{"paper_id":"b9b6dda7-7b91-470b-acdf-d4b146baf3b1","body_text":"730   A journal of the AMERICAN Journal of Pediatric Medicine and Health Sciences                   www. grnjournal.us  \n \n \nAMERICAN Journal of Pediatric Medicine and  \nHealth Sciences   \nVolume 01, Issue 10, 2023    ISSN (E): 2993-2149 \n \n                              \nModern Directions in the Study of the Etiology and Patho genesis of \nEndometriosis \n \nOripova Nargiza Akhtamovna  \nBukhara State Medical Institute named after Abu Ali ibn Sina, Uzbekistan,  \nhttps://orcid.org/ 0009-0009-4091-031X \n \n Summary: Endometriosis is one of the most common gynecological diseases, which \nreflects the medical and social significance of the problem of ef fective diagnosis and treatment. \nTo date, the causes, diagnosis and treatment of this disease remain the subject of controversy. The \npathogenesis of the disease is multifactorial and has not been stud ied enough, non-invasive \nexamination methods have a relative diagnostic value, so modern therapeutic approaches often do \nnot provide a complete cure.  \n Keywords: endometriosis, diagnostics, proteins, genes, mikro RNK. \n \n Relevance. Endometriosis is a tumor pathological process in which benign tiss ue growth \noccurs outside the uterine cavity, similar in morphological and functiona l properties to the \nendometrium. In the structure of gynecological diseases, endometriosis is in third place, following \ninflammatory diseases of the uterine appendages and fibroids. If at the beginning of the twentieth \ncentury. S. Menge and E. Oritz in the <Manual of Gynecology= (1914) wrote that <...genital \nendometriosis is not of particular practical importance,= then already at the end of the century, due \nto the widespread increase in the frequency of this pathology, endometri osis began to be \nconsidered as a new disease of civilization. Currently, endometriosis is reasonably recognized as \nthe most common and severe disease of women of reproductive age, negat ively affecting the \ngeneral condition, performance and quality of life of patients [1 –4]. According to population \nstudies of the World Endometriosis Research Foundation (WERF), cur rently more than 176 \nmillion women in the world suffer from endometriosis (up to 10% of women of reproductive age) \n[5], and the economic costs of its treatment, rehabilitation and compensation for disability amount \nto more than $76 billion/year. Moreover, the costs associated with compensation for loss of ability \nto work are 2 times higher than the costs directly for medical c are. Clinical manifestations of \nendometriosis depend on the localization of the process, the degree of dam age to the genitals and \nadjacent organs, and the individual pain threshold. Painless (asymptoma tic) forms of \nendometriosis occur even with severe infiltrative lesions, but this is always the exception. The \n<calling card= of endometriosis is symptoms directly related to menstruation and most pronounced \nduring this period: dysmenorrhea (mainly algomenorrhea) - 82.7 –83.4%; pain syndrome of \nvarying severity - 48.3 –50%; dyspareunia - 33.4 –34.5%. Bleeding with endometriosis is also \npredominantly cyclical in nature - as a rule, hyper- and polymenorrhea a re noted, and prolonged \nperimenstrual bleeding and anemia are also characteristic. Dysur ia (urinary disorders) and \ndyschezia (painful and/or difficult defecation) are observed with infiltrative lesions of adjacent \norgans (bladder and/or ureters and intestines, respectively). The literature describes the <four dis= \n\n731   A journal of the AMERICAN