Volume 03 Issue 04-2023
107
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
107-111
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
In approaches to the treatment of infectious lesions of the myocardium, contradictions remain. Scientific studies
evaluating the effectiveness of various drugs in infectious myocarditis that developed against the background of acute
respiratory infections are few and contradictory. Metabolic agents for various pathologies of the myocardium,
according to some authors, are undoubtedly necessary, but others consider their appointment unreasonable. Almost
80% of patients with various acute infectious diseases reveal certain changes in cardiovascular activity. Most of them
represent a natural functional reaction of the div to the action of the pathogen and completely disappear as a result
of the treatment of the underlying pathology.
KEYWORDS
Research Article
BIOCHEMICAL CHANGES IN THE BLOOD INFLAMMATORY DISEASES OF
THE NOSE AND PARANASAL SINS IN PATIENTS WITH MYOCARDITIS
Submission Date:
April 16, 2023,
Accepted Date:
April 21, 2023,
Published Date:
April 26, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue04-16
Djuraev J.A.
Tashkent Medical Academy, Uzbekistan
Khasanov U.S.
Tashkent Medical Academy, Uzbekistan
Khodjanov Sh.Kh.
Tashkent Medical Academy, Uzbekistan
Akhundjanov N.A.
Tashkent Medical Academy, Uzbekistan
Makhamadaminova Sh.A.
Tashkent Medical Academy, Uzbekistan
Jumanov D.A.
Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 04-2023
108
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
107-111
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Myocarditis, sinusitis, acute heart failure.
INTRODUCTION
Infectious diseases, despite the modern possibilities of
treatment and prevention, remain the main pathology
of the population [2]. Today , it is believed that from 1
to 5% of all patients with acute respiratory diseases,
including influenza, have signs of infectious
myocarditis [1,5] . It is very difficult to establish the true
frequency, since latent and mild forms, which are most
characteristic of childhood, range from 24 to 33%, are
rarely diagnosed and end on their own in the absence
of any special treatment, or transform into a chronic
process with nonspecific symptoms [2,3, 7].
The immediate cause of death is acute heart failure,
which progresses against the background of water and
electrolyte disorders, intoxication, and the direct
effect of the pathogen or its toxin on cardiomyocytes
[6]. Any infectious disease may be accompanied by
certain changes in the functioning of the
cardiovascular system of varying severity and duration.
Dysfunction of the cardiovascular system can occur in
about 80% of patients with various acute infectious
diseases [4,9]. Most of them are a natural functional
reaction of the div, they end on their own, without
additional special treatment. But some patients
develop rhythm disturbances and heart failure, often
with a long protracted course, and sometimes with a
risk of death.
It is now known that any of the known pathogens can
cause myocardial damage, including myocarditis [5].
Often, viruses that can directly interact with
cardiomyocytes become an etiological factor , which
leads to cell apoptosis [6].
The diagnosis of myocarditis or cardiomyopathy is not
in doubt, usually in severe forms of myocardial
damage. With mild or moderate severity, the observed
clinical symptoms of complications are nonspecific and
varied, depending not only on the etiology and severity
of the manifestations of the underlying process, but
also on the individual characteristics of the organism.
In approaches to the treatment of infectious lesions of
the myocardium, contradictions remain. Scientific
studies evaluating the effectiveness of various drugs in
infectious myocarditis that developed against the
background of acute respiratory infections are few and
contradictory.
Metabolic
agents
for
various
pathologies of the myocardium, according to some
authors, are undoubtedly necessary, but others
consider their appointment unreasonable [5,10].
Almost 80% of patients with various acute infectious
diseases have certain changes in cardiovascular activity
[ 8]. Most of them represent a natural functional
reaction of the div to the action of the pathogen and
completely disappear as a result of the treatment of
the underlying pathology. However, in some cases, an
independent pathological process develops in the
heart, which can directly affect not only the course of
infection, its duration and outcome, but also determine
the quality and life expectancy [4,9].
The purpose of this study is to identify biochemical
changes in the blood during inflammatory diseases of
the nose and paranasal sinuses in patients with
myocarditis .
Materials and research methods. The study included
186 patients with myocarditis who were hospitalized at
the Republican Specialized Center of Cardiology. The
patients were divided into two groups. The first group
consisted of 80 patients with chronic inflammatory
Volume 03 Issue 04-2023
109
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
107-111
SJIF
I
MPACT
FACTOR
(2021:
5.
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(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
diseases of the nose and paranasal sinuses. The second
group consisted of 106 patients without pathology of
the nose and paranasal sinuses. All patients were
subjected to a comprehensive clinical and laboratory
study, which included the collection of an anamnesis of
the disease, laboratory tests, nasal endoscopy, X-ray
examination and biochemical studies. The control
group consisted of 20 healthy volunteers from the staff
of the 2nd clinic of the Tashkent Medical Academy.
Research results. Group I patients complained of
difficulty in nasal breathing (92.5%), nasal discharge
(78.4%), impaired sense of smell (22.2%), subfebrile
fever (36.4%), general weakness ( 42.5%). Headaches
were also often noted (78.4%), more in the maxillary
region. Patients of the II group had practically no
complaints from the nose and paranasal sinuses. With
comparative indicators of blood tests in the studied
groups (Table 1), it was revealed:
Table 1
Parameters of the general blood test in patients with myocarditis
Indicators
I , M±m
( n =80 )
II
group, М±m
( n =106)
Control group, M±m
( n =20)
Leukocytes (10
9
/l)
7.54±0.60*
6.84 ± 0.52 _ _
6.15±0.39
ESR (mm/h)
21.05±3.40*
18.73 ± 3.05 * _ _
6.36±0.80
Lymphocytes (%)
22.64±1.96
26.45 ± 1.87 _ _ _
30.87±1.90
Monocytes (%)
4.61±0.56
4.25 ± 0.42 _
3.58±0.37
Eosinophils (%)
1.24±0.26
1.46 ± 0.30 _
2.47±0.32
Band (%)
4.23±0.77
3.2 8 ± 0.62 _
2.66±0.36
Segmented (%)
67.22±1.50
6 4 .55 ± 1.62 _
60.75±1.86
*- the difference is highly significant, p< 0.001.
