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Fixation of appendages are made with certain silk ligatures to the lateral divisions of the abdominal wall in the hypochon-drium; this makes available to remove the ovaries of the zone of possible exposure in postoperative period; during topometry their location is determined on the plain film of abdominal cavity. This sequence of surgical operations ensures the safety of ovaries and their vascular "pedicles".
The main clinical criteria of the effect of antitumor treatment are the immediate objective effect, the development of side effects, recurrence and period of their development, the survival rate of patients within 3 years of observations.
Overall survival analysis of patients showed that the efficacy of treatment in study and in control group were almost the same, in study group is slightly higher than in control.
Table 2. - Survival rate depending on the stage ( %)
1 year 2 year 3 year
Stage 100 100 100
T2aNoMo 100 97.1 94.2
T2bNoMo 98.5 95.5 92.5
T2bN1Mo 96.7 89.2 81.3
T3aNoMo 96 76 72
T3aN1Mo 86 71.5 67.5
To study the quality of life is a relatively new field of clinical research. However, it attracts more and more attention in the study of oncology diseases and can serve as the main criterion for clinical
efficacy. Quality of life is considered one of the key parameters in the study of ultimate results of the treatment. Quality of life of patients in the dynamics of observation was determined by American system MENQOL. Dynamic monitoring of patients was carried out with full examination every 3 months during the first year after treatment completion, in the sequel every 6 months. Observation periods vary more than 3 years.
Conclusions
Technology of functionally - sparing treatment of CC in fertile age women is a new approach without detriment to the outcomes of therapy for cancer patients. To spare the functional activity of the ovaries in young patients with favorable prognostic factors (early stage, high differentiation of the tumor, the absence of ovary affection, the ovaries with preserved function) allows avoiding violations, developing at different times after removal of gonads.
These studies testify the possibility of preserving the uterus and ovaries in women of fertile age with careful pre- and intraoperative examination.
Analysis of conducted data (over 3 years) shows that the fertility - sparing volume of surgery improves the immediate and long-term results of treatment.
Overall, the organ and function-sparing approaches in the treatment of gynecological cancer patients is relevant and promising research direction, allowing not only to cure the patient, but also to maintain the basic functions offemale body, to improve greatly the quality of life, reduce the time of social and psychological rehabilitation.
References:
1. Aksel E. M., Davydov M. I. Mortality in Russia and CIS countries from cancer in 2008.//Vestnik RORC after N. N. Blokhin, RAMS. -2010. - V. 21, № 2s: 87-117.
2. Antipov V. A., Novikov O. V., Balahontseva O. S. Conserving therapy of early forms of invasive adenocarcinoma of cervix//Siberian J Oncol. - 2010. - № 1: 5-11.
3. Navruzov S. N., Gafoor- Ahunov M. A., Aliyev D. A. Prospects for the development and improvement of cancer services in Uzbekistan// Coll. scientific. art.: "Problems of Oncology". - Tashkent, 2002. - issue 2: 3-8.
4. Yuldasheva N. Sh., Navruzova V. S., Akhmedov O. M., Navruzova R. N., Umarova N. A. Defining the role and place of the biopsy in pathological changes of the cervix/II Congress of oncologists of Uzbekistan. October 6-7, 2011. - Tashkent city, 2011. - P. 272.
5. Navruzova V. S., Navruzov R. S. Treatment of cervical cancer in younger women//News of dermatovenerology and reproductive health. - Tashkent, 2012. - № 2. - P. 35-36.
6. Arbyn M., Anttila A., Jordan J., Ronco G., Segnan N., Schenck U., Wiener H., Herbert A., von Karsa L. European guidelines for quality assurance in cervical cancer screening. Second edition-summary document//Annals of Oncology. - 2010. - V. 21, № 3: 448-458.
7. Beneditti-Paniti P., Bellati F., Manci N. et al. Neoadjuvant chemotherapy followed by radical surgery in patients affected stage IVA cervical cancer//Ann Surg Oncol. - 2007. - 14(9): 2643-2648.
