No. 1 (2020) Journal of hepato-gastroenterology research

Мақолалар

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  THE ACTIVITY OF ANTIMICROBIAL PEPTIDES AND PRO-INFLAMMATORY CYTOKINES IN THE MIXED FORM OF CYSTIC FIBROSIS IN CHILDREN Determine the activity of fecal β-defensin-2 and calprotectin and pro-inflammatory cytokines in young children with a mixed form of cystic fibrosis. The study involved 37 children with cystic fibrosis aged 2 months to 3 years, who were hospitalized in the Department of Gastroenterology RSSPMC of Pediatrics. It was found a four-fold increase in fecal calprotectin in children with cystic fibrosis compared with the control (p <0.001). Fecal β defensin-2 was increased 1.6 times in patients with cystic fibrosis (р<0.05). The results of measuring the activity of tumor necrosis factor alpha in children with cystic fibrosis showed an increase in its values in patients with cystic fibrosis - 6.9 + 2.3 ng / ml at a rate of 4.3 + 0.7 ng / ml (p <0.05). The highest results were observed in IL1 10.4 + 3.9 ng / ml (p <0.001), which reflects the increased activity of macrophages involved in maintaining the inflammatory process. Thus, there is clear evidence of intestinal inflammation in children with a mixed form of cystic fibrosis, which can negatively affect the patient’s nutritional status, which in turn adversely affects pulmonary function and survival. The data obtained are the basis for optimizing therapy aimed at improving bowel function.

  Altinoy Komilova , Zulkhumor Umarnazarova , Dilrabo Abdullayeva, Svetlana Geller, Shozoda Sultonkhodzhaeva, Abdumalik Aripov, Zukhra Khudoyorova

  56-62

  163   25

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  MODERN VIEWS OF THE DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE JAUNDICE ON THE BACKGRAUND OF CIRRHOSIS

  Shukhrat Urakov, Laziz Kenzhaev

  104-108

  128   18

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  REVIEW OF RECOMMENDATIONS FOR BREAST FEEDING INFANTS IN THE PANDEMIC COVID-19 PERIOD Nutrition of children is a very delicate and responsible topic. In the early stages of life, the baby needs breast milk, because only breast milk can provide the baby’s growing body with all the nutrients and protect it from various diseases in the future. In the context of the COVID-19 pandemic, many questions arose for doctors regarding the diagnosis, treatment and prevention of the disease, in particular, how should the nutrition of newborn children be carried out, as well as what still outweighs the choice of this or that approach: the risk of infection of the child or the benefits of breastfeeding? There is increasing evidence in the literature that COVID-19 can be transmitted vertically from mother to newborn. This article discusses recommendations on breastfeeding for mothers with the status of COVID-19 in developed foreign countries of the world, including in Uzbekistan.

  Shukhrat Uralov

  98-103

  85   26

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  THE EFFECTIVINESS OF DIET THERAPY FOR PATIENTS WITH CHRONIC HEPATITIS IN ENVIRONVENTALLI UNFAVORABLE ARAL AREAS In consideration of national traditions of Uzbek and Khorezm cooking, also take account their domestic specific nutrition designed and recommended for practice in patients with chronic hepatitis new version of ration- diet №5Khz (Khorezm).

  Azada Yakubova , Ravshanbek Abdullaev

  94-97

  65   19

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  THE ROLE OF POLYMERASE CHAIN REACTION IN THE DIAGNOSIS OF ENTEROVIRUS INFECTION IN PATIENTS WITH MANIFESTATIONS OF ACUTE INTESTINAL INFECTION Results of a laboratory research of 170 patients with acute intestinal infection regarding identification of enteroviruses are presented in article. It was taped that an appreciable part of acute intestinal infection is presented AII to an enteroviral etiology. Features epidemiological features and a clinical picture of a disease were defined.

