LIST of recommended scientific editions for publication of basic scientific results of dissertations by Supreme attestation commission of the Republic of Uzbekistan. Approved by the Resolutions of the Presidium of the Supreme Attestation Commission of the Republic of Uzbekistan. – Tashkent: 2019. – 160 p. The Journal of Biomedicine and Practice is an international, reviewable journal containing comprehensive material on fundamental and clinical medicine. The main topics include and are not limited to: Physiology, Biochemistry, Biophysics, Biotechnology, Molecular Biology, Medical Genetics, Immunology, Microbiology, Virology, Pathology, Hematology, Cardiology, Dermatology, Emergency Medicine, Endocrinology, Gastroenterology, Gastroenterology Nephrology, Obstetrics and Gynecology, Allergology, Oncology, Ophthalmology, Orthopedics, Pediatrics, Pharmacology, Health, Pulmonology, Radiology, Rehabilitation, Surgery, Urology. The international, edited online Journal of Biomedicine and Practice invites experts in the field of theoretical and applied medicine, as well as those interested in the current state and prospects of biomedicine and clinical practice. The publication in the Journal of Biomedicine and Practice provides an opportunity for researchers from local and foreign organizations, as well as all authors interested in publishing themselves and their scientific discoveries.
PROGNOSTIC SIGNIFICANCE OF CD123 (IL3RA) EXPRESSION IN PATIENTS WITH ACUTE LEUKEMIAS
This study evaluated the clinical and prognostic significance of CD123 (IL3RA) expression in patients with acute leukemia. A total of 116 patients were included in this single-center observational study. CD123 expression in bone marrow blast cells was assessed by multiparameter flow cytometry and quantified as the percentage of CD123-positive cells. CD123 expression was detected in 79.3% of patients, with high expression (≥50%) observed in 68.1%. The highest levels were found in myeloid, myelomonocytic, and monoblastic variants. High CD123 expression was associated with increased bone marrow blast infiltration, aggressive disease course, primary resistance to therapy, and early relapse. A prognostic risk score incorporating CD123 expression, blast percentage, and leukemia subtype was developed and demonstrated acceptable predictive performance (AUC ≈0.74). The findings support the inclusion of CD123 in routine immunophenotyping panels and highlight its role as a prognostic biomarker for risk stratification and individualized therapeutic decision-making in acute leukemia.
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EFFECT OF IMMUNOSUPPRESSIVE REGIMENS ON THE RELAPSE RATE AND CUMULATIVE CORTICOSTEROID DOSE IN CHILDREN WITH FREQUENTLY RECURRENT NEPHROTIC SYNDROME
Background: Frequently relapsing nephrotic syndrome (FRNS) represent major challenges in pediatric nephrology due to repeated relapses and prolonged corticosteroid therapy that may cause significant adverse effects. Objective: To evaluate the effectiveness of two mycophenolate‑based immunosuppressive regimens in reducing relapse frequency and cumulative corticosteroid exposure in children with FRNS. Methods: A prospective cohort study included 89 children with nephrotic syndrome. Patients were treated with either mycophenolate mofetil (MMF) + tacrolimus + prednisolone (n=34) or mycophenolate mofetil + prednisolone (n=55). Clinical variables analyzed included relapse frequency, cumulative prednisolone dose, demographic characteristics, and histopathological findings. Results: Both treatment regimens were associated with a significant reduction in relapse frequency and cumulative steroid exposure. Mean relapse number decreased from 6.7 to 2.0 episodes in the triple‑therapy group and from 3.9 to 0.9 episodes in the MMF + prednisolone group. Conclusion: Mycophenolate‑based immunosuppressive therapy significantly reduces relapse frequency and corticosteroid exposure in children with FRNS.
CURRENT CONCEPTS OF NECROTIZING ENTEROCOLITIS IN NEWBORNS: PATHOGENESIS, DIAGNOSIS AND NUTRITIONAL SUPPORT
Objective: To systematize current knowledge on the pathogenesis, diagnosis, and nutritional support of necrotizing enterocolitis in newborns based on an analysis of domestic and international literature sources. Necrotizing enterocolitis (NEC) is a severe, multifactorial disease that predominantly affects preterm neonates and is characterized by inflammatory and necrotic damage to the intestine, with a high risk of complications and mortality. The pathogenesis involves several key mechanisms, including intestinal ischemia, alterations in the gut microbiota, immune activation, and functional immaturity of the intestinal barrier. The clinical presentation varies widely, ranging from nonspecific symptoms to severe forms with intestinal perforation and sepsis. Diagnosis is based on a combination of clinical, laboratory, and instrumental findings, commonly using the Bell staging classification. Management includes cessation of enteral feeding, antibiotic therapy, parenteral nutritional support, and surgical intervention in complicated cases. Preventive strategies play a crucial role, particularly the use of breast milk and probiotics.
THE INFLUENCE OF GSTM1 GENETIC POLYMORPHISM ON THE DEVELOPMENT OF BRONCHIECTASIS
The article presents a comprehensive analysis of a retrospective, diagnostic study of bronchiectasis in the population of the Samarkand region. The inclusion and exclusion criteria of patients were carefully studied, which confirmed the validity of the selected study groups. Particular attention is paid to the comparative histological and genetic analysis of patients with bronchiectasis. Bronchiectasis is more common in the city of Samarkand, Urgut and Narpay districts. The disease is seasonal, reaching its peak in spring and autumn. For the study, the results of pathomorphological - general histological, histochemical and morphometric examination of the bronchi and lung segments of 48 patients who underwent lobectomy due to bronchiectasis, as well as the results of laboratory biopsies (blood) to study the mutation of the GSTM1 gene polymorphism (dell) from 60 patients with bronchiectasis were studied.
RISK FACTORS ANALYSIS AND MODERN APPROACHES TO THE PREVENTION OF INFECTIOUS COMPLICATIONS IN MANDIBULAR FRACTURES
Mandibular fractures are among the most common injuries in maxillofacial trauma and are frequently complicated by infectious and inflammatory processes. Despite advancements in surgical treatment techniques and antimicrobial therapy, the incidence of infectious complications, including osteomyelitis, remains high. This article presents an analysis of risk factors, mechanisms, and clinical features of infection-related complications in mandibular fractures. Particular attention is paid to microbial contamination, timing of surgical intervention, dental status, and general somatic conditions. The article summarizes the importance of accurate diagnostics, timely surgical management, and comprehensive prevention strategies in minimizing complications.
MODERN APPROACHES TO ENSURING RESPIRATORY TRACT CONDUCTIVITY WHEN PERFORMING OPERATIONS ON THE MAXILLOFACIAL REGION IN CHILDREN
This article presents the results of applying one of the new methods of nasotracheal intubation in children during maxillofacial surgery. The effectiveness and safety of the method, as well as its impact on gas exchange and hemodynamic parameters, were studied in 60 patients who underwent maxillofacial surgical procedures. The obtained results demonstrated that the two-stage nasotracheal intubation technique is an effective and safe method. Complications were observed very rarely, adequate gas exchange was maintained during anesthesia, and no significant hemodynamic reactions were noted during tracheal intubation.
USING MONOCLONAL ANTIBODIES IN THE TREATMENT OF STEROID-SENSITIVE NEPHROTIC SYNDROME IN CHILDREN
Introduction. Nephrotic syndrome (NS) is one of the most common glomerular diseases in childhood. Although corticosteroids remain the cornerstone of initial therapy, approximately 50% of affected children develop frequently relapsing or steroid-dependent disease. In cases refractory to conventional immunosuppressive agents, rituximab - a chimeric anti-CD20 monoclonal antibody - has emerged as a promising therapeutic option. Aim. To evaluate the efficacy of rituximab in achieving sustained remission in children with steroid-sensitive nephrotic syndrome and to identify clinical predictors of favourable treatment outcomes. Methods. A prospective study enrolled 85 children with primary NS treated at the National Children's Medical Centre between 2021 and 2025. All patients received two rituximab infusions (750 mg/m²) administered 14 days apart; those maintaining remission received repeated infusions every six months (three courses total). Statistical analysis included the Mann–Whitney U test for continuous variables and Fisher's exact test with odds ratio (OR) calculation for categorical data. Results. Sustained remission was achieved in 68 patients (80%); post-treatment relapse occurred in 33 children (38.8%). Statistically significant predictors of remission included older age at disease onset (5.07 vs 3.49 years; p=0.023), older age at the time of rituximab administration (11.57 vs 8.90 years; p=0.013), and low pre-treatment relapse frequency (p=0.010). Continued immunosuppressive therapy after rituximab was associated with lower odds of remission (OR=0.172; 95% CI: 0.053–0.560; p=0.004), most likely reflecting confounding by indication. Gender, biopsy findings, and disease duration prior to treatment were not significant predictors. No serious adverse events were recorded; mild infusion reactions occurred in 7.1% of patients. Conclusion. Rituximab is a highly effective and well-tolerated treatment for steroid-sensitive nephrotic syndrome in children, achieving sustained remission in 80% of patients with a six-monthly re-dosing protocol. Older age at disease onset, older age at first infusion, and low pre-treatment relapse frequency are associated with favourable outcomes. Prospective studies are needed to optimise dosing regimens and re-treatment intervals.
