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of individual interviews, the complaints typical for AMD appeared during the work at close distance (96 % patients) and professional activity (68 %), which is explained by patho-morphological changes of central sections of the retina typical for this pathology. In the majority of cases, the indicators of social adaptation (increased irritability, emotional lability and desire to stay at home) were reduced significantly. Realization of own dependence on others, a feeling of helplessness, according to the assessment of the patients, reduces QL significantly, and the analysis of this indicator allows detecting the way how the disease and its treatment influence all components of normal existence of the man. From our point of view, the expressiveness of complaints typical for AMD consistently reflects significant deterioration of the patient's medical-psychological status and QL in the whole.
Conclusions
1. Reduction of the QL of the patients with AMD revealed by us is in direct dependence on the indicators ofvisual functions.
2. Use of medotilin in a complex AMD treatment allows stabilizing socio-psychical health of the patients with significant increase of their QL in combination with significant improvement of clinical-functional indicators of the eye.
3. It is reasonable to include medotilin in a complex treatment of patients with initial and later manifestations of AMD in order to increase their QL.
4. Conducted statistical analysis showed that VFQ-25 questionnaire (in Uzbek language) is valid and reliable, and can be recommended for the purpose of clinical application in ophthalmological practice in the Republic of Uzbekistan to assess the QL of patients with AMD.
References:
1. Zhuravleva L. V. Assessment of the quality of life of patients with late stage of AMD (according to the results of NEI VFQ-25 questionnaires/Points of the report at IX meeting of the ophthalmologists of Russian. - M., 2010. - P. 263.
2. Lisochkina A. B., Kuznetsova T. I. Application of NEI VFQ-25 questionnaire to assess the quality of life of patients with age-related macular degeneration//Ophthalmological news. - 2010. - V. 111, № 1. - P. 26 -29.
3. Nerpina M. E., Pozharitskaya E. M., Yuzhakova O. I. Assessment of the quality of life of patients at late stages of age-related macular degeneration//Current problems of ophthalmology. VI All-Russia scientific conference of young scientists. Collection of scientific works. - Moscow, 2011. - P. 199 -201.
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6. Kowalski J. W., Rentz A. M., Walt J. G. et al. Rasch analysis in the development of a simplified version of the national eye institute visual-function questionnaire-25 for utility estimation//Qual. Life. Res. - 2012. - Vol. 21, № 2. - P. 323 -334.
7. Marella M., Pesudovs K., Keeffe J. E. et al. The psychometric validity of the NEI VFQ-25 for use in a low-vision population//Invest. Ophthalmol. Vis. Sci. - 2010. - Vol. 51, № 6. - P. 2878 -2884.
8. Orr P., Rentz A. M., Margolis M. K. et al. Validation of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) in age-related macular degeneration//Invest. Ophthalmol. Vis. Sci. - 2011. - Vol. 52, № 6. - P. 3354 -3359.
9. Pesudovs K., Gothwal V. K., Wright T. et al. Remediating serious flaws in the National Eye Institute Visual Function Questionnaire//J. Cataract. Refract. Surg. - 2010. - Vol. 36, № 5. - P. 718 -732.
Tursunhodzhaeva Lyudmila Alexandrovna, Head of the Department of Addiction and adolescent psychopathology of the Tashkent Institute of Postgraduate Education,
Republic of Uzbekistan Bakhramov Furkat Shuhratovich, Assistant Department of Addiction and adolescent psychopathology of the Tashkent Institute of Postgraduate Education E-mail: evovision@bk.ru
Analysis of contributing factors and prevent the spread of drug abuse among female contingent population
Abstract: The study of the socio-demographic, clinical and biological characteristics of the 82 drug-dependent women in Tashkent, registered municipal narcological dispensary for early 2015. The study identified factors that promote and prevent the spread of drug addiction among the female segment of the population.
Keywords: addiction, female contingent of the population, socio-demographic factors.
The urgency of the problem. Considering drug addiction as a disease of complex etiology, with the participation of numerous social, psychological, and biological factors, the researchers emphasize the existence of gender differences in the degree of their influence [5]. Among the causes of drug addiction dominant women called life and family problems [4; 6], the influence of microsocial
groups [2], personal characteristics, such as the desire for risk and thrill of[3]. Among the biological factors emphasize the role of genetic predisposition [1], as well as purchased on premorbid stage organic disease of the central nervous system.
Compared with other countries, in the Republic of Uzbekistan the share of women among the total number of drug users has always
Analysis of contributing factors and prevent the spread of drug abuse among female contingent population
been relatively small, and it has been steadily declining in recent years. From 2002 to 2015, this figure has decreased from 10.1 % to 3.0 %. In this regard, there was an interest in the study of factors that contribute to or, conversely, prevent the spread of drug addiction among the female segment of the population. It is of exceptional importance to improve approaches to the prevention of drug addiction and its negative health and social consequences.
The venue of the study was elected Tashkent — the central city of the Republic of Uzbekistan, which recorded the highest number of drug-dependent women and their share in the total number of drug users is 1.3 times higher than the national average.
