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19xalqaro ilmiy-amaliy anjumani
2022 yil 30 noyabr | scientists.uz
MICROCIRCULATION DISORDERS IN THE VASCULAR SYSTEM OF THE BULBAR CONJUNCTIVA IN THE INITIAL MANIFESTATIONS OF CEREBRAL
BLOOD SUPPLY DEFICIENCY Farrukh Shernazarov
Samarkand State Medical University Department of Ophthalmology
Associate Professor Jalalova Dilfuza Zuhridinovna
Samarkand State Medical University https://doi.org/10.5281/zenodo.7367530
Abstract. Cerebrovascular diseases are one of the urgent problems of modern medicine. According to the World Health Organization, this disease is very common in all countries. Incidence is from 1.5 to 7.4 (per 1000 population), death is 10-15 percent, disability is 30-35 percent. It can be seen that at present this issue is not only a medical problem, but it is becoming one of the social tasks.
In recent years, the problem of the risk of ischemic stroke has attracted everyone's attention. It is characterized by the fact that it remains the main reason for 1/2 of death and disability in developing and developed countries, despite the development of pharmacology, clinical examinations, and primary and secondary prevention of the disease. Given that cerebrovascular diseases are getting younger day by day, it is possible to understand how urgent this problem is. 6 million in one year around the world. population suffers from cerebral stroke. It is sad that only 20% of these patients return to active life.
Key words: hypercholesterolemia; atrial fibrillation; taking oral contraceptives; hormone replacement therapy during menopause, excessive alcohol consumption.
Acute cerebrovascular accident is a brain injury caused by vascular changes, characterized by focal symptoms, general brain symptoms, meningeal symptoms or a combination of these symptoms. Transient cerebrovascular disorders and strokes differ depending on how long neurological deficits persist in the patient. Patients with frequent emotional stress, lack of movement, smoking, high body weight, diabetes, arterial hypertension, dyslipoproteinemia, genetic predisposition to diseases of the cardiovascular system are patients with a high probability of this disease.
The ischemic type of acute cerebral blood circulation disorder occurs as a result of the inability of the brain to meet the need for oxygen and energy substrates, the blood coming to the brain, and the sudden deterioration of blood circulation in the brain. On the basis of the hemorrhagic type of acute cerebrovascular blood circulation disorder, bleeding into the brain tissue, cerebral ventricles, and under the meninges occurs as a result of the violation of the integrity of the walls of cerebral blood vessels.
As a result of the study of the causes of cerebrovascular diseases, it was found that there are several risk factors: the age of patients plays an important role in the development of the disease, the risk of developing the disease increases with age. Although the disease poses a threat mainly to the elderly and elderly part of the population, as people age, the risk of developing cerebrovascular diseases doubles every 10 years, for example, 1:30000 in 0-14 years of age, 35 It is 1:5000 in the 44-year-old age group, 1:100 in the 65-74-year-old age group, 1:50 in the 75-84-year-old age group, 1:30 in the 84-year-old age group and above. It should be noted that in elderly and elderly people, disorders of the cerebrovascular system and lipid metabolism are interrelated with the origin of atherosclerosis pathology, and the development of atherosclerosis, in turn, leads to hypertension. will bring.
Heredity - Heredity plays a big role in the origin of heart disease and atherosclerosis.
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2022 yil 30 noyabr | scientists.uz
Atherosclerosis is an important cause of death and disability in the developed countries of the world. In ischemia of all organs in the body, especially in diseases of the central nervous system and cardiovascular system, damage to large and medium-sized arterial blood vessels plays a key role. In this case, as a result of the proliferation of the inner layer (intima) of arterial blood vessels, which consists of smooth muscle cells, and the deposition of lipids in this area, the narrowing of the blood vessel space occurs.
