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Section 7. Medical science
decrease of protective functions of gastric and duodenal mucous membrane, and its blood supply.
For the detection of the mechanism of antiulcer effect we studied the influence of glycytrinate on secretory function of stomach and acidity of gastric juice on rats. Results of the experiment showed that, in the control group of rats the volume of gastric juice was 2.05 ml, pH = 1.33, total acidity 0.5 ml, titrated unit was 100 TU. Under the influence of the agent the volume of gastric juice decreased to 39%, pH = 3.25, total acidity 0.37, titrated unit 74 TU.
Development of ulcerous process proceeded together with background decrease of SOD antioxidant system enzyme activity [1.07 (1.0±1.14)] and catalase [1.41 (0.94±1.88)]. Glycytrinate
3.3 folds increased the activity of catalase in comparison with the control [4.76 (1.96±7.6)], and activity of super oxide dismutase [1.24 (1.14±1.34)].
Thus, under the influence of the agent pH shifted to alkali side
1.4 folds; total acidity decreased to 26%. The agent decreased the speed of mucocytes exfoliation, and by these means increased formation of mucin and bicarbonates, which neutralize hydrogen ion, increasing mucous viscosity in stomach. Development of ulcerous process in animals was accompanied by significant decrease of enzyme activity of antioxidant protection. So we can state that, expressed antiulcer effect of glycytrinate is conditioned by its anti-oxidant properties.
We performed clinical testing of glycytrinate on patients with gastric and duodenal ulcers in the gastroenterology unit of Tashkent Medical Academy.
It was revealed that glycytrinate has antiulcer and anti-inflammatory effect. It is sufficiently effective and has no side-effects. Its efficiency and tolerance is similar to the agent for comparison De-nol.
Earlier we determined that, trinatrium salt of glycyrrhizic acid — "Glycytrinate" was little toxic, even in doses over 40005000 mg/kg, in case of per oral administration on rats it had no toxic effect, as it did not cause lethal outcome [3]. According to antiulcer activity on the models of rats' gastric mucous membrane destruction caused by indometacin, ortophen, and reserpin, it was determined that, glycytrinate had expressed antiulcer effect [2].
On formalin model the agent was characterized by anti-inflammatory effect [8]. In experiments on various animals the agent doses with antiulcer effect did not have a significant influence on CNS, vegetative innervations, breathing, and arterial pressure. The study of chronic toxicity revealed that the agent had no local irritating, accumulative, or embryonic toxic effect [3].
Thus, it was determined that "Glycytrinate" agent was little toxic and had expressed antiulcer activity. The mechanism of antiulcer effect of glycytrinate is linked with its antioxidant property and suppression of the secretory function of gastric glands.
References:
1. Aminov S. D. Antiulcer activity of pinocembrine. Actual problems of gastroenterology and dietology. [Materials of Republican scientific-practical conference.] Protivoyazvennaya aktivnost pinocembina. Aktualniye problemi gastroenterologii I diyetologii. Materiali respublikanskoy nauchno-practicheskoy conferencii. Urgench, November 14-15, 2005. P. 182-183 (in Russian).
2. Aminov S. D., Babayeva L. T. Poisk novikh protivoyazvennikh preparatov sredi trizameshennikh soley glycirizinovoy kisloti. [The search of new antiulcer agents among trireplaced salts ofglycyrrhizic acid. Infection, immunity and pharmacology.] 2012; - № 3: P. 12-13 (in Russian).
3. Aminov S. D. Redjepov J. The study of chronic toxicity of gastro protector agent glycytrinate. [Bulletin of South Kazakhstan pharmaceutical Academy. Republican scientific journal.] Izucheniye khronicheskoy toksichnosti gastroprotektornogo preparata glycytrinat. - № 3, 2014, P. 93-96. (in Russian).
4. Brusov O. V., Gerasomiv A. I., Panchenko L. V. The impact of natural inhibitors of radical reactions on the auto oxidation of adrenalin. Vliyaniye prirodnikh ingibitorov radikalnikh reaktsiy na autookisleniye adrenalina. [Bulletin of experimental biology and medicine]. 1976. - № 1. - P. 33-35 (in Russian).