To date, Fournier’s gangrene remains an insufficiently studied acute surgical disease of a purulent-necrotic nature. This pathology represents one of the rare forms of infectious necrotizing fasciitis of the genital and perineal regions with polymicrobial etiology. The prevalence of Fournier’s gangrene as a life-threatening surgical condition has been increasing annually. The disease is characterized by a rapid clinical course accompanied by signs of severe intoxication. In most cases, the outcome depends on the timing of surgical intervention from the onset of the disease. Timely diagnosis, prompt surgical treatment, and adequate antibiotic therapy can significantly reduce the incidence of complications and mortality.
Based on the results of practical observation of patients with congenital cholesteatoma, the authors point to a unique course of the disease and complications. The results of surgical treatment of two patients, aged 26 and 36 years, with congenital cholesteatoma of the middle ear are presented. In one of them, congenital cholesteatoma was isolated in the mastoid process, while in the second, the cholesteatoma was located in the tympanic cavity, which destroyed the facial nerve canal and labyrinth. It is concluded that otomicroscopy, MSCT, and MRI examination of the mammillary processes allow the diagnosis of congenital cholesteatoma. The development of congenital cholesteatoma requires urgent debridement. According to the authors, maximum debridement of the mastoid process should be performed alongside adequate comprehensive therapy. If facial nerve palsy, labyrinthitis, or intracranial complications are detected, immediate surgical intervention in the middle ear is necessary. Early detection of congenital cholesteatoma and comprehensive emergency intensive care are key to successful treatment.
IMPROVING THE METHODS OF TREATMENT AND PREVENTION OF COMPLICATIONS DURING THE ADAPTATION PERIOD OF PATIENTS TO REMOVABLE DENTURES
The relevance of the topic is determined by the increasing number of elderly patients requiring removable dentures. During the adaptation phase, complications often occur, affecting comfort, masticatory function, and overall quality of life. The aim of the study was to identify the frequency and causes of complications and to develop recommendations for their correction. The study included 60 patients with complete and partial edentulism. Results showed that timely individual adjustment of dentures reduces complications and improves patient adaptation.
ETIOLOGY AND MOLECULAR GENETIC IDENTIFICATION OF CONGENITAL FEMALE GENITAL TRACT ANOMALIES
Congenital malformations of the reproductive system organs represent a significant factor in female infertility and are traditionally associated with an unfavorable obstetric prognosis. Although the implementation of modern assisted reproductive technologies (ART) has substantially expanded therapeutic possibilities, the effectiveness of these programs is largely determined by the timely verification of the anomaly. Optimization of reproductive outcomes requires not only early diagnosis of malformations but also the development of rational patient management algorithms, including targeted endometrial preparation for implantation
DIGITAL VISUAL LOAD, ACCOMMODATIVE DISORDERS, AND COGNITIVE FATIGUE IN SCHOOL-AGED CHILDREN
Objective. To assess the relationship between the level of digital visual load, the severity of Digital Asthenopic Syndrome (DAS), accommodative function parameters, and cognitive performance in school-aged children. Materials and Methods. This prospective analytical cohort study included 98 children (196 eyes) aged 8–16 years. Based on daily screen time duration, participants were divided into three groups: ≤2 hours/day (n=28), 2–4 hours/day (n=38), and ≥4 hours/day (n=32). DAS was assessed using a modified CVS-Q questionnaire. A comprehensive ophthalmological examination was performed, including measurement of relative accommodation reserve, accommodative stability after 40 minutes of visual load, near point of convergence, and tear film break-up time (TBUT). Cognitive performance was evaluated using tests assessing attention, working memory, and information processing speed. Statistical analysis was conducted at a significance level of p<0.05. Results. DAS was diagnosed in 42.9% of children, with its prevalence significantly increasing with longer screen time (p<0.05). High digital visual load was associated with decreased relative accommodation reserve (p<0.05), increased accommodative fatigue (p<0.05), and reduced TBUT (p<0.05). Moderate correlations were found between asthenopia severity and decreased attention stability (r=0.46), working memory (r=0.38), and information processing speed (r=0.42). The strongest association was observed between the duration of continuous visual work and the cognitive fatigue index (r=0.51). Conclusion. High digital visual load in children is associated with functional accommodative disorders, tear film instability, and reduced cognitive performance.
OPTIMIZATION OF THE SELECTION OF SURGICAL TREATMENT METHODS FOR CHRONIC COLOSTASIS BASED ON COMPREHENSIVE CLINICAL AND FUNCTIONAL ASSESSMENT
Chronic colostasis (chronic cologenic constipation) remains one of the most relevant problems in modern abdominal surgery and coloproctology, characterized by a prolonged course, low response to conservative therapy, and a significant decline in patients’ quality of life. This article presents a comprehensive assessment of clinical, functional, instrumental, and laboratory parameters influencing the choice of surgical treatment in patients with chronic colostasis. The study considered disease duration, the degree of colonic motility impairment, anatomical and functional changes, patient age, and comorbid conditions, which enabled the development of individualized criteria for selecting the optimal type and extent of surgical intervention. The obtained results contribute to improving the effectiveness of surgical treatment, reducing postoperative complications, and shortening rehabilitation periods.
THE ROLE OF GENETIC AND BEHAVIORAL FACTORS IN FORMING THE SEVERITY OF ALOPECIA IN POSTBARIATRIC PATIENTS
Objective: This article examines the characteristics of anamnestic factors influencing the severity of alopecia in patients after bariatric surgery. Materials and Methods: Based on data analysis, key risk factors were identified: family history and hair treatments, such as hair dyeing. Results:A strong statistical association was found between hereditary predisposition and severe forms of alopecia (p < 0.001), as well as an increased proportion of progressive stages in patients who regularly dye their hair (p = 0.002). Conclusion: The study emphasizes the need to consider genetic predisposition and hair damage methods when developing preventive and therapeutic measures, which will improve the effectiveness of therapy and reduce the risk of severe hair loss in post-bariatric patients.
CURRENT STATE OF THE PROBLEM OF DIAGNOSIS AND TREATMENT OF PERIODONTAL DISEASES IN PATIENTS WITH SOMATIC PATHOLOGY (RHEUMATOID ARTHRITIS): PATHOGENETIC RELATIONSHIPS AND CLINICAL APPROACHES
This review article is devoted to a comprehensive analysis of the pathogenetic, clinical, and diagnostic relationship between inflammatory periodontal diseases and a significant systemic pathology: rheumatoid arthritis (RA).
FEATURES OF CARRYING OUT CHILDREN WITH PRIMARY CONGENITAL GLAUCOMA ASSOCIATED WITH STERGE-WEBER SYNDROME
The article presents a retrospective and prospective analysis of the examination and treatment outcomes of 21 children with primary congenital glaucoma associated with Sturge–Weber syndrome. Clinical and instrumental features of the disease course are analyzed, including vascular abnormalities of the anterior chamber angle and episcleral vessels and their impact on intraocular pressure. The effectiveness of a combined surgical approach aimed at simultaneous influence on the main aqueous humor outflow pathways, along with preoperative hemostatic preparation, is evaluated. The results demonstrate that the proposed surgical technique provides effective intraocular pressure control in most patients; however, it is associated with a high risk of prolonged postoperative hypotony and choroidal complications. The study concludes that management of glaucoma in children with Sturge –Weber syndrome requires an individualized surgical strategy and careful postoperative monitoring.
TOTAL COLECTOMY FOR COMPLICATED FORMS OF CROHN’S DISEASE OF THE COLON
Crohn’s disease is frequently assosiated with a wide range of local and systemic complications. Local complications include bleeding, toxic megacolon, bowel perforation, fistulas, intra-abdominal infiltrates and abscesses, strictures and malignancy. As the disease progresses, intestinal bleeding has been reported in 8–14% of patients. In most cases, bleeding can be controlled by conservative measures; however, in some patients it is necessary to resort to surgical intervention. Profuse intestinal bleeding may represent an indication for surgical intervention when conservative and endoscopic measures fail. The aim of this study is to develop effective methods for the diagnosis and treatment of Crohn’s disease with total involvement of the colon complicated by bleeding.
