Pseudomembranous colitis as a complication in Covid-19.

OBJECTIVE: Aim: To improve the results of treatment of patients with pseudomembranous colitis against the background of coronavirus infection. PATIENTS AND METHODS: Materials and Methods: The study presents the results of a retrospective analysis of 96 patients with pseudomembranous colitis, who were treated in the infectious Covid department at the base of the Uzhhorod City Clinical Hospital since 2020 to 2022. The average age of patients was 55.2 years, there were 38 (39.5%) men and 58 (60.5%) women. Diagnosis of complications - pseudomembranous colitis (PMC) - was based on clinical data, ultrasound and CT of the abdominal organs, fibrocolonoscopy, laparoscopy. RESULTS: Results: The frequency of PMC from the total number of patients who were in hospital treatment (8205 patients) due to COVID-19 was 1.17%, and this indicator was 0.62% in 2020, and 2.28% in 2021. Indications for operative treatment were: colon perforation - 9.4% of patients; peritonitis (diffuse, widespread) without obvious perforation of the colon wall - 85.5% of patients; mesenteric thrombosis - 4.1% of patients. In the case of perforation of the colon, resection of the colon was performed with the formation of a proximal colostomy and ileostomy. In case of mesenteric thrombosis, resection of the affected part of the small intestine was performed. In case of peritonitis without clear intraoperative detection of perforation of the colon wall, intraoperative lavage was performed. CONCLUSION: Conclusions: 1) The frequency of detection of PMC in patients with COVID-19 in 2020 was 0.62%, and in 2021 - 2.28%. 2) The sensitivity of CT in the diagnosis of surgical complications of PMC was 72%, and the specificity was 58%. 3) Conservative treatment was effective in patients with PMC in 88.8% of cases, 21.2% had complications that required emergency surgical interventions. 4) The total mortality in patients with PMC was 11.36%, although this indicator was significantly higher in the event of surgical complications and operative treatment (22.4%).

Use of technomolecular silver preparations in complex treatment of infected wounds.

OBJECTIVE: The aim: To improve the results of treatment of infected wounds. PATIENTS AND METHODS: Materials and methods:The clinical material is based on clinical observation and treatment of 29 patients with in fected wounds, whose treatment included combination drugs of local action on the basis of techno-molecular silver (in particular «Cadefort-Spray¼), by application to the wound surface. RESULTS: Results: Wound microbial factor, dynamics of wound process, indicators of immune status were evaluated: localadaptive immunity, atopic reactions. CONCLUSION: Conclusions: High efficiency of treatment was observed regardless of the phase of the wound process, which allowed to accelerate wound repair and stimulate the processes of regeneration, strengthen local adaptive immunity, prevent atopic reactions.

[Bipolar electroexcision and endoscopic laser photocoagulation colon polyps].

OBJECTIVE: Introduction: An important problem in the prevention of colon cancer is the diagnosis and treatment of its precancerous diseases, in particular polyps. The aim: The purpose of the study is to conduct a comparative description of the treatment outcomes using different methods of excision of polyps. PATIENTS AND METHODS: Materials and methods: The study included 134 patients with clinical manifestations of colon disease. Polyps of the colon have been diagnosed in 86 patients. In 45 (52.3%) patients endoscopic laser polypectomy was performed, in 41 (47.7%) patients electroexcision using a bipolar coagulator was performed. At control colonoscopies, after 6 months, the relapse of the disease was diagnosed in 4.65% of patients. RESULTS: Results: Relapses occurred in patients after laser coagulation as well as after electroexcision, due to technical difficulties in performing endoscopic surgery because of the form of the polyps. Conducting a comparative analysis of the rate of healing of postoperative defects as a consequence of the removal of polyps by different methods, we came to the conclusion that no significant difference was found between the methods of polypectomy. But attention is drawn to the fact that after the removal of polyps on a broad basis by the method of laser polypectomy, wound healing is significantly faster (p≤0.05) compared with the method of bipolar electroexcision. CONCLUSION: Conclusion: Polypectomy with fibrocolonoscopy is an effective method of diagnosis and treatment of benign tumors of the large intestine in ambulatory conditions. When removing polyps on a broad basis, the advantage should be given to the method of laser coagulation because healing of the wound occurs faster compared with the method of bipolar electroexcision.