Georgian medical news最新文献

{"title":"IDEOLOGICAL FAULT LINES IN PHARMACEUTICAL POLICY OF KAZAKHSTAN: A Q-METHODOLOGICAL APPROACH.","authors":"D Aliyeva, I Fakhradiyev, M Shoranov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pharmaceutical sector in Kazakhstan faces a complex interplay of regulatory, economic, and social challenges, including a high dependency on imports, fragmented policy perspectives, and limited integration of international innovation practices. This study applied Q-methodology to identify and structure the dominant and latent viewpoints within the professional community regarding the development of Kazakhstan's pharmaceutical industry. A set of 39 statements was developed through literature review, policy document analysis, and preliminary interviews with sector stakeholders. Twenty experts were selected based on professional relevance from public agencies, academia, and the pharmaceutical industry. Factor analysis using principal components with varimax rotation was conducted to extract shared perspectives. Three distinct factors were identified, representing structured ideological positions. Factor 1 supports strong state involvement in pricing, R&D, and domestic production; Factor 2 expresses skepticism toward state-led strategies, emphasizing economic pragmatism and reliance on imports; Factor 3 advocates for deregulation, market-driven growth, and international integration. Each factor was aligned with specific professional backgrounds and interpreted through follow-up interviews. Market indicators (imports, investment projects, sales dynamics) were used to contextualize the factor interpretations and to illustrate how each viewpoint reads the same empirical baseline, rather than to validate the factors as accurate or inaccurate. The findings reveal a significant divergence of expert opinion, which may hinder cohesive policy development in the pharmaceutical sector. Ideological fragmentation poses risks in the context of weak institutional coordination and external market pressures. Q-methodology proved effective in mapping nuanced perspectives and may serve as a tool for informed policy dialogue in healthcare governance.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"110-119"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OVERWEIGHT AMONG TUNISIAN SCHOOL-AGED CHILDREN: PREVALENCE AND ASSOCIATED FACTORS.","authors":"S Khamassi, E Bornaz, N Tayari, A Gamoudi, K Ounaissa, H Abdesselem, I Ammar, B Riahi, D Bousnina, H Jamoussi, Ch Amrouche","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To estimate the prevalence of overweight among school-aged children in Tunisia and to identify factors associated with overweight.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional descriptive study between January and April 2025 among children aged 6-11 years attending a Maternal and Child Protection Center in Tunis. Anthropometric measurements were collected, and dietary intake was assessed using a 24-hour dietary recall. Body mass index (BMI) categories were defined according to International Obesity Task Force (IOTF) references. Sociodemographic, perinatal, behavioral, and nutritional variables were analyzed. Multivariable logistic regression was used to identify factors associated with overweight.</p><p><strong>Results: </strong>A total of 225 children aged 6 to 11 years (mean age 9.18±1.73 years; 58% girls). The mean BMI was 18.05±3.6 kg/m². Based on French and IOTF growth references, 26.7% of participants were overweight, including 11.6% classified as obese, and 16.9% showed visceral fat excess. Multivariate analysis identified early adiposity rebound (OR=1.43; p<0.001), grade retention (OR=3.28; p=0.039), maternal obesity (OR=1.5; p=0.035), breastfeeding duration under 6 months (OR=2.61; p=0.003), introduction of cow's milk before 6 months (OR=1.78; p=0.003), hyperphagia (OR=2.03; p=0.001), snacking (OR=4.45; p=0.019), lack of physical activity (OR=4.02; p=0.019), low vitamin A intake (OR=1.02; p=0.029), and high sodium intake (OR=1.15; p=0.043) as independent factors associated with overweight.</p><p><strong>Conclusion: </strong>These findings highlight the importance of early identification and intervention on modifiable behaviors and dietary habits to reduce the burden of childhood overweight.