5. Grigoriyev P. Y., Yakovenko E. P., Yakovenko A. V. Modern branches in pharmacotherapy of digestive system diseases. Sovremenniye napravleniya v farmacoterapii bolezney organov pishevareniya. [Clinical medicine]. 1999. - № 10. - P. 7-10.
6. Zemlyanskaya N. R., Adilova Z. A., Orlova Y. Y., Mirkhanova F. A., Novikova I. U., Makhkamov K. M. Isolation of glycyrrhizic acid from Radix glycyrrhizae. Videleniye glicirrizinovoy kisloti iz solodkovogo kornya. [Pharmaceutical journal]. 2004. - № 2. P. 30-31.
7. Korolyuk M. A. et al. Method of definition of catalase activity. Metod opredeleniya aktivnosti katalasi. [Laboratory affair]. 1988. - № 1. P. 16-19.
8. Rejepov J., Zemlyanskaya N. R., Makhkamov K. M. Anti-inflammatory activity of glycytrinate. Protivovospalitelnaya aktivnost glicitri-nata. [Pharmaceutical journal]. 2007. - № 3. P. 18-20.
9. Strelkov R. V. Statistical tables for acceleration of quantitative assessment of pharmacological effect. Statisticheskiye tablitsi dlya uskore-nnnoy kolichestvennoy otsenki farmacologicheskogo effekta. [Pharmacology and toxicology]. - 1986. - № 4. P. 100-104.
Muratova Shakhlo Tahirjanovna, MD, PhD, researcher at the Thyroidology Department of Republican Specialized Scientific and Practical Medical Center of Endocrinology, Uzbekistan.
E-mail thyrlab@list.ru
The anxious state in the adolescents with Graves' disease under conditions of Iodine deficit
Abstract: In 19 adolescent children with Graves' disease were studied especially the psycho-emotional state with using test of Spielberg (STPI — State Trait Personal Inventory), modified by A. D. Andreeva. In this group of children identified
The anxious state in the adolescents with Graves' disease under conditions of Iodine deficit
expressed vegetative symptoms, stress symptoms et al., and also in this group dominated phenomenon anxiety and negative emotional experiences, but cognitive activity was lower when compared with those of the control group. Further it's necessary to study of emotional expressions and anxiety syndrome in adolescents with Graves' disease. Keywords: adolescents, Graves disease, thyrotoxicosis, anxious syndrome.
According to the traditional system the anxious disorders are related to the group of neurotic disorders (neurosis). In the ICD the anxious disorders present clusters F40-F41. The basic feature of generalized anxious disorder (F41.1 by ICD-10) is the anxiety which seems to be generalized and persistent, is not limited by any ambient conditions and even does not arise at all with obvious pref-erability under these circumstances. The symptoms are expressed mostly often as:
1. Fear (anxiety about the future failures, sensation of excitement, difficulty in concentration etc.);
2. Motor tension (fussiness, headaches of effort, shiver, impossibility to relax);
3. Vegetative hyperactivity (sweating, tachycardia or tachypnea, epigastral discomfort, dizziness, dryness in a mouth and etc.).
Epidemiologic study "RAPSODY" showed that among the patients suffering from chronic pain syndromes, 14% had only disturbing disorders, in 17% — only depressive disorder, and in 36% — combination of anxiety and depression [5, 13]. The anxiety disorders are diagnosed only at 50% of the patients with clear symptoms [15, 16]. Clinical typical anxiety occurs in 5-7% in the general population, and in 25% or more patients observed by the general practitioner. Morbidity rate due to anxiety disorders may accounts more than 30% [7, 9].
