ACUTE ABDOMEN - A PRACTICAL APPROACH
Abstract: In the present article, the author presents practical approaches that allow the correct diagnosis in acute abdomen using sonography and computed tomography, differentiating the various pathologies. It is shown that survey radiography of abdomen, besides the detection of kidney stones or pneumoperitoneum, useful in rare cases. For all other indications necessarily conduct sonography or computed tomography. It is also noted that in case of acute pain in the abdomen is advisable to use a two-stage approach involving radiological study confirming or excluding the most common diseases and to identify common signs of pathology.
Keywords: acute abdomen pain, diagnosis, sonography, computed tomography, the differentiation of abnormalities
Aliyev Sh.H., Bakhshaliyev Z.F., Aliyev T.M.
HEMORROIDS, ECTOPIC VARICES AND PORTAL HIPERTENSION
Abstract: Gastrointestinal bleeding in patients with portal hypertension is usually secondary to esophageal varices, but massive bleeding from gastric mucosal lesions and colonic mucosal lesions including colorectal varices, have been variably described. These lesions are called portal hypertensive gastropathy and colopathy. The clinical feature and profile of portal hypertensive colopathy is classified two groups, which are named colorectal varices and colonic mucosal lesions. Although colorectal varices are usually seen at rectum and sigmoid colon, colonic mucosal lesions are seen all part of colon. Significant relationship between colorectal varices and liver disease has been reported and colorectal varices is highly appeared in patients with extrahepatic portal obstruction. Many advances in the management of portal hypertension and variceal hemorrhage have occurred during the last 10 years: nonselective beta blockers, terlipressin, somatostatin or its analogues and endoscopic therapy (sclerotherapy, band liqation), transjugular intrahepatic portosystemic shunt (TIPS) etc.
Keywords: portal hipertension, esophageal varices, anorectal varices, hemorroids, cirrotic patients
K.E.Eyvazov, R.R.Aliyev, B. E.Eyvazov
DEGENERATIVE DEFORMITIES OF THE SPINE IN ADULTS: METHODOLOGY OF ASSESSMENT AND TREATMENT
Abstract: The proposed article is devoted to the actual problem of modern health care – degenerative spinal deformity. The article discusses the approach, epidemiology, clinical assessment, diagnosis and treatment of degenerative spinal deformity.
Keywords: spine, deformity, scoliosis, sagittal alignment, coronal alignment, spinal biomechanics, back pain
Akbarova I.K., Kazımov A.K.
THE FACTORS INFLUENCED ON THE SURGICAL TREATMENT OF LIVER TRAUMA
Abstract: The experience of examination and treatment of 128 victims with hepatic injuries has been described. The outcomes of researches about frequency and structure of hepatic wound in peace time have been shown. The information on outcomes of diagnostics and treatment of these damages, and also causes of postoperative unfavorable outcomes have also been observed.
Keywords: injury of liver, diagnostics, surgical treatment
R.S. Haciyeva, P.M.Aliyeva
THE ROLE OF CYTOKINES IN THE DEVELOPMENT OF PLACENTAL INSUFFICIENCY
Abstract: The aim of the study - evaluation intracellular production of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) placental decidua macrophages in women with pregnancy complicated and physiological. The materials of the study were 84 placenta of pregnant women, who were divided into 2 groups: a core group of 59 women with complications of pregnancy, the control group - 25 women with uncomplicated pregnancy. Placentas of pregnant core group content of TNF-α was on average 2.7 times higher relative to the control group (p<0.05), while the level of IL-10 - 1.8 times lower (p<0.05), the pregnancy complications have been accompanied by significant changes in the level of TNF-α and IL-10. Pregnancy complications in 32 patients proceeded against the backdrop of placental insufficiency, and in 27 women were diagnosed with fetal growth retardation (FGR).The placentas of pregnant women with placental insufficiency of the amount of TNF-α exceeded the benchmark by an average of 2.8 times (p<0.05) in the group of pregnant women with FGR - 2.4 times (p<0.05).The level of IL-10 in pregnant women with placental insufficiency and FGR concerning the control decreased respectively by 1.9 times (p<0.05) and 1.2 times. Comparative analysis of the content of cytokines between the groups of pregnant women with placental insufficiency and FGR has shown that the level of TNF- α in the placenta of pregnant women with placental insufficiency was higher by 15.9%, and the content of IL-10 lower by 33.0% (p<0.05). Determination evidence of the increase in its index ratio of TNF/IL-10 in the placentas of pregnant women with complications of pregnancy: when placental insufficiency - 5.2 times (p<0.001), and for pregnancy complications FGR - 3.0 times (p<0, 01). In pregnant women with complications of pregnancy by increasing anti-inflammatory cytokines levels remained reduced, which was assessed as uncompensated type of imbalance cytokines. The findings suggest that an important role in the formation of the placenta plays an adequate production of cytokines, and its breach can lead to structural and functional changes.
