Dushanbe, Tajikistan

Tajik State Medical University

tajmedun.tj
Dushanbe, Tajikistan

Tajik State Medical University is a public university in Tajikistan. Established in 1939, it is located in Dushanbe and named after Avicenna. It is managed by the Ministry of Health. During its membership in the Soviet Union, it was the second best university in the USSR. Wikipedia.

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In Cologne (Germany), on the 24-25th of June, 2016 the Fifth symposium dedicated to the issue of a permanent vascular access in patients with chronic kidney disease (CKD) undergoing hemodialysis was held. Vascular surgeons, interventional radiologists, nephrologists, nurses from different cities of Germany as well as from the United States, the Netherlands and Tajikistan took part in the symposium. Two master classes on the upper limb vascular surgical anatomy and practical surgery of forming different types of A-V shunts in the upper limb were carried out during the symposium. The different types of arteriovenous fistulas and their immediate and long-term results were presented and discussed from the current point of view; new data on the results of using cutting baloons and the drug-coated baloons in the surgery of stenotic changes of A-V shunts were demonstrated at the symposium. At the symposium a special attention was given to the use of new systems in patients in whom almost all ways of using veins have been exhausted. The newest trend in the surgery of access for hemodialysis in "difficult" patients is the application of the device Surfacer. The results of the implanted graft - Hemodialysis Reliable Outflow graft (HeRO) were represented too. The article also provides the overview dedicated to necessity of the blood flow monitoring prior, within and after the endovascular interventions in treating the patients with A-V shunts stenosis; the formation of the A-V shunt by means of endovascular techniques, the application of Nitinol stent-like-devices VasQ to improve the maturation and patency of A-V anastomosis. A number of reports were devoted to the issue of the dilation of arteries after the formation of A-V shunt and aneurysms.


Kurbonov K.M.,Tajik State Medical University | Nazirboev K.R.,Tajik State Medical University
Novosti Khirurgii | Year: 2017

Objectives. To study some indices of endtoxicosis and the level of cytokines in blood serum and bile in patients with non-tumor obstructive jaundice. Methods. The studies are based on a comparative analysis of indicators of endotoxemia and cytokine profile in the blood serum and duct bile in 38 operated patients. Patients on the basis of the severity of obstructive jaundice (OJ) were divided into 3 groups according to the classification of E.I. Galperin et al. There were 12 patients with OJ in mild form (31,6%), with moderate severity - 14 (36,8%) and with severe form of OJ - 12 (31,6%). To diagnose the severity of OJ, laboratory studies of endotoxemia indices and cytokine concentration in the blood serum and duct bile were performed, and morphological data of the liver biopsy samples were also studied. Results. Analysis of the study results has shown the concentration of the proinflammatory cytokine IL-6 in OJ of medium severity is 50,4% higher than normal, and at a severe degree in the blood serum it turns out to be the highest in case of OJ complicated by purulent cholangitis - by 2,4 times. The concentration of proinflammatory cytokine IL-6 in the bile has been found to be elevated in patients with OJ (a moderate severity) and OJ (severe form). During the study, the concentration of proinflammatory cytokine IL-4 in the blood serum in OJ of a mild degree was 27% higher than normal, and in patients with OJ of a moderate severity - 67,3% higher. However, the concentration of IL-4 in the bile appeared to be elevated in case of the initial forms of the disease compared with patients with OJ of a moderate severity against the destructive cholecystitis. Conclusion. The results of a comprehensive study of patients with OJ have revealed significant changes in indices of the cytokine status and endotoxemia in the blood serum and bile as well as morphofunctional changes in the liver.


Kurbonov K.M.,Tajik State Medical University | Makhmadov F.I.,Tajik State Medical University | Nazirboev K.R.,Tajik State Medical University | Aminov A.A.,Tajik State Medical University
Khirurgiia | Year: 2016