ETIOPATHOGENETIC ASPECTS OF THE NEW CORONAVIRUS INFECTION COVID-19. (LITERATURE REVIEW)
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has created a serious threat to public health. Today, the development of medicine in our country requires the adaptation of the medical system to the requirements of international standards, the study of the spread, diagnosis, treatment and prevention of infectious diseases, and the reduction of the development of complications. The relevance lies in the study of the epidemiological features and clinical manifestations of COVID-19, the dependence of clinical variants of the disease on various strains of the SARS-Cov-2 virus, the study of the virulence and pathogenicity of the SARS-Cov-2 virus, the substantiation of the development of severe and complicated forms of the disease, the study of the pathogenetic features of COVID-19, justification of the development of adverse outcomes, study of the relationship between the genetic and phenotypic characteristics of the SARS-Cov-2 virus and clinical and laboratory manifestations of the new coronavirus infection, study of the effectiveness and safety of vaccines against COVID-19. Today, the development of medicine in our country requires adapting the medical system to international standards, studying the spread, diagnosis, treatment, and prevention of infectious diseases, and reducing the risk of complications.
MODERN CONCEPTS OF TREATMENT IN ACCELERATED TOOTH TISSUE DESTRUCTION
Accelerated tooth tissue destruction represents a significant challenge in modern dentistry due to its rapid progression and multifactorial etiology. This condition is associated with biological, behavioral, and environmental factors, including microbial activity, dietary habits, reduced salivary function, and systemic health disorders. Modern treatment concepts focus on early diagnosis, risk assessment, and minimally invasive approaches aimed at preserving hard dental tissues. Preventive strategies, remineralization therapy, bioactive materials, and individualized treatment planning play a key role in controlling disease progression. An interdisciplinary and patient-centered approach is essential for achieving long-term clinical success and improving oral health outcomes.
COMPLEX THERAPY OF RETROBULBAR NEURITIS OF VIRAL ORIGIN
In recent years, the number of viral eye diseases has been increasing due to the widespread use of hormonal drugs. To study the peculiarities of clinic, diagnostics and treatment of retrobulbar neuritis of viral origin. Out of 38 examined patients (70 eyes) 24 patients with 45 (63,2%) eyes had the process of uveoneuritis. In 14 patients in 25 (36,7%) eyes the process was in the form of retrobulbar neuritis. All patients received complex local and general drug therapy in combination with hormonal preparation, it had a positive effect on the course and outcome of the disease: visual acuity in 80% of eyes increased to 0.6-0.7, peripheral visual field boundaries and color perception were restored to normal.
POSTERIOR CRUCIATE LIGAMENT INJURY OF THE KNEE JOINT DIAGNOSIS AND ARTHROSCOPIC SURGERY
Among knee joint injuries, posterior cruciate ligament (PCL) injuries—especially in isolated cases—occur less frequently compared to anterior cruciate ligament (ACL) injuries. Regardless of age or gender, the annual incidence is approximately 2 per 100,000 people. The PCL serves as the primary stabilizer against posterior translation of the tibia. Anatomically and biomechanically, it can be divided into two bundles: the anterolateral (AL) bundle and the posteromedial (PM) bundle. In general, isolated PCL injuries are difficult to diagnose and are often identified late or may even remain undiagnosed. Anterior-posterior stress radiography is a commonly used diagnostic method for accurately detecting chronic PCL injuries. Conservative treatment for PCL injuries can yield relatively good clinical outcomes, but accurate diagnosis is critical. Key factors include the timing of the injury, the degree of posterior tibial translation, and whether other ligaments are also involved. In our surgical approach, we preserved the anatomical graft insertion on the tibia, eliminating the need for additional tibial fixation. As a result, we were able to reduce both operative time and material costs. This also contributed to earlier graft tenodesis and faster rehabilitation for the patient.
CASES OF DRUG-INDUCED LIVER DAMAGE IN THE FIBROUS STAGE OF CHRONIC VIRAL HEPATITIS “В”
Drug-induced liver injury (DILI) accounts for approximately 10% of all adverse reactions associated with pharmacological therapy. According to data from the World Health Organization, medications are responsible for 10–15% of cases of acute liver failure. The aim of this study was to compare the occurrence and features of DILI in patients with chronic viral hepatitis at fibrotic stages with those at non-fibrotic stages. It has been well established that in chronic viral hepatitis, both direct and indirect viral effects contribute to endogenous intoxication and promote the development of liver fibrosis, thereby increasing hepatic vulnerability to drug-related injury. In this context, pharmacological agents represent an additional metabolic burden on the liver. The present study evaluated and compared cases of drug-induced liver injury in patients with advanced fibrotic stages of chronic viral hepatitis В and in patients without fibrosis.
ETIOLOGY AND PATHOGENESIS OF POSTOPERATIVE COMPLICATIONS FOLLOWING DENTAL IMPLANTATION
The article presents data on risk factors after surgical complications of dental implantation. It was found that the effectiveness of dental prosthetics depends not only on the functional mechanical stresses on the implants, but also on biological factors associated with the developing processes in the tissues of the oral cavity and on the surface of the implant.
COMPARATIVE ASSESSMENT OF RADIATION EXPOSURE TO THE SKIN OF THE HANDS OF NUCLEAR MEDICAL PERSONNEL
Positron emission tomography (PET) is one of the modern, highly informative radionuclide tomographic methods for examining internal human organs. PET enables comprehensive assessment of tumor spread, allows measurement of absolute activity within the examined organ, and provides quantitative evaluation of physiological processes. Work with radiopharmaceuticals involves close contact between the skin of the hands of medical personnel and ionizing radiation and is associated with significant surface radiation doses. Therefore, substantial radioactive exposure to the skin of the hands of personnel represents an important radiation protection issue in medical PET/CT centers. In this study, annual surface doses to the skin of the hands of nurses who performed dispensing of radiopharmaceuticals with specified activity and intravenous administration to patients were assessed. On average, these values ranged from 117 mSv to 250 mSv, which corresponds to the annual dose limit for the skin of the hands of 500 mSv in accordance with SanRaR No. 0193-06 “Radiation Safety Standards (NRB-2006) and Basic Sanitarian Rules for Radiation Safety (OSPORB-2006)”.
METABOLIC DISORDERS AND THE RISK OF MULTIMORBIDITY IN PATIENTS WITH COPD
Abstract. Chronic obstructive pulmonary disease is regarded as a systemic metabolic-inflammatory disorder in which comorbid conditions substantially determine disease severity, functional limitations, and adverse prognosis [11, 13]. The aim of the study was to assess the pattern of metabolic disturbances in patients with chronic obstructive pulmonary disease and to determine their significance in the development of multimorbidity risk. The study was based on the examination results of 100 patients with COPD aged 38–82 years, of whom 81.0% had stage III–IV disease. It was established that, as COPD severity increased, hyperglycemia, insulin resistance, atherogenic dyslipidemia, C-reactive protein, and uric acid levels also increased, whereas body mass index decreased at advanced stages, leading to the formation of a catabolic phenotype. Comorbidity was identified in 76.0% of the examined patients and was associated with more severe dyspnea, higher CAT scores, lower FEV1 values, and more pronounced disturbances in the metabolic profile. The most significant predictors of multimorbidity risk were hs-CRP ≥3.0 mg/L and uric acid ≥6.0 mg/dL (OR=3.1), HOMA-IR >2.5 (OR=2.7), atherogenic coefficient ≥4.0 (OR=2.6), and fibrinogen ≥4.0 g/L (OR=2.5). A combined model including HOMA-IR, CRP, and triglycerides demonstrated high predictive accuracy (AUC=0.89; sensitivity 86.8%; specificity 83.3%).
DETERMINATION OF STABILITY CHARACTERISTICS OF PSEUDOMONAS AERUGINOSA STRAINS USED IN AN EXTERNAL QUALITY ASSESSMENT PANEL
To study the stability characteristics of Pseudomonas aeruginosa for the development of an external quality assessment (EQA) panel. Materials and Methods: The study was conducted during 2023–2025 in the reference laboratory of the Antimicrobial Resistance Center of the RSSPMCEMIPD. A total of 29 P. aeruginosa strains and one control strain — Pseudomonas aeruginosa NCTC 12934 — were included in the study. Identification was performed using conventional methods and the BD Phoenix (USA) automated system. Antimicrobial susceptibility testing and determination of minimum inhibitory concentrations (MICs) were carried out.To assess strain stability, two preservation methods were evaluated: storage at ultra-low temperature (–80 °C) and lyophilization. Under –80 °C storage conditions, testing was performed four times, and after lyophilization, three times.Results: Using the disk diffusion method, the coefficient of variation (CV) did not exceed 10% for AK30, CN10, CIP5, and LEV5. For IMI10 and MRP10, slight fluctuations in mean inhibition zone diameters were observed at 12 months; however, CV values remained within acceptable limits. For FEP30, CV reached 13–14%, but the mean values and 95% confidence intervals remained comparable across storage periods.Analysis of MIC measurements demonstrated stability of minimum inhibitory concentrations for AK30, CN10, LEV5, FEP30, and CAZ10 throughout all storage durations.Conclusion: The study of P. aeruginosa strain stability showed that not all strains retain their characteristics during storage. According to our results, 6 strains of P. aeruginosa (21%) maintained their properties and were selected for the formation of the EQA panel.