  Munisa Ergasheva, Makhbuba Yarmukhamedova , Lyubov Lokteva, Lilya Garifulina

  91-93

  72   18

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  PROSPECTS FOR THE USE OF BETAIN, GLUCURONIC ACID AND NICOTINAMIDE, AS AN INTEGRAL PART OF THE COMPREHENSIVE TREATMENT OF RECURRENT HEPATIC HYDATID CYSTS The article presents modern views on the etiology, pathogenesis and treatment of recurrent hepatic hydatid cysts. The toxic effects on the liver of drugs of the Albendazole group are considered. Modern views on the hepatoprotective effect of trimethylglycines are considered. Recommendations are given.

  Stanislav Shekhovtsov, Zafar Kurbaniyazov

  87-90

  146   40

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  HYPOACID STATE OF THE GASTRIC JUICE IN CHILDREN AS AN ESSENTIAL RISK FACTOR OF ECHINOCOCCOSIS INFECTION The study presents the acidity of gastric juice in 389 children with echinococcosis, as well as in 133 members of their families from 42 households. All children with echinococcosis were operated on in the 2nd clinic of Samarkand State Medical Institute. The nature of the acid-forming function of the stomach in the general population of children was studied on the basis of a survey of 60 healthy children. Studies of the acid-forming function of the stomach showed that echinococcosis in 81.7% of children is associated with a hypoacid state of gastric juice.

  Jamshid Shamsiev, Azamat Shamsiev, Sukhrob Zayniev

  83-86

  139   21

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  EXTERNAL HEPATITIS MANIFESTATIONS OF CHRONIC VIRAL HEPATITIS C Hepatitis C virus has not only hepatotropy, but can also affect various organs and systems. The main role in this pathology is played by cryoglobulins

  Visola Rakhimova, Intizor Egamova , Nargiza Yarmukhamedova

  79-82

  158   31

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  RESEARCH OF THE LONG-TERM OUTCOMES OF PORTOSYSTEMIC SHUNTING DEPENDING ON THE ETIOLOGY OF LIVER CIRRHOSIS Purpose. Conduct a summary analysis of the results after the portosystemic shunting depending on the etiology of liver cirrhosis. Material and methods. The study selected 109 patients with cirrhosis of the liver, operated operated by the RSSPMCS named after acad. V.Vakhidov in 2014-2017. With hepatitis B, B + D and C - 72 patients. To compare the features of the course of the late postoperative period, the study included patients with alcoholic cirrhosis of the liver (n = 21) and idiopathic form (n = 16). Results. In hepatitis B liver cirrhosis within 5 years after portosystemic shunting, 10 out of 32 (31.3%) patients died, in HBV and HDV cirrhosis - 18 out of 26 (69.2%), HCV - 4 out of 14 (28, 6%), alcoholic– 7 out of 21 (33.3%) and idiopathic - 4 out of 16 (25%) patients. In the structure of mortality in HBV, hepatic failure accounted for 21.9% (7 of 32) cases, hemorrhagic syndrome - 9.4% (3), with HBV and HDV cirrhosis, these figures were 53.8% (14 of 26) and 15.4% (4) respectively, with HCV - 21.4% (3 out of 14) and 7.1% (1), with alcoholic - 23.8% (5 out of 21) and 9.5% (2) and for idiopathic, 12.5% (2 of 16) and 12.5% (2). A total of 66 (60.6%) patients were alive in all species in terms of 5 years of follow-up after surgery, the mortality rate was 39.4% (43 of 109 patients).

  Feruz Nazirov , Andrey Devyatov , Azam Babadjanov , Sanjar Ruziboev

  74-78

  75   13

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  DIETHERAPY IN FUNCTIONAL DISORDERS OF THE GASTROINTESTINAL BODIES IN CHILDREN OF EARLY AGE The article discusses modern ideas about the causes of the most common functional disorders of the gastrointestinal tract in young children. The data on correction of nutrition with therapeutic mixtures and their effectiveness in functional disorders of the gastrointestinal tract in children aged 1.5 to 6 months who are on artificial feeding are presented.

