J.EXPERIMENTAL  &  CLINICAL  MEDICINE

2020, № 1

1. E.ZOIDZE

THE ROLE OF THE STATE IN PROTECTING THE MENTAL HEALTH

OF THE POPULATION

Grigol Robakidze University, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-9-21.

According to the constitution of the WHO, “Health is a state of complete physical, mental and social well-being, not just a lack of illness”. Today, developed countries seek to create a single chain of services based on needs that will provide differentiated services to people with mental illness and their families. The conceptual basis of this reform is a new approach - “Balanced Psychiatric Care”. Therefore, our country needs to regularly seek the reality of people with mental needs, analysis of existing services and reality (financial opportunities, quality of staff training, etc.) should be considered in the process that ensures the above-mentioned “balance of mental health”.

2. T.SHISHNIASHVILI, T.ORDENIDZE

ASSESSMENT OF PERIODONTAL TISSUE IN THE ADOLESCENT STUDENTS OF RUSTAVI PUBLIC SCHOOLS

Tbilisi State Medical University, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-21-26.

Sustaining dental health not only contributes to the health of the jaw-teeth system and general well-functioning of the human body, but also to the quality of life. The condition of periodontal tissue is an integral part of the overall state if the body. Moreover, identification of the various influencing factors on the periodontal tissue, is divergent and depends on the functional state of the body, especially in adolescents.

The goal of our study was to analyze the frequency and severity of the periodontal tissue pathology in adolescents; study the influence of unwanted risk factors, determine their role in the development of inflammatory periodontal diseases and aberrations in the periodontal tissues; determining the correlation with the hormonal state during puberty.

To achieve this goal, 381 adolescents of the ages from 11 to 16, were examined for the study.

The frequency and severity of the periodontal disease was assessed via analysis of the research results (index PMA, CPI). It was discovered that 57.7% in the age group of 11-12, already exhibited signs of the disease. This indicator would increase and reach 93.6% of the age group of 14-16, among which 19.8 exhibited more severe disease of the periodontal tissues, and the average number of healthy sextants would equal 3.2.

Thus, study results showed us the effect of risk-factors on the inflammatory diseases of periodontal tissues, among which hormonal condition during puberty is substantial.

3. I.BARBAKADZE, S.MGHEBRISHVILI, N.KIPIANI, KH.DAVARASHVILI

ASSESSMENT OF TOOTH ROOT CANAL OBTURATION QUALITY DURING THE TREATMENT OF PULPITIS AND PERIODONTITIS CHRONIC FORMS

Tbilisi I.Javakhishvili State University; Tbilisi State Medical University,

Kutaisi Unik University, Georgia.

J. Experimental and Clinical Medicine, 2020, 1, pp-26-28.

Distant results (after 22-24 years) were studied on the use of paste containing Braunol during endodontic treatment of chronic forms of pulpitis and periodontitis. We have especially emphasized tooth root canal’s obturation quality.

We have observed 19 patients (9 men, 10 women, age: 43-61 years). Group 1 was composed of 9 patients with chronic forms of pulpitis, but group 2 was composed of 10 patients with chronic forms of periodontitis.

It was established that paste containing Braunol hermetically covers tooth root canal even after 22-24 years, provides efficient treatment in 94,74% cases and due to this reason it may be considered as an efficient filling material for root canal of tooth.

4. T.KIKNADZE, G.TEVDORASHVILI, T.MUZASHVILI, M.GACHECHILADZE, G.BURKADZE

MARKERS OF LEIOMYOMA RECURRENCE AFTER LAPAROSCOPIC MYOMECTOMY

Tbilisi State Medical University, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-28-35.

Laparoscopic myomectomy represents the less invasive procedure for the treatment of uterine leiomyomas. However, the risk of relapse after laparoscopic myomectomy is high. We investigated the potential markers of myoma recurrence in specimens obtained by laparoscopic myomectomy. Study included altogether 65 patients, from which 35 were classic leiomyoma, 11 were bizzare/atypical leimyoma and 19 cases were smooth muscle tumors with uncertain malignancy potential (STUMP). From 35 cases of classic leiomyoma 15 cases after recurrence, from 11 bizzare/atypical leiomyoma 5 cases were after recurrence and from 19 cases of STUMP 7 cases were after recurrence. We have analysed central and peripheral parts of the lesion. The following markers were investigated: Ki67, Cas3, ER and PR.

