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Efficiency in phytotherapy endogenous intoxication syndrome in pregnant women with infectious risk
ameter, comparable with the coronary arteries, a sufficient length and resistance to pressure, the relative ease of isolation, a good postoperative results [1].
Studies have shown that as the muscular artery, radial artery has all inherent in this type ofvessel shell. Since the coronary arteries, also referred to as the arteries of muscular type Ham, Koprmak [3], Ross [7] morphologically justified the use of the radial artery for coronary artery bypass grafting. Besides these basic morphometric parameters coincide vessels Mamchur S. E., et al [2].
Comparative studies of the radial artery at various ways of their allocation showed that the structural safety of the shells of the radial artery, especially the inner lining depends on the method of their selection.
"Skeletonization" leads to disruption of the integrity of the inner shell, it is especially the endothelial layer, which is the most vulnerable. Deendothelization of inner shell can promote thrombus formation in the graft.
References:
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2. Mamchur S. E., Vechersky Y. Y., Mikhail Fadeev. The morphology of the internal thoracic and radial arteries in patients undergoing coronary artery bypass grafting//Bul. Sib. medicin. - 2004. - № 2. - S. 85-89.
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Rabbimova Gulnora, Samarkand State Medical Institute, assistant department of obstetrics and gynecology E-mail: gulnora_1968_r@mail.ru
Efficiency in phytotherapy endogenous intoxication syndrome in pregnant women with infectious risk
Abstract: To evaluate the dynamics of changes of lipid peroxidation (LPO) and antioxidant activity in the peripheral blood, the level of endogenous intoxication in pregnant women with infectious risk in depending on the reception phytocombination. To study the parameters of endogenous intoxication are a predictor of condition assessment and the course of pregnancy in infection risk. The inclusion of herbal tea in a comprehensive prevention and treatment promotes faster the removal of endogenous intoxication of 96.4% and a decrease in complications by 82.1% in pregnant women with infectious risk.
Keywords: phytocombination, pregnant women, infectious risk.
Prevention and treatment of infectious complications of the urogenital tract in pregnant women remains an urgent problem researchers in the basic sciences and clinical doctors ofvarious specialties [2; 6]. Despite significant advances in diagnosis and treatment ofurogenital infections, their frequency has a strong tendency to increase, presenting a danger, both for the mother and fetus [1; 5]. In recent decades, a steady trend worldwide increasing incidence of infections transmitted mainly through sexual contact, the dominance of surgical abortion method ofproduction, the growth of extragenital infection focal diseases of inflammatory etiology that reduce the body's immunoresistance and irrational use of antimicrobial agents contributed to a significant increase in the prevalence of infectious diseases and dysbiotic genitalia in the female population [1; 3].
One notable vectors medicine of the 21st century is no medicaliza-tion treatment process, avoiding polypharmacy in general and on the
prevalence of synthetic substances in the therapeutic arsenal of doctors all specialties. Deciphering the human genome has given significant reason for denying a large part (80%) "is traditionally appointed by" drugs, as irrefutable evidence of their inefficiency were obtained [5]. Given the increasing antibiotic resistance, increasingly attempts to move away from the use of antibiotics, even in cases of non-severe forms of lower urinary tract infection [4; 5]. Rational use of the algorithm of medical possibilities formulated Hippocrates: "For a man of healing, there are three things: first — floor, second — the grass, the third — the knife" [5; 7]. Studies demonstrating non-ideal treatment by synthetic means in comparison with the quite effective and quite safe herbal remedies, once again confirms that it is not necessary to "reinvent the wheel" if nature has created all the necessary [4; 5].
