Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-53-63
О. Nejmatzoda, A. Gaibov, D. D. Sultanov, O. F. Soliev, H. A. Yunusov
Aim: To evaluate the effectiveness of mechano-chemical obliteration in the treatment of varicose enlargement of the great saphenous vein.Material and Methods: The results of mechano-chemical obliteration of 57 patients (49 (85.9%) women, 8 (14.1%) men; average age 27.2±4.1 years) with varicose disease were analyzed. In 39 patients (36 women and 3 men), the second, and in 18 (13 women and 5 men) – the third class of varicose transformation of subcutaneous veins was observed. The average body mass index of patients was 28.2±2.4 kg/m2, and the average duration of varicose disease was 7.6±1.8 years.Results and Discussion: The average diameter of the great saphenous vein was 10.4±2.1 mm. Insufficiency of perforating veins with an average diameter of 3.2±0.8 mm was detected in 31 (54.4%) cases. The technical success of the procedure was 100%. No intraoperative complications occurred in any patient. The average duration of mechanochemical obliteration was 24.2±4.8 minutes, and the entire operation – crossectomy, mechano-chemical obliteration, and excision of dilated tributary veins – lasted 98.5±25.5 minutes. The average length of the great saphenous vein subjected to mechano-chemical obliteration was 94.2±6.1 cm. The level of pain on the first day after surgery was 3.8±0.6 points, decreasing to 0.9±0.1 points before discharge. Only on the day after the intervention, patients required narcotic analgesics (average volume of used anesthetics – 1.5±0.5 ml); on other days, patients received non-steroidal anti-inflammatory drugs (average duration 3.5±0.5 days, volume – 10.5±1.5 ml).Conclusion: Mechano-chemical scleroobliteration is one of the effective methods for eliminating pathological vertical reflux, with its effectiveness observed in the vast majority of patients in the long term.Moreover, due to its minimal invasiveness and capability for repeated application, it can be recommended for widespread clinical use. To improve the results of mechano-chemical obliteration and reduce the frequency of recanalization of the great saphenous vein, it is necessary to supplement the procedure with crossectomy and miniphlebectomy.
{"title":"Results of mechano-chemical obliteration of the trunk of the great saphenous vein in varicose vein disease","authors":"О. Nejmatzoda, A. Gaibov, D. D. Sultanov, O. F. Soliev, H. A. Yunusov","doi":"10.52888/0514-2515-2023-359-4-53-63","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-53-63","url":null,"abstract":"Aim: To evaluate the effectiveness of mechano-chemical obliteration in the treatment of varicose enlargement of the great saphenous vein.Material and Methods: The results of mechano-chemical obliteration of 57 patients (49 (85.9%) women, 8 (14.1%) men; average age 27.2±4.1 years) with varicose disease were analyzed. In 39 patients (36 women and 3 men), the second, and in 18 (13 women and 5 men) – the third class of varicose transformation of subcutaneous veins was observed. The average body mass index of patients was 28.2±2.4 kg/m2, and the average duration of varicose disease was 7.6±1.8 years.Results and Discussion: The average diameter of the great saphenous vein was 10.4±2.1 mm. Insufficiency of perforating veins with an average diameter of 3.2±0.8 mm was detected in 31 (54.4%) cases. The technical success of the procedure was 100%. No intraoperative complications occurred in any patient. The average duration of mechanochemical obliteration was 24.2±4.8 minutes, and the entire operation – crossectomy, mechano-chemical obliteration, and excision of dilated tributary veins – lasted 98.5±25.5 minutes. The average length of the great saphenous vein subjected to mechano-chemical obliteration was 94.2±6.1 cm. The level of pain on the first day after surgery was 3.8±0.6 points, decreasing to 0.9±0.1 points before discharge. Only on the day after the intervention, patients required narcotic analgesics (average volume of used anesthetics – 1.5±0.5 ml); on other days, patients received non-steroidal anti-inflammatory drugs (average duration 3.5±0.5 days, volume – 10.5±1.5 ml).Conclusion: Mechano-chemical scleroobliteration is one of the effective methods for eliminating pathological vertical reflux, with its effectiveness observed in the vast majority of patients in the long term.Moreover, due to its minimal invasiveness and capability for repeated application, it can be recommended for widespread clinical use. To improve the results of mechano-chemical obliteration and reduce the frequency of recanalization of the great saphenous vein, it is necessary to supplement the procedure with crossectomy and miniphlebectomy.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"35 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-72-76
