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Practical domestic monitoring of the menstrual cycle requires measurements of urinary metabolites of reproductive hormones: oestrone glucuronide (E1G) and pregnanediol glucuronide (PdG). Data reported in the literature are expressed as (i) concentration, without or with either creatinine- or specific gravity correction, or (ii) excretion rates. This variation in such a fundamental issue prompts consideration of the relationships between the four measures. Because the menstrual cycle kinetics of E1G and PdG are complex, we consider measurements of urinary creatinine, urea, galactose, xylose and inulin which tend to be more stable. We show that uncorrected concentration measurements of these urinary analytes can be positively correlated, negatively correlated or uncorrelated with the serum concentration. Based on measurements of urinary creatinine concentrations, urinary specific gravity and creatinine excretion rates, we conclude that urinary analyte concentration are likely to be more reliable when creatinine-corrected rather than corrected using specific gravity, but that both are less reliable than measurements of the excretion rate. This has implications for the quantitation of any urinary analyte, but especially for the monitoring of the menstrual cycle in which changes in E1G and PdG from one day to the next can be physiologically significant for a woman monitoring her fertility.


Background: Historically, the Rod of Asclepius is considered as the correct symbol of Medicine. Unfortunately, many medical/health institutions in the world have erroneously interchanged the Rod of Asclepius symbol with erroneous symbols (e.g. Caduceus) to depict Medicine. This study aims to assess the official logos (i.e. institutional symbols) of university teaching hospitals in Nigeria and determine if these logos actually depict the true symbol of Medicine.

Methods: This study was a cross-sectional online survey of teaching hospitals in Nigeria on their official logos. A total of 40,556 operating hospitals and clinics in Nigeria were identified. After systematic screening, a total of 35 hospitals were identified as university teaching hospitals and used for the survey. Official information about the geopolitical zone, ownership and official logo of the selected hospitals was obtained (via online and offline search). Data collected was analysed using SPSS version 22 software.

Results: Out of the 35 surveyed university teaching hospitals, only 7 did not have snake(s) as part of their official logo. However, out of the remaining 28 hospitals that have snake(s) as part of their official logos, only 57.1% (16/28) of them have only one snake in their logo. Exactly half of the surveyed hospitals having logos with two entwined snakes (i.e. Caduceus) were owned by the federal government. Bivariate analysis showed that there exists statistically significant relationship between the geopolitical zone where a hospital is situated and the number of entwined snakes indicated in their official logo (p-value=0.034).

Conclusion: This study shows that the correct symbol of Medicine is not universally indicated in the official logos of the university teaching hospitals in Nigeria.


The problem of physiological gait stereotype restoration in patients with post-stroke central hemiparesis remains relevant to this day. This is primarily associated with high risk of falls in this category of patients. At this point, there is a wide variety of methods related to exercise treatment and robotised correction or restoration of impaired gait against the background of post-stroke hemiparesis. At the same time, the problem of management of talipes equinovarus associated with this syndrome remains quite complex and not completely solved. We have analysed existing methods of talipes equinovarus correction with different levels of evidentiality.


Glial cells play a significant role in the link between the endocrine and nervous systems. Among hormones, thyroid hormones (THs) are critical for the regulation of development and differentiation of neurons and glial cells, and hence for development and function of the central nervous system (CNS). THs are transported into the CNS, metabolized in astrocytes and affect various cell types in the CNS including astrocyte itself. Since 3,3’,5-triiodo-L-thyronine (T3) is apparently released from astrocytes in the CNS, it is a typical example of glia-endocrine system.

The prevalence of thyroid disorders increases with age. Both hypothyroidism and hyperthyroidism are reported to increase the risk of cognitive impairment or Alzheimer’s disease (AD). Therefore, understanding the neuroglial effects of THs may help to solve the problem why hypothyroidism or hyperthyroidism may cause mental disorders or become a risk factor for cognitive impairment. In this review, THs are focused among wide variety of hormones related to brain function, and recent advancement in glioendocrine system is described.