In recent years, an important role in the pathogenesis of many infectious complications during pregnancy given to system-
Section 7. Medical science
ic inflammatory response syndrome, metabolic disorders in the body of the mother [3; 8]. On the other hand central to the pathogenesis of many disease processes, including obstetric pathology, is a disorder of redox processes involving violation of the biological barrier of cell membranes and activation of free radical oxidation reactions. Changes in the activity of this process leads to disruption of cell function and, consequently, to develop a pathology [2; 10], which lead in particular to the endogenous toxicity [5; 9]. Based on the above relevant in terms of assessment of the state and the course of pregnancy, as well as the selection of evidence-based diagnosis and treatment is the study of endogenous intoxication in pregnant women infection risk, as well as the development of therapeutic and preventive measures based on herbal remedies.
Objective. To evaluate the dynamics of changes oflipid peroxidation (LPO) and antioxidant activity in the peripheral blood, the level of endogenous intoxication in pregnant women with infectious risk in depending on the reception phytocombination.
Material and methods. The study included 68 pregnant women the group infection risk between the ages of 18 to 35 years, 23 (33.8%) were the first pregnancy and nulliparous, in 45 (61.2%) had two or more pregnancies. All patients were informed about the purpose of the study and signed a written voluntary informed consent before participation. The groups were matched by age, according to the somatic and obstetric and gynecological history. The criteria for inclusion in the main group were pregnant woman's consent for the study, the presence of urogenital infections, clinical medical history of vaginitis, gestational pyelonephritis, the threat oftermination ofpregnancy during the entire period ofgestation, the presence ofpolyhydramnios during this pregnancy, pregnant, miscarriage and premature labor infectious genesis in the history of gestation 32-40 weeks. Pregnant divided into 3 groups: I of the group — the main (the n = 28) and II group — the comparison (the n =20), III of the group — control (the n = 20) with physiological pregnancy. Pregnant core group phytocombination reception (he was appointed for the prevention of infectious complications and improve antioxidant defenses and decreasing endogenous intoxication the n = 28), in a comparison group of pregnant phytocombination did not use (the n = 20). A survey of all pregnant women included an assessment of the traditional clinical and laboratory parameters, microbiological research by bacteriological, ultrasonic scanning system mother-placenta-fetus and kidneys. All surveyed pregnant core group determined viral and bacterial infection. In order to evaluate the endogenous intoxication caused by the breach of peroxide lipid peroxidation (LPO) using the following biochemical parameters: the content of secondary product of lipid peroxidation — malondialdehyde (MDA), by which you can judge the intensity of peroxide processes, the activity of the antioxidant enzyme catalase (CA), the contents of the average mass of molecules (IMS280, IMS254), ratio of MDA/CA — POL shift measure prooxi-dant or antioxidant side and MSM280/MCM254 — resistance protein ratio (AFB), which indicates a decrease of protein conversion to a degraded form. In plasma, venous blood was measured markers of endogenous intoxication — IMS280 and IMS254 method Gabrielyan and V. I. Lipatova, MDA method S. G. Konyukhova, SC method M. A. Koroljuk et al. Calculate the ratio of MDA/CA and KUB. Following the approval of the ethics committee and informed consent of pregnant core group for the purpose of treatment and prevention of inflammatory complications included phytocombination consist-
ing of above-ground parts of the plant Codonopsis Lanceolatae [6; 10] and Pimpinélla anisum of L. [6; 9] in the component ratio by weight of 9:1 as the selected medicinal plants possess strong antibacterial, antioxidant, immunomodulatory properties, stimulates protein synthesis, cell growth processes, and other properties. 5 grams collection brewed a thermos and take 200 ml 5-6 times a day for 30 minutes before meals for up to 5 days. Statistical processing of the data was performed using Student's coefficient at P>0.95.
