Scientists warn that rapid advances in AI and neurotechnology are outpacing our understanding of consciousness, creating serious ethical risks. New research argues that developing scientific tests for awareness could transform medicine, animal welfare, law, and AI development. But identifying consciousness in machines, brain organoids, or patients could also force society to rethink responsibility, rights, and moral boundaries. The question of what it means to be conscious has never been more urgent—or more unsettling.
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Pak J Pharm Sci. 2026 Mar;39(3):878-886. doi: 10.36721/PJPS.2026.39.3.REG.12881.1.
ABSTRACT
BACKGROUND: Septic shock is a life-threatening complication of sepsis, often accompanied by cardiopulmonary dysfunction, which significantly increases the mortality of patients. Norepinephrine (NE) is a commonly used vasopressor in the treatment of septic shock, but single-drug therapy may not fully achieve cardiopulmonary protection. Antidiuretic hormone (ADH) has potential regulatory effects on hemodynamics and inflammation, but its combined efficacy with NE in cardiopulmonary protection for septic patients remains to be further verified.
OBJECTIVES: This study aims to investigate the effectiveness of ADH combined with NE in providing cardiopulmonary protection for septic patients.
METHODS: A total of 100 patients with septic shock admitted to our hospital from March 2022 to March 2023 were enrolled in this study. They were randomly divided into an observation group and a control group, with 50 patients in each group. The observation group was treated with ADH combined with NE, while the control group received NE monotherapy. Relevant indicators of the two groups were dynamically monitored and compared.
RESULTS: Statistical analysis showed that tumor necrosis factor-α (TNF-α), cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) had significant differences in group effect, time effect, and interaction effect (P<0.05). Interleukin-1 (IL-1) and interleukin-6 (IL-6) only showed significant time effect (P<0.05), but no significant group effect or interaction effect (P>0.05). Arterial partial pressure of oxygen (PaO2) and PaO2/fraction of inspired oxygen (P/F ratio) exhibited significant time effect and group effect (P<0.05), but no significant interaction effect (P>0.05). After treatment (T3), compared with the control group, the observation group had significantly lower levels of TNF-α, IL-1, IL-6, cTnI, BNP, and creatine kinase isoenzyme MB (CK-MB) (P<0.05), and significantly higher PaO2 and P/F ratio (P<0.05).
CONCLUSION: ADH combined with NE can effectively improve the inflammatory response, cardiac and pulmonary function indexes of septic patients, and exert significant cardiopulmonary protection effects. It is a viable and effective therapeutic strategy for septic patients.
PMID:41620916 | DOI:10.36721/PJPS.2026.39.3.REG.12881.1
Pak J Pharm Sci. 2026 Mar;39(3):597-603. doi: 10.36721/PJPS.2026.39.3.REG.14269.1.
ABSTRACT
BACKGROUND: Diabetic macular edema (DME) is a predominant cause of visual impairment among patients. The concurrent administration of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids may yield synergistic therapeutic benefits.
OBJECTIVE: In this study, we evaluated the efficacy and safety of aflibercept (AFL) in combination with dexamethasone (DEX) intravitreal implant for the treatment of DME.
METHODS: A total of 80 patients with DME admitted to a hospital from June 2022 to June 2024 were enrolled. 42 patients in the AFL group received monotherapy, and 38 patients in the AFL+DEX group received combination therapy. The best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and aqueous humor inflammatory factors (IL-1β, MCP-1, IL-6, VEGF) were evaluated monthly. Efficacy was graded according to criteria at 4 months after treatment, and adverse events were recorded.
RESULTS: The findings revealed no statistically significant difference in the overall clinical efficacy rate between the AFL+DEX group and the AFL group (P>0.05). However, the AFL+DEX group demonstrated superior best-corrected visual acuity (BCVA) at 1, 3 and 6 months post-treatment, alongwith a significant reduction in central macular thickness (CMT) compared to the AFL group (P<0.05). Furthermore, aqueous humor analysis indicated markedly lower levels of inflammatory cytokines in the AFL+DEX group following treatment (P<0.05). In terms of safety profiles, the AFL+DEX group required fewer intravitreal injections (P<0.05).
