Aim. To study the epidemiology of chronic kidney disease according to official statistic reports in the Republic of Tajikistan. Material and methods. Retrospective analysis of the yearly reports of Statistics Center under the President of the Republic of Tajikistan of a 2011-2017 period on different kidney and urinary ways diseases of the adult population of 18-90 years old was conducted. Study of the morbidity of chronic kidney disease was conducted separately for all regions of the country (Sogd, Khatlon, Gorno-Badakhshan) including regions of republican subordination and Dushanbe as well as for the population of the Republic in general. Results. On a scale of the Republic, Chronic Kidney Disease of different stages was found in 918 people (477 man and 441 women), which made 18,7 cases for 100000 of the adult population (general number of population for 2011 was 4906700) in 2011. Dynamics of the change of morbidity in both genders for the studied period showed that in 2011, 441 women had chronic kidney disease, while in 2017 the number increased to 605 cases (р=0,0086). In the Sogd region as well as in the Republic in general, the significant increase of chronic kidney disease was found in the period of 2011-2017 in man. That shows a higher rate of risk factors for chronic kidney disease for this sector. Conclusion. The spread of the chronic kidney disease for 100000 population made 18,7-21,9. In some regions of the Republic, year by year, a significant increase of different stages of chronic kidney disease is observed, especially in elderly (75 and older) and male population. A high rate of chronic kidney disease in Tajikistan shows the necessity of revision of some strategic tasks of the nephrology service and the renal replacement therapy service.

Aim. To evaluate the clinical efficiency of hemorrhoidectomy technique. Material and methods. From 2017 to 2019 Institution «Istiqlol» Health Complex hospitalized and treated 59 patients with chronic internal hemorrhoids of II - III grade. The patients were divided into two groups: the first, main group included 31 patients, operated by the improved method. The second, control group included 28 patients who underwent traditional Milligan - Morgan hemorrhoidectomy in the 2nd modification of the Scientific and Research Institute of Coloproctology. The immediate and long-term results were studied after the surgery. Results. The main group of patients had no complications. 6 (21.4%) patients of the control group had a complication like bleeding (2 patients), reflex urinary retention (2 patients), chronic constipation (1 patient), and repeated recurrences of hemorrhoids (1 patient) in the postoperative period. Conclusion. Thus, hemorrhoidectomy using «Ligasure» apparatus is an effective, safe, pathogenetically sound method for the treatment of the chronic hemorrhoids. This technique allows reducing the intensity and duration of the postoperative pain, and also reduces the duration of surgical intervention. Due to the high efficiency of this technique, we recommend its use in other institutions.

Aim. To study the clinical picture, etiology, diagnosis, morphological structure and optimization of the treatment of patients with TSACVPA. Materials and methods. Prospective analysis of the etiology, morphological structure and clinical data of 70 patients with TSACVPA and assessment of the effectiveness of treatment of 67 patients with TSACVPA was conducted in Republican Oncology Scientific Center. Results. Etiology of malignant TSACVPA of 63 patients was: a) 53 (84%) patients - exposure to solar radiation; b) 7 (11%) patients - light skin color (high photosensitive to solar radiation); c) 3 (5%) patients - thermal and photo burns. Pathological examination of 70 (100%) patients with TSACVPA showed malignant tumors in 63 (90%) patients, benign tumors in 7 (10%) patients. Evaluation of the effectiveness of therapy was carried out in 67 patients with TSACVPA and showed that 58 (86.5%) excellent results; 3 (4.5%) good results; 3 (4.5%) satisfactory; 3 (4.5) unsatisfactory results of treatment. The life quality according to Karnovsky scale increased from a minimum of 60% up to 100%. Conclusion. The use of adequate methods of treatment of TSACVPA allowed achieving satisfactory and excellent results and improved life quality in 96% of patients.

Aim. To characterize features of the broncho-pulmonary system pathology in children with HIV. Material and methods. The main group consisted of 28 HIV infected children and the comparison group consisted of 12 children of the same age. Boys made 18 (64.28%) and girls 10 (35.71%) of all observed children in the main group. All children underwent a serological test to identify antibodies to the human immunodeficiency virus, by ELISA method. Results. More than half of the surveyed HIV - infected children 15 (53.5%) were born prematurely with signs of intrauterine growth restriction and CNS pathology. The most evident symptom for every 4 children was a weak increase or a complete absence of the dynamics of change in body weight; every third child (9 - 32.14%) suffered from Pneumocystis pneumonia. Conclusion. HIV-infected children are suffering from broncho-pulmonary pathology; lagging behind in physical and psychomotor development; subjected to frequent relapses of infections; cases of lymphadenopathy, hepatomegaly and splenomegaly are observed.