N. H. Olimzoda, S. A. Avezov, D. M. Ishankulova, M. H. Khuzhamurotov, R. I. Odinaev
Aim. To assess the frequency of functional gastrointestinal diseases after COVID-19 and identify factors associated with the post-COVID esophageal syndrome.Materials and methods. The study included data from 72 (31 men and 41 women) patients over the age of 18 who had COVID-19. Patients were divided into two groups: with or without gastroenterological symptoms during acute coronavirus infection.Results and Discussion: After 6 months from the onset of the coronavirus infection, Irritable Bowel Syndrome (IBS) developed in 29% of patients with gastrointestinal symptoms and only in 7% of patients without symptoms in the acute stage of infection. The concurrent development of two digestive system diseases (more often a cross syndrome of Functional Dyspepsia and IBS) was 2.6 times more common in the first group of patients. Statistically significant risk factors for the development of post COVID functional digestive diseases were: diarrhea, abdominal pain, anorexia, anosmia, and agenesis.Conclusion. The presence of gastrointestinal symptoms at the baseline level of COVID-19 was more frequently associated with the development of functional gastrointestinal tract disorders during a six-month follow-up.
{"title":"Post-covid functional diseases of gastrointestinal tract","authors":"N. H. Olimzoda, S. A. Avezov, D. M. Ishankulova, M. H. Khuzhamurotov, R. I. Odinaev","doi":"10.52888/0514-2515-2023-359-4-72-76","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-72-76","url":null,"abstract":"Aim. To assess the frequency of functional gastrointestinal diseases after COVID-19 and identify factors associated with the post-COVID esophageal syndrome.Materials and methods. The study included data from 72 (31 men and 41 women) patients over the age of 18 who had COVID-19. Patients were divided into two groups: with or without gastroenterological symptoms during acute coronavirus infection.Results and Discussion: After 6 months from the onset of the coronavirus infection, Irritable Bowel Syndrome (IBS) developed in 29% of patients with gastrointestinal symptoms and only in 7% of patients without symptoms in the acute stage of infection. The concurrent development of two digestive system diseases (more often a cross syndrome of Functional Dyspepsia and IBS) was 2.6 times more common in the first group of patients. Statistically significant risk factors for the development of post COVID functional digestive diseases were: diarrhea, abdominal pain, anorexia, anosmia, and agenesis.Conclusion. The presence of gastrointestinal symptoms at the baseline level of COVID-19 was more frequently associated with the development of functional gastrointestinal tract disorders during a six-month follow-up.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-38-45
Sh. M. Kurbonov
Aim. To improve early diagnosis of postoperative obstetric and gynecological peritonitis.Material and Methods. This study was conducted among 110 women who developed peritonitis in the postoperative period following primary surgical interventions for obstetric and gynecological pathologies. Comprehensive approaches in clinical and laboratory diagnostics of postoperative obstetric and gynecological peritonitis were applied, including the assessment of hemostasis parameters, endogenous intoxication, acute phase proteins, and cytokines.Results and Discussion. The analysis of the results shows that in the clinical and laboratory parameters, there are relative changes observed in localized peritonitis, and significant shifts in widespread postoperative obstetric and gynecological peritonitis, with and without abdominal sepsis. For instance, in this group of patients, the average values of middle molecular weight molecules were 1674.6±143.5 µg/ml, malondialdehyde - 5.6±0.21 mmol/l. In the group with widespread peritonitis, the level of procalcitonin in the blood was 5.6±0.04 ng/ml, C-reactive protein levels averaged 235.2±0.8 mg/ml, and interleukin-6 levels were 134.5±3.7 ng/ml. In the group with peritonitis without abdominal sepsis, these indicators were lower, being 3.67±0.04 ng/ml, 180.77±18.3 mg/ml, and 112.7±2.1 ng/ml, respectively.Conclusions. The identified pathogenetic changes in homeostasis, particularly the shifts in the levels of procalcitonin, C-reactive protein, and interleukin-6, serve as markers for the early diagnosis of infectious-inflammatory pathologies in the abdominal cavity.
