Colposcopic features of cervical mucus associated with certain urogenital infections
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Table 1. — Lymphocyte antigen display in various forms to treat brucellosis
АВД to ТАГ Norm n = 23 Brucellosis
Acute n = 90 Under acute n = 35 Secondary chronic n = 66
Brain 2. 2б t Q. 13 3. 75 t 0. 16* 3. 91 t 0. 18* 4. 00 t 0. 17
Liver 1. б4 t Q. 13 5. 14 t 0. 16* 5. 23 t 0. 26* 4. 37 t 0. 19* '-**
Kidney 1. 93 t Q. 13 3. 82 t Q. 11* 4. 06 t 0. 28* 3. 80 t 0. 14*
Joint capsule 2. Q4 t Q. 21 4. 60 t Q. 15* 5. 00 t 0. 21* 4. 75 t 0. 30*
n = 19 n = 17 n = 15
Ovary 2. 32 t Q. 13 3. 35 t 0. 34* - 4. 47 t 0. 20* ,**
Endometritis 1. 74 t Q. 15 2. 29 t 0. 19* - 2. 73 t 0. 08* '-**
Myometrium 1. 37 t Q. 11 2. 07 t 0. 03* - 2. 07 t 0. 03*
Note: * - P & lt- 0. 05 with respect to the accuracy of performance standards- ** - P & lt- 0. 05 with respect to the accuracy of the indicators of the acute form.
Comparative analysis between the studied forms ofbrucellosis organs. So BLA performance to allow the TA of different organs to showed significantly higher values in ABL to TA ovarian and endo- evaluate the nature, frequency and degree of involvement ofvarious metrial secondary chronic brucellosis. Based on what we can assume organs in the disease process when brucellosis, allowing clinicians to that in chronic processes occur deeper destructive changes in these spend in addition to causal treatment Organotropic specific therapy.
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Mirsaidova Munisa Abdushukurovna, Republican Specialized scientific-practical medical Centre of Dermatology and Venereology of the Health Ministry of the Republic of Uzbekistan, Tashkent
E-mail: munisa876@mail. ru
Colposcopic features of cervical mucus associated with certain urogenital infections
Abstract: There conducted a colposcopy study of women in sexually transmitted infections and reproductive health department of RSSPMC D and V and identified certain changes in the cervical mucus which had the combination of ureaplasma, chlamydia and HPV, characterized by atypical colposcopic picture.
Keywords: sexually transmitted infections, colposcopy, cervix of uteri.
Colposcopic features of cervical mucus associated with certain urogenital infections
Today cervical pathology is an urgent problem. Much attention is attracted women of peri — and postmenopausal age with background and precancerous diseases, since they are at increased risk of developing cervical cancer (CC). Cervical cancer is extremely common problem and is leading in the structure of cancer incidence and mortality, and is one of the important health and social problems in the developed countries [1- 3- 4].
At present, the importance is attached to the mixed Chlamydia — and Mycoplasma-viral infections. Given chlamydia tropism to columnar epithelium, the primary lesion in women is a cervical mucosa in which the pathogens can persist for months or even years, causing a variety of pathological changes. The frequency of cervical lesions in urogenital chlamydiosis is 49−53%, and according to some sources up to 93%. The most common manifestation ofurogenital chlamydial infections is cervicitis, the development of which is often accompanied by desquamation of stratified squamous epithelium of the cervix to form a true or pseudo-erosion. There was a direct correlation of chlamydial infection of cervix uteri with the presence of histiocytes, lymphocytes, and an unidentified short bacteria stained by Papanicolaou in the scraping preparations [3- 5- 6].
Currently, colposcopy is one of the informative clinical and endoscopic methods for the study of pathological processes in the cervix uteri that allows to estimate the prevalence of lesions and identify their location on the border of flat and cylindrical epithelium, which can not be done in the ordinary examination. In assessing the colposcopic presentation it is used international colposcopic terminology adopted at the World Congress of Pathology and Colposcopy of cervix uteri in Rome in 1990: normal colposcopic presentation, original squamous epithelium, columnar epithelium, normal zone transformation, abnormal colposcopic patterns [2- 4].
