Journal «MEDICINA» 2/2022

A great number of intraocular lenses of various models and manufacturers is present on the ophthalmic market. The difficulty lies in choosing a specific lens model for each eye. In this work, we compare the characteristics of some monofocal IOLs most often implanted in Orenburg branch of the S. Fyodorov Eye Microsurgery Federal State Institution over the past 5 years, as well as the results of their implantation and the economic component. There were no significant differences in the medical efficiency of implantation of different models of lenses, and therefore the leading guideline for choosing an IOL may be the factor of economic efficiency.

Key words: monofocal intraocular lenses, choice of IOL model, cost-effectiveness

Purpose: evaluate the safety and convenience of self-use by users of the intraocular pressure tonometer TVGD-02 in home practice without the involvement of medical professionals. Material and methods. 42 people formed 30 pairs: user-patient and user-assistant. In 18 cases (9 pairs), each person from the pair was in the role of both a patient and an assistant. The participants were independently trained at home in the technique of transpalpebral measurement of intraocular pressure (IOP), tested on the control circuit of the device and measured IOP to the user-patient. In the questionnaire, users assigned points, rating the convenience and safety of use of the tonometer. Results. Among the assistant users, individuals were represented (59.68±17.2 [22; 83] years) with different educational levels. Of the patient users (60.64±17.1 [22; 82] years), 82.14% of the study participants were persons with ocular pathology, and 35.7% of the patients had glaucoma with concomitant pathology. In 100% of cases, the participants were able to independently figure out how to properly prepare the tonometer for operation and perform IOP measurement. The accuracy and reproducibility of the measurement results significantly increased with the improvement of the skills of working with the tonometer: on the 1st day, the dispersion in the series of control measurements was 2.07±1.7 [7; 0] mm Hg. article, and IOP of the user-patient of 2.89±1,91 [8; 0], and on the 5th day, the measurement accuracy is significantly increased, and dispersion decreased to 1.21±0,72 [2; 0] and 0.85±0,69 [2; 0] mm Hg. accordingly. Users rated the ease of performing various stages of using the device from 4.21±0.67 to 5.0±0.0 points. Conclusion. Transpalpebral tonometry using the TVGD-02 tonometer makes it possible to adequately assess IOP in patients with assisted tonometry in home practice. Independent study of information about the principles of operation of the device and the method of working with it makes it possible to acquire the skills of using the tonometer without the participation of medical personnel.

Key words: transpalpebral tonometry, intraocular pressure, glaucoma, self-monitoring

Introduction. When developing new pharmacologically active compositions and introducing them into extemporaneous manufacturing and industrial production, a comprehensive study of the properties of the medicinal product applying modern methods of analysis combining high metrological characteristics, expressiveness, sensitivity, accuracy, availability, reliability is mandatory. Development of analytical methods for quality control of new drug compositions is an urgent task of modern pharmaceutical analysis. Aim. Development and validation of a method for quantitative determination of bisoprolol in a new pharmacological composition «Bisoprolozol». Material and methods. To perform the analysis, we used pharmaceutical substance bisoprolol fumarate, glycerol hydrophilic gel «Tizol», ointment «Bisoprolozol» consisting of 0,5% of selective beta-blocker in titanium-containing glycerohydrogel. During the experiment, spectrophotometer SF-2000 and the method of absorption spectrophotometry in the ultraviolet region were used. Regression analysis of data obtained was performed in Microsoft Office Excel 2016 (OFS.1.1.0013.15 «Statistical processing of the results of chemical experiment»). The technique was evaluated according to validation parameters: specificity, linearity, correctness, and precision. Results. Studying the electronic spectral curves of bisoprolol we determined that its analysis is rationally performed at a wavelength of 274 nm (experimentally determined maximum absorption). In the course of the study we determined the sensitivity of the determination of the drug, which is equal to 5.260 µg/ml at A(min) = 0.02. The results of quantitative analysis of bisoprolol in the pharmacological composition «Bisoprolozol» showed that the mass of the selective blocker of adrenergic receptors (0.0409-0.0536 g) is within the acceptable limits according to the regulatory documentation for soft pharmaceutical forms (Order of the Russian Ministry of Health № 751n of 26.10.2015). Conclusion. In the present experiment, optimal conditions for the spectrophotometric method of analysis were selected, based on which the method of quantitative determination of bisoprolol in the new pharmacological composition «Bisoprolozol» with an error not exceeding ± 1.89 % was developed, validated and presented.