Aim. To study the influence of the pyloric function recovery on the results of organ-preserving operation and life quality of patients with cicatrix-ulcer duodenal stenosis. Material and methods. The results of the surgery of 150 patients with duodenum ulcer complicated by stenosis were studied. Patients were divided into two groups: first - 90 patients that underwent selective proximal vagotomy in combination with duodenoplasty; second - 60 patients after selective proximal vagotomy with gastric drainage operations. The stage of recovery ofpyloric “mechanism” was presented by the speed and type of stomach evacuation, duodenogastric reflux, rate and extent of the dumping syndrome. Results. Duodenoplasy and gastric drainage operations are not the same from the position of pyloric “mechanism” function. The addition of the drainage operation to selective proximal vagotomy creates a condition for quick evacuation of stomach content. That brings to a complex of disorders that are specific to dumping syndrome and reflux-gastritis. Conclusion. Selective proximal vagotomy with duodenoplasy is the most rational treatment approach of ulcer disease complicated by duodenum stenosis, due to the preservation of pyloric function. It recovers normal morphologic and functional relations in the gastroduodenal complex which improves the life quality of patients up to population norm.

Aim. To analyze the effectiveness of bioresonance therapy in the treatment of patients with diabetes mellitus (DM) type 2 on the basis of clinical and biochemical signs and functional research methods. Material and methods. The study included the results of treatment of 413 patients with type 2 diabetes, which were divided into 3 comparable groups: 198 patients in the main group, 72 patients in the control group and 143 patients in the placebo group. In addition to pharmacotherapy, the main group received bioresonance therapy (BRT); the control group received only pharmacotherapy; the placebo group received pharmacotherapy and simulated BRT procedures. Such indicators like glycated hemoglobin (HbA1c), blood sugar before taking food, blood sugar 2 hours after eating, glucose in the urine, lipidogram, and body mass index (BMI), were evaluated on admission and 3 months after treatment for all patients. Results. After conducting bioresonance therapy, along with the pharmacotherapy of patients with type 2 diabetes in the main group, all the studied parameters: glycated hemoglobin (HbA1c; from 7.89 ± 0.06% to 5.89 ± 0.02%), fasting blood sugar (from 10.26 ± 0.09 mmol / l to 5.7 ± 0.02 mmol / l), blood sugar 2 hours after meals (from 13.28 ± 0.12 mmol /1 to 6.84 ± 0.04 mmol /1), glucose in urine (from 47.51 ± 0.97 mmol /1 to 0.50 ± 0.02 mmol /1), lipidogram and body mass index (from 30.09 ± 0.26 mmol /1 to 26.51 ± 0.18 mmol /1) was statistically significantly reduced compared with the control group and the placebo group. Conclusion. The research data and the dynamics of the treatment of the studied patients with type 2 diabetes indicate the effectiveness of using bioresonance therapy as one of the modern innovative methods in the complex treatment of patients with type 2 diabetes. BRT contributes to the activation offunctional reserves of the body, which leads to long-term compensation of diabetes.

Aim. To improve the quality of diagnosis of combined abdominal injuries and to develop the most informative algorithm for the comprehensive instrumental study of patients. Material and methods. The work is based on a retrospective analysis of survey data of 167 patient with combined abdominal injuries for the period 2012-2018. Study group included 108 (64.7%) men and 59 (35.3%) women. The combination of abdominal injuries with a traumatic brain injury was observed in 34.7% cases. The diagnostic algorithm of the instrumental examination complex in the acute period of combined abdominal injuries was performed in the standard sequence: ultrasound, radiography, MSCT, and video laparoscopy. Results. 142 patients with combined abdominal injuries underwent MSCT. Liver damage in combined abdominal injuries was observed in 36 (21.8%) patients. Video laparoscopy that was performed in 11 (6.6%) cases was considered the last and most effective method of operation of injuries of the gastrointestinal tract and mesentery. Conclusion. Combined abdominal injuries due to the scarcity of anamnestic data, the limitation of clinical research methods and the necessity to determine the prevailing damage that determines the severity of the patient’s condition, make the process of diagnostics very complicated

Aim. To study tumors and tumor-like formations of the maxillofacial area using computer technologies. Material and methods. The analysis of a study of 94 patients in the age of 18 - 60 with tumors and tumor-like formations of the maxillofacial area was conducted. X-ray examination of patients was made using modern computer technologies. Results. All 94 patients, before and after surgery underwent 192 x-ray examinations including multislice computed tomography (MSCT), magnetic resonance imaging (MRI) and orthopathography (OPG). The findings are: odontogenic tumors of the jaws (ameloblastoma - 32 (34.0%), odontoma - 21 (22.4%)); osteogenic tumors (osteoblastoclastoma - 17 (18.1%), osteoma - 13 (13.8%)); cystic masses of the jaws - 11 (11.7%). Conclusion. Usage of modern computer technologies on a basis of MRI, MSCT, and OPG plays a big role in a diagnostics of pathologic processes of maxillofacial area, including tumors and tumor-like formations. It significantly increases the quality of information, that allows specialists to conduct more effective treatment, clearly plan the scope of operation in this category of patients.

