International Journal of Medicine and Medical Research <p><em>International Journal of Medicine and Medical Research (IJMMR) is the peer-reviewed international journal published semiannually. The overall goal of the IJMMR is to promote medical research and to serve as a platform dedicated to increasing the exchange of experience and collaboration in all fields of medical research, including dentistry and pharmacology. IJMMR accepts original research, reviews, commentaries and letters to the editor in the areas of medicine and medical research covering non-clinical and clinical subjects, population health sciences and public health topics.</em><br><em><strong>ISSN 2414-9985 (Online), ISSN 2413-6077 (Print)</strong></em></p> en-US <p>Authors who sent their manuscript to International Journal of Medicine and Medical Research agree to the following terms:</p> <p>1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="">Creative Commons Attribution License</a> CC-BY-NC that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.</p> <p><a href="" rel="license"><img style="border-width: 0;" src="" alt="Лицензия Creative Commons" /></a></p> <p>2. Authors able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.</p> <p>3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="">The Effect of Open Access</a>).</p> (Prof. Mykhaylo Korda) (Ihor Kovbasyuk) Mon, 16 Nov 2020 00:00:00 +0200 OJS 60 SERUM LIPID PROFILE AND ARTERIAL STIFFNESS IN NON-DIPPERS <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background. </span></strong><span lang="EN-US">A non-dipping blood pressure profile (NDP) is associated with increased arterial stiffness and other cardiovascular target organ damage. Serum lipid profiles have been shown to be important determinants of arterial stiffness. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objective. </span></strong><span lang="EN-US">The aim of the research was to assess serum lipid profiles and arterial stiffness in non-dippers. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods. </span></strong><span lang="EN-US">This cross-sectional study was conducted involving 796 (288 males and 508 females) participants of black African origin. A twenty-four-hour ambulatory BP monitoring was done using a Spacelabs 90207 (Spacelabs Inc., Redmond, Washington, USA) monitor. Carotid-Femoral pulse wave velocity measurements were performed using a high fidelity SPC-301 micromanometer (Millar instruments Inc., Houston, TX).</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results. </span></strong><span lang="EN-US">Of the 288 males, 140 were classified as non-dippers. Of the 508 females, 273 were classified as non-dippers. In the general population, males had higher triglycerides when compared with females 1.46±0.96 vs 1.13±1.02, p&lt;0.0001. Additionally, dipper males had higher serum TRGL when compared with dipper females 1.32±0.98 vs 1.06±0.58, p = 0.0012. Non-dipper males also had higher serum TRGL when compared with non-dipper females 1.61±2.05 vs 1.19±1.14, p=0.0078. Serum HDLc was lower in the non-dipper male group when compared to the non-dipper female group (p=0.008). In both male and female groups, non-dippers had higher CFPWV when compared with dippers; 7.53±3.60 vs 5.74±2.47, p&lt;0.0001 and 6.64±2.52 vs 5.98±2.23, p=0.0021 respectively. However, non-dipper males had significantly higher CFPWV when compared with non-dipper females (7.53±3.60 vs 6.64±2.52, p=0.0031). </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions. </span></strong><span lang="EN-US">Therapies targeting a reduction of serum triglycerides levels might be beneficial in improving arterial compliance with or without the presence of non-dipping.</span></p> A.B. Bawa-Allah, M. M. Mashao, T. F. Nyundu, E. M. Phukubje, B. G. Nkosi, M. V. Ngema, B. W. Mlambo, M. J. Maseko Copyright (c) Mon, 09 Nov 2020 00:00:00 +0200 DISSEMINATED HISTOPLASMOSIS LEADING TO HAEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN AN IMMUNOCOMPETENT PATIENT <p><strong>Background</strong>: Emerging fungal infections can pose a serious threat in contemporary healthcare due to host variations, clinical presentation and emerging resistance. Histoplasma capsulatum is a thermally dimorphic fungus, which acts as a Trojan horse by residing inside macrophages. Histoplasmosis is an emerging infection and its association with hemophagocytic lymphohistiocytosis (HLH) in immunocompetent patients has been scantily reported in the literature.</p> <p><strong>Objective.</strong> The aim of the study was to explore disseminated histoplasmosis with the help of case report.