  Lola Mukhamadieva , Gulnoza Rustamova , Lilya Garifulina

  69-73

  129   21

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  SEVERE COMBINED BUMP INJURY Severe combined trauma to the abdomen is a particular type of injury and one of the leading causes of deaths of the wounded and injured both in peacetime and war time. Damage to the abdomen is directly correlated with 30% of fatal out comes recorded annually due to car accidents and has a significant impact on the outcome in another 58% of accidents; abdominal trauma is usually accompanied by significant dysfunctions of the vital organs of the abdominal cavity and retroperitoneal space, which subsequently cause a metabolic disorder, the activities of other organs and systems. Most patients with severe combined abdominal trauma can be saved with a quick diagnosis (peritonitis and hemoperitonium), as well as modern active surgical tactics.

  Ishnazar Mustafakulov, Khudoyberdi Karabaev , Furkat Mizamov , Golibjon Elmurodov , Khushvakt Umedov

  63-68

  457   19

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  THE CURRENT STATE OF PEDIATRIC GASTROENTEROLOGY IN UZBEKISTAN

  Mardonkul Rustamov, Nurali Shavazi

  6-8

  98   20

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  INTESTINAL BARRIER FUNCTION IN GASTROINTESTINAL FORMS OF FOOD ALLERGY IN CHILDREN Objective: To evaluate the intestinal barrier function in gastrointestinal forms of food allergy in children. Materials and methods: We examined 109 children aged 3 months to 3 years old with a diagnosis of gastrointestinal form of food allergy. Permeability of the intestinal wall was assessed by the method of Petrov et al (Volgograd Medical Academy), and the level of secretory IgA in feces was determined. Results: 25 patients (35%) showed an increase in the permeability of the intestinal wall compared with the control group of healthy children. During spectrophotometry, the ratio of the optical densities of mannitol and lactulose in the samples obtained from patients was negative for FPIES - (-0.15 + 0.008), and for allergic enteropathy (- 0.1 + 0.005.). The sIgA values in the group of children with FPIES are 1.5 times, and with allergic enteropathy they exceeded the norm by 1.6 times. It was found that the higher the sIgA value, the harder the disease progressed. Conclusions: Thus, in FPIES and in allergic enteropathy, an increase in the permeability of the intestinal wall is noted. It is likely that increased intestinal permeability is a direct consequence of the disease or it may be an etiological factor in the development of gastrointestinal food allergy.

  Altinoy Komilova , Inobat Akhmedova, Zulkhumor Umarnazarova , Dilrabo Abdullaeva, Shozoda Sultonkhodzhaeva, Svetlana Geller

  50-55

  176   24

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  LONG-TERM RESULTS OF SURGICAL AND ENDOSCOPIC TREATMENT OF PATIENTS WITH BLEEDING OF PORTAL GENESIS The research method was to determine the quality of life by calculating the calculated indicators of the SF-36 questionnaire in 338 patients aged 22 to 50 years who were urgently admitted for inpatient treatment for ongoing bleeding from varicose veins of the esophagus and stomach arising from portal hypertension cirrhotic origin. All study participants were divided into 2 groups depending on the methods used to stop bleeding: endoscopic ligation and / or sclerotherapy (group No. 1, n = 162) and surgical azigo-portal isolation according to M.D. Paсiora (group No. 2, n = 176). SF-36 values were determined before treatment, 3 months, 1, 2 and 3 years after treatment. Results. After 3 months, 1, 2 and 3 years after using endoscopic hemostasis methods, in all patients, without exception, the SF-36 indices were 11-74% higher than those who underwent surgery according to M.D. Paсiora. Conclusion. The use of endoscopic ligation and / or sclerotherapy in order to stop bleeding from varicose veins of the esophagus and stomach in patients of different sex and age provides for at least three years after the intervention a higher quality of life compared to that after the operation of azigo-portal dissociation according to the method of M.D. Paсiora

  Rustam Qodirov

  43-49

  111   17

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  INTESTINAL DYSBIOSIS IN CHILDREN WITH FOOD ALLERGY 48 young children with food allergy were examined. Intestinal microflora was studied according to the generally accepted method. Identified dysbiotic disorders of the intestinal microflora are interrelated with the severity of clinical symptoms and laboratory data in food allergies in children, affecting to the functional ability of the gastrointestinal tract, contribute to the sensitization of the child’s body.