Keywords: pregnancy, complications of pregnancy, placental insufficiency, fetal growth retardation, cytokines, imbalances
R.S. Haciyeva, Z.F. Mahmudbekova
FACTOR HEREDITARY BURDEN IN PREGNANT WOMEN WITH PRE-ECLAMPSIA AS A POSSIBLE PROGNOSTIC CRITERIA
Abstract: In order to analyze the heredity of pregnant women with pre-eclampsia (PE) examined 110 pregnant women in gestational age 24-28 weeks. Pregnant women were divided into 2 groups: main group – 90 pregnant women with PE, the control group – 20 pregnant women without complications of pregnancy. Significant frequent occurrence of family history in the study group compared with the control – 82,2% (n = 74) and 20,0% (n = 4) (in 4.1 times, p<0.01).Cases of deaths from relatives of pregnant women with PE aged 40-50 years accounted for 10.0%, and stroke met with relatives 1 and 2 lines of kinship. Relatives 1 pregnant kinship line with PE were significantly more frequent chronic hypertension and stroke – by 5.5 times (p<0.001), myocardial infarction, and diabetes – 3.1 times (p<0.05).In pregnant mothers basic group PE occurred in 32.2% of cases (n = 29) versus 5.0% (n=1) in the control group, which was statistically significantly (6.4-fold, p<0.001); Chronic hypertension – in 77.8% of cases (n=70) versus 15.0% (n=3), the difference was 5.2 times (p<0.001); stroke – in 22,2% (n=20) cases, against 5,0% (n=1) in the control group, a statistical difference was 4.4 – fold (p<0.01); diabetes – in 12,2% (n=11) of cases (p<0.01); myocardial infarction – in 5,6% (n=5) cases in the control group mothers did not meet this pathology. Paternal chronic hypertension, diabetes mellitus, myocardial infarction, and stroke was significantly more common in pregnant women with PE fathers compared with the control group. Chronic hypertension, stroke, and diabetes occurred only in patients with PE fathers 5.5%, 11.1% and 15.6%, respectively. Myocardial infarction fathers pregnant core group compared with the control group met in 2.0 times more likely (10.0% vs. 5.0%, p<0.05). Taking into account the results of studying heredity 1 kinship lines in patients with PE, it is possible to ascertain the importance of the analysis in the planning of pregnancy and in the first two trimesters of pregnancy.
Keywords: pregnancy, preeclampsia, heredity, kinship, history, somatic, gynecological diseases
Abstract: Anemia is widely spread among the patients with chronic heart failure (CHF) from 7 up to 15% and has a major clinical significance and is independent predictor of mortality.
Purpose. The purpose of investigation to study relation to levels of erythropoietin and pathological cytokine of patients in chronic heart failure with anaemic syndrome and erythropoietinic effect and security of continuous erythropoietin receptor activator methoxy polyethilenglicol-epoietin beta (MEB) its impact on this relation and on regress of symptoms chronic heart failure.
Methods. 94 patients with chronic heart failure by New York Heart Association (NYHA) class ІІІ-ІV a left ventricular ejection fraction of 40% or less with anaemia were included in investigation. Mean age of patients 59.7±1.6 years (55 males, 39 females). A hemoglobin level of less 120 g/l by males and less 110g/l by females. 46 patients were treated basis treatment of CHF (І group) and 48 patients were treated with MEB (ІІ group). Percutaneus MEB in dose 50 IU in day in one month’s patients without iron deficiency to receive in follow-up on 6 months. Echocardiografic indices of LV systolic and diastolic function, plasma NT pro BNP, cytokine, erythropoietin, ferritin and 6 minute walked distance were assessed at baseline and posttreatment.