8. DiSaia P. J., Creasman W. T. (eds.) Clinical gynaecologic oncology. 7th ed. - Mosby Elsevier, 2007. - P. 812.
9. Randall-Whitis L., Monk B. J., Han E. S. et al. Markers of angiogenesis in cervical cancer: a Gynecologic Oncology Group Study. // J Clin Oncol, ASCO Annual Meeting Proceedings. - 2007. - 25(18S): 5536.
Normatova Shakhnoza Anvarovna, Fergana branch of the Tashkent medical academy, Head of the department of hygiene and public health E-mail: [email protected]
Hygienic assessment of persistent organochlorine pesticides in milk products
Abstract: In this article the hygienic assessment of averages entering the body in the milk and milk products daily doses of persistent organochlorine pesticides in the towns of the Ferghana valley (Ferghana, Andijan, Namangan region). According to a special formula has been determined the actual level of pesticides and on the results of the study made the appropriate conclusions.
Keywords: milk and dairy products, organochlorine pesticides, the sample, the average number, of daily dose, a residue, risk.
Hygienic assessment of persistent organochlorine pesticides in milk products
Pesticides are the only pollutant that person deliberately introduced into the environment. In many countries of the world pays great attention to the problems of the environment, feed and food contamination by hazardous chemicals in various anthropogenic and natural origin.
The role of organochlorine pesticides as a pollutant of the ecological system is now an established fact. They are carried for many kilometres from the place of their use and cause contamination of soil, water and plants. Researchers pay special attention to persistent organochlorine pesticides and, above all, to DDT and hexachloran (HCCH). Danger to animals associated with the chronic effects of pesticides and the consequences of their influence of small doses, now stands in the first place because of their daily contact with the body.
Whole cow's milk and prepared from milk products it is an important component of the human diet. Therefore, the content in milk products of harmful substances (eg, organochlorine pesticides) in excess of the maximum allowable levels (MALs) may cause a risk to public health. Among different age groups at high risk of exposure to organochlorine pesticides (OCPs) and products of their transformation are children who consume more dairy products than adults. Particularly at risk are young children and young children, for whom milk and dairy products are a major and indispensable part of the diet. The ability of organochlorine pesticides to stand out in the composition of milk is in itself sufficient reason for a particularly rigorous approach to the valuation of these pesticides. The presence of OCP in the milk leads to permanent its content in all dairy products derived from this milk. A particularly large number of OCP observed in dairy products with high fat content [1; 2; 3].
Purpose of the study
On the basis ofhygienic assessment set content in the milk and milk products of residues of persistent organochlorine pesticides (DDT and its metabolites, hexachloran — HCCH).
Materials and methods
Determination of pesticides and their metabolites in dairy products was carried out using gas chromatography mark "Tsvet". Hygienic assessment of pesticide residues is given on the basis of sanitary rules and norms 42-123-4540-87, as well as with the use of sanitary regulations "Methods for determination of the maximum permissible level of pesticides in food".
The following formula was used to calculate the complex, and the combined effect ofpesticides on the human body, the proposed E. I. Spinu [4]:
M£
ncn
<= 1,
where R — integral criterion, which reflects the actual risk of the
4>on © '
pesticide; A^ — quantity characterizing the total radiation dose for admission of substances to food, water and air; ACA — acceptable daily intake for humans.
The object of study: dairy products manufactured in dairy farms of the Fergana valley (it includes Fergana, Andijan and Namangan region).
Study and discussion of results
The observation points in the Fergana Valley are given hygienic assessment quantitative indicators of organochlorine pesticides. It is known that in the sanitary-toxicological against the most dangerous pesticides which have one or the following combination of properties: high toxicity, high stability in the external environment and long-term persistence in soil, water and food, high toxicity, pronounced cumulative properties, long stay in the body, the ability to discharge from the body through the milk of lactating animals
and nursing mothers through milk, resistant ability to form long-oil emulsions and these emulsions stored in the processing of fruit and other plant products used in human nutrition.
