1-2015

THEORY AND PRACTICE OF MEDICINE

Abdulhaeva Sh.R.,Mirzoeva Z.A., Nazirova N.K., Shodieva Sh.K.

EARLY DETECTION OF DYSPLASIA OF THE HIP OF CHILDREN

IN THE PRACTICE OF FAMILY DOCTORS

Department of Family Medicine of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Early detection and implementation of adequate therapeutic measures CHD in newborns and children under one year through screening methods by family doctor on the basis of the City Health Center №1 of Dushanbe.

Materials and methods. During the monitoring period, 156 newborns were examined, of which 75 boys (48%) and girls – 81 (52%). During preventive examinations family doctor used screening methods to identify CHD. Methods: clinical, statistical – identification of congenital hip dysplasia in children.

Results. Screening established pathology in 38% of newborns. At girls pathology HD determined 4 times more often than at boys that is, girls accounted 80% (47), boys- 20% (12). Hemilesion encountered 2,3 times more often bilateral, accordingly 69% (41) and 31% (18).Thus the injury of the left hip joint was determined at 1.7 times more often than the right hip joint and accordingly was 63% (26) and 37% (15).The combination of positive methods detected in 83%, and usually limitations determined by a combination of breeding and asymmetry of skin folds. Test subjects with known positive techniques were consulted by an orthopedist, and then diagnosis of CHD has been confirmed in 87% of children. This again confirms relatively high sensitivity and specificity of application of these methods for early diagnosis of hip joint pathology in children in the first year of life in the practice of family doctor.

Conclusion. Thus, the use of special screening methods allowed family doctor in primary patronage of newborns and their dynamic observation to detect abnormalities of the hip joints, that has been confirmed after orthopedic examination in 87% of children.Early diagnosis through the application of simple methods of clinical diagnosis, which do not require extra costs, determines the effectiveness of timely initiated an adequate medical treatment and in the future prevention of complications and disability.

   Key words: screening, hip dysplasia, limiting abduction in the hip joints, reception of Ortolani-Barlow, asymmetry of skin folds, family doctor

 

Amindjanova Z.R., Ismoilov A.A., Karimov S.M.

MAIN RESULTS OF INVESTIGATION ON STUDIES OF THE INITIAL INDICATORS OF PARODONTOLOGICAL STATUS IN PATIENTS WITH SOMATIC DISEASES

Department of Therapeutic Dentistry of State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

 

Aim. Study of the initial indicators of parodontological status in patients with disadvantage somatic background.

Materials and methods. Organized complex examination of the dentistry status among 936 somatic patients with duration of the disease from 1 to 10 years and more. Control group consisted of 103 practically healthy persons of the same age with dentistry pathology. Out of the total amount of examined persons 41% patient had pathology of gastrointestinal tract, 33% – of cardiovascular system, 26% patient – endocrine systems pathology. To the detailed analysis following leading indexes were subjected: prevalence of periodontal disease; increase in prevalence and intensity of periodontal disease; structural analysis of the constituent elements of the periodontal status; increase and reduction of the constituent elements of periodontal index.

Results. Installed that in group of somatic patients with protractedly accompanying pathology up to 3 years amount of revealed persons with heavy degree of diffuse parodontitis is significantly lower. High defeat of parodontitis with heavy degree of the inflammation existed at protractedly accompanying somatic pathology up to 5 and 10 years. Among patients suffering somatic pathology more than 10 years, opposite, prevalence of heavy forms of parodontitis was significantly lower.

Conclusion. Amongst examined patients important particularity of parodontal's pathology is quick progressive of inflammatory process in nearteeth tissue, as evidenced the average values of high frequency of the parodontitis of light, average and heavy form.

Key words: somatic pathology, parodontal disease, prevalence of parodontitis, intensity of parodontological status, reduction of periodontal pathology

 

^*AhmedovF.A., ^**Hamidov D.B., Saidov X. Sh., AkramovR.A.

INFLUENCE OF LATREN ON RHEOLOGICAL PROPERTIES OF BLOOD

IN PATIENTS WITH ACUTE DESTRUCTIVE PANCREATITIS

^*Department of Pharmacy of State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

^**Department of Anesthesiology and Reanimatology of State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

 

Aim. Studying of influence of Latren on rheological properties of blood in patients with acute destructive pancreatitis

Materials and methods. Examined 62 patients with acute destructive pancreatitis at the age from 20 to 83 years. Patients were divided into 2 groups depending from the integrated into the program of infusion therapy with a solution of  Latren.

Rheological properties of blood were studied by determining relative viscosity of the blood by viscometer VK-4, hematocrit, fibrinogen and erythrocyte sedimentation rate by standard methods.

Results. In patients with acute destructive pancreatitis after incorporated into the program of infusion therapy of Latren (main group) there is a considerable improvement of the rheological properties of blood, compared with a control group who received crystalloid and colloids.

Conclusion. In patients with acute destructive pancreatitis occurs a considerable violation of the rheological properties of blood. Inclusion of Latren into the program of infusion therapy in patients with acute destructive pancreatitis promotes correction of violations of the rheological properties of blood, compared with the results of the group of patients who did not receive the drug.

Key words: acute destructive pancreatitis, infusion therapy, Latren, rheology

 

*Ashurov G.G., **Sadikov F.O.

AN ELECTROMETRIC ESTIMATION OF MARGINAL ADJOININGOF COMPOSITE FILLING MATERIALS DEPENDING FROM THE WAY

OF ISOLATION OF THE WORKING FIELD

*Department of Therapeutic Dentistry of State Educational Establishment "Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan"

**Society with limited liability "Eurodent"

 

Aim. Estimation of the condition of marginal stability of composite filling materials depending from the way of isolation of the working field and combined influences of the way of curing of the filling material, vitality of pulp, level caries of the teeth.

Material and methods. Work is based on analysis of results of the survey of 152 patients, among which 92 woman, 60 man. During the operative-reconstruction therapy of the carious teeth 26,3% formed molars, premolars – 22,7%, incisor and canines – 51,0%. In 40% of cases filling of the teeth produced with relative isolation of the working field by cotton roller (first group), in 60% with absolute when use rabberdam (second group). About uncomplicated caries were filled 66,7% of teeth, complicated caries 33,3%. Patients with low clinical level of resistance to caries were treated in 40% cases, with average level of resistance in 60%. Marginal adjoining of fillings was assessed by the scale of R. G. Buyankina, where the index of the amperage less than 2 mkA matched a normal residual marginal penetration of high-quality fillings, 2,1-5,2 mkA – infringement of marginal adjoining without the development of secondary caries

Results. While isolating teeth with chemically hardening materials cotton roller  the current at the end was 1,31±0,04 mkA and was lower by 1.2 times than in the isolation of the working field by rubberdam. A year later, opposite, the electrical conductivity at absolute isolation was 1,85±0,09 mkA, which was much lower by 14.4% than at a relative using cotton roller. Marginal adjoining of light-cured composites with rubberdam isolation was better immediately after the restoration, also the immediate and long-term periods of research, compared to chemical hardening materials.

Conclusion. In teeth with uncomplicated caries amperage were realistically below at the average on 12,2%, than when recovering of depulpited teeth. After 1,5 year in the second group patient with absolute insulation of vitally teeth average importance of conduction formed 1,55±0,08 мкА and was less in 1.5 times, than when work with cotton's wool platen.

Key words: composite filling material, marginal adaptation, electrometric, vitally teeth, resistance of teeth, insulation, isolation of the working field

 

BuzrukovaN.D., MahkamovK.K.

RISK FACTORS OF OFTEN ILL CHILDREN BORN WITH LOW,

VERY LOW AND EXTREMELY LOW  BIRTH WEIGHT

Department of Neonatology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Measure the health status of babies born with low and extremely low birth weight, during the recovery period.

Materials and methods. Under observation were 56 often ill children who were born prematurely. Often ill children – children who suffered from respiratory infections more than 5-6 times a year. Babies were divided into 3 groups according to body weight at birth. The first group consisted of 8 babies, born with extremely low birth weight. The second group consisted of 16 babies, born with very low birth weight and the third group consisted of 32 babies, born with low birth weight.

During the research was an analysis of data on the health status of mothers during their pregnancy and childbirth; the health status of babies in the recovery period of life; the results of clinical, biochemical, bacteriological and tool methods of research.

Results. It has been established the influence of ante- and intranatalis factors on the severity of the health status of LBW babies in acute and recovery period, that it is need to enter LBW babies into a special group of risk on various pathologies, performance of certain diagnostic and treatment activities at the level of specialized departments.

Conclusion. This paper presents a material that reflects aspects of birth and the health status of premature babies. Course of pregnancy, high infection index and various of extragenital diseases can cause premature birth and the birth of a sick child.LBW babies during the first year of life constitute a contingent of often ill children. They need to be select at-risk for the development of various pathologies and to adopt certain diagnostic and treatment activities.

Key words: risk factors, LBW babies, often ill children, psychomotor development, development forecast

 

Gurezov M.R., Nurov D.I., Sultonov M.Sh.

CHANGE OF THE LEVEL OF MARGINAL PENETRATION OF FILLING MATERIALS

DEPENDING OF INDIVIDUAL CARIESRESICTANCE

Society with limited liability "Erodent"

Department of Therapeutic Dentistry of State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

 

Aim. Determine the level of marginal penetration of filling materials depending from the resistance of tooth

Materials and methods. Examined 323 persons among which were found 523 fillings: 480 from composite, 13 – from amalgam, 30 – from cements. Under clinical observation in dynamics were 123 patients. Depending of the using during the treatment of caries of facilities these patients were divided into 8 subgroups: 4 subgroups with low and middle levels of intensity of caries and 4 subgroups with high and very high levels of intensity of caries. In subgroups with low and middle levels of intensity of caries as a pickling agent was used 10% maleic acid, in second subgroup additionally performed postfilling fluoridation; in third and fourth subgroups enamel  was pickled with 35% phosphoric acid, in fourth subgroup additionally performed postfilling fluoridation.

Results. Established that at a low level of resistance the choice of pickling agent and application of postfilling fluorination authentically influence at the marginal penetration of the fillings and their clinical condition. A year after the imposition of fillings in patients with low and middle level of resistance their safety is 97.6% and the indicators of marginal penetration while using different pickling agents and postpfillings fluorination not different. In a group of patients with high and very high levels of intensity of caries after a year 91.4% of fillings were retained 8.6% – considered "unacceptable", a significant increase of disturbance of  marginal adaptation of fillings are found in the case of 35% phosphoric acid in all periods of observation.

Conclusion. After filling of carious cavities using fluorine compounds helped to reduce marginal penetration of fillings in the early period of observation.

Key words: secondary caries, resresistance of enamel, pickling agent, postfilling fluoridation, marginal penetration   

 

^**Kasymov O.I., ^*Ahmedov A.А., ^**Kasymov A. O., ^***Rahimova T. P.

To the issue of pathogenesis of alopecia areata

^*Department of Public Health, Health Economics and Management with the course of Medical Statistics of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

^**Department of Dermatology and STIs of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

^*** Republican Diagnostic Centre

 

Aim. To study the content of pro-inflammatory (IL-1β, IL-6, IL-8 and TNF-α) and anti-inflammatory (IL-10) cytokines in serum of patients with alopecia areata.

Materials and methods. Examined 62 patients, of whom 35 (56,5%) – men, 27 (43,5%) – women (ratio 1.2: 1) aged from 15 to 46 years old. Methods: clinical, statistical, microscopic

Results. It is established that patients with alopecia areata observed an inflammatory process that leads to an imbalance between pro-inflammatory and anti-inflammatory cytokines.. The content of cytokines depended on the process severity. The more hair is damaged, the more TNF-α and IL-1β and the less IL-10 produced. Levels of proinflammatory and anti-inflammatory cytokines depends from severity of the process and the amount of serum pro-inflammatory TNF-α and IL-1β was proportional but anti-inflammatory IL-10 – inversely proportional the severity of the disease, i.e., as more the hair coat degree pronounced so much  larger production of TNF-α and IL-1β and less production of IL-10.

Conclusion. In the serum of patients with alopecia areata observed hyperproduction of proinflammatory cytokines, which involves the use of promising of anticytokine drugs in the therapy patients with focal hair loss.

Key words: alopecia areata, pathogenesis, cytokines

 

^*Kasymov O.I., ^**Ahmedov F.A., ^*Kasymov A.O.

EXPERIENCE OF NOVOSALIK USING IN THE TREATMENT OF ECZEMA

^*Department of Dermatology and STIs of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

^**Department of Pharmacy of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim.To study the efficiency of Novosalik in the treatment of eczema.

Materials and methods. The study included 48 patients with eczema aged from 16 to 73 years, with duration of the diseasefrom a few months to 20 years or more. There were20 men, 28 women, ratio 1:1.4. The age of patients ranged from 16 to 64 years. 8 patients were aged between 16 and 19 years (m – 3, w – 5), from 20 to 29 years – 10 (m – 5, w – 5), from 30 to 39 years old – 12 (m – 5, w – 7), from 40 to 49 years – 8 (m – 4, w – 5), from 50 to 59 years – 5 (m – 3, w – 4), 60 years and older – 5 (m – 2, w – 4). Methods: clinical, statistical, microscopic.

Results.So, itching as the main subjective symptom of eczema in the main group, began to weaken from an average after 3-4 days of treatment, in the control group – after 4-5 days, stopped completely in most patients of the main group to an average of 8-9 day, in all patients – to 12-13 day, in the control group – respectively 11-12 and 14-15 days. Blanching of erythema and edema reduction in the study group began with an average after 3-4 days, their complete disappearance occurred in an average of 15-16 day, in the control group – respectively to 5-6 days and 18-19 days. Infiltration of the skin lesions in patients of the main group began to decrease an average from 6-7 days, fully resolved – to 11-12 day, in the control group – from 8-9 and 14-15 days. Rejection of crusts and scales was from 4-5 days of therapy, culminating in an average to 7-8 day, in the control group – to 6-7 and 10-11 days.

Conclusion. Our studies have shown high efficiency of complex treatment of eczema with Novosalik. Clinical recovery and significant improvement were achieved in 75% of patients, the traditional treatment – only in 60% of patients.

Key words: eczema, Novosalik, efficiency, allergodermatoses

 

Muradov A.M., Tuychiboeva M.N., Shumilina O.V.

The IR spectroscopic method of diagnostics of

Endotoxemia in Critical Conditions.

Advantages and prospects.

Department of Efferent Medicine and Intensive Care of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. By a method of molecular IR spectroscopy to receive the IR spectra of blood, depending on the degree of intoxication in patients with endotoxemia. Conduct a comparative analysis with other known methods from the viewpoint of efficiency, informativity, reliability, availability, affordability and to determine application prospects.

Materials and methods. Materials were blood samples of patients with endotoxemia which were exactly confirmed by conventional biochemical studies.Were determined indicators of toxicity of blood plasma: bilirubin, creatinine, leukocyte index of intoxicationaverage molecules paramentsit test, necrotic bodies, circulating immune complexes, total and effective albumin concentration index of intoxication.

IR spectra were recorded using molecular infrared spectroscopy. Obtained data were compared with the standard measurements.

Results. In patients with endotoxemia is observed intensification of lipid peroxidation, immunosuppression, decreased antioxidant protection and detoxification ability of the organism. This is confirmed by corresponding changes in homeostasis and toxicity.Their dynamics are correlated with the stages of endogenous intoxication.IR spectra of healthy and diseased of endotoxemia significantly differ from each other in form, intensity, position of the peak frequency of the individual bands, relative to the stretching vibrations of -OH and -NH groups and to the stretching vibrations of –CH group and on the integral intensity. These changes are characteristic features and are distinguished between different nosologies in critical conditions and correlate with integral indicators of toxicity.

Conclusion. The method of molecular IR spectroscopy is the most efficient, non-traumatic, clear and informative. At diagnostics of endotoxicosis in critical conditions in the early stages of the disease consider it appropriate to supplement traditional biochemical research by data analysis of IR spectra of blood of patients.

Key words: molecular IR spectroscopy, endotoxemia, toxic blood components, infrared spectroscopy

 

^*Muhamadieva S.M., ^**Pulatova A.P.

FAMILY  PLANNING AND DEVELOPMENT 

OF CONTRACEPTION AID TO POPULATION OF REPUBLIC OF TAJIKISTAN

^*Department of Obstetrics and Gynecologyof State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan »

^**State Establishment "Scientific-Research Institute of Obstetrics, Gynecology and Perinatology"

 

Aim. Explore stages of family planning service development and particulars of contraception aid to population of Republic of Tajikistan.

Materials and methods. Normative and legal documents, annual reports of reproductive health centers, materials of science conferences and historic statements were analyzed.

Results. In this article, the historical data on development of contraception aid in Tajikistan for the past 25 years were presented. It is established that first specialized state consultations on family planning in country were organized in 1990 as “Family Health Consultation”. Then, the Reproductive Health Centers were created, new reporting forms were developed, legal acts revised, the specter of contraception has widened and the contraception behavior of population has changed; the contraception coverage has grown more than for twice and even more (34,6%), the changes occurred in training and re-training of cadres.

Conclusion. In 25 years, there have been significant changes in expansion of access to contraception service sand the leading role of the Centers of reproductive health in improvement of reproductive health of population, solution of demographic, social and medical problems in decrease of maternal death in the country has been identified.

Key words: family planning, contraception, intrauterine means, oral contraception, injection and under-skin contraception, condoms, voluntary surgical sterilization, contraception coverage

 

^*Ochilzoda A.A., ^**Solieva M.S.

EFFECTIVENESS OF REHABILITATION OF SURDUSPEDAGOGICAL

SCHOOL-AGE CHILDREN WITH SENSORINEURAL HEARING LOSS

COMBINED WITH CEREBRAL PALSY

^*Khujand City Health Center number 2

^**Sughd Regional Hospital, Tajikistan

 

Aim. Evaluating the effectiveness of surduspedagogical rehabilitation of sick children with sensorineural hearing loss in combination with cerebral palsy by modern methods of medical treatment, physical therapy action and serduspedagogical rehabilitation methods, using stationary sound-amplifying device "Audio filter MT".

Materials and methods. Were examined 75 children aged from 7 to 14 years for the period of 2009 – 2013 in the conditions of the Regional Surduslogical Center.In medical, psychological and pedagogical department of the City Health Center №2 of Khujand.Were studied 41 boys (54.6%) and 34 girls (45.3%).All the patients underwent complete otorhinolaryngological examination, hearing test using tone threshold and speech audiometry, examination of and neurological status, CT and MRI of the brain, EEG was recorded, REG, EchoECG, consulting of neurologist and ophthalmologist for evidence of cerebral palsy.

Results. The results of complex course of treatment have shown that school-age children has greatly improved the motor area, normalized muscle tone, increased Personal self-service skills, the children began to take on their own hands: toys, spoons, began to move with the help of outsiders. In the course of daily surduspedagogical  activities children gradually began to try to repeat after the teacher uttered sounds, starting with the most simple articulatory.

Conclusion. An effective surduspedagogical rehabilitation of school-age children with sensorineural hearing loss in combination with cerebral palsy is achieved by using a complex of medical treatment and new physiotherapy treatments with simultaneous surduspedagogical classes using stationary sound-amplifying device "Audio Filter-MT."

Key words: rehabilitation, sensorineural hearing loss, cerebral palsy, sound-amplifying device "Audio Filter-MT"

 

^*Rasulov S.R., ^**Karimov A.M.

ANALYSIS OF MORBIDITY OF COLORECTAL CANCER

IN REPUBLIC OF TAJIKISTAN

^*Department of Oncologyof  State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

^**StateEstablishment "Republican Oncological Scientific Center" of Ministry of Health and Social Protection of population of Republic of Tajikistan

 

Aim. To perform statistical analysis and identify the most characteristic features of colorectal cancer in the population of Republic of Tajikistan.

Materials and methods. Clinical data of 115 patients with colorectal cancer in the age of 18 to 92 years, who were treated indepartment of oncoproctourology ofStateEstablishment "Republican Oncological Scientific Center" of Ministry of Health of Republic of Tajikistanin 2012 was studied. Tumor morphologically verified in all patients.  In a planned regularity were hospitalized 89 patients, by emergency indications – 26 patients. To all performed endoscopy of the intestine, ultrasonic and review roentgenologic researches of the abdomen.

Results. Frequency of morbidity is somewhat more among males (52,2%). Peak of morbidity occurs in the age of 50-69 years (46,9%). Up to 40 years colorectal cancer diagnosed in 14,8%, over the age of 70 years – in 18,3%.In the majority of cases the tumor located in rectum (67%), then in sigmoid – 9,6%, in downstream parts of the large bowel – 6,1% and less in transverse section – 0.9%. Patients with early stages of tumor development (T1-2N0-1M0) constituted only 9,1%. In 67,3% of patients established locally advanced process, 23,6% had distant metastases. Metastases often observed in liver (42,3%) in liver and lung (23,1%), in peritoneum (19,2%) and less in skeletal bones and distant lymph nodes. Intestinal obstruction was observed in 17,4% of patients, intestinal bleeding – in 5,2%.

Conclusion. The most frequent localization of colorectal cancer is in straight line, then in sigmoid colon and in caecum. Peak of morbidity occurs in the age of 50-69 years (46,9%). In the primary appeal for medical assistance 89,1% of patients had locally advanced (67,3%) or generalized (21,8%) process.

Key words: colorectal cancer, Republic of Tajikistan, morbidity

 

^*Rahmatulloev Sh.R., ^**Saidmuradova G.M., ^*Rahmatulloeva S.I., Tolibov A.H.

EXPERIENCE IN DEVELOPMENT AND INTRODUCTION

OF CLINICAL PROTOCOLS ON CHILDHOOD DISEASES

 IN MEDICAL PRACTICE OF REPUBLIC OF TAJIKISTAN

^*Ministry of Health and Social Protection of Population of Republic of Tajikistan

^**Department of Pediatric Infection Diseases of Tajik State Medical University

 

Aim. Studying experience of development of clinical protocols in other countries to improve national clinical protocols for childhood diseases.

Materials and methods. During the period from 2002 to present time, total were developed 4 clinical guidelines and protocols (CP) on the main diseases of childhood. Main purpose of creating of CP is to ensure the target groups with an exhaustive instructions for making decisions on their use in clinical practice. Rational use of clinical protocols depends of complying of all design rules with the search and evaluation of the best available evidence.Basic requirements for compiling of CP is using of evidence based medicine (EBM) with a systematic generalization of scientific proofs in their development.

Results. Earlier developed clinical protocols were little informative, compiled in an incomplete volume, while topics of discussed nosologies were duplicated from the previous protocol. After the introduction and application of CP in practice treatment of childhood diseases on the place were not held follow-up assessment monitorings.

Conclusion. Was established, that the adaptation of the existing pocket book of WHO of hospital care for children in view of features of local medical practices with limited economic and financial resources, with coverage of priority conditions of childhood is considered appropriate because it does not require the high cost of the adaptation process

Key words: clinical protocols, pocket book, child mortality

 

Salimov B.M, Kasymov O.I, Munieva S.H.

AZIKAV IN COMPLEX TREATMENT OF HERPES ZOSTER

Department of Dermatology and STIs of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. A study of the effectiveness of atsikav (acyclovir) in the complex treatment of patients with herpes zoster.

Materials and methods. Under observation were 48 patients with herpes zoster. Among the patients with herpes zoster were 32 (66,2%) men and 16 (33,3%) women aged between 18 and 84 years. Methods: clinical, statistical.

Results. Treatment of patients has gone well. Side effects and complications of the drugs were not at any patient. The results showed the effectiveness of the treatment by complex therapy. So excellent results (clinical recovery) with typical form of herpes zoster in the end of the 1st week of observation in the complex therapy was achieved in 83.3% of patients and after 12 – 14 days in 100%. Among patients with bullous form of herpes zoster to the end of the 1st week of observation treatment has given excellent results in 80%. In hemorrhagic and generalized forms of herpes zoster to the end of the 1st week of treatment, a significant improvement was observed in 65% of patients and after 12 – 14 days in 80%. It should be noted that atsikav had no hepatotoxicity to any patient.

Conclusion. Patients with herpes zoster most frequently observed over the age of 60 years. More common at men. In winter, autumn and spring incidence is higher than in summer. Concomitant diseases were more common at older age groups. Atsikav antiviral drug can be recommended in the complex treatment of patients with herpes zoster.

Key words: azikav, herpes zoster, clinical forms

 

Shamsidinov B.N., ^*Azizov K.N., Muhtorova P.R., Shaydoev S.S.

VALUE OF THE WEBER TEST IN DIAGNOSIS

OF DIFFERENT FORMS OF OTOSCLEROSIS

Department of Otorhinolaryngology of State Educational Establishment «Institute of Postgraduate Education in Sphere of Republic of Tajikistan»

^*National Medical Center of Republic of Tajikistan

 

Aim. To evaluate the impact of sound perception and sound conduction disorders in otosclerosis on the lateralization of sound, to determine the forms of disease, in which the experience of Weber is most effective, set the value of the experiment at two intensities for detecting of lesions of cochlea in otosclerosis.

Materials and methods. We analyzed audiograms of 100 patients with otosclerosis. Information of threshold tonal audiometry, binaural balance of loudness and also difference in the threshold of differentiation on 500 and 2,000 Hz were compared with experimental results of Weber.

Results. Revealed that dependence of lateralization from the value  of bone-air interval  in "pure" and mixed form of otosclerosis is not always observed. In this paper the experimental data of Weber were compared with thresholds differentiation. In order to identify destruction of hair apparatus the data of lateralization was compared with the results of binaural loudness balance.In this case, the change in lateralization of sound at above-threshold intensity was observed.Thus, in the direction of sound on above-threshold intensity it is possible to judge about degree of preservation of receptor on the worse hearing ear.

Conclusions. Weber test is suitable for determining of significant differences in sound-conducting and sound-apparatus on both sides. The test results can be properly evaluated only after comparison with the results of other tests.Weber's experience desirable to perform on two intensities, because it increases its clarity allows to identify in individual cases the accelerated increase of volume and to solve the problem of bone-air "rupture" in the ear with  large lesion sound-system.

Key words: otosclerosis, Weber test, bone conduction, air conduction

 

^*Sharipov A.A., ^*Narzuloeva M.F., ^**Saiburkhonov D.S.

SOME FEATURES OFCROSS BORDER TRANSMISSIONOF MALARIA TOTHE REPUBLIC OF TAJIKISTAN IN PREDELIMINATIONPERIODS

^*Department of Infectious Diseasesof State Educational Establishment "Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan"

^**State Establishment"NationalCenter forTropical Diseases"

 

Aim. To exploresome featuresof cross-bordermalaria transmission in theterritory of the Republicof Tajikistan inpredeliminationperiods.

Materials and methods. Are used reporting documentation of the National Centre for Combating Tropical Diseases (Malaria), medical history of patients with malaria hospitalized in Clinical Infectious Diseases Hospital and Medical Center of Dushanbe. In the subsequent were calculated the arithmetic mean value of all the obtained results, and also evaluation given to them.

