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Section 8. Medical science
69,8 ± 5,3 mmol/l). Only the difference in creatinine was sig- The table below reflects the nature of the changes relat-
nificantly (P <0,05). ed to blood electrolytes in pregnant women with mild pre-
eclampsia (for comparison, the data of the control group).
Table 2. - Biochemical parameters of the blood of women with mild preeclampsia
Indicators Mild preeclampsia (n=100) Control group (n=50) P
natrium, mmol/l 137,7±2,51 130,5±3,20 <0,05
Potassium, mmol/l 3,7±0,06 3,6±0,03 >0,05
Calcium, mmol/l 1,90±0,034 2,45±0,02 <0,001
Urea, mmol/l 5,67±0,09 4,4±0,04 <0,001
Creatinine, mmol/l 96,3±1,81 69,8±2,10 <0,001
The table shows that the greatest change in the electrolyte composition of pregnant women with mild preeclampsia as for calcium, the level of which is even more reduced relative to that in healthy pregnant women. As for the solution, despite a statistically significant increase relative to the control of its numbers, its values do not exceed the physiological norm.
In general, women with mild preeclampsia there is an increase in the blood concentration of electrolytes (except calcium) without going beyond the normal range normal. Decline was the coefficient of purification of urea in pregnant women with mild preeclampsia by 13.5% compared to healthy pregnant women. Urea purification factor in the control group was 85,9 ± 1,9%, while in the test group it was equal 74,3 ± 2,6% (P <0,001).
Indicators clearance of all investigated electrolytes in mild preeclampsia was at the lower limit of normal and lower than those in the control group. The clearance of sodium was 0,62 ± 0,03 ml/min at 0,73 ± 0,05 ml/min in women with normal pregnancy. Clearance potassium — decreased by 39.0%. Clearance calcium — was lower by 20.5%. All the data were statistically significant (P <0,05)
Thus, the results of the data obtained, it should be emphasized that among the many disorders of various body functions pregnant women with mild preeclampsia. The most prominent is hypovolemia due to preferential reduction of plasma volume, hypoproteinemia due to proteinuria and reduced renal perfusion parameters with the deterioration of their functional capacity.
References:
1. Vereina N.K, Sinitsyn S.P, Stockings V.S Dynamics of homeostasis’ at physiological pregnancy//Clinical Laboratory. -2012. - № 2. - S. 43-45.
2. Gaysin I. R. Valeev R.M, Maksimov N. I. cardio renal continuum of pregnant women with hypertension//Hypertension. -2009. - V. 15, № 5. - S. 60-65.
3. Manuhin I.B, Markova EV Markova L.I, R.I Stryuk Combined low-dose antihypertensive therapy in pregnant women with preeclampsia and hypertension//Cardiology. - 2012. - № 1. - S. 32-38.
4. Strizhakov A.N Early diagnosis, prevention and treatment of placental insufficiency in pregnant women at high risk of perinatal pathology./A.N Strizhakov//“Issues of gynecology, obstetrics and perinatology.” 2009. - № 3. - P. 1-3.
5. Alper A. B., Yi Y., Weber L. S. et al. Estimation of glomerular filtration rate in preeclamptic patients//Am. J. Perinatol. -2007. - Vol. 24. - Р 569.
6. Myers J. E., Hart S., Armstrong S., Mires G. S., Beynon R., Simon J. Gaskell S. J., Baker P. N. Evidence for multiple circulating factors in preeclampsia.//Am. J. Obstet. Gynec. 2007. - 196 (3). - P. 266.
Botirjon Jurabaevich Kurbanov — doctor epidemiologist, Sanjar Nurmatovich Atabekov — doctor oncologist, Bokijon Djuraevich Matkarimov — doctor epidemiologist (Republican AIDS Center Ministry of Health of Uzbekistan)
E-mail: [email protected]
About the detection of HIV — infection in relation to gender of surveyed persons
Abstract: The authors been studied the specific significance of men and women in the amount of detected HIV-infected patients in the republic for 1987-2013 years. Presents a comparative evaluation of detection of HIV infections among men and women as well as depending on the regions of the country for 2008-2013 years. Despite
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About the detection of HIV — infection in relation to gender of surveyed persons
the increase in the number tested for HIV infection between men and women in 2013 compared with 2008 figures detection of HIV-infected women have decreased in 2,0-3,8 times, which indicates a decline in detection of the infection in the whole country. Relatively high detection rate of HIV observed among men than among women. Keywords: HIV, AIDS, gender, men, women, incidence, detection.