</p> <p><strong>Methods</strong>: A case report of histoid leprosy is presented.</p> <p><strong>Results</strong>: A male patient of 47 yearsof age, under treatment for chronic obstructive pulmonary disease for five years and diabetes mellitus Type-II for two years, presented with fever of unknown origin (FUO) with evidence of HLH in the bone marrow. Core biopsy of the liver and spleen showed a dense tissue infiltrate with vacuolated histiocytes containing histoplasma capsulatum, eosinophils, some lymphocytes and plasma cells.</p> <p><strong>Conclusion</strong>: Histoid leprosy is a discrete infrequent form of multibacillary leprosy with distinctive clinical, bacteriological and histomorphological features. Histopathologic examination with modified fite stain remains the mainstay of diagnosis.</p> I. D. Khan, M. Brijwal, I. Joshi, B. Singh, B. Poonia, G. Gonimadatala, S. Mangalesh, A. Yadav, H. Rajput, N. Bhuttay Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 IMPACT OF MOLECULAR METHOD FOR THE DIAGNOSIS OF ACUTE BACTERIAL MENINGITIS IN A TERTIARY HEALTH CARE CENTRE IN NORTH INDIA <p><strong>Background.</strong> Acute bacterial meningitis is one of the significant infectious diseases that add an immense burden to the health system. Proper management of meningitis is an invincible need to overcome the severe consequences.</p> <p><strong>Objectives.</strong> The aim of the study is detection of the etiological agents of acute bacterial meningitis by PCR.</p> <p><strong>Methods.</strong> Total 267 CSF samples collected from suspected bacterial meningitis cases were processed for the detection of S. pneumoniae, H. influenzae, N. meningitidis, E. coli and Group B streptococci by conventional and molecular diagnosis method. CSF was inoculated on Blood, chocolate and MacConkey agar plates and incubated at 37 °C for 24-48 hrs. Bacteria grown were identified by Matrix assisted laser desorption/ionization time of flight (MALDI-TOF). Multiplex PCR of the enlisted bacteria was performed using DNA extracted from CSF by DNA extraction kit (Qiagen, USA).</p> <p><strong>Results.</strong> 5 (1.87%) out of the total 267 CSF samples were culture positive (3 S. pneumoniae and 2 E.&nbsp;coli) and 28 (10.49%) had detectable DNA by conventional PCR. Out of these 28 samples, 20 (71.43%) were S. pneumoniae and 8 (28.57%) were E. coli. 15 (53.57%) out of total S.&nbsp;pneumoniae were present in children below 5 years of age. Similarly, E. coli was predominant in neonates. Sensitivity and specificity of the PCR was 100% and 95-98% respectively.</p> <p><strong>Conclusions.</strong> Streptococcus pneumoniae is the commonest cause of community acquired bacterial meningitis in children below five years of age. Hence, for the promising outcome, PCR should be implemented for the diagnosis of acute bacterial meningitis.</p> M. S. Raza, B. K. Das, V. Goyal, R. Lodha, R. Chaudhry, S. Sood, V. Sreenivas, D. Nair, S. Mohapatra, H. Gautam, A. Kapil Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 THE SYSTEMIC OXIDATIVE STRESS AS A SURROGATE OF CORONARY ATHEROSCLEROTIC PLAQUE INSTABILITY AND RUPTURE PREDICTOR <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background</span></strong><span lang="EN-US">. Oxidative stress is crucial in developing broad spectrum of diseases, including atherosclerosis and related life-threatening conditions, such as acute coronary syndrome (ACS) mainly caused by atherosclerotic plaque vulnerability. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objective</span></strong><span lang="EN-US">. To clarify the relation between oxidative stress and plaque instability we decided to compare oxidative profiles of patients with acute coronary syndrome (ACS) and with chronic coronary syndrome (CCS), evaluated at admission to the coronary care unit (CCU) of LTD Clinic-LJ (Kutaisi, Georgia) in April 2018 - June 2019, who underwent successful primary percutaneous coronary intervention (PCI). </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods</span></strong><span lang="EN-US">. 191 patients were enrolled (100 patients with ACS in Group 1 and 91 patients with CCS in Group&nbsp;2) into the study. Using the CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) – Callegari Point of Care instrument we evaluated free oxygen radical test (FORT), free oxygen radicals defense (FORD), calculated REDOX Index and the overall Profile of oxidative stress. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results</span></strong><span lang="EN-US">. The mean/median concentration of Free Oxygen Radicals was significantly higher in the patients with ACS (404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p&lt;0.0001). Significant correlation was found between advanced oxidative stress and acute coronary syndrome (OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI (2.31-4.60) with high diagnostic characteristics (sensitivity of 82% and specificity of 92.3%; positive predictive value of 92% and positive likelihood ratio of 11).</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusion</span></strong><span lang="EN-US">. Oxidative stress is crucial in life-threatening acute coronary events. Measurement of overall oxidative stress profile, as a surrogate of plaque instability and rupture predictor, could help the clinicians in risk stratification and prevention of acute coronary syndrome (ACS). </span></p> Z. Lominadze, K. Chelidze, L. Chelidze, E. Lominadze Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 NONSPECIFIC DYSPLASIA OF THE CONNECTIVE TISSUE – A FACTOR OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN ENDOPROSTHETICS OF HIP JOINTS <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background.</span></strong><span lang="EN-US"> Important part of orthopedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movement and the support ability of lower limbs. But some complications usually take place; venous thromboembolism is leading among them. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objective. </span></strong><span lang="EN-US">The aim of the study was to investigate endothelial dysfunction and activity of the hemocoagulation system at different levels of VTEC risks and thus to work out the strategy of thromboprophylaxis in patients with osteoarthrosis of the hip joint and femoral neck fracture combined with non-specific dysplasia of the connective tissue.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods.</span></strong><span lang="EN-US"> 219 patients of a mean age of 64.7±3.8 years old underwent surgery. In 137 (62.1%) cases, a total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients underwent total and unipolar cement hip replacement for cervical femoral neck fractures. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results.</span></strong><span lang="EN-US"> Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients that was confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) cases. The level of indicators of endothelium status dysfunction was much more significant in the patients in cases of nonspecific dysplasia of connective tissue. Operative intervention on the hip joint in the patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by development of venous thrombosis. In the patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) cases. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions.</span></strong><span lang="EN-US"> Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by high levels of endothelial dysfunction and increased activity of the blood-coagulation system.</span></p> I. K. Venher, N. I. Herasymiuk, S. Ya. Kostiv, I. I. Loyko, D. V. Khvalyboha Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 NECROTIZING PANCREATITIS: THE WAYS OF IMPROVEMENT OF SURGICAL TREATMENT <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background. </span></strong><span lang="EN-US">In connection with a steady increase of patients with destructive forms of acute pancreatitis, the proportion of which takes from 10-15 to 20-30%, despite of the wide range of treatments for non-biliary necrotizing pancreatitis, the rate of mortality reaches 80-90% in case of infected forms and needs further improvement of therapies.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objective. </span></strong><span lang="EN-US">The purpose of this study is to improve the results of treatment of patients with nonbiliary necrotizing pancreatitis, by optimizing surgical tactics.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods. </span></strong><span lang="EN-US">The study examined the cases of 120 patients, whose age ranged from 22 to 83 years, including patients under the age of 50 years old who accounted for 60.0%. There were 80 males (66.7%) and 40 females (33.3%). Disease duration up to 24 hours was found in 36 (30.0%) patients, from 25 to 72 hours - in 25 (20.8%) individuals, more than 72 hours - in 49 (49.2%) patients.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results. </span></strong><span lang="EN-US">The research claims in non-necrotizing pancreatitis, left-sided retroperitoneal phlegmon often develops in 64.2% (mortality rate 26.0%) of patients, right-sided in 24.2% (mortality rate 6.8%) of patients, and bilateral - in 11, 6% (mortality rate 64.2%) individuals. Moreover, the highest mortality was observed with a combination of retroperitoneal phlegmon cellulose and abscess of the pancreas and/or omental bursa - 39.1%.