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Section 4. Medical science
Conclusions: 3. Women with GD have decreased quality of life, as shown
1. Within 1 year after single intake of radioactive iodine 52.2 % by low indicators of physical (by 30.3 %), and psychological of patients of the 1st group were diagnosed euthyroid. 34.5 % of (by 26.6 %) components of health.
women have reached euthyrosis during the period of 1-5 years, 4. After RIT, physical (the general count has increased
13.0 % within 5-10 years after RIT. by 38.2 %) and psychological (by 33.4 %) components of quality of
2. In 10.7 % of women of the 2nd group, hypothyroidism was life considerably improved and became closer to the similar indica-diagnosed within 1 year after RIT, in 42.9 % — in 1-5 years, in tors of the group of clinical comparison. Patients in euthyroid state 46.4 % of patients — within 5-10 years after therapy with iodine. are characterized by the better indicators of quality of life.
Referenses:
1. Zaycev I. A., Kirienko V. T., Jidkix V. N. and others. Evolution of the quality of life in healthy individuals. - 2010. - № 2 (48). - P. 30-36.
2. Ismailov S. I., Ubaydullaeva N. B., Nasirkhodjaev Ya. B., Mirzaeva U. Z. Pregnancy and, delivery outcomes in women with diffuse toxic goiter after radioiodine//Infection, immunity and pharmacology. - 2014. - 5. - P. 66-72.
3. Ismailov S. I., Akbutaev A. M., Elov A. A. The quality of life of patients on thyroxine and combination thyroxin and triiodothyronine after total thyroidectomy in patients with Graves' disease//International Journal of Endocrynology. - 2014. - № 5 (61). - P. 52-55.
4. Muratova Sh. T., Ismailov S. I. Graves' disease the impact on the psycho- cognitive status of children and adults (literature reviews/International Journal of Endocrynology, Ukraine. - 2015. - № 6 (70). - P. 86-90.
5. Rossoshanskaya E. I. Evalution of short- and long-term results of surgical treatment of thyroid disease: abstract. dis... PhD. - Yaroslavl, 2012. - 23 p.
6. Ubaydullaeva N. B., Xakimdjanova D. M. The effect of conservative treatment on the health status of reproductive age women// Internation al Journal of Endocrynology, Ukraine. - 2012. - № 2(42). - P. 109-114.
7. Bahn R., Burch H., Cooper D. et al. Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists//Endocr Pract. - 2011. - Vol. 17. - P. 456-520.
8. Bukvic B., Zivaljevic V., Sipetic S. et al. Improvement of quality oflife in patients with benign goiter after surgical treatment//Langen-becks Arch Surg. - 2014. - Vol. 399(6). - P. 755-764.
9. Karyampudi A., Hamide A., Halanaik D. Radioiodine therapy in patients with Graves' disease and the effects of prior carbimazole therapy//Indian J Endocrinol Metab. - 2014. - Vol. 18(5). - P. 688-693.
Israilov Khikmatjon Tuygunovich, Doctor of Republican Specialized Science Practical Medical Center of Dermatology & Venereology, Republic of Uzbekistan
E-mail: [email protected]
The clinical manifestations of recurrence of genital herpes
Abstract: The clinical manifestations of genital herpes (GH) was characterized as vesicular in 67.3 % cases, in 18.2 % erosive, in 10 % erosive- ulcer and in 4.5 % cases as a ulcer lesion of the skin and mucous membranes of the genitals by predisposing a massive discharge of herpes viruses into the environment and which is epidemiologically unfavorable factor due to the spreading of these viruses among the population.
Keywords: genital herpes, symptom, new approaches.
The main clinical evidence of genital herpes has been vesico-bullous and erosive — ulcerative elements, affecting the skin and mucous membranes of the genitals [1; 3; 4]. Destructive elements transpire as the main symptoms ofherpes infection lead to dissemination of herpes viruses into the environment as well as being a gateway for other STIs and especially for HIV infection [3].
Material and methods. 220 patients had been observed with symptomatic recurrence of genital herpes. Exploring of the duration of disease relapse revealed that the clinical manifestations of genital herpes in 15.5 % of patients was up to 6 months, 12.7 % — up to 1 year, at 29.1 % and 20.0 % up to 2 and 3 years, respectively; 10.9 % of patients herpes symptoms recurred within 5 years and in 11.8 % the disease relapsed more than 5 years. The basic amount of 66 patients (60.0 %) had disease duration from 1 year to 5 years.
Results and discussions
Studying the frequency of recurrences of genital herpes showed that core group of86 (39.1 %) patients with a frequency relapse was from 6 to 8 times per year. 32 (14.5 %) patients had two relapses per year, 58 (26.4 %) patients 4 relapses per year. In 36 (16.4 %)
cases of relapse were established 9-12 times per annum. 8 (3.6 %) patients — from 1 to 2 times a month, which was accounted more than 12 recurrences per year.
Changes in localization of the lesion elements in each new relapse of genital herpes was diagnosed in 64 (29.1 %) patients. Compare to the 70.9 % of cases (156 patients) rash relapse which was observed at the primary place of the initial lesion.
In 41.8 % of cases patients indicated repeated recrudescence of GH after sexual contact, frigorism or cold-related diseases, intake of alcohol, to be more detailed, women had GH often in the period before or after menstruation. The majority — 58.2 % of the patients were not able to specify the obvious reasons for the recurrence of the disease.
The study of the clinical manifestations of genital herpes in the examined group of patients admitted to determine some appropriate characteristics in the clinical course of the disease. In the study of lesions of genital herpes was found that of 178 male patients in 100 of them (56.2 %) lesions were observed on the skin of phallus with a common site elements in the bridle or coronal sulcus. In 60 (33.7 %) patients localized on the skin of the pubis or at the root of the coles,
Indicators psychological status in patients with chronic heart failure
in 18 (10.1 %) cases were different combinations offocalization of the lesion (genitals, pubic area skin, the inner surface of the skin thigh).
