Aim. To asses socio-economic effectiveness of measures improving the water supply of the population and associated decrease of typhus and bacterial dysentery. Material and methods. Information on 48 patients with typhus and 37 patients with bacterial dysentery that were treated in an infectious disease hospital was used to calculate the economic damage from these diseases. Results and discussion. An increase in the population’s access to high-quality drinking water ensured a relatively positive sanitary and epidemiological well-being of the population and made it possible to reduce the incidence of typhus and bacterial dysentery. At the same time, it has decreased socio-economic damage to 1,590,479.1 US dollars (683,628 from typhus and 906,851.1 from bacterial dysentery). Conclusion. The decrease in the socio-economic damage from only these diseases for 4 years amounted to 1,590,479.1 US dollars (683,628 from typhoid fever and 906,851.1 from bacterial dysentery).

Aim. To study clinical features, diagnosis and to evaluate the effectiveness of rehabilitation of patients with salivary gland tumors. Material and methods. A retrospective analysis of clinical data of 78 patients with various tumors of the salivary glands and evaluation of the effectiveness of their rehabilitation was conducted in the State Institution “Republican Oncological Scientific Center " of the MH and SPP of the RT from 1985 to 2000. Results and discussion. Therapy effectiveness assessment of 48 (100%) patients with BSGT, showed excellent results in 14 (29%) cases, good results in 10 (21%) cases, satisfactory results in 24 (50%) cases. Therapy effectiveness assessment of 30 (100%) patients with MSGT showed excellent results in 9 (30%) cases, good results in 5 (17%) cases, satisfactory results in 14 (47%) cases, and unsatisfactory results in 2 (6%) cases. The life quality of patients with BSGT improved from a minimum of 70% to 100%, and the life quality of patients with MSGT improved from a minimum of 40% to 100% according to the Kornovsky scale. Conclusion. Surgical treatment of BSGT made it possible to cure 50% of patients, and combined treatment with MSGT made it possible to cure in 47% of patients.

Aim. To study long-term results of coronary artery bypass grafting in patients with acute coronary syndrome and multivessel lesion. Material and methods. The work analyses two-year treatment observation results of patients with acute coronary syndrome and multivessel coronary artery disease, who underwent stenting of a clinically dependent artery for emergency indications, and coronary artery bypass grafting in a period of up to 90 days. The efficacy and safety were assessed according to the criteria of “non-inferiority " in comparison with the literature data of coronary artery bypass grafting in patients with coronary heart disease. Results and discussion. The results of our study show the absence of significant differences in the occurrence of large cardiovascular events between the staged approach in patients with ACS and multivascular disease and CABG in patients with coronary heart disease, which confirms the effectiveness and safety of the staged approach. Conclusion: Surgical myocardial revascularization in the early periods after stenting of the clinically dependent artery in patients with acute coronary syndrome and the multivessel lesion has an advantage over aorta coronary bypass surgery at the combined point of major cardiovascular events.

Aim. To study the causes of hemorrhoids recurrence and development ofpathogenically justified methods of treatment. Material and methods. 2500 chronic hemorrhoids surgeries and its complications in the last 5 years were the subjects of the analysis. Long term results of a character and scope of the surgical intervention to 980 patients were studied. Presence of the recurrence presented in 80 (8,2%) of patients. Results and discussion. The frequency of the recurrence after minimally invasive approaches was identified in 60 (75,0%) cases. 28 (35,0%) cases were found after sclerotherapy, 18 (22,5%) cases after hemorrhoidopexy, and 14 (17, 5%) cases after various bandages or stitching of the hemorrhoidal nodes. After various modifications of hemorrhoidectomies according to Milligan-Morgan, recurrence of the disease was noticed in 20 patients. The most often reason for the complications and recurrence of the disease in 35,6% of cases was the conduction of a wides hemorrhoidectomy in an ambulatory condition by general surgery specialists with a little experience and no special skills in examination and treatment of proctology patients. In 18,6% of cases, the recurrence of the hemorrhoids was caused by an incomplete or “careful” hemorrhoidectomy Conclusion. Chronic hemorrhoids is a widespread proctology disease that requires treatment in a specialized proctology center.

Aim. To improve the immediate results of surgical treatment of injuries of the chest and abdomen by introducing endovideosurgical technologies into the comprehensive diagnosis and treatment. Material and methods. Over the past 15 years, 249 patients with injuries to the chest and abdomen were treated in the Clinic of Surgical Diseases №1 of the Avicenna Tajik State Medical University based on Dushanbe Emergency Hospital. Results and discussion. Endovideosurgical technologies for the diagnosis and treatment of abdominal injuries were used for 45 patients out of 57 patients with abdominal injuries. 22 patients had stab-cut penetrating wounds of the abdomen, 20 patients had a closed abdominal injury and 3 patients had gunshot wounds. Endosurgical technologies in 50.4% of cases were transformed into medical aid, and in 11.5% of cases, they allowed avoiding unreasonable thoracotomy and laparotomy. Conclusion. In the case of injuries of the chest and abdomen, endovascular surgery technologies are highly informative diagnostic methods that optimize further surgical approach.