Results. During the analyzed period in the country there is a decrease in the incidence of malaria, especially local. At the same time, is growing the percentage of imported malaria cases among the registered patients (2011 – 28,2%, 2012 – 45,5% and in 2013 – 78,6%).From the total nu 38 of imported cases during the analyzed period in Tajikistan in 30 malaria cases caused by Plasmodium vivax (78,9%) and in 8 cases – malaria caused by Plasmodium falciparum (21,1%). Importation of malaria caused by Plasmodium vivax, was mainly from Asia (Afghanistan – 15 cases, Pakistan – 10 cases, India – 3 cases, Iran – 1 case), and only in 1 case – from South America (Guyana).Malaria caused by Plasmodium falciparum, was imported mainly from African countries (Guinea – 4 cases, from Sierra Leone, Nigeria, Sudan – one case each), and 1 case of Afghanistan.In all 10 cases of diseases brought into the country by mosquitoes, malaria was caused by Plasmodium vivax, that has occurred as a result of flight infected mosquitoes from the nearby Islamic State of Afghanistan. All cases of infection of citizens (7 local residents and 3 military border guards) were recorded in the border areas of Shuroabad district of Khatlon region.

Conclusion. It was established that import cases of malaria in the analyzed period were recorded in 17 cities and districts of the republic, most of which according to climatic and geographical features of conditions for reproduction and produce progeny of disease vectors (mosquitoes kind of Anopheles). Untimely identification of patients and do not implementation of the relevant anti-malaria activities will contribute to risk of exposure to the local population of imported malaria cases

Key words: malaria, cross-border transfer, predeliminationperiods, imported cases, skidof malaria,border regions

 

REVIEW

 

Abdurahmanova R.F., Izzatov K.N., Khadibaeva G.R., Sharifova B.A., Rashidova O.A.

PRIMARY CEREBRAL STROKE PREVENTION

(article overview)

Department of Neurology and Medical Geneticsof State Educational Establishment«Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

The article describes main directions of primary prevention of cerebral stroke. It is shown that the system of primary prevention of stroke is divided on population strategy and high-risk strategy.Population strategy is aimed at informing the public about modifiable risk factors associated with lifestyle, and possibility of their correction. Apopulation strategy is aimed at informing the public about modifiable risk factors associated with lifestyle, and possibility of their correction.Strategy of a high risk means early identification of patients in high risk groups followed by preventive medicamental and (if necessary) of vascular surgery treatment.Thus, changes in lifestyle, adequate antihypertensive, antithrombotic, hypoglycemic therapy, normalization of lipid metabolism, reasoned surgery on carotid arteries can significantly reduce the risk of a first stroke.

Key words: risk factors, primary prevention, cerebrovascular disease, ischemic stroke

 

A CASE FROM THE PRACTICE

 

Rahmonov V.D., Qosimova S.J.

two cases of late diagnosis of acromegalia

Сourse of Endocrinology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

This article describes 2 cases of late diagnosis of acromegaly caused by pituitary adenomas. Showing difficulties primary diagnosis of the disease. Demonstrated experience in application of modern methods of drug therapy Sandostatin LAR in adequate doses to the achievement of the inactive phase of the disease

Key words: acromegalia, diagnosis, drug therapy

 

2-2015

THEORY AND PRACTICE OF MEDICINE

Ahmedov Sh.M., Sirodzhov K.H., Muradov A.M., Holov D.I., Rahimov A.T.

Optimized approach to the treatment of limb fractures in patients with orthopedic trauma

Department of Traumatology and Orthopedics of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim .Optimization of diagnostics and surgical treatment of fractures in patients with multiple injuries.

Material and methods. The work is based on analyzing results of diagnosis and treatment of 183 patients in the period 2001-2013, which were divided into 2 groups. In the main group osteosynthesis of fractures optimized with the lipid spectrum of blood plasma, in the control group  treatment of fractures is traditionally held. The examination program of patients included: clinical examination, beam diagnostics, clinical laboratory tests, the study of the concentration of total lipids, catalase, atherogenic index calculation, the concentration of cholesterol, low density lipoprotein, very low density lipoproteins, determine the extent of fat globulemya.

Results. An important criterion of the outcome of treatment of patients with multiple injuries is the number of complications during the acute period of traumatic disease. Organ dysfunction were observed in 3.0 and 4.9% patients respectively in groups, which in 0.9% and 2.4% of cases have led to deaths. Venous insufficiency of limb was observed in 2.0% and 3.7% of patients, kompartmen syndrome – 0.9% and 2.4% of cases, fat embolism syndrome was observed in 1.2% of patients in the control group.

Conclusion. The positive effect of the results of treatment of patients of the main group due to an optimized approach to the treatment of fractures with the use of of lipid spectrum and sparing ways of osteosynthesis. Modified isovolemic hemodilution allows to withdraw patient from a state of shock, improves blood oxygen transport minimizes amount of blood loss, the degree of endogenous intoxication, the risk of fat embolism syndrome and other vital violations.        Key words: optimization, trauma, shock, damage, complicating disease, outcome, osteosynthesis

 

Ahunova N.Т., Holova Z.U., *Niyazov F.I.

ANTIDESTRUCTIVE ACTION  OFGLUCOCORTICOIDS

AT EARLYREUMATOID ARTHRITIS

Department of Therapy of  the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

*Department  of  Internal  Disease № 3 of the Tajik Medical State University named after Abuali-ibn-Sino

 

Aim. Study of antidestructive actionsof glucocorticosteroids on the background of the basic treatment of early rheumatoid arthritis by methotrexate.

Materials and methods. Present results of treatment of 42 patients (all women) in the age of 32 to 58 years (mean 45 years). Duration of disease from 0,5 to 2 years with a valid RA (ARA criteria, 1987), observed during the year. Exclusion criteria were the presence of stomach ulcer or 12-duodenal ulcer. Patients with IV stage of radiographic disease. All patients were divided into two groups: 1 – 22 persons receiving methotrexate 10 mg per week and glucocorticosteroids 7,5 mg / day; 2 – 20 patients treated only by methotrexate. Nonsteroidal anti-inflammatory drugs were allowed in both groups. To assess the therapeutic effect was used clinical, laboratory and radiographic performances.

Results. In the 1st group in 8 of 22 patients decline was registered of the index of Larsen. Mainly due to the decrease or disappearance of cystoid enlightenment and of phenomena of periarthric osteoporosis.In the second group decrease of this indicator was observed only in three patients. Reduction of the index of Larsen did not correlate with the expected decrease in erosion, growth of erosions in the two groups was almost the same (2.0 and 2.4 respectively).

Conclusion. In patients with early rheumatoid arthritis reception of corticosteroids in combination with methotrexate helps to reduce osteochondral destruction, estimated by the index of Larsen.

Key words: early rheumatoid arthritis, corticosteroids, methotrexate

 

Ashurov Z.Ya., Mirzoeva Z.A., Davlyatova D.D.

STUDY OF INJURIES STRUCTURE AND IMPROVEMENT OF PREVENTATIVE ACTIVITY OF FAMILY PHYSICIANS

IN THE CITY HEALTH CENTER №1 C. DUSHANBE

Department of Family Medicineof the State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

 

Aim. Analyze the traumatism in the city health center №1 c. Dushanbe, evaluate its structure, suggest ways of preventing in practice of family doctor.

Material and methods. For the analysis of traumatism in the city health center №1 c. Dushanbe statistical data of emergency station №3 at city health center №1 c. Dushanbe of 2012 -2013  years were used.

Results. Concerning street traumatism in 2012 1937 persons (40,4%), in 2013 – 1997 (38,4%) appealed. In 2013 decrease of cases of street traumatism on 2% is observe. Concerning home traumatism for medical care 2854 – 59,6% of patients, and in 2013 – 2495 – 47,9% (decrease 11,7%) appealed. 459 pupils received injuries at school (5,2%) in 2012, in 2013 – 241 (4,6%).Sports injuries in 2012 accounted 459 cases (9,5%), in 2013 – 388 (7,4%) (positive dynamics). Over the wound in 2012 1771 children (37,0%), in 2013 – 1440 (27,6%) appealed. Open fractures in 2012 included 8 cases (0,1%), in 2013 – 11 (0,2%) (increase on 0,1%); closed – 1568 (32,7%) in 2012 and 1275 (24,5%) in 2013. Dislocations in 2012 reached 281 case (5,6%), in 2013 – 205 (3,9%). With burns in 2012 18 persons (7,3%), in 2013 – 186 (3,7%), of animals bites 369 patients (7,1%) in 2012 and 320 (6,1%) in 2013 addressed.

Conclusion. At the present time, there are serious problems in the prevention of traumatism due to the low level of education of the population, poor public and society awareness.

Key words: traumatism, structure, prevention

 

Bahodurov J.T., Ibodo vH.I., Rofiev R.R., Asadov S.K., Nurov M.S.

ULTRASOUND SCANNING AS AN EFFECTIVE METHOD

OF DIAGNOSING OF EXUDATIVE PLEURISY IN CHILDREN

Department of Pediatric Surgery, Anesthesiology and Reanimatologyof the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Determination of the value of ultrasound scanning in the diagnosis of lung diseases such as exudative pleurisy in children.

Materials and methods. Investigated the clinical and laboratory, radiographical, CT, MRCI and ultrasound scan data of 76 patients with a diagnosis of pleural effusion in age from 1 month to 15 years.

Results. Based on the clinical and laboratory, radiographical, MRCI and ultrasound scan data of 76 patientsin3diagnosed lung cancer, in 5 specific process, and in rest 68 children set pulmonary-pleural form of bacterialdestructive pneumonia. At bacteriological research in 15 patients sown staphilococcus, in 6 – streptococcus, and in 7 – klebsiella. In other 43 cases, microorganism growth is not detected. At ultrasound examination of presumptive defeat zones lung tissue was visualized as a set of cellular structures or destructive changes, and at a depth of 0,5-0,9 cm from pleural sheets started to delaminate planar structures formed vessels and bronchial tubes. At empieme of pleural cavity the presence of echogenic suspensions was revealed, the maximum thickness of the parietal pleura was 5,2±0,3 mm, as opposed to other types of pleuritis. A reliable signs of metastatic pleuritis were: homogeneous pleural contents, the minimum thickness of parietal pleura 3,5±0,3 mm.

Conclusion. Comparison results of ultrasound examination of pleuritis with data  morphological research, obtained at puncture biopsy of pleura controlled by ultrasound examination, showed their high correlation in identifying of etiology of pleural effusion. Using of duplex ultrasound scan  at complex ultrasound examination allowed to reveal flow in the formations subpleural located in lung parenchyma of tumor etiology, in contrast to formation of inflammatory genesis.

Key words: chest, pleural cavity, pericardial effusion, pleuritis, childhood, ultrasound scanning of pleuritis

 

Bobieva N.H., Gadoev S.H., Subhonova Z.I., *Sunatulloev D.S.

POSITIVE INFLUENCE OF SORBITOL IN PATIENTS WITH

CHRONIC RENAL FAILURE

Department of Internal Disease № 3 of the Tajik Medical State University named after Abuali-ibn-Sino

*Department of Therapy of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. To estimate actions of sorbitol in combination with enterosorbents on gastrointestinal tract in the complex treatment of chronic renal failure.

Materials and methods. The study included 40 patients with chronic renal failure. Diagnosis and assessment of severity of uremia was conducted by determination of glomerular filtration rate (the level of urea and creatinine in blood), the A / D profile  and the degree of edemas.

Results. In patients on background of reception of sorbitol 10-15 days earlier than in the control group, marked decrease in the level of nitrogenous wastes in the peripheral blood (urea, creatinine), reduction of edemas, reduction of hypertension.         Reception of sorbitol accompanied by a decrease symptoms of uremic intoxication and improvement of the patient. Improvement comes after 7-10 days of treatment. This is manifested in decrease of pruritus, nausea and vomiting, headache and decrease in levels of nitrogenous wastes in the peripheral blood.Wellness at reception of sorbitol saved from 1 to 6 or even 12 months.

Conclusion. The use of sorbitol in combination with other enterosorbents significantly complements traditional dialysis therapy, hemodialysis pushing the starting date.

Key words: sorbitol, chronic renal failure, enterosorbents, nitrogenous slags

 

Bobohodjaeva M.O., *Ahmedov A., *Kasymova M.K.

SOME FEATURES OF STI/HIVDISSEMINATION

IN THE MODERN SOCIAL AND ECONOMIC CONDITIONS

Department of Obstetrics and Gynecology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

*Department of Public Health, Economics, Management with a course of medical health statistics of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Definition of features STI/HIV transmission in modern social and economic conditions.

Material and methods. Conducted a sociological survey of 400 workers, providing sexual services (SW) in Dushanbe. The survey was anonymous, voluntary on the basis of an oral informed consent. The questionnaire included questions that reflect the issues of social characteristics, sexual and reproductive behavior and health of the PC and users of their services.

Results. On growth and spread of STI / HIV infection in a certain way affect behavioral factors of SW. In epidemiological process involved not only persons with risky behavior (drivers, businessmen), as well as students of secondary and higher educational institutions, employees of state agencies, including foreign nationals. Foregoing facts explain such fast spread of STI / HIV among the population. During the days of SW had from 2 to 5 sexual partners – 47,8% of respondents; from 6 to 9 – 20,5% SW, 10 and more – 11,7%, 1 sexual partner were 17,3%, 2,7% did not answer. The respondents have taken alcohol at least once a week – 16,0%, several times a week – 12,0%. The proportion of drug users among sex workers was 2,9%.Sex workers who were injecting drug users do not use disposable syringes. 37,0% occasionally use condoms, and only 12,0% – permanently.

Conclusion. Due to the wide spread of STI / HIV, behavior of SW has become one of the most important indicators of risk because it reflects the potential danger of mass infection in the community.

Key words: STI/HIV, sex workers, injecting drug users, behavioral risk factors

 

Gulmuradov T.G,  Amonov Sh.Sh, *Prudkov M.I., Sangov D.S.

MINIMALLY INVASIVE SURGERY OF LIVER ECHINOCOCCOSIS
Department of Cardiovascular and Plastic Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

*State Budgetary Educational Institution of Higher Professional Education Ural State Medical University, Ekaterinburg, Russia

 

Aim. Improving results of surgical treatment of hepatic echinococcosis by applying minimally invasive technology.

Material and methods. Under the supervision during the period 2002-2013 there were 149 patients with hepatic echinococcosis. From them 52 were examined at the Department of Surgical Diseases advanced training faculty and postgraduate training. The remaining 97 patients – in endosurgical department of the Republican Scientific Center for Cardiovascular Surgery in Dushanbe. Among them were men 63 (42,2%) and 86 women (57,8%). In 105 (70,4%) patients echinococcal cysts were located in the right liver lobe (18 – V; 24 – VI; 31 – VII; 28 – VIII), in the left lobe – 44 (29,6%) of 2 – I; 12 – II; 19 – III; 13 – IV segments. According to the size and scope of the cysts distinguish between: medium to 10 cm – 80 patients, large 20 cm – 46 patients and giant than 20 cm – 23 patients. The average size of cyst was 102,77±3,7mm (46 – 280 mm).From the 149 patients 42 patients underwent echinococcectomy of the traditional approaches, 40 patients underwent laparoscopic echinococcectomy when echinococcus cyst localized to visually accessible segments of the liver S III, IV, V, VI; 67 operations performed minilaparotomiya access using a set of tools "Mini-Assistant".

Methods of surgical treatment of echinococcal cysts of the liver involves surgical access, puncture and aspiration of the cyst contents, opening the cyst and the revision of its cavity, cyst processing by adsorbed 33% solution of hydrogen peroxide (perhydrol) and the elimination of residual cavity (wide fenestration, in a number of cases a large portion of tamponade gland, external drainage with low vacuum aspiration).

Results. Postoperative complications were observed in 9 (21,4%) of 42 patients operated by conventional methods.Of the 107 patients operated using minimally invasive technology (mini-access and laparoscopically), complications were observed in 14 (13,1%) patients. Especially favorable postoperative course was after the intervention of the small incisions. Case of an expression enteroparesis and systemic were no complications.

Conclusion. Using minimally invasive techniques allow to improve results of surgical treatment of liver echinococcosis. Minimal trauma, high economic efficiency are the main advantages of these methods.

Key words: minimally-invasive technology, liver echinococcus, echinococcectomy

 

Muminov S., *Kurbonov K.M., RasulovN.A., *KayumovA.A.

IMPROVEMENT OF CLASSIFICATION OF

BILIOUS PERITONITIS

Department of Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

*Department of Surgical Diseases №1 of the Tajik Medical State University named after Abuali-ibn-Sino

 

Aim. Improve and introduce classification of bile peritonitis.

Materials and methods. For a basis of this research the experience of complex diagnosis and surgical treatment of 87 patients with bilious peritonitis was put. Patients treated in the City Clinical Hospital of Emergency Medical Care Dushanbe. Also, evidence to date classification of peritonitis, and in particular, the bilious was analyzed and studied.

Results. The сlinical manifestation of bilious peritonitislargely depended from reasons ofdisease arising andseverity of endotoxemia. Based on the study and review ofavailable clinical data the clinical classification of bilious peritonitis was developed. It would greatly optimize the further tactics and thus improve results of treatment.

Conclusion. Conducted operations on the biliary tract are often associated with great technical difficulties which require from surgeon of relevant experience in the field of hepato-biliary surgery.So the given classification would greatly simplify and improve further tactics of selection of operative intervention volume. A significant danger is presented by a septic symptoms which indicate the need for timely selection of treatment of this patients.

Key words: pathogenesis of bilious peritonitis, bilious peritonitis classification

 

Mustafokulova N.I., Ganieva M.P., Аhunova N.T., Boronov J.B.

FEATURES OF PSYCHOSOMATIC MANIFESTATIONS

AT ACUTE MYELOBLASTIC LEUKEMIA

Department of InternalDiseases №3 of Tajik State Medical University named after Abuali-ibn-Sino

Department of Therapy with a Course ofGerontology of State Educational Establishment«Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Rate features of psychosomatic manifestations and quality of life of patients at acute myeloblastic leukemia.

Materials and methods. The study protocol includes prospective and perspective (from 2009 to 2014 years) observation of 140 patients with acute and chronic myeloblastic leukemia. The average age is 35,9 ± 0,7 years. Male – 62 (45.9%), women – 78 (54.1%). Of which 70 patients amounted to 1 group with acute myeloleukemia, 2 group – 70 patients with chronic myeloleukemia. Both groups the determination of the level of psycho-emotional sphere with the help of ospital Anxiety and Depression Scale (HADS) was conducted. To assess the quality of life and efficiency of rehabilitation activities in patients with acute leukemia the use of SF-36 questionnaire was provided. The calculation was made according to special transformation of scales. Evaluation was performed on a 100-point system.                        

Results. Study of patients by anxiety and depression scale (HADS) was performed on the second or third day admission to the hospital and again two weeks after the therapy. The test results on the scale of HADS led to the conclusion of reliable differencesthe of level of anxiety  in both groups: 1 group with high levels of anxiety included 6 patients (12 points) and 2 group at high risk of anxiety included 12 patients. Subclinically expressed depression on a scale of HADS  detected in 8 patients. In patients with chronic myeloblastic leukemia subclinically expressed depression detected in 13 patients (8 points). At a combination of anxiety and depression  on a scale of HADS in 1 group more number of patients – 39 (14/14), in the second group – 31 patients (14/13). Subclinically expressed stage in 1 group observed in 3 (10.9), in 2 group – in 10 (19/9 points), which is high in both groups. It is established that the quality of life of patients with acute and chronic myeloleukemia, determined using the SF-36 questionnaire significantly reduced. After 4 weeks of using assigned sedative therapy showed a significant (p <0.05) improvement in the quality of life of patients with acute and chronic myeloleukemia.                 

Conclusion. Stress and psychological disorders in patients with acute myeloid leukemia accompanied by high levels of a combination of anxiety and depression, clinically significant in 55.7%. Psychophysiological violations identified in patients with chronic myeloid leukemia in 44.3% of cases. In order to improve the quality of treatment at depressive states, recommended using of sedative drugs, tranquilizers, at high performance – with using of programs of antidepressants  that increase the educational level of  patients: holding the conversation, lectures and autogenous training.          

Key words: leukemia, depression, quality of life, scale, psycho-emotional state

 

Muhamadieva  S.M., Sabirovа G.A., Pulatova A.P.

PHYSICAL DEVELOPMENT AND GYNECOLOGICAL STATUS

AMONGGIRLS AND WOMEN WITH HELMINTH INFECTIONS

WHILE IODINE DEFICIENCY DISEASES 

Department of Obstetrics and Gynecology of the State Educational Establishment "Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan"

State Establishment "Scientific-Research Institute of Obstetrics, Gynecology and Perinatology"

 

Aim. To study the physical development and frequency of helminth infections among girls of pubertal age with iodine deficiency diseases.

Materials and methods. The complex observation of 160 girls in the age of 10-16 who turned to the children's gynecology department and to consultation and diagnostics polyclinic of Scientific and Research Institute of Obstetrics, Gynecology and Perinatology was conducted: anthropometrical indicators, index of body mass (Brey), for evaluation of mammary glands development the Tanner's formula was used.  All of the girls went through clinical analysis of blood and urine, flora smear, analysis of faeces for helminth eggs and lamblia cysts, scrape for enterobiasis, ELISA (immunoglobulins G and M) to antigens lamblia in blood, biochemical analysis of blood with evaluation of activity of Alanine Aminotransferase, AST, Ultrasound Examination of thyroid gland and organs of abdominal cavity and pelvis minor.

Results. Iodine deficiency diseases (IDD) and helminth infections form low index of health of girls and women of pubertal age. Combination of anemia and goiter is in 92,8% of patients, pyelonephritis – 60,0%, cold diseases in anamnesis in 99,9%, each second had disorder of period cycle. Physical development of girls of main group was behind the control group: average height of patients was 145,6±1,4 cm. The average index of Brey was 17,5 whichcorresponds to low border norm. Delay of sexual development had 21,4%, whereas in control group this indicator was 1,7 times lower (37,1%).

Conclision. Helminthic infections effect on the physical development and formation of reproductive function of girls and women which have iodine deficiency diseases. Use of modern technologies will allow quickly identify this category of patients and heal them.

Key words: iodine deficiency diseases, helminthiases, girls of pubertal age

 

Nazirova N.K., Mirzoeva Z.A., Vositzoda Z.F.

EFFECTIV Treatment of Urinary Tract InfectionS

IN PRIMARY CARE IN THE PRACTICE OF FAMILY physician

Department of Family Medicine of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Evaluate the effectiveness of schemes treatment of urinary tract infections UTI based on the principles of evidence-based medicine.

Materials and methods. We observed 28 patients with UTI, with average age 23,3±2,4 years. Children and adolescents comprised 42,9% (12 people) ,adults – 57,1% (16 people), among them women – 60,7%, men – 39,3%. Methods applied: clinical and statistical.

Results. Among those who were diagnosed UTI first established in 11 people (39,3%): acute cystitis observed among 63,6% (7 people), acute pyelonephritis – 36,4% (4 people). Patients with recurrent episodes of UTI comprised 60,7% (17 people): 58,8% (10 people) with cystitis, 41,2% (7 people) with pyelonephritis. 71,4% of cases of recurrent episodes of pyelonephritis were observed in patients with urolithiasis.

UTI was treated with consideration of gender, age and diagnosis. Children younger than 12 years with cystitis and pyelonephritis received amoxicillin in combination with clavulanic acid 20-40 mg/kg per day in 3 divided doses for 5 (7-10) days. All patients older than 12 years received 100 mg of nitrofurantoin 2 times a day for 5 days (level of evidence A) or 500 mg of ciprofloxacin (alternative) 2 times a day 3-5 (7-10) days. Patients with recurrent UTI after adequate therapy and bacterial eradication were received long-term prophylaxis with nitrofurantoin, as 50 or 100 mg at bedtime for 6-12 months. As a result of treatment, based on evidence-based medicine, we observed positive dynamics of clinical and laboratory manifestations of UTI.

Conclusion. There is a necessity of strict adherence to the recommended schemes in accordance with the conclusive data, and avoidance of excessive use of antimicrobial drugs and use antibiotics without evidence.

Key words: urinary tract infection, clinical protocol, evidence-based medicine

 

RafikovS.R., *MahmadovF.I., *KurbonovK.M., *RahimovA.R.

DIAGNOSIS AND CORRECTION OF FUNCTIONAL DISORDERS

OF LIVER AND LUNG IN PATIENTS WITH SUBDIAPHRAGMATIC

LIVER ECHINOCOCCOSIS

Department of Surgical Diseases of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

*Department of Surgical Diseases №1 of the Tajik Medical State University named after Abuali-ibn-Sino

 

Aim. Improvement of results of treatment of subdiaphragmatic echinococcosis of liver and its complications.

Material and methods. The present research is based on the analysis and treatment of 76 patients with hepatic echinococcosis of subdiaphragmatic location. The vast majority were persons older than 40 years. There were 33 males (43,4%) and 43 women (56,6%). Complicated forms of echinococcosis was observed in 63,1% (n=48) patients (abscess – 27, a breakthrough in the bile way – 21).

Results. Echinococcosis of the liver accompanied by significant destruction of hepatocytes, a violation of indicators of the level of proinflammatory cytokines and nitric oxide, especially in the complicated course and subdiaphragmatic location, indicating that altered functions of liver and lungs. With the growth of  volume of hydatid cysts in the subdiaphragmatic space and in long-term course of the disease violated ventilation and gas exchange function of the lungs.

Conclusion.To patients with hepatic echinococcosis subdiaphragmatic localization advisable to conduct in the preoperative period antihypoxic therapy to significantly improve functional state of the liver and lungs.

Key words: subdiaphragmatic hydatid disease of the liver, indicator of liver enzymes, proinflammatory cytokines, nitric oxide, ventilation and gas exchange in the lung function

 

Rustamov S.G.

MEDICAL-SANITARY SERVICE OF TAJIK RAILWAY:

ACTUAL AND UNSOLVED PROBLEMS

Department of Public Health, Economicsand Management with a course of medical health statistics of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Road Hospital of medical-sanitary service SUE "Tajik Railway", Dushanbe

 

Aim. Determination of actual and unsolved problems in the activity of medical-sanitary service of Tajik Railway (TRW)

Materials and methods .Analyzed the materials of archive department of the State Unitary Enterprise "Rohi Ohani Tojikiston" and statistical office of his medical-sanitary service.

Results. In 2014, to the road hospital polyclinic on station Dushanbe-1 addressed 57 226 people. Pre-trip checkups of TRW locomotive crews performed by 7 feldsher stations with total number of inspections more than 2500 per year. The highest level of morbidity with temporary disability per 100 employees among the employees of passenger service  – 13,3 cases and 219,7 days, locomotive service – 8,9 cases and 211,1 days, wagon service – 7,3 132,3 cases days.Indicator of dispensary observation amounts 141,3 per 1000 people. Primary disability decreased over the past 5 years from 4 to 2.9 per 1000 workers. Mortality rate over the last 5 years slightly increased – from 1 to 1,7 per 1000 workers.

Conclusion. At the present time in the railway health system of Tajikistan the appropriate infrastructure was created, but there is a number unresolved issues. In the presence of appropriate financing and special education is possible to extend preventive and rehabilitative directions of service activity. It will allow improving of health status of railway workers

Key words: medical-sanitary service, Tajik Railway, prevention of diseases, treatment and preventive assistance, railway medicine

 

Sirodzhov K.H., Isupov Sh.A., Holov D.I., Boymurodov A.N.

