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with persistent acting in there diapason with the length of wave 0.67 mkm, in the dose 4.87 Jg\sm3.
Laserotherapy was performed in the following way. During the bronchoscopy it was carried out lavage with use of physiologic saline until the clear irrigated waters from the orifice of segmental bronchus. Subsequently, it was irradiated by the use of the light of gallium-arsenide laser with exposition during 1 minute.
From the sediment of BALF centrifugation it was prepared the smear with the following fixation. Calculation of the cells elements was performed under the immersion for 100 cells with the percentage evaluation of the cytological composition.
The distinctive clinical features of die diseases in children were the frequency of cough and the amount of expectoration; these cough was more frequent and the expectoration amount was larger in children who had chronic pneumonia. Also, auscultative data were distinguished: the presence of the local bubbling rales in children with chronic pneumonia, scattered dry and single bubbling rales in children with recurrent bronchitis.
During the bronchological investigation in all patients it was diagnosed purulent end bronchitis. The control group was characterized with prevailed amount of alveolar macrophages (AM) 91.4±2.0; low amount of neutrophils (NP) 10.8+2.0 and lymphocytes (LC 7.8±1.2. In all examined children, except children
from the control group, it was determined the increasing amount of neutrophils and lymphocytes and die sharp decreasing amount of alveolar macrophages.
After treatment of children with CB, receiving laser therapy, reliable decrease of neutrophils number to 67,1±6,4 is noted in comparison with the data before treatment 89,7±2,7 (p<0,01), the number of alveolar macrophages increases to 25,8±7,4 in comparison with the data before treatment 4,9±1,7 (p<0,01), the amount of cytosis decreases to 1,8±0,7 in comparison with the data before treatment — 11,7±0,6. The number of lymphocytes also increases.
The results obtained after treatment in children with CB receiving laser therapy show reliable decrease of neutrophils number to 73,1±3,5 in comparison with the data before treatment-90,4±6,3 (p<0,01). The number of alveolar macrophages increases to 15,1±3,1 in comparison with the data before treatment -2,8±0,1 (p<0,01), the amount of cytosis decreases in comparison with the data before treatment 6,9±1,2 (p<0,01).
Thus, treatment with the use of gallium-arsenide laser is one of the acceptable and effective methods of treatment of purulent endobronchitis in children with NLD. This method allows reaching during the short time a restoration of the bronchial patency, regression of the inflammatory process in bronchus and also restoration of the local lungs defense.
References:
1. Artamonov R. The importance of the bronchial patency disorders in children with bronchial pathology, Pediatrics, - 1982. - Vol. 1, - P. 6-9.
2. Бубнова Н. И. Хронические неспецифические заболевания легких у детей.//в кн. Клеточная биология легких в норме и при патологии. (под редакцией Ерохина В. В., Романовой Л. К.) - М. - 2000. - С. 351-357.
3. ГурарийН. И. Количественный анализ Т- и В - лимфоцитов и их антиген связывающих субпопуляций у здоровых и больных пневмонией детей.//Автореф. дисс... канд. мед.наук. - Самарканд. - 1981. - 23 с.
4. Калуцский П. В., Шварцкопф Е. С., Окушко Р. В.//Педиатрия. - 2011. - 90. - № 1. - С. 124-126.
5. Капранов Н. И. Фармакотерапия при бронхолегочных поражениях у детей, больных муковисцидозом://Руководство по фармакотерапии в педиатрии и детской хирургии. - М. - 2002. - 267 с.
6. Палеев Н. Р., Ильченко В. А. Хронический бронхит.//Болезни органов дыхания.//В кн. Руководство по внутренним болезням. (под редакцией Палеева Н. Р.) - М. - Медицина. - 2000. - 287 с.
7. Рачинский С. В., Таточенко В.К., Волков И. Б. Место хронической пневмонии и хронического бронхита в бронхолегочной патологии у детей//Педиатрия. - 2004. - № 1. - С. 58-66.
8. Резолюция конгресса ХШконгресса Педиатров России с международным участиемАктуальные проблемы педиатрии//Российский педиатрический журнал. - 2010. - № 3. - С. 61.
