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             \author[1]{Yulduz M.  Isamukhamedova}

             \author[2]{Adiba A.  Usmankhodjaeva}

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\date{\small \em Received: 8 December 2017 Accepted: 3 January 2018 Published: 15 January 2018}

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\begin{abstract}
        


This paper discusses improving the quality of life of patients with various pains on their back, depending on the sex, age, and nature of the pain syndrome. 130 patients (46 men and 84 women) with vertebrogenic back pain were examined and were on ambulatory treatment in the neurological department of TMA. Age grade was from 20 to 55 years. According to the results of the examination, all patients were divided into three groups, depending on the presence or absence of pain syndromes.

\end{abstract}


\keywords{pain syndrome, quality of life, patients, chronic pain, acute pain}

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\let\tabcellsep& 	 	 		 
\section[{I. Introduction}]{I. Introduction}\par
ne of the most pressing problems of medicine is pain syndromes, which are a heterogeneous group of common conditions, the medical and social significance of which is difficult to overestimate \hyperref[b0]{[1,}\hyperref[b1]{2,}\hyperref[b2]{3]} . The reason for patients to seek medical help is often the emergence or intensification of pain \hyperref[b3]{[4,}\hyperref[b4]{5]} . The most common cause of back pain is dystrophic spinal lesions \hyperref[b5]{[6]} . According to experts of the International Association for the Study of Pain, pain lasting more than 3 months is considered chronic \hyperref[b6]{[7,}\hyperref[b7]{8]} . It is the relief of chronic pain in the back is the main task in the treatment of this category of patients. At the same time, in 80\% of patients, the pain disappears under the influence of treatment within a month, but in the rest, they take a chronic course. Despite significant advances in the development of issues of pathogenesis, diagnosis, and treatment of neurological manifestations of lumbar osteochondrosis, many aspects of this pathology remain poorly understood. Of particular importance is the problem of outpatient treatment due to the fact that the methods of therapeutic measures used in most medical institutions are adapted exclusively to the inpatient stage \hyperref[b8]{[9]} . Such a template approach, not taking into account the stage, etiological and pathogenetic factors, peculiarities of cyanogenetic reactions in a particular patient leads to a breakdown of compensatory reactions and worsens the results of rehabilitation activities \hyperref[b2]{[3,}\hyperref[b9]{10]} . The lack of sufficiently effective care for patients with diseases of the spine, usually proceeding chronically, with alternating remissions and exacerbations, leads to a loss of confidence in the doctor. According to a number of experienced clinicians, the passivity of the doctor isunacceptable, as it can lead to the psychosocial death of the patient long before his biological death \hyperref[b0]{[1,}\hyperref[b7]{8]} . In this regard, it is of interest to study the various components of the quality of life for vertebral back pain. Their analysis will make it possible to rationalize medical tactics for this pathology, which determined the goal and objectives of this study.\par
The purpose of the study is to assess the quality of life of patients with back pain, depending on gender, age and nature of pain. 
\section[{II. Material and Methods}]{II. Material and Methods}\par
The object and subject of the study were 130 patients (46 men and 84 women) with vertebral back pain and were on outpatient treatment in the neurological department of TMA. Patients with acute and chronic back pain between the ages of 20 and 55 years. 
\section[{III. Results}]{III. Results}\par
According to the survey results, all patients were divided into three groups depending on the presence or absence of pain syndromes. 1 st Group consisted of patients whose pain was once.\par
Group II patients -having pain less than 3 months.\par
Group III included individuals with algic manifestations that met the criteria for chronic pain.\par
