Author Archives: gou ipovsz

МИЛДРОНАТ® В КОМПЛЕКСНОЙ ТЕРАПИИ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА В УСЛОВИЯХ ВЫСОТНОЙ ГИПОКСИИ

* RAKHIMOV Z.YA., **KUDRATBEKOVA., * NARZULLAYEVA A.R.
**CARDIOLOGISTS ASSOCIATION OF THE REPUBLIC OF TAJIKISTAN
*DEPARTMENT OF CARDIOLOGY WITH THE COURSE OF CLINICAL PHARMACOLOGY TIPGPMP
The article is devoted to the study of the use of Meldrony in 30 patients with chronic coronary heart disease, stable angina of II-III class combined with arterial hypertension of II degree with high and very high risk of cardiovascular complications in conditions, Midlands Gorno-Badakhshan Autonomous region of Tajikistan. Among the examined patients on the background of the drug Meldrony in a daily dose of 1000 mg, showed a significant improvement cardiohaemodynamic indicators. Simultaneously, a decrease of the average frequency of angina attacks a day with 2,77±0,26 to 1,52±0,17. Also noted a decrease of the daily quantity of consumed nitroglycerin from 2,4 to±0,23 to 1,4±0,16 and significant increase of tolerance to physical activity detected test 6-minute walk from 388±33 m up to 512±39 m Significantly increased the degree of shortening the anterior-posterior size of the left ventricle and the speed of the circular of the shortening of the fibres infarction. Examine the safety and efficacy of the use of Meldrony patients with stenocardia voltage conditions, Midlands Pamir confirmed distinct antianginal its properties.

ANALYSIS OF THE ONE-YEAR MORBIDITY OF BREAST CANCER IN THE REPUBLIC OF TAJIKISTAN

RASULOV S.R.
КАФЕДРА ОНКОЛОГИИ ТИППМК
The work presents the results of scientific and statistical analysis of materials of primary breast cancer patients registered at the polyclinic of the Republican oncological scientific center of the Republic of Tajikistan in 2012. Analysis of data of out-patient cards of 215 patients ages 25 to 97 years, with the presence of a tumor in the breast. Study of age-related data breast cancer patients showed that up to 24 years of age are not encountered a single case of the disease. In the 25-29 age noted only 3,3% of women with this pathology. The peak incidence of pathology occurs at the age 45-49 years, accounting for 16,7% of the total number of women. Analysis of statistical material has shown that starting from the age of 60, breast cancer risk is gradually fading. Of the total number of patients for 64,7% of the нозологией were residents of rural areas, 35,3% is urban. On топическому location of the cancer in 54% of cases localized in the right breast, in one case, occurs bilateral defeat of the mammary glands, which amounted to 0,5%. Locally common cancer was 83,3%. Metastases in supraclavicular lymph nodes on the side of formerly belonged to the M1, and since 2002 became as N3, that the demand to include them in the group of patients with locally advanced process. Patients with category N3 in this group are 4,5%. The incidence of breast cancer in the Republic of Tajikistan increases from year to year and steadily occupies the first rank place among malignant neoplasms of the female population.

CLINICO-FUNCTIONAL FEATURES OF ARTERIAL HYPERTENSION AND ISCHEMIC HEART DISEASE IN THE PERIMENOPAUSAL PERIOD

NARZULLAEVA A.R., NARZULLAEVA Z.R., KARIMOVA L.M.
DEPARTMENT OF CARDIOLOGY WITH THE COURSE OF CLINICAL PHARMACOLOGY TIPGPMP
The article presents the results of a study of clinical and functional features of arterial hyperten¬sion and ischemic heart disease in 95 of women ages 37 to 55 years in the perimenopausal period. Depending on the degree of disorder of menstrual function surveyed women were divided into 2 groups. Group I includes 30 women perimenopausal period, also women, whose registered irregular menstrual cycles over the past 3-11 months. The second group included 65 women in the postmenopausal period. For the majority of the surveyed women typically early development perimenopausal changes. In 20% of patients recorded premature menopause, 30,8% of women early. Among persons with postmenopausal 53,8% of women aged 35-45. Correlation of time of appearance of complaints on the blood pressure rises with the beginning of the menstrual cycle disorders noted 73,3% of women in the first group and 55,4% of the women in the second group . In 10% of cases among patients in group I and in 38,5% among the patients of group II perimenopausal period was characterized by a worsening of arterial hypertension. In the course of the study the peculiarities of the clinical and functional flow data diseases depending on the severity of climacteric syndrome..

