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Moreover, an increase in the overall incidence of diseases associated with an increase ofpathology in urinary organs (218,2 and 333,3%o), endocrine system (175,8 and 272,7%o), the blood and blood-forming organs (133,3 and 169,7%o), organs of digestion (151.5 and 175.8%) and other classes of disease (Table. 2).
The study of general morbidity of women, depending on age also shows an increase in its level with increasing of age. The lowest overall incidence is set at the age of 20-29 years (1381,3%), and the highest in the age of 40-49 years (1612,0%). The increase of the overall incidence of women with mastopathy was mainly due to the increase of diseases of the genitourinary system (231.3 and 41,7%). The peak incidence of infectious and parasitic diseases, neoplasms, diseases of the nervous system, ear and mastoid process, respiratory, urogenital system between the ages of 60 years and older. The highest incidence of diseases of the blood and blood-forming organs, the endocrine system, the eye and its adnexa, digestive system is installed in aged 50-59 years, and the highest level of mental illness was registered in the age of40-49 years.
A special place among negative factors responsible for the occurrence of mastitis is thyroid dysfunction; the presence of nodes in the thyroid, goiter, and hypothyroidism is obvious or hidden. In addition, the mastopathy may develop in dysfunction of the liver. This disease is also common for women with a history are suffered from cholecystitis or hepatitis [4; 5].
Thus, detailed study of themastopathypathology of and overall morbidity of women with mastopathy, led to the following conclusions:
1. Morbidity of mastopathy has distinctive seasonality. Mostly mastopathy is registered in the spring and autumn seasons. The highest rate of appealing is in the April and October months. Sea-sonality should be considered while scheduling the treatment and prevention.
2. The level of general morbidity of women with mastopathies is averagely 1590,3 from 1000 cases of women. The lowest level of the general morbidity of women is established in 20-29 years of age (1381.3%), the highest level in 60 and older years of age, 1916,7% (p< 0,01).
3. Out of the total incidence of women with mastopathy has a leading place in: diseases of the genitourinary system, endocrine disorders of nutritional and metabolic systems, diseases of the digestive organs, blood and blood-forming organs, respiratory system organs. Five classes of diseases listed above, 60% of is related to the mastopathy.
4. It is really important to pay attention to the prevention of inflammatory diseases of pelvic organs, gynecological diseases, pathologies of thyroid gland, and diseases of digestive system and formation of healthy life style clues.
References:
1. Andreeva Y. N. Main aspects of the etiology and pathogenesis offibrotic-cystous pathologies of the breast//Obstetrics and gynecology news. - 2008. - No 6. - P. 7-10.
2. Letyagin V. P. Mastopathy//Russia.med. magazine. - 2010. - Vol. 8, - No 11. - P. 28-34.
3. Lee L. A. Contemplation of the Oncologist about the meaning and content of medicinal treatment of mastopathy//Oncology. - 2006. -No 4. - P. 35-38.
4. Makarenko N. P. Mastopathy//Med. Magazine - 2003. - No 7. - P. 10.
5. Mezinova N. N. Breast and hormones. - Almaty. - 2008.
6. Mirrahimova D. T. Mastopathy//Medical magazine of Uzbekistan - 2007. - No 5. - C. 73-76.
DOI: http://dx.doi.org/10.20534/ESR-16-11.12-92-95
Tuychibaeva Dilobar Miratalievna, Tashkent State Stomatology Institute, Associate Professor, PhD E-mail: [email protected]
Use of citicoline for the complex therapy of patients suffering from the primary open-angle glaucoma
Abstract: Article presents the results of the study the neuroprotective influence of Ronocit drug on the patients with POAG having normalized IOP basing on the clinic and functional data of the visual organ. Analysis of the obtained results indicated to high enough clinic efficiency of Ronocit (Citicoline) drug for the conservative treatment of patients with POAG and compensated IOP. This drug might be recommended as the background neuroprotective therapy.
Keywords: glaucoma, primary open — angle glaucoma, interoccular pressure, neuroprotective treatment.