{"title":"Clinical-laboratory diagnosis of postoperative obstetric-gynaecological peritonitis","authors":"Sh. M. Kurbonov","doi":"10.52888/0514-2515-2023-359-4-38-45","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-38-45","url":null,"abstract":"Aim. To improve early diagnosis of postoperative obstetric and gynecological peritonitis.Material and Methods. This study was conducted among 110 women who developed peritonitis in the postoperative period following primary surgical interventions for obstetric and gynecological pathologies. Comprehensive approaches in clinical and laboratory diagnostics of postoperative obstetric and gynecological peritonitis were applied, including the assessment of hemostasis parameters, endogenous intoxication, acute phase proteins, and cytokines.Results and Discussion. The analysis of the results shows that in the clinical and laboratory parameters, there are relative changes observed in localized peritonitis, and significant shifts in widespread postoperative obstetric and gynecological peritonitis, with and without abdominal sepsis. For instance, in this group of patients, the average values of middle molecular weight molecules were 1674.6±143.5 µg/ml, malondialdehyde - 5.6±0.21 mmol/l. In the group with widespread peritonitis, the level of procalcitonin in the blood was 5.6±0.04 ng/ml, C-reactive protein levels averaged 235.2±0.8 mg/ml, and interleukin-6 levels were 134.5±3.7 ng/ml. In the group with peritonitis without abdominal sepsis, these indicators were lower, being 3.67±0.04 ng/ml, 180.77±18.3 mg/ml, and 112.7±2.1 ng/ml, respectively.Conclusions. The identified pathogenetic changes in homeostasis, particularly the shifts in the levels of procalcitonin, C-reactive protein, and interleukin-6, serve as markers for the early diagnosis of infectious-inflammatory pathologies in the abdominal cavity.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-15-22
R. Berdiev, S. Najibullo
Aim. To study the outcomes of surgical interventions using the anterior cervical approach in spinal cord injuries.Material and Methods. This study examined 86 patients with SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) who were hospitalized from June 2018 to March 2021. Based on treatment methods, patients were divided into two groups: a control group (n=38) and a primary group (n=48). In the control group, patients received conservative treatment. In the primary group, patients underwent anterolateral total laminectomy with decompression, internal fixation, and spinal fusion using a bone graft.Results and Discussion. The JOA (Japanese Orthopedic Association) score in the primary group was 14.98±2.75 six months post-operation, compared to 12.16±2.54 in the control group (p<0.05). The improvement coefficient of the JOA index in the postoperative period was higher in the primary group than in the control group (p<0.05). Postoperative health status, physiological function, and role physical condition scores in the primary group were 23.18±1.09, 22.75±1.54, and 22.64±1.46 respectively, significantly higher than in the control group, which scored 20.94±1.65, 20.26±1.78, and 19.56±1.82 respectively (p<0.05).Conclusion. Performing anterolateral total laminectomy with decompression, internal fixation and spinal fusion using a bone graft in patients with SCIWORA contributes to a more effective restoration of the function of the cervical spinal cord and improves the prognosis and quality of life. Independent prognostic factors for patients include: type of cervical spinal cord injury according to the ASIA classification; MRI findings, the extent of cervical spinal cord injury; time from the moment of injury to the start of treatment.
