USEFULNESS OF ULTRASONOGRAPHY IN DIAGNOSIS OF TYPHOID FEVER

Definitive diagnosis of typhoid fever is made by hemoculture and serological tests, namely Widal test. The present study was conducted to assess the usefulness of Ultrasonography (USG) in diagnosis of typhoid fever. 74 cases of clinically and laboratory confirmed cases of typhoid fever of both genders underwent USG. Out of 74 patients, males were 44 and females were 30. At day 5 on USG, out of 74 patients, 38 had mesenteric lymph nodes enlargement, 52 patients had splenomegaly, 32 had bowel thickening, 24 had Hepatomegaly and 36 had acalculus cholecystitis. At day 10, 20 had MLNs, 40 patients had splenomegaly, 12 had bowel thickening, 9 had hepatomegaly and 14 had acalculus cholecystitis. At day 10, 8 had MLNs, 23 patients had splenomegaly, 1 had bowel thickening and 5 had acalculus cholecystitis. The difference was significant (P< 0.05). USG was useful in assessment of typhoid fever. Most common USG findings were MLNs, splenomegaly, bowel thickening, hepatomegaly and acalculous cholecystitis.

TUNNELED ADULT PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) FOR CENTRAL VENOUS ACCESS IN PAEDIATRICS: A SINGLE CENTRE EXPERIENCE

Objective: Long term intravenous access in paediatrics is challenging in terms of ease of procedure, maintenance of catheter and complications. Small calibre of peripheral veins in children make insertion of peripheral long-term access difficult. Our centre adopted the use of tunneled adult Peripherally Inserted Central Catheter (PICC) for central venous access in paediatrics with the hope to improve these challenges. We describe a single institute 3-year experience of this technique. Material & Methods: Retrospective analysis of patients aged less than 12 years old who had tunneled PICC insertions from January 2018 till December 2020. The following data was recorded and studied: indication, reason for removal, duration of PICC, vessel inserted, device type and complications. Results: Eleven adult PICCs were inserted from this technique in 10 children. The average age was 35.7months and weight was 13.2kg. The youngest patient was 3 months old at 6.9kg. Most common indication for insertion was for long term antibiotics (82%) and the remainder were for difficult intravenous access. The procedure was done under local anaesthetic with sedation in 90% of cases. Average duration of PICC was 26.8 days. Out of 11 PICCs only 1 had line related infection that required premature removal of the catheter. 55% completed the intended duration while 27% of PICCs had dislodged. Conclusion: Tunnelled adult PICC for central venous access in paediatrics is a feasible option for long term vascular access and has a lower risk of infection. However, almost a third of the catheters inserted still suffered premature dislodgement.

MULTIMODAL APPROACH TO DIAGNOSTIC RADIOLOGY OF PULMONARY COMPLICATIONS OF PNEUMONIA IN CHILDREN

Introduction. Pneumonia and its complications are one of the leading causes of death in children worldwide. According to the WHO in 2017, 808,694 children under the age of 5 died of pneumonia, accounting for 15% of all deaths of children under the age of 5 worldwide. Materials and methods. The object of the study was 154 children with pulmonary and pleural complications of pneumonia in the age aspect from 3 months to 18 years, who were examined and treated at the clinic of the Tashkent Pediatric Medical Institute for the period from 2014 to 2019. A comprehensive examination of children was carried out at the TashPMI clinic. Digital radiography was the main and primary radiation method of investigation for suspected pulmonary complications of pneumonia in children. In case of destructive pneumonia, the zones of infiltration of the lung tissue (“darkening”) with a decrease in its airiness were determined on X-ray images. It was obligatory to perform radiographs in two projections – direct and lateral. Results and Discussion. We have identified radiation signs of pulmonary complications in children. Pulmonary complications accounted for 92 children, of whom 75 (57.0%) were diagnosed with pulmonary destruction and 17 (43.0%) with lung abscess. Destructive changes in lung tissue were found in young children, mainly up to 3 years of age. Conclusion. Thus, the results of our study showed that the use of high-tech methods of radiation examination significantly increases the accuracy of diagnosing lung lesions with complications of pneumonia at different stages of examination and treatment of patients.

ASSESSMENT OF RISK FACTORS AND COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY

Cholecystectomy is one of the most common abdominal surgical procedures in developed countries. 74 patients of cholecystectomy of both genders were enrolled. was recorded. A thorough clinical examination was done. Lipid profile, Etiology and complications were recorded. Common etiology found to be cholestasis in 38, hyperlipidemia in 24, hereditary spherocystosis and idiopathic cases. The difference was significant (P< 0.05). Complications were intraoperative bleeding, biliary peritonitis, intra-abdominal collections bile duct injury, ligation of CBD, bile leakage, SSI, and retained CBD stones cases. The difference was significant (P< 0.05). Authors found that common etiology found to be cholestasis, hyperlipidemia, hereditary spherocystosis and idiopathic.

