The 10th International Medical Congress for Students and Young Doctors, 24-27 April, 2024 http://repository.usmf.md:80/xmlui/handle/20.500.12710/27983 2026-08-27T00:22:55Z 2026-08-27T00:22:55Z Cemortan, Maria Bubulici, Cristina Vicol, Maria-Magdalena Grajdean, Elena Scripnic, Gabriela Manic, Milena http://repository.usmf.md:80/xmlui/handle/20.500.12710/29004 2024-11-22T10:38:10Z 2024-01-01T00:00:00Z

Assessment of the cases of postpartum hemorrhage in multiparous women Cemortan, Maria; Bubulici, Cristina; Vicol, Maria-Magdalena; Grajdean, Elena; Scripnic, Gabriela; Manic, Milena Introduction. Postpartum hemorrhage (PPH) is one of the leading obstetric complications, affecting 5-15% births. Being a major factor in maternal mortality and morbidity, PPH causes about 25% of maternal deaths worldwide. Aim of study. The aim of the study was to assess the cases of PPH in multiparous women, admitted to the Tertiary Perinatal Center. Methods and materials. The retrospective study was performed by assessing 81 clinical cases of PPH in multiparous women. Total blood loss in labor or C-section was performed by using graduated vessels, and all the sterile material used was weighted. For continuous variables, the mean values and standard deviation of the mean were calculated; the median (Me) as well as the interquartile range (Q1;Q3) in the case of a distribution of characteristics that differs from the normal. Results. The average age of women was 31.6±5.5 years (Me 32 (28;35.5)), varying in the limits of 20-42 years. The majority of participants delivered for the second time - 38 cases (46.9% (95% CI 33.3-59.9)), however, 30 women (37.0% (95% CI 25.9-48.2)) gave birth for the third time, and 13 women (16.1% (95% CI 8.5-27.4)) had 4th – 9th delivery. In 41 cases (50.6% (95% CI 40.7- 61.7)) a c-section was performed. The mean blood loss in vaginal delivery was 850±308 (Me 800 (600;1050)) mL, varying in the limits of 500– 1600 mL. Compared to the mean blood loss in Csection – 1752±1093 (Me 1500 (1100;1850)) mL, varying in the limits of 1000 – 5250 mL. In the structure of PPH there were assessed 26 cases (32.1% (95% CI 20.9-47.0)) of the placental defect or placenta adherens, 15 cases (18.5% (95% CI 10.3-30.5)) of lacerations of the birth canal, 11 cases (13.6% (95% CI 7.4-23.4)) of uterine atonia, and 2 cases (2.5% (95% CI 0-7.3)) of uterine rupture. Hence, in 46 women (56.8% (95% CI 44.6-69.1)) it was applied conservative management of the cases. However, in 20 cases (24.6% (95% CI 15.0-38.1)) an operative management was applied, from which 7 cases (8.6% (95% CI 3.7-14.7)) hemostatic sutures were applied. In 13 cases (16.0% (95% CI 8.5-27.4)) hysterectomy was performed, from which 9 cases (69.2% (95% CI 31.6-100)) subtotal hysterectomy without annexes was the elective method for definitive hemostasis. Conclusion. PPH is a major obstetric complication, which occurs more frequently in multiparous women, in association with placental pathology and birth canal trauma, explained by overextension of the uterus and coagulation disorders, requiring extensive surgical management.

2024-01-01T00:00:00Z Kuzhipurayidathil, Vijayakumar Anaswara http://repository.usmf.md:80/xmlui/handle/20.500.12710/28509 2024-11-26T13:42:25Z 2024-01-01T00:00:00Z