{"title":"Surgical tactics and prognostic factors in spinal cord injuries without radiological signs","authors":"R. Berdiev, S. Najibullo","doi":"10.52888/0514-2515-2023-359-4-15-22","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-15-22","url":null,"abstract":"Aim. To study the outcomes of surgical interventions using the anterior cervical approach in spinal cord injuries.Material and Methods. This study examined 86 patients with SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) who were hospitalized from June 2018 to March 2021. Based on treatment methods, patients were divided into two groups: a control group (n=38) and a primary group (n=48). In the control group, patients received conservative treatment. In the primary group, patients underwent anterolateral total laminectomy with decompression, internal fixation, and spinal fusion using a bone graft.Results and Discussion. The JOA (Japanese Orthopedic Association) score in the primary group was 14.98±2.75 six months post-operation, compared to 12.16±2.54 in the control group (p<0.05). The improvement coefficient of the JOA index in the postoperative period was higher in the primary group than in the control group (p<0.05). Postoperative health status, physiological function, and role physical condition scores in the primary group were 23.18±1.09, 22.75±1.54, and 22.64±1.46 respectively, significantly higher than in the control group, which scored 20.94±1.65, 20.26±1.78, and 19.56±1.82 respectively (p<0.05).Conclusion. Performing anterolateral total laminectomy with decompression, internal fixation and spinal fusion using a bone graft in patients with SCIWORA contributes to a more effective restoration of the function of the cervical spinal cord and improves the prognosis and quality of life. Independent prognostic factors for patients include: type of cervical spinal cord injury according to the ASIA classification; MRI findings, the extent of cervical spinal cord injury; time from the moment of injury to the start of treatment.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"14 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-64-71
S. J. Niyazova
Aim. To determine the diagnostic effectiveness of modern methods of examination in patients with benign breast neoplasms.Material and methods. The results of the examination of 290 patients with benign breast neoplasms hospitalized in the gynecological department of the “Research Institute of Obstetrics, Gynecology and Perinatology of the Republic of Tajikistan” from 2015 to 2022, were analyzed.Results and Discussion. The article evaluates modern methods of examination of the pathology of the mammary glands in women. Ultrasound examination, elastography, as well as elastography in combination with color Doppler mapping – are non-invasive, effective and safe methods, applicable across all age groups. Mammography, widely recommended by many authors for the differential diagnosis of benign and malignant neoplasms, has, however, age restrictions and should be used in combination with ultrasound. The study of the tumor marker CA-15-3 has an important laboratory and diagnostic value for clarifying pathology.Conclusion. Thus, the study shows the need to use a differentiated diagnostic algorithm and an integrated approach in the management of patients with benign diseases of the mammary glands against the background of inflammatory diseases of the pelvic organs and benign ovarian neoplasms.