AIM: to prove the efficacy and safety of video-assisted techniques in diagnosis and treatment of victims with thoracic and abdominal trauma.MATERIAL AND METHODS: It was analyzed treatment of 249 patients with thoracic (n=82), abdominal (n=122) and thoracoabdominal injuries (n=35) who were divided into 2 groups depending on treatment. Control group of conventional diagnosis and treatment included 130 (52%) patients. Group 2 consisted of 119 (48%) patients in whom differentiated surgical approach combined with current technologies was applied.RESULTS: Video-assisted techniques did not reveal thoracic (n=9) and abdominal (n=7) injuries in 16 out of 103 cases. There was conversion to open surgery in 20 patients. In group 2 conventional thoracic (n=15) and abdominal (n=22) interventions were made in 37 (36%) cases while endoscopic surgery was used in other 66 (64%) patients. Postoperative complications after endoscopy were observed in 8 patients. There were 2 deaths.CONCLUSION: Rational and effective use of video-assisted surgery for thoracic and abdominal trauma significantly improves outcomes in these severe patients.


Karim-Zade K.,Tajik State Medical University | Leak C.,London School of Hygiene and Tropical Medicine | Karim-Zade B.,Tajik State Medical University
Ophthalmic Epidemiology | Year: 2016

Purpose: Pediatric eye injury (PEI) is the leading cause of preventable monocular vision loss in children, with an estimated prevalence of 5.7 million cases. Epidemiological information on PEI is rare, skewed towards high-income countries, and commonly overlooked by non-governmental ophthalmological organizations. This study aims to quantitatively and qualitatively determine incidence of PEI in the Republic of Tajikistan. Methods: Data were collected from all pediatric eye injury records (N = 454) admitted to three pediatric ophthalmology hospitals in two regions of Tajikistan between 2010 and 2012. Results: A review of the records revealed a cumulative annual incidence of 12.8 PEI cases/100,000, with marked inter- and intra-regional differences. Mean age was 7.0 years (95% confidence interval, CI, 6.7–7.4), and male to female ratio was 2.5:1. PEI occurred predominantly outdoors (63%), in rural settings (76%) during unsupervised play, and typically resulted from the eye being hit (53%) by a pointed object (51%), resulting in an open-globe injury (56%). Median time-to-presentation was 24 hours (range 9.6 hours–10 days) and median duration of hospitalization was 15 days (range 2–29 days). Of the 454 cases, 111 (25%) resulted in a blind eye, 62 (14%) in severe visual impairment, and 45 (10%) in moderate visual impairment. Conclusions: PEI is a major cause of pediatric monocular visual impairment in Tajikistan, with a high rural incidence of severe blinding injuries. Potential risks and outcomes relate to Tajikistan’s cultural, historical, and physical settings. We anticipate that the information provided by this study will facilitate development of culturally derived strategies to reduce PEI in Tajikistan. © 2016 Taylor & Francis


Versporten A.,University of Antwerp | Abilova V.,Analytical Expertise Center for Medicines | Pyshnik G.,Ministry of Health | Spasojevic T.,Agency for Medicines and Medical Devices of Bosnia and Herzegovina | And 10 more authors.
The Lancet Infectious Diseases | Year: 2014

Background: There are no reliable data on antibiotic use in non-European Union (EU) southern and eastern European countries and newly independent states. We aimed to collect valid, representative, comparable data on systemic antimicrobial use in these non-EU countries of the WHO European region. Methods: Validated 2011 total national wholesale antibiotic-use data of six southern and eastern European countries and regions and seven newly independent states were analysed in accordance with the WHO anatomical therapeutic chemical (ATC)/defined daily doses (DDD) method and expressed in DDD/1000 inhabitants per day (DID). Findings: Total (outpatients and hospital care) antibiotic use ranged from 15·3 DID for Armenia to 42·3 DID for Turkey. Co-amoxiclav was mainly used in Georgia (42·9% of total antibiotic use) and Turkey (30·7%). Newly independent states used substantial quantities of ampicillin and amoxicillin (up to 55·9% of total antibiotic use in Azerbaijan). Montenegro and Serbia were the highest consumers of macrolides (15·8% and 19·5% of total antibiotic use, respectively), mainly azithromycin. Parenteral antibiotic treatment is common practice: 46·4% of total antibiotic use in Azerbaijan (mainly ampicillin; 5·3 DID) and 31·1% of total antibiotic use in Tajikistan (mainly ceftriaxone 4·7 DID). Interpretation: This study provides publicly available total antibiotic-use data for 13 non-EU countries and areas of the WHO European region. These data will raise awareness of inappropriate antibiotic use and stimulate policy makers to develop action plans. The established surveillance system provides a method to develop quality indicators of antibiotic use and to assess the effect of policy and regulatory actions. Funding: Netherlands Ministry of Health, Welfare, and Sport, and EU. © 2014 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved.