9. Шамсиев Ф. М., Каримов У А., Азизова Н. Д. Структура заболеваемости органов дыхания в регионах республики.//Вестник врача общего профиля. -Самарканд. -2004. - № 4. (32) - С. 113-115.
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-86-88
Narzullaev Nuriddin Umarovich, PhD, Assistant of Department of Otorhinoloryngology of the Bukhara State Medical Institute, Bukhara, Uzbekistan E-mail: ss-1961@mail.ru
FarGALS efficiency in complex treatment of HIV-infected children with acute purulent sinusitis
Abstract: The effectiveness of the local treatment of inflammatory purulent processes can be significantly increased through the use of evidence-based many-component compositions based on etiology, pathogenesis, the difference between the current process, where each of the components of the targeting to a particular inflammatory factor. Under our supervision there were 62 HIV-infected children, treated in a children's ENT clinic for acute purulent sinusitis. FarGALS use solution to complex treatment and rehabilitation of ENT-organs from HIV- infected children, improve hygienic index by 43%, reduces up to the
FarGALS efficiency in complex treatment ofHIV-infected children with acute purulent sinusitis
full version of inflammation, enhances the non-specific protective functions of the mucous membranes of up-per respiratory tract and is pronounced positive effect on mucociliary transport mucous mem-brane of the nasal cavity and sinuses. Keywords: treatment, a HIV-infection, drug, FarGALS, acute sinusitis, acute, sinusitis.
A variety of clinical manifestations of HIV-infection due to the addition of opportunistic infections, among which the most important are fungal, bacterial and viral infections. At AIDS children may manifest a typical or recurrent diseases ofthe ear, sinuses, mastoiditis, tonsillitis, pharyngitis, an inflammation of the orbital and periorbital tissue, oropharyngeal candidos and infectious lesions of teeth [1; 2; 10].
Treatment of acute purulent sinusitis (APS) in HIV-infected children should be based on a limited use of antibiotics and the impact on the various links in the pathogenesis of inflame-mation in the paranasal sinuses. Features of the etiology, clinical manifestations, trends and spe-cifics of ENT diseases complications in HIV-infected people in each of the stages of the disea-se, including background an-tiretrovirusal therapy are fundamental to the definition of a strategy and tactics of treatment. This dictates the urgent need to implement the study. In the structure of the incidence of upper respiratory tract acute sinusitis in HIV-infected children kniting toil is one of the leading places. A. Y. Ovchinnikov and colleagues point out that over the past 10 years in HIV-infected children of morbidity sinusitis increased by 3 times, and the patients hospitalized in the Department of LOR — about diseases of the paranasal sinuses, now account for 2/3 of the total number of HIV children infected patients [3; 4; 6].
Diagnosis of acute sinusitis is not complicated. History, rhinoscopy, sinus X-ray graphy in direct projection, ultra sound, when the need to computer tomography is almost always allow to diagnose correctly. "The gold standard" in the diagnosis of sinusitis is sinus puncture, obtain-ning of the con-tents, followed by smear microscopy study it.
At present, the treatment of HIV-infected children with APS is more appropriate to use non-invasive methods. To this end, locally and parentation morally they appointed someone an-tibiotics broad-spectrum, antihistamines, mucolytics, decongestants. It is proved that the local use of antibacterial drugs has substantial advantage over the system [3; 8; 11; 12].
The effectiveness of the local treatment of chronic inflammatory processes can be signi-ficantly improved by of evidence-based multicomponent-component compositions based on etiology, pathogenesis, the difference between the current process where each component direc-tedtion acts on this or that factor of inflammation, therefore drug is FarGALS. Group of authors of Uzbekistan developed and patented technology for production of a new drug that has no ana-logues in the world. Clinical trials of the drug have been conducted, and it was registered under the name "FarGALS". On the technology it has been declared an international priority in the 110 countries in the European Patent Office.