Aim. To study the emotional status of patients with oncological pathology of organs and tissue of the oral cavity before and after radiotherapy. Materials and methods. The research was conducted on the basis of the oncological and therapeutic dentistry departments of the State Educational Institution «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan» from January to September 2018. The research included 12 patients, 8 men, and 4 women. An initial examination was put after finding a clinical diagnosis. The second examination was conducted in 1 month after the 1st course of the radiotherapy. Clinical and psycho-emotional methods were applied using the following methods: The Hospital Anxiety and Depression Scale (HADS), Diagnostic test of well-being, activity and mood and Hamilton Depression Rating Scale (HAM-D). Results. Comparison of the indicators before and after radiotherapy showed worsening of such indicators as emotional state, components of well-being, activity and mood, and the Hamilton Depression Rating Scale (HAM-D) were identified. Conclusion. Patients suffering from oncological pathology of organs and tissue of the oral cavity had changes of emotional status like an increase of depressive symptoms after radiotherapy that is to consider during the complex therapy and rehabilitation of these patients.

Aim. To analyze modern methods of the examination of colon pathologies and its functional state during chronic colonic stasis. Material and methods. The work is based on the results of a study of 140 patients with chronic colonic stasis. 53 of them (37.9%) were operated in a planned manner. There was 106 women (75.7%) and 34 men (24.3%). The scheme of examination included traditional approaches along with colon electrothermometry. Results. Analysis of the results shows that chronic colonic stasis on the background of developmental anomalies and colon fixation is accompanied by a set of specific changes of the functional state, which can be identified using special examination methods. To evaluate the colon motility state, the study of the biopotentials, registered from the surface of the mucous membrane is rational. Specific changes of bioelectric irritability depend on the disease stage and the localization in the colon. Conclusion. The algorithm of the diagnostics of chronic colonic stasis should involve the use of a set of instrumental methods: irrigography; monitoring of the barium movement through the gastrointestinal tract; colonoscopy with electrothermometry; MSCT with 3D modeling; “virtual colonoscopy”.

Aim. To conduct an analysis of the own material on a study of rare diseases in pediatric cardiology and cardiac surgery. Material and methods. The study included 18 newborns and children observed for the period of 2010-2019. All children underwent standard examination methods: ultrasound examinations of the heart and blood vessels (Echocardiography); angiocardiography; ECG; CT according to indications; laboratory and histological studies; macro preparations examination; “dry drop” method for congenital metabolic diseases. Results. Examined patients included: 5 newborns; 5 patients up to 1 year; 8 patients up to 5 years. Following rarely encountered diseases were found: multiple heart rhabdomyomas - in 6 patients (33%), one of whom had confirmed congenital tuberous sclerosis (Pringle-Bournville disease); an isolated giant cyst of the right atrium-1 (5.5%), mitral and aortic valve defects with the development of marked myxematous deformation and functional insufficiency were found in 6 children with mucopolysaccharidosis (33.3%); mitral valve fibroma in a newborn -1 (5.5%); isolated right ventricular hypoplasia - 1 case (5.5%); 1 case with the Marfan triad (5.5%). The features of clinical and instrumental examination of these patients categories are presented. Conclusions. Based on the results of the analysis, we consider the necessity of a multidisciplinary approach for children with complex congenital defects of heart and blood vessels, especially with comorbidities. This is necessary to consider choosing the tactics and timing of operations on the heart and blood vessels, dynamic observation and the medication prescription.

The analyzed material includes a review of the current literature on the diagnostics, treatment and prevention of suture incompetence of the duodenal stump. There are many ways to cover the duodenal stump, but none of them is secure enough. This is the reason that maintains the relevance of the suture incompetence of the duodenal stump. According to the literature, suture incompetence of the duodenal stump occurs in 0.9% - 18% cases and more, which is the most formidable complication of the resection of the stomach by Billroth - II. The main cause of death of patients with incompetence of the duodenal stump is fistulous exhaustion and peritonitis. To make diagnosis of incompetence of the duodenal stump, physical, laboratory and instrumental tests are used. Ther treatment of incompetence of the duodenal stump is surgical. Prevention of the condition requires an integrated approach: reliable stitching of the stump and its peritonization. Some authors recommend prescribing drugs that reduce intraduodenal pressure directly or indirectly.

The paper presents information on the condition and usage of modem approaches in early diagnosis of mammary gland diseases including mammary gland cancer in a system of treatment and prevention institutions of Tajikistan. It also presents data on modem diagnostic approaches in other countnes. The issue is quite topical due to the absence of a complex approach in the implementation of the modem diagnostic methods of mammary glands diseases. The current topic requires further research and implementation of methods into the routine of medical institutions in Tajikistan.

This review contains brief literature data on the main risks of cardiovascular diseases.lt was established that CVD cardiovascular diseases along with other diseases of the metabolic syndrome (obesity, diabetes mellitus) are the main markers of disability and disability of the population. According to the disability forecast (DALY) in 2020, the growth of the disabled population in the world increases to about 150 million, which is 70 million more than in 1990, thus CVDs remain the leading causal disability of the population. WHO estimates that in 2015, 17.7 million people died of CVD, which accounted for 31% of all deaths in the world. Of this number, 7.4 million people died from coronary heart disease and 6.7 million people as a result of a stroke. (WHO, 2015). According to the UNDP-2010 data, the mortality rate per 100,000 thousand of the population from NCD in the Republic of Tajikistan was -884, RF-904, Kazakhstan - 1145 cases, which is 2 times more than in Western Europe and the USA and 1.4 times more than in China.