Objective: To study the prevalence of inflammatory periodontal diseases and the level of provision of periodontal care to the population of the Andijan region of the Republic of Uzbekistan.
Material and methods: A dental examination was carried out on 177 people aged 15 to 74 living in different districts of the Andijan region. All surveyed were divided into 4 age groups: from 15 to 34 years; from 35 to 44 years; from 45 to 64 years; 64-74 years old. Results: The prevalence of inflammatory periodontal diseases in the Andijan region is at a high level, more than 50% of the population of the republic need preventive measures; and 20% require qualified periodontal care with the participation of not only a periodontist, but also other specialists: a dental surgeon and an orthopedist. Conclusions: It is necessary to think about a new system for organizing care for periodontal patients, providing for the complexity and consistency of our actions in the real conditions of the dental service.
Topicality and demand of the subject of dissertation. Bronchial asthma (BA) is one of the most common and serious diseases, which in the world suffer from 3 to 12% of the child population of the globe. Proportion of adolescents with asthma, is one third of all children with this disease. High prevalence of asthma in the numbers of teenagers, characteristics of the disease, age-related aspects of the functioning of the endocrine and immune systems of teenagers that cause difficulties which arise in the course of the diagnostic process, highlight the need to find innovative approaches to diagnosis and treatment of this disease.
It is known that the key immune mechanisms in the pathogenesis of the vast majority of AD cases is real and indisputable fact. Currently, considerable interest to researchers involved in the pathogenesis of positions of allergic diseases, especially asthma, along with IL-4 and IL-13 causes a number of other (IL-6, IL-8, IL-10, IL-5, INF-a and INF-y) immunoregulatory cytokines.
Genetic predisposition plays an important role in the development of allergic diseases. Currently available data on the relationship with asthma and associated with disease symptoms polymorphism approximately 150 genes. Important role as the main contender for the predisposition to asthma gene is a gene encoding flchain of high affinity receptor IgE. Interaction elevated levels of antigen-specific IgE with FceRip plays a central role in the pathogenesis of allergic asthma. Particularly attractive candidate gene asthma is also one of the enzyme genes biotransformation - GSTirl, encoding glutathione S-transferase and л1 express almost exclusively in the pulmonary tissue. This gene is located at the locus 11 ql 3, for which repeatedly shown clutch with atopic symptoms. Accumulated in the literature say about the relationship of gene polymorphism FceRI, GSTnl with different allergic diseases.
From this perspective, the study of immunological and genetic mechanisms of the pathogenesis of this disease for the construction of rational treatment and prevention emphasizes the relevance of this thesis research.
From the earliest days of independence, the country has successfully implemented state programs aimed at reforming the health care system. As a result, the targeted implementation of organizational health and research activities aimed at effective diagnosis, prevention and treatment of asthma among adolescents, with some success in the treatment of this disease in the country. However, now the problem of early diagnosis and the development of effective programs for treatment and prevention among adolescents with asthma remain one of the most important issues of modern health care. This research work was carried out in the framework of the tasks set by the Resolution of the Cabinet of Ministers of the Republic of Uzbekistan "On additional measures to improve the health of women and the younger generation," dated 25.01.2002 for the №32. In this regard, the need to deepen the information received about the state of cellular and humoral immunity among adolescents, asking pathogenetic informative immunogcnctic studies in asthma arc one of the important criteria demand the dissertation topic.
Purpose of research is study the immunological and genetic mechanisms of the pathogenesis of asthma in adolescents and form the basis of this plan rational diagnostic and therapeutic measures in this pathology.
In To achieve this goal the following tasks of research is solved:
to establish the clinical course of asthma in the population of adolescents living in the Samarkand region, in the early stages of the pathological process in the bronchopulmonary system.
explore the features of the state of cellular and humoral immunity, as well as activation markers in asthma in adolescence by determining the immunophenotype of lymphocytes in the peripheral blood.
to examine the level of production of immunorcgulatory cytokine interleukin-6 and interfcron-y and install them pathogenetic informative in asthma among adolescents.
to determine the features of distribution of allele and genotype frequencies of polymorphic variants of genes and FceRip GSTnl population Uzbek people with asthma, compared with the healthy part of the population.
examine the clinical and immunological aspects effectiveness of therapies using drugs and polioksidony tsikloferon in patients with asthma in adolescence.
on the basis of studies to develop a multivariate model of formation of bronchial asthma and develop an optimal algorithm for the diagnosis, treatment, prevention in adolescents with this pathological condition.