Results. On the patients CHF with anemic syndrome in ІІ group MEB treatment the level Hb increased on 22.4% (p<0.05) and erythropoietin levels in serum plasma increased to 29.3±4.3 IU/ml (p<0,001).The increase the level of erythropoietin connected with the decrease of level pathological cytokines: IL-1on 36.6% (p<0.001), IL-6 on 54,3% (p<0,05), TNF-α on 48.3% (p<0,05) compared with of patients receiving І group. MEB treatment had a significantly increase LVEF on 19.04% (p<0.05) as compared with of patients receiving І group. A greater 6-minute distance walked on exercise testing increased on 76.6% (p<0.05) after treatment MEB. There was also a significant fall in serum NT pro BNP levels from 387.4±52.3 fmol/ml to 198.1±30.3 fmol/ml (p<0.01).
Conclusion. On the patients of CHF with anemic syndrome erythropoietin failure increase sytokincal aggression with worsens clinical picture of the illness. Correction of anemic syndrome with application of percutaneus MEB in dose 50 IU in day in one month in follow-up 6 months effective to improve erythropoietin failure and cytokinic aggression connected to it and anemia; clinical symptoms and quality of life in anaemic CHF patients.
Keywords: chronic heart failure, anemia, erythropoietin, iron deficiency, pathological cytokine
THE LEVEL OF THYROID HORMONES IN WOMEN WITH INFERTILITY
Abstract: The aim of this study was to characterize the level of thyroid hormones in women with primary and secondary infertility. We observed 556 women with infertility, in women 394 noted the primary, at 162 - secondary infertility. All women identified thyroid stimulating hormone (TSH, T4). Primary screening of thyroid hormones in infertile women provided information about thyroid dysfunction. Relatively frequently observed symptoms of hypothyroidism met (>19.8%). The average amount of blood TSH ovulation disorders and other causes of infertility differ (respectively 1.59±0.08 and 1.72±0.06 mME/l). Results showed that the characteristic feature for fertile women had a low level of TSH and T4 (respectively 20.1% and 19.8% of the time). When infertility related to ovulation disorders and other reasons, the greatest difference was manifested in the content of free thyroxine. In the primary infertility associated with ovulatory disorders, the TSH and T4 levels low. Infertility, ovulatory disorders based, mainly associated with the lack of free thyroxine (65.1%). Diagnostic specificity (in women of reproductive age the probability of hormone levels in the normal range) high studied hormones (78.1-95.0%). In assessing the thyroid hormones in infertile women to use the results of determination of such markers as sensitivity, specificity, predictive value and relative risk, increase data value.
Keywords: infertility, thyroid gland, thyroid stimulating hormone, free thyroxin, the sensitivity, specificity, relative risk
Abstract: The purpose of the article: to find out the objective indicators of clinical and laboratory data in the preparation of clinical remission during the conservative treatment of benign prostatic hyperplasia (BPH) and to develop criteria for withdrawal and resumption of therapy. To this end, we conducted a study in 58 patients with BPH who have held conservative therapy, finasteride 5mg+silodosin 4mg per day. It is established that the criteria for the deletion of conservative therapy following: the international system of the total evaluation of diseases of the prostate IPSS≤8 points, assessment of quality of life QoL≤2 scores; decrease prostate volume by 20% or more; the maximum urinary flow rate Qmax>12 ml/s; residual urine volume <10 cm3; LET≥3. Upon receipt of the above indicators of treatment needs to be interrupted and take the patient to the dynamic monitoring. When re-examination if there is a negative dynamics of the indicators, compared to the above regulations, the treatment should be renewed – intermittent conservative treatment. Thus, the claimed method of conservative therapy in patients with BPH to choose the optimal duration of treatment for each patient, which greatly improves the quality of treatment and reduce the time and cost of therapy to reduce pill burden on the patient.
Keywords: benign prostatic hyperplasia (BPH), prostate specific antigen (PSA), fnasteride, silodosin, laboratory markers of treatment efficacy (LMTE), intermittent therapy
Huseynov N.M., Panahian V.M., Mammadova O.B., Shakhverdiyeva A.E.
THE TREATMENT OF CHRONIC SUPPURATIVE OTITIS MEDIA COMPLICATED WITH POLYP AND GRANULATION
Abstract: In the article presented the results of treatment of 37 patients with chronic suppurative otitis media complicated with polyp and granulation. It is evaluated the effectiveness of treatment of chronic suppurative otitis media and prospects for the use of this treatment in these patient group.
