out with 52 newly diagnosed ALL patients ranging from 1.5 to 12 years admitted at DMCH, from January to December 2015. Platelet indices such as plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PLT) were monitored from admission to induction of remission phase of chemotherapy and were analyzed.
Result: Mean PLT was found 93442.3±29966.4 cmm before treatment, 137442.3±27217.9 cmm in 1st week and 231653.8±42543.5 cmm in 4th week. Mean PCT was found 0.09±0.11% before treatment, 0.16±0.11% in 1st week and 0.25±0.18 % in 4th week. Both PLT & PCT was increased significantly during induction of remission after one and four weeks. Mean PDW was found 13.1±3.9 fl before treatment, 12.9±3.5 fl in 1st week and 12.0±3.1 fl in 4th week. MPV was found 10.6±2.1 fl before treatment, 11.0±1.4 fl in 1st week and 10.7±1.4 fl in 4th week. The change of MPV & PDW were not statistically significant when compared with that of before treatment.
Conclusion: It can be concluded that among four important platelet indices, PLT and PCT were significantly associated with remission in ALL during induction of remission.
Bangladesh J Child Health 2020; VOL 44 (1) :34-39
Nevus of Ota: The Unusual Birthmarks: A Case Report
Authors: Begum Tamanna , Rai Punam , Kaur Gursharan , Islam Rafiqul , Kadir Sadika 
Published: October 2020

Nevus of Ota is a benign congenital melanosis bulbi. It is a rare entity, commonly seen in female. It occurs among Asians and Africans. It mainly involves the eye, skin and ear. It is predominantly unilateral but could be bilateral. Typical clinical manifestation was present in our case, however, biopsy is the investigation of choice. There is no specific treatment but ophthalmological and dermatological intervention can be opted. Outcome is remarkably good. Here we reported a case of a child with Nevus of Ota who was primarily admitted at paediatric department with enteric fever. We managed her conservatively and followed up in specific department.
Bangladesh J Child Health 2020; VOL 44 (1) :60-63
Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses
Authors: Rahman Maksudur , Mamun Mohammad Abdullah Al , Chowdhury MAK Azad , Munsi Abu Sayeed 
Published: October 2020

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses.
Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed.
Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9).
Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates.
DS (Child) H J 2019; 35(2) : 100-104
Pediatric Germ Cell Tumors: An Experience of 7 Years in a Tertiary Hospital of Bangladesh
Authors: Kabir SM Rashed Zahangir , Akhtar Md Waheed , Yasmin Farida 
Published: October 2020

Introduction: Germ cell tumors are a group of tumors with different clinical presentation and histological and biological characteristics. Malignant germ cell tumors occur at all ages with a trend of bimodal distribution in infancy and adolescence.
Objective: To evaluate the demographic characteristics, distribution of different types of germ cell tumor, treatment modalities and outcome of germ cell tumor in children in a tertiary care hospital of Bangladesh.
Methods: In this retrospective study, data regarding age and sex distribution, location, types of tumors, management of germ cell tumor in children were retrieved from the medical records of pediatric oncology department in NICRH, Dhaka from 2008 to 2014.
Results: Out of total 87 patients female were 50 and male 37. Most of the patients were up to 5 years of age. The gonadal germ cell tumors (80%) were more than extragonadal tumor (20%) in both male and female patients. The most common germ cell tumor was dysgerminoma (32%) followed by yolk sac tumor (29.8%) and teratoma (19.5%). Yolk Sac Tumor (51.4%) was the most common in male and dysgerminoma (56%) the commonest in female. Out of 87, seventy two (82.7%) received chemotherapy following surgery. Among those 72 patients who received chemotherapy 49 (68 %) patients completed their treatment. Until the last follow up 71.4% patients remained alive and tumor free.
Conclusion: Germ cell tumors are the most variable tumor of all childhood malignancies that has difference in age, sex, location and histological subtypes. Gonadal tumors have better prognosis than extragonadal tumors in both the sex.
DS (Child) H J 2019; 35(2) : 119-122