Journal of Pediatric Medicine and Health Sciences                   www. grnjournal.us  \n \n \nsyndrome (dysmenorrhea, dyspareunia, dysuria, dyschezia), observed during me nstruation in \npatients with endometriosis. Infertility is one of the most signifi cant (including socially) and \npainful symptoms of endometriosis; its frequency is 35–40%. Thus, the fertility rate (the ratio of \nthe number of childbirths to the number of women of reproductive age) in healthy women is 0.15–\n0.20, in patients with endometriosis – 0.02–0.1, i.e. it is an order of magnitude lower [6] . \nEndometriosis is the only disease in which a benign proliferative proc ess affects the unchanged \ntissue of neighboring organs. The characteristic features of endometri osis are the ability for \ninfiltrative growth, the absence of a pronounced capsule around the endometrioid lesion (with the \nexception of endometrioid cysts), and the possibility of metastasis to dis tant organs. The severity \nof the disease, the ambiguity of tactical approaches and the lack of pathogenetic treatment methods \nhave predetermined the interest of many domestic and world researchers in a comprehensive study \nof this disease, however, despite numerous studies, the results remain unsa tisfactory: 35–50% of \npatients with endometriosis suffer from pain or infertility, rela pses are observed in almost half \n(40–45%) of patients during the first 5 years after surgical treatme nt [7]. Although several \npathogenetic hypotheses have been proposed, the exact pathogenesis of endometrios is remains \nunclear. At the same time, it is obvious that endometriosis develops as a result of dissemination of \nthe endometrium into ectopic areas with the subsequent formation of ec topic endometrial \ncomplexes [1]. It is the presence of these ectopic lesions that is thought to give rise to the symptoms \nassociated with the disease. \nEctopic tissue of endometrial origin consists of glandular epithelium  and stroma and is \ncharacterized by a predominance of benign characteristics combined wi th features (invasion and \nneoangiogenesis) that make it similar to malignant neoplasms. Many theories have been proposed \nto explain the causes of the development of endometriosis [5], depending on the fac tors causing \nits development: retrograde menstruation, genetic predisposition, perit oneal cell metaplasia and \nimpaired immunological control. \nSampson's theory is the most popular and generally accepted theory of the origin of endometriosis: \nit is assumed that endometrioid implants arise as a result of retrograde menstrual reflux of \nendometrial tissue into the abdominal cavity through the fallopian tubes, whi ch is confirmed by \nthe detection of endometrial fragments. The spontaneous development of endom etriosis only in \nhumans and primates supports the assumption that this disease can only affect menstruating \nspecies. At the same time, retrograde menstruation is probably a very c ommon phenomenon, but \nendometriosis develops only in a part of women, which indirectly indicates the role of other factors \nin its development (immunological, genetic, disturbances in the biochemica l composition of the \nenvironment in the abdominal cavity). In addition, the alternative embryonic germ theory suggests \nthat endometriosis may develop from Müllerian cells scattered in the peritoneal cavity, which, \nwhen exposed to certain biochemical stimuli, can become activated and for m endometrial tissue. \nAnother hypothesis, which also helps explain the extraperitoneal localizat ion of the disease, \nsuggests that the origin of endometrioid