Вестник Института последипломного образования в сфере здравоохранения Республики Таджикистан

DIAGNOSIS OF BRONCHIAL ASTHMA IN FAMILY DOCTOR’S PRACTICE
11.01.2016

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.
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EFFECTIVENESS OF DIAGNOSTICS AND TREATMENT OF MULTIDRUG RESISTANT FORM OF TUBERCULOSIS
11.01.2016

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
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INTERVENTIONAL METHOD OF ANESTHESIA ON INOPERABLE PATIENTS WITH STOMATOLOGICAL CANCER
11.01.2016

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…
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THE PREVALENCE AND FEATURES OF FORMATION OF THE HEROIN ADDICTION OF FEMALE BY RESULTS OF ANONYMOUS QUESTIONNAIRE POLL AMONG SOCIALLY VULNERABLE STRATA OF THE POPULATION OF REPUBLIC OF TAJIKISTAN
11.01.2016

Aim. The revelation of the true picture of prevalence and features of formation of heroin addiction of female in Republic of Tajikistan rose as an object of this paper.
Materials and methods. Carried out an anonymous questionnaire poll among 4077 women from the group of socially vulnerable strata of the population of Republic of Tajikistan. The number of the urban inhabitants made up 2065 women and village – 2012.
Results. Revealed that among the urban respondents in comparison with urban the beginning of sexual life and early attaching to consumption of a drug, less duration conjugal bonds, few children, at the same time greater narcology aid appeal ability is marked, that on the present is caused by availability by the specialized narcology aid in the city.
Conclusion. On account of sparsity of the voluntary applying for narcology aid a just picture of prevalence and feature of heroin formation of the drug addiction among the people of female remains unsufficiently investigated. The lack of some essential distinctions in the social – hygienic factors of development and clinical factors of narcomonia among the questionnaire poll of the urban and village inhabitants dictates the necessity of realization of more extended research among vulnerable strata of the population in Republic of Tajikistan with a purpose of revealing a just picture of heroin dependence.
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REIEW OF BISOPROLOL EFFICIENCY IN CARDIOVASCULAR DISEASES THERAPY
30.10.2015

Narzullaeva A.R., Shohzodaeva Z.O., Sharipova F.

REIEW OF BISOPROLOL EFFICIENCY IN CARDIOVASCULAR DISEASES THERAPY

Department of Cardiology with the course of clinical pharmacology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Considering the pathophysiological and etiopathogenetic preconditions purpose of beta-blockers in cardiovascular diseases, as well as their ability to improve health and life prognosis of patients with very high cardiovascular risk, the review covered issues of bisoprolol application in the treatment of cardiovascular diseases. After analyzing of its clinical pharmacology have been provided evidence from randomized controlled studies that show its high efficiency and safety in the pharmacotherapy of diseases such as hypertension, coronary heart disease, chronic heart failure. Bisoprolol has a strong cardioprotective effect. Different by minimal side effects, metabolic neutrality, and positive influence on prognosis of cardiovascular diseases. High-P1-selectivity of bisoprolol make safe its application in patients with chronic obstructive pulmonary disease and metabolic disorders as well as opens up the possibility of its use in patients with underlying liver and kidney function without correction dose of drug. Debated question of the application of this drug for the treatment of cardiovascular disease in pregnant women and nursing. In addition, pharmacokinetic characteristics contribute to high adherence and does not degrade the quality of life of patients with various diseases of the cardiovascular system. Regular and long-term treatment of hypertension, angina, chronic heart failure with bisoprolol leads not only to reduce blood pressure to target levels, organoprotective effect, reduce the frequency of angina attacks and symptoms of heart failure, but also a substantial reduction of serious complications, thereby improving the health and life prognosis of patients, increasing their life span.
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CLASSICAL ANTHROPOLOGY (EXPERIENCE OF CONSTRUCTION OF SYSTEM THEORY)
30.10.2015

Muzaffari M., Zokirov R., Safarov N.

CLASSICAL ANTHROPOLOGY (EXPERIENCE OF CONSTRUCTION OF SYSTEM THEORY)

Course of Philosophy of Medicine and Medical Anthropology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Analysis and definition of “anthropology” as the source and the base term with categorical status for building system theory of classical anthropology.

Results. In the comparative analysis and the definition of semantic and shades of meaning other synonymous concepts were identified and established the classical meaning of the term “anthropology”. In the course of the study anthropology estimated as total integrative and interdisciplinary science about human. Different directions of anthropology, in essence, do not study the nature of the person but the results of his activities. Thus different directions of anthropology, cultural type, “social” and the like, are not anthropological sciences.

Conclusion. A result of analysis defined the semantic content of the classical concept of “Anthropology” and shows its relation to other equivalent concepts that express human’s nature.
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SPECIFIC FEATURES OF COURSE OF DRUG ALLERGY
30.10.2015

Akbarova M.M., Juraev M.N., Karimova N.I.

SPECIFIC FEATURES OF COURSE OF DRUG ALLERGY

Department of Allergy and Immunology of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Over last three years in the City Allergological Center 5 cases of Lyell-Langs syndrome were observed. This emergence is associated with the use of drugs. Uniqueness of this incident is the combination of heavy drug allergy with insect allergy and diabetes mellitus. Monitoring of condition of the patient by place of residence was held.
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MODERN ASPECTS OF ANTIPHOSPHOLIPID SYNDROME. INFLUENCE OF EXOGENOUS RISK FACTORS OF THROMBOSIS IN THE ANTIPHOSPHOLIPID SYNDROME.
30.10.2015

Holova Z.U., Ahunova N.T., Sharipov H.S.