Etiology, pathogenesis, clinical picture, efficacy and cost ofvari-ous methods of treatment of Graves' disease are subjects of multiple studies [2, 10], at the same time not enough attention is given to the patient — dependent characteristics, especially to their psychological state and quality of life. [3]. Thus the significant importance in occurrence and progressing of GD is given to the extrathyroid effects as factors contributing to realization of genetic predisposition to development of GD which are expressed by personal characteristics, emotional state of the patient, presence of psycho-injuring situation (acute, chronic stress) (6), and at the same time thyrotoxicosis itself seems to be factor provoking stress, severe psychic trauma that worsens the psychic state of the patient. Thyroid hormones are mediators in the hyppocampal neurogenesis and effect on the mood, stimulate reticular formation and cortical processes in the central nervous system [1; 12; 14], while thyrotoxicosis induces worsening of the general and central hemodynamics being responsible for such changes in the brain which, in their turn, resulted in pathological cerebral changes, creating so called "the closed circle" [10].
Thus, the Graves' disease has negative effect on the psychic state of the patients, contributes to development of secondary psycho-vegetative disorders of ithyreotoxic encephalopathy, progressing of thyrotoxicosis [1].Involvement of the central nervous system into the pathological process in thyrotoxicosis seems to be so clear, that the physicians from the end of nineteenth century to beginning of the twentieth century called this state "neurothyrosis" "thyroneu-rosis" [3; 8].
Research objective: to study characteristics of the psychoemo-tional state in adolescents with Graves' disease with use of Spilberg's test, modified by A. D. Andreeva.
Materials and methods
On the basis of clinic of RSRPMC of Endocrinology of the Ministry of Health of the Republic of Uzbekistan there were studied 19 children of the adolescent age with Graves' disease. At the same
time there were observed 12 healthy adolescents without endocrine pathology, pupils of the secondary school in Tashkent, forming control group.
Diagnosis of the thyroid gland pathology (TG) was made on the basis of clinical data (examination and palpation), laboratory investigations, radioimmune assay (TSH, fT3, f T4, AT-TPO), needle aspiration biopsy (if required), ultrasonography of the thyroid gland.
The study of the anxiety syndrome in the adolescents with Graves' disease was performed with use of questionnaire of Spilberg (STI — State Trait Personal Inventory), modified by A. D. Andreeva (1988). This questionnaire includes scales of the cognitive activity, anxiety and negative emotional worry, characterizing personal characteristics of the subject. Each of these scales consists of 10 points, distributed in the special order. At answer the studied subjects use four-point rating scale: "Almost never" (1 point), "Sometimes" (2 points), "Often" (3 points), "Almost always" (4 points) [4, 11].
Thus, for each individuum the information were obtained about general level of the main emotional processes — anxiety, cognitive activity and negative emotional feeling — and character of their expressions.
Results and discussion
The average age of the studied adolescents with Graves' disease was 13,0±0,6 years, the average age of control group had no reliable differences from studied group and accounted for13,7±0,2 years. However gender distribution differed reliably between groups — in group of the control the girls was 7 (58,3%), and boys 5 (41,7%), whereas in group of the teenagers with GD in the girls the diagnosis of thyrotoxicosis was made more often than 5,3 times in comparison with boys (16 cases (84,2%) against 3 (15,8%), respectively), OR 3,8; DI (0,7-20,5).
The average duration of illness in group of the adolescents with thyrotoxicosis was, on the average, 2,5±0,4 years (range from 2 months till 8 years). By results of radioimmune analysis the mean values of the thyroid status indicated about presence of thyro-toxicosis in the studied children: TSH 0,16±0,02 mIU/1 (norm 0,174,05), fT3 5,8±0,1 pmol/1 (norm 2,5-5,8), fT4 24,1±0,3 pmol/1 (norm 11,5-23), AT-TPO 14,02±1,9 IU/ml (norm less than 12).
Endocrine orbitopathy was diagnosed in 13 (68,4%) adolescents with thyrotoxicosis. At the moment of this article has being written 14 (73,7%) children continue to receive thyrostatic therapy with drugs of thyamazole, in 2 (10,5%) there is noted remission of thyrotoxicosis, 3 (15,8%) children was carried out total/peritotal thyroidectomy and the replacement therapy was prescribed with preparations of sodium Levothyroxine, registered in the Republic of Uzbekistan, in appropriate dosage.