{"title":"Efficiency of modern methods of examination of benign breast diseases in women","authors":"S. J. Niyazova","doi":"10.52888/0514-2515-2023-359-4-64-71","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-64-71","url":null,"abstract":"Aim. To determine the diagnostic effectiveness of modern methods of examination in patients with benign breast neoplasms.Material and methods. The results of the examination of 290 patients with benign breast neoplasms hospitalized in the gynecological department of the “Research Institute of Obstetrics, Gynecology and Perinatology of the Republic of Tajikistan” from 2015 to 2022, were analyzed.Results and Discussion. The article evaluates modern methods of examination of the pathology of the mammary glands in women. Ultrasound examination, elastography, as well as elastography in combination with color Doppler mapping – are non-invasive, effective and safe methods, applicable across all age groups. Mammography, widely recommended by many authors for the differential diagnosis of benign and malignant neoplasms, has, however, age restrictions and should be used in combination with ultrasound. The study of the tumor marker CA-15-3 has an important laboratory and diagnostic value for clarifying pathology.Conclusion. Thus, the study shows the need to use a differentiated diagnostic algorithm and an integrated approach in the management of patients with benign diseases of the mammary glands against the background of inflammatory diseases of the pelvic organs and benign ovarian neoplasms.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"38 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-46-53
S. Kurbonov, R. E. Ishmirzoev, I. A. Davlyatov
Aim. To determine the morphofunctional characteristics of tissue changes in the structure of the gallbladder in chronic calculous cholecystitis.Materials and Methods. The macro- and microscopic structural walls of the gallbladder were studied using the method of injection anatomical dissection, histology, and morphometry in 61 patients (aged 36 to 60) with chronic calculous cholecystitis.Results and Discussion. The results of a morphological study show that in chronic calculous cholecystitis, changes are always observed in all layers of the gallbladder wall. The most severe dystrophic and sclerotic changes are observed in the mucous membrane and submucosal base, since, this layer has in functional, topographical and quantitative features, as well as a direct contact with stones (mechanical impact).Conclusion. Transformation of the gallbladder in chronic calculous cholecystitis are characterized by vascular tissue restructuring of the structures of the organ wall, accompanied by the phenomena of adaptive, exudative and proliferative transformations, and in the later stages (5-6 years) undergo sclerotic changes in the gallbladder wall.
{"title":"Tissue structure transformations of the gallbladder in chronic calculous cholecystitis","authors":"S. Kurbonov, R. E. Ishmirzoev, I. A. Davlyatov","doi":"10.52888/0514-2515-2023-359-4-46-53","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-46-53","url":null,"abstract":"Aim. To determine the morphofunctional characteristics of tissue changes in the structure of the gallbladder in chronic calculous cholecystitis.Materials and Methods. The macro- and microscopic structural walls of the gallbladder were studied using the method of injection anatomical dissection, histology, and morphometry in 61 patients (aged 36 to 60) with chronic calculous cholecystitis.Results and Discussion. The results of a morphological study show that in chronic calculous cholecystitis, changes are always observed in all layers of the gallbladder wall. The most severe dystrophic and sclerotic changes are observed in the mucous membrane and submucosal base, since, this layer has in functional, topographical and quantitative features, as well as a direct contact with stones (mechanical impact).Conclusion. Transformation of the gallbladder in chronic calculous cholecystitis are characterized by vascular tissue restructuring of the structures of the organ wall, accompanied by the phenomena of adaptive, exudative and proliferative transformations, and in the later stages (5-6 years) undergo sclerotic changes in the gallbladder wall.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"30 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-10-15
S. M. Ahmadzoda, B. D. Safarov, D. M. Kurbonov, A. S. Saidmurodov, S. A. Nazurov
Objective: To determine prognostic value of instrumental methods in the diagnosis of complicated forms of malignant forms of focal liver lesion.Material and methods: The experience of treating 112 patients with primary and secondary tumor lesions of the liver was analyzed. Life-threatening complications, such as spontaneous rupture of the tumor node leading to massive intraperitoneal bleeding and cancerous peritonitis, were noted in 32 (28.5%) cases. Clinical and echographic signs of the threat of this complication developing were observed in 26 (23.2%) patient. Ultrasound (US) and CT semiotics of the tumor node rupture included signs of hemoperitoneum, focal heterogeneous formation with the presence of perilesional hematoma, active extravasation of contrast medium, and focal discontinuity of the liver contour at the site of the focal formation.Results and discussion: Most often, the size of the tumor node exceeded 8.0 cm (in 65% of patients). Protrusion of the tumor through the liver surface was noted in 23 (39.6%) cases. Invasion of the tumor into adjacent organs and tissues was observed in 16 (27.5%) patients. Sites of phlebothrombosis, predominantly in the system of hepatic veins, detected by echo-Dopplerography of liver vessels, were present in 12 (20.6%) patients.Conclusion: Predictors of spontaneous rupture of the tumor node may include: size of the formation more than 5 cm; protrusion of the tumor through the liver surface; phlebothrombosis by tumor masses, leading to increased intramural pressure; extraliver invasion of the tumor into adjacent organs and tissues.
