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12MEDICAL SCIENCES
MEDICAL AND SOCIAL CHARACTERISTICS OF PATIENTS WITH BRONCHIAL ASTHMA
Alikulova D.,
Self applicant for the Center for Advanced Training of Medical Personnel
Razikova I.,
Director of the Republican Scientific Specialized Allergological Center
Mirpaizieva M.,
Assistant at the Department of Allergology, Clinical Immunology and Nursing, Tashkent Medical Academy
Abdullaeva B.
Assistant at the Department of Allergology, Clinical Immunology and Nursing, Tashkent Medical Academy
Abstract
In the world today, bronchial asthma is a serious disease, with long-lasting attacks of suffocation, occurring with severe respiratory failure, threatening the life of patients, remains one of the most pressing problems in medicine. Despite the improvement in the methods of diagnosis and treatment of bronchial asthma, the incidence of morbidity, disability and mortality from this disease is increasing from year to year all over the world. The article provides an analysis of the incidence of bronchial asthma and the leading risk factors in the Syrdarya region of the Republic of Uzbekistan. The obtained results show that the majority of patients with bronchial asthma have a genetic tendency. The work schedule of patients is improperly organized, there are many harmful occupational factors. Living conditions, family psychological environment, patients' attitude to medical services are not satisfactory. Frequent acute respiratory viral infections, bad habits, genetic predisposition, age composition, attitude to one's health, diet, alcohol consumption, going to a doctor with an acute form of the disease, social status, nature of work, attitude to medical care are the leading risk factors for the disease.
Keywords: Bronchial asthma, morbidity, risk factors, lifestyle, quality of life
Bronchial asthma is a chronic inflammatory disease of the airways of the airways, accompanied by bronchospasm, caused by specific immunological (sen-sitization and allergy) or nonspecific mechanisms, manifested by repeated episodes of wheezing, shortness of breath, chest congestion and coughing [1,5,7,8,13 ,15].
Bronchial obstruction is partially or completely reversible, spontaneously or under the influence of treatment. The incidence of bronchial asthma in the world is from 4 to 10% of the population [8,10,11,14,17]. The disease can occur at any age; in about half of patients, bronchial asthma develops up to 10 years, in another third - up to 40 years. Among children with bronchial asthma, there are two times more boys than girls. By the age of 30, the sex ratio levels off [8].
The WHO estimates that 235 million people suffer from asthma. Predictive analyzes show that this figure will reach 400 million by 2025.
In order to deepen the reforms of the health care system in the country, extensive program measures are being taken to improve the quality and efficiency of medical care provided to the population, in particular, the organization of effective prevention and treatment of bronchial asthma. Despite the reforms in the health care system, one of the main tasks of medical workers is to prevent morbidity, disability and mortality among various segments of the population due to complications of bronchial asthma [6]. Based on this, it is important to develop in scientific research a system for the prevention and early detection of bronchial asthma in primary health care facilities (PHC), a system of timely high-quality diagnosis and treatment on an outpatient
basis and in a hospital, prognostic indicators for reducing complications after treatment, a systematic approach. to prevent disease, improve lifestyle and quality of life, as well as identify the leading risk factors for morbidity, disability and mortality from bronchial asthma.
Purpose of the study. Study of the morbidity from bronchial asthma, risk factors, as well as the development of scientifically based measures aimed at improving the quality of medical care.
Material and research methods. At the epidemio-logical stage of the study (2018-2020), the prevalence of bronchial asthma in cities and districts of the Syrdarya region was studied using the method of general retrospective observation. Intensive and standardized scores are calculated according to gender and age composition.
The risk factors that cause the onset and formation of the disease have been studied using the case-control method of the subject of evidence-based medicine. To study the lifestyle, quality of life and risk factors preceding the development of the disease, 300 patients with bronchial asthma (case group) and 300 people living in similar conditions, but not suffering from bronchial asthma (control group) were recruited by selection. A questionnaire was prepared aimed at studying the lifestyle, quality, living conditions and health status of patients with bronchial asthma. Taking into account the living conditions, sociological and economic factors, the patients involved in the sociological study were chosen by the stratified method of the Syrdarya region. Patients in the acute stage of the disease, status asthmaticus, who were also treated in the hospital for
the disease in the last 4 weeks, were not involved in the study.
The complex influence of risk factors on the incidence rate was studied using a point system, the relative risk indicator was studied by the method of odds ratio, "weight coefficient", a comprehensive assessment of normalized intensive indicators (T.I. Iskandarov, B. Mamatkulov, 1994, B. Mamatkulov, 2013 ).
