The aim of the study was to assess the level and depth of various types of anesthesia by studying the BIS-index in intraocular operations in children.
The data of the study of the dynamics of the BIS-index and, accordingly, the depth of sedation indicated the effectiveness of the anesthesia options used, including the use of inhaled anesthetics sevoflurane and isoflurane in the anesthetic support of intraocular operations. The following combinations were used to provide anesthetic protection in 46 children with intraocular surgery: fentanyl with sevoflurane (group 1), fentanyl with isoflurane (group 2). At the stage of basic anesthesia in patients of group 1, the BIS index was in the range of 45,8-57,4, in group 2, the BISindex was in the range of 37,61- 53,6.
All the proposed options of anesthesia provide a sufficient level of sedation of patients during intraocular operations and can be used in practice. Thus, conducting anesthesia using BIS-monitoring allows you to reduce the doses of drugs used, reduce the amount of excessively deep and superficial anesthesia, and reduce the time of recovery of consciousness after the end of the operation
Kirish. Anesteziologiyani rivojlantirishning hozirgi tendentsiyalari jarrohlik aralashuvga stress reaktsiyasini kamaytiradigan usullarni joriy qilish bilan anesteziyaga yangi yondashuvlar bilan bog'liq holda perioperativ davrda bemorlarni boshqarish taktikasini o'zgartirishni talab qiladi. Tadqiqotning maqsadi urologik kasalliklarga chalingan bolalarni davolashning perioperativ bosqichida tizimli gemodinamika va stress belgilarini o'rganishga Fast-Track kontseptsiyasini joriy etish edi. Materiallar va usullar. 09.2016 yildan 04.2021 yilga qadar orqa miya anesteziyasi (SA) yordamida operatsiya qilingan 42 nafar urologik kasalliklari boʻlgan bemorlarning natijalarini istiqbolli retrospektiv tahlili oʻtkazildi. Har bir holatda markaziy gemodinamikaning perioperativ parametrlari va stressga javob berishning biokimyoviy belgilari tahlil qilindi. Natijalar. Yosh bolalarda SA gemodinamikasining barqarorligi dalillar bazasiga va fiziologik tushuntirishga ega.Turli anesteziya usullari fonida stress reaktsiyasi belgilarining o'zgarishi SAda umumiy behushlikdan ko'ra aniqroq stressdan himoya qiluvchi ta'sirni aniqladi. Xulosa. O'tkazilgan tadqiqotlar shuni ko'rsatdiki, bolalarda urologik operatsiyalarda kombinatsiyalangan SA dan foydalanish umumiy behushlikdan ko'ra gemodinamika va metabolizmning stressli reaktsiyalarining namoyon bo'lishini samaraliroq va ishonchli tarzda oldini olish va to'xtatish imkonini beradi. Bolalar urologiyasida Fast-Track texnologiyasining joriy etilishi operatsiyadan keyingi tiklanish davri va ushbu toifadagi bemorlarning tibbiy muassasada qolish muddatini qisqartirdi.
The largest number of drug-resistant epilepsies occur in childhood, which is associated primarily with early maturation of excitatory glutamatergic and delay the formation of the brake GABAergic systems. This can cause the development of resistance due to the predominance of excitatory neuron pool of brake and confirmation of neural network theory. The theory of neural networks is confirmed not only in the study of drug-resistant epilepsies of childhood.
Acute appendicitis is the most common urgent disease in pediatric surgery (75% of emergency operations). Not only pediatric surgeons, but also pediatricians, pediatric gastroenterologists, and pediatric gynecologists have to deal with appendicitis in children. In childhood, inflammation of the cecum develops rapidly, which causes an increase in destructive changes in the appendix in a relatively short time. With appendicitis in a child, the peritoneum is often involved in the inflammatory process, leading to the development of appendicular peritonitis. The peak incidence of appendicitis in children (more than 80% of cases) is at school age, in preschool children the disease occurs in 13%, in toddlers - in 5% of cases.
