The aim of the study is to development of an algorithm for managing pregnancy and childbirth by studying the functional state of the mother-placenta-fetus system in pregnant women who have undergone COVID-19 in different trimesters of pregnancy.
The object of the study was 105 pregnant women who, were treated at the Samarkand Regional Perinatal Center and a specialized maternity center for pregnant women with COVID-19
Тhe scientific novelty of the research consists of the followings: for the first time in pregnant women infected with COVID-19, a relationship was established between the course of pregnancy, childbirth, the postpartum period and the development of complications depending on the trimester and severity of the disease; a direct correlation has been established between the state of the vessels of the mother-placenta-fetus system (resistance and pulsation indices, Endothelin-1 indicators), disorders in the hemostasis system (D-dimer, platelet aggregation) and the clinical course of the disease in pregnant women who underwent COVID-19; it has been established for the first time that the developed scale for assessing risk factors for non-developing pregnancy in women infected with COVID-19 (age, BMI, obstetric history, gestation period, hemostasis system status, endothelial function and severity of the disease) can serve as a prognostic marker of the degree of risk of pregnancy complications; it was proved for the first time that the choice of effective therapy for restoring hemodynamics in the mother-placenta-fetus system, in women who underwent COVID-19 at different stages of pregnancy, leads to a decrease in the number of thrombophilic complications.
Implementation of the research results. The results of the scientific research were introduced into the practical activities of the Samarkand Regional Perinatal Center by Order No. 128/1 of 01.09.2022 and the Samarkand City Maternity Complex No. 1 by order No. 58/1 of 03.10.2022. In pregnant women who underwent COVID-19 at different periods of pregnancy, changes in the mother-placenta-fetus system were determined using simple and effective research methods, such as ultrasound and Dopplerography, and this saved 53,000 soums; obstetricians and gynecologists, as well as neonatologists and therapists, are needed to diagnose signs of complications in the echocartin, that is, it has been proven that there is no need for other highly qualified specialists for this, due to the lack of need to train new personnel, state budget funds have been saved. With early detection of disorders in the hemostasis system in pregnant women with COVID-19: the period of stay of patients in the hospital was reduced from 10.5 days to 7.5 days and the number of hospital bed days was reduced; due to the reduction of the period of stay in the hospital for several days, the number of necessary drugs was reduced (on average, drugs are used for 1 day in the amount of 130,000 soums). Examination of pregnant women infected with viral diseases using simple and effective research methods such as ultrasound and Dopplerography served to save 85,000 soums: in the early stages up to 16 (10-11 weeks. - fetometry), 19-21, 32-34, 38-40 weeks of pregnancy; due to the absence of the need to use other research methods, it was possible to reduce costs by 23.5%; early detection of changes in the hemostasis system and endothelial dysfunction using fast, budgetary and effective research methods, contributed to the prevention of possible pregnancy complications, as well as the absence of the need to use long-term and expensive research methods, and this saved 106 000 soums: the coagulogram was checked in 105 (100%) patients, time was saved and efficiency was increased; endothelin-1 was also determined in 105 (100%) patients, efficiency was increased by 78.6%.
Improving the functionality of blood circulation in the uteroplacental and fetal-placental systems, a comprehensive analysis of possible complications during pregnancy and childbirth in women who have had viral infections, improving diagnostic, preventive and prognostic measures for managing pregnancy and childbirth contributed to the birth of live, full-term and healthy newborns in women who experienced COVID-19 during pregnancy, as well as a decrease in maternal mortality and perinatal mortality, 43% of women underwent rehabilitation in the postpartum period, 23.8% of women who underwent severe COVID-19 improved their quality of life.
To introduce scientific novelty on the topic “The impact of COVID-19 on the state of hemodynamics in the mother-placenta-fetus system in pregnant women”, a letter was sent to the Ministry of Health from Samarkand State Medical University on November 9, 2022 under No. 4295 (Conclusion of the Ministry of Health No. 8 n-z / 679 of December 15, 2022).
The structure and volume of the dissertation. The content of the dissertation consists of an introduction, five chapters, conclusion, list of used references. The volume of the dissertation consists of 113 pages.
Objects of inquiry: 107 women with rheumatoid arthritis in climacteric period.
Aim of inquiry: studying clinical-immunologic and roentgenologic indices in females with rheumatoid arthritis in connection with climacteric periods and perfecting therapeutic approaches.
Methods of inquiry: clinical studies, assessment of pain syndrom under visual analogous scale (VAS), determination of pro-inflammatory cytokins in blood scrum, roentgendensitometry, determination of body mass index, gravity of climacteric syndrom under modified menopausal index, determination of osteosyndrom by Ritchie and Lee test.
