RUDN Journal of Medicine
type: channel
description: EDITOR IN CHIEF: Zhanna D. KOBALAVA, Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Department of Internal Medicine with a course of cardiology and functional diagnostics named after V.S. Moiseev, Medical Institute, RUDN University, Moscow, Russia; ISSN: 2313-0245 (Print) ISSN: 2313-0261 (online) Founded in 1997. Publication frequency: quarterly PUBLISHER: Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) Open Access: . APC: no article processing charge Peer-Review: double blind. Publication language: Russian, English Indexation: White List, Russian Index of Science Citation, Scopus (Q3 Cite Score), Google Scholar, Ulrich's Periodicals Directory, WorldCat, ResaerchBib, Lens, Research4Life, Dimensions, DOAJ, JournalTOCs, British Library, Bodleian Libraries (University of Oxford), Ghent University Library
publisher: Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)
language: ru-RU
publication name: RUDN Journal of Medicine
issn: 2313-0245
copyright: The right of authorship belongs to the authors of articles. The authors transfer the rights to use the article (including the use and distribution of an article in the Open Access) to the publisher of the journal on a non-exclusive license (Publishing Agreement (Public Offer)). At the same time, authors remain full rightsholders. Publishing Agreement (Public Offer) to Publish an Article in an Academic Periodical 'RUDN Journal of Medicine' The Federal State Autonomous Educational Institution of Higher Education "Peoples’ Friendship University of Russia named after Patrice Lumumba” (RUDN University), represented by the Vice-Rector for Scientific Work Andrey Aleksandrovich Kostin, acting under a Power of Attorney No 0044-09/20-198 dated 29.07.2020, hereinafter referred to as the Publisher, on the one hand, hereby offers to the public at large, hereinafter referred to as the Author, on the other hand, hereinafter collectively referred to as the Parties, to enter into this agreement, hereinafter referred to as the Agreement, regarding publication of scholarly materials, hereinafter referred to as the Article, in the Journal named 'RUDN Journal of Medicine', hereinafter referred to as the Journal, under the following terms. 1. General Terms and Conditions 1.1. Pursuant to Clause 2 of the Article 437 of the Russian Federation Civil Code, this Agreement shall be recognized as the public offer, hereinafter referred to as the Offer. Subject to Article 438 of the Russian Federation Civil Code, this Offer shall be deemed to have been completely and irrevocably accepted after the Author had submitted his/her materials by uploading those onto the network electronic system of the article acquisition for review available at the respective section of the Journal's site at URL: http://journals.rudn.ru/index.php/medicine/author/submit/1 on the Information and Communication Network known as the Internet, hereinafter referred to as the Internet. 1.2. Pursuant to the Russian Federation e…
items: Meta-analysis of mid-term survival and clinical results of left ventricular surgical reconstruction
items: Surgical strategy for severe trauma and frostbite in polar regions under limited resource conditions
items: Employing seamless mesh implants during Lichtenstein hernia repair with the use of insights enabled by artificial intelligence
items: Auto-graft vs 3D printed implant in reconstruction of frontal bone region
items: Musculoaponeurotic layer structural alterations of the anterior abdominal wall in ventral hernias: insights from CT texture analysis
items: Application of monoclonal antibodiesin primary chronic osteomyelitis of the mandible in children
items: Non-invasive diagnostics of monomorphic maculopapular cutaneous mastocytosis
items: Effect of polydeoxyribonucleotide therapy on the regeneration of long-term non-healing postoperative skin defects
items: Virus-induced changes in peroxisomal markers among HIV-infected patients
items: Bacteriophages: an alternative to antibiotics in the era of antimicrobial resistance
items: Antibiotic use density in trauma intensive care unit at a tertiary care hospital in Western Rajasthan

Meta-analysis of mid-term survival and clinical results of left ventricular surgical reconstruction
type: item
