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Art of Medicine
International Medical Scientific Journal

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Art of Medicine
International Medical Scientific Journal

Volume-1
Issue-1

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ART of MEDICINE

 International Medical Scientific Journal

Volume 1, Issue 1, May   2021



Volume-1
Issue-1

Art of Medicine
International Medical Scientific Journal

3

Founder and Publisher Pascual Izquierdo-Egea
Published science may 2021 year. Issued Quarterly.
Internet address: http://artofmedicineimsj.us
E-mail: info@artofmedicineimsj.us
11931 Barlow Pl  Philadelphia, PA 19116, USA +1 (929) 266-0862

Art of Medicine
 International Medical Scientific journal

CHIEF EDITOR

Dr. Pascual Izquierdo-Egea

EDITORIAL BOARD

Prof. Dr. Francesco Albano

Dr. Catherine J. Andersen

Prof. Dr. Sandro Ardizzone

Dr. Dmitriy Atochin

Prof. Dr. Antonio Aversa

Prof. Dr. Tamam Bakchoul

Prof. Dr. Pierre-Gregoire Guinot

Prof. Dr. Rainer Haak

Prof. Henner Hanssen



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CONTENT

Tursunova L. D., Jabbarov O. O.
APPLICATION OF SAKABUTRIL/VALSARTAN IN PATIENTS WITH CHRONIC
KIDNEY DISEASE WITH TYPE 2 DIABETES MELLITUS...............................5

L.S. Khamraeva., D.U. Narzullaeva
FEATURES OF CALCULATING THE OPTICAL POWER OF AN
INTRAOCULAR LENS IN CHILDREN WITH CONGENITAL CATARACTS
AT THE RISK OF DEVELOPING PSEUDOMYOPIC MYOPIA.....................10

Kasimova M. S., Iminova M. M., Ashurov O. M.
OPHTHALMOLOGIC COMPLICATIONS IN THE STRUCTURE OF THE
CLINICAL FEATURES OF NOVEL CORONAVIRUS INFECTION
(COVID-19)......................................................................................................14

Fattayeva D.R., Rizayev J.A., Rakhimova D.A.
IMPROVEMENT OF METHODS FOR CORRECTION OF CLINICAL AND
IMMUNOLOGICAL DISORDERS IN COMORBID STATE OF CHRONIC
GAYMORITIS AFTER COVID-19....................................................................17

Polatova D.Sh., Abdukarimov Kh.G., Davletov R.R., Savkin A.V., Sultanov B.B
FEATURES OF IMMUNOBIOLOGICAL HETEROGENEITY IN PATIENTS
WITH OSTEOSARCOMA.................................................................................25



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OPHTHALMOLOGIC COMPLICATIONS IN THE STRUCTURE OF THE
CLINICAL FEATURES OF NOVEL CORONAVIRUS INFECTION (COVID-19)

Kasimova Munirakhon Sadikjanovna,
Iminova Mufazzal Muzaffarovna

Ashurov Olimjon Mirzazhanovich
Center for Development of Professional Qualifications of Medical Workers

Republican Clinical Ophthalmology Hospital
Tashkent Emergency Hospital

Abstract.
The data from 26 patients suffering from COVID-19 during the manifestation of the

disease served as the material for the research. The features of pathological processes in
various parts of the organ of vision have been demonstrated with the help of ophthalmologic
and standard examination methods. The data received, together with information from the
reference materials, allow us to draw conclusions about the damage to the structures of the
organ of vision under COVID-19, depending on the concomitant somatic pathology and
the state of homeostasis in the body. Emphasis is placed on mutiltifactory lesion of both the
front segment and the vitreoretinal interface. Today, the variability of ophthalmic complications
is demonstrated in the form of catarrhal conjunctivitis, vascular and inflammatory lesions,
in the flesh to the phlegmon of the orbit and thrombosis of the carotid-cavernous sinus,
which is a frightful and life-threatening condition. In the light of the foregoing, it can be
concluded that today the organ of vision is a target organ under COVID-19. Thus,
ophthalmologists are required to develop a unified classification for ophthalmic complications
under COVID-19, which facilitates the effective management and pathogenetic targeted
correct therapy.