  Bakhora Zokirova , Nurali Shavazi , Mukhiba Ataeva, Maxim Lim, Kamola Azimova

  38-42

  117   18

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  CLINICAL AND IMMUNOLOGICAL PARALLELS OF ULCERATIVE COLITIS. The pathogenesis of ulcerative colitis was studied, which confirms the importance of changes in individual parts of the immune system: a decrease in the total number of T-lymphocytes, heterogeneity of their subpopulations, as well as violations from B-lymphocytes and natural killers.

  Abdigafur, Nigora Mamurova

  34-37

  80   17

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  FEATURES OF THE ESTIMATION OF THE HEPATIC ENCEPHALOPATHY IN PATIENTS WITH LIVER CIRRHOSIS Purpose. To determine the features of assessing the severity of hepatic encephalopathy in patients with liver cirrhosis. Material and methods. The study included 490 patients with liver cirrhosis. The criterion for assessing the severity of hepatic encephalopathy at the stages of portosystemic shunting was the results of determining the critical flicker frequency obtained using the HEPAtonormTM-Analyzer. All patients were operated on in a planned manner: selective shunting (distal splenorenal anastomosis) - 306 (62.4%); central - 184 (37.6%): proximal splenorenal anastomosis with splenectomy - 13 (2.7%); latero- lateral splenorenal anastomosis - 62 (12.7%); splenosuprarenal anastomosis - 84 (17.1%); H-splenorenal anastomosis - 25 (5.1%). Results. In 100.0% of cases, portosystemic shunting worsens the rate of critical flicker (from 39.5 ± 0.9 to 37.8 ± 1.2 Hz, P <0.001), and if before the operation, hepatic encephalopathy was absent or was in latent form in 76.3% of patients, already in the early stages after the intervention, this figure decreased to 46.7%, and the majority of patients had clinically significant signs of hepatic encephalopathy. Against the background of postoperative conservative therapy, the tendency to improve the level of the critical flicker rate was more pronounced after selective portosystemic shunting (39.5 ± 1.1 Hz), whereas in the group of patients with central decompression the rate of critical flicker improves with less intensity, reaching discharge moment is only 38.3 ± 1.2 Hz (P <0.001). Conclusions. The level of the critical flicker frequency when planning for system-bypass shunting is of fundamental importance, which leads to a high probability of the development of postoperative severe liver failure with initially low rates.

  Andrey Devyatov, Sanzhar Ruziboev , Azam Babadjanov

  28-33

  125   17

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  ALGORITHM FOR THE MANAGEMENT OF PATIENTS WITH BILE DUCT AFTER CHOLECYSTECTOMY Relevance. Cholecystectomy is the most frequent operation, and the number of cholecystectomies performed annually exceeds 500 thousand. Purpose of the study. To optimize diagnostic and surgical tactics in patients with bile duct after cholecystectomy in the early postoperative period by introducing modern diagnostic and minimally invasive treatment methods. Material and research methods. We analyzed the results of surgical treatment of 2268 patients who underwent cholecystectomy in the 1st clinic of the Samarkand State Medical Institute in the period 2010-2019. The results of the study. After the differentiated course of treatment among 52 patients with bile leakage, various complications in the early postoperative period were noted in 5.8% of patients. In the long-term postoperative period, strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy.