CONCLUSION: These findings underscore the potential of AFL combined with DEX intravitreal implant to enhance visual outcomes and modulate intraocular inflammation in DME patients, highlighting its substantial clinical utility.
PMID:41620889 | DOI:10.36721/PJPS.2026.39.3.REG.14269.1
Wiad Lek. 2025;78(12):2830-2836. doi: 10.36740/WLek/214048.
ABSTRACT
OBJECTIVE: Aim: To identify and analyze the factors that mandate the technologization of iatrogenic crime investigation process and to propose actionable strategies for integrating modern technologies and algorithms into investigative practices for this class of criminal proceedings.
PATIENTS AND METHODS: Materials and Methods: This research is based on an analysis of official WHO documents, 31 relevant judgments from the European Court of Human Rights (ECHR) concerning adverse medical outcomes, 19 verdicts and decisions from Ukrainian courts on medical malpractice, and statistical data from the Prosecutor General’s Office of Ukraine for the period 2016-2021. The primary analysis is supplemented by a review of recent scientific articles from leading academic databases.
CONCLUSION: Conclusions: It has been proven that although patient harm resulting from the provision of low-quality medical care is very widespread worldwide and often becomes the subject of criminal investigation, Ukraine demonstrates a very low level of investigation and detection of iatrogenic crimes. It is proposed that these shortcomings be corrected through technologization, which includes the algorithmization of investigative actions and the application of the latest technologies.
PMID:41620885 | DOI:10.36740/WLek/214048
Wiad Lek. 2025;78(12):2742-2750. doi: 10.36740/WLek/214419.
ABSTRACT
OBJECTIVE: Aim: Identifying of key criteria that influence the process of dispensing medicines by pharmacists by electronic prescriptions, and establish its’ relationship with the frequency of problems while paying off prescriptions.
PATIENTS AND METHODS: Materials and Methods: In our work we used the survey method involving questionnaires. To screen the obtained results, we used the method of intelligent data analysis depending on building the associative rules. The survey subjects were pharmaceutical clerks employed by pharmacies in the Western, Central, Eastern, Northern and Southern regions of Ukraine, who directly sold MPs to the population. Respondents included individuals of different sexes, ages, and professional experience. The questionnaire contained several blocks that were dedicated to the analysis and identification of the main difficulties that arise when dispensing drugs by e-prescriptions and the criteria that influence the choice of a drug for dispensing by trade name when dispensing by e-prescriptions. A total of 2233 specialists were surveyed.
RESULTS: Results: We analyzed the criteria that had influenced a choice of trade name of prescription medicines filled for patients by a pharmacist under e-prescription in the form of an international non-proprietary name.
CONCLUSION: Conclusions: We have determined the criteria for selecting medicinal products by pharmaceutical clerks while filling e-prescriptions, which can be used in the practical activities of pharmaceutical workers as an integral part of the process of optimizing pharmacy inventories. The most important criteria have been found the amount of co-payment for medicine, the country of manufacture/medicines manufacturer, and the history of medicine administration by the patient. The criteria of the presence or absence of evidence-based data on the efficacy of a particular medicine and the medicine`s belonging to generics or original medicines have been found the least important. The inability of a pharmaceutical clerk/pharmacy worker to select a medicine based on one or more of the above selection criteria is considered one of the reasons for failure to dispense up to 20% of medicinal products under e-prescriptions.
PMID:41620874 | DOI:10.36740/WLek/214419
Wiad Lek. 2025;78(12):2707-2716. doi: 10.36740/WLek/213629.
ABSTRACT
OBJECTIVE: Aim: The relationship between diabetes mellitus (DM) and lifestyle quality become important in diabetes research in last year. The present study aims to study the influence of metformin response in sleep in diabetes mellitus patients type 2.
PATIENTS AND METHODS: Materials and Methods: A cross sectional study was designed to achieve study goal, glycemic parameters included fasting blood glucose (FBG), glycated protein (HbA1c%), insulin (IN), insulin resistance (HOMA-IR) and insulin sensitivity (IS). PCR sequencing was used to detect SLC47A2 intronic variants and its related with glycemic control and sleep status.
