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DOI: http://dx.doi.org/10.20534/ESR-17-1.2-148-150
Shadiev Sadulla Samekhjanovich, Samarkand State Medical Institute Senior Staff Scientist of the Department of Maxillofacial Surgery
E-mail: sadi14@mail.ru Fazilova Dilshoda Ulugbekovna, Samarkand State Medical Institute Master of 3d Year of Study, Department of Maxillofacial Surgery
E-mail: dilichka@mail.ru
The effectiveness of ozone therapy in treatment of acute osteomyelitis of jaws in children
Abstract: 29 children aged from 7 to 16 years old have involved to investigation and analyses of fatty acids have carried out by gas-fluid chromatography. Markers of endogenic intoxication molecules of average mass (MAM) — MAM254, MAM280, malone dialdehyte (MDA), activity of antioxidant enzyme of catalase (CA), coefficient ofMDA/CA and MAM280/MAM254 — coefficient of protein resistance (CPR) have determined in plasma of venous blood. Ozone therapy consisted in performing procedures of the local and general action. It is established that ozone therapy in children with acute osteomyelitis of jaws respectively reduces concentrations of MDA, MAM254, MAM280, proportion of MDA/CA and increases activity of catalase and coefficient of protein resistance (CPR), it is also established a reliably reduction the concentration palmitinic and palmi-tolien acids and increase of oleic acid.
Keywords: osteomyelitis of jaw, gas-fluid chromatography, endogenic intoxication, fatty acids, ozone therapy.
Introduction. In spite of the preventive measures for the last years frequency of inflammation processes of maxillofacial area in children steadily increases, most often rapid progressive types of disease course is observed [1; 5]. Odontogenic infection is become the cause of purulent-inflammatory processes in the soft tissues of maxillofacial area (MFA) in 65-70% of patients. Patients with inflammatory processes of maxillofacial area are from 40 to 60% of all hospitalized patients. From all inflammatory processes of maxillofacial area in children osteomyelitis of jaws is 15-33% [1; 5; 7].
In 65,7-74,3% of patients chronic osteomyelitis of jaws lasts from 6 months to several years and provides prolonged treatment including repeated performing of surgical interventions. Chronic course of the process very often leads to such dangerous complications as chronic generalized sepsis, disseminating of the process to neighboring areas, mediastenitis, deformation of jaws, ankyloses of temporal-mandibular joint and so on [1; 5; 9]. One of the basic causes of failure of mechanisms of specific and unspecific resistance in purulent-inflammatory diseases are oxidative stress characterizing by decompensating of antioxidant activities, accumulation of lipid peroxide products, intensification of free-radicial oxidation which lead to the disorders of metabolic processes. Basic areas promoting to the solve of this problem are elaboration and improvement, and also realization in the clinical practice the new more effective methods of diagnostic, treatment and prediction of osteomyelitis of jaws [5; 7; 9].
The most acceptable and widely used in the practical medicine methods and remedies of treatment have unilateral action, causes side effects. In the last years big interest attends to non-pharma-cologic methods of general and local treatment, since they do not cause allergic reactions and tolerance. Ozone therapy possessing antihypoxic, antibacterial, immune-corrected, indirect antioxidant, disintoxicated, anti-aggregate and other actions in the last years has widely disseminated in many fields of medicine [2; 7]. From the literary sources it is known that ozone entering into connection with polyunsaturated fatty acids (PUFA) of membranes of erythrocytes is generated peroxides and ozonizes. Besides membrane is
become elastic which gives possibility to the newly generated peroxides on the one hand better entered to the cell, and on the other hand deformability of erythrocytes is improved. Increase ability of erythrocytes to change its forms gives them the possibility to enter into the most hard to reach areas of bloodstream which promotes the improvement of microcirculation [2]. That is why optimization of using ozone in the treatment of osteomyelitis of jaws is become the actual objective.
The aim of this investigation was the assessment of the effectiveness of ozone therapy in the complex treatment of acute osteomyelitis of jaws in children.
Materials and methods of investigation. 29 children aged from 7 to 16 years old with phlegmons of MFA who were in the hospital treatment in the Department of Maxillofacial Surgery of District Multidisciplinary Medical Center of Samarkand city (head doctor PhD M. K. Azizov) and 15 healthy children (control group) of the same age in the period from 2014 to 2016 have involved to investigation.
Patients were divided into 2 groups: 15 patients getting traditional treatment were included in the 1 group and 14 patients getting in the complex treatment ozone therapy were included in the
2 group.