ASSESSMENT OF MEDICAL SERVICES DURING CONTRACEPTIVE AID

MUKHAMADIEVA S.M.
DEPARTMENT OF OBSTETRICS AND GYNECOLOGY TIPGPMP
Many of the problems associated with a reduction in reproductive losses have not been ful¬filled. In the given aspect determining role belongs to the provision of contraceptive security. To understand the knowledge, attitudes and practices of women of reproductive age who use family planning services, those who are these services are provided, and also to determine the quality of contraceptive assistance to the population of medical institutions, conducted socio-logical research on the quality use of contraceptives by women of reproductive age. A specially designed questionnaire survey was conducted among 200 specialists of medical institutions for a professional assessment of knowledge, attitude and practice professionals providing contra¬ceptive services in the Republic. There was set low level of awareness of modern methods of contraception, the confidentiality of provision of contraceptive services and principles of coun-seling, post-Natal and postabortal contraception and voluntary surgical sterilization, methods of emergency contraception, indications and rules of their use, on the principles of counseling condom use. Specialists have an insufficient level of knowledge on the indication, duration of use and unwanted effects with the use of oral contraceptives and Depo-Provera.

INDICATORS OF DISABILITY ON TUBERCULOSIS IN TAJIKISTAN

ZAKIROVA K.A., MAKHMOUDOV R.U., MAKHMUDOVA P.U., SULTONOVA S.K.
THE DEPARTMENT OF PHTHISIOLOGY TIPGPMP
We studied the influence of medico-social and economic factors on the incidence of tuberculosis. The main contingent of patients is unemployed young men aged 20 to 29 years, with incomplete secondary education, under-financed vital food, a living area (lower health standards), with a monthly income below the subsistence minimum of a large family living crowding, who have dependent from 6 to 10 people. By level of education 67% of respondents were with primary and secondary education, respondents with special secondary education was 22%, with higher and incomplete education – 11%. According to the social status of unemployed amounted to 53% of patients, the retirement age of 16%, working – 22%, employees – 5%, entrepreneurs – 3,7% of patients. Respondents living on income below the subsistence level, among the unemployed was 53%, working – 21%, pensioners – 16%, employees – 2,1%, entrepreneurs – 0,3%. To reduce the level of disability from tuberculosis is encouraged to improve the early diagnosis of disease through routine inspections, surveys of the population, promotion of a healthy lifestyle, improvement of living and working conditions, higher wages and the quality of expertise disability vulnerable part of the population.

TRIOIN’S EFFECT ON CARDIOVASCULAR SYSTEM (EXPERIMENTAL WORK)

BAKHROMI M.T.
THE DEPARTMENT OF CARDIOLOGY WITH THE COURSE OF CLINICAL PHARMACOLOGY TIPGPMP
The article presents results of studies on the action of a solution trionini on the cardiovas¬cular system. Work is based on the experiment on animals: 20 white rats weighing 200-220 g, cats weight from 3 to 4 kg under uretan anesthesia. Impact trionini on blood pressure were also studied in healthy intact rabbits and rabbits with experimental caused by atherosclerosis. There were 86 series of experiments conducted more than 150 biochemical, 25 haematological analy-ses, prepared 40 drugs from the internal organs of the experimental and control series animals. Heart rate became less 20-22%, the amplitude of the pulse wave increased respiratory activity remained unchanged. There has been little increase of pulse wave and slowing the pace of car¬diac function at 8-10%. In rabbits with atherosclerosis latent phase actions trionini reached 26 seconds, in healthy animals, it was 3-5 sec., that can be associated with morphological changes in the aorta, as well as changes in the General reactivity of the cardiovascular system. The results obtained allow to note that the developed solution trionini whose performance is not inferior to the well-known drugs.

DYNAMICS IMMUNOLOGICAL INDICES IN PATIENTS OF CHRONIC GENERALIZED PERIODONTITIS DURING THERAPY WITH MELLINOL

AKHROROVA Z.K., KOMILOV F.M., NOSIROV A.F., FAYZOV K.S.
THE DEPARTMENT OF ORTHOPEDIC STOMATOLOGY TIPGPMP
With the purpose of correction of immunological changes in dental patients has been studied the influence of the drug mellinol in the treatment of generalized periodontitis in 32 patients with chronic viral hepatitis b and C. The results obtained show that in the group of patients with chronic viral hepatitis b and C using the drug significantly increased rates of T-lymphocyte subpopula¬tions of T-helpers, a marked increase the number of B-lymphocytes and natural killer cells, and increased the number of cells expressing a chain of the IL-2 receptor and receptor to transferrin that shows a marked improvement periodontal status among the surveyed population. Initially reduced rates of T-lymphocytes and T-helpers, expression markers of activation, as a manifestation of immune dysfunction in patients with chronic viral hepatitis b and C, during the therapy with mellinol significantly increased. When using the drug in the least degree of expression is subjected to a subpopulation of cytotoxic T-lymphocytes, which are responsible for the clearance of the virus and the production of cytokines, controlling viral replication. It is revealed that the immunotropic effects of the drug mellinol of periodontal patients with chronic viral hepatitis b and C is manifested positively, regardless of the type of virus that caused the disease, and correlates with the notable restoration of fabrics of parodont.

