The purpose of the study is to analyze the incidence rates of age-related macular degeneration (AMD) in the Republic of Uzbekistan for the period 2010-2019, by region. Methods: the analysis of the dynamics of indicators of the general and primary incidence of AMD over a 10-year period was carried out, by copying and statistical methods. Results: over the period of study, the indicators of general and primary morbidity in the regions of the republic are uneven and tend to steadily increase. Conclusions: The overall incidence in Uzbekistan for the period 2010-2019. increased by 1.8 times and in 2019 amounted to 24.45 per 100,000 population. The primary incidence over this period increased by 2.3 times and in 2019 amounted to 8.38 per 100,000 population. The incidence in the regions of the republic varies considerably, which necessitates a number of measures to improve the quality of medical care.
The aim of the research consists in development of offers and recommendations about further improvement of criminal-legal and criminological measures of fight against crimes in the sphere of information technologies and safety.
The object of the research work is the system of the public relations regulating criminal-legal, criminological and organizational measures for counteraction to crimes in the sphere of information technologies and safety.
The scientific novelty of the research consists of the following:
the expediency of establishment of administrative responsibility for violation of personal privacy at compliance with the law about protection of private life, ensuring protection of the rights of citizens and also completion of legal gaps is proved;
need of establishment of responsibility for infringement of personal privacy in article 1411 Criminal Code of the Republic of Uzbekistan when ensuring criminal legal protection of personal privacy and inevitability of responsibility is proved;
for ensuring the principles of justice and humanity in the criminal legislation the expediency of awarding punishment in the form of restriction of freedom on the persons who have committed crimes in the sphere of information technologies is proved;
high degree of public danger of some crimes (illegal activities for attraction of money and (or) other property (article 1881 of CK), production, storage, distribution or demonstration of the materials containing threat of public safety and to public order (article 2441 of CK)) committed with use of networks of telecommunications and the Internet is explained;
establishment of responsibility for bringing to suicide and inducement to suicide with use of networks of telecommunications and the Internet is proved;
need of introduction of responsibility of the blogger for placement of public negative information of a certain look for the Internet is proved;
inadmissibility of use of personal data of the participants at implementation of electronic commerce for who aren't provided by the contract, need of nondisclosure of the specified data are proved;
establishment of the ban on distribution among children of the information justifying illegal behavior and promoting commission of offense, calling for promotion of the destructive ideas in society and also responsibility for the specified acts is offered;
expediency of application of a method of «confidential dialogue» concerning the persons who have committed information crimes, need of implementation of inquiry, the investigation and preventive measures proceeding from their psychological state are specified;
need of recognition of the actions exerting negative impact to life, health and morality of the personality, made with use of means of information technologies as socially dangerous act is offered.
Implementation of research results. The results of the study are used:
the proposal on establishment of administrative responsibility for violation of personal privacy has found the reflection in article 461 of the Code of the Republic of Uzbekistan about the administrative liability entered by the Law of the Republic of Uzbekistan of September 23, 2016 No. ZRU-411 (the act of Committee on the legislation and the judicial-legal matters of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from September 28, 2016, No. 06/1-05/1148-vkh). This change provides compliance with the law about personal privacy, protection of the rights of citizens and also completion of a legal gap in the legislation;
the proposal on establishment of criminal liability for violation of personal privacy has found the reflection in article 1411 of the Criminal code of the Republic of Uzbekistan entered by the Law of the Republic of Uzbekistan of September 23, 2016 No. ZRU-411 (the act of Committee on the legislation and the judicial-legal matters of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from September 28, 2016, No. 06/1-05/1148-vkh). Establishment of criminal liability for commission of the act breaking personal privacy provides criminal legal protection of private life of the person and inevitability of responsibility;
offers on expediency of awarding punishments in the form of restriction of freedom concerning the persons who have committed crimes in the sphere of information technologies, have found the reflection in articles 2781-2786 Criminal Code of the Republic of Uzbekistan according to the Law of the Republic of Uzbekistan from August 10, 2015 No. ZRU-389 (the act of Committee on the legislation and the judicial-legal matters of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 06/1-05). This offer serves purpose of alternative punishment for crimes in the sphere of information technologies;
high degree of public danger of commission of some types of crimes with use of networks of telecommunications and the Internet has found reflection in article 1881, the «g» point of third part of article 2441 Criminal Code of the Republic of Uzbekistan according to the Law of the Republic of Uzbekistan of April 25, 2016 No. ZRU-405 (the act of Committee on the legislation and the judicial-legal matters of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 06/1-05). According to this offer criminal liability for use of information technologies in criminal intents has been established;
responsibility for bringing to suicide, the inducement to suicide made with use of networks of telecommunications and the Internet have been established in article 103 and 1031 Criminal Code of the Republic of Uzbekistan according to the Law of the Republic of Uzbekistan of June 13, 2017 No. ZRU-436 (the act of Committee on the legislation and the judicial-legal matters of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 06/1-05). This offer has served establishment of criminal liability for the information attacks encroaching on human life;
