Subject of the inquiry: 148 patients with degenerative dystrophic diseases of the hip joint, of them 103 with osteoarthritis and 45 with avascular necrosis of the femoral head.
Aim of the inquiry: improvement of the diagnosis of degenerative-dystrophic diseases of the hip using possibilities of ultrasonography and magnetic resonance imaging.
Methods of research: X-ray, ultrasonography and magnetic resonance imaging.
The results achieved and their novelty: For the first time, the role of ultrasonog-aphy and magnetic resonance imaging in osteoarthritis and avascular necrosis of the hip was established in comparison with conventional X-ray. The result have shown that sensitivity of ultrasonography in osteoarthritis was low (57.7%) in the detection of femoral head deformation. In avascular necrosis of the hip detection of femoral head deformation was revealed better - 89.7%, which can be explained by differences in the mechanism and localization of deformation in these diseases. Ultrasonography was quite sensitive to changes of the joint capsule both in osteoarthritis and avascular necrosis, the sensitivity 86.0% and 84.6% respectively. MRI was superior to X-ray in the assessment of space orientation of the joint surfaces, necrosis zone, synovitis, subchondral cysts, structural changes and joint effusion. X-ray was more preferable for the detection of ostephytosis, subchondral sclerosis and changes of the joint space in osteoarthritis.
Practical value: of the work consisted in the concretization of sonographic and MRI signs of degenerative dystrophic diseases of the hip joint and in the suggested algorithm of using radiological methods for establishing the nature of hip joint pathology.
Degree of inculcate: the results of research were introduced in the Radiology Department of First Tashkent Medical Institute and the Department of Large Joint Pathology Department of the Traumatology and Orthopedy Research Institute.
Sphere of usage: radiology, traumatology and orthopedy, rheumatology.
To analyze the section of the ICD-10, in which odontogenic inflammatory diseases, i.e. pulpitis, periodontitis, osteomyelitis are classified as diseases of the digestive system, and their complications, such as abscess, phlegmon, lymphadenitis of the face, head and neck, are diseases of the skin and subcutaneous tissue.
The Aim of this work was to study the functional activity of monocytes, neutrophils and cytokines in twin children with Inflammatory diseases of the paranasal sinuses in comparison with non-twins. It was found that with various rhinosinusitis in children, phagocytic activity of monocytes in blood decrease, which causes the development of a chronic purulent focus and is characterized by an increase in monocytes with viral inclusions. In patients with Inflammatory diseases of the paranasal sinuses, the activity of non-specific protective factors of the body is significantly reduced, which is expressed in a decrease phagocytic activity of monocytes and an increase monocyte with viral inclusions, which is more evidently in twin children than in non-twin children. Serum cytokines in children with Inflammatory diseases of the paranasal sinuses were significantly increased in relation to the data of healthy children. In children-twins and non - twins, the parameters of anti-inflammatory cytokines changed in different directions.
Most of allergic diseases are caused by allergic skin lesions.The aim of the study was to assess the effectiveness of the enzyme agents in the correction of pancreatic insufficiency in children with atopic dermatitis.As a result of the study clinical and laboratory markers of relative pancreatic insufficiency were identified in 69.7% of the patients, who required the prescription of enzyme agents. The results also showed that in 92.5% of patients the correction of exocrine function disorders to a certain extent affects the regression of dermal manifestations. In the scatological tests the loss of neutral fat, normalization of the amount of elastase in feces serve to be a marker of the effectiveness of the enzymatic therapy.
The analysis of prehospital factors influencing the severity of the course of odontogenic purulent- inflammatory diseases and its outcome was carried out. The total number of patients during the study period was 1305 patients (2018-675, 2019-630 patients). The most common cause of the development of pyoinflammatory diseases is the lower molars. A detailed study showed that in 5 5 % of cases the tooth was removed during surgery, which indicates a low level of therapeutic and surgical debridement among the population. In patients with acute toothache, from the first day of illness, pathological changes are observed in the tissues surrounding the tooth, underestimation of this fact can lead to the development of severe purulent-inflammatory complications.