ADVANTAGE OF ROD OSTEOSYNTHESIS IN PATIENTS WITH COMPLEX OPEN FRACTURES OF FEMORAL BONE

Department of Traumatology and Orthopedics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Optimization of surgical treatment of open fractures of the femur with concomitant injury.

Materials and methods. The results of diagnosis and treatment of 87 patients with combined open fractures of the femur were analyzed. Patients were divided into2 groups: the main group resorted to early stable fixation of long bone fractures external fixation device (EFD) on the first day. In the control group osteosynthesis produced in delayed and planned manner.

Research methods: radiography, computed tomography, ultrasound examination of organs, clinical and laboratory research. To determine the severity of injuries and status of patients, the degree of shock, blood loss volume and other vital violations the objective point scale assessments were used.

Results. Stabilization of fractures of the femur EFD conducted in all cases amid continuing anti shock measures or after appropriate infusion-transfusion therapy and improve the overall condition of the victims. By using of optimized surgical treatment of open fractures of the femur at combined injury good results established respectively in 27 (29,9%) and 18 (20,7%), satisfactory -in 11 (12,6%) and 19 (21,8%)and unsatisfactory–in 3 (3,4%) and 9 (10,3%) patients.

Conclusion. Considering the low traumatism and how antishock eventt, early osteosynthesis of open fractures of the femoral EFD performed independently from the severity of the victim, making the patient transportable. This method helps to normalize the function of important organs, reducing early-threatening complications and verticalization of the patient.

Key words: injury, shock, fracture, complications, stable osteosynthesis

 

Holova Z.U., Ahunova N.T., Sharipov H.S.                                                          

MODERNASPECTSOFANTIPHOSPHOLIPIDSYNDROME.

INFLUENCE OF EXOGENOUS RISK FACTORS OF THROMBOSIS IN THE
ANTIPHOSPHOLIPID SYNDROME.

Department of Therapy of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Studying of the relationship between thrombosis, their recurrence and exogenous risk factors in APS.

Materials and methods. The study included 80 patients (63 women and 17 men). They were divided into 3 groups: 1-22 patients with systemic lupus erythematosus (SLE), 2-30 patients with SLE and APS, 3-28 patients with primary APS. All patients were interviewed by a specially designed map Fiscal registrar (FR). Also assessed the impact on development of thrombosis treatment with corticosteroids and cyclophosphan.

Results. As the prevalence of exogenous risk factors (abuse of fat and fried food, coffee, alcohol) group of patients were not significantly different. The connection of these FR with a history of thrombosis was not found. Physical inactivity was the most characteristic of patients with APS (23,1% compared with 10,7% of patients with SLE without APS), a greater number of patients with APS are marked theexcessive body weight (38%). In patients with primary APS percentage of smokers was higher, however, the influence of smoking on the development of thrombosis was not revealed. The direct correlation of the presence of occlusion with the intake of corticosteroids and cyclophosphamide method dopplergram vessels. By the method ofvascular dopplerography the direct connection between thepresence of occlusion with the intake of corticosteroids and cyclophosphamide was found.

Conclusion. The risk factors of venous thrombosis in patients with APS (primary and secondary) are obesity and glucocorticosteroids.

Key words :risk factors of thrombosis, systemic lupus erythematosus, antiphospholipid syndrome

 

CASE FROM PRACTICE

 

Juraev M.N., Akbarova M.M., Karimova N.I.

SPECIFIC FEATURES OF COURSE OF DRUG ALLERGY

 

Department of Allergy and Immunologyof the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Over last three years in the City Allergological Center  5 cases of  Lyell-Langs syndrome were observed. This emergence is associated with the use of drugs. Uniqueness of this incident is the combination of heavy drug allergy with insect allergy and diabetes mellitus. Monitoring of condition of the patient by place of residence was held.

Key words: drug allergy, insect allergy, diabetes mellitus

 

 

PHILOSOPHYCAL PAGE IN MEDICINE

 

Muzaffari M., Zokirov R., Safarov N.

CLASSICAL ANTHROPOLOGY

(EXPERIENCE OF CONSTRUCTION OF SYSTEM THEORY)

Course of Philosophy of Medicine and Medical Anthropology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Analysis and definition of "anthropology" as the source and the base term with categorical status for building system theory of classical anthropology.

Results. In the comparative analysis and the definition of semantic and shades of meaning other synonymous concepts were identified and established the classical meaning of the term "anthropology". In the course of the study anthropology estimated as total integrative and interdisciplinary science about human. Different directions of anthropology, in essence, do not study the nature of the person but the results of his activities.Thus different directions of anthropology, cultural type, "social" and the like, are not anthropological sciences.

Conclusion. A result of analysis defined the semantic content of the classical concept of "Anthropology" and shows its relation to other equivalent concepts that express human’s nature.

Key words: anthropology, philosophy, classical, physical, mental, social anthropology

 

 

REVIEW

 

Narzullaeva A.R., Shohzodaeva Z.O., Sharipova F.

REIEW OF BISOPROLOL EFFICIENCY

IN CARDIOVASCULAR DISEASES THERAPY

Department of Cardiologywith the course of clinical pharmacologyof the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Considering the pathophysiological and etiopathogenetic preconditions purpose of beta-blockers in cardiovascular diseases, as well as their ability to improve health and life prognosis of patients with very high cardiovascular risk, the review covered issues of bisoprolol application in the treatment of cardiovascular diseases. After analyzing of its clinical pharmacology have been provided evidence from randomized controlled studies that show its high efficiency and safety in the pharmacotherapy of diseases such as hypertension, coronary heart disease, chronic heart failure. Bisoprolol has a strong cardioprotective effect. Different by minimal side effects, metabolic neutrality, and positive influence on prognosis of cardiovascular diseases. High-β1-selectivity of bisoprolol make safe its application in patients with chronic obstructive pulmonary disease and metabolic disorders as well as opens up the possibility of its use in patients with underlying liver and kidney function without correction dose of drug. Debated question of the application of this drug for the treatment of cardiovascular disease in pregnant women and nursing. In addition, pharmacokinetic characteristics contribute to high adherence and does not degrade the quality of life of patients with various diseases of the cardiovascular system. Regular and long-term treatment of hypertension, angina, chronic heart failure with bisoprolol leads not only to reduce blood pressure to target levels, organoprotective effect, reduce the frequency of angina attacks and symptoms of heart failure, but also a substantial reduction of serious complications, thereby improving the health and life prognosis of patients, increasing their life span.

Key words: ß-adrenoblockers, bisoprolol, pharmacotherapy, cardiovascular disease

 

3-2015

THEORY AND PRACTICE OF MEDICINE

Baybabaev A.A.,  Saidmurodov D.U.

THE PREVALENCE AND FEATURES OF FORMATION OF THE HEROIN ADDICTION OF FEMALE BY RESULTS OF ANONYMOUS QUESTIONNAIRE

POLL AMONG SOCIALLY VULNERABLE STRATA OF THE POPULATION

OF REPUBLIC OF TAJIKISTAN

Course of Psychiatry and Narcology of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. The revelation of the true picture of prevalence and features of formation of heroin addiction of female in Republic of Tajikistan rose as an object of this paper.

Materials and methods. Carried out an anonymous questionnaire poll among 4077 women from the group of socially vulnerable strata of the population of Republic of Tajikistan. The number of the urban inhabitants made up 2065 women and village – 2012.

Results. Revealed that among the urban respondents in comparison with urban the beginning of sexual life and early attaching to consumption of a drug, less duration conjugal bonds, few children, at the same time greater narcology aid appeal ability is marked, that on the present is caused by availability by the specialized narcology aid in the city.

Conclusion. On account of sparsity of the voluntary applying for narcology aid a just picture of prevalence and feature of heroin formation of the drug addiction among the people of female remains unsufficiently investigated. The lack of some essential distinctions in the social – hygienic factors of development and clinical factors of narcomonia among the questionnaire poll of the urban and village inhabitants dictates the necessity of realization of more extended research among vulnerable strata of the population in Republic of Tajikistan with a purpose of revealing a just picture of heroin dependence.

Key words. Premorbid features, hereditary load, motives of consumption of the psychoactive substances, heroin addiction, female narcotic dependence, psychical dependence, abstinent syndrome

 

¹Gafarov H.O., ¹Shakirov M.N., ²Stolyarenko P.Yu,¹Mangutov I. H.

INTERVENTIONAL METHOD OF ANESTHESIA ON INOPERABLE

PATIENTS WITH STOMATOLOGICAL CANCER

¹Department of Maxillofacial Surgery with Children’s Stomatology of State Education ²Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Improved methods of prolonged regional blockade (PRB) branches of the trigeminal nerve to use as the intervention method of cupping of chronic pain syndrome in inoperable oncostomatologicalpatients.

Materials and methods. As an element of access to the nerve trunks was used "catheter on the needle".Fixation was performed by nikelid-titanium thread grade TH-20, blockade – by anesthetics of IV-V generations.Was conducted palliative treatment of 48 oncostomatological l patients (22 men, 26 women, mean age 57,6 years).Were taken into account: the incidence of complications after the procedure, the duration of functioning of established catheter, adequacy and duration of analgesia, the incidence of side effects.

Results.Using of "catheter on the needle" reduced the number of used tools and simplified the technique of the PRB.The complication rate was 16,6% (8 patients).The duration of the functioning of the catheter was 1-3 months.On the 10th day of the intensity of pain syndrome was 12,0±0,8 mm in visual analog scale (VAS), duration of analgesic action – 5,9±0,3 hours.

Conclusion. Application of an improved method of PRB as interventional pain management in palliative care on patients with stomatological cancer provides an adequate relief of CPS in advanced stages of the disease, the absence of any significant side effects is the basic premise of improving the quality of life of patients.

Key words: prolonged regional blockade, interventional pain management, patients with stomatological cancer

 

Zakirova K.A., Mahmudova P.U., Mahmudova R.U., Sultanova S.K.

EFFECTIVENESS OFDIAGNOSTICS AND TREATMENT

OF MULTIDRUGRESISTANT FORM OF TUBERCULOSIS

Department of Phthisiopulmonologyofthe State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Examine the effectiveness of diagnostic and effectiveness of treatment of multidrug-resistant tuberculosis in Republic of Tajikistan.

Materials and methods. Performed analysis of an officially published statistics on drug-resistant tuberculosis from 2008 to 2012, of the National Center for Tuberculosis Control in the framework of the "Program to protect the population from tuberculosis in Republic of Tajikistan for 2010-2015".

Results. Drug resistance to antituberculosis drugs (anti-TB drugs) started to define with the support of WHO. In 2008 in Dushanbe and Rudaki district (population 324 thousand. man – 13,9% of the countrys population).Cultures studied in supranational laboratory inGauting (Germany).The first study on drug resistance was conducted in 2008-2009 to the main anti-TB drugs. Multidrug resistance was 16.8% among newly diagnosed patients, including previously treated – 61%. The second study – a test to determine drug susceptibility (DST) – carried out in 2010-2011: cases of MDR-TB were 13% and 53,6%, respectively (a decrease among new cases 3.8% among the patients treated early – on 7,4%).

Conclusion.Obtained results indicate a qualitative improvementofindicators of effectiveness of treatment of patients with MDR-TB in the republic – from 53% to 58,4%, mortality rate decreased from 14,2% to 11,3%.

Key words:efficiency, diagnostics, treatment of drug-resistant forms of tuberculosis

 

 

Kabirov K.M., Mirzoeva Z.A., Davlyatova D.D.

DIAGNOSIS OF BRONCHIAL ASTHMA IN FAMILY DOCTOR'S PRACTICE

Department of Family Medicine of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Evaluation of status of patients with a diagnosis of "bronchial asthma", consisting on the dispensary in hospital of Tursunzade city.

Materials and methods. Were examined 30 patients aged 20 to 70 years (20 women, 10 men), consisting in dispensary with a diagnosis of "bronchial asthma". Patients were full explored in: palpation, percussion, auscultation of the chest, the assessment heart rate respiratory rate, calculated body mass index, peak flow and pulsoxymetry performed.

           Results.10 patients (33,3%) had a mild intermittent, 8 (26,7%) – with mild persistent, 7 (23,3%) – with moderate, 5 (16,7%) – with severe bronchial asthma severity. In 11 (36,7%) diagnosed with lung exacerbation of asthma. According to the datas of peakflowmetry in 17 of examined obstruction has an corresponding partially controlled asthma, 13 – severe degree. Among 5 patients pulseoximetry were below 95%, which indicates the presence of respiratory failure.

            Conclusion. In spite of the existing protocols on keeping major respiratory diseases at PHC level, a survey of patients and their assigned treatment was not carried out.

            Key words:bronchial asthma, peak flow meter, a pulse oximeter, stethoscope, family doctor

 

Каsimova Z.N., Kobilov S.S.

ANALYSIS OF MATERNAL MORALITY

IN THE SOGD REGIONAL MATERNITY HOSPITAL

The course of obstetrics and gynecology of Hujand department of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Sogd regional maternity hospital                                                                         

 

Aim. Toexamine the structure of maternal mortality in the Sogd regional maternity hospital and identify ways to reduce it.

Material and methods. It was done the prospective analysis of the history of the birth of the dead women, analyzed data from collated critical cases and annual reports of ARDS in the period from 2010 to 2014.

Results.Revealed the tendency to increase to maternal death. Her reasons: complications associated with extragenital pathology – 41,3%, obstetrical bleeding – 23,5%, sepsis – 23,5%, hypertensive disorders during pregnancy (eclampsia, HELLR syndrome) and pulmonary thromboembolism – 5,9%.

Conclusion.  The leading cause of maternal mortality at the maternity hospitals (41,37%), as well as throughout the country, prevails extragenital pathology.Before Health Organization is an issue of development and implementation in practice of maternity hospitals protocols for management of women with extragenital diseases during pregnancy, childbirth and the postpartum period.

Key words:maternal mortality, extragenital pathology, hemorrhage, sepsis, hypertensive disorders

 

Muradov A.M., Muradov A.A., Hamrokulov A.A., Shumilina O.V.

COMPARATIVE ANALYSIS OF LUNGS FUNCTION BY REGULATION

OF ELECTROLYTES AT PATIENTS WITH DIFFERENT PATHOLOGY

IN THE CRITICAL STATE

Department of Efferent Medicine and Intensive Therapy of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan

 

Aim. Carry out a comparative analysis of lung function by regulation of electrolytes in patients with different pathologies in critical states in dependence from hypocoagulating function.

Materials and methods. In order to determine the participation of lungs in regulation of blood electrolytes were compared the patients in critical states with different pathologies : I group – 119 puerperas with hemorrhagic syndrome, complicated by acute renal failure (ARF), II – 85 patients with severe craniocerebral trauma (SCCT), III – 110 patients with bronchial asthma at bronhoastmatic state. The findings were compared with the control group (IV) – 20 healthy people. Lung function by regulation of blood electrolytes was determined by veno-arterial difference between mixed venous blood (MVB) and flowing arterial blood (FAB), taken simultaneously, by indicators of electrolytes – potassium, sodium – in plasma and erythrocytes and calcium.

Results. At patients in critical states with different pathology observed disorders of water-electrolyte balance in the form of retention by light Na+ from plasma of the FAB.It points to the beginning of interstitial hypostasis of lungs, not yet manifested in the radiological examination of lungs. Process of retention of sodium by lungs has a direct correlation dependence with the degree of disorders of hypocoagulating lung function and severity of patients status, compounded from 1 to 3 group, which influences to severity of patients. Detected the process of transmineralization or "sick cell syndrome" during the transition of sodium into the cell and potassium from the cell, growing in more severe patients of 2-3 groups. Consumption by lungs of calcium from blood, as clotting factor, occurs particularly active from 1 group to 3 under all studied pathologies during disorders of hypocoagulating lung function.

Conclusion. Determination of concentration of Na⁺ and K⁺ in plasma and erythrocytes, Ca²⁺ in plasma of MVB and FAB has diagnostic and prognostic value for determining and early diagnosis of interstitial hypostasis of lungs and  cellstransmineralization syndrome, and also status of hypocoagulating lung function in critical states, which makes possible to determine the severity of state and  disease outcome.

Key words: hypocoagulating lung function, mixed venous blood, flowing arterial blood, electrolytes, acute renal failure, severe craniocerebral trauma, bronchial asthma, syndrome of transmineralization

 

NozirovDzh. H., Muminova M., Karimov D., Rahimov E.

OVERWEIGHT AND OBESITY AS A RISK FACTOR FOR HEART AND CIRCULATORY DISEASES AMONG THE REPUBLIC OF TAJIKISTAN

Department of Public Health, Economics, Management with a Course of Medical Statistics of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Department of Cardiology with the course of clinical pharmacology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. To explore regional and gender-sensitive prevalence of overweight and obesity among the population of the Republic of Tajikistan.

Materials and methods. Implemented screening study of 16,500 people. Aged 15-59 years: 7193 (43,6%) – men, 9307 (56,4%) – women. Besides survey and questionnaire (questionnaire of Rose), conducted anthropometric measurements. Estimation of body mass index was carried out on Quetelet (WHO, 1995).

Conclusion. Revealed features in the prevalence of overweight and obesity among the surveyed population polo-age aspect in individual regions and the whole country are the basis for the local health authorities in the planning of preventive measures aimed at modifying risk factors -excess weight and obesity.

Key words: cardiovascular disease, excessive body weight, obesity, screening

 

Nozirov Dzh. Hh., Narzulloeva A.P., Shorirov T.M.

PREVALENCE OF ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE AMONG UNORGANIZED POPULATION

OF GANCHI DISTRICTS OF SUGHD

Department of Public Health, Economics, Management with a Course of Medical Statistics of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Department of Cardiology with the course of clinical pharmacology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. To explore polo-age features of the prevalence of arterial hypertension (AH) and coronary heart disease (CHD) among the unorganized population of Ganchi district of Sogd region.

Material and methods.According to WHO guidelines, screening is carried out 3024 people (1368 (43,2%) men and 1656 (54,8%) women) aged 15-59 years. The questionnaire for the detection of coronary artery disease consisted of 12 points, which determine the presence of coronary genic (CHD) and noncoronary genic pain (cardiology) (Rose questionnaire). Measuring blood pressure sphygmomanometer was performed by standard methods (WHO / ISH 1999, DAG-1.2000). Additionally were used clinical, anthropometric, biochemical laboratory and functional diagnostics methods.

Results. Among surveyed contingent AH of stage I often suffered males and of stage II and III – females. Coronary heart disease and arterial hypertension are age range correlated in both sexes with the largest discovery in the older age groups (55-59 and 45-54 years), 1.5 times more in women.

Conclusion. Features in the prevalence of hypertension and coronary heart disease in the region are key to developing a more concrete action plan aimed at reducing the growth rate of hypertension and coronary artery diseasetaking into account age-appropriate distribution.

Key words: arterial hypertension, coronary heart disease, blood pressure, screening

 

Ortikova M.M., Mirzoeva Z.A.

DETERMINATION OF TOTAL IMMUNOGLOBULIN CLASSES M AND G – INFORMATIVE METHOD OF DIAGNOSIS OF GIARDIASIS, ASCARIASIS

Department of Family Medicine of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. Conducting a study on the presence of total immunoglobulin classes M and G to antigens of ascarids, giardia in human blood by immunoenzyme analysis.

Materials and methods. The study involved 35 family members living in the city of Dushanbe GTSZ №1 without complaints. There were 19(54%) men and 16 (46.0%) – women.

Results.During the study of blood for presence of total immunoglobulin classes M and G to antigens of Ascaris, by ELISA positive results were found in 14 (31,4%) members of the family: 8 women (57,1%), 6 males (42,8%); 8 (57,1%) had organized (working) population, 6 (42,8%) of unorganized (non-working). In our study, the titer of antibody was determined to determine the duration of the disease. By titration of AT 1: 100-5 (35,7%), AT-1: 200 – 9 (64,9%). In the study of antibodies to roundworm found that the infestation is more common among females, have organized a contingent of the population. Of those studied, 64.9% of family members infected with ascariasis.

Blood test for the presence of total immunoglobulin classes M and G lamblia antigens by ELISArevealed positive responses in 10 persons (28,5%) among the surveyed family members, of whom – 4 women (40,0 %), 6 men (60%). Of the total number of persons with a positive result to the antigens of Giardia organized (working) – 8 (80%), fugitive (non-working) – 2 people (20%).According to the definition of titer: AT – 1 200 – 8 people (80%), AT – 1: 800-2 person (20%). Of the total study 20% of family members infected with Giardia, the prevalence of greater among organized among males.

Conclusion. Concurrent use of koprological and serological methods of diagnosis allows more reliably and efficiently identify ascariasis, giardiasis.

Key words: immunoglobulins M, G, diagnostics, giardiasis, ascariasis,task, a family physician, primary care

 

¹Rajabov F.F., ²Shahmatov A.N., ³Hudoidodov B.

Changes OF biochemical parameters Of rabbitS blood

DURING EXPERIMENTAL TOXIC HEPATITIS

UNDER THE INFLUENCE OF TIMOCIN

¹Laboratory affairscourseinthe State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

²Laboratory LLC "Zand", Dushanbe

³Center of forensic-medical expertise, Dushanbe

 

Aim. Assess the biochemical indices of animals blood at experimental toxic hepatitis caused carbon tetrachloride.

Materials and methods. Investigations were performed on 10 outbred rabbits a mass 2-3 kg with standard diet and content. Toxic hepatitis was induced by introducing to animals of carbon tetrachloride in admixture with vegetable oil (1: 1) in an amount of 2 ml for 10 days once per day.

For research was used immunomodulatory drug timocin (26092014 series, valid until 26.09.2014, the manufacturer LLC "TibBaroishumo", Tajikistan). Timocin was injected to animals after injection of carbon tetrachloride for 10 days once a day at a dose of 0.01 ml per 1 kg of animal body weight.

Before administration and after administration in the blood serum determined the: total protein content, cholesterol, bilirubin (total, bound and free), urea, creatinine, glucose, triglycerides, HDL cholesterol, uric acidactivity of enzymes ALT, AST, and amylase).

Results. The introduction of carbon tetrachloride contributed to the development of toxic hepatitis in rabbits, which was confirmed by a considerable increase of bilirubin, ALT and AST activity. After applying of timocinthe positive dynamics of changed biochemical indices: significantly reduces the content of bound and free bilirubin, which led to the normalization of total bilirubin. ALT and AST also falls below the physiological norm.

Conclusion. Application of timocin normalize the content of bilirubin, glucose, cholesterol, ALT and AST activity, which indicates the presence of hepatoprotective properties in it.

Key words: timocin, toxic hepatitis, biochemical indicators, hepatoprotective properties

 

Samadova G.A., Dadabaeva B.S., SharipovaSh.T.

IMPLEMENTATION OF NATIONAL STANDARTS OF ANTENATAL CARE FOR PREGNANT WOMEN IN THE WORK OF THE FAMILY NURSES

Department of Nursing in Family Medicine of State Educational Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. To analyze work of family nurses on the implementation of national standards of antenatal care for pregnant women.

Materials and methods. Analysis of family nurses work on antenatal management of 72 pregnant women was conducted from submitted family nurses reports, Form 111, pregnant women registration journal.

Results. Out of 72 observed women at the labor age 43 (59,7%) were pregnant women. Only 19 (26,4%) women were established first pregnancy. 34 (47,2%) of pregnant women were native inhabitants of the region, who timely on their own registered themselves on clinical account. 41,6%  of pregnant women were identified by family nurses. All of them were settlers.  Normal BMI had 63 (87,5%) of pregnant women, 8 (11,1%) had heightened, 2 (1,4%) lowered. It was established moderate intensity direct correlation (Ґ=0,53±0,05; p<0,05) between BMI and gestation. 86,1 % women had anemia.  Correlations between BMI and hemoglobin content in the blood of pregnant women had weak intensity (Ґ=0,26±0,16; p<0,05) but between hemoglobin content in the blood of nulliparous and multiparous women strong intensity (Ґ=0,99±0,17; p<0,05). Only 22,2% of pregnant women were observed by a doctor at the health center seven times.

Conclusion. Study of nurses’ work on the implementation of national standards of antenatal care in the clinical practice has shown the need for timely registration on clinical account of pregnant women for tests and registration on Form-111, which allows to organize conditions for safe motherhood. Standard indicators – measuring BMI, blood (hemoglobin in blood plasma) allow family nurses systematically correct status of pregnant women in some cases together with the family physician. Obtained results of the correlation interdependency of BMI with pregnancy, hemoglobin levels in blood plasma of pregnant women allowed to see the importance of these standards and gives nurses the ability to prognosticate pregnancy flow and childbirth. The need of 7 visits of specialists in the center according the standard requires further study. In our case pregnant women, who have registered under 12 weeks of pregnancy were checked at the doctors only 5-6 times.

Key words: national standards, antenatal care, pregnant women, family nurse

 

Hairulloev P.J., Hairulloeva E.J.

ACTUAL PROBLEMS OF VISUALIZATION OF THE PANCREAS

Department of Gastroenterology and Dietelogy of the State Educational Establishment «Institute of Postgraduate Education in Health sphere of Republic of Tajikistan»

 

Aim.  Determine the criteria dimensions normal pancreas depending from ages, gender and the type of constitutional.

Materials and methods. Carried out an ultrasonic examination in 78 people do not make any complaints about the diseases of the pancreas in different age groups (15 to 63 years)  considering constitutional body types and gender. Used ultrasound machine company Sanoscape with convex power sensor 5 Mhz.

Results. Studies have shown that, depending on the constitutional body type, age and gender of the pancreas dimensions may vary norm established criteria recommended by various authors.

Conclusion.  Ultrasound examination of the pancreas is difficult to study because of the location and its retroperitonalno, syntopy to surrounding organs. In estimating the size of the pancreas should be considered age-related changes, the constitutional body type and gender. Before, ultrasound of the pancreas, we recommend pre-acquainted with the medical history of the patient, taking into account the results of laboratory tests to compare them with the results of ultrasound.

Key words:  visualization, pancreas, constitutional type, age and gender

 

REVIEWS

Abdurahmanova R.F., Izzatov H.N., Hadibaeva G.R., Sharipova B.A., Rashidova O.A., Umarova Z.

DIAGNOSTICS AND TREATMENT OF

VASCULAR COGNITIVE DISORDERS (PART II)

Department of Neurology and Medical Genetics of the State educational establishment «Institute of postgraduate education in health sphere of Republic of Tajikistan»

 

The review considers serious consequences of cerebrovascular diseases – disorders of cognitive functions.In case of chronic insufficiency of cerebral blood supply the cognitive disorders became the main symptom which reflects the severity of vascular lesions of the brain.Most characteristic are the cognitive impairment of "frontal" type. Defects in intellectual-mnestical functions appear.Timely detection of cognitive disorders, before forming of vascular dementia  promotes to an earlier conducting of pathogenic therapy what slows down the disorders of informative functions.At the stage of dementia it is expedient to combine neurometabolic drugs with drugs influencing on synthesis of acetylcholine and/or acetylcholinesterase inhibitors.