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions.</span></strong><span lang="EN-US"> The use of various surgical interventions depending on the involvement in the pathological process of various sections of the abdominal cavity/ retroperitoneal space, which made it possible to reduce mortality and hospitalization time of patients in the hospital by 1.5-2 times is proposed. </span></p> O.V. Rozenko Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 CHROMOSOMAL DISEASES IN THE HUMAN PATHOLOGY <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background.</span></strong><span lang="EN-US"> Chromosomal diseases are the cause of 45-50 % of multiple birth defects. Basic research on mutations is performed using genomic technologies to identify a correlation between genotype and phenotype in aneuploidies and to understand its pathogenesis.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objective. </span></strong><span lang="EN-US">The aim of the research is to study the etiology, pathogenesis of symptoms and diagnostics for patients with Down, Klinefelter, Turner syndromes and double aneuploidies by 21 and sex chromosomes.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods. </span></strong><span lang="EN-US">A literature review by the keywords “Down syndrome”, “Klinefelter syndrome”, “Turner syndrome”, “double aneuploidy” for the period of 2000-2020 was carried out.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results. </span></strong><span lang="EN-US">Down, Klinefelter and Turner syndromes are the most common aneuploidy among viable newborns. Frequency of meiotic non-disjunction events causing these aneuploidies increases with the age of a woman. Identified genes are responsible for pathogenesis of symptoms in trisomy 21, Turner and Klinefelter syndromes. Diagnostics of chromosomal diseases includes prenatal screening programs and postnatal testing.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions.</span></strong><span lang="EN-US"> Cytogenetic variants of Down syndrome are simple complete trisomy 21, translocation form and mosaicism. Trisomy 21 is associated with advanced maternal age. Phenotypic manifestations of Down syndrome are associated with the locus 21q22. The maternal and parental nondisjunction of X-chromosomes in meiosis causes Klinefelter and Turner syndromes. These chromosomal diseases are variants of intersexualism with intermediate chromosomal sex. Down-Klinefelter and Down-Turner syndromes are double aneuploidies. Patients have a Down syndrome phenotype at birth, and signs of Klinefelter and Turner syndromes occur during puberty. Diagnosis of aneuploidy is based on the cytogenetic investigation (karyotyping), DNA analysis, ultrasonography and biochemical markers of chromosomal pathology. </span></p> T.V. Bihunyak, Yu. I. Bondarenko, O. O. Кulyanda, S. M. Charnosh, A. S. Sverstiuk, K. O. Bihuniak Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 STAPHYLOCOCCUS WARNERI CLINICAL ISOLATE SUSCEPTIBILITY TO ANTIBIOTICS AND ITS MODIFICATION BY EMOXYPINE <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background.</span></strong><span lang="EN-US"> S. warneri is a common commensal organism, but it can cause serious infections. One of the ways to increase a susceptibility of this microorganism to antibiotics is their combining with adjuvant remedies.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objectives. </span></strong><span lang="EN-US">The aim of the research is to study the susceptibility of S. warneri clinical isolate to antibiotics and its modification by emoxypine - 2-ethyl-6-methyl-3-hydroxypyridine hydrochloride. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods.</span></strong><span lang="EN-US"> Samples of purulent wound exudation were obtained from a patient with infective complications after a bone fracture and osteosynthesis by metal plates. Susceptibility of S. warneri clinical isolate to antibiotics and their combinations with emoxypine (1000 μg/disk) was studied by a standard disc diffusion technique. In the case of microbial resistance, the susceptibility of the investigated isolate to such antibiotic was determined by a serial broth dilutions method without or with emoxypine and evaluated according to the minimum inhibitory concentration (MIC).</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results.