In the pharmaceutical properties of the drug is related to the antiseptic and wound-healing agents. FarGALS has a broad spectrum of antimicrobial activity: active against Gram-positive and Gramnegative, aerobic and anaerobic, asporogenous and spore-forming bacteria (Escheri-chiacoli, Staphylocoscus aureus, Pseudomonas aeruginosa, Bacillus subtilis, Clostridium perfri-ngens, Citrobac-ter freundii, Enterobacter agglomerans, Serratiam arcescens, Morganella morga-nii, Acinetobacter calcoaceticus, Bacteroides fragi-
lis, Salmonella typhimurium, Salmonella ty-phi, Shigella sonnei,
Proteus mirabilis, Candida genus fungi, and Helicobacter pylori), contribu-tes to improving the vascularization of is chemic areas. It has a wound-healing and anti-inflam-matory effect. In addition, the laboratory of the Na-tional collection of bacteria and pathogens of
groups I—II infections studied the drug on FarGALS representatives of cultures: Vibrio cholerae, Iersiniapestis, Brucella abortusbovis, Bacillus anthracis and the identified pathogenic effect on these cultures [5; 7; 8; 9].
Clinical trials of the drug FarGALS conducted at the Medical Academy of Uzbekistan (Department of General Surgery, Department of Obstetrics and Gynecology № 2) Contaminated Surgery Center.
The aim of this study was to investigate the clinical effectiveness of antiseptic FarGALS drug in the complex therapy in HIV-infected children with APS by local use.
Materials and methods. Under our supervision there were 62 HIV-infected children aged 6 to 16 years, treated in a children's ENT clinic for APS. The study included about an equal number of boys and girls (21 and 41). Diagnosis of sicknees in all cases was confirmed by X-ray examinations and diagnostic punctures sinuses. In determining the species composition of the microflora of the sinuses, it was noted that the most frequently sown Streptococcus pneumonia — 32%; Haemophilus influenzae — 20%; Moraxella catarrhalis — 21%; other microflora (including Staphylococcus aureus, Staphylococcus epidermum) — 27%.
All in coming studied history, data rhinoscopy, rinopneumom-etry, as well as conducted clinical standard examination.
Results of Research and discussion. Patients were divided us into two groups — basic and control. Patients of the main group (n=32) after application anesthesia mucous nasal hull 10% lidocaine through the lower nasal passage needle puncture is made Kulikovski upper ma-xillary sinuses. Sinus washed "clean water" 0.9% sodium chlorite solution of chloride. After re-moving the supernatant was injected into the sinus FarGALS 5 ml diluted 1:3 with isotonic so-dium chloride solution chlorite. After that, the patient is put to bed for 30 minutes on the side of the affected sinus.
Parenteral patients was resepted — on 1,0 x 2 times daily intramuscular ceftriaxone, car-ried giposensibiliziating therapy ves-selness in nose drops. In the control group of patients (n=30) were treated similarly, but after washing their FarGALS sinus cavity is not administered.
During the observation noted that the main group in 32 (84.4%) persons on the 3 rd day from the beginning of treatment to normal body temperature, aching pain disappear in the cheek on the side ofinflamed sinuses, became nasal breathing disappeared of conventionally pain. In the control group it occurred on 4-5 th day.
A particularly pronounced effect turns out to be the solution to FarGALS mucosiliartion clearance of the mucous membrane of the nasal cavity and sinuses, leading to more fast. The physiological cleansing the sinuses of pus. He showed marked secretoliation effect, resulting in 3 days earlier than in the control group, was restored patency of the natural sinus governmental fistulae.
In the main group of patients with APS after two punctures and administration FarGALS solution improves the general condition of the control group — after 3-4 punctures.
Clinical cure patients of the group occurred 2-3 days earlier than the control.
Conclusions: Application FarGALS solution to complex treatment and rehabilitation of upper respiratory tract in HIV-infected children to a large extent and in a shorter time, reduces the clinical symptoms of inflammation during bacterial, fungal
infection, improves hygienic in-dex by 43%, reduces up to complete reduction of inflammation, enhances the non-specific protective functions of the mucous membranes and upper respiratory
tract was pronounced posi-tive effect on mucosiliartion transport the mucous membrane of the nasal cavity and sinuses.