Key words: discirculatory encephalopathy, cognitive disorders, vascular dementia, the risk factor

 

Ochilzoda A.A.

HEARING LOSS OF SOIL RELATED TO MARRIAGE

AS A FACTOR IN HEREDITARY DISEASE

The course of otorhinolaryngology of Hujand department of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”   

City Health Center, Hujand, Tajikistan

 

In review identified reasons of bradyacuasiaas risk factors of hereditary diseases on the basis of related marriage.According to thetajik authors is presented geographypopulation of hereditary diseases, factors such as inbreeding, because of the existence of geographic isolation. It was the analyzed clinical andaudiological features of bradyacuasiabasis of related marriage.It was noted that among local residents of Tajikistan exist hereditary-familial form of bradyacuasia.

Key words: hereditary diseases, inbreeding, interfamily marriages, audiology

 

INCULCATION OF NATIONAL STANDARDS AND PROTOCOLS

Saidmuradova R.H., Mahkamov K.K., Buzrukova N.J., Hojibekova N.A.

SEPSIS OF NEWBORN (INTRODUCTION OF NATIONAL PROTOCOL)

Departmentof Neonatologyof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

The reviewed work outlines the national protocol on sepsis of newborn, which is approved by the Ministry of Health and Social Protection of Population of the Republic of Tajikistan in 07.06.2011 (№ 318). The instructions of the said protocol indicate specific steps of actions at suspicion to sepsis in newborn. Introduction of the protocol in practical medicine has promoted the reduction in prenatal mortality rate. Material is based on available data of evidence-based medicine towards the practice in diagnostics and treatment of sepsis in the newborn of many countries in the world, including the own country experience and complies with the WHO recommendations.

Key words: sepsis of newborn, neonatal care, epidemiology, classification, sepsis clinics, risk factors, specific and non-specific symptoms, bacteremia, screening for sepsis,  treatment, breast feeding

 

4-2015

THEORY AND PRACTICE OF MEDICINE

 

Abduloev Kh.Dzh.

RISK ASSESSMENT AND DYNAMICS OF BASIC PARAMETERS OF METABOLIC SYNDROME AGAINST THE BACKGROUND OF ANTIHYPERURIKEMIC THERAPY IN PATIENTS WITH GOUT

Department of Therapy of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim.to study the effect of antihyperurikemic therapy on dynamics of basic parameters of the metabolic syndrome in patients with gout.

Materials and methods.Investigated 46 male patients to whom prescribed: allopurinol, antihypertensive drugs and statins (indicated). Criteria of the effectiveness of therapy: reduction in the frequency and duration of exacerbations, reduction in total CVD risk. Determined: glucose content (glucose oxidase method) and uric acid (UA) (colorimetric enzymatic method) in blood serum, lipid-protein blood spectrum – total cholesterol (TC), triglycerides (TG) and cholesterol of high density lipoproteins (CHDLP) by colorimetric method.

Results.While therapy with allopurinol in all patients noted a decrease of frequency and duration of exacerbations. At control examination after 12 months target values of UA < 360 mmol/l were achieved in 20 (36%) patients. In the group of "control of UA level" frequency (median 1,0 [0,0 – 2,5]) and duration (median 2,5 [0,0 – 4,0]) of exacerbations was significantly lower compared with the group "no control of UA level» (p <0,01), revealed a significant reduction of body weight (p <0,001): average BMI for each patient decreased on 0,69 kg/m². The recommended therapy (in addition to allopurinol) significantly effect on reduction of levels of SBP, LDL cholesterol, TG (p <0,001).In control terms of survey revealed a significant decrease of risk values of cardiovascular diseases by rating scales (p <0,001), while at SCORE risk decreased from high to low and medium and on a scale PROCAM – from moderate to low.

Conclusion.Risk assessments in gout patients with metabolic syndrome on a scale PROCAM is more adequate.Drug therapy with anti hyperuricemic, lipid-lowering and hypotensive drugs leads to a genuine reduction of frequency and duration of exacerbations of arthritis in patients with gout in combination with the metabolic syndrome.

Key words: allopurinol, hyperuricemia, lipoproteins, body mass index, uric acid, the risk

 

Abduloev Kh.Dzh.    

FEATURE OF ARTICULAR SYNDROME IN GOUT PATIENTS

WITH AND WITHOUT DIABETES MELLITUS TYPE 2

Department of Therapy of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim.To study peculiarities of articular syndrome in gout patients with the diabetes mellitus type 2 and without it.

Materials and methods. The study included 80 patients (78 men, 2 women) suffering from gout. 15 patients (18,7%) were diagnosed diabetes mellitus type 2 (DM type 2). All patients were determined: glucose levels (glucose oxidase method) and uric acid (UA) (colorimetric enzymatic method) in blood serum, the lipid-protein blood spectrum (colorimetric method).

Results. Prevailing in patients was arthritis of intermittent type. The duration of the articular attacks ranged, but most lasted 1-3 weeks. Constantly taking non-steroidal anti-inflammatory drugs (NSAIDs), 26 patients with chronic arthritis (32,5% of total patients). In 66,1% of patients observed hyperuricemia (HU). The average serum level of MC in patients 0,400±0,01 mmol/l in the control group 0,210±0,01 mmol/l. Among gout patients with DM type 2 were more patients with chronic gouty arthritis, average number of affected joints and frequency of arthritis attacks per year.

Conclusion.High serum levels of MC in patients with DM type 2 is associated with more severe course of the articular syndrome.

Key words: intermittent arthritis, hyperuricemia, uric acid, diabetes mellitus

 

Ashurov G.G., Karimov S.M.

EFFECTIVENESS OF TREATMENT OF COMPLICATED FORMS OF CARIES

USING THE BONDING SYSTEMS

Department of Therapeutically Dentistry of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim.Clinical and X-ray estimation of efficiency of the using dentin bonding systems under treatment of the complicated forms of caries.       

Materials and methods. In series of clinical-anamnesis and X-ray investigation studied material, received at checkup patient on mass dentistry acceptance. Basis for scientific data were the 160 patients (92 men, 68 women) aged from 20 to 50 years. In the course of endodontic examination in 94 (58,75%) patients was diagnosed chronic fibrous pulpitis, 66 (41,25%) – chronic granulating periodontitis.

Results. At nearest period of endodontic treatment beside 100% patient with chronic fibroses of pulpitis (experienced group) after filling of root channel was not revealed complaints. 20% patients of checking group (4 person) presented the complaints on weaken painful under pressure on teeth that characterized the reaction of periodont. Similar picture existed under the treatment of "chronic granulating periodontitis": in experienced group was not revealed complaints; having small reaction of endodontic treatment of the teeth on percussion was discovered in checking group beside 2 (10%) patients and these phenomenal disappeared on 2-3 day.

Conclusion. Got results graphically demonstrate that reaction bone fabrics on irritation from filling material at treatment of pulpitis was small in experienced group patient. At estimation remote result treatments of the chronic granulematosis periodontitis established reliable advantage positive result, got when use the root adhesive system in contrast with lateral condensation method of dowel.

Key words: caries, bonding system, chronic fibrosis of pulpitis, root channel, endodontic treatment

Baybabaev A.A.  Saidmurodov D.U.

ABOUT THE CLINICAL FEATURES OF

HEROIN ADDICTION IN WOMEN

Course of Psychiatry and Narcology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim.Study the features of formation and clinical manifestations of heroin addiction among women in Dushanbe.

Materials and methods. Object of clinical and katamnistical and statistical studies were 150 women – residents of Dushanbe, suffering from heroin addiction and in-patient treatment at the National Clinical Center of Narcology in the 2002-2012 years.

Results.The largest number of patients used the heroin for the first time by the intravenous route at the age from 15 to 24 years. Causes of heroin use: involving by sexual partner-drug addict (husband or domestic partner), the influence of the microenvironment, curiosity, the desire to experience new sensations.

The period of formation of psychic dependence does not exceed 4 weeks. The first treatment, on average, was preceded by the systematic use of heroin during 1,5-2 years.

Conclusion.The growth of female heroin addicts in Dushanbe due to a number of social and hygienic factors. It is characterized by a distinct influence of heroin on clinical and dynamic parameters of the female drug users, late referral to drug treatment, short-term of therapeutic remission, easily relapse.

Key words:heroin addiction, women's addiction, the motives of drug use, abstinence syndrome, remission

 

KakharovM.A., DzhuraevKh.A., AkilovKh.D.,MuminovF.B.

RESULTS OF HEMICOLECTOMY IN THE TREATMENT

OF VERIOUS VARIANTS OF MEGACOLON

Department of Surgery with the course of Topographic Anatomy Khujand compartmentof the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”, Khujand

 

Aim.Assessment of the effectiveness of left-sided hemicolectomy in surgical treatment of various versions of dolichocolon.

Materials and methods. Analysis of surgical treatment of 32 patients with various versions of dolichocolon was presented. Women were 22 (69%), men – 10 (31%) aged from 16 to 76 years (average age 44,3±6,5 years). In the planned order operated 21 (66%) patients in the emergency – 11 (34%). Algorithm of survey include: collection of general clinical analyzes, ultrasound, ergography, colonoscopy, roentgenography, according to testimony – other methods.

Results. The indication of emergency surgery was sigmoid colon volvulus. All surgeries made from the middle-midline route. Taking into consideration disproportion of the diameter of abductor and efferent colons, the content of handouts was about left-sided hemicolectomy with appliance of end transverse colostoma. At operated on an emergency basis noted 3 complications: in one case necrosis and retraction of stoma, in 2 cases – wound complications. In the period from 3 to 8 months, patients were re-hospitalized for reconstructive surgery.

Indications for planned operative measure were set after a comprehensive survey.All the patients (21) were operated: 18 (86%) made a left side hemicolectomy, 3 (14%) – extended hemicolectomy in left. The complication was observed in one patient in the form of anastomotic leak. In 2 patients were postoperative wound complications.

Conclusion.As emergency order at various variants of dolichocolon recommended execution of the two-stage surgical interventions, as well as planned – execution simultaneous hemicolectomy in the left by overlay of tarnsverzosigmoid anastomosis.

Key words: Payr's disease, megacolon, dolichosigma, hemicolectomy

 

Mukhtarova P.R., Shamsidinov B.N., Shaidoev S.S., Olimov T.K.

THE RECURRENT ADENOID OVERGROWTH AMONG CHILDREN

Department of Otorhinolaryngology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. To determine the etiologic factors of adenoid vegetation relapse.

Materials and methods. The study involved 70 children with recurrent adenoids. Was collected the anamnesis, skin tests with bacterial allergens was performed, the study of peripheral blood, cytology of the nasal mucosa and throat.

Results. Among the examined patients boys (60%) were prevailed. During the study in 72% of surveyed determined the I-II degree of adenoid overgrowth. Most recurrences occurred more often in children aged from 3 to 7 years. Adenotomy was held from 1 to 3 times, prevailed patients in whom the operation was carried out once. 43% of children suffered from various allergic diseases. In the investigation of peripheral blood, in 32% revealed eosinophilia, not connected with worm infestation which indicates the organism sensibilization.

In 57% (40) adenoids were removed partially, possibly because of a technical error or any anatomical features of patients cranium.

Conclusion. The most common causes of recurrent of adenoid overgrowth are factors such as allergic diseases, as well as incorrectly carried out adenotomy.

Key words: adenoid overgrowth, lymphoid tissue, adenotomy, eosinophilia

 

OdilovA.Yu., KadyrovZ.A.,  IshonakovKh.S., SaydulloevL.

CURVE OF LEARNING DURING SINGLE-PORT

LAPAROSCOPIC NEPHRECTOMY

Department of Endoscopic urology of advanced training faculty of medical workers ofMedical Institute of Peoples' Friendship University of Russia

 

Aim.The definitions of curves learning of specialists with the single-port laparoscopic nephrectomy.

Materials and methods.The paper summarizes the results of analysis of examination and treatment of 79 patients after a single-port and multi-port laparoscopic nephrectomy on the bases of Treatment and rehabilitation Center of Ministry of Health of the Russian Federation and the City Clinical Hospital №7 of Moscow.

Results. The main group consisted of 37 (46,8%) patients undergoing nephrectomy from a single laparoscopic access. Control group consisted of 42 (53,2%) patients who underwent multi-port laparoscopic nephrectomy. The average duration of operation in the main group was 140 minutes in the control group – 130 min. Total intraoperative complications in the two groups were 7 (8,8%) cases. Frequency of intraoperative complications in the main group was in 2,5 times are lower compared with the control. Intraoperative complications in the main group arise in 2 (5,4%) patients in the control group – in 5 (11,9%). Postoperative complications were observed in 6 (16,2%) patients of the main and 4 (9,5%) – the control group.

Conclusion. During the assessing of results of nephrectomy from a single laparoscopic access (volume of intraoperative blood loss, length of postoperative hospital days, the time of surgery) learning curve accounted 21 operation. Implementation of nephrectomy from a single laparoscopic access may be the method of choice.

Key words: single laparoscopic access, single-port laparoscopic nephrectomy, multi-port laparoscopic nephrectomy

 

Rofieva Kh.Sh., Narzullaeva A.R., Muradov A.M.

SOME STRUCTURAL FEATURES AND INDICATORS OF INTRACARDIAL HEMODYNAMICS AMONG WOMEN WITH ACUTE MYOCARDIAL

INFARCTION IN PERIMENOPAUSAL PERIOD

ACCORDING TO RESULTS OF ECHOCARDIOGRAPHY

Republican Clinical Cardiology Center of Dushanbe

Department of Efferent Medicine and Intensive Care of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Department of Cardiology with the course of clinical pharmacology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Aim. Studying of echocardiography researches at women with acute myocardial infarction (MI) in perimenopausal period

Materials and methods.  Research is based on studying of clinical and functional features results of an ischemic heart disease at 99 women of the age from 45 to 60 years in perimenopausal period.Depending on infringement degree menstrual functions all patients have been divided into 2 groups: I-st group was consist of50 women in preminopausal period, and also women at whom was registered irregular menstrual cycle for last 3-11 months (middle age – 45,1±0,6 years). 49 women have been included in II-nd group (middle age60,6±0,6 years) at whom was not observed menstrual function more than 1 year, i.e. the woman in postmenopausal period.

Results. The research has shown high prevalence of a left ventricular (LV) hypertrophy in both investigated groups – 88 % of women that is an indicator of high risk of cardiovascular complications, in this case an acute myocardial infarction. The tendency to higher degrees of eccentric LV hypertrophy expressiveness at women in postmenopausal period, in comparison with women in premenopausal and menopausal periods that is caused by deeper reorganisation of haemodynamics (systolic dysfunction and heart cavities expansion) at the given category of patients, owing to transferred extensive MI with a severe clinical current is revealed also.

Conclusion. Higher degree of eccentric LV hypertrophy expressiveness at women in postmenopausal period, in comparison with women in in premenopausal and menopausal periods, it is caused by deeper reorganisation of haemodynamics (systolic dysfunction and heart cavities expansion) at the given category of patients, owing to transferred extensive MI with a severe clinical current.

Key words: acute myocardial infarction, perimenopausal period

 

 

Khayrulloeva E.D., Ismailova M.A., Zamirova N.S.

                       HEALTH STATUS OF CHILDREN'S FIRST YEAR OF LIFE 

IN DIFFERENT TYPES OF FEEDING

Department of Pediatric of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim. To study the features of development of children's first year of life, depending from the nature of the feeding in order to optimize nutrition.

Materials and methods.Under the supervision during the year were 86 children (46 boys and 40 girls) of the first year, I-II health groups, receiving different types of feeding (breast milk and baby milks, characterized by the composition).

Results.Work was carried out in 3 stages: I stage – analysis of feeding of first year children in Dushanbe; II stage – characteristics of children and their health, depending from the type of feeding; III stage – prospective study after children during 1 year.The number of children which are on breastfeeding in Dushanbe, increased over the last 13 years in all age groups: from birth to 3 months from 47% to 91,5%; 3-6 months – from 25% to 75,3%; 6-12 months – from 10% to 52,9%. In country, the figure is averaged about 80-86%.

Conclusion.Feeding by breast milk or baby milks, enriched with long chain polyunsaturated fatty acids and prebiotics, promotes to harmonious physical and psychological development, improve the body's resistance of children, improving intestinal microbiocenose and reduction of functional disorders of the digestive system.

Key words: feeding of children, state of health, children up to 1 year, physical and neuropsychological development

 

Khaknazarov Kh. Sh., Amonov B.P., Nurova A.S., Azizov A.T.

BASIC PRINCIPLES OF IMMUNOSEROLOGICAL

SAFETY DURING BLOOD COMPONENTS TRANSFUSION

Course of transfusiology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

LHPGKB №5them.ak. K.T.Tadzhieva, Dushanbe

 

Aim.To optimize the system of complex laboratory inspection of donors and recipients, targeted on prevention posttransfusion reactions and complications in the conditions of multidisciplinary health care facilities.

Materials and methods.In order to investigate the distribution of blood groups in the system of AB0 in Dushanbe were transfused blood from 9895 donors to 6780 patients during 2010-2014. Before the transfusion erythrocyte-containing components of blood was conducted the definition of the phenotype of  8 transfusion dangerous antigens: A, B, D, C,E, c, e, K.

Results. Were analyzed the frequency of occurrence of antibodies of "Rezus" system  in donors and recipients. The overall index of sensitization among the population of Dushanbe was 1,10%. It is revealed the following distribution of antibody specificity: anti-D antibody occurred in 42,5% of the examined persons, anti-S in 12,5%, anti-C in 13,8%, anti-E in 30,0%, anti-e – in 1,2%.

Conclusion.In most cases, in a careful performing of trial on group and rhesus compatibility detected agglutination of red blood cells caused by the incompatibility by the antigens, which does not belong to the system of AB0 and rhesus.

Key words:antigens, antibodies, phenotypes, incompatibilitygroup factors, transfusion environ, blood components

 

KhushvakhtovD.I., ShakirovM.N., RizoevR.R., DzhonibekovaR.N. 

CYSTECTOMY WITH THE FILLING OF THE BONE CAVITY

 POROUS-PERMEABLE NIKELID–TITANIUM ENRICHED

WITH PLATELET DERIVED MASS

Department of Maxillofacial Surgery with Children Stomatology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Aim.Improving the efficiency of surgical treatment of patients with odontogenic cysts of the jaws based on the use of finely granulated porous-permeable nikelid titanium enriched with platelets.

Materials and methods.Carried out surgical treatment of 32 patients with cystic formations jaw bones for the period of 2013-2014.There were 21(57,1%) men and 11 (42,9%) women aged from 19 to 55 years. In 22 (72,8%) patients diagnosed with radicular cysts, 3 patients (6,3%) – follicular, 7 (21,6) – cystogranuloma. For the "sealing" of bone cavities after cystectomy is used finely granulated nikelid titanium having a particle size of 10 to 500 micrometers and the porous membrane from the same material in combination with platelet-rich mass obtained ex temphorae.

Results. Observations of patients after surgery for a year testify to the high effectiveness of the used method. Primary bone regeneration in the bone cavity is completely formed within 6-8 months, as evidenced by indicators with integrated digital orthopantomography finely granulated nikelid titanium.

Conclusion. Treatment of patients with the proposed method demonstrates its advantages, allowing to obtain selective bone formation in the operated area with the formation of their own bone regeneration in a short time. The method is convenient, simple, affordable, economically viable and can compete with other methods.

Key words: cystic formation, finely granulated nikelid titanium, tissue nikelid titanium, platelets

 

ShamsiddinovA.T., AkhmedovA., TanzhikholovU.Kh., RakhimovM.D.

THE SPREADING AND STRUCTURE OF TEETH AND JAW’S PATHOLOGY IN CHILDREN AND TEENAGERS IN DUSHANBE AND THE NECESSITY OF THEIR CORRECTION

Department of Orthopedic Stomatology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Department of Public Health, Economic, Management and Medical Statistics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Stomatological Center of the Khatlon Region

 

Aim. Estimate the spreading and structure of teeth and jaw’s pathology in children and teenagers in Dushanbe and the necessity of their correction.

Materials and methods. There by the authors had spent retro prospective and prospective analyses of the cards of 1596 patients, which were applied for orthodontic treatment during 2014 into the children stomatological clinics, according to established by the WHO card (1983) “The combined card for the stomatological research and the determination of the necessity  for  treatment”.

Results. Investigations have established that in a significant number of surveyed children of school age were observed joint of anomalies of teeth, anomalies of the row of teeth and teeth position with the pathology of bite and also the presence of some kind of biting at the same time. Anomaly ofbite in children under school’s age found in 46,38%, which is connected with the earlier extraction of the milk teeth and the presence of bad or harmful habits.

Conclusion.The milk – teeth of young children catch the measure of the preventive treatment  of caries easily, that may allow to keep the wholeness of the rows of teeth of the child and to bring down the number of anomalies.

Key words: complex treatment, caries, dentoalveolar anomalies, children, teenagers

 

Sharopova N.M, Zokirov A.Kh., Gafurova Sh.A.

EXPERIENCE OF APPLICATION MEDOLAPRAMA

IN THE THERAPY OF PANIC DISORDER

Department of psychiatry and narcology named after professor M. G. Gulyamov of  the TSMU named after Abuali ibn Sino

 

Aim. To research the effectiveness of medolapram in patients with panic disorder who received outpatient treatment by a psychiatrist in the 2014-2015.

Materials and methods. The research is based on the results of application of Medolapram in 50 patients with panic disorder in an outpatient setting. From the total number of surveyed 96% (n = 48) were men and 4% (n = 2) – women. Average age was 37 years. Medolapram given to patients 10 mg per day, once in the morning. In the absence of the effect the dose was increased after a week to 20 mg in one dose. The duration of therapy was 1 month. In work were used clinical-psychopathological and clinical statistical methods.

Results.Results showed that the clinical effect manifested itself, starting the 2nd week in therapeutic doses: decreases feeling of alarm, improves appetite, sleep, mood. Noted subjective significant for the patient's improvements: partial restoration of capacity for productive activities, reducing of physical stress, discomfort, panic. To the completion of the course of therapy – an almost complete reduction of the symptoms of panic disorder.

Conclusion.Proved highly effective of medolapram combined with good tolerance by patients and convenience of its application – once morning.

Key words: panic disorder, medolapram, depression, psychiatry

 

REVIEWS

 

Abdurakhmanova R.F., Izzatov Kh.N., Khadibaeva G.R., Sharifova B.A., Rashidova O.A.

DEPRESSION IN NEUROLOGICAL PRACTICE:

USE OF ANTIDEPRESSANTS

Department of neurology and medical genetics of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Actuality of the problem determined by the widespread of depressive disorders in the general population, the tendency to prolonged and chronic course and a high suicide risk. There is a high comorbidity of depressive disorder with neurological disorders: then longer the neurological disease, the higher the risk of depression. In neurological practice observed atypically occurring, somatisation depressions when patients do not impose specific complaints, and constantly experiencing persistent physical symptoms, such as constant fatigue, chronic pain or multiple autonomic disorders. The basis of depression amounts a violation of synthesis and metabolism of serotonin and norepinephrine in the synaptic cleft. When is chronic depression is noted hypercortisolemia which promotes the formation of insulin resistance, arterial hypertension, hyperproduction of steroids, hyperglycemia, hypercholesterolemia, and a hypercoagulation, increase the risk of cardiovascular complications. Antidepressants reduced levels of monoamines, improve neuroplasticity.

To neurologists need knowledge about the risk factors, mechanisms of development and about clinical depressions. In the treatment of antidepressants second and third generation preferred that are easily transported, are not toxic, are safe for overdose, have no behavioral toxicity and have a minimum of drug interactions.

Key words: depression, antidepressants, neuronal plasticity, depressive disorders, cognitive disorders

 

DzhuraevM.N., KarimovaN.I., RakhimovaS.A., AkbarovaM.M., KurbonovN.M.

LATEX ALLERGY

Department of Allergology and Immunology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

From 1990 the problem of latex allergy began acquiring the features of epidemic of allergy. More often messages of the various manifestations of latex allergy especially among health workers, among workers engaged in the manufacture of rubber, and other employees, typically use rubber gloves (for example, working in greenhouses) appear. From 50% to 65% of patients with latex allergy are also sensitive to plant products, especially to fruits and vegetables which due to similar epitopes of protein molecules of latex and plant products. The article presents the data of different authors about the epidemiology, etiopathogenesis of this, clinical variants, diagnosis, treatment and prevention of latex allergies.

Key words: latex, rubber, caoutchouc, atopy, polyvalent allergy

 

INCULCATION OF NATIONAL STANDARDS AND PROTOCOLS

 

MakhkamovK.K., BuzrukovaN.Dzh.,SaidmuradovaR.Kh.

HEMOLYTIC DISEASE OF THE NEWBORN

(NATIONAL PROTOCOL)

Department of Neonatology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

In this study, consecrated national protocol – hemolytic disease of the newborn, adapted in the form of training material, tests for monitoring the acquired knowledge of Department of Neonatology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan” and included in the training program of neonatologists on cycles of residency, internship, specialization and thematic improvement.

The instructions in this protocol conform to WHO recommendations are based on evidence-based medicine, and provide specific action steps at the incompatibility of blood between mother and child.

Key words: hemolytic disease of the newborn, hemolysis, neonatal care, classification of jaundice, erythrocyte, phototherapy, blood, blood transfusions, the treatment standard

 

 

IN ASSIST TO PRACTICAL PHYSICIAN

 

Khisomova Kh.K., Mirzoeva Z.A.

USING OF THE TEST STRIPS IN THE DIAGNOSIS OF URINARY TRACT INFECTION

IN THE PRACTICE OF FAMILY DOCTORS

 

Department of Family Medicine of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

 

Systematic studies at different levels of health care services demonstrate high accuracy of the test in the diagnosis "infection of urogenital system" (IUS). The effectiveness of the test was assessed among the general population, including children, pregnant women, elderly patients, patients with urological pathology. The sensitivity the test using the nitrite or leukocytes was highest at IUS in patients at the primary level (90%) and relatively low in pregnant women (68%). The specificity of the diagnosis of IUS at the primary level was 65%. Clinical value of analysis depends on the likelihood of disease. For the diagnosis of UTI is important the test for definition of leukocyte esterase and nitrites.

Introduction into the practice of family doctors the use of the test strips will reduce the duration of diagnosis, increase cost-effectiveness.

Key words:urinary tract infection, family medicine, diagnostics

 

 

 

 

 

 

 

 

 

 

1-2016

THEORY AND PRACTICE OF MEDICINE

 

AbdurahimovZ.Z., GulmuradovT.G., KarimovE.E., AminovR.S., KurbonovaM.A.,

NazarovSh.

 

MODERN ASPECTS OF DIAGNOSTIC AND SURGICAL TREATMENT

OF HEART ATRIUMMIXOMS

 

Department of Cardiovascular, Endovascular and Plastic Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Evaluation of informativeness of diagnostics methods and treatment results of heart atrium myxoma.

Materials and methods.In the Republican Scientific Centre for Cardiovascular Surgery (clinical base of the department of Cardiovascular, Endovascular and Plastic Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”) from 2005 to 2015 15 patients with cardiac myxoma between the ages of 13 to 75 years (mean age 38,4 years) were investigated. There were 5 men, 10 – women.   

