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.
The purpose of this study is to investigate, know, and analyze the effect of corporate governance in moderating the effect of profitability, leverage, company size, and dividend policy on company value. The object of research in this study is the LQ45 Index listed on the Indonesia Stock Exchange for the 2017-2022 period. We use associative quantitative methods. The number of samples in this study based on criteria was obtained as many as 90 data from 15 companies for 6 years with the EViews testing tool. The analysis techniques used are descriptive statistical analysis, panel data regression testing, classical assumption testing, and interaction testing (MRA). The results showed that some profitability and dividend policies had a positive and significant effect on the value of the company, while leverage and company size did not have a significant effect on the value of the company. While the interaction test (MRA) results show that corporate governance can moderate profitability and dividend policy affects company value, corporate governance cannot moderate the effect of leverage and company size on company value. These findings provide valuable insights for companies in structuring sustainability activities and shaping dividend policies related to ownership structures. It also offers policy prescriptions on the Indonesia Stock Exchange in the field of corporate financing policies.
This study aims to determine (1) the effect of humans resources development on employees performance, (2) to determine the effect of information technology on performance, and (3) to determine the effect of job promotion on employee performance of information and technology directorate of PT Telkom Seluler Indonesia . This research method uses a quantitative descriptive research design. The population is all employees of information and technology directorate of PT Telkom Seluler , totaling 52 people and the sample used is taken from the entire population. The sampling technique used the census sampling method. Data collection by using a questionnaire. The data analysis technique used was statistical analysis, namely multiple linear regression, F test, t test and the coefficient of determination. The results showed that partially the development of human resources had a significant effect on the performance of information and technology directorate of PT Telkom Seluler . Partially, information technology has a significant effect on the performance of information and technology directorate of PT Telkom Seluler . Partially, promotion has a significant effect on the performance of information and technology directorate of PT Telkom Seluler Indonesia .
The purpose of the study is to study the sensitivity of microbes to certain drugs in vitro! Material and Methods: to establish this research method, we have prepared 18-hour cultures of microbes - taking into account the most frequent inhabitants in the oral cavity. 1-2 ml of the studied microbes were applied to the surface of the dried nutrient medium by Mueller Hinton. The preparation sea buckthorn oil had an antibacterial effect on most microbes, although among them the most sensitive were such microbes as streptococci, proteas and pseudomonas. At the same time, the chlorhexidine drug had an effect on most microbes, but the effect was insignificant and only streptococci were the most sensitive and amounted to 18.0 ± 0.3 mm. Conclusions: the drugs used to treat sick children belonging to the group of traditional therapy have a weak antibacterial effect. At the same time, drugs from the special treatment group have a more pronounced antibacterial effect, especially on microbes of the genus streptococci.
The subject of this article is the analysis of the theory of direct action, the study of the experience of foreign countries, the study of the principles and practice of direct action of the Constitution in Uzbekistan, as well as their impact on the legal system and society.
The purpose of this exploring is a comprehensive analysis of the principles of direct application of the Constitution in Uzbekistan, including historical development, judicial practice, and comparative analysis with other jurisdictions.
Research methods: analysis of the theory of direct effect to explore the development of constitutional law in Uzbekistan, comparative legal method to analyze similarities and differences with other countries, cases for detailed analysis of specific court cases.
Research results: based on the analysis, problems were identified in defining the theory of direct action and ineffective law enforcement.
Scientific novelty:
The study will provide a unique analysis of modern constitutional practice in Uzbekistan, especially in the context of the direct effect of the Constitution, and its comparison with international practices.
Practical significance:
The results may be useful for lawyers, legislators and researchers in the field of constitutional law, as well as contribute to improving law enforcement and legislative development in Uzbekistan conclusions
At the end of the article, the main conclusions will be presented, emphasizing the importance of the direct effect of the Constitution in the legal system of Uzbekistan and proposals for further strengthening of constitutional principles..
The present study investigated the hypolipidemic effect of the ethanolic seed extract of Baccaurea ramiflora in Wister albino rats. Hyperlipidemia is a major risk factor for cardiovascular diseases, and natural plant extracts have gained attention as potential therapeutic agents for managing lipid disorders. In this study, Wister albino rats were orally administered with different doses of the ethanolic seed extract for a specified duration. The lipid profile, including total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), was measured to assess the hypolipidemic effect of the extract.