The results of the study indicated that proliferation and apoptosis markers are significantly higher in leiomyomas after recurrence, compared to control group. In addition, ER and PR expression can be reliably used for the evaluation of lesion margins. Particularly, if the lesion is removed within the borders of healthy tissue. The evaluation of the lesion margins as well as the evaluation of phenotypic characteristics of leiomyomas is important for the assessment of the risk of recurrence after laparoscopic myomectomy, which can also be used for the correct clinical management of patients with uterine leiomyoma.

5. ¹N.LORTKIPANIDZE, ²I.BUCHUKURI, ³ M.LORTKIPANIDZE, ⁴ M.TEVZADZE, ²G.CHALATASHVILI, ² T.BOBOKHIDZE, ² A.NARSIA, ¹N.KHUTSISHVILI

CICATRICIAL ALOPECIAS, CLASSIFICATION AND THE ROLE OF TRICHOSCOPY IN DIFFERENTIAL DIAGNOSIS

¹D.Tvildiani Medical University; ²P.Shotadze Tbilisi Medical Academy; ³V.Tsitlanadze Rheumatology S/P Center; ⁴Tbilisi State Medical University, Tbilisi, Georgia.

J. Experimental and Clinical Medicine, 2020, 1, pp-35-45.

Cicatricial alopecia is a group of heterogenous disorders, causing permanent damage to the affected hair follicles at different levels, leading to irreversible hair loss. The disease is classified into primary and secondary. Both types include different subtypes of disorders of different origin. This article is mostly focused on primary cicatricial alopecia. Primary cicatricial alopecia is a folliculocentric disease, which includes a myriad of diseases, such as discoid lupus erythematosus, lichen planopilaris, dissecting cellulitis, frontal fibrosing alopecia and folliculitis decalvans. Although the cause of these disorders is not fully understood, their signs and symptoms are well described. Secondary cicatricial alopecia occurs secondary to follicular infections that lead to scaring and fibrosing of the affected hair follicles. Diagnosis and differentiation of these disorders can be easily be achieved using trichoscopy, that appears to be a promising method of evaluation.

6. S.ZEIKIDZE, A.SULADZE

FREQUENCY OF DAMAGED CORONARY ARTERIES DURING HEART ASYMPTOMATIC ISCHEMIA PATIENTS WITH MODERATE DILATATION OF LEFT VENTRICLE

David Aghmashenebeli University of Georgia, School of Medicine and Dentistry;

Tbilisi Heart and Vascular Clinic, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-45-48.

The aim of this study is to determine whichcoronary artery gets injured mainly in patients with asymptomatic ischemia moderate dilatation of left ventricle. The study took place in Tbilisi Heart and Vascular clinic analysis has been studied in 117 patients (104 male, 13 female). Results has shown us that highest rate of stenosis appears in primarily left anterior ascendance artery 57 (55,14%) and lowest appears in left main artery 4 (3,78%).

7. SH.KEVLISHVILI, G.GALDAVA, G.DURGLISHVILI

EPIDEMIOLOGY OF SEXUALLY TRANSMITTED DISEASES IN HIGH RISK-GROUP OF MEN WHO HAVE SEX WITH MEN - MSM

Iv. Javakhishvili Tbilisi State University, Faculty of Medicine,

Department of Dermatology and Venerology, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-48-53.

Sexually transmitted diseases (STD) still remain as an important problem of world health. Despite of positive results the incidence of Syphilis, Gonorrhea and Chlamydia is sharply increased due to increased coverage of screening programs and high incidence of these STD in high risk-groups. Men have sex with men (MSM) take leading place among these groups. MSM indicate very high values of incidence and prevalence of STD in developed countries. Along with medical problems the socium-related factors play the special role, especially the social stigma related with this group.