Identify colposcopic features of cervical epithelium associated with a variety of STIs.
Materials and Methods
We examined 70 patients with different STIs in STI and RH department ofRSSPMC D and V over the period from 2015 to 2016. Complaints ofpatients were discharges from the genital tract ofvari-ous kinds, underbelly pains, itching, burning. Screening for sexually transmitted infections was made by PCR diagnosis and bacteriological studies of separated genitals. It was performed extended colposcopy in stages: first, the cervix was purified from discharge with cotton swab, then, surface was lubricated with diluted acetic acid solution and then, cervical uteri was treated with Lugol'-s solution (Schiller test) to determine the status of cervical epithelium and the localization of the pathological focus.
Of 70 studied patients, in 35 were found Ur. urealyticum, in 15 Chl. trachomatis, in 7 HPV type 16/18, in the rest of13 patients STIs was no detected.
Complaints of patients were: mucopurulent discharges in 50% of patients, in 40% of patients — underbelly aches, in 40% of patients — itching and burning, When viewed with the naked eye, all patients visually presented endocervicitis, cervical ectopia. All women underwent colposcopy study. Thus, 60% of studied patients presented ectopia of the cervix, which seemed mucosal site, devoid of epithelium with distinct protruding edges- the bottom is uneven, rough, bright red in color, sometimes with loose necrotic overlays. When performing extended colposcopy in women without STIs after processing of cervical mucosa with 3% acetic acid solution colposcopic pattern showed incomplete metaplasia
of stratified squamous epithelium in 100% of women. When applied Lugol'-s solution on cervical portion, devoid of epithelium, there followed the phenomena of iodine negative zone (pathological lesions of modified keratinized epithelium) in 30% of women who had unstable nature, punctuation phenomenon (atypical epithelium with fine mottle, presenting atypical vascular loop), of mosaic (foci above the surrounding tissue, resembles a mesh marbling, is often found on the periphery of transformation zone which presents branched stromal papilla with vessels inside) was not observed. Women with combined chlamydial infection, while extended colposcopy, presented normal transformation zone in 50% of women, iodine negative zone in 70% of women, acetowhite epithelium in 50% of women, punctuation phenomenon, mosaics and atypical vessels were absent. The same results were followed in women with ureaplasma infection. About 20% of studied patients were colposcopicaly diagnosed cervical leukoplakia which had the appearance of white spot or thin dense plaque strongly associated with the underlying tissue while normal colposcopy and did not disappear after drying cervical mucosa with swab. Extended colposcopy for women without STIs in the spots identified horny overlay with rough, scaly or folded surface — the base of leukoplakia. 90% of women were detected iodine negative zone, 50% of women — punctuation phenomenon and mosaics, 90% of women — unstable acetowhite epithelium. Women with leukoplakia coupled with chlamydia presented iodine negative zone and acetowhite epithelium of resistant nature in 100% of women, in 80% - punctuation, in 70% - delicate mosaic, women with urea-plasmosis presented the same patterns. Women with leukoplakia coupled ureaplasmosis and chlamydia with HPV were observed iodine negative zone and stable acetowhite epithelium, coarse mosaic phenomenon and punctuation in all women. Colposcopy, in 10% of surveyed patients were diagnosed cervical dysplasia, that was characterized on the background of whitish or erythematous areas by defining areas of leukoplakia and its varieties, erythroplakia, iodine negative zones in 60%, and margins of stable acetowhite epithelium, rising above the mucosal level with keratinization of glands and vascular atypia were observed in 50% of women. Coarse punctuation was observed in 60% and mosaic in 55% of women. The most suspicious of gland malignancy with a broad rim with matte shade around the mouth of the duct.
Atypical corkscrew vessels, non-contracted under the effect of acetic acid, were observed in 60% of patients. At dysplasia in combination with chlamydia and ureaplasmosis in colposcopic presentation were phenomena of iodine negative zones in 80% and acetowhite epithelium in 60% of women, coarse mosaic phenomenon in 70% and punctuation in 70% of women, abnormal blood vessels in 80% of women. In women with HPV, 90% of women noted iodine negative zone and 70% of women — stable acetowhite epithelium, 100% of women — coarse punctuation and mosaic, atypical tree network of vessels.