The purpose of research: the study of the factors that facilitate and impede the spread of drug addiction among the residents of Tashkent.
Material and methods
The object of the study were 82 women contingent of drug addicts among the residents of Tashkent and registered city Narcological Dispensary in early 2015. To analyze the factors that help or hinder the spread of drug addiction, examined socio-demographic, clinical and biological characteristics of the patients.
Among the socio-demographic factors included ethnicity, education level, occupation, marital status before the initiation of drug abuse. The biological characteristics of the assigned age of initiation to drugs, type and method of drug use. In order to forecast the situation were studied clinical and social indicators of drug dependence in women at the time of the study.
Results. Analysis of socio-demographic factors showed that the distinguishing feature of the female population of drug users in Tashkent is a multi-ethnic composition. Moreover, the ethnic Uzbek persons amounted to only 25.6 % of the number of drug-dependent women with reliable prevalence (74.4 %; P < 0.05) of other nationalities. Among them, 46.3 % were persons of Slavic (Russian, Ukrainian), 10.9 % — Tatar, 6.1 % — the gypsy. For all other nationalities (Georgians, Armenian women, Uigur, Koreans, Kazakhs and others.) In total accounted for 11.1 %.
The level of education among women in general was low. Most of them have only primary — 7.3 %, or secondary (high school) — 61.0 % education. Persons with special secondary (24.4 %), incomplete higher (1.2 %) and the highest (6.1 %), education accounted for a much smaller percentage of drug users (P < 0.05). In other words, before the initiation of drug abuse only 30.5 % of women had a certain profession.
Before exploring the drug 54.8 % of women did not work. Of these, only 6.1 % purposefully dedicated themselves to the household. The remaining 48.7 % (P < 0.05) had no definite occupation. Among the 45.2 % of working women dominated persons employed in the service sector (14.6 %), engaged in unskilled labor (8.5 %) and trade (10.9 %). On a more skilled activities (work in education and educational, medical and other institutions), including private business, had 10.0 %. Students of higher education institutions was only 1.2 %.
The study of marital status showed that before the drug vast majority ofwomen (57.3 %) did not have their own family. Of these, 40.2 % were single women, which are dominated by persons under the age of 20 years (21.9 %). Attention is drawn to a high enough percentage of divorced (14.6 %), 2.4 % were widows. Held in marital relationships (including unmarried) 42.7 % (P > 0.05) women. The proportion of women with children (58.5 %), significantly higher than the proportion of women who are married. 15.8 % of women before initiation of drug abuse alone engaged in the upbringing of children born out of wedlock.
Some women (9.7 %) before the drug had been convicted of various offenses, of which 50 % were engaged in selling drugs.
Studying the role of environment in mikrosotsialnogo admission of psychoactive substances found that familiarity with the drug in the vast majority ofwomen (81.7 %) occurred under the influence of friends (51.2 %) or in the company of friends (30.5 %). Attention is drawn to a sufficiently high frequency (14.7 %) ofwom-en's involvement in drug use from relatives (husband, common-law partner, brothers). Much less often (3.6 %), the first drug reception took place under the influence of random factors (in a bar, a disco, etc.). The motive for the first trial of the drug often served as a curiosity, excited by women drug users from among persons mikros-otsialnogo environment.
It should be noted that most of the women (85.4 %) were involved in drug consumption in the period from 1985 to 2006, the peak of the spread of drug use accounted for 1998-2000 (1997 — 7.3 %, 1998 — 8.5 %, 1999 — 10.9 %, 2000 — 13.4 %). Prior to 1990, used drugs, 7.4 % ofwomen. In the period from 2007 to 2012 gained access to drugs is only 14.6 % of the patients.
Analysis of clinical and biological factors testified about the beginning of the most frequent drug use in young (under 30 years), age (71.9 %). Most of the first dose of drug cases were in the age range from 21 to 30 years (45.1 %). An introduction to drugs in adolescence and early adulthood (up to 20 years) occurred less often (26.8 %) than the age of 30 years (28.1 %). Attention is drawn to a large enough percentage of women who try drugs for the first time over the age of 35 years (13.4 %).
Characteristically, the majority of women from the first time resorted to the most dangerous method of drug use, mainly opioid series. The vast majority of the first in the life of a narcotic drug turned out to be heroin (66.5 %) and other opiates (15.8 %), most often cooked artisanal. Only 17.1 % (P < 0.05), women start dating a drug smoking hemp products, and 0.6 % — to receive psychostimulants ("ecstasy") from outside the country. At the time of the first dose of opiates 39.6 % resorted to the intravenous route of administration, 32.9 % — by inhalation, 4.9 % — to the reception inside, and 4.9 % — for smoking. The injection method of use has contributed extremely rapid formation of addiction with the subsequent transition to the regular intake of the drug.
