The aim of the study is to improve the results of diagnosis and surgical treatment of victims with closed abdominal injury by developing a new approach to ultrasound assessment of the amount of hemoperitoneum, expanding and specifying indications for laparoscopy, taking into account the volume of free fluid in the abdominal cavity.
The object of the study were 160 patients with closed abdominal injury with stable hemodynamics, was hospitalized in the surgical Department of the Republican specialized scientific and practical center for emergency medicine of the Samarkand branch (clinical departments of surgical diseases № 2 and surgery postgraduate faculty of Samarkand state Medical Institute) for the period from 2010 to 2019.
The scientific novelty of the study is as follows: a fundamentally new approach to ultrasound evaluation of discrete volumes of free fluid in the abdominal cavity is proposed, based on taking into account the thickness of the fluid layer and its prevalence in the abdominal cavity zones; The expediency of using the ultrasound indicator "free fluid in the abdominal cavity < or >500 ml" in choosing the tactics of surgical treatment of patients with closed abdominal injury is substantiated; an algorithm for choosing surgical tactics for the treatment of patients with closed abdominal trauma was developed based on an ultrasound assessment of the volume of free fluid in the abdominal cavity.
Implementation of research results. Based on the results of a scientific study to improve the diagnosis and surgical treatment of patients with closed abdominal trauma:methodological recommendations "The choice of tactics for surgical treatment of closed abdominal trauma based on ultrasound assessment of the nature and severity of the injury" have been developed (certificate of the Ministry of Health No. 8n-z/1282 dated November 15, 2022). The proposed recommendations made it possible to increase the effectiveness of the diagnosis of intra-abdominal injuries in patients with abdominal trauma;
The results of scientific research on improving the diagnosis and surgical treatment of patients with closed abdominal injury have been introduced into medical practice, including the clinical practice of the Republican Scientific Center for Emergency Medical Care and its Samarkand, Surkhandarya and Navoi branches (conclusion of the Ministry of Health No. 8 n-z/699 dated December 21, 2022). The introduction of the obtained results into clinical practice allowed to improve the quality of high-tech surgical care provided to patients with isolated and combined abdominal injuries, to reduce the frequency of postoperative complications from 11.9 to 3.1% (p=0.144).
The structure and volume of the dissertation. The dissertation consists of an introduction, 4 chapters, conclusions and a list of cited literature. The volume of the text material is 107 pages.
Subjects of the inquiry: 103 patients with rheumatoid arthritis, 20 healthy individuals.
Aim of the inquiry: To study therapeutic effect of low frequency physical factors on the cytokines and the processes of lipid peroxidation and to confirm scientifically the efficacy of their use based on the their effect on the clinical laboratory findings.
Methods of investigation: Clinical and laboratory investigations, immunological analyses of the blood scrum cytokine levels and synovial fluid, biochemical examinations of the lipid peroxidation and antioxidant system indicators, phospholipase-A2 activity, nonspecific phosphatases and free oxyprolinc in the blood serum of patients.
The results achieved and their novelty: There was studied clinical efficacy of ultraphonophoresis with benzketozon during treatment and rehabilitation of the patients with rheumatoid arthritis. It was proved that disbalance between inflammatory and anti-inflammatory cytokines as well as lipid peroxidation activation activity in the erythrocyte membranes and blood scrum destabilized cellular membrane structures, increase in phospholipase-A2 activity and, consequently, stimulating prostaglandines, inflammation mediators, synthesis. There was shown that complex therapy with inclusion of low frequency physical factors, particularly ultraphonophoresis with benzketozon, gave marked positive effect normalizing interrelation ship between inflammatory and anti-inflammatory cytokines reducing activity of phospholipase-A2, lipid peroxidation products and rising the levels of antioxidant system indicators.
Practical value: There has been shown rationality of inclusion of the physical-pharmacological method ultraphonophoresis with benzketozon into clinical practice. The differential indicators developed for application of low-frequency physical methods of therapy for rehabilitation of the patients with rheumatoid arthritis allow prolongation of the remission, improvement of the patients life quality.
Degree of embed and economic effectivity: The practical recommendation and guidelines have been applied in the clinical practice of the out-patient special course of arthrological treatment in the Republican Rhcumatological Center, Clinical Hospital N 1, Central Hospital of Zangiota district of Tashkent province. Sphere of usage: Rheumatology, physiotherapy.
The article is devoted to the process of reforming the system of the representative body of state power on the ground in Uzbekistan and to the problem of assessing the factors influencing the efficiency. Factors influencing the quality of activity of representative bodies of state power are classified.
The article discusses the issues of assessing the effectiveness of technologies used in the cultivation of sweet cherries in greenhouses, as well as the issues of export and cultivation of
sweet cherries in Uzbekistan. The effectiveness of the introduction of innovative technologies in the cultivation of sweet cherry was calculated using performance indicators. The article gives recommendations and suggestions for the protection of intensive cherry orchards grown in the information and consulting center of the Tashkent State Agrarian University.