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CLINICAL AND LABORATORY COURSE OF BRUCELLOSIS IN CHILDREN
AND THE ROLE OF PHYSIOTHERAPY IN TREATMENT
Sultanov Ravshan Komiljonovich, Arsariyev Elmurod Rasulovich
Termez University of Economics and Service
PhD, Associate Professor, Department of Fundamental Medical Sciences
Termez University of Economics and Service
Treatment work student of group 23-08
E-mail:
Abstract:
This article presents the clinical course of brucellosis in children, changes in
laboratory analyses, and the effectiveness of physiotherapy in modern treatment. The study
was conducted on 140 patients with acute brucellosis aged 3 to 17 years who were
hospitalized in the Children's Department of the Surkhandarya Regional Infectious Diseases
Hospital.
Premorbid anemia negatively affects the course and outcome of acute brucellosis in children.
Additionally, to prevent various complications in the bones and joints as well as disability,
patients were recommended for rehabilitation in sulfur and radon-rich resorts, specifically
the Sherabad and Omonkhona resorts, taking into account the damage to their
musculoskeletal and nervous systems.
Keywords:
Surkhandarya, children, acute brucellosis, rehabilitation, disability,
physiotherapy, arthralgia, fever.
BOLALARDA BRUSELLYOZ KASALLIGINING KLINIK LABARATOR
KECHISHI VA DAVOLASH MUOLAJALARIDA FIZOTERAPIYANING O‘RNI
Annotasiya:
Ushbu maqolada bolalarda brusellyoz kasalligining klinik kechishi, labarator
tahlillaridagi o‘zgarishlari, zamonaviy davolashda fizioterapiyaning o‘rni samaradorligi
keltirilgan. Tadqiqot ishi Surhondaryo viloyat yuqumli kasalliklar shifoxonasida Bolalar
bo‘limida yotib davolangan 140 nafar o‘tkir brusellyoz bilan zararlangan 3 yoshdan 17
yoshgacha bo‘lgan bemorlarda olib borildi.
Bolalardagi o‘tkir brusellyoz oqimiga va oqibatiga premorbid anemiya holati salbiy ta’sir
ko‘rsatadi. Shu bilan birga suyak bo‘g‘imdagi turli xil asoratlarni, nogironlikni oldini olish
uchun reabilitatsiya maqsadida bemorlarga harakat-tayanch va asab tizimini
zararlanganligini hisobga olgan holda oltingugurt va rodonga boy oromgohlarga Sherobod
oromgohida va Omonxona oromgohida davolanishga tavsiya berildi.
Kalit so‘zlar:
Surhondaryo, bolalar, o‘tkir brusellyoz, reabilitatsiya, nogironlik, fizoterapiya,
artralgiya, istma.
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КЛИНИКО-ЛАБОРАТОРНОЕ ТЕЧЕНИЕ БРУЦЕЛЛЕЗА У ДЕТЕЙ И РОЛЬ
ФИЗИОТЕРАПИИ В ЛЕЧЕБНЫХ МЕРОПРИЯТИЯХ
Аннотация:
В данной статье представлены клиническое течение бруцеллеза у детей,
изменения в лабораторных анализах, роль и эффективность физиотерапии в
современном лечении. Исследование проводилось на 140 пациентах с острым
бруцеллезом в возрасте от 3 до 17 лет, находившихся на стационарном лечении в
детском отделении Сурхандарьинской областной инфекционной больницы.
На течение и исход острого бруцеллеза у детей отрицательно влияет наличие
преморбидной анемии. Вместе с тем, для профилактики различных осложнений
костно-суставной системы и инвалидности, с целью реабилитации пациентам
рекомендовано лечение в санаториях, богатых серой и радоном, таких как "Шерабад"
и "Омонхона," с учетом поражения опорно-двигательного аппарата и нервной
системы.
Ключевые слова:
Сурхандарьинская область, дети, острый бруцеллез, реабилитация,
инвалидность, физиотерапия, артралгия, лихорадка.
The relevance of the problem:
In the countries of Central Asia, the incidence of brucellosis
remains high among infectious diseases, with the disease being registered in approximately
10 administrative districts of Uzbekistan (accounting for 80% of the Republic). Notably,
80% of cases manifest in chronic form, leading to disability in 30% of patients. This, in turn,
negatively impacts the economic and social development of our country [1].
The urgency of the brucellosis problem is undeniable. However, while numerous studies
have focused on the clinical presentation and other aspects of brucellosis in adults, the issue
of brucellosis in children has been somewhat neglected. In fact, more than one-tenth of
brucellosis cases in our country occur in children. The course of brucellosis is related to the
div's resistance characteristics. School-age children have unique features of resistance to
infection and the ability to eliminate it from their bodies. Therefore, addressing the problem
of brucellosis in the field of pediatrics should be considered of utmost importance [3-4].
Research objective:
To evaluate the continuity of clinical laboratory indicators and the role
of physiotherapy in the treatment of brucellosis in school-age children.
Research methods and materials:
All patients in the study were examined in the Children's
Department of the Surkhandarya Regional Infectious Diseases Hospital. For the study, we
took 140 patients with acute brucellosis aged 3 to 17 years. All of them were confirmed by
MRI, CT, MSCT, general blood and urine biochemical studies, basic Wright and Hedelson
tests. The examination of patients was conducted in patients who received inpatient
treatment in 2021-2024. The studies were conducted in the virology and bacteriology
laboratories of the Surkhandarya Regional and Termez City Sanitary and Epidemiological
Centers.
