No. 3 (2021) Journal of hepato-gastroenterology research

Мақолалар

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  Significance of risk factors in the development of clinical forms of COVID-19 in children Objective: to study the significance of risk factors in the development of clinical forms of Covid-19 in school- age children. Material and methods. A retrospective study of the medical records of schoolchildren who have undergone Covid-19 disease was carried out, confirmed by a positive laboratory test for the presence of RNA or SARS-CoV-2 antigen. All children included in the study were randomly divided into 2 groups depending on the severity of the infection. Group 1 included 30 children with asymptomatic Covid-19. The second group consisted of 82 children with mild and medium-severe forms of Covid-19 and 3 children with severe forms of Covid-19. Results. The study calculated the relative risks of developing clinical forms of Covid-19 (mild, medium-severe and severe) in school-age children. It was found that the relative risk of developing clinical forms of Covid-19 is significantly higher in children: with perinatal CNS lesions by 1,299 times (p <0,05), with low resistance to acute infections (more than 4 times a year) by 1,249 times (p < 0,05), with allergic diseases (dermatitis, rhinitis, bronchial asthma) 1,301 times (p <0,05), with a body mass index (BMI) more than + 2 SDS, taking into account the child's age and sex, 1,307 times (p < 0,05), with the age of 15 years and older – 1,459 times (p <0,05). Conclusion. Thus, the incidence of severe clinical forms of Covid-19 in the general structure of infected children is 2,6 %, while the risk factors for the development of clinical forms of Covid-19 are perinatal CNS injuries, allergic diseases, obesity, low resistance to infectious diseases and adolescence. age (15-17 years old).

  Vladimir Bekezin , Tatiana Druzhinina , Anastasia Melnikova , Sergey Mikhalkov , Victoria Zhilina

  70-72

  86   22

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  Efficiency of application of phyto - and vitamin therapy in the complex treatment of endemic goiter With endemic goiter, it is recommended to use anise root and elecampane in the form of powder 1 teaspoon 3 times a day for 1 month, along with the appointment of a complex of B vitamins (B1, B2, B6), vitamin PP and ascorbic acid for 3 days, depending on the severity of the disease. It has been proven that the use of phyto- and vitamin therapy in the complex treatment of patients with endemic goiter helps to restore impaired intestinal absorption, improve iodine absorption and is an effective method of therapy.

  Shoira Ibatova , Nurali Mukhamadiev

  126-127

  61   19

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  Role of vitamin D in various diseases in children The purpose of the study: the role of vitamin D in various diseases of children with a clinical example. Material and methods: a literary review of scientific research no more than 10 years old, a clinical example. Results: observational studies indicate a strong correlation between low levels of 25-hydroxycalciferol, the main active metabolite of vitamin D, and susceptibility to ARI [3,4,5]. Vitamin D has a large number of biological effects due to its effect on the vitamin D receptor, which is present in most body tissues. An important effect of vitamin D is also its suppression of inflammatory processes. Conclusions: The available evidence points to the prospects of using vitamin D preparations and supplements for the treatment and prevention of respiratory tract infections, including those caused by respiratory syncytial virus RSV and influenza A virus.

  Amina Zeynebekova , Sandugash Dyusenova

  123-125

  93   27

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  Influence of the season of the year on the incidence of the gastroduodenal system in children in the conditions of the Zarafshan valley of Uzbekistan The aim of the study was to study the influence of meteorological factors and seasons on the incidence of the gastroduodenal zone in children under the conditions of the Zarafshan Valley. 86 children with gastroduodenal pathology were examined. The work carried out has shown that in the conditions of the sharply continental climate of Uzbekistan, the exacerbation of the disease is observed mainly in the winter and spring periods of the year, the minimum number of exacerbations occurs in the summer. All this dictates the need for rationally substantiated meteorological prophylaxis and anti-draining treatment in unfavorable seasons

  Bakhora Zakirova, Nurali Shavazi , Mardonkul Rustamov , Xurshida Murodova, Kamola Azimova

  119-122

  131   24

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  The problems of the diagnosis of thyroid nodes at the present stage (literature review) Abstract: the question of modern possibilities of complex diagnostics of thyroid nodules is considered. Despite the large number of studies conducted, it is not always possible to correctly establish an accurate morphological diagnosis of thyroid nodules, which indicates the need to improve existing and search for new, more informative diagnostic methods. In this regard, reports on the use of measurements of tissue pressure in the thyroid gland for the differential diagnosis of various pathologies of this organ are very promising.

