Providing the population with high-quality and affordable medical care is an important and priority area of healthcare in Uzbekistan The planned dissertation work is devoted to the development and improvement of diagnostic and rehabilitation measures taking into account risk factors, clinical course and differential diagnosis of this pathology The data obtained during the study lead to an improvement in the quality of life of patients with this pathology This determines the priority areas of research and development in the Republic
Non-alcoholic fatty liver disease (NAFLD) high prevalence, a tendency to an increase in morbidity, disease progression, coverage of the most efficient part of the population, the severity of clinical manifestations only in the late stages makes it possible to classify NAFLD as socially significant, of course, makes NAFLD one of the urgent problems of clinical medicine. The main feature of NAFLD is the absence of symptoms; the disease is often detected by chance, based on laboratory or instrumental tests. This article studied clinical and laboratory analyzes of 98 patients with non-alcoholic fatty liver disease. With steatohepatitis, higher ALT and AST values are noted than in patients with hepatic steatosis. The main differential difference between non-alcoholic steatosis and steatohepatitis, available in clinical practice, may be the severity of the biochemical syndrome of cytolysis. The article contains clinical features and prognosis in patients with fatty hepatosis and non-alcoholic steatohepatitis (NASH). Dyslipidemia (hypertriglyceridemia, decreased HDL, increased LDL) occurs in about 65-85% of patients. The basal insulin level, according to the results of our studies, in persons with NAFLD at the stage of steatosis and steatohepatitis was significantly increased.
Ischemic stroke is a growing medical, social and economic problem that is becoming epidemic in scope. Despite relatively stable incidence rates and declining mortality rates, there has been an increase in the number of life-years adjusted for disability and deaths associated with stroke over the past two decades. Despite the undoubted achievements in this area, the problem of the negative impact of neurological deficits on the effectiveness of rehabilitation measures, short-term and long-term prognosis, functional status and quality of life of patients does not become less significant. Dementia and stroke are often associated with each other, and this combination is associated with higher mortality, poorer recovery, increased readmission rates, and higher economic costs.
Chronic obstructive pulmonary disease (COPD) is an independent nosologically form representing a disease characterized by a limitation of the air flow velocity associated with a pathological inflammatory process in the lungs. With chronic obstructive pulmonary disease, this process is irreversible, constantly progressing and leading to severe complications from the cardiovascular system. the study of the clinical features of the functional state of the cardiovascular system in patients with chronic obstructive pulmonary disease, depending on the stage of the disease, hence the severity of right ventricular failure, and later left ventricular failure, the frequency of arrhythmias, the formation of a chronic pulmonary heart, changes in the imbalance of the blood coagulation system, microcirculation are of great importance in the further study of this important problem.
The study involved 136 children with scoliosis. Using the method of 3D computer photometry with graphic-analytical interpretation of the image and system analysis, such anatomical parameters as length, width, angle of the 1st and 5th fingers, heel angle were obtained. An automated complex has been developed for screening and express diagnostics of flat feet in children with scoliosis.
This work aimed to study the relationship of the acetylator phenotype with the features of the clinical course of brucellosis in patients to develop prognostic criteria for the development of complications and indications for the use of antibiotics depending on the degree of N acetyltransferase activity. Materials and methods. The study included 178 patients with various clinical forms of brucellosis. The acetylation phenotype was determined in urine by the method of A.M. Timofeeva modified by G.A. Ponomarev. Results. The results obtained showed that brucellosis in SA has a longer duration with destructive and necrotic lesions of organs such as the myocardium, liver, brain, and joints. Since the process of SA is sluggish, intermediate products of inflammation accumulate in the body, and high endogenous intoxication develops. The transition of an acute process to a chronic one increases. The conducted antibiotic therapy has a positive effect since a high concentration of the antibiotic accumulates in the body, but the toxic effect of the drug on the liver increases. For patients with FA the process proceeds quickly, due to this, endogenous intoxication in patients is low, the antibiotic therapy carried out is temporary, since the antibiotic is released from the body faster and the expected effect is not observed. Due to this, in 24.5% of adults with FA, the acute process becomes chronic. Conclusions: obligatory determination of the type of acetylation phenotype: in cases of detection of a slow type of acetylation, the appointment of combined antibiotic therapy should be controlled depending on the value of ABL to the TA of the joints with cancellation or continuation of treatment and add hepatoprotection to prevent hepatotoxic effect and detoxification therapy; in cases of detection of a rapid type of acetylation, the appointment of a longer course of combined antibiotic therapy, depending on the value of ABL to TA of the joints, cancel or continue treatment.
The article presents the results of studying the morphometric parameters of the prostate gland in children in early postnatal ontogenesis according to ultrasound data. On the basis of the data obtained, the growth rates of organometric parameters of the prostate gland of children in postnatal ontogenesis were established. The thickness of the organ from the neonatal period to the second period of childhood increases by 1.81 times, the width by 2.94 times, the length by 1.91 times, and the volume growing by 9.42 times. It was revealed that the highest growth rate of the anatomical parameters of the prostate gland is observed by the end of the second period of childhood: thickness - 25.3%, width - 62.1%, length - 28.97%, and the volume of the organ increases 1.5 times. Thus, the growth and development of morphometric parameters of the prostate gland is uneven and depends on the age characteristics of the organ.