Actuality. Every year one person of every 1000 ones of the 40-45 years old groups falls ill. Currently about 60-70 millions of patients of the world suffer from glaucoma and every ten one of them have already become blind. Depending on the stage of the glauco-matosis a part of nerve fibres of the optic nerve undergoes atrophy and the other part of them is at the parabioses state. It allows to hope that restoration of their functions is possible by the therapeutic or surgical methods of treatment [2; 6].
The essence of the neuroprotective treatment is to prevent the cascade of reactions defecting the neurons, mainly being the result
of the ischemia development. It should be pointed out that it concerns namely, the consequently developed reactions in which new and new neurons are involved in the pathologic process unless the defected tissue surrounding them becomes the source of the pathologic processes. That is why the neuroprotective treatment should be carried out within the limits of the so-called therapeutic frame (window) before the effected nerve tissue has not become irreversible [1; 4; 5].
The aim of our research work was to study the neuroprotective influence of Ronocit drug on the patients with POAG having
Use of citicoline for the complex therapy of patients suffering from the primary open-angle glaucoma
normalized IOP basing on the clinic and functional data of the visual organ.
Material and methods: Sixty patients (38 women and 22 men), their average age was 60,75 ± 12,83 with the diagnosed open-angle glaucoma at I, II, III stages. The disease duration was from 6 months to 10 years, in average 3,1 ± 0,6 years. The examined patients included in this group were the patients whose IOP was achieved either by drug therapy or surgery and did not undergo neuroprotectoric treatment during the last six-months period.
All the patients were divided in two groups — basic and control ones. Both groups of patients were representative by their basic clinical indications. The control group included 28 patients (47 eyes) who were given the routine traditional therapy: 1% solution of Emoxypine in 1,0 ml dose parabulbarly; 10% solution of Pyracetam 5,0 ml dose intravenously; 1% solution of Riboflavine mononucleotide in 1,0 ml dose, 5% solution of Pyridoxine hydrochloride in 1,0 ml dose, 5% solution of Ascorbic acid in 2,0 ml dose intramuscular injection for 10 days; One pill of Cavinton 3 times a day, Aevit one pill three times a day during one months.
The basic group included 32 patients (52 eyes) and were treated by the traditional therapy and Ronocit (Rotopharm, Great Britain) injected intravenously in the isotonic solution in 1000 mg/day dose for 10 days.
All the patients were examined by: visometria with the optimal correction, biomicroscopia, computer perimetria on the Humphrey field analyser (HFA II 740), gonioscopia, tonographia, eye- botton examination with Volk lens, optic cocherred tomography (OCT), defined the threshold of the optic nerve electric sensitivity and lability by phosphene, controlled the patients adherence to the treatment.
There were specified side effects, keeping to the instillation regime, change in the patientis self-appraisal of his (her) mood and state.
The clinical efficiency of the treatment have been estimated by: visual acuity (V. A), mean deviation of the retinal photosensitivity in the central zone, threshold of the phosphene electric sensitivity (ThPhES) critical frequency of phosphene fusion flickers (CFPh F.F) at the "3,0" regime.
Results and Discussion: Good local and systemic endurability to Ronocit was observed at every stage in the course of treatment.
0,8
0,6
0,4
0,2
ItMt
I stage
II stage
III stage
Before the treatment after the treatment after the treatment
control group basicgroup
Figurel. The visual acuity dynamics before and after the treatment
Note: p - reliability of various indices if compared to that before the treatment at the same stage of POAG.
It is demonstrated on fig.1 that V.A of patients of the basic group has reliably improved after the therapy and was 0,80 ± 0,02 at the first stage of the disease; 0,54 ±0.02 at the second stage and 0,23 at the third stage. The V.A of patients in the control group was: 0,79 ±,02 at the first stage; 0,38 ±0,02 at the second stage and 0,10 ±0,02 at the third stage. There was noted some improvement of the eye-vision in this group but the indices are not reliable (p > 0,05).
Thus, treatment of the patients with POAG by the drugs according to the scheme elaborated by us, the V.A has reliably improved
to 0,08 ± 0,2, that is four times higher than that after the traditional therapy. This is, by our opinion, the result of correct selection of the drugs combinations, taking into consideration the continuity of the therapeutic effect and their synergism. It is known that V.A at POAG is not the objective indicator for GON but nevertheless it influences essentially on the patient's life quality.
