The materials of rendering aid to 78 patients with fractures of the scaphoid bone in different periods after the injury were analyzed. The patients underwent treatment in the Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics in the department "Hand and foot surgery" 2019-2021. In the process of diagnosis, 14 patients were diagnosed between the years 2019-2021 , with modern methods of clinical examination, early diagnostic weight loss and primary medical treatment, and in suspected cases, CSCT and MRT examinations have clarified the diagnosis.
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.
The paper identifies the clinical, functional and radiological features of COPD in diabetes mellitus, the possibility of predicting its development. The examined patients were divided into 3 groups: patients with COPD in combination with diabetes mellitus, patients with COPD and patients with diabetes mellitus. In the structure of COPD, the pulmonary component and systemic manifestations arc distinguished, which can aggravate the disease. The manifestations of diabetes mellitus are based on micro- and macroangiopathies that affect pulmonary microcirculation. When managing patients with COPD in combination with diabetes mellitus, attention was drawn to more pronounced clinical manifestations of respiratory failure (shortness of breath, participation in breathing of auxiliary muscles, hypoxemia), especially in stage III COPD, compared to patients with COPD. To diagnose microvascular lesions in patients with COPD and diabetes mellitus, to predict the course of nonspecific lung diseases, based on the specific results of the study, multispiral computed tomography was performed. In patients with COPD, the assessment of the degree of impaired ventilation in the lungs should be carried out under CT conditions performed in the inspiratory and expiratory phases. Diagnostically significant for COPD during computed tomography is a symptom of expiratory "air trap", in combination with expansion and deformation of bronchi of various sizes, up to broncho- and bronchioectasis. When MSCT in patients with COPD and diabetes mellitus, pathognomic changes characterizing microangiopathy and fibrotic changes. The clear-cut shape of microvessels is a specific X-ray morphological sign in patients with COPD in combination with diabetes mellitus.
This article presents an actual problem of our century-the causes and mechanisms of flatfoot development, as well as our experience and methods of its correction. Republican Specialized Scientific and Practical-Medical. Center of Traumatology and Orthopedics in the department of "Hand and foot surgery" a research was carried out in the patient treated with 29 flatfoot diagnoses from 2019 to 2021. In this patients were used methods of CT, radiography, podometry, MRI and clinical examination. The average age of the patients is from 10 to 22 years (12±4) 12 female 17 male, mainly adolescent patients