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    The Importance of Individual Clinical and Laboratory Indicators in the Differential Diagnosis of Postpartum Septic Complications
    (Trakya Üniversitesi, 2018) Vamsi, Varahabhatla; Tekwani, Vinisha; Ivanovich, Pavliuchenko Myhaelo
    Aims: To perform a comparative analysis of individual clinical and laboratory indicators in the differential diagnosis of conditionally limited and generalized forms of postpartum septic complications.Methods: The study included 34 patients at Gynecology Department of the Zaporizhzhia Regional Clinical Hospital from 2013 to 2016 with postpartum purulent-septic diseases. Patients were divided into 2 groups. Group I consisted of 15 women who were diagnosed with a conditionally limited postpartum purulent-inflammatory disease (endometritis). Group II included 19 women with generalized forms of postpartum purulent-inflammatory diseases (peritonitis, sepsis). For the diagnosis of Multiple Organ Failure due to sepsis, we used the Sequential (Sepsis-Related) Organ Failure Assessment and quick Sequential (Sepsis-Related) Organ Failure Assessment. The differences between the first and second group were assessed by using the Mann-Whitney U test and STATISTICA Version 10. Results: Body temperature was increased in all 34 patients. The average heart rate in group I was 91.6 ± 8.35 beats/ min and 102.26 ± 16.42 beats/min in group II. The average respiratory rate was 19.07 ± 2.49 breaths/min in group I and 24.16 ± 5.09 breaths/min in group II. In group I, none of the patients scored a total of two or more points on the Sequential (Sepsis-Related) Organ Failure Assessment and quick Sequential (Sepsis-Related) Organ Failure Assessment scales; in group II, there were 5 (26.32%) patients who had scored two points or more on the Sequential (Sepsis-Related) Organ Failure Assessment scale; and 2 (10.53%) patients had scored 2 points or more in the quick Sequential (Sepsis-Related) Organ Failure Assessment scale. Conclusion: Clinical cases of postpartum period with inflammation of uterus and signs of multiple organ failure should be; regarded as a septic state, assessed by the Sequential (Sepsis-Related) Organ Failure Assessment scale as they require urgent medical help.
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    The Influence of Metabolic Therapy on Clinical and Hemodynamic Parameters in Patients With Stable Angina
    (Trakya Üniversitesi, 2018) Vamsi, Varahabhatla; Virajitha, Maganty; Ivetta, Lihasenko
    Aims: The objective of our study is to investigate the antianginal activity of meldonium and its influence on the hemodynamics and clinical parameters in patients with stable angina who fall under III-IV functional classes according to the classification of the Canadian Heart Association. Methods:The study was carried out including 105 patients with stable angina pectoris who were in III-IV functional classes at the age of 42-72 years. The first group (n=52) was administered the standard treatment (beta-blockers, aspirin, atorvastatin). The second group of patients (n=53) were given a combination of basic therapy along with meldonium 10% solution of 5 ml intravenously for 10 days then 1000 mg per day orally for 10-12 weeks. Suitable healthy people were selected as the control group (n=36). Results: Patients with stable angina pectoris were characterized with the reduction of workload, double work, time loading on bicycle ergometer, increased specific and total peripheral vascular resistance, increased central sympathetic activity on heart, decreased vagal and humoral activity on heart rate. The analysis of the data indicated a decrease in the frequency of anginal attacks after treatment in the first group by 45% and reduced daily nitroglycerin requirement by 48%. Combination therapy resulted in a decrease of the parameters by 71.8% and 76%, respectively. Conclusion: After the treatment in both groups, we detected an improvement in physical exertion tolerance, reduction in total peripheral vascular resistance and sympathetic activity of the heart. Combination therapy with meldonium significantly reduced the central smypathetic activity and peripheral vascular resistance, also increased the workload, run time compared to the basic therapy.
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    New Treatment Approaches to Prevent Premature Rupture of Membranes in Pregnant Women With Varicose Disease
    (Trakya Üniversitesi, 2018) Tekwani, Vinisha; Vamsi, Varahabhatla; Nataliya, Gaidai
    Aims: To investigate modern methods to prevent premature rupture of membranes by the use of chlorhexidine inpregnant women with varicose disease.Methods: The data of 39 pregnant women with varicose disease, who delivered between 2014 and 2016 at MaternityHospital No. 3, Zaporozhye were analyzed using SPSS software. Patients were divided in 3 groups according totheir medical history, complications during pregnancy, childbirth and postpartum period. The 1st group consistedof 13 pregnant women who did not receive prenatal vaginal douching with chlorhexidine; the 2nd group consistedof 13 patients with varicose disease, who received douching of birth canal with vaginal suppositories with chlorhexidine1 time per day for 10 days before their delivery, but did not undergo a rehabilitation at the sanatorium; and the3rd group had 13 pregnant women who received sanatorium rehabilitation at ‘‘Veliki lug’’ during the II. trimester oftheir pregnancy with the course of 1 chlorhexidine suppository per day for 10 days before delivery.Results:In the 1st group, the percentage of premature death was 61.5%; anemia and significant ultrasound markerswere present in 46.2%; the percentage for the presence of hematometra was 38.5%; premature rupture of membranes,anomalies of labor and polyhydroamniosis were 30.8%; chorioamnionitis 15.4%; and intrauterine infection offetus was 7.7%. In the 2nd group, anemia was present in 35%, 23.1% showed anomalies of labor; premature ruptureof membranes, ultrasound markers, premature death, and hematometra were present in 15.4%. Whereas in the 3rdgroup, anemia and anomalies of labor were present in 15.4%, premature rupture of the membranes and prematuredeath were present in 7.7% of the patients.Conclusion: With its broad antibacterial and antiviral effect, chlorhexidine in antiseptic form was found to bebeneficial and it is found to promote the restoration of the vaginal microflora.