Pregnancy and childbirth in women from among the indigenous minorities of the north in the context of urbanization

Data on the health status of the population of the indigenous small-numbered peoples of the North of Khanty and Mansi, who migrated to the city and changed the traditional nomadic way of life, are few and not systematized.The aim of the study was to study the course of pregnancy and childbirth among the indigenous peoples of the north who migrated and live in the city of Khanty-Mansiysk, Khanty-Mansiysk Autonomous Okrug-Yugra. An increase in the frequency of gynecological diseases was revealed: menstrual irregularities (in 38.5%), inflammatory diseases of the cervix (in 42.3%) and inflammatory diseases of the uterus (in 19.2%). Half of the observed women had gastritis (50%), cholecystitis (51.9%), every fourth cystitis (23.1%), anemia was diagnosed in every third in 30.8%. Pregnancy in women of the study cohort was often complicated by early toxicosis, anemia, gestational diabetes mellitus, threatening premature birth. Childbirth in pregnant women from among the indigenous small peoples of the north living in the city was complicated by anomalies in labor, indications for emergency operative delivery. This requires further study of the health status of the indigenous peoples of the north and the development of a health improvement program.Materials and methods. The course of pregnancy, childbirth and the postpartum period was retrospectively analyzed in 168 women selected by the continuous sampling method. Women from the Khanty and Mansi KMNS living in the village of Berezovo, in the camps and in Khanty-Mansiysk were examined. Statistical processing was performed in the software package SPSS, Statistica 8.0, as well as using the Microsoft Excel analysis package.Results. The results of the study showed that the least number of deviations in the state of health were among women from the number of KMNS living in the village and in the camps and leading a traditional nomadic lifestyle. The course of pregnancy rarely had complications and 100% of women ended in spontaneous labor on time.Conclusion. The urbanization of women from among the indigenous small-numbered peoples of the north has an adverse effect on the state of somatic and reproductive health, characterized by a high frequency of gynecological diseases, pregnancy complications, labor anomalies and operative delivery.

Prediction of the Mechanisms by Which Quercetin Enhances Cisplatin Action in Cervical Cancer: A Network Pharmacology Study and Experimental Validation

Yimucao has been used as an herbal medicine to treat gynecological diseases. Common genes of Yimucao active compounds were investigated using network pharmacology. The components and targets of Yimucao were retrieved from the TCMSP database. Cervical cancer targets were collected from GeneCards, TTD, DisGeNET, and KEGG. Cisplatin-related genes were downloaded from GeneWeaver. The protein-protein interaction (PPI) network was created using the STRING database. A drug-bioactive compound-disease-target network was constructed using Cytoscape. GO and KEGG analyses were performed to investigate common targets of quercetin and cisplatin in cervical cancer. We found that quercetin was the highly bioactive compound in Yimucao. The drug-bioactive compound-disease-target network contained 93 nodes and 261 edges. Drug-related key targets were identified, including EGFR, IL6, CASP3, VEGFA, MYC, CCND1, ERBB2, FOS, PPARG, and CASP8. Core targets were primarily related to the response to metal ions, cellular response to xenobiotic stimulus, and transcription factor complex. The KEGG pathway analysis revealed that quercetin and cisplatin may affect cervical cancer through platinum drug resistance and the p53 and HIF-1 pathways. Furthermore, quercetin combined with cisplatin downregulated the expression of EGFR, MYC, CCND1, and ERBB2 proteins and upregulated CASP8 expression in HeLa and SiHa cells. Functionally, quercetin enhanced cisplatin-induced anticancer activity in cervical cancer cells. Our results indicate that quercetin can be used to overcome cisplatin resistance in cervical cancer cells.

Urgent gynecology: a new look

To improve the diagnostics and treatment of urgent gynecological diseases 1000 patients with the pathology were examined. 700 women were subjected to laparoscopy. The following structure of acute gynecological diseases was defined: 47% ectopic pregnancy, 24% acute inflammatory diseases of adnexa uteri, 17% ovarian apoplexy, 7% torsion of ovarian cyst pedicle, 4% uterine myoma associated with the disturbances of alimentation of the ganglion, 1% perforation of the uterus. On the basis of the analysis of complains, anamnesis, clinical symptoms and results of supplementary examinations the algorithm of management of patients with suspected acute gynecological diseases including diagnostic laparoscopy was elaborated

Pain syndrome with genital endometriosis

In the clinical lecture contemporary possibilities of endoscopic surgery in diagnostics and correction of reproductive health disturbances in women are demonstrated. Wide range of indications for laparoscopy in case of different gynecological diseases is shown, relative contraindications are determined. The authors analyze the effectiveness of different endovideosurgical invasions applied for treatment of womens reproductive health dysfunction.

