Treatment of overactive bladder symptoms in women with Diunorm®: preliminary results report

Introduction. Overactive bladder (OAB) with or without urgent incontinence tends to progress with age and occurs in both men and women. However, the frequency of occurrence in the female population averages about 25%.Purpose of the study. To assess the effectiveness and safety of the drug Diunorm® (in caps.) in the prevention and treatment of OAB in women.Materials and methods. The statistical analysis includes the results of a survey of 28 women with symptoms of OAB, whose average age was 35.3 years. The drug Diunorm® was used for treatment in dosage 400 mg QD for 90 days. Patients completed the Overactive Bladder Awareness Tool and a urination diary. Additionally, urinalysis, bacteriological examination of urine, uroflowmetry, bladder ultrasound and cystoscopy were performed.Results. All women throughout the study had negative urine cultures and no pyuria in urinalysis, which excluded an infectious etiology of urinary dysfunction. During therapy, a statistically significant decrease in irritative symptoms was recorded according to the Overactive Bladder Awareness Tool questionnaire. The sum of points after 1 and 3 mo decreased by 3.0 and 4.3 points, respectively (p < 0.05). Positive dynamics in terms of the points' sum was noted in 75%, in relation to nocturia in 82% of patients (p < 0.01). The average urination rate increased from 13.3 ± 0.7 ml/s to 15.1 ± 0.7 ml/s and 15.4 ± 0.5 ml/s after 1.5 and 3 months, respectively (p < 0,0001). A similar trend was observed for maximum urine flow and residual urine volume. The maximum urine flow when taking Diunorm® increased from 15.9 ± 0.6 ml/s to 17.4 ± 0.5 ml/s and 18.1 ± 0.4 ml/s (p < 0.001). Residual urine volume decreased throughout the study. When included in the study, after 1,5 and 3 mo, this indicator was 19.9 ± 1.4; 12.2 ± 1.6 and 6.4 ± 1.1 ml, respectively (p < 0.001).Conclusion. Diunorm® can become a worthy alternative to traditional first-line OAB therapy. Comparative studies are required to obtain a high-level evidence base

Combination therapy for benign prostate hyperplasia-related urinary symptoms

Introduction. Non-neurogenic lower urinary tract symptoms (LUTS) are a serious polyetiologic problem in the male population. The side effects of the medication agents used to treat LUTS significantly reduce treatment compliance. According to the literature data, the frequency of refusal for the proposed treatment during the year varies from 20 to 80%. Several studies have shown the benefits of herbal medicine for LUTS concerning the fewer side effects and increased adherence to treatment. However, to obtain a high-level recommendation base, clinical trials are required.Purpose of the study. To evaluate the effectiveness of Gardaprost® in LUTS combination therapy.Materials and methods. The study included 57 men aged 60 – 70 years with diagnosed medium- or large-volume benign prostatic hyperplasia (BPH) and moderate-to-severe LUTS according to I-PSS, morphologically excluded prostate cancer, without urinary infection signs. The patients were randomized into two follow-up groups. Tamsulosin 0.4 mg q.d. was prescribed to patients in the control group. Patients of the main group received Gardaprost® 0.4 mg q.d. in addition to Tamsulosin. The follow-up period in both groups was one-year. The statistical analysis includes data from 56 men. To evaluate therapy at the screening visit and on days 180 and 360, I-PSS, urination diary, IIEF-5, urinalysis, prostate-specific antigen, uroflowmetry, ultrasound were analyzed. Paired t-test and one-way ANOVA test were used to determine intergroup differences in normally distributed variables. For variables with a distribution other than normal, Friedman's two-way ANOVA for related samples was used. Events with a probability greater than 95% were considered statistically significant.Results. At the time of inclusion in the study, the groups were comparable concerning the control parameters. In the main group, there was a more pronounced positive dynamics in the I-PSS score, maximum urine flow rate, and post-void residual urine volume, which corresponded to 7.9 ± 2.1 points, 18.0 ± 7.3 ml/sec, 23.6 ± 13.6 ml vs 19.7 ± 7.2 points, 10 ± 3.5 ml/sec, 65.9 ± 33.2 ml in the main and control groups, respectively (p < 0.001). Additionally, in the main observation group, a decrease in prostate volume was recorded by 18.8% (p < 0.001) was recorded.Conclusion. We have obtained encouraging long-term results from the use of Gardaprost® in combination therapy of moderate-to-severe LUTS caused by medium- and large-volume BPH

