Category Archives: №2

REIEW OF BISOPROLOL EFFICIENCY IN CARDIOVASCULAR DISEASES THERAPY

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.

SPECIFIC FEATURES OF COURSE OF DRUG ALLERGY

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.

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

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.

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

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.

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

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

DIAGNOSIS AND CORRECTION OF FUNCTIONAL DISORDERS OF LIVER AND LUNG IN PATIENTS WITH SUBDIAPHRAGMATIC LIVER ECHINOCOCCOSIS

Rafikov S.R., *Mahmadov F.I., *Kurbonov K.M., *Rahimov A.R.

DIAGNOSIS AND CORRECTION OF FUNCTIONAL DISORDERS OF LIVER AND LUNG IN PATIENTS WITH SUBDIAPHRAGMATIC LIVER ECHINOCOCCOSIS

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

*Department of Surgical Diseases №1 of the Tajik Medical State University named after Abua- li-ibn-Sino

Aim.Improvement of results of treatment of subdiaphragmaticechinococcosis of liver and its complications.

Materials and methods. The present research is based on the analysis and treatment of 76 patients with hepatic echinococcosis of subdiaphragmatic location. The vast majority were persons older than 40 years. There were 33 males (43,4%) and 43 women (56,6%). Complicated forms of echinococcosis was observed in 63,1% (n=48) patients (abscess-27, a breakthrough in the bile way – 21).

Results.Echinococcosis of the liver accompanied by significant destruction of hepatocytes, a violation of indicators of the level of proinflammatory cytokines and nitric oxide, especially in the complicated course and subdi-aphragmatic location, indicating that altered functions of liver and lungs. With the growth of volume of hydatid cysts in the subdiaphragmatic space and in long-term course of the disease violated ventilation and gas exchange function of the lungs.

Conclusion. To patients with hepatic echinococcosissubdiaphragmatic localization advisable to conduct in the preoperative period antihypoxic therapy to significantly improve functional state of the liver and lungs.

EFFECTIV TREATMENT OF URINARY TRACT INFECTIONS IN PRIMARY CARE IN THE PRACTICE OF FAMILY PHYSICIAN

Nazirova N.K., Mirzoeva Z.A., Vositzoda Z.F.

EFFECTIV TREATMENT OF URINARY TRACT INFECTIONS IN PRIMARY CARE IN THE PRACTICE OF FAMILY PHYSICIAN

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

Aim. Evaluate the effectiveness of schemes treatment of urinary tract infections UTI based on the principles of evidence-based medicine.

Materials and methods. We observed 28 patients with UTI, with average age 23,3±2,4 years. Children and adolescents comprised 42,9% (12 people), adults – 57,1% (16 people), among them women – 60,7%, men – 39,3%. Methods applied: clinical and statistical.

Results. Among those who were diagnosed UTI first established in 11 people (39,3%): acute cystitis observed among 63,6% (7 people), acute pyelonephritis – 36,4% (4 people). Patients with recurrent episodes of UTI comprised 60,7% (17 people): 58,8% (10 people) with cystitis, 41,2% (7 people) with pyelonephritis. 71,4% of cases of recurrent episodes of pyelonephritis were observed in patients with urolithiasis.UTI was treated with consideration of gender, age and diagnosis. Children younger than 12 years with cystitis and pyelonephritis received amoxicillin in combination with clavulanic acid 20-40 mg/kg per day in 3 divided doses for 5 (7-10) days. All patients older than 12 years received 100 mg of nitrofurantoin 2 times a day for 5 days (level of evidence A) or 500 mg of ciprofloxacin (alternative) 2 times a day 3-5 (7-10) days. Patients with recurrent UTI after adequate therapy and bacterial eradication were received long-term prophylaxis with nitrofurantoin, as 50 or 100 mg at bedtime for 6-12 months. As a result of treatment, based on evidence-based medicine, we observed positive dynamics of clinical and laboratory manifestations of UTI.

Conclusion. There is a necessity of strict adherence to the recommended schemes in accordance with the conclusive data, and avoidance of excessive use of antimicrobial drugs and use antibiotics without evidence.

PHYSICAL DEVELOPMENT AND GYNECOLOGICAL STATUS AMONG GIRLS AND WOMEN WITH HELMINTH INFECTIONS WHILE IODINE DEFICIENCY DISEASES

Muhamadieva S.M., Sabirovа G.A., Pulatova A.P.

