No. 3/2 (2021) Journal of Biomedicine and Practice

Viral hepatitis C (HCV) is one of the most important problems of modern medicine. According to WHO statistics, there are between 500 and 700 million HCV carriers worldwide. The aim of the study was to study the clinical and immunological features of the course of chronic viral hepatitis C, depending on the genotype of the virus, and to assess the diagnostic and prognostic value of immunological disorders. The clinical and laboratory features of the course of chronic viral hepatitis C depending on the genotype of the virus, the immunological features of the course of chronic viral hepatitis C depending on the genotype of the virus were studied, the diagnostic and prognostic value of immunological indicators as objective criteria for assessing the severity of the disease and the prognosis of the disease was determined. We examined 83 patients with chronic viral hepatitis, 35-50 years old with chronic viral hepatitis C, and 20 practically healthy individuals of the same age and gender.

One of the problems of acute laryngotracheitis is associated not only with its widespread spread, but also with a high probability of developing a number of complications and leading to a state of death. It is worth noting that acute stenosis laryngotracheitis is also characterized by a tendency to recurrence.
If acute primary stenosis laryngotracheitis develops in young children - mainly from 6 months to 3 years, in children up to 4 months, this disease is almost not observed. In addition, in the latter years, there is often an increase in the number of repeated episodes of laryngotracheitis in children, which not only complicates the respiratory disease, but can also lead to the appearance of life-threatening ("false" croup).
In this regard, it is of practical interest to study the specific features of the formation of recurrent stenosis laryngotracheitis (QSLT), depending on the age of the child, respiratory and allergic Anamnesis.

Polypoid rhinosinusitis is quite common, but oddly enough, poorly understood pathology of the nasal cavity and paranasal sinuses. The very name "polyp" (from the Greek poly - many and pus -leg) is a collective term used to refer to pathological formations of various origins, towering above the surface of the mucous membranes of the gastrointestinal tract, respiratory and urinary tract, and uterus. Polyps represent a rather variegated picture of a wide variety of diseases, far from homogeneous in etiological, pathogenetic and morphological terms from benign tumors to hyperplastic formations of an allergic or inflammatory nature. Therefore, it makes no sense to look for any analogies in the etiology and pathogenesis of polyps of the paranasal sinuses and, for example,the gastrointestinal tract or urinary tract. Polypoid rhinosinusitis is a completely independent disease, in no way associated with polyps of other localizations, neither etiologically, nor morphologically, nor pathogenetically. Polyps of the nasal cavity and paranasal sinuses have nothing to do with the group of benign tumors, although sometimes they are mistakenly placed in the textbooks in the section "Benign nasal tumors". In the presence of a large number of polyps, the term "polyposis" is used, although the border between the concepts "multiple polyps" and "polyposis" is arbitrary. According to most researchers, the term "polyposis" should be used when the number of polyps is more than 10 - 20. Sometimes you can find the term "polyposis of the nose", which is not entirely correct grammatically or "nasal polyposis", like tracing paper with "nasal polyposis", the most the designation of this disease common in the English-language literature. But still, from our point of view, the most legitimate name for this etiopathogenetic form will be "polyposis rhinosinusitis", since it is the paranasal sinuses and, first of all, the cells of the ethmoid labyrinth that are the place of localization of this process.

The syndrome of bronchial obstruction in pediatric practice is very common. One of the essential manifestations of bronchial obstruction is cough and bronchospasm, which a pediatrician has to meet on a daily basis. Due to the fact that many causes of cough are currently known, a clear differentiation of its characteristics is required with subsequent correct interpretation and the choice of optimal therapy, taking into account the characteristics of the onset, development and mechanisms of the pathological process.

To date, many methods of surgical treatment of funnel chest deformity have been proposed, but they all have one pronounced and significant drawback - very high trauma. Despite the fact that the first operation for funnel chest deformity was performed more than 100 years ago, the problem of treating this disease cannot be considered completely solved. This is indicated by the fact that more than a hundred methods and modifications of surgical intervention are used to correct the funnel-shaped deformity of the chest in children.