Atherosclerotic plaque develops in the primary damaged area of the blood vessel. The clinical presentation of atherosclerosis depends on which organ's blood vessels are damaged and its character. For example: coronary atherosclerosis is the cause of angina or myocardial infarction, damage of cerebral arteries can be the cause of brain stroke. Atherosclerosis of renal arteries is an important factor in the origin of arterial hypertension, and at the same time it is considered a risk factor for atherosclerosis. Atherosclerosis has a wavelike course. Atherosclerotic plaques can develop over several years or several decades. Atherosclerosis affects the arteries in different ways, usually the atherosclerotic plaques restrict the flow of blood by causing stenosis and occlusion in the blood vessel cavity, or else it can cause aneurysm of the vessels by widening the blood vessel cavity. . This condition is typical for the aortic blood vessel.
Because aneurysm rupture or expansion is more common here compared to stenosis and occlusion.
Inactivity can be the cause of various cardiovascular diseases.
Diet is an elemental factor that can cause heart disease and atherosclerosis. As a result of the investigation, Japanese scientists came to the opinion that the consumption of white rice and table salt more than the standard is the cause of heart disease and cerebral hemorrhage.
Smoking doubles the risk of stroke, accelerates the development of atherosclerosis in carotid and coronary arteries. In people who stop smoking, the risk of stroke may decrease only after 2-4 years.
The psycho-emotional factor F. Ablyalitov's investigation during the earthquake shows that sudden disruption of homeostasis control in patients leads to acute cerebral blood circulation disorders, especially transient disorders.
Haffagan disease is a primary (essential hypertension) or secondary increase in systolic and/or diastolic arterial blood pressure.
Hypertension is one of the main risk factors for both hemorrhagic and ischemic stroke. Studies show that an increase in blood pressure of 50 mm Hg increases the risk of stroke by 1/3 times; 90 mm of AD. s. exceeding it increases the risk of stroke. Blood pressure is 160/95 mm. s. she is. t. The risk of stroke in patients with hypertension is 4 times higher than in people with normal blood pressure. 200/115 mm.s.u.t. and it was observed to be 10 times higher in patients with high blood pressure. Arterial hypertension causes focal and diffuse changes in the brain.
Focal changes - when arterial pressure increases (also when hypertensive crisis is observed); vessel wall myocyte necrosis, plasmorrhagia and its fibrinoid necrosis are observed. This leads to the development of aneurysms, resulting in bleeding in the brain. At the same time, bending of the walls, narrowing or closing of the arteriole space causes the development of a lacunar infarction of the brain.
Acute cerebrovascular accident is a complication of the cerebral variant of hypertensive crisis and manifests as hypertensive encephalopathy, transient cerebrovascular accident, hemorrhagic or ischemic stroke.
A hypertensive crisis is a sudden rise in arterial pressure compared to the individual blood pressure, with deep manifestations of hypertensive symptoms and/or the appearance of additional symptoms.
The influence of external environment and ecology on infectious diseases and poisoning
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Infectious-allergic encephalitis, syphilis, acquired immune deficiency syndrome (AIDS). Diabetes (sometimes complicated by cerebral infarction). In this case, lipid metabolism disorders, arterial hypertension, and atherosclerosis are the main factors.
Also read this article: Is discirculatory encephalopathy a pre-stroke disease?
Taking hypoglycemic drugs in patients with diabetes does not reduce the risk of stroke:
hypercholesterolemia;
atrial fibrillation;
taking oral contraceptives;
hormone replacement therapy in menopause;
excessive consumption of alcohol.
It slows down blood circulation in the blood vessels, resulting in permanent O2 deficiency in the brain cells. As a result, memory degradation occurs. Alcohol causes early onset of sclerotic changes in the veins and increases the risk of bleeding.
Hemodynamic factors. Decreased arterial pressure, heart rhythm disorders, bleeding, orthostatic hypotension, iatrogenic effects, etc. from myocardial infarction.
The presence of several of the above-mentioned factors in one patient develops cerebrovascular disease.
