Medical science of Uzbekistan

PRONE-LATERAL RADIOGRAPHY AND TRANSPERINEAL ULTRASONOGRAPHY IN PEDIATRIC ANAL ATRESIA: AN ALTERNATIVE APPROACH TO DETERMINING

Sun, 19 Jan 2025 00:00:00 +0500

Recently, some data has emerged regarding the use of ultrasonographic techniques in diagnosing anorectal malformations (ARMs). However, there is a lack of comprehensive scientific research widely covering the results of studies on this technique.

Objective. To evaluate the effectiveness of echographic ultrasonography in determining the type of anal atresia in neonates and to assess its applicability in clinical practice.

Materials and Methods. The study involved a comparative analysis of the diagnostic sensitivity and accuracy of radiological visualization and ultrasonographic methods for measuring the distance between the rectal pouch and the skin in 27 neonates with anal atresia. In all neonates, invertography, prone-lateral radiography, and transperineal ultrasonography were performed.

Results and Discussion. The results indicated that congenital anomalies of the gastrointestinal tract constituted the majority of developmental defects among the studied neonates. Out of 27 patients, 4 cases of fistula and 3 cases of cloacal malformation were excluded from the study due to their specific nature, leaving 20 patients for analysis. Among them, the low type of ARM was found in 13 cases, while intermediate and high types were identified in 7 cases, with 3 and 4 patients, respectively. A receiver operating characteristic (ROC) analysis was conducted to evaluate the specificity and sensitivity of prone-lateral radiography and perineal ultrasonography in diagnosing anal atresia, as well as the informativeness of quantitative tests. The Area Under the Curve (AUC) value for ultrasonography was high (0.92), indicating its superior sensitivity in diagnosing anal atresia, providing correct diagnoses in 92% of cases. The AUC value for prone-lateral radiography was lower (0.58), reflecting its reduced sensitivity and accuracy compared to ultrasonography. Ultrasonography demonstrated a sensitivity of 92.3%, indicating a high probability of correct diagnosis, with a specificity of 85.7%, highlighting its high diagnostic efficiency. In contrast, radiography showed a sensitivity of 15.4%, indicating low detection capability, although it had a specificity of 100%, confirming its accuracy in clear-cut cases.

Conclusion. Transperineal ultrasonography can be promptly utilized for the early diagnosis of congenital anorectal anomalies, allowing real-time identification and assessment of anatomical characteristics and aiding in precise surgical planning. Additionally, the lack of radiation exposure makes this technique preferable to radiography.

PATHOMORPHOLOGY OF CHONDROMATOUS HAMARTOMA DEVELOPED IN LUNG TISSUE

Rakhmanova Nargizaxon Sodikjon qizi — Sun, 19 Jan 2025 00:00:00 +0500

The aim of the scientific work. Hamartoma is the most common benign tumor of various organs and is considered a benign tumor arising from non-epithelial mesenchymal tissue, the exact cause of which is still not fully understood. Hamartoma consists of cells developing in any tissue and characteristic of this organ. Endobronchial hamartomas occurring in the lung tissue make up 12-20%. It is characterized by a chondromatous and vascular structure in composition and a nodular appearance during microscopic examination. In this study, it was found that hamartoma of the respiratory tract was morphologically manifested in cases of bleeding by the vascular type. Materials and methods. Autopsies, ileum and oral mucosa materials of various forms of myeloblastic leukemia and sepsis were delivered and organized to the center of pathological anatomy of the republic. Of these, 43 male and 26 female materials were received. The prepared pieces are studied morphologically. Results. When analyzing the results of the morphological study, it was noted that the hamartoma, which grew from the large bronchi, was located in the endobronchial tissue structures of the bronchi. It was found that chondromatous changes in the chondromatous tissue of the hamartoma occur in the nodes and bronchial wall of the chondroma and have an atypical structure. It was noted that the cytoplasm of chondrocytes is strongly vacuolated. Among the pieces of chondromatous tissue, the appearance of tubercles and cystic structures among bundles consisting of soft tissues of the bronchial wall was detected. Summary. It was found that 13.4% of chondromatous hamartomas of the respiratory system are located in the wall of large bronchi, 56.2% in the front segments of the lungs, and the rest in the back segments of the lungs (30.2%). It was found that the hamartoma developed in the wall of the large bronchi consists of multifocal and irregularly located chondromatous tissue nodules, and around them, the soft tissues of the bronchial wall and the mucous membrane have grown in a dysregenerative manner. It was observed that in the hamartoma developed from the bronchi within the lung tissue, chondromatous foci appeared both in the wall of the bronchi and in the alveolar tissue.