COMPLEX REHABILITATION EXPERIENCE OF CONSERVATIVE TREATMENT OF LUMBAR DISC HERNIATION
Aim - to evaluate the effectiveness of conservative treatment of intervertebral disc herniation using physiotherapeutic procedures. Materials and methods: An analysis of the results of inpatient treatment of 98 patients with spinal osteochondrosis was conducted in the Vertebrology Department of the National Center for Rehabilitation and Prosthetics of Persons with Disabilities for the period 2024-2025. There were 66 men and 32 women. Results and their discussion: Against the background of receiving conservative treatment, the intervertebral disc becomes more elastic, "resilient", increases in height, as if rejuvenated. Physiotherapy enhances the regeneration of disc tissue, which restores its normal shape and its shock absorber function. Conclusions: conservative treatment in the form of pharmacotherapy, physiotherapy and exercise therapy is the method of choice for non-invasive treatment of patients with spinal disc herniations.
MODERN TREATMENT METHODS OF BREAST CANCER
Breast cancer is one of the most pressing issues in oncology. This is evidenced by the fact that breast cancer incidence rates are not among the best in the world, indicating the scale of this problem. This article analyzes the opinions of various scientists on various historical and modern breast cancer treatment methods and types, as well as their research.
HYPOTENSIVE AND ORGANOPROTECTIVE PROPERTIES OF TELMISARTAN, A MEMBER OF THE SARTAN GROUP OF ANTIHYPERTENSIVE DRUGS
A regular increase in arterial pressure above normal levels, manifesting as arterial hypertension (AH) syndrome, occurs alongside cardiovascular diseases as well as other conditions. According to World Health Organization (WHO) analyses, AH is observed in 27% of the population over the age of 20. By 2025, this figure reached 29%. Among the population of Uzbekistan aged 40-60, AH was observed in 30.4% of cases. In this regard, there are numerous types of antihypertensive drugs used for AH, which are recommended to patients based on the mechanisms of blood pressure elevation and specific indications. This text examines the primary mechanisms of action of drugs belonging to the class of Angiotensin II receptor antagonists (ARAs), primarily telmisartan.
OPTIMIZATION OF THE EDUCATIONAL CYCLE IN AN INTERNATIONAL ACADEMIC HUB: ANALYSIS OF FOREIGN EXPERIENCE AND DEVELOPMENT OF A MODEL BASED ON MICROSOFT PROJECT
The article focuses on optimizing the management of the educational cycle in international academic hubs using project management methodology and digital tools. An original model implemented in Microsoft Project, including a Work Breakdown Structure (WBS) and a system of control points, is presented. The pilot implementation demonstrated a 15–20% reduction in schedule coordination time and an increase in classroom utilization up to 85%.
CLINICAL AND DYNAMIC ASSESSMENT OF SOCIAL ACTIVITY AND QUALITY OF LIFE INDICATORS IN ELDERLY PATIENTS WITH DEPRESSIVE CONDITIONS ASSOCIATED WITH PSYCHOORGANIC SYNDROME
In recent decades, depressive disorders have gained significant scientific and practical importance. This is associated with the high prevalence of depression and its negative impact on patients’ quality of life. Although the overall prevalence of depressive disorders ranges from 10–15%, this rate is observed to be twice as high among the elderly population. Changes in socio-economic conditions also contribute to specific psychological alterations in older individuals. These factors largely lead to the widespread occurrence of depressive disorders. In addition to the impact of psychological trauma, the comorbidity of somatic diseases in elderly patients is of great significance. Moreover, cardiovascular pathology in older adults often results in cerebrovascular complications, and cerebrovascular diseases of the brain are increasingly becoming a major cause of psychoorganic disorders. At the same time, mild cognitive impairment is observed in combination in 25–50% of elderly patients. The coexistence of depression with psychoorganic disorders of vascular origin is associated, on the one hand, with the high prevalence of these pathologies, and on the other hand, with the high probability of their comorbidity in the same patient. At the same time, despite numerous studies, the combined occurrence of depressive disorders with vascular-origin psychoorganic syndrome remains a relevant and pressing problem. The social functioning and quality of life of elderly patients suffering from depressive disorders represent one of the most significant contemporary issues. The definition of quality of life includes criteria applied both in traditional medical practice and in the field of psychiatry. The concept of quality of life is one of the key factors across medical disciplines and involves the assessment of an individual’s mental well-being. Considering the stages in the development of quality-of-life assessment, the evaluation of patients’ quality of life can be divided into two stages. Initially, in the 1970s, scales were introduced to assess psychological well-being, and they were specifically used for this purpose. In the second stage, the concepts of well-being and satisfaction were expanded to include the broader notion of life functioning.
MYOSTEATOSIS IN METASTATIC GYNECOLOGIC CANCER: CURRENT STATE OF THE PROBLEM
Myosteatosis, defined as fatty infiltration of skeletal muscle, is an important component of body composition disorders in oncology. In metastatic gynecologic cancers, this condition is frequently underestimated when relying on conventional anthropometric measures, despite its significant impact on treatment tolerance and prognosis. This review summarizes current evidence on the pathophysiological mechanisms of myosteatosis, its association with chemotherapy-related toxicity, and its influence on overall and progression-free survival. Computed tomography–derived muscle density is shown to be an independent prognostic factor of adverse oncologic outcomes, particularly in patients with preserved or increased body mass index. The integration of myosteatosis assessment into multifactorial risk stratification models may improve personalized management strategies for patients with metastatic gynecologic malignancies.
CLINICAL AND FUNCTIONAL CHARACTERISTICS OF WOMEN WITH ISCHEMIC HEART DISEASE IN THE SELECTION OF MYOCARDIAL REVASCULARIZATION METHODS
Objective. To assess the clinical and functional characteristics of women with ischemic heart disease (IHD), including the pattern of comorbidities, and to determine the choice of revascularization method—coronary artery stenting (CAS) or coronary artery bypass grafting (CABG). Materials and Methods. This retrospective study included 302 women with IHD. 198 patients underwent CAS, and 104 underwent CABG. All patients underwent: assessment of comorbidities, anthropometry with calculation of body mass index (BMI), echocardiography, multislice computed tomography coronary angiography with calculation of the coronary calcium score (CCS) according to Agatston, spirometry, and calculation of the oxygen delivery index (DO2). Statistical analysis included the chi-square test, calculation of odds ratios (OR) with a 95% confidence interval (CI), and Student’s t-test. Results. The leading comorbid conditions were hypertension (96%), post-infarction cardiosclerosis (51%), diabetes mellitus (36.7%), and obesity grades I–III (44,1%). An analysis of BMI revealed that being overweight is statistically significantly associated with a preference for CAS (OR = 2.48; 95% CI 1.28–4.81). When assessing the CCS index, a strong statistically significant association was found with the choice of revascularization method (χ² = 96.47; p<0.001). A CCS of 0 was associated with CAS (OR = 8.80; 95% CI 4.42–17.51), whereas a CCS > 400 was associated with CABG (OR = 0.025; 95% CI 0.006–0.107). Echocardiography revealed a moderate decrease in ejection fraction (EF = 54.4 ± 0.65%) and signs of left ventricular remodeling (myocardial mass index 102.75 ± 2.1 g/m²). The oxygen delivery index (DO2) averaged 803.0 ± 186.0 mL/min, indicating compensated but reduced oxygen transport capacity. Spirometry revealed a moderate decrease in FEV1 (forced expiratory volume in 1 second, 2.3 ± 0.5L) and FEV1/FVC (ratio-76.6 ± 16.6%) with preserved FVC (forced vital capacity-3.0 ± 0.6 L), indicating subclinical obstructive abnormalities. Conclusion. In women with coronary artery disease, a high prevalence of comorbid conditions is associated with obesity, moderate systolic dysfunction, myocardial remodeling, reduced oxygen-carrying capacity, and subclinical obstructive abnormalities of respiratory function (RF). The coronary calcium index is a powerful predictor for selecting a revascularization method. The data obtained support the need for a multidisciplinary approach with mandatory assessment of the CCS, RF, and DO2 when planning revascularization for this category of patients.
CURRENT ISSUES IN THE DIAGNOSIS AND TREATMENT OF THE RECTAL ULTRA-SHORT SEGMENT FORM OF HIRSCHSPRUNG’S DISEASE IN CHILDREN (LITERATURE REVIEW)
The clinical and anatomical characteristics of Hirschsprung’s disease are substantiated to be directly dependent on the child’s age, the length of the aganglionic segment, and the degree of disease compensation. The literature review demonstrates that the main objective of surgical treatment is the elimination of the pathological aganglionic segment. In recent years, increasing attention has been paid to minimally invasive endoscopic techniques and single-stage surgical procedures.