Diagnosis of cardiac myxoma was carried out on basis of common clinical examination, data of chest radiography, echocardiography and morphological study of tumors.

Results.According to echocardiographic data, in 12 patients myxoma located in the left atrium. Ejection fraction was 60% or higher. The dimensions of left atrium in 10 patients were greater than 40 mm, ranged between 40-54 mm. The dimensions of right atrium were increased from 47 to 50 mm.The dimensions of the tumor of left atrium ranged from 50×30mm to 100×80 mm. The operation was performed under extracorporeal circulation. The tumor was removed by the leg with its cauterization using coalescent.Excision of the oval window reduced by a patchwork from autoperikard by imposition of continuous prolene suture 4/0.The postoperative period in all patients was uneventful, wound healing by was first intention. All patients were discharged in a satisfactory condition.

Conclusion:Myxoma of left atrium heart often accompanied by embolism of vessels of vital organs. The main method of diagnosis of heart myxoma is echocardiography. During the diagnosis of heart myxoma patients neededin emergency surgery to remove the tumor under extracorporeal circulation.

Key words: diagnostics, atrial myxoma, echocardiography, surgical treatment, extracorporeal circulation

 

Akhmedov F. A., Juraev Kh. Sh., Zabirov N. N., Saidov A. A., Pirmatova D. A.

 

INVESTIGATION OF CHEMICAL COMPOSITION AND SOLUBILITY OF CHOLESTERIC STONES OF DIFFERENT GENERATION

 

 

State Scientific Research Institute of Nutrition of Republic of Tajikistan

Department of Pharmacy of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

The National Diagnostic Center

Aim. Investigation of the chemical composition and solubility of cholesterol stones of different generations.

Materials and methods.Studied the cholesterol stones, removed during surgery. Exploration of density subjected on gallstones of three generations by classification of Kh. Kh. Mansurov. By various techniques (an IR-spectrometry, nuclear magnetic resonance, emission spectral analysis and others) the components of stones were identified. Pure cholesterol took up a control sample.

Results. At physicochemical studies revealed that cholesterol structure at the base of cholesterol stones does not differ from the cholesterol extracted from the sediment of bile in cholelithiasis and crystalline cholesterol. By the method of semiquantitative spectral analysis were identified micro- and macroelements in a whole stone, in his shell and in core. The results showed that the most dense stones were at 1st generation, where cholesterol is equal to 88,4%, and the least dense – stones of the 3rd generation, in which cholesterol content was equal to 45,0%. After gallstones processing by chenodeoxycholic, ursodezooksiholic acids and their mixtures was determined the dependence of their solubility from density and generation.

Conclusion.The solubility of cholesterol stones is directly dependent from the generation of stones and of their density.

Key words: cholesterol, cholesterol stones, chemical composition, micro- and macroelements, cholelithiasis

 

Ashurov G.G., Mullodzhanov G.E., Karimov S.M.

 

USING OF THREE-DIMENSIONAL DENTAL COMPUTER TOMOGRAPHY FOR ORTHOPEDIC TREATMENT OF OCCLUSION DEFECTS BY DENTAL IMPLANTS UNDER DIFFERENT DIRECTION OF BETWEENSYSTEMIC  DISORDERS

 

Department of Therapeutic Dentistry of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

Aim.Estimation the results of using three-dimensional computer tomography in step of planning of dental implantations and the further orthopedic treatment of occlusion defects beside patients with accompanying somatic pathology.

Materials and methods.Studies conducted on clinical base of the Department of Therapeutic Dentistry of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan» (society with limited liability of «Smile»), being single dentistry clinic in Republic of Tajikistan, giving x-ray facilities with using of three-dimensional dental computer tomography. Work is founded on test result using of three-dimensional dental computer tomography beside 65 patients with disadvantage somatic background. Amongst examined persons from accompanying diseases are discovered: beside 22 (33,8%) patient – hypertensive disease, beside 15 (23,1%) – ischemic disease of the heart (7 of them carried the heart attack of the myocardium), beside 5 (7,7%) – polyvalent allergy, beside 23 (35,4%) – diabetes mellitus 2nd type in compensative form.

Results. The experience of using of three-dimensional dental computer tomography is indicative of high infirmity of this method when use of dental implants, as well as about possibility of increasing of quality and efficiency of implantology treatment on the base of got given beside patients with commonsomatic pathology. Dental's three-dimensional tomography allowed executing visual and metric studies of the bone structures of the jaw bones, in three mutually perpendicular plane, conduct linear and angular measurements, use of densitometry in conditional unit for estimation of bone density in zone of supposed implantations.

Conclusion. Due of high contrast scenes of the bone structures of teeth-jaw's system, as well as possibility of the study of the patient in miscellaneous plane without change of its position and without additional beam load, three-dimensional dental computer tomography is very informative method for complex feature of the zone of dental implantations.

Key words: teeth-jaw's system, three-dimensional dental computer tomography, somatic pathology, mandibular canal, upper jaw's sinus.

 

Kasymova M.K., Bobokhodzhaeva M. O.

 

SEXUALLY TRANSMITTED INFECTIONS, AND HIV,

MORBIDITY OF COMMERCIAL SEX WORKERS

 

¹Department of Public Health, Economics, Management of health with the course of medical statistics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

²Department of Obstetrics and Gynecologyof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.Analysis of the dynamics of STIs/HIV among commercial sex workers during the implementation of integrated approach in order to change behavioral factors and reduction of STI/HIV infection risk in vulnerable groups of women of reproductive age.

Materials and methods.The study included 1220 women, who engaged commercial sex work in Dushanbe. Was studied theirdeviant behavior, conducted a sociological survey.

Conducted clinical and laboratory tests for STIs/HIV before and after the introduction of integrated approachin order to change behavioral factors and reduction of STI/HIV infection risk.Privacy and anonymity was ensured by the coding system.

Rezults.On the growth and spread of STI/HIV infection influence behavioral factors ofsex workers such as: early age of onset of commercial sex, multiple sexual contacts, disregard the rules of safe sex.

Revealed the limited access to services of reproductive and sexual health, as well as the phenomenon of stigmatization.The result of research was a developed integrated approach method in oder to change behavioral factors and reduce the risk of infection with STI/HIV in vulnerable groups of women of reproductive age.

Conclusion.The developed method is effective for a significant reduction of STI/HIV morbidity and proving its effectiveness in changing of behavioral factors in the case of a single holistic approach.

Key words: STI/HIV, sex workers, an integrated approach, the risk factors

 

Kosimov Z. K., Abdulloev S.S, Khidirov A.F., Khonov Dzh., Atakulaev N.B.  

 

HEMODYNAMIC PARAMETERS OF GREATER CIRCULATION IN PATIENTS WITH PERITONITIS

 

Department of Anesthesiology and Reanimotology of  State Educational Establishment

«Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.Set the degree of functional disorders of hemodynamics of greater circulation and reveal the dynamics of these changes according to the degree of severity of peritonitis.

Materials and methods.The study included 50 patients with peritonitis on the following parameters: heart rate; stroke index, ejection second volume; cardiac index; total peripheral vascular resistance; systolic arterial pressure; diastolic arterial pressure; mean dynamic arterial pressure ; left ventricular work index.

Results.In patients with peritonitis observed interrelated and changing during the pathological process disorders of the central hemodynamics, which severity depended from the degree of severity of toxemia. Comprehensive dynamic study of general hemodynamics in patients with peritonitis revealed the development of circulatory failure as a result of development of cardiovascular disease which is in direct dependence from the severity of toxemia.

Conclusion. With increasing of severity of peritonitis progressively increases insufficiency of hemodynamics of greater circulation caused by hypovolemia, reduction of cardiac output, inhibition of the contractile function of the heart.

Keywords:hemodynamics, peritonitis

 

Makhkamo vK.K., Buzrukova N.D., Saidmuradova R.Kh., Khоjibekova N.O.

 

SOME ASPEKTS OF CYTOMEGALOVIRUS INFECTION

IN NEWBORNS

 

Depatment of neonatology and of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.To study some epidemiological and clinical aspects of cytomegalovirus infection (CMV) in newborns.

Materials and methods.Conducted clinical and laboratory examination of 180 newborns with congenital pathology and their mothers.

Results. The complex comprehensive clinical and laboratory examination of mothers and newborns with symptoms of congenial CMV infection or related to high – risk realization of intrauterine infections has showed unspecific character which characterized by prematurity, defeat of central nervous system (CNS), liver, kidneys and lung. Abortion and stillbirth has been was noted in 45,3% of women. In 27,1% of women pregnancy has passed on the background of acute respiratory diseases. In 43,3% of cases the pregnancy were finishing with premature birth.

Significantly more frequently cytomegalovirus infection was observed in boys. The leading features of violations of adaptation in the early neonatal period, in these newborns were asphyxia and CNS involvement. These indicators in most cases have been observed in premature (p< 0,001).

Conclusion. Assessment of risk factors for CMV infection is essential for early diagnosis and treatment of this group of children.

Key words: newborn, cytomegalovirus infection, risk factors of intrauterine infection realization

 

¹MinasovB.Sh., ¹YakupovR.R., ¹AskarovA.F., ¹KarimovK.K., ²SirodzhovK.Kh., ²KholovD.I., ²IsupovSh.A., ²RakhimovA.T.

 

SURGICAL TREATMENT OF PATIENTS

With Post-traumatic lesions of the proximal unit 

femur under arthroplasty technology

 

¹SBEI HPE "Bashkir State Medical University" Ministry of Health of the Russian Federation, Ufa

²State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”, Dushanbe

Aim. Comparison of results of curing patient for arthroplastyhip jointtechnologyafter heterotypic-reparative  maneuver  of proximal unit of femus.

Materials and methods.124 patients were examined, of which two groups were formed: basic – 81 patients identified in two subgroups,who underwent hip joint arthroplasty after reduction-reconstructive surgery at the proximal femur;43 patients presented control group with idiopathic hip joint osteoarthritis who underwent primary arthroplasty.

Results.hip arthroplasty in patients after the reduction-reconstructive surgery at the proximal femur accompanied by a decrease in the range of useful properties of this surgical technology that requires a special approach to the treatment of these patients.

Conclusion.Revealed that using of modern possibilities of radiation diagnosis, in pre-surgical design process based on solid modeling and optimization of rehabilitation allows to improve the results of treatment: reduce the level of pain, improve functional status and quality of patients life.

Key words:hip joint, arthroplasty, reducing-reconstructive surgery, phase state, connective tissue

Mirzoev M.Sh., Shakirov M.N., Mirzozoda Sh.M., Salimov B.A.

 

COMPREHENSIVE TREATMENT OF ODONTOGENIC ROTTEN NECROTIC PHLEGMON OF THE MAXILLOFACIAL REGION IN A HOT CLIMATE OF THE REPUBLIC OF TAJIKISTAN

 

Department of Maxillofacial Surgery with Children’s Stomatology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Improving the efficiency of complex treatment of patients with odontogenic putrid necrotic phlegmon of the maxillofacial region in a hot climate of the Republic of Tajikistan.

Materials and methods. The article presents materials of treatment of 38 patients with putrid-necrotic phlegmon of the maxillofacial region in age from 18 to 67 (men – 22, women – 16). For drainage of opend spaces had been used different dilatation devices from NiTi alloys brand of VT-10 and VT-20. For correction of the immunological status was used immunomodulatory drug timofer in an amount of 1 ml (148 mg) intramuscularly course of 10 days. For drainage of wounds were used dilatation devicesaccording to topographic anatomical localization of the pathological process; muscle tension power, the prevalence of suppurative inflammation and the presence of necrotic masses.

Results.Treatment outcomes were evaluated on parameters: no complaints, good general condition, normalization of appetite, disappearance of edema, exudation termination, resorption of infiltration, granulation and epithelialization of wounds, normalization of white blood cell count, as well as the patient's stay in the bed.

Conclusion.Application of immunomodulator-timofer on background of dilatation method of drainage of purulent wounds demonstrates its high performance in complex treatment of patients with putrid-necrotic diseases of the maxillofacial region in a hot climate, it normalizes the immune status of patients, improves tissue regenerative capabilities.

Key words:putrid-necrotic phlegmon, maxillofacial area, dilators from NiTi, timofer

 

Ortikova M.M., Mirzoeva Z.A., Davlyatova D.D.

 

SCREENING OF HELMINTH DISEASES IN 2015

 IN CITY HEALTH CENTER №1 OF DUSHANBE

 

Department of family medicine of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Study and analysis of the prevalence of helminthic infestation among fixed population of City Health Center №1 Dushanbe Republic of Tajikistan of  2015.

Materials and methods.Monitored 134 patient cards retrospective method of fixed population of City Health Center №1 Dushanbe Republic of Tajikistan for the period from January 1 to December 31, 2015. Was the screening of helminth diseases among the fixed population. Were estimated basic knowledge of specialists of family medicine on the treatment and prophylactic medical examination, according to the national protocol of Ministry of Health and Social Protection of Population of the Republic of Tajikistan.

Results. The greatest number of helminth diseases identified in April 2015 – 27 (20,1%), in February – 22 (16,4%), the lowest – in March (4 – 2,9%) in December (6 – 4,4 %). Monitoring has shown that the practice of family doctors are not proficient in the full volume non-drug and drug treatment, appointments are not comply to the standards of treatment, no use data of evidence-based medicine, appointed by the irrational antihelminthic therapy.

Conclusion."The national program of struggle against helminth diseases in the Republic of Tajikistan for the period 2011- 2015 years" in City Health Center №1 Dushanbe, whose purpose – reducing the helminth diseases among the population, carried out by screening of helminthic invasion among family members, and timely treatment.

Key words: screening, family doctor, helminth infections, primary health care

Rasulov S.R., Boeva Kh.K.

 

RESULTS OF COMPLEX TREATMENT OF FIBROCYSTIC DISEASE OF THE MAMMARY GLANDS USING PREPARATION “FARESTON”

 

Department of Oncology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.To explore the effectiveness of fareston drug in treatment of fibrocystic mammary glands disease.

Materials and methods. We observed 45 female patients with fibrocystic disease aged 32-51. Quantity of births from 1 to 4. There were complaints about the pain and heaviness in mammary gland for a few days before menstruation, a sense of engorgement, increased density of the mammary glands, the presence of palpable seals. Earlier 86,7% (39) patients received complex treatment, including indinol drug, without the desired effect. Fareston assigned in a dose of 60 mg / day to 9 (20%) patients and 20 mg / day to 36 (80%) patients. Treatment duration was 2 months.

Results.Regardless of the dose of the drug, in 21 (46,7%) patients after two months of therapy completely disappeared pain and engorgement in mammary gland, not palpable compaction. In 11 (24,4%) of women recorded significant reduction in symptoms and consolidation of the mammary gland. The lack of effect was observed only in 2 (4,4%) patients. In the first weeks of therapy in 2 (4,4%) women noted persistent headaches, dizziness, nausea and vomiting, in connection with which the drug was canceled.

Conclusion.The high efficiency of Fareston in patients with proliferative forms of dishormonal hyperplasia of the mammary gland (70,7% of cases) allows to recommend this drug in the treatment of this disease. Side effects while taking the drug are negligible. The duration of treatment may be from 2 to 4 months.

Key words: mammary gland, fibrocystic disease, fareston

 

¹Rafikov S.R., ²Makhmadov F.I., ¹Rasulov N.A., ¹Muminov S., ¹Zokirov R.Kh.

 

WAYS OF IMPROVING RESULTS OF SURGICAL

TREATMENT OF "DIFFICULT" GALLBLADDER

 

¹Department of Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

²Department of Surgical Diseases №1 of Tajik Medical State University named after Abuali-ibn-Sino

Aim.Improving the results of surgical treatment of patients with "difficult" gallbladder by developed methods of prevention of sub- and postoperative complications.

Materials and methods. It is showed analysis of results of surgical treatment of 79 patients with "difficult" gallbladder who underwent laparoscopic cholecystectomy in the City Clinical Hospitals ambulance in Dushanbe.

Results. During the laparoscopic cholecystectomy authors applied a number of developed methods as for the diagnosis as well prevention of iatrogenic injury. At the same time length of hospital stay after surgery was 4,9±1,1 days. Conversion was performed in three patients after conducted sub operating cholangiography, which revealed abnormalities of hepaticocholedochus, including Mirizzi syndrome III-type (n = 2) and a short cystic duct (n = 1).

Conclusion. In "difficult" the gallbladder in conjunction with the adhesive process in all six patients of the main technical challenge was the surgical approach. In all cases it was performed according to Husson. After installing the first trocar and video cameras have established additional trocars and laparoscopic dissection of adhesions was performed only within optimal access to perform laparoscopic cholecystectomy.

Key words: cholelithiasis, "difficult" gallbladder, laparoscopic cholecystectomy, Mirizzi syndrome

 

Shamsidinov A.T., Fayzov K.S., Tanzhikholov U.Kh., Ismoilov F.N.

 

SYSTEM FOR EARLY DETECTION AND REHABILITATION OF CHILDREN AND ADOLESCENTS WITH DENTOALVEOLAR ANOMALIES IN DUSHANBE

 

Department of Orthopedic Dentistryof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

prospects of its development and development of complex measures for its improvement.

Materials and methods.Conducted research of 2940 children aged 3-15 years in 2012-2015, who applied to children's dental clinic for treatment, and 419 just surveyed.All children and adolescents were divided into four age groups according to the stages of formation of temporary and permanent occlusion of teeth. Particular attention was paid to the presence of concomitant somatic pathology. Survey results were recorded in the WHO chart.

Results. High prevalence of dentoalveolar anomalies and deformations in surveyed children and adolescents (62,48%)was revealed. It characterized by the age variability.Bad habits contribute to the emergence of majority of dentoalveolar systems anomalies.The lowest frequency of dentoalveolar anomalies noted during temporary occlusion – 37,52%, in the early and late stages of mixed dentition it increases to 66,9%.The highest level of availability in oral cavity of orthodontic apparatus observedin the group of 6-9 years (11,54%).

Conclusion.Early diagnosis and prevention of dentoalveolar anomalies and their timely treatment prevent resistant of occlusion abnormalities and facial shape changesas, well as common disorder of the body.

Needs in children's orthodontic care in districts of Dushanbe was: Sino district – 76,2%, Shohmansur district – 69,4%, Somoni district – 77,7%, Firdavsi district – 75,7%.          

Key words: early removal of teeth, dentoalveolar anomalies, orthodontic treatment

 

Shamsidinov B.N., ¹Azizov K.N., Mukhtarova P.R., ²Karimov K.Kh.

 

NEXT AND LONG-TERM RESULTS OF SANITIZE

EAR SURGERY WITH TYMPANOPLASTY

 

Department of Otorhinolaryngology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

¹National Medical Center of Republic of Tajikistan

²CityHealthCenter№ 5

Aim.Evaluate the efficacy of surgical treatment of patients with chronic suppurative otitis media.

Materials and methods.Present the results of treatment of 34 patients with chronic suppurative otitis, which was carried out sanation surgery with different variants of hearing improving operations.Achieved general and otorhinolaryngological studies. Hearing investigated by whisper, spoken, loud speech, also patients were examined by kamertonal and audiometric examination.Checked the patency of auditory tube, stapes mobility and the round window membrane.To all patients was made ear CT. Depending from the degree of destructive changes in the structures of the middle ear, the patients were divided into 4 groups.Selection of tactics of surgical treatment directly depended from degree of destructive changes of structures of the middle ear and hearing impairments.

Results.As a result of the treatment in all patients of the first group (10) with radical surgery with small plastic rheum ended. In the second group of patients (7) with epitimpanalnoy cholesteatoma was performed  the attikoantrotomy and tympanoplasty.In all patients also rheum stopped, hearing improved in the postoperative period. However, one patient hearing began to deteriorate in the future. A third group were (10) made radical surgery and a small tympanic system was created.In the fourth group of patients in whom lacked one or both legs of the stirrup was held tympanoplasty type IV.

Suppuration of the ear stopped in all examined patients. Two patients of late complications observed perforation of the flap in one patient we observed the formation of granulation.Also observed an improvement of hearing in 93% of patients. Thus, in 64% of patients with hearing loss by sound conduction showed improvement of hearing by 41%.In patients with impaired of hearing on the mixed type hearing improvement was only by 28%.

Conclusion.Carrying out sanitizing operations should be performed simultaneously with tympanoplasty, because observed a speedy postoperative wound healing, most patients showed hearing improvement.

Key words: hearing improving operations, tympanoplasty, cholesteatoma

 

REVIEWS

Baybabaev A.A., Saidmurodov D.U.

 

CLINICODYNAMIC CHARACTERISTIC

OF THE HEROIN ADDICTION OF FEMALE

 

Course of Psychiatry and Narcology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

The review contains information about some features of the formation of women's heroin addiction. In particular, the clinical manifestations of drug addiction among women differ in quick transition to systemic administration of the drug, rapid increase of tolerance, strongly pronounced dependence and compulsive addiction to drugs, prevalence of progredient rate of current of disease, prevalence of affective, anxiety and panic disorders, low self-esteem, low remission rates and high frequency of relapses.In women, earlier and faster comes psychosocial desadaptation.

Among the reasons of rarely handling of women to the seeking drug treatment and premature discontinuation of treatment are:the lack of specialized women's treatment programs, the fear of separation from child, the financial problems caused somatic problems, the lack of child care centers, the inability to replace her responsibilities in family, as well as gender issues.

Key words: women drug addiction, medical and social consequences of drug addiction, anti-drug therapy problems, remission, relapse

 

Mullodzhanov G.E., Ashurov G.G.

 

ANALYSIS OF MODERN LOOK AT PROCESSES OF THE INTEGRATION OF DENTAL IMPLANTS IN BONE TISSUES

 

Department of therapeutically dentistry of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

This communication devoted to the analysis of modern views on the process of integration of dental implants into bone tissue, including the modification of their surface. The analysis showed that in recent years the views of researchers on the processes taking place in the area of contact "implant-bone tissue", have undergone striking and fundamentally important changes. These changes to a large extent arose from the development of scientific technology in fundamental biology and medicine, and their practical application scientific research in stomatology problems. Changes in views on the nature of the processes occurring in of organism systems, living tissues, and their relationships with objects of bone matter is so rapid that we can have 1-2 years to observe the emergence of new concepts and new paradigms to refute our now obsolete submission and forcing us to reconsider what was familiar and well a learned truth. What was said above is no less true of the problem of the integration of dental implants into bone tissue. The integration of the dental implant in the adjacent bone tissue is a process of inclusion in the interaction, which does not occur effect of rejection. A dental implant is intentionally introduced into a system in which, as a matter of fact a dead body, it coexists with the living bone and the substrate takes on the functional load corresponding to the intended purpose of  substituted tooth.

Key words:dental implant, bone tissue, osseointegration, fibrin, fibronectin, macrophage

 

2-2016

THEORY AND PRACTICE OF MEDICINE

 

BoltuevK.H.

 

VIDEOLAPAROSCOPIC TREATMENT OF ACUTE APPENDICITIS

COMPLICATED BY PERITONITIS

 

Department of surgical diseases and endosurgeryof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

City Clinical Hospital № 5с. Dushanbe

Aim.Тo examine the results and effectiveness of the use of minimally invasive technologies to patients with acute destructive appendicitis complicatedby peritonitis.

Materials and methods.In the city hospital 5 the department of General surgery 1 video laparoscopic intervention were subjected 130 patients wits acute destructive appendicitis complicated by peritonitis aged 18 to 70 years. Men 56, women 74. Diagnosis of acute appendicitis complicated by peritonitis was based on the presence of complaints of patients, the peritoneal symptoms and the stage of endovideosurgical interventions.

Results. According to the morphological study of the vermiform appendix after laparoscopic operations performed for acute appendicitis, local peritonitis diagnosed 81 patients 32 diffuse, generalized in 17 cases. All patients were operated using endovideosurgical method under endotracheal anesthesia. The volume of operations was the removal of the appendix, hygiene, methodical lavage of the abdominal cavity with an antiseptic solution. Drainage of the abdominal cavity.

Conclusion. Minimally invasive intervention in peritonitis of appendicular origin, are performed according to indications have undeniable advantages over traditional methods the main advantages of minimally invasive procedures is a significant reduction in the severity of surgical aggression, the frequency of purulent – septic complications, less trauma of internal organs and the probability of adhesion formation. The cost of treatment and rehabilitation of patients with peritonitis of appendicular origin is much lower when minimally invasive interventions.

Key words: videolaparoscopy, acute appendicitis, peritonitis

 

Dzhabarova T.S., Mukhiddinov N.D., Odinaev F.I.

 

MAIN TENDENCIES OF FORMATION OF PERSONNEL POTENTIAL OF THE HEALTHCARE SYSTEM IN THE REPUBLIC OF TAJIKISTAN

 

Department of public health, economics, health care management with the course of medical statistics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.Studying positionsthat significantlyinfluence on the formation of high-quality potential of health personnel, regardless of the type of institution and level of funding.

Material and methods. To analyze the major trends shaping the human resource capacity of medical institutions, we conducted a survey among the heads of district health facilities (754 people, including 251 chief physicians, 302 deputy chief physicians and 201 heads of departments), medical health facilities (1258 doctors, including 223 heads of departments and 1035 medical specialists), nurses (of 2578, of which the principal and senior medsester- 254, 564 midwives, nurses, 1760) followed by SWOT analysis.

Results. That the change of work place, 58.3% of the polled health workers. Among the medical staff, the number was 49,8 ± 1,4%, the average medical workers changed jobs in 67,3 ± 0,8% cases. The frequency change of the place of work is different. 40,2 ± 0,9% of health professionals were looking for a new job on the recommendation of friends, 30,8 ± 0,7% came to a medical facility on the ad, 5,8 ± 0,2% for distribution after graduation, 24, 7 ± 0,6% previously worked in this institution and returned, 66,8 ± 0,8% indicated other reasons. Neither was not involved in the study aims Employment Service

Conclusion.On the formation of quality of personnel significantlyinfluence a number of features: lack of involvement in hiring HR specialists of health care institutions, human resources department in the new economic environment remains underutilized and inefficient structure in health facilities, lack of system of selection of candidates for the position, which manifests itself in a variety of professionals involved in the selection and admission to an institution of experts on the basis of only the interview, and sometimes without it.

Key words:personnel service, heads of healthcare institutions,physicians, nurses

 

Kadyrov Z.A., Ishonakov H.S., Saydulloev L.

 

RESULTS OF TRANSRECTAL RESEARCH OF PROSTATE

IN PATIENTS WITH CHRONIC INFLAMMATORY DISEASES OF THE RECTUM AND PROSTATE GLAND

 

Department of endoscopic urology of the faculty of qualification improvement of health care workers of the medical institute PFUR, Moscow

Department of Urology and Andrology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim. To analyze the results of transrectal research of prostate in patients with chronic inflammatory diseases of the rectum and prostate gland.

Materials and methods. The study included 140 male patients with chronic inflammatory diseases of the rectum and prostate gland. Patients were divided into 4 groups: I group – 61 (43,6%) patient with chronic hemorrhoids (CH), II group – 55 (39,3%) patients with chronic prostatitis, III group – 12 (8,6%) with fistula of the rectum (FR), IV group – 12 (8,6%) patients with chronic anal crack (CAC). Patients age was from 20 to 69 years (mean age 42,5 ± 0,5 years). All patients underwent a complex clinical and laboratory research, transrectal ultrasound research, uroflowmetry, instrumental research of the rectum and others.