lesions may be associated wi th metaplasia of peritoneal \ncells and differentiation of mesothelial cells into endometrial cells. Finally, it has been suggested \nthat blood and lymphatic vessels may play a role in the dissemination of endometrial cells over \nlong distances. The human endometrium contains a small population of cells that have functional \nstem cell properties with corresponding markers and functional chara cteristics, which has \nsuggested a role in the pathogenesis of endometriosis. Under physiological conditions, endometrial \nstem cells undergo cyclical monthly regeneration after menstruation. The se cells are presumably \nresponsible for the proliferation and cyclic regeneration of endometrial tissue after menstruation. \nAccording to this hypothesis, endometriosis may result from the migrati on of endometrial stem \n\n732   A journal of the AMERICAN Journal of Pediatric Medicine and Health Sciences                   www. grnjournal.us  \n \n \ncells into the peritoneal cavity, their proliferation, peritoneal invas ion, and differentiation into \nendometrial cells in ectopic locations. \nReferences: \n1. %4D><EB64, \u001f. \u0016., \u001e4R@B64, \u0017.  ., & '@<8B64, !. !. (2018).  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BDHB?B7<K9E><9 < @BDHB@9FD<K9E><9 BEB59AABEF< C9K9A< 59?OI \n59ECBDB8AOI FD9I @9ESKAOI >DOE CBE?9 FS:ё?B= K9D9CAB-@B;7B6B= FD46@O \n6O;64AAB= Q>EC9D<@9AF4?PAO@ CGFё@ //BARQARORLIK VA YETAKCHI \nTADQIQOTLAR ONLAYN ILMIY JURNALI. – 2021. – &. 1. – №. 6. – %. 557-563. \n20. Oglu M. Z. M., Zokirovna O. A.  \"$(\"\u001f\"\u0017\u001c+\u0019%\u001e\u001c\u0019 \u001c  \"$(\" \u0019&$\u001c+\u0019%\u001e\u001c\u0019 \n#\u0014$\u0014 \u0019&$/ #\u0019+\u0019!\u001c \u0015\u0019\u001f/) \u0015\u0019%#\"$\"\u0018!/) \u001e$/%, #\u0019$\u0019!\u0019%,\u001c) \n1\u001e%#\u0019$\u001c \u0019!&\u0014\u001f0!'2 +\u0019$\u0019#!\" - \"\u001b\u0017\"\u0016'2 &$\u0014\u0016 ' #\"%\u001f\u0019 \n \u0019\u0018\u001c\u001e\u0014 \u0019!&\"\u001b!\"\u001d \u001e\"$$\u0019\u001e*\u001c\u001c //JOURNAL OF BIOMEDICINE AND \nPRACTICE. – 2023. – &. 8. – №. 1. \n21. \"?<@B64 \u0014. \u001b., &GD8<96  . $. \u0015')\"$\" ,\u0014Ҳ$\u001c\u0018\u0014  \u0019.\u0018\u0014 \u0016\u0014 Ў! \u001c\u001e\u001e\u001c \n\u0015\u0014$ \"Қ\u001f\u001c \u001c+\u0014\u001e 3$\u0014%\u001c '+$\u0014, 1#\u001c\u0018\u0019 \u001c\"\u001f\"\u0017\u001c3%\u001c //Oriental renaissance: \nInnovative, educational, natural and social sciences. – 2022. – &. 2. – №. 4. – %. 642-647. \n22. Zokirovna O. A. Modern Concepts of Idiopathic Pulmonary Fibrosis //American Jour nal \nof Pediatric Medicine and Health Sciences. – 2023. – &. 1. – №. 3. – %. 97-101. \n23. Zokirovna O. A. Pathology of Precancerous Conditions of the Ovaries //American Journal \nof Pediatric Medicine and Health Sciences. – 2023. – &. 1. – №. 3. – %. 93-96. \n24. \u001bB><DB6A4, \"?<@B64 \u0014;<;4 < &9L496 ,GID4F \u0018:G@496<K. « BDHB?B7<K9E><9 \n4EC9>FO C9K9A< 59?OI 59ECBDB8AOI >DOE CBE?9 FS:9?B= K9D9CAB-@B;7B6B= FD46@O, \n6O;64AAB= Q>EC9D<@9AF4?PAB 6 6<89 8BDB:AB -FD4AECBDFAB7B \nCDB<EL9EF6<S». Scholastic: Journal of Natural and Medical Education  2.2 (2023): 59-\n62. \n25. Zokirovna O. A. Comparative characteristics of the morphological parameters of the liver \nat different periods of traumatic brain injury //Euro-Asia Conference s. – 2021. – %. 139-\n142. \n26. Zokirovna O. A. Macroand microscopic structure of the liver of threemonthly whi te rats \n//Academic research in educational sciences. – 2021. – &. 2. – №. 9. – %. 309-312. \n27. \"?