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Sirozhiddinova Khiromon Nuriddinovna, senior research worker, 2 nd year competitor on "Pediatrics" specialty,
Samarkand State Medical Institute Abdullaeva Muhiba Negmatovna, d. m.s., professor, Head of the Chair of Neonatology of Samarkand State Medical Institute E-mail: [email protected]
Contemporary aspects of intrauterine infectivity in perinatal pathology
Abstract: The results of research concerning the study of nosological forms and etiology of diseases of 140 newborns with perinata l pathology have been presented. Perinatal pathology is manifested as sepsis, neonatal pneumonia and as a type of diarrhea. The main causative agent of sepsis, pneumonia and neonatal dispepsia is Staphylococcus aureus.Coincidence of phagostandard essential quality of staphylococcus isolated in mothers and newborns proves that the main source of newborns' infection are mothers.
Keywords: newborns, perinatal pathology, purulent inflammatory diseases, source of infection.
At present the efforts of specialists of different countries are directed to improvement of mothers' health condition and giving birth to healthy children. In spite of introduction of more informative diagnostic methods and extension of the studied causative agents spectrum the problem of intrauterine infections and intrauterine infectivity remains actual in perinatology, neonatology and pediatrics [4; 10]. Intrauterine infection is congenital. At present among congenital infections rubella, chlamidiosis, mycoplasmosis, toxoplasmosis, infection by simple herpes virus and cytomegalovirus occur. According to evaluated data about 400 cases of congenital rubella may be observed every year in RF [5]. Frequency of congenital cy-tomegaloviral infection in RF is unknown, in the USA it is evaluated as 1% of the number of all newborns, frequency of congenital infection by the virus of simple herpes is 1 case among 1000 newborns, parvoviral infection is 1case among 400 newborns [8; 9].
It is known that congenital infections are carecterized by severity of their course and high frequency of unfavourable outcomes. Death rate in congenital toxoplasmosis makes 12%, congenital viral infection of simple herpes — to 90%, enteroviral infection- 80% and congenital rubella — 100%. Intrauterine infection always has clear clinical signs [2].
There are opportunistic infections (opportunistic microbiots) which are transferred from mothers to fetus, inhibit in the newborns
A higher percentage of diarrhea is marked compared to the other types of pathologies. Sepsis takes the second place and is registered in 29 (20,7%) of 140 examined newborns. Altogether purulent inflammatory processes including sepsis are marked in 67 (47,8%)newborns. It is known that in perinatal period upper mentioned diseases like sepsis, neonatal pnewmonia and diarrhea appear to be themain and basic cause of newborns' death [3; 6]. So the study of clinical manifestations and etiological role of microorganisms in perinatal pathology are of great practical interest. In order to determine microbe etiology in perinatal pathology feces, blood, mucus from fauces and pus are taken for bacteriological study. The
body and produce persistency for a long time. They cause various pathologic conditions in perinatal and neonatal periods which finally result in formation of frequently sick children [1; 7].
Aim of the research. To study the causes of perinatal pathology of the newborns associated with mothers' health and to determine etiological role of opportunistic microorganisms.
Material and methods of research. In order to find out the course of perinatal pathology and intrauterine infectivity there were examined 140 newborns admitted to the Regional Children's Multiprofile Medical Center, the Department of newborns pathology of Samarkand. The mothers of the newborns also underwent statisticoanamnestic and partially bacteriological study. Statistical processing of the results included evaluation of the average meaning authenticity of dimensions according to Student criterion with assigned level of reliability (p < 0,05).
Results of the research and their discussions.The received results show that of 140 examined newborns 106 (75,7%) were admitted to DNP from the 1st to the 7th day of their life. The rest 34 (24,3%) were admitted later from the 8th day to one month of age. Hospitalization of the newborns with various pathology show that they had ante-or internatal infectivity. On analysis of nosological forms of the disease diarrhea, sepsis, neonatal pneumonia and other purulent inflammatory diseases were revealed (Table № 1).
analysis of the received data show (Table № 2) that gram-positive flora prevailed in feces contents. It was noted that in sepsis and purulent inflammatory diseases gram-negative bacilli and streptococci were inferior to staphylococci. Probably these changes in etiological structure of a number of purulent inflammatory diseases took place under the influence of many factors but mainly as a result of obtaining resistance by staphylococci to many antibiotics.
