Vol. 3 No. 04 (2021)

Irritable bowel syndrome (IBS) is a biopsychosocial disease consisting of a set of functional disorders not explained by organic changes in the intestine. A total of 117 patients and healthy people were examined. Patients were divided into 2 groups: the first group were patients with IBS, which were divided into 2 subgroups: IBSd (diarrhea) - 51 patients (20 men and 31 women), IBSc (constipation) - 66 patients (33 men and 33 women). More abdominal pain syndrome was noted in patients with a clinical form of IBS with a predominance of diarrhea. The ordinal assessment of the severity of SRC symptoms allows to objectify the severity of clinical manifestation of intestinal dysfunction in patients, identify the clinical features of the course of this pathology.

The study includes 557 patients with ulcer of the stomach and duodenal intestine complicated by bleeding. The control group was 290 patients, of which 48 patients with active bleeding were performed by standard endoscopic hemostasis techniques, and in 242 cases, when verifying stopping bleeding, endoscopy was limited to the diagnostic step with subsequent conservative patient management. The main group includes 267 patients in addition to endoscopic hemostasis with active bleeding (46 patients), the manipulation was supplemented with the implementation of the proposed method of endoscopic treatment of gastroduodenal bleeding of ulcerative genesis. When revealed bleeding (221 patients), endoscopic intervention was also accompanied by the implementation of the proposed method.

The application of the composite polymer material over the ulcerative defect contributed to a decrease in the frequency of the nearest recurrences of hemorrhagic syndrome from 9.0% to 1.9%, reduce the need to perform operational treatment from 6.6% to 1.1% and levity indicator from 1.7% up to 0.7%, which generally affected the increase in the share of patients discharged without complications from 90.7% to 97.8% and reducing the timing of the hospital phase of treatment.

The functioning of the female reproductive system depends on the proper development and regulation of the hypothalamic-pituitary-ovarian axis. It is based on the secretion of GnRH, which stimulates the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There have been many studies investigating the factors that regulate the secretion of gonadotropins. In recent years, the significance and role of kisspeptin and its receptor has aroused interest. This review will provide data from foreign studies and literature on the role of kisspeptin in the regulation of the female reproductive system.

Aphthous stomatitis is a focal inflammation of the oral mucosa, in which round ulcers (aphthae or erosion) form. Aphthae affect the inner surface of the cheeks, palate, tongue, become covered with a gray or yellowish coating, cause pain and discomfort. Usually the disease proceeds chronically, from time to time exacerbates, after 7-10 days it goes into remission.

The   modern   screening   test   was   performed   in   1323   women, which   live   in   Fergana   valley.  Our   results   have   shown   that   first    of   all,   the   more   cases   were   polipathy.   The   second,  more   cases   were   in  35-49   age   women .  Third ,  we   found   evidence   it   importance  of   epidemiological   study   of   findings   polipathy   and   we   recommend   this   project   to   using   in   practice.   

The high quality of drinking water is the result of a comprehensive solution to a number of problems, the main of which are the development and implementation of modern water treatment technologies, the use of effective laboratory control mechanisms, optimization of water supply, an integral approach to assessing the quality of drinking water, the use of hygienically sound solutions in terms of water supply and sanitation.

A late diagnosis of secondary hemochromatosis was made to a 38-year-old man with chronic hepatitis B, who after poisoning with alcohol surrogate (which was a year ago) had episodes of macrohematuria with signs of acute kidney damage, which required treatment in the ICU and hemodialysis sessions, after which kidney function was restored. In August 2020, the patient had  a contact with a COVID-19 patient, but upon admission to the hospital, the results of tests for COVID-19 were negative. During the examination in our department, after the exclusion of the urological disease, the diagnosis of interstitial nephritis of toxic etiology, hemolytic anemia, chronic viral hepatitis B was made. Then in-depth study of iron metabolism, bone marrow, and MRI of parenchymal organs revealed secondary hemochromatosis.