ASSESSMENT OF TYPE AND CLINICAL FEATURES IN FEMALES WITH OBSTETRIC FISTULA – A CLINICAL STUDY

Obstetric fistula is an injury that occurs during prolonged and obstructed labor causing tissue damage to organs inside the pelvis and resulting in urine and fecal incontinence or both. The present study was conducted to record type and clinical features in females with Obstetric fistula. 60 patients with Female genital fistula were involved. A thorough clinical examination along with types and clinical features were recorded. Age group 10-20 years had 14 patients, 20-30 years had 26, 30-40 years had 12 and >40 years had 8 patients. The difference was significant (P< 0.05). Type of fistula was VVF in 48, RVF in 7 and RVVF in 5 cases. Clinical features comprised of urine incontinence in 38, fecal incontinence in 20 and both urine and fecal incontinence in 2 cases. The difference was significant (P< 0.05). Most common cause was VVF and RVVF. Clinical features comprised of urine and fecal incontinence

ASSESSMENT OF CORRELATION OF LACTATE /ALBUMIN RATIO IN SEPSIS PATIENTS ADMITTED IN ICU

Sepsis is life-threatening organ dysfunction caused by dysregulated host responses to infection, and septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are sufficiently profound to substantially increase mortality. Patients with sepsis are usually treated in the intensive care unit (ICU). Hence; under the light of above-mentioned data, the present study was undertaken for determining the correlation of lactate /albumin ratio in outcome of patients of sepsis in ICU. The present study was undertaken for determining the correlation of lactate /albumin ratio in outcome of patients of sepsis in ICU. A total of 30 patients were enrolled. The resulting patients were subjected to detailed history and examination followed by investigations (CBC, ESR, CRP), Bacterial culture, liver function test, renal function test, arterial blood gas analysis for lactate, serum albumin level). Mean Lactate value was 4.59 while mean albumin value was 25.12. Mean lactate to albumin ratio was 0.18. While correlating lactate to albumin ratio with Serum Procalcitonin levels, significant results were obtained. While correlating lactate to albumin ratio, it was seen that higher lactate to albumin ratio was associated with higher mortality. Lactate/albumin ratio is an independent predictor for the mortality among sepsis patients admitted to ICU.

A STUDY OF CLINICAL PROFILE AND QUALITY OF LIFE IN PATIENTS WITH SCABIES AT RURAL TERTIARY CARE CENTRE

Scabies, a highly contagious parasitic skin infestation, is instigated by Sarcoptes scabiei mite. This study was performed to evaluate the clinical profile and quality of life in patients with scabies. 132 scabies patients of both genders were assessed using the revised Dermatology Life Quality Questionnaire (mDLQI) for scabies. The clinical features were also recorded. Clinical features of itching were seen in 104 patients, night aggravation in 86 and skin lesion in 78 patients. Family history was present in 80 patients, past history in 28 and secondary infection in 30 patients. The difference was significant (P< 0.05). 65% subjects reported not feeling embarrassed, in 63% school work was not at all affected, in 70% playing was not at all affected, 81% were not at all experiencing teasing and in 88% friendship was not at all affected. The difference was significant (P< 0.05). Quality of life was affected in scabies patients. Common clinical features were itching, night aggravation and skin lesions

ASSESSMENT OF TRAUMATIC BRAIN INJURY WITH CT SCAN

Traumatic brain injury (TBI) is a major health issue responsible for considerable mortality and long-term morbidity worldwide. The present study was conducted to determine role of CT in TBI. 93 cases of traumatic head injury underwent CT scan obtained with Planmica CT machine. All CT images were read by trained radiologist for the presence, absence of brain abnormalities. Out of 93 cases, males were 50 and females were 43. Diagnosis was mass effect in 10, cerebral edema in 12, subdural hematoma in 24, extradural hematoma in 30, intra cerebral hematoma in 7 and intra ventricular hemorrhage in 6 cases. The difference was significant (P<0.05). CT scan found to be effective in assessment of brain injuries

MODERN ASPECTS TO THE PROBLEM OF THE PREVALENCE OF HELICOBACTER PYLORI ASSOCIATED STOMACH DISEASES IN UZBEKISTAN

Introduction. We studied the regional epidemiological and genetic characteristics of the prevalence of Helicobacter pylori among the population of Uzbekistan. The work is based on the totality of the results of clinical, biochemical, immunological, genetic and instrumental research methods. Materials and Methods. It was established that Uzbekistan belongs to the regions with a high degree of H. pylori infection of the population (80%). 84% of the population of Uzbekistan have a mixed IceA1- / IceA2-genotype CagA. In peptic ulcer disease, the pathogenic strain CagA + VacA s1, VacA m2 and IceA 1,2 prevails, in chronic gastritis (type B) associated with H. pylori, the strain Cag + VacA s1, VacA m2 and IceA 1. Results and Discussion. The level of resistance of H. pylori strains to clarithromycin reaches 13.3%. Prolongation of eradication therapy up to 10 days and the addition of BTD to it makes it possible to increase the efficiency of H. pylori eradication up to 95%. Conclusion. Due to the presence of HP resistance to clarithromycin in 13.3% of cases and taking into account the low effectiveness of triadotherapy (72.5%), it is advisable to use quadritherapy with the inclusion of BTD in the standard of treatment, which contributes to an increase in the eradication efficiency up to 95%.

CONNECTIVE TISSUE HEART DYSPLASIA IN CHILDREN (LITERATURE REVIEW)

This article highlights the main domestic and foreign publications on the problem of connective tissue dysplasia of the heart in children. An interpretation of minor heart anomalies is given. Currently, the collection of additional high-quality data on the course and treatment of children is important to identify the most effective algorithms for patient management. Proper monitoring, early detection of complications of the disease, and the possibility of timely treatment are essential.