An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

Background. In Ukraine among perinatal losses, a high proportion of stillbirth remains, the level of which depends on many factors, including the presence of somatic and genital pathology in a woman, pathological conditions during pregnancy, including eclampsia (PE), iron deficiency anemia of pregnant women (IDA), chorioamnionitis (CA). These conditions can be combined with each other, which increases the risk of fetal death during pregnancy or childbirth. Objective. To conduct a somatic and gynecological diseases, complications of pregnancy in pregnant women with preeclampsia (PE), iron deficiency anemia (IDA) and chorioamnionitis (CA), whose pregnancy ended in ante-intrapartum fetal death at 30-40 weeks of gestation. Methods. We investigated 58 cases of stillbirth at 30-40 weeks of gestation from pregnant women with PE (n = 16), IDA (n = 16), CA (n = 26) on the basis of the Communal non-profit enterprise "City Perinatal Center "Kharkov. The clinical data of the mothers, the protocols of the pathological examination of the placenta were studied. Results. Based on the study, it was found that in women whose pregnancy was complicated by PE and IDA, the most frequent types of somatic pathology were hypertensive disorders (32% and 12.5%, respectively) and chronic diseases of the digestive system. (25% and 12.5%, respectively), among gynecological diseases, uterine leiomyoma and endocervicosis were more common, among complications of pregnancy and childbirth - premature birth (50% each, respectively) pathology of the placenta (50% and 68.8%, respectively) and disorders of the content amniotic fluid (31.3% and 18.8%, respectively).The extragenital pathology in pregnant women with CA was presented with the infectious diseases (30.7%), an acute respiratory viral infections (19.2%), the cardiovascular pathology (11.5%), and the chronic inflammatory diseases of various localization (7.6%). The most frequency gynecological pathology were inflammatory genital diseases (23.21%). The pregnancy and labor were often complicated with the placental pathology (50%), premature birth (38.5%), preeclampsia (19.2%), and anemia (19.2%). During pregnancy, placental dysfunction diagnosed only in 31.3% of cases with PE, 25% with IDA and 3.8% with CA, but in pathological examination, morphological signs of placental insufficiency recorded in almost every case of all groups. Conclusion. In pregnancy, aggravated by PE, IDA or CA, the presence of extragenital pathology, gynecological diseases, and other complications of pregnancy were additional factors that increased the severity of placental insufficiency and fetal hypoxia, which was the cause of its death. Timely diagnosis of placental dysfunction and the implementation of therapeutic measures aimed at reducing the associated negative impact on the fetus can help reduce perinatal mortality.

Image classification of vaginal microecology detection based on gabor texture and LSTM model

BACKGROUND: Gynecological diseases threaten women’s health, and vaginal microecological testing is a common method for detecting gynecological diseases. Efficient and accurate microecological testing methods have always been the goal pursued by gynecologists. OBJECTIVE: In order to automatically identify different types of microbial images in vaginal micromorphology detection, this paper proposes a vaginal microecological image recognition method based on Gabor texture analysis combined with long and short-term memory network (LSTM) model. METHOD: Firstly, we denoise the microecological morphological im-ages, which selects the area of interest and sets the label of the microorganism according to the doctors label. Secondly, texture analysis is carried out for the region of interest, which uses Gabor filters with 8 directions and 5 scales to filter the region of interest to extract the texture features on the image. Comparing the differences between different microbial image features, and screening suitable features to reduce the number of features. Then, we design an LSTM model to analyze the relationship of image features in different categories of microorganisms. Finally, we use the full connection layer and Softmax function to realize the automatic recognition of different microbial images. RESULTS: The experimental results show that the image classification accuracy of 8 common microorganisms is 81.26%. CONCLUSION: Texture analysis combined with LSTM network strategy can identify different kinds of vaginal micro ecological images. Gabor-LSTM model has better classification effect on imbalanced data sets.

PROCEDURE FOR FORMING AN EFFECTIVE SELECTION PROCESS RATIONAL REHABILITATION MEASURES FOR TREATMENT GYNECOLOGICAL DISEASES