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE MOST COMMONLY PRESCRIBED MEDICATIONS BY PEDIATRICIANS IN MOSUL CITY.","authors":"A Bashi, N Abdulmonim, N Salem, S Nayf, T Ammar, Y Ismaeel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pediatric diseases and thus their medications are described as rarely occurring, moderately occurring, and frequently occurring. The purpose of this study is to identify the most frequently prescribed categories of pediatric medications by pediatric specialists in the city of Mosul.</p><p><strong>Methods: </strong>100 medical prescriptions written by pediatric specialists in their private clinics from various locations in the city of Mosul. Upon receiving a prescription from one of these doctors, the research member would copy the prescription and keep it. When 100 prescriptions were collected, each prescription was examined, and the prescribed medications were classified into groups according to their pharmacological effect.</p><p><strong>Results: </strong>The highest frequency of prescribed drug categories by pediatric specialists in Mosul was antibiotics, with a usage rate of 27.77%, followed by gastrointestinal drugs at 22.22%, then analgesics and antipyretics at 18.88%, then antihistamines at 14.44%, followed by vitamins and nutritional supplements at 8.88%, and lastly respiratory system drugs at 7.77%.</p><p><strong>Conclusion: </strong>The results of the current study show that the most prescribed drug class by pediatricians in Mosul city are the antibiotics. Also, the types of antibiotics prescribed differ significantly in all three countries, and this depends on the protocol of treatment in each country. Other classes of drugs in the other studies show some similarity, as in Mosul City and sometimes show significant differences from Mosul City, and this depends on different factors and on different climates.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"136-142"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CERTAIN PROPERTIES OF Β-GLUCOSIDASE FROM YUCCA GLORIOSA FLOWERS.","authors":"Ts Giorgadze, T Gognadze, L Dolidze","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The search for rational synthetic pathways for steroid drugs from accessible plant sources represents an important and relevant objective. Yucca gloriosa presents significant interest as a source of tigogenin-a valuable sapogenin for steroid hormonal drug production. Along with traditionally utilized leaves, the flowers of this plant contain 1.25-1.48% tigogenin and possess several technological advantages: simpler extraction of the target product due to lower lipophilic substance content and softer raw material texture. Endogenous β-glucosidase plays a key role in the tigogenin production process, catalyzing the conversion of oligofurostanoside to oligospirostanoside. This work investigated the properties of β-glucosidase from flowers of Yucca gloriosa cultivated in Georgia. Two enzyme forms differing in substrate specificity were identified. The first form (30% ammonium sulfate saturation fraction) hydrolyzes both natural oligofurostanoside and synthetic substrate 4-nitrophenyl-β-D-glucopyranoside, whereas the second form (80% saturation fraction) cleaves only the synthetic substrate. For the first β-glucosidase form, which has practical significance for tigogenin production, optimal operating conditions were determined: pH6.3 and temperature 47°C. Notably, the temperature optimum for the flower enzyme (47°C) proved higher than for the leaf enzyme (37°C). Heating at 57°C for 10 minutes reduces enzyme activity by 29%, while at 67°C it reduces activity by 79%.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL EFFECTIVENESS OF TRADITIONAL TREATMENT METHODS FOR GRADE III CHEMICAL ESOPHAGEAL BURNS IN CHILDREN.","authors":"A Shamsiev, A Shakhriev, B Yuldashev, L Khakimova, F Khalimova, N Sagirayev","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chemical esophageal burns in children, especially grade III injuries, frequently lead to cicatricial strictures, persistent dysphagia, and prolonged hospitalization, creating a high risk of complications and disability. Traditional dilation methods (blind bougienage and gastrostomy with string-guided bougienage) remain widely used; however, they are associated with limited effectiveness and a risk of perforation. This study aimed to evaluate real-world outcomes of these traditional approaches and to define their main clinical limitations.