{"title":"Prognostic value of instrumental research methods in the diagnosis of complicated forms of liver malignant tumors","authors":"S. M. Ahmadzoda, B. D. Safarov, D. M. Kurbonov, A. S. Saidmurodov, S. A. Nazurov","doi":"10.52888/0514-2515-2023-359-4-10-15","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-10-15","url":null,"abstract":"Objective: To determine prognostic value of instrumental methods in the diagnosis of complicated forms of malignant forms of focal liver lesion.Material and methods: The experience of treating 112 patients with primary and secondary tumor lesions of the liver was analyzed. Life-threatening complications, such as spontaneous rupture of the tumor node leading to massive intraperitoneal bleeding and cancerous peritonitis, were noted in 32 (28.5%) cases. Clinical and echographic signs of the threat of this complication developing were observed in 26 (23.2%) patient. Ultrasound (US) and CT semiotics of the tumor node rupture included signs of hemoperitoneum, focal heterogeneous formation with the presence of perilesional hematoma, active extravasation of contrast medium, and focal discontinuity of the liver contour at the site of the focal formation.Results and discussion: Most often, the size of the tumor node exceeded 8.0 cm (in 65% of patients). Protrusion of the tumor through the liver surface was noted in 23 (39.6%) cases. Invasion of the tumor into adjacent organs and tissues was observed in 16 (27.5%) patients. Sites of phlebothrombosis, predominantly in the system of hepatic veins, detected by echo-Dopplerography of liver vessels, were present in 12 (20.6%) patients.Conclusion: Predictors of spontaneous rupture of the tumor node may include: size of the formation more than 5 cm; protrusion of the tumor through the liver surface; phlebothrombosis by tumor masses, leading to increased intramural pressure; extraliver invasion of the tumor into adjacent organs and tissues.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"99 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140433466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.52888/0514-2515-2023-359-4-22-29
A. Ganiev, Sh. K. Nazarov, J. P. Eraj
Aim: To optimize the immediate outcomes of surgical treatment of patients with postoperative ventral hernias.Material and Methods. This prospective cohort study analyzed the results of comprehensive diagnostics and surgical treatment of 114 patients with postoperative ventral hernias, admitted to the Dushanbe City Emergency Medical Center between 2014 and 2022. Patients were divided into two groups based on the surgical treatment method used. The control group included 59 (51.8%) patients who underwent hernioplasty using tension techniques. The main group consisted of 55 (48.2%) patients who underwent hernioplasty using non-tension techniques.Results and Discussion. The two groups differed not only in hernioplasty methods but also in pain management techniques, both intraoperatively and postoperatively. Among the 59 patients in the control group, general endotracheal anesthesia was used in 57 (96.6%) patients, while regional pain relief methods were employed in the remaining 2 (3.4%). Coexisting pathologies affecting the degree of surgical risk were identified in 21 (35.6%) patients. Large hernia sizes were observed in 29 (49.2%) patients. Among 55 patients of the main group, the presence of concomitant diseases affecting the degree of operational risk was detected in 23 (41.8%). Large hernias were found in 37 (67.3%) patients. In 41 (74.5%) cases, endotracheal anesthesia was used in patients of this group, and in the remaining 14 (25.5%) cases, regional methods of anesthesia were used, the use of endotracheal anesthesia was combined with the use of spinal anesthesia.Conclusion. Selecting the most optimal anesthesia method, hernioplasty technique using high-quality synthetic material, local application of the drug Diprospan, and extensive use of ultrasonic methods for postoperative monitoring in patients with postoperative ventral hernias (PVH) can improve the outcomes of their surgical treatment.
