Subjects of the inquiry: patients with acute intestinal obstruction.
The aim of the inquiry: improvement of treatment results of the patients with acute bowel obstruction by means of the perfection of the methods of intestinal decompression and enteral correction of metabolic disturbance of the organism with nutritive blend “Perative”.
Methods of inquiry: general clinical laboratory investigations, roentgenological studies, statistical technologies, clcctrocntcrography.
Novelty of inquiry: In complex treatment of the patients with acute bowel obstruction the improved intestinal tube has been used for intraoperative decompression of the gastrointestinal tract and it has been demonstrated of its effectiveness. The active intra- and postoperative decompression of the gastrointestinal tract, gut lavage, enteral [tube] feeding effectiveness in complex treatment of the patients with acute bowel obstruction has been proved. The necessity of addition of the complex treatment of the patients with acute bowel obstruction the enteral correction of metabolic disturbance of the organism has been proved and the balanced nutritive blend “Perative” efficacy has been defined.
Practical value: The application of the improved intestinal tube allowed accomplishing of the adequate evacuation of the toxic contents of the gastrointestinal tract and reducing of the enteric pressure. It has contributed to earlier recovery of the all gastrointestinal tract function and it has created the favourable conditions for enteral [tube] feeding. Carrying out of the enteral [tube] feeding with semi - substrate nutritive blend “Perative” has promoted to earlier replacement of the loss of power and plastic material needs. Clinical application of the developed patients management with acute bowel obstruction has promoted to the reduction of the complications rate (from 33,9% to 6,0%) and mortality (10,7% to 0%).
Degree of embed and economical effectivity: The main regulations of the dissertation have been applied in practical work of the urgent surgical department of the second clinic of the Second Tashkent State Medical Institute and it is used in process of 4-6 years students teaching in the Second Tashkent State Medical Institute.
Sphere of usage: urgent surgical help.
The purpose of the study was to determine and evaluate the features of morphological changes in the liver parenchyma of 5-month-old white outbred rats under the influence of anti inflammatory drugs under conditions of polypharmacy.
The object of study for experimental studies was taken 250 white male rats weighing 200-250 g.
The scientific novelty of the research is as follows: polypharmacy of anti-inflammatory drugs negatively affects all parameters of liver structures. Under the influence of polypharmacy, there is a decrease in the absolute mass of the liver, volume and morphological parameters of the liver parenchyma. The decrease in morphometric parameters depends on the number of drugs in polypharmacy; under conditions of polypharmacy, the state of the hepatic capillaries and internal bile ducts, as well as biological membranes, was studied, as a result of which the structural structure of the liver, the development of destruction of the hepatic tissue were studied, and the morphofunctional foundations of this condition were shown.
Implementation of the research results. Based on the obtained scientific results, the morphofunctional characteristics of the liver of rats in the norm and under the influence of polypharmacy were determined:
Approved methodological recommendations: "Methodology for determining the morphometric parameters of the liver during polypharmacy of anti-inflammatory drugs" (Conclusion No. 8n-r / 265 dated 14.03.2022 of the Ministry of Health of the Republic of Uzbekistan) and "Methodology for determining the morphometric parameters of the liver during polypharmacy of anti-inflammatory drugs" (Uzbekistan, Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z 180 of 2022), electronic program No. DGU 1038 "Program for studying the comparative characteristics of morphological changes caused by polypharmacy in the liver."
The scientific results obtained in the study of morphological and functional properties and morphometric changes in the structure of the liver under the influence of polypharmacy have been introduced into the practice of the Samarkand branch of the Republican Specialized Oncological and Radiological Scientific and Practical Medical Center of the Samarkand City Medical Association (Order of the Ministry of Health of the Republic of Uzbekistan dated March 14, 2022, 8n-r / 265-No. and conclusion No. 8 n-z 180 of 2022). The implementation of the obtained research data allows developing methods for early diagnosis, treatment and prediction of organopathology by morphological parameters, improving the quality of life and reducing the number of complications.
The structure and scope of the dissertation. The structure of the dissertation consists of an introduction, three chapters, a conclusion and a list of references. The volume of the dissertation was 103 pages.