The functions of the inner layers of the retina and the axial band of the optic nerve have been estimated by the method used for definition the ThPhES and electric lability by phosphene (CFPhFF) in the examined patients suffering from POAG.
Figure 2. Change in the Threshold of electric sensitivity by Phosphene
Note: p - reliability of various indices if compared to that before its treatment at the same stage of POAG.
It is demonstrated in the fig.2, that in the basic group of patients with the first stage of POAG the threshold of electric sensitivity to phosphene was 138,8 ± 9,3 ^kA before the therapy, after the treatment the index became reliably lower (p < 0,001) (by 22,7%) and was 107,3 ±6,4 ^kA ifcompared to that ofprior the treatment at the same stage of the disease designated as 100%; at the second stage ofPOAG the index was 170,8 ± 13,0 ^kAbefore the therapy and after the therapy it has reliably (p < 0,001) decreased (by 20,7%) to 135,4 ± 10,9 ^kA ifcompared to the indices before the treatment at the same stage of the disease designated as 100%. At the third stage ofPOAG the index before the therapy was 210,7 ± 17,2 ^kA and after the treatment it has become reliably lower (p < 0,001) (by 17%) to 175,6 ± 12,8 ^kA ifcompared to that of prior the treatment at the same stage ofthe disease designated as 100%.
In the control group at the first stage of POAG the ThPhES index was 130,0 ± 7,0 ^kA before the treatment and after the treatment it has reliably (p < 0,001) decreased (by 7,6%) if compared to the indices before the treatment indicated as 100% and was 120,1 ± 6,5 ^kA; at the second stage of POAG before the therapy index
was 177,4 ± 11,3 ^kA and after the treatment it has become insignificantly lower (p < 0,05) to 157.9 ± 11,6 ^kA, by 10,9% lower if compared to that designated as 100%; at the third stage of POAG the index was 208,7 ± 16,5 ^kA before the treatment and after that it has become significantly lower (p < 0,05) to 198,5 ± 16,8 ^kA, by 4,9% less if compared to the indices before the treatment at the same stage of the disease.
It was revealed that if the first drug recommended to the patient were droplets of the Prostaglandine analogues group the ThPhES index was usually less than that in the other groups. This is obviously the result of achievement the target pressure more quickly and retaining the electric sensitivity of nerve fibres and also the neuroprotective effect of the drug itself. The ThPhES higher efficiency we have noted also in patients of the basic group with less period of the POAG desease duration who was given the combined therapy during course of complex treatment. The results of investigation of the C Ph FFF indices of the examined patients with POAG are presented in fig.3.
Basic group
40
20
lililí
Before the treatment
After the treatment
Figure 3. Changes in the CPhFFF in patients with POAG Note: p — reliability of the index differences when compared to that before the treatment at the same stage of POAG.
Fig.3 demonstrates the reliable growth of the CPh FFF indices by 14,5% in average (before the treatment — 33,8 ± 1.5; after the treatment — 38,70 ± 0,87) at the first stage and by 13,9% at the second stage (before the treatment — 27,30 ± 0,76; after the treatment — 31,1 ± 0,5) while in the control group it was by 2,7 and 2,4% respectively if compared to the indices before the treatment at the same stage of the disease, indicated as 100%. It is reliably lower than in the patients of the first group, treated by the recommended by us therapy.
Control group
This indicates the reliably higher activisation of the retinal ganglions cell and their axons in the patients of the basic group.
Thus, use of the Ronocine in the complex therapy for the patients with POAG helps to activate to a greater degree the visual analyzer.
The results of investigation of the threshold sensitivity of the retina (dB) according to the data obtained by the computer statistic Humphrey perimetria are given in fig.4.
Basic group
-2
-4
-6
-10
-12
- r t ; . .. .
-12
Figure 4. Change of the retinal threshold sensitivity obtained by the computer statistic Humphrey perimetria
Note: p — reliability of the indices distinction in comparison with its value prior the therapy at the same stage in POAG.