RESULTS: Results: Among the study population, about 26.3% achieved well glycemic control, 30% were moderately controlled, and 43.8% were poorly controlled. Sleep quality assessment showed that the majority of participants in all glycemic groups experienced intermediate sleep. The prevalence of insomnia increased with worsening glycemic control, from 4.8% in the well-controlled group to 17.1% in poorly controlled participants, in non- statistically significant (p = 0.722). Biochemical parameters confirmed significant differences in fasting blood glucose and HbA1c across the three glycemic categories (p < 0.001), insulin, HOMA-IR, and insulin sensitivity did not differ significantly. Multiple regression analyses indicated that none of the biochemical predictors significantly explained sleep in any group (p > 0.05), in poorly controlled patients, non-significant opposing trends were observed for insulin and insulin resistance, sociodemographic factors included supplement use, education level, and employment were associated with better sleep among poorly controlled patients. Genetic analysis of two intronic variants in the SLC47A2 gene (g.19716681G>C and rs1597652185) revealed no significant associations with glycemic control or sleep, though both showed similar distribution patterns across groups. Statistical analysis didn’t find significant association between either variant and glycemic or sleep status (p > 0.05).
CONCLUSION: Conclusions: Poor glycemic control was common and associated with higher insomnia prevalence. While demographic and clinical factors showed no clear links with glycemic control or sleep, supplement use emerged as a protective factor. FBG and HbA1c strongly differentiated control groups, but other biomarkers and SLC47A2 variants were not predictive. Findings suggest that combining metabolic management with supportive measures like supplementation may improve sleep and outcomes in type 2 diabetes..
PMID:41620870 | DOI:10.36740/WLek/213629
Wiad Lek. 2025;78(12):2677-2684. doi: 10.36740/WLek/215808.
ABSTRACT
OBJECTIVE: Aim: To assess hormonal status and vitamin D metabolic features in women of reproductive age presenting with abnormal uterine bleeding and associated extragenital conditions.
PATIENTS AND METHODS: Materials and Methods: The study was conducted at the clinical base of the Department of Obstetrics, Gynecology, Pediatric Gynecology, and Medical Genetics of Kharkiv National Medical University (KhNMU). A total of 110 women of reproductive age were examined and divided into two clinical groups. The first group (main group, MG) included 80 patients diagnosed with abnormal uterine bleeding (AUB) in combination with extragenital cconditions. The second group (control group, CG) consisted of 30 somatically healthy women who presented for routine preventive examinations. Hormonal status was assessed by measuring serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone (PRG), estradiol (E2), and vitamin D using enzyme-linked immunosorbent assay (ELISA) methods. Statistical analysis was performed using the general-purpose software package Statistica 6.0.
RESULTS: Results: The average age of the participants was 31.5 ± 13.5 years. Among women in the main group, the most frequently observed extragenital conditions were diseases of the endocrine, circulatory, and digestive systems. Analysis of serum hormone levels revealed a decrease in FSH (1.84-fold), LH (1.64-fold), and PRG (2.6-fold) (KWT, p < 0.01). Conversely, E2 levels were elevated by 3.52-fold in the MG (KWT, p < 0.01). Serum vitamin D levels in the MG were reduced by 2.25-fold compared to the CG (KWT, p < 0.01). A statistically significant (p < 0.05) positive correlation was found between serum E2 and vitamin D levels (r = 0.61).
CONCLUSION: Conclusions: The study revealed distinct features of the hormonal profile and vitamin D metabolism in women of reproductive age with abnormal uterine bleeding and concomitant extragenital conditions. Specifically, this patient population demonstrated decreased serum levels of LH, FSH, PRG, and vitamin D, accompanied by hyperestrogenemia. A statistically significant correlation was observed between serum E2 and vitamin D levels.
PMID:41620867 | DOI:10.36740/WLek/215808
Wiad Lek. 2025;78(12):2661-2668. doi: 10.36740/WLek/213488.
ABSTRACT
OBJECTIVE: Aim: To determine the relationship between telomere length and telomerase activity and indicators of oxidative stress in patients with СА and T2DM.