Childhood glaucoma is a chronic vision threatening condition that may significantly impact an individual’s psychosocial well-being. The prognosis of glaucoma largely depends on early and accurate diagnosis and successful treatment, including control of increased. The purpose is to determine the effectiveness of modified tonometers (Maklakova) NGm2-"OF TP" in performing tonometry and tonography in infants and children with microphthalmos and blepharophimosis. We have proposed modified models of Maklakoff tonometers weighing 5, 10, and 15 g, made of silver, the weights on both sides have contact plates, which are made of medical plastic and have a diameter of the applanation area d=8 mm. Methods: Tonometry and tonography using the simplified method of Nesterov A.P. were carried out in 30 (60 eyes) children aged from birth (0) to 16 years. Results: Our recommended design of weights showed results that do not differ from those obtained using standard Maklakov tonometers. At the same time, modified weights provide the opportunity to determine tonometric IOP and eye hydrodynamics in newborns and patients with microphthalmia and/or blepharophimosis, which greatly facilitates the work of pediatric ophthalmologists and reduces examination time.
In order to determine the correspondence of the diuretic ultrasonography parameters to the theoretical laws of hydrodynamics, a retrospective analysis of the research results was carried out in 31 patients with grade III-IV hydronephrosis, who were operated on for obstruction of the pyeloureteral segment. The analysis of the state of urodynamics in congenital hydronephrosis in children shows that, according to the remote control data, the examined patients have different degrees of resistance to the urine flow in the pyeloureteral segment area. This is due to the different pathogenesis of urodynamic disturbances, depending on the type of structural pathology in the area of the parochal ureter
Clinically, neurotrophic disorders manifest themselves most often in acute brain diseases (strokes, injuries, meningoencephalitis, etc.), accompanied by the involvement of the hypothalamus - pituitary gland, brain stem, sympathetic and vagus nerves [3]. At the same time, the greatest functional and morphological disorders are observed in the gastrointestinal tract (ulcers, erosion, hemorrhages), lungs (edema, pneumonia) and pancreas (transient hyperglycemia) [1, p. 529] and liver (4, p. 170] Despite the fact that the main theater of action is expressed in a local catastrophe of the brain and neurological disorders, most researchers and practitioners do not pay due attention to the essential role of the "main laboratory" of the body - the morphofunctional state of the liver [7, p. 876].
Anorectal malformations in children are still one of the most difficult problems in pediatric coloproctology. Most pediatric surgeons continue to adhere to the opinion about the advisability of preliminary colostomy and delayed proctoplasty, motivating this tactic with the possibility of creating the optimal conditions for performing a complex intervention, reducing anesthetic risk, avoiding technical errors. The work is based on the results of treatment of 154 children with anorectal malformation and preliminary colostomy. The use of colostomy in children with anorectal malformation made it possible to carry out the necessary surgical tactics in a timely and differentiated manner, to reduce the frequency, nature of complications and early disability, and to improve the quality of life and social adaptation of patients.
The article provides a comparative analysis of the study of the diameter of the cornea in children with primary congenital glaucoma. Three methods, which are used in pediatric ophthalmology, are described. The first method is measuring the diameter of the cornea using a school ruler, the second method is using a surgical compass and the third is a new method developed with the use of a gauge in the form of glasses and a computer program. All the positive and negative aspects of methods for studying the diameter of the cornea are described in detail.
The article provides an analysis of patients in terms of the frequency, causes and epidemiological features of eye injuries caused by animals in childhood for 2010 to 2021 according to the data of the clinic of the Tashkent Pediatric Medical Institute. Up to 50% of all accidents occur before the age of 15. The data presented in the analysis showed that boys aged 5–7 years are most susceptible to injury to the eye and its appendages at home during contact with pets. The high level of injuries and complications resulting from them requires an intensive study of this issue with the development and implementation of effective preventive measures.
The article is devoted to the scientific, medical and educational activities of the veteran of the Department of Ophthalmology, Pediatric Ophthalmology of the Tashkent Pediatric Medical Institute Basit Abidovich Zakhidov, who trained more than a hundred pediatric ophthalmologists and devoted more than 45 years to medicine.
В ходе исследования было изучено особенности ультразвуковой диагностики при синуситах у детей раннего возраста. Исследования проводилось на базе клиники ТашПМИ. Для проведения исследования было обследовано 56больных с риносинуситами. По итогам исследования было получено ожидаемые результаты и пришли к выводу, чтоультразвуковое исследование при синуситах является безопасным и информативным методом при диагностике.