Microbe scenery of perinatal pathology in the newborns.
In order to study pathogenic properties and antibioticosensitiv-ity pathological material of 1-2 stapphylococcal strains were isolated from each sample. 150 strains were isolated and studied. All
Table 1. - Nosological forms of the diseases in the newborns
The number of examined newborns Types of neonatal pathology The number of pathologies
Diarrhea 49 (35,1%)
Sepsis 29 (20,7%)
140 Neonatal pneumonia 24 (17,1%)
Pemphigus of the newborns 20 (14,3%)
Omphalitis 16 (11,4%)
Conjunctivitis 2 (1,4%)
Contemporary aspects of intrauterine infectivity in perinatal pathology
of them were hemolytic, had golden colour of pigment and 96 (64%) of 150 coagulated plasma. The study of antibioticosensitivity shows that staphylococcal strains appeared to be resistant to amy-cocin, amoxiclav, cephazolin and ciprofloxacin. Of 150 strains only 20 (13,3%) manifested high resistance to amycocin, 10 (6,6%) to amoxiclav, 17 (11.3%) to cephazolin, 33 (22%) to ciprofloxacin. The rest strains had average and mild sensitivity. Staphylococcal strains appeared to be very sensitive to gentomycin (60-40%), cefotoxin (45-30.1%) and ceftriaxion (61-40,6%). So the most effective anti-
It is impossible to establish the source of infection on the basis of study of Candida, Streptococcus, Klebsiella, E. Coli biological properties isolated in medical staff, mothers and newborns as these microorganisms are identical in all sources. However while studying staphylococcal phagosensitivity it is possible to determine the source of infection in perinatal pathology of the newborns. For this purpose we isolated 56 strains of staphylococci from mothers' nipples and 96 strains from various pathological of the newborns and their phagostandard essential quality.
According to phagostandard results most of staphylococcal cultures were lasered by phages of the I and III group. We were interested in coincidence ofphagostandard results between staphylococcal strains isolated in mothers and their newborns. It should be noted that phagoscenery of staphylococci isolated from mothers' nipples and from various foci of damage to the newborns are rather
biotics against staphylococci are gentomycin, cefotoxin, ceftriaxion.
The study of anamnestic data concerning health of 34 mothers of the newborns with perinatal pathology show that all mothers (100%) have anemia; during their pregnancy 24 of 34 mothers underwent the grippe, 17-toxicosis, 11 had threat of fetal loss and 5 had pyelonephritis. Physiological course of the delivery period is noted in 17 cases, intramuscular and intravenous stimulation was carried out in 7 cases, cesarean section delivery in 4 cases. Waters were dirty in 13 cases.
similar and epidemic phagotypes: 80, 81, 83A prevail among them. This circumstance makes it possible to suggest that in the conditions of maternity wards mothers' role in the development of perinatal pathology is great.
Conclusions.
1. On the basis of the performed study it can be said that anemia, pyelonephritis, viral infection suppress natural factors of protection of mother's body which effects unfavourably the formation of fetal immune status and development of perinatal pathology.
2. Among perinatal pathology diarrhea then sepsis and pneumonia prevail. Etiological role is mainly attributed to gram- positive antagonistic staphylococci.
3. Coincidence of phagostandard essential quality isolated in mothers proves that the main source of newborns' infection are mothers.
