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ECG FEATURES IN CHILDREN WITH RESPIRATORY DIFFICULTY SYNDROME
Koshimbetova G. K.
Tashkent Pediatric Medical Institute, Republic Uzbekistan, Tashkent
Introduction.
Acute and chronic nonspecific lung diseases are one of the most important
urgent problems of pediatric pulmonology. Dysfunction of the cardiovascular system is often
accompanied by complicated pneumonia in children and develops from the first hours; at the same
time, circulatory disorders, unlike in adults, from complications of the underlying disease and
determine its outcome. These changes are diverse and depend on the severity of the underlying
disease, the patient's age, and the premorbid background. According to scientists, carditis in young
children, as a complication of acute myocardial infarction, occurs in 4% to 23% of cases. Diagnosis
of the disease is difficult due to the lack of clear clinical manifestations, ranging from minimal
changes in the ECG to cardiogenic shock and sudden death.
Objective.
To study the ECG characteristics of septicemia complicated by respiratory
distress syndrome in children.
Material and methods.
Our study was conducted on 68 children aged 1 to 10 years with
pneumonia complicated by respiratory distress syndrome treated at the 4th Children's Clinical
Hospital of Tashkent. In all patients, the medical history was analyzed, spirometry was assessed,
chest X-ray, clinical and laboratory and ECG analyses were performed. The diagnosis was made
according to the nomenclature of the ICD-10 classification. Statistical processing was carried out
using standard methods and modern software (Statistica 6.0). Differences were considered
significant at P < 0.05.
Results and discussion.
According to our results, pathological changes in the ECG were
detected in 77% of the examined patients. Of these, 25% had signs of left ventricular hypertrophy,
15% had signs of right ventricular hypertrophy. During the observation, the duration of the disease
ranged from 2 to 4 months. Left ventricular hypertrophy formed a strong positive correlation
(r=+0.90) with the duration of the disease and the state of obstruction. Premature ventricular
contractions (prolonged PQ interval) were detected in 22% of children. Ectopic conduction during
the transition of the pacemaker from the sinus node to the bundle branch node was detected in
28% of cases. In 16.6% of patients, changes in the Q-T interval were detected, with a short duration
of 0.33 ± 0.01 s. and a duration of 0.42 s.
Conclusion.
In all children with complicated septicemia with respiratory distress
syndrome, due to impaired cardiac conduction, it is necessary to examine the cardiovascular
system and recommend correction of treatment.
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MANAGEMENT AND TREATMENT OF PATIENTS WITH BRONCHIAL ASTHMA
IN OUTPATIENT SETTINGS
Koshimbetova G. K.
Tashkent Pediatric Medical Institute, Republic Uzbekistan, Tashkent
Introduction.
Bronchial asthma is highly prevalent among all age groups and, according
to epidemiological studies, occurs in 1–18% of individuals depending on the region of the
world.Bronchial asthma (BA) is a global problem of modern health care, which is due to its high
prevalence and the significant socio-economic damage caused by this disease. According to
epidemiological studies, more than 300 million people in the world suffer from BA, and the
prevalence of BA increases annually.
Objective
. To study the management and treatment of patients with bronchial asthma in
outpatient settings.
Materials and methods.
The study was conducted in a family clinic. During the study, a
retrospective analysis of outpatient records of patients with bronchial asthma was conducted.
Compliance with treatment standards for patients with bronchial asthma at the outpatient stage
was studied, as well as the identification of features of dispensary registration of patients diagnosed
with bronchial asthma.
Results and discussion.
The analysis of the structure of patients with bronchial asthma, the
effectiveness of medical examination and compliance of treatment with clinical recommendations
and standards of medical care for this disease was carried out. In this group of patients, controlled
bronchial asthma was noted in 20 people (40.0%), partially controlled in 6 people (12.0%),
uncontrolled in 16 people (32.0%), in 8 patients (16.0%) the level of control in the primary
documentation is not indicated.By the severity of bronchial asthma: intermittent –– in 4 (8.0%),
mild persistent – in 8 (16.0%), moderate persistent – in 18 (36.0%), severe persistent – in 4 (8.0%),
in 16 patients (32.0%) the severity is not specified. A burdened allergological anamnesis is
observed in 28 people (56.0%). Examination and treatment in a therapeutic hospital were received
by 38 (76.0%). Data on consultation with an allergist were noted in 10 (20.0%).
Conclusion.
In 20.0% of cases, the analysis of outpatient records revealed a discrepancy
between the diagnosis of the disease in the doctor's notes and the formulation of a detailed clinical
diagnosis indicating the characteristics of the course of the disease in a particular patient. In
patients whose treatment complies with clinical recommendations and standards of medical care,
asthma control was achieved in 81.25% of cases. The frequency of dispensary examinations of
patients took place in 48 (81.25%) outpatient records.Thus, treatment of asthma exacerbation is an
important component of preventing disease progression and development of adverse outcomes.