To improve the STD epidemiologic data it is necessary that specialists should have the opportunity to obtain any information related to STD symptoms – urethral discharge, diuresis, genital and perianal ulcers, regional lymphadenopathy, skin rash, proctitis-related anorectal symptoms (e.g., pain during defecation and anal act); it is also necessary to carry out the evidence-based consultations about the safe sex.

8. L.JANASHVILI, M.GOGOLADZE, T.GABRICHIDZE, L.KAJAIA

THE TRENDS OF STAPHYLOCOCCUS AUREUS (SHORT REVIEW)

New Vision University; Tbilisi State Medical University; Zugdidi Infectious Disease Clinic

J. Experimental and Clinical Medicine, 2020, 1, pp-53-58.

Staphylococcus aureus causes healthcare-associated infections (HAI), which may develop sepsis and cause death especially when the infections are caused by methicillin resistant staphylococcus aureus.

We analyzed studies published between 2008 and 2019 about MRSA decolonization therapies for preventive HAI. The recent researches about Staphylococcus aureus show that in spite of interventions connected with this particular microbe death and illness cases are still high.

Considering the existing circumstances, it is important to learn about the epidemiology of Staphylococcus aureus in Georgian population and the schemes of decolonization which will positively impact treatment efficacy, the amount of healthcare-associated infections and the grows rate of resistance of Staphylococcus aureus.

9. ¹M.PHAILODZE, ¹M.IOBASHVILI, ¹T.GAMEZARDASHVILI, ²M.BERADZE-JONSON,

³M.JORBENADZE, ¹M.GOGOLADZE

RETROSPECTIVE ANALYSIS OF PREGNANCY PATHOLOGY AND CAUSES OF STILLBIRTH

¹K.Eristavi National Center of Clinical and Experimental Surgery; ²Batumi Shota Rustaveli

State University; ³Iv.Javakhishvili Tbilisi State University, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-58-65.

Infant mortality is a major public health issue in developing countries. It is linked to both health and social determinants. Among them is the psycho-social, economic, demographic, ecological environment. According to the literature, there are 2.6 million cases of stillbirth worldwide every year. 98% of cases occur in low-income countries.

Reason of research. The purpose of this study is to identify the causes of pregnancy pathology and stillbirths in early pregnancy. The archive material of 2013-2017 was processed through retrospective analysis of the results of pathomorphological research on dead fetuses and placentas.

The archive material is processed using SPSS-21 Mathematical Statistics Computer Software Package. Pearson’s x2 criterion was used to test the reliability.

Results obtained: A total of 43 cases were studied, including 15 (28-28 weeks) stillbirth. The age of pregnant women ranged from 18 to 37 years.

Conclusion. 1) Retrospective analysis of the pathology of pregnancy and the causes of stillbirth revealed structural changes of the severe form of the placenta Hypoplasia and premature maturation.

2) The low rate of compensatory transformation in the placenta in early mortality indicates an inhibition of its functional activity, carrying out a qualitative compensatory-adaptive response.

3) Severe environmental conditions is today-atmosphere and soil is contamination by heavy metals and their accumulation in soil It can be represented a risk factor for fetal antenatal growth-retardation, hypertrophy and stillbirth.Therefore, it is advisable to conduct appropriate studies to identify the role of heavy metals, consumed by pregnant women from the atmosphere and food, in order for the purpose of giving birth to a healthy newborn.

10. ¹M.SHAKARASHVILI, ²D.TABIDZE

MODERN ACHIEMENTS AND PROBLEMS IN DEVELOPMENT OF THE HEALTH CARE SYSTEM OF GEORGIA

Iv.Javakhishvili Tbilisi State University Medical Department; Tbilisi State Medical University, Public Health, Management, Policy and Health Economics Department, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-65-68.

Georgia has a state universal healthcare program that covers 99% of the population. However, the scale of the program has created some risks - the current trend of increased spending raises the risk that the state will no longer provide necessary financial resources to implement the program. In this respect, it is recommended to take into account European experience: increasing the role of a non-profit hospitals, encouraging the forms of filling and replacing private health insurance, participation of the patient’s in a certain part of service costs, improvement of methods of services management and pharmaceutical sector regulations, development of the primary health care system, supporting family doctor institutions.