Results achieved and their novelty: for the first time in RA women in climacteric an interrelation between clinical laboratory RA manifestations and an expression of reproductivity disorders has been revealed. An interplay between acute phase indices, rheumatoid arthritis and Lee test and grade of severity of climatcric period has been established. An intcraggravating effect of RA and climacteric syndrom was approved. Predictive valuable factors in RA women in climacteric were determined. Osteoporosis in females with RA was began earlier before climacteric, it lasted more pronounced with lowering mineral density of bones. An advancing lowering of mineral density of bones in RA began in climacteric was shown. Dependance between a level of pro-inflammatory cytokins and duration of disease has been revealed, and less expressed regression of IL-ip indices in women with preserved menstrual function. Recommendations for strategy of RA treatment in women in climacteric taking into consideration features of a course of disease were worked out.
Practical value: rocngcnometry in females with RA, determination of TNF-a, IL-ip cytokins, modified menopausal index by Kuppermann contributed to diagnosis and prediction, management of an adequate therapy. Using of plasmapheresis and climadinon in complex therapy of rheumatoid arthritis reduced manifestations of disease and climacteric syndrom.
An implementation degree and economic efficacy: results of studies were implemented into activities of the Republican Arthrology Center, Specialized Qualified Ambulance Treatment, departments of Rheumatology, Cardiorhcumatology, 1st clinic of the Tashkent Medical Academy, in teaching process on a department of Faculty & Hospital Therapy, Oriental Medicine and Internal Diseases of the medico-preventive faculty.
A field of application: Internal Diseases, Rheumatology
The purpose of the article is to review and analyze the measures taken to prevent violence against women in Uzbekistan. The author gives a detailed overview of regulatory legal acts, a thorough analysis of their provisions, basic concepts, as well as mechanisms for their implementation. The author concludes that the more a woman is protected from violence, the better her living conditions. The level of violence against women is one of the indicators that can be used to judge the level of well-being of women. The author considers the elimination of violence against women as the most important factor in improving the position of women in society.
This article presents the results on the species composition of the genus Lactobacillus of the vaginal tract in women of fertile age. Having data on changes in this microorganism in different states of the body, it became interesting to study pregnant women in the first trimester with a normal course of pregnancy and women after an abortion on day 5. The results showed a significant difference in the species composition of lactobacilli in these two studied groups
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.
This article analyses women's issues in Turkestan, including parandja (vail) abuse of their rights, the movement of the “Khudjum”, women's spiritual educational life, social status in the family, religious-political situation in Turkestan, factors that led to the religious-political situation, gender characteristics from historical retrospectives in philosophical context. It also considers broadly the main aims and trends of the work of the East and West ideologists on parandja (vail), the issues of Islam and the Sharia law, discovering and the rights of modern women. The article shows the discourses of local scientists, their proposals and discussions set in the press of Turkestan about parandja, the ideas of the place of women in the family created under dogmatic pressure of the Sharia, that there is no need to study for women, that they should stay at home and hold the house, about restricting the rights and freedom of women, that the main task is not forcibly removing the parandja, that women should be familiarized with their rights and achieve the goal on a conscious level. It also provides statistical information about that, as a result of a violent policy, our national values, oriental way of life were attacked openly by political forces, families turned into enemies for each other, the field of crimes and murders were expanded, the sacred concept of the family suffered by spiritual crisis, that the revolutionary system, opening the way for such bloodthirstiness, committed the greatest sin, pursuing the most reactionary national policy, which ultimately led to the fact that many women, subjected to mental and religious torture, became victims of the policy of "removing the parandja". The article concludes with suggestions and reflections on the importance of studying and analyzing the religious and political life of the past in solving problems relating to religious factors at the present time.
A total of 241 lactating women with varying degrees of severity of iron deficiency anemia were examined. In breast milk, there is a decrease in the content of food ingredients (proteins, fats, carbohydrates) and calories, depending on the age of the mothers, the parity of childbirth, the lactation period and the severity of the pathology.
In sick women with grade III anemia in all groups, there is a significant drop in the content of all food ingredients and caloric value of breast milk, which leads to a significant deficit in the consumption of nutrients and energy by their children, which can serve as the basis for the development of nutritional deficiency states. Among nursing mothers with degree I anemia, there is a category of women who have a decrease in proteins, fats, carbohydrates and its caloric value in the composition of GM. In women with II degree of anemia in the composition of GM, there is a significant decrease in the content of food ingredients and calories. The latter are even more visible in groups of women aged 30 years and older, parity of 3 or more births and a lactation period of more than 6 months. The energy cost of GM is supported by carbohydrates