The article analyzes the factors of students’ psychological readiness affecting the success of tr aining at the initial stage of studying at university. Psychological readiness for training is an integral formation, an important prognostic factor for rapid adaptation to the conditions of study at university and the success of mastering a curriculum. The results of the research showed that psychological readi ness could be viewed as a longterm forecast of the effectiveness of educational and professional activi ties in a medical school. During the initial period of training, the factor of psychological readiness is the psychological state reflecting the peculiarities of adaptation in students with varying degrees of ac ademic achievement at university. Adaptation of the «least successful» students is accompanied by o verstrain and exhaustion of personal psychological resources. Changing the subjective assessment of  the state of health, fixing on violations in the communicative and activity spheres allows for early det ection o a decrease in psychological readiness and timely correction aimed at increasing it.

Conversance on questions about tuberculosis among patients and sound persons was detected. Patients and health person have shown the interest in reception of additional information on this infectious disease. As sick, so sound persons considered that information about tuberculosis as infectious disease must given to them physicians, sound persons have noted that want to read the newspapers and listen the radio broadcasts on discovery, spreading and preventive maintenance tuberculosis. Majority patients know that treatment tuberculosis long, however 35% sound respondent consider that tuberculosis shall easy cure that can create certain difficulties in shaping beside them adherences to long treatment

This article is devoted to one of the main problems of not only surgery, but also medicine -sepsis. Despite the development of medicine and diagnostic methods, the issue of timely diagnosis of sepsis remains open. At the same time, about 30% of cases of sepsis remain without bacteriological confirmation. The most urgent problem is considered to be complex and surgical methods of sepsis treatment.

Thermal injury is a serious medical, social and economic problem. The development of the heavy and chemical industries, as well as the widespread use of electricity in everyday life and industry, will contribute to a significant increase in burn injuries. Purpose. In case of burn injuries, the burn consists in the study of disorders in the hemostasis system in the shock phase. The object of the study was patients admitted to the department of combustiology of the Samarkand branch of the Republican Scientific Center for Emergency Medical Aid in the period from 2017 to 2020. In the phase of burn shock with deep burns from 10 to 35% of the body surface 95 (out of 112 main groups). The age of the patients ranged from 18 to 75 years, the average age was 54.3 ± 0.7. There were 142 (65.43%) men and 75 (34.56%) women. There was a poorly developed increase in the coagulation system (tolerance to heparin 253.4 ± 21.3 seconds, thrombotest - 4.06 ± 0.2 degrees), PTI decreased to 87.6 ± 3.1% (R <0.05). there was a constant decrease in fibrinolytic activity. However, a sharp decrease in fibrinolytic activity was observed, amounting to 6.58 ± 0.69% (P <0.05). Conclusions. When all patients are hospitalized, comprehensive anti-shock measures should be taken to improve the water-salt balance, acid-base balance and disruption of homeostasis.

Our scientific work examines the characteristics of labor migrants from the Samarkand region who have left and returned to the country over the past 5 years. The study found that migrant workers are more likely to be infected with sexually transmitted diseases regardless of the type of departure, mainly HIV / AIDS, as in such cases people diagnosed with the disease are limited in access to medical care and face many barriers. Going on. Sexually transmitted diseases are one of the most acute problems of the human body, which is not only a "battlefield" with various microorganisms, viruses and harmful external influences, but also a reflection of the general health of the body. Most AIDS patients are self-medicated at home. Because of AIDS in the human body, the immune process is weakened, which mainly fights against microorganisms. One fifth of labor migrants with clinical signs of STIs self-medicate.

