Scientific supervisors: Zhuravka N. V., assistant; Shop I. V., PhD, associate professorАктуальні питання сучасної медицини: Тези доповідей XVІ Міжнародної наукової конференції студентів, молодих вчених та фахівців 28-29 березня 2019 р. – Х.: ХНУ імені В. Н. Каразіна, 2019. – C. 336-337

Edema Temituoyo Folusho

Електронного архіву Харківського національного університету імені В.Н.Каразіна (Electronic Archive V.N. Karazin Kharkiv National University)

МІНІСТЕРСТВО ОСВІТИ І НАУКИ УКРАЇНИ MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE  ХАРКІВСЬКИЙ НАЦІОНАЛЬНИЙ УНІВЕРСИТЕТ ІМЕНІ В.Н. КАРАЗІНА V.N. KARAZIN KHARKIV NATIONAL UNIVERSITY    XVІ Міжнародна наукова конференція студентів,  молодих вчених та фахівців  АКТУАЛЬНІ ПИТАННЯ  СУЧАСНОЇ МЕДИЦИНИ  ТЕЗИ ДОПОВІДЕЙ (28-29 березня 2019 року, м. Харків, Україна)   16th International Scientific Conference of Students, Young Scientists and Specialists  TOPICAL ISSUES  OF MODERN MEDICINE  ABSTRACTS  (March 28-29 2018, Kharkiv, Ukraine)     ХАРКІВ – 2019      XVI Міжнародна наукова конференція студентів, молодих вчених та фахівців                         19 ___________________________________________________________________________________ COMMUNITY-ACQUIRED PNEUMONIA ON THE BACKGROUND OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: CLINICAL CASE Boakye – Yiadom Valentina ..................................................................................... 320 INFECTIVE ENDOCARDITIS IN INTRAVENOUS DRUG USER Bogun N. Yu., Brynza M. S., Khmara V. T., Babaeva E.Sh. .................................... 321 DIAGNOSTICS ISSUES OF SYSTEMIC SCLEROSIS ON THE EXAMPLE OF CLINICAL CASE Brahmbatt Harshkumar Kirankumar ......................................................................... 322 EFFECT OF THE SESSION ON THE PSYCHOEMOTION STATE OF KNMU STUDENTS Вulynina O., Senna D.. ............................................................................................. 323 COMPARATIVE EVALUATION OF RESULTS OF SURGICAL TREATMENT OF ACUTE ADHESIVE INTESTINAL OBSTRUCTION Chubuk I. V., Voronova D. I. ................................................................................... 324 POST-STROKE APHASIA: CURRENT INTERVENTION APPROACHES FOCUSING ON INDIVIDUAL’S PARTICIPATION Daher Q. ................................................................................................................... 325 RELATIONSHIP BETWEEN REPEATED EXPOSURE TO TRAUMA IN WAR AND MENTAL HEALTH IN EASTERN MEDITERRANEAN REGION AND UKRAINE Daher Q. ................................................................................................................... 326 CHANGES IN LIVER FUNCTION IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS Dankwah Philip Sedem, Panko N. O. ....................................................................... 327 THE EFFECT OF POOR SLEEP ON STUDENT HEALTH PREVENTION OF INSOMNIA Dankwah Philip Sedem ............................................................................................. 328 ASSESSMENT OF THE HEPATOPROTECTIVE AND ANTI-OXIDANT POTENTIALS OF THE TWIGS OF ANDROGRAPHIS PANICULATA IN CCL4- INDUCED LIVER DAMAGE IN WISTAR ALBINO RATS. David O. L. ............................................................................................................... 330 THE EFFECT OF CHIKUNGUNYA VIRUS ON THE NERVOUS SYSTEM David O. L. ............................................................................................................... 331 COMPARATIVE STUDY OF THE TREATMENT OF EXTERNAL GENITAL WARTS WITH MONOTHERAPY AND COMBINATION THERAPY David Prasad Catherine Preethi, Gradil O. G. .......................................................... 332 INFLUENCE OF IL-6 ON FORMATION PATHOLOGY OF MYOCARDIUM IN PATIENTS FOR TYPE 2 DIABETES MELLITUS Dehtiar K. O., Onikova A. O. ................................................................................... 