THE IMPACT OF SYNTHETIC CATHINONES ON SUICIDAL BEHAVIOR: A RETROSPECTIVE ANALYSIS OF PATIENTS WITH DEPENDENCE
Synthetic cathinones (SC), a prominent class of new psychoactive substances (NPS), have gained increasing popularity in illicit drug markets. Their widespread availability and perceived legal status contribute to rising consumption rates, despite emerging evidence of severe psychiatric consequences. Among these, suicidality remains a significant concern. However, research on the association between synthetic cathinone use and suicidal behavior remains limited. This study aimed to investigate the relationship between SC use and suicidality risk. Methods. An observational retrospective cohort study was conducted at the Republican Specialized Scientific-Practical Medical Center of Mental Health in Uzbekistan between 2022 and 2024. A total of 138 patients diagnosed with substance use disorders were included, stratified into two groups: main group (n = 98): patients with synthetic cathinone dependence (ICD-10 code F15.2); comparison group (n = 40): patients dependent on other psychostimulants. Data were collected through clinical records, structured clinical interviews, and standardized questionnaires, including the Columbia-Suicide Severity Rating Scale (C-SSRS). Odds ratios (OR), relative risks (RR), and the number needed to treat (NNT) were calculated to assess the association between SC use and suicidality. Results. The findings revealed a significant association between Alfa-PVP use and increased suicidality risk (OR = 2.76, 95% CI: 1.19–6.39, p = 0.026; RR = 2.07, 95% CI: 1.09–3.95, p = 0.026). The NNT for harm (4.97) suggests that for every five individuals using Alfa-PVP, one additional case of high suicidality occurs. Conclusions. The results underscore Alfa-PVP as a substance of concern, given its strong association with suicidality, necessitating increased clinical monitoring. Further research is required to explore underlying mechanisms and validate these findings through adjusted models and prospective studies.
MORPHOLOGICAL FEATURES OF KIDNEY DAMAGE IN CHILDREN WITH IGA NEPHROPATHY
Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide and renal biopsy remains the gold standard for diagnosis and provides valuable information about disease severity and prognosis. Objective: To evaluate renal biopsy findings in children with IgA nephropathy and analyze associations between morphological lesions and clinical parameters at the time of diagnosis. Methods: A retrospective observational study included 27 children with biopsy‑proven IgA nephropathy. Renal biopsy specimens were evaluated using light microscopy and immunohistochemistry. Histological lesions were classified according to the Haas classification and Oxford MEST‑C scoring system. Clinical and laboratory parameters were analyzed at the time of biopsy. Results: IgA nephropathy accounted for 45.8% of nephritic syndrome cases in the cohort. The most common clinical manifestations were asymptomatic microhematuria and hematuria with proteinuria. Mesangial proliferation was observed in 73% of biopsies, segmental glomerulosclerosis in 52%, and tubulointerstitial damage in 10%. Immunohistochemical analysis revealed predominant mesangial IgA deposition accompanied by complement component C3. Conclusion: Renal biopsy findings in pediatric IgA nephropathy are characterized by mesangial proliferation and immune complex deposition. Oxford MEST‑C classification provides important prognostic information and helps identify children at increased risk of disease progression.
ERYTHEMA MULTIFORME EXUDATIVE IN THE ORAL CAVITY
Objective:To increase the clinical effectiveness of treatment of erythema multiforme of the oral cavity by developing and implementing a comprehensive therapeutic and hygienic algorithm for local therapy. Materials and methods. 123 patients with MEE affecting the oral cavity aged from 20 to 60 years were under observation, 68 (55.3%) of them were women and 55 (44.7%) men. All patients were randomly assigned to the main group (74 people), which received a developed complex of local treatment, and the control group (49 people), where standard local therapy was performed. Results. The oral form of MEE is characterized by a combination of facial skin rashes and erosive and ulcerative lesions in the oral cavity. All patients had multiple painful erosions on the mucous membrane of the lips, cheeks, tongue and palate, covered with fibrinous plaque. The red border of the lips was affected in 78% of cases, often with the formation of bloody crusts and cracks. Patients complained of intense pain and burning in the mouth, inability to eat properly, hypersalivation and decreased taste sensations. In 46% of cases, concomitant skin elements (spots, papules) on the face and trunk were recorded. The general condition during the exacerbation period was characterized by weakness, subfebrility; 12% of patients had prodromal symptoms (malaise, headache) 1-2 days before the rash. Conclusion: The introduction of complex local therapy into clinical practice makes it possible to achieve a faster and more sustainable cure of multiform exudative erythema of the oral cavity. The data obtained substantiate the need to pay attention to the condition of the oral cavity in the treatment of MEE and actively correct local disorders (inflammation, microbial imbalance, dryness of the mucous membrane) along with systemic treatment. The proposed algorithm can be recommended as an addition to the standard protocols of oral MEE therapy to increase the effectiveness and shorten the rehabilitation time of patients.
PROBLEMS AND PROSPECTS IN THE MANAGEMENT OF HEMOLYTIC ANEMIAS: A NARRATIVE REVIEW
Objective: To systematize current evidence on diagnostic and therapeutic challenges in hemolytic anemias (HA) of various origins, identify key contradictions in existing approaches, and outline directions for further research. Methods: A narrative literature review was conducted covering the period 2020–2026 using PubMed, Scopus, and Google Scholar databases. Search queries included: "hemolytic anemia diagnosis," "autoimmune hemolytic anemia treatment," "hereditary spherocytosis," "paroxysmal nocturnal hemoglobinuria," "warm autoimmune hemolytic anemia." Twenty-one sources meeting inclusion criteria were selected: original studies, systematic reviews, and clinical guidelines. Results: The diagnosis of HA remains a multi-layered challenge: the direct antiglobulin test (DAT) yields false-negative results in 2–11% of autoimmune HA (AIHA) cases, and differential diagnosis between hereditary and acquired forms frequently takes months. Glucocorticosteroid (GCS) therapy for AIHA is effective in 70–85% of patients in the short term, yet relapse occurs in 30–40%. Rituximab and newer targeted agents — complement inhibitors and anti-CD38 — are reshaping the therapeutic landscape, but the evidence base for several HA subtypes remains limited. Molecular genetic methods in hereditary HA are being adopted unevenly. Conclusions: Hemolytic anemias are a heterogeneous group of conditions for which a unified diagnostic algorithm is not applicable. Prospective multicenter studies, standardization of laboratory protocols, and the development of personalized therapeutic strategies are required.
GENETIC BASIS OF STEROID-RESISTANT NEPHROTIC SYNDROME IN CHILDREN AND CLINICAL CORRELATES
Introduction. Steroid-resistant nephrotic syndrome (SRNS) carries a high risk of progression to end-stage renal disease. Next-generation sequencing (NGS) has shown that a significant proportion of pediatric cases have a monogenic cause, with direct implications for therapy and prognosis. Aim. To characterize the mutational spectrum of pediatric SRNS and congenital nephrotic syndrome (CNS) in a National children’s medical center cohort and examine genotype–phenotype associations. Methods. 54 pediatric patients with confirmed SRNS or CNS underwent targeted NGS panel testing. Associations were assessed using Mann-Whitney U, chi-square, and Fisher’s exact tests. Results. A total of 54 pediatric patients with genetically confirmed SRNS or CNS were included to the study. 34 distinct genetic entities were identified. COL4A-family mutations (COL4A3/4/5) were the most prevalent category (27.8%), with COL4A5 being the single most common gene (14.8%) and showing significant male predominance (M:F = 7:1; OR = 4.32, p = 0.038). CNS patients were significantly younger than SRNS patients (p = 0.022). COQ2 mutations accounted for 5.6%, all presenting as CNS. Digenic mutations were found in 20.4% of patients. Conclusion. COL4A mutations dominate pediatric SRNS genetics, contrasting with NPHS2 predominance in Western cohorts. Comprehensive genetic panel testing should be standard of care in all pediatric SRNS patients.
THE ROLE OF ETIOLOGICAL FACTOR IN THE SELECTION OF TACTICS FOR TREATING CHRONIC RHINOSINUSITIS IN CHILDREN
Pediatric chronic rhinosinusitis is highly prevalent and prone to relapse. In a cohort of 86 children, a pathogenetically informed, etiology-driven treatment strategy showed strong clinical effectiveness, yielding excellent and good outcomes in 96.5% of cases and shortening recovery times.
OUR EXPERIENCE IN THE TREATMENT OF ALLERGIC RHINITIS
Based on the results of a clinical and instrumental examination and an analysis of case histories, the authors evaluate the problems of allergic rhinitis. A study was conducted on 44 patients aged 18 to 60 years diagnosed with allergic rhinitis. The study included allergy histories, objective data, an endoscopic examination of the nasal cavity, and cytological and bacteriological examination of nasal and nasopharyngeal swabs. Patients received comprehensive treatment for allergic rhinitis, including elimination, hyposensitizing, immune, antifungal, and topical therapy, as well as nasal septum resection with vasectomy of the inferior turbinates. As a result, pronounced positive effects were observed in 74.3% of patients, a minor effect was observed in 21.6%, and 4.1% of patients experienced no positive effect from the treatment. The presented system of complex therapy allows for improved treatment results and enhances the quality of life of patients with allergic rhinitis.