Keywords: chronic suppurative otitis media, polyp, granulation
Mahyadinova G.T., Zeynalov A.F., Guliyeva N.F., Rustamov R.R., Huseynova S.D.
PREVALENCE OF CARBOHYDRATE METABOLISM DISORDER IN THE POPULATION OF SABUNCHU AREA OF BAKU CITY
Abstract: The article presents results of epidemiological survey among male and female living in the Sabunchu area of Baku city.
Purpose: Determine the prevalence carbohydrate metabolism disorder.
Results: Established that the prevalence of carbohydrate metabolism disorder dominated among female. Frequency of Diabetes Mellitus type II among male and female was not different. Strategy of prevention glucose intolerance should be priority in the Sabunchu area of Baku city.
Keywords: carbohydrate metabolism disorder, non-organized population, epidemiology
Abstract: 352 patients were examined by this work. Of these, 121 patients with chronic obstructive pulmonary disease (COPD) (I group), 113 patients with COPD in conjunction with ischemic heart diseases (IHD) (II - main group), 118 patients with IHD (III group). With a decrease of stroke volume and E/attack rate patients in group 2 decreased Index E/attack rate, indicating possible violations of diastolic RV function, running parallel with impaired LV systolic function. Stroke volume and directly correlated E / attack rate connotation Spd (r=-0,53, p=0,08 and r=-0,82, p=0,02), which corresponds to the blood flow through the tricuspid valve in the right atrium systole.
Keywords: chronic obstructive pulmonary disease, coronare artery disease, central hemodynamics, the left ventricle, the correlation
L.M. Rzaquliyeva, M.S. Musaeva, G.T. Suleymanova
CYTOKINE LEVELS IN THE SERUM OF WOMEN WITH THALASSEMIA
Abstract: In order to clarify the influence of cytokines in patients with thalassemia, as in pregnancy, and outside of pregnancy, were studied in the concentration of γ-interferon (IFN), interleukin (IL) 2 and tumor necrosis factor-α (TNF-α). Determination of the concentration of cytokines in the blood serum was carried out in 20 pregnant and 76 nonpregnant women with various forms of thalassemia. The analysis amount of cytokines in the serum of pregnant women depending on the form of thalassemia showed that the maximum values of IFN- and TNF-α were observed in 3 (50.0%) of pregnant women with the intermediate 1 (11.1%) with low β-thalassemia and 1 (20,0%) α-thalassemia. In nonpregnant thalassemia levels of all 3 cytokines was determined by the above test, but it was significantly higher content of IFN concentration is on average higher than 1.6 times the control (p<0.05), the difference in the amount of IL-2 and TNF-α was 29.1 and 7.7%. Thus, on the basis of determining the level of IFN, IL-2, and TNF cytokine profile changes expressed high concentrations of IFN and elevated levels of IL-2 from women with all forms of thalassemia, but also moderately increased amount of TNF-α in patients with a large β-thalassemia.
Keywords: women, thalassemia, serum, cytokines, interferon, tumor necrosis factor-α, interleukin-2
N.Y. Mammadova, G.H. Babayeva
A MULTIDISCIPLINARY APPROACH TO THE ARTICULAR SYNDROME IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Abstract: Inflammatory bowel disease (IBD) have a diverse clinical picture with a variety of intestinal complications and extraintestinal manifestations (EM); this pathology with social value, which is determined by the prevalence of the disease among the young people of working age and a tendency to chronic pathological process, deteriorating the quality of life of patients and generated a high demand for hospital treatment. In this article, the authors present the results of their own research, corresponding to world literature data, as well as the provisions of the first European Consensus on extraintestinal manifestations in IBD. The severity and aggressiveness of current joint syndrome in IBD, its contribution to the deterioration of the quality of life of the patient and the risk of disability requires a multidisciplinary approach in solving this problem, and is one of the key requirements of ECCO (European Organization for Crohn's disease and colitis) on the treatment and rehabilitation of patients with ulcerative colitis and Crohn's disease.
Keywords: inflammatory bowel disease, ulcerative colitis, Crohn's disease, extra-intestinal manifestations of articular syndrome, arthropathy, arthritis