Results. In 88 (62,9%) patients sizes of prostate were increased, in 20 (14,3%) – were reduced, and in 32 (22,9) – were normal. In 18 (12,9%) patients the increase of prostate gland was connected with benign hyperplasia. Echogenity was increased in 66 patients, in 24 (17,1%) – was reduced and in 50 (35,7%) – was heterogeneous. Hypoechogenic changes in various parts of the prostate were detected in 28 (17,9%) patients.

Conclusion. The data of results of transrectal ultrasound research show the associated defeats in most patients with chronic diseases of the rectum.

Key words: prostate gland, rectum, chronic inflammatory diseases, research

 

КаsimovaZ.N.

 

TACTICS OF HOLDING OF CHILDBIRTH IN WOMEN WITH DISEASES OF CARDIO-VASCULAR SYSTEM IN SOGD REGIONAL MATERNITY HOSPITAL

 

The course of Obstetrics and Gynecology of Hujands department of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Sogd Regional Maternity Hospital

Aim. To study methods of holding and birth outcomes in women with diseases of cardio-vascular system according to data of the Sogd regional maternity hospital (SRMH).

Materials and methods. A retrospective analysis of 77 stories of women childbirth with diseases of the cardiovascular system according to data SRMH during the period from 2014 to 2016 was conducted.

Results. During this period there were 77 hospitalized woman with the disease of cardiovascular system. Between them there was multiparous – 56(72,7%), nulliparous –21(27,3%). Average age of women was 25,4 years old. There were69 (89,6%)woman  from village, from city 8 (10,4%). In 11,7% of cases childbirth was premature, in 88.3% – term.Prevailed among the hospitalized pregnant women with acquired heart deasease (58,4%). Women after the correction of defects were 18%cases. With a predominance of obstetric indications and severity of heart disease in в 72,7% delivers finished by operation in 27,3% the delivers finished by physiological way. Noted one case of maternal mortality due to acute heart failure in the early postoperative period. In 5 cases due to the immaturity state of the newborn  early neonatal mortality was observed.

Conclusion.Timely inspection of women to pregnancy, with a nosometry and  type of vices heart, valuable to  antenatal care and predelivery hospitalization with the decision of obstetric tactics, prophylaxis of complications in a down-lying,  far improve  the end of luing-ins of this category of women.

Key words: diseases of cardio vascular system, pregnancy, childbirth, congenital and purchased defects

 

KasymovaS.D., TurdalievaN.M.

 

INFLUENCE OF IODINE DEFICIENCY ON THE SEXUAL MATURATION OF TEENAGERS

 

Course on Endocrinology of the State Educational Institution of “Institute of Postgraduate Studies” in the Health Sector of the Republic of Tajikistan

Republican Clinical Center of Endocrinology

Aim. Assessment of the nature of thyroid pathology of teenagers and its impact on sexual maturation under the conditions of iodine deficiency.

Materials and methods. After conducted preventive examination of pupils of 3-10 grades (216 girls and 228 boys), the teenagers with thyroid body increased growth were selected for further examination. Sexual maturation of 69 girls and 58 boys under research was assessed according to Tanner, ultrasonography of thyroid body, level of thyrotropic hormone, T₃, T₄.    

Results. Endemic goiter was revealed for 28.9% of boys and 36.8% of girls. According to ultrasonography data, girls more often had deviations in the structure of thyroid body in puberty period and reproductive age. In 92.7% of cases, girls had euthyroid hyperplasia of thyroid body, and 7.3% had sub-clinic thyreoid deficiency. Each 3^rd girl and each 4^th boy had deviations in sexual maturation.

Conclusion. The results of the research show the negative impact of iodine deficiency on the sexual maturation of teenagers. It is necessary to start the treatment of impaired puberty under the condition of iodine deficiency with pathogenetic therapy of thyroid body diseases.

Key words: iodine deficiency, sexual maturation of teenagers

 

MakhmudovaR.U., ZakirovaK.A., MakhmudovaP.U.

 

THE PREVALENCE OF TUBERCULOSIS

AMONG HIV-INFECTED PERSONS

 

Department of Phthisiopulmonologyofthe State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.To study the prevalence of co-infection of TB/HIV, and to develop preventive measures for the early detection of tuberculosis among HIV-infected persons.

Materials and methods. Studied and analyzed prevalence of tuberculosiscombinedwith HIV-infection, on the grounds of approved accounting and reporting documents of the Republican Center on struggle against tuberculosis and AIDS during the period of 2006-2014 years.

Results.Comparative analysis of epidemiological data over the country during the period of 2006-2014 years on co-infection shows an annual increase in the number of HIV-infection among surveyed tuberculosis patients.

Conclusion.The problem of prevalence of tuberculosis and HIV-infection in the country remains tense.In order to reduce the prevalence of HIV-infection among tuberculosis patients is necessary to strengthen the integration of centers on struggle against tuberculosis and AIDS, attraction of Narcological Centres, PHC, SSES, NGOs, dermatovenerologic institutions and all segments of the population.

Key words:tuberculosis, HIV-infection, prevalence, early diagnosis, prevention

 

MullodzhanovG.E.,Karimov S.M., GurezovM.R., YorakovF.M.

 

CLINICAL AND X-RAY RESULTS OF PROTETIC TREATMENT OF SOMATIC PATIENTS BY DENTAL IMPLANTATION

 

Therapeutically Dentistry Department of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim. Estimation the possibility of the improvement quality of dentistry aspect's health among somatic patients with defect of the teeth rows by implant's orthopedic design.

Materials and methods. Studied condition of dentistry status and system health of 275 somatic patients (134 men and 141 women) from 20 to 60 years and senior with partial secondary anodontia.  All primary addressed patient organized: complex dentistry examination with calculation of the factors of prevalence and intensities of caries, as well as parodontal diseases, hygiene oral cavity; classification defect of the teeth rows on Kennedy; x-ray (3D CT) and common's clinical examination. Patients in depending of elected method of the treatment were portioned on 2 groups: main (prosthesis with using of dental implants) and group of the comparison (traditional with fixed and removable partial denture). Main group consist of 103 patients with anodontia (54 men and 49 women). Group of the comparison was presented by 89 patients (42 men and 47 women) with defect of the teeth rows.

Results.           At nearest periods after installing of dental implants beside somatic patients good results of implantlogy treatments noted in 86,2% events, satisfactory and unsatisfactory – accordingly in 10,7% and 3,1% events. At remote periods of the observation amongst examined contingent patients merit criteria on three positions corresponded 81,7%, 12,9% and 5,4%.

Conclusion. More high degree of satisfactory by quality of the prosthesis was revealed beside somatic patients having implantation prosthetic devices, in comparison with one, used traditionally made with fixed and removable partial prosthetic device.

Key words:оcclusion defect, implantology treatment, three-dimensional dental x-ray, somatic pathology

 

¹MuminovS., ²KurbonovK.M., ¹RasulovN.A., ¹RafikovS.R., ²KhovariN.

 

ULTRASOUND SIGNS AT CHOLEPERITONITIS

¹Department of Surgery of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

²Department of Surgical Diseases №1of the Tajik State Medical University named after Abuali ibn Sino

Aim. Explore the possibilities of ultrasound research in patients with cholelithiasis and identify graphical signs, allowing suspect bile peritonitis.

Materials and methods. The present study is based on the experience of complex diagnostics and surgical treatment of 87 patients with bile peritonitis treated at the City Hospital ambulance Dushanbe. It was held 64 US (73.5%) patients for the diagnosis of gallbladder and its causes.

Results. During the ultrasound integrated along with the identification of various degrees of destructive changes in the gall bladder and ducts identified various signs of bile peritonitis (DGP). During ultrasound in 8 cases diagnosed with the presence of "bubbles" of air in the lumen of the gall. When released JP in 59 (67,8%) observationsonultrasonograms determined the presence of free fluid in the abdominal cavity.

Of great importance in the diagnosis of gallbladder is defined as two simultaneous ultrasonographic symptoms such as symptoms of paralytic ileus and availability anechoic fluid in the lumen of the intestine.

The study found that 32 (36,8%) cases the cause of the gallbladder is destructive forms of acute calculouscholecystitis in 12 (13,8%) choledocholithiasis in 10 (11,5%) – suppurative cholangitis.

Conclusion. Implementation of an integrated ultrasound, along with the identification of various degrees of destructive changes in the gall bladder and ducts revealed graphic signs, allowing suspected bile peritonitis.

Key words: signs of ultrasound, bile peritonitis

 

Mukhiddinov N.D., Dzhabarova T.S., Dzhurakulova F.M.

 

OPTIMIZATION OF THE ROLE OF NURSES IN ASSISTING

OF PRIMARY HEALTH CARE TO THE POPULATION

 

The State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan

Aim. Based on the study of basic statistical indicators of human resources, especially nurses to identify their responsibility in the provision of primary health – care, consider the promising approaches to optimize their working conditions in order to increase their role in providing quality services to the population.

Materials and methods. Studied the data of official statistics conducted in 12 of city health centers in Dushanbe questioning FHN and their subsequent statistical analysis.

Results. In the Republic of Tajikistan for 2015 are working in all 43 677 nurses, including a paramedic, 1477 and 4533 midwives,   nurses 32219. Provision of 10 000 inhabitants is 51,6, including 1,8 – physician assistants, 5,4 – midwives and nurses – 32,8.

Provision of population with medical personnel with secondary education tends to rise on the Republic of Tajikistan from 46,1 to 10 thousand. In 2010, to 51,8 per 10 thousand. Population in 2015.

The completeness nursing – 85-95%, but the staffing is achieved through the combination.

Development of the role of nurses in the field of public services provided by the National Strategy for health for 2010-2020, developed in accordance with the main objectives of the health system development concept.

Conclusion. The organization of independent activity of the family doctor nurses at PHC facilities, promotes public accessibility to quality health care and the growth of the importance of specialists with secondary medical education in the health system.

Key words: nurses, statistics, the availability of nursing staff, primary health care, questioning, the dynamics of medical personnel

 

¹Rakhimov N.G., ¹Amonova Sh.Sh., ²Davlyatova G.K., ¹Muradov A.M., ¹Muradov A.A., ²Amonova Sh.Sh.

 

FEATURES OF CENTRAL AND PULMONARY HEMODYNAMICS

IN PREGNANT WOMEN WITH PRE- AND ECLAMPSIA

 

¹Department of Efferent Medicine and Intensive Care of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

²Scientific-Research Institute of Obstetrics and Gynecology

 

Aim. Study features of central and pulmonary hemodynamics in pregnant women with pre- eclampsia to determine the mode of circulation and the relationship with impairment hypocoagulating lung function.

Materials and methods. Results of treatment of 88 pregnant women in the third trimester, divided into 3 groups: 1 group – pregnant women with mild pre-eclampsia; Group 2 – with severe pre-eclampsia; Group 3 – with eclampsia.The control group consisted of 10 women with physiological pregnancy.We studied hemodynamics in the system of "mother-placenta-fetus" by  echocardiographic method; heart, central hemodynamics – doppler on the basic parameters.

Results. Hemodynamic revealed heterogeneity in pregnant women with pre- and eclampsia in 3 trimester.In 25 (71,4%) of pregnant women 1 group with mild preeclampsia marked disturbances in the form of hyperkinetic, in 10 (28,6%) – eukinetic type circulation.In 20 (64,5%) pregnancy with severe preeclampsia (group 2) revealed a hypokinetic, in 7 (22,6%) – eukinetic, in 4 (12,9%) – hyperkinetic type of circulation with an increase in pulmonary pressure and strengthening the work of the left and right ventricles of the heart.In the group 3 hypokinetic, eukinetic and hyperkinetic circulation types were detected in 13 (59,1%), 5 (22,7%) and 4 (18,2%) patients, respectively. This was accompanied by an increase in pulmonary pressure, strengthening of the work of the left and right ventricle of the heart in all groups of patients with the hypokinetic type (2 or 3 groups) – they are not enough.

Conclusion. Pregnant women with pre- and eclampsia in selecting treatment strategies need to determine the type of hemodynamics, the level of its infringement with the aim of individual selection of antihypertensive drugs that act on a specific mechanism – anxiety or myocardial contractility, arterial tone.

Key words: pregnancy, pre-eclampsia, eclampsia, type of blood circulation, antihypertensive drugs

 

Nozirov J.Kh., Shokirov T.M., Narzulaeva A.R.

 

EXTENDED FEATURES OF CARDIOVASCULAR RISK FACTORS AMONG THE UNORGANIZED POPULATION OF TURSUNZADE DISTRICT ACCORDING TO THE RESULTS OF SCREENING STUDIES AND THEIR PREVENTION

 

Department of Cardiology with a course of clinical pharmacology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Study features of spread of cardiovascular risk factors among the population of Tursunzoda district

Material and methods.One-stage screening research included a survey of 1912 surveyed (794 men and 1118 women) aged 15 to 59 years.The survey to identify coronary artery disease of heart, hypertension and risk factors was carried out according to standard procedures and to the WHO recommendations.Carried out general clinical anthropometric, biochemical laboratory, functional and statistical methods.

Conclusion. In order to increase the effectiveness of preventive measures necessary to develop and implement information materials on the methods of detection and an integrated multi-CVD prevention with broad involvement of educational institutions, mahalla councils, the media, non-governmental organizations based on the experience of international organizations.

Key words: cardiovascular disease, coronary heart disease, hypertension screening, risk factors

 

Nurov D.I., Ashurov G.G.

 

MUTUALCONDITIONED CHANGE OF LEVEL ENAMEL RESISTANCE, INTENSITIES OF CARIES AND REMINERALIZATION ABILITY OF ORAL LIQUID BESIDE SOMATIC PATIENT

 

Department of therapeutically dentistry of State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

Aim. Study regularities of the associated change of level enamel resistance, intensities of caries and remineralization's ability of oral liquid beside patient with disadvantage somatic background.

Materials and methods.Object of the study served the intact teeth between 97 volunteers with disadvantage somatic background at age from 20 before 50 years and senior. Using express-method, amongst examined contingent defined structured-functional resistance of enamel teeth.  Velocity of the defect by acid etching of enamel was measured through 1, 2, 3, 5 and 7 day.

Results.Beside somatic patient with compensate dentistry status source roughness, expressed in the form of intensity coloration enamel surface, has formed 50%. On the following day value under investigation factor was is 40%, on 3 day – 20% and on 5 day of the observation intensity coloration of enamel got to minimum importance (10%). Most low remineralization's activity of oral liquid with variation from 60% before 90% is discovered amongst examined persons with decompensate level of dentistry status.

Conclusion. Comparative study reset rate relief of damaged surfaces of enamel confirms the opinion about the most low remineralization ability of oral liquid beside somatic patients.

Key words: resistance of enamel, intensity of caries, oral liquid, remineralization, acid etching

 

Ortikova M.M., Mirzoeva Z.A, Gulomova M.O., Davlyatova D.D.

 

INVESTIGATION AND ANALYSIS OF RISK FACTORS OF PREVALENCE OF HELMINTH DISEASES AMONG FAMILY MEMBERS RESIDING IN THE CITY OF ISTARAVSHAN, ASHT REGION, SOGD REGION, HAMADONI REGION, KHATLON REGION, DUSHANBE OF TAJIKISTAN

 

Department of family medicine of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Investigation and analysis of risk factors of prevalence of helminth diseases among family members residing in the city of Istaravshan, Asht region, Sogd region, Khamadoni region, Khatlon region, Dushanbe of Tajikistan.

Material and methods. Were investigated 7050 people in view of the climate and water sources in the city of Dushanbe, Khatlon region, Khamadoni region, Asht region, Istaravshan city of Sughd region.Were interviewed 4005 residents of Khamadoni region, 1000 residents of Asht region, 1000 residents of Istaravshan (in which people use water from irrigation ditch), and 1045 the inhabitants of Dushanbe (the source of water supply – centralized tap water).Object of study were members of the family from birth to old age. Questionnaires of children under 7 years were filled by parents.

Results. The prevalence of helminths in the population depends on the profession, the number of members in a family, level of material wealth of the family.The main factors of the prevalence of helminthic infestations are population-demographic – 87.9%, health and social reasons: the number of members in a family (52.4% in household consists of 6-10 people), the nature of the water supply and sewerage condition (only 53.3 % of the patients have access to permanent cold water), awareness of the parasitic infestations and transmission (32.2% have information).

Conclusion. Low level of sanitary culture of the population, poor sanitation and living conditions contribute to the high prevalence of helminth diseases, so we need to strengthen of primary and secondary prevention among family members.

Key words: study, prevalence factors, family doctor, helminth infections, prevention

 

Sadikov F.O., Karimov S.M., Ashurov G.G.

 

QUALITY CRITERIAS OF EVALUATION TOOTH RESTORATION

 

Department of therapeutically dentistry of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Conduct a retrospective evaluation of the quality of dental fillings in public and private dental offices.

Material and methods. Among 96 surveyed persons has been examined 250 previously supplied seals. In order to assess the state of the seals multi-criteria method peer review was used, which included 3 gradations: excellent, satisfactory, unsatisfactory.

Results. In the clinical evaluation of marginal adaptation state seal was assessed as excellent in 51,3% of cases, satisfactory – in 42,9%, unsatisfactory – in 5,8%. Anatomical shape of the seal in 40% of cases was evaluated as "excellent", 53,6% – as "satisfactory" and 6,4% as unsatisfactory. Specific weight excellent ratings was 88,2% for the seals imposed during the last year, and only 1,8% – for the seals more than 5 years. In the first case there were no unsatisfactory marks, in the second, their share was 8,8%.

Conclusion. Percentage of unsatisfactory seals ratings imposed state in dental offices, it was 2-fold higher compared with commercial structures (14,0% and 6,8% respectively). If seals of photocurable material 60% were rated as excellent, the seal upon application of the active materials of chemical polymerization rate was only 3,6%, and from conventional materials as excellent, and no satisfactory evaluation.

Key words: light-curing filling, chemical filling, polymerization shrinkage, marginal adaptation, secondary caries

 

Samadova G.A., Dadabaeva B.S., SharipovaSh.T., Mulloev A.M.

 

SOME SOCIO-ECONOMIC ASPECTS OF TAJIK FAMILIES.

 

DepartmentofNursinginFamilyMedicineofthe State Educational Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan

Aim. To study some socio-economic aspects of life of tajik families.

Materials and methods. With an aid of specially designed questionnaire 123 families were interviewed. Social and economic factors that influence health of adult members of the family were studied.

Results. Research has shown that 73,2% of 123 families were nuclear, 21,9% extended, 2,5% mixed families and 2,4% with one parent. Age peak of men accounted for 30-34 years, women – 25-29 years. There were practically no age difference between husband and wife in 62 (50,4%) cases. 29,2% were accounted for the small families (with few children), 38,3% middle families, 32,5% large families. 74,2% men and 21,2% women have permanent work. 75,2% women in the families are unemployed. 57 men and 23 women had higher education. Family income per person per day in 41,2% families was from 6 to 10 somon, 22,4% 11-15 somon, 21,7% it was minimal up to 5 somon. 64 (52,0%) families asked for medical help from time to time. 37 men (57,8%) and 55 women (85,9%) were asking for help. 24 men and 46 women knew about their chronic diseases. Among the diseases men frequent response was "gastritis" and women "anemia, pyelonephritis."

Conclusion. Thus, a survey of tajik families found out that wives, despite having a high school education, for various reasons, prefer to be housewives and do not participate in the construction of family welfare. Families’ status from the social and economic aspects is unsatisfactory. All respondents were of working age, but only in 24 (19,5%) families both spouses were working. Influence of socio-economic factors on the health of family members has led to that the majority of spouses (52,0%) seek medical care, and 31,1% of men and women are aware of their chronic diseases.

Key words: family, respondents, family welfare, social and economic aspects

 

Sirodzhov K.Kh., Kholov D.I., Rakhimov A.T., Safarov A.

 

OPTIMIZED APPROACH FOR THE TREATMENT OF PATIENTS

WITH ASSOCIATED FRACTURES OF EXTREMITIES WITH ABNORMALITY

OF SOME ASPECTS OF LIPID SPECTRUM

 

Department of Traumatology and Orthopedicsof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim. Optimization of diagnostics, conservative and surgical treatment of the manifestations of traumatic brain injury and fractures of extremities in patients with associated injury and prevention of complications.

Materials and methods. Analyzethe results of diagnostics and treatment of 183 patients with concomitant brain injury, which were divided into 2 groups: the main and control. For valuation of injury severity was used AIS scale, severity of injury was determined by E.K. Gumanenko and severity of traumatic brain injury –by Glasgow coma scale. Was used X-ray diagnostics, clinical laboratory tests, with special attention paid to the study of blood lipids.

Results. Due to research of lipid spectrum of venous blood plasma of patients and the use of modified hemodilution isovolumic managed to optimize the treatment of head trauma and limb fractures in the main group patients.  Achieved the reduction of the number of complications and unsatisfactory results in treatment of this pathology.

Conclusion. Modified isovolumichemo dilutionallows you to view the patient's state of shock, hypoxia reduces hematic and prevents interstitial edema, minimizes blood loss and the degree of endogenous intoxication, reduces the risk of fat embolism syndrome and other vital disorders.

Key words: optimization, trauma, shock, edema, damage, complications, outcomes, osteosynthesis

KhayridinovM.T., SafarovM.I., KhayridinovD.M., KurbanovaKh.A.                                                                                                                              

 

CORRECTION OF INSULIN  RESISTANCE IN PATIENTS WITH INSULIN –INDEPENDENT DIABETES  MELLITUS  WITH FULL  METABOLIC  SYNDROME

 

Department of sisterly business in therapy of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Explore the possibilities of correction of insulin resistance during concomitant antihypertensive and lipid-lowering therapy in patients with non-insulin dependent diabetes mellitus with full metabolic syndrome.

Material and methods. Study included 60 patients (24 men and 36 women) aged 40 to 69 years (mean age 53,02±0,7), who was identified metabolic syndrome in combination with insulin dependent diabetes mellitus. It was conducted an open study of the effect of combined treatment with enalapril 10 mg / dL and simvastin 10 mg / day for 8 weeks on the manifestation of IR during  metabolic syndrome.

Results. In the group of patients receiving concomitant antihypertensive and lipid-lowering therapy, for 10 weeks, showed a reduction in systolic levels by 13,2%, DBP by 11,4%, OXC by 16,2%. The two-week break in treatment with simvastatin was associated with increased total serum cholesterol to levels indistinguishable from the original. Treatment of this background in small doses of simvastatin resulted in lower total serum cholesterol level by 14,6% compared to baseline values. These results allow us to evaluate the effect of simvastatin 5 mg / day in patients with GLP insulin dependent diabetes mellitus, treatment as significant.

Conclusion. These results allow to consider appropriate comprehensive approach to drug correction of patients with insulin dependent diabetes mellitus with a cluster of metabolic risk factors not only for the impact on the individual links in a single chain of metabolic disorders, but also to reduce the risk of coronary events.

Key words: insulin resistance, non-insulin dependent diabetes mellitus, metabolic syndrome, risk factors

REVIEW

 

Salimov B.M., Kasymov O.I., Munieva S.Kh.

 

IMMUNOLOGICAL DISORDERS IN ONIHOMIKOSIS

 

Department of Dermatology and STIs of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Ringworm affected 15-25% of the world population, of which the most frequent are the tinea pedis.Particular note is the problem of foot mycoses with the defeat of the nail plate, which occurs in 20-55% of patients with fungal infections, especially among urban residents, elderly people, hard treatable, has a tendency to recur.Skin is the primary target for various immune responses and participates in the development of both local and systemic immune responses.

Ringworm, especially with multiple nail ringworm lesions accompanied by significant impairment of the immune system, affecting the main elements of its implementation – cellular, humoral and phagocyte system.

Key words: immunological changes, onychomycosis

 

 

CASE FROM PRACTICE

DzhamolovF.P., OchilzodaA.A., MutalibovA.Z., BobodzhanovR.U.

 

CASE OF DESCENDEDINGINTO THE HYPOPHARYNX

CHOANAL POLYP, BESIDE CHILD AGEDSEVEN MONTHS

 

Sughd regional clinical hospital named after S. Kutfidinov, Khujand

Presented a case of descendinginto the hypopharynx choanal polyp, beside child agedseven months

A feature of this case lies in rarity of the location of choanal polyp at this age, course of disease, accompanied by voice, swallowing and breathing disorders.

Key words: choanal polyp, hypopharynx, polypectomy

 

3-2016

 

THEORY AND PRACTICE OF MEDICINE

 

AbdulloevD.A., GayratovT.G., Kholov В.А.

 

WAYS OF IMPROVE THE TREATMENT RESULTS OF PATIENTS

WITH BURNS OF THE LOWER EXTREMITIES

 

Department of General Surgery № 2 of the Tajik Medical State University named after Abuali-ibn-Sino

City clinical hospital № 3, Dushanbe

Aim.To study the effectiveness of regional anti-bacterial and antioxidant therapy and a staged surgical treatment of patients with burns of the lower extremities.

Materials and methods. This article analyzes the results of examination and treatment of 55 patients with lesions of the flame in accidents at home and in the production of varying severity over the period of 2013-2015. All patients were divided into 2 groups: the main group consisted of 26 (47,2%) patients, control group consisted of 29 (52,7 per cent) patients. The study group was comparable to the area of the burn, age, time elapsed from the disease onset to admission.

Results. With the aim of improving the results of surgical treatment we applied the method of intra-arterial administration of antibiotics (including sensitivity) and antioxidants (Mexidol), as well as used records "Takhokomb^R" NYCOMED firm, Austria GmbH., when bleeding after necrectomy and temporary cover of burn wounds. The study showed that patients of the main group showed positive dynamics of the flow of burn wounds compared to control patients. This facilitates timely cleaning of wounds, growth and stimulation of granulation on the burnt surface, which creates conditions for the early implementation of free autodermoplasty.

Conclusion.Thus, intra-arterial administration of antibiotics depending on the sensitivity in combination with antioxidant drugs in patients with burn wounds of the lower extremities has reduced the clearance of the wounds to the free autodermoplasty by 13.7% and by itself to reduce the time patients stay in hospital for 7-8 days.

Key words: intra-antibiotic therapy, mexidol, phased autodermoplasty "TakhokombR" plate

 

¹ArtyukhovS.V., ²MukhiddinovN.D., ³KubachevK.G, ³ZarkuyaN.E.

 

CLINICAL AND STATISTICAL GROUPS OF PATIENTS WITH OBTURATIVE COLONIC OBSTRUCTION CANCER

 

                                                                                             

¹SPb GBUZ "Aleksandrovskaya hospital", Saint-Petersburg, Russia

²Department of Surgical Diseases and Endosurgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

³Department of surgery named after Monastyrskiy N. D. FGBOU VO "Northwest State Medical University named after I. I. Mechnikov". Ministry of Health of the Russian Federation, St. Petersburg

Aim.To identify the various epidemiological aspects in patients with acute intestinal obstruction in cancer of the left colon.