The majority of clinical effects of thyrotoxicosis have been connected with effect of exceed amount of thyroid hormones on the sympathetic nervous system. As a result of this the tachycardia occurred, tremor of the fingers of the outstretched arms (Mary's symptom), whole-body tremor, of the tongue, hyperhidrosis, irritability, feeling of anxiety and fear, hyperactivity, restlessness. Besides, thyroid hormones stimulate reticular formation and cortical processes in the central nervous system.
All surveyed adolescents with GD had vegetative symptoms: tachycardia or palpitation, hyperhidrosis, feeling heat, fine tremor of fingers, and also complained on feeling of an asphyxia (89,5%),
Section l. Medical science
rough breathing (84,2%), discomfort in the chest (68,4%). From the symptoms of tension there was noted muscular tension and/or pain in the muscles (63,2%), restlessness and inability of relaxation (100%), feeling of nervousness (100%), «have a broad back» or to be on psychic tension (100%), sensation of a lump in the throat (94,7%) or difficult swallowing (73,7%). Besides, the other not specific symptoms are revealed:
- strengthened reaction to unexpectedness or on a fright (63,2%);
- difficulties in a concentration of attention or «emptiness in a head» because of an alarm or trouble (47,4%);
- constant irritability (94,7%);
- difficult falling asleep due to restlessness (worry) (63,2%).
By results of the performed research of anxiety by Spilberg's
questionnaire (STPI — State Trait Personal Inventory), modified by A. D. Andreeva (1988), in the adolescents we revealed, that among children with thyrotoxicosis the signs of anxiety and negative emotional feeling prevailed, and cognitive activity appeared to be lower in comparison with parameters of the control group (Fig.1) the phenomena of uneasiness and negative emotional experiences prevailed, thus познавательная the activity has appeared below, at comparison with those parameters of control group (Fig. 1).
Figure 1. Parameters of the Spilberg's test in children with GD and group of control. Thus in group of the adolescents with toxic goiter in 100% of high degree of negative emotional experience, and in third of chil-children the high level of an alarm was revealed (range of points dren (31,6% (6)) the middle degree of negative emotional experi-24-40), in the same group children prevailed (68,4% (13)) with a ences (Fig. 2) was diagnosed.
Figure 2. Results of a questionnaire STPI among the adolescents with Graves' disease.
Whereas the analysis of similar parameters in control group has shown, that in 50% (6) of healthy teenagers the low level of an alarm was revealed, in other half — middle level of an alarm was revealed; children with a high degree of negative emotional experiences in this group were absent, the adolescents with middle degree
(75% (9)) of negative emotional experiences (Fig. 3) prevailed. At the same time in control group at 91,7% (11) of children there has appeared high cognitive activity, whereas among the patients with thyrotoxicosis the low (10,5% (2)) and middle (89,5% (17)) level of cognitive activity was revealed.
Figure 3. Results of a questionnaire STPI among the teenagers of control group.
The combined effect of complex mixes of poisons on the organism of white rats in 30-day round-the-clock inhalation.
After consultation of neurologist in 14 (73,79%) adolescents with thyrotoxicosis there has been diagnosed endocrine encephalopathy, of them in 8 (57,4%) — neurasthenia.
Conclusion
1. In all adolescents with Graves' disease there are noted vegetative expressions of thyrotoxicosis, connected with influence of exceed quantity of thyroid hormones on the sympathetic nervous system.
2. Among children with thyrotoxicosis the phenomena of anxiety and negative emotional experiences prevailed, thus cognitive activity has appeared below in comparison with those parameters of control group.
3. The further research of emotional expressions and anxiety syndrome in the adolescents with Graves' disease would be required.
References:
1. Antonova K. V. Thyrotoxicosis. Changes of mentality. Treatment opportunities//RMJ. - 2006. - Vol.14. - № 13. - P. 14-15.