Risk factors of the development of arterial hypertension in children in Uzbekistan regions
Fig.4 demonstrates that in patients with POAG at the first stage the threshold of retinal sensitivity was 4,50 ± 0,08 dB before the treatment, after the treatment the index increased reliably (p < 0,001) by 22,2% and was 3,50 ± 0,07 dB; at the stage II the POAG index before the treatment was 7,20 ± 0,08 dB, after the therapy the index increased (p < 0,001) by 15.3% and was to 6,10 ± 0,09 dB if compared to that before the treatment at the same stage of the disease indicated as 100%; at the third stage the POAG index prior the therapy was 11,7 ± 0,09 dB and after the treatment increased (p < 0,001) (by 9,4%) to 10,6 ± 0,08 dB if compared to the index before the treatment at the same stage of the disease.
In the second group (fig.4) at the first stage of POAG the threshold of the retinal sensitivity was 4,6 ± 0,1 dB before the treatment
and after the treatment the index (p < 0,05) increased (by 4,3%) and was 4,40 ± 0,09 dB; at the second stage of POAG the index before the treatment was 7,00 ± 0,13 dB and after the therapy it increased (p > 0,05) to 6,8 ± 1,4 dB being by 2,9% higher if compared to the index before the treatment at the same stage of the disease taken for 100%; at the third stage of POAG the index before the therapy was 11,5 ± 0,13 dB, and after the treatment it elevated (p > 0,05) to 11,3 ± 0,08 dB which was by 1,7% higher if compared to the data before the treatment at the same stage.
According to the data obtained by computer statistic Humphrey perimetria, there was increase in the photosensitivity of retina, decrease in quantity, size and depth of the scotoma, widening the area with normal photosensitivity in patients of the basic group (fig.5).
Figure 5. Humphrey perimetria of the left eye of the patients with second stage of POAG before and after the treatment
Thus, Ronocit (Citicoline) induces marked neuroprotective effect at POAG, rendering the effective protection of the nerve tissue and slow down the apoptosis. Besides the improvement of the clinic and functional indices of the visual organ we have observed the improvement of the general feeling, attention and working ability in all the patients.
Conclusion:
1. Analysis of the obtained results indicated to high enough clinic efficiency of Ronocit (Citicoline) drug for the conservative treatment of patients with POAG and compensated IOP.
2. This drug might be recommended as the background neuroprotective therapy.
References:
1. Kurishova N. I. The role of the methods of visualization of the optic nerve disc and the nerve fibres layer of retina at the earlier diagnostics of glaucoma. Glaucoma, - 2007, - 1; 16-22 p.
2. Kurishova N. I. Glaucoma optic neuropathia. - Moscow, Med Press Inform, - 2006, - P. 315.
3. Kuroyedov A. V., Gorodnichiy V. V. Computer retinotomography (HRT): diagnostics, dynamy and reliability. - Moscow, - 2007, -126 p.
4. Shkarlova S. I. Glaucoma and catarracta. Seria "Medicina dlya vas" Rostov on Don; Fenix; - 2001; - 192 p.
5. Nesterov A. P. Glaucoma. - Moscow; MIA; - 2008, - 357 p.
DOI: http://dx.doi.org/10.20534/ESR-16-11.12-95-97
Ubaydullayeva Sevara Abdullayevna, Senior scientific assistant, applicant to the department of Ambulatory Medicine, Tashkent Pediatric Medical Institute E-mail: [email protected]
Risk factors of the development of arterial hypertension in children in Uzbekistan regions
Abstract: The article was dedicated to the study of children performed according to multi stage program, in the process of which it was determined, that the most significant risk factors of arterial hypertension in children and adolescents in the Republic of Uzbekistan were sedentary style of life, irrational nutrition, and heredity.
Arterial hypertension (AH) is one of the most important risk factors of cardiovascular pathology development and it is one of the leading reasons of lethal outcomes in the world [1; 2]. In the modern time it is doubtless, that origin of AH is in childhood and adolescence, when neurogenic and humoral mechanisms of cardiovascular system regulation are formed [5].