{"title":"Ultrasonic monitoring of the abdominal wall in ventroplasty","authors":"A. Ganiev, Sh. K. Nazarov, J. P. Eraj","doi":"10.52888/0514-2515-2023-359-4-22-29","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-359-4-22-29","url":null,"abstract":"Aim: To optimize the immediate outcomes of surgical treatment of patients with postoperative ventral hernias.Material and Methods. This prospective cohort study analyzed the results of comprehensive diagnostics and surgical treatment of 114 patients with postoperative ventral hernias, admitted to the Dushanbe City Emergency Medical Center between 2014 and 2022. Patients were divided into two groups based on the surgical treatment method used. The control group included 59 (51.8%) patients who underwent hernioplasty using tension techniques. The main group consisted of 55 (48.2%) patients who underwent hernioplasty using non-tension techniques.Results and Discussion. The two groups differed not only in hernioplasty methods but also in pain management techniques, both intraoperatively and postoperatively. Among the 59 patients in the control group, general endotracheal anesthesia was used in 57 (96.6%) patients, while regional pain relief methods were employed in the remaining 2 (3.4%). Coexisting pathologies affecting the degree of surgical risk were identified in 21 (35.6%) patients. Large hernia sizes were observed in 29 (49.2%) patients. Among 55 patients of the main group, the presence of concomitant diseases affecting the degree of operational risk was detected in 23 (41.8%). Large hernias were found in 37 (67.3%) patients. In 41 (74.5%) cases, endotracheal anesthesia was used in patients of this group, and in the remaining 14 (25.5%) cases, regional methods of anesthesia were used, the use of endotracheal anesthesia was combined with the use of spinal anesthesia.Conclusion. Selecting the most optimal anesthesia method, hernioplasty technique using high-quality synthetic material, local application of the drug Diprospan, and extensive use of ultrasonic methods for postoperative monitoring in patients with postoperative ventral hernias (PVH) can improve the outcomes of their surgical treatment.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"70 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140433877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.52888/0514-2515-2023-357-2-94-99
A. Razumovskij, V. O. Teplov, N. Stepanenko, N. Kulikova, A. V. Adler
Aim. To enhance the treatment outcomes in children with complications following an esophageal burn caused by a disk battery.Materials and Methods. We analyzed the treatment outcomes of 102 patients suffering from esophageal burns from a disk battery, who were treated at the N.F. Filatov Children’s City Hospital of the Moscow Healthcare Ministry from 2009 to 2021. Children who developed complications (n=57) were divided according to the treatment strategy employed: conservative tactics (n=36, 63.2%) and radical surgery (n=21, 36.8%).Results and Discussion. The types of surgical interventions carried out for tracheoesophageal fistula (TEF) (n=31) included laparoscopic fundoplication and gastrostomy (38.7%), separation of TEF (41.9%), and tracheal plastic surgery with an esophageal flap and extirpation of the esophagus (19.4%). Assessment of the outcomes of TEF post laparoscopic fundoplication and gastrostomy demonstrated spontaneous closure in 63.6% of the cases. The average time until closure was 5 months. Among children with esophageal stenosis (n=24), esophageal bougienage was performed in 95.8% of the cases. All children identified with esophageal perforation (n=4) were successfully treated conservatively. Tactics for managing laryngeal paresis or paralysis included conservative therapy and observation in 33.3% of cases, tracheostomy in 29.2%, and lateralization procedures in 37.5%.Conclusion. Conservative tactics demonstrated superior results in all complications, minimizing the number of postoperative complications (16.7%) and ensuring favorable long-term outcomes.