<@B64 \u0014. \u001b. +4EFBF4 \u0016EFD9K49@BEF<  <B@O  4F>< ' \u001a9AM<A \u0016 $9CDB8G>F<6AB@ \n\u0016B;D4EF9 //BARQARORLIK VA YETAKCHI TADQIQOTLAR ONLAYN ILMIY \nJURNALI. – 2021. – &. 1. – №. 6. – %. 551-556. \n28. Zokirovna O. A., Abdurasulovich S. B. Ovarian Diseases in Age of Reproductive Women: \nDermoid Cyst //IJTIMOIY FANLARDA INNOVASIYA ONLAYN ILMI Y JURNALI. \n– 2021. – &. 1. – №. 6. – %. 154-161. \n29. Zokirovna O. A. Cytological screening of cervical diseases: pap test research in the \nbukhara regional diagnostic center for the period 2015-2019. – 2022. \n30. Zokirovna O. A., PREVALENCE R. M. M. EPIDEMIOLOGY OF CANCER OF THE  \nORAL CAVITY AND THROAT IN THE BUKHARA REGION //Web of S cientist: \nInternational Scientific Research Journal. – 2022. – &. 3. – №. 11. – %. 545-550. \n\n734   A journal of the AMERICAN Journal of Pediatric Medicine and Health Sciences                   www. grnjournal.us  \n \n \n31. Olimova A. Z. The frequency of occurrence of my uterus In women of reproductive a ge \n//JOURNAL OF ADVANCED RESEARCH AND STABILITY (JARS). – 2021. – &. 1. \n– №. 06. – %. 551-556. \n32. Olimova Aziza Zokirovna. (2023). MODERN PRINCIPLES OF THE EFFECT  OF \nHEMODIALYSIS THERAPY ON HEART RATE. International Journal of Integrative \nand Modern Medicine , 1(1), 80 –85. Retrieved from \nhttp://medicaljournals.eu/index.php/IJIMM/article/view/28 \n33. Olimova Aziza Zokirovna. (2023). PATHOMORPHOLOGICAL CHARACTERIST ICS \nOF THE EPIDIDYMIS UNDER IRRADIATION. International Journal of Integrative \nand Modern Medicine , 1(1), 96 –100. Retrieved from \nhttp://medicaljournals.eu/index.php/IJIMM/article/view/31 \n34. Olimova Aziza Zokirovna. (2023). THE INCIDENCE OF CANCER OF THE OR AL \nCAVITY AND PHARYNX IN THE BUKHARA REGION. International Journal of \nIntegrative and Modern Medicine , 1(1), 86 –89. Retrieved from \nhttp://medicaljournals.eu/index.php/IJIMM/article/view/29 \n35. Olimova Aziza Zokirovna. (2023). INFLUENCE OF ALCOHOL INTOXICATI ON ON \nTHE HEART TISSUE OF RATS IN THE EXPERIMENT. International Journal of \nIntegrative and Modern Medicine , 1(1), 90 –95. Retrieved from \nhttp://medicaljournals.eu/index.php/IJIMM/article/view/30 \n36. Olimova Aziza Zokirovna. (2023). Modern Aspects of the Etiology of Gastric Ulcer and \nIts Complications. American Journal of Pediatric Medicine and Health Sciences (2993-\n2149), 1(3), 163 –166. Retrieved from \nhttp://grnjournal.us/index.php/AJPMHS/article/view/208 \n37. Zokirovna O. A., Jumaevich T. S. Morphological Aspects of the Liver of White Outbred \nRats After Severe Traumatic Brain Injury Caused Experimentally in the Form of a Road \nAccident //Scholastic: Journal of Natural and Medical Educati on. – 2023. – &. 2. – №. 2. \n– %. 59-62. \n38. Aziza Zokirovna Olimova GASTRIC ULCER AND ITS COMPLICATIONS // Scientific \nprogress. 2022. №3. URL: https://cyberleninka.ru/article/n/gastric-ulcer-and-its-\ncomplications (84F4 B5D4M9A<S: 28.09.2023). \n39. Olimova Aziza Zokirovna. (2022). TECHNIQUE FOR CUTTING BIOPSY AN D \nSURGICAL MATERIAL IN THE PRACTICE OF PATHOLOGICAL A NATOMY \nAND FORENSIC MEDICINE. Web of Scientist: International Scientific Research \nJournal, 3(7), 116–120. https://doi.org/10.17605/OSF.IO/PSQ59 \n40. Zhumayevich N. F., Zokirovna O. A. PATHOMORPHOLOGY OF GASTRIC CANCER \n//BARQARORLIK VA YETAKCHI TADQIQOTLAR ONLAYN ILMIY JURNALI. – \n2022. – %. 330-333. \n41. Zokirovna O. A. Epidemiological and Etiological Data of Morphogenesis and  \nPathomorphology of Congenital Heart Diseases in Children //American J ournal of \nPediatric Medicine and Health Sciences. – 2023. – &. 1. – №. 4. – %. 88-91.","source_license":"CC0","license_restricted":false}