Gas-chromatographic analyses of fatty acids from blood urea have been carried out by the method described N. K. Mukham-madiev and Sh. M. Ibadova [6]. Markers of endogenic intoxication — molecules of average mass (MAM) — MAM254, MAM280, malone dialdehyte (MDA) and activity of antioxidant enzyme of catalase (CA) have determined in plasma of venous blood. Coefficient of MDA/CA and MAM280/MAM254 — coefficient of protein resistance (CPR) has been calculated [3; 4; 8].
Ozone therapy consisted in performing procedures of the local and general manipulations. Local manipulations were consisted in realization of sequesterectomy before surgical operation, oral-baths with ozonized distilled water barbotaged with concentration of ozone-oxygen gas mixture 4-6 mg/l no more than
3 times per day, washing-out of sinus tract on the skin by ozonized
The effectiveness of ozone therapy in treatment of acute osteomyelitis of jaws in children
distilled water barbotaged with concentration of ozone-oxygen gas mixture 2-4 mg/l one time per day and blockades on the peripheral part of inflammation infiltrate by ozonized 0,9% sodium chloride solution barbotaged with concentration of ozone in solution 0,8-1,0 mg/l. After surgical operation oral-baths were carried out by ozonized distilled water barbotaged with low concentration of ozone-oxygen gas mixture (0,5-1 mgl). General ozone therapy was consisted in performing sequesterectomy before surgical operation, intravenous injection of 100 ml of ozonized 0,9% sodium chloride solution in concentration of ozone-oxygen gas mixture 10 mcg per 1 kilogram of child's body weight in maximal concentration no more than 800 mcg/l gas mixture on the way out of apparatus. After surgi-
cal operation we have carried out intravenous injection of 100 ml of ozonized 0,9% sodium chloride solution in concentration of ozone-oxygen gas mixture 10 mcg per 1 kilogram of child's body weight in maximal concentration 0,6-0,8 mg/l of gas mixture on the way out of apparatus (2-4 procedures). Transfusion speed was 90-110 drops per minute.
Statistic processing of the obtained digital data was carried out with the use of Student criterion on Microsoft Excel 2010 program.
Results and discussion. The obtained results according to determination of the parameters of endogenic intoxication and concentration of fatty acids before and after ozone therapy are presented in table 1.
Table 1. - The importance of the indicators of endogenic intoxication and concentration of fatty acids in sick children with osteomyelitis of jaws before and after ozone therapy
Parameters Measurement unit Groups
Control Before treatment After treatment
Traditional Ozone therapy
Parameters of endogenic intoxication
MDA mcmol/l 3,50±n,23 9,42± 0,78* 6,87±0,42 5,94±0,24
Catalase mccat/sec-l n,9n±n,06 n,12± 0,02* 0,44±0,05 0,65±0,05
MAM_ SU n,24±n,03 0,88± 0,05* 0,58±0,03 0,42±0,03
MAM?sn SU n,28±n,03 0,79± 0,05* 0,62±0,04 0,46±0,03
CPR SU 1,16±n,07 n,9n±n,n6* 1,07±0,06 1,^0,05
MDA/Catalase mcmol*sec mccat 3,89±n,16 78,52±3,26* 15,61±0,95 9,14±0,58
Concentration of fatty acids
C (16:0) % 28,48±2,02 32,16±2,84 31,66±2,01 31,22±1,96
C (16:1) % 6,74±n,44 8,93±0,74* 7,98±0,49 7,66±0,42
C (18:0) % 2,32±n,16 2,65±0,17 2,58±0,13 2,46±0,12
C (18:1) % 18,63±1,32 15,93±0,78* 16,12±0,82 16,66±0,84
C (18:2) % 35,64±2,46 33,83±2,11 34,12±2,02 34,58±1,87
C (18:3) % n,62±n,04 n,6n±n,n6 0,61±0,02 0,61±0,03
C (20:4) % 2,86±n,16 2,16±0,18 2,34±0,14 2,62±0,17
Others % 2,98±n,12 3,74±0,51* 3,26±0,13 3,58±0,14
1 USFA 64,49±n,54 61,45±0,82* 61,17±0,66 62,13±0,72
From the data of table 1 it is seen that concentration of secondary products of LP — MDA was decreased by 13,54% with respect to traditional treatment and by 36,94% with respect to indexes during admission to hospital. Activities of catalase was increased by 147,72% with respect to the group with traditional treatment and by 541,66% with respect to indexes during admission to hospital, being closer to parameters of the control group. Proportion of MDA/CA was decreased by 41,44% with respect to the group with traditional treatment and by 88,36% with respect to indexes during admission to hospital. Concentration of MAM254 was decreased by 27,58% with respect to the group with traditional treatment and in 52,27% with respect to indexes during admission to hospital, and concentration of MAM280 was decreased by 25,81% and by 41,77% respectively being closer to the normal parameters (P<0,001). Besides coefficient of protein resistance was increased by 102,80% with respect to the group with traditional treatment and by 122,22% with respect to indexes during admission to hospital (P<0,001). Also it is seen that in the blood of sick children concentration of palmitinic (16:0) acid was decreased by 1,39% with respect to the group with traditional treatment and by 2,92%
with respect to indexes during admission to hospital, concentration of palmitolien (16:1) acid was decreased by 4,01% and by 14,22% respectively. At the same time concentration of oleic (18:1) acid was relatively increased by 3,34% with respect to the group with traditional treatment and by 4,58% with respect to indexes during admission to hospital. Also total concentrations ofunsaturated fatty acids were increased by 1,57% with respect to the group with traditional treatment and by 1,10% respectively.
