IMPACT OF MICROBIOME COMPOSITION ON QUALITY OF LIFE IN HEMODIALYSIS PATIENTS.

Accumulating evidence showed that chronic inflammation is a risk factor for increased cardiovascular mortality in the population with Kidney Failure (KF) remaining on Kidney Replacement Therapy (KRT). The gut microbiome is altered in patients with Chronic Kidney Disease (CKD) and is one of the major sources of chronic inflammation. Uremic gut microbiome may have serious effects on patients' quality of life (QoL) and, especially, on their psychological, social, and economic prosperity. Factors that influence health-related quality of life (HRQOL) in patients with ESRD have received little attention. Aim - this study aimed to investigate changes of QOL in HD patients by the correction of intestinal microflora. The sample study consisted of 33 HD patients (age 18-75) from "The clinical center for development of nephrology". Data was collected through the completion of a specially designed questionnaire. For assessment of Qo was used the "Missoula VITAS Quality of life index. Fecal samples were analyzed before and after treatment with probiotics. It was revealed alteration of the colonic microbial composition in the sample of the hemodialysis patients. Also, there was a strict correlation between gut dysbiosis and HD patients' QoL. Our study demonstrates important relationships between gut dysbiosis and QoL in HD patients. Correction of intestinal flora with probiotics-containing L. acidophilus, B. longum, and S. Thermophilus for a long period of at least 12 weeks improves the quality of their lives.

NEEDS ASSESSMENT FOR EFFECTIVE CONTINUOUS PROFESSIONAL DEVELOPMENT OF PHYSICIANS IN GEORGIA.

At all levels--from individual to national- Continuing medical education (CME,) competency-based continuing professional development (CPD) planning should incorporate objectively determined quality, program utilization, and other objective data as well as more subjectively determined needs as perceived by individual physicians. The study aims to conduct self-recognized/perceived needs assessment for CME/CPD among certified physicians working at TSMU University Clinics and TSMU affiliated clinics different regional cities of Georgia: Kutaisi, Batumi, Kareli; Provide quantitative and qualitative analysis of the completed questionnaires to identify discrepancies and find the differences between forecasts and actual data, recognize their causes and devlop recommendations for clinical skills development, new knowledge dissemination, and barrier avoidance. Medical Doctors were interviewed by specially designed on-line surveys in various regions of Georgia, including the capital. The answers provided by respondents indicate, that clinicians today are responsive to activities that are practice-relevant, efficient, effective, rewarding, and more personalized. Physicians prefer evidence-based, clinical CME topics that address a major aspect of their practice and that potentially provide an opportunity to learn new skills.

DISTRIBUTION OF CARIOUS AND NON-CARIOUS CERVICAL LESIONS AND GINGIVAL RECESSION AT AGE RELATED ASPECTS.

The current study aims at differentiating carious and/or non-carious diseases developed in Class 5 region and detecting the distribution rate at the age aspects. The study was conducted at the Dental Clinicand Educational-Research Center "Unident" LTD and Dental Clinic "Dens". 256 patients were involved in the study. All patients underwent a routine dental examination, while rentgenovisiography and CT were performed in case of need. For gathering the detailed medical history and integrated study of Class 5 defects, a special questionnaire/survey, providing detailed information on each patient, was developed. The conducted study revealed the following: The patients were divided into 3 age groups: 16-30 of ages (77 patients, I study group), 30-50 of ages (97 patients, II study group) and 50-70 of ages (82, III study group), respectively. In total 5802 teeth were examined. The subject of our interest was identification of intact and damaged teeth (affected with caries and non-carious diseases) in the above-mentioned contingent. It was found that carious disease of cervical zone of tooth (Class 5) most often was revealed in 30-50 age group (202 cases), which is 1.8-fold higher than the same index in the I study group (144) and 1.4-fold higher in the III study group (183), respectively; The highest rate of non-carious lesions (erosion, abrasion, abfraction) of dental neck was recorded in examined 50-70 age group (294 cases), which was 4.6 -fold higher than in the I study group (64) and 2.1 -fold higher in II study group (140), respectively; The lowest incidence of gingival recession was in the I study group (65 cases), which is 6.3 -fold lower than in the II study group (412) and 7.5-fold lower than - the III group (493).

Blood pressure patterns in urban and rural children and adolescents of the Kakheti region (East Georgia).

