Author Archives: gou ipovsz

PRIMARY CEREBRAL STROKE PREVENTION

Abdurahmanova R.F., Izzatov K.N., Hadibaeva G.R., Sharifova B.A., Rashidova O.A.

PRIMARY CEREBRAL STROKE PREVENTION

Department of Neurology and Medical Genetics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

The article describes main directions of primary prevention of cerebral stroke. It is shown that the system of primary prevention of stroke is divided on population strategy and high-risk strategy. Population strategy is aimed at informing the public about modifiable risk factors associated with lifestyle, and possibility of their correction. A population strategy is aimed at informing the public about modifiable risk factors associated with lifestyle, and possibility of their correction. Strategy of a high risk means early identification of patients in high risk groups followed by preventive medicamental and (if necessary) of vascular surgery treatment. Thus, changes in lifestyle, adequate antihypertensive, antithrombotic, hypoglycemic therapy, normalization of lipid metabolism, reasoned surgery on carotid arteries can significantly reduce the risk of a first stroke.

SOME FEATURES OF CROSS BORDER TRANSMISSION OF MALARIA TO THE REPUBLIC OF TAJIKISTAN IN PREDELIMINATION PERIODS

*Sharipov A.A., *Narzuloeva M.F., **Saiburkhonov D.S.

SOME FEATURES OF CROSS BORDER TRANSMISSION OF MALARIA TO THE REPUBLIC OF TAJIKISTAN IN PREDELIMINATION PERIODS

*Department of Infectious Diseases of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”

**State Establishment “Republican Center for control of Tropical Diseases”

Aim. To explore some features of cross-border malaria transmission in the territory of the Republic of Tajikistan in predelimination periods.

Materials and methods. Are used reporting documentation of the National Centre for Combating Tropical Diseases (Malaria), medical history of patients with malaria hospitalized in Clinical Infectious Diseases Hospital and Medical Center of Dushanbe. In the subsequent were calculated the arithmetic mean value of all the obtained results, and also evaluation given to them.

Results. During the analyzed period in the country there is a decrease in the incidence of malaria, especially local. At the same time, is growing the percentage of imported malaria cases among the registered patients (2011 – 28,2%, 2012 – 45,5% and in 2013 – 78,6%). From the total nu 38 of imported cases during the analyzed period in Tajikistan in 30 malaria cases caused by Plasmodium vivax (78,9%) and in 8 cases – malaria caused by Plasmodium falciparum (21,1%). Importation of malaria caused by Plasmodium vivax, was mainly from Asia (Afghanistan – 15 cases, Pakistan – 10 cases, India – 3 cases, Iran – 1 case), and only in 1 case – from South America (Guyana). Malaria caused by Plasmodium falciparum, was imported mainly from African countries (Guinea – 4 cases, from Sierra Leone, Nigeria, Sudan – one case each), and 1 case of Afghanistan. In all 10 cases of diseases brought into the country by mosquitoes, malaria was caused by Plasmodium vivax, that has occurred as a result of flight infected mosquitoes from the nearby Islamic State of Afghanistan. All cases of infection of citizens (7 local residents and 3 military border guards) were recorded in the border areas of Shuroabad district of Khatlon region.

Conclusion. It was established that import cases of malaria in the analyzed period were recorded in 17 cities and districts of the republic, most of which according to climatic and geographical features of conditions for reproduction and produce progeny of disease vectors (mosquitoes kind of Anopheles). Untimely identification of patients and do not implementation of the relevant anti-malaria activities will contribute to risk of exposure to the local population of imported malaria cases

VALUE OF THE WEBER TEST IN DIAGNOSIS OF DIFFERENT FORMS OF OTOSCLEROSIS

Shamsidinov B.N., *Azizov K.N., Muhtorova P.R., Shaydoev S.S.

VALUE OF THE WEBER TEST IN DIAGNOSIS OF DIFFERENT FORMS OF OTOSCLEROSIS

Department of Otorhinolaryngology of the State Educational Establishment «Institute of Postgraduate Education in Sphere of Republic of Tajikistan»

*National Medical Center of Republic of Tajikistan

Aim. To evaluate the impact of sound perception and sound conduction disorders in otosclerosis on the lateralization of sound, to determine the forms of disease, in which the experience of Weber is most effective, set the value of the experiment at two intensities for detecting of lesions of cochlea in otosclerosis.

Materials and methods. We analyzed audiograms of 100 patients with otosclerosis. Information of threshold tonal audiometry, binaural balance of loudness and also difference in the threshold of differentiation on 500 and 2,000 Hz were compared with experimental results of Weber.