MODERN STRATEGIES AND INNOVATIVE APPROACHES IN COMPREHENSIVE REHABILITATION OF PATIENTS WITH MANDIBULAR FRACTURES
Mandibular fractures occupy one of the leading positions in the structure of maxillofacial trauma, which is associated with the anatomical and functional characteristics of this bone as well as contemporary social conditions. Rehabilitation of patients after such injuries is a multistage process that includes not only surgical reconstruction but also functional, physiotherapeutic, and psychosocial support. The article analyzes the main etiological factors of trauma, biomechanical features of the mandible, and modern osteosynthesis approaches that determine the effectiveness of the recovery period. The possibilities of conservative and surgical treatment, the application of endoscopic and digital technologies, as well as the use of bioresorbable osteosynthesis systems are discussed. It is shown that a comprehensive and personalized approach is a key condition for full functional recovery and improvement of patients’ quality of life.
ASSISTED REPRODUCTIVE TECHNOLOGIES IN THE TREATMENT OF INFERTILITY IN WOMEN WITH PCOS
The article discusses modern approaches to the diagnosis and treatment of infertility associated with PCOS in the context of ART methods. The authors analyze the effectiveness of intrauterine insemination (IUI) and in vitro fertilization (IVF), emphasizing the importance of individualized stimulation protocols. Particular attention is paid to safety issues, in particular the prevention of ovarian hyperstimulation syndrome (OHSS), and the role of metformin in preparing for ART cycles. The work is based on current recommendations from international communities (ESHRE, ASRM, NICE).
ASSESSMENT OF IRON LEVELS DEPENDING ON THE TYPE OF ANEMIA IN CHRONIC KIDNEY DISEASE IN CHILDREN
According to 2024 data, chronic kidney disease in children ranges from 15 to 74.7 cases per million children. Objective: To study the characteristics of iron indices depending on the variant of anemic syndrome course (absolute or functional) at different degrees of CKD in children. Material and methods of the study. The object of the study were 95 children from 4 to 15 years old with anemic syndrome in CKD, who were divided into 4 groups: Group Ⅰ consisted of children with anemic syndrome in CKD stage Ⅱ (n=25); Group Ⅱ included children with anemic syndrome in CKD stage Ⅲ (n=51); Group Ⅲ included children with anemic syndrome in CKD stage Ⅳ (n=19), Group Ⅳ consisted of 30 children with iron deficiency anemia without signs of renal pathology. Results and discussion. Functional anemia is more closely associated with clinical and laboratory changes characteristic of KD than absolute anemia. Its dependence on declining renal excretory function becomes apparent as the stage of CKD progresses, leading to worsening of the disease and aggravation of the body's condition. Conclusions: Anemia has been proven to be one of the leading complications of chronic kidney disease in children, occurring in 100% of patients examined.
THE SIGNIFICANCE OF THE C47T (RS4880) POLYMORPHISM IN THE SOD2 GENE IN THE DEVELOPMENT AND PERIOD OF COMPLICATIONS OF DIABETES
The antioxidant defense system is a complex, multi-component network of physiologically active substances, comprising enzymatic and non-enzymatic compounds that work sequentially, complementing each other, thereby controlling oxidative reactions and inactivating a wide range of toxic products. It is through the coordinated interaction of antioxidant enzymes that oxidative processes are maintained at the level necessary for the normal functioning of numerous physiological processes at the cellular level. When the processes of ROS formation and neutralization spiral out of control, the balance between the intensity of prooxidant and antioxidant reactions is disrupted, leading to the accumulation of free radical oxidation products and the development of oxidative stress (OS). This damages various cellular structures and disrupts biochemical processes, ultimately leading to the development of persistent pathological conditions and diseases affecting virtually all human systems and organs.
THE INFLUENCE OF CONCOMITANT DISEASES AND INDIVIDUAL FACTORS ON THE DEGREE OF ALOPECIA IN PATIENTS AFTER BARIATRIC INTERVENTIONS
Objective: This article examines the influence of comorbidities and individual factors on the development and severity of alopecia in patients after bariatric surgery. Materials and Methods: The study analyzed clinical, demographic, and anamnestic data from 321 patients, divided into groups based on the severity and location of hair loss using the Sinclair classification. Results: The results showed that the presence of type 2 diabetes mellitus and hypertension was not significantly associated with the level and severity of alopecia (p=0.490), indicating a weak relationship between these conditions and hair loss progression. It was also found that the location of the lesion is more often determined by individual characteristics of skin structures and blood supply, rather than the presence of concomitant metabolic pathologies. Conclusion: This study highlights the need for a comprehensive and personalized approach to the diagnosis and treatment of alopecia in postbariatric patients, taking into account their genetic, metabolic, and environmental factors.
DENTAL HEALTH ASSESSMENT INDICATORS FOR MECHANICAL ENGINEERING WORKERS
The highincidence of modernindustrialworkersin mechanical engineering,includingsomaticdiseases,alongwithoccupationalandoccupationaldiseases, is characterized by a significantdecreaseorloss of working capacitydue to inconveniencesintemporaryandpermanentworkprocesses,aswell as highmortality,especiallyamongmen of workingage.Providingdentalcare to industrialworkersisoneof the most importantprinciples of organizingmedical and preventivecare for the population, which has a significantimpacton the health of the workforce.Atthe same time, the lack of a unifiedscheme for providingdentalcare to workersinindustrialenterprisesleadsto a sharpdecrease in the effectivenessandquality of primaryandperiodicdentalexaminations, which are the mainlink in the system of prevention of dentaldiseasesamongworkersexposed to harmfulanddangerousoccupationalfactors.
CURRENT DIRECTIONS IN RESPIRATORY THERAPY IN PRETERM INFANTS: PATHOGENESIS MECHANISMS, COMPLICATION PREVENTION MEASURES, AND EVALUATION OF THERAPEUTIC EFFECTIVENESS (LITERATURE REVIEW)
Objective: To assess the health of premature infants after mechanical ventilation and develop strategies to prevent post-ventilation complications using caffeine citrate. Materials and Methods. The study is being conducted at the Samarkand Regional Children's Multidisciplinary Medical Center, in the neonatal intensive care unit. The study will include 90 premature infants (gestational age less than 37 weeks) who received mechanical ventilation in the early neonatal period. Premature infants often require respiratory support. However, prolonged use of mechanical ventilation is associated with the risk of complications, including bronchopulmonary dysplasia, retinopathy of prematurity, infections, and neurodevelopmental disorders. Studying the relationship between mechanical ventilation duration and health status will help optimize management strategies and reduce adverse outcomes. Premature infants constitute the most vulnerable category of neonatal patients, requiring comprehensive respiratory support in the early postnatal period. Mechanical ventilation (MV) can save lives, but prolonged exposure to positive airway pressure carries the risk of bronchopulmonary dysplasia, retinopathy, infectious complications, and neurovegetative dysfunction. According to current research [38], more than 30% of infants undergoing mechanical ventilation develop signs of chronic respiratory failure and metabolic disorders in the first months of life. One promising approach to preventing these complications is the use of caffeine citrate, which has proven effective in reducing the incidence of apnea, improving ventilation-perfusion ratios, and shortening the duration of mechanical ventilation. Studying the health of premature infants after mechanical ventilation and evaluating the effectiveness of preventive therapy are relevant scientific and practical challenges in modern neonatology.
SURGICAL TREATMENT OF CHRONIC COLOSTASIS: RISK FACTORS FOR UNFAVORABLE OUTCOMES AND STRATEGIES TO IMPROVE POSTOPERATIVE QUALITY OF LIFE
Chronic colostasis (chronic cologenic constipation) remains one of the most challenging problems in modern coloproctology and abdominal surgery due to its prolonged course, frequent resistance to conservative treatment, and marked variability of functional disorders of the colon. Contemporary surgical management of chronic colostasis requires careful patient selection and a comprehensive preoperative assessment of colonic motor-evacuatory function, as inappropriate selection and incomplete diagnostics are major predictors of unfavorable outcomes. This study summarizes current (2023–2025) evidence on risk factors associated with unsatisfactory surgical results, addresses the prevention of early and late postoperative complications, and proposes a practice-oriented strategy aimed at improving postoperative quality of life based on clinical-functional assessment and principles of evidence-based medicine.
MODERN DYNAMICS OF SPREAD AND CLINICAL MANIFESTATIONS OF BACTERIAL INFECTIONS OF THE GASTROINTESTINAL TRACT
Acute intestinal infections (AI) have always been and remain to this day a complex health problem. The aim of the study was to determine the structure and clinical characteristics of bacterial intestinal infections in young children. A survey and observation of 260 children aged from 3 months to 3 years was carried out. General clinical, immunological, bacteriological, serological and static research methods were used. Clinical and laboratory studies conducted in children with bacterial intestinal infections revealed the presence of multidrug-resistant strains of salmonellosis (Salmonella typhimurium var. Сopengagen) in 63% of cases and 36% of Clostridi difficile cases. The incidence of dysentery and escherichiosis among children over one year of age is 2-3 times higher than among children under one year of age. In case of Salmonella and Shigella infections, the intestinal microbiocenosis was characterized by an association of microorganisms. The clinical course of bacterial intestinal infections in young children in modern conditions is determined by the dependence of the etiology of the pathogen, combined damage to parts of the gastrointestinal tract and the tendency to develop relapses of the disease.