Research was conducted in urban and rural areas of the city Telavi in 2012-2013. 493 public school pupils aged 6-18 were studied (267-urban resident, 226-rural resident). Results are grouped separately for all (13) aging clusters. This indicator is compared to each other by sex and living area (urban/rural) and received results are then grouped for 3 aging groups: I - early childhood 6-8 years of age n=136 (boys - 71, girls - 65; II - middle childhood 9 - 11 years of age n=147 (boys - 82, girls - 65) and III - adolescence 12-18 years of age n=213 (boys - 98, girls - 115). Measurements were taken on the right arm, three times with 3 minutes intervals. Both rural and urban area resident children's (boys, girls) SAP/DAP was evaluated. Data was processed statistically by "ANOVA". To determine correlation between different study groups, parametric and nonparametric methods were used.Significance was determined with 95% of variability. Results of the comparison of systolic and diastolic blood pressure for boys and girls living in rural and urban areas demonstrated: There seems to be no significant difference between boys and girls living in urban and rural areas. The biggest difference was identified in: 1) Boys in Aging Group I - SAP rural pupil boys averagely is 5.7 mm/Hg higher compared to urban resident boys; 2) For girls in Aging Group III of rural residents, SAP is averagely 3mm/Hg higher compared to same group of urban residents. Same difference was identified in girls considering DAP data.This may be due to several reasons, such as: 1) village inhabitants are more physically active. 2) BMI of the residents living in the rural areas is lower compeard to the residents living in the citie. Our findings are in line with the results obtained in Iraq and Russia.

[Tobacco consumption among teenagers of school age in the East Georgian region of Kakheti].

The aim of the article was to study tobacco consumption in the East Georgian region of Kakheti among rural and urban pupils using the anonymous epidemiological questionnaire. The survey was carried out on 412 pupils aged 15-18 years (220 girls and 192 boys). Research showed that 98,3% of teenagers are informed about tobacco harm; 71,3% of respondents did not know of the dangers of passive smoking. 63,9% of urban teenagers are non-smokers; 73,9% of rural teenagers are non-smokers. It was found that smoke (44,4 ± 8,28%). of 16 year old, 19,4 ± 6,6% of 17 year old, and 33,4 ± 7,9%. of 18 year old pupils. 2,8 ± 2,7% of 15 year old pupils consume tobacco. Tried tobacco for the first time at the age of: 12 (16,9 ± 1,78%), 14 (17,7 ± 1,8%) and 16 (21,7 ± 3,7%) Did not smoke (73,9 ± 4,6%), of rural pupils and (63,8 ± 2,7%) of urban pupils. The investigation showed that in Kakheti the consumption of tobacco among pupils is less than in other regions of Georgia (8,7% and 23,3% respectively), passive smokers (62,9% and 93,3% respectively) and incidental consumers of tobacco (25,2 % and 42%). In the region of Kakheti there are less passive smokers than in other regions of Georgia. There are no places separately allocated for smokers in Kakheti. It is concluded that it is necessary to increase the information of population in the region (local telecasting, booklets and other educational actions), concerning harm of consumption of tobacco and especially about harm of passive smoking. It will improve indicators of consumption of tobacco and will positively be displayed on indicators of chronic non-contagious diseases.

Child and adolescent body mass index data according to who new child growth standards in Georgia (Kakheti region).

The Studies were carried in Georgia among 6-18 years old 854 children and adolescent; (417girls, 437 boys). Measurements of weight, height and chest circumference were taken from following standard techniques. The Body Mass Index of each child was computed as weight/height2. The calculated BMI was compared to the World Health Organization BMI - for-age centiles tables (5-19 years old girls and boys). According the given results the nutritional status was defined: thinness-2.6%, overweight- 13%, obesity-7.2%. The most 6-18 years old children BMI is adequate to 25th, 50th and 75th centiles of the World Health Organization standard BMI -for-age percentile tables. The thinness was revealed only among the children of 6-12 age group. With the prevalence among the girls. The high number of thin children is fixed with both 6 years. old girls and boys(6.4%).12 years old girls (11.1%),but the number of underweight children is less than the number of the same age schoolchildren in Tbilisi. The number of fat and overweighted children increases within the age and dominates among the boys. The highest percent of obesity was revealed among the children of both sex at the age of 11 (21.5%) also among the 18 years old boys(17.6%). The data analysis of the carried studies, allow comparisons with the other studies, carried out in different countries of the world. The data analysis showed that underweight, overweight and obesity distribution among the schoolchildren in Georgia is close to the statistics data of the Eastern and Central Europian countries.