Gaibov A.D.,Tajik State Medical University
Novosti Khirurgii | Year: 2015

Objectives. To evaluate the results of complex diagnostics and surgical treatment of patients with pheochromocytoma. Methods. Treatment results of 25 patients with pheochromocytoma (PCC) have been analyzed (15 (60%) females and 10 (40%) males). The average age of patients was 35,9±4,2 years. Average duration on the disease was 4,6±1,7 years. Diagnosis was confirmed by ultrasonography (US), computerized tomography (CT) and determination of metanephrines (MN) and vanillylmandelic acid (VMA) levels. Depending on the preoperative tactics all patients were divided into 2 groups. ?-blockers of short-acting (phentolamine) were used to the patients of the first group (n=8) only during the operation. ?-blockers (doxazosin) were administered to the patiens of the second group (n=17) in the preoperative period. Results. In all cases a reliable increase of MN and VMA levels was registered. No difference was found in studying MN excretion level depending on the tumor size and disease duration. Sensitivity of US and CT in PCC diagnostics made up 92% and 100%, and specificity 52% and 91,3%, respectively. In the 1st group 2 (25%) patients died due to the development of "uncontrolled hemodynamics" syndrome. There was no lethal outcome in the 2nd group (?<0,05). Complications were observed in 5 (21,7%) patients during the operation (n=2) and in the early postoperative period (n=3). There was 1 (4,3%) lethal outcome after adrenalectomy. In the long-term period (1-8 yrs) good results were obtained in 21 (91,3%) operated patients and satisfactory - in 1 (4,3%). Conclusion. The use of minimally invasive techniques in the treatment of pheochromocytoma can help reduce the incidence of postoperative complications and duration of hospitalization. In all cases the preoperative preparation should be carried out with the use of α-blockers. The patients are required clinical medical examination and proper conduction of hormone replacement therapy to prevent and treat adrenal insufficiency.


Sadriev O.N.,Tajik State Medical University | Gaibov A.D.,Tajik State Medical University
Novosti Khirurgii | Year: 2015

Objectives. To justify the choice of surgical approaches to adrenalectomy based on the data of instrumental findings. Methods. Comparative results of adrenalectomies through different surgical approaches in 51 patients with adrenal tumors have been analyzed. To choose an optimal surgical approach to adrenalectomy it's necessary to take into consideration the depth of the adrenal tumor location, the angle of surgical action, the size of adrenal tumor, its location, presence of an accompanying pathology requiring surgical treatment. The parameters mentioned above were determined by means of ultrasonography (US), computer tomography and multislice computed tomography (MSCT). All data obtained from this run compared with the intraoperative findings. Results. The depth of adrenal location was measured by means of US, CT, MSCT from various surgical approaches made up from 5,7±0,5 up to 12,9±0,6 and from 5,6±0,7 up to 12,8±0,9 cm (M±σ), respectively. The surgical action angle determined by means of CT and MSCT varied from 36° up to 142° in all cases coinciding with intraoperative findings. The length of mini-lumbotomic approach (n=19) was from 4,8 up to 6,5 cm, (the average 5,4±0,2 cm (M±σ). Only 5,9% of cases there are data inconsistency in comparison the results of US, CT and MSCT with intraoperative one. Adrenalectomy from thoraco-phrenico- lumbotomic (TPL) approach was performed in 30 (58,8%) patients, from mini-lumbotomic (ML) approach - in 21 (41,2%) patients. Conversion frequency of ML approach made up 9,5%. Intraoperative complications at TPL approach were registered in 6,7% cases, at ML approach - in 4,8%. Conclusion. Application of US, CT and MSCT permitted to determine maximally accurately the size and location of the adrenal tumor, to establish the tumor location, required different surgical approaches as well as the expected angle of surgical action thus to contribute to the optimal choice of surgical approach. © 2015, Vitebsk State Medical University. All rights reserved.