Materials and methods. The basis of the research is based on retrospective and prospective analysis of treatment of 2200 patients with cancer of the left half of the colon hospitalized in GBUZ "Aleksandrovskaya hospital" St.-Petersburg for 2003 – 2012. The data obtained were entered into a spreadsheet, which was subsequently subjected to statistical analysis.

Results. Were men and 973 (44,2%), women – 1227 (55, 8%). Patients older than 60 years – 75,3%. The majority of patients (70,4%) delivered within 48 – 72 hours from the onset of the disease. The severity according to APACHE-II only 21.3% of patients were rated below 15 points. At 88.7% of patients, operative and anesthesiological risk was consistent with IV – V degree. Various comorbidities were found in 97,7% of patients. Each patient had a 1,8 associated complications. Most often the tumor is in the sigmoid colon (39,4%), 22% of the tumour was in the rectosigmoid Department. In 18% of cases it was located in the descending colon. At about the same frequency was found a lesion of the left third of the transverse colon and rectum (about 5%). A tumor of the splenic flexure was diagnosed in one patient 10.

Conclusion. The data obtained should be taken into account in the daily work planning inspection scope, choice of tactics of conducting patients.

Key words: colorectal cancer, obstruction, epidemiology

 

¹Artyukhov S.V., ²Mukhiddinov N.D., ³Kubachev K.G, ³Zarkuya N.E.

 

RADICAL OPERATION IN CANCER OF RECTOSIGMOID

AND RECTUM, COMPLICATED BY INTESTINAL OBSTRUCTION
 

                                                                                               

¹SPb GBUZ "Aleksandrovskaya hospital", Saint-Petersburg, Russia

²Department of Surgical Diseases and Endosurgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

³Department of surgery named after Monastyrskiy N. D. FGBOU VO "Northwest State Medical University named after I. I. Mechnikov". Ministry of Health of the Russian Federation, St. Petersburg

Aim.  To determine the optimal tactics and improve the results of treatment of patients obstructive intestinal obstruction caused by rectosigmoid cancer Department and rectum.

Materials andmethods. Treatment analysis of 631 patient suffering from acute obstructive intestinal obstruction due to cancer R and rectum for 2003-2012. The volume of examination and treatment consistent with the medical – economic standards in accordance with the International classification of diseases (ICD-10).

Results. Of the 631 patient object of the study were 276 patients who at the primary intervention have not been identified in distant metastases and performed radical surgery. Primary removal of a tumor with the elimination of intestinal obstruction was performed in 157 (46,3%) patients, removal of obstruction through the formation of Stom or recanalization of the tumor – 119 (53,7%) patients. Mortality among patients in whom stoma was formed, was 9,8% and in the group of patients with a primary bowel resection with tumor – 16,1% (p<0,05).

Conclusion. The results of treatment in patients who originally performed the also or recanalization, and the second stage a radical operation, reliably better (p<0,05)

Key words: colorectal cancer, cancer of the rectosigmoid Department, obstructive intestinal obstruction, surgical approach, laparoscopy, endoscopy

 

¹KubachevK.G, ¹ZarkuyaN.E.,  ²MukhiddinovN.D.

 

SURGICAL  TACTIC IN TREATMENT OF PERIAMPULAR CANCER COMPLICATED WITH OBSTRUCTIVE JAUNDICE

                                                                                             

¹Department of surgery named after Monastyrskiy N. D. FGBOU VO "Northwest State Medical University named after I. I. Mechnikov". Ministry of Health of the Russian Federation, St. Petersburg

²Department of Surgical Diseases and Endosurgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Aim. To find the best surgical tactic in treatment of periampular cancer complicated with obstructive jaundice.

Materials and methods. In this research 479 periampular cancer complicated with obstructive jaundice patients were studied and retrospective analysis was made. The age of patients varied from 25 to 78 years old. 62.7 % of patients had tumor in head and uncinate process of pancreas, 71 (23,7%) had tumor germination into the bilious ducts, 229 (76,3%) patients had circular impaction of bilious duct, 25/5% of patients had jaundice because of extrahepatic bile ducts cancer. Modern diagnostic methods were used (Ultrasound, Endoultrasound, MSCT, MRI, Endosurgical technologies, Cholangioscopy and Intraoperative ultrasound).

Results. The incidence of periampular cancer with different locations in male and female had significant difference. 70,6% males and only 38,9% females used to have pancreatic head cancer. Prehospital period of our patients was from 11 till 27 days. In the day of hospitalization Bilirubin level ranged from 180-915 mcmole/L, with average Bilirubin level – 382 mcmole/L. We refused one-stage radical surgery, traditional internal drainage technics and preferred minimally-invasive drainage procedure. Endoscopic methods were used for bilious duct drainage if we had technical capacities. We made endoscopic surgery at 282 patients (59,1%). Common bile duct stenting procedure was used as preoperative care or in patients with late stages of cancer with lifetime not more then 4-5 months. Patients with cholangitis went through biliary drainage procedure.

Even though we found biliary drainage procedure effective for our patients, 57(12%) of them had no biliation in the first 2 days because of Hepaticcell failure.

From 479 patients with periampular cancer 117(24,4%) went through radical surgery. In all other cases tumor was found as inoperable. 107 patients had Wipple procedure, 4 – pancreaticoduodenal resection (Traverso-Longmire operation). 281 patient had only palliative surgery.

Conclusion. Surgical treatment of periampular cancer has high risk of postoperative complications and the best choice of management in such patients is two-stage surgery. Drainage procedure should be used as the first stage. Endoscopic technologies of biliation are more physiologic and radical surgery should be done only after hemostasis normalization.

Key words: periampular cancer, jaundice, minimally-invasive technologies

 

¹Mirzoev A.S., ²Pirmamadov Kh.K.

 

PROBLEMS OF ANTIMICROBIAL RESISTANCE

AND SOLUTIONS IN THE REPUBLIC OF TAJIKISTAN

 

¹Department of Epidemiology, Hygiene and Environment of the State Educational Establishment «Institute of Postgraduate in Health Sphere of the Republic of Tajikistan».

²Department of Specially Dangerous infections of the State Sanitary Epidemiological Services of the Ministry of Health and Social Protection of population of the Republic of Tajikistan

Aim.To study the problem of antimicrobial resistance in the country and identifying its solution.

Materials and methods.Analysing of legal materials of the Republic of Tajikistan in the field of antimicrobial resistance, studying materials of EURO on the Global Plan of Action on antimicrobial resistance.

Results. The article shows the results of analysis of legal materials of international level in particular, materials of EURO for the Global Plan of Action on antimicrobial resistance, as well as the state of affairs in this area. It was found that the population has unlimited access to any type of antimicrobials. Moreover, 80% of patients visited doctor are prescribed antimicrobials. There is no Coordinating body in the republic to monitor and analyze the usage of antimicrobials. The control of meat and dairy products imported from countries which widely use antimicrobials as growth promoters for plants and animals.

Conclusion. Study of the problem has revealed pure controlling of either antimicrobials, and of food, containing the agent. Lack of an authorized boardy for studying the antimicrobial resistance and advising on addressing the shortcomings.

Key words: antimicrobial resistance, Tajikistan, problems and solutions

 

Mukhamedov Sh.Sh.,  Ashurov G.G.

 

RESULTS OF THE STUDY OF HYDRODYNAMIC'S MARGINAL PARODONT

OF  VITALY AND  DEVITALY  SUPPORTING TEETH IN SYSTEMS 

OF  METALCERAMIC DESIGNS

           

Department of Therapeutic Dentistry of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

Aim. Study dynamics of amount gum's liquids under different correlation of the edge of metalceramic crowns and gums in depending of vitally of supporting teeth.

Materials and methods. Under observation were found 156 patients after prosthesis included defect of the teeth rows by fixed partial metalceramic's prosthetic device. Were formed two groups in the depending of endodontic condition of supporting teeth: the first group – 60 persons with depulpited of supporting teeth; the second group – 96 persons, having supporting teeth with pulp. Group of the comparison included 30 persons – practically sound, holistic teeth rows and intact parodont.

Results. On the grounds of called on studies is installed that edge of metalceramic crowns, being situated at a rate of gums as vitally and devitally supporting teeth, does not cause damaging and irritating effect that, finally, does not promote the development of the inflammation in the tissues of marginal parodont. 

Conclusion. Average values amount of gum's liquids in the field of teeth with intact parodont and in the field of teeth with metalceramic crown, possible use as merit test, allowing characterize the condition fabric marginal parodont.

Key words:gum's liquid, supporting teeth, metalceramic, vitally teeth, devitally teeth, marginal parodont

 

NarzuloevaM.F., Sharipov A.A.

 

EPIDEMIOLOGICAL EVALUATION OF BRUCELLOSIS INFECTION

IN THE REPUBLIC OF TAJIKISTAN

 

Department of Infectious Diseases of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Aim.Investigate epidemiological situation of brucellosis among population of the Republic of Tajikistan in 2005-2014.

Materials and methods.Were used data from reports of Republican Center of medical statistics and information under the Ministry of Health and Social Protection of the Republic of Tajikistan. In the course of the study the analysis of data was performed and the epidemiological situation of brucellosis among population was assessed.

Results.In the last ten years the detection and diagnosis of different forms of brucellosis in the Republic of Tajikistan have increased considerably. It was also revealed that incidence curve among population is wavy.

Conclusion.It was revealed that incidence of brucellosis among population of the Republic of Tajikistan in 2005-2014 has generally a declining tendency and rates vary significantly by regions prevailing in upland and foothill districts.

Key words: brucellosis epidemiology, brucellosis incidence, brucellosis prevalence

 

Nurov D.I., Ismoilov A.A.

 

EVALUATION OF INITIAL VALUE RESISTANCE OF THE ENAMEL

DEPENDING ON THE INTENSITY DENTAL CARIES

IN PERSONS WITH BURDENED ANAMNESIS

 

Department of therapeutic dentistry of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

Aim.Determination of the source value of enamel resistance in depending of caries' intensity beside somatic patient.

Materials and methods.Carried out researches on the teeth of 280 volunteers from the number of somatic patients with high levels of structural and functional resistance of enamel (73), with the average (68), lower (74) and very low (65) levels of the test indicator. In persons with high levels of structural and functional resistance of enamel intensity staining of enamel surface was in average 2,12±0,23 points. With an average level of enamel caries average value of the identification of staining was equal to 4,24 ± 0,40 points. Among the study groups with low and very low levels of resistance of enamel staining intensity pickled area was 5,98±0,74 and 9,06±0,94 points, respectively.

Results.At a low level of caries intensity in the examined individuals value of structural and functional resistance of enamel averaged 21,9%, with average and high intensity levels – respectively 31,0% and 47,1%.

Conclusion.Beside persons with burdened anamnesis there is inverse dependency between level intensity of caries from structured-functional resistance factor of enamel organ.

Key words:level resistance, intensity of the caries, somatic pathology, dentistry status

 

¹PirovB.S., ²MukhiddinovN.D., ²KalmykovE.L., ¹RummoO.O.

 

RISK FACTORS FOR CHRONIC RENAL FAILURE

IN A RELATED DONOR KIDNEY

 

¹National Scientific Center of transplantation of human organs and tissues, Dushanbe

²Belarusian Medical Academy of Postgraduate Education, Minsk

Aim. To conduct a retrospective analysis of the history of related donors for kidney transplantation and identify chronic disease risk factors before and after the transplant donor kidney.

Materials and methods. A retrospective analysis of 82 stories related donors for 2011 2014, in the Republic of Tajikistan on the basis of the National Scientific Center of transplantation of human organs and tissues (NNTsTOiTCh), which conducted additional research methods: X-ray, ultrasound diagnostic ultrasound, endoscopy, CT, angiography, anthropometric: height, weight, BMI and laboratory studies in which the study of various risk factors have been identified – the various options vascular anatomy. Obesity, smoking tobacco in the form of powder. Women accounted for 47 (57,3%) and 35 men (42,7%).

Results.In angiography, and computed tomography of kidney blood vessels only in 20,4% of cases identified various options for renal vascular anatomy, only in 10,8% cases, these options are treated vessels eksplantecion kidneys. In 48,78% of donors revealed inflammatory diseases of the esophagus, stomach and duodenum 12, who treated conservatively. It was revealed that 57,3% of the surveyed, there are various degrees in 24% of obesity, including obesity before 4,8%, obesity I 16,8% II – III 8,4% and the degree – 7,2 % and 13,2% of men with I and II obese.

Conclusion. As a result, with 37,2% revealed obesity, smoking tobacco in the form of powder (nasvay) at 9,6%, of which 18% was an increase in creatinine donor from 115 to 143 mkmol/l, and for gastro endoscopy revealed varying degrees, with deformation of bulbs 12 duodenal ulcer. With timely application nefroprotektors and elimination of risk factors lead to the normalization of kidney function, in the form of increasing and decreasing GFR creatinine to normal values.

Key words: kidney transplantation, body mass index, smoking, obesity, creatinine, GFR, ultrasound, CT, renal vessels

1RasulovN.A., 2KurbonovK.M., 2NazirboevK.R.

TRANSENTERALNOE RADIATION EXPOSURE AREA FORMED 

IN PREVENTION GEPATIKOEYUNOANASTOMOZOV scar STRICTURES

¹Department of Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

²Department of Surgical Diseases №1 of the Tajik Medical State University named after Abuali-ibn-Sino

 

Aim. Study of a method of the prevention and treatment of scar stricture hepatitiskoeyunanastomoses formed by exposing the anastomosis zone through optical - fiber input via drainages Roux loop.

Materials and methods. This study analyzes the results of treating of 62 patients, who were operated on in about the "iatrogenic" injuries of the extrahepatic bile ducts. From them emerged in time after laparoscopic and conventional cholecystectomy in 41 cases of "iatrogenic" damage to the bile ducts - 21. Restorative surgeries were performed only 15 (24%) cases, in - 47 (76%) cases made ​​reconstructive surgery.

  For the treatment, "iatrogenic" damages the bile ducts and prevent the  risk of scarring strictures formed biliodigestive anastomoses in the clinic developed a method of forming hepatitiskoeyunanastomoses with painted drainage tube through a short section of the Roux- loop to the anastomosis area for regional postoperative laser irradiation.

The effectiveness of this technique studied indicators of endotoxemia level, cytolytic enzymes (ALT, AST), alkaline phosphatase, and the level of IL - 6 before and after laser therapy. Also performed a dynamic ultrasound, MRCP indicated.

Results. So the results of the study show that endotoxemia indicators before and after the regional transterally laser largely began to decline, such as reducing the ACAT activity (0,49±0,02mmol/g/l) and AlAt (0,35±0,01mmol /g/l). Similar changes were observed in the dynamics of endotoxemia parameters - CRP (111,7±0,2mg/l) and IL- 6 (4,75±0,09pg/ml).

    Conclusion. Thus, the formation of a local hepatitiskoeyunanastomoses conducting laser therapy is a highly effective anti-inflammatory and wound-healing treatment, which necessitates the feasibility of applying the method in practice biliary surgery for the prevention of the development of scar stricture formed biliodigestive anastomoses.

    Key words: iatrogenic damage of hepatitiskoeyunanastomoses, laser therapy, prevention, scar stricture

 

¹Saburov S.K.,²Karimov S.M., ³Tairov U.T.

 

RESULTS OF CLINICAL AND MICROBIOLOGY ESTIMATIONS

OF THE HYGENIC CONDITION OF ORAL CAVITY IN PATIENT WITH ACCOMPANYING PATHOLOGY AFTER PROSTHESIS DEFECT TEETH ROW

BY FIXED PARTIAL DENTURE

 

¹Department of Orthopedic Dentistry of Tajik Medical State University named after Abuali-ibn-Sino

²Department of therapeutic dentistry of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

³Society with limited liability "Diyor"

Aim. Clinical and microbiological estimation hygiene efficiency of oral cavity by oral irrigator for preventive of prosthetic's defeats of marginal parodont after orthopedic reconstruction of occlusion defects beside patient with accompanying somatic pathology.

Materials and methods. Beside 56 patient with somatic pathology for irrigation of fixed partial denture and mucous of oral cavity were used air guns of modern dentistry equipment with local reservoir. Amongst examined patient irrigation of fixed partial denture and mucous of oral cavity  in this zone held at scheme: once at day processing by water and one week in each three months with using of 0,001% solution bigluconat chlorgexydine.

Results. Got as a result of clinical examination data allow to note that on 30 day signs inflammations in the field of supporting teeth practically are not defined amongst commonsomatic patient with presence of fixed partial denture in oral cavity. Such is a clinical effect from use of oral irrigator with chlorgexydine existed beside 97,6% patient. After use the course of the preventive treatment in the field of supporting teeth gums pale-rose color registered at checkup, tightly adjoining to surfaces of the supporting teeth, not bleeding when flexing.

Conclusion. Clinical effect from use of oral irrigator with chlorgexydine existed beside 97,6% patient with accompanying somatic pathology. After use the course of the preventive treatment in the field of supporting teeth registered gums with pale-rose color tightly adjoining to surfaces of the supporting teeth.

Key words: dental plaque, occlusion defect, fixed partial denture      

 

Sadikov F.O., Karimov S.M., Ashurov G.G.

 

RESULTS OF THE COMPARATIVE ESTIMATION MARGINAL PERMEABILITY OF COMPOSITE FILLING MATERIALS ON STAGE

OF OPERATIVE-RECONSTRUCTION TREATMENT OF THE CARIES (in vitro)

 

Department of therapeutic dentistry of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

Aim.To conduct comparison of marginal permeability of the composite fillings when using the different ways of its warning.

Materials and methods. Object of the experimental study were shown extracted teeth in amount 20 pieces, in which were prepared cavities I class on Blake. Formed cavities were filling by filling materials. Teeth are arbitrarily divided into 4 groups on 5 samples: I group (checking) – postbonding and surface fluoridation was not conducted; II – postbonding by means of adhesive system Single Bond; III – postbonding by means of surface герметика Opti Guard; IV group – organized deep fluoridation of the border seal-teeth by means of enamel-germetic's liquid. Following stage of the experimental study was thermocycles in mode of 1400 cycles at difference of the temperature from 5 before 60 С during 2 weeks.

Results. Most depth penetration of  dye staff is noted in checking group.  Best results are received when use surface germetic and when undertaking the deep fluoridation (the depth of the penetration of the dye staff in cavity sample has not an essential difference).

Conclusion. For the reason preventive maintenances of marginal permeability of the filling materials most effectively follows to consider use of special cover systems, containing fluorides, or deep fluoridation.

Key words: caries, composite filling material, marginal permeability, deep fluoridation, postbonding, adhesive system

 

¹Safarov A.M., ²Kosimov Z.K., ²Khamidov Dzh.B.

 

THE EFFECT OF PSYCHOLOGICAL STATUS AND COGNITIVE DYSFUNCTION ON QUALITY OF LIFE AFTER TRADITIONAL CHOLECISTECTOMY ON DISTANT PERIOD, BY TAKING IN TO ACCOUNT THE AGE OF PATIENT

 

Department of anesthesiology and reanimatology of  the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»

City Clinical Hospital of emergency medical services

Aim.To determine the effect of psychological status and cognitive dysfunction on quality of life after traditional cholecistectomy on distant period, by taking in to account the age of patient.

Materials and methods.The number of 252 patients with gallbladder stones/cholelithiasis prepared for surgery in Tajik state emergency hospital. They were examined on their psycho-neurological status and cognitive function after the traditional cholecistectomy in 24 months.  

Results.In the period of 24 months the changes of psycho-neurological condition and cognitive parameters have been fixed. The patients of a middle age of 8,5%, the patients of old age of 10, 3% and the senile patients of 3,2%. 

Conclusion.The emotional and cognitive dysfunctions for a quality of life were linked together on patients after traditional cholecistectomy in distant period.

Key words: Cholelithiasis, traditional cholecistectomy, patients of middle, old and senile ages, quality of life, questionnaire – F-36, psychological status by «MMSE» methods, cognitive dysfunctions

 

¹Shomurodova B.S., ¹Shamsidinov A.T., ²Muzaffari M.

 

EFFICIENCY OF TREATMENT OF PERIODONTAL DISEASES WITH THE USE OF PHYTOPREPARATIONS AND ORTHOPEDIC CORRECTION

 

¹Department of orthopedic dentistry of State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

²Course of philosophy of medicine and medical anthropology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Aim.To estimate efficiency of treatment of periodontitis of middle degree of weight with the use of the, planet–based preparations and orthopaedic manipulations.

Materials and methods.Inspection of 62 patients, among them 27 women and 35 men with a diagnosis of chronic generalized periodontitis of moderate severity in age from 30 to 50 years. There are 28 persons in a control group, they were conduct by traditional treatment. In the basic group of 34 persons, besides traditional treatment – based preparations of phytogenous wich were used Plastins “CM”, “CM2”, “Tonzinal” applied in a flow 15-20 days 2 times per days on 1,5 – 2 hours.

As criteria of effectiveness were taken into account of treatment health index of Fedorov-Volodkina, periodontal index for the Russell index for bleeding Myullemanu, X-ray examination.

The state of fabrics of parodontium was estimate in 3, 6, 9 months and year after the conducted treatment.

Results.Data of parodontological indexes patients before conducted treatment had considerably higher than norm. For the patients of control group, treated on a traditional chart, the improvement of fabrics of  paradontium was marked, but these  paradontal indexis notedly fell behind from the indexes of basic group of research.

In the basic group parodontological indexes data and data of roentgenologic method were most favorable with the decline of initial indexes before treat almost two times.

Conclusion.Treatment of periodontitis of moderate severity with the help of herbal remedieswith subsequent orthopedic correction gives good results, having a high degree of efficiency, long period of remission and persistent positive effect on periodontal tissue.

Key words:parodontitis, herbal remedies, orthopedic correction

 

REVIEWS

 

AbdurakhmanovaR.F., IzzatovKh.N.,KhadibaevaG.R., SharipovaB.A., KakharovaM.Kh.

 

MULTIPLE SCLEROSIS: ETIOLOGY, PATHOGENESIS AND CLINICS

(PART I)

 

Department of Neurology and Medical Genetics of the State Educational Establishment «Institute of postgraduate education in health sphere of Republic of Tajikistan»

Multiple sclerosis (MS) – is one of the most socially significant problems of modern neurology. The most important reason of increasing the amount of people with MS is because of absolute growth of diseases and rising the quality of diagnostic and widening the probability of therapy. MS came in first place among the diseases that lead to disability of youth. The perception of MS has been changed to a disease that  "damages myelin sheath of the brain and spinal cord conductors", where the periods of exacerbation followed by periods of almost complete clinical well-being. It is also known that in the early stages of this disease there is damage to the axons themselves, therefore MS is not only considered as an autoimmune demyelinating disease, but also as neurodegenerative. The trigger of the disease are viruses, psycho-emotional stress and poor environmental conditions. This disease has a geographical aspect, the farther from the equator people live, the greater the probability tocontract this disease. The disease is characterized by a variety of clinical manifestations. The variety of neurological symptoms is due to a multiplicity of foci of demyelination and their localization in brain and spinal cord.  Therefore, there may be a wrong diagnosis of the debut of MS, which in turn leads to improper change in current therapy of MS.

Key words:  multiple sclerosis, demyelination, autoimmune disease, neurodegeneration

 

¹Khamidov A.K., ¹Rasulov S.R., ²Muradov A.M., ³Khamidov Dzh.B.

 

MALIGNANT NEOPLASMS

AND THE SYNDROME OF ENDOGENOUS INTOXICATION

 

¹Department of Oncologyof  the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

²Department of Efferent Medicine and Intensive Care of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

³Department of Anesthesiology and Reanimotology of the State Educational Establishment

«Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

Endogenous intoxication Syndrome of (EIS) is found in almost every patient with a malignant tumor. Its manifestations depending localization of the tumor, stage of the process and other factors.Severe clinical manifestations of the syndrome (asthenovegetative, dyspeptic disorders) not only negatively affect the well-being of patients, reducing the indicators of quality of life, but also limit the time frame of the phases of special treatment.Endogenous intoxication is most pronounced in patients with advanced lung cancer, kidney and breast cancer, is less pronounced – when I-II stages of these cancer sites. On the stages of chemo-radiotherapy is increasing levels of endotoxemia indicators.

 Key words: cancer, syndrome of endogenous intoxication

 

CASE FROM PRACTICE

 

SitoraiAkbar, RakhmatovB.M., NarzullevaA.R., RadzhabzodaM.E.

 

INVASIVE TREATMENT OF ISCHEMIC ATRIOVENTRICULAR BLOCK

 

Department of Cardiology with the Course of Clinical Pharmacology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

There is a case of invasive treatment of ischemic atrio-ventricular blockade. The peculiarity of the clinical case was the using of myocardial revascularization such as percutaneous coronary intervention when developed conduction-type atrioventricular block with subsequent recovery of conduction in a short time and without complications.

Key words: ischemic heart disease, atrioventricular block, coronary stenting

 

IN ASSIST TO PRACTICAL PHYSICIAN

 

MurodovaSh.M.

 

DIAGNOSTICS AND CONSERVATIVE TREATMENT

OF CHRONIC LARGE INTESTINE STASIS

 

Department of Surgical Diseases №1 of the Tajik Medical State University named after Abuali-ibn-Sino

Aim. Optimization of diagnostics  and conservative treatment of chronic colonic stasis.   

Materials and methods.During the period from 2014 to 2016 in the Clinical Hospital № 5 on the basis of the Department of General Surgary № 1 of the Tajik State Medical University named after Abuali ibn Sino, we examined 53 patients which were on the conservative treatments.                      

Results.During the ergography from 53 patients in 41 cases were revealed the presence of dolichosigma, in 4 cases the presence transvezoptoz combined with dolichosigma. in 8  patients a combination dolichosigma with a Payer’s  syndrome. In 17 patients  of the total number of observed failure bauginial  flap.                                                                           

Conclusion. It is very important to use specially designed tables for the diagnostic of chronic  colon stasis. Leading instrumental method for detecting various pathological conditions of colon is ergography and virtual colonography. Patients suffering from constipation with the appointment of  laxatives is extremely effective prescription stimulate intestinal peristalsis vitamins and sedatives.

Key words: dolichosigma, diagnostics, conservative treatment

 

4-2016

THEORY AND PRACTICE OF MEDICINE

 

AbdulloevJ.A., SaifudinovSh.Sh.,BilolovM.K.

 

POSTCHOLECYSTECTOMY SYNDROME PREVENTION

 

Department of General surgery №2of the Tajik Medical State University named after Abuali-ibn-Sino

Aim. Improve the results of treatment of patients with cholelithiasis.

Materials and methods.The work analyzes the results of the diagnostic and videolaparoscopic correction of reflux-gastritis and сholedocholithiasis during cholecystectomy in 26 patients with cholelithiasis for the period of 2014-2016. The control group of 21 patients, which went through cholecystectomy onlyand, if necessary, choledocholithotomy with drainage of common bile duct and the subsequent conservative treatment of reflux-gastritis.

Results. The results of research have shown a significant advantage of videolaparoscopic correction of choledocholithiasis and reflux-gastritis during cholelithiasis, whereas, 7 (33,3%) patients of control group were repeatedly received in the clinic with postcholecystectomy syndromediagnosis and repeatedly underwent surgery.