Scientific novelty of dissertational research consists in the following:
proposed introduction to the work of doctors teen clinics layered approach testing can significantly improve the detection rate of asthma in adolescence and optimize treatment and preventive measures in high-risk groups;
first defined the peculiar characteristics of the quantitative parameters of the immune status of patients with asthma in the cohort of adolescence and the corresponding proposed regulations and guidance documents for the healthy part of the adolescent population;
for the first time presents a comprehensive assessment of the cytokine profile of blood serum in bronchial asthma in adolescents. Specific features of products immunorcgulatory cytokines IL-6 and INF-y and their pathogenetic and regulatory information content in asthma among adolescents;
first analyzed the distribution of alleles and genotypes of polymorphic gene variants and gene FceRip GSTirl among patients with different phenotypic variants of AD and healthy individuals of Uzbek nationality, which resulted in the identified markers of increased risk or, conversely, resistance to the development of asthma in adolescents Uzbek ethnicity;
algorithms for phase diagnosis, treatment and prevention of asthma in adolescence in terms of disclosure of important moments of the pathogenesis of the disease, allowing to build a rational sequence of diagnostic search, aimed at verifying the diagnosis and expedient construction of preventive measures.
Conclusion
1. Set the frequency of occurrence of the disease and the structure of "asthma" in the arid zone among teens. Said pathology is recorded in 9,6% of the population surveyed adolescents, while the disease is more common among females. In the structure of the disease prevails periodical exposure and mild persistent form.
2. Identified by clinical features of asthma among adolescents living in the arid zone, indicate a high frequency of lesions of the bronchial tree association with allergic processes in other organs and tissues: in 73,9% of the AR, 53,7% with AK. 16,6% with BA and 14% with urticaria/angiocdcma.
3. Found that in the study population of patients with asthma adolescence occur expressed disturbances of the immune status, manifested deficit indicators as cell (CD3‘, CD4+, CD8 , CD16+), and humoral immunity (CD19 , IgA, IgG, IgM) and activation markers (CD23+, CD95). The immune status of patients with asthma in young people, adolescence has distinctive features, the depth of detected violations immunoreactivity was most pronounced in the younger age group.
4. In patients with bronchial asthma in adolescence revealed distinct changes in cell-cell interactions in the immune system: a significant increase in the content of Th2-cclls secreted IL-6 is a regulator of maturation of antibodies and immunoglobulin production itself, and vice versa reducing regulator activity of Th 1-cell cytokine INF-y.
5. It was found that the contents of cytokines IL-6, INF-y and in the peripheral blood is in communication with one pathogenic disease. It is shown that the lowest level of INF-y production in the scrum is characteristic of allergic clinical pathogenic variant asthma in adolescence. Adolescents suffering from predominantly infectious form of asthma, there is a sharp trend towards increased production of IL-6 in peripheral blood.
6. Revealed that markers of increased risk of allergic forms of asthma in adolescents Uzbek ethnicity arc genotype FceRip-109T/T allele FceRip-109T, low-risk markers - FcsRip-109C/C and allele Fc£Rip-109C. A high degree of cohesion genotype FcsRip-109T/T allele and FcsRip-109T with hereditary burden of asthma in the Uzbek population.
7. Among females ethnic Uzbek Association revealed lie-105 allele and genotype Ilc-105/Ilc-105 polymorphic gene locus GSTkI at high risk for asthma. Revealed that the genotype associated with the development Ilc-105/Ilc-105 allergic form of asthma in adolescents Uzbek population.
8. Complex therapy with adolescents’ patients with asthma ciklofcron and polyoxidonium, providing immunocorrective effect, enhances the clinical efficacy of basic therapy. In the study of prophylactic efficacy of immunomodulators positive indicators prevailed in the group of patients receiving polioksidony, necessitating its inclusion in the priority scheme of integrated treatment and prevention of asthma in adolescents.