PHYSICAL DEVELOPMENT AND GYNECOLOGICAL STATUS AMONG GIRLS AND WOMEN WITH HELMINTH INFECTIONS WHILE IODINE DEFICIENCY DISEASES

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. To study the physical development and frequency of helminth infections among girls of pubertal age with iodine deficiency diseases.

Materials and methods. The complex observation of 160 girls in the age of 10-16 who turned to the children’s gynecology department and to consultation and diagnostics polyclinic of Scientific and Research Institute of Obstetrics, Gynecology and Perinatology was conducted: anthropometrical indicators, index of body mass (Brey), for evaluation of mammary glands development the Tanner’s formula was used. All of the girls went through clinical analysis of blood and urine, flora smear, analysis of faeces for helminth eggs and lamblia cysts, scrape for enterobiasis, ELISA (immunoglobulins G and M) to antigens lamblia in blood, biochemical analysis of blood with evaluation of activity of Alanine Aminotransferase, AST, Ultrasound Examination of thyroid gland and organs of abdominal cavity and pelvis minor.

Results. Iodine deficiency diseases (IDD) and helminth infections form low index of health of girls and women of pubertal age. Combination of anemia and goiter is in 92,8% of patients, pyelonephritis – 60,0%, cold diseases in anamnesis in 99,9%, each second had disorder of period cycle. Physical development of girls of main group was behind the control group: average height of patients was 145,6±1,4 cm. The average index of Brey was 17,5 which corresponds to low border norm. Delay of sexual development had 21,4%, whereas in control group this indicator was 1,7 times lower (37,1%).

Conclision. Helminthic infections effect on the physical development and formation of reproductive function of girls and women which have iodine deficiency diseases. Use of modern technologies will allow quickly identify this category of patients and heal them.

FEATURES OF PSYCHOSOMATIC MANIFESTATIONS AT ACUTE MYELOBLASTIC LEUKEMIA

Mustafokulova N.I., Ganieva M.P., Ahunova N.T., Boronov J.B.

FEATURES OF PSYCHOSOMATIC MANIFESTATIONS AT ACUTE MYELOBLASTIC LEUKEMIA

Department of Internal Diseases №3 of Tajik State Medical University named after Abuali-ibn-Sino Department of Therapy with a Course of Gerontology of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»

Aim. Rate features of psychosomatic manifestations and quality of life of patients at acute myeloblastic leukemia.

Materials and methods. The study protocol includes prospective and perspective (from 2009 to 2014 years) observation of 140 patients with acute and chronic myeloblastic leukemia. The average age is 35,9±0,7 years. Male – 62 (45,9%), wom¬en – 78 (54,1%). Of which 70 patients amounted to 1 group with acute myeloleukemia, 2 group – 70 patients with chronic myeloleukemia. Both groups the determination of the level of psycho-emotional sphere with the help of ospital Anxiety and Depression Scale (HADS) was conducted. To assess the quality of life and efficiency of rehabilitation activities in patients with acute leukemia the use of SF-36 questionnaire was provided. The calculation was made according to special transformation of scales. Evaluation was performed on a 100-point system.

Results. Study of patients by anxiety and depression scale (HADS) was performed on the second or third day admission to the hospital and again two weeks after the therapy. The test results on the scale of HADS led to the conclusion of reliable differencesthe of level of anxiety in both groups: 1 group with high levels of anxiety included 6 patients (12 points) and 2 group at high risk of anxiety included 12 patients. Subclinically expressed depression on a scale of HADS detected in 8 patients. In patients with chronic myeloblastic leukemia subclinically expressed depression detected in 13 patients (8 points). At a combination of anxiety and depression on a scale of HADS in 1 group more number of patients – 39 (14/14), in the second group – 31 patients (14/13). Subclinically expressed stage in 1 group observed in 3 (10,9), in 2 group – in 10 (19/9 points), which is high in both groups. It is established that the quality of life of patients with acute and chronic myeloleukemia, determined using the SF-36 questionnaire significantly reduced. After 4 weeks of using assigned sedative therapy showed a significant (p <0,05) improvement in the quality of life of patients with acute and chronic myeloleukemia. Conclusion. Stress and psychological disorders in patients with acute myeloid leukemia accompanied by high levels of a combination of anxiety and depression, clinically significant in 55,7%. Psychophysiological violations identified in patients with chronic myeloid leukemia in 44,3% of cases. In order to improve the quality of treatment at depressive states, recommended using of sedative drugs, tranquilizers, at high performance - with using of programs of antidepressants that increase the educational level of patients: holding the conversation, lectures and autogenous training.