PATIENTS AND METHODS: Materials and Methods: to investigate relationship between telomere length and cognitive function and identify predictors of cognitive impairment in patients with cerebral atherosclerosis and type 2 diabetes mellitus. The MMSE and MoCA scales, which are widely used in most modern epidemiological and clinical studies, were used for screening and assessment of cognitive disorders.
RESULTS: Results: Patients were divided into 2 groups: I – with scores on MMSE scale < 26 (moderate cognitive deficit, 26 people), II – with scores on MMSE scale 3 26 (mild cognitive deficit, 135 people). As a result of analysis, it was found that length of telomeres was statistically significantly shorter in patients of group I, the patients studied less, they had more pronounced situational anxiety, more pronounced intima-media thickness in both carotid arteries, and according to MoCA scale, they had pronounced impairment of cognitive functions (p<0.05). Group II patients had longer telomeres, studied longer, and had high personal anxiety.
CONCLUSION: Conclusions: patients with cerebral atherosclerosis and type 2 diabetes mellitus with mild cognitive impairment have longer telomeres, high personal anxiety, and a higher level of education.
PMID:41620865 | DOI:10.36740/WLek/213488
Wiad Lek. 2025;78(12):2642-2647. doi: 10.36740/WLek/215804.
ABSTRACT
OBJECTIVE: Aim: To provide a quantitative assessment of the clinical effectiveness of the high-energy Nd:YAG laser therapy versa traditional pharmacotherapy in patients with papulopustular rosacea.
PATIENTS AND METHODS: Materials and Methods: The study included 40 patients with clinically diagnosed papulopustular rosacea. Participants were divided into two subgroups: one received standard pharmacotherapy with systemic retinoids, and the other underwent fractional Nd:YAG 1064 nm laser treatment. Clinical outcomes were assessed using digital image analysis (ImageJ software), with erythema quantified in pixel units and relative facial area involvement. Statistical evaluation was performed with Student’s t-test, considering p < 0.05 as significant.
RESULTS: Results: Both treatment modalities demonstrated clinical improvement; however, outcomes were more pronounced in the laser-treated group. Traditional pharmacotherapy achieved a 22% reduction in erythema area, while Nd:YAG laser therapy resulted in a 79% reduction. The proportion of erythematous facial area decreased from 24.4% to 16.7% in the pharmacotherapy group and from 27.6% to 5.7% in the laser group. No systemic or local adverse effects were reported.
CONCLUSION: Conclusions: Nd:YAG FRAC3R laser therapy demonstrated superior efficacy over pharmacotherapy in reducing erythema and inflammatory manifestations in papulopustular rosacea. These findings support its role as an effective and safe alternative or adjunct to standard pharmacological management.
PMID:41620863 | DOI:10.36740/WLek/215804
Wiad Lek. 2025;78(12):2626-2633. doi: 10.36740/WLek/215795.
ABSTRACT
OBJECTIVE: Aim: The aim of our study is to optimize modern adhesive protocols through experimental investigation.
PATIENTS AND METHODS: Materials and Methods: During the study, we used the following methods: laboratory, experimental, scanning electron microscopy, morphological studies and analysis of the elemental composition of structures (samples) were carried out using a scanning electron microscope and statistical.
RESULTS: Results: Scanning electron microscopy of ceramic samples after etching showed changes in the surface structure, which consisted in an increase in microspaces, more frequent and deeper relief of irregularities with increasing etching time, acid concentration and activation of the etching gel. On the surface of samples etched for 60 seconds in 9% HF, irregularities of the cellular structure with a size of 5 to 18 μm were detected. The differences between statically and dynamically etched samples are clearly visible.
CONCLUSION: Conclusions: Thus, our study confirms the safety of using sandblasting to clean ceramics, the importance of dynamic etching at the stage of preparing ceramics for fixation, and the effectiveness of using an alcohol adhesive protocol. The results obtained, based on the principles of evidence-based medicine, can be used by dental professionals to improve the quality of treatment of patients with defects in the hard tissues of the teeth.
PMID:41620861 | DOI:10.36740/WLek/215795