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed in 115 children (aged 1-14 years) with chemical esophageal burns treated in a hospital setting. Grade III esophageal burns with subsequent cicatricial stricture formation were diagnosed in 46 patients. The severity of stenosis was assessed using the Yu.I. Gallinger classification. Treatment selection was determined by the severity of deformity: direct bougienage was performed when luminal passage was possible, while gastrostomy with string-guided bougienage was used in cases of severe stenosis, inability to safely pass a bougie, or after ineffective blind bougienage. Final clinical outcomes were assessed during hospitalization (at discharge). Because treatment selection depended on stenosis severity and technical feasibility, between-method comparisons were interpreted descriptively in view of confounding by indication.</p><p><strong>Results: </strong>All patients with grade III burns had cicatricial stenoses of grades II-IV: grade II - 45.6%, grade III - 43.5%, and grade IV - 10.9%. Direct bougienage was feasible as the primary method in 45.7% of cases, whereas gastrostomy with string-guided bougienage was used in 54.3%; this distribution should be interpreted with caution because gastrostomy was preferentially selected for more severe deformity or after failed blind bougienage. Esophageal perforation was recorded in 6.9% of patients. In alkali burns, a 1.6-fold higher need for gastrostomy was observed than in acid burns (73.3% vs 45.2%), but the difference did not reach statistical significance (p=0.115). The mean length of hospital stay was 41.1±2.9 bed-days. Final in-hospital clinical outcomes were: good - 67.4%, satisfactory - 19.6%, and unsatisfactory - 13.0%.</p><p><strong>Conclusion: </strong>Traditional treatment methods for grade III chemical esophageal burns in children demonstrate important clinical limitations, including a risk of perforation and a frequent need for gastrostomy in severe cases. Given the retrospective design, selection by indication, and the absence of a direct comparison with visually controlled techniques, further comparative studies are needed to determine whether safer dilation under visual or guidewire control improves outcomes.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"182-186"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COGNITIVE RESERVE IN PATIENTS AFTER CORONAVIRUS INFECTION.","authors":"D Khramtsov, O Chernyshov, O Stoyanov, V Gryb, Y Vorokhta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing evidence of persistent cognitive dysfunction after COVID-19, the role of cognitive reserve as a modifying factor of post-infectious neurocognitive outcomes remains insufficiently explored, particularly in relation to disease severity and premorbid lifestyle characteristics.</p><p><strong>Objective: </strong>To analyze the characteristics of cognitive reserve in patients after SARS-CoV-2 infection and to assess its impact on the structure and severity of post-COVID cognitive impairments.</p><p><strong>Materials and methods: </strong>The study included 247 patients aged 31-67 years who had recovered from COVID-19 (93 hospitalized and 154 treated on an outpatient basis) and 50 age-matched controls without a history of COVID-19. Cognitive reserve and related factors were assessed using the Cognitive Reserve Questionnaire (CRQ), Test of Premorbid Functioning (TOPF), Montreal Cognitive Assessment (MoCA), Trail Making Test A/B, Digit Span Backward, and semantic verbal fluency test. Premorbid lifestyle characteristics, occupational cognitive complexity, physical activity, disease severity, body mass index, and inflammatory markers (peak C-reactive protein) were recorded. Multivariate linear regression models were constructed with global cognitive performance (MoCA score at 12 months) as the dependent variable.</p><p><strong>Results: </strong>Post-COVID patients demonstrated significantly lower CRQ total scores compared with controls (7.82±0.12 vs 9.41±0.15; p<0.001), with the lowest values observed in hospitalized patients. Educational level and premorbid intelligence (TOPF) did not differ between groups, indicating preserved premorbid cognitive capacity. Reduced CRQ scores were primarily driven by lower occupational cognitive complexity and diminished cognitively active lifestyle, suggesting impaired utilization of cognitive reserve rather than loss of reserve capacity. MoCA scores were significantly lower in post-COVID patients (25.4±0.19 vs 27.8±0.22; p<0.001), with predominant impairment of executive functions, attention, and processing speed. In multivariate analysis, better cognitive outcomes were independently associated with higher CRQ scores, greater occupational complexity, and higher premorbid physical activity, while disease severity, elevated inflammatory markers, and older age were associated with poorer MoCA performance (Adjusted R²=0.521; p<0.001).