The aim of the research work is determination of the prospects for the use of a domestic agent for the prevention of adhesion formation in thoraco-abdominal surgery on the basis of experimental and morphological studies.
Research objectives were white outbred rats in the amount of 62 individuals, in two experimental studies on the abdominal and pleural cavities, in each series of experiments the studies were carried out in 2 comparative groups, control and main. Experiments on the formation of adhesions in the abdominal and pleural cavities were carried out on the basis of the Republican Specialized Scientific and Practical Medical Center of Surgery named after acad. V.Vakhidov in the Department of Experimental Surgery for the period from 2019 to 2020.
The scientific novelty of the research consists of the followings: it is proved according to the data of experimental research that when modeling the adhesion process in the abdominal cavity, the local application of an anti-adhesion coating made of cellulose derivatives reduces the processes of adhesiogenesis and the development of changes in architectonics, bends and narrowings of the intestinal lumen; it was found in an experimental study that when modeling the adhesion process in the chest cavity, the local use of an anti-adhesion implant provides a significant decrease in the risk of adhesiogenesis in the form of the formation of coarse adhesions or planar adhesions; it was determined that when blood serum was applied over a powder implant, the quality of adhesion and the uniformity of its distribution on the surface of the experimental defect of the peritoneum or lung did not change, but, in contrast to activation by blood (to ensure a hemostatic effect), it was not accompanied by the development of cellular inflammation due to the resorption of thrombotic masses; it was found that the formation of a gel film over the area of damage to the peritoneum in the absence of cellular elements of blood makes it possible to achieve biodegradation of the coating without a pronounced cellular-inflammatory reaction, providing cicatricial replacement of defects with a significant reduction in the risk of developing a massive adhesive process; the morphostructural features of the formation of the adhesive process when using an anti-adhesive coating, characterized by regression in the dynamics of the number of connective tissue cells of the inflammatory infiltrate with scarring of the defect zone without the development of adhesive conglomerates with the surrounding tissues, have been determined.
Introduction of the research results. According to the results of a scientific study on a comparative analysis of the use of a domestic agent for the prevention of adhesion formation in thoraco-abdominal surgery: methodological recommendations were developed: "New technologies for the prevention of adhesions in thoraco-abdominal surgery" (certificate of the Ministry of Health No. 08-09/10055 of August 12, 2021). The proposed recommendations for performing surgical interventions on the organs of the abdominal and thoracic cavities will allow for sparing local hemostasis, as well as prevent the formation of a coarse adhesive process in the abdominal cavity.
The obtained scientific results on a comparative analysis of the use of the domestic remedy for the prevention of adhesion formation in thoraco-abdominal surgery have been introduced into the practical activities of health care, including in the Republican Specialized Scientific and Practical Medical Center for Surgery named after V.I. Academician V. Vakhidov, surgical departments of the clinics of the Andijan and Samarkand State Medical Institutes (certificate of the Ministry of Health No. 08-09/10055 of August 12, 2021). Based on the proposed results of experimental studies, it was shown that the use of an anti-adhesive coating made of cellulose derivatives made it possible to reduce the risk of adhesion formation from 60% to 20%, bowel deformation without manifestations of obstruction from 33.3% to 13.3% and the possibility of acute adhesive intestinal obstruction from 6.7% to 0%.
Structure and scope of the dissertation. The dissertation consists of an introduction, four chapters, conclusions, practical recommendations and a list of cited literature. The volume of work is 113 pages.
Purpose. An analysis of complications in case of penetrating injuries of visual organ in children and methods of their elimination.
Material and methods. There were in the follow-up 36 patients (36 eyes) aged from 6 to 14 years with various ocular injuries: boys - 70% of cases, girls - 30% of cases. All children underwent ophthalmic and clinical examinations.
Results. The primary surgical treatment (PST) was performed in all patients at the place of residence in different regions of the Republic. The secondary surgical treatment (SST) was carried out according to the following indications: swelling cataract, filtration of corneal and scleral injuries, local endophthalmitis, iris incarceration, hypotension, secondary glaucoma, sutures failure, torpid uveitis, deformation of eyelids, abruption of lacrimal canaliculi, non-sutured scleral wound, suspect intraocular foreign body, the destruction of the eyeball, suspected intraocular foreign body, the destruction of the eyeball. Causes of PST complications were: the severity of injuries (47.2%), an unskilled first aid (41.7%), a late appeal of patient (47.2%).
Conclusion. As a SST result the inflammatory response was stopped and the eyes were maintained as an anatomical organ in 99.6% of cases, visual functions were preserved in 67.4% of cases. It is necessary to intensify educational work among the population, to improve the quality of emergency eye care and the adequate rehabilitation of patients.
This study explains the concept of the "digital divide" as factor of competitiveness of the tourist regions of Uzbekistan, developed a map of the country's macroinformation space, and on the basis of the matrix of the tourist macro- information space, the directions of improving the tourist information space of the country are determined.