Key words: organ of vision, papilophlebitis, hemophthalmos, caratid-cavernous sinus,
retrobulbar neuritis

Relevance of the topic. After severe respiratory syndrome and Middle East respiratory 
syndrome in 2004, the 2019 global pandemic caused by a novel β-coronavirus virus, called 
SARS-CoV-2, was the third coronavirus pandemic in 2019. The source of SARS-CoV-2 has not 
yet been identified, but there are suggestions about the zoonotic type of infection. Human-to-
human transmission occurs through close contact with an infected person, due to airborne-
droplets, air-dust transmission path. Also, recorded and described the contact-household and 
fecal-oral transmission routes. The average infected age is 51. The most severe course develops 
in patients 60 years and older, with concomitant diseases such as diabetes mellitus (20%), 
arterial hypertension (15%), and other cardiovascular diseases (15%) [1]. The clinical picture can 
vary from acute respiratory viral infection (mild course) 80%, to pneumonia with symptoms of 
respiratory failure, ARDS, respiratory distress syndrome, sepsis and septic (infectious toxic) 
shock (severe course). It gives negative impacts, with lesions of target organs such as heart, 
brain, kidneys and eyes to multiple organ failure. Hypoxemia develops in more than 30% of 
those infected (SpO² less than 88%) [2]. The disease can be attributed to generalized vasculitis, 
and the developing lung pathology is a variant of angiogenic pulmonary edema. The 
pathogenesis of COVID-19 fits not only into the picture of catarrhal phenomena in the upper and 
lower respiratory tract. One of the main damaging factors is a violation of blood coagulability 
with the start of intravascular disseminated coagulation. 



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At an early stage of the epidemic, ophthalmic symptoms manifested themselves in the
form of follicular conjunctivitis. With the passage of time, and the clinical symptoms
were studied in more depth, the sources report increasingly of damage to the posterior
segment of the eyeball and the adnexa of the organ of vision. Patients with confirmed
SARS-CoV-2 manifested central retinal vein thrombosis in combination with thrombosis
of the lower extremities [3]. A case of papilophlebitis was registered - it is a variety of
occlusion of the central retinal vein. In both cases the authors indicate that the cause was
hypercoagulation [4]. In addition, there is data on the registration of vitriitis and other
diseases of the choroid of an inflammatory nature. The authors suggest this can be caused
by the autoimmune genesis of the disease [5].

As of today, the sources do not portray the variations of ophthalmic complications
and specific management tactics for patients with severe forms of damage to the organ
of vision under COVID-19.

Aim of the study. Develop generalization and summary of the variability of ophthalmic
complications under (when infected with) COVID-19.

Materials and methods used. The findings from clinical and functional studies were
based upon the analysis of data from 26 (52 eyes) patients with a confirmed diagnosis of
COVID-19 during the period of manifestation of the disease, with ophthalmological
complications. They were hospitalized in the emergency ophthalmology department of
the Tashkent Clinical Emergency Hospital in the period from 09.10.20 - 20.11.2020.
Among them, there were 13 males, 11 females, aged 18 to 81. The SARS-CoV-2 virus
was detected through PCR testing in 18 (69%) patients. All patients were diagnosed
with polysegmental viral pneumonia with the 1-3rd degree of severity of lung lesions,
according to computed tomography (CT) and through ARF (Acute Respiratory Failure)
testing - 1-2nd degree severities. In the medical history of somatic diseases, hypertension
was recorded in 5 (19%) patients, type II diabetes mellitus was recorded in 9 (34.6%)
patients, 5 (19%) patients had mild and moderate iron deficiency anemia, 5 (19%)
patients had rhinosinusitis, sinusitis was recorded in 2 (7.6%). 2 patients suffered from
ophthalmic complications in the form of moderate myopia, open-angle glaucoma was
found in 1 patient, cataracts was found in 3 patients, diabetic retinopathy in the paired
eye was found in 4 patients, and 2 patients had hypertensive angiopathy.

The research involves: collection of anamnestic data and complaints about the presence
of changes in taste and smell; clarification of the degree of severity CT according to
medical records.

In compliance with the Temporary Methodological Recommendations developed by
the Ministry of Health of Uzbekistan, with purpose of prevention, diagnosis and
treatment of new coronavirus infection, patients with COVID-19 received symptomatic,
immune-modulatory, antiviral, anticoagulant, prophylactic antibacterial therapy.