Conclusions. To identify cholelithiasis, its complications and comorbidities, the  comprehensive preoperative examination is required, and after identification – the respective correction during cholecystectomy as prevention method of postcholecystectomy syndrome. The operation of choice is laparoscopic operation and, if necessary,two-stage endoscopic method. Pathogenetically substantiated videolaparoscopic correction of reflux-gastritis and choledocholithiasis during cholecystectomy significantly reduce the incidence of postcholecystectomy syndrome.

Key words:reflux-gastritis, choledocholitiasis, chronic disorder of duodenal permeability, videolaparoscopic correction

 

Akbarov М.М.

 

USINGNITI SUPERELASTIC FOIL IN ELIMINATION

OFNASALCAVITYDEEPATRESIA

 

Department of Maxillofacial Surgery with Children Stomatology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.Toimprovethetreatmentresultsofpatients with profound nasal cavity atresia.

Materials and methods.The work is based on clinical observation of 50 patients with defects and deformations of skeletal and cartilaginous nasal division in the age of 16 to 45 years old, 31 men (62%),  19 women (38%). Theprofoundnasalcavity atresiawasobservedin 3 (6%) of them, surgical removalof which was performed using autogenic materials. Finalnasal meatusformationwasperformedusingsuperelasticNITIfoil.

Results.Theuseoffull-layerskin and fatgraftofnasolabialfold, andasasupport – cartilageofauricleofpatientcontributestocompletefreerestorationofnasalbreathandalsoeliminationofaesthetic deficiency.

Conclusion.Final nasal meatus formation during elimination of profound atresia using super elastic foil in patients during postoperative period provides tight and reliable attachment of grafts, improves regeneration without formation of harsh scars, restores function disorders. Absenceofrecurrencesindicateshighefficiency.

Keywords:profoundnasalcavity atresia, autogenic materials, super elastic NITI foil

 

AlievS.P.

 

STATISTICAL, DYNAMICAL AND CADASTRAL APPROACHES OF ESTIMATION AND FORECASTING OF MALARIA IN THE REPUBLIC OF TAJIKISTAN

 

Tajik Research Institute of Preventive Medicine of Ministry of Health and Social Protection of Population of Republic of Tajikistan

Aim.To study capacity of monitoring and evaluationapproach in predicting malaria based on creation and usage of consolidated, statistical, dynamical and cadastral informational database.

Materials and methods. During the study, the field retrospective, scientific and statistical and other available information materials were used.  As a basic research method the comparative and cumulative consolidation of information from various sources was chosenwhich contributed to increasing of the purity’s degree and scientific validity of obtained results.

Results.The quality and efficiency  level of malaria center analysis and, correspondingly, forecasting of the general malariological situation in specific geographical areas of the country, significantly depends on the volume, scope and requirements used for informational and statistical resources, as well as methodological approaches in their analytical processing.

Conclusion. Providing of optimized, complex assessment and qualitative situational forecasting is most effectively achievable with formation and active using of consolidated statistical-dynamical and cadastral databases, including data on prevalence of malaria vectors, temperature factors, morbidity among the population, as well as taking into account the landscape and cadastral, climate and anthropogenic changes of areas including business-related specifics. Using of the proposed approach will predict and carry anti-malarial activities more differentiated, pointwise, effectively and economically justified.

Key words: forecasting, database, cadaster, mapping

 

AchevaG.А., OdinaevSh. F., OdinaevF. I.

FEATURES OF MICROFLORA IN LUNG

OF PATIENTSWITH CHRONIC PNEUMONIA

The department of internal diseases №1of the Tajik Medical State University named after Abuali-ibn-Sino

Aim. To evaluate the composition type of phlegm and bronchial content microscopic flora of patients with chronic pneumonia.

Materials and methods. The parallel study of phlegm and bronchial content obtained from patients with chronic non-specific pneumonia was conducted. Totally, 102 phlegm samples and the same amount of material obtained during bronchoscopywere examined.

The material was seeded on 5% blood agar. The Endo medium was used for isolation of Enterobacteriaceae, and the Saburo medium was used for detection of fungal flora.

During the study of biological properties of Staphylococcus strain isolated from phlegm and strains isolated from the contents of bronchi, their growth in nutrient media, morphological characteristics, and abilities to coagulate plasma, to ferment mannitol, to cause hemolysis were studied. The basis for judgment of pathogenicity, the reaction of plasma-coagulation was set.

Results.Out of total number of selected strains, Staphylococcus is extracted from the phlegm more often compare to bronchial content. The isolated strains of Staphylococcus from the phlegm and contents of the bronchi can be attributed to pathogenic as isolated Streptococcus strains from phlegm and bronchi. In addition to the coccal flora in biological substrates of patients, the Gram-negative flora (E. coli, Proteus, Pseudomonas aeruginosa) was detected.

Microorganisms in biological substrates of patients with purulent-inflammatory diseases of lungs were observed in monoculture and in associations. All associations are characterized by the presence of Gram-positive coccal flora, with predominance of the association of Staphylococcus and Streptococcus.

Сonclusion. Bacteriological studies of phlegm and bronchial contents of patients with chronic lung diseases showed presence of polymicrobal flora with predominance of Gram-positive coccal species (Staphylococcus and Streptococcus).

Key words: pneumonia, microflora, species composition, sensitivity to antibiotics

 

GulmuradovT.G., AmonovSh.Sh., SangovD.S.

 

МINIMALLY INVASIVE SURGICAL TREATMENT OF LIVER ECHINOCOCCOSIS
 

Department of cardiovascular, Endovascular and Plastic Surgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Republican scientific center of cardio-vascular surgeryof  Ministry of Health and Social Protection of Population of Republic of Tajikistan

Aim. Evaluation of the efficacy of minimally – invasive surgical treatment
of liver echinococcosis.

Materials and methods. The results of diagnostics and surgical treatment of 163
patients with liver echinococcosis were analyzed. In 105 (64,4%) patients, the
echinococcosis cysts were localized in the right lobe of the liver (segments
18-24 V-VI; 31-VII; 28-VIII) and in 58 (35,6%) in the left lobe segments
2-I; 14-II; 19-III; 23-IV. Most of the patients were women which made 108
(66,2%) of the patients and men made 55 (33,7%) of the patients. Depending on
the size and volume of the cyst, they were distinguished by average up to 10
cm in 80 patients, big up to 20 cm in 46 patients and gigantic of more than 20
cm in 23 patients. The average size of echinococcosis cysts made up 102,43 ±
3,7 mm (46-280 mm). Out of 163 patients 86 (52,8%) patients went through
laparoscopic echinococcectomy when echinococcosis cysts were localized in
visually achievable liver segments (II, III, IV, V, VI). 77 (47,2%) of
patients with I-VIII segment localization cysts went through surgery with
minilaparotomic access using a standard set of tools "mini-Assistant".

Results. The duration of hospital treatment of patients with laparoscopic
echinococcectomy was 5 to 8 days, which averaged 6,1 ± 0,7 days, while with
minilaparotomic echinococcectomy average hospital stay of patient was 7-14
days, which averaged to 10±0,8 days. Out of 163 patients operated using
minimally invasive technology (using laparoscopic method and mini-access),
complications were observed in 23 (14,1%) patients. Thus, among all of the
patients, 9 had moderate bile bleeding which stopped by itself. Festering of
remaining cavity was in 3 (3,1%) of patients, under-liver abscess was in 2
patients which needed sanitation and drainage of infected remaining cavities
and under-liver abscess. Patients with minilaparatomy echinococcectomy didn’t
have cases of remaining cavity festering and post-surgery wounds.

Conclusion. Application of minimally invasive technology, while respecting
strict patient selection principles, antiparasitical treatment and surgical
technique allows improvement of the results of surgical treatment of liver
echinococcosis.

Key words: liver echinococcosis, minimally-invasive surgery, echinococcectomy

¹IkromovM.K..

 

THE EFFECTIVENES OF TEMPORARY LIGATION OF EXTERNAL

CAROTID ATERY IN SURGICAL TREATMENT

OF JUVENILE ANGIOFIBROMA OF SKULL BASE

 

¹Department of Otorhinolaryngology of the State Educational Establishment «Institute of  Postgraduate  Education in Health Sphere of  Republic of  Tajikistan»

Aim. Optimization of surgical treatment of juvenile angiofibroma of skull base.

Materials and methods. We observed 47 male patients diagnosed  with “Juvenile angiofibroma of skull base” (JASB). After pre-treatment all inspected were hospitalized for surgical treatment with temporary ligation of the external carotid artery (first group consisted of 20 people).The second control group of 27 people consisted of patientswho were operated using traditional methods (without temporary ligation of the external carotid artery).

Results. The intraoperative blood loss in patients of first group was 200–600 ml; in patients of second group – 650–1,800 ml which required intravenous transfusion of group-match erythrocytes and newly frozen plasma. The average hospital stay of first group patients was 12,5 days, and the second group patients – 19,9 days.

Conclusion. Surgical treatment of juvenile angiofibroma of skull base with temporary ligation of the external carotid artery is the most optimal method compare to traditional method.

 Key words: angiofibroma of skullbase, ligation, carotid artery

 

¹KamilovaM.Y., ²RazzokovaN.Kh., ¹NuralievaSh.A., ³MamarajabovaM.M.

 

THE ROLE OF SEVERE PREECLAMPSIA CRITICAL CASE ANALYSIS USE IN SERVICE QUALITY IMPROVING IN 3-RD LEVEL HOSPITALS

 

¹Tajik Research Institute of Obstetrics, Gynecology and Perinatology Ministry of Health of the Republic of Tajikistan

²Region delivery home of Kurgan-tube city

³The center of reproductive health №1(Dushanbe-city)

Aim.  To estimate the role of decisions, which was form after analysis of missed opportunities in patients with preeclampsia in delivery home of Kurgan-tube city.

Materials and methods. The protocols of preeclampsia near-miss audit and reports for a years in Kurgan-tube delivery home were analyzed.

Results. It was shown, that the missed opportunities was organization of the aid and the low level of the knowledge’s. The systematization of the missed opportunities causes helps brings reality and low expense decisions.

Conclusion. These effective decisions  after realization improve the quality aid to pregnant woman with preeclampsia.

Key words: analysis of the near miss, preeclampsia, missed opportunities, decisions

 

¹KubachevK.G, ²MukhiddinovN.D., ¹ZarkuyaN.E., ¹Lisitsin А.А.

 

CLINICAL AND STATISTICAL GROUPS OF PATIENTS WITH OBTURATIVE COLONIC OBSTRUCTION CANCER

 

¹Department of surgery named after N.D. Monastyrskiy FGBOU VO "Northwest State Medical University named after I.I. Mechnikov". Ministry of Health of the Russian Federation, St. Petersburg

²Department of Surgical Diseases and Endosurgery of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Aim.To conduct analysis of direct results of treatment of patients with tumor of hepatopancreaduodenal zone organs complicated with mechanical jaundice.

Materials and methods. Research is based on comparative and retrospective analysis of 952 patient case histories with mechanical jaundice of different genesis out of which 479 (32%) subsequently were diagnosed with cancer of hepatopancreaduodenal zone organs. General clinical and special method inspections were conducted.

Results. Frequency of cancer of hepatopancreaduodenal zone of different localization in men and women is different. 149 patients had laparoscopic and mini-access surgeries directed to temporary divert bile using different methods in order to decompress and release of mechanical jaundice. Conducting radical surgery or forming biliodigestive anastomosis was only after full recovery of liver functions, normalization of fibrillation system parameters.

Conclusion.Presence ofmechincal jaundice requires verification of its development reasons. In periampullary cancer complicated with mechanical jaundice, the two-stage surgery is indicated. Drainage method choice is based on tumor localization, and topographic and anatomical features of biliary system. Radical surgeries are conduced after complete normalization of liver functions.

Key words: cancer of hepatopancreaduodenal zone organs, obstructive jaundice, bile-duct drainage methods

 

¹KurbonovK.M., ²RasulovN.A., ¹NazirboevK.R.

 

 

DIAGNOSIS AND TREATMENT TACTICS of bile duct RE-strictures

and formed biliodigestive ANASTOMOSIS

 

¹Department of Surgical Diseases №1 of the Tajik Medical State University named after Abuali-ibn-Sino

Department of Surgery of the State Education Establishment “Institute of Postgraduate ²Education in Health Sphere of Republic of Tajikistan”

Aim. To improve the results of complex treatment of injuries and cicatricial bile duct strictures.

Materials and methods. This paper presents the results of treatment of 41 patients with re-stricture of VZHP (n=28) and formed biliodigestiveanastomosis (n=13).In all cases, the cause for cicatricial bile duct stricture was iatrogenic traumaduring primary surgery.

Results. The number of patients with VZHPre-stricture and formed biliodigestive anastomosis with condition severity indicators according to APACHE II was 13 (31.7%) which corresponded to the number of patients with satisfactory and moderate severity conditions. Patients with higher APACHE II indicators were 19 (46.3%), and in 9 (22%) cases, the condition severity indicator of patients was more than 20 points.

The increase in the level of cytokines (IL – 2 – 8,2 ±0,8pg/ml IL – 6 – 16,5 ± 0,6 pg / ml IL – 8 – 54,4±1,0 pg/ml and FNOα – 6.0±0.2pg/ml), and MDA (3,8±0,05nmkmol/l) indicate the presence of inflammation in the area of narrowing and impaired formation of normal connective tissue.In 38 observations, in order to identify the level and length of stricture and their complications,the direct methods of bile duct contrasting which are ERCP(n= 20), CHCHHG (n = 9) and percutaneous cholangiography (n = 8), and in 6 cases MRCP were performed.

Identified predictors of VZHPre-stricture and formed biliodigestive anastomosis occurrence allowed when performing surgical procedures to hold a number of provisions that allow you to minimize the risk of stricture recurrences.

Conclusion.In treatment of patients with VZHPre-stricture and formed biliodigestive anastomosis an integrated approach taking into account predictors of recurrence of strictures that allow in each case to choose the most optimal variant of surgical correction is required.

Key words: bile duct, iatrogenic trauma, biliodigestive anastomosis, re-stricture

¹MakarenkoO.A., ¹AlyanskiyA.L., ¹IvanovaN.E., ¹GolovachevaA.A., ¹KuzmichE.V., ¹KucherM.A., ¹Babenko Е.V., ¹Estrina М.А., ¹PevtcovD.E., ²BakhovadinovB.B., ¹AfanasyevB.V.

 

the role of unrelated donor bone marrow registry development in Russian Federation and effectiveness of search

 

¹Raisa Gorbacheva Memorial Institute for Children Oncology, Hematology and Transplantation, Saint-Petersburg, Russian Federation

²First State Pavlov Medical University of Saint-Petersburg

Aim. To increase the incidence of successful search for an unrelated donor of bone marrow for citizens of Russian Federation and CIS countries via Russian search system «Bone Marrow Donor Search» («BMDS»).

Materials and methods. Since 2012 several measures are being held in Raisa Gorbacheva Memorial Institute for Children Oncology, Hematology and Transplantation to develop and to promote «BMDS» service, which now include data from 13 Russian registries. From November 2012 to March 2016 34 patients with malignancies and hematology diseases were enrolled to the study to undergo alloHSCT: all patients were found HLA-compatible donor in «BMDS»

Results. Currently «BMDS» includes 50 000 potential donors, which allowed to perform 34 alloHSCT from HSC donors recruited in Russian registries for 3,5 years: 2012 year – 1; 2013 year – 3; 2014 year – 5; 2015 year – 21; 1 quarter of 2016 year – 4. Effectiveness of search was greatest in 2015 year – 14% (n=17), which is a historical maximum. In 30 cases (88,2%) – 10/10 HLA-compatibility was observed, in 4 cases (11,8%) – 9/10 HLA-compatibility. AB0-compatible HSCT were only in 7 cases (20,6%). Engraftment was observed in 79,4% of cases (n=27).

Conclusion. Increasing efficiency of search with the use of «BMDS» for a HLA-compatibleunrelated HSC donorfor Russian and CIS citizens was found, with comparable qualityof graftin comparisonwith international database «BMDW».

Key words: hematopoietic stem cell transplantation, bone marrow donor search, «BMDS»

 

¹NozirovDzh.Kh., ¹NarzullaevaA.R., ²IsomidinovA.I.

 

THE PREVALENCE OF CHRONIC MENTAL AND EMOTIONAL STRESS AMONG THE UNORGANIZED COUNTRYSIDE POPULATION OF TAJIKISTAN

 

¹Department of Cardiology with the Course of Clinical Pharmacology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

²Department of oriental medicine, physical therapy and exercise therapy

Aim. Screened method to investigate the prevalence of chronic emotional stress among the countryside population of the Republic of Tajikistan.

Materials and methods. Comprehensive screening study examined 16,500 people. (7193 men – 43,6% and 9307 women – 56,4%) in the age of 15-59 years. To determine the level of stress L. Ridera scale was used, which included 7 questions with 4 replies tothem. Evaluation of the level of emotional stress was carried out according to value of the mean summary score: 1-2 points for men and 1-1,62 points for women regarded as high; 2,01-3 points for men and 1,63-2,82 for women points regarded as average; 3,01-4 points for men and 2,83-4 points for women regarded as low.

Results. In the both of country 40,2±1,7% of the number of surveyed (35,2±1,1% of men and 44,1±1,0% women) were exposed to stress. It is established that gender and age dependence of chronic emotional stres level with the highest frequency of detection in men aged 55-59 years (45,4±2,6%). In women, such a pattern observedaged under 54 years onwards (in 55-59 years) it was a slight decline. Faithful gender difference (1,4 times) in the prevalence of chronic emotional stress observed in the range 45-54. Comparative analysis of the prevalence of factor chronic emotional stress the population of different regions of the country showed relatively high prevalence among residents of Vakhdat district RRS – 60,4% (56,5% – men and 63,2% – women), less – among the residents of Tursunzade – 48,9% (36,1% – men and 58,0% – women). The lowest indicatorsat inhabitants of Vanj district of GBAO – 22,5% (23,5% – men and 21,7% – women) and Ganchi district of Sughd region – 25,2% (22,5% – men and 27,5% – women).

Conclusion. Taking into account theidentifiedof regional and polo-age features there is an urgent need to strengthen of preventive work among the population of surveyed regions.

Key words: cardiovascular disease, screening, chronic psihoemotsionalnoe stress

 

¹Rakhimov A.T., ²Muradov A.M.

 

INFLUENCE OF 0,06% SOLUTION OF SODIUM HYPOCHLORITE ON SOME BIOCHEMICAL AND TOXIC BLOOD PARAMETERS IN PATIENTS WITH ISOLATED SHIN BONES FRACTURES AND SEVERE DIABETES MELLITUS

 

¹Department of Traumatology and Orthopedics of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

²Department of Efferent Medicine and Intensive Care of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

Aim.Studying the effect of 0,06% solution of sodium hypochlorite on some biochemical and toxic blood parameters in patients with isolated shin bones fractures and severe diabetes mellitus.

Materials and methods.Analyzed the results of treatment of 61 patients with isolated shin bones fractures (ISBF) combined with severe diabetes mellitus (SDM), over the age of 40 years, 60,5% – males, women – 39,5%.Patients randomized into two groups: 1 – 31 (50,8%) patients who underwent traditional treatment of fractures; 2 group – 30 (49,2%) patients in addition to traditional treatment was used intravenous injection of 0,06% solution of sodium hypochlorite (NaOCl).Determined content in theblood of toxic products (metilsulfonilmetan, urea, creatinine, circulating immune complexes), the concentration of glucose, bilirubin, ALT, AST, and calculated the index of intoxication and leukocyte index of intoxication after 4-6, 6-12, 12-24 hours after the infusion of hypochlorite sodium according to conventional techniques.

Results.After including to the program of intensive therapy infusion 0,06% NaCIO solution indicated a statistically significant improvement of homeostatic parameters: reduced levels of hydrophilic, hydrophobic, amphiphilic, low-, metilsulfonilmetan and oligopeptides of high weight, an expressed antifermental activity and hypoglycemic effect with the ability to release hemoglobin out of HbA1c.

Conclusion. After including to the program of treatment of intravenous infusion of 0,06% solution of sodium hypochlorite indicated a higher effectiveness of the therapy.

Key words: diabetes, shin bones fractures, injuries, sodium hypochlorite, indirect electrochemical oxidation, blood toxicity

 

RakhmatovaR.A., RakhmonovaP.E., TilloyevaF.Kh.

 

STUDYING OF HEAVINESS OF STATEOF NEWBORN CHILDREN

BORN FROM MOTHERS WITH OVERBURDENED

OBSTETRICAL ANAMNESIS

 

"Republican Scientific and Clinical Center of Pediatrics and Child's Surgery" State Institution

Aim.To evaluate the heaviness of state of newborn children born from mothers with overburdened obstetrical anamnesis.

Materials and methods.The analysis of observation results of 170 newborn children was conducted. The women in laborwere divided into two groups: group 1 – 125 patients with high risk of intrauterine infection; group 2 – 40 pregnant healthy women. Clinical, laboratory, ultrasonic and doplerographic research methods were applied.

Results.170 children were born alive from 165 women in labor: 139 – full-term, 31 – premature. Clinical signs of a prematurity were seen in 27 (21%) of newborn of the first group of patients and 4 newborn (10%) of the second group.

The average body weight of the children born from women recently confinedwhich make the first group was around 2,855±0,88 grams andbody height 51,2±0,48 cm. Children who were born in control group of research, the body mass was around 3000±0,96 grams and body height was53,8±0,49 cm.

Conclusion. The overburdened anamnesis during pregnancy is related to risk factors of occurrence of septic process during the newborn period. The leading factor of pathologic process occurrence is the combination of bacterial and viral infection. There is a high risk of infection occurrence in newly born from mothers with overburdened obstetrical anamnesis.

Key words: women in labor, prenatal period, genitourinary apparatus, pathological state

 

RakhmonovaP.E., TilloevaF.Kh., NabievZ.N.

 

THE STUDY OF THE IMMUNOLOGIC STATUS DURING PNEUMONIA

IN NEWBORNS ANDCHILDREN OF EARLY AGE

 

"Republican Scientific and Clinical Center of Pediatrics and Child's Surgery" State Institution

Aim. Use of an immunoglobulin in intensive complex carein severe form of pneumonia.

Materials and methods. On the basis of clinical observation of 53 ill children in the age of 7 days to 1 year who received treatment in reanimation unit, intensive therapyunit and unit for children of early age of somatic unit of the National medical center in 2013.

Results.Newly born and children of early age because of changes in the bronchopulmonary system and oppression of immune disorders, clinical and laboratory parameters had deviations from indicator norms. 16 (30,2%) patients had leukocytosis and 11 (20,8%) patients had neutrophilic leftward shift change. Because of changes in blood formula in all the studygroups of patients high erythrocyte sedimentation rate data, which was 29,5±3,4 mm / h was indicated. 21 (39,6%) of patients had high indicators of C-reactive protein.

Conclusion.These study data provide evidence of the need for immunoglobulin use in the complex therapy of ill children with respiratory diseases.

Key words: children, immune status, pneumonia, immunoglobulins

 

Saidmuradova R.Kh., Makhkamov K.K., Khodzhibekova N.O., Buzrukova N.D., Kholinova M.M.

 

ASPECTS OF NURSING OF UNDERWEIGHT CHILDREN AND OPTIMIZATION OF PROGNOSIS OF THEIR FURTHER DEVELOPMENT

 

Department of Neonatologyof the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim. To study the features of nursing and prognosis of further development of underweight children.

Materials and methods. Carried out a clinical study of 120 newborns, who were born weighing up to 1500 grams. They were divided into 3 groups.

Results. Comprehensive survey of children with low body mass revealed a number of clinical, functional and metabolic characteristics, based on them we must built a program of nursing. Not fully formed functional systems of organism cause a high frequency of postnatal adaptation disorders syndromes: respiratory distress syndrome – 80%, edema syndrome – almost 100%, convulsive syndrome – 40%. Noted the correlative dependence of intraventricular hemorrhage with gestational age less than 30 weeks, fast childbirth, mechanical ventilation of lungs in child. Prevention of hypothermia due to the morphofunctional immaturity of premature children is important, therefore is necessary to maintain the water and electrolyte metabolism. Hypoglycemia observed in 68%, hypocalcemia – in 42%, hypernatremia – in 30% of investigated children. In 62% of children marked the realization of septic process in early neonatal period.

Conclusion. Improvement of organizational forms of rendering of assistance during the antenatal period and period of early adaptation of children with low body mass, adequate reanimation and their rehabilitation should be the main direction in solving of mentioned problems.

Key words:newborn, low birth body mass, delay of prenatal development, reanimation, prevention

 

RuziyevM.M.

 

FEATURES OF HIV INFECTION PREVALENCE

AMONG CHILDREN IN TAJIKISTAN

 

"Republican Center for Prevention and Fight against AIDS"State Institution

Aim.The study of the prevalence of HIV infection among children and their factors of transmission risk.

Materials and methods.The official materials of republican and regional centers on prevention and fight

Results. As of December 2015, the cumulative number of officially registered HIV-positive children under 15 years old in Tajikistan is 637. Moreover, 370 or 58,3% of themdid nothave HIV-positive mothers and their mode of transmission was registered as "unknown." However, the nosocomial transmission of infection during certain manipulations associated with skin and mucous membrane damages,in particular, during home deliveries, ear-piercing, circumcision, acupuncture, etc., outside of health facilities, for instance, by quacks (parents addressing to them) isn’t excluded.

Conclusion. The results indicate that the AIDS center employees should take measures to indicate the mechanism of HIV transmission in each case of children with "unknown" was of transmission.

Key words: HIV infection, risk factors, ways of transmission, pregnant women, children, people living with HIV

 

 

REVIEWS

 

JabarovaT.S., MuhiddinovN.D.

 

STAGED IMPROVEMENT OF UNDER- AND POSTGRADUATE MEDICAL EDUCATION SYSTEM IS THE GUARANTEE OF QUALITY HEALTH SERVICES TO THE POPULATION

OF REPUBLIC OF TAJIKISTAN

 

State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

 

The article discusses the current system of under and postgraduate education of health workers in the Republic of Tajikistan. We provide the results of the analysis of the regulatory documents of medical education and recommendations for optimization and intorduction of continuous postgraduate medical education for doctors and nurses.

Key words:doctor,postgraduate eduction, continuous education, health services to population, hospital services and primary health care

 

¹MirzoevaF.O., ^1,2Bobokhojaev O.I.

 

COMPARATIVE ANALYSIS OF TUBERCULOSIS EPIDEMIOLOGICAL

SITUATION IN DIFFERENT REGIONS OF THE WORLD

 

¹Department of Public Health, Health Economics and Management with the course of Medical Statistics of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

²National Centre for protection of population from tuberculosis

The article analyzes the tuberculosis morbidity evaluation in all six WHO regions. 22 countries were allocated with the highest burden of tuberculosis that have the greatest impact on the "global burden" in the world, based on their contribution (80% of new cases) in the total number of cases in the world. The incidence rate is very sharply varies in different countries and regions. It largely depends on the socio-economic development, the level of medical care and, as a consequence, methods of identifying patients, the quality of the inspection with the use of these methods, the completeness of registration.

Keywords: tuberculosis, epidemiological situation, regions of the world