Purpose of the study. Based on a retrospective analysis, to determine prognostic markers for the progression of fibrosis of the pulmonary parenchyma and the development of unfavorable endpoints in patients with postcovid syndrome.
Material and research methods. The material of the study was the case histories of 128 patients who underwent COVID-19 and are in early medical rehabilitation. A retrospective analysis of the data of case histories and their statistical processing were carried out.
Research results. Patients with progressive pulmonary fibrosis were more comorbid (p<0.001). BA (p <0.05), CIPD (p <0.05), obesity and steatohepatitis (p <0.001) and thromboembolic events within a month after discharge from the infectious hospital (p <0.001) were significantly more frequent in them. Thromboembolic events occurred in 66 patients (51.56%), 12 patients died (9.38%), the combined endpoint (death + thromboembolism) occurred in 70 patients (54.69%). The risk of adverse endpoints is significantly higher in patients with severe and extremely severe COVID-19. In these patients, the average number of background pathologies was significantly higher (p <0.001), among which COPD (p <0.001), type 2 diabetes (p <0.05), obesity and steatohepatitis (p <0.001), Parkinson's syndrome ( p <0.05). Also, the group of patients with the development of thromboembolism and deaths was distinguished by more pronounced lung damage (p <0.05), a higher incidence of severe and extremely severe infections (chi square = 6.98, p <0.01).
Conclusion. Retrospective analysis showed that the risk of progression of fibrosis of the pulmonary parenchyma in patients with COVID-19 increases in the presence of AD by 1.83 times (p<0.05), CIBD - 2.46 times (p <0.05), obesity and steatohepatitis - 7.22 times (p <0.001), the development of thromboembolic events during the first month - 9.39 times (p <0.001). The risk of developing a combined unfavorable endpoint (death and thromboembolic events) COVID-19 increases 1.63 times in severe and extremely severe disease, 2.33 times in the presence of COPD (p <0.001), 1.63 times - in the presence of type 2 diabetes (p <0.05), 3.64 times - in the presence of obesity and steatohepatitis (p <0.001). 

Purpose of the study. Determination of the clinical and pathogenetic characteristics of COVID-19 in the early rehabilitation period according to retrospective analysis
Material and research methods. A retrospective analysis of the case histories of 128 patients who underwent COVID-19 and persistent symptoms of the disease was carried out. The number and frequency of underlying diseases and clinical manifestations of various pathological syndromes were determined.
The results of the analysis of case histories of patients showed that 44 patients suffered moderate severity of COVID 19, 45 patients - severe, 39 - extremely severe. 40 patients were diagnosed with a lesion of 25% of the lungs or less (CT 1), in 43 patients - more than 25 to 50% of the lung volume (CT-2), in 32 patients - more than 50 to 75% (CT-3) and in 13 patients - more than 75% (CT-4). On average, the number of background pathologies was 4.53 ± 2.20. The average number of background diseases was significantly higher in patients of the older age group (p <0.001). In patients with severe and extremely severe infections diabetes and obesity were more common (p <0.05 for both comparisons). In the group of patients with moderate severity of infection, chronic viral hepatitis was more common (p <0.05). Clinical syndromes pathogenetically associated with an autoimmune inflammatory reaction were observed in 99 patients (77.34%), cell dystrophy - in 123 patients (96.09%), coagulopathy - in 73 patients (57.03%), fibrosis - in 44 patients (34.38%). Conclusion. According to the data of retrospective analysis, the average number of background diseases was significantly higher in patients of the older age group. Diabetes and obesity were more common in patients with severe and extremely severe COVID-19. In patients with moderate severity of infection, chronic viral hepatitis was more common. The pathogenetic syndrome of an autoimmune inflammatory reaction was observed in 77.34% of patients, cell dystrophy syndromes in 96.09%, coagulopathic in 57.03% and fibrosis in 34.38% of patients.

Currently, the most effective method of treating chronic purulent middle otitis is tympanoplasty surgery. In our clinic, the introduction of laser radiation into the vein is used to improve the effectiveness of tympanoplasty. With the help of the method of irradiation of blood in the vein to the reparative processes of blood in the postoperative area, the increase in microcirculation of the mucous membrane under the influence of laser irradiation of blood was studied.

The causes of complications and death in children with salmonellosis were studied. In the disease of salmonellosis, called polyresystent strains of salmonella, the specificity of symptoms of intoxication, changes in the activity of the gastrointestinal tract, central nervous system, urogenital area were noted. It has been proved that the severe and complication course of the disease depends on the extreme resistance of salmonella to antibiotics, which they call this disease.

Проведены клинические, бактериологические исследования у детей в возрасте от 6 месяцев до 3 лет, находившиеся на лечении в стационаре по поводу диареи неясной этиологии. Отягощающим фактором для роста грибов рода Candida, является часто нерациональное применение антибиотиков широкого спектра действия. Ассоциации грибов рода Candida с острыми диареями способствует более длительному сохранению интоксикации, кишечной дисфункции и удлиняют сроки выздоровления.

