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Section 4. Medical science
Ahrarova Nigora Abdugapparovna, MD, assistant professor of Propaedeutics childhood diseases,
Tursunov Oliya Abduraufovna, Assistant Department propaedeutics childhood diseases Umarov Marguba Sayfutdinovna, Assistant Department propaedeutics childhood diseases, Ahrarova Feruza Mahmudzhanovna, Assistant Department of Faculty Pediatrics, Tashkent Pediatric Medical Institute E-mail: [email protected]
Antagonism of microelements and the impact on mineral Exchange in newborns
Abstract: Researches order to assess content level of some microelements in newborns, born with normal and low weight also determine the impact on their growth and development especially the relationship of trace elements of iron gland and calcium. Deficiency of vitamins and bio-elements is a common cause dysfunction of organs and systems, intrauterine fetal growth retardation, indicating that the value a comprehensive approach in the treatment of anemia in pregnant women. Keywords: microelements, antagonism, newborns, prenatal development.
Urgency. Among the various conditions disease risk newborns in the neonatal period, an important place belongs to fetal growth retardation, which is the result of various pathological conditions in pregnant women. Despite numerous studies on the disclosure of the reasons for low birth weight, the problem is still relevant in Pediatrics [5]. Migrated anemia in women during pregnancy and their treatment only iron supplements can cause an imbalance of calcium and iron in the body of the fetus and the child after birth. Microelements are involved in all the metabolic processes of the body and Their disadvantage, altering the functioning of enzymes and other proteins, reduces the intensity of metabolism and causes a delay in fetal growth [1; 4].
The cause of micronutrient deficiencies in the body may be the interaction of trace elements, as antagonism or synergism [2; 8]. Items similar to each other in their physical and chemical properties or size of atoms can actively interact or compete in systems that perform absorption, transport or metabolism [6]. In the body of excess phosphorus and iron may interfere utilization of calcium and promotes its removal from the bone.
So, a large amount of calcium inhibits the absorption of Zinc. Use of nutritional supplements that contain zinc in doses exceeding the daily requirement of more than 10 times leads to copper deficiency, and anemia [3]. At a high content of phosphorus disturbed absorption of magnesium and iron (up to 3 %), etc. Last years, with the advent of parenteral use in different types of microelements prevalence of such disorders has increased [7].
The question of the possible effect of iron on the bioavailability of calcium studied for a long time both in animal experiments and in human studies. Numerous works have shown that iron is reduces intake of calcium, exerting an inhibitory effect or to transport it in the gastrointestinal tract, or receptor binding [1; 7]. Our studies have focused on the identification of calcium metabolism in the body of the newborn when used by pregnant only iron-containing preparations (ICP) for the treatment of anemia.
The aim of research — to evaluate the levels of some microelements in newborns, born with normal and low birth weight and to determine the effect of the interplay between microelements of iron and calcium in their growth and development.
Materials and methods. Were examined 20 newborns born with low birth weight (LW) of mothers with anemia. The control group
consisted of 35 apparently healthy term infants with normal weight (NW) of mothers without anemia and their mother. All children conducted determination of iron content (Fe), calcium (Ca), and other microelements (ME) in the cord blood serum, amniotic fluid and breast milk ofmothers. Research of microelements was conducted in the Republican Center for Forensic Science by mass spectrometry inductively coupled plasma the instrument on ICP-MS (mass spectrometer with inductively coupled plasma, production of Japan — 2001.) AT 7 500 mode "Semiguant" by the method "Test/M". Conduct a full anthropometry, clinical examination of children, the severity of those or other pathological signs, Apgar scores. All newborns were examined blood on the basic parameters.
Results and discussion. The research resulted in it was revealed that all the clinical indices children with low birth weight are inferior for newborns with normal weight. By weight of children with LW superior to 931.1 grams in average indicators of children with CF (3 370.6 ± 2.19 and 2 439.5 ± 0.87 respectively). Gestational age is also greater in the group of newborns with NW at 1.6 (39.5 ± 1.2 and 37.9 ± 2.3, respectively).
In the WHO data to assess the physical development of the child, there is a table with the body mass index (BMI) is the ratio ofweight to length (height). This table can be used for all children up to 5 years [3]. When BMI above the number of 12.0 corresponds to children born with normal weight relative to growth at birth and gestational age, and children with indicators below that — born with LW.
Assessment of the Apgar score testifying to decrease of performance in these children at birth. At 1 and 5 minutes, she was 6 and 7 points in 3 children from 20 newborns (15.0 %) were born with LW, and in 1 child 5 and 6 points (5.0 %). A basic number of children assessment of 7 and 8 points, that was 75 %, only in one child 8 and 8 (5 %).
Physiological jaundice in newborns with NW from mothers without anemia was observed on average during 2.7 ± 0.37 days, and in newborns with LW from mothers with anemia who received ICP physiological jaundice is observed on average during 6.6 ± 0.41 days, an increase of 3.9 days.
Based on the scientific researches proved that the hemoglobin content in the blood in healthy term infants with NW basically not
Cliniс-biological features of alcoholism in patients with deviant behavior
affected. Level on the average made 191.5 ± 5.8 g/l, erythrocytes — 5.9 ± 0.2 mln. And leukocytes — 14.4 ± 0.6 thousand, in newborns with LW lower — 165.9 ± 3.9 g/l, 5.8 ± 0.4 mln. and 13.7 ± 0.8 thousand, respectively. In 12 children from 20 constituting this group, there was a decrease in the level hemoglobin in the blood, i. e. anemia (60 %).