Key words: bisoprolol, gel «Tizol», spectrophotometry, validation, quantitative determination

Medicinal plant raw materials have always been actively used in traditional and folk medicine. This is due to the wide range of medicinal plants therapeutic effect. Due to its therapeutic effect, Mentha asiatica Boriss is widely applied in the Republic of Tajikistan. It is used in the treatment of headaches, respiratory diseases and gastrointestinal tract disorders. To achieve the necessary level of pharmacological effect, it is necessary to take into account that the component composition of biologically active substances can change at different stages of plant development. Therefore, the aim of the study was to determine the component composition of Mentha asiatica essential oil at the stage of budding and flowering. Materials and methods: Samples of the Mentha asiatica essential oil were obtained during budding and flowering to conduct the study by method 1 of the State Pharmacopoeia XIV edition. The chemical composition of Mentha asiatica essential oils was studied by gas-liquid chromatography-mass spectrometry on Agilent 7890 A gas chromatograph with Agilent 5975C mass-selective detector. As a result, components such as limonene, eucalyptol, menthone, pulegone and isopulegone were found in the essential oil of flowering Mentha asiatica. Limonene, caryophyllene, carvone, trans-dihydrocarvone, and beta-bourbonene were found in samples of Mentha asiatica essential oil at the budding stage. It was found that all identified biologically active compounds have a wide range of therapeutic effects. Therefore, detailed studies of the Mentha asiatica essential oils pharmacological activity are of importance.

Key words: Mentha asiatica, essential oil, gas-liquid chromatography-mass spectrometry

Thrombotic complications are the most dangerous manifestations of COVID-19. This justifies the need for anticoagulant therapy in a new coronavirus infection. The effects of enoxaparin at therapeutic and prophylactic doses in COVID-19 were assessed from a meta-analysis of 5 randomized clinical trials (RCTs). Search for RCTs was performed in the MEDLINE, Cochrane, PubMed, and ClinicalTrials.gov databases. Odds ratio (OR) with 95% confidence interval and heterogeneity were calculated applying RevMan 5.4.1 software. Combined criterion for the effectiveness of anticoagulant therapy included mortality and thrombotic events (arterial and venous thrombosis). The safety of enoxaparin was assessed by the frequency of bleeding (secondary outcomes). There were no statistically significant differences in mortality in COVID-19 patients receiving enoxaparin at therapeutic doses compared with prophylactic doses [OR = 0.98; 95% CI 0.84 – 1.16; p = 0.85]. The frequency of thrombosis and thromboembolism when using enoxaparin in therapeutic doses was lower compared with prophylactic doses [OR = 0.80; 95% CI 0.66 – 0.98; p = 0.03], while the frequency of bleeding was higher [OR = 2.11; 95% CI 1.36 – 3.30; p = 0.0009]. This meta-analysis suggests a greater efficacy of enoxaparin at therapeutic doses in reducing the incidence of thrombotic complications in hospitalized COVID-19 patients, however, these data require clarification. Further multicenter randomized controlled trials are needed to determine the optimal anticoagulant regimens in COVID-19 patients.

Key words: enoxaparin, meta-analysis, systematic review, COVID-19

Currently, the search for antiseptic agents is being actively conducted, including in connection with the spread of the SARS-CoV-2 virus. One of the promising antiseptics is cetylpyridinium chloride (CPC). The published analysis of the Pubmed database provides a general idea of the use of CPC in modern medical practice as an antibacterial, antifungal and antiviral agent in the composition of various medicines and products for dentistry.