Gaibov A.D.,Tajik State Medical University | Anvarova S.S.,Tajik State Medical University
Novosti Khirurgii | Year: 2016

Objectives. To assess the possibilities of computed tomography at differential diagnostics of adrenal tumors. Methods. Correlation analysis between the results of computed tomography (CT) and morphologiocal structure of the adrenal tumors in patients (n=54) with pheochromocytoma (PCHC) (n=23; 42,6%), aldosteroma (AS) (n=18; 33,3%) and corticosteroma (CS) (13; 24,1%) has been analyzed. At 3-phase CT such parameters as the tumor size, structure and contours, the presence of the capsule, native and maximum density at contrasting, washout time of contrast medium by more than 60% have been assessed. Results. While comparing the size of PCHC, CS and AS the reliable difference between them has been registered. Round and oval tumors are more typical for CS and AS; PCHC tumors are of irregular shape. Uneven contours, heterogeneity of the structure and the presence of inclusions in the structure of the tumor turned out to be typical mainly for PCHC, while at CS and AS those signs were practically absent. At comparative assessment of PCHC density (+22 (20-25) UH, CS(+14 (11-16) UH; and AS(+6 (4,25-8,5) UH) in the native regimen and at contrasting, PCHC - +41 (40-45) UH; CS - +20 (16-20,5) UH; AS - +11 (9,25-13) UH), their reliable difference has also been established (p<0,001). While comparing washout time of contrast PCHC (+14 (11-15) min.) and adrenocortical tumors (+8 (6-12,75) min. and +4,9 (3,5-6,625) min. for CS and AS, statistically reliable diference has been registered. Conclusion. The analysis of tumor size, structure, density in different phases of contrasting and washout time of contrast medium, revealed at CT permits to differentiate the different nosological forms of adrenal tumors and to be clinically significant in the choice of further treatment tactics.


PubMed | University of Paris Pantheon Sorbonne and Tajik State Medical University
Type: | Journal: BMC surgery | Year: 2015

Management of asthma in chronically affected patients is a serious health problem. Our aim was to show that surgical treatment of chronic bronchial asthma by unilateral resection of the internal branch of the superior laryngeal nerve (ib-SLN) is an adequateand lasting remedial response.In a retrospective study, 41 (26 male and 15 female) patients with bronchial chronic asthma were treated surgically during the period between 2005 and 2013. It consisted of a unilateral resection of the ib-SLN under optical zoom, on patients placed in supinator position. 35 patients (24 male and 11 female) who were un-operated were included as a control.In all patients, medication was reduced progressively. When the results were compared with the control group, it was seen that in 26% of the patients, both forced expiratory volume (FEV) and peak expiratory flow (PEF) increased significantly (p<05) and only modestly in 53.6% of patients (FEV, p<05 and PEF, p<05). In the remaining 20% of patients, these parameters remained however unchanged. Overall, in 80% of patients unilateral resection of the ib-SLN gave satisfactory results because it shortened the intervals and duration of asthmatic attacks, rendering thereby a reduction in medication.This minimal-invasive method helped prevent/cure asphyxias in chronic bronchial asthma without affecting cough reflex,respiratory control and phonation and it helped patients avoid severe crisis. This approach is of interest for patients with severe and/or uncontrolled bronchial asthma in settings with limited access to drug treatment.


PubMed | Tajik State Medical University
Type: | Journal: Khirurgiia | Year: 2016

to prove the efficacy and safety of video-assisted techniques in diagnosis and treatment of victims with thoracic and abdominal trauma.It was analyzed treatment of 249 patients with thoracic (n=82), abdominal (n=122) and thoracoabdominal injuries (n=35) who were divided into 2 groups depending on treatment. Control group of conventional diagnosis and treatment included 130 (52%) patients. Group 2 consisted of 119 (48%) patients in whom differentiated surgical approach combined with current technologies was applied.Video-assisted techniques did not reveal thoracic (n=9) and abdominal (n=7) injuries in 16 out of 103 cases. There was conversion to open surgery in 20 patients. In group 2 conventional thoracic (n=15) and abdominal (n=22) interventions were made in 37 (36%) cases while endoscopic surgery was used in other 66 (64%) patients. Postoperative complications after endoscopy were observed in 8 patients. There were 2 deaths.Rational and effective use of video-assisted surgery for thoracic and abdominal trauma significantly improves outcomes in these severe patients.

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