Unmasking the technological innovations: insights through the encode project Kuzhipurayidathil, Vijayakumar Anaswara Introduction. The Encode (Encyclopaedia of DNA Elements) Project, launched over a decade ago has played a significant role in the research world by aiding in the elucidation of the intricate human genome and its fundamental components. The Encode Project provides accessibility to the blueprint of human life by decoding DNA. Encode has used a wide range of cutting-edge technologies, including complex computational studies and powerful sequencing methods, to shed light on the regulatory roles and functional significance of previously undiscovered areas of the genome. Aim of study. This paper examines the innovations in technology that enabled this project, from the ability of ChIP-seq to elucidate protein-DNA interactions to the three-dimensional insights gained by Hi-C and 3C approaches. It highlights the project's noteworthy accomplishments, exposing regulatory elements and offering a glimpse into the future directions of genomics, predictive modeling, and personalized medicine. Methods and materials. The research is based on bibliographic sources that were analyzed using PubMed, Google Scholar, Science Direct and other web sources, published within the period of 2013-2023. Results. Through this review it was understood that, the ENCODE project's interdisciplinary approach harnesses a multitude of technological innovations. Using high-throughput sequencing methods including as ChIP-seq, RNA-seq, and ATAC-seq, scientists have tracked the dynamics of chromatin accessibility, transcription factor binding, and gene expression with exceptional resolution and accuracy. Innovative CRISPR-based methods made it possible to precisely modify genetic regions, leading to a better comprehension of their functional significance.Significant progress has been made in our understanding of the human genome because to the ENCODE Project, which annotated functional portions previously believed to be junk DNA or non-functional DNA. Via integrative analysis of many genomic datasets, it was found that about 80% of the genome contains components that are biochemically active and involved in regulatory processes. Advanced techniques like ChIP-seq have made it feasible to study protein-DNA interactions across many cell types by revealing intricate regulatory networks. These investigations identified transcription factor binding sites and described histone alterations associated with gene regulation.It demonstrated the intricate arrangement of regulatory components, offering insight into the synchronization of gene expression and cellular function. Furthermore, the project's use of Methyl-seq to explore epigenetics and the important findings from proteomic analyses have deepened our understanding of the intricate regulatory networks governing our genetic inheritance. Conclusion. The ENCODE Project is an expression to human resourcefulness and technological mastery. Through a symphony of cutting-edge methods and relentless scientific research, this massive project has illuminated so far obscured pathways inside our genetic landscape. Future possibilities seem promising for single-cell resolutions, predictive modeling, and multi-omics integrations, as the project advances and the scientific community makes use of these technologies. Ongoing cooperation and free access to data will contribute to our growing understanding of disease mechanisms and the development of tailored therapy. played a significant role in the research world by aiding in the elucidation of the intricate human genome and its fundamental components. The Encode Project provides acce ssibility to the blueprint of human life by decoding DNA. Encode has used a wide range of cutting-edge technologi es, including complex computational studies and powerful sequencing methods, to shed light on the regulatory roles and functional significance of previously undiscovered areas of the genome . Aim of study. This paper examines the innovations in technology that enabled thi s project, from the ability of ChIP-seq to elucidate protein-DNA interactions to the three-dimensional insights gained by Hi-C and 3C approaches. It highlights the project's noteworthy accomplishmen ts, exposing regulatory elements and offering a glimpse into the future directions of genomics, predi ctive modeling, and personalized medicine. Methods and materials. The research is based on bibliographic sources that were an alyzed using PubMed, Google Scholar, Science Direct and other web sources, published w ithin the period of 2013-2023. Results. Through this review it was understood that, the ENCODE project's in terdisciplinary approach harnesses a multitude of technological innovations. Using high-throughput se quencing methods including as ChIP-seq, RNA-seq, and ATAC-seq, scientists have trac ked the dynamics of chromatin accessibility, transcription factor binding, and gene expression with exceptiona l resolution and accuracy. Innovative CRISPR-based methods made it possible to precisely modify geneti c regions, leading to a better comprehension of their functional significance.Significant progr ess has been made in our understanding of the human genome because to the ENCODE Project, which annotate d functional portions previously believed to be junk DNA or non-functional DNA. Via integrati ve analysis of many genomic datasets, it was found that about 80% of the genome contains components that are bio chemically active and involved in regulatory processes. Advanced techniques like ChIP-seq have m ade it feasible to study protein-DNA interactions across many cell types by revealing intricate regulatory networks. These investigations identified transcription factor binding sites and described histone alterations associated with gene regulation.It demonstrated the intricate arrangement of regu latory components, offering insight into the synchronization of gene expression and cellular function. Furthe rmore, the project's use of Methyl-seq to explore epigenetics and the important findings from proteomic analyses have deepened our understanding of the intricate regulatory networks governing our genetic inher itance. Conclusion. The ENCODE Project is an expression to human resourcefulness and technological mastery. Through a symphony of cutting-edge methods and relentless scientifi c research, this massive project has illuminated so far obscured pathways inside our genetic landsc ape. Future possibilities seem promising for single-cell resolutions, predictive modeling, and multi-omics inte grations, as the project advances and the scientific community makes use of these technologies. Ongoing coopera tion and free access to data will contribute to our growing understanding of disease mechanisms and the development of tailored therapy. Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica Moldova

2024-01-01T00:00:00Z Vasilachi, Cristian http://repository.usmf.md:80/xmlui/handle/20.500.12710/28656 2024-11-26T10:14:47Z 2024-01-01T00:00:00Z