Key words: antiseptics, cetylpyridinium chloride, antimicrobial activity, antiviral effect

Objective. Determination of the stability of different series of the drug «Piron film-coated tablets, 50 mg», when stored in natural conditions. Materials and methods. Three experimental series of new anti-inflammatory drug Piron tablets were analyzed. The stability study was carried out in accordance with the requirements of the State Pharmacopoeia of the XIV edition, GOST Р 57129-2016 and ICH Q1A: 2003 «Study of the stability of new pharmaceutical substances and drugs.» During storage in natural conditions (temperature not higher than 25 ºС, in a dry place protected from light), in accordance with the current regulatory documentation and draft specification all three series of the drug were analyzed by indicators: description, authenticity, mass uniformity, dissolution, dosage uniformity, impurities, microbiological purity, quantitative determination. Results. As a result of stability analysis of the finished dosage form «Piron film-coated tablets, 50 mg», we can conclude that during the storage period in natural conditions (temperature not higher than 25 ºС, in a dry place protected from light) quality parameters met specification requirements. Conclusion. The stability of tablets of the new modern non-steroidal anti-inflammatory drug «Piron film-coated tablets, 50 mg» during storage was investigated and confirmed, when stored under natural conditions. The shelf life is at least two years.

Key words: osteoarthritis, tablets, non-steroidal anti-inflammatory drugs (NSAIDs), stability

Choroidal melanoma is one of the most malignant tumors of the organ of vision, the development of which is associated with the risk of metastasis and the possibility of death, which indicates the relevance of the search and application of effective methods of treatment of this pathology. To date, in the treatment of choroidal melanoma, preference is given to organ-preserving methods aimed at achieving local control over the tumor. One of the promising organ-preserving techniques is photodynamic therapy, which is a treatment method based on the ability of a photosensitizer to absorb light, receive energy and interact with chemical substances, with the further development of toxic photodynamic reactions in target tissues, the occurrence of which is possible with the simultaneous presence of three components: a photosensitizer, light and oxygen. In our country, there is a number of studies devoted to the treatment of choroidal melanoma with PDT, basically presenting experimental research, pilot studies and demonstrating clinical cases. The purpose of this review is to summarize data on photodynamic therapy and the use of this technique in the treatment of choroidal melanoma.

Key words: choroidal melanoma, photodynamic therapy, uveal melanoma, photosensitizers, ophthalmooncology, treatment of choroidal melanoma

The prevalence of Proctalgia fugax (PF) in the population ranges from 4 to 18%, with functional PF (FPF) occurring in 5,6% of cases. It is necessary to identify FPF using the MDCalc medical calculator, questionnaires. The coloproctologist should exclude non-functional proctalgia (NPF) and functional PF (FPF), coccygodynia, organic diseases of the pelvic organs. Patients with NPF, NPF, coccygodynia should be examined and treated by doctors of narrow specialties. Treatment of patients with NPF in combination with puborectal nerve neuritis (PRNN), changes in the spine, bone structures and pelvic organs should be carried out by narrow specialists (neurologist, neurosurgeon, orthopedist, gynecologist, urologist). The most common cause of FPF is intraanal sphincter hypertrophy (IASH), which is treated by relaxing the IAS. Treatment of patients with FPF in combination with irritable bowel syndrome (IBS) should be carried out in accordance with the Roman Criteria 4 (RC4). A psychogastroenterologist should conduct research and treatment of patients with PF and with mental health disorders. The study and treatment of patients with PF of unclear etiology should be carried out after a consultation of doctors based on the modern concept of functional gastrointestinal disorders (FGR) – violations of the brain-intestine relationship and the use of an algorithm.

Key words: Proctalgia fugax, etiology, diagnosis, treatment, algorithm