ЭПИДЕМИОЛОГИЯ И ЭТИОЛОГИЧЕСКИЕ ФАКТОРЫ ЭРЕКТИЛЬНОЙ ДИСФУНКЦИИ У ПАЦИЕНТОВ НА ПОЧЕЧНОЗАМЕСТИТЕЛЬНОЙ ТЕРАПИИ И ПОСЛЕ ТРАНСПЛАНТАЦИИ ПОЧКИ

Today the problem of better life quality of patients with end stage renal disease and after renal transplantation and their sexual adaptation is considered to be more impotent. The clinical part of the investigation is the obser- vation of 205 patients – men with terminal stage renal disease. Erectile dysfunction is represented in 91,4% (64) of patients getting haemodialysis, 92,3% (24) of patients getting peritoneal dialysis, 61,5% (67) of patients after renal transplantation. According to International Index of Erectile Function the mean score of erectile function is 16,7 ± 5,2 in haemodialysis patients, 19,46 ± 3,6 in peritoneal dialysis patients, 21,9 ± 5,6 in patients after renal transplantation. The analysis revealed great prevalence of erectile dysfunction and interest in improvement among the patients with end stage renal disease and after renal transplantation. На сегодняшний день стала актуальной проблема улучшения качества жизни больных, находящихся на заместительной диализной терапии и после трансплантации почки, их сексуальной адаптации. Клиниче- ская часть исследования включает наблюдение 205 пациентов – мужчин с терминальной стадией хрони- ческой почечной недостаточности. Эректильная дисфункция выявлена у 91,4% (64) пациентов, получаю- щих заместительную терапию методом программного гемодиализа, у 92,3% (24) пациентов, получающих заместительную терапию методом перитонеального диализа, у 61,5% (67) пациентов после пересадки почки. Средняя сумма баллов эректильной функции МИЭФ составила 16,7 ± 5,2 у пациентов на гемо- диализе, 19,46 ± 3,6 на перитонеальном диализе и 21,9 ± 5,6 после трансплантации почки. Проведенный анализ выявил значительную распространенность эректильной дисфункции и актуальность улучшения у пациентов на программном диализе и после трансплантации почки.

The Diplomacy of Small States: Exploring Opportunities and Limitations in the Case of Timor-Leste

This article examines the diplomacy of small states, focusing on the case of TimorLeste. It analyzes the foreign policy strategies of small states, which encompass bilateral and multilateral diplomacy, engagement in international organizations and global governance, and the utilization of public diplomacy. These diplomatic tools enable small states to pursue their foreign policy objectives despite their limited resources, while also fostering cooperative relationships with larger powers. Diplomacy is regarded as a universal mechanism through which small states like Timor-Leste can integrate into the global international relations system.Given the inherent limitations of small states in contesting with major and middle powers, they seek to enhance their international influence through collective actions, such as forming or joining coalitions in international organizations or intergovernmental forums. Additionally, small states employ public diplomacy to draw attention to their issues and needs, thereby reducing their reliance on greater powers and forging more advantageous collaborations with other states. Strategies such as imitation and balancing, participation in coalitions, promotion of international initiatives, provision of expertise, and adherence to the principles of international law are utilized to cultivate a positive image of small states as responsible actors in international relations and reliable partners.The article concludes that Timor-Leste has been successful in maintaining bilateral and multilateral relations and actively participating in international organizations. However, it faces systemic challenges in effectively employing public diplomacy mechanisms. These challenges can be attributed to underdeveloped national public institutions and the enduring influence of greater powers, which affect not only Timor-Leste but also the wider region

EPIDEMIOLOGY AND ETIOLOGICAL FACTORS OF ERECTILE DYSFUNCTION IN PATIENTS ON DIALYSIS AND AFTER RENAL TRANSPLANTATION

Today the problem of better life quality of patients with end stage renal disease and after renal transplantation and their sexual adaptation is considered to be more impotent. The clinical part of the investigation is the obser- vation of 205 patients – men with terminal stage renal disease. Erectile dysfunction is represented in 91,4% (64) of patients getting haemodialysis, 92,3% (24) of patients getting peritoneal dialysis, 61,5% (67) of patients after renal transplantation. According to International Index of Erectile Function the mean score of erectile function is 16,7 ± 5,2 in haemodialysis patients, 19,46 ± 3,6 in peritoneal dialysis patients, 21,9 ± 5,6 in patients after renal transplantation. The analysis revealed great prevalence of erectile dysfunction and interest in improvement among the patients with end stage renal disease and after renal transplantation