2. Balabolkin M. I., Klebanova E. M., Kreminskaya V. M. Differential diagnostics and treatment of endocrine diseases: Manual Book. - M.: medicine, 2002. - 752 p.
3. Frigorieva E. A., Pavlova E. Павлова Е. A. Depression and thyrotoxicosis//Socialnaya and clinicheskaya psychiatry. - 2010. - № 2. - P. 100-107.
4. Dermanova I. B. A questionnaire for research of anxiety in the senior teenagers and young men (Spilberg Ch. D. Adaptation by Andreeva A. D.)/Diagnostics of emotional -moral development. - SPb., - 2002. P. 75-80.
5. Muratova Sh. T., Ismailov S. I. Influence of Graves' disease on psychic-cognitive state of children and adults (review of the litera-ture)//Mejnarodniy endokrinologichniy journal, Ukraine. - № 6 (70), 2015. - with 86-90.
6. Fadeev V. V. Diseases of the thyroid gland in the regions of mild iodine deficit.
7. Cytko E. V., Korotaev A. V., Naumenko E. P., Kudlacevich S. B. Specific features ofvegetative regulation and structural-functional heart parameters in diffusive toxic goiter three months later the thyroidectomy. Problemi zdoroviya I ecologii.-2013.-2 (36). - P. 70-75.
8. Shereshevskiy N. A. Klinical endocrinology. - M., - 1957, 307 p.
9. Cao Y., Liu Z. Factor structure and factorial invariance of the State-Trait Anxiety Inventory for Chinese children and adolescents//Psych J. 2015 Jun; 4 (2): 74-87.
10. Dement M. M., Ozmen B., Deveci A. et al. Depression and anxiety in hyperthyroidism//Arch. Med. Res. 2002. Vol. 33, N 6. P. 552-556.
11. Julian L. J. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A)//Arthritis Care Res (Hoboken). - 2011. Nov; 63 Suppl 11: S467-72.
12. Kelly S., Hall L. Measuring anxiety in adolescents exposed to community violence: a review, comparison, and analysis of three mea-sures//Issues Ment Health Nurs. 2010 Jan; 31 (1): 28-38.
13. Mignon A., Linkowski P., Van Heeringen C., Dramaix M. Registry of patients with painful symptoms and observation of depression and anxiety.//19th Congress of European college of Neuropsychopharmacology, Paris, France, 16-20. Sep. 2006.
14. Muratova Sh. T., Ismailov S. I. Mental characteristics of teenagers with Graves' disease in Uzbekistan//European science review (Vienna). - № 7-8 (July-August) - 2015. - Р. 77-80.
15. Orgil S. M., Spence S. H., Huedo-Medina T. B., Espada J. P. Spanish validation of the Spence Children's Anxiety Scale//Child Psychiatry Hum Dev. 2012 Apr; 43 (2):271-81.
16. Van Wijk C. H. The use of Spielberger's State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists//Int J. Occup Med Environ Health. 2014. Dec; 27 (6): 959-66.
Mirzakarimova Malokhat Abduvakhidovna, Scientific Research Institute of Sanitary, Hygiene and Occupational diseases, candidate of biological sciences, senior researcher E-mail: ludmilamedlib@mail.ru
The combined effect of complex mixes of poisons on the organism of white rats in 30-day round-the-clock inhalation and measures of biological prevention
Abstract: The direction of "biological prevention" in the field of hygiene of the environment, which is understood as the complex of measures directed to the increase in resistance of individual person and population to exposure of harmful factors of the industrial and ambient environment, are increasingly being developed over the last years. For biopreventive maintenance only the means are used harmless at long application in preventive effective dosage. In this context in the industrial towns for residents of ecologically unfavourable territories there are used pectin, glutamate, adaptogenes ofvegetative origin and additives containing calcium, iodine, iron, cuprum, various vitamins and some aminoacids as bioprotectors.
Keywords: environment pollution, poisons, rats, bioprotectors.
Last years the persistent interest has been observed to devel- poisons by method of correction of metabolic processes directed to opment of methods of bioprevention of intoxications with various the lowering of their toxic effect [4].