regulations on responsibility of the blogger for dissemination of public negative information of some look on the Internet are introduced in articles 3 and 121 of the Law of the Republic of Uzbekistan from December 11, 2003 No. 560-II «About informatization» (the act of Committee on questions of innovative development, information policy and information technologies of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 05/2-01-71). This offer serves prevention of various crimes committed with use of the Internet;
offers on inadmissibility of use of personal data of the participants at implementation of electronic commerce for who aren't provided by the contract need of nondisclosure of the specified data have found the reflection in article 18 of the Law of the Republic of Uzbekistan of May 22, 2018 No. ZRU-385 «About electronic commerce» (the act of Committee on questions of innovative development, information policy and information technologies of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 05/2-01-71). This offer became a basis for the ban illegal use of personal data from participants of electronic commerce;
offers on establishment of the ban on distribution among children of the information justifying illegal behavior and promoting commission of offense, calling for promotion of the destructive ideas in society and also responsibility for the specified acts are introduced in article 16 of the Law of the Republic of Uzbekistan of September 8, 2017 No. ZRU-444 «About protection of children from information doing harm to their health» (the act of Committee on questions of innovative development, information policy and information technologies of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 05/2-01-71). This offer has served recognition of dissemination of information among children of information doing harm to their health as illegal behavior;
offers on improvement of criminal liability for crimes in the sphere of information technologies and safety have been used by preparation of analytical notes within the Concept of improvement of the criminal and criminal procedure legislation approved by the resolution of the President of the Republic of Uzbekistan of May 14, 2018 No. PP-3723 (the act of Committee on questions of innovative development, information policy and information technologies of the Legislative Chamber of the Oliy Majlis of the Republic of Uzbekistan from July 2, 2018, No. 05/2-01-71). This offer serves a proving of inevitability of responsibility for crimes in the sphere of information technologies and information security;
offers on expediency of application of a method of «confidential dialogue» concerning the persons who have committed information crimes, need of implementation of inquiry, the investigation and preventive measures proceeding from their psychological state have been introduced in activity of the relevant structural divisions of the Ministry of Internal Affairs of the Republic of Uzbekistan (the act of the Ministry of Internal Affairs of the Republic of Uzbekistan from July 2, 2018 No. 33/1985). This offer has served increase in efficiency of prevention of crimes in the sphere of information technologies and information security;
offers on need of definition of external influence, level of competence and practical skills of employees, motives of offense when studying the reasons of crimes in the sphere of information technologies and information security and also conducting monitoring of social networks have been introduced in activity of the relevant structural divisions of the Ministry of Internal Affairs of the Republic of Uzbekistan (the act of the Ministry of Internal Affairs of the Republic of Uzbekistan from July 2, 2018 No. 33/1985). This offer has served definition of the reasons and early warning of crimes in the sphere of information technologies and information security;
offers that the information security is object of criminal legal protection taking into account its direct connection with the state interests have found the reflection in the Law of the Republic of Uzbekistan «About modification and additions in the Law of the Republic of Uzbekistan «About the principles and guarantees of freedom of information» (the act of the Center of information security and assistance in ensuring public order at the Ministry of information technology development and communications of the Republic of Uzbekistan from November 13, 2017 No. 03-07-02/124). This offer has served protection of information security as object of criminal legal protection;
offers on need of implementation of complex measures from law enforcement agencies for ensuring information security at information security have found the reflection in the Law of the Republic of Uzbekistan «About modification and additions in the Law of the Republic of Uzbekistan «About the principles and guarantees of freedom of information» (the act of the Center of information security and assistance in ensuring public order at the Ministry of information technology development and communications of the Republic of Uzbekistan from November 13, 2017 No. 03-07-02/124). This offer has provided orientation of activity of law enforcement agencies on information security;
offer that threats of information security exert essential harm to the interests of the personality, society and state information have found the reflection in the Law of the Republic of Uzbekistan «About modification and additions in the Law of the Republic of Uzbekistan «About the principles and guarantees of freedom of information» (the act of the Center of information security and assistance in ensuring public order at the Ministry of information technology development and communications of the Republic of Uzbekistan from November 13, 2017 No. 03- 07-02/124). This offer has allowed to estimate high degree of public danger of information threats as a factor of commission of information crimes;
the rule about protection of the personality against illegal information influence taking into account that impact on consciousness of the personality with use of means of information technologies exerts negative impact on life, health and morality of the personality, has found the reflection in the Law of the Republic of Uzbekistan «About modification and additions in the Law of the Republic of Uzbekistan «About the principles and guarantees of freedom of information» (the act of the Center of information security and assistance in ensuring public order at the Ministry of information technology development and communications of the Republic of Uzbekistan from November 13, 2017 No. 03-07-02/124). This offer has served recognition of the specified actions as socially dangerous act.
Structure and volume of the dissertation. The thesis consists of an introduction, four chapters, a conclusion, a list of used literature and applications. The volume of the thesis is 260 pages.