Aim. To study the results of laparoscopic hernioplasty in elderly patients. Material and methods. The basis of the work is an analysis of the results of the diagnosis and treatment of 47 patients of elderly patients who underwent treatment for inguinal hernias. There were 41 patients with primary hernias (87.2%) and 6 (12.8%) patients with relapses. Among the examined patients, the most common concomitant disease was a coronary heart disease 40 (85.1%), hypertension - 35 (74.5%), diabetes - 24 (51.1%) and obesity - 14 (29.8%). Results. A comparative analysis of laparoscopic and traditional hernioplasty showed that laparoscopic interventions have significant advantages according to such criteria as the duration of the operation, the average bed day, postoperative complications, and complete rehabilitation. An important criterion is also an incision that directly affects the intensity of the pain syndrome in the postoperative period. Laparoscopic hernioplasty is conducted through 3-4 punctures of 5.0 mm and 10.0 mm with trocars, and traditional hernioplasty is performed with incision of 10 or more cm. Conclusions. For elderly patients with inguinal hernias, laparoscopic hernioplasty, when properly selected is the method of choice.

Aim. Timely diagnostics and early conduction of complex rehabilitation of children with the perinatal lesion of the central nervous system. Material and methods. 80 children of the main group, of up to1 year old, were studied in Children’s regional clinical hospital of Khujand for the period 2015-2016 year. Results and discussion. The complex approach to patients included conduction of the speech therapy that showed positive results in the comparison group. Conclusion. It was found that speech therapy contributed to the elimination of bulbar disorders, improved formation of the visual and acoustic reactions, removed pathological adjusting reflexes and improved motor skills.

Aim. To establish characteristic features and morphological signs of drowning deaths. Material and methods. 139 cases of drownings in reservoirs of the city of Dushanbe were analyzed in the current study. Also, cases of drowning between 2015 and 2019, and a retrospective analysis of all additional data from the conclusions of forensic medical examinations were studied. Results and discussion. Cases of drowning were mainly observed in people of working age, more often in men, and less than half of the cases were accompanied by alcohol intoxication. The data shows that it is advisable to subdivide all the morphological features that of a corpse extracted from water into three groups because these signs are revealed either during external and internal research or during laboratory tests. Conclusion. Detection of diatoms in the internal organs suggests that they got along with the blood flow while alive and can be considered an irrefutable sign of drowning.

Aim. To study histological features of the placenta in women with diffuse euthyroid goiter. Material and methods. 12 placentas of women with euthyroid goiter were the histopathology object of the study. Results and discussion. Histologic changes of the placenta of women with diffuse euthyroid goiter are characterized by chronic placental insufficiency with mild or severe blood circulation disorders, insufficient maturation of villi of a hypoplastic type. Conclusion. The main mechanism of the placental insufficiency during diffuse euthyroid goiter is a disorder of microcirculation in chorionic villi.

Aim. To evaluate the effectiveness of intraoperative damage of the nasal septum mucosa repair by application and fixation of a splint from a conventional x-ray film. Material and methods. In 2019, 1089 patients were hospitalized in the 1st otorhinolaryngology department due to the deformation of the nasal septum of various severity. A limited thinning of the mucous membrane of the nasal septum on its most convex deformed area was observed in 103 (9.5%) patients, which was a likely risk of intraoperative rupture of the mucous membrane. All patients underwent general clinical, otorhinolaryngological, and radiological examinations during the hospital stay. Research results and discussion. Injury of the mucous membrane of the nasal septum after removal of coarse bone segments was recorded in 56 patients. Prevention measures of the postoperative defects for these patients included replacement of the bone-cartilaginous base (perpendicular plate of the ethmoid bone) of the nasal septum by homocartilage grafts according to the size by pulling the mucous membrane over the defect and temporary double-sided application and seamed fixation of a splint from a conventional x-ray film. The effectiveness of the treatment was evaluated clinically after a persistent restoration of the integrity of the nasal septum and its physiological state. Conclusion. Usage of a bone-cartilage base or homo-cartilage grafts and its fixation using a splint from a conventional X-ray film for the prevention of intra- and postoperative perforation in case of the intraoperative injury of a nasal septum mucosa is recommended for wide usage.

Aim. To conduct a systematic analysis of the pregnancy course, study the clinical and laboratory data that affect the development of labor abnormalities in women of the Belgorod region. Materials and methods. 484 women that were randomly divided into 2 groups were observed. The first group consisted of women with parturition anomalies (N = 344). The second group consisted of women without any complications (control, N = 140). Results and discussion. It was found that women with parturition abnormalities in the first half of pregnancy had frequent cases of toxicosis, abortion threat, isthmus-cervical insufficiency, gestational diabetes mellitus, hypertensive neurocirculatory dystonia, exacerbation of pyelonephritis and sexually transmitted infections. These pregnant women were 9 times more likely to experience anemia. Additionally, pregnant women of the main group had 10 times more combined pathologies. Conclusion. As a result of the study, it was found that pregnant women, with parturition abnormalities, had some clinical and laboratory particularities in the first half of gestation. That can be used to build an individual prognosis of the labor complication.