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When the circulation stops, you can try to restore it by "walking" the
projectile. If it does not resume within 2-3 minutes, it is necessary to lift the
projectile.
Along with the EPH complexes, rotary drilling of large-diameter wells
(up to 500 mm) in placers is also carried out using pneumatic drills - IP-
4603, СÐ-134, etc.
List of used References::
1. Shkurko A.K. Drilling of wells by face impact machines. - L .: Nedra,
1982.
Togaeva Gulnora Siddiqovna, Assistant Department Of Internal Medicine
With Endocrinology, Samarqand State Medical Institute,Samarqand,
Republik Of Uzbekistan
Davranova Aziza Davranovna, Assistant Department Of Internal Medicine
With Endocrinology, Samarqand State Medical Institute,Samarqand,
Republik Of Uzbekistan
FEATURES OF STUDYING MULTIFACTOR MANAGEMENT OF TYPE
2 DIABETES
G.Togaeva, A.Davranova
Abstract: The steadily increasing prevalence of the combination with the
mild frequency and severity of complications of diabetes mellitus and the
fact that it takes a lot of steps to treat this disease and prevent it from turning
biological into social. Stage-by-stage multifactorial exercise by type 2
diabetes mellitus according to the standards provides ideal glycemic
compensation and reduces plants for treatment.
Keywords: diabetes mellitus, glycemic, multifactorial exercise, glucated
hemoglobin
Relevance of the problem: Type 2 diabetes mellitus (DM) is one of the
leading medical, social and economic problems of modern healthcare [1.2].
A British prospective study of type 2 diabetes (UKPDS, 1999) demonstrated
the need to maintain normoglycemia in patients with type 2 diabetes to
reduce the risk of developing microvascular complications, and a 7-year
follow-up of patients after completion of the study proved more consistent
with the earlier selection of optimal glycemic control to reduce risk of
developing myocardial infarction of general mortality in type 2 diabetes
[3.4]. The recognition of the fact that achieving the target values of glycemia,
arterial pressure (BP), and lipid profile indicators will significantly reduce
the progression of the disease, has made the effectiveness of treatment a
Scientific research results in pandemic conditions (COVID-19)
121
priority (D.M. Nathan, 2008) in this regard, a new concept for the treatment
of type 2 diabetes has been adopted suggesting a multifactorial approach to
therapy, taking into account the individualization of the target criteria for
metabolic compensation.
Target: Our study is an assessment of the clinical and economical-
effectiveness of phased multifactorial management of type 2 diabetes.
Materials and research methods. The 60 Patients with type 2 diabetes
aged 35 to 75 years were examined. Patients with a disease duration of at
least 6 months were included in the study. Patients with diabetes
complications at the terminal stage of their development, pregnant women,
and patients with mental illnesses were looked up from the study. The study
lasted for 12 months. Depending on the tactics of therapy, all patients were
divided into 2 groups. 22 patients were admitted to the main group of
intensive care (IT), which was carried out according to the phased
management algorithms for type 2 diabetes, and to the comparison group of
standard therapy (CT), supervised according to generally ââaccepted
practice, â38 patients were listed in the above mentioned medical
institutions. To assess carbohydrate metabolism, the glucose content in
capillary blood and the level of glycated hemoglobin are used. The state of
fat metabolism was assessed by measuring various lipid fractions in blood
serum: total cholesterol, thyroid hormones, high density lipoproteins, low
density lipoproteins. In addition, other biochemical parameters were
studied (total protein, creatinine, Urea, AlT, AST). An assessment of renal
function was performed: general analysis of microalbuminuria (MAU), daily
proteinuria. Of the instrumental methods, according to indications, an
ultrasound
examination
of
the
abdominal
cavity
organs,
electrocardiography and x-ray studies were carried out. Patients underwent
examination by a neurologist, ophthalmologist, cardiologist, doctor in the
office of a diabetic foot, and other specialties.
Results and discussion. Evaluation of glycemic control data in the
observations showed that the average fasting blood glucose level in the IG
group significantly decreased (from 8.0-1.2 mmol to 6.1±1.3 mmol / l. P
<0.001). There was also a decrease in ÐЬÐ
1Ñ
-from 8.7±1.5 to 7.6±1.1 mmol
/ L, p <0.001. In the CT group, there was a tendency to a decrease in fasting
blood glucose (from 8.2±1.5 mmol L to 7.4±0.8 mmol, p> 0.05) and ÐЬÐ
1Ñ
(from 8.3±1.4% to 8.1±1,1%, p> 0.05), which did not reach statistical
significance.
The initial blood pressure data indicated that there was no satisfactory
compensation for hypertension among the patients included in the study:
average systolic blood pressure was 142.38-19.67 mm. Hg and 136.21-14.44
mm Hg, dystolic blood pressure 90.03 + 12.62 mm Hg and 87.84-8.95 mm
Hg in the group of IT and ST respectively. During the observation period, a
Scientific research results in pandemic conditions (COVID-19)
122
statistically significant decrease in the mean SBP to 133.21314.1 mm Hg, p
0.001 was observed in the main group; in the ST group, the average SBP
decreased to 132.18â13.7 mm Hg, p-0.05. By the end of the observation, the
average DBP level decreased to 82.13-7.7 mmHg, p <0.05- in the main group
and to 84.93-8.8 mmHg, p 0.05-in the group comparisons. When evaluating
the lipid profile after 12 months of observation, the IT group showed a
significant decrease in the average total cholesterol values from 6.13-1.1
mmol / L to 5.12-1.0 mmol / L, p <0.05%; and LDL-c 3.77-0.9 to 2.99-0.78
mmol / L, p: 0.001. In the CT group, the average content of total cholesterol
increased from 5.62-1.2 mmol to 5.94-1.2 mmol / L, p-0.05%; LDL-C from
3.29-1.0 mmol / L to 3.71-1, 1 mmol, p> 0.05
Conclusions: The results of the studies indicate that in the main group of
patients there was a statistically significant improvement in glycemia, blood
pressure and lipid profile compared with the comparison group. Using
algorithms for step-by-step management of diabetes mellitus 2 prevention
of complications of type 2 diabetes
References:
1.
Dedov I.I., Melnichenco G. A., Fadeev B.B. Endocrinology //.- Ð.:
GEOTAR-Media,, 2012 г. С 263-272
2.
Ametov A.S., IvanovaE.V. The effectiveness of a multifactorial
approach to the treatment of type 2 diabetes mellitus/ Clinical
Pharmacology and Therapy 2012 âT.19. N2 c48-52.
3.
Ametov A.S., Karpova E.V., IvanovaE.V. Effective and safe management
of type2 diabetes mellitus at the modern level // Diabetes mellitus. 2014.
N2.c.18-24.
4.
Ametov A.S., IvanovaE.V. Postprandial hyperglycemia// Type 2
diabetes mellitus// Problems and Solutions-M.: GEOTAR-Media, 2016 c.704
