Ruxshona Izzatbekovna Toxirova

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Dhjetor 27, 2024 - 01:19 Përditësuar: Dhjetor 27, 2024 - 01:22
Ruxshona Izzatbekovna Toxirova
New Methods for the Diagnostic Algorithm and Management of Patients with Complicated
Forms of Diabetes Mellitus Associated with Pulmonary Tuberculosis
 
G.A. Kholmatova, R.I.Tokhirova Andijan State Medical Institute
 
Fluorographic screening should be conducted not only when clinical symptoms suggestive of tuberculosis appear, but also as part of a systematic preventive examination for all diabetes patients at least once a year. For patients with severe diabetes or those in contact with tuberculosis infections, screenings should be conducted every six months. These activities should be coordinated between an endocrinologist and a phthisiatrician.
 
This study aimed to identify the clinical and epidemiological features of diabetes and pulmonary tuberculosis in patients with concurrent pathology: age of onset, gender distribution, ratio of urban and rural residents, diabetes severity distribution, and tuberculosis distribution by clinical forms and bacterial release. A retrospective cross- sectional study was conducted among 60 patients over 18 years old (average age 49.1 ± 2.2 years), diagnosed with tuberculosis and diabetes, who received inpatient treatment at the Andijan State Medical Institute clinic and Andijan Regional Anti-Tuberculosis Dispensary.
 
Among the patients included in the study, most were women (53%), with the majority (80%) residing in urban areas. Tuberculosis was diagnosed for the first time in 54 patients (90%),
while 6 patients had recurrent tuberculosis. In most cases, pulmonary tuberculosis was detected during preventive screening – 47 patients (79.7%) – and upon seeking medical help in 13 cases (20.3%). Infiltrative pulmonary tuberculosis was the most frequently diagnosed form (81.7%), with fibrocavernous forms accounting for 10%, tuberculoma for 6.7%, and disseminated tuberculosis for 1.7%. In 3.3% of cases, the disease was accompanied by pleural tuberculosis, and in 6.7% by extrapulmonary manifestations in the form of generalized tuberculosis.
 
Among the patients studied, tuberculosis was observed as a widespread process in 60% of cases. Drug resistance was found in 21.7% of patients, with multiple drug resistance identified in 92.3% of those cases. Considering the effectiveness of anti-tuberculosis therapy, the following outcomes were recorded: worsening in 15% of cases, no change in 10%, and improvement in the majority of cases (71.7%), with surgical intervention performed in 18.6% of cases and significant improvement in 3.3%.
 
Thus, despite the low reactivity of the immune system in patients with tuberculosis and diabetes, high efficacy was observed in anti-tuberculosis treatment. The proliferation of tuberculosis bacteria in a patient with diabetes further disrupts pancreatic function, leading to worsening and progression of diabetes. In this “vicious cycle,” one disease exacerbates the other. Therefore, diagnosing pulmonary tuberculosis is a challenging but essential task in diabetic patients. Pulmonary tuberculosis in diabetic patients is often asymptomatic or with minimal symptoms, typically detected during preventive fluorographic examinations. In diabetic patients, pulmonary tuberculosis may present as widespread forms (affecting part or more than one lobe of the lung or involving both lungs) but may lack pronounced symptoms.
 
Keywords: diabetes mellitus, tuberculosis, decreased immunity.
 
Ruxshona Izzatbekovna Toxirova was born on July 25, 2004, in the Oltinkoʻl district of Andijan region. She is Uzbek by nationality. From 2011 to 2022, she studied at the 48th general secondary school in the Oltinkoʻl district. Currently, she is a third-year student at the Faculty of Pediatrics at Andijan State Medical Institute. She graduated from school with excellent grades and achleved numerous successes, actively participating in subject Olympiads. She is the coordinator of the Girls' Club. She participated in the conference "INNOVATIVE APPROACH TO CURRENT ISSUES IN MEDICINE" held on March 29, 2024. She is also the author of many articles.
 
The article was published without interference!