Aim. To assess the parameters and gender characteristics of the life quality of preschool children and the influence of a complex of factors on them.
Material and methods. A study of the quality of life of 354 children was carried out. Ther were divided into two subgroups - younger (3-4 years old, 97 children) and senior preschool age (5-7 years old, 257 children). The PedsQL ™ 4.0 questionnaire was used to assess the QoL of children.
Results and discussion. It was found that with age, the parameters of QOL increase on the scale of “emotional functioning”, and on the scale of “functioning in kindergarten” - decreases. The children of 5-7 years old themselves rated such aspects of QOL as emotional and role functioning significantly higher. Gender differences had specificitiesthe QOL of boys in the younger preschool group was higher in terms of emotional functioning. According to children, differences were established on the scale of “social functioning”, where this indicator was significantly higher in girls. The interrelation of various risk factors on the QOL indicators of children has proved to be valid.
Conclusion. The results of the survey showed that parents tend to assess the QOL of their children in this age category somewhat lower than the children themselves. The results once again confirm the influence of various medical and social factors on the QOL of children.

Aim. To study results of unsuccessful primary rhinoplasty that require repeated interventions.
Material and methods. The work summarizes the analysis of the causes of unsuccessful rhinoplasty in 106 patients who had previously suffered a primary septorhinoplasty in various health facilities in Tajikistan in the period from 1 to 7 years. The main reason for the visit was dissatisfaction with the previous rhinoplasty.
Results and discussion. After primary rhinoplasty, patients most often had the following deformities: deformity of the tip of the nose (72 patients); deformity of the “parrot beak” type (14 patients); deformation similar to the inverted “V” (12 patients); deformation of the contours of the nasal dorsum (13 patients); defects of the nasal septum in the lower caudal region (21 patients). All patients underwent secondary rhinoplasty.
Conclusion. Unsuccessfully executed as a primary rhinoplasty leads to respiratory dysfunction and aesthetic defects that require more complex secondary surgical operations.

Aim. To study the structure of the morbidity of young people with somatic diseases according to the data on admittance.
Material and methods. The research materials are based on data from the Republican Center for Medical Statistics and Information of the Ministry of Health and Social Protection of the Republic of Tajikistan and reports of the youth medico-advisory departments of the Health Centers.
Results and discussion. In total, 58103 people contacted YMAD in all regions of Tajikistan over two years (2018- 2019), including 18070 boys (31,1%) and 40033 girls (68,9%). Somatic diseases were revealed in 1030 cases among boys (55,1%) and in 840 cases - among girls (44,9%). Among the main somatic diseases among young people, the most common are diseases of the urinary tract (35,3%; endocrine diseases (24,1%); anemia (17,6%); helminthic invasions (14,4%); diseases of the gastrointestinal tract (10,2%). The combination of two or more of the listed diseases was observed in young men in 71,4% of cases, and in young women in 28,6 cases.
Conclusions. Thus, the data shows a low level of the somatic health index of young people, which undoubtedly affects the quality of life and creates an unfavorable background for the realization of reproductive function in the future. Chronic somatic diseases contribute to the discussion of the quality of life of young people in the physical and emotional spheres.

Aim. To study the efficacy of endoscopic correction of vesicoureteric reflux in children using bulk synthetic material.
Material and methods. From 2016 to 2020, we studied the results of treatment of 63 children with vesicoureteric reflux. The children ranged in age from 6 months to 17 years. The degree of vesicoureteral reflux was as follows: grade I was observed in 2 (3.1%) patients, grade II in 16 (25.3%), grade III in 30 (47.6%), grade IV in 13 (21.98%), and grade V in 2 (3.1%). Among 63 patients with CKD, grade I was found in 26 (41.3%), grade II - in 16 (25.4%); grade III - in 13 (20.6%); grade V - in 2 (3.1%). - III stage - 13 (20,6%); IV stage - 8 (12,7%); IV stage - 4 (12,6%). - (12,7%), and there were no patients with V stage of CKD were absent. Unilateral vesicoureteric reflux was noted in 45 (71.4%) children, bilateral - in 18 (28.5%) children. Endoscopic intravesical correction of vesicoureteral reflux was performed by suburethral injection of “Dam+”.
Results and discussion. Summarizing the results of our study, it should be noted that positive results were achieved concerning the relief of urinary tract infection, elimination of urine outflow from the upper urinary tract, improvement of renal function after PMR correction using “Dam+”. Positive results of VUR correction amounted to 75,01%.
Conclusions. Endoscopic correction of VUR is one of the effective and low-traumatic methods of treatment. Application of the biocompatible synthetic material “Dam+” in the correction of vesicoureteric reflux contributes to positive results.