</p><p><strong>Conclusions: </strong>Post-COVID cognitive impairment occurs despite preserved premorbid cognitive reserve and is characterized by reduced utilization and engagement of reserve mechanisms, particularly following severe disease.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARATIVE SUSCEPTIBILITY PROFILES OF CLINICAL AND REFERENCE BACTERIAL STRAINS ACROSS MULTIPLE ANTIBIOTIC CLASSES.","authors":"G Melik-Andreasyan, F Tkhruni, K Karapetyan, S Atoyan, N Aleksanyan, N Kotsinyan, A Israyelyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a major global public health threat, undermining the efficacy of commonly used antibiotics. Resistance patterns differ across bacterial taxa, including Enterobacteriaceae, non-fermenting Gram-negative bacilli, and Gram-positive cocci. This study aimed to provide a comparative analysis of antimicrobial susceptibility among reference strains with defined susceptible and resistant phenotypes, alongside selected clinical isolates, to evaluate the preservation of phenotypic traits and the impact of antibiotic use. Reference susceptibility strains exhibited high susceptibility across most antibiotics, whereas resistant reference strains demonstrated multidrug resistance. Among Enterobacteriaceae, reference strains harboring ESBL and AmpC mechanisms displayed resistance to penicillins, cephalosporins, and carbapenems. Non-fermenters, including Pseudomonas aeruginosa and Acinetobacter baumannii, showed both intrinsic and acquired resistance to multiple classes, particularly carbapenems and fluoroquinolones. Gram-positive cocci largely retained susceptibility to glycopeptides and linezolid, while MRSA, high-level aminoglycoside-resistant enterococci, and penicillin-resistant Streptococcus pneumoniae posed significant therapeutic challenges. Comparative analysis revealed that antimicrobial susceptibility is influenced not only by bacterial taxonomy but also by patterns of uncontrolled or inappropriate antibiotic use. Clinical strains of Klebsiella pneumoniae and Streptococcus pneumoniae displayed reduced and more variable susceptibility compared to the predictable profiles of reference strains. These findings highlight the importance of continuous surveillance, strict adherence to antimicrobial stewardship, and the use of standardized reference strains to ensure reliable susceptibility testing. Early detection of emerging resistance patterns is essential to guide effective therapy and mitigate the public health impact of multidrug-resistant pathogens.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A NOVEL NON-INVASIVE MODULATION OF ORTHODONTIC RELAPSE: INSIGHTS FROM A RABBIT MODEL.","authors":"S Al Qassar, O Alluazy, A Ali, E Aljewary","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Low-intensity pulsed ultrasound (LIPUS), such as Exogen device, stimulates osteogenesis and angiogenesis without harmful thermal effects, enhancing bone strength and shortening recovery time. This experimental study evaluated the application of Exogen low-intensity pulsed ultrasound (LIPUS) device in promoting alveolar bone healing and reducing post-orthodontic relapse in rabbits model after induction of teeth movement by semi orthodontic appliance.</p><p><strong>Materials and methods: </strong>12 adult rabbits underwent orthodontic tooth movement for lower anterior teeth, followed by appliance removal. Animals were randomly assigned to two groups: a control group with no LIPUS treatment, and an Exogen group that received daily low-intensity pulsed ultrasound (LIPUS) therapy for 20 days. Clinical measurements of relapse distance were recorded at days 0, 10, and 20 in mm. Histological and histomorphometric analyses were performed to assess osteoblast and osteoclast counts, vascular density, and periodontal ligament (PDL) width in both cervical and apical regions.</p><p><strong>Results: </strong>showed that the Exogen group exhibited a significantly smaller relapse distance from day 10 onwards (p≤0.01) and approximately 35% less relapse at day 20 compared with controls. Histomorphometric data revealed higher osteoblast counts, lower osteoclast counts, increased vasculature, and narrower PDL width in the Exogen group, indicating enhanced bone formation, reduced bone resorption, and improved periodontal stability. Histological examination confirmed greater organization of lamellar bone, denser osteoblastic lining, and more pronounced vascularization in treated animals.