OPTIMIZATION OF ORTHOPEDIC DENTAL TREATMENT METHODS IN PATIENTS WITH ARTERIAL HYPERTENSION
Arterial hypertension is one of the most common chronic cardiovascular diseases and represents a significant challenge in modern dental practice. Persistent elevated blood pressure adversely affects oral tissues, inflammatory processes, and the outcomes of orthopedic dental treatment. This article analyzes the specific features of orthopedic treatment in patients with arterial hypertension, identifies key risk factors for complications, and substantiates approaches for optimizing dental orthopedic care. The findings demonstrate that an individualized and comprehensive treatment strategy improves clinical outcomes and enhances the safety of dental interventions in this patient population.
CLINICAL AND FUNCTIONAL CHARACTERISTICS OF VISUAL FUNCTIONS IN CHILDREN WITH PARTIAL ATROPHY OF THE VISUAL NERVE
In this article, the authors studied the features of the visual consequences of partial optic nerve atrophy of various origins in children. Research material and methods. The following research methods were used: ophthalmological (visometry, perimetry, biomicroscopy, ophthalmoscopy with photographic registration), clinical-laboratory and instrumental examination methods: MRI or MSCT of the brain and visual evoked potentials (VEP), and consultations with narrow specialists were organized: neurologist, anesthesiologist, and pediatrician.
THE ROLE OF TRIBULUS TERRESTRIAL PREPARATIONS IN THE TREATMENT OF SEXUAL DISORDERS IN MEN
This non-systematic literature review comprehensively summarizes the phytotherapeutic potential of Tribulus terrestris in the treatment of male sexual dysoreders, including erectile dysfunction (ED), decreased libido, and others. The review combines data from pharmacological, experimental, and clinical studies to elucidate the mechanisms of action, bioactive composition, and therapeutic value of Tribulus terrestris in the treatment of ED and male sexual disorders.
DIAGNOSIS OF BACTERIAL COMPLICATIONS IN COVID-19-ASSOCIATED PNEUMONIA
Bacterial complications of COVID-19 are very common and directly impact the severity and outcome of the disease. This study identified a spectrum of clinically significant bacterial pathogens in samples collected from patients with COVID-19 associated pneumonia, as well as obtained data on the sensitivity of antibiotics to isolated pathogens. The results of antibiotic susceptibility testing of isolates isolated from patients allowed us to develop evidence-based recommendations for the selection of empirical antibacterial therapy for patients with COVID-19 associated pneumonia. Secondary bacterial infection with the SARS-CoV-2 virus is rare, so in outpatient practice, antibacterial agents should not be prescribed unjustifiably, and overdiagnosis and polypharmacy should be avoided. However, patients hospitalized in hospitals need to be given special attention to prevent the development of nosocomial infections, including COVID-19.
IMPROVEMENT OF ADHESIVE TECHNOLOGIES APPLICATION FOR THE PREVENTION OF COMPLICATIONS AFTER TOOTH BLEACHING
This study focuses on improving adhesive technologies for the prevention of post-bleaching complications. Hydrogen peroxide and high-concentration carbamide peroxide used in tooth bleaching may adversely affect enamel and dentin microstructure and reduce adhesive bond strength. Increased hydrodynamic fluid movement within dentinal tubules after bleaching often results in tooth hypersensitivity. The study evaluated the effects of peroxide-based agents on enamel microhardness, adhesive bond strength, and clinical sensitivity. A comparative assessment of antioxidant treatment and bioactive universal adhesive application after bleaching was conducted. The results demonstrated that a comprehensive approach reduces hypersensitivity, enhances bond strength, and promotes remineralization of enamel. Optimization of adhesive protocols after bleaching significantly improves clinical outcomes and patient quality of life.
UNRESOLVED ISSUES OF MEDICATION RELATED OSTEONECROSIS OF THE JAW IN BISPHOSPHONATE TREATMENT OF BONE METASTASES FROM PROSTATE CANCER
The article focuses on unresolved issues of medication‑related osteonecrosis of the jaw (MRONJ) in patients with bone metastases from prostate cancer receiving bisphosphonate therapy. Current concepts of the role of antiresorptive treatment in the management of skeletal metastases are summarized, and key stages in the pathogenesis of MRONJ under prolonged bisphosphonate exposure combined with androgen deprivation and systemic anticancer therapy are discussed. Particular attention is paid to risk factors specific to the prostate cancer population, including advanced age, multimorbidity, duration and intensity of antiresorptive therapy, poor oral health, and traumatic dental procedures. Diagnostic challenges are analyzed, such as early detection and differential diagnosis of jaw lesions in oncologic patients. Existing conservative and surgical treatment strategies for MRONJ are reviewed, with emphasis on controversial issues regarding the extent of surgery and the management of antiresorptive therapy once osteonecrosis has developed. The concluding section outlines the major unresolved problems and highlights future research directions, including the need for individualized risk prediction models and prevention algorithms tailored to patients with metastatic prostate cancer.
THE RELATIONSHIP BETWEEN VITAMIN D LEVELS AND ANXIETY-DEPRESSIVE DISORDERS AND THE SEVERITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Objective: to study the relationship between serum vitamin D levels, the presence of anxiety and depressive disorders, and the severity of the clinical course of chronic obstructive pulmonary disease.Materials and methods. The study included 100 patients with COPD aged 38-82 years who underwent examination and treatment at the Republican Specialized Scientific and Practical Medical Center of Phthisiology and Pulmonology named after Academician Sh.A. Alimov. Psychoemotional status was assessed using the HADS and CES-D scales, dyspnea severity using the mMRC scale, symptom burden using the CAT questionnaire, and pulmonary function by forced spirometry with determination of FEV1. Serum 25(OH)D concentration was measured.Results. Anxiety and depressive disorders (HADS >=11 and/or CES-D >=17) were identified in 78.0% of patients. Severe COPD was more common in patients with anxiety and depressive disorders: the proportion of GOLD III-IV was 91.0% versus 45.5% in the group without these disorders. Patients with anxiety and depressive disorders had lower FEV1 values (35.1+-1.5% vs 55.9+-5.6% of predicted; p<0.001), higher CAT scores (25.9+-0.6 vs 15.1+-1.6 points; p<0.001), and more pronounced dyspnea according to mMRC (3.3+-0.08 vs 1.73+-0.26 points; p<0.001). The serum 25(OH)D concentration in the COPD+anxiety/depression group was significantly lower than in patients without anxiety and depressive disorders (30.58+-1.9 vs 46.9+-2.8 ng/mL; p<0.001), and logistic regression analysis showed that 25(OH)D levels <30 ng/mL were associated with an increased risk of a more severe clinical course (OR=3.8).Conclusion. The obtained data confirm the relationship between anxiety and depressive disorders, more severe COPD, reduced FEV1, and low vitamin D levels. Assessment of serum 25(OH)D and psychoemotional status may be considered an important component of the comprehensive evaluation of patients with COPD.
CLINICAL MANIFESTATIONS OF DERMATOLOGICAL DISEASES IN CHILDREN WITH HIV INFECTION
The purpose of the study was to study the features of the clinical course of HIV-associated dermatoses in children. Observation was conducted on 50 children with confirmed HIV infection. The study analyzed the structure of skin diseases, their clinical manifestations, frequency of occurrence, and correlation with immunodeficiency levels. The obtained data allow for a more accurate approach to the diagnosis and treatment of dermatoses in this category of patients.
EFFICACY OF THE MONTESSORI METHOD IN COMPLEX REHABILITATION OF SCHOOL-AGE CHILDREN WITH CEREBRAL PALSY
Relevance. Cerebral palsy (CP) is one of the leading causes of childhood disability requiring long-term multidisciplinary rehabilitation. The limitations of conventional approaches necessitate the implementation of integrative methods based on the principles of neuroplasticity. Aim. To evaluate the effectiveness of the Montessori method in the complex rehabilitation of school-age children with cerebral palsy. Materials and methods. A prospective clinical-analytical study included 100 children with cerebral palsy aged 7–17 years. The GMFCS scale, the Modified Ashworth Scale, and QUEST were used. The observation period was 6 months. Results. A statistically significant improvement in motor function, a reduction in spasticity, and an increase in upper limb functionality were found (p<0.05). Conclusions. The Montessori method demonstrates clinical effectiveness as a component of comprehensive rehabilitation in children with cerebral palsy.