description: Relevance. Post-infarction aneurysm of the left ventricle significantly reduces the length and quality of life of patients. The results of comparisons of different methods for surgical restoration of the left ventricle are ambiguous and often contradictory, complicating the choice of an effective treatment strategy and the ability to objectively assess the survival prospects of such patients. The aim of the meta-analysis is to assess the one-year survival of patients after surgical reconstruction of the left ventricle, to determine the functional class of heart failure, and to study the morphological and functional characteristics of the heart. A comparative analysis of the results of the meta-analytic assessment of patient survival after left ventricle reconstruction using the DOR (SAVER) method will be performed in comparison with other treatment methods. Materials and Methods. As a result of a systematic search in two specialized databases (PubMed, Google Scholar), 1,875 articles were selected. A total of 15 studies were included in the final analysis. The total number of patients in these studies was 1,089. To objectify the assessment of the effectiveness of different surgical approaches, two patient groups were formed. The first group underwent only surgical reconstruction of the left ventricle using the Dor procedure or surgical anterior ventricular endocardial restoration (SAVER); the second group received other methods of surgical ventricular reconstruction, depending on the surgical feasibility. Results. The mean age of the examined patients was 62.1 (95% CI: 60.2-64.1) years. The study included 56% (95% CI: 42-69) men. Anterior aneurysm occurred in 87% (95% CI: 74-99) of patients. The mean EuroSCORE value corresponded to 9.7% (95% CI: 7.3-12.1). Before the operation, the patients had a high functional class of heart failure according to NYHA [3 functional class (95% CI: 2.82-3.1)], low left ventricular ejection fraction [31.3% (95% CI: 29.2-33.3)], dilatio…
creator: Maxim L. Mamalyga
rights: Copyright (c) 2026 Mamalyga M.L. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 9
ending page: 30
doi: 10.22363/2313-0245-2025-30-1-9-30

Surgical strategy for severe trauma and frostbite in polar regions under limited resource conditions
type: item
description: Relevance. Severe trauma remains one of the leading causes of preventable death worldwide. In well-resourced systems, early definitive surgery in a specialized trauma center is the standard of care. In remote Arctic settlements, polar stations and ships, this approach is often unattainable because of limited equipment and personnel, lack of specialists, and prolonged evacuation delays; therefore, a surgeon or general practitioner must make time-critical decisions that directly determine outcomes. Aim: To summarize international experience in surgical care for severe trauma and frostbite in polar regions, analyze the applicability of damage control surgery/damage control resuscitation (DCS/DCR) and prolonged field care (PFC) in resource-limited settings, and outline the role of telemedicine and inter-facility collaboration in supporting surgical decision-making. Materials and methods. A narrative (scoping) review of the literature (1990-2025) was performed using PubMed/MEDLINE, Embase, Scopus, RSCI, and the Cochrane Library, as well as national and institutional guidelines on military, field, and polar medicine. Publications addressing DCS/DCR/PFC, polar surgery, frostbite, evacuation, telemedicine, and organization of medical care in the Arctic and Antarctica were considered. Results and Discussion. Principles of DCS/DCR, originating from military surgery, are adaptable to polar conditions and enable staged management of severe trauma and frostbite when evacuation is delayed and resources are scarce. Key determinants include selecting the location and extent of intervention with respect to logistics, anesthesia and critical care capacity, team composition, and evacuation risk in adverse weather. The concept of a “polar surgical module” is justified as a compact autonomous operating and critical care unit; approaches to triage and surgical tactics for frostbite during prolonged isolation are also discussed. Conclusion. A staged strategy using DCS/DCR/PFC in polar reg…
creator: Timofey A. Skurlatov
rights: Copyright (c) 2026 Skurlatov T.A. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 31
ending page: 54
doi: 10.22363/2313-0245-2025-30-1-31-54