The results obtained and their discussion. According to the research results, the Syrdarya region ranks third in the republic in terms of the incidence of bronchial asthma. The incidence rate per 10,000 population averages 12.0 ± 0.23. The bulk of patients with bronchial asthma are people aged 40-60 years. % part of patients with bronchial asthma are able-bodied part of the population (18-59 years old). The disease in women is more than in men. This ratio is - 51:49 (p <0.05).
Based on the study of social and hygienic characteristics, risk factors and quality of life of patients with bronchial asthma, the main risk factors preceding bronchial asthma, lifestyle, quality of life and the results of medical activity of patients were determined. Most of the patients involved in the study (46%) have secondary education. They have been living in places of their permanent residence for more than 5 years. It was found that 52.0% of patients have close relatives with bronchial asthma. 76.4% of patients claimed that they had ARVI of the upper respiratory tract 2-4 times or more per year. Among the risk factors preceding bronchial asthma, the leading ones are home, street, plant, tobacco dust.
In 28.8% of patients with bronchial asthma, the work schedule is improperly organized, in 21.9% of patients there are harmful working conditions. In percentage terms, this is 2 times more than in the control group. The bulk of those involved in the work are workers in the industrial and agricultural sectors. 72.5% of patients have more than 10 years of work experience. Including work experience in the specialty for more than 10 years is observed in 61.9% of patients. Long-term work at hazardous enterprises is the impetus for the development of the disease.
The level of household and living conditions has a direct impact on human health. The results of the study found that 59.9% of patients do not fully meet these requirements. 16.8% of patients expressed incomplete satisfaction with their household and living conditions.
In 59.2% of patients with bronchial asthma, the diet is improperly organized. Also, 27.3% of patients stated that they readily accept spicy, salty foods rich in cholesterol. They do not pay attention to the norms in the diet. In particular, 44% of patients do not consume adequate amounts of protein-rich foods, fruits and vegetables.
Bad habits in patients are important in the development of the disease. 58.6% of the case group stated that they did not engage in physical exercise and sports at all. Among all smokers, 37.3% had a smoking experience of 20 years or more. The consumption of alcoholic beverages from adolescence in the case group is 3.2 times higher than in the control group. 28.0% of patients in the case group, and 7.5% of patients in the control group, started drinking alcohol at the age of 15-20 years.
The negative psychological environment in the house also affects the course and exacerbation of the disease. In the case group, the psychological environment is 79.6% worse than in the control group. It was found that 20.4% of patients do not read medical literature at all. The attitude of patients towards medical services is negative. 26.5% of patients are not satisfied with the provided medical services. In general, they did not undergo a medical examination and did not go to a doctor, even when they were ill, they were treated on their own.
The number of patients who assess their state of health as poor is 6.2 times more than in the control group. The health status of patients negatively affects their physical activity. In the control group, in 10% of patients, their health condition negatively affected their physical activity. For most patients, performing some physical activities, such as jogging, walking long distances, climbing several steps, present significant difficulties.
частые ОРВИ 12,3
5 4,4 ,7 ,6
употребление табака
наследственная предрасположенность
возрастной состав
характер питания 3
употребление спиртных напитков 3,2
обращение к врачу с острой стадией болезни 3,1
характер труда 3
стаж курения 2,5
прохождение мед.осмотра в последние 2-3 года 2,4
г 0 2 4 6 8 10 12 14
Rice. 3. Leading risk factors for the appearance of bronchial asthma
The disease affects the mood and emotional state of patients. 33.4% of patients in the last 4 weeks did not feel awake at all. As a result of the emotional state, most patients had to shorten their work time.
According to the results of numerous studies [5,13,16] and according to our data, the leading risk factors for the onset of bronchial asthma are: ARVI disease, tobacco use, hereditary predisposition, age composition, dietary habits, alcohol consumption, smoking experience, medical attention with acute form of the disease, nature of work, medical examination (Fig. 3).