“Anesthesiology and resuscitation is one of the most complex and difficult specialties, requiring a wide range of intelligence, deep knowledge and dexterity from the doctor at the same time.” Improving the pediatric resuscitation service and improving the quality of care for children in critical condition is one of the main directions of the healthcare organization of the Republic of Uzbekistan. Regardless of the location of the patient, the availability and quality of medical care at the resuscitation stage of treatment often determines the outcome of the underlying disease. Due to significant differences in the nature of anatomical and physiological characteristics and pathological processes, critical situations occur more often in children than in adults. “A child is not a miniature adult; his body has its own anatomical and physiological characteristics and throughout childhood undergoes characteristic age-related changes.” The anatomical and physiological characteristics of the child’s body are one of the main factors that determine the etiology of the process in children, the mechanism of development and the outcome of a critical condition. In pediatrics, a classification is widely used to describe the anatomical and physiological characteristics of the child’s body, where childhood is divided into six periods: 1. Infant period (neonatal period) – up to 4 weeks. 2. Breastfeeding period – from 4 weeks to 1 year. 3. Preschool (kindergarten) period – from 1 to 3 years. 4. Preschool period – from 3 to 6 years. 5. Junior school age (from 7 to 11 years). 6. Senior school age (from 12 to 18 years). Intensive care and resuscitation is one of the most important sections of such scientific and practical areas as anesthesiology and resuscitation. The practical methods of our specialty (respiratory support, transfusion and infusion therapy, tracheal intubation, nutritional support, efferent detoxification methods, etc.) are the same as the organization of services in most healthcare institutions.
In modern abdominal surgery, one of the current areas for research continues to be the improvement of various options for plastic surgery of postoperative hernias. More than 2,100,000 operations for ventral hernia are performed annually in the world, and 42% of them are postoperative hernias. In recent years, there has been a clear trend toward the expanded use of various types of biological meshes in hernioplasty. “A pooled analysis of seven PCSTAR studies for incisional hernias using retromuscular mesh showed a hernia recurrence rate of 5.7%”[1]. The use of standard surgical interventions such as alloplasty in the onlay position does not solve the problem of early postoperative complications: seroma discharge, mesh migration, adhesive disease, high frequency of hernia recurrence, etc. At the same time, hernia repair with local tissue creates the problem of increased intra-abdominal pressure and late complications in the form of recurrent hernias. “An increase in postoperative intra-abdominal pressure leads to multiple organ failure, then abdominal compartment syndrome, and even death.” [2]. Currently, there is no consensus on the surgical approach for giant postoperative abdominal wall hernias, and therefore the need to continue to develop new technologies and improve There is no doubt about the tactics. In world practice, at present, the most relevant studies continue to be studies aimed at studying the morphological and functional aspects of recurrent postoperative ventral hernias; electron microscopy reveals ultrastructural destructive changes in skin cells, aponeurosis and muscles, which indicates morphofunctional insufficiency of abdominal wall tissues; issues of cell engineering are discussed new innovative materials, experimental studies are being carried out on animals testing the biotechnical properties, texture and elasticity of new polymers, research is being conducted on open approaches with division of the posterior component with the release of the transverse abdominis muscle and a retrograde mesh, robotic operations have begun. Modern aspects of the development of domestic healthcare include many measures aimed at improving the results of treatment of patients with postoperative ventral hernias and associated pathological conditions through the introduction of modern principles of intensive care and surgical tactics. The development strategy of New Uzbekistan for 2022-2026 in seven priority areas includes tasks to improve the quality of provision of qualified medical services to the population[3]. The implementation of these tasks, including by optimizing tactical and technical approaches to the choice of hernioplasty method, as well as the development of methods for the prevention of purulent-inflammatory complications in the field of alloplastic material, is one of the current areas of abdominal surgery and medicine in general, due to the high medical and social the significance of this pathology.
This dissertation research to a certain extent serves to fulfill the tasks approved by the Decree of the President of the Republic of Uzbekistan “On comprehensive measures to radically improve the healthcare system of the Republic of Uzbekistan” No. UP-5590 dated December 17, 2018, the Resolutions of the President of the Republic of Uzbekistan “On measures to transform the surgical service, improving the quality and expanding the scale of surgical operations in the regions" for No. PP-5254 dated October 4, 2021 and "On additional measures to ensure public health by further increasing the efficiency of medical prevention work" for No. PP-4891 dated November 12, 2020, and as well as other regulatory documents adopted in this area. Compliance of the research with the priority directions of development of science and technology of the republic. The dissertation research was carried out in accordance with the priority direction of development of science and technology of the VI Republic “Medicine and Pharmacology”. Review of foreign scientific research on the topic of the dissertation.[4] Research work aimed at improving the quality of therapeutic and preventive care for patients with ventral hernias, carried out by many leading scientific centers and higher educational institutions in the world, including the Department of Surgical and Perioperative Sciences, Umeå University, Umeå (Sweden), Department of Surgery, Kingston General Hospital, 76 Stuart Street, Kingston (Sweden). nada), Department of Surgery, Helsinki University Hospital, Helsinki ( Finland), Service de chirurgie digestive et oncologique, CHU d'Amiens (France), Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa (USA), Department of Surgery, Howard University College of Medicine, Washington (USA) , Yong Loo Lin School of Medicine, National University of Singapore (Singapore), Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA; University of Calgary, Calgary (Canada), Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia (USA), Brigham and Women's/Faulkner Hospital, Harvard Medical School, Boston (USA) , Department of Surgical Sciences, Uppsala University Hospital, Uppsala (Sweden), Department of Surgery, University of Texas Health Sciences Center at Houston, Houston (USA), Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam (Netherlands), Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka (Japan), National Medical Research Center for Surgery named after A.V. Vishnevsky" (Russia), Republican Scientific Center for Emergency Medical Care (Uzbekistan), Tashkent Medical Academy (Uzbekistan), Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov (Uzbekistan).
