Вестник Института последипломного образования в сфере здравоохранения Республики Таджикистан

FAMILY PLANNING AND DEVELOPMENT OF CONTRACEPTION AID TO POPULATION OF REPUBLIC OF TAJIKISTAN
28.10.2015

*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.
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THE IR SPECTROSCOPIC METHOD OF DIAGNOSTICS OF ENDOTOXEMIA IN CRITICAL CONDITIONS.ADVANTAGES AND PROSPECTS.
28.10.2015

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.
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EXPERIENCE OF NOVOSALIK USING IN THE TREATMENT OF ECZEMA
28.10.2015

*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.
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TO THE ISSUE OF PATHOGENESIS OF ALOPECIA AREATA
28.10.2015

**KasymovO.I., *Ahmedov А.А., **KasymovA.O., ***RahimovaT.P.

TO THE ISSUE OF PATHOGENESIS OF ALOPECIA AREATA

*Department of Public Health, Health Economics and Management with the course of Medical Statistics of the State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

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

*** Republican Diagnostic Centre

Aim.To study the content of pro-inflammatory (IL-1p, IL-6, IL-8 and TNF-а) and anti-inflammatory (IL-10) cytokines in serum of patients with alopecia areata.

Materials and methods. Examined 62 patients, of whom 35 (56,5%) – men, 27 (43,5%) – women (ratio 1.2: 1) aged from 15 to 46 years old. Methods: clinical, statistical, microscopic.

Results. It is established that patients with alopecia areata observed an inflammatory process that leads to an imbalance between pro-inflammatory and anti-inflammatory cytokines. The content of cytokines depended on the process severity. The more hair is damaged, the more TNF-а and IL-1p and the less IL-10 produced. Levels of proinflammatory and anti-in¬flammatory cytokines depends from severity of the process and the amount of serum pro-inflammatory TNF-а and IL-1p was proportional but anti-inflammatory IL-10 – inversely proportional the severity of the disease, i.e., as more the hair coat degree pronounced so much larger production of TNF-а and IL-1p and less production of IL-10.

Conclusion. In the serum of patients with alopecia areata observed hyperproduction of proinflammatory cytokines, which involves the use of promising of anticytokine drugs in the therapy patients with focal hair loss.
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CHANGE OF THE LEVEL OF MARGINAL PENETRATION OF FILLING MATERIALS DEPENDING OF INDIVIDUAL CARIESRESICTANCE
28.10.2015

Gurezov M.R., Nurov D.I., SultonovM.Sh.

CHANGE OF THE LEVEL OF MARGINAL PENETRATION OF FILLING MATERIALS DEPENDING OF INDIVIDUAL CARIESRESICTANCE

Society with limited liability “Eurodent”

Department of Therapeutic Dentistry of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Determine the level of marginal penetration of filling materials depending from the resistance of tooth.

Materials and methods.Examined 323 persons among which were found 523 fillings: 480 from composite, 13 – from amalgam, 30 – from cements. Under clinical observation in dynamics were 123 patients. Depending of the using during the treatment of caries of facilities these patients were divided into 8 subgroups: 4 subgroups with low and middle levels of intensity of caries and 4 subgroups with high and very high levels of intensity of caries. In subgroups with low and middle levels of intensity of caries as a pickling agent was used 10% maleic acid, in second subgroup additionally performed postfilling fluoridation; in third and fourth subgroups enamel was pickled with 35% phosphoric acid, in fourth subgroup additionally performed postfilling fluoridation.

Results.Established that at a low level of resistance the choice of pickling agent and application of postfilling fluorination authentically influence at the marginal penetration of the fillings and their clinical condition. A year after the imposition of fillings in patients with low and middle level of resistance their safety is 97,6% and the indicators of marginal penetration while using different pickling agents and postpfillings fluorination not different. In a group of patients with high and very high levels of intensity of caries after a year 91,4% of fillings were retained 8,6% – considered “unacceptable”, a significant increase of disturbance of marginal adaptation of fillings are found in the case of 35% phosphoric acid in all periods of observation.

Conclusion. After filling of carious cavities using fluorine compounds helped to reduce marginal penetration of fillings in the early period of observation.
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RISK FACTORS OF OFTEN ILL CHILDREN BORN WITH LOW, VERY LOW AND EXTREMELY LOW BIRTH WEIGHT
28.10.2015

Buzrukova N.D., Mahkamov K.K.