The obtained data have been testified that ozone therapy shortens periods of clinical recovery for 2-4 days and promotes to the achievement of positive balance in prooxidant — antioxidant system.
Conclusions:
1. Ozone therapy in children with acute osteomyelitis of jaws is respectively decreases concentration of MDA, MAM254, MAM280, proportion of MDA/CA, and increases activity of catalase and coefficient of protein resistance (CPR).
2. In children with acute osteomyelitis during ozone therapy it has been established a reliable reduction of concentration of palmitinic, palmitolien acids and increasing concentration of oleic acid being closer to the normal parameters.
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DOI: http://dx.doi.org/10.20534/ESR-17-1.2-150-152
Shadmanov Mirzamahmud Alisherovich, assistant of Andijan State Medical Institute, Uzbekistan
Mamasaliev N.S.,
Professor of Andijan State Medical Institute, Uzbekistan
E-mail: evovision@bk.ru
Factors causing the structure of urinary tract infections in hiv-infected populations in Uzbekistan's Fergana valley
Abstract: The results of clinical and population-based analysis of 507 HIV-infected population with an infection of the urinary tract (HIVUTI) . It is proved that the implementation of results of specific epidemiological studies in practice are potentially capable of interrupting the formation of the final "hard points" from HIVUTI: in 80-85% of cases, improving prognosis and determine effective ways to prevent HIVUTI still in preclinical stages.
Keywords: urinary tract infections, HIV-infection, HIV-population.
The problem of urinary tract infections (UTI) in HIV-infected people (HIVUTI) in modern urology remains relevant not only because of the frequency of occurrence, but also due to the need to review the pathogenetic mechanisms of the development and optimization of the treatment strategy against the background of specific therapy.
It should be noted that it is not always possible to identify the causative agent of UTI in HIV-infected patients (HIV-population) and assign causal treatment. In these clinical situations of particular importance, along with the so-called empiric therapy of elimination preventive measures against factors causing morbidity UTI, active and urgent prevention HIVUTI [1; 2; 3; 4].
The fact that the development and/or morbidity HIVUTI exert pathogenic effects on the one hand, structural or functional changes/urinary system violation and other -HIV infection and risk factors. Consequently, for the theory and practice of Urology are of interest not only to basic and clinical work on and epidemiological studies on the development of new prevention technologies HIVUTI [5; 6; 7; 8].
However, it is still not subjected to a focused study of factors that may affect the prevalence of UTI at HIV- patients. Practically not used a preventive approach and methods in this regard.
Materials and methods. Of the population HIV- lists were issued the passport data of persons aged 20-69 years previously drawn up a contract with the National Centre for AIDS and its departments in the field. The date of the start of the study and the date of its completion ■ strictly taken into account the rules of sampling to ensure a thorough and active preparatory work was carried out with high response: On the basis of a random representative sample and work with the HIV population was carried out in strict accordance with the pre-defined protocol in the following sequence has been formed HIV- population and personnel screening group: ■ before the screening test was carried out epidemiological study ofa random sample of50 HIV-positive people ■ people during training (trial) of the primary study population standardized approaches, methods of treatment worked and inviting representatives of the population in a screening center, the order and the procedure for comprehensive health survey. In the case of sampling errors (wrong information about the presence of HIV in a person who is in the sample, patients younger than 20 years; deaths -Face HIV in the sample prior to the study), these persons were excluded from the calculation of the response. In the absence of the respondent (all cases of refusal to participate in a survey of persons included in the sample, who died during the study period, no cases of the possibility of establishing contact with the respon-dent during multiple attempts)
