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 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 high prevalence of major dental diseases dictates the need to find optimal means, methods of prevention and treatment, taking into account the pathogenetic mechanisms of development. There is a close connection between the pathology of the teeth and the mucous membrane with general diseases of the body, a special place among which is occupied by diseases of the digestive and circulatory systems, respiratory and blood organs, endocrine and reproductive systems, which is dueto the commonality of the main links of pathogenesis. It was determined that inflammatory and destructive periodontal diseases caused by various pathogenic microorganisms induce reactions in tissues and organs. However, the condition of the oral cavity also changes with various diseases of the internal organs. Recommendations on joint medical activity of gastroenterologists and dentists are given. So, a dentist should have information about the presence and severity of somatic pathology, compensation for these diseases, which is necessary when developing a strategy and tactics for the treatment of periodontal diseases in each specific case.
It is necessary to look at history of inquest institution to explain the meaning of the institution. If we study the history of inquest institution in Uzbekistan we find no informa-
tion about it until the second chapter of XIX century 2 . The term of "inquest" was used in legal documents of courts for the first time in 1864. At that times news about of any crime were determined by preliminary searching bodies
and inquest was simply a verification activity of administrative police. It didn’t have a process feature 3 .
In this article, the notion of provision the openness of the activities of public authorities and the peculiarities of its management is highlighted on the basis of the opinions of scientists, with their own ideas regarding the openness of the activities of these bodies, proposals and recommendations necessary for improving the organizational and legal bases for ensuring the openness of the activities of state bodies power and management are revealed.
In the structure of inflammatory diseases of the internal genital organs in women, a special place is occupied by purulent-inflammatory lesions, which are the main cause of disability in women of reproductive age due to the need for surgical treatment. In 4–5% of women, purulent inflammatory diseases of the fallopian tubes and ovaries are diagnosed. The purpose of this study was to introduce and evaluate the effectiveness of new methods of treatment and prevention of purulent-inflammatory diseases of the small pelvis in women. In order to develop preventive measures for the development of purulent-inflammatory diseases of the small pelvis, we examined 240 women of reproductive age. Our evaluation of the clinic and the results of the research methods used, as well as the outcomes of the process, made it possible to distinguish two groups with purulent-inflammatory diseases of the pelvic organs - volumetric (50; 20.8%) and non-volumetric (190; 79.2%). The diagnostic research methods used in our work contributed not only to the verification of the pathological process and the assessment of the degree of anatomical changes in the focus of inflammation, but also to the implementation of dynamic monitoring of the effectiveness of therapy with an emphasis on the implementation of the proposed optimized complex for managing patients with purulent inflammatory diseases of the pelvic organs.
In the introductory part of the article the author
characterizes concept and essence of selfovernment institutions of citizens. In the basic part questions of perfection of organizational-legal bases of self-government institutions of citizens are considered. In the conclusion the author makes the offers on perfection of organizational-legal bases of selfgovernment institutions of citizens.