В статье рассматривается ряд методов интеллектуальной поддержки принятия решений в диагностике и лечении гинекологических заболеваний. При применении высоких медицинских технологий возрастает роль лечащего врача (ЛВ), который по-прежнему остается лицом, принимающим решение (ЛПР). Однако применение этих методов принятия решений должно увязываться с логикой деятельности ЛВ, быть доступно для практического использования, освобождать ЛВ от "рутинной" работы и способствовать целенаправленному и эффективному лечебно-диагностическому процессу. Процессы диагностики и лечения гинекологических заболеваний характеризуются большим числом переменных и определяются индивидуальными характеристиками пациенток, рядом неопределенности при выборе тактики лечения. Процедура математического описания процессов лечения состоит из выбора метода моделирования в условиях неоднородностей. Выбор тактики лечения сводится к поиску эффективных алгоритмов, индивидуализирующих особенности каждой больной в процессе лечения, и позволяет врачу на основе опыта и интуиции принимать адекватные решения в любой момент времени. Вот почему, прежде всего, при выборе рациональных реабилитационных мероприятий в условиях неполной априорной информации требуется интеллектуальная поддержка принимаемых решений ЛВ. Для интеллектуальной поддержки принимаемых решений применяются методы имитационного эксперимента, основанные на априорной информации лечащего врача и эксперта для организации и алгоритмизации диалогового режима в ускоренном и реальном масштабе времени. Рассматривается алгоритмическая процедура процессов лечения The article discusses a number of methods of intellectual support for decision-making in the diagnosis and treatment of gynecological diseases. With the use of high medical technologies, the role of the attending physician (PD) increases, who still remains a decision-maker (DM). However, the application of these decision-making methods should be linked to the logic of the drug's activity, be available for practical use, free the drug from "routine" work and contribute to a purposeful and effective treatment and diagnostic process. The processes of diagnosis and treatment of gynecological diseases are characterized by a large number of variables and are determined by the individual characteristics of patients, a number of uncertainties in the choice of treatment tactics. The procedure for the mathematical description of treatment processes consists of the choice of a modeling method under conditions of inhomogeneities. The choice of treatment tactics is reduced to the search for effective algorithms that individualize the characteristics of each patient in the treatment process, and allows the doctor, based on experience and intuition, to make adequate decisions at any time. That is why, first of all, when choosing rational rehabilitation measures in conditions of incomplete a priori information, intellectual support for the decisions made by the dispensary is required. For the intellectual support of the decisions made, the methods of the simulation experiment are used, based on the a priori information of the attending physician and the expert for the organization and algorithmization of the dialogue mode in accelerated and real time. An algorithmic procedure for treatment processes is considered

Spinal anesthesia vs general anesthesia in gynecological laparoscopic surgery: a systematic review and meta-analysis.

Introduction: In the last years, spinal anesthesia (SA) has emerging as alternative to general anesthesia (GA) for the laparoscopic treatment of gynecological diseases, for better control of postoperative pain. The aim of the review is to compare the advantages of SA compared to GA. Methods: MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until March 2021. Randomized controlled trials (RCTs) and non-randomized studies (NRSs) about women who underwent SA and GA for gynecological laparoscopic surgery. Relevant data were extracted and tabulated. Results: The primary outcomes included the evaluation of postoperative pain (described as shoulder pain), postoperative nausea and vomiting, and operative times. One hundred and eight patients were included in RCTs, 58 in NRSs. The qualitative analysis had conflicting results and for the most of parameters (hemodynamic variables, nausea and postoperative analgesic administration) no statistically significant differences were observed: in the NRSs studies, contradictory results regarding the postoperative pain in SA and GA groups were reported. Regarding the quantitative analysis, in the RCT studies, women who received SA had not significantly lower operative times (RR -4.40, 95% CI -9.32 to 0.53) and a lower incidence of vomiting (RR 0.51, 95% CI 0.17 to 1.55); on the other hand, in the NRS studies, women who received SA had longer operative times (RR 5.05, 95% CI -0.03 to 10.14) and more episodes of vomiting (RR 0.56, 95% CI 0.10 to 2.97) compared to those with GA: anyway, the outcomes proved to be insignificant. Conclusions: Current evidence suggests no significant advantages to using SA over GA for laparoscopic treatment of gynecological diseases.

Effect of immunoprophylaxis on reproduction function of highly productive cows

The article describes a method of preventing postpartum obstetric-gynecological diseases and improving cow reproductive function due to the increase of body nonspecific resistance with the application of electropuncture and biopreparation Prevention-N-C (Chuvash State Agrarian University, Russia) and Salus-PE (Chuvash State Agrarian University, Russia). The cows of the 1st group were injected three times 45-40, 25-20 and 15-10 days before calving intramuscularly at a dose of 10 ml/head with the biopreparation Prevention-N-C, and the cows of the 2nd group were injected according to the same scheme and the same term with Salus-PE, and the cows of the 3nd group electropuncture was performed on the Vocal-B device (BIORS, Russia) immediately after childbirth, three times, after 48 h. The use of biopreparations during critical periods of cow steeliness reduced the risks of subinvolution of the uterus, endometritis and mastitis in the postpartum period and increased the reproductive qualities of cows. It has been shown that after the use of Salus-PE, 100% of cows are fertilized, 60% of which are fertilized in the first sexual hunt, and 40% - in the second. The insemination index was 1.4.