Author Archives: gou ipovsz

IMPLEMENTATION OF NATIONAL STANDARTS OF ANTENATAL CARE FOR PREGNANT WOMEN IN THE WORK OF THE FAMILY NURSES

Aim. To analyze work of family nurses on the implementation of national standards of antenatal care for pregnant women.
Materials and methods. Analysis of family nurses work on antenatal management of 72 pregnant women was conducted from submitted family nurses reports, Form 111, pregnant women registration journal.
Results. Out of 72 observed women at the labor age 43 (59,7%) were pregnant women. Only 19 (26,4%) women were established first pregnancy. 34 (47,2%) of pregnant women were native inhabitants of the region, who timely on their own registered themselves on clinical account. 41,6% of pregnant women were identified by family nurses. All of them were settlers. Normal BMI had 63 (87,5%) of pregnant women, 8 (11,1%) had heightened, 2 (1,4%) lowered. It was established moderate intensity direct correlation (F=0,53±0,05; p<0,05) between BMI and gestation. 86,1 % women had anemia. Correlations between BMI and hemoglobin content in the blood of pregnant women had weak intensity (F=0,26±0,16; p<0,05) but between hemoglobin content in the blood of nulliparous and multiparous women strong intensity (F=0,99±0,17; p<0,05). Only 22,2% of pregnant women were observed by a doctor at the health center seven times. Conclusion. Study of nurses’ work on the implementation of national standards of antenatal care in the clinical practice has shown the need for timely registration on clinical account of pregnant women for tests and registration on Form-111, which allows to organize conditions for safe motherhood. Standard indicators - measuring BMI, blood (hemoglobin in blood plasma) allow family nurses systematically correct status of pregnant women in some cases together with the family physician. Obtained results of the correlation interdependency of BMI with pregnancy, hemoglobin levels in blood plasma of pregnant women allowed to see the importance of these standards and gives nurses the ability to prognosticate pregnancy flow and childbirth. The need of 7 visits of specialists in the center according the standard requires further study. In our case pregnant women, who have registered under 12 weeks of pregnancy were checked at the doctors only 5-6 times. Key words: national standards, antenatal care, pregnant women, family nurse

CHANGES OF BIOCHEMICAL PARAMETERS OF RABBITS BLOOD DURING EXPERIMENTAL TOXIC HEPATITIS UNDER THE INFLUENCE OF TIMOCIN

Aim. Assess the biochemical indices of animals blood at experimental toxic hepatitis caused carbon tetrachloride.
Materials and methods. Investigations were performed on 10 outbred rabbits a mass 2-3 kg with standard diet and content. Toxic hepatitis was induced by introducing to animals of carbon tetrachloride in admixture with vegetable oil (1: 1) in an amount of 2 ml for 10 days once per day.
For research was used immunomodulatory drug timocin (26092014 series, valid until 26.09.2014, the manufacturer LLC «Tib Baroi shumo», Tajikistan). Timocin was injected to animals after injection of carbon tetrachloride for 10 days once a day at a dose of 0.01 ml per 1 kg of animal body weight.
Before administration and after administration in the blood serum determined the: total protein content, cholesterol, bilirubin (total, bound and free), urea, creatinine, glucose, triglycerides, HDL cholesterol, uric acidactivity of enzymes ALT, AST, and amylase).
Results. The introduction of carbon tetrachloride contributed to the development of toxic hepatitis in rabbits, which was confirmed by a considerable increase of bilirubin, ALT and AST activity. After applying of timocin the positive dynamics of changed biochemical indices: significantly reduces the content of bound and free bilirubin, which led to the normalization of total bilirubin. ALT and AST also falls below the physiological norm.
Conclusion. Application of timocin normalize the content of bilirubin, glucose, cholesterol, ALT and AST activity, which indicates the presence of hepatoprotective properties in it.