The results of surgical treatment of 197 patients with ventral hernias were analyzed, while 104 (52.8%) patients underwent simultaneous operations to correct the surgical pathology of the abdominal cavity organs and the anterior abdominal wall. In 20.1% of patients, the simultaneous stage of the operation was performed using a separate minilaparotomic approach. Tension alloplasty methods were performed in 48.2%, non-tension methods - in 51.8%, while 26.4% of patients underwent dermatolipidectomy. The study of the level of stress hormones during simultaneous operations on the abdominal cavity and abdominal wall organs in patients with ventral hernia showed that the degree of surgical aggression in most cases was influenced by the "tension" method of plasty of the anterior abdominal wall and the duration of the operation. Performing the stage of the operation to correct the pathology of the abdominal organs did not significantly affect the level of stress hormones.

Pituitary adenomas (PA) are monoclonal tumors arising from the cells of the adenohypophysis and represent approximately 10-15% of all intracranial tumors and 90% of the tumors of the sellaturcica. Pituitary adenomas occur in almost 20% of the general population. The estimated annual morbidity of pituitary adenoma is approximately 20 cases per 100,000of population, making it the third most common primary intracranial tumor after gliomas and meningiomas [9].

In Uzbekistan, too, the number of women applying to plastic surgery in connection with the change of appearance is increasing. It is natural that this will certainly give birth to a favorable psychological problem. A special place is occupied by the attitude of a woman to her appearance. The external appearance determines not only the internal psychological sensations of a woman, but also her position in society. Therefore, every woman aspires to the beauty of external appearance and in some cases refers to a plastic surgeon. Recently, such cases have increased.

This article analyzes the rules and principles of assessment of external signs in physiognomy, the shape of the face, the appearance of its limbs, the identification of symptoms depending on the change, the description of the study.

Rasional psychoterapiya (rpt) is distinguished from other psychoterapetic techniques by its simplicity, no special psychological exercises are required, easy reception by patients and the result is quickly noticeable [1-3]. During psychotic Sessions, psychotic experiments are not conducted, the patient is not encouraged to perform various tasks, giving the House special tasks, the next day his answer is not asked. This means that in rpt the patient is put freely and the existing psychological conflicts in it are easily resolved [6-7].

Spina bifida-is a defect in the development of the neural tube, which is a splittinq of the spinal canal and is one of the most common conqenital malformation of the fetus. Worldwidt, the incidence of fetal neural tube defects ranqes from 0,17 to 6,39 per 1000 newborns. This article describes methods for early diaqnosis of fetal neural tube malformation in earle preqnancy and the results of studies of preqnant woman at different staqes of  preqnancy.

Diabetes is a major cause of chronic kidney disease (CKD). Poor blood sugar control accelerates the progression of CKD to terminal renal failure. Chronic kidney disease is also an important co-morbidity of diabetes. Impaired renal function further increases the risk of cardiovascular events in diabetic patients and ultimately carries a severe social and economic burden. Altered fibroblast growth factor 23 (FGF-23) and Klotho levels are considered the earliest biochemical abnormality of chronic kidney disease, the mineral and bone disease syndrome.

Currently, the role of food security in maintaining public health is high. Gastrointestinal and many other diseases can develop if the composition of food does not meet sanitary and hygienic requirements. As a result of the development of agro-industry, as a result of excessive and irregular application of nitrogen fertilizers, the amount of nitrate in fruits and vegetables is increasing. The negative and positive effects of nitrates on the body have been identified, and it has been found that nitrates consumed on a daily basis are important in maintaining our health.

Evaluation of markers of endothelial dysfunction (endothelin-1 and nitric oxide) and elemental status (zinc, iron, magnesium) of chronic kidney disease (CKD). The study includes 104 patients with different stages of CKD: 63 patients with I stage of CKD, and 26 patients with CKD stage III and 15 patients with CKD V stage. Results: in patients with CKD, endothelin-1 increased with simultaneous decrease in production of nitric oxide in the progression of CKD from I to V stage. The increase of the content of endothelin-1 by 2.5 times determined in patients with stage V CKD, which was accompanied by a decline of the ratio of the concentrations of NO/ET-1 by 5.5 times. In patients with CKD, elemental status impairments were detected, manifested by a decrease in the content of zinc, iron, and magnesium in the serum of blood at the first stage, with the maximum implementation in stage III CKD. Hypertension was detected in 68.3% of patients with CKD. Direct correlations were found between the content of serum iron and magnesium with the level of arterial pressure in patients with stage I CKD. In III and V stage CKD, a direct correlation of serum magnesium with blood pressure level and nitric oxide concentration was established. Conclusion: children with CKD have endothelial dysfunction and elemental status disorders, beginning with the first stage of CKD development, which can be considered as factors determining the progression of the pathological process in the kidneys.