</span></strong><span lang="EN-US"> By the disk diffusion method, S. warneri isolate was susceptible to all tested antibiotics, except chloramphenicol. The growth inhibition zones also were formed around disks containing emoxypine, but the susceptibility of S. warneri to this agent was low. Applying of emoxypine on the disks with antibiotics resulted in the increase of S. warneri growth inhibition in all cases, except using the amikacin, gentamicin, and fusidic acid. The most significant changes were evidenced for a composition chloramphenicol / emoxypine. Using chloramphenicol alone in the liquid medium, the MIC was over a cut-off point. Adding of emoxypine (209 μg/ml) decreased the MIC of the antibiotic and restored the susceptibility S.&nbsp;warneri to chloramphenicol. </span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions. </span></strong><span lang="EN-US">The susceptibility of S. warneri clinical isolate to antibiotics can be increased by combining with emoxypine, which among other overcomes the resistance of the studied microorganism to chloramphenicol.</span></p> N. A. Bobrova, E. M. Vazhnichaya, G. A. Loban, M. O. Faustova, M. M. Ananieva Copyright (c) Tue, 10 Nov 2020 00:00:00 +0200 MORPHOMETRIC EVALUATION OF SPERMATOGENIC EPITHELIOCYTES STRUCTURE UNDER THE RUBOMYCIN INFLUENCE IN RATS <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Background.</span></strong><span lang="EN-US"> Over the last 20 years, the quality of men’s sperm around the world has deteriorated twice. The causes are poor environment, stress, sedentary lifestyle, prevalence of sexually transmitted infections, obesity, alcohol abuse and various stimulants. The structure and function of the testes, when exposed to various drugs and chemicals, attracts the attention of present researchers.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Objectives. </span></strong><span lang="EN-US">The aim of the research was to study the structural changes of the spermatogenic epithelium in testicular damage caused by rubomycin hydrochloride.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Methods. </span></strong><span lang="EN-US">The spermatogenic epithelium of the testes of 30 white adult white male rats, which were divided into 2 groups, was morphometrically examined. The 1<sup>st</sup> group comprised 15 experimental intact animals, the 2<sup>nd</sup> – 15 rats, in which testicular damage with rubomycin hydrochloride was simulated. Euthanasia of rats was performed by bloodletting under thiopental anesthesia one month after the experiment beginning. Quantitative morphological parameters were statistically processed. In spermatocytes of the 1<sup>st</sup> P-order, spermatogonia and spermatids of testes, their height, diameter of nuclei, nuclear-cytoplasmic ratio and relative volumes of damaged cells of spermatogenic epithelium were evaluated.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Results. </span></strong><span lang="EN-US">It was established that spermatogenic epithelial cells were damaged in the simulated experimental conditions, which was morphometrically confirmed by changes in nuclear-cytoplasmic relations in the 1<sup>st</sup>, 2<sup>nd</sup> order spermatocytes, spermatogonia and spermatids. The relative volumes of damaged spermatogenic epithelial cells also increased significantly. The most significant morphometric parameters were altered in spermatids. Thus, the nuclear-cytoplasmic ratio in the studied cells was statistically significantly (p &lt;0.001) increased by 7.4% compared with the similar control morphometric parameter. The relative volume of damaged spermatids in these experimental conditions reached (32.50±0.18) %, which with a high statistically significant difference (p&lt;0.001) exceeded the same control value in almost 15.8 times. Optically, histological preparations of the testes showed severe vascular disorders, characterized by dilation and plethora mostly of venous vessels, which pointed to violation of venous drainage of the studied organs.</span></p> <p class="a"><strong><span lang="EN-US" style="font-style: normal;">Conclusions. </span></strong><span lang="EN-US">According to the attained research results it has been established that nuclear-cytoplasmic relations are an objective and valuable informative indicator of a functional condition of cells and their structural changes in pathological conditions. When rubomycin hydrochloride is exposed to experimental animals, the most significant changes in nuclear-cytoplasmic relations are found in spermatic spermatozoa.