As a result of studies conducted around the world to increase the effectiveness of alloplasty for postoperative ventral hernias and reduce the risk of complications in the postoperative period, a number of scientific results were obtained, including: it was determined that patients who underwent reconstruction of the abdominal wall have an increased risk of postoperative respiratory failure, understanding the epidemiology of this complication can improve prevention (the Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health & Science University, USA); It has been proven that the larger the hernia, the higher the risk of early surgical complications, including such as respiratory decompensation, since hernias often increase in size over time, delaying surgery can lead to an increase in the size of the hernia and, therefore, a greater risk of complications (CentreforDigestiveDiseases, KarolinskaUniversityHospital, Stockholm, Sweden); it has been shown that the ratio of the hernia volume to the volume of the abdominal cavity <20% is an independent factor in tension-free closure, which justifies the interest in preoperative volumetry to adapt the tactics of surgical care (Servicedechirurgiegénérale, digestiveetendocrinienne, CHU LyonSud, HospicescivilsdeLyon, France); It has been determined that in patients undergoing elective laparoscopic hernia repair, predictors of mortality are older age and certain concomitant diseases: congestive heart failure, pulmonary circulatory disorders, coagulopathy, liver disease, metastatic cancer, neurological disorders and paralysis (Department of Surgery, College of Medicine, University of Oklahoma, Tulsa , USA); Older age, ascites, preoperative renal and pulmonary insufficiency have been found to be independent predictors of 30-day mortality, and in the presence of these risk factors, conservative treatment should be seriously considered (Department of Surgery, University of Kentucky College of Medicine, Lexington, USA); The American College of Surgeons (ACS) Universal Surgical Risk Calculator has been shown to accurately predict thirty-day outcomes, including major complications: venous thromboembolism, medical morbidity, surgical site infection, unplanned reoperation, mortality, and length of hospital stay (Department of Plastic Surgery, Brown University and Rhode Island Hospital, Providence, USA). At the present time in the world, the most relevant research in surgery continues to be the development of new methods of hernioplasty for large and giant ventral hernias, each of which has its own pros and cons depending on the complexity of implementation, the risk of postoperative complications and relapse, large randomized clinical trials are being conducted, comparing existing methods of traditional hernioplasty with laparoscopic access and robotic surgery, which has become increasingly widespread in the last 10 years, a search is being made for new synthetic and biological materials developed for the production and use of composite meshes that have the necessary strength and the ability to prevent fatal local complications in a contaminated environment. However, despite technical advances in this field, no modern hernia repair method or prosthesis meets all the requirements. One of the key problems is that existing synthetic endoprostheses do not have sufficient elasticity, resistance to infection, high mechanical strength and integrity over a long period of time. Further research into these clinical aspects will undoubtedly improve the current understanding of the capabilities of biocompatible endoprostheses and will make it possible to develop an optimal method for their placement during allohernioplasty. The degree of knowledge of the problem. The current period of development of abdominal surgery is characterized by an emphasis on the problems of the effectiveness of introducing new installation methods and techniques for attaching bioprostheses, options for various suture materials to determine the most promising directions for the development of these technologies [5]. Researchers led by BittnerR.[6] (2019) state that a giant postoperative abdominal wall hernia, the maximum diameter of which exceeds 12 cm or the ratio of the volume of the hernial sac to the abdominal cavity more than 20%, is difficult to treat, with a high recurrence rate and a large number of complications. One of the most challenging problems is that after the hernia contents return to the abdominal cavity, postoperative intra-abdominal pressure will increase, leading to multiple organ failure, then abdominal compartment syndrome (ACS), and even death. There is currently no agreement on the surgical approach for these giant incisional abdominal wall hernias. To prevent recurrences, some articles recommend placing the hernia mesh in the sublayer position and or linings (KirkpatrickAW.)[7]. According to CornetteB.[8], to prevent recurrence, it is recommended to place the hernia mesh in a sublayer or underlay position, and to achieve better mesh expansion, a component separation technique (CST) may be a suitable solution, but with a significant risk of complications and recurrence. JensenKK, et al. believe that truly successful giant hernia repair requires effective bridging or augmentation that will prevent recurrence with an acceptable risk of complications[9]. Another pressing issue in abdominal surgery is that patients with incisional hernias are extremely difficult to treat due to a number of factors including obesity, previous hernia repair, previous mesh placement, domain loss, and other variables.