Ranges of risk groups were developed based on risk factors for patients. On the basis of a systematic approach to the prevention of bronchial asthma, two-stage complex health-improving measures have been developed. On the basis of this program, a systematic approach is carried out in two stages. The first stage is carried out in PHC facilities. At this stage, doctors working in PHC facilities regularly improve their knowledge of early detection, diagnosis, treatment and prevention of bronchial asthma, create a database of morbidity, disability and mortality from this disease: the GP forms risk groups of individuals and patients at risk ; collects data on persons and patients with risk factors: the socio-economic status of the family, the composition of the family, the nature of work, hazardous production, economic and household living conditions, bad habits, medical knowledge and medical culture, the nature of the physical and emotional state; determines the degree of risk of disease and forms risk groups; in persons with risk factors, forms the skills of a healthy lifestyle. In these groups, the risk of disability and morbidity from bronchial asthma is analyzed. According to the data received, it is planned to provide medical services: limiting contact with allergens, timely detection and treatment of acute respiratory viral infections of the upper respiratory tract, the formation of skills in providing first aid for an asthmatic attack in a patient, his family members and those around him, drawing up a plan for timely active clinical examination and monitoring, development of measures for primary prevention. At the second stage, on the basis of the obtained database, at the first stage, complex health-improving measures are developed and carried out among risk groups. Family health schools are being formed. Measures are being taken aimed at: helping the patient and oneself with asthmatic attacks, taking timely and correct medications, regularly monitoring the condition, studying preventive skills, developing the medical activity of patients, timely seeking medical services for severe asthmatic attacks, social and emotional support , secondary prevention of disease and ensuring the activity of patients.
An individual step-by-step approach in the treatment and recovery of patients with bronchial asthma: initially develop a plan of activities in SVP, SSP, SP, etc. Planning for the rehabilitation of activities carried out in conjunction with sanatorium institutions.
Conclusion. 1. Most AD patients have a genetic tendency. The work schedule of patients is improperly organized, there are many harmful occupational factors. Living conditions, family psychological environment, patients' attitude to medical services are
not satisfactory. Frequent acute respiratory viral infections, bad habits, genetic predisposition, age composition, attitude to one's health, diet, alcohol consumption, going to a doctor with an acute form of the disease, social status, nature of work, attitude to medical care are the leading risk factors for the disease. These factors negatively affect the quality of life of patients, which leads to a sharp decrease in physical activity, emotional and psychological state of patients.
2. The quality of life of patients with bronchial asthma depends on the degree of the disease, sex and age characteristics, social status, bad habits, spiritual and psychological climate in the family and attitude to medical care. The decline in health status negatively affects the physical and emotional well-being of patients. These indicators negatively affect not only the patient, but also his family members.
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STUDY OF ANTIMICROBIAL ACTION COMPLEX DRUG OF «KARTULEX»
Krasilnikova N.
Ph.D. (Biol.Sc.) student,
Federal state budgetary institution "national medical research center of cardiology" of the Ministry of
health of the Russian Federation
ИЗУЧЕНИЕ АНТИМИКРОБНОГО ДЕЙСТВИЯ КОМПЛЕКСНОГО ПРЕПАРАТА
«КАРТУЛЕКС»
Красильникова Н.В.
соискатель ученой степени Ph.D. (Biol.Sc.), Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр кардиологии» Министерства здравоохранения Российской Федерации
Abstract
The problem of resistant infections has not only clinical (increased mortality, including among people of working age, disability of patients), but also economic consequences. Thus, at the level of the healthcare system, additional costs are associated with an increase in the consumption of resources of the healthcare system (additional days in the intensive care unit, prolongation of hospitalization, additional diagnostic studies, surgical interventions, etc.), at the level of society, economic losses are associated, among other things, with the inefficiency of other medical technologies, the use of which is accompanied by the appointment of antimirobial drugs (bone marrow transplantation, nursing of newborns with low body weight, etc.). In this regard, it is relevant to study the antimicrobial effect of the drug of "Kartulex". The conducted studies have shown that when studying the antimicrobial action, it was found that Kartulex in dilutions 1:2500, 1:5000, 1:7500, 1:10000 distilled water completely suppresses the growth of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter calcoaceticus. With prophylactic intragastric administration 24 hours before infection of mice with a lethal dose of Staphylococcus aureus, Kartulex prevents the development of a deadly staphylococcal infection in animals. At an optimal dose of 0.01 mcg/kg, Kartulex increases the survival rate of mice to 75.0% with 83.3% death in the control.
Аннотация
Проблема резистентных инфекций имеет не только клинические (повышение смертности, в том числе среди лиц трудоспособного возраста, инвалидизация пациентов), но и экономические последствия. Так на уровне системы здравоохранения дополнительные расходы связаны с увеличением потребления ресурсов системы здравоохранения (дополнительные дни в отделении реанимации и интенсивной терапии, пролонгация госпитализации, дополнительные диагностические исследования, оперативные вмешательства и т.д.), на уровне общества экономические потери связаны в том числе с неэффективностью других медицинских технологий, применение которых сопровождается назначением антимиробных препаратов (трансплантации костного мозга, выхаживание новорожденных с низкой массой тела и так далее). В этой связи является актуальным изучение антимикробного действия препарата картулекс. Проведенные исследования показали, что при изучении антимикробного действия установлено, что картулекс в разведениях