Results.Revealed that dependence of lateralization from the value of bone-air interval in “pure” and mixed form of otosclerosis is not always observed. In this paper the experimental data of Weber were compared with thresholds differentiation. In order to identify destruction of hair apparatus the data of lateralization was compared with the results of binaural loudness balance. In this case, the change in lateralization of sound at above-threshold intensity was observed. Thus, in the direction of sound on above-threshold intensity it is possible to judge about degree of preservation of receptor on the worse hearing ear.

Conclusions. Weber test is suitable for determining of significant differences in sound-conducting and sound-apparatus on both sides. The test results can be properly evaluated only after comparison with the results of other tests. Weber’s experience desirable to perform on two intensities, because it increases its clarity allows to identify in individual cases the accelerated increase of volume and to solve the problem of bone-air “rupture” in the ear with large lesion sound-system.

AZIKAV IN COMPLEX TREATMENT OF HERPES ZOSTER

Salimov B.M, Kasymov O.I, Munieva S.H.

AZIKAV IN COMPLEX TREATMENT OF HERPES ZOSTER

Department of Dermatology and STIs of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.A study of the effectiveness of atsikav (acyclovir) in the complex treatment of patients with herpes zoster.

Materials and methods. Under observation were 48 patients with herpes zoster. Among the patients with herpes zoster were 32 (66,2%) men and 16 (33,3%) women aged between 18 and 84 years. Methods: clinical, statistical.

Results. Treatment of patients has gone well. Side effects and complications of the drugs were not at any patient. The results showed the effectiveness of the treatment by complex therapy. So excellent results (clinical recovery) with typical form of herpes zoster in the end of the 1st week of observation in the complex therapy was achieved in 83.3% of patients and after 12-14 days in 100%. Among patients with bullous form of herpes zoster to the end of the 1st week of observation treatment has given excellent results in 80%. In hemorrhagic and generalized forms of herpes zoster to the end of the 1st week of treatment, a significant improvement was observed in 65% of patients and after 12-14 days in 80%. It should be noted that atsikav had no hepatotoxicity to any patient.

Conclusion. Patients with herpes zoster most frequently observed over the age of 60 years. More common at men. In winter, autumn and spring incidence is higher than in summer. Concomitant diseases were more common at older age groups. Atsikav antiviral drug can be recommended in the complex treatment of patients with herpes zoster.

EXPERIENCE IN DEVELOPMENT AND INTRODUCTION OF CLINICAL PROTOCOLS ON CHILDHOOD DISEASES IN MEDICAL PRACTICE OF REPUBLIC OF TAJIKISTAN

*RahmatulloevSh.R., **SaidmuradovaG.M., *RahmatulloevaS.I., TolibovA.H.

EXPERIENCE IN DEVELOPMENT AND INTRODUCTION OF CLINICAL PROTOCOLS ON CHILDHOOD DISEASES IN MEDICAL PRACTICE OF REPUBLIC OF TAJIKISTAN

*The Ministry of Health and Social Protection of Population of Republic of Tajikistan

**Department of Pediatric Infection Diseases of the Tajik State Medical University

Aim.Studying experience of development of clinical protocols in other countries to improve national clinical protocols for childhood diseases.

Materials and methods. During the period from 2002 to present time, total were developed 4 clinical guidelines and protocols (CP) on the main diseases of childhood. Main purpose of creating of CP is to ensure the target groups with an exhaustive instructions for making decisions on their use in clinical practice. Rational use of clinical protocols depends of complying of all design rules with the search and evaluation of the best available evidence. Basic requirements for compiling of CP is using of evidence based medicine (EBM) with a systematic generalization of scientific proofs in their development.

Results. Earlier developed clinical protocols were little informative, compiled in an incomplete volume, while topics of discussed nosologies were duplicated from the previous protocol. After the introduction and application of CP in practice treatment of childhood diseases on the place were not held follow-up assessment monitorings.

Conclusion. Was established, that the adaptation of the existing pocket book of WHO of hospital care for children in view of features of local medical practices with limited economic and financial resources, with coverage of priority conditions of childhood is considered appropriate because it does not require the high cost of the adaptation process

ANALYSIS OF MORBIDITY OF COLORECTAL CANCER IN REPUBLIC OF TAJIKISTAN

*Rasulov S.R., **Karimov A.M.

ANALYSIS OF MORBIDITY OF COLORECTAL CANCER IN REPUBLIC OF TAJIKISTAN

*Department of Oncology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

**State Establishment “Republican Oncological Scientific Center” of the Ministry of Health and Social Protection of population of Republic of Tajikistan

Aim. To perform statistical analysis and identify the most characteristic features of colorectal cancer in the population of Republic of Tajikistan.