  Salim Davlatov, Kosim Rakhmanov, Zainiddin Saidullaev

  23-27

  289   23

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  RISK FACTORS OF DEVELOPMENT OF ULCER DISEASE IN CHILDREN, CLINICAL COURSE AND THERAPY A total of 25 children with peptic ulcer and duodenal ulcer were examined. It was revealed that repeated acute respiratory infections and acute intestinal infections and uncontrolled use of antibiotics with a short duration of breastfeeding were the highest risk for the development of peptic ulcer. The polymorphism of the clinical symptoms of peptic ulcer in children and adolescents with better efficacy in the treatment and prevention of recurrence of this pathology of rabeprazole was revealed.

  Lilya Garifulina, Dilafruz Turaeva

  20-22

  114   24

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  SIGNIFICANCE OF THE DYNAMICS OF THE LEVEL OF A SERUM LIVER FIBROSIS MARKER WFA + - M2BP IN PATIENTS WITH CHRONIC HEPATITIS B Objective. To determine the role of the dynamics of the level of serum marker of liver fibrosis WFA+-M2BP in patients with chronic hepatitis В.. 56 patients with chronic hepatitis В who received antiviral therapy were examined. The degree of liver fibrosis was determined by indirect elastometry. Patients with the degree of liver fibrosis F0 were 8 people, F1 – 17 people, F2 - 6 people, F3 - 12 people and F4 - 13 people. The level of WFA+-M2BP was determined before the appointment of antiviral therapy, 6 month and 12 months. It was shown that both in patients with chronic hepatitis В and in patients with cirrhosis of the liver, a decrease in the levels of serum marker WFA+-M2BP in the dynamics of antiviral therapy is noted. The average value of WFA+-M2BP with liver fibrosis F3 (p<0,01) and F4 (p<0,01) was significantly higher than with the degree of fibrosis F0. In chronic hepatitis В with an increase in the degree of liver fibrosis, there is an increase in WFA+-M2BP levels and a decrease in the value of this biomarker in the dynamics of antiviral treatment. The determination of the dynamics of the level of this biomarker will allow timely detection of early degrees of liver fibrosis and monitoring of fibrosis in patients receiving antiviral therapy.

  Nadezhda Volkova, Nargiza Yarmukhamedova

  16-19

  112   24

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  CLINICAL AND LABORATORY INDICATORS OF FUNCTIONAL GASTROINTESTINAL DISORDERS IN CHILDREN Functional digestive disorders in young children are common. Objective: to compare the features of clinical and laboratory parameters in children with functional gastrointestinal disorders. The study involved 30 children with functional gastrointestinal disorders. Patients were conditionally divided into 3 groups depending on the type of disorders: group I consisted of 10 patients with functional constipation, group II consisted of 10 children with functional diarrhea, group III included children with intestinal colic. Children of all groups underwent a general analysis of blood, urine, feces and objective studies. Thus, functional gastrointestinal disorder manifested in the form of intestinal colic is more acute compared with constipation and diarrhea, with a large number of complaints expressed by steatorrhea and the presence of mucus and leukocytes in the stool, which reflects the lipolytic ability of the pancreas, depends on the pH of the duodenum , intraduodenal pressure.

  Nargiza Akhmedzhanova, Ismoil Akhmedzhanov, Fozil Abdurasulov

  12-15

  89   22

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  INCIDENCE OF DIGESTIVE SYSTEM DISEASES IN WOMEN OF REPRODUCTIVE AGE LIVING IN THE KHOREZM REGION The purpose research was revealing of diseases of bodies of digestion at women at the fertile age, living in the Khoresm area. The analysis of the received results has shown women have a chronic gastritis which 1/3 patients with diseases of digestive system suffer. High percent of women (27,3%) suffer also a chronic cholecystitis. It is especially necessary to underline that fact, that chronic diseases of digestive system prevail over the others nosological units.

  Ravshanbek Abdullaev, Azada Yakubova

  9-11

  87   20

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