The approach to patients with incisional hernias has changed significantly over the past 20 years due to both advances in mesh technology and surgical approaches. Key factors for successful outcome include modification of risk factors preoperatively, such as smoking cessation and weight loss, selection of mesh appropriate for the type of hernia and planned mesh location, and wide mesh coverage beyond the hernia defect. New techniques such as transabdominal muscle release and component separation with retrograde mesh placement and robotic approaches to abdominal wall hernia are increasingly being used in these patients[10]. Recent years have seen an increase in the number of biological meshes available for abdominal wall hernia repair. Biological meshes typically consist of materials obtained from humans, pigs, or cattle. The rationale for using biological meshes is that they can act as a scaffold for the growth of natural tissues. In addition, there are absorbable synthetic meshes that have properties similar to those of biological meshes, but with theoretically less risk because they are not derived from animal or human material. The choice of mesh for a ventral hernia depends on many factors, which include both the properties of the mesh and its location, for example, whether it should be placed intraperitoneally, preperitoneally, or retrorectus. BaierKF[11](2021) believes that the guiding principle should be to avoid placing uncoated polypropylene mesh in an intraperitoneal location where it may be in direct contact with internal organs. In addition, the type of hernia defect is another risk factor, such as whether the wound is clean or dirty, and whether the repair is performed with a bridge or abutment. Lightweight or biologic meshes to bridge the defect should be avoided due to increased recurrence rates. Holihan JL [12] (2016), Hodgkinson JD [13] (2018) believe that the principle of anatomical restoration to achieve a reliable, tension-free repair with reinforced mesh reduces the incidence of early postoperative complications and late recurrence of hernia compared with bridging mesh. The analysis of the literature concerning the theoretical aspects and clinical experience of using technologies for improving modern synthetic and biological prostheses that can provide a better plastic effect, as well as methods for preventing recurrence of ventral hernias, indicates that this is one of the priority areas in modern abdominal surgery. An unresolved issue remains the choice of the optimal endoprosthesis, which is highly effective and meets international standards for such properties as biological inertness and mechanical strength, as well as the method of positioning the mesh in relation to the layers of the abdominal wall. Considering that many of the allohernioplasty methods used today are not without drawbacks, the current direction is the development of new methods of repair for giant ventral hernias and methods for the prevention of postoperative complications in conditions of a contaminated wound, with justification of their effectiveness in a clinical experimental study. The connection between the dissertation research and the research plans of the research institution where the dissertation was completed. The dissertation research was carried out within the framework of the research work plan of the State Institution “RSNPMCH named after. acad. V. Vakhidov" under the project AL-422105574 "Development of new biocompatible mesh implants made of composite materials for reconstructive surgery of abdominal and diaphragmatic hernias" (2022-2024).
The purpose of the study is to improve the results of surgical treatment of large and giant postoperative ventral hernias by introducing new laser technologies and improving the tactical and technical aspects of surgical treatment. Objectives of the study: to study the structure of immediate complications after various types of prosthetic plastic surgery; to clarify the influence of obesity factors, primary or repeat hernioplasty on the incidence of immediate and long-term complications; to evaluate the role of the immediate complicated course of the postoperative period in the incidence of long-term complications of hernioplasty; to improve the technical aspects of alloplasty for large and giant postoperative ventral hernias (POVH); to improve the technique of photodynamic therapy (PDT) of the wound surface after prosthetic plastic surgery; to study in an experiment the effectiveness of using the proposed technique of alloplasty and PDT; evaluate the morphological features of the condition of tissues during prosthetic plastic surgery using the proposed method; in a comparative aspect, evaluate the clinical effectiveness of the proposed alloplasty options in the immediate and long-term periods. The object of the study was the results of allohernioplasty in 448 patients with extensive (large) and giant POVH, who were operated on at the surgical department of the 1st clinic of the Samarkand State Medical Institute in the period from 2012 to 2021, as well as experimental animals on which the effectiveness was assessed developed a technique for prosthetic repair of postoperative ventral hernias and applied the technique of photodynamic therapy.