DETERMINATION OF TOTAL IMMUNOGLOBULIN CLASSES M AND G – INFORMATIVE METHOD OF DIAGNOSIS OF GIARDIASIS, ASCARIASIS

Aim. Conducting a study on the presence of total immunoglobulin classes M and G to antigens of ascarids, giardia in human blood by immunoenzyme analysis.
Materials and methods. The study involved 35 family members living in the city of Dushanbe GTSZ N»1 without complaints. There were 19 (54%) men and 16 (46.0%) – women.
Results. During the study of blood for presence of total immunoglobulin classes M and G to antigens of Ascaris, by ELISA positive results were found in 14 (31,4%) members of the family: 8 women (57,1%), 6 males (42,8%); 8 (57,1%) had organized (working) population, 6 (42,8%) of unorganized (non-working). In our study, the titer of antibody was determined to determine the duration of the disease. By titration of AT 1:100 – 5 (35,7%), AT-1: 200 – 9 (64,9%). In the study of antibodies to roundworm found that the infestation is more common among females, have organized a contingent of the population. Of those studied, 64.9% of family members infected with ascariasis.
Blood test for the presence of total immunoglobulin classes M and G lamblia antigens by ELISA revealed positive responses in 10 persons (28,5%) among the surveyed family members, of whom – 4 women (40,0 %), 6 men (60%). Of the total number of persons with a positive result to the antigens of Giardia organized (working) – 8 (80%), fugitive (non-working) – 2 people (20%). According to the definition of titer: AT-1:200 – 8 people (80%), AT-1:800 – 2 person (20%). Of the total study 20% of family members infected with Giardia, the prevalence of greater among organized among males.
Conclusion. Concurrent use of koprological and serological methods of diagnosis allows more reliably and efficiently identify ascariasis, giardiasis.

PREVALENCE OF ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE AMONG UNORGANIZED POPULATION OF GANCHI DISTRICTS OF SUGHD

Nozirov Dzh. Hh., Narzulloeva A.P., Shorirov T.M. PREVALENCE OF ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE AMONG UNORGANIZED POPULATION OF GANCHI DISTRICTS OF SUGHD Department of Public Health, Economics, Management with a Course of Medical Statistics of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan” Department of Cardiology with the… Read More »

OVERWEIGHT AND OBESITY AS A RISK FACTOR FOR HEART AND CIRCULATORY DISEASES AMONG THE REPUBLIC OF TAJIKISTAN

Aim. To explore regional and gender-sensitive prevalence of overweight and obesity among the population of the Republic of Tajikistan.
Materials and methods. Implemented screening study of 16,500 people. Aged 15-59 years: 7193 (43,6%) – men, 9307 (56,4%) – women. Besides survey and questionnaire (questionnaire of Rose), conducted anthropometric measurements. Estima¬tion of body mass index was carried out on Quetelet (WHO, 1995).
Conclusion. Revealed features in the prevalence of overweight and obesity among the surveyed population polo-age aspect in individual regions and the whole country are the basis for the local health authorities in the planning of preventive measures aimed at modifying risk factors – excess weight and obesity.
Key words: cardiovascular disease, excessive body weight, obesity, screening

COMPARATIVE ANALYSIS OF LUNGS FUNCTION BY REGULATION OF ELECTROLYTES AT PATIENTS WITH DIFFERENT PATHOLOGY IN THE CRITICAL STATE

Aim. Carry out a comparative analysis of lung function by regulation of electrolytes in patients with different pathologies in critical states in dependence from hypocoagulating function.
Materials and methods. In order to determine the participation of lungs in regulation of blood electrolytes were compared the patients in critical states with different pathologies : I group – 119 puerperas with hemorrhagic syndrome, complicated by acute renal failure (ARF), II – 85 patients with severe craniocerebral trauma (SCCT), III – 110 patients with bronchial asthma at bronhoastmatic state. The findings were compared with the control group (IV) – 20 healthy people. Lung function by regula¬tion of blood electrolytes was determined by veno-arterial difference between mixed venous blood (MVB) and flowing arterial blood (FAB), taken simultaneously, by indicators of electrolytes – potassium, sodium – in plasma and erythrocytes and calcium.
Results. At patients in critical states with different pathology observed disorders of water-electrolyte balance in the form of retention by light Na+ from plasma of the FAB. It points to the beginning of interstitial hypostasis of lungs, not yet manifested in the radiological examination of lungs. Process of retention of sodium by lungs has a direct correlation dependence with the degree of disorders of hypocoagulating lung function and severity of patients status, compounded from 1 to 3 group, which influences to severity of patients. Detected the process of transmineralization or «sick cell syndrome» during the transition of sodium into the cell and potassium from the cell, growing in more severe patients of 2-3 groups. Consumption by lungs of calcium from blood, as clotting factor, occurs particularly active from 1 group to 3 under all studied pathologies during disorders of hypocoagulating lung function.
Conclusion. Determination of concentration of Na+ and K+ in plasma and erythrocytes, Ca2+ in plasma of MVB and FAB has diagnostic and prognostic value for determining and early diagnosis of interstitial hypostasis of lungs and cells transmineralization syndrome, and also status of hypocoagulating lung function in critical states, which makes possible to determine the severity of state and disease outcome.
Key words: hypocoagulating lung function, mixed venous blood, flowing arterial blood, electrolytes, acute renalfailure, severe craniocerebral trauma, bronchial asthma, syndrome of transmineralization