Purpose: transition of anemia chronic disease along with other chronic diseases
Materials and methods: 82 patients with chronic anemia were observed
Results: Anemia occurs in infectious diseases, non-infectious diseases, asthma, and autoimmune diseases. The frequency of anemia in chronic diseases is 100%. In terms of prevalence, anemia ranks second after iron deficiency anemia in the elderly, from 2.9 to 61% in men and 3.3 in women. from 41%. Chronic anemia occurs in half of all patients with systemic diseases of the connective tissue. In chronic diseases of the kidney, the hemoglobin level is below 100 g/l. In the treatment of anemia in this category, the main disease is treated first (in infectious diseases, antibacterial treatment against infection, basic and anti-inflammatory treatment in rheumatic diseases, surgery treatment if there is an indication (abscess in the head of the abdomen, purulent pyelonephritis, etc.
Recommending iron preparations and vitamin 12 to these patients will be ineffective because the underlying disease must be treated:
Conclusion: Anemia aggravates the course of a chronic disease if it is accompanied by other chronic diseases.
In the Republic of Uzbekistan, an online survey was conducted among various age groups in order to determine the most frequently consumed drinks (240 respondents). The pH values of 26 drinks were measured using litmus tests and a pH meter. The drinks were determined based on these pH values and distributed into groups of liquids according to their erosion potential. Five drinks - pineapple juice, lemon juice, red wine, white wine and green tea - were used in the enamel resistance test (ERT). The most aggressive liquid for the hard tissues of the teeth was determined. The results of the experiment showed that the drink that has the most aggressive effect on the hard tissues of the tooth is lemon juice, which reduces the resistance of enamel to caries by 3.33 times within three days. Keywords: acidity of beverages, hard tooth tissues, caries resistance Erosion of hard tooth tissues is a gradual loss of enamel and dentin as a result of acid dissolution. The prevalence of dental erosion is high and is steadily increasing among the population [3]. A recent study conducted in Israel [4] showed that the prevalence of erosion is 36.6% in the 15-18 age group and 61.9% in the 55-60 age group. One of the main factors contributing to the occurrence of erosions is the frequent consumption of low-pH beverages; consumption of low-pH soft drinks continues to grow, and knowledge of their erosive potential is important for dietary and dental counseling. The drinks consumed contain various acids, including carbonic acid, organic acids from fruits, tartaric acid, citric acid, malic acid and tartaric acid [1-3]. In recent years, diets using low-pH foods and beverages (such as lemon and vinegar diets) have become increasingly popular, but not everyone is aware of their harmful effects. More and more people use sweet carbonated or non-carbonated drinks instead of plain water to quench their thirst, which also (but not exclusively) negatively affects the condition of the hard tissues of the teeth.
In the structure of diseases of the endocrine system, one of the main places is occupied by the pathology of the thyroid gland (TG), the growth of which in recent years has acquired an expanded geographical distribution. The current situation cannot be explained only by the increased interest in the study of thyroid diseases, as well as the improvement of methods for their diagnosis. The development of modern therapeutic and surgical methods for the treatment of this pathology slightly improves the problem [7, 1]. This trend applies to all age groups: from children to older people. The situation is aggravated by the fact that in violation of the functions of the thyroid gland, lesions of other organs and tissues, including the cardiovascular, as well as the nervous system with the development of secondary pathological circles that form dysregulatory pathology [3,4].
Hereditary coagulopathies characterized by reduced blood clotting occupy a special place among diseases of the blood system. The most common of these are hemophilia and Willebrand's disease. Hemophilia-the disease of "royals" - is an old, but still relevant disease.
Hereditary coagulopathies, characterized by reduced blood clotting, occupy a special place among diseases of the blood system. Based on who data and the likely frequency of research on these diseases, the prevalence of hemophilia ranges from 3 to 25 patients per 10,000 population.