Conclusions and Discussion
Thus, study results indicate that while extended colposcopy for cervical uteri diseases in conjunction with STIs have been observed the marked changes exhibiting with increased detection rate of atypical colposcoic indicators — mosaic, punctuation and atypical vessels, particularly pronounced in women with cervix uteri diseases associated with sexually transmitted infections. This study demonstrates that some of urogenital infections have a certain role in the progression and malignancy of processes in the cervical mucus, which requires the need for early detection and elimination of STI data.
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Murodov Alijon Salimovich, Assistant of the Department GP surgery, Tashkent Medical Academy
Teshaev Oktyabr Ruhullaevich, Sadykov Rasul Rustamovich, E-mail: dr. alimurod@mail. ru
Improved results of treatment purulent destructive diseases of soft tissues using laser treatments
Abstract: The aim of research was to study the effectiveness of photodynamic treatment and CO2 laser destructive purulent wounds of soft tissues. The use of CO2 laser has allowed for the possibility of early and bloodless nekroektomii, improve wound repair, and reduces microbial contamination of purulent wounds. Method has photo coagulating and sterilizing properties effects on the tissue.
Photodynamic therapy is a very effective non-invasive and gentle treatment of purulent wounds and serve as justification for the use of the method of photodynamic therapy in clinical practice for the treatment of acute local inflammatory processes combined with CO2 laser and traditional treatments.
Keywords: Photodynamic therapy, photosensitizer, methylene blue, purulent wound, microbe, CO2 laser, laser surgery, planimetry.
The questions about surgical infection now remain one of the priority tasks in clinical medicine and this is connected both to high morbidity rate and significant difficulties in treatment. According to the data of the literature, the quantity of the patients with acute purulent diseases of soft tissues accounts 30−60% among all surgical patients (Svetukhin A. M. et al, 2002- Gorunov S. V., 2004- Abaev Yu. K. ). Thus till 70−80% of them admit to the hospital due to urgent events. In the structure of postoperative complications the surgical infection shares from 32 up to 75% (Efimenko N. A., 2005). More than 30% lf all lethal outcomes in the postoperative period is connected with various purulent — inflammatory processes (Novojilov A. A., 2006).
In spite of the fact that the history of the question of treatment of these pathologies accounts not one decade, and to the present time the plenty of various techniques being proposed, the problem of efficiency and quickness of the results obtaining remains not resolved up to the end Baranov E. V. . The use of laser methods of treatment appeared to be one of perspective directions in the modern medicine for solution of this problem. For today the antibacterial photodynamic therapy associated with CO2 laser in the treatment of purulent wounds is the most effective method. CO2 laser have photocoagulating properties and sterilizing action on the tissues. Thereof the section of tissues is carried out without blood loss and the surface of wound section remains to be absolutely sterile.
The photodynamic therapy (PDT) represents a rather new method of treatments based on application of medicinal preparations — Photosensitizer (of substances, sensitive to light) and laser radiation with certain length of a wave appropriate to peak of absorption of photosensitizer (Ischuk, 2009).
The purpose of research: To improve results of treatment of the patients with purulent — inflammatory diseases of the soft tissues with complex application of C02 laser and FDT.
Materials and methods
For the solution of the tasks determined it was performed examination and treatment of 327 patients with purulent wounds of soft tissues of various etiology and location of age from 16 till 82 years, treated in the department of purulent surgery of the 1st Clinical hospital on the basis of the Chair of the GP surgery of Tashkent Medical Academy during 2010−2015. Depending on the treatment performed the patients were divided into 3 groups: Group 1 (control) included 109 patients being treated by the common traditional methods- group 2 (main group I) consisted of111 patients, who received in a complex of traditional methods of treatment with FDT together with 0. 05% buffer solution of methylene blue. Group 3 (main group II) comprised 107 patients who received complex of traditional methods of treatment with CO2 laser and FDT. Among the studied patients there were 97 (57.8%) men, and 71 (42.2%) women at the age from 16 till 85 years. According to nosological forms at the patients there were prevailed erysipelatous inflammation in 38 patients (22.6%) and phlegmons ofvarious localization in 22 (13%) patients.