PRECISION OPTIMIZATION OF RADIOTHERAPY PLANNING FOR HEAD AND NECK TUMORS BASED ON THE INTEGRATION OF MULTIPARAMETRIC IMAGING DATA
The aim of the study was to evaluate the clinical effectiveness and safety of multimodal radiotherapy planning for head and neck tumors through the integration of CT, MRI, and PET/CT imaging data. A prospective-retrospective comparative analysis included 22 patients treated with radical IMRT/VMAT (66–70 Gy). Two imaging protocols were compared: CT + MRI (n=15) and CT + MRI + PET/CT (n=7). The integration of PET/CT reduced the systematic error (Σ) from 3.2 to 1.8 mm and the random error (σ) from 2.1 to 1.2 mm, resulting in a 43% reduction of the calculated CTV–PTV margin (from 9.3 to 5.4 mm). The high-dose volume (70 Gy) decreased by 28% (p<0.05), with significant dose reduction to the brainstem and spinal cord. No increase in severe radiation toxicity was observed. A significant correlation was found between the PTV 66–70 Gy volume and dysphagia (r=0.42; p<0.05), and a threshold relationship was identified between xerostomia and parotid mean dose >26 Gy. Multimodal imaging-based planning with mathematically justified margin individualization enhances precision in radiotherapy and reduces toxicity without compromising oncological control.
THE IMPORTANCE OF FATTY TISSUE OF THE EPICARDIUM IN THE PATHOGENESIS OF CARDIOVASCULAR DISEASES (LITERATURE REVIEW)
Cardiovascular diseases are the main cause of death and disability worldwide. In recent years, interest in the role of the visceral fat layer of the heart - the epicardium fat tissue - in the development of cardiovascular diseases has been increasing [1]. The fatty tissue of the epicardium is anatomically directly related to the myocardium and coronary arteries, which produce various biologically active substances, including inflammatory cytokines, adipokines, and mediators of oxidative stress. This article analyzes modern scientific data on the morphological and functional characteristics of epicardial fat tissue, its participation in metabolic and inflammatory processes, as well as its clinical significance associated with cardiovascular diseases and diagnostic methods.
A SYSTEM FOR TRAINING SPECIALISTS IN BIOLOGICAL SAFETY AND BIOLOGICAL PROTECTION IN MEDICAL ORGANIZATIONS
This paper presents a systematic approach to training healthcare professionals in biological safety and biological protection as one of the key areas for ensuring the biological safety of the population and the environment. The need for improving the educational process is substantiated, and priority and promising areas for increasing the effectiveness of training specialists whose activities involve handling pathogenic biological agents of pathogenicity groups III–IV are identified.
THE GROWING CHALLENGE OF SYNTHETIC CATHINONES AND PRESCRIPTION DRUG MISUSE IN UZBEKISTAN
The increasing prevalence of synthetic narcotic substances and psychoactive pharmaceutical drug use has become a significant public health concern. This study analyzes trends in substance use in Uzbekistan from 2022 to 2024, focusing on demographic patterns, shifts in drug preferences, and the rising misuse of prescription medications. Methods. A retrospective observational cohort study was conducted using official national registries and medical statistical reports. The study included all registered users of synthetic cathinones, anticonvulsants, and other psychoactive substances during the three-year period. Descriptive and inferential statistical methods were applied, including trend analysis, chi-square tests, correlation analysis, and logistic regression modeling, to assess patterns of substance use by age, gender, and drug type. Results. The total number of registered users nearly doubled between 2022 (409 cases) and 2024 (933 cases), highlighting a sharp rise in synthetic drug use. Males accounted for approximately 89–90% of all cases, while the number of female users increased from 41 in 2022 to 102 in 2024. The 18–34 age group represented the highest-risk demographic, with nearly 70% of all cases. Among synthetic cathinones, α-PVP replaced mephedrone as the most commonly used stimulant, with cases rising from 36 in 2022 to 319 in 2024. Pregabalin misuse also increased, becoming the most frequently abused anticonvulsant (274 cases in 2024). While tropicamide use remained relatively stable (25–30 cases annually), its share in the overall structure declined. Conclusions. The findings indicate a rapid transformation in substance use patterns in Uzbekistan, with synthetic cathinones and prescription drugs gaining popularity. The dominance of α-PVP and the increased misuse of pregabalin underscore the need for stricter pharmaceutical regulation, targeted prevention strategies, and expanded access to treatment programs. Addressing these trends requires a comprehensive public health response.
A POPULATION-BASED APPROACH TO CERVICAL CANCER: THE CONTEMPORARY IMPORTANCE OF CANCER REGISTRIES, SCREENING, AND SURVIVAL ANALYSIS
This narrative review highlights the contemporary importance of a population-based approach to cervical cancer (CC). We summarize global and regional epidemiologic patterns of CC, the etiologic role of high-risk human papillomavirus (HPV), major risk factors, and the prevention framework built on HPV vaccination, organized screening, and early diagnosis. Cancer registries are discussed as the core information infrastructure for cancer control, including their definition, main types, and their value for surveillance, planning, and evaluation. The role of international standards and registry networks (IARC/IACR, ENCR, SEER, NPCR) and global initiatives such as Cancer Incidence in Five Continents (CI5) is outlined with regard to data comparability, quality assurance, and cross-country benchmarking. We also address the organization of oncology services in Uzbekistan and the limitations of aggregated official reporting for robust outcome assessment. Strengthening the population-based cancer registry, implementing systematic data quality control, ensuring continuous follow-up, and integrating registry data with mortality and screening databases are emphasized as prerequisites for valid population survival estimates. Key survival metrics (overall, relative, and net survival), common analytical approaches, and interpretation issues are briefly reviewed. Evidence from EUROCARE and CONCORD demonstrates that international differences in CC survival largely reflect screening coverage and the completeness and quality of registry data.
STUDY OF THE ANALGESIC ACTIVITY OF N-BENZYL CYTHIZINE DERIVATIVES AND 1-PHENYLISOQUINOLINE DERIVATIVES
In modern medicine, painkillers are widely used to treat diseases and complications of some diseases. One of the main tasks facing researchers is to study the spectrum of action of alkaloids extracted from plants that contain substances with analgesic properties.
SURGICAL METHODS FOR THE CORRECTION OF RENAL FUNCTION DISORDERS IN CHILDREN
Among the common pathologies requiring surgery, special attention is paid to vesicoureteral reflux (PMR). The article discusses modern surgical methods for treating this pathology, including endoscopic and traditional surgical techniques, such as injection of periurethral fillers and ureteral reimplantation. Assessment of the effectiveness of these methods, as well as their impact on the restoration of kidney function, allows you to choose the optimal treatment depending on the degree of disease and the patient's condition. The article discusses the results of the postoperative period, the benefits of minimally invasive technologies and the prospects for further development of surgical treatment.
DIAGNOSTIC VALUE OF PHENOTYPIC SIGNS AND THE BEIGHTON AND VAS SCALES IN IDENTIFYING UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA IN DORSOPATHY
In recent years, dorsopathies have gained increasing significance due to their rising prevalence among young patients. In individuals under 40 years of age, chronic pain in the lumbar and cervical regions, as well as the early development of vertebrogenic neurological syndromes, are considered in the context of undifferentiated connective tissue dysplasia as an important pathogenetic factor. Undifferentiated connective tissue dysplasia is associated with congenital disorders of collagen and elastin metabolism and manifests with multiple clinical and phenotypic features involving the musculoskeletal, cardiovascular, and nervous systems. Therefore, early identification of undifferentiated connective tissue dysplasia in patients with dorsopathies is essential for optimizing diagnostic and therapeutic strategies.
ANALYSIS OF URODYNAMIC PARAMETERS IN THE ASSESSMENT OF OVERACTIVE BLADDER IN PATIENTS WITH PROSTATE CANCER
Androgen deprivation therapy is a widely used treatment for metastatic prostate cancer. Androgen deprivation therapy can be administered medically or surgically and aims to suppress androgen production or block its receptors. Although androgen deprivation therapy can provide rapid symptomatic relief in patients with metastatic prostate cancer, it is not a cure, but rather a palliative measure.
EFFICACY OF (GANOZHI PLUS) APPLICATION IN ADOLESCENTS FOLLOWING ORTHODONTIC BRACKET SYSTEM TREATMENT
The present study was conducted to investigate the effect of local application of the preparation "GANOZHI PLUS" on tooth enamel and dentin in children following the use of an orthodontic bracket system. A comparative clinical assessment of TER-test indices was performed in a cohort of 15 adolescent subjects. Accordingly, the patients were stratified into two groups: those with caries-resistant enamel and those with caries-susceptible enamel. The level of oral hygiene was evaluated in children aged 10 to 14 years, with no identified concomitant pathologies and who had undergone complete dental sanitation. The results demonstrated that 7 out of 15 adolescents exhibited a pale blue coloration upon the express test, which is indicative of high resistance of the teeth to secondary caries development