This article gives new information about the life and scientific activities of qadi Ixtiyar that lived at the end of the reign of the Timurds in Herat. Cadi Ixtiyar worked as a cadi and a chief of cadies. While working as a qadi, he wrote a guide ‘Mukhtar al-ixtiyar’ for qadies. In addition, the author of this article gives also the information about this work.
Вопрос выбора лечебной тактики детей с инвагинацией кишечника остается актуальным и сегодня. В большинстве случаев основной метод лечения пациентов с кишечной инвагинацией - консервативный. Не вызывает сомнения, что абсолютными показаниями к оперативному лечению являются осложнения со стороны брюшной полости (перфорация, перитонит) и неэффективность консервативной дезинвагинации. Однако, несмотря на значительное количество публикаций, все еще остаются вопросы, в отношении которых нет единой точки зрения. Так, многие детские хирурги в течение долгого времени показаниями к оперативному лечению считали: сроки от начала заболевания более 12 часов, возраст ребенка старше 1 года и рецидив инвагинации. Выбор этих критериев был обусловлен предположением развития более высокой частоты некроза кишки и более высокой частотой встречаемости анатомических причин в старшем возрасте. Следовательно, на сегодняшний день эти показания не являются абсолютными.
Развитие современной торакальной хирургии у детей идет по пути максимально бережного отношения к легочной ткани. До настоящего времени не выработаны единые показания к выбору метода хирургического вмешательства при мальформации легких в зависимости от объема и степени пораженной части легкого. Вторично развивающиеся деформирующие бронхиты и бронхоэктазии, явления функциональной неполноценности в виде прогрессирующей легочно-сердечной недостаточности, которая нарастает по мере увеличения срока, прошедшего после операции, а оставшаяся легочная ткань подвергается эмфизематозным и пневмосклеротическим изменениям после обширных резекций легких, требует дифференцированного подхода при выборе объема и метода оперативного вмешательства при мальформации легких у детей.
Янги аср ва мингйиллик. бошланиши билан глобал экологик барқарор тараққиётда бир- бири билан узвий боғлиқ икки глобал тенденция устуворлашмоқда.
Among rheumatic diseases reactive arthritis occupies one of the leading places in terms of prevalence and it is one of the most common chronic inflammatory joint diseases. When the process is chronic, destructive processes in the joints develop up to ankylosing. This article presents the results of studies on the features of the clinical course of reactive arthritis of post-enterocolitic and urogenital forms. The study was carried out in 120 patients with an established diagnosis of reactive arthritis.
Улучшить результаты ранней диагностики хронических бронхолегочных заболеваний у детей
The article provides a gradual presentation of the historical works that led to the artistically perfect depiction of the epic horse in the epics. The place of the horse in the history of the Turkic peoples, the confessions of historians in this regard, the findings of the horse in ancient manuscript sources, in short, the ideology of the Turkic peoples is compared with the image of a war horse in the epics.
As characteristic of the war horses described in folk epics, they appear to be the most perfect of the natural horses, as well as the horse features expressed in mythological and totemistic beliefs. In this respect it was understood that the war horses in the epics must be directly or indi- rectly dependent on water horses and celestial horses in order to be true tulpars.
In this article, we will take a closer look at the natural, religious beliefs and views that underlie the creation of the epic horse image in folk epics.
The article also includes “nomadic mavaniyer”, “animal-mother” traditions and beliefs, “Devonu lug'otut-turk” and commentary on Turkish words related to the horse, analysis of the image of the horse in the Karvash folk epics and interpretations took place.
Emotional stress syndrome is a chronic stress caused by emotional, mental and physical exhaustion. The development of this syndrome is primarily characteristic of the following professions: health workers, teachers, psychologists, social workers, rescuers, law enforcement officers, firefighters.
One of the achievements of the last decade in the field of health care of the Republic of Uzbekistan is the rapid introduction of many types of high-tech medical care. First of all, this significantly increases the demands on medical personnel in terms of their theoretical knowledge and practical skills. The development of market relations in all spheres of economic and social life, including healthcare, requires the training of specialists with the necessary competencies. Global problems based on medical errors and significant risks of negative scenarios require further development of educational technologies and improvement of their quality in all areas of training of medical professionals in the future. does.