To date, it has been established that 70% of people involved in tobacco growing have various diseases [4,6,]. Comparison of morbidity rates with temporary disability of workers employed in tobacco growing and the control group shows that tobacco growers get sick more often than others. The number of diseases they have is 37%, and the number of days of disability is 30% higher than in other types of agricultural work [8,4,1]. Diseases of the respiratory and gastrointestinal tract, infectious and allergic diseases, nervous and cardiovascular systems, skin and subcutaneous tissue occupy the leading place in the structure of tobacco growers' morbidity.
The oral cavity plays a special role in the perception of undesirable factors of tobacco smoke, and the state of the oral organs is an informative indicator that dynamically reflects and reacts to its effects. This article examines the peculiarities of the influence of tobacco smoke components on the development of major dental diseases of the oral cavity in young people. The specifics of the occurrence and course of the main dental diseases - caries, inflammatory diseases of the ligamentous apparatus of the periodontal and oral mucosa are discussed. It was found that in young smokers, compared with non-smokers, dental caries is more common, mild chronic generalized periodontitis is more often diagnosed, and diseases of the oral mucosa with hyperkeratosis as the main sign are more common. Almost all (98.7%) smokers were diagnosed with cheilitis. Oral hygiene was "unsatisfactory" in the non-smokers group and "poor" in the smokers group.
In the course of the study, the need and degree of participation of narrow-profile specialists in the treatment ofparadontal diseases was determined for the timely detection of comorbid pathology and the appointment of adequate therapy.
We studied 225 patients with generalized parodontitis of varying severity. 40 patients without generalized parodontitis (GP) and pathology of the oral mucosa (POM) formed a control group.
Statistically significant differences in the frequency of registered pathology in patients of the compared groups with control indicators, as well as correlations between the frequency of detected diseases and the severity ofparadontal pathology, were established. Thus, the total incidence of previously existing diseases increased in the series of mild generalized parodontitis (MGP), moderate generalized parodontitis (MODERGP) and severe generalized parodontitis (SGP) from 32.47 ± 5.34% with MGP; up to 51.25 ± 3.83% with MODERGP up to 86.96 ± 3.14% in patients with SGP (linear correlation coefficient χ² = 96.167; P ≤ 0.001); the corresponding dynamics of the newly discovered pathology was 42.86 ± 5.63%; 47.65 ± 3.83% and 13.04 ± 3.14% (χ² = 65.087; P ≤ 0.001); and the corresponding frequency of all somatic pathology requiring systematic drug correction was 75.32 ± 4.93%; 99.41 ± 0.52% and 100.00 ± 0.00% (χ² = 235.351; P ≤ 0.001).
Based on the studies performed, local therapy tactics should be determined for the following pathogenetic mechanisms of the development of parodontitis: microcirculation disorders, the prevalence of lipid peroxidation processes, an increase in cytokine aggression and an increase in bone resorption.
When making a diagnosis, the scope and methods of therapy should be maximally individualized based on an assessment of the patient's individual clinical and laboratory parameters, by identifying markers that determine the priority mechanisms of the development of the disease.
Хирургическое лечение глаукомы, особенно на ранних стадиях заболевания, применение вазореконструктивных операций для стабилизации глаукоматозного процесса, экстракция катаракты у больных, перенесших антиглаукоматозные операции (АГО) продолжает интересовать офтальмохирургов, как одна из актуальных проблем.
The aim of the study to improve the results of surgical treatment of patients with ventral hernias and concomitant abdominal pathology by optimizing the tactical and technical aspects of the simultaneous performance of simultaneous operations with the priority use of endovideosurgical technologies and tension-free plasty methods.
The object of the study were 331 patients with ventral hernias and concomitant simultaneous pathology of the abdominal organs, who were hospitalized in the surgical departments of the clinic of the Samarkand State Medical University for a period from 2012 to 2021.