Materials and methods. Clinical data of 115 patients with colorectal cancer in the age of 18 to 92 years, who were treated in department of oncoproctourology of State Establishment “Republican Oncological Scientific Center” of Ministry of Health of Republic of Tajikistan in 2012 was studied. Tumor morphologically verified in all patients. In a planned regularity were hospitalized 89 patients, by emergency indications – 26 patients. To all performed endoscopy of the intestine, ultrasonic and review roentgenologic researches of the abdomen.

Results. Frequency of morbidity is somewhat more among males (52,2%). Peak of morbidity occurs in the age of 50-69 years (46,9%). Up to 40 years colorectal cancer diagnosed in 14,8%, over the age of 70 years – in 18,3%. In the majority of cases the tumor located in rectum (67%), then in sigmoid – 9,6%, in downstream parts of the large bowel – 6,1% and less in transverse section – 0.9%. Patients with early stages of tumor development (T1-2N0-1M0) constituted only 9,1%. In 67,3% of patients established locally advanced process, 23,6% had distant metastases. Metastases often observed in liver (42,3%) in liver and lung (23,1%), in peritoneum (19,2%) and less in skeletal bones and distant lymph nodes. Intestinal obstruction was observed in 17,4% of patients, intestinal bleeding – in 5,2%.

Conclusion. The most frequent localization of colorectal cancer is in straight line, then in sigmoid colon and in cae¬cum. Peak of morbidity occurs in the age of 50-69 years (46,9%). In the primary appeal for medical assistance 89,1% of patients had locally advanced (67,3%) or generalized (21,8%) process.

EFFECTIVENESS OF REHABILITATION OF SURDUSPEDAGOGICAL SCHOOL-AGE CHILDREN WITH SENSORINEURAL HEARING LOSS COMBINED WITH CEREBRAL PALSY

*OchilzodaA.A., **SolievaM.S.

EFFECTIVENESS OF REHABILITATION OF SURDUSPEDAGOGICAL SCHOOL-AGE CHILDREN WITH SENSORINEURAL HEARING LOSS COMBINED WITH CEREBRAL PALSY

*Khujand City Health Center number 2

**Sughd Regional Hospital, Tajikistan

Aim.Evaluating the effectiveness of surduspedagogical rehabilitation of sick children with sensorineural hearing loss in combination with cerebral palsy by modern methods of medical treatment, physical therapy action and serdusped- agogical rehabilitation methods, using stationary sound-amplifying device “Audio filter MT”.

Materials and methods. Were examined 75 children aged from 7 to 14 years for the period of 2009-2013 in the conditions of the Regional SurduslogicalCenter.In medical, psychological and pedagogical department of the City Health Center №2 of Khujand. Were studied 41 boys (54.6%) and 34 girls (45.3%). All the patients underwent complete otorhinolaryngological examination, hearing test using tone threshold and speech audiometry, examination of and neurological status, CT and MRI of the brain, EEG was recorded, REG, EchoECG, consulting of neurologist and ophthalmologist for evidence of cerebral palsy.

Results. The results of complex course of treatment have shown that school-age children has greatly improved the motor area, normalized muscle tone, increased Personal self-service skills, the children began to take on their own hands: toys, spoons, began to move with the help of outsiders. In the course of daily surduspedagogicalactivities children gradually began to try to repeat after the teacher uttered sounds, starting with the most simple articulatory.

Conclusion. An effective surduspedagogical rehabilitation of school-age children with sensorineural hearing loss in combination with cerebral palsy is achieved by using a complex of medical treatment and new physiotherapy treatments with simultaneous surduspedagogical classes using stationary sound-amplifying device “Audio Filter-MT.”

FAMILY PLANNING AND DEVELOPMENT OF CONTRACEPTION AID TO POPULATION OF REPUBLIC OF TAJIKISTAN

*Muhamadieva S.M., **Pulatova A.P.

FAMILY PLANNING AND DEVELOPMENT OF CONTRACEPTION AID TO POPULATION OF REPUBLIC OF TAJIKISTAN

*Department of Obstetrics and Gynecology of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan »

**State Establishment “Scientific-Research Institute of Obstetrics, Gynecology and Perinatology”

Aim. Explore stages of family planning service development and particulars of contraception aid to population of Republic of Tajikistan.

Materials and methods. Normative and legal documents, annual reports of reproductive health centers, materials of science conferences and historic statements were analyzed.