RISK FACTORS FOR REPEATED ECTOPIC PREGNANCY

Sun, 19 Jan 2025 00:00:00 +0500

Relevance. Ectopic pregnancy is a serious threat to the reproductive health of women, and in some cases is the cause of death. The frequency of EP has a stable upward trend, amounting to 0.8-2.4% in relation to childbirth, a repeated episode occurs in 7.5-22% of women. The purpose of the study is to develop criteria for quantitative assessment of the degree of individual risk and a method for predicting the likelihood of repeated ectopic pregnancy. Materials and methods of the study. The results of a survey of 246 women living in the Andijan region were analyzed, of which 166 had two ectopic pregnancies and 80 had one episode of ectopic pregnancy. Correlation, regression and discriminant analysis according to Fisher were carried out on 48 features of the unified survey card using the SPSS 15 software package. Research results. To assess the degree of individual risk of recurrent ectopic pregnancy and to develop a method for individual prediction, the information significance and prognostic value of each risk factor were determined. Three degrees of risk were identified: high - with a sum of coefficients of 13 points or more (the probability of recurrent ectopic pregnancy is 90%); medium risk with a sum of 12 to 3 (the probability of recurrent ectopic pregnancy is 50%); and low from 2 points or less (the probability of pathology is less than 20%). Conclusion. A high information index of the occurrence of a recurrent episode of ectopic pregnancy has such signs as unfavorable social status, a history of infertility, previous surgeries, inflammatory diseases of the genitals, sexually transmitted diseases, the time from the appearance of the first clinical signs to the start of surgery, conservative operations on the fallopian tubes, complicated course of the postoperative period.

CONGENITAL BRONCHIAL ANOMALIES: ENVIRONMENTAL AND GENETIC FACTORS. ANALYSIS AND RESEARCH IN NEWBORNS

Shevketova Lilya Shevketovna, Makhkamov Nosirjon Jurayevich — Sun, 19 Jan 2025 00:00:00 +0500

Anomalies of the respiratory tract in newborns impact their primary physiological function—breathing, leading to respiratory diseases at an early age. Objective. To study the significance of environmental and genetic factors in the development of congenital bronchial anomalies. To conduct analysis and research on newborns. Materials and Methods. The study involved 40 patients with congenital bronchial anomalies and 20 newborns from the control group. Biopsy materials from the trachea, bronchi, and lungs were used. Environmental factors such as the newborns' region of birth and harmful substances in the atmosphere, including toxic compounds, were considered. Results and Discussion. Microscopic analysis of tissue samples revealed abnormal epithelial structures (green cells) in the trachea and bronchi. Infiltrates formed by lymphocytes and neutrophils, as well as epithelial lipid abnormalities, were identified. It was found that high concentrations of toxic substances and aerosols in the atmosphere of the studied region significantly increased the likelihood of congenital bronchial anomalies. For example, elevated levels of nitrogen oxides, ozone, aerosols, and toxic chemicals acting as environmental stress factors contributed to the development of these anomalies. Environmental analysis showed that an increase in the number of bronchial and tracheal anomalies correlated with high levels of air pollutants. Conclusion. Based on the results of the scientific analysis of congenital bronchial anomalies in newborns, the following conclusions were drawn: environmental factors, particularly the influence of harmful substances, aerosols, and toxic compounds, play a critical role in the development of congenital bronchial anomalies in newborns.

NECROTIC ENTEROCOLITIS OF NEWBORNS (literature review)

Chartakov Dilmurod Kaxromonovich — Sun, 19 Jan 2025 00:00:00 +0500

Necrotizing enterocolitis (NEC) is a neonatal inflammatory bowel disease and is one of the most threatening disease in neonatal gastroenterology. The average incidence of necrotizing enterocolitis 2,4:1000 infants (1 to 10:1000), or about 2.1% (from 1 to 7%) of the total number of children entering the neonatal intensive care unit. The incidence of disease increases with decreasing gestational age at birth. The share of full-term infants accounts for 10-20% of cases of NEC. In recent years, necrotic enterocolitis has remained one of the leading causes of morbidity and mortality among premature infants with low body weight. The active study of the most important diagnostic factors in the early stages of the disease, which is difficult to diagnose, the choice of a treatment method is one of the first tasks of neonatologists and surgeons of the children's department.