Regional anesthesia in frequently used during the perioperative period in both adult and pediatric patients to achieve better pain control and faster recovery after surgery. Significant progress in regional anesthesia has been achieved recently due to the availability of ultrasound guidance. In this systematic review and meta-analyses, randomized trials on the use of regional blocks
in anesthesiology were evaluated, including new blockade techniques that expand the possibilities of regional anesthesia.
Interfascial blocks are considered a subgroup of peripheral nerve blocks, a set of techniques that have been already employed in perioperative pain management. Their advantages include less invasiveness, significant reduction in the need for opioid analgesics, low complication rates, and flexibility of approaches to accommodate specific surgical needs. Despite considerable interest in interfascial blocks in pediatric anesthesiologists, data on its safety are lacking, with a few randomized controlled trials providing low-quality evidence. Future prospective studies are warranted to evaluate interfascial blocks in the pediatric population.
Purpose of the study. Assess the effectiveness of reforms in the field of pediatric anesthesiology and resuscitation and identify reserves for further reduction of child mortality in this area. Materials and methods. In order to assess the effectiveness of the reforms carried out in the healthcare system in the segment of the pediatric anesthesiology and resuscitation (DAR) service, statistical, archival data, as well as the results of a survey of the heads of the departments of anesthesiology and resuscitation of the Regional Children's Multidisciplinary Medical Centers, regional branches of the Republican Scientific Center for Emergency Medical Care (RSCEMC) were studied. ), as well as regional perinatal centers. Results. The positive effect of the optimization and regionalization of the pediatric surgical and perinatal services has been established; the technological equipment and staffing of the DAR have significantly improved. It is shown that the reserves for further reduction of infant mortality are the rejuvenation and advanced training of DAR doctors, the introduction of modern technologies for nursing low-birth-weight newborns and seriously ill and injured children.
This work is to study the effectiveness of topical glucocorticosteroids in the treatment of adenoid vegetations in preschool children. The study included 50 children (mean age 4.25 ± 0.24 years) with adenoid vegetations. The patients were divided into 2 groups. Group 1 included 25 children (mean age 4.0 ± 0.22 years) who received irrigation therapy with fluticasone furoate, 1 injection of 55 μg into each half of the nose once a day for at least 1 month. Group 2 - 25 children (average age 4.5 ± 0.5 years), who were prescribed irrigation therapy with saline solution, 3-5 ml in each half of the nose 3 times a day for at least 1 month. Intranasal use in patients with adenoid vegetations of fluticasone furoate for a month led to a decrease in the size of the hypertrophied pharyngeal tonsil and an improvement in nasal breathing, thereby improving the quality of life of a sick child.
To study the state of systemic immunity and local immunity before and during chemotherapy in patients with gastric adenocarcinoma.
From 2017 to 2018 at the Tashkent city branch of the Republican specialized scientific and practical medical center of oncology and radiology 20 primary metastatic patients with gastric adenocarcinoma received chemotherapy. The sampling of biological material (peripheral blood, tumor tissue) was carried out twice (before treatment and during the first control examination, after 3 courses). The percentage of the degree of infiltration of tumor tissue by lymphocytes (CD45+CD14-TILs) was estimated by flow cytometry; T cells (CD3+CD19-TILs); B cells (CD3-CD19+TILs); NK cells (CD3-CD16+CD56+TILs); CD16 and CD8 effector cells and their cytotoxic potential (CTP) (CD16+Perforin+TILs; CD16CTPTILs), (CD8+Perforin+TILs; CD8CTPTILs); regulatory T cells - NKT cells (CD3+CD16+CD56+TILs), CD4 (CD4+CD25+CD127-TILs) and CD8 (CD8+CD11b-CD28-TILs) regulatory cells and these parameters of systemic results. The factor of a favorable prognosis for PFS in patients with metastatic gastric cancer in the peripheral blood was an increase in the number of CD8 + T-regulatory cells (5.1% - 12.1%, p = 0.019), and in tumor tissue - an increase in the perforin potential of effector CD16 cells (0.5% - 4.9%, p = 0.030) and their cytotoxic potential (13.2% - 55.7%, p = 0.011). When assessing the changes in the indices of local immunity during chemotherapy, it was noted a negative effect of an increase of T cells (22.0% - -9.7%, p = 0.012), NKT - cells (207.9% - -13.8%, p = 0.002) and CD4 + T-regulatory cells (190.7% - -25.2%, p = 0.002). In contrast, an increase in the level of effector CD16 cells during chemotherapy increases the likelihood of surviving PFS - 9 months (-69.5% - 9.1%, p = 0.013).