Employing seamless mesh implants during Lichtenstein hernia repair with the use of insights enabled by artificial intelligence
type: item
description: Relevance. Globally, there are now 32.53 million hernia cases, up from about 23.92 million during the previous 3 decades. Many authors lack statistical knowledge, which could jeopardize healthcare. The aim was to use artificial intelligence as a statistical technique to assess the potential effects of AdhesixTM self-gripping mesh implants, HertraTM mesh implants, and LintexTM glue-fixed mesh implants on the outcomes of inguinal hernia patients who underwent open inguinal hernia repair in Lichtenstein. Materials and Methods. We performed 120 Liechtenstein-compliant inguinal hernia repair procedures on three evenly split patient groups (n = 40) using AdhesixTM, HertraTM, and LintexTM mesh implants. The parameters for comparison were the time-frame of the procedure, hospital-stays, challenges afterwards surgery, and issues that arose during the brief follow-up. Results and Discussion. Patients of the first group were hospitalized for shorter periods of time than those in the second and third groups (group A-4.9 bed /day, group B-4.9.5 bed /day, and group C-4.95 bed /day), with no statistically significant differences. Patients in the first group experience a significantly shorter procedure time, followed by those in the second and third groups (27.8 min, 31.4 min, and 38.9 min respectively). Unlike the third group, which included 3 patients with postoperative discomfort and 1 with postoperative seroma formation, the first and second groups’ postoperative hospitalization stays were free of complications. In contrast to the third group’s 2 patients who experienced mesh migration and hernia recurrence, the first and second groups’ patients experienced no complications during the short-term follow-up. Conclusion. Compared to LintexTM mesh implants, the operative times using AdhesixTM and HertraTM are significantly shorter with no post-operative complications or hernia recurrence.
creator: Andrey V. Protasov
creator: Mekhaeel Sh. F. Mekhaeel
creator: Sameh M.A. Salem
rights: Copyright (c) 2026 Protasov A.V., Mekhaeel M.S., Salem S.M. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 55
ending page: 65
doi: 10.22363/2313-0245-2025-30-1-55-65

Auto-graft vs 3D printed implant in reconstruction of frontal bone region
type: item
description: Relevance. Fibrous dysplasia is a pathological condition characterized by the substitution of normal bone with fibrous tissue. The progression of this disorder generally stabilizes with increasing age. Clinically, it may manifest as painless swelling and facial asymmetry. Radiographic examination reveals well-defined margins, intramedullary expansion, maintenance of a smooth cortical contour, and ground-glass appearance. Histologically, the condition is distinguished by the presence of fibrous tissue replacing bone, along with irregularly arranged and randomly oriented bony trabeculae. Current treatment approaches frequently involve surgical intervention utilizing custom-fabricated polyether ether ketone (PEEK) implants or autogenous bone grafts, such as calvarial grafts. Materials and Methods. In the Department of Maxillofacial Surgery of the Russian Children’s Clinical Hospital (RCCH) - a branch of the Federal State Autonomous Educational Institution of Higher Education Russian National Research Medical University named after. N.I. Pirogov of the Ministry of Health of the Russian Federation of Moscow, 65 patients, from 2016 to 2023, were treated for histologically confirmed fibrous dysplasia in the frontal bone. Among them, 2 patients (7 years old girl, and 17 years old boy) were treated with 3D implants made from PEEK, and 2 patients (6 years old boy, and 9 years old girl) were treated with calvarial graft. Results and Discussion. The application of 3D implants has effectively enforce the primary stability of the reconstructed area. The lesion was successfully addressed, achieving an optimal aesthetic outcome characterized by a combination of strength, lightweight properties, and biocompatibility, without any observed complications or failures. Notably, recurrences have been recognized in patients who underwent treatment with calvarial grafts over five years after the operation. Conclusion. PEEK is a thermoplastic polymer characterized by its non-absorbable and n…