THE DEPENDENCE OF THE INDICES OF CENTRAL HEMODYNAMICS AND SYNDROME OF ENDOGENOUS INTOXICATION FROM ABDOMINAL PRESSURE IN TERMINAL STAGE OF PERITONITIS

MURADOV A.M., AKILOV KH.D., SHUMILINA O.V., KAKHAROV M.A.
THE DEPARTMENT OF EFFERENT MEDICINE AND INTENSIVE THERAPY OF TIPGPMP
THE DEPARTMENT OF ANESTHESIOLOGY AND REANIMATOLOGY TIPGPMP
THE DEPARTMENT OF SURGERY WITH COURSE OF TOPOGRAPHIC ANATOMY KHD TIPGPMP
Increasingly important for evaluation of the patient, forecasting the severity of the disease and treatment outcomes acquires indicator of intra-abdominal pressure, which affects all organs and body systems, including the cardiovascular system, manifested by inhibition of the indices of Central hemodynamics. The article presents the results of monitoring of the parameters of Central hemodynamics 24 patients in the terminal stage of peritonitis in the preoperative period and at different times after the surgery. In parallel was monometry intra-abdominal pressure. Clinical observations have shown that an increase intraperitoneal pressure to levels I and II degrees has an identical effect on the indices of Central hemodynamics. Among the surveyed, there is reduction of the pay and minute performance of the heart due to the decreasing venous return to the heart. Toxemia accompanied by a decline in heart emission and support perfusion of tissues was provided by a moderate ascending indicators poststrain result of voltage humoral factors. The obtained results showed that patients in the terminal stage of peritonitis observed gypokinetical type of circulation, which is characterized by pronounced hypovolemia and reduced poststrain. Against the background of peripheral vascular insufficiency noted the inconsistency of the Central mechanisms of hemodynamics, due to the depression of the myocardium contractile function. Indicator intraperitoneal pressure is a prognostic criterion of the severity of the syndrome of endogenous intoxication and can be applied at the preoperative stage of examination and treatment of patients in the terminal stage of peritonitis.

ULTRASOUND DIAGNOSTICS THYROID PATHOLOGY IN CHILDREN AND ADOLESCENTS

KASYMOVA S.D., AYUBOVA G.SH., RAHMONOV V.D., BOYMATOVA M.B.
THE COURSE OF ENDOCRINOLOGY AT DEPARTMENT OF THERAPY TIPGPMP REPUBLICAN CLINICAL CENTRE OF ENDOCRINOLOGY
In connection with the exceptional importance of the thyroid gland problem of pathology of the organ of children is the focus of endocrinologists. Pathology of the thyroid gland in the regions of iodine deficiency, which includes the Republic of Tajikistan, occupies the leading position in the endocrine pathology in children and adolescents. Diagnostics of thyroid pathology in this category includes a phased investigation with the decision of the question concerning the goitrous increase the authority and assessment of the functional state of the thyroid gland. Many tasks successfully done with the use of ultrasonic technologies. The article suggests the use of ultrasound diagnostics for estimation of structural and functional changes of the thyroid gland, 93 children and adolescents with a duration of pathology from 6 months to 2 years. Depending on the functional state of the examined organ children and adolescents were divided into the following groups: I group amount¬ed to 61,3% of patients with diffuse nontoxic goiter, II – 20,4% of individuals autoimmune, with tireoidita III group – 18,2% of surveyed with hypopituitarism thyroid gland. Results of ultrasonic research show the greatest increase in volume of the thyroid gland in the group 2 patients with au¬toimmune thyroiditis. Analysis of results of ultrasonic research showed that in the 1 group of the examined enlargement of the thyroid gland was moderately expressed. The largest increase of the volume of the thyroid was noted in group 2 patients with autoimmune thyroiditis. Of the 17 patients with subclinical hypothyroidism last group in 58% of cases of thyroid volume slightly increased in 42% of cases, the value remains in the normal range. The results obtained allow to note that for the estimation of structural and functional changes of the thyroid gland are essential ultrasound diagnostics.

COMPARATIVE EVALUATION OF EFFICIENCY APPLICATION OF MODERN METHODS OF DIAGNOSTICS TOXIC BLOOD COMPONENTS DURING ENDOTOXEMIA

TUYCHIBOEVA M.N., MURADOV A.M. SHUKUROV T., SHUMILINA O.V.
COURSE “LABORATORY WORK” TIPGPMP
One of the most urgent problems in the structure of modern somatic pathology remains endo¬toxicosis, which is a basic component of the formation of the severity of the General condition. The article presents the results of analysis of toxic blood components 206 patients endotoxemia developed in the result of acute renal failure, peritonitis and septicemia in comparison with the figures of 20 healthy donors. Material for the study served as the blood of patients aged from 17 to 62 years, of which men made up 59,3% of women – 40,3%. The study used biochemical, gel-chromatography and infrared spectroscopic methods of diagnostics indicators token to reflect the level of intoxication. Found that the toxicity index in patients endotoxemia increases by more than 700%, compared with the control. On the basis of carried out research we can conclude that the patients endotoxemia occur intensification of lipid peroxidation, depression of immunity, reduction in antioxidant protection and detoxification abilities of organism. The comparison of the curves fractionation of blood plasma during endotoxemia and in healthy people showed that the patients of the main group there was a significant increase in fractions of A and D, to a lesser extent faction Century There was a tendency to a decrease in blood levels of medium-weight molecules due to their concentration redistribution that may be characteristic only for endotoxicosis