In a laboratory blood test, all patients showed leukocytosis and an increase in ESR, especially these changes were
more pronounced in patients with chronic inflammatory diseases of the nose and paranasal sinuses. At the same time,
in this group, the number of leukocytes was 7.54±0.60x10 9 /l, and the ESR was increased to 21.05±3.40 mm/hour.
Table 2
Indicators of biochemical blood tests in patients with myocarditis and in the control group
Indicators
I , M±m
II
group, М±m
Control group, M±m
Volume 03 Issue 04-2023
110
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
107-111
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
( n =80 )
( n =106)
( n =20)
Creatinine ( µmol /l)
78.12±3.10
82.22±2.92
84.60±2.82
Urea (mmol/l)
5.04±0.23
5.85±0.30
6.65±0.45
ALT (mmol/ g.l )
0.70±0.09
0.64±0.07
0.42±0.06
AST (mmol/ g.l )
1.13±0.23*
0.94±0.18
0.48±0.06
LDH (mmol/ g.l )
7.97±1.24*
7.20±1.03*
4.90±0.28
CPK (mmol/ gl )
10.68±3.10*
8.76±2.74*
2.86±0.49
Protein (g/l)
73.40±1.51
72.25±1.52
70.18±1.65
*- the difference is highly significant, p< 0.001.
As shown in Table 2, the biochemical analysis of blood
also shows more pronounced changes in patients of
the first group than in patients of the second group.
An increase in AST (1.13±0.23 mmol/ gl ) in patients with
myocarditis is associated with cell destruction or
increased plasma membrane permeability. There was
also an increase in creatine phosphate kinase (CPK) in
patients of both groups (10.68±3.10 mmol/ gl and
8.76±2.74 mmol/ gl , respectively), which indicates
increasing myocardial damage.
When examining troponin levels I quantitative method
in patients of the first group with chronic diseases of
the nose and paranasal sinuses, its average
concentration was significantly higher (p = 0.0001)
than in patients of the second group without
pathology of the nose and paranasal sinuses (0.49 ±
0.09 Ng / ml and 0.39±0.06 Ng /ml, respectively ).
Troponin test data I quantitative method are
presented in table 3.
Table 3
Troponin level I quantitative method in patients with myocarditis
Groups
of patients
n
Troponin level I , Ng / ml,
M±m
I group
80
0.49±0.09
II group
106
0.39±0.06
Control group
20
0.05±0.02
*- the difference is highly significant, p< 0.001.
Volume 03 Issue 04-2023
111
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
107-111
SJIF
I
MPACT
FACTOR
(2021:
5.
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(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
CONCLUSIONS
In connection with the foregoing, a laboratory study
showed specific changes in the blood in the
myocardium, as well as a comparative assessment of
pronounced changes in the simultaneous course of
inflammation in the myocardium and paranasal
sinuses. Thus, our studies of patients with myocarditis
revealed the fact that the clinical course of myocarditis
is more pronounced in patients with chronic
inflammatory diseases of the nose and paranasal
sinuses due to the presence of an infection focus in the
ENT organs.
REFERENCES
1.
Khasanov US, Juraev Zh.A., Toshpulatov Zh.
Features of diseases of the nose and paranasal
sinuses in patients with myocarditis. Young
scientist. 2016(10):547-50.
2.
Shamsiev D.F., Vohidov U.N., Karimov O.M. A
modern view on the diagnosis and treatment
of chronic inflammatory diseases of the nose
and paranasal sinuses. Young scientist.
2018(5):84-8.
3.
Buggey J., ElAmm CA Myocarditis and
cardiomyopathy. Curr Opin Cardiol . 2018
May;33(3):341-346.
4.
Ghogomu N., Kern R. Chronic rhinosinusitis :
the rationale for current treatments. Expert
Rev Clin Immunol . 2017 Mar;13(3):259-270.
5.
Hekimian G., Combes A. Myocarditis . Rev Med
International . 2017 Aug;38(8):531-538.
6.
Mlejnek D., Krejčí J. Myocarditis and
inflammatory cardiomyopathy. Vnitr Lek . Fall
2017;63(7-8):507-512.
7.
Slovick A., Cornet M., Surda P., Tomazic PV
Chronic rhinosinusitis : New understanding of
specific and general Quality of life scores.
Rhinology . 2016 Dec 1;54(4):289-291.
8.
Van Linthout S., Tschöpe C. Inflammation -
Cause or Consequence of Heart Failure or
Both? Curr Heart Fail Rep . 2017 Aug;14(4):251-
265.
9.
Vokhidov UN State of reticular fibers in various
forms of polypoid rhinosinusitis. European
science review. 2015(7-8):39-40.
10.
Wu J., Jain R., Douglas R. Effect of paranasal
anatomical variants on outcomes in patients
with limited and diffuse chronic rhinosinusitis .
Auris Nasus Larynx . 2017 Aug;44(4):417-421.