It should be noted that under the influence of weather and other factors pesticide spread over large distances and the space, and as a result, recently found pesticides in the environment, even in facilities that have never been processed. For example, DDT was detected in adipose tissue and milk dolphins in Antarctica, where organochlo-rine never used drugs.
In the studied observation points us Andijan region quantitative level of DDT and its metabolites in the human body was designed, and the rate was on average 0.08 ± 0.05 mg/kg (MALs — 1.25 mg/kg). The daily dose of exposure was equal to 0.0028 mg. In Namangan region 0.07 ± 0.003 mg/kg, daily dose of 0.0025 mg. In Fergana region 0.07 ± 0.006 mg/kg, daily dose of 0.0025 mg. In the city of Fergana, the figure amounted to an average of 0.09 ± 0.009 mg/kg, daily dose in the human body is equal to 0.0032 mg. Total average daily intake of DDT and its metabolites in the body was 0.077 ± 0.0045 mg/kg. Daily dose — 0.0027 mg.
A study of residual quantities of DDT and its metabolites in dairy products have been identified in yogurt in an amount of 0.04 mg/kg, in a cream 0.05 mg/kg, in sour cream 0.02 mg/kg, in curdled 0.001 mg/kg, in sour milk 0.006 mg/kg.
The content in milk products of DDT and its metabolites averaged 0.007 mg/kg. This value does not represent a serious danger to public health. However, its daily total dose in the diet may give rise to potential danger [5]. Therefore, currently of great importance strict control to prevent proper penetration of the drug across the border.
Hexachlorocyclohexane or HCCH is widely used as an insecticide in the Fergana Valley, its working dose of 1.0 kg/ha. Remains of this drug in dairy products have been investigated in 2002-2004 by international organizations on the territory of Kazakhstan and Karakalpakstan.
We've found that in the Andij an region of the Ferhana Valley the average value of the drug was 0.00052 ± 0.00001 mg/kg, daily dose of the drug entryinto the bodyis equal to 0.000018 mg. Ifthe dailyvalue of Namanganregion HCCH was0.00071 ± 0.00002mg/kg, the dailydose was 0.000025 mg. The observation points of the Fergana region quantitative indicators of the drug amounted to 0.00061 ± 0.00002 mg/kg, and the daily dose is equal to 0.000021 mg. As for the city of Fergana quantitative indicator — 0.00054 ± 0.00009 mg/kg, daily dose — 0.000019 mg.
Among the samples taken at observation points is the maximum dosage has been identified in the city of Fergana, which is 0.019 m g/kg (daily dose — 0.00067 mg). The daily dose limit HCCH product is 0.05 mg/kg. Mean values of the data amount to 0.0006 mg/kg, a daily dose of exposure is equal to 0.000021 mg. Also fresh milk contained in HCCH cream in an amount 0.0035 mg/kg, 0.00012 mg. daily dose; sour cream 0.0046 mg/kg, daily dose intake of 0.00016 mg; in kefir 0.0018 mg/kg, 0.000064 mg. daily dose; feta cheese in 0.0041 mg/kg, daily dose of 0.0014 mg; in cheese 0.0038 mg/kg and the daily dose of 0.00013 mg. Obviously, the reasons for the relatively high content of organochlorine pesticides in acidic dairy products may be linked to the presence of fat. On this basis, it is believed that low-fat dairy products do not contain HCCH.
Thus, the need to develop a system of hazard analysis and critical control points to establish accounting and reporting hazards at all stages of the production process the milk and milk products. Also, streamlined application system, storage and transportation
of pesticides and fertilizers. Strictly comply with hygiene regulations, such as dosage, frequency of application, waiting period, the quarantine period, MAC (maximum allowable concentration), MALs and other hygiene regulations.
Conclusions:
1. It was found that the actual level of the HCCH equal to 0.0008 mg. Given the low cumulative properties HCCH,
after 60 days (0.0008 x 60) can be argued about the dangerous dose of education to human health.