  Alisher Zayniyev , Kosim Rakhmanov , Jamshid G’ozibekov

  115-118

  64   16

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  Indicators of peripheral erythron in iron deficient anemia in children Summary: The aim of the study is to identify the features of changes in peripheral erythron indices in infants with iron deficiency anemia. Research methods. Morphological composition of peripheral blood, fraction of total hemoglobin, life expectancy of erythrocytes and their functional state, hematocrit, reticulocytes, some indicators of protein and iron metabolism. The results obtained: Clinical and hematological features were revealed in infants with iron deficiency anemia, a decrease in erythropoiesis, a reduction in the life expectancy of erythrocytes, an increase in fetal hemoglobin. Phase contrast microscopy allowed a more objective assessment of the morphofunctional state of erythrocytes. Conclusions: as a result of studying clinical semiotics in infants with iron deficiency anemia, its features were revealed, such as frequent lesions of the cardiovascular and nervous systems, morphofunctional and quantitative changes in red blood at various degrees of anemia severity were revealed.

  Asliddin Zhalilov , Feruza Achilova , Sarvinoz Khaidarova

  109-114

  120   37

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  New approaches in treatment of celliakia in children An increase in the indicators of glycolytic processes may indicate the activation of the anaerobic pathway of energy production as compensatory reactions to a decrease in oxidative processes. An increase in the concentration of lactic acid in the observed children may be associated not only with an increase in glycolytic processes, but also with a violation in the liver of the resynthesis of lactic acid into glycogen. In children with enteric insufficiency, an increase in the indicator of the state of lactate / pyruvate was stated, which indicates the predominance of tissue hypoxia in children, which, apparently, is associated with the duration of the pathological process. In contrast to the basic therapy, the treatment of patients with enteric insufficiency using a phytoecdysteroid reduces the duration of clinical and laboratory symptoms among patients with celiac disease.

  D Dustmukhamedova , A Kamilova

  105-108

  91   25

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  Health assessment of children with down syndrome in the early neonatal period. Objective of the study: To study the health status of children with Down syndrome in the early neonatal period. Materials and methods. 80 newborns were examined. The studied newborns were divided into 2 groups: 1 - the group consisted of 40 newborns with Down syndrome (main), 2 - a group of 40 full-term newborns (comparison group). Results. When assessing the condition of newborns on the Apgar scale at 1 and 5 minutes of life, it showed that children with diabetes had lower average values on the Apgar scale (p <0.01). There was established a significant predominance of the number of children with an initial loss of body weight, as well as the frequency of its pathological loss (more than 8%) in the main group than in the comparison group. Transient dysbacteriosis, icteric syndrome, manifestation of uric acid infarction and sexual crisis were found significantly more often in the main group (p <0.05). A feature of the icteric syndrome was its protracted course. The investigated indicators of NPV and heart rate. were within the age norm, however, in the process of adaptation, the body of a child with diabetes reacted with higher numbers. Among the concomitant pathologies in the early period of adaptation, the PPCNS was in the foreground, 2 times less IUI.

  M Gulyamova, Z Rakhmankulova, Kh Khodzhimetov , F Tursunbaeva

  100-104

  335   24

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  Rogressive familial intrahepatic cholestasis: literature review and own observation The article contains a short bibliographic review on progressive familial intrahepatic cholestasis, which presents not only the classic 3 types of the disease, but also its new variants, as well as other genetic diseases manifested by cholestatic liver damage in young children. The genetic, pathophysiological and clinical aspects of the pathology are considered. Clinical polymorphism of these diseases is shown. A clinical case of the diagnosis of progressive familial cholestasis in a 2-month-old child with genetic verification of the diagnosis and successful treatment, including liver transplantation, is presented. Two mutations in a heterozygous state have been identified: the previously described pathogenic mutation CM033442 and a previously undescribed mutation in the PGM1 gene.