The principles of the "fast track" program in obstetrical emergencies Vasilachi, Cristian Introduction. Currently, the trend of contemporary surgery is to ensure a perioperative result of an increased quality, with the reduction of the stressful impact of the surgical act on the internal homeostasis of the human body. In Urgent Obstetrics, this element is very important, given the fact that it involves a pregnant patient, whose birth requires a quick solution, while ensuring, at the same time, high-performance results. It is exactly at this stage, when the ERAS (Enhanced Recovery After Surgery) programs steps in, especially "Fast Track" protocols. Given the specificity of these programs (they can be applied mainly in scheduled interventions), it is desired to determine those principles and manipulations, provided by them, which can also be useful during urgent interventions. The purpose of this study is to evaluate the procedures of the ERAS programs that can be applied in urgent obstetric situations, which would have a significantly better effect on the body of both the mother and the fetus; the conditions in which they can be applied and their efficiency, in order to ensure perioperative results of an increased quality. Aim of study. As for now, there exist different ERAS Society guidelines for perioperative care in obstetrics, regarding interventional delivery, that provide best practice recommendations in each phase of medical care, but almost all of them are implementing practice principles that could be used only in scheduled interventions. In the meantime – the efficiency and applicability of those are questionable regarding fast birth delivery, via cesarean surgical intervention. Thus it is extremely important to create a „focused” pathway process for urgent ERAS Cesarean Delivery, starting from „decision to operate” (up to 30 min before skin incision) – to hospital discharge, and therefore postpartum monitoring. Methods and materials. There was made a literature review, including recent studies made between 2017 - 2023, regarding the applicability of prophylaxis and treatment options, used in programmed cesarean delivery, that could be used in emergency surgical - birth solutions. Titles and abstracts were analyzed to identify potentially relevant articles. Meta Analysis, systematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series were considered for each individual topic. Results. Guidelines for perioperative care in cesarean delivery: Enhanced Recovery After Surgery Society recommendations, that were demonstrated as grade A : Antibacterial prophylaxis is mandatory less than an hour before skin-incision Use of body-warm solutions and increased operating room temperature results in better post-operative recuperation Special cesarean delivery surgical techniques do not improve the final outcome, in comparison with the traditional ones Perioperative fluid management should be done using the 2 : 1 coefficient, regarding the overall blood loss Regardless of the fetal status – immediate neonatal resuscitation team is mandatory Use of analgesic potentiators is essential, in order to reduce the need of morphine derivated drugs Early patient mobilization (4h after cesarean delivery) results in faster recuperation of self-care and child-care activities Conclusion. We are looking to detect optimized perioperative conduct methods, to elaborate a guideline, in order to improve the surgical result of obstetrical patients, increase the efficiency of the medical act, reduce its costs and enhance the trust level of citizens towards the local health system. increased quality, with the reduction of the stressful impac t of the surgical act on the internal homeostasis of the human body. In Urgent Obstetrics, this element is very important, given the fact that it involves a pregnant patient, whose birth requires a quick solution, while ensuring, at the same time, high-performance results. It is exactly at this stage, when the ERAS (Enhanced Re covery After Surgery) programs steps in, especially "Fast Track" protocols. Given the specificity of these programs (they can be applied mainly in scheduled interventions), it is desired to determine those pr inciples and manipulations, provided by them, which can also be useful during urgent interventions. The purpos e of this study is to evaluate the procedures of the ERAS programs that can be applied in urgent obstetri c situations, which would have a significantly better effect on the body of both the mother and the fetus; t he conditions in which they can be applied and their efficiency, in order to ensure perioperative results o f an increased quality. Aim of study. As for now, there exist different ERAS Society guidelines for perioperative care in obstetrics, regarding interventional delivery, that provide best practi ce recommendations in each phase of medical care, but almost all of them are implementing practice prin ciples that could be used only in scheduled interventions. In the meantime – the efficiency and applicabi lity of those are questionable regarding fast birth delivery, via cesarean surgical intervention. Thus it is extremely important to create a „focused ” pathway process for urgent ERAS Cesarean Delivery, starting from „decision to operate” (up to 30 min before skin incision) – to hospital discharge, and therefore postpartum monitoring. Methods and materials. There was made a literature review, including recent studi es made between 2017 - 2023, regarding the applicability of prophylaxis and treatment opt ions, used in programmed cesarean delivery, that could be used in emergency surgical - birth sol utions. Titles and abstracts were analyzed to identify potentially relevant articles. Meta Analysis, syst ematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series were con sidered for each individual topic. Results. Guidelines for perioperative care in cesarean delivery: Enhanc ed Recovery After Surgery Society recommendations, that were demonstrated as grade A : Antibact erial prophylaxis is mandatory less than an hour before skin-incision Use of body-warm solutions and increased operating room temperature results in better post-operative recuperation Special cesarean delivery surgical techniques do not improve the final outcome, in comparison with the traditional ones Perioperative fluid management should be done using the 2 : 1 coefficient, regarding the overall blood loss Regardless of the fetal status – immediate neonatal resuscitation team is mandatory Use of analgesic potentia tors is essential, in order to reduce the need of morphine derivated drugs Early patient mobilization (4h af ter cesarean delivery) results in faster recuperation of self-care and child-care activities Conclusion. We are looking to detect optimized perioperative conduct methods, to elaborate a guideline, in order to improve the surgical result of obstetrical patient s, increase the efficiency of the medical act, reduce its costs and enhance the trust level of citizens towards the local health system. Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica Moldova