The purpose of the study was to evaluate the effectiveness of the selective α2-adrenoreceptor agonist dexmedetomidine for short-term controlled sedation and treatment of delirium in the early postoperative period in children after cardiac surgery. Material and Methods: Dexmedetomidine infusions were performed for sedative purposes against the background of anesthesia with Kktoprofen and trimeperidine in 28 children who underwent surgery for atrial and ventricular septal defects under general combined anesthesia and in 9 children with clinical manifestations of delirium in the early postoperative period. Results and discussion: against the background of infusions of dexmedetomidine in medium therapeutic doses, a moderate and mild level of sedation was registered, which lasted up to 8 hours. Pain syndrome did not exceed 1 point on the V\S scale in 96% of patients. Additional administration was required only in 23% of patients. Of the side effects, bradycardia (39%) and arterial hypotension (36%) were most often detected. Dexmedetomidine therapy provided the most optimal level of sedation compared with other drug combinations in children with delirium, as measured by the sedation-arousal and wakefulness scales.
Fast track surgery (FTS), or rapid recovery surgery, is a fundamentally new approach to surgery. FTS was developed by Kehlet F.I. (1993) and assumed the following aspects to minimize stress reactions and significantly reduce the recovery period of patients: regional anesthesia, minimally invasive operations, aggressive postoperative rehabilitation (early enteral nutrition and activation of patients). Wind J. (2006) specified FTS as follows: informing the patient, avoiding bowel preparation and premedication, using probiotics, avoiding preoperative dry fasting, oral glucose (5%, 150 ml 2 hours before surgery), regional anesthesia or anesthetics short-acting, adequate perioperative infusion, surgical mini-invasiveness, prevention of hyposermia, non-opioid analgesia, avoidance of routine nasogastric tubes and drains, early removal of the urinary catheter, prokinetics, early enteral nutrition and patient activation.
Among the methods of instrumental diagnosis of respiratory diseases in pediatrics, bronchoscopic studies occupy one of the leading places. Perhaps this is due to the development of endoscopic equipment, low invasiveness and high information content. An urgent problem in the anesthetic management of FBS in children is ventilatory support and ensuring adequate gas exchange. Ensuring airway patency and adequate ventilation can be carried out by tracheal intubation or installation of a laryngeal mask (LM), which has certain advantages over an endotracheal tube in the form of less trauma, complications and severity of hemodynamic changes during installation
According to the researchers, the incidence of sepsis in the pediatric population is 4.2 million children each year, of which 3 million are newborns. Three out of ten deaths due to neonatal sepsis are thought to be due to antimicrobial-resistant pathogens [1,2]. Sepsis can be a clinical manifestation of nosocomial and nosocomial infections. Currently, the etiological structure of nosocomial sepsis pathogens has remained almost the same in most large intensive care units. They are named after the first letters of the type of pathogens: "no ESCAPE" ("no exit", escape - English. escape) Enterococcus faecium, Staphylococcus aures, Klebsiella pneumonia, Acinetobacter baumanni, Pseudomonas aeruginosa, Enterobacter spp. All these bacteria are characterized by increasing resistance to all mentioned antibiotics along with the formation of Pan-resistance phenomenon, which is the leading factor leading to lack of clinical response to treatment and rapid development of sepsis and septic shock [3]. According to the new definition, sepsis is a life-threatening dysfunction of internal organs caused by a violation of the body's response to infection [4].
Parenteral nutrition (PN) is the most complex and technological variant of clinical nutrition, carried out by intravenous administration of nutrients into the body. It is intended for patients in whom it is impossible or insufficient to use other methods of nutrition and occupies the highest level in the hierarchy of clinical nutrition options, since it is considered the most difficult both in terms of technique and in terms of the variety of decision-making when prescribing it in clinical practice in the most difficult contingent of patients. . One of the main causes of death in patients with multiple organ failure is the development of an immune and inflammatory response. A number of studies have shown a decrease in the severity and incidence of septic complications in patients on enteral nutrition, after severe mechanical and thermal injuries, after major surgical interventions, it also allows you to maintain and maintain the barrier function of the intestine, which prevents the translocation of microflora. Based on the foregoing, it can be assumed that enteral nutrition will have a positive effect on the course of multiple organ failure.