Results. In this article, the historical data on development of contraception aid in Tajikistan for the past 25 years were presented. It is established that first specialized state consultations on family planning in country were organized in 1990 as “Family Health Consultation”. Then, the Reproductive Health Centers were created, new reporting forms were developed, legal acts revised, the specter of contraception has widened and the contraception behavior of population has changed; the contraception coverage has grown more than for twice and even more (34,6%), the changes occurred in training and re-training of cadres. Conclusion. In 25 years, there have been significant changes in expansion of access to contraception service sand the leading role of the Centers of reproductive health in improvement of reproductive health of population, solution of demographic, social and medical problems in decrease of maternal death in the country has been identified.

THE IR SPECTROSCOPIC METHOD OF DIAGNOSTICS OF ENDOTOXEMIA IN CRITICAL CONDITIONS.ADVANTAGES AND PROSPECTS.

Muradov A.M., Tuychiboeva M.N., Shumilina O.V.

THE IR SPECTROSCOPIC METHOD OF DIAGNOSTICS OF ENDOTOXEMIA IN CRITICAL CONDITIONS.ADVANTAGES AND PROSPECTS.

Department of Efferent Medicine and Intensive Care of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.By a method of molecular IR spectroscopy to receive the IR spectra of blood, depending on the degree of intoxication in patients with endotoxemia. Conduct a comparative analysis with other known methods from the viewpoint of efficiency, informativity, reliability, availability, affordability and to determine application prospects.

Materials and methods. Materials were blood samples of patients with endotoxemia which were exactly confirmed by conventional biochemical studies. Were determined indicators of toxicity of blood plasma: bilirubin, creatinine, leukocyte index of intoxication average molecules paramentsit test, necrotic bodies, circulating immune complexes, total and effective albumin concentration index of intoxication.

IR spectra were recorded using molecular infrared spectroscopy. Obtained data were compared with the standard measurements.

Results. In patients with endotoxemia is observed intensification of lipid peroxidation, immunosuppression, decreased antioxidant protection and detoxification ability of the organism. This is confirmed by corresponding changes in homeostasis and toxicity. Their dynamics are correlated with the stages of endogenous intoxication. IR spectra of healthy and diseased of endotoxemia significantly differ from each other in form, intensity, position of the peak frequency of the individual bands, relative to the stretching vibrations of -OH and -NH groups and to the stretching vibrations of -CH group and on the integral intensity. These changes are characteristic features and are distinguished between different nosologies in critical conditions and correlate with integral indicators of toxicity.

Conclusion. The method of molecular IR spectroscopy is the most efficient, non-traumatic, clear and informative. At diagnostics of endotoxicosis in critical conditions in the early stages of the disease consider it appropriate to supplement traditional biochemical research by data analysis of IR spectra of blood of patients.

EXPERIENCE OF NOVOSALIK USING IN THE TREATMENT OF ECZEMA

*Kasymov O.I., **Ahmedov F.A., *Kasymov A.O.

EXPERIENCE OF NOVOSALIK USING IN THE TREATMENT OF ECZEMA

*Department of Dermatology and STIs of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

**Department of Pharmacy of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim.To study the efficiency of Novosalik in the treatment of eczema.

Materials and methods. The study included 48 patients with eczema aged from 16 to 73 years, with duration of the disease from a few months to 20 years or more. There were 20 men, 28 women, ratio 1:1.4. The age of patients ranged from 16 to 64 years. 8 patients were aged between 16 and 19 years (m – 3, w – 5), from 20 to 29 years – 10 (m – 5, w – 5), from 30 to 39 years old – 12 (m – 5, w – 7), from 40 to 49 years – 8 (m – 4, w – 5), from 50 to 59 years – 5 (m – 3, w – 4), 60 years and older – 5 (m – 2, w – 4). Methods: clinical, statistical, microscopic.

Results. So, itching as the main subjective symptom of eczema in the main group, began to weaken from an average after 3-4 days of treatment, in the control group – after 4-5 days, stopped completely in most patients of the main group to an average of 8-9 day, in all patients – to 12-13 day, in the control group – respectively 11-12 and 14-15 days. Blanching of erythema and edema reduction in the study group began with an average after 3-4 days, their complete disappearance occurred in an average of 15-16 day, in the control group – respectively to 5-6 days and 18-19 days. Infiltration of the skin lesions in patients of the main group began to decrease an average from 6-7 days, fully resolved – to 11-12 day, in the control group – from 8-9 and 14-15 days. Rejection of crusts and scales was from 4-5 days of therapy, culminating in an average to 7-8 day, in the control group – to 6-7 and 10-11 days.

Conclusion. Our studies have shown high efficiency of complex treatment of eczema with Novosalik. Clinical recovery and significant improvement were achieved in 75% of patients, the traditional treatment – only in 60% of patients.