ANALYSIS OF MATERNAL MORALITY IN THE SOGD REGIONAL MATERNITY HOSPITAL

Aim. To examine the structure of maternal mortality in the Sogd regional maternity hospital and identify ways to reduce it.
Materials and methods. It was done the prospective analysis of the history of the birth of the dead women, analyzed data from collated critical cases and annual reports of ARDS in the period from 2010 to 2014.
Results. Revealed the tendency to increase to maternal death. Her reasons: complications associated with extragenital pathology – 41,3%, obstetrical bleeding – 23,5%, sepsis – 23,5%, hypertensive disorders during pregnancy (eclampsia, HELLR syndrome) and pulmonary thromboembolism – 5,9%..
Conclusion. The leading cause of maternal mortality at the maternity hospitals (41,37%), as well as throughout the country, prevails extragenital pathology. Before Health Organization is an issue of development and implementation in practice of maternity hospitals protocols for management of women with extragenital diseases during pregnancy, childbirth and the postpartum period.
Key words: maternal mortality, extragenital pathology, hemorrhage, sepsis, hypertensive disorders

DIAGNOSIS OF BRONCHIAL ASTHMA IN FAMILY DOCTOR’S PRACTICE

Aim. Evaluation of status of patients with a diagnosis of “bronchial asthma”, consisting on the dispensary in hospital of Tursunzade city.
Materials and methods. Were examined 30 patients aged 20 to 70 years (20 women, 10 men), consisting in dispensary with a diagnosis of “bronchial asthma”. Patients were full explored in: palpation, percussion, auscultation of the chest, the assessment heart rate respiratory rate, calculated body mass index, peak flow and pulsoxymetry performed.
Results. 10 patients (33,3%) had a mild intermittent, 8 (26,7%) – with mild persistent, 7 (23,3%) – with moderate, 5 (16,7%)
– with severe bronchial asthma severity. In 11 (36,7%) diagnosed with lung exacerbation of asthma. According to the datas of peakflowmetry in 17 of examined obstruction has an corresponding partially controlled asthma, 13 – severe degree. Among 5 patients pulseoximetry were below 95%, which indicates the presence of respiratory failure.
Conclusion. In spite of the existing protocols on keeping major respiratory diseases at PHC level, a survey of patients and their assigned treatment was not carried out.

EFFECTIVENESS OF DIAGNOSTICS AND TREATMENT OF MULTIDRUG RESISTANT FORM OF TUBERCULOSIS

Aim. Examine the effectiveness of diagnostic and effectiveness of treatment of multidrug-resistant tuberculosis in Re¬public of Tajikistan.
Materials and methods. Performed analysis of an officially published statistics on drug-resistant tuberculosis from 2008 to 2012, of the National Center for Tuberculosis Control in the framework of the “Program to protect the population from tuber¬culosis in Republic of Tajikistan for 2010-2015”.
Results. Drug resistance to antituberculosis drugs (anti-TB drugs) started to define with the support of WHO. In 2008 in Dushanbe and Rudaki district (population 324 thousand. man – 13,9% of the countrys population). Cultures studied in supranational laboratory in Gauting (Germany). The first study on drug resistance was conducted in 2008-2009 to the main anti-TB drugs. Multidrug resistance was 16.8% among newly diagnosed patients, including previously treated – 61%. The second study – a test to determine drug susceptibility (DST) – carried out in 2010-2011: cases of MDR-TB were 13% and 53,6%, respectively (a decrease among new cases 3.8% among the patients treated early – on 7,4%).
Conclusion. Obtained results indicate a qualitative improvement of indicators of effectiveness of treatment of patients with MDR-TB in the republic – from 53% to 58,4%, mortality rate decreased from 14,2% to 11,3%.
Key words: efficiency, diagnostics, treatment of drug-resistant forms of tuberculosis

INTERVENTIONAL METHOD OF ANESTHESIA ON INOPERABLE PATIENTS WITH STOMATOLOGICAL CANCER

1 Gafarov H.O., 1Shakirov M.N., 2Stolyarenko P.Yu, Mangutov I.H. INTERVENTIONAL METHOD OF ANESTHESIA ON INOPERABLE PATIENTS WITH STOMATOLOGICAL CANCER Department of Maxillofacial Surgery with Children’s Stomatology of State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan” Aim. Improved methods of prolonged regional blockade (PRB) branches of the trigeminal nerve to… Read More »