RISK FACTORS OF OFTEN ILL CHILDREN BORN WITH LOW, VERY LOW AND EXTREMELY LOW BIRTH WEIGHT

Department of Neonatology of State the Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim. Measure the health status of babies born with low and extremely low birth weight, during the recovery period.

Materials and methods. Under observation were 56 often ill children who were born prematurely. Often ill children – children who suffered from respiratory infections more than 5-6 times a year. Babies were divided into 3 groups according to body weight at birth. The first group consisted of 8 babies, born with extremely low birth weight. The second group consisted of 16 babies, born with very low birth weight and the third group consisted of 32 babies, born with low birth weight.

During the research was an analysis of data on the health status of mothers during their pregnancy and childbirth; the health status of babies in the recovery period of life; the results of clinical, biochemical, bacteriological and tool methods of research.

Results. It has been established the influence of ante- and intranatalis factors on the severity of the health status of LBW babies in acute and recovery period, that it is need to enter LBW babies into a special group of risk on various pathologies, performance of certain diagnostic and treatment activities at the level of specialized departments.

Conclusion. This paper presents a material that reflects aspects of birth and the health status of premature babies. Course of pregnancy, high infection index and various of extragenital diseases can cause premature birth and the birth of a sick child. LBW babies during the first year of life constitute a contingent of often ill children. They need to be select at-risk for the development of various pathologies and to adopt certain diagnostic and treatment activities.
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AN ELECTROMETRIC ESTIMATION OF MARGINAL ADJOINING OF COMPOSITE FILLING MATERIALS DEPENDING FROM THE WAY OF ISOLATION OF THE WORKING FIELD
28.10.2015

*Ashurov G.G., **Sadikov F.O.

AN ELECTROMETRIC ESTIMATION OF MARGINAL ADJOINING OF COMPOSITE FILLING MATERIALS DEPENDING FROM THE WAY OF ISOLATION OF THE WORKING FIELD

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

**Society with limited liability “Eurodent”

Aim. Estimation of the condition of marginal stability of composite filling materials depending from the way of isolation of the working field and combined influences of the way of curing of the filling material, vitality of pulp, level caries of the teeth.

Materials and methods. Work is based on analysis of results of the survey of 152 patients, among which 92 woman, 60 man. During the operative-reconstruction therapy of the carious teeth 26,3% formed molars, premolars – 22,7%, incisor and canines – 51,0%. In 40% of cases filling of the teeth produced with relative isolation of the working field by cotton roller (first group), in 60% with absolute when use rabberdam (second group). About uncomplicated caries were filled 66,7% of teeth, complicated caries 33,3%. Patients with low clinical level of resistance to caries were treated in 40% cases, with average level of resistance in 60%. Marginal adjoining of fillings was assessed by the scale of R. G. Buyankina, where the index of the amperage less than 2 mkA matched a normal residual marginal penetration of high-quality fillings, 2,1-5,2 mkA – infringement of marginal adjoining without the development of secondary caries.

Results. While isolating teeth with chemically hardening materials cotton roller the current at the end was 1,31±0,04 mkA and was lower by 1.2 times than in the isolation of the working field by rubberdam. A year later, opposite, the electrical conductivity at absolute isolation was 1,85±0,09 mkA, which was much lower by 14.4% than at a relative using cotton roller. Marginal adjoining of light-cured composites with rubberdam isolation was better immediately after the restoration, also the immediate and long-term periods of research, compared to chemical hardening materials.

Conclusion. In teeth with uncomplicated caries amperage were realistically below at the average on 12,2%, than when recovering of depulpited teeth. After 1,5 year in the second group patient with absolute insulation of vitally teeth average importance of conduction formed 1,55±0,08 мкА and was less in 1.5 times, than when work with cotton’s wool platen.
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INFLUENCE OF LATREN ON RHEOLOGICAL PROPERTIES OF BLOOD IN PATIENTS WITH ACUTE DESTRUCTIVE PANCREATITIS
28.10.2015

*AhmedovF.A., **HamidovD.B., SaidovH.Sh., AkramovR.A.

INFLUENCE OF LATREN ON RHEOLOGICAL PROPERTIES OF BLOOD IN PATIENTS WITH ACUTE DESTRUCTIVE PANCREATITIS

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

**Department of Anesthesiology and Reanimatology of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Studying of influence of Latren on rheological properties of blood in patients with acute destructive pancreatitis.

Materials and methods.Examined 62 patients with acute destructive pancreatitis at the age from 20 to 83 years. Patients were divided into 2 groups depending from the integrated into the program of infusion therapy with a solution of Latren.