11. B.JAPARIDZE, L.EZEISHVILI

THE REPRODUCTIVE HEALTH INDICATORS OF WOMEN WORKING IN SODIUM CYANIDE PRODUCTION

TSMU, Department of Environmental Health and Occupational Medicine;

TSMU, The First University Clinic, Department of Perinatal Medicine, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-68-71.

Within the scope of the complex research, the reproductive health indicators of women working in sodium cyanide production were studied. 69.5% of the studied women in the main group turned to have different types of gynecological pathologies which is 2.5% higher than the indicators of the control group. The general level of gynecological diseases equals to 146.7 cases per 100 studied patients and it is 2.1% higher than the indicators of the control group. Overall, the structure of gynecological diseases in the main and control groups significantly differ from each other. 39,9% of labour cases in the main group are with complications and exceed control group indicators (1,8). The difference between main and control groups by labour complications is statistically reliable.

The women who have been working in the production area for a long time are developing important reproductive health disbalance, which later will be reflected on their offsprings.The results of the conducted research is a basis for future preventive measures.

12. K.UKLEBA, L.GVETADZE

PECULIARITIES OF TREATMENT OF PATIENTS WITH DIABETES MELLITUS TYPE-2 ORAL ANTIDIABETIC MEDICINES IN PRIMARY HEALTH CARE

Medical Faculty of Unik - Kutaisi University, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-71-77.

The purpose of our research was improving the service quality for the patients with Diabetes Mellitus type 2 in Primary care.

The work was based on the audit of medical service of the patients with Diabetes Mellitus, which was held in Kutaisi Family Medical Center. Medical map of 65 patients with Diabetes Mellitus type 2 were selected. All kinds of information were collected with the interviews of family doctors and nurses, also by considering all records of medical forms. Criteria and standards were ascertained for audit.

For criteria standard we took Biguanides group in 50%; as the research showed, the number was then 35% (P<0,05) and it was out of standard. It can be explained for the fact, that doctors are still cautious about prescribing Biguanides as it may cause many side effects; they also take their high price into consideration that is very important risk factor in today’s social and economical conditions. As for the Incretins group, 30% was considered with standard (Dpp4 inhibitors, ULp1 analogous), but the results have shown 10% (p<0,05). it can be explained with the fact that these medicines are quite expensive, though, their effectiveness is obvious, this group is new and is not included in Georgian market. As for the Sulphanil Urea group, it was considered in 20% by standard, though the result (55%) was nearly 2,5x more (p<0,05); this happened so as the medicines of this group is more available not only in terms of its cost, but also according to its spread on market.

13. N.KHOTIVARI, KH.KHUCHUA

CRITERIA FOR EVALUATING OBSTETRIC INJURIES AFTER VAGINAL DELIVERY

J. Experimental and Clinical Medicine, 2020, 1, pp-77-79.

The aim of our study was to determine the ultrasound criteria of pelvic floor and perineum in puerperal period. We developed criteria according to the following parameters: height of the perineum, thickness of the perineum, and the shape and size of the m.bulbocavernosus .. Criteria have been established by comparative analysis of these parameters during pregnancy and in puerperal period, that makes possible of early prediction of distant complications.

14. I.AGDGOMELASHVILI, B.MOSIDZE, S.KAJAIA, G.MERABISHVILI

DIFICULTIES IN IMPLEMENTING ERAS GUIDELINE

Center of High Medical Technologies, University Clinic; Tbilisi State Medical University, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-79-83.

Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. These protocols are gaining popularity in order to modify surgical stress responses after colonic surgeries. However, they are not straight forward to implement. Our goal was to identify areas that may need attention in order to successfully change practice. This implementation process is very challenging. Barriers to multimodal recovery pathways should be addressed.

15. N.KORSANTIA, KH.DAVARASHVILI, T.ZHVITIASHVILI, B.KORSANTIA

CLINICAL CONDITION OF PATIENTS WITH HERPES OF SKIN AND ORAL CAVITY IN TREATMENT OF LAZOLEX

¹Tbilisi State Medical University; ²Kutaisi Unik University, Georgia.

