Вестник Института последипломного образования в сфере здравоохранения Республики Таджикистан

OPTIMISATION OF COMPLEX TREATMENT OF DAMAGES OF A SKELETON AT PATIENTS WITH A POLYTRAUMA
06.05.2015

SIRODZHOV K.KH., RAHIMOV A.T.
THE DEPARTMENT OF TRAUMATOLOGY AND ORTHOPEDICS TIPGPMP
The unsatisfactory results of complex treatment of skeletal injuries and injury outcomes in patients polytrauma testify to the social and economic importance. The paper analyzes the results of studying the peculiarities of the structure of multiple and associated injuries skeleton, ways to optimize the treatment of fractures on the basis of orthopedic «Damage control» of 30 trauma patients. In the structure of combined trauma of the skeleton in the 81,7% of cases, there were fractures of long bones, 36,3% – fractures of other departments, 21,3% – pelvic bones, in 5,3% of cases – fracture of the spine. Fractures of the long bones in 78,4% of cases were of indoor and 21,6% of cases – the open character. Methods of early reposition fractures in the study group used in 30,4% of the observations, delayed – 15,7%, and later – in 9,5% of cases. In the control group received digital values amounted to, respectively, of 15,4%, 11,4 per cent to 17,3 per cent. Fractures of long bones of victims of the main group in 51,8% of the observations used for conservative treatment, 48,2% – by various methods of osteosynthesis with the use of stable forms (36,5%) and methods of osteosynthesis with additional external immobilization (11,7%).
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EVALUATIONS OF NURSING OF CHILDREN WITH LOW BIRTH WEIGHT
06.05.2015

SAIDMURADOVA A.D., MAHKAMOV K.K.
DEPARTMENT OF NEONATOLOGY TIPGPMP
The evaluating of results of health surveillance and provided neonatal care bantam children, depending on body weight at birth, were divided into 5 groups. In the first group was composed of 11 children born weighing less than 1000 g, second – 62 children weighing from 1000 to 1490 gr., third – 112 children weighing from 1500 to 1999 gr., fourth – 200 newborns weighing from 2000 to 2499 gr., in the fifth group – 32 newborns weighing 2500 gr. The adequacy of resuscitation was directly dependent on birth weight. Resuscitative measures were timely and adequate most of un-derweight children studied groups. 2,1 often observed late start resuscitation in children weighing less than 1499gr. as a result of underestimating the doctor of the child and not a diagnosed chronic intrauterine hypoxia. Essential influence on a condition of a newborn provided incomplete volume resuscitation measures. 15,8% of children with very low body weight, born in severe asphyxia, were not conducted adequate ventilation of the lungs, tracheal intubation. The overwhelming majority of children of I-II groups in 91,1% of cases were examined неонатологом immediately after birth, in the III group accounted for 55,8% of at the appropriate values of 9,1% and 5,5% in the IV and V of the investigated groups. To increase the level of survival rate of underweight children must take into account many factors, ranging from the improvement of the quality of antenatal protection of the fetus to the improvement of medical, given their low readiness to extrauterine life.
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FORENSIC MEDICAL EXAMINATION OF THE DAMAGE, INFLICTED BY SLASHING WEAPON – TESHA
06.05.2015

RAKHMONOV T.R., RAKHIMOV A.ZH., TARAKUL A.
THE COURSE OF FORENSIC MEDICAL EXAMINATION TIPGPMP
The article contains results of injuries on four corpses of people at the age of 22 to 70 age, caused to the national instruments of labor produced artisanal – tesha. The attack does concave and direct blades. Just suffered 12 strokes, 8 of them on the head, 2 in the facial area, 2 in the back surface of the right hand. Concave blade coated with a 7 hits, direct – 5. After hitting measured the thickness of the soft tissue of the head and bones of the skull on average, the Department of wounds and/or a cut in the cases of penetration of the blade into the cranial cavity. Damage studied macro- and stereomicroscopically, photographed and put on the outline scheme. It is established that in the area of damage to the thickness of the skin ranged from 0,1 to 0,3cm, soft tissues of 0,1-0,2 cm bones of cranial fornix – 0,3-0,7 see the Wounds from direct blade when strictly per¬pendicular to the direction of impact to surface-to-injure area usually had the appearance of an irregular oval. When an inward-curving blade form of RAS was arched, which is the distinctive feature of the wounds inflicted by axes. In 8 cases the length of the wound to the head match the width of the blade, and obviously depends on the fact that if the mass of tesha from 620 to 710 g blade width her a little. The length of the wound does not exceed the width of the blade. It is revealed that the damage by tesha, have their own characteristics, allowing to distinguish them from injuries inflicted by other cutting tools, you can also determine the strength and direction of the shot, also the interrelationships between the victim and the attacker in the moment of injury.
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МИЛДРОНАТ® В КОМПЛЕКСНОЙ ТЕРАПИИ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА В УСЛОВИЯХ ВЫСОТНОЙ ГИПОКСИИ
06.05.2015

* 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.
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ANALYSIS OF THE ONE-YEAR MORBIDITY OF BREAST CANCER IN THE REPUBLIC OF TAJIKISTAN
06.05.2015

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.
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CLINICO-FUNCTIONAL FEATURES OF ARTERIAL HYPERTENSION AND ISCHEMIC HEART DISEASE IN THE PERIMENOPAUSAL PERIOD
06.05.2015

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..
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ASSESSMENT OF MEDICAL SERVICES DURING CONTRACEPTIVE AID
06.05.2015

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.
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INDICATORS OF DISABILITY ON TUBERCULOSIS IN TAJIKISTAN
06.05.2015

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.
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TRIOIN’S EFFECT ON CARDIOVASCULAR SYSTEM (EXPERIMENTAL WORK)
06.05.2015

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.
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DYNAMICS IMMUNOLOGICAL INDICES IN PATIENTS OF CHRONIC GENERALIZED PERIODONTITIS DURING THERAPY WITH MELLINOL
06.05.2015

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.
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