Table № 2. - Microbe scenery of perinatal pathology in the newborns
The number of exam- Type Material for The number Type of microbe It is revealed
ined newborns of pathology study of samples
St.aureus 5 16 (32,7%)
St.aureus 5 + Candida 12 (24,5%)
Diarrhea Feces 49 ЭПЭК 5+ Candida 11 (22,5%)
ЭПЭК5 6 (12,2%)
Candida 4 (8,1%)
St.aureus 19 (65,7%)
Sepsis Blood 29 St.aureus+ Candida 3 (10,5%)
Streptococcus 4 (13,9%)
140 E. Coli 2 (6,9%)
Neonatal pneu- Mucus from 24 St.aureus+ Candida 15 (62,5%)
monia fauces Klebsiella + Candida 9 (37,5%)
Pemphigus of the newborns St.aureus 12(60%)
Pus 20 Streptococcus 4 (20%)
St.aureus+ Candida 4 (20%)
Omphalitis Pus 16 St.aureus 10 (62,5%)
St.aureus+ Candida - 6 (37,5)
Conjunctivitis Pus 2 St.aureus 2(100%)
References:
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5. Методические указания 3.1.2.2356-08 «Эпидемиологический надзор за врожденной краснухой». - 2012; 31:3: 123-131. stpravo. ru/rossijskoje/bs-pravila/04k.htm (Methodical instructions 3.1.2.2356-08 «Surveillance of congenital rubella.» stpravo. ru/rossijs-koje/bs-pravila/04k.htm - 2012; 31:3: 123-131).
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7. Shabalov N. P. General biological problem: regularities and consequences of perinatal human infectivity.
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Tashpulatova Guzal Alievna, the Research Institute for Sanitary, Hygiene and Occupational Diseases under the Ministry of Health of the Republic of Uzbekistan,
Senior Researcher E-mail: [email protected];
Mavlyan-Hodzhaev Ravshan Shukhratovich, the Tashkent Institute of Post-Diploma Medical Training, Professor
Morphological aspects of poly-organic impact of radio frequency electromagnetic radiation in experiment
Abstract: The impact of radio frequency electromagnetic radiation (RFEMR) on morphological responses of some organs of experimental animals has been studied. The RFEMR effect was shown to manifest itself by pathological changes in the structure of the majority of organs and tissues with the critical impact of the micro-vascular bed impairment on not only morphological, metabolic but also many other homeostasis shifts that occurred.
Keywords: radio frequency electromagnetic radiation, morphological research, experimental animals.
Morphological changes in the body are the direct reflection of the processes which are responsible for compensatory and adaptive responses to the effect of environmental factors, as well as for detoxi-cation of exo- and endotoxins, for regulation the immune response, homeostasis and other functions as well. Therefore, studying the morphological response at different levels of the of biological system organization being under the exposure to RFEMR is an important and urgent problem both from the point of view of understanding the mechanisms of the biological action and evaluation of its danger for human health [1,5-19; 2, 124-140].
Proceeding from the above-stated, the goal of the research was defined, i. e. to reveal the profile and dynamics of the morphological and functional changes in some organs and tissues (the brain, lungs, liver, stomach, large and small intestines, spleen, kidney, android glands) of rats in experiment with their exposure to RFEMR.
The experiment involved 72 white male rats weighing 220280 g. All animals were randomly divided into four groups (20 animals in each group under study and 12 controls). The animals, have acclimatized for at least 1 week prior to any experimental procedures, were housed, monitored and exposed in accordance
with the institutional animal ethics requirements. Food and water was provided ad libitum. Once acclimatized, groups of rats were placed into standard plastic cages with modified plastic lids, instead of metal lids, in order to avoid interference with the radiation. Animals of three groups under study were exposed to RFEMR at 1800 MHz frequency and energy stream density (ESD) of 50, 500 and 1000 mcW/cm 2, accordingly; group 4 (controls) was not exposed to RFEMR. SM-300 generator, BLWA 1719-20 capacity amplifier (20 watt), HL040 passive aerial (Germany) were used as the RFEMR source. The RFEMR set exposure was checked daily by measuring instruments of the energy stream density PZ — 18 (Russia) and NBM — 550 (Germany) with isotropic gauges. The experiment consisted of two stages: one month (the acute stage) and three months (the chronic stage) round-the-clock exposure (with a break for feeding). The laboratory animals (rats) were killed according to the IACUC recommendations (1) on the basis of PHS Policy. Morphological research was conducted by the standard methods of light microscopy with hematoxylin-eozin staining (h-e) [3, 36-37]. The following organs have been examined: the liver, brain, stomach, small and large intestines, spermary, heart.
Figure 1. The rat's liver after 1-month exposure to 500 mcW/cm 2 (h-e, 10 x 16). Impairment of hepatocytes complexes, moderate hyperchromatism and degeneration (vacuiolization) of hepatocyte's nucleus
