Вестник Института последипломного образования в сфере здравоохранения Республики Таджикистан

THE DEPENDENCE OF THE INDICES OF CENTRAL HEMODYNAMICS AND SYNDROME OF ENDOGENOUS INTOXICATION FROM ABDOMINAL PRESSURE IN TERMINAL STAGE OF PERITONITIS
06.05.2015

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.
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ULTRASOUND DIAGNOSTICS THYROID PATHOLOGY IN CHILDREN AND ADOLESCENTS
06.05.2015

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.
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COMPARATIVE EVALUATION OF EFFICIENCY APPLICATION OF MODERN METHODS OF DIAGNOSTICS TOXIC BLOOD COMPONENTS DURING ENDOTOXEMIA
06.05.2015

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
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PERFORMANCE EVALUATION DIAGNOSTIC CENTERS AT THE PRESENT STAGE
06.05.2015

SAFAROV Z.SH., AHMEDOV A. A., SAFAROVA T.M.
NDC MPH RT
DEPARTMENT OF PUBLIC HEALTH, ECONOMY AND MANAGEMENT BY PUBLIC HEALTH WITH COURSE OF THE MEDICAL STATISTICS TIPGPMP
At the present stage of development the aim of the health system is the organization of qualita¬tive models of infrastructure and management schemes. In the given aspect the most urgent health problem is to build a high-quality system of medical care. The article summarizes the results of the situational analysis of medical activities and evaluation of diagnostic services at the present stage in the conditions of state financing and transition to full cost accounting in the Republic of Tajikistan. Analysis of normative-legal documents showed that of 2866 institutions of primary health care 3,8% of them are represented by the district and city health centers, 26,5% of rural health centers, 10,8% in the specialized outpatient centers, 58,9 per cent – houses of health. Analysis of the equipment of the medical equipment in the period 1990-2011, showed that mostly diagnostic equipment prevailed in medical-preventive institutions, Dushanbe and Sughd regions (25,4% and 23,8%). On the balance of research institutions, Republican specialized hospitals and centres, it amounted to 19,9%. Oth¬er administrative territories of the Republic of equipment diagnostic equipment was significantly lower. Analysis of the activity of the services on provision of diagnostic help to the population of the Republic of Tajikistan in the modern socio-economic conditions showed that the main factors in the development of diagnostic centers and efficiency of delivered medical assistance are: good governance, improving financing with the purpose of modernization, improvement of quality and successful use of personnel and technological potential.
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STUDY OF THE IMPLEMENTATION OF NATIONAL STANDARDS FOR ANTENATAL CARE FOR PREGNANT WOMEN
06.05.2015

SAMADOVA G.A., MULLOEV A.M., DODOBAEVA B.S.
THE DEPARTMENT OF NURSE WORK IN FAMILY MEDICINE TIPGPMP
DEPARTMENT OF PUBLIC HEALTH, ECONOMY AND MANAGEMENT BY PUBLIC HEALTH WITH COURSE OF THE MEDICAL STATISTICS TIPGPMP
Over the past two years the birth rate in the Republic of Tajikistan ranged 29,3-by 28,7 per 1,000 popu¬lation. Along with high fertility, maternal mortality was 45,0 is 37,0 per 100,000 liveborns, the main reasons for which 25% of the cases considered bleeding, 15% and 12% – gynecological infections and eclampsia. The picture presented defined the purpose of the present research is to study the indicators of National standards of antenatal care for pregnant women with an analysis of the correlation between them. Under the supervision were 72 pregnant women aged from 17 to 40 years of age, living in one of the areas with a population of 1722 person. Analysis of work of specialists in antenatal care among women up to 12 weeks of pregnancy showed that only 47,2% of the total number of timely addressed to specialists and were taken to the dispensary registration. In the later stages of pregnancy 52,8% of women with repeated pregnancies are under dispensary observation. The majority of women in a timely manner became the dispensary reg¬istration pregnancy, were the original inhabitants of the area under study. The reason of late treatment of women with a long pregnancy, with a view to their taking on dispensary account that is linked with the arrival of hard-to-reach areas of the Republic. The obtained results allow to predict the state of pregnancy and timely to organize a correction of care for prevention of possible antenatal complications.
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INFLUENCE OF MELDONY ON CARDIOTOXITY OF DOXORUBICINE IN PATIENTS WITH ACUTE LEUKEMIAS
06.05.2015