Diseases that cause cerebral circulation disorders:
atherosclerosis;
heart disease;
coexistence of atherosclerosis and heart disease;
increase in blood pressure in other diseases - symptomatic hypertension; hypotension and symptomatic hypotension;
heart disease - myocardial infarction and arrhythmias, congenital heart diseases;
vasculitis, endoarthritis (rheumatic syphilitic, allergic, toxic);
aneurysms;
blood diseases (aplastic anemia, erythremia, leukemia, thrombocytopenic purpura, etc.);
crushing of arteries and veins (in spine diseases and tumors);
endocrine diseases;
oncological diseases;
vegetative dystonia syndrome;
intoxications (exo- and endogenous).
Preventing the development of cerebrovascular diseases as a result of the above-mentioned factors is in everyone's hands.
Because azithromycin has been shown to provide good results with a single oral dose, it is now used as the first choice. Neonatal
Conjunctivitis Neonatal conjunctivitis is defined as conjunctivitis that occurs in the first month of life. The most important are gonococcal, chlamydia, simple bacterial and chemical conjunctivitis.
Chemical conjunctivitis is a reaction to antibiotics or silver nitrate used to prevent gonococcal infection and usually develops as mild conjunctival hyperemia within the first few hours after birth and resolves within 24 hours.
Gonococcal conjunctivitis is a hyperacute purulent conjunctivitis that begins 1-3 days after birth and is characterized by chemosis, eyelid edema, pseudomembrane or membrane formation. It is transmitted from the mother at birth.
Since keratitis and corneal perforation can develop if treatment is delayed, treatment should be urgent and the patient should be hospitalized with close monitoring. In the treatment, topical and systemic penicillin (benzyl penicillin 50,000 U / kg / day divided into two parts for 7
xalqaro ilmiy-amaliy anjumani
2022 yil 30 noyabr | scientists.uz
days) is given. A single dose of 100 mg/kg cefotaxime (Cefoxim) is a good alternative therapy. In addition, parents should check for genital infection.
Chlamydial conjunctivitis is the most common cause of neonatal conjunctivitis. It usually develops in the form of acute mucous-purulent conjunctivitis within 5-14 days after birth. There is a papillary reaction in the conjunctiva, but the follicular reaction does not develop (because lymphoid tissue is not present in the first three months).
Correct diagnosis and treatment are important because corneal opacity can develop due to keratitis. Systemic complications such as otitis, rhinitis, pneumonia may develop.
Treatment should include topical tetracycline and oral erythromycin (2 x 25 mg/kg, 14 days). Mother and father should be checked for genital infection.
Simple Bacterial conjunctivitis can appear at any time after birth, and the most common causative agent is staphylococci. Local treatment is sufficient.
ALLERGIC CONJUNCTIVITIS
Seasonal allergic mine. This is a common type 1 hypersensitivity reaction that is triggered by antigens such as pollen, chalk dust, carpet and wool particles. It is characterized by episodes of itching, redness and watering, especially in the spring months. On examination, hyperemia passes with mild chymosis and diffuse papillary reaction.
Perennial AK: Clinically similar to seasonal allergic conjunctivitis, but differs in that it occurs at any time of the year.
Topical mast cell stabilizers (2% Na-cromolyn, lodoxamide 4x1) are used in the treatment. In very severe cases, topical steroids and systemic antihistamines may be used for a short time. New generation antiallergic drops; olopatadine (Patanol), epinastine (Relestat), Ketotifen fumarate 0.025% (Zaditen) and 2 x 1 are used. Cold compresses help in treatment.
Acute allergic conjunctivitis: This is an acute urticaria-like reaction that occurs when large amounts of allergen reach the conjunctiva. It usually occurs in young children after playing on the grass. It is clinically characterized by sudden onset of valves and sinus edema. Most resolve on their own within a few hours.
Vernal Keratoconjunctivitis (VKC)
VKC is a recurrent, bilateral, external ocular inflammation affecting children and young adults (ages 5-18). It is more common in men. Both type 1 and type 4 hypersensitivity reactions play a role.
Itching is the main complaint. It is accompanied by watering, photophobia, burning, itching, redness, sensation of a foreign body in the eye and light burring (mucous secretion). Complaints are present throughout the year, but increase in spring and summer.