In the study of the ME content special attention is paid parameters of iron and calcium. The study of iron in the cord blood in the studied groups of newborns with NW reveals that in normal umbilical cord blood contains an average of 98.66 ± 0.62 g/ml of iron, in the amniotic fluid, the figure was 97.51 ± 0.62 g/ml.
Maximum values up to 139.35 g/ml reaches the Fe content of umbilical cord blood in children with LW under the influence of the regular admission ICP mothers with anemia, as opposed to the lower content of amniotic fluid — 82.09 ± 0.50 g/ml. The highest rates of Fe in the cord blood, and conversely the lowest in the amniotic fluid in children with LW from mothers with anemia who received ICP.
Analyzing the average calcium content of the umbilical cord blood of newborns in the study group with NW from mothers without anemia, found that its content is 55.37 ± 0.50 g/ml, in the amniotic fluid 58.87 ± 0.53 g/ml. In the group of newborns with LBW from mothers with anemia with receiving ICP content of Ca in cord blood expectedly low, and is 42.23 ± 0.35 g/ml, in the amniotic fluid 77.17 ± 0.60 g/ml, indicating that Ca excretion into the amniotic fluid.
The studies revealed pathological distribution of iron on the background of anemia and low birth weight, which indicates the
failure of adaptive and compensatory mechanisms of the body ofMother and Child by pharmacological "support" of iron, which is for the whole group research the disastrous mistake in respect of iron homeostasis in the system "mother-placenta-fetus". It is this feature of the conduct of mothers with anemia and LBW presence of the fetus necessary to consider doctors in own practice that will benefit undeniable practical health.
The results of our research and analysis of the literature suggest that the iron ions are able to reduce the level of calcium absorption. The possibility of such interactions are most relevant and should be considered in the treatment of iron deficiency anemia and calcium deficiency states, particularly in high-risk groups (children, pregnant women, the elderly). Based on these studies should be noted that the deficit or imbalance ME mothers and newborns is a common cause of intrauterine fetal growth retardation, anemia and disorders adaptation of the newborn in the early neonatal period.
Conclusion. Thus, between the ME exists some interaction, wherein the individual ME with respect to each other and to the metabolic processes come as synergists or antagonists. Studies have also proved some interaction between some of the ME. A competent separation of vitamin and mineral components, as well as the use time of reception is a prerequisite for efficiency of their application. In this case it is convenient to use vitamin and mineral complexes that provide separate intake of iron and calcium.
References:
1. Abaturov A. E. The microelement balance and anti-infective protection in children//Child Health. - 2008. - № 1(10). - P. 47-50.
2. Akhmedova D. I., Rakhimdjanov Sh. A. The growth and development of children. Methodical recommendation. - Tashkent, 2006.
3. Saygitov Z. T. Micronutrients and physical development of children: a meta-analysis of randomized controlled studies//Current Pediatrics. - 2008. - № 3. - P. 58-65.
4. Sidorova I. S. Risk factors for intrauterine growth retardation in terms of evidence-based medicine/I. S. Sidorova, E. I. Borovkova, I. V. Martinova//[Electronic resource]. - Available from: http://online.zakon.kz/Document/?doc_id=30721477 (May 20, 2006).
5. Arredondo M., Martinez R., Nunez M. T. et al. Inhibition of iron and copper uptake by iron, copper and zinc//Biol. Res. - 2006. - 39: 95-102.
6. Cavill I., Auerbach M., Bailie G. R. et al. Iron and the anaemia of chronic disease: a review and strategic recommendations//Curr. Med. Res. Opin. - 2006. - Vol. 22, № 4. - P. 731-737.
7. Guinote I., Fleming R., Silva R. et al. Using skin to assess iron accumulation in human metabolic disorders//Ion Beam Analysis. -2006. - 249: 697-701.
8. Linder M. C., Moriya M., Whon A. et al. Vesicular transport of Fe and interaction with other metal ions in polarized Caco2 Cell monolayers//Biol. Res. - 2006. - 39: 143-156.
Ashurov Zarifjon Sharifovich, Ph.D, associate professor, Head of the Department of Psychiatry and Addiction, Tashkent Medical Academy
E-mail: [email protected]
Cliniс-bioloдical features of alcoholism in patients with deviant behavior
Аbstract: We studied the clinical features of alcohol dependence in patients with behavioral disturbance and psychological conditions that contribute to their formation. The study involved 200 patients with alcoholism with deviant behavior and without any indications of behavioral disorders. The results may indicate that the presence of premorbid comorbidity, family history, and personality characteristics have an important influence on the formation of alcohol dependence and the presence of deviant behavior in these patients.
Keywords: alcoholism, deviant behavior, genetic predisposition, personality disorder.
In the analysis ofEnglish literature quite often possible to meet opinion that patients with alcohol dependence comorbid with personality disorders have a low level of social functioning, low motivation for treatment, a high risk of relapse addiction, and hence the poor results of treatment [1; 3; 4; 6; 7].
It is known that in recent years more and more interest takes the study of deviant behavior, which is widely covered in the foreign literature [2; 5].
The objective is to study clinical features of alcohol dependence in patients with deviant behavior.