Anesthesia of patients in the postoperative period is one of the most important tasks and problems of modern intensive care. Over the past decades, the possibilities of surgery have increased many times over. This fully applies to the surgical treatment of children. Surgical interventions are performed in patients with severe malformations, extensive traumatic injuries.
Was assessing both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia abdominal operations in children. The authors examined 61 children aged 1 to 14 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanyl (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery
The aim of the study was to evaluate the effectiveness of using dexmedetomidine for the treatment of delirium in the early postoperative period of cardiac surgery in children. Materials and methods. The study was conducted in 28 children (3*7 years old) who underwent surgery for an atrial (ASD), interventricular (VSD) septal defect under general combined anesthesia (OCA), and 9 children (3-7 years old) with clinical manifestations of delirium in the early postoperative period (POP). Upon admission of children to the ICU, after cardiac surgery, intravenous infusion (50 μg/kg/h) of dexmedetomidine was performed, and analgesic therapy was also carried out: ketoprofen. trimeperidine. The level of sedation was assessed by Ramsay. RASS-scale AJdrete score VAS-scale. In the absence of consciousness, a visual assessment of motor excitation, lacrimation, sweating, negative facial expressions, vocal signs of pain (groans) was carried out. In patients with delirium, the type of delirium, the day of occurrence, the doses of administered drugs, the duration of therapy and the duration of the episode of psychomotor agitation, the incidence of side effects, and the number of days in the ICU were assessed. Results. The use of dexmedetomidine provides a dose-dependent level of sedation and retrograde amnesia with intact verbal contact with the patient, does not cause respiratory depression, reduces the duration of mechanical ventilation, and facilitates care. The need for narcotic analgesics is reduced, since the drug has an independent analgesic effect. The high efficacy of Dexdor in the treatment of delirium continues after the cessation of the infusion of the drug.
This article presents a brief review of sepsis/SS, reflecting the unresolved issues of pediatric sepsis and the results of our own study of surgical sepsis in children. Optimization of diagnostics and schemes of pathogenetic intensive therapy of surgical sepsis in children based on clinical and laboratory criteria and
bacteriological monitoring. Research period - 2018-2020. The subject of the study (n=73) was children with surgical pathology (widespread peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, trauma to the abdominal organs, etc.). Studies have shown the effectiveness of complex intensive care in 86.3% of cases. Mortality was stated in 13.7% of cases. Patients with severe surgical pathology died: fecal, widespread peritonitis, severe TBI + coma with irreversible neurological disorders, urosepsis against the background of chronic renal failure, after repeated surgical interventions, due to the development of refractory SS.
The assessment of status severity of the perioperative period of the cardiac surgery operations was investigated the children with the diagnostic scales APACHE-II, APACHE-III, SAPS-II, 67 children were with "blue" and "pale" defects before connecting to the device of CBM and after disconnecting. It is found that most of the indicators of the diagnostic systems АРАСНЕ-II, АРАСНЕ-III, SAPS-II objectively reflect the changes proceeding before connecting the patient to the CBM, when the state of the patients changes according to the dynamics of the pathological process, with a direct correlation between the severity of patients before connecting to CBM expressed in points of the investigated scales and with the mortality. It is found that the diagnostic system APACHE-III most accurately characterizes the severity of the condition of children with acute blood loss, before connecting to the CBM, and can use to assess the dynamics of the severity of the children states in the stages of cardiac surgery operations and intensive therapy.
The article presents findings which may be useful for solving an urgent medical problem on the adequacy of anesthetic management during planned surgical interventions in children with abdominal pathology.
In the treatment of patients with acute surgical diseases, even in the presence of multiple organ disorders and sepsis, prolonged artificial lung ventilation (ALV) through a tracheostomy is often required.
Any operation is a stressful situation, which causes the psychological state of patients to deteriorate. Psychological assistance to patients before and after surgery is considered the most necessary direction of a medical nurse. In inpatient treatment facilities, the patient is faced with unaccustomed situations, which causes a feeling of discomfort. The purpose of our study of the above issues is to study the psychological state and satisfaction of patients with treatment