  Roman Gudkov , Natalia Fedina , Valeria Petrova , Andrey Dmitriev

  94-99

  137   36

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  Arterial hypertension in children and adolescents Recently, the problem of arterial hypertension (AH) in our country attracts the attention not only of therapists, cardiologists, but also pediatricians. This is due to the fact that primary hypertension is significantly "younger", that is, it is more common among children, especially adolescents. Given that the initial insignificant rise in blood pressure in childhood is closely linked with the subsequent development of hypertension, it is necessary to pay attention to each fact of high blood pressure in childhood and take timely treatment. The article cites arterial hypertension in obese adolescents. 54 children aged 14 to 17 years were comprehensively examined. Indicators of fat and carbohydrate metabolism, daily blood pressure monitoring, condition of the vascular wall were checked. The results showed that in the development of hypertension in obese adolescents there is an increase in the standard deviation of TMI by 2, impaired cholesterol metabolism, hyperinsulinemia, increased HOMA index, as well as hypersympathetic, changes in daily blood pressure.

  Lilya Garifulina , Zilola Kholmuradova

  89-93

  97   18

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  Influence of childhood obesity on hepatobiliary system Of the children we examined, 58 were obese and 20 were of normal weight. We conducted a series of comprehensive tests to determine their obesity and the state of the hepatobiliary system. Our trials consisted of clinical, laboratory and instrumental studies. In this case, we performed a number of biochemical analyzes, determination of carbohydrates and lipids in blood serum, ultrasound examination of the hepatobiliary system. Studies have shown that most obese children have non-alcoholic fatty liver disease and an increase in liver enzymes by one third, as well as changes in the colloidal composition of bile.

  Lilya Garifulina , Dilafruz Turaeva

  86-88

  74   31

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  Obesity as a risk factor for kidney damage in children Obesity and metabolic syndrome influence the functions of child’s body’s systems, provoke a progressive kidney damage and are development factors of chronic nephron number in reference to body mass. A long-term impact of these factors leads to glomerulosclerosis and chronic renal failure development. The detection of kidney disease. The kidney damage in case of obesity is related to the adipokine production failure, activation of the renin-angiotensin system, chronic inflammation, dyslipidemia, violation of kidney hemodynamics, reduction of early signs and biomarkers of the kidney damage at children is a necessary condition for prevention of the renal failure development.We studied impact of overweight and obesity in children and adolescents on renal tubular function and glomerular filtration rаte.

  Lilya Garifulina , Nargiza Goyibova

  82-85

  151   25

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  The significance of metabolic status and markers of inflammation in prolonged neonatal hyperbilirubinemia. The scientific work presents the causal mechanisms of prolonged neonatal hyperbilirubinemia. The modern methods of studying inflammation markers are described. The early markers of inflammatory activity in prolonged hyperbilirubinemia were analyzed.

  Nigora Boboeva , Muhiba Abdullayeva

  79-81

  79   22

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  Ohumoral structures of the lungs during the period of embryogenesis and Pneumonia in children Abstract: Objective: To identify in the comparative aspect, the features of the structure of the endocrine apparatus of the lungs of the lungs during embryogenesis, as well as precipolology caused by inflammatory and tumor processes. Materials and methods: Histological preparations of the lungs in human fetus on 9-28 weeks of intrauterine development and endangered newborns are studied. A comparative study of histological preparations of children who died from respiratory diseases aged 7 months to 2 years has been carried out. Results: In the lungs in fetus 9-10 weeks of development of endocrine cells in the bronchi epithelium and in epithelial tubes are not detected. Starting from 11 weeks, arginic apidocytes are revealed in large bronchi. Apidocytes and Nat are found in all children with inflammatory lung diseases. The number of them is much larger than in the lungs in children who have died from diseases that are not related to respiratory authorities. Findings: Embryonic development of the lungs is accompanied by the complication of the structural components of the endocrine apparatus of the lungs. Branching of the bronchial tree is predetermined by closed apudocytes and neuroepithelial bodies. The large number of Apidocytes and NEB was found in all children with inflammatory processes in the lungs.