The results demonstrated that the ethanolic seed extract of Baccaurea ramiflora significantly reduced total cholesterol, triglycerides, and LDL-C levels, while increasing HDL-C levels in hyperlipidemic rats. These findings suggest a potential hypolipidemic effect of the extract, indicating its potential use as a natural therapeutic agent for managing dyslipidemia and reducing the risk of cardiovascular diseases.
The issues of assessing synergistic effects in the field of tourism in Uzbekistan are currently only at the initial stage of discussion. A study of scientific sources devoted to synergy, especially in this area, has shown that there is still no optimal methodology for assessing synergistic efficiency from internal and horizontal integration in a tourist destination. An analysis of the presented methods allows us to state that for the most part they are focused on calculating a purely economic (quantitative) synergistic effect and economic efficiency. In the article, the author proposes methods for calculating the synergistic effect based on the coefficient of social and economic efficiency, which differs from the developed methods by using programming, which facilitates the calculation of the effect of synergy.
Всегда остается актуальной проблема лечения рубцов лица. Для решения проблемы рубцов применяются высокотехнологичные разработки в области медицины, такие как применение технологии DOUBLE SYNERGIC EFFECT компании HYALUAL.
The motivation behind the investigation is to examining those elements that are affecting upon the reception of E-HAE(Electronic Human Asset Executives). The respondents of the examination were 288 workers from the colleges. Analyst has embraced the survey through the writing and taken the reactions sufficiently from the representatives of University. This exploration model has been planned with regards to acknowledgment and decides the adjustment in conduct towards embracing the EHAE in Universities alongside the effect of expanded specialized help and trust on EHAE in Universities. This model is useful in deciding the effect of various highlights, for example, convenience, value, trust and specialized help on conduct towards the EHAE in Universities. The external components of the model are Technical help or help and trust. This examination broadens the Technology Acceptance Model. The investigation results recommend that two elements are significant that are specialized help and trust affecting upon the convenience and helpfulness; alongside this effect of usability and handiness is upon the mentality and the effect of demeanor is upon the reception of E-HAEin colleges. The examination additionally talks about the specific limtations and gives suggestion to the partners.
The effect of sulfated polysaccharides on the hemostatic system in conditions in vitro. Platelet-rich plasma was obtained by centrifugation at 200 g for 10 minutes. The remaining citrate blood was further centrifuged at 1500 g for 10 min to obtain platelet-poor plasma. The antithrombin activity of the compounds was evaluated in vitro by their effect on the recalcification time, thrombin, and prothrombin time of human blood plasma stabilized with a 3.8% sodium citrate solution in the ratio of 9:1. In studies conducted on the blood plasma of rats, it was found that the studied compounds, to varying degrees, lengthen the APTT, APTT, prothrombin time. At the same time, anticoagulant activity was established to block one of the factors II, V, X. Polysaccharide exhibit a combined anticoagulant effect in the body, due to which they are classified as anticoagulant and antithrombin agents.
The effect of immunomodulin and phytin substances on lipid peroxidation was studied in experimental toxic hepatitis in rats. The results showed that the tested substances showed an antioxidant effect when poisoned with tetrachloromethane. The combined use of these substances led to an increase in the antioxidant effect.
Subjects of the inquiry: 103 patients with rheumatoid arthritis, 20 healthy individuals.
Aim of the inquiry: To study therapeutic effect of low frequency physical factors on the cytokines and the processes of lipid peroxidation and to confirm scientifically the efficacy of their use based on the their effect on the clinical laboratory findings.
Methods of investigation: Clinical and laboratory investigations, immunological analyses of the blood scrum cytokine levels and synovial fluid, biochemical examinations of the lipid peroxidation and antioxidant system indicators, phospholipase-A2 activity, nonspecific phosphatases and free oxyprolinc in the blood serum of patients.