2024-01-01T00:00:00Z Jurca, Denisa-Amalia http://repository.usmf.md:80/xmlui/handle/20.500.12710/28662 2024-11-26T10:38:06Z 2024-01-01T00:00:00Z

What do students know about sexually transmitted diseases and methods of contraception? A survey study about knowledge and sexual risk behaviours among university students Jurca, Denisa-Amalia Introduction. Sexual life is of considerable importance, particularly in youngsters, not only because of its Sexual life is extremely important, especially for young people, not just because it affects intellectual development but also because of potential health effects. STIs are among the most prevalent diseases in the world, and unwanted pregnancies and sexually transmitted diseases (STDs) rank among the most serious issues globally. Every day around the world, more than 1 million STIs are acquired and every year there are around 500 million new infections, most commonly syphilis, chlamydia, trichomoniasis and gonorrhoea (WHO,2014). Sexual behaviour is the key determinant of STI transmission all over the world. ( Fenton, 2004). Adolescents and young adults are at higher risk for such behaviour, frequently as a result of their immature decision making. Additionally, these sexual risk behaviour patterns may persist into adulthood (Epstein et al., 2014). Aim of study. This study aims to investigate the level of knowledge, perception, sexual risk behaviours and attitudes about sexual matters, among university students. Furthermore, to improve strategies for family planning and sexual health education among youths. Methods and materials. The study was conducted with an online survay questionnaire. The link was shared with students attending different universities. The questionnaire was divided into 3 parts: the first part includes general information; the second includes questions related to sexual matters; the third aims to assess students’ knowledge. The statistical analysis was conducted using SPSS software. Results. The total number of participants was 564. The majority were Romanians, female, Orthodox, 21-25 years old, Caucasian, single and studying at a biomedical university. The most knowledgeable students about sexual matters were Serbians studying in a biomedical faculty. The most commonly used source of information was the Internet-TV (76.80%) while the most commonly used contraceptive method was the condom. Most students never received sexual health education (51.06%), and among those who received it, the majority were Serbians. Regarding FP, the majority would like to have their first child at 26-29 years. Students who were less engaged in sexual risk behaviors were females, Muslims black/African-American with few sexual partners. Students who used the EC pill multiple times were mainly Romanian. Conclusion. Students who received sexual education were more knowledgeable about sexual matters. Sociodemographic and cultural factors are all aspects that influence sexual risk behaviours. Improvement of students’ knowledge, perceptions, and attitudes towards these topics is still needed. because of its Sexual life is extremely important, especia lly for young people, not just because it affects intellectual development but also because of pote ntial health effects. STIs are among the most prevalent diseases in the world, and unwanted pregnancies and sexually transmitted diseases (STDs) rank among the most serious issues globally. Ever y day around the world, more than 1 million STIs are acquired and every year there are around 500 million new infections, most commonly syphilis, chlamydia, trichomoniasis and gonorrhoea ( WHO,2014). Sexual behaviour is the key determinant of STI transmission all over the wor ld. ( Fenton, 2004). Adolescents and young adults are at higher risk for such behaviour, frequently as a result of their immature decision making. Additionally, these sexual risk behaviour patterns ma y persist into adulthood (Epstein et al., 2014). Aim of study. This study aims to investigate the level of knowledge, perce ption, sexual risk behaviours and attitudes about sexual matters, among university students. Furthermore, to improve strategies for family planning and sexual health education amon g youths. Methods and materials. The study was conducted with an online survay questionnaire. The link was shared with students attending different universities. The questionnaire was divided into 3 parts: the first part includes general information; the sec ond includes questions related to sexual matters; the third aims to assess students’ knowledge. The statistical analysis was conducted using SPSS software. Results. The total number of participants was 564. The majority were Romanians, female, Orthodox, 21-25 years old, Caucasian, single and studying at a biomedical university. The most knowledgeable students about sexual matters were Serbians st udying in a biomedical faculty. The most commonly used source of information was the Internet -TV (76.80%) while the most commonly used contraceptive method was the condom. Most stude nts never received sexual health education (51.06%), and among those who received it, the major ity were Serbians. Regarding FP, the majority would like to have their first child at 26-29 ye ars. Students who were less engaged in sexual risk behaviors were females, Muslims black/African-Amer ican with few sexual partners. Students who used the EC pill multiple times were mainly Romani an. Conclusion. Students who received sexual education were more knowledgeable about sexual matters. Sociodemographic and cultural factors are all as pects that influence sexual risk behaviours. Improvement of students’ knowledge, perceptions, and attitudes towards these topics is still needed. Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica Moldova

2024-01-01T00:00:00Z