  Sofya Blinova , Firdavs Oripov , Madinabonu Shamsiddinova

  76-78

  103   27

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  Prevention of vascular complications in type 1 diabetes mellitus in children Type 1 diabetes mellitus (DM) is a severe chronic disease characterized by the development of specific complications that cause early disability and a decrease in the life expectancy of patients. The main damaging factor in the development of diabetes complications is chronic hyperglycemia and concomitant metabolic changes: hyperlipidemia, increased lipid peroxidation processes, increased glycosaminoglycan synthesis, activation of the renin- angiotensin-aldosterone system, etc.

  Nurlan Bekenov

  73-75

  76   43

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  Samarkand pediators school Provides information on the creation of a pediatric school in Samarkand. A great contribution to this was made by Karakhodzhaev B.Kh., Hamraеv A.Kh., Rustamov M.R., Ishkabulov Dzh.I., Beknazarova Z.N., Mamatkulov Kh.M., Salomov I.T., Shavazi N.M. Russian scientists played an important role in the development of pediatrics in Samarkand.

  Jasur Rizaev, Nurali Shavazi , Mardonkul Rustamov

  2-4

  123   33

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  The relationship between polymorphic genes of matrix metalloproteinases (mmps) and their tissue inhibitors cystatin c, in chronic glomerulonephritis in children Currently, methods of molecular diagnostics have begun to actively develop, which not only complement traditional research methods, but also provide insight from the point of view of molecular pathophysiology. It is expected that a key role in the diagnosis of kidney disease is played by the identification of genes and their changes in the course of the disease, which predict the course of the disease. Changes in chromosomal polymorphic genes of matrix metalloproteinase and its tissue inhibitors, as well as their effect on glomerular filtration rate in chronic glomerulonephritis in children, determines the prognosis of the disease.

  Nigina Bazarova , Shukhrat Ziyadullaev , Botir Yuldashev

  67-69

  74   32

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  Delayed psychomotor development in children against the background of somatic burden The purpose of the study: to study the features of psychomotor development in sick children with somatic burden. Materials and methods of research: to fulfill the tasks of scientific research, a sample was created with the allocation of two groups of clinical observation: 60 children of the main group with somatic pathology and 25 conditionally healthy children of the comparison group. All children underwent a generally accepted clinical examination, including the collection of complaints and anamnesis, a general examination, clinical and neurological and psychodiagnostic studies. To assess the psychomotor development of children, we used the scale of assessment of the neuropsychic development of G. V. Pantyukhina - K. L. Pechora - E. L. Frucht. Results: When studying the clinical and neurological features of sick children, a syndrome of motor disorders of 10%, a syndrome of neuro-reflex excitability of 20%, a myotonic syndrome of 11.70%, a vegeta-visceral syndrome of 18.30%, an MMD syndrome of 28.3% and a cerebrastenic syndrome of 31.7% were revealed. A delay in psychomotor development for 1 epicrisic period in the main group was revealed to 34 sick children (57%), of which 19 (32%) were boys, 15 (25%) were girls. The delay of psychomotor development for 1 epicrisic period in the control group was 4 (16%) children. Conclusions: Thus, carrying out a quantitative assessment of the formation of VPF in children allows us to determine which functions suffer more, and therefore require more correction. The results according to the psychodiagnostic method showed a delay in sensory and speech development and a violation of fine motor skills.