It is generally recognized that HIV infection is one of the most dangerous infectious diseases in humans. The infection remains one of the most pressing problems for practical health and medical science in all countries without exception. HIV infection — greatly increasing the cost of national budgets, leads to a budget deficit and has a negative impact on economic growth [2; 4; 5; 6; 8]. HIV epidemic swept the globe and has long become a pandemic. According to estimates by WHO and UNAIDS on 1 January 2010, the number of HIV-infected world is 33.4 million persons [1; 3; 10; 11; 12]. However, the geography of HIV infection is inhomogeneous and globally women account for half of all cases of HIV infection. Prevalence of HIV infection among women involved in the street sex business the city of Moscow SW is variously estimated from 3.1 to 14.0%. More than 80.0% SWs have sexually transmitted infections, 22.0% subject to sexual violence and more than 30.0% did not use a condom by sexual contact with a commercial partner [2; 4; 8; 9; 10]. Women, because of anatomical and physiological features are the most sensitive group to HIV infection [3; 7; 9; 13].
The purpose of work
Given the above purpose to this work was to study the specific importance of men and women in the amount of detectable HIV-infected patients in 1987-2013 and comparative evaluation of detection of HIV infection among men and
women, and also depending on the regions of the country in 2008-2013.
Materials and Methods
The material for this work were used the reported data about detection of HIV infection among different populations obtained from the national, regional AIDS centers and inter district AIDS laboratories. The diagnosis of HIV infection is confirmed in accordance with the applicable country to normative documents; obtain 2-fold positive results of the blood sample to the IFA followed by confirmation of the result by immunoblotting (IB). Analyzed the data registers HIV infected persons, maps the epidemiological investigation case detection HIV infection. A statistical analysis of the indicator of the detection of HIV infection among different populations depending on of their sex to calculating the mean values of 10 thousand the surveyed. In the work have been used laboratory, epidemiological and statistical methods of research.
Results and discussion
The first case of HIV infection in the country was recorded in 1987 and for 13 years (1987-1999) in the country have been identified only 76 HIV-infected individuals. Since 2000, in the Republic, there was a step climb detection of HIV infection. However, this increase on one hand is of a statistical nature since been associated with increasing amounts of tested for HIV infection (picture 1).
Figure1. Amount tested for HIV infection and the amount of people identified HIV infected patients in republic in 2000-2013 (in absolute number and in%%)
For example, in 2000, testing for HIV were covered ing of material and technical and legal framework AIDS ser-
527.0 thousand persons that in 2013 amounted to more than vices, organization and implementation in practice of cabinets
2564.5 thousand, which was associated with the strengthen- for anonymous testing and counseling for HIV infection.
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Section 8. Medical science
Should be noted that increasing the amount of test persons for HIV in 2013 has also been associated with measures adopted in the performance of the protocol of the meeting of the Republican Commission for the coordination of activities on counteraction the spread of HIV infection (№ 165 of 1 June 2013) “About the survey HIV infection of citizens of Republic Uzbekistan, long visited foreign countries and improve the effectiveness prevention activities spreading of diseases”.
LOO 90 80 70 60 50 40 30 20 10 0
Currently HIV infection is detected in all regions of the republic. Though, indicators of detection of this infection depending on the region, remains not identical. In the epidemic process involved nearly all sectors of the population, regardless of age, gender and social background. Analysis of available data shows that in the last years in the total number revealed HIV-infected patients is increasing the proportion of women (picture 2).