The scientific novelty of the research is as follows: laparoscopic technologies were applied at certain stages of surgical intervention, which justified itself, since at the same time it allows to eliminate the hernia of the abdominal wall and the simultaneous pathology of the abdominal organs and correct it in a minimally invasive way; it was found that more than ½ (52.8%) of patients with ventral hernias have concomitant abdominal pathology that requires a one-time surgical correction, since the performance in a subsequent repeated operation levels out the results of hernioplasty; justified the use of laparoscopic technologies at certain stages of the operation, which allows correcting the simultaneous pathology of the abdominal cavity in a minimally invasive way with a significant removal of it from the hernial defect of the abdominal wall; the effectiveness of endovideosurgical technology for performing alloplasty in W1 and W2 hernias has been proven; the high information content of CT-hernioabdominometry has been proven, which makes it possible to identify defects in the topography of the anterior abdominal wall before surgery, determine the relative volume of the hernia to the volume of the abdominal cavity and choose the optimal method of hernioalloplasty; improved technical and tactical aspects of non-tension methods of hernioplasty for ventral hernias W3 and W4; the study of the dynamics of stress hormones proved that the implementation of the simultaneous stage of the operation does not significantly affect the degree of surgical aggression and thus justifies the expediency of a one-time correction of the combined pathology of the anterior abdominal wall and abdominal organs; optimization of tactical and technical aspects of one-time surgical correction of ventral hernia and combined abdominal pathology with the priority use of endovideosurgical technologies and tension-free alloplasty methods significantly improved the results of treatment.
The practical results of the study are as follows: According to the results of a scientific study to improve the diagnosis and surgical treatment of patients with ventral hernias and concomitant abdominal pathology: a methodological recommendation “Surgery of abdominal hernias and combined pathology of the anterior abdominal wall” was developed (certificate of the Ministry of Health 8н-р / 1080 dated October 7, 2022); a methodological recommendation "Surgical correction of combined abdominal pathology in ventral hernias" was developed (certificate of the Ministry of Health 8н-р / 1086 dated October 7, 2022). The proposed recommendations made it possible to optimize the choice of tactics for surgical treatment of patients with ventral hernias and concomitant surgical diseases of the abdominal organs; the obtained scientific results on improving the quality of diagnosis and surgical treatment of patients with ventral hernias and simultaneous surgical diseases of the abdominal organs have been introduced into the practice of healthcare, in particular, in the departments of surgery of the Samarkand city medical association, the Samarkand regional multidisciplinary medical center, the multidisciplinary clinic of Samara State Medical University, Shakhrisabz city medical association, Surkhandarya regional diversified medical center, Jizzakh regional diversified medical center (certificate of the Ministry of Health 8н-д / 570 dated October 24, 2022). The introduction of the results of research on improving the tactical and technical aspects of the surgical treatment of patients with ventral hernias and simultaneous surgical diseases of the abdominal organs substantiated the possibility of simultaneous performance of simultaneous operations in the combined pathology of the abdominal organs and the anterior abdominal wall, avoiding repeated operations after hernia alloplasty.
The structure and scope of the dissertation. The dissertation consists of an introduction, seven chapters, a conclusion, and a list of references. The volume of the main material is 153 pages.
The detection of concomitant surgical diseases of the abdominal organs during the examination of the patient or during laparotomy raises the question of the necessity and possibility of its elimination by performing a simultaneous operation. If we take into account that in recent years 20-30% of patients admitted to surgical hospitals have been diagnosed with combined diseases of the abdominal organs requiring surgical correction, then the urgency of the problem is beyond doubt.
The improvement of surgical techniques, the successes of anesthesiology allow [to expand the indications for performing simultaneous operations in abdominal surgery.
Simultaneous surgical correction of several diseases is in many ways preferable to multi-stage treatment, since it relieves the patient from two or more diseases, from the need for repeated surgery and possible postoperative complications associated with it.
Simultaneous operations also have certain economic advantages due to a reduction in the duration of the patient's stay in a medical institution and temporary disability in comparison with multi-stage surgical treatment.