{"title":"Results of treatment of children with complications after burns of the esophagus from button batteries","authors":"A. Razumovskij, V. O. Teplov, N. Stepanenko, N. Kulikova, A. V. Adler","doi":"10.52888/0514-2515-2023-357-2-94-99","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-357-2-94-99","url":null,"abstract":"Aim. To enhance the treatment outcomes in children with complications following an esophageal burn caused by a disk battery.Materials and Methods. We analyzed the treatment outcomes of 102 patients suffering from esophageal burns from a disk battery, who were treated at the N.F. Filatov Children’s City Hospital of the Moscow Healthcare Ministry from 2009 to 2021. Children who developed complications (n=57) were divided according to the treatment strategy employed: conservative tactics (n=36, 63.2%) and radical surgery (n=21, 36.8%).Results and Discussion. The types of surgical interventions carried out for tracheoesophageal fistula (TEF) (n=31) included laparoscopic fundoplication and gastrostomy (38.7%), separation of TEF (41.9%), and tracheal plastic surgery with an esophageal flap and extirpation of the esophagus (19.4%). Assessment of the outcomes of TEF post laparoscopic fundoplication and gastrostomy demonstrated spontaneous closure in 63.6% of the cases. The average time until closure was 5 months. Among children with esophageal stenosis (n=24), esophageal bougienage was performed in 95.8% of the cases. All children identified with esophageal perforation (n=4) were successfully treated conservatively. Tactics for managing laryngeal paresis or paralysis included conservative therapy and observation in 33.3% of cases, tracheostomy in 29.2%, and lateralization procedures in 37.5%.Conclusion. Conservative tactics demonstrated superior results in all complications, minimizing the number of postoperative complications (16.7%) and ensuring favorable long-term outcomes.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"506 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132387305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.52888/0514-2515-2023-357-2-119-127
A. T. Korokhonov
This article presents an analysis of both domestic and international publications, focusing on the aspects, diagnostics, and treatment of acute hematogenous osteomyelitis of the hip joint bones in children. While the etiology and pathogenesis of acute hematogenous osteomyelitis have generally been well-studied, the literature scarcely covers the early diagnosis and treatment of this disease as it impacts the bones of the hip joint in children. Modern diagnostic methods are often effective only after the disease has been present for three days, which is why traditional diagnostic methods continue to hold significance. The surgical treatment of acute hematogenous osteomyelitis of the hip joint bones in children remains an unresolved issue. The choice of surgical tactics is primarily complex because the disease often comes with complications such as osteomyelitic coxitis, which exacerbates the treatment process and hinders the prevention of orthopedic complications. Therefore, the selection of optimal surgical and preventive care, based on the stage of the disease, the extent of the purulent process, and the degree of destruction and compression of the osteoarticular system, is of utmost importance.
{"title":"Questions of diagnosis and treatment of acute hematogenous osteomyelitis of the hip joint bones in children","authors":"A. T. Korokhonov","doi":"10.52888/0514-2515-2023-357-2-119-127","DOIUrl":"https://doi.org/10.52888/0514-2515-2023-357-2-119-127","url":null,"abstract":"This article presents an analysis of both domestic and international publications, focusing on the aspects, diagnostics, and treatment of acute hematogenous osteomyelitis of the hip joint bones in children. While the etiology and pathogenesis of acute hematogenous osteomyelitis have generally been well-studied, the literature scarcely covers the early diagnosis and treatment of this disease as it impacts the bones of the hip joint in children. Modern diagnostic methods are often effective only after the disease has been present for three days, which is why traditional diagnostic methods continue to hold significance. The surgical treatment of acute hematogenous osteomyelitis of the hip joint bones in children remains an unresolved issue. The choice of surgical tactics is primarily complex because the disease often comes with complications such as osteomyelitic coxitis, which exacerbates the treatment process and hinders the prevention of orthopedic complications. Therefore, the selection of optimal surgical and preventive care, based on the stage of the disease, the extent of the purulent process, and the degree of destruction and compression of the osteoarticular system, is of utmost importance.","PeriodicalId":345517,"journal":{"name":"Health care of Tajikistan","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114681936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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