In an experimental model of gastric ulcer in rats, it was found that the components of antiulcer therapy omeprazole, metronidazole have a multidirectional effect on the NO formation system and increase the content of lactic acid in the mucous tissue. Among the components of antiulcer therapy, de-nol and rebamipide are the best.

The effect of glyceram and silibor on the secretion of bile and its ingredients was studied in white sexually mature rats with acute toxic hepatitis. It was established that glyceram has a more pronounced choleretic effect than silibor. Recommend the use of glyceram as a pathogenetic treatment of liver disease.

The aim of our study was to study the course of diabetic polyneuropathy in patients who had undergone coronavirus infection. The analysis of the factors of the elementary element in diabetic polyneuropathy is planned. Currently, the study of the effect of coronavirus on the nervous system, including the peripheral nervous system, is the most urgent.

This research shows the results of a study of 30 newborns with severe respiratory failure in conditions of intensive therapy. They evaluated the effectiveness of high-frequency oscillatory ventilation of the lungs compared with children on traditional methods of mechanical ventilation of the lungs. Hemodynamics was assessed according to EchoCG, measuring blood pressure, heart rate. The dynamics of oxygen saturation, laboratory exams and clinical examination were carried out.
It was found that in all newborns with HFOV, they improved the oxygen saturation and earlier weaning from MV.

There arc results were analyzed: students' perception and digestibility of educational materials on emergency pediatrics using simulation equipment. Simulation training is a relatively new and very rapidly developing area of medical education. This teaching method is especially important for mastering the skills of emergency and emergency care for children. High demands on the quality of training of doctors, limited opportunities to work out new practical skills on patients (especially children), increased attention to the safety of medical care for patients and medical personnel, and adherence to ethical standards led to a new paradigm of medical education - the use of simulation methods of training.

In this study, in order to assess the prognostic efficiency of integral scales in assessing the severity of critical conditions in children, 143 children aged 12 to 18 years old were selected who were admitted to the TashPTI clinic through the emergency medical service of the city of Tashkent. Sick children arc divided into two groups. The first group included 63 deceased patients, and the second group included 80 surviving patients. When assessing the state and timing of fire outbreaks in children with critical conditions between mortality and the total number of points of assessment on the MODS scale, only three systems determined the presence of an exact correlation. It was determined that the use of the MODS assessment method for only three systems in the early stages of intensive care is important in determining the effectiveness of therapy.

This article presents the results of surgical treatment of benign prostatic hyperplasia (BPH) by the method of transvesical adenomectomy. Tamponing of the removed adenoma bed, suturing of the bed, lowering the bladder neck and the use of a 10% infusion of lagochilus as a local hemostatic were used as methods of hemostasis in adenomectomy. The results of surgical treatment are presented depending on the presence or absence of chronic kidney disease (CKD) in patients. The influence of the hemostasis technique on the improvement of renal function in the postoperative period is shown.

The article presents a structural analysis of intra- and postoperative complications of 242 patients who underwent thymectomy for thymoma with myasthenic syndrome. In the comparison group, the number of intraoperative complications was 11.8%; in the main group, due to the use differentiated choice of surgical access, their number decreased to 5%. Postoperative complications in the comparison group amounted to 22.3%, and in the main group, their number was reliably reduced to 6%. 

The article provides a review of the literature on the study of a new class of drug ARNI (angiotensin receptor neprilysin inhibitor) LCZ696 - thе combines a molecule of valsartan and an inhibitor of neprilysin sacubitrile in a molar ratio of 1: 1. The results of experimental and clinical studies on the use of ARNI in cardiovascular pathology are presented. The nephrological aspects of ARNI use in patients with chronic heart failure are also shown.

As is known to science, the reproductive system is a collection of interrelated structural elements, such as the hypothalamus, pituitary gland, ovaries, target organs and other endocrine glands, which ensures reproductive function. Hormonal changes are key during pregnancy. One of the most important parts of the neuroendocrine system is the thyroid gland (thyroid gland), which hasa significant effect on reproductive function. Since thyronines are involved in all types of metabolism and affect sexual development, menstrual function and ovulation, a normal level of thyroid hormones is a prerequisite for the harmonious functioning of a woman's body. This article examines analyzes of pregnant women with autoimmune thyroiditis.