There are two types. In the valve type, which is more common in our country, when examining the conjunctiva of the upper eyelid, papillae with giant stones, chemosis, serum secretion and conjunctival hyperemia are observed. In the limbal type, seen mostly in blacks, papillae and nodules are seen at the limbus. Punctate epitheliopathy, non-healing macroerosions, pseudogerontoxon formation similar to arcus senilis are seen in the cornea. Keratoconus is common in VKC patients.
Steroids are often needed in treatment along with mast cell stabilizers. Patients are often advised to wear cool clothes and use sunglasses.
AUTOIMMUNE CONJUNCTIVITIS
1. Ocular cicatricial pemphigoid (OSP): This is a type 2 hypersensitivity reaction. This is a disease that occurs in elderly women. Dry eye, symblepharon, ankyloblepharon, cicatricial entropion, trichiasis and lagophthalmos and associated keratopathy are the most important ocular findings. Topical steroids, artificial tear drops, and prophylactic antibiotics may be used during the acute phase. Systemic immunosuppressive agents (steroids, dapsone, azothioprine, cyclophosphamide) can be used.
xalqaro ilmiy-amaliy anjumani
2022 yil 30 noyabr | scientists.uz
2. Stevens-Johnson syndrome: This is a type 3 hypersensitivity reaction triggered by drugs (sulfanilamides) or infections (mycoplasma pneumonia and HSV infections). It is common in young men. The lesion mainly consists of skin and bone. This is a picture of acute vasculitis affecting. On examination, bullous lesions on the skin are accompanied by erosion of the mucous membrane of the oral cavity and conjunctiva. It can heal without consequences or lead to conjunctival fibrosis and keratinization. In treatment, topical steroids prevent conjunctival infarction by controlling vasculitis.
Artificial tear drops can also be used.
CHEMICAL VOLUNTEERS
Acid burns: Acids precipitate tissue proteins, causing them to coagulate and form a barrier that prevents them from penetrating deeply. The secret circle is limited to the conjunctiva, eyelids and cornea.
Alkaline burns: This is one of the ophthalmological emergencies. The alkaline substance quickly penetrates the layers of the cornea, the anterior chamber, the angular region, the iris, the lens, and the ciliary body and causes very serious problems such as cataract, uveitis, secondary glaucoma, bulbar phthisis, as well as damage to the conjunctiva and cornea. Ischemic necrosis can be observed in the limbus.
TREATMENT: Flush immediately with plenty of fluids!!! This is the first and most important treatment that should be done. Irrigate with 500-1000cc of SF by opening the eye or inserting an eye speculum, and irrigation should be continued until the pH returns to normal by checking.
The uveitis reaction can be suppressed with topical steroids. Close monitoring and eye closure with antibiotics and artificial tear drops is essential. If necessary, surgery can be performed after the acute picture subsides (this may take several months).
CONJUNCTIVE DEGENERATION
Pinguacula: This is a slightly raised lesion consisting of yellow-white deposits on the bulbar conjunctiva near the nose or temple of the limbus. It is caused by degeneration and sometimes calcification of collagen fibers. This is a very common lesion. It usually does not require treatment.
Pterygium: This is a triangular fibrovascular tissue that extends into the cornea, usually in the nose. It is especially common in people living in hot climates. The sun is a factor in the development of pterygium. Bowman's membrane and superficial stroma were damaged in the cornea below the lesion.
Treatment is surgery. The indication for surgery may be for cosmetic reasons or for reasons such as displacement of the lesion towards the visual axis or astigmatism as a result of corneal compression. In surgical practice, removal of the affected area with a limbal autograft and grafting of the lesion site is the optimal method. In this way, recurrence rates are reported to be significantly reduced.
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2022 yil 30 noyabr | scientists.uz
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2022 yil 30 noyabr | scientists.uz
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F. Shernazarov, J. Tohirova, D. Jalalova TYPES OF HEMORRHAGIC DISEASES, CHANGES IN NEWBOENS, THEIR EARLY DIAGNOSIS // SAI. 2022. №D5. URL:
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