Epidemiological procedure, clinical-specific brucellosis in physiological and excretory criteria and prognostic criteria. In the analyzed morbidity, patients and 86 hot tubes with impedance were studied, guarantee rejection, an infectious disease, rotting and characteristic, severe brucellosis.
This article presents data on the study Atopic Dermatitis (AD) patients with intestinal parasites. The pprevalence of Enterobius vermicularis, Hymenolepis nana and Giardia lamblia in patients and control individuals was similar, the prevalence of Ascaris lumbricoides was higher (P < 0.05) in AD patients. The infestation with Blastocystis sp. exceeded the infection rate of Chilomastix mesnili, Jodamoeba buetschlii and Endolimax nana by 4.4, 1.8 and 6.6 times, respectively. Total serum IgE level in patients with Blastocystis infection was significantly higher compared to patients without parasites. Anti-parasitic therapy addition to anti-allergic one decreased the total serum IgE level in all cases and improved patient’s status with the SCORAD index. Intestinal parasites and Blastоcystis sp. can be considered as additional triggers of allergy. Addition of anti-parasitic drugs to the therapy significantly decreased of the total serum IgE level and reducing SCORAD index in AD patients.
The aim of our study was to evaluate the role of polymorphism genes rs1799998 of the CYP11B2 and rs198389 NPPB in patients with chronic heart failure (CHF). In patients with CHF 152 Uzbek nationality have been studied the alleles and genotypes genes rs1799998 CYP11B2 and rs198389 NPPB. T / T genotype of the polymorphic locus rs1799998 of the CYP11B2 gene plays a significant role in the formation of CHF and is a risk factor for the development of a severe course of the disease. The difference in the distribution of the NPPB gene (rs198389) frequency of the unfavorable C allele between the group of CHF patients and the control group was characterized by its clear increase among patients by 1.4 times and was accompanied an increase in the unfavorable genotypes T / C and C / C compared to those in the control group by 1.2 and 1.5 times.
Neuropathy of the facial nerve represents about 4% of diseases of the entire peripheral nervous system. Since the main symptom of the disease, regardless of the topography of the affected area, is a lack of movement in the facial muscles of half of the face, the aim of the study was to assess the degree of damage to the facial nerve in patients with idiopathic neuropathy using the House Brackmann scale and the Nottingham system, as well as to conduct a correlation between them on background of rehabilitation measures. Material and research methods. 65 sick children were examined in the acute period of the disease (main group). The control group consisted of 41 children without focal neurological symptoms. During the observation process, all sick children of the main group were divided into 2 subgroups: the 1st subgroup included 39 (60%) children who, in addition to the main treatment, received electrical stimulation on the affected side on the circular muscles of the eyes and mouth during the entire period of hospitalization and were applied kinesiological tapes on the affected side of the face. The second subgroup of comparison included 26 (40%) children who were prescribed standard treatment for neuropathy of the facial nerve. Results and its discussion. In the comparative subgroup, although there was a positive trend, it was significantly lower in comparison with the main subgroup. Along with this, the use of electromyostimulation in combination with standard therapy in the main subgroup made it possible to achieve the most effective results, due to the suspension of demyelination processes and the highest quality regeneration. The same group of patients showed the greatest increase in the amplitude of the M-response after the treatment.
When a patient has a severe degree of intra-abdominal pressure, the signs of remodeling of the right and left ventricles with the signs of volumetric hypertrophy of the left ventricle (LV) will develop, the cavity of the right ventricle (RV) and the RV outflow tract expands, the thickness of the anterior wall of RV (AWRV) increases, the trunk of the left pulmonary artery (PA) expands, the systolic pressure in the PA (SDPA) increases, as well as type first diastolic dysfunction of the ventricles of the heart will occur.
Hypnotherapy has been successfully used as an effective method for treating neuroses, affective, dissociative, emotional and behavioral disorders. Encephalographic methods of recording the psychotherapeutic effect of hypnotherapy have been studied. Differences in the EEG activity of the brain in hypnotic catalepsy and in the state of catatonic stupor in schizophrenia were found. Clinical hypnosis is the most dynamic method of psychotherapy, and experimental hypnosis is a unique scientific method for studying human mental processes.
Background: Diagnosis and management of interstitial ectopic pregnancy is challenging. Resistance of decidual vessels to vasopressin when compared to rest of the uterine vasculature taken into consideration in laparoscopic excision of interstitial ectopic pregnancies to demarcate the margins and to minimize blood loss. Method: Case series of nine patients diagnosed with interstitial ectopic, who underwent laparoscopic surgery, were injected with diluted vasopressin to the myometrium prior to make the surgical resection. Results: The myometrial tissue turned pale in contrast to pink and vascular interstitial ectopic revealing a clear margin between the two tissues. Vasopressin injection significantly reduced the blood loss as oppose to procedure done without vasopressin. Conclusion: Injection of vasopressin in to the myometrium prior to resection of an interstitial ectopic pregnancy provides well-demarcated zones to aid complete laparoscopic resection while minimizing the blood loss.