Figure 2. Proportion of men and women in the amount revealed HIV-infected persons in republic in the 1987-2013 years. (in%%)
For example, in 2005 detected among the HIV-infected 47.5%. At first glance, it seems that from year to year in republic
proportion ofwomen was 21.7%, which in 2012 amounted to amount of HIV infected women is increasing (picture 2).
Figure 3.The number of tested for HIV infection and number of revealed men among them of HIV positive people in the republic in 2008-2013 (in absolute number and in%%)
Given this situation and in order to ascertain the true prevalence HIV infection among the population according to gender, we analyzed the detection of HIV infection in the population according to gender. As seen in Picture 3, in 2008, HIV infection been tested 394.0 thousand men and in 1569 established the presence of HIV infection. The detection was 0.4%. Despite the increase in the following years, the number of tested for HIV infection of men increased from 394.0 thousand to 864.5 thousand, detection in 2013,
compared with 2008 declined is almost 2-fold (from 0.4% to 0, 22%).
As seen in Picture 4, in republic from year to year also increases amount oftested for HIV infection for women. This phenomenon has also been associated with the implementation of the order of the Ministry of Health of the Republic of Uzbekistan (№ 74 of 18.03.2009) “About the Measures for the prevention of HIV transmission from mother to child in the maternity institutions system of the Ministry of Health’!
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About the detection of HIV — infection in relation to gender of surveyed persons
If in 2008 for HIV infection been tested 401.5 thousand amount of tested women was 1533.7 thousand and in women (revealed 1323 HIV-infected, detectability totaled 1967 established the presence of women HIV infection,
0.33% to the total number of women surveyed) in 2013, detectability totaled 0.13%.
Figure 4. The number of tested for HIV infection and number of revealed woman among them of HIV positive people in the republic in 2008-2013 (in absolute number and in%%)
Thus, spite of 3.8 fold increase in amount of tested for HIV infection the women in 2013, compared to 2008, the rate of detection of HIV-infected women has decreased 2.5 times that shows a decline in the prevalence of HIV infection among women in the observed period.
The analysis of the data is also installed unequal detection of HIV infection in men and women, depending on the region. During the period analyzed detection indicators of HIV infection in men in the city of Tashkent, Andijan and Tashkent regions several greater than average the republican level detection of HIV infection among men. Indicators of detection of HIV infection among women in Tashkent city, Andijan, Tashkent, Syrdarya and Fergana regions several greater than average the republican level detection of HIV infection among women. In general, comparatively high detectability of HIV infection is observed among men than in women. All this testifies to a comparatively high prevalence of HIV infection in men than in women in the republic.
It should also note that the indicator of the detectability of HIV infection is also dependent on contingent surveyed persons. In this regard, one of the further tasks is the increase in among of tested for HIV infected of persons belonging to high-risk group.
Thus, may assume that revealed epidemiological features of HIV infection in of our republic requires the development and implementation of modern targeted and effective preventive measures in healthcare practice, taking into account the prevalence of HIV infection among the various segments of the population according to gender of tested for HIV persons and by region.
Necessary to consider that one of the most effective method of HIV infection is considered sanitary — explanatory work among the population for the prevention of this infection. In actions on counteraction epidemic spread of HIV infections should be involved not only state and official structures, but all of society and the people themselves are living with HIV, since they know their own experience the whole burden and problems associated with HIV infection. By joint efforts possible to provide a sharpen focus and efficiency response to the epidemic HIV infections.
^n^sions:
1. Under the conditions of the Republic of Uzbekistan of HIV infection are registered in all regions of the country. Spite of the increasing the number of detected HIV-infected persons, caused an increase in coverage tested on this infection persons since 2008 there is a perceptible decrease in detection of HIV infections, as the whole republic, and among men and women.
2. The epidemic of HIV infections in the republic is characterized by involvement in the epidemic process of all sectors of the population and unequal detectability of this infection among men and women, depending on the region.
3. The comparatively high detectability of
HIV infections is observed in men than in women, suggesting a comparatively high prevalence their of HIV infection.
4. The revealed epidemiological features of
HIV infections must be considered when organizing and conducting of preventive and anti-epidemic actions to fight this infection.