When studying the sex composition during the study, there were 90 (64%) men and 50 (36%)
women. No statistically significant differences were observed in the groups by sex
composition.
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When studying the age-specific morbidity rate of all patients during the study, 33.7% of
cases were observed in the age group of 17 years and older. When studying the incidence of
acute brucellosis in the sex ratio, the incidence in men and women was 1.3 times higher than
in men. This is due to the fact that when studying the complaints and anamnesis data of all
male patients, they were fattened with small ruminants and cattle and consumed more raw
milk and dairy products. Abuse of wine and alcoholic beverages was also detected.
Table 1
Information on the age and gender of the patient children in the study.
Age
Boys
N=90
Girls
N=50
Total
N=140
M
%
M
%
M
%
3-7 young
17
19
5
10
22
15,7
7-11 young
36
40
18
36
54
38,6
7-17 young
37
41
27
54
64
45,7
Today, despite the infant mortality rate being 15.6 per 1,000 live births, the birth rate
remains very low at 9.1% [2-5]. In recent times, the incidence of acute brucellosis among
children has been increasing. The main reasons for this are the deterioration of the
ecological environment and a sedentary lifestyle, as well as violations of hygienic
requirements in livestock farming facilities.
Results of the study:
The onset of the disease was manifested by respiratory syndrome in 2
patients (8%), diarrhea in 5 (20%), astheno-vegetative symptoms in 5 (20%), flu-like
manifestations in 7 (28%), and arthralgia in 6 (24%). The clinical course was severe in 5
(20%) patients and moderate in 20 (80%). Half of the patients in the study experienced a
disease duration of more than one week, with 20% of patients progressing to a subacute
form. The study showed that the classic symptoms of brucellosis in children are similar to
those in adults. In iron-deficiency anemia, the adaptation of a child's div to brucellosis
infection is significantly weakened, leading to a prolongation of the disease. This conclusion
was confirmed by all the methods applied in the study.
Based on our observations of patients, we have determined that secondary chronic
brucellosis is characterized by intoxication syndrome, manifested as undulating fever, chills,
and sweating, while in primary brucellosis, these symptoms are less pronounced. Damage to
the organs of the reticuloendothelial system is also more evident in secondary chronic
brucellosis compared to primary chronic brucellosis (57.6±5.1%). In brucellosis, the main
pathological process occurs in the musculoskeletal system. It should be emphasized that in
primary chronic brucellosis, signs of arthralgia were observed in 77.9±4.2% of cases. In
patients with secondary chronic brucellosis, arthritis with visible joint changes (swelling,
redness, limited mobility) is characteristic, occurring in 70.6±4.7% of cases compared to
20.0±4.1% in primary cases (p<0.05).
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In treating the disease, we employed etiological and symptomatic therapies during the acute
inflammatory phase, taking into account the pathological processes occurring in the
musculoskeletal system. After the inflammation had somewhat subsided (following the
completion of the first course of etiotropic treatment), patients were recommended various
physiotherapeutic procedures. These included mummy electrophoresis to alleviate joint pain
and reduce inflammation, lidase phonophoresis to enhance absorption, paraffin and mud
applications, and hydrocortisone ultrasound to reduce spasms. For cases of arthrosis-arthritis,
osteochondrosis, neuritis, and radiculitis, massage therapy was also recommended.
Conclusion:
Premorbid anemia negatively affects the course and outcome of acute
brucellosis in children. Therefore, once this condition is identified, it becomes necessary to
make appropriate adjustments to the treatment protocols.
Based on the above, it is crucial to conduct physiotherapeutic procedures in combination
with etiotropic, pathogenetic, and general strengthening therapy when treating children with
acute brucellosis. This approach aims to reduce the inflammatory process in the
musculoskeletal system, maintain motor function in this system, and prevent various joint
complications and disabilities resulting from inflammation. Additionally, for rehabilitation
purposes, considering the damage to the musculoskeletal and nervous systems, patients were
recommended to undergo treatment at resorts rich in sulfur and radon, specifically at the
Sherobod and Omonkhona sanatoriums.
References:
1. Imomaliyev U. N., Kosimov O. Sh., Ibragimov A. A. Nucleotide Composition and
Homology of Brucella DNA // Infection, Immunity and Pharmacology. - Тошкент, 2016. -
No 6. - P. 41-42. (14.00.00; No15).
2. Qosimov O. Sh., PhD thesis abstract. Microbiological and genetic analysis of pathogens
isolated from brucellosis foci in Uzbekistan and improvement of epidemiological
monitoring of the disease. Tashkent-2017.
3. Yarmukhammedova N.A., Rustamova Sh.A., Muminova Sh.Sh. Age-related
characteristics of brucellosis in the Samarkand region. "Problems of Biology and Medicine."
Samarkand, June 14-15, 2018.
4. Tuychiev L. N., Mamatkulov I. Kh., Kasimov O. Sh. Sources and factors of brucellosis
transmission in the Republic of Uzbekistan // 66th Annual Brucellosis Research conference.
- Тошкент, 2016. - P. 50-51.
5. Sultonov R., Qurbonov B. INFEKTSION KASALLIKLAR: SABABLARI, OLDINI
OLISH VA DAVOLASH USULLARI //Journal of science-innovative research in
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