MODERN ASPECTS OF ANTIPHOSPHOLIPID SYNDROME. INFLUENCE OF EXOGENOUS RISK FACTORS OF THROMBOSIS IN THE ANTIPHOSPHOLIPID SYNDROME.

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

Aim.Studying of the relationship between thrombosis, their recurrence and exogenous risk factors in APS.

Materials and methods. The study included 80 patients (63 women and 17 men). They were divided into 3 groups: 1-22 patients with systemic lupus erythematosus (SLE), 2-30 patients with SLE and APS, 3-28 patients with primary APS. All patients were interviewed by a specially designed map Fiscal registrar (FR). Also assessed the impact on development of thrombosis treatment with corticosteroids and cyclophosphan.

Results. As the prevalence of exogenous risk factors (abuse of fat and fried food, coffee, alcohol) group of patients were not significantly different. The connection of these FR with a history of thrombosis was not found. Physical inactivity was the most characteristic of patients with APS (23,1% compared with 10,7% of patients with SLE without APS), a greater number of patients with APS are marked the excessive body weight (38%). In patients with primary APS percentage of smokers was higher, however, the influence of smoking on the development of thrombosis was not revealed. The direct correlation of the presence of occlusion with the intake of corticosteroids and cyclophosphamide method dopplergram vessels. By the method of vascular dopplerography the direct connection between the presence of occlusion with the intake of corticosteroids and cyclophosphamide was found.

Conclusion. The risk factors of venous thrombosis in patients with APS (primary and secondary) are obesity and glucocorticosteroids.
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ADVANTAGE OF ROD OSTEOSYNTHESIS IN PATIENTS WITH COMPLEX OPEN FRACTURES OF FEMORAL BONE
30.10.2015

Sirodzhov K.H., Isupov Sh.A., Holov D.I., Boymurodov A.N.

ADVANTAGE OF ROD OSTEOSYNTHESIS IN PATIENTS WITH COMPLEX OPEN FRACTURES OF FEMORAL BONE

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

Aim.Optimization of surgical treatment of open fractures of the femur with concomitant injury.

Materials and methods. The results of diagnosis and treatment of 87 patients with combined open fractures of the femur were analyzed. Patients were divided into2 groups: the main group resorted to early stable fixation of long bone fractures external fixation device (EFD) on the first day. In the control group osteosynthesis produced in delayed and planned manner.

Research methods: radiography, computed tomography, ultrasound examination of organs, clinical and laboratory research. To determine the severity of injuries and status of patients, the degree of shock, blood loss volume and other vital violations the objective point scale assessments were used.

Results. Stabilization of fractures of the femur EFD conducted in all cases amid continuing anti shock measures or after appropriate infusion-transfusion therapy and improve the overall condition of the victims. By using of optimized surgical treatment of open fractures of the femur at combined injury good results established respectively in 27 (29,9%) and 18 (20,7%), satisfactory – in 11 (12,6%) and 19 (21,8%) and unsatisfactory – in 3 (3,4%) and 9 (10,3%) patients.

Conclusion. Considering the low traumatism and how antishockeventt, early osteosynthesis of open fractures of the femoral EFD performed independently from the severity of the victim, making the patient transportable. This method helps to normalize the function of important organs, reducing early-threatening complications and verticalization of the patient.
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MEDICAL-SANITARY SERVICE OF TAJIK RAILWAY: ACTUAL AND UNSOLVED PROBLEMS
30.10.2015

Rustamov S.G.

MEDICAL-SANITARY SERVICE OF TAJIK RAILWAY: ACTUAL AND UNSOLVED PROBLEMS

Department of Public Health, Economics and Management with a course of medical health statistics of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Road Hospital of medical-sanitary service SUE “Tajik Railway”, Dushanbe

Aim. Determination of actual and unsolved problems in the activity of medical-sanitary service of Tajik Railway (TRW)

Materials and methods.Analyzed the materials of archive department of the State Unitary Enterprise “RohiOhaniTojikiston” and statistical office of his medical-sanitary service.

Results. In 2014, to the road hospital polyclinic on station Dushanbe-1 addressed 57 226 people. Pre-trip check¬ups of TRW locomotive crews performed by 7 feldsher stations with total number of inspections more than 2500 per year. The highest level of morbidity with temporary disability per 100 employees among the employees of passenger service – 13,3 cases and 219,7 days, locomotive service – 8,9 cases and 211,1 days, wagon service – 7,3 132,3 cases days. Indicator of dispensary observation amounts 141,3 per 1000 people. Primary disability decreased over the past 5 yearsfrom 4 to 2.9 per 1000 workers. Mortality rate over the last 5 years slightly increased – from 1 to 1,7 per 1000 workers.

Conclusion. At the present time in the railway health system of Tajikistan the appropriate infrastructure was created, but there is a number unresolved issues. In the presence of appropriate financing and special education is possible to extend preventive and rehabilitative directions of service activity. It will allow improving of health status of railway workers
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