J. Experimental and Clinical Medicine, 2020, 1, pp-83-88.

For the first time, the domestic drug Lazolex (pericarpium extract of unripe walnut) was tested, which passed the necessary preclinical trials and began to be successfully used as an antiherpetic agent. The inclusion of lazolex in the complex treatment of herpes of the skin, lips and oral cavity contributed to a significant acceleration of the relief of the infection process and an increase in the duration of remission. A recommendation is made for a wider use of the drug for viral infections.

16. T.ORDENIDZE, T.SHISHNIASHVILI

SALIVARY CORTISOL LEVEL AS A MARKER OF THE PERIODONTAL INFLAMMATORY DISEASES

Tbilisi State Medical University; David Agmashenebeli University of Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-88-93.

The problem of periodontal pathology is of general medical and social importance, because the signs of periodontal pathology can be the first symptoms of serious diseases of the body, which increases the responsibility of the pediatric dentist for their timely identification and treatment.

Recent studies have shown that cortisol-dependent mechanisms are interested in the mechanisms of gingival tissue damage and the induction of the local immunopathological process.

The aim of this study was to characterize the changes in the level of cortisol in schoolchildren of the puberty period and to establish its effect on the state of periodontal tissues.

The results of an enzyme-linked immunosorbent assay show an increase in the levels of cortisol in salivary secretion with age and coincides with the puberty. Studying the effect of cortisol shifts on the condition of periodontal tissues, it turned out that in the control group (practically healthy) the level of cortisol was almost within the normal range (1.07±1.10 ng/ml), and in the 3^rd study group with clinical symptoms of severe periodontal disease, a relatively high level of cortisol was recorded (2.59±1.81 ng/ml on average).

Thus, the obtained data indicate that cortisol plays an important role in the induction of a regional inflammatory process in the soft tissues of the oral cavity.

17. ¹S.OMIADZE, ²M.NIKOLAISHVILI, ³T.SHISHNIASHVILI, ²S.ZENAISHVILI, ⁴I.IGNATIEVA

THE ROLE OF MICROFLORA IN THE ORAL CAVITY AND THE INHALATION OF WATER FROM TSKHALTUBO RADON AND ITS USE AS A RINSE

¹S.Omiadze Dental Clinic; ²I.Beritashvili Experimental Biomedicine Center;

³Iv.Javakhishvili Tbilisi State University; ⁴DAUG Dental Clinic; Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-93-98.

A study of microorganisms obtained from periodontal tissue in the oral cavity of people with periodontitis from clinical material (Porphyromonas gingivalis, Treponema denticola, Streptococcus mutans, Streptococcus oralis, Streptococcus salivarius, Streptococcus sanguis, Streptococcus sobrinus), sensitive to high specificity, which is important A slow factor in the laboratory diagnosis of periodontitis. Therefore, the molecular-diagnostic study of patients with periodontitis allows us to make an etiological diagnosis of the disease, to assign adequate phytotherapy, directed to the patient, in order to release it from the excitatory microorganisms. It improves the activity of various organs and immune systems, leads to the regulation of impaired homeostasis and the defense mechanism, neutralizes free radicals, their separation from the body, reduces hypoxia.

18. ¹S.CHIKOBAVA, ¹M.GOGIBERIDZE, ²M.NIKOLAISHVILI

BLOOD BIOCHEMICAL, NEUROLOGICAL AND PSYCHOLOGICAL INDICATORS OF MANDIBULAR JOINT PAIN (NSAID) PAIN DYSFUNCTION SYNDROME

¹Tbilisi St. Michael Archangel Multidisciplinary Clinical Hospital; ²I. Beritashvili Experimental Biomedicine Center; Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2020, 1, pp-98-102.

The results of our study confirm the psycho-emotional disorder, muscle pain and hypertension, in particular, the tension of the masticatory muscles, which plays a very important role in the pathogenesis of the development of pain dysfunction syndrome. Intensifies Psycho-emotional disorders in patients and leading to catabolism of metabolic processes, pain in the group of patients with a moderate form of painful dysfunction of the SCC at the end of complex treatment against the background of hyaluronic injection did not bother 69% of patients. Six patients complained of deafness in the scalp at night.