The subject of the study is to analyze the effectiveness of the developed alloplasty of postoperative ventral hernias and intraoperative photodynamic therapy in abdominal surgery in experiments and in the clinic. Research methods. To achieve the goal of the study and solve the assigned problems, general clinical, instrumental, biotechnological, experimental, histomorphological, microbiological and statistical research methods were used. The scientific novelty of the study is as follows: it was established that the need for extensive tissue mobilization and, as a consequence, the intersection of lymphatic capillaries during implantation of the prosthesis in the onlay position, as well as the lack of sufficient resorption function of the hernial sac in the inlay position causes a high risk of the formation of clinically significant seromas; It was determined that with prosthetic hernioplasty, along with the volume of the defect, the type of plastic surgery and the degree of obesity, the most significant predictor of the risk of developing immediate complications is the factor of re-intervention in case of recurrent hernia with the presence of a “dormant infection” hidden in the remaining ligature granulomas or scar tissue; the structure and clinical features of the course of long-term complications of hernioplasty for giant and extensive hernias were clarified, taking into account the results of the immediate postoperative period, as well as the option of fixing the prosthesis, primary or repeated hernioplasty and the degree of obesity; the method of surgery for large hernias of the anterior abdominal wall has been improved, characterized by a combination of factors such as the formation of tension-free prosthetic repair, preservation of local resorptive function to prevent the development of fluid accumulations and reducing the risk of infection; the method of preventing the development or progression of wound infection during alloplasty of ventral hernias has been improved, aimed at enhancing the antibacterial effect and stimulating reparative activity through the photosensitizing and photodynamic effect of low-energy laser radiation; It was determined in an experimental model of prosthetic plastic surgery that the proposed method of fixing the prosthesis in combination with the use of the effect of photodynamic therapy through laser radiation helps to enhance reparative processes with a reduced risk of wound complications; It has been proven that all methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic plastic surgery enhance preventive measures against the development of local infection, but are ineffective in the case of an already developed purulent-inflammatory process against the background of the use of alloplastic material. The practical results of the study are as follows: it has been determined that the implantation of synthetic materials for giant and extensive hernias is accompanied by a significant number of wound complications caused by both the surgical technique itself and the reaction of surrounding tissues to a foreign body, requiring improvement of tactical and technical approaches when performing hernioplasty; it was clarified that scar-degenerative changes in the tissues of the aponeurosis in giant and extensive hernias are a predisposing factor to the occurrence of post-prosthetic hernias, especially when implanting the prosthesis in the “inlay” position and, accordingly, require increasing the efficiency of their fixation and engraftment, as well as reducing the risk of developing local complications; it was determined based on the data of an experimental study that the proposed method of alloplasty for large ventral hernias makes it possible to achieve adequate reconstruction of the anterior abdominal wall, reduce the incidence of infection in the wound, and also use a smaller size of prosthetic material; it was determined that the proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant allows maintaining physiology, reducing the number of complications, shortening treatment time and reducing the risk of hernia recurrence; It has been determined that the proposed method for preventing the development or progression of wound infection during alloplasty of ventral hernias can reduce the frequency of suppuration, shorten the treatment time and the likelihood of relapse; It has been proven that the use of the proposed tactical and technical aspects of prosthetic repair for postoperative ventral hernias can reduce the incidence of specific complications, reduce rehabilitation time and the risk of hernia recurrence. Reliability of the research results. The reliability of the results is justified by the use of objective criteria for assessing the condition of patients, modern methods of diagnosis and treatment, the correct application of methodological approaches and sets of statistical analysis, methods for solving the problems discussed in the dissertation are based on modern scientific and practical concepts and approaches to the diagnosis and surgical treatment of patients with giant postoperative hernias. Scientific and practical significance of the research results. The results obtained make a significant contribution to the expansion of irradiation of existing ideas about the structure and clinical features of complications of hernioplasty for giant and extensive ventral hernias by identifying the morphological features of the development of a purulent-inflammatory process against the background of the use of alloplastic material, studying predictors of the risk of developing immediate complications, mechanisms for enhancing reparative processes through the use of an improved method of fixing the prosthesis in together using the effect of photodynamic therapy through laser radiation, which made it possible to enhance the antibacterial effect and improve the wound healing process. The practical significance of the study is that, based on the results obtained, the tactical and technical aspects of prosthetic hernioplasty have been optimized, the features of methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic repair have been revealed, enhancing preventive measures for the development of local infection, and the method of surgery for large anterior abdominal hernias has been improved walls, characterized by a combination of factors such as the formation of tension-free prosthetic plasty, preservation of local resorptive function to prevent the development of fluid accumulations, thereby reducing the risk of developing postoperative complications, reducing the frequency of unsatisfactory results, length of hospitalization and the likelihood of relapse. Implementation of research results. According to the results of a scientific study to optimize the tactical and technical aspects of surgical treatment of large and giant postoperative ventral hernias: the “method for plastic surgery of giant hernias of the anterior abdominal wall” has been improved (invention patent No. IAP 2022 0148 dated April 18, 2022). The proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant made it possible to reduce the number of complications, shorten the treatment time and reduce the risk of hernia recurrence; the “method for preventing the progression of infection during alloplasty of infected hernias” has been improved (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). The proposed method made it possible to reduce the frequency of wound purulent-inflammatory complications and shorten the period of rehabilitation of patients after allohernioplasty; methodological recommendations “Tactical and technical aspects of prosthetic repair for large and giant postoperative ventral hernias” have been developed (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022) . The developed recommendations made it possible to optimize the tactical and technical aspects of allohernioplasty in patients with large and giant postoperative ventral hernias; The scientific results obtained were introduced into the practical activities of healthcare, in particular, in the departments of surgery of the Khorezm and Andijan regional multidisciplinary medical centers, the clinic of the Samarkand State Medical University (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). Improving the tactical and technical aspects of prosthetic repair for postoperative ventral hernias has made it possible to reduce the incidence of specific immediate complications from 40.9% to 15.6%, to reduce rehabilitation time from 8.6±2.7 to 7.1±1.5 days, and also reduce the likelihood of long-term complications from 11.7% to 3.1%. Approbation of research results. The results of this study were discussed at 8 scientific and practical conferences, including 5 international and 3 republican ones. Publication of research results. 26 scientific works have been published on the topic of the dissertation, including 9 journal articles, 4 of which in republican and 5 in foreign journals recommended by the Higher Attestation Commission of the Republic of Uzbekistan for publication of the main scientific results of doctoral dissertations. Structure and scope of the dissertation. The dissertation consists of an introduction, seven chapters, a conclusion, conclusions, practical recommendations and a list of cited literature. The volume of work is 200 pages.