The method of laser osteoperforation developed experimentally was approved in 142 patients with chronic osteomyelitis of different forms. A diode laser was used in which wavelength was 970 nm and power – 30 W. Laser osteoperforation was performed transcutaneously in a contact way with a quartz light guide of 0, 4 mm diameter in the projection of bone destruction foci with formation of 2-20 holes. Normalization of temperature and blood indices as well as pain decrease, reduce of soft tissue tension and edema was observed in all the patients in the immediate days after surgery. As a rule, fistulae closed by 4-10 day. In case of chronic osteomyelitis persistent remission is noted during 2-5 years by the objective data (roentgenography, flowmetry, densitometry). Thus, the experience of laser osteoperforation clinical use demonstrates its high effectiveness in treatment of osteomyelitis different forms. The method is of little invasiveness and it allows to reduce the periods of treatment and rehabilitation to a great extent.

The article describes the pathogenesis of occurring  of iron deficiency anemia. The study was conducted in Bukhara. According to him, in each critical period, specific etiological factors predominate, and it is the elimination of these factors in the first place that increases the effectiveness of treatment.  The main factors of iron defiency anemia are alimentary insufficiency of  in girls of childbearing age is the onset of menstruation, and in women of childbearing age, improper use of intrauterine devices, frequent abortions, metroragias for various reasons, alimentary insufficiency and incomplete acceptance of the previous course of ferrotherapy.

The aim of the study was to identify predictors of decreased glomerular filtration in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We analyzed 145 case histories of patients diagnosed with COPD. The majority (84.1%, n = 122) of them are males (the average age of men is 60.7 ± 0.9 years, the average age of women is 62.0 ± 2.7 years). A comparative analysis of the prevalence of risk factors for chronic kidney disease (CKD) in patients with COPD: age, gender, smoking, arterial hypertension, overweight, etc. The glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) formula, according to which the patients were divided into 6 groups: group 1 - hyperfiltration, group 2 - GFR CKD – EPI ≥ 90 ml / min / 1 , 73 m2, 3rd - GFR CKD – EPI 60–89 ml / min / 1.73 m2, 4th - GFR CKD – EPI 45–59 ml / min / 1.73 m2, 5th - GFR CKD – EPI 30 - 44 ml / min / 1.73 m2 and 6th-GFR CKD-EPI <30 ml / min / 1.73 m2. Results. Patients with COPD have a high incidence of CKD risk factors. A correlation was found between the prevalence of CKD risk factors and the severity of COPD. The main predictors of the development of CKD in patients with COPD: duration of COPD> 9 years, body mass index> 26.5 kg / m2, smoking index> 51.3, albumin> 44.0 g / l, total protein> 70.0 g / L, forced expiratory volume in the first second ≤ 1.6 L, right atrial size> 35.5 mm, systolic pressure in the pulmonary artery> 36.6 mm Hg. Art., the thickness of the posterior wall of the left ventricle> 10.5 mm, Tiffno's index ≤ 62%. Conclusion. It was found that patients with COPD

The features of the epidemiology, clinical picture, diagnosis and treatment of chronic diffuse liver diseases in combination with anemia are considered according to the literature on this problem.

It has been shown that anemia aggravates the course, causes progression and worsens the prognosis of chronic diffuse liver diseases. The incidence of anemia in chronic diffuse liver diseases reaches 80%. Disclosure of the mechanisms of anemia in chronic diffuse liver diseases is necessary for timely correction and prevention of the progression of both pathological changes in red blood and underlying liver disease.

The article presents two cases of hepatitis-associated aplastic anemia in the last year. The literature data on the new nosology are presented. The clinical picture, diagnosis and treatment are discussed. The questions of diagnosis and treatment that affect the prognosis are raised. Treatment preference should be given to allogeneic bone marrow transplantation, as it has better results than aggressive immunosuppressive therapy that is difficult for patients to tolerate.