The general experience of anesthesia at the time of applying for medical assistance ranged from 3 months to 27 years. It is characteristic that most of the women were found in the early stages of the disease. So, with the experience of drug use no more than 3 years of registered 67.2 % of women and 29.3 % in the duration of anesthesia does not exceed 1 year. The proportion of women with experience of drug abuse more than 3 to 5 years was 12.2 %, more than 5 to 9 years — 10.9 %, 10-15 years — 7.3 %, more than 15 years — 2.4 %.
By the time of recourse 80.6 % of women had been addicted to heroin, 3.6 % — from homemade cooked opium drugs, 6.1 % — by cannabinoids, 9.7 % — polysdependence by opiates and cannabi-noids. At 2.4 % ofwomen at this point there was a state of remission with complete abstinence from drug use.
In order to assess the dynamics of the state of women drug addicts under the influence of therapeutic intervention has been studied for their clinical and social characteristics on 01.01.2015 year.
The patients' age at the time of the study ranged from 25 to 57 years old. Persons under the age of 30 years accounted for only 10.9 %, over 30 years old — 89.1 % (p < 0.05) of those aged 31 to 40 years — 43.9 %. The vast majority of women were between the ages of 41 to 57 (45.2 %). On 01.01.2015, the continued
drug use 35.5 % ofwomen. At the same time receiving the original drug continued to 10.2 % of patients switched from opiate use to cannabinoids — 3.6 %, for alcoholic beverages — 19.3 %, to drugs (sedative-hypnotic group) — 2.4 %. In 2014, 4.8 % of women, who at the time of the study were in the prisons have been convicted.
The remaining 64.5 % of women completely stopped taking psychoactive substances. Moreover, remission occurred in 3.6 % up to 1 year over 1 year to 2 years — in 12.2 %, more than 2 years — from 48.7 % (p < 0.05) patients. By the time of the study, 19.5 % of women diagnosed HIV-positive, 1.2 % — in the period of drug transferred sexually transmitted diseases.
The study of the social characteristics showed that the never married 39.1 % ofpatients were in married or cohabiting — 43.9 %, divorced — 14.6 %. Widows were 2.4 % of patients. 52.4 % ofwomen did not work, preferring in remission do housework, 3.6 % — drawn up on the old-age pension. Compared with the premorbid phase proportion of women (30.5 %) at the time of the study was reduced by only 2.4 %.
Thus, the study of the socio-demographic characteristics of the female contingent of addicts in Tashkent showed that before the drug most women were influenced by a variety of adverse social factors that impede full coping and creating conditions for the initiation of drug abuse as the most easy way of avoiding life's difficulties. These factors include the lack of a specific profession
and occupation, unsettled personal life, the negative impact mik-rosotsialnogo environment.
The study of the chronology of initiation to drugs showed that the highest number ofwomen was involved in drug use at a time when the spread of drug abuse in the Republic of Uzbekistan was of epidemic with the rapid increase of the primary indicators and the overall incidence of drug abuse among the general population. More frequent involvement in drug use residents of Tashkent city as compared to other regions could contribute to their multi-ethnic composition, reducing the positive role of the patriarchal family order and features of education, characteristic of the indigenous population of the republic.
Mostly young age of initiation of drug abuse, the use of opioids with the highest narcogene (heroin), initially inject able route of administration contributed to the rapid development of drug dependence.
Identifying drug at a relatively early stage of the disease, timeliness and regularity of therapeutic intervention had a significant impact on the effectiveness of drug treatment to women, providing a fairly high percentage of stable remission and preventing the reduction of social adaptation of patients. The lack of a significant influx of young women drug addicts, "aging" of patients, the tendency to change their behavior towards the discontinuation of opioids suggest a further decline in the proportion of women among the total number of drug addicts registered in Tashkent.
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4. Moise R., Reed B., Ryan V. Issues in the Treatment of Heroin-addicted women: A Comparison of Men and Women entering Two Types of drug Abuse Programs//Int.J. Addict. - 2002. - № 1. - P. 109 -139.
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Bekmirzayev Rahimjon Melikuziyevich, Senior Researcher, Department of tumors of the head and neck, National Research Center of Oncology, Ministry of Health of the Republic of Uzbekistan, Tashkent E-mail: bekmirzaev_1980@mail.ru Khasanov Akbar Ibragimovich, D. m. s., Scientific leader Head and Neck tumors department, National Research Center of Oncology E-mail: akbarkhasanov@mail.ru
Non-epithelial malignant tumors neck, features of clinical current and treatment
Abstract: In this article were studied features of clinical current and treatment results of malignant non-epithelial tumors of the neck. During the 2003-2012 yy. We treated 28 patients with malignant non-epithelial tumors of the neck. Of the 28 patients, complex treatment were 14 (50 %) patients, combined treatment carried 8 (28.5 %) patients, of whom 6 (21.4 %) patients received chemo-radiation therapy and in 2 (7.1 %) patients underwent surgery and radiation therapy, 4 (14.3 %) patients received chemotherapy, and 2 (7.1 %) patients underwent symptomatic treatment. Results: The immediate results of neoadjuvant chemo-radiation therapy were partial response was observed in 11 (39.2 %) patients, stabilization in 2 (7.1 %)