332 MODERN MEDICAL APPROACH TO MANAGEMENT OF VAGINISMUS Dlamini T. T. ............................................................................................................ 333 EXERCISE TOLERANCE AND PHYSICAL ACTIVITY IN CHILDREN WITH CHRONIC HEALTH CONDITIONS Dsouza Allwin Jenifer .............................................................................................. 334 A CASE OF UNEXPLORED DYSPEPSIA Dwayat Yazan .......................................................................................................... 335 THE DEVELOPMENT OF ATHEROSCLEROSIS IN A PATIENT WITH DIABETES MELLITUS Edema T. F. .............................................................................................................. 336 THE RELATIONSHIP OF THE FUNCTIONAL ACTIVITY OF THE PITUITARY-THYROIDAL SYSTEM AND SEROTONIN PRODUCTION IN EARLY AGE CHILDREN Edema T. F., Itepu A. E. ........................................................................................... 337 THE COMBINED EFFECT OF SUCCINIC AND ASCORBIC ACIDS 336                                                              АКТУАЛЬНІ ПИТАНАННЯ СУЧАСНОЇ МЕДИЦИНИ ___________________________________________________________________________________ use the term “unexplored dyspepsia”. This primary syndromic diagnosis requires either empirical symptomatic or anti-Helicobacter pylori treatment, or further examination of the patient, especially esophagogastroduodenoscopy (EGDS) in order to establish organic or functional causes of dyspepsia. Clinical case. The man, 49 years old, with complaints of constipation up to 5 days, pain in the upper abdomen, persistent, decreasing after eating, feeling of bloating in the epigastric region after eating, 12 kg weight loss since April 2018. Was repeatedly examined, took treatment without a pronounced effect. Anamnesis vitae is unremarkable. Physical examination: BMI = 24 kg / m2. The tongue is wet, at the root is coated with white bloom. On palpation, the abdomen is soft, painless. On auscultation, the abdominal intestinal peristalsis saved. Stool - a tendency to constipation, last stool 2 days ago with a laxative. The rest of physical examination is unremarkable. EGDS (02.01.19) shows: Сhronic superficial antrum gastritis. Papular antral gastropathy 1 degree. Colonoscopy (28.08.18): dolichosigma, hypomotor syndrome. CT scan of the abdominal organs (30.10.18): pathological lesions in the projection of the stomach and intestinal loops are not defined. Clinical diagnosis: Unexplored dyspepsia dyspepsia: postprandial distress syndrome, syndrome of epigastric pain. Irritable bowel syndrome with constipation with colon dyskinesia of hypomotor type.  Pharmacological treatment: Omeprazole 20 mg twice a day, domperidone 10 mg thrice a day. Taking into account the presence of “red flag” such as significant  mass loss in association with non-conclusive results of EGDS we highly recommend patient to undergo EGDS with biopsy and rapid urease test to confirm the diagnosis of chronic gastritis and clarify its type in order to prescribe optimal therapy. Conclusion. Dyspepsia is a common, long-recognized condition with a number of upper abdominal symptoms. But diagnosing this condition requires exclusion of organic diseases of digestive tract.    UDC 616.132.2-004.6:616.379-008.64 THE DEVELOPMENT OF ATHEROSCLEROSIS IN A PATIENT WITH DIABETES MELLITUS Edema Temituoyo Folusho V. N. Karazin Kharkiv National University, School of Medicine, Kharkiv, Ukraine Department of Internal Medicine Scientific supervisors: Zhuravka N. V., assistant; Shop I. V., PhD, associate professor   Introduction. Numerous studies have shown that patients with diabetes mellitus have accelerated atherosclerotic vascular disease, and major advances in understanding its pathogenesis have made. Violation of glycemic homeostasis has a direct stimulating effect on the formation, increase in the number and size of atherosclerotic plaques. Factors that may