“Matlai sadain wa majmai Bahrain” of Abdurazzak Samarkandi is the main source for studying the history of the Timurid period. From the source, we can obtain valuable information about socio-political events, diplomatic relations, culture and education, construction and improvement. The article analyzes the information presented in the source in the field of architecture and landscaping. The Temurid period is notable for large-scale creative and landscaping works. Is there such information in “Matlai sadain”? What architectural monuments can We get information about? The article deals with similar issues. After the death of Amir Temur, the struggle for the throne reached a highest point, and many devastations occurred. According to sources, during this period, construction work was mainly focused on defense facilities. After Shahrukh Mirza consolidated Saltanat in his hands, the construction work shifted mainly to the enlightenment buildings. During this period, many mosques, mausoleums, madrasas, and gardens were built. Along with the construction of architectural structures, much attention is paid to the improvement of cities. In particular, agriculture was developed in Merv and Balkh. The book contains a lot of information about the buildings built and sponsored by Shahrukh Mirza and his sons. There is also information about the construction work carried out by the Timurid ladies. In addition to the activities of the Timurids, many emirs built mosques and madrasas. This can also be found in the source. This period, which was followed by constant war, is characterized by numerous destructions. The areas where the war was going on were often devastated. The destruction was mainly directed at defensive structures.
The article explores the relationship between ancient Arab history, in particular, the political life of the caliphate and the Umayyads with the literature of that century. The author highlights how the political picture of the Umayyad era influenced literary life. It is well known, that the period of ruling of the Umayyad caliphs was full of endless wars, conflicts, instability, and yet, despite this, this is the era of great conquests in the history of the Arabs. At that time, when the unrest in the country was at its peak, as well as when the greatest things in the history of the Arabs took place, the Arab rulers themselves also made various speeches. The author of the article claims, that the appearance of numerous sects, groups, parties and other communities on the map of the political life of the Umayyads, constant wars and differences between them - inevitably led to the need for the art of public speaking. At the end of the article, the author carefully analyzes the speech of one of the governors of the Umayyads Ubaidullah bin Ziyad as an example of public speaking and literary heritage.
The paper aims to explore the comparative points between the two poets of India i.e. Amir Khusraw and Mirza Abdul Qadir Bedil, the former lived during Saltanat period and the latter in the Timurid. The two greatest Persian poets of India,Amir Khusraw and Bedil, who never visited Iran or had any genealogical connection with.Both born and brought up entirely in the Indian socio-cultural environment and were ethnically Turks and having no literary background. Besides, that four centuries separate Amir Khusraw and Bedil, but still we find striking similarities between the two. Bedil unlike Khusraw was never attached to any Amir or King, but he too, closely observed and was well aware of the changing socio-political situation of his period. Both were Sufis by heart and their poetry reveals sufistic mysteries. Besides, as poet too their creative perusal and their aspiration to comprehend the classical tradition of great masters of the past for further innovations appear identical. This is the reason, why both the poets had greatest impact on the literary traditions of the following periods. The paper also looks into the general characteristics of the Persian poetry i.e. spirituality, liberalism and tolerance, ethics and sorrow.
Латинский язык (lingua latina), или латынь, — язык древних рымлян, употреблявшийся в Римской империи. Язык латино-фалискской ветви италийских языков индоевропейской языково семьи.Ни один народ мира не разговаривает на латинском языке, но в истории мировой цивилизации влияние латинского языка сохраняется и сегодня.
The aim of the research work is to improve the results of treatment of patients with combined injuries of the pelvis and femur, by developing tactical and technical aspects based on the severity of the injury and the severity of the condition.
The object of the study was 130 patients with injuries of the pelvic and hip bones with concomitant trauma, treated at the Republican Scientific Center for Emergency Medical Aid and its Samarkand branch for the period 2016-2021 years.
The scientific novelty of the research work is the following: the structure and frequency of combined injuries of the pelvis and femur in the general structure of injuries, in the structure of injuries to the pelvis and femur separately were evaluated. the risk factors for the development of unsatisfactory results of treatment of concomitant injuries of the pelvis and hip, based on traditional clinical and diagnostic standards, have been determined; a direct relationship has been proven in the dynamics of the condition of the victims and the prognosis, taking into account the type and nature of segmental injuries; the device for external fixation for stable functional minimally invasive osteosynthesis has been improved and the possibility of expanding the indications for surgical treatment for combined injuries of the pelvis and hip in the early period of traumatic disease has been proved; the technical advantages of a complete set of an improved rod device for external fixation have been proved, the pelvic and femoral versions of which make it possible to use them for effective stabilization of the pelvis and hip separately during anti-shock measures, and for the final reposition of bone fragments; the direct dependence of treatment results on the proposed tactics of providing trauma care at an early hospital stage, depending on the type, nature, severity of pelvic and hip injuries, and the severity of the condition has been proved.
