Background To determine the effect of genetic polymorphism of drug transporters on the efficacy of treatment with Rosuvastatin, Atorvastatin and Simvastatin in patients with hyperlipidemia. Methods The study consists of 180 patients, aged 40–75 years, with hyperlipidemia. All patients were divided into two equal groups: patients with different SLCO1B1 (521CC, 521CT and 521TT) and MDR1 (3435CC, 3435TC and 3435TT) genotypes. Each group was divided into rosuvastatin-treated, atorvastatin-treated and simvastatin-treated subgroups. The lipid-lowering effect of statins was assessed by tracing changes in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels. Results The use of statins over a 4-month period led to substantial reductions in TC and LDL-C levels. The hypolipidemic effect of studied agents was seen in both groups. However, it was less pronounced in patients with 521CC genotype. No statistically significantly differences were found between carriers of 3435TT, 3435CT and 3435CC genotypes. Conclusions The lipid-lowering efficacy of rosuvastatin was higher compared to other two statins. Patients with SLCO1B1 521CC genotype are more likely to encounter a decrease in the hypolipidemic effect of statins. Such a risk should be considered when treating this category of patients. MDR1 polymorphism had no significant effect on statin efficacy.

Management for Type 2 Diabetes Mellitus (T2DM) is connected with urbanization because 2/3 of T2DM-patients live in towns, that is reflected in the term «urban diabetes». The T2DM-onset and T2DM-progression are depended not only on complex interaction of modified and non-modified risk factors, but also and sociodemographic determinants (and its modification at municipal level allowed to neutralize the unfavorable risk factors of T2DM&obesity. The urban non-rational food, disturbance of circadian rhythm, low T2DM-pths compliance stimulate onset of obesity, deterioration of glycemic control, high postprandial hyperglycemia, glucolipotoxicity, epigenetic changes and negative metabolic memory. Meanwhile the city politics may affect to the non-modified T2DM-risk factors at carrying the municipal policy directed to the rational catering, mass sports, organization of recreational zones, decrease of excessive urban traffic, improvement of ecology. The paper considers the features of migration to urban, religious fasting, COVID at the urban T2DM. The «urban diabetes» must be considered at therapeutic education and affected to form the active T2DM-pts-management.

IntroductionInflammatory bowel disorders (IBD) are chronic diseases with severe course. In this regard, research aimed at identifying adaptive behavior styles potentially significant for individual resilience to disease-related stress is of particular importanceObjectivesThe study population included 45 patients with the inflammatory bowel disorders: 19 male, 26 female (mean age 36,0±4,8), whose clinical and experimental psychological characteristics were studied.MethodsThe following methods were used: ‘Life Style Index’ by R. Plutchik, Н. Kellerman, ‘Ways of Coping’ by R. Lazarus, S. Folkman.ResultsThe experimental psychological study revealed interdependence of psychological defense mechanisms and coping behaviors. Thus, in female patients, such psychological defense mechanisms as ‘denial r=-0,51’ and ‘compensation г=-0,43’ showed negative correlation with ‘planning problem-solving’ coping strategy and positive correlation with such coping strategies, as ‘escape - avoidance г=0,38’ and ‘confrontation г=0,32’ р<0,05; in male patients, such psychological defense mechanisms as ‘regression г= -0,41;’ and ‘displacement г= -0,30’ demonstrated negative correlation with ‘planning problem-solving’ and ‘exercising self-control’, but positive correlation with such coping strategies, as ‘escape - avoidance г= 0,34’, ‘confrontation г= 0,40;’, р<0,05. Maladaptive attitude towards disease correlated with avoidance reactions in both male and female patients, which is indicated by the central rank position in disease coping structure of ‘confrontation’ coping strategy М=69,3±0,1, along with insufficient utilization of ‘planning problem-solving’ coping strategy М=39.3± 0,1, р< 0,001.ConclusionsThe identified manifestations of psychological maladaptation in both male and female inflammatory bowel disorder patients are moderately pronounced, but require psychotherapeutic correction

Constipation is one of the key problems of modern therapy for elderly people. The research aim was to study the features of the psychological and microbiological status of the advanced and senile age patients with functional constipation and to see the effect of educational programmes on compliance of the patients with the therapy in the out!patient departments. The investigation showed that depression was more frequent in the patients of group 1 (68.4 % of the cases) with compensated function of the large gut whereas in the 2nd group – 34.6 % (compensated) and in the 3rd group – 41.5 % (subcompensated)cases. The 3rd degree dysbiosis was found in all patoents irrespective of the extern of disorder of the motor!kinetic function in the large gut.

Objective: With the gradual aging of the world’s population, selecting an effective treatment regime for arterial hypertension (AH) becomes increasingly important. This article aims to analyze the pharmacokinetic and pharmacodynamic properties of parent enalapril and generic drugs in elderly patients suffering from AH. Materials and methods: The study is randomized, implying random distribution of patients into study groups. The study was conducted in 2018 among 200 patients diagnosed with AH. All elderly patients (mean age 77.5 ± 1.5 years) were divided into two equal groups. Group 1 was prescribed 10 mg of original enalapril orally, and Group 2 similarly took 10 mg of generic enalapril. The blood pressure of all patients was measured 1, 2, 4, 6, 8, and 11 hours after dosing and one day after treatment. Also, blood samples were taken after blood pressure measurements. Results and Discussion: After 1 hour, differences between Groups 1 and 2 (p ≤ 0.001) were found at the level of 29.84 ng/1 ml for the original drug and 19.01 ng/1 ml for the generic. Further, these values were 38.2 ng/1 ml vs. 28.7 ng/1 ml (p ≤ 0.001) after 2 hours, 36.6 ng/1 ml vs. 26.5 ng/1 ml (p ≤ 0.001) after 4 hours, and 9.2 ng/1 ml vs 5.1 ng/1 ml (p ≤ 0.001) after 24 hours, respectively. The maximum concentration-time curve values for both medications corresponded to the period of 2 hours after administration. Conclusion:Thus, generics are much less effective as an antihypotensive medication than the original enalapril. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 562-569