play an important role in the more rapid progression of atherosclerosis in patients with diabetes mellitus: inflammation, neovascularization and hemorrhage inside plaques. As a result, patients with diabetes mellitus and coronary heart disease are subject to higher morbidity and mortality have compared with patients without diabetes. XVI Міжнародна наукова конференція студентів, молодих вчених та фахівців                         337 ___________________________________________________________________________________ Clinical case. The man, 55 years old, with complaints of attacks of dyspnea at night, stopped in a sitting position on their own, sometimes dyspnea attacks are accompanied by pain in the chest, transient rises in blood pressure, headaches. Anamnesis is remarkable significant for arterial hypertension (AH) (max 240/180 mm Hg, adapted to 130-140/80 mm Hg), he takes antihypertensive therapy, chest pains since 2012, In May 2015, during ECG holter, a pathological number of ventricular extrasystoles and paroxysms of unstable ventricular tachycardia were detected. In June 2015 - coronary angiography followed by stenting of PKA. In December 2018 due to the deterioration of the condition - re-coronary angiography followed by stenting of the PNA. In January 2019 the deterioration. Diabetes mellitus since 1998. Anamnesis vitae is unremarkable. Physical examination: BMI = 40 kg / m2. BP 140/80 mm Hg. Oedema of lower third of both shins. HR =80 bpm, heart sounds are muted. Pulsation on a. dorsalis pedis and a. tibialis posterior are reduced. The rest of physical examination is unremarkable. Complete blood count (17.01.19) shows erythrocytosis. Fasting blood glucose (17.01.19) - 17, 95 mmol/l. Echocardiography (17.01.19): atherosclerotic cardiosclerosis, aorta atherosclerosis, LV hypertrophy. Electrocardiography (ECG) (16.01.19): Atrial fibrillation with heart rate 75-112/ min. Hypertrophy of the myocardium of the left ventricle. Subendocardial ischemia. Clinical diagnosis: Ischemic heart disease. Stable angina, II functional class. Arterial hypertension, II stage, 3 degree. CVD risk very high. Atherosclerosis of the coronary arteries. PКA stenting (22.05.15) PNA stenting (13.12.18) Ventricular extrasystolic arrhythmia with episodes of unstable ventricular tachycardia. Heart failure III FC, stage C. Diabetes mellitus II type, severe degree, decompensation. Diabetic polyneuropathy. Conclusion. Atherosclerotic changes develop not only faster, but also earlier in patients with diabetes, while reducing their life expectancy. In patients with diabetes compared with those without this disease, even though a normal in cholesterol level of low-density lipoproteins in the blood achieved, poor glycemic control in patients with diabetes mellitus is associated with the progression of atherosclerotic changes.   UDC 616.8-008.6:[616.32+616.441-008.64]-053.4 THE RELATIONSHIP OF THE FUNCTIONAL ACTIVITY OF THE PITUITARY-THYROIDAL SYSTEM AND SEROTONIN PRODUCTION IN EARLY AGE CHILDREN Edema T. F., Itepu A. E. V. N. Karazin Kharkiv National University, School of Medicine, Kharkiv, Ukraine Department of Pediatrics No. 2 Scientific Supervisor: Shlieienkova H. O., PhD, assistant   Introduction. Serotonin plays a significant role in the regulation of the formation and functioning of the Central Nervous System. It is formed by conversion of the amino acid L - tryptophan. In the embryonic period, like thyroid hormones, it affects glia proliferation, differentiation of neurons, myelination of axons and accelerates the maturation of the nervous system. In the early neonatal period it affects branching of neurons. At any age serotonin acts as a neurotransmitter of synaptic transmission of nerve impulses. The aim of the study. To study the functional activity of serotonin and pituitary-thyroid system and to evaluate their impact on mental development and neurological status of young children.  