Indicators of local and systemic immunity serve as additional prognostic factors for gastric cancer.
In experimental toxic hepatitis caused by the hepatotropic poison carbon tetrachloride, a decrease in bile synthesis, bile-releasing function of the liver was revealed. There was a decrease in the composition of bilirubin, cholesterol and bile acids in the bile. In the treatment of experimental hepatitis with cobalt and silibor fiat, cholestasis decreased, the chemical composition of bile improved, as the content of bilirubin, cholesterol and total bile acids increased.
The article provides an analysis of the literature on the process of post-stroke rehabilitation, timing and types. Neurorehabilitation is a process aimed at restoring lost or reduced function in patients with stroke. Early initiation of neurorehabilitation leads to the achievement of the necessary level of selfcare of the patient, his social, psychological, physical adaptation and finally restoration of ability to work in the post-stroke period, as well as reduction of post-stroke disability in society and improvement of patients' quality of life
According to the stroke registry, in 2019, the frequency of new and repeated cases of brain stroke was more than 63,000 cases. During the pandemic, we identified 36,975 new and repeated cases of stroke, which obliges us to emphasize that the incidence of stroke during the pandemic did not decrease due to a decrease in the true incidence rates, but probably due to the Covid-19 pandemic that occurred , in which a large number of patients who had suffered from ONMC,fearing to become infected with a viral infection , received treatment at home, without official registration in state medical institutions.
Генитальный туберкулез (ГТ) является актуальной медицинской и социальной проблемой, так как чаще всего поражает женщин активного репродуктивного возраста (20–45 лет) и является причиной женского бесплодия в 10-27,8% случаев. Бесплодие является характерным и часто единственным для туберкулеза гениталий симптомом, встречается у 60–95 % пациенток. Локализациямикобактерии туберкулеза (МБТ) в 90-100% представлена в маточных трубах. Одновременно у 10-60% пациенток выявляется туберкулезное поражение эндометрия. Яичники поражаются в 6-30% случаев; туберкулез вульвы, влагалища и шейки матки встречается реже – в 1-15%.Туберкулез женских половых органов относится к наиболее трудно диагностируемым локализациям внелегочного туберкулеза и выявляется, зачастую, на поздних стадиях, когда, несмотря на проводимую терапию, восстановления менструальной и репродуктивной функций женского организма не происходит. Длительное течение воспалительных заболеваний органов малого таза и бесплодие, отсутствие эффекта от лечения воспалительных заболеваний органов малого таза, высокая частота оперативных вмешательств на придатках матки, наличие кальцинатов в миометрии и/или яичниках по УЗИ позволяют заподозрить туберкулез гениталий. Раннее выявление наряду со своевременной и адекватной специфической терапией позволяют до 34 % случаев восстановить фертильность.
According to the researchers, the incidence of sepsis in the pediatric population is 4.2 million children each year, of which 3 million are newborns. Three out of ten deaths due to neonatal sepsis are thought to be due to antimicrobial-resistant pathogens [1,2]. Sepsis can be a clinical manifestation of nosocomial and nosocomial infections. Currently, the etiological structure of nosocomial sepsis pathogens has remained almost the same in most large intensive care units. They are named after the first letters of the type of pathogens: "no ESCAPE" ("no exit", escape - English. escape) Enterococcus faecium, Staphylococcus aures, Klebsiella pneumonia, Acinetobacter baumanni, Pseudomonas aeruginosa, Enterobacter spp. All these bacteria are characterized by increasing resistance to all mentioned antibiotics along with the formation of Pan-resistance phenomenon, which is the leading factor leading to lack of clinical response to treatment and rapid development of sepsis and septic shock [3]. According to the new definition, sepsis is a life-threatening dysfunction of internal organs caused by a violation of the body's response to infection [4].