</p><p><strong>Conclusion: </strong>These findings suggest that the Exogen LIPUS device may serve as an effective adjunct tool in orthodontics to accelerate alveolar bone healing and to achieve greater stability of teeth following orthodontic interventions.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"33-44"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PHYTOCHEMICAL SCREENING AND LIPID LOWERING EFFECTS OF TERMINALIA CHEBULA FRUIT EXTRACTS IN ALBINO WISTAR RATS.","authors":"Z Tawffiq, I Ahmed, L Al-Obaidy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Terminalia chebula fruit is a medicinal plant high in bioactive compounds that have potential therapeutic benefits. The current study targeted to determine the phytochemical profiles and hypolipidemic effects of aqueous and methanol-based extracts of Terminalia chebula fruits in high-fat diets that made hyperlipidemic Wistar rats. According to qualitative phytochemical examination, the aqueous extract contained phenols, flavonoids, tannins and saponins, whereas the methanol extract contained alkaloids, tannins, and flavonoids, Induction of hyperlipidemia significantly raised total serum cholesterol, triglycerides, LDL, and VLDL levels in the group with high-fat diet when compared to the normal control. Treatment with the methanol extract of Terminalia chebula (200 mg/kg) resulted in significant decreases (P<0.05) in blood total cholesterol (26.6%), triglycerides (17.3%), LDL cholesterol (43.8%), and VLDL cholesterol (17.3%) compared to hyperlipidemic control group. Similarly, the aqueous extract significantly decreased total cholesterol (15.8%), triglycerides (12.8%), LDL cholesterol (28.2%), and VLDL cholesterol (12.8%) (P<0.05). Atorvastatin treatment resulted in a significant improvement in lipid parameters and acted as a positive control. No substantial increase in HDL cholesterol levels was seen in the extract-treated groups. In conclusion, Terminalia chebula fruit extracts had considerable hypolipidemic action, with the methanol extract exceeding the aqueous extract. These effects could be attributable to the presence of polyphenols and flavonoids, which supports Terminalia chebula's potential use as a natural treatment for hyperlipidemia control.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"177-181"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OPTIMIZING SPINAL ANESTHESIA IN URGENT CESAREAN DELIVERY: THE TAYLOR APPROACH IN A PARTURIENT WITH CORRECTED SEVERE SCOLIOSIS AND PULMONARY COMPLICATIONS: A CASE REPORT.","authors":"E Daku, L Hajdari, B Morina","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Severe scoliosis with prior corrective spinal surgery poses significant anesthetic challenges in obstetric patients due to altered spinal anatomy and potential respiratory compromise. Conventional neuraxial or general anesthesia may be risky, making alternative approaches necessary for safe cesarean delivery. The Taylor paramedian technique provides an effective option by bypassing distorted midline anatomy.</p><p><strong>Case report: </strong>A 35-year-old primigravida (G1P0) at 37±1 week's gestation with surgically corrected thoracolumbar scoliosis and restrictive pulmonary disease, complicated by bronchopneumonia, was admitted for cesarean delivery. Preanesthetic assessment revealed limited cervical mobility, restricted mouth opening, and challenging spinal landmarks. Initial midline puncture at L3-L4 failed, so a paramedian Taylor approach at L5-S1 using anatomical landmarks was performed. Intrathecal 12 mg plain 0.5% bupivacaine with 20 µg fentanyl achieved complete sensory and motor block. Maternal hemodynamics remained stable with normal oxygenation. Cesarean section was completed uneventfully, delivering a healthy neonate weighing 3 kg with Apgar scores 8 and 9. Postoperative recovery was smooth, and the patient was discharged on day 3.</p><p><strong>Conclusion: </strong>Paramedian Taylor spinal anesthesia is a safe and effective alternative in parturients with severe scoliosis and restrictive pulmonary disease. Individualized planning, technical expertise, and careful execution allow complete sensomotor block, minimize respiratory risk, and ensure successful cesarean delivery in high-risk patients.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 371","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}