2. As a result of the data obtained, it can be argued that in order to neutralize the milk and milk products from or-ganochlorine pesticides, it is necessary to produce sour — milk products, as well as recommended steps to remove the fat in the milk.
References:
1. Hooper K. et al. Analysis of brest milk to assess exposure to chlorinated contaminantes in Kazakhstan//Tnvironmental health perspectives. - 1997. - Vol. 105. - Р. 1254.
2. Бахритдинов Ш. С. Гигиеническая оценка реальной и обоснование допустимой нагрузки пестицидов в районах их интенсивного изменения: Дисс. ... д-ра мед. наук. - Москва, 1989.
3. Норматова Ш. А., Бахритдинов Ш. С. Фактическое употребление молока и молочных продуктов и оценка степени их загрязне-ния//Журнал Гигиена и Санитария. - М., 2011. - № 2. - С. 65-67.
4. Проданчук Н. Г., Спыну Е. И. Принципы и пути оценки опасности комплексного и комбинированного действия пестицидов на организм человека//Современные проблемы токсикологии. - 2001. - № 2. - С. 3-7.
5. Норматова Ш. А., Ашурова М. Д., Эрматова Г. А., Хожиматов Х. О. и др. Актуальные проблемы экологии и здоровья населения в Узбекистане//Актуальные проблемы гуманитарных и естественных наук. - 2014. - № 5(64). - С. 208-211.
Shayhova Guli Islamovna, Tashkent Medical Academy, professor, department of hygiene of children, adolescents, and nutrition hygiene Zufarov Anvar Komildjanovich, professor, head physician of the city nephrology hospital of Tashkent city
Otajonov Ilhom Otaboevich, Tashkent Medical Academy, lecturer, PhD, Department of hygiene
of children, adolescents, and hygiene E-mail: [email protected] Zakirov Jourat Fatihovich, PhD, doctor of city nephrology hospital of Tashkent city
Characteristics of social and living conditions, the incidence of patients with CRF
Abstract: The high level of clinical entities of identified diseases in patients with chronic renal failure (CRF), which are conditioned by their functional state, body resistance, living conditions, working conditions, leisure and everyday life have been identified. The incidence has been studied at average for 2 years (2014, 2015), as it is studied for general morbidity of the population. The study included 105 patients whose social conditions had been studied, as well as morbidity rate. They studied the rates of overall morbidity in 325 patients with CRF who are on the dispensary at the city nephrology hospital of Tashkent city.
Keywords: patients with CRF, social conditions, clinical entities of diseases.
The number of patients with kidney disease is being increased all over the world, due to the incidence rate not only of the kidneys but also the increasing number of patients with diabetes, obesity, aging, damaged renal vascular nature, in particular renal ischemia [1; 2; 8; 9; 10; 11]. A steady rise in the level of CRF has been noted in the world. The number of patients with CRF in the world, who are receiving renal replacement therapy has been more than 4-5 times over the last 20 years [5; 6]. In the US, the prevalence of CRF in 1996 reached up to 268 per 1 million population [7]. In Russia in the past decade — CRF has been diagnosed in adults from 100 to 600 people [3; 4]. In the Republic of Uzbekistan (Uzbekistan), the prevalence of CRF in 2014 is 19 701 to 30.759 million of population.
Aim: description of the social conditions, the incidence of patients with CRF in Tashkent city.
Materials and methods
Subjects of study: adult population, patients with chronic kidney disease and CRF, who are being treated in the clinic (105) and 325 patients with CRF who are on the dispensary in Tashkent city.
Medical and social research included: the copy of the medical record data (form № 025/U). When studied anamnestic data in patients with CRF (105) the particular attention was made to past illnesses, the presence of chronic diseases and foci of infections. The incidence analysis was carried out in accordance with the International Statistical Classification of Diseases and Related Health (ICD-10, 2000).
We studied the rates of overall morbidity in 325 patients with CRF who are on the dispensary at the city nephrology hospital of Tashkent city. The incidence has been studied for average 2 years (2014-2015), as is the case for the study of general morbidity of