creator: Alexander Yu. Kugushev
creator: Andrey V. Lopatin
creator: Farah Sadek
creator: Suzan Dagher
rights: Copyright (c) 2026 Kugushev A.Y., Lopatin A.V., Sadek F., Dagher S. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 66
ending page: 79
doi: 10.22363/2313-0245-2025-30-1-66-79

Musculoaponeurotic layer structural alterations of the anterior abdominal wall in ventral hernias: insights from CT texture analysis
type: item
description: Relevance. Postoperative ventral hernias (POVH) remain a significant surgical challenge, characterized by remodeling of the musculoaponeurotic layer of the anterior abdominal wall and loss of functional integrity. Computed tomography (CT) texture analysis enables an objective assessment of tissue microarchitecture, facilitates the identification of structural changes, and optimizes preoperative planning and surgical decision-making. Aim. To evaluate structural changes in the musculoaponeurotic layer of the anterior abdominal wall in healthy individuals and patients with W2 and W3 POVH using texture analysis, identify intergroup differences, and determine the topographic-anatomical characteristics of affected tissues. Materials and Methods. This study included 90 patients (30 without hernias, 30 with W2-POVH, 30 with W3-POVH) examined between 2020 and 2024. All patients underwent multislice computed tomography (MSCT), and axial slices were segmented using Roboflow. The resulting masks were analyzed for texture characteristics, including brightness (mean_gray), contrast (contrast), correlation (correlation), kurtosis (kurtosis_gray), skewness (skewness_gray), standard deviation (std_gray), LBP, wavelet analysis, and gabor filtering. Statistical analysis included ANOVA, the Kruskal-Wallis test, and Tukey’s post-hoc analysis. Results and Discussion. Texture analysis revealed significant differences in Wavelet and Gabor response (p < 0.0001). Group 2 exhibited marked structural alterations, while Groups 1 and 3 demonstrated similar tissue characteristics (p > 0.05), suggesting adaptive remodeling in patients with severe hernia defects. Further, Group 2 showed significant changes in contrast (p < 0.0001), correlation (p < 0.0001), and kurtosis (p = 0.001), while brightness (mean_gray) and homogeneity (homogeneity) did not differ significantly (p > 0.05). Conclusion. The most pronounced structural disorganization was observed in W2-POVH patients, indicating morphofunctiona…
creator: Andrey V. Protasov
creator: Liya B. Kanakhina
creator: Olga I. Mazurova
rights: Copyright (c) 2026 Protasov A.V., Kanakhina L.B., Mazurova O.I. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 80
ending page: 91
doi: 10.22363/2313-0245-2025-30-1-80-91

Application of monoclonal antibodiesin primary chronic osteomyelitis of the mandible in children
type: item
description: Relevance. Primary chronic osteomyelitis (PCO) is a rare condition that poses diagnostic challenges, primarily affecting children between the ages of 5 and 17. It can occur in various bones, including the mandible in the maxillofacial region. The complexity of distinguishing PCO from infections, tumors, metabolic disorders, and other inflammatory conditions has led to misdiagnoses, resulting in inappropriate treatment strategies and recurrent episodes. Currently, there is no standardized treatment protocol for PCO, with most therapies starting with non-steroidal anti-inflammatory drugs (NSAIDs) to manage symptoms. The purpose of this case report is to find a new treatment approach by using monoclonal antibodies such as Denosumab in the treatment protocol. Monoclonal antibodies like Denosumab have shown promising results by targeting the RANKL-RANK interaction, inhibiting osteoclast activity, and reducing inflammatory bone resorption. Materials and Methods: In the Department of Maxillofacial Surgery of the Russian Children’s Clinical Hospital - a branch of the Federal State Autonomous Educational Institution of Higher Education Russian National Research Medical University named after. N.I. Pirogov of the Ministry of Health of the Russian Federation of Moscow from 2015 to 2023, 45 children underwent inpatient treatment for primary chronic osteomyelitis (PCO). Of these, 17 children received combination therapy, which included decortication with removal of all granulomatous tissue and administration of the drug Denosumab, and that is after receiving negative culture results which conforms the diagnose of PCO. From these 17 patients, a 9-year-old girl with a persistently relapsing course was selected for this article. Results: The treatment methods employed in this clinical case successfully increased the density of the affected area. However, if small cystic components were retained and the sanitation of the granulated tissues was incomplete, a relapse occurred, necessi…
