The objective and the goal of this study was to determine how ERAS guidelines affected on hospital stay days and other complications rates in case of elective colorectal surgery in our clinic, compared to traditional care methods. First of all, all team members including surgeons, anesthetists, nurses were being trained in ERAS guidelines principals during two months and we started active implementation process after this. 87 patients, who were needed to be done colorectal surgery treatment, were actively treated according to ERAS guidelines and these patients were gathered in experimental group. At the same time, we started to collect data retrospectively from last 2 years elective colorectal surgery cases and sorted them according to preoperative, intraoperative surgical and anesthesia data, postoperative analgesia, all type of complications. 120 patients were placed in traditional care group (control group). In traditional care group open colorectal surgery was associated with long length of stay 8-10 days. High rates of surgical site infection-24.2%, readmission rate during 30 days-30.8%, PONV-44.2%, respiratory complication-6.7%, deep vein thrombosis-3.3%, urinary retention-2.5%, prolonged postoperative ileus 16.7%. We included 87 patients in ERAS care group during 2 years. In this group our study showed big reduction of hospital stay days and it was average 5 days. Compared to traditional care group incidence of respiratory complications was 0, postoperative PONV- 6.9%, postoperative ileus-5.7%, deep vein thrombosis-0, urinary retention-0, readmission rate-0, surgical site infection-3.4%.The aim of the study is to establish the effectiveness of mechanical support of blood circulation of patients with end-stage heart failure depending on the method of surgical correction. The results of the study are based on the data of examination and dynamic observation of 73 patients (median age 44 (16-69) years, men 68 patients, women 5 patients) who were treated from 2008-2019 іn the following medical institutions Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of Cardiac Surgery on the Basis of KL «Feofania» DUS. Patients were examined during the initial examination, after 3 months and after a year. The results of surgical treatment of patients with critical heart disease insufficiency after direct UTS 24 (92%) patients were treated with positive result, 2 (8%) patients died. There were 18 (46%) patients performed secondary UTS, patients who were on LVAD therapy. 18 (46%) patients who continue LVAD therapy. On LVAD-therapy 3 (8%) patients died. The cause of death is purulent-septic lesions. https://www.selleckchem.com/products/SRT1720.html Which patients were on BiVAD - therapy secondary UTS performed 4 patients (50%). 4 (50%) patients died on BIVAD therapy. The cause of death in 2 (50%)cases of purulent-septic lesions, and in 2 (50%) cases it is an organ field insufficiency. Analysis of the results of the differential approach to surgical treatment patients with heart failure III-IV FC according to NYHA patients with critical heart failure in the presence of contraindications to direct transplantation heart rate, it is advisable to consider the use of long-term mechanical circulatory support based on LVAD therapy (p less then 0001) and BiVAD - therapy (p less then 0001) as a mechanical bridge to heart transplantation. Applied long-term mechanical support of blood circulation in patients with high indicators of pulmonary hypertension (p less then 0001), allows to normalize the pressure in the pulmonary artery and consider performing a secondary heart transplant.Meningiomas are benign, slow-growing tumors originating from arachnoid gap cells. They constitute 15%-20% of all intracranial tumors in adults and 04%-4% in the pediatric age group. Meningiomas in the posterior fossa in the pediatric period do not initially come to mind. In the case presented here, there was a cystic meningioma showing heterogenous contrast and obstructive hydrocephaly was observed associated with 4th ventricle pressure. the tumor was totally removed, then the ventriculo peritoneal shunt was applied.Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder that is characterized by multiple dome-shaped cutaneous venous malformations on the skin and visceral organs. Typical extra-cutaneous lesions have the appearance of blueish nipple-shaped nodules that can easily compress and refill. We described a rare case of a 23-year-old female with BRBNS and tuberous sclerosis complex (TSC) that presented with central nervous system (CNS) involvement including unprovoked focal impaired awareness seizure. Her BRBNS presents with hemangiomas involving multiple organs in the body including the brain, gastrointestinal (GI) system, and skin. This case highlights the importance of studying and understanding the association between BRBNS and TSC as it may lead to improved understanding.
To present the experience on stroke thrombolysis of a tertiary care center in Riyadh, KSA.

Cross-sectional, observational study of patients thrombolyzed between January 2012 and December 2018.

Thrombolysis was performed in 148 patients (mean age 58.2±14.5 years), 94 (63.5%) of them were men. The median onset-to-door time was 81 minutes, and 25% of the patients arrived within 1 hour. The median National Institute of Health Stroke Scale score upon admission was 13. Hypertension (68.9%), diabetes (56.1%), and dyslipidemia (40.5%) were the most common risk factors for stroke. The most common mechanism of stroke was cardioembolism (43.2%), which was associated with a more severe presentation (
=0.031). Intravenous thrombolysis alone was given to 98 patients (66.2%); the rest received intravenous tissue plasminogen activator plus endovascular therapy or endovascular therapy alone. The median door-to-needle (DTN) time was 70.5 min, with a significant improvement from 2012 (111.6 minutes) to 2018 (69.9 minutesat cardioembolic strokes were the most frequent and had severe presentation and were likely the cause of the slight increase in mortality and sICH.
To compare the clinical outcomes of repetitive paravertebral block (PVB) combining oral medication in the treatment of zoster-related pain (ZP) with different courses.

Sixty-seven patients with ZP were divided into 3 groups based on their course of herpes zoster (HZ). Group I 24 patients with acute herpetic neuralgia (within one month of disease onset); group II 22 patients with subacute herpetic neuralgia (disease onset from 1 to 3 months); group III 21 patients with postherpetic neuralgia (more than 3 months since disease onset). All patients received ultrasound-guided repetitive PVB with oral gabapentin and tramadol sustained-release tablets. The VAS and QS scores and the incidences of hematoma, dizziness, nausea, and drowsiness were compared at 1 day, 3 months, and 6 months after treatment.

Pain intensity and sleep quality of the 3 groups improved to varying degrees after treatment. The best efficacy was achieved in the acute group, followed by the subacute group, and the poorest efficacy was observed in the chronic group.