Azerbaijan Medical University

The title mol­ecule, C13H17Cl2FO3, crystallizes in the ortho­rhom­bic space group P212121 with one mol­ecule in the asymmetric unit. The skeleton of the mol­ecule exhibits an anti conformation with a C—C—C—C(Ph) torsion angle of −174.97 (18)°. The species are weakly hy­dro­gen bonded to form a polymeric chain elongated in the direction of the b axis. This inter­action is realised by the hydroxyl group with an ether O atom of a symmetry-related species [O—H⋯O hy­dro­gen-bond distance of 2.975 (2) Å]. No π-stacking inter­action involving the fluoro­benzyl moiety is detected in the crystal structure. Hirshfeld surface analysis, confirming the O—H⋯O donor–acceptor inter­actions, indicates that the most important contributions to the surface contacts are H⋯H (47.0%), Cl⋯H (19.5%), C⋯H (12.1%) and F⋯H (10.7%).

Background Over the past few years, Iran has experienced several earthquakes. The literature has highlighted the significant role played by Iranian nurses in the Kermanshah earthquake. However, few studies have been conducted to investigate nurses’ responses to disasters. This study aimed to explore the impacts of rescue experiences on nurses who cared for the injured following the Kermanshah earthquake. Method This is a qualitative study utilizing a conventional content analysis approach, following the Granheim and Landman framework. Sixteen nurses with experience in caring for earthquake survivors in Kermanshah were selected using a purposeful sampling method. Data were collected through in-depth semi-structured interviews, with ethical considerations applied at all stages of the research. MAXQDA software (version 10) was employed to assist in managing the data. Results The study included 16 nurses: nine females (56.25%) and seven males (43.75%). The mean age of the participants was 34.13 ± 5.78 years, and the mean work experience was 10.75 ± 5.3 years. Following the coding of the interviews, 274 initial codes were extracted. These codes were merged to form 17 subcategories, five categories, and two main themes. The main themes were (i) Positive impacts (professional maturity, and the emergence of a new horizon in the meaning of life) and (ii) Negative impacts (psychological trauma, a decline in professional performance, and spiritual despair). Conclusion In the context of this type of care, nurses experience dual impacts: on one hand, it uplifts their personal lives and professional performance, while on the other hand, it poses significant threats to them.

Aim Ingestion of corrosive substances is a difficult and important medical problem to manage. The aim of this study is to present an algorithm that will regulate the treatment and follow‐up of paediatric patients with corrosive ingestion. Methods Children who were admitted to the paediatric emergency department with corrosive substance ingestions between July 2015 and December 2021 were included. Between July 2015 and January 2020, endoscopy was performed on all patients. After January 2020, endoscopy was performed only for patients presenting with hypersalivation and dysphagia. Results 172 patients were followed up and treated in our clinic due to corrosive substance ingestion. Endoscopic evaluation of 19 patients with hypersalivation revealed oesophageal corrosion stages as follows: grade I in 5 patients, grade II‐A in 1 patient, grade II‐B in 3 patients, and normal findings in the remaining patients. Of the 14 patients with dysphagia, 1 had grade I, 2 had grade II‐A, and 4 had grade II‐B corrosion, and the remaining patients had normal endoscopic findings. In the long‐term follow‐up of the patients without hypersalivation and dysphagia, no complications developed and no additional treatment was required. Conclusions In patients presenting with suspicion of ingestion of high risk corrosive substances, there is no need for endoscopy unless hypersalivation and dysphagia are present simultaneously.