Among the 42 patients 20 (47.6 %) members of genital herpes distributed on the skin of the labia majora, even in 8 (19.0 %) with the transition to the mucosa of the labia minora, 6 (14.3 %) cases, isolation of the mucous shell inner surface of the labia minora, skin of pubis in 4 (9.5 %) cases. Combinations of the lesions on the skin of the labia majora and the inner surface of the skin of the hips were examined in 4 (9.5 %) patients.
In the study of clinical manifestations in a group of tested patients, 67.3 % (148 patients) were diagnosed with vesicular form of GH, which was represented by small bubble elements (from single (1-3 pcs.) In addition, the multiple types of lesion, from 12 to 30-40 pcs. with serous, serous-purulent contents, grouped character, positioning the modest swelling on the hyper-emic skin and mucous of the genitals. Among 4 cases of manifestations of bullous form transformations of GH with bubbles from the larger size of 1.0 cm. to 3-4 cm. Accompanying by subjective symptoms namely itching (67.3 %), burning (56.4 %) and hyperesthesia as a feeling of tingling at 62.0 % of patients. Regression of lesions was on average in 7-8 days.
Erosive form of GH was defined in 18.2 % (40 patients) and patients had superficial defect of skin and mucous membranes of the genitals with a scalloped form, unclear edges follow the contours of the former bubble elements on the wet hypermetric surface with the character of serous exudation. Epithelialization was performed average within 9-10 days. Erosive form of GH in the majority of cases have been presented with subjective symptoms such as burning (18.2 %) and pain (15.4 %) in the local lesions.
Among the observed patients in 10 % of cases was erosive and ulcerative form GH, which was presented as a profound lesions (dermal tissue of skin), in combination with a surface defect of skin and
mucous membranes of the genitals. Along with this, 4.5 % of the patients had ulcerative lesions GH presented deep lesions of the skin of the genitals. Ulcers form GH was presented sweepingly-oval form, ranging in size from 0.5 to 1.0 cm. in diameter with irregular, slightly infiltrated eminence as well as with hyperemic edges. The bottom is covered with serous-hemorrhagic exudate with local granulation tissue. Subjective symptoms of ulcerous and erosive ulcerous forms of GH was pain in the lesions. The course of these forms of the disease was prolonged, averages 14-16 days with a slow epithelialization of lesions and cicatricle tissue.
In the studied group of patients, local subjective symptoms in 30 patients (13.6 %) has been neuralgic pains radiating to the groin and lower limbs along the sciatic nerve, weakness, aches, headache, and increasing body t ° from 37 to 5 - 38 °C. In 20 (18.2 %) patients had complications in the form of a unilateral inguinal lymphadenitis (32 patients), with an increasing size of a hazelnut and tenderness as well as in 8 patients was defined the accession of secondary pyogenic infection.
Thus, based on the study of clinical materials has been found that 60 % of patients with recurrent disease GH was prolonged in a duration irom 1 to 5 years, with the frequency of recurrence of genital herpes in 55.5 % of patients between 6 and 12 relapses in a year. The clinical manifestations ofGH characterized in 67.3 % cases ofvesicular, erosive 18.2 %, 10 % erosive peptic ulcer and 4.5 % forms of skin lesions and mucous membranes of the genitals, which predispose a massive eruption of herpes viruses in the environment and which was an epidemiologi-cally unfavorable factor in the spread of these viruses among population.
Conclusion. Taking into account the peculiarities of the clinical course of GH, it is necessary to assign the new approaches in therapy. Hence, for the possibility to contribute to more rapid epithelialization of destructive lesions which could be considered as prevention of the epidemiological spread of the viral etio-agent and reducing the number of relapses of the disease.
References:
1. Дробышева Н. Н. Вопросы диагностики генитального герпеса//Вестн. дерматол. - 2002. - № 5. - С. 21-23.
2. Дубенский В. В. Генитальная герпетическая инфекция//Российский журнал кожных и вен.бол. - 2002. - № 3. - С. 54-56.
3. Марченко Л. А. Генитальная герпетическая инфекция у женщин (клиника, диагностика, лечение): Автореф. дис. ... д-ра мед. наук. - М., 1997. - 41 с.
4. Марченко Л. А. Генитальный герпес у женщин (клиника, диагностика, лечение)//М^епа medica. - 1996. - № 2. - С. 53-73.
Kadirova Shahlo, Bukhara State Medical Institute Kamilova Umida Kabirovna, Prof., Republican Specialized Scientific-Practical Medical Center of Therapy and Medical Rehabilitation JSC, Uzbekistan E-mail: [email protected]
Indicators psychological status in patients with chronic heart failure
Abstract: In patients with heart failure to study the psychological status of the relationship between indicators of psychological status and progression of the disease: patients with FC III identified more often more severe disorders with revalence of depressive disorders.
Keywords: chronic heart failure, psychological state, depression, anxiety.
Chronic heart failure (CHF) — progressive and unfavorable the risk of mortality, and the mortality rate of patients in amounts prognosis disease of the cardiovascular system, a major cause of dis- of15-50 % throughout the year. The problem is closely related mental ability and violation of reduced life expectancy in developed coun- and physical health does not cease to be relevant for many thousands tries. According to the Framingham study, its frequency doubles ev- ofyears [1; 2; 3]. In recent years greatly increased interest in the study ery decade, and in the next 20-30 years, it will increase by 40-60 %. of psychosomatic aspects, reflecting the rise and for cardiovascular The disease worsens the quality oflife ofpatients is 4 times increases disease. Multicenter study INTERHEART Study involving 52 coun-