Results of the study. Analysis of the results showed that in pregnant women the main group MDA content increased 1.6-fold (5,84 ± 0,36) compared with the control group, which indicates that the intensification offree radical oxidation of the destabilization ofthe membrane structures of cells in the background reducing enzyme SC 0,31 ± 0,02 (p <0.001) at 2.9 times the ratio ofMDA/CA in pregnant women compared to the control group increased 4.8 times 18,84 ± 1,14 (p<0.001), which also pointed to significant activation of free radical oxidation in pregnant group infectious risk, there is an accumulation in the blood plasma of MSM: MSM content 254 increases 2 times 0,44 ± 0,04 (p<0.001), and MSM280-0.42 ± 0,03 1,6 times compared to the control (p <0.001), which indicates the degree of degradation of protein molecules. This KUB reduced 1.3 times 0,92 ± 0,06 (p < 0.001). As a result of the activation of lipid peroxidation and accumulation of iree radicals is a violation of the structural and functional integrity of the cell membrane, the release of lysosomal enzymes that ultimately leads to pathological processes in the cell and the organism as a whole. Thus, in pregnant women at risk of infection occurs the development of endogenous intoxication syndrome, i. e. against the background of activation of free radical oxidation of accumulation in the plasma hydrophilic endotoxemia markers — MSM and most distinctive parameters of endogenous intoxication can be used in the assessment of pregnant women with the infection risk. On the other hand, the above necessitates the inclusion in a complex of therapeutic and preventive measures phytocombination appointment, leading to inhibition of lipid peroxidation reactions, increase antioxidant status and decrease in plasma endotoxemia hydrophilic components.
Revealed differences in terms of endogenous intoxication in pregnant women with infection risk compared with normal pregnancy during treatment and preventive measures: MDA in the application of herbal tea decreased by 1.5 times; catalase increased 2.8 times; MSM254 decreased by 1.76 times; MSM280 after taking herbal tea decreased by 1.9 times, KUB increased 1.31 times; the ratio ofMDA/catalase after decreased 4.34 times. Thus, the prevention and treatment of infectious complications in pregnant women at risk of infection in the use of herbal tea, leads to normalization of endotoxemia markers, which has antioxidant and detoxication properties and more rapid normalization of these indicators.
Thus, the inclusion ofherbal tea in the range of therapeutic and preventive measures facilitates a more rapid (3-5 days) the removal of endogenous intoxication in pregnant women with infectious risk slowing down the process of lipid peroxidation and improve antioxidant protection indicators
Conclusions. 1. To study the parameters of endogenous intoxication are a predictor of condition assessment and the course of pregnancy in infection risk. 2. The inclusion of herbal tea in a comprehensive prevention and treatment promotes faster (3-5 days) the removal of endogenous intoxication of 96.4% and a decrease in complications by 82.1% in pregnant women with infectious risk.
References:
1. Ветров В. В., Пестряева Л. А. Значение синдрома эндогенной интоксикации в патогенезе гестоза // Эфферентная терапия. -2005. - Т. 11. - №. 3. - С. 3-9.
Сallus distraction for congenital fourth brachymetatarsia
2. Кан Н. Е., Сироткина Е. А., Тютюнник В. Л., Высоких М. Ю., Курчакова Т. А., Володина М. А., Тарасова Н. В., Пятаева С. В. Особенности антиоксидантной защиты беременных в системе «мать-плацента-плод» при внутриутробной инфекции // Акуш. и гинекол. 2016, - № 1, С. 40-46.
3. Ломова Н. А., Орджоникидзе Н. В., Ванько Л. В. Синдром системного воспалительного ответа и беременность (обзор литературы) // Акушерство и гинекология. - 2012. - №. 1. - С. 23-27.
4. Радзинский В. Е. и др. Treating imbalances of vaginal microbiota: are we standing in place or going forward?//Reproductive Endocrinology. - 2014. - №. 18. - С. 92-100.
5. Радзинский В. Е., Симоновская Х. Ю. Фитотерапия в акушерстве и гинекологии. Новый век -новая идеология. Концепция фитониринга как этап развития фитотерапии. Информационный бюллетень. - Изд. 2-е, испр. и доп. - М.: Редакция журнала Status Praesens, 2015. - 16 с.
6. Al-Bayati F. A. Synergistic antibacterial activity between Thymus vulgaris and Pimpinella anisum essential oils and methanol ex-tracts//Journal of ethnopharmacology. - 2008. - Т. 116. - №. 3. - С. 403-406.