Congenital anomalies pose significant challenges in medicine due to their high morbidity and mortality rates. These anomalies are more prevalent in low‐ and middle‐income countries, where variations exist in intensive care admissions and treatment protocols for critical cases. Our study aimed to investigate the prevalence of congenital anomalies among patients under the age of one admitted to the level III intensive care unit. The study focused on diagnosing anomalies, reasons for intensive care admission, structural analysis, classification based on system involvement, surgical requirements, duration of intensive care stay, and treatment outcomes. A total of 8276 patients were admitted to the intensive care unit of our Pediatric Research Institute between 2019 and 2022. Among them, 1256 patients (15.2%) were diagnosed with congenital anomalies. The majority of infants (73.3%) were admitted within the neonatal period, whereas 21.2% were admitted from 29 days to 6 months and 5.5% between 6 months and 1 year of age. Ultimately, 1084 (86.3%) patients survived, and 172 (13.7%) patients died. Structural analysis of congenital anomalies in a tertiary intensive care unit in Azerbaijan indicated comparable frequencies of anomalies, surgical requirements, and mortality rates to those published in articles from developed countries. Additionally, differences in anomaly distribution among organ systems were observed, with congenital heart defects being more prevalent.

This article aims to highlight the advantages of using scleral contact lenses as a therapeutic approach for Pellucid Marginal Degeneration (PMD). PMD is a rare non-inflammatory corneal ectatic disorder. Due to its similar features to Keratoconus, it is harder to correctly diagnose and use effective therapeutic approaches for PMD. After a definitive diagnosis of PMD using corneal topography, we have evaluated the change in best corrected visual acuity (BCVA) both after the use of scleral contact lens and in hybrid lens. It is vital to remember that various cases of misdiagnosis may not only delay the management and treatment modalities, but also these could further result in complications, especially when the therapeutic approach between two diseases may differ. Keywords: pellucid marginal degeneration, scleral contact lens, astigmatism, keratoconus, hybrid contact lens, corneal topography, visual rehabilitation

Introduction A realistic phantom created from a 3D-reconstructed digital patient model would enable researchers to investigate the morphological aspects of the pathologic spine, thereby resolving the issue of scarce cadaveric specimens. We designed a patient-specific, human-like, reliable, and cost-effective prototype of the examined pathologic spine through open-source editing software analysis, a desktop 3D printer, and alginate material. We aimed to validate that the major surgical steps and anatomy replicated the real surgery as it would be conducted in actual patients. Materials and methods We cover the fundamental principles and procedures involved in 3D printing, from spine imaging to phantom manufacturing. Three representative simulation cases were included in the study. All phantoms were sequentially evaluated by surgeons for fidelity. Following each surgery, participants were given a survey that included 20 questions regarding the fidelity of the training phantom. Results We validated this simulation model by analyzing neurosurgeons' performance on the phantom trainer. Based on a 20-item survey to test content validity, and reliability, there was little variation among participants’ ratings, and the feedback was consistently positive. The gross appearance of the phantom was analogous to the cadaveric specimen and the phantoms demonstrated an excellent ability to imitate the intraoperative condition. The plastic material expenditure ranged from 170 to 470 grams, and the alginate expenditure was 450 grams. The total cost of ABS varied from $5.1 to$17.6 ($0.03 per gram of ABS), whereas the total cost of alginate was$14.3. The average cost of our phantoms was approximately $25.7, and the 3D printer used in this study costs approximately$200. Conclusions The basic properties of this phantom were similar to cadaveric tissue during manipulation. We believe our phantoms have the potential to improve skills and minimize risk for patients when integrated into trainee education.

Objective Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a complex etiology. Interleukin-18 (IL-18) possesses pro-inflammatory properties and plays a central role in the development of SLE. In this study, we assessed the association between two functional variants that affect the expression of IL-18 , namely −607C > A (rs1946518) and −137G > C (rs187238), and the risk of SLE development. Methods As a case-control study, 251 peripheral blood samples were collected from 121 SLE patients and 130 healthy participants. Genotyping of these polymorphisms was performed using the high-resolution melting (HRM) method, which employs real-time polymerase chain reaction. Results Our findings revealed a significant association between the AA genotype and A allele in rs1946518, showing a decreased risk of SLE (AA vs CC; OR: 0.386; 95% CI [0.174–0.828], A vs C; OR: 0.548; 95% CI [0.369–0.809]). Analogously, the CC genotype and C allele in rs187238 exhibited a similar trend (CC vs GG; OR: 0.240; 95% CI [0.055–0.803], C vs G; OR: 0.604; 95% CI [0.390–0.928]), indicating a reduced risk of SLE Moreover, SLE subjects with the protective allele in rs1946518 (AA + AC) demonstrated significantly lower levels of CRP, and Anti-dsDNA, suggesting lower disease activity. These patients also had a later age of onset, and a lower incidence of renal involvement and creatinine levels, indicating milder disease severity ( p < .05 ). Conclusion The study indicates a significant relationship between the rs1946518 and rs187238 variants in IL-18 and a reduced risk of SLE. Furthermore, rs1946518 was found to be associated with certain clinical features related to disease activity and severity.