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Section 8. Medical science
References:
1. Atabekov N. S. The situation of HIV in Uzbekistan. Compilation of theses of scientific - practical conference “Modern approaches in diagnostics prevention and treatment of HIV infection”, Tashkent city, 1-2 Dec. 2010. P. 12-13.
2. Gil A., Kakorina E. P. Cost-effectiveness of service of HIV prevention among high-risk women. Journal “Problems of health management”, 2010, № 2 (51). P. 72-75.
3. DaminovT. A., Tuychiyev L. N., Hudaykulova G. A., Azizov B. S., Abidov A. B., Atabekov N. S., Giyasova G. M., Mahmoudov J. - HIV infection, 2011. P. 10-12.
4. Dementyeva L. A., Goliusov A. T. Features of the HIV epidemic in Eastern Europe and Central Asia at the modern stage, Journal of Microbiology, 2010, № 2. P. 32-34.
5. Demina M. A., Tyukov YU. A. The main modern trends spreading of infectious diseases sexually transmitted. Journal
“Problems of Social Hygiene Health and of history of medicine”, 2009, P. 6, 19-22.
6. Lebedev P. V., Bogdanov R. R. Characterization of the epidemic process of HIV infection in the Krasnodar region. Journal of Microbiology, 2008, № 5. P. 105-107.
7. Matkarimov B. D., Radjabov G. H., Isayeva G. N., Hozinova E.Sh., Kobilova D. Some questions of Epidemiology of HIV in Uzbekistan. Compilation of theses of scientific - practical conference “Modern approaches in diagnostics prevention and treatment of HIV infection”, Tashkent city, 1-2 Dec. 2010. P. 46.
8. Matuschenko E. V., Gnatko YU.V, Goliusov A. T. Laboratory diagnosis of HIV infection in the Siberian Federal District. Journal of Microbiology, 2011, № 5. P. 86-89.
9. Musabekova M.Sh., Toshtemirova O. G., Ismailova N. K., Shaynazarov F. J., Razhabov G. H., Matkarimov B. D., Modern trends in HIV prevalence according to gender. Compilation of theses of the Republican scientific - practical conference “Actual problems of gastroenterology, Session 9 of the National School of Gastroenterology and hepatologists of the Republic of Uzbekistan, Andijan - 2013. P. 500.
10. Onishchenko G. G. Actual problems of modern epidemiology, Journal of Hygiene and Sanitation, 2011, 4. P. 4-6.
11. Onishchenko G. G., Smolensky VYU. The role of the priority national project in the health sector in implementation of the strategy to fight the HIV epidemic in the Russian Federation, Journal of Hygiene and Sanitation, 2011, № 2. P. 9-12.
12. Shavkhalov R. N. Prevention of infectious diseases in the framework of the national project “Health”, Journal “Problems of Social Hygiene Health and of history of medicine”, 2009, 6. P. 14-16.
13. Sharapov MB, NS Atabekov IVF-infektsiyasi: Tibby nazorat Islands davolash samarasini oshirish Yullari, 2012. P. 66.
Djurayev Akhrorbek Makhmudovich, Chief of Children's orthopedic department of Scientific research institute of Traumatology and Orthopedics Ministry of Health Care of the Republic of Uzbekistan, MD, Professor Valiyeva Kamola Nurullayevna, Junior scientific assistant, Radiography department, Scientific research institute of Traumatology and Orthopedics, Ministry of Health Care of the Republic of Uzbekistan Ismatullayeva Mukharram Nodirovna, Chief of Polyclinic department, Scientific research institute of Traumatology and Orthopedics, Ministry of Health Care of the Republic of Uzbekistan, CMD. E-mail: [email protected]
The choice of surgery and principles of rehabilitation of aseptic necrosis of caput femori in children
Abstrart: The choice of surgical intervention method depends on the stage and severity of pathologic process. Rehabilitation of children with aseptic necrosis of caput femori is a complex process and it demands many-years clinical follow-up and therapy for its salvation.
Keywords: aseptic necrosis of caput femori, surgical therapy, children.
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