  Umida Babadjanova, Yakuthon Majidova

  64-66

  102   17

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  Electrical disorder in children with noninfected ventricular partition On the basis of the Samarkand Regional Multidisciplinary Children's Medical Center in the department of cardio-rheumatology, we examined 77 sick children under 16 years of age with non-closure of the interventricular septum. To calculate the corrected QT interval, we have developed an algorithm for the most reliable and informative clinical and electrocardiographic criteria for the diagnosis of prolonged QT interval syndrome. When analyzing anamnestic data, it was found that in healthy children the duration of the corrected QT interval is equal to 385 ± 4.7 ms according to Bazett; Fridericia 354 ± 3.8 ms; Sagie 358 ± 3.4 ms. With non-closure of the interventricular septum according to the Bazett formula, QT interval lengthening is revealed in 9.1%, according to the modified Bazett formula in 14.3%, according to Fridericia in 6.5% and according to Sagieu 3.9% of sick children. The most evidence-based in the diagnosis of non-closure of the interventricular septum QT is the algorithm of clinical symptoms and the analysis of the corrected QT interval according to the Fridericia formula.

  Feruza Achilova , Dilfuza Rabbimova, Shoira Ibatova

  60-63

  87   16

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  Assessment of the main factors of pathogenesis of accentuation of character in adolescents in cultural and social conditions of the fergana valley of Uzbekistan Objective of the study: comparative age study of the dynamics of clinical manifestations and assessment of the main factors of the pathogenesis of character accentuation in the cultural and social conditions of the Fergana Valley of Uzbekistan. Material and methods: The observation covered 141 adolescents aged 12 to 18 years with different types of character accentuation. All patients had no history of pronounced organic or psychopathological symptoms. Results: Analysis of complaints presented by children and adolescents with accentuations of the nature of complaints showed its massive somatization, which was characterized by polymorphic vegetative-visceral disorders in various organs and systems (digestive, skin, respiratory, motor, cardiovascular, excretory, endocrine) thermoregulation disorders and algic manifestations ... Conclusions: The high frequency of symptoms of vegetative-visceral disorders and their polymorphism and polysystemic nature in our schoolchildren indicate the possible role of vegetative imbalance in the genesis of the manifestation of character accentuation. Abstract: The presented clinical facts indicate that the onset of puberty, endocrine-vegetative and genetic relationships affect the development of the personality in its new conditions and lead to the manifestation and disclosure of features of a certain endogenously determined type of character accentuation.

  Abduraiim Arzikulov , Mark Agranovskiy , Madina Abdumukhtarova

  55-59

  87   30

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  Preoperative preparation of children with diaphragmatic hernia. Purpose of the study: To study the experience of preoperative preparation of newborns with diaphragmatic hernia. Material and methods: The basis of the work was the analysis of diagnosis and treatment of 51 children with congenital diaphragmatic hernia (IDH) who were born and were hospitalized in the neonatal intensive care unit of the ODMMC for the period from 2000 to 2020. There were 23 boys (45.1%), girls 28 (54.9%). The results of preoperative preparation of newborns were assessed both by physical data and by the results of objective research methods. At the same time, in particular, attention was paid to the dynamics of mechanical ventilation modes necessary for adequate life support. The values of Fi02, PIP, and respiratory rate were estimated according to the available data in 21 case histories of group I and in 23 case histories of patients in group II. Conclusions. Thus, during mechanical ventilation in patients of both groups, the respiratory rate was maintained close to physiological for newborns. At the same time, the proven decrease in the child's body demand for additional oxygen after intensive preoperative preparation in group I was achieved using more "rigid" ventilation modes and to a lesser extent than in group II.

  Yusufjon Akhmedov , Islomjon Akhmedov , Mirfozil Mirmadiev , Ulugbek Hayitov , Fazliddin Fayzullaev , Dilbar Akhmedova