The results achieved and their novelty: There was studied clinical efficacy of ultraphonophoresis with benzketozon during treatment and rehabilitation of the patients with rheumatoid arthritis. It was proved that disbalance between inflammatory and anti-inflammatory cytokines as well as lipid peroxidation activation activity in the erythrocyte membranes and blood scrum destabilized cellular membrane structures, increase in phospholipase-A2 activity and, consequently, stimulating prostaglandines, inflammation mediators, synthesis. There was shown that complex therapy with inclusion of low frequency physical factors, particularly ultraphonophoresis with benzketozon, gave marked positive effect normalizing interrelation ship between inflammatory and anti-inflammatory cytokines reducing activity of phospholipase-A2, lipid peroxidation products and rising the levels of antioxidant system indicators.
Practical value: There has been shown rationality of inclusion of the physical-pharmacological method ultraphonophoresis with benzketozon into clinical practice. The differential indicators developed for application of low-frequency physical methods of therapy for rehabilitation of the patients with rheumatoid arthritis allow prolongation of the remission, improvement of the patients life quality.
Degree of embed and economic effectivity: The practical recommendation and guidelines have been applied in the clinical practice of the out-patient special course of arthrological treatment in the Republican Rhcumatological Center, Clinical Hospital N 1, Central Hospital of Zangiota district of Tashkent province. Sphere of usage: Rheumatology, physiotherapy.
A content analysis of the pharmaceutical market range of drugs with sedative effect was conducted. In the analysis of drugs with sedative effect, "West trade", "Floromed", "Grand farm", "Tabletka", "Dava", "Shafran farm", "Glucose", "Tetra", "Kobiljon Obidjon", "Pharmacy diabetes", "Navbahor", "777 pharmacy", "999 pharmacy", "pharmacy Malikabonu" pharmacies, the Department of neurology of the II clinic of the Tashkent Medical Academy, the State Department of medicines and medical products the basis of the register was. Determination of the share of products of manufacturing enterprises in the pharmaceutical market was the main objective of the study carried out.
This study examines the boomerang effect of firms' investments in corporate social responsibility (CSR) during product recalls. While previous research has shown that CSR investments can enhance a firm's reputation and mitigate negative perceptions during crises, we propose that excessive CSR investments during product recalls may lead to a boomerang effect, where stakeholders perceive these investments as insincere or strategic attempts to deflect attention from the recall itself. Drawing on the theory of attribution, we argue that stakeholders are more likely to attribute strategic motives to excessive CSR investments during product recalls, resulting in negative evaluations of the firm's sincerity and reputation. We test our hypotheses using a combination of survey data and experimental designs. The findings suggest that there is an inverted U-shaped relationship between firms' CSR investments during recalls and stakeholders' perceptions of the firm's sincerity and reputation. Moreover, this boomerang effect is moderated by the level of stakeholders' pre-existing trust in the firm. Overall, our study sheds light on the complex relationship between CSR investments and crisis management strategies, highlighting the need for firms to carefully calibrate their CSR efforts during product recalls.
Trinatrium salt of glycyrrhizic acid (Glycytrinate) with strong anti-ulcerous activity combined with anti-inflammatory effect was synthesized on the basis of glycyrrhizic acid. According to the parameters of acute toxicity in experiments on white mice and rats with per oral administration Glycytrinate was included to the group of little toxic substances. And according to the assessment of anti-ulcerous activity on the models of rats’ gastric mucous membrane destruction caused by indo metasin, ortophen, and reserpin glycytrinate has an expressed antiulcer effect. The mechanism of glycytrinate’s antiulcer effect is linked with its antioxidant property and suppression of the secretory function of gastric glands.
In the article, there is the scheme and principle of the work of the cotton cleaner from small litter includes a composite pin drum with elastic elements and a vibrating mesh surface on elastic hinges. Theoretically, the torsional-vibrational motion of a two-mass system of a composite shoe drum has been studied, and the regularities of the dependence of changes in the parameters of the pin drum have been obtained. Based on the approximate analytical solution of the integro-differential equation, the law of angular vibrations of the net surface on the elastic supports of the cotton cleaner is studied. Experimental studies revealed regularities of loading and a change in the speed of rotation of the drum. The results of the full-factor experimental studies of the sample of the composite fluke drum are given. Based on the study of each of the three factors on the changes in the cleansing effect of cotton, the graphical dependencies of the parameters are postrene. The best values of the factors at which a high purifying effect of cotton from small weeds are achieved are recommended. Production tests revealed that the cleaning effect in comparison with the existing version of the drum spindle in the recommended increases by an average of 2.7%.