The frequency of pain in patients of the second group in 40\% of cases was once a month or was once. In persons of the third group, the most frequent pain occurred daily (17.6\%). 
\section[{O}]{O}\par
Localization of pain syndrome, for the most part, was traditional -cephalalgia or dorsalgia. Attention was drawn to the fact that these algic violations were not isolated in most cases. Thus, in the group with acute pain, only 29 (16.9\%) respondents complained of pain in the two other zones and only 5 (2.9\%) in three or more respondents. In the group with chronic pain disorders, almost every third respondent indicated two localizations -32 people (32.3\%), and three or more -16 people (16.2\%). To relieve pain, the subjects took analgesics: irregularly -41.4\% of men and 57.5\% of women, regularly -10.3\% and 24.6\%, respectively. Relief or sleep helped to relieve pain -79.5\% of men and 85.2\% of women, sedatives -30.1\% of men and 49.5\% of women. Patients awoke because of the pain of 25.1\% of men and 58.5\% of women. Thus, women regularly resorted to more painkillers than men. 
\section[{IV. Conclusion}]{IV. Conclusion}\par
As a result of the study, it was found among people who did not currently seek medical help for pain syndromes, 47.7\% suffered from acute and 52.3\% chronic algic disorders. Significant gender differences were revealed both in the clinic and in the attitude of patients to pain syndromes. Both acute and chronic pain syndromes are more often recorded in women, the percentage of women in groups with chronic pain is higher than in groups with acute pain, although the difference is within the margin of error -30\% and 33\%, respectively. But, with acute pain syndromes, men were almost 2 times less likely to be referred for examination and treatment (44\%) than women (66\%). A comparative analysis of the ways to relieve pain revealed that women more often (49.5\%) than men (30.1\%) use both drug and non-drug methods (85\% and 79.5\%, respectively). 
\section[{Contributors}]{Contributors}\par
Y. I. conceived and designed the study. Y. I. is the Principal Investigator and the study statistician who prepared the analyses. A. U. wrote the protocol, the Chief Investigator for the Y. I. All authors provided input and approved the final version. 
\section[{Declaration of Interests}]{Declaration of Interests}\par
Authors declare that there is no competing interest.\begin{figure}[htbp]
\noindent\textbf{1} \par 
\begin{longtable}{P{0.1825503355704698\textwidth}P{0.2795302013422819\textwidth}P{0.03993288590604027\textwidth}P{0.03422818791946308\textwidth}P{0.04563758389261745\textwidth}P{0.2681208053691275\textwidth}}
\tabcellsep \multicolumn{4}{l}{Acute Pain Men Women Men Women Chronic Pain}\tabcellsep Total\\
Once\tabcellsep 10\tabcellsep 18\tabcellsep 11\tabcellsep 13\tabcellsep 52 (40\%)\\
On Several Times\tabcellsep 9\tabcellsep 16\tabcellsep 9\tabcellsep 21\tabcellsep 55 (42,3\%)\\
Regularly\tabcellsep 3\tabcellsep 6\tabcellsep 4\tabcellsep 10\tabcellsep 23 (17,6\%)\\
All\tabcellsep 22\tabcellsep 40\tabcellsep 24\tabcellsep 44\tabcellsep 130 (100\%)\end{longtable} \par
 
\caption{\label{tab_0}Table 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{2} \par 
\begin{longtable}{P{0.6572674418604652\textwidth}P{0.13343023255813954\textwidth}P{0.059302325581395345\textwidth}}
Investigated Parameters\tabcellsep \multicolumn{2}{l}{Index Men Women}\\
Rest or Sleep (\% of Patients)\tabcellsep 79,5\tabcellsep 85,2\\
Sleep with Sleeping Pills (\% of Patients)\tabcellsep 30,1\tabcellsep 49,5\\
Awakening due to Pain (\% of Patients)\tabcellsep 25,1\tabcellsep 58,5\end{longtable} \par
 
\caption{\label{tab_1}Table 2 :}\end{figure}
 		 		\backmatter   			 
\subsection[{Acknowledgments}]{Acknowledgments}\par
We thank the Phenomenon-Uzbekistan collaboration investigators for their hard work and dedication, and the participants in this trial, their families, and the many individuals not specifically mentioned in the paper who have supported this study; and Bekhzod Abdullaev for his assistance with preparation of this paper. The trial was initially supported by authors' themselves and additional support was received from Tashkent Medical Academy. 			  			  				\begin{bibitemlist}{1}
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\end{document}