Active diarrhea is the leading infectious disease. The article examines the clinical course of active diarrhea and identifies the etiological picture of the causative agents of the disease. For this purpose, clinical and laboratory studies revealed polyresistance strains of the pathogen in 84 patients with active diarrea; leading clinical signs have been identified with active diarrea; the state of intestinal microbiocenosis in patients active diarrhea with was studied.
Torsion and necrosis of the omentum strand is a casuistic disease and occurs in 0.06% – 0.14% of all urgent surgical pathologies in the abdominal organs. Taking into account the rare occurrence and the absence of a characteristic symptoms complex in the torsion of the omentum strand the preoperative diagnosis is correctly established in single cases. The etiology of the development of this pathology remains amystery in modern medicine and attracts more interest in itself due to the difficulty in diagnosis namely in the preoperative period. There are predisposing factors (adhesions in the abdominal cavity, ventral hernia, obesity, chronic inflammation of the abdominal organs) and producing factors (physical activity, eating a large amount of food, a sharp increase in intra-abdominal pressure or sudden contraction of the muscles of the anterior abdominal wall). Most often, the clinic of torsion of the omentum strand simulates such abdominal pathologies as acute appendicitis, acute intestinal obstruction of adhesive etiology, acute cholecystitis. Over the past decade, minimally
invasive surgery has become widespread, in particular laparoscopic surgery, as a
multi-port and single-port. The article highlights the difficulties of preoperative
diagnostics, the role of laparoscopy in differential diagnostics and the features of the
clinical course of torsion and necrosis of the fatty structures of the abdominal cavity
Ўткир ичак инфекциялари муаммоси ҳозирги кунда ҳам педиатрия соҳасида муҳим ўрин тутиб келмоқда. Болаликнинг эрта даврида учраши, кенг тарқалганлиги, ўз кечими жараёнида оғир ва асоратли касаллик шаклларини ривожлантириши ва овқат ҳазм қилиш системасида турли хил инфекцион жараёнларни келтириб чиқариши билан алоҳида аҳамият касб этади (М.С.Григорович, Г.А.Зайцева, 2002й.)
Вирусли диареалар орасида Ротавирус инфекциясининг аҳамияти жуда катта (60-80%). Сўнгги йилларда ўткир ротавирусли ичак инфекцияси билан зарарланиш кескин даражада ортиб бормоқда. Яна шуни таъкидлаб ўтиш лозимки, касаллик асосан қишки-баҳорги мавсумда кўп учрайди (Л.Н.Мазанкова,Н.О.Ильина, О.А.Кондракова, А.М.Затевалов, 2005)
ЖССТ маълумотларига асосан денёда ҳар йили 1 млрд.га яқин диареяли касалликлар қайд қилинади ва ўшбу касалланганлардан 4 млн.га яқинида ўлим ҳолати қайд қилинади. Ўлганлар орасида 14 ёшгача бўлганлари 60 70% ни ташкил этади. Барча ўткир ичак инфекцияларининг 25% дан 60% гача бўлган миқдорини ротавирус инфекцияси чақиради. Ўткир ротавирусли диареядан эса, ҳар йили 2 млн.га яқин одам ўлади (М.И.Горбунова, Н.В.Тикунова, 2008й).
Ротавирусли инфекциянинг юқори контагиозлиги ва ташқи муҳитга чидамлилиги соғлиқни сақлаш муассасаларида катта муаммо туғдиради. Ривожланган мамлакатларда 27%, ривожланаётган мамлакатларда 32% гача касалхона ичида ротавирусли инфекциянинг беморлар орасида юқиши аниқлангани ҳақида маълумотлар бор. Янги туғилган чақалоқлар орасида симптомсиз кечиши ва 25% ҳолатларда саёҳатчилар касаллиги номини олади (А.Б.Горелов).
Ротавирус инфекцияси 5 ёшгача бўлган болалар орасида оғир диареяга сабаб бўлувчи асосий омил саналади ва натижада ривожланмаган давлатларда касалланиш ва ўлим сонини кўпайишига сабаб бўлади (Е.Т.Исакбаева,.Э.Мусабаев, Л.Антил, 2006).