  49-54

  165   40

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  Primary immunodeficiencies: state of the problem in Uzbekistan This overview highlights the main issues related to PID issues. Since there are more problems and difficulties than we know, we should speak out and cover this problem. Thus, awareness of practical Healthcare is necessary, today there is no Alertness on PID; it is important to create a National Register of PID Patients in order to record PID patients with various forms, frequency of occurrence, peculiarities of clinical manifestations and therapy, create genetic bases, develop diagnostic criteria and PID therapy regimens, control the quality of care / life, promote genetic research and clinical trials, and also improving our understanding of natural medical history and immune system function; The PID Patient Organizations have an important role to play; need to address the issue of bone marrow transplant (BMT) and hematopoietic stem cell transplant (HSCT) are possible options for permanent treatment of several types of life- threatening immunodeficiency; constant availability of all treatment methods is needed (antibacterial, antiviral, IVIG replacement, anticytokine / cytokine) ; it is important to provide patients with PID with affordable, adequate and reliable medical care and infrastructure by government agencies; there is a need to raise awareness among physicians and health systems; vaccination with attenuated vaccines must be monitored: oral polio and measles-mumps-rubella vaccines may not be suitable for children with PID, which can result in extremely severe clinical course and even death. It is also known that, in addition to infection, significant morbidity and mortality in PID can be caused by non- infectious forms. It has been shown in the world literature that the absence of these factors contributes to delayed and missed diagnosis and treatment, which can lead to a fatal prognosis.

  Tamara Aripova, Adolat Ismailova , Tatiana Petrova, Ramazan Rozumbetov , Umid Akbarov , Akbar Rakhimjonov , Larissa Cher, N Amanova

  44-48

  170   39

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  Clinical features of the course of urolithiasis in children This article deals with the diagnostic aspects of urolithiasis in childhood. The prevalence and clinical features of urolithiasis among children are discussed, along with a description of the most effective methods of calculus imaging. It is concluded that an individualized diagnosis of a number of metabolic markers in urine in children with urolithiasis is necessary for the purpose of metaphylaxis and recurrence of the disease in the future.

  Nilufar Anvarova, Jamshid Shamsiev, Zafar Makhmudov

  41-43

  97   28

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  The significance of pro- and anti-inflammatory cytokines in the physiological adaptation of newborn children It has been shown that in the early period of postnatal immune adaptation of healthy full-term newborns against the background of a high antigenic load, the development of laboratory signs of a systemic inflammatory reaction is noted, which is expressed in a significant increase in serum and plasma concentrations of pro-inflammatory cytokines and changes in the levels of proteins of the acute phase of inflammation. The identified laboratory signs in physiological conditions are not accompanied by the development of the clinical picture of systemic inflammation, infectious toxicosis and multiple organ failure. The balance of pro- and anti-inflammatory cytokines can be a key factor in determining the clinical condition of a child. Its violation with the development of complications of the neonatal period can lead to clinical manifestation of diseases.

  Nodira Amanova , Adolat Ismailova

  37-40

  79   41

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  Features of tuberculosis in children under COVID-19 pandemic The aim of this study was to study the features of pulmonary TB in children who lived in family foci of TB infection and in foci of COVID-19 and TB. Materials and methods: The study was conducted in two groups of children formed according to the principle "case-control" study. The first group included 12 children with pulmonary tuberculosis from families where adults suffered with TB. The second group included 12 children with pulmonary tuberculosis from families where COVID-19 cases were initially registered, and then TB cases were registered. Indicators of the general blood test were analyzed. Results: Children with pulmonary TB who lived in family foci of TB infection and in foci of COVID-19 and TB did not differ in clinical forms of TB. On objective examination, vesicular respiration, single dry wheezing, systolic noise at the apex, and enlargement of peripheral lymph nodes were detected in children of both groups with almost the same frequency of occurrence. Children with pulmonary TB who lived in COVID-19 and TB family centers had peeling of the hands skin. This complaint was absent in children with pulmonary TB who lived in family foci of TB infection. When comparing the indicators of the general blood test, no significant differences were obtained. It was found that the ratio of monocytes to peripheral blood lymphocytes was higher in children with pulmonary TB who lived in COVID-19 and TB family foci, compared with children with pulmonary TB who lived in TB family foci. Conclusions: Further studies are needed to establish the prognostic value of the ratio of monocytes to peripheral blood lymphocytes in children with TB and COVID-19.

  Dinara Adjablaeva , Larisa Gorbach, Svetlana Khodzhaeva , Ugiloy Pardaeva

  32-36

  115   20

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