creator: Alexander Yu. Kugushev
creator: Andrey V. Lopatin
creator: Suzan Dagher
rights: Copyright (c) 2026 Kugushev A.Y., Lopatin A.V., Dagher S. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 92
ending page: 101
doi: 10.22363/2313-0245-2025-30-1-92-101

Non-invasive diagnostics of monomorphic maculopapular cutaneous mastocytosis
type: item
description: Relevance. Monomorphic maculopapular cutaneous mastocytosis (mMPCM) is a rare and diagnostically challenging form of cutaneous mastocytosis, often mimicking other pigmentary and papular dermatoses. The increasing incidence of mMPCM and the complexity of its differential diagnosis underscore the need for effective, non-invasive diagnostic methods. The aim of the study was to evaluate the dermoscopic features of mMPCM and compare them with findings from optical coherence tomography (OCT) and histopathological criteria, aiming to establish a non-invasive diagnostic algorithm. Materials and Methods. The study included 30 patients aged 14-30 years with mMPCM, observed at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Russia from 2022 to 2024. All patients underwent clinical examination, dermoscopy, and, in selected cases, OCT imaging. Dermoscopic and OCT findings were systematically compared with histopathological results from skin biopsies. Results and Discussion. Dermoscopic examination of mMPCM lesions revealed increased yellow-brown pigmentation, preservation of skin appendages, unchanged vellus hairs, pigment pseudonetwork, and a weakly expressed asymmetric vascular pattern. Darier’s sign was more frequently detected under dermoscopy than on clinical examination. OCT imaging visualized clusters of mast cells as round or oval low-intensity signal zones, most often located in the reticular dermis, corresponding to histological mast cell infiltrates. The combination of dermoscopy and OCT allowed differentiation of mMPCM from other subtypes of cutaneous mastocytosis based on the depth and distribution of infiltrates. Notably, non-invasive methods provided valuable information for diagnosis and monitoring, reducing the need for routine biopsies. Conclusion. Integrating dermoscopy and OCT into the diagnostic workflow for mMPCM offers informative, non-invasive alternative to traditional histopathology, facilitating early and accurate diag…
creator: Elena I. Kasikhina
creator: Ksenia S. Petrova
creator: Maria N. Ostretsova
creator: Vladislav Yu. Udzhukhu
creator: Olesya N. Goeva
creator: Elizaveta K. Sukhina
creator: Anastasia A. Korobova
rights: Copyright (c) 2026 Kasikhina E.I., Petrova K.S., Ostretsova M.N., Udzhukhu V.Y., Goeva O.N., Sukhina E.K., Korobova A.A. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 102
ending page: 113
doi: 10.22363/2313-0245-2025-30-1-102-113

Effect of polydeoxyribonucleotide therapy on the regeneration of long-term non-healing postoperative skin defects
type: item
description: Relevance. Chronic wound healing currently remains a serious problem due to its frequency and associated complications. Polydeoxyribonucleotide therapy, which promotes angiogenesis and tissue regeneration, offers a promising treatment. Aim: to analyze the proliferative and apoptotic activity of regenerative wound surface cells in biopsy samples of long-term non-healing postoperative skin defects at the stages of its healing during polydeoxyribonucleotide therapy. Materials and Methods. We used 24 C57/B1 white mice aged 4-6 months weight 32 ± 0.01g, divided into control (n = 12) and main (n = 12) groups. In the main group 0,38 ml of polydeoxyribonucleotide solution was injected into the bottom and around the surgical ischemic skin defect. On days 4, 7, 10, and 12 after wound modeling, biopsies were embedded in paraffin, stained with hematoxylin and eosin. Biopsy cells in a state of mitotic division, proapoptosis, and with expression of the anti-apoptotic Bcl-2 gene were identified immunohistochemically using primary antibodies Ki-67 (Monoclonal rabbit [SP6] Cell Marque, USA), p53 (Polyclonal rabbit, (GTX50438) GeneTex Inc, USA) and Bcl-2 ([N1N2), (GTX100064) GeneTex Inc, USA), respectively. Secondary antibodies (HiDef Detection™ HRP Polymer system, Cell Marque, USA) conjugated with horseradish peroxidase, were used as secondary antibodies. To adequately represent the structure of the regeneration, the biopsy sections were additionally stained with Mayer’s hematoxylin. The index of antigen-positive cells was determined by counting their number per 100 cells at a microscope magnification ×1350, followed by calculation of the index as a percentage. Statistical analysis included testing for normal distribution using the Shapiro-Wilk test, the Mann-Whitney test for pairwise comparisons, and group data were described using the median, first and third quartiles (interquartile range). Results and Discussion. By day 12 in the main group, the granulation tissue of the biopsy s…
creator: Alexey G. Baranovskiy
creator: Yelena Yu. Shapovalova
creator: Yuri G. Baranovskiy
creator: Boris I. Kuzminov
creator: Svetlana V. Harchenko
creator: Igor A. Lugin
creator: Lilian A. Kutuzova
creator: Tatiana P. Sataieva
creator: Sergey V. Popov
creator: Kamil R. Bakhtiyarov
creator: Daniil Yu. Yuferov
creator: Grigory A. Demyashkin
rights: Copyright (c) 2026 Baranovskiy A.G., Shapovalova Y.Y., Baranovskiy Y.G., Kuzminov B.I., Harchenko S.V., Lugin I.A., Kutuzova L.A., Sataieva T.P., Popov S.V., Bakhtiyarov K.R., Yuferov D.Y., Demyashkin G.A. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 114
ending page: 123
doi: 10.22363/2313-0245-2025-30-1-114-123

Virus-induced changes in peroxisomal markers among HIV-infected patients
type: item
description: Relevance. It is been currently known that viruses rewire the metabolic machinery host’s cell to promote successful viral replication via reprogramming host energy flows, resource, metabolic tools and further, the reorganization of cellular structures. Recent studies indicate that the human immunodeficiency virus significantly reduces the number of peroxisomes in infected cells. However, there is still no clear understanding of the reasons for this apparent HIV intervention. The aim of the study was to confirm the hypothesis about the causes of the decrease in the number of peroxisomes in HIV infection. In this study, changes in several hematological markers of peroxisomal metabolism were assessed in connection with data on the unique role of these organelles in the catabolism of the amino acid L-lysine, the level of which correlates with the level of viral RNA in the blood plasma of HIV-infected individuals. Materials and Methods. A study was conducted on the levels of total cholesterol, catalase, L-lysine, and its derivative L-carnitine among HIV-infected individuals (controllers and patients with rapidly progressive disease) in comparison with similar indicators in cohorts of HIV-infected patients and healthy individuals. Results and Discussion. The study confirms the presence of significant differences in plasma levels of markers associated with peroxisomal metabolism, such as catalase, cholesterol, and the amino acid L-lysine, in the compared groups of HIV controllers and patients with rapidly progressing disease. The most negative changes in peroxisomal markers were detected among patients with accelerated HIV disease progression and, to a lesser extent, in individuals from the overall cohort. Conclusion. The results of this study indicate that HIV interference with host peroxisome biogenesis is accompanied by a concomitant dysregulation of peroxisomal enzyme systems and L-lysine-related substrates. Virus-induced reprogramming of the catabolism of this essenti…
creator: Evgeny V. Butorov
rights: Copyright (c) 2026 Butorov E.V. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 124
ending page: 138
doi: 10.22363/2313-0245-2025-30-1-124-138

Bacteriophages: an alternative to antibiotics in the era of antimicrobial resistance
type: item