7. Bin Q. I. U. et al. GC-MS Analysis and Antimicrobial Activity of Essential Oils from the Fresh and Dried Roots of Codonopsis cordi-folioidea//Natural Product Research & Development. - 2010. - Т. 22. - №. 3.
8. Chang-Seon Yoo, Sung-Jin Kim Methanol Extract of Codonopsis pilosula Inhibits Inducible Nitric Oxide Synthase and Protein Oxidation in Lipopolysaccharide-Stimulated Raw Cells//Tropical Journal of Pharmaceutical Research October - 2013; 12 (5): 705-710.
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Ravashanov Shavkat, the junior scientific researcher, department of adolescents orthopedics, Scientific Research Institute of Traumatology and Orthopedics of the Ministry of Health of the Republic of Uzbekistan E-mail: sixatfarm@mail.ru
Oallus distraction for congenital fourth brachymetatarsia
Abstract: 22 metatarsal lengthening procedures by callus distraction using mini-fixator were performed in 15 patients with congenital fourth brachymetatarsia. The mean age at the time of the surgery was 16.3 years (range, 11-28 years). The mean duration of follow-up was 1.3 years (range, 6 months-2.0 years). The bones were lengthened at a rate of 1.0 mm/day by a mean of 17.8mm (range, 11-22 mm), which was 37.7% of their original length (range, 33.3-53.6%). The mean healing index was 52.8 days/cm (range, 39-68.7 days/cm). In all cases we achieved the restoration of metatarsal parabola, most patients satisfied with the result of surgery. The evaluation according to AOFAS score was excellent in 20 cases and good in 2 cases. The most common complication was stiffness of the metatarsophalangeal joint (5) and hypertrophic scarring (2), premature consolidation (1) and dislocation of finger (1). Distraction osteogenesis for fourth brachymetatarsia can give satisfactory cosmetic and functional results. Most complications can be treated effectively and succes sfully even though additional surgery may be warranted.
Keywords: brachymetatarsia, Callus distraction, external fixator, complication.
Introduction
Congenital brachymetatarsia is an abnormal shortness of the metatarsal bones due to a premature closure of the epiphyseal plate. It may be congenital, post-traumatic, or iatrogenic, or the disease can be associated with such systematic diseases [2-7]. This condition affects one, usually the fourth, or more metatarsals, unilaterally or bilaterally [1-11]. Compliments ofpatient are the dorsally displacement of digit, metatarsalgia, shoe irritation, tyloma formation and deformation of adjacent fingers (hallux valgus, varus of fifth finger) [2; 4; 5; 6]. The main option of surgical correction is restoration of metatarsal and finger parabola.
Two surgical methods: one-stage lengthening or distraction osteogenesis is widely used. Each method has its own advantages and disadvantages. The advantages of one-stage lengthening include a shorter period of bony union, better patient compliance, and less scar formation. However, this method has the disadvantages of donor site morbidity, neurovascular impairment, and smaller length gain. The advantages of distraction osteogenesis include: no need for
bone grafting, easier tendon stretching, fewer neurovascular complications, early weight bearing, and a larger length gain, whereas disadvantages include stiffness or subluxation of the metatarsophalangeal (MTP) joint, cavus or angulation deformity, pin tract infection, and a longer period of bony union [1; 3; 7; 9].
The purpose ofthis study was to review the results oftreatment 15 patients with congenital fourth brachymetatarsia, for whom a total of 22 gradual lengthening procedures were performed by callus distraction using external fixator which was designed by the author.
Patients and methods
Between 2013 and 2016 at Scientific Research Institute of traumatology and orthopedics, Tashkent, Uzbekistan, 14 girls and one boy underwent 22 fourth metatarsal lengthening procedures by callus distraction. The mean age at the time of the surgery was 16.3 years (range, 11-28 years). The mean duration of follow-up was 1.3 years (range, 6 months-2.0 years). All the patients complained of finger shortening and the cock-up deformity, pain on walking, 4 patients had hallux valgus. 5 patient had bilateral, 5 -left sided and