Ҳозирги вақтда Россияда Ртоавирус инфекцияси билан касалланиш доимий ўсиб бормоқда. Бу эса инфекциянинг кенг тарқалганлиги ва патологиянинг ташхисотни анча ривожланганлини билан тушунтирилади (О.В.Тихомирова).
Ротавирус инфекцияси антгенлик хусусиятига кура 5 та гурух ва 9 та серотипларга ажратилади. Бу гурухлар орасида А гурухи ва биринчи тўртта серотипи аҳамият касб этади. 1-4,8,9 серотиплари инсонда касаллик чақиради, 5-7 серотиплари ҳайвонларда аниқланган ва одам учун патоген ҳисобланмайди (Ферьева).
Болаларда ротавирусли гастроэнтеритни эрта аниқланиши касалликни ўз вақтида ва тўғри даволаш (регидратацион, дезинтоксикацион, симптоматик даволаш) ва вируснинг тарқалиш даражасини камайтириш имконини беради. (А.Г. Боковой, Л.Г. Карпович, 2000й.). Касалликнинг давомийлиги ва оқибати ўз вақтида ва тўғри даволашга боғлиқ.
Вирус этиологияли диареяларга ташхис қўйишдаги энг муҳим хусусиятлардан бири бу осмотик турдаги диареядир ва бу ўз навбатида адекват даво чораларини талаб қилади.
Ҳозирги кунда фекаль-орал йўл билан юқувчи вирусли инфекциялар тарқалиши буйича ҳаво-томчи орқали юқувчи инфекциялардан кейинги ўринда туради. Барча касалликларнинг 16% ини ошқазон-ичак трактида вирусли диарея синдроми билан кечадиган касалликлар ташкил қилади. (Р.Х.Жўраев, Э.Т.Мусабоев 2006й.).
Ротавирусли гастроэнтерит касаллигини даволаш чора тадбирлари самарадорлигини ошириш учун жараённинг патогенезини, иммун системасининг айнан қайси қисмида ўзгариш кетаётганлигини билиш муҳим аҳамият касб этади. (М.С. Григорович, Ю.В. Залоторев, Г.А. Зайцева, 2001й.).
Болаларда ротавирусли гастроэнтерит микст шаклда ҳам кенг тарқалган.Ҳар бир микст шаклдаги инфекция келтириб чиқарадиган касалликнинг ўзига хос клиникаси мавжуд бўлиб, эрта ёшдаги болаларда моноинфекция шаклидан кескин фарқ қилади. Бу эса ёш болаларда микст ва моноинфекцион жараёнларни ўрганишда мақсадни тўғри қўйишни талаб қилади.
Клиник ташхисни тасдиқлаш учун ИФА усулида нажасда ротавирус антигенини аниқлаш, микст шаклида эса, нажасда ичакдаги патоген ва шартли- патоген микроорганизмларни бактериологик текширув орқали тасдиқлаш лозим бўлади (Ю.Б. Белан, Н.А. Полянский, 2008й.).
Сўнгги йиллардаги изланишлар шуни кўрсатмоқдаки вирус этиологияли ўткир ичак инфекцияларини клиник кечишида катарал ўзгаришлар аниқланмоқда ва бу ўзгаришларнинг 81,2% улуши ротавирус инфекциясига тегишлидир.(Т.А. Даминов; Л.Н. Туйчиев; Н.У. Таджиева, 2000й.)
Ротовирусли диарея синдроми кузатилган беморларда замонавий диагностика усулларидан фойдаланиб эрта ташҳис қўйиш, лаборатор кўрсаткичлар асосида сифатли ва ишончли маълумотлар олиш борасида услубий тавсиянома ишлаб чиқиш ва амалиётга жорий этиш катта аҳамиятга эгадир.
The study was carried out in 2018-2020 in the cardio rheumatology department of the 4th Children's City Hospital in Tashkent. We observed 254 children aged 7 to 15 years with acute rheumatic fever, who received corticosteroids. According to our results, despite the positive efficacy of hormone therapy in acute rheumatic fever, side effects are observed with a very high frequency (73%). It is recommended to prescribe hormonal therapy with caution and only in case of severecomplications of the disease, since the termination of the use of hormones can lead to a syndrome of cancellation or exacerbation of the process.