FORENSIC MEDICAL ASPECTS OF PATHOLOGICAL CONDITIONS IN THE THANATOGENESIS OF SUDDEN DEATH IN ISCHEMIC HEART DISEASE

Аннотация

Child and adolescent mortality is one of the common problems affecting virtually all countries worldwide. The ongoing efforts to reduce child and adolescent mortality rates annually, the diversity of causes, types, and forms of fatal incidents, as well as the necessity to determine the prevalence of such cases in the Republic of Uzbekistan, have further heightened interest in studying this issue. Keyword: Child and adolescent mortality: forensic medical examination. Analysis of data from the Ministry of Health of the Republic of Uzbekistan over the past 10 years has shown that the majority of child mortality is due to respiratory diseases. In 2002, respiratory diseases ranked first in the structure of child mortality at 46.9%, followed by perinatal causes at 31.5%, and intestinal infections at 5.9%. Research has demonstrated that a low maternal health status index and complications during pregnancy and childbirth are the most crucial indicators determining the level of child mortality. The structure of child mortality over time can be conditionally divided into three periods: the early neonatal period, late neonatal period, and postnatal period. Of the total number of deaths in the early neonatal period, 62.9% occurred within the first 24 hours after birth, 9.9% between 24-47 hours, 8.3% between 48-72 hours, and the remaining 19.0% between 72-168 hours. The leading causes of death observed on the first day are respiratory disorders at 24%, birth injuries at 18%, asphyxia at 14%, and pneumonia at 13.2%. The primary causes of infant mortality in the late neonatal period are birth trauma (23.9%), intrauterine pneumonia (15.1%), intrauterine infection (14.8%), respiratory diseases (10.9%), and congenital malformations (11.9%). These statistics are attributed to 53 ISSN (E): 2181-4570 ResearchBib Impact Factor: 6,4 / 2024 SJIF 2024 = 5.073/Volume-3, Issue-8 the presence of chronic bacterial infections of the urinary tract and reproductive organs in pregnant women during the latent period, as well as inadequate consultations, examinations, treatment, and preventive measures for women. In total, 41.5% of infant mortality (children under 1 year old) occurs during the postnatal period, with 45.4% of these deaths taking place in children's hospitals, 10% in pediatric infectious disease hospitals, 8.5% in district central hospitals, and another high percentage (20.8%) occurring at home. It should be noted that, unlike the previously mentioned periods, the majority of deaths during this period are caused by respiratory diseases (38%), as well as infectious and parasitic diseases (18%), congenital malformations (12%), and accidents (injuries, poisoning, burns, mechanical asphyxia) (9%). According to WHO data, the worldwide incidence of sudden infant death syndrome ranges from 0.6 to 3.5 per 1,000 live births. In countries such as New Zealand, Australia, England, the USA, and Russia, where this indicator is relatively high, sudden infant death syndrome accounts for 15% to 30% of the child mortality structure. The most frequent risk factors for sudden infant death were studied, which included: single-parent families (23.4%), young families (12.0%), insufficient living space (less than 2 sq.m per person), alcoholism in one of the parents, number of maternal abortions (more than 3), fourth pregnancy, maternal age (less than 17 years), short intervals between pregnancies (less than 2 years), and infant weight disproportion (less than 2.5 kg or more than 4.0 kg). A direct link has been established between sudden infant death and stress, infectious agents, antibiotics, diphtheria and tetanus vaccination, and surgical procedures. Infant mortality rate is an important demographic indicator recognized as a measure of socio-economic development, primarily related to the population's living conditions, medical culture, and organization of healthcare institutions. Indeed, improving the quality of medical services is the most crucial factor in reducing child and adolescent mortality. When comparing the health status and availability of medical services for children and adolescents in urban and rural areas of the republic, it was found that diseases of the nervous system and sensory organs, circulatory system, digestive system, musculoskeletal system, as well as injuries increase with age and persist into adolescence. This pattern is characteristic of children's health development in both urban polyclinics and rural medical stations. According to statistical data, the overall morbidity rate of children under 14 is 780-846 per mille. Research shows that between 2001 and 2006, the 54 ISSN (E): 2181-4570 ResearchBib Impact Factor: 6,4 / 2024 SJIF 2024 = 5.073/Volume-3, Issue-8 infant mortality rate in Tashkent decreased from 13.7 to 9.6, with almost half of these deaths occurring in the neonatal period. The epidemiology of child mortality in Nebraska, USA, was studied through forensic medicine. The Forensic Department of the Lancaster Co