Shahsuvaryan M.L.,Yerevan State Medical University
International Eye Science | Year: 2013
Retinalvein occlusion (RVO) is the most common visually disabling disease affecting the retina after diabetic retinopathy. Although the disease entity has long been known, its management is still controversial. Macular edema is the main reason for decreased visual acuity (VA) in this retinal vascular disorder. Recently the vitreous cavity has increasingly been used as a reservoir of drugs for the direct treatment of macular edema through intravitreal injection route. The most widely injected drugs so far have been triamcinolone acetonide (TA) and bevacizumab. The objective of this review is to evaluate the evidence and discuss the rationale behind the recent suggestions that intravitreal pharmacotherapy by corticosteroids and anti-vascular endothelial growth factors may be useful in the treatment of retinal vein occlusion.
Dunamalyan R.A.,Yerevan State Medical University
New Armenian Medical Journal | Year: 2014
The research objective was to scientifically justify the use of quality of life indicator as a criterion for health state assessment in children of the early age. The object of the study made respondents from 3 months to 3 years inclusive. Till present, in Armenia there were no tools for quality of life assessment in children of an early age, thereby the most acceptable " Qualité de vie du Nourrisson" -QUALIN questionnaire was used as a basis to create the Armenian version. The process of the Armenian-language questionnaire creation was carried out according to the standard procedure of linguistic ratification and validation. The questionnaire was presented to the international " MAPI" Research Institute (France) on quality of life studies. The official permission was received to develop a key to this tool. In the answers of all respondents there was a tendency to appreciate higher such scale aspects as " behavior and communication" and " family environment", thus the levels of parameters " neurologic-andbehavioural development and physical health? and, especially, " ability to stay alone" were lower. As age features, there was noted an increase of values on the scale aspects " ability to stay alone "(p<0.01). The possible gender differences in quality of life of younger children were studied. According to parents, the quality of life in boys is higher than that of girls, both according to the general point and the separate aspects such as " ability to stay alone" and " family environment". Doctors also gave higher appreciation to quality of life of boys. Establishing possible influence of the state of health in children on quality of their life was one of the main objectives of our research. In order to detect the features distinctive to the influence of diseases on the quality of life, the comparison of quality of life was carried out among healthy children and the children having certain pathology. In the studied sample the most widespread impairments were diseases of skin and hypodermic tissue. It is obvious that quality of life in children with skin diseases was lower than that of healthy children; this latter especially concerned the aspects of " neurologic-and-behavioural development and physical health? and " ability to stay alone". Thus, the influence of health state on the quality of life significantly differed depending on the illness. Age features consisted only in the increase of the values on the scale aspect " ability to stay alone". Among the components of quality of life, such parameters as " behaviour and communication" and " neurologic-and-behavioural development and physical health" mostly reflected the health state of a child, while " family environment" and " ability to stay alone" parameters reflected the social environment.
Stepanian S.,Yerevan State Medical University
Georgian medical news | Year: 2011
The results of treatment of 16 patients with abdominal adhesive disease are presented. In the surveyed group there were 7 women and 9 men. The average age of patients was 47,7 ± 14,0 (23-71). Mean duration of history of intestinal obstruction were 48,9 ± 31,5 (5-120) hours. 12 patients underwent surgery for acute adhesive small bowel obstruction. In 7 patients obturative and in 5 patients strangulated obstructions were revealed. In 9 patients laparoscopic resolution of obstruction was performed (no cases of conversion), in 3 patients open surgery is done. 4 patients were operated on for abdominal chronic pain, among them in three cases laparoscopy was performed, in one case open adhesiolysis was done. In order to prevent adhesions antiadhesive seprafilm membrane was applied in all patients. During laparoscopy the following technique was used - rolling of the film seprafilm with protective paper wrapper, the introduction into the abdominal cavity, the deployment of the roll, application of film to the anterior abdominal wall and the surfaces of omentum or intestines. No intra- and postoperative complications were observed. During observation no evidence of intestinal obstruction was observed in the operated patients. There was no mortality. The combination of laparoscopic adhesiolysis with antiadhesive barrier seprafilm is one of the best methods of treatment and prevention of adhesive disease of abdomen.
Petrosyan L.,Yerevan State Medical University
Journal of Clinical and Translational Endocrinology | Year: 2015
Objective Thyroid hormones as modulators of adaptive thermogenesis can potentially contribute to development of obesity. The purpose of our study is to observe a relationship between TSH and BMI, blood lipids, BP and HbA1c in type 2 diabetic subjects with euthyroidism. Methods A total of 120 subjects with type 2 diabetes were recruited for this study from November 2012 to June 2014. Subjects were included in the study with TSH values between 0.4 and 4.5 mU/l, who did not take any thyroid medication and had a similar iodine diet. Subjects were weighed and anthropometric indices, lipid parameters, fasting plasma glucose, HbA1c, eGFR, blood pressure (BP) were documented. TSH was measured by an electrochemiluminescence immunoassay. Statistical analysis was performed by using SPSS 18(P value <0.05 was considered significant). Results The mean age of the participants was 60.6 ± 11.6 years with a BMI of 25.3 ± 3.1 kg/m2. Serum TSH levels were significantly and positively associated with BMI, systolic and diastolic BP, serum triglyceride and HbA1c levels, whereas negatively with eGFR. Subjects with a TSH in a higher normal range (2.5-4.5 mU/I, n = 58) had a significantly higher BMI (26.7 ± 3 vs. 24.1 ± 2.7) and this relation remained significant adjusted for age and sex (P < 0.001). When TSH was in low normal range, the number of patients with glycemic goal (HbA1c > 7%) decreased from 27.5% to 12.5% (P = 0.02, adjusted for age and sex). Conclusion In type 2 diabetic subjects with biochemical euthyroidism we found significant association between high normal TSH levels and components of metabolic syndrome. High normal TSH levels were associated with more number of subjects with glycemic goal (HbA1c >7%). © 2015 The Author.
Minasyan A.,Yerevan State Medical University
Georgian medical news | Year: 2012
Cardiorenal anemia syndrome (CRAS) refers to the simultaneous presence of anemia, heart failure (HF), and chronic kidney disease (CKD) that forms a pathologic triad with an observe impact on morbidity and mortality. Certain researches were made regarding the usage of erythropoietin (EPO) in patients with the above mentioned disorders. This leads to the improvement of left ventricular function, quality of life and physical tolerance with decreased risk of hospitalization. Despite successful anemia treatment with EPO in dialysis patients with CKD, HF and cardiorenal syndrome type 2, it should be important to reveal the target Hb level and role of EPO in this category of patients. According to European guidelines in 85% of hemodialysis patients targeted Hb level should be no more than 11g/dl, moreover, the treatment of anemia can be organized before dialysis and it will certainly increase the quality of life in this type of patients.