PURPOSE. To investigate changes in macular thickness in patients with cataract and primary open-angle glaucoma (POAG) receiving prostaglandin analogues (PGA) during the perioperative period of phacoemulsification (PE), based on optical coherence tomography (OCT) data. METHODS. The study included 80 patients (126 eyes) divided into four groups: the control group (group 1) without POAG, and three POAG groups receiving different therapies: group 2 — tafluprost 0.0015% (Taflotan); group 3 — a fixed combination of brinzolamide 1% and timolol maleate 0.5% (Azarga); group 4 — Taflotan and Azarga. Macular thickness was assessed using OCT preoperatively, on postoperative day 7, and at 1 and 3 months in the central, superior, inferior, nasal, and temporal sectors. Statistical analysis was performed using nonparametric methods, including Pearson's χ² test, the Kruskal–Wallis H-test, and Fisher's F-test. RESULTS. One month postoperatively, the proportion of patients without pathological macular thickening exceeded 88% in all groups: 88.2% (group 1), 94.6% (group 2), 100% (group 3), and 90% (group 4) (p>0.05).At 3 months, retinal thickness remained above normal in two cases in group 1, two cases in group 2, none in group 3, and one case in group 4. CONCLUSION. The use of Taflotan during the perioperative period of PE in patients with cataract and POAG did not increase the risk of cystoid macular edema compared to the control and comparison groups.

The 2023 ESC guidelines changed previously recommended a strategy of early treatment in patients with STEMI. Pre-treatment with a P2Y12 receptor inhibitor may be considered in patients undergoing a primary PCI strategy (Class IIb, Level of evidence B). However, the available scientific evidence justifies a personalized approach differentiating the indications for pre-treatment with oral P2Y12 receptor inhibitors depending on the concomitant administration of opioids. In our opinion, in patients undergoing primary PCI not treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be applied, while in patients undergoing primary PCI treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be considered.

This surveillance study examined the status of theranostics in West Asia, analyzing data from 15 countries. The research assessed availability, production, coverage, staff density, infrastructure density, financial and political impacts. All surveyed countries except Yemen offered theranostic services, with 452 centers and 1,426 theranostic physicians across the region. Over half of the countries reported densities exceeding one theranostician, nuclear medicine technologist, physicist, and nurse per million inhabitants. Scientific and social activities were available in nine and ten countries, respectively. Countries with gross domestic product (GDP) below $200 billion showed significantly lower infrastructure and manpower resources, particularly in cyclotron availability and theranostic agents (p < 0.05), compared to those with higher GDP. Politically stable countries demonstrated statistically higher densities of theranostic personnel than unstable nations (p < 0.05). The study emphasizes the importance of collaboration between model countries and those lacking adequate services to enhance theranostic practice and availability in West Asia.