The article presents the result of a survey of 35 patients after extracapsular extraction cataract with IOL implantation at the age of 8 months to 13 years.Patients underwent: viziometry, biomicroscopy, keratorefractometry, skiascopy, A, B-scan ultrasound, ophthalmoscopy, consultation of related specialists. The calculation of the optical power of IOL was performed using the SRK II formula. Refraction in the early postoperative period in children from 8 months to 6 years corresponded to the age range, from 6 to 13 years was presented in the form of ametropia.According to the authors , ametropia is a consequence of post-traumatic scarring of the cornea, tension of the stitches , swelling of the cornea and mistakes made at the calculation of the power of the IOL according to the formula SRK II.
The explores in a flock the legal status of creditor’s bodies and their role in shaping insolvency proceedings in the Czech Republic, a member country of the European Union. It specifically explores the legal framework governed by Sections 46-68 of Act No. 182/2006 coll., the Insolvency Act, and how this shapes the rights and obligations of creditors’ bodies.
Синдром Марфана представляет собой наследственное заболевание соединительной ткани с преимущественным нарушением метаболизма коллагена. Признаки заболевания проявляются с момента рождения ребенка. Разнообразие клинических проявлений при синдроме Марфана, функциональная несостоятельность многих систем, развитие осложнений, несовместимых с жизнью, служат основанием для изучения заболевания различными специалистами.
The aim of the study is to improving the quality of treatment of ventral hernias in patients with morbid obesity by improving the tactical and technical aspects and optimizing the choice of hernioplasty method.
The object of the study were 121 patients with ventral hernias and morbid obesity who were hospitalized in the surgical department of the 1st clinic of the Samarkand State Medical University in the period from 2012 to 2021.
The scientific novelty of the study is as follows: a method was developed for preoperative preparation of patients with ventral hernia and morbid obesity using a modified pneumatic belt-bandage to adapt the cardiovascular and respiratory systems to intra-abdominal hypertension after hernioplasty; improved technical aspects of the reconstruction of the anterior abdominal wall in patients with morbid obesity; the surgical instrument "retractor" has been improved for technical optimization of the stage of suturing the anterior abdominal wall for fixing the prosthesis in patients with concomitant obesity and abdominal ptosis; clarified clinical and instrumental criteria for the specific unification of the scale for assessing the quality of life of patients after hernioplasty and abdominoplasty for ventral hernias and morbid obesity with differentiation of the value of physical, mental and social daily activity. 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 morbid obesity: improved "retractor". The use of the proposed tool made it possible to level the technical difficulties in fixing the prosthesis against the background of severe overweight with a reduction in the operation time; developed guidelines "Technical aspects of hernioplasty for ventral hernias in patients with morbid obesity" (certificate of the Ministry of Health 8n-r / 905 dated October 12, 2021), "Criteria for the choice of surgical treatment of patients with ventral hernias and obesity" (certificate of the Ministry of Health 8n-r /906 dated October 12, 2021). The proposed recommendations made it possible to optimize the choice of tactics for surgical treatment of patients with ventral hernias and morbid obesity; the obtained scientific results on improving the quality of diagnosis and surgical treatment of patients with ventral hernias and morbid obesity have been introduced into the practice of health care, in particular, in the departments of surgery of the 1st clinic of the Samarkand State Medical Institute, the Jizzakh Regional Multidisciplinary Medical Center and the Sh. Rashidov District Medical Association of the Jizzakh region (certificate of the Ministry of Health 8n-z / 368 dated October 22, 2021). The implementation of research results by improving the tactical and technical aspects of the surgical treatment of patients with ventral hernias and morbid obesity made it possible to reduce the overall incidence of postoperative complications from 14.8% to 8.9%, including wound complications from 11.1% to 4.5% and extra-abdominal from 7.4% to 4.5%, as well as significantly reduce the duration of surgical treatment and rehabilitation periods after various types of hernioplasty and abdominoplasty. The structure and scope of the dissertation. The dissertation consists of an introduction, five chapters, a conclusion, conclusions, practical recommendations and a list of cited literature. The volume of the text material is 107 pages.
In this article the author gives critical review of the famous conception of ‘orientalism’ and critically considers its antinomy – ‘occidentalism’. Irrelevance of both conceptions is shown.
The аrticle exаmines the role of the Islаmic fаctor in the domestic politics of Syriа, аnаlyzes the evolution аnd trаnsformаtion of Syriаn society, the uniqueness of politicаl government. The positions аnd аpproаches of religious opposition orgаnizаtions regаrding the trаnsformаtions in Syriа аnd the role of Islаmic orgаnizаtions in the conflict in Syriа, the trаnsformаtion of their politicаl goаls into the tаsk of estаblishing а theocrаtic stаte аre investigаted. It аlso presents аn аssessment of the results of the Syriаn leаdership's politics regаrding building relаtions with leаding Islаmic orgаnizаtions. Dаmаscus demonstrаtes its position regаrding the construction of а democrаtic society tаking into аccount the internаl situаtion. The аrticle аlso аnаlyzes the circumstаnces of the beginning of the аrmed conflict in Syriа, which wаs once quite а prosperous country, аnd it hаs now become the epicenter of the globаl politicаl crisis. It is noted thаt the opposition, which opposed the legitimаte government of Syriа, during the yeаrs of the conflict showed its politicаl immаturity, disunity, fаilure to solve serious stаte problems аnd dependence on externаl sponsors аnd pаtron stаtes in аll mаtters.