</span></p> M. S. Hnatiuk, S. О. Konovalenko, L. V. Tatarchuk, О. B. Yasinovsky Copyright (c) Wed, 11 Nov 2020 00:00:00 +0200 INFLAMMATION AND IMPACT OF VINCRISTINE AND ENTEROSORPTION USE IN CHEMICALLY INDUCED COLON CARCER IN RATS <p><strong>Background</strong>. The increasing incidence of colon malignant tumors is one of the most urgent matters of contemporary medicine. In the study of carcinogenesis of the colon the attention is paid to the state of the body’s immune system and activation of inflammatory processes in experimental animals.</p> <p><strong>Objective.</strong> The aim of the study was to estimate the level of markers of inflammation in the serum of experimental animals with chemically induced carcinogenesis and their dynamics in case of administration of the cytostatic Vincristine secondary to AUT-M carbon enterosorbent.</p> <p><strong>Methods. </strong>The study was performed on white male rats. Animals were modeled for colon cancer by administration of 1.2-dimethylhydrazine hydrochloride at a dose of 7.2&nbsp;mg/kg body weight for 30 weeks. AUT-M enterosorbent was administered intragastrically daily during 7 and 21 days after modeling of carcinogenesis at a dose of 1 ml of suspension (corresponding to 0.2 g of drug weight) per 100 g of animal body weight. The antitumor drug was administered to the animals with induced carcinogenesis intragastrically daily during 14 days at a dose of 0.23 mg/kg of body weight after a 21-day detoxification therapy. The activity of inflammatory processes was evaluated by the content of pro-inflammatory interleukin 6 and anti-inflammatory interleukin 4, C-reactive protein in the serum of experimental animals.</p> <p><strong>Results. </strong>It was established that introduction of 1.2-dimethylhydrazine hydrochloride in the rats caused changes in the cytokine profile and the content of C-reactive protein. In the affected animals an increase in the content of pro-inflammatory interleukin 6, C-reactive protein, as well as a decrease in the content of anti-inflammatory interleukin 4 was evidenced in all periods of the study. AUT-M enterosorbent contributed to normalization of these parameters. The cytostatic Vincristine had a negligible effect on development of inflammatory processes in the studied animals.</p> <p><strong>Conclusions</strong>. In cases of induced carcinogenesis, an imbalance in the content of pro- and anti-inflammatory cytokines, an increase in the content of acute-phase C-reactive protein was established. The positive effect of the cytostatic Vincristine secondary to a previous detoxification therapy with AUТ-M sorbent during a progressive development of inflammatory processes in the presence of modeled carcinogenesis was evidenced.</p> O. I. Kachur, L. S. Fira, P. H. Lykhatskyi Copyright (c) Wed, 11 Nov 2020 00:00:00 +0200 WEB-BASED 5-DIMENSIONAL ELECTRONIC PORTFOLIO (5DEP) AS A COMPETENCY-BASED ASSESSMENT TOOL IN POST-GRADUATE MEDICAL TRAINING <p><strong>Background</strong>. New challenges of permanently changing context of healthcare system requires new methods of medical education and new assessment tools, as well. Competency-based Medical Education (CBME), framework which has been adopted as a new approach in medical education, needs appropriate assessment tool such as portfolio. Portfolio is learner-centered assessment instrument which evaluates learner’s progression towards outcomes and enables both residents and teachers to engage in a process of learning through assessment.</p> <p><strong>Objective</strong>. In this paper we aim to share our successful experience of an effective use of web-based 5-Dimensional Electronic Portfolio (5DeP) as an assessment tool in the Pilot Group.</p> <p><strong>Methods. </strong>Pilot Group of sixteen residents (six first year residents of Obstetrics/Gynecology and ten first year residents of Internal Medicine. Tbilisi State Medical University Institute of Postgraduate Medical Education and Continuous Professional Development) and twelve mentors (four Obstetrics/Gynecology mentor and eight Internal Medicine mentors) reported some feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool.</p> <p><strong>Results</strong>. Feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool from mentors and students demonstrated efficiency of the program. It enables assessment within a framework of transparent and declared criteria and learning objectives; provides a model for lifelong learning and continuing professional development; increases competence in a wider context with benefits to both professional and personal roles; improves organizing skills.</p> <p><strong>Conclusions</strong>. 5DeP have been recognized as an extremely effective assessment tool.</p> Z. Bokhua, K. Chelidze, K. Ebralidze Copyright (c) Wed, 11 Nov 2020 00:00:00 +0200