Using unified and developed methods, some hematological, biochemical and indicators of the micro- and macroelement status of the body in Bukhara women of fertile age with a normal hemoglobin health index and iron deficiency have been studied. It has been shown that there are certain pathological fluctuations in some hematological, biochemical and essential hematopoietic microelements in women of fertile age when they develop an iron deficiency state. In particular, there is hypoproteinemia, hypoferremia, hypocincemia, hypocuremia, and hypertransferrinemia. This phenomenon can be used to monitor the state of hemoglobin health in women of fertile age.

HCV infection remains one of the leading problems in the diagnosis and treatment of chronic liver disease, given the scale of hepatitis C virus infection worldwide, the significant number of unexamined but at-risk patients, and the incidence of cirrhosis and liver cancer. Anemia is the most common hematological adverse event, which in turn significantly reduces the quality of life of patients during antiviral therapy, their adherence to treatment, and increases the risk of developing cardiovascular, renal and cerebral disorders.

Objective – To improve the results of surgical treatment of various defects of the auricle by improving the methods of otoplasty.

Material and Methods - The study included patients with acquired traumatic defects and III degree inborn folded auricle. The work was carried out in the Department of Plastic and Reconstructive Microsurgery of the State Institution " RSSPMCS named after Academician V. Vakhidov" for the period from 1990 to 2020. In general, the comparative analysis of the results included 38 patients in the main group, among them in 13 (34.2%) cases there were defects with extension to the central part of the auricle, 15 (39.5%) patients with III degree deformity of the auricle (folded auricle), as well as in 9 cases - marginal defects of the auricle and in 1 case a patient with a total traumatic defect. The comparison group included 28 patients, 16 (57.1%) - defects with extension to the central part of the auricle and 12 (42.9%) patients with III degree deformity of the auricle. Accordingly, the effectiveness of the proposed otoplasty method for ear defects was assessed according to two categories of pathologies - defects with extension to the central part of the auricle and grade III ear deformity (folded auricle). The average age in the main group was 22.4 ± 1.3 years, in the comparison group 19.4 ± 1.9 years.

Results - Improved methods of reconstruction of an amputated but preserved auricle, with a peripheral defect of the auricle, with a folded auricle, and reconstructive otoplasty with defects with the capture of the central parts of the auricle are proposed. In total, complications developed in 8 (29.6%) patients in the comparison group and 2 (7.1%) in the main group. At the same time, the incidence of surgical complications, which subsequently led to the need for re-reconstruction, was 11.1% in the comparison group. There were no complications in the main group. In total, 6 (22.2%) additional stages of otoplasty were performed in the comparison group. In the main group, an additional stage of surgery was required only in 1 (3.6%) case of the formation of an unnatural skin fold. There was also a statistically significant difference in the number of additional plastic surgery stages performed for the complications noted above (criterion χ2 = 4.305; df = 1; p = 0.039). The average duration of surgery in the comparison group for all stages of reconstructive otoplasty was 220.7 ± 2.7 minutes, and in the main group after 2-stage otoplasty according to the proposed method - 189.5 ± 1.9 minutes (t-criterion = -9 , 60; p <0.05).

Conclusion - The improved method of otoplasty in case of grade III defects or deformities of the auricle made it possible to reduce the overall incidence of complications from 29.6% to 7.1%, and to reduce the need for repeated reconstructive interventions from 22.2% to 3.6%, which, in general, led to a decrease in the period of complete rehabilitation from 4.4 ± 0.1 to 3.7 ± 0.1 months.

In the presented article, the features of the structure and function, morphological and morphometric parameters of the main structures of the spleen, which belongs to the peripheral organ of the immune system, are studied, the patterns of development of this organ at the stages of postnatal ontogenesis are revealed. The article analyzes the data of domestic and foreign literature on the influence of environmental factors on structural changes in the spleen at the organ, tissue and cellular levels. Further study of the spleen will make it possible to identify and analyze the patterns of their structural and functional changes when exposed to a genetically modified product (soybeans).