RASULOV U.R., SHARIFOV M.M., SHAMSOV A.T., KHASANOV D.M., RAKHIMOV B.R., SUN’ATULLOEV D.S.
THE DEPARTMENT OF THE INTERNAL DISEASES №3 TSMU BY NAME ABUALI IBN SINA THE DEPARTMENT OF THERAPY WITH COURSE OF THE ENDOCRINOLOGY TIPGPMP
Acute leukemia, as a rare disease, is only 3% of human malignancies. The aim of treatment of acute leukemia is eradication of leukemic clone restore normal blood, achieveming long-term disease free survival of patients. This is achieved through the use of myelotoxical anticancer drugs that cause deep aplasia haemopoesis. In the present
paper summarises the results of the antitumor antibiotic antratcycline stimulants doxorubicin, with a joint appointment cardioprotector meldony. Under the supervision were 147 patients with acute leukemia. Among the observed patients 85 people received chemotherapy initially, 62 people – previously been subjected to chemotherapy effects. For the induction of remission patients of the 1st group was appointed polychemotherapy by the scheme “7+3”. Patients in group 2 received similar polychemotherapy together with cardioprotector Mildronate. During the treatment of patients of group 1 in 32% of cases were observed sinus tachycardia, atrial and ventricular arrhythmia, changes in segment ST, 7% of cases developed a complete atrioventricular block that shows the development of early cardiac toxicity of doxorubicin. In 19,04% of cases in patients of group 2 were observed ventricular tachycardia, and changes in segment ST.
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THE DEPENDENCE OF THE INDICES OF CENTRAL HEMODYNAMICS AND SYNDROME OF ENDOGENOUS INTOXICATION FROM ABDOMINAL PRESSURE IN TERMINAL STAGE OF PERITONITIS
06.05.2015

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.
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DEATHS FROM RESPIRATORY DISEASES IN THE REPUBLIC OF TAJIKISTAN
06.05.2015

MURADOV A.M., YAKUBOV M.R.
THE DEPARTMENT OF EFFERENT MEDICINE AND INTENSIVE THERAPY OF TIPGPMP
Diseases of respiratory organs are in the lead in the overall morbidity of the population, taking 1st place in the structure of primary morbidity worldwide and deaths from which is on the 4th place in the overall structure of death after circulatory diseases, injuries, poisoning and cancer. In work the analysis of indicators of mortality from respiratory diseases in the Republic of Tajikistan for the period 2000 to 2010. It is revealed, that in structure of total mortality from diseases 2010 diseases occupied the 4-th rank place, after malignant neoplasms. As a result of statistical analysis revealed a trend towards increased mortality among people of working age. This situation is explained by the fact that the majority of persons of working age due to fear of job loss, despite not feeling well, continue to work and this leads to late start of therapy and adherence complications. In 2002, the mortality from pneumonia in the Republic remained at a high enough level that is connected with late referral for medical care, medical errors in diagnosis of the disease and inadequate selection of therapy. The second by frequency of mor¬tality in 2002 followed acute respiratory infections of the upper respiratory tract. Based on the structural analysis of deaths from chronic lower respiratory disease, States that the greatest contribution to the formation of this indicator belong mortality from bronchitis, asthma and other respiratory diseases affecting mainly the interstitial tissue.
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TREATMENT AND PREVENTION OF VIRAL INFECTIONS WITH THE USE OF INTERFERON INDUCTORS
06.05.2015

MIRZOYEVA Z.A., KHISOMOVA KH.K.
THE DEPARTMENT OF FAMILY MEDICINE TIPGPMP
Today viral infections are the leading cause of morbidity worldwide, the role of which in the overall morbidity will only increase. Recently in the treatment of viral infections extensive use of immunomodulators, the range is constantly expanding. The most promising drugs in the given as¬pect are interferon inducers. The article presents the results of studies of prophylactic effectiveness and treatment of acute respiratory viral infections interferon inducers of 150 patients aged from 1 month to 17 years. The results obtained showed that anaferon having a pronounced curative and prophylactic efficiency of the flu, when before vaccine period increases the functional activity of specific antibodies that reduce the intensity of morbidity. The ability of the drug to reduce the number of bacterial complications allowed authors to effectively apply anaferon in the treatment of viral infections in children with secondary immunodeficiency condition. The inclusion of anaferon in the standard therapy of acute intestinal virus infection in children significantly reduced the duration of the main symptoms of the disease.
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ULTRASOUND DIAGNOSTICS THYROID PATHOLOGY IN CHILDREN AND ADOLESCENTS
06.05.2015

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.
Read more