AIM: Laparoscopic Sleeve Gastrectomy (LSG) is an accepted safe procedure and the most common surgical method used in the treatment of morbid obesity. Leakage and staple line bleeding are significant postoperative complications that can cause concern due to the long staple line. The purpose of this study to examine the risk of complications that may arise due to the lack of staple line reinforcement during the surgery. METHODS: Between March 2021 and May 2023, 426 consecutive patients who underwent LSG in Avrupa Safak Hospital were identified through a retrospective database. The patients included in the study were divided into two groups according to the staple line reinforcement. Group A (n = 210) received staple line reinforcement (SLR) and Group B (n = 204) received non-staple line reinforcement (NSLR). Twelve patients who did not meet the inclusion criteria were excluded from the study. Patient demographics, operative time, postoperative and perioperative complications such as staple line leak, bleeding, conversion to open surgery, length of hospital stay, abdominal pain, morbidity and mortality-related data were analyzed. RESULTS: The mean age, body mass index (BMI), and ASA scores were similar in both groups. Operative time was longer in SLR group (p < 0.001). Postoperative complications occurred in 6 (2.9%) and 9 (4.4%) patients in Groups A and B respectively (p = 0.397). There was no staple line leak in either group. There were two strictures in Group A. Mean length of postoperative hospital stay was 2.17 and 2.16 days in Groups A and B respectively (p = 0.830). There was no in patient death. CONCLUSIONS: Reinforcing the staple line after LSG is not necessary to reduce the risk of staple line leaks and bleeding.

The purpose of the work is to study the effect of a mixture of venom proteins and manganese nanoparticles on the composition of blood cells. Materials and methods. Experiments were carried out on 20 white outbred laboratory rats, weighing in the range of 200-220g, which were intraperitoneally injected with viper poison (Macrovipera lebetina obtusa) at a dose of 0.02mg/kg body weight and manganese nanoparticles. Research results and discussion. As a result, after the introduction of viper venom in combination with manganese nanoparticles, significant changes were observed in the blood of experimental animals. The content of leukocytes in the blood decreased by 12.1%, 19.5%, 26%, granulocytes, monocytes and neutrophils increased, respectively, by 8.6%, 3.8%, 3.9%. Analysis of daily blood showed that the content of leukocytes in the blood began to decrease, tending to intact values. The content of erythrocytes in the blood, on the contrary, during the entire study period increased by 2.5%, 4.2% and 8.5%, respectively. The content of red blood cells in the blood increased by 17.5% after 72 hours. Conclusion. The results of laboratory studies showed that significant changes occur in the content of leukocytes and erythrocytes in the blood, which do not pose a threat to the animal’s body. Intraperitoneal administration of microdoses of viper venom mixed with manganese nanoparticles leads to quantitative changes in the composition of blood cells. Thus, intraperitoneal administration of a mixture of viper venom and manganese nanoparticles to white laboratory rats helps to normalize the composition of blood cells and stops the process of growth and reproduction of tumor cells and thereby eliminates the threat of tumor growth.

Objective Various assessment scales have been developed to evaluate the severity of critical conditions in patients admitted to neonatal intensive care units (NICUs), predicting the length of stay, likelihood of complications, and death. Congenital anomalies, though a significant portion of NICU admissions, are often excluded from such studies. The aim of our study was to compare the informativeness of different scoring systems in the assessment of critical patients with congenital anomalies treated in the NICU, as well as their applicability in predicting complications and fatal outcomes. Materials and Methods Between 2019 and 2022, we evaluated the severity of the critical condition of 921 newborns diagnosed with congenital anomalies at the Scientific Research Pediatric Institute named after K. Farajova using the National therapeutic intervention evaluation system (NTISS), scores for neonatal acute physiology (SNAPPE II), clinical risk index for babies (CRIB), and the mortality index for neonatal transportation score (MINT) scales. Results Of the 921 neonates with congenital anomalies admitted to the NICU in critical condition, 271 (29.4%) were preterm (≤37 weeks) and 650 (70.6%) were term. In 921 patients diagnosed with congenital anomalies, the mean NTISS score according to the scales was 18.6; SNAPPE II 14.2; CRIB 4.6; MINT 6.9. In these patients, when the mean score of preterm and term births was compared according to gestational week, the SNAPPE II and MINT points were statistically significantly higher in preterm babies than terms. In the comparative analysis between the patients of the surviving and lethal groups, it was found that all the scales (SNAPPE II, NTISS, CRIB, MINT) were statistically significant. Conclusion National therapeutic intervention evaluation system, SNAPPE II, CRIB, and MINT scales are useful in predicting mortality in newborns with congenital anomalies. However, these scales do not account for the severity of the congenital anomalies, system damage relationships, complication effects, or treatment needs (need for surgical intervention). Tailored scale usage corresponding to medical service levels in different countries would improve affordability and predictability.