Few studies of the oral cavity in patients with hemophilia have shown a high level of dental diseases, poor hygiene of the oral cavity. This is due to the lack of proper oral care, and dispensary monitoring, fear of prolonged bleeding after dental manipulations. For this reason, dentists try to avoid treating dental diseases in this category of patients.
At the same time, modern achievements of medical science in the field of Hematology and the development of effective replacement therapy allow to prevent almost all types of bleeding.
However, this group of patients is still unable to receive timely and high-quality dental treatment and prevention, which largely determines the high prevalence of inflammatory diseases of the maxillofacial region.
All of the above is evidence of the presence of many predisposing factors of damage to the dental system in patients with hemophilia, as well as the need for preventive, therapeutic, including orthopedic dental measures for this category of patients.
Epidemiological studies show that only 12% of people have healthy periodontal tissues, 53% have early inflammatory changes in the supporting tissues of the teeth and 23% have destructive changes. Of these, 12% of patients have moderate to severe changes. These figures also apply to patients without orthopedic dental treatment, however, the presence of dentures in the oral cavity contributes to the emergence and development of inflammatory and destructive processes in periodontal tissues due to poor oral hygiene [2]. Most periodontal diseases are inflammatory in nature. Inflammation occurs under the influence of microbial plaque products, but at the same time, the role of local trauma, including iatrogenic causes, should be noted. According to statistics, endodontic lesions are the cause of premature removal of denture crowns in 17% of cases, mechanical destruction of cermet crowns and abutment teeth occurs in 27% of cases, and aesthetic deficiency due to destructive changes in the periodontal ligament occurs in 64% [3]. To date, most non-removable dentures are made using prepared teeth as abutments without bite, which naturally leads to chronic injury and a sharp decrease in hygiene due to the preservation of food residues and dental deposits at the edges of non-removable elements (crowns, linings, etc.).
In modern dental literature (textbooks, manuals) periodontitis is presented as an inflammatory disease of periodontal tissues in the region of the tooth root. The authors believe that this definition does not affect the dryness of the pathological process. Periodontal tissue is located in the periodontal lining - its inflammation is periodontitis. But if the process has gone beyond the periodontal gap into the alveolar bone, it should be referred to as osteitis. Based on this situation, the authors propose a new clinical and anatomical classification of inflammatory diseases of periapical tissues.
In modern society, diseases of the oral cavity are of humanitarian, socio - economic significance. Today, tooth decay and periodontal disease remain the most common dental disease not only among adults, but also among younger populations around the world. According to recent epidemiological studies conducted on healthy children, the incidence of dental pathology is high, with the prevalence of caries among healthy age groups 12-15 years old is 63.3-83 years, 4% and 81.7-88.7%, intensity 3.02 -3.75 and 4.6-5.73, and the prevalence of periodontal tissue diseases in the group of healthy 12- year-old children ranged from 37.8% to 50%, in the 15-year-old group of children it ranged from 57.7% to 84, 7%. The prevalence of caries is also high in children with mental retardation of preschool and school age, while the intensity of caries is higher in children aged 13–18 years with mild mental retardation (MAD). These indicators increase with age and depend on the severity of the underlying disease.
We carried out a program for the prevention of dental diseases in children with disabilities, however, most of them were focused on children with mild and moderate mental retardation, where not only the degree of mental retardation was taken into account, but also teaching them oral care skills, the degree of socialization and the child's diet.
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.
Psoriasis is a chronic non-infectious disease of a multifactorial nature, which often occurs in the form of rashes and peeling of the skin. Psoriasis occupies a significant share in the dermatological structure of diseases at the present time. [1, 2]. Despite the numerous scientific studies conducted by scientists in many countries regarding the etiology, pathogenesis, clinic and treatment of psoriasis, there is still a question about the main cause of the disease.In a significant number of patients with psoriasis, lesions of the nervous system, cardiovascular, gastrointestinal pathology, pathology of the genitourinary system, as well as, often with damage to the articular systems of the skeleton together with disorders of the immune system, were revealed. All this indicates the multifactorial nature of the disease. In this regard, the search for optimal drugs that would affect several pathogenetic links of the disease is currently underway. [3, 4,]. Therefore, today, we consider this issue relevant.