Currently, along with the expansion of protected ground areas, the intensification of greenhouse crop production is carried out, providing for a higher organizational and technological level, providing effective ways to accelerate the growth and development of plants, as well as protect them from numerous pests and diseases. In solving the problems of supplying the country's population with fresh vegetables throughout the year, providing flower and ornamental plants, as well as carrying out year-round plant breeding, an important role should be played by greenhouse plant growing [5, 7, 11].

We present an analysis of the results of surgical treatment of 182 patients with pulmonary echinococcosis (126 patients with uncomplicated and 56 with complicated pulmonary echinococcosis). Of these, only in 23 patients out of 25 planned, it was possible to carry out echinococcectomy purely thoracoscopically through trocar punctures. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. All patients underwent anterolateral thoracotomy. Basically (97.67%) performed organ-preserving operations with the elimination of the residual cavity in the light suture plastics in various modifications. In 2 patients with marginal location and pneumocirrhosis, marginal resection of the lung with an echinococcal cyst was performed.With combined echinococcosis of the lungs and liver, 10 patients were operated on. 6 patients underwent surgical interventions on the lungs and liver through separate approaches at the same time. The use of minimally invasive techniques for pulmonary echinococcosis is possible in more than 2/3 of patients.

Analysis of modern views on the problem of anemia in chronic heart failure (CHF), on the main pathogenetic mechanisms of its formation and the possibility of drug correction. The CHF problem has a number of interdisciplinary aspects. One of the pathologies often encountered in CHF is anemia, which aggravates hemodynamic disturbances and worsens the prognosis in patients. Understanding the mechanisms of the development of anemia in CHF is of great importance for the choice of treatment tactics. The review discusses the views on the pathogenetic mechanisms of the formation of anemic syndrome in patients with CHF. The approaches to its treatment from the point of view of pathogenesis are considered. Anemia in CHF is associated with an increased risk of death, worsening of the course of concomitant diseases and an increase in the functional class of heart failure, but it is a potentially reversible condition.

To perform a comparative analysis of anemia of chronic disease (ACD) and iron-deficiency anemia (IDA) in late middle-aged and  elderly patients with chronic heart failure (CHF) by ferrokinetic parameters, inflammation indexes, and their associations. Materials and methods. 65 patients with ischemic heart disease were evaluated, including 35 patients with CHF and ACD, 10 patients with CHF and IDA, and 20 patients without CHF, ACD, and IDA (control group, CG). Results. Patients with CHF and IDA had true iron deficiency whereas 54% of patients with CHF and ACD had functional iron deficiency, and 46% of patients had no iron deficiency. Levels of acute phase proteins, ferritin and hepcidin, C-reactive protein (CRP), and interleukin-6 (IL-6) were highly significantly different in patients with CHF and ACD and patients with CHF and IDA; positive and significant correlations were found for levels of IL-6 and ferritin, IL-6 and CRP, and CRP and hepcidin. In patients with CHF and IDA, levels of acute phase proteins, ferritin and hepcidin, CRP, and IL-6 were low and correlations of IL-6 with ferritin, IL-6 with CRP, and CRP with hepcidin were non-significant. Concentrations of erythropoietin were significantly higher in patients with CHF and ACD and patients with CHF and IDA compared to the control group; however, significant differences between them were absent.

The review is dedicated to the analysis of ecological aspects of pollen allergy (pollinosis). The characteristic of pollen as a natural aerosol component is given. The information related to aeropalinological monitoring and its importance in public health service is presented. The peculiarity of this pathology is its regional variety associated with differences in plant species compositions and pollen periods. The problem of immune response formation to pollen has been studied most profoundly. At that it is known that sensibilization is not always associated with clinical signs. Russian and foreign data about correlation studies between the pollen quantity and the disorder symptom load are discussed. It is shown that there is no decisive answer to the question about threshold pollen counts of certain plants and its impact on different stages of respiratory diseases. The detailed analysis of the correlation between the symptoms and quantitative variables of pollen allergens may provide useful information for risks evaluation of disease exacerbation as well as for tactics elaboration of hypoallergic measures. This is a cross-disciplinary issue involving allergology, aerobiology and ecology. The perspective of further development of this subject in order to obtain more accurate vision of the reasons, mechanisms and patterns of all parts of multifactorial process of pollinosis formation is discussed.