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DESIGNING AND RECOMMENDING FORECAST-BASED
OPTIMIZATION ALGORITHMS FOR ACUTE GLAUCOMA CONTROL
IN VALLEY CONDITIONS
Mamasoliyev Z.N.
Rustamjonov A.B.
Andijan State Medical Institute, Republic of Uzbekistan.
https://doi.org/10.5281/zenodo.16537369
Relevance.
In recent years, there has been an increase in clinical guidelines
dedicated to the prevention of chronic diseases and their complications. These
guidelines serve as a convenient "reference" encompassing modern data,
defining scientific and practical directions, widely introducing preventive
concepts within specialties, and improving clinical practice by at least 80%. Such
directions and recommendations in glaucomatology are very rare or have not
been developed at all for certain regions and populations. In preventive
glaucomatology, studying the issues of optimizing the prevalence, clinical
course, and treatment and prevention of acute glaucoma attacks is considered
one of the urgent scientific topics.
For example, in the population with a comorbid background, in particular
with glaucoma, the modification of lifestyle taking into account cardiovascular
diseases (CVD) has a medical, economic, and social effect. Similar results were
achieved and conclusions were drawn in non-communicable chronic diseases.
In glaucoma and GCC with cardiocomorbidity, this practical and
scientifically significant issue has not been fully resolved and has not been
specifically studied in individual populations and regions.
The development of these basic principles of preventive medicine in
ophthalmology, particularly in the case of glaucoma and AGA, represents a
pressing problem and scientific issue.
Because, despite the constant development of fundamental and clinical
glaucomatology, glaucoma continues to remain one of the main health problems
and the main cause of irreversible blindness worldwide.
Material and method.
The relative risk of the occurrence of an acute
glaucoma attack depending on risk factors in the valley population and the
gender characteristics of the algorithm for its prediction were studied and
evaluated. The development of algorithms for the prevention of primary and
secondary glaucoma is an important theoretical and scientific activity, especially
in various regions. The dissertation research on such a scientific topic was
specifically devoted to the acute glaucoma attack and was not carried out in the
regions of Uzbekistan, in particular, on the example of the valley. Such a study
was conducted for the first time, and in this dissertation work, an algorithm for
calculating the relative risk and prognosis of the occurrence of an acute
glaucoma attack depending on risk factors in the valley population was
developed.
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In the population of women of the valley, 15 risk factors directly related to
the acute glaucoma attack - low, high, and extremely high risk of developing an
acute glaucoma attack - were identified and confirmed. These are ≥ 40 age factor
> 60 age factor, hereditary factor, smoking, obesity, alcohol consumption,
hypodynamia, stress, comarbidity, cardiovascular diseases (CVD), respiratory
diseases (RD), gastrointestinal diseases (GD), urinary system diseases (UIS), and
diabetes mellitus (DM2). Under the influence of the age factor >40 and >60
years, the risk of AGA development increases insignificantly (P>0.05)..
In this case, in the female population, a factor (P>0.05), stress factor
(P>0.05), cataract (P>0.05), CVD (P>0.05), DUS (P>0.05), and D2 (P>0.05) are
confirmed as risk factor that significantly increase the risk of seizures.
In women with glaucoma, smoking (r= 0.5/9; P<0.001) and alcohol
consumption (r= 0.329; P<0.001) are factors associated with 8 high levels of
AGA. A high risk for AGA is directly related to obesity as a risk factor (P>0.01).
Lower risk levels for AGA are associated with hypodynamia (r= 0.090; P<0.05),
comorbidity (P>0.05), DRO (r= 0.095; P<0.05), and GD (r= 0.086; P<0.05).
The 8th highest risk of an acute course of glaucoma in the male population
is associated with smoking (P<0.001) and alcohol consumption (P<0.001). A low
risk level is predicted in hypodynamia (P>0.05), DRO (P>0.05), and GD (P>0.05).
Insignificant risk is predicted under the influence of 15 other risk factors: > 40
years and > 60 years, hereditary factors, obesity, stress, comarbidity, cataracts,
CVD, DUS and D2.
"Implementing preventive measures as a barrier" against 2 to 8 strong and
3 strongly negative factors completely eliminates AGA (primary glaucoma
prevention) or slows it down to an unknown degree (secondary glaucoma
prevention).
In the urban population of Andijan (Table 4), smoking (P<0.05; p= -0.078),
comarbidity (P<0.05; p= -0.084), and cataract (P<0.05; p= -0.078) are confirmed
as risk factors for a significant but low-degree glaucoma attack.
Among the remaining 12 risk factors, an insignificant degree of risk leads to
the occurrence of an acute glaucoma attack.
The following tables 5-6 show algorithms for assessing/predicting the
relative risk of developing an acute glaucoma attack in relation to risk factors in
the population aged <60 and ≥60 years.
A very high risk of AGA occurrence is associated with or predicted by
hypodynamia (P<0.001; p=0.322) and cataracts (P<0.001; p=0.311).
A high level of AGA risk is confirmed/prognosed depending on CVD
[P<0.01; p=0.217].
Low level of risk. In the origin of AGA DRO (P<0.05; p=0.115), GD (P<0.05),
comorbidity (P<0.05; p=0.093) and obesity (P<0.05; p=0.050) were associated.
In other risk factors, such a risk is predicted insignificantly. In the
development and recommendation for practical activities of optimization
algorithms based on the prediction of the treatment and prevention of acute
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glaucoma attacks in the population aged ≥60 years, the leading or main
important risk factor is hypodynamia (under the influence of this factor, an
extremely high risk of AGA occurrence is confirmed; P<0.001), cataract
(extremely high risk; P<0.01), CVD (poses a high risk; P<0.01), comorbidity
(creates a low risk; P<0.05), DRO (creates a low risk level; P<0.05) and GD
(creates a low risk level; P<0.05).
In conclusion:
the implementation of the developed algorithms and their
use in measures for the timely diagnosis, control and prevention of glaucoma: 1)
the level of early detection and elimination of an acute glaucoma attack - reaches
more than 50%; 2) blindness and other ophthalmological complications caused
by glaucoma attacks also decrease at least in every second patient (reaching
50%); 3) losses from the acute course of glaucoma (of socio-economic
significance) are reduced by half; 4) the risks from medications used in the
context of glaucoma and its attacks are almost completely eliminated, reaching
100.0%.
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