Pregnancy and the postpartum period are characterized by a tendency to hypercoagulability. The pathology of the hemostasis system of congenital or acquired genesis against the background of pregnancy can lead to an unfavorable outcome in the form of non-developing pregnancy and miscarriage, and maternal mortality. In the presence of a burdened obstetric history, examination of the hemostasis system, including tests for the diagnosis of thrombophilia, is mandatory. In this article, 4 clinical cases of patients with hemostasis problems during pregnancy, with confirmed APS and received therapy, are considered.
In accordance with the purpose and objectives of this study, we studied the clinical course of labor and the postpartum period in 112 pregnant women who had a history of massive obstetric postpartum hemorrhage. At the 1st stage, 112 pregnant women in the 1st and 2nd trimester with a history of postpartum hypotonic bleeding were examined, aged 18 to 45 years, constituting the 1st group. Group II - a control group, consisted of 30 patients, comparable in age, without gynecological pathology, severe somatic diseases and severe metabolic disorders, with a physiological history of pregnancy and childbirth. After examination and identification of the risk group for the occurrence of postpartum hypotonic bleeding, pharmacotherapy is prescribed according to the developed algorithm in group 1A, which will include 52 patients. Group 1B will include 60 patients with the traditional method of management.
Purpose of the study: to study pulmonary arteries morphological structure. Materials and methods. For the experiment, 60 white outbred laboratory rats, weighing 220-280 grams, male aged 4-5 months were used. The structure of the pulmonary arteries layers and their morphometry were studied. Conclusion: to compare pulmonary arteries morphological structure, we studied them at 6 levels. Arteries of the 1st and 3rd level belong to the muscular-elastic type, arteries of the 4th-6th level - to the arteries of the muscular type. For a more thorough examination, the arteries were divided into three groups: arteries of small, medium and large caliber. The results of our research show that a spiral smooth muscle layer develops on grade 3 and 4 arteries. This layer appears in cross-section as a separate pillow-like bulge. It is located close to the outer elastic membrane on the side of the adventitia. Output. In conclusion, we can say that during the transition of the muscular-elastic arteries to the muscular arteries on the side of the adventitia, an additional muscle layer is formed, which surrounds the vessel wall in the form of a spiral. As a result, the size of the middle layer of the artery increases. This leads to a change in the Kernogh index.
Malignant neoplasms are often combined with mental disorders of the depressive and anxiety spectrum, which aggravate the course and prognosis of the underlying disease. The article discusses the problems associated with the identification of comorbid emotional disorders in cancer patients, analyzes the diagnostic value of psychometric methods for assessing the symptoms of anxiety and depression. It is concluded that further development of topical issues of diagnosis, therapy and prevention of anxiety and depressive conditions in cancer patients requires the integration of scientific and practical activities of oncologists, psychiatrists, and psychotherapists.
Object. To assess the features of the clinical course and the hemostasis system in children with acute pneumonia in environmentally unfavorable living conditions. Methods. We studied 55 children with acute community-acquired pneumonia aged 1 to 3 years living in different regional conditions, of which 35 sick children (main group), permanently residing in the Aral Sea region (in the Khorezm region) and 20 children with community-acquired pneumonia (comparison group) living in Tashkent. The control groups consisted of 20 practically healthy children permanently residing in the Aral Sea region (in the Khorezm region) and 20 children with community-acquired pneumonia living in Tashkent. Results: the main risk factors for the development of community-acquired pneumonia in patients living in ecologically unfavorable regions was a premorbid background. Analysis of the data obtained showed that 89.1% of children admitted to inpatient treatment had concomitant diseases. In this case, rickets were diagnosed in 80.0% of children, protein-energy deficiency of PEM - in 62.9% of children, anemia - in 97.1% of children. Whereas in children from Tashkent, the burden of premorbid background was recorded in 65% of children, which is 24.1% lower than in children from Khorezm. The severity of the condition of the children at admission was assessed as moderately severe - in 48.6% of cases in the main group and as severe - in 51.4% of cases, in the comparison group 45% of children were admitted to a serious condition, and 55% - in a moderately severe condition. The unfavorable influence of the ecological environment on the development of imbalance in the hemostasis system, characterized by the transition of hypercoagulation to hypocoagulation in 45.7% and the development of hemorrhagic syndrome, has been established. In children living in Khorezm, the indicators of the coagulation link of the hemostasis system showed high thrombotic readiness for DVS syndrome. The imbalance of hemostasis indices dictates the advisability of correcting and preventing these conditions for more successful control over the process and timely complete treatment.
Exudative otitis media is a polyetiological disease, often caused by a combination of several causal factors. With tumors located near the pharyngeal mouth of the auditory tube, early manifestations may be symptoms from the ear and the auditory tube-the phenomenon of exudative otitis media. In this article, we present the features of the clinical course of exudative otitis media in benign neoplasms of the nose, paranasal sinuses and nasopharynx.
