Yerevan State Medical University
Yerevan, Armenia

Yerevan State Medical University named after Mkhitar Heratsi is a leading medical school in Yerevan, Armenia. Wikipedia.

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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.

Tonoyan T.,Yerevan State Medical University | Tonoyan T.,Economics and International Relations at the National Institute of Health | Muradyan L.,Yerevan State Medical University
International Journal for Equity in Health | Year: 2012

Introduction: Prevailing sociopolitical and economic obstacles have been implicated in the inadequate utilization and delivery of the Armenian health care system. Methods: A random survey of 1,000 local residents, from all administrative regions of Armenia, concerned with health care services cost and satisfaction was conducted. Participation in the survey was voluntary and the information was collected using anonymous telephone interviews. Results: The utilization of health care services was low, particularly in rural areas. This under-utilization of services correlated with low income of the population surveyed. The state funded health care services are inadequate to ensure availability of free-of-charge services even to economically disadvantaged groups. Continued reliance on direct out-of pocket and illicit payments, for medical services, are serious issues which plague healthcare, pharmaceutical and medical technology sectors of Armenia. Conclusions: Restructuring of the health care system to implement a cost-effective approach to the prevention and treatment of diseases, especially disproportionately affect the poor, should be undertaken. Public payments, increasing the amount of subsidies for poor and lower income groups through a compulsory health insurance system should be evaluated and included as appropriate in this health system redesign. Current medical services reimbursement practices undermine the principle of equity in financing and access. Measures designed to improve healthcare access and affordability for poor and disadvantaged households should be enacted. © 2012 Tonoyan and Muradyan; licensee BioMed Central Ltd.

The embryonal antitumor modulator (EATM) reveales a hypoglycemic effect in streptozoto-cin-induced diabetes in rats. However, the mechanisms, by which EA{cyrillic}T{cyrillic}M{cyrillic} stabilizes erythrocyte membranes and membranes of serum exosomes associated with characteristic changes of nico-tinamide adenine dinucleotide phosphate-oxidases (Nox) of erythrocyte membranes and serum exosomes in patients with diabetes types 1 and 2, are yet to be elucidated. It was shown that aerobic incubation of the aqueous mixture of erythrocyte membranes, serum of healthy donors and patients with diabetes mellitus types 1 and 2 in the presence of EATM re-sulted in suppression of Nox release process from erythrocyte membranes in diabetes types 2 and 1 patients and healthy donors by 45.5%, 31.6% and 25.1%, respectively. Under the same condi-tions reduced activity of extracellular Nox (eNox) released from the serum of patients with dia-betes types 2 and 1 and blood serum of donors by 47.9%, 31.3% and 29.3%, respectively, was observed. The most effective concentration of EATM was 0.15 mg/ml. Suppression mechanism for Nox and eNox releasing by EATM at types 1 and 2 diabetes mel-litus is associated with decrease in lipid peroxidation that brings to membrane stability increase. Apparently, the latter is a novel mechanism of the membrane stabilizing effect exerted by EATM ex vivo. This allows to foresee some scientific prospects for EATM as an agent in vivo stabilizing the erythrocyte membranes and exosomes at diabetes type 1 and, especially, type 2.

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.

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.

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.

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.

Manvelyan H.M.,Yerevan State Medical University
New Armenian Medical Journal | Year: 2016

Pain is the most common reason for physician consultation in most developed countries. Pain is considered as a devastating symptom in many medical conditions, which reflects on human quality of life and social economic activity. Despite of devastating nature the pain by itself has become an independent target for research, however, the methods of pain assessment and management of patients with pain syndrome are still poorly studied. One of the actual problems of modern medicine is metabolic syndrome related particularly to vitamin D deficiency. Recent literature data and clinical observations prove the presence of strong correlations between neuropathic and chronic pain and severity of vitamin D deficiency. Moreover, it was revealed, that supplementation of vitamin D was beneficial for all observed patients in both pain reduction and improvement of well-being. Thus, prioritization of further investigations in this field and possible inclusion of low cost safe medicine are necessary for effective management of the pain. © 2016, Yerevan State Medical University. All Right Reserved.

Avagyan S.A.,Yerevan State Medical University
New Armenian Medical Journal | Year: 2016

Determination of the role of polyamines (putrescine, spermidine and spermine) in the integrative activity of mammal organism is a subject for a broad discussion at present. At the same time, the putrescine-mediated mechanisms, interested in the implementation of incretory and excretory functions of pancreatic gland, are studied insufficiently. The shifts in somatostatin content in blood serum and pancreatic gland were studied in the conditions of putrescine administration to intact animals similar to those in blood serum of higher mammals in various time intervals. Authors discuss possible putrescine-dependent total and regional endocrine-mediated mechanisms providing the function of β-cells of pancreatic insular apparatus based on the analysis of conducted own researches and literary sources. From total mechanisms somatostatin and somatotropin of central genesis, which are relatively produced in hypothalamus and pituitary, play an important role. Due to the conducted enzyme immunoassay it was established, that exogenous putrescine, inserting to intact rats in extremely low concentrations maximally close to those revealed in blood serum or a series of mammals, leads to the decrease of somatostatin level in blood serum. Apparently, the function of β-cells of pancreas insular apparatus is activated on the background of somatostatin low level, and the effect of somatotropin on β-cells is indirectly implemented – by the activation of insulin-like growth factor-1 synthesis in the liver and twisted intestine. Direct stimulating effect of putrescine on β-cells of Langerhans islets is not excluded, which is confirmed in analyzed literary sources of present article. On the basis of conducted studies and literary data analysis it is hypothesized that putrescine plays a significant role in the formation of functional hormonal-mediator loop, the effect of which is implemented both on the level of brain central structures (hypothalamus and pituitary), and digestive system organs (pancreatic gland and intestinal tract) under the conditions of normal functioning of higher mammalians organism, produced in various organs and tissues. © 2016, Yerevan State Medical University. All Right Reserved.

The role of melatonin and somatostatin produced in digestive system in lesion mechanisms of excretory apparatus of pancreas on arginine pancreatitis model was investigated from immunoenzymometric and morphological aspects. The study was held in two directions: • Investigation of the role of somatostatin produced in the pancreas in induction and process of arginine pancreatitis. • Investigation of the role of melatonin produced in intestines in the induction of bacterial translocation. Analyzing the results in the context of available literature data, an assumption is made, according to which the process of intestinal bacterial translocation in acute pancreatitis is melatonin-dependent. This process is mostly associated with disturbance of melatonin synthesis in endocrinocytes located in mucous membrane of lesser intestines, as well as acinar cells of pancreas. Somatostatin also has an important role in the induction mechanism of arginine pancreatitis. High concentration of somatostatin in blood serum and pancreas of experimental animals in early stages of regional pathological process should be considered as an adverse factor, because, on the one hand, high concentration of somatostatin may inhibit synthesis of somatotropin in hypophysis, on the other hand, it may inhibit secretory processes in endocrine and exocrine apparatus of pancreas. A hypothesis has been made, according to which autonomous paracrine melatonin- and somatostatin-dependent functional loops providing regional and bacterial homeostasis are involved in digestive system, preventing the migration of opportunistic intestinal microorganisms into new econiches of the host under the conditions of normal functioning of higher mammals’ organisms. © 2016, Yerevan State Medical University. All Right Reserved.

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