Aim. To identify the features of the sexual behavior of young people that cause the spread of sexually transmitted infections.
Material and methods. A questionnaire was developed and a survey was conducted among 500 men and women that belong to various social groups of the population. The age of participants was 18 - 30 years and they were coming from 4 districts of republican subordination. The survey was based on a typical sample of the mentioned age group. Collected data were statistically processed using MS OFFICE 2007 packages.
Results and discussion. It was found that the awareness of respondents about sexually transmitted infections and measures for their prevention remains at a very low level. More than 21.0% of respondents have active sexual life, and at least one in five does not associate this with the possible realization of the risk of contracting STIs / HIV / AIDS. About 17.0% of young people believe that if they become infected with these diseases, they will seek medical help only from their friends, physicians that they are familiar with, and paramedics.
Conclusion. It is known for a fact that virtually all models of sexual behavior and all types of sexual relationships are present among young people today. However, in Tajikistan, there are certain features of the sexual behavior of young people (polygamy and civil marriage). A low level of knowledge and the need to raise awareness among adolescents and young people about the negative consequences of risky sexual behavior have been established.

Aim. To study the formation of anti-diphtheria post-vaccination immunity in practically healthy, and frequently sick children vaccinated with pentavalent, ADTP, and ADT vaccine.
Material and methods. We observed 50 practically healthy and 92 frequently sick children. All children were vaccinated three times with a pentavalent vaccine, as well as revaccination with ADTP and ADT. The formation of specific anti-diphtheria immunity was detected for all children after 6 months, after 1 year, and after 5 years. The results were interpreted according to the final value of the optical density levels of protection: basic from -0,01 to 0,1; full protection -> 0.1; long-term protection -> 1.0.
Results and discussion. After 6 months the intensity of post-vaccination immunity in both practically healthy and frequently sick children was the highest: full protection (> 0.1) (45,8%), basic protection (0,01 to 0,1) (31,0%). Statistical significance decreased after a year: full protection (45,8% versus 12,1%, p <0,001), and lack of protection increased (2,6% versus 55,7%, p <0,001), which indicated to the development of unstable immunity, therefore revaccination with ADTP and ADT vaccines were performed. 5 years after revaccination specific immunity tended to increase in both healthy and often-ill children.
Conclusion. To create stable and long-term immunity when using “killed” vaccines and toxoids, revaccination vaccinations are required at various times after the course of vaccination for frequently ill children, as indicated by the data of basic and complete protection.

Aim. To analyze trends in the number and structure of physicians in the healthcare system of the Republic of Tajikistan during the period of healthcare reform.
Materials and methods. The sources of information were the official data of the Republican Center for Statistics and Medical Information, the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan (MoHSP), departments of science, medical and pharmaceutical education, and the personnel department of the MoHSP, and other regulatory legal documents.
Results and discussion. In 2019 there were 19,268 doctors active in the health sector, which is 20.7 doctors per 10,000 population. In 2019, there were only 76 private health facilities (WHO, 2020).
Conclusions. The even geographic distribution of health workers appears to be one of the challenges in improving access to healthcare in Tajikistan.

Aim. To present a comprehensive assessment of rheumatic diseases in association with osteoporosis.
Material and methods. A retrospective analysis was made of 180 case histories with various RDs, who were under inpatient observation at the Sughd Regional Clinical Hospital for the period 2018-2019 for the frequency of osteoporosis (OP). Densitometry was used to determine the projection mineral density (in g / cm2) in various parts of the skeleton.
Results. When asked about a history of fractures, every third respondent (33.3%) answered positively. According to the results of densitometry, osteoporosis in patients with inflammatory RD was diagnosed in 32.2% of patients. At the same time, the indicators differed significantly by nosology, and the frequency of OP correlated with the intake of corticosteroids. Osteoporosis was detected in every third patient with OA according to densitometry data and in 25% of cases in patients with gout. The results of the analysis to assess the absolute risk