This article describes the United States Agency for International Development Transform: Primary Health Care Activity supported a twinning partnership strategy, which was implemented between districts (woredas) in the different performance categories. This study presents the details of the partnership and the result observed in health systems strengthening in Ethiopia. The twinning partnership strategy was implemented with six steps. The established relationship helps the health systems to build the skill and capacities of the health workforce at primary healthcare entities. Both partner woredas improved their performances through the established win-win relationship and institutionalized the characteristics of a learning organization.


ABO blood group system discovery was an important step in development of such areas as transplantation and transfusion medicine. At the same time understanding of fundamental role of antigenic determinants in physiological functions maintenance and pathological conditions development remained unexplained for a long time. Today it is known that A and B antigens are widely represented not only on erythrocytes membrane but also on other cells and tissues: platelets, epithelial tissue, oral and spermal fluids. Earlier authors studied metabolic and coagulation profiles, as well as blood cells composition in clinically healthy individuals on more than 180,000 donations, thus revealing group-specific features for each blood group. The review provides synthesis of association of such pathological conditions as coronary heart disease, thromboembolic complications, tumors of various localizations, inflammatory and destructive oral diseases, psychiatric and some infectious diseases with the presence or absence of antigenic determinants A and B. 0 (I) blood group carriers are more resistant to development of diseases, excepting H. pylori-associated gastrointestinal diseases. Carriers of “antigenic” blood groups A (II), B (III), AB (IV) are more susceptible to infections, cardiovascular diseases, and oncological diseases. The data presented may contribute to a personalized patient approach formation, based on antigen-associated biological variability of various signs in norm and pathology.


We reported a case of a twenty-one-year-old man with an atrial flutter as the first manifestation of progressive cardiac conduction disease. The patient was admitted to the cardiology department due to complaints of shortness of breath and a decrease in exercise tolerance, which had happened after physical exercises (running). During ambulatory ECG monitoring persistent AFL was observed with atrial rate 262-297 bpm and ventricular rate 26-136 bpm (average 56 bpm). AV conduction was very variable – 4:1-14:1. The results of ambulatory ECG monitoring during the whole period of recording indicated signs of atrioventricular conduction disturbances. After cardioversion sinus rhythm was restored additional rhythm and conduction disorders were revealed. Ambulatory ECG monitoring was performed two weeks after the initial one, and throughout this recording were registered sinus rhythm on the background of first-degree AV block; transient Mobitz I AV block; and type 2 second-degree sinoatrial block. Trans-esophageal electrophysiology study was performed. During pharmacological denervation of the heart, signs of slowing of the atrioventricular conduction and sinus node recovery time persisted. These changes along with right bundle branch block were regarded as a progressive cardiac conduction disease with an apparently hereditary cause.


Objective: to know the prevalence of depression in patients with moderate-severe acne vulgaris.

Hypothesis: the incidence of depression increases in patients with moderate-severe acne vulgaris and will therefore decrease the quality of life.

Background: acne is a very frequent dermatosis in the outpatient clinic, it is not considered a life-threatening disease. It has been associated with negative emotional status. Also, suffering from it for a long time has been associated with depression, anxiety and frustration. The complications of acne in the psychosocial aspect are related to academic or vocational performance, self-esteem and adolescents’ quality of life.

Materials and Methods: the type of study was retrospective cross-sectional descriptive observational study. The sampling was carried out at the facilities of the Popular Autonomous University of the State of Puebla, taking into account any person within the institutional organisation within the range of 12-20 years of age, with a total of 50 participants. The Hamilton assessment scale of depression and the Cardiff Acne disability index were applied to all patients with dermatological diagnosis of moderate-severe vulgar acne in a period between February-October 2019. Results: a total of 50patients were analysed, of which 28 were women aged 12 to 20 years and 22 men (28 women and 13 men) and severe acne in 9 patients, all over 17 years of age and male. According to the degree of depression, 28% (n = 14) of the patients were obtained without some degree of depression; 60% (n = 30) with minor depression; 12% (n = 6) with moderate depression. Regarding the quality of life: 40% (n = 20) of the patients showed good quality of life, 46% (n = 23) regular quality of life and 14% (n = 7) showed poor quality of life.

Conclusion: orderly study of the psychic impact of acne and other skin diseases on people suffering them is recent and is carried out through questionnaires that try to measure the impact the diseases have on the patients’ quality of life.