The introduction of research results. Based on the results of scientific research to improve the surgical aspects of providing assistance to victims with concomitant injuries of the pelvis and femur: based on the results of the development of a device for the treatment of fractures, a patent for an invention was obtained from the Intellectual Property Agency of the Russian Federation "Apparatus for the treatment of combined fractures of the pelvic and hip bones" (patent No. 2749897 dated 06/18/2020). The results obtained made it possible to improve the tactics of surgical treatment of patients, to shorten the period of hospitalization and the period of postoperative rehabilitation, to ensure the possibility of patients with minimal economic costs; on the basis of the results of scientific research on the diagnosis and treatment of concomitant injuries of the pelvic and femur bones, methodological recommendations were approved "Method for the treatment of victims with concomitant injuries of the pelvis and hip, depending on the severity" (Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z / 288 dated August 31, 2021 of the year). The results obtained made it possible to improve the quality of wound diagnosis and rehabilitation of patients with injuries of the pelvic and hip bones in concomitant injury; approved methodological recommendations "Tactics of rendering assistance to victims with combined injuries of the pelvis and hip, taking into account the severity of the condition" (Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z / 288 of August 31, 2020). The results obtained made it possible to improve the tactical and technical aspects in the treatment of injuries to the pelvic and hip bones, based on the severity of the injury and the severity of the patient's condition.
Scientific results have been introduced into the practical activities of healthcare, in particular, the Samarkand branch of the Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics, the Jizzakh Branch of the Republican Scientific Center for Emergency Medical Aid, the Samarkand branch of the Republican Scientific Center for Emergency Medical Aid (certificate of the Ministry of Health No. 08-09 / 18979 dated December 02, 2021). The proposed tactics for the treatment of combined injuries of the pelvis and femur made it possible to reduce the incidence of postoperative complications of excellent and good long-term functional results from 66.1% to 92.6%.
The structure and scope of the dissertation. The dissertation consists of an introduction, five chapters, conclusions, practical recommendations, a list of referencesand applications. The volume of the text material of the work is 111 pages.
The study of disability indicators by ophthalmopathology is of great importance for solving a wide variety of scientific and practical problems in healthcare. An analysis of the literature data showed that there are no regional studies on AMD that provide the main way to disability.The purpose of the study was to study the state and dynamics of disability due to AMD in the Republic of Uzbekistan and the city of Tashkent for the period from 2010 to 2019.Results. For the first time, indicators of general and primary disability in Uzbekistan are presented, which for 2019 are 3.44 and 0.61 per 100 thousand of the adult population, respectively. General and primary disability in the city of Tashkent for 2019 is 1.02 and 0.43 per 100 thousand population, respectively. The disability rate did not decrease during the study period from 2010 to 2019.Achieving the highest performance with an integrated approach is possible if these activities are carried out in a timely manner and in compliance with the phasing, continuity and continuity.
Subject of the inquiry is the social structure of society in the territory of Uzbekistan and its transformations in conditions of colonial and Soviet regimes.
Aim of the inquiry: is a complex investigation of transformations of the social stratification of society in the territory of Uzbekistan in close entwinement with political and socioeconomic events during the period from the end of the 19lh century up to the end of the 1930s.
Method of the inquiry: the research has employed the problcm-and-chronological and retrospective-historical methods, the methods of comparative and of system analyses.
The results achieved and their novelty: the dissertation is the first to make an attempt of approaching the studying of the problem of social stratification of society in the territory of Uzbekistan and to do a complex, multifaceted research covering a long historical period. The research was pursued from the new conceptual - methodological positions of the theory of stratification of society, what has not been used in domestic historiography until now.
Practical value: the materials systematized in the dissertation can help and contribute to more profound knowledge of the historical past of Uzbekistan thereby assisting to the formation of the worldview and ideology of the youth.
Degree of embed and economic efficiency: the material of the disscrtational work is reflected in 38 publications including the monograph, 21 journal articles(including three articles in foreign journals), and three educational books. Currently these publications are used by university students and researchers.
Sphere of usage: material of the research might be useful to scholars of social and political sciences, to historians in their writing works on the history of Uzbekistan and in writing scientific-methodical study guides for students of higher education establishments and secondary-special educational institutions, as well as for professional training of high-skilled specialists.
The aim of the study was a comparative assessment of the results of electrophysiological and electroacoustic methods for studying hearing in patients with Meniere's disease during an attack and between attacks. A total of 47 patients with a reliable or confirmed diagnosis of Meniere's disease were under observation, which constituted the main group. The results of the study showed that TEOAE was not recorded in the period between attacks in 89,4%, PIOAE - in 76%, while this indicator during an attack of BM was 100% and 89,4%.
Характерной чертой пищеварительного процесса в период новорожденности является низкий уровень желудочной секреции, что обусловливает более высокую функциональную нагрузку на тонкий кишечник. С целью выяснения адаптационных возможностей пищеварительной системы в этот период изучали влияние искусственного вскармливания заменителем молока на белок переваривающую функцию желудка и тонкого кишечника в модельных опытах на новорожденных крысятах