description: Relevance. Antibiotic resistance is one of the most urgent global health challenges, caused by the widespread and often inappropriate use of antibiotics and by evolutionarily entrenched bacterial adaptation mechanisms. By 2050, antimicrobial resistance is projected to cause up to 10 million deaths annually, underscoring the urgent need for novel therapeutic strategies. In this context, bacteriophages - viruses that specifically infect bacteria - emerge as a promising alternative to antibiotics. This review analyzes the primary mechanisms by which bacteria develop resistance, including β-lactamase-mediated drug inactivation, efflux pump activity, target modification, and horizontal gene transfer, as well as the clinical significance of the ESKAPE pathogen group. We discuss phage classification into lytic and lysogenic types, their morphological characteristics, and life cycles. Special attention is given to modern methods of phage delivery (oral, topical, parenteral, and inhalational) and to phage-host immune interactions, including antibody production and immunomodulatory effects on macrophages, neutrophils, and lymphocytes. A dedicated section addresses the clinical applications of phage therapy in surgery and chronic wound management. We summarize outcomes from cardiothoracic, abdominal, and orthopedic surgical settings, combined phage-antibiotic regimens, and the implementation of vacuum-assisted wound therapy with phage instillation, all of which demonstrate accelerated healing, reduced microbial burden, and fewer postoperative complications. Conclusion. Phage therapy offers several advantages - high specificity, efficacy against multidrug-resistant strains, compatibility with antibiotics, and minimal side effects. On the other hand, its broad clinical implementation requires addressing challenges such as standardizing phage preparation manufacturing, establishing centralized phage banks, developing algorithms for strain selection in personalized therapy, and ad…
creator: Georgy V. Khamidulin
creator: Yulia S. Paskhalova
creator: Valery A. Mitish
creator: Alexander A. Ushakov
creator: Saida A. Orujeva
creator: Samera D. Magomedova
creator: Vladislav K. Boranenkov
rights: Copyright (c) 2026 Khamidulin G.V., Paskhalova Y.S., Mitish V.A., Ushakov A.A., Orujeva S.A., Magomedova S.D., Boranenkov V.K. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 139
ending page: 158
doi: 10.22363/2313-0245-2025-30-1-139-158

Antibiotic use density in trauma intensive care unit at a tertiary care hospital in Western Rajasthan
type: item
description: Relevance. The excessive use of antibiotics is a public health issue that has hampered poor and middle-income nations and is linked to rising healthcare expenses and antimicrobial resistance, which is regarded as an important risk to world health. In addition, resistance raises expenses, prolongs hospital stays for patients, and causes mortality. Defined daily dose (DDD) represents the average adult daily maintenance dose of a specific drug applied according to its primary indication. Antibiotic use density is expressed as defined daily doses/ 100 patient-days. Aim. The aim of this study is to evaluate the pattern of usage of antibiotics and to find out antibiotic use density in trauma intensive care unit (ICU). Materials and Methods. In this prospective observational study prescription data of 100 consecutive patients at admission into the trauma ICU was audited. Patients of all age of either gender admitted in the trauma ICU during the study period, which have been prescribed with antibiotics. The study was conducted over a period of eight months from August 2022 March 2023. During this period, all the included patients were followed up for their entire duration of stay in trauma ICU. Results and Discussion. The prescriptions of 100 consecutive patients admitted into the ICU were analyzed. On analyzing comorbidities it was noted that 79% were affected with contusions in brain/ intracerebral hemorrhage/ subdural hematoma followed by 5% with pnumothorax. According to DDD/100 bed days in our study piperacillin+tazobactam (10.64), cefoperazone+sulbactam (5.21), amikacin (7.5), vancomycin (3.2) and linezolid (3.2) were most consumed drugs in trauma ICU patients. Conclusion. Present study results conclude that overuse of antibiotics can cause antibiotic resistance, increased duration of stay in hospitals and reason of mortality.
creator: Deepak Kumar Verma
creator: Anusuya Gehlot
creator: Neeta Kumari
creator: Rajkumar Rathore
rights: Copyright (c) 2026 Verma D.K., Gehlot A., Kumari N., Rathore R. https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-15
publication date: 2026-03-15
volume: 30
number: 1
starting page: 159
ending page: 167
doi: 10.22363/2313-0245-2025-30-1-159-167