References:
1. Bessarab T. P., Kozlov A. B. Orofaringoezofagalny candidiasis in HIV infection and AIDS//News of Otorhinolaryngology and logopa-tology. - 2001. - 1: 21-2. (In Russian).
2. Bessarab T. P. Aspects of HIV and AIDS-infectons in otorhinolaryngology//Journal of oto-rhinolaryngology. - 2004. - 1: 15-23. (In Russian).
3. Bogomilskiy M. R., Rumyantsev A. G. et al. LOR-organ lesions in AIDS in children//Journal of Otolaryngology. - 2002. - 1: 4-6. (In Russian).
4. Bogomilsky M. R. Acute sinusitis in children and their rational therapy//Rinology. - 2002. - 3: 41-8. (In Russian).
5. 5.Bondarev R. V. Application FarGALSa in treatment purulent inflammation of soft tissues: Author. Dis. .. .PhD. - Lugansk, - 1999. -34 p. (In Russian).
6. Garaschenko T.I, Bogomilsky M.R Mucoactive drugs in the treatment of diseases of the upper respiratory tract"//Rinology. - 2002. -6; 2: 28-39. (In Russian).
7. Mitin J.V Krinichkiy L. R., Ostrovskaya O. A. Peculiarities of treatment of acute rhinosinu-sitis//Journal of The Ear, Nose and Guttural Diseases. - 2006. - 1: 55-9. (I n Russian).
8. Yurochko FG Acute sinusitis in children//Journal of The Ear, Nose and Guttural Diseases. - 2010. - 1: 84-9. (In Russian).
9. Hadley J. A., Pfaller M. A. Oral ß-lactams in the treatment of acute bacterial rhinosinusitis//Diagnostic Microbiology and Infectious Disease. - 2007. - 57: 47-54.
10. GwaltneyJ. M.Jr., Phillips C. D., Miller R. D. et al. Computed tomography study of the com-mon fold//N. Engl. J. Med. - 1994. - 330: 25.
11. Gwaltney J. M.Jr. Acute Community - afguired sinusitis»//Clin. in Ect Di. - 1996. - 23. - 1209.
12. Lazar R. H., Younis R. T. Comparison of plain radiographs, CT scans and intraoperative in-dings in children with chronic recurrent sinusitis//Otolaryng. Head Neck Surg. - 1990. - 103: 83.
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-88-93
Niyazov Shukhrat Tashmorovich, Samarkand State Medical Institute Assistant Professor of the Department of Neurology, Neurosurgery,
Traumatology and Orthopedics, PhD.
E-mail: shucrat@mail.ru Djurabekova Aziza Takhirovna, Samarkand State Medical Institute Professor, Chief of the Department of Neurology, Neurosurgery, Traumatology and Orthopedics, PhD.
E-mail: shucrat@mail.ru Igamova Saodat Suratovna, Samarkand State Medical Institute Assistant Professor of the Department of Neurology, Neurosurgery,
Traumatology and Orthopedics E-mail: saodat-igamova@mail.ru
Morphological structure of encephalomyelitis and myelitis using several treatments (experimental research)
Abstract: A special place among the infectious diseases of the central nervous system (CNS) occupy encephalitis (brain inflammation), and myelitis (segmental spinal cord injury caused by acute inflammation) in children. One of the treatments, the use of which is possible in the acute stage and the recovery stage is ozone.
Thus, the proposed scientific research is devoted to solving problems identifying of morphopathogenesis CNS lesions, early morfodi-agnostik comprehensive, effective treatment, reduce disability and mortality myelitis and encephalomyelits.
Keywords: encephalitis, myelitis, perivascular and pericellular edema, ozone, glial cell, microcirculation, pathogenetic therapy.
Introduction. A special place among the infectious diseases cent years there has been a significant increase in the incidence of of the CNS occupies encephalitis and myelitis in children. In re- encephalitis and myelitis, with the number ofpatients with compli-