All patients received traditional ophthalmological examinations, such as: visometry
with determination of the maximum corrected visual acuity, according to the table
(HCP 700, Huvitz, Korea), auto-refractometry, tonometry (Maklakov), non-contact
ophthalmotonometry (TRK-1P, Topcon, Japan), B-scanning, statistical perimetry (HFA
745 i, Carl Zeiss, Germany), direct and reverse ophthalmoscopy (with a 90.0D non-
contact lens, in addition to the standards, optical coherence tomography (OCT) was
performed on the RTVue 100 apparatus (Optovue, USA). The patients also received
MRI of the brain as well as consultation based on indications from ENT specialists,
neurosurgeons, hematologists and endocrinologists.

Analysis of the statistical data. Details are presented for continuous values as average
and standard deviation; for an overview of the presence of signs, the absolute number
of patients and the percentage of the total group size are presented. Fisher's exact test



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was used to compare the data. P < 0.05 was considered a statistically significant difference.
Statistical data processing was carried out on a personal computer using Microsoft Excel
2016 software.

Results
Bacterial conjunctivitis encountered in 2 (7.5%) cases, and acute catarrhal conjunctivitis

in 2x (7.5%) cases.
All patients with ID (iron deficiency) anemia of varying degrees suffered from acute

herpetic keratitis - 4 (15%); acute iridocyclitis was observed in one patient with type II
diabetes mellitus and in 2 patients with rhinosinust (11.5%); posterior uveitis in 4
(15%) patients with type II diabetes mellitus; in 3 patients with hypertension of various
degrees and type II diabetes mellitus and in one patient isolated with hypertension,
hemophthalmus was recorded in total - 4 (15%); acute circulatory disorders in the
central retinal artery in 2 (7.6%) patients with hypertension; neurovasculitis was observed
in the 1 (3.8%) patient with ID anemia; the patient with retrobulbar neuritis had no
concomitant pathology -1 (3.8%); phlegmon of the orbit, followed by thrombosis of the
cavernous sinus - was observed in 3 patients (11.5%) with rhinosinusitis and sinusitis.

Findings
The cited arguments justify the cause of multifocal damage to the organ of vision

when infected with COVID-19. The degree and nature of disorders in the tissues of the
organ of vision depends on the individual characteristics of the organism.

Provided we consider ID anemia as a factor influencing immunodeficiency, then the
level of ID anemia under COVID-19 can contribute to the development of other viral
infections (in our cases Herpes simplex). Metabolic syndrome have brought vascular
complications such as ischemic (in nature), and complications of an inflammatory
nature. The latter was complicated ENT pathologies up to cavernous sinus thrombosis.
Based on the afore-mentioned, it can be concluded that today the organ of vision is a
target organ under COVID-19, and ophthalmologists need to develop a unified
classification concerning ophthalmic complications under COVID-19. This facilitates
the management and pathogenetic targeted correct therapy.

References:
1.Îíóôðèé÷óê Î.Í., Ãàçèçîâà È.Ð., Ìàëþãèí Á.Ý., Êóðîåäîâ À.Â.

Êîðîíàâèðóñíàÿ èíôåêöèÿ (COVID-19) îôòàëüìîëîãè÷åñêèé ïðîáëåìû. Îáçîð
ëèòåðàòóðû /015/ Îôòàëüìîõèðóðãèÿ. - 2020. - ¹3. - Ñ. 115-125

2.Hoffman M., Kleine-Weber H., Schroeder S. et al. SARS-CoV-2 cell entry depends
on ACE2 and TMPRSS2 find is blocked by a clinically proven protease inhibitor // Cell.
- 2020. - Vol. 181. - P. 1-10.

3.Insausti-Garcia A., Reche-Sainz J.A., Ruiz-Arranz C. et al. Papillophlebitis in a
COVID-19 patient: Inflammation and hypercoagulable state // Europ. J. Ophthalmol. -
2020. - Vol. 30. - P.55-59 https://doi.org/10.1177/1120672120947591

4.Marinho P., Marcos A., Romano A. et al. Retinal findings in patients with COVID-
19 // Lancet. - 2020. - Vol. 395 (10237). - P. 1610.

5.Sadjoro de Figereyredo K., Raoni O., Gestal-de-Araujo E. SARA-CoV2,
ïîðàæàþùèé ñåò÷àòêó: âçàèìîäåéñòâèå õîçÿèíà ñ âèðóñîì è âîçìîæíûå
ìåõàíèçìû âèðóñíîãî òðîïèçìà // Ocul. Immunol. Inflamm. - 2020. - Vol. 28, ¹8. -
P. 1301-1304.