Rheological properties of blood were studied by determining relative viscosity of the blood by viscometer VK-4, hematocrit, fibrinogen and erythrocyte sedimentation rate by standard methods.

Results. In patients with acute destructive pancreatitis after incorporated into the program of infusion therapy of Latren (main group) there is a considerable improvement of the rheological properties of blood, compared with a control group who received crystalloid and colloids.

Conclusion. In patients with acute destructive pancreatitis occurs a considerable violation of the rheological properties of blood. Inclusion of Latren into the program of infusion therapy in patients with acute destructive pancreatitis promotes correction of violations of the rheological properties of blood, compared with the results of the group of patients who did not receive the drug.
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MAIN RESULTS OF INVESTIGATION ON STUDIES OF THE INITIAL INDICATORS OF PARODONTOLOGICAL STATUS IN PATIENTS WITH SOMATIC DISEASES
28.10.2015

Amindjanova Z.R., Ismoilov A.A., Karimov S.M.

MAIN RESULTS OF INVESTIGATION ON STUDIES OF THE INITIAL INDICATORS OF PARODONTOLOGICAL STATUS IN PATIENTS WITH SOMATIC DISEASES

Department of Therapeutic Dentistry of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Study of the initial indicators of parodontological status in patients with disadvantage somatic background.

Materials and methods.Organized complex examination of the dentistry status among 936 somatic patients with duration of the disease from 1 to 10 years and more. Control group consisted of 103 practically healthy persons of the same age with dentistry pathology. Out of the total amount of examined persons 41% patient had pathology of gastrointestinal tract, 33% – of cardiovascular system, 26% patient – endocrine systems pathology. To the detailed analysis following leading indexes were subjected: prevalence of periodontal disease; increase in prevalence and intensity of periodontal disease; structural analysis of the constituent elements of the periodontal status; increase and reduction of the constituent elements of periodontal index.

Results. Installed that in group of somatic patients with protractedly accompanying pathology up to 3 years amount of revealed persons with heavy degree of diffuse parodontitis is significantly lower. High defeat of parodontitis with

heavy degree of the inflammation existed at protractedly accompanying somatic pathology up to 5 and 10 years. Among patients suffering somatic pathology more than 10 years, opposite, prevalence of heavy forms of parodontitis was significantly lower.

Conclusion. Amongst examined patients important particularity of parodontal’s pathology is quick progressive of inflammatory process in nearteeth tissue, as evidenced the average values of high frequency of the parodontitis of light, average and heavy form.
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EARLY DETECTION OF DYSPLASIA OF THE HIP JOINTS OF CHILDREN IN THE PRACTICE OF FAMILY DOCTORS
28.10.2015

AbdulhaevaSh.R., Mirzoeva Z.A., Nazirova N.K., ShodievaSh.K., Sharipov I.G.

EARLY DETECTION OF DYSPLASIA OF THE HIP JOINTS OF CHILDREN IN THE PRACTICE OF FAMILY DOCTORS

Department of Family Medicine of the State Education Establishment “Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan”

Aim.Early detection and implementation of adequate therapeutic measures CHD in newborns and children under one year through screening methods by family doctor on the basis of the City Health Center №1 of Dushanbe.

Materials and methods. During the monitoring period, 156 newborns were examined, of which 75 boys (48%) and girls – 81 (52%). During preventive examinations family doctor used screening methods to identify CHD. Methods: clinical, statistical – identification of congenital hip dysplasia in children.

Results. Screening established pathology in 38% of newborns. At girls pathology HD determined 4 times more often than at boys that is, girls accounted 80% (47), boys – 20% (12). Hemilesion encountered 2,3 times more often bilateral, accordingly 69% (41) and 31% (18). Thus the injury of the left hip joint was determined at 1.7 times more often than the right hip joint and accordingly was 63% (26) and 37% (15). The combination of positive methods detected in 83%, and usually limitations determined by a combination of breeding and asymmetry of skin folds. Test subjects with known positive techniques were consulted by an orthopedist, and then diagnosis of CHD has been confirmed in 87% of children. This again confirms relatively high sensitivity and specificity of application of these methods for early diagnosis of hip joint pathology in children in the first year of life in the practice of family doctor.

Conclusion. Thus, the use of special screening methods allowed family doctor in primary patronage of newborns and their dynamic observation to detect abnormalities of the hip joints, that has been confirmed after orthopedic examination in 87% of children. Early diagnosis through the application of simple methods of clinical diagnosis, which do not require extra costs, determines the effectiveness of timely initiated an adequate medical treatment and in the future prevention of complications and disability.
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