The development of atherosclerosis in a patient with diabetes mellitus

Scientific supervisors: Zhuravka N.V., Assistant of the Department of Internal Medicine; 

Shop I. V.,  Сandidate of Medicine, Associate Professor of the Department of Internal Medicin

THE DEVELOPMENT OF ATHEROSCLEROSIS IN A PATIENT WITH DIABETES MELLITUS. Edema Temituoyo Folusho V. N. Karazin Kharkiv National University School of Medicine, Kharkiv, Ukraine Scientific supervisors: Zhuravka N.V., Assistant of the Department of Internal Medicine;  Shop I. V.,  Сandidate of Medicine, Associate Professor of the Department of Internal Medicine ATHEROSCLEROSIS The word atherosclerosis is of Greek origin and literally means focal accumulation of lipid (ie, athere [gruel]) and thickening of arterial intima (ie, sclerosis [hardening]). Atherosclerosis is a disease of large and medium-sized muscular arteries and is characterized by the following: ● Endothelial dysfunction ● Vascular inflammation ● Buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall  Atherosclerotic buildup results in the following: ● Plaque formation ● Vascular remodeling ● Acute and chronic luminal obstruction ● Abnormalities of blood flow ● Diminished oxygen supply to target organs By impairing or obstructing normal blood flow, atherosclerotic buildup causes myocardial ischemia.  TYPE 2 DIABETES MELLITUS Type 2 diabetes is characterized by a combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells. Insulin resistance, which has been attributed to elevated levels of free fatty acids and proinflammatory cytokines in plasma, leads to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat. OUR PATIENT A 55 year old male who presented with complaints of attacks of dyspnea at night, which usually resolved in a sitting position, these attacks were sometimes accompanied by pain in the chest, transient rises in blood pressure, headaches.  Anamnesis was significant for arterial hypertension (AH) (max 160/100 mm Hg, adapted to 140-130/80 mm Hg), he takes antihypertensive therapy (bisoprolol 10 mg per day, enalapril as required), chest pains since 2012 (he takes nitrates as needed). In May 2015, during ECG holter, a pathological number of ventricular extrasystoles and paroxysms of unstable ventricular tachycardia were detected. In June 2015 - coronary angiography followed by stenting of PKA. In December 2018 due to the worsening of his condition - re-coronary angiography followed by stenting of the PNA. In January 2019 another deterioration. Diabetes mellitus since 1998, patient is taking metformin. Anamnesis vitae is unremarkable. Physical examination: BMI = 30 kg / m2. In lung auscultation weakened breath. RR – 16/min. Heart borders extended to the left on 2 cm of mid clavicular line, HR = 68 bpm, regular, no pulse deficiency, heart sounds are muted, accent of the II tone above the aorta. BP - 140/80 mm Hg. Liver: near the rib edge, no pain on palpation of the right hypochondriac region. Spleen: not palpated. Oedema of lower third of both shins.  Pulsation on a. dorsalis pedis and a. tibialis posterior are reduced. The rest of physical examination is unremarkable.  ● Complete blood count (17.01.19) shows erythrocytosis.  ● Fasting blood glucose (17.01.19) - 17, 95 mmol/l.   ● Glycosylated hemoglobin (19.01.19)  - 7,2 %. ● Blood lipid spectrum (17.01.19) : within normal ● Echocardiography (17.01.19): atherosclerotic cardiosclerosis, aorta atherosclerosis, LV hypertrophy.  ● Electrocardiography (ECG) (16.01.19): Left axis deviation, unifocal ventricular extrasystoles,  HR = 68/min. Hypertrophy of the myocardium of the left ventricle. Subendocardial ischemia. ● X-ray (16.01.19): within age changes.  CLINICAL DIAGNOSIS Ischemic heart disease. Stable angina, II functional class.  Arterial hypertension, II stage, 3 degree. CVD risk very high.  Atherosclerosis of the coronary arteries. PКA stenting (22.05.15) PNA stenting (13.12.18)  Ventricular extrasystolic arrhythmia with episodes of unstable ventricular tachycardia.  Heart failure III FC, stage C.  Diabetes mellitus II type, severe degree, decompensation. Diabetic polyneuropathy.  Obesity 1 degree.  PATHOGENESIS OF DIABETES RELATED ATHEROSCLEROSIS Current suggestions show endothelial injury as the initial event in the genesis of atherosclerosis, followed by platelet adhesion and aggregation at the site of injury.  - Hyperglycemia from insulin resistance with insulin deficiency increases oxidative stress and glycation. This release of free radicals increases lipid and lipoprotein peroxidation contributing to foam cell formation on arterial walls. - Insulin resistance plays a role by contributing to endothelial dysfunction through loss of nitric oxide. - Diabetes promotes platelet aggregation due to an increased inflammatory response that augments the generation of growth factors and also stimulates the proliferation and migration of smooth muscle cells both of which are associated with thrombosis. Diabetes is a prothrombotic state which can lead to an imbalance in atherosclerotic lesions and plaque instability. OUR RECOMMENDED TREATMENT LIFESTYLE MODIFICATION  Diet  Control of compliance to medical recommendations PHARMACOLOGICAL TREATMENT  Transfer of the patient to insulin  Bisoprolol 10 mg per day   Perindopril 4 mg per day  Rosurvastatin 10 mg 1 time per day • Clopidogrel 75 mg 1 time per day • Torasemide 10 mg 1 time in 3 days, under the control of urea, creatinine, electrolytes  CONCLUSION ● It is believed that the patient’s earlier condition (Diabetes Mellitus) was the foundation for the rapid development of a more severe course of Cardiovascular Disease precipitated by atherosclerosis. ● Atherosclerotic changes develop not only faster, but also earlier in patients with diabetes, while reducing their life expectancy. In patients with diabetes compared to those without this disease, even though a normal cholesterol level of low-density lipoproteins in the blood is achieved, poor glycemic control in patients with Diabetes Mellitus is associated with the progression of atherosclerotic changes. So special attention should be directed to control level of glucose and continuous statin treatment as the benefits in foster prevention the In-stent restenosis under control of lipid profile and LFTs.   

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The development of atherosclerosis in a patient with diabetes mellitus

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Електронного архіву Харківського національного університету імені В.Н.Каразіна (Electronic Archive V.N. Karazin Kharkiv National University)

Електронного архіву Харківського національного університету імені В.Н.Каразіна (Electronic Archive V.N. Karazin Kharkiv National University)