Introduction The persistent challenge of temozolomide (TMZ) resistance and the eventual recurrence of tumors underscore the need for ongoing research and the development of novel therapeutic strategies. We aim to consolidate existing evidence related to the safety and efficacy of TMZ as adjuvant therapy to radiotherapy (RT). Methods Various electronic platforms were used to conduct a systematic literature review, including PubMed, Europe PMC, SCOPUS, and clinicaltrials.gov. The approach aimed to identify all pertinent studies published up to July 25, 2024. The search incorporated terms such as “glioblastoma,” “temozolomide,” “monotherapy,” and “adjuvant” alongside relevant Medical Subject Headings (MeSH). The key metrics were overall and progression-free survival, while secondary measures concentrated on treatment-related adverse effects, notably hematological issues like anemia, leukopenia, thrombocytopenia, and neutropenia. Results The overall effect estimates from the forest plots show significant differences favoring TMZ + RT over RT alone. The HR for overall survival is 0.64 (95% CI: 0.58, 0.71), showing a considerable improvement with TMZ + RT. Progression-free survival shows a HR of 0.51 (95% CI: 0.45, 0.58), also demonstrating a significant benefit for TMZ + RT. Conclusions Combining TMZ with RT generally leads to better overall and progression-free survival outcomes compared to RT alone. However, the two treatment groups have similar toxicity.

Background Mesothelioma, a cancer primarily caused by asbestos exposure, has been increasing in the Middle East and North Africa (MENA), raising concerns about the region’s occupational and environmental health landscape. With varying Sociodemographic Index (SDI) and differing asbestos regulations across MENA, understanding mesothelioma trends over time is crucial. Methods Using data from the Global Burden of Disease (GBD) Study 2021, we analyzed mesothelioma incidence, mortality, and disability-adjusted life years (DALYs) in MENA from 1990 to 2021. Age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability rate (ASDR) were assessed by age, sex, and country. Trend analyses were conducted using joinpoint regression to identify significant shifts in disease burden over the study period. Results Between 1990 and 2021, mesothelioma cases rose from 597 to 1365, with ASIR declining at an average annual percent change (AAPC) of −0.49% ( P < 0.001). Countries like Oman and Saudi Arabia exhibited rising burdens, while the United Arab Emirates and Turkey saw declines. Males and older age groups had higher ASIR, ASMR, and ASDR rates, indicating gender- and age-based disparities. Conclusion While the mesothelioma burden in MENA has declined overall, significant increases in certain countries highlight the need for uniform asbestos regulations and targeted health interventions, especially among high-risk demographics. Further research on occupational exposure and Sociodemographic Index (SDI) improvements could help reduce mesothelioma rates across the region.

Introduction : Self-efficacy is accepted as a mediator of behavioral change and has been shown to be related to achievement. Thus, self-efficacy is a vital variable in evaluating the overall curriculum. Methods : The MASS is an 18-item, five-point Likert-type scale. The minimum and maximum scores that can be obtained from the scale vary between 18–90 points. It was reported that Cronbach's alpha for the original form of the scale was 0.89, and item-total score correlations ranged between 0.39 and 0.64. The study was conducted with undergraduate military medical students at Azerbaijan Medical University (n = 250). A panel of experts translated the scale and then back-translated it. Cronbach alpha was calculated to determine the scale's reliability. Item-total correlation was calculated, and the scores of low-performing and high-performing groups were compared using a t-test. Exploratory factor analysis was conducted to determine the construct validity. Results : The original MASS based on the competency frameworks of CanMEDs and The Five Star Doctor indicated its content validity. The Azerbaijani form of the scale was examined by four experts for face validity and was found appropriate. The reliability of the scale was found to be high (Cronbach’s α = 0.95). Item-total correlation coefficients of the Turkish MASS ranged from 0.61 to 0.85. Lower and upper score groups were compared to indicate the discriminant validity. All items discriminated significantly between lowly and highly performing students. Factor analysis showed that the scale has a one-factor structure, which explains 56.26% of the variance. Factor loadings ranged from 0.59 to 0.84. Conclusions : The Azerbaijan adaptation of the MASS was found to be reliable and has construct validity.

The asymmetric unit of the title salt, C6H4FN2Se⁺·Cl⁻, contains one planar 4-fluoro­benzo[c][1,2,5]selena­diazol-1-ium mol­ecular cation and a chloride anion. In the crystal, inter­molecular N—H⋯Cl hydrogen bonds link the 4-fluoro­benzo[c][1,2,5]selena­diazol-1-ium mol­ecules, which are arranged in parallel layers along (104), to the chloride anions. The cationic layers, in turn, are stacked along [001]. A Hirshfeld surface analysis of the crystal structure indicates that the most important contributions for the crystal packing are from H⋯Cl/Cl⋯H (22.6%), H⋯F/F⋯H (13.9%), H⋯N/N⋯H (11.9%), H⋯C/C⋯H (10.2%) and H⋯H (7.7%) inter­actions. The volume of the crystal voids and the percentage of free space were calculated to be 44.80 ų and 5.91%, showing that there is no large cavity in the crystal packing.

AIM: To investigate the effects of adenosine triphosphate (ATP) and melatonin, which have antioxidant and anti-inflammatory activities, on potential 5-fluorouracil (5-FU)-induced optic nerve damage in rats. METHODS: Twenty-four rats were categorized into four groups of six rats: healthy (HG), 5-FU (FUG), ATP+5-FU (AFU), and melatonin+5-FU (MFU). ATP (4 mg/kg) and melatonin (10 mg/kg) were administered intraperitoneally and orally, respectively. One hour after ATP and melatonin administration, rats in the AFU, MFU, and FUG were intraperitoneally injected with 5-FU (100 mg/kg). ATP and melatonin were administered once daily for 10d. 5-FU was administered at a single dose on days 1, 3, and 5 of the experiment. After 10d, the rats were euthanized and optic nerve tissues were extracted. Optic nerve tissues were biochemically and histopathologically examined. RESULTS: ATP and melatonin treatments inhibited the increase in malondialdehyde (MDA) and interleukin-6 (IL-6) levels, which were elevated in the FUG. The treatments also prevented the decrease in total glutathione (tGSH) levels and the superoxide dismutase (SOD) and catalase (CAT) activities (P<0.001). This inhibition was higher in the ATP group than in the melatonin group (P<0.001). ATP prevented histopathological damage better than melatonin (P<0.05). CONCLUSION: ATP and melatonin have the potential to be used in alleviating 5-FU-induced optic nerve damage. In addition, ATP treatment shows better protective effects than melatonin.

Onobrychis Adans. species, known as ‘sainfoin,’ are commercially valuable plants cultivated to produce high‐protein animal feed. In this study, the ethanol extract of Onobrychis buhseana Boiss., which is widely distributed in Azerbaijan, was subjected to silica gel column and thin‐layer chromatography for the first time, leading to the isolation of a new natural hydroquinone oligomer, named buhseanol (1), along with two known compounds, β‐arbutin (2) and a inositol derivative (3). The chemical structure of buhseanol (1) was characterized by 1H‐NMR, 13C‐NMR, APT NMR, and LC‐MS/MS. Buhseanol (1), β‐arbutin (2), and the ethanol extract were evaluated for their anti‐Alzheimer's, anti‐glaucoma, and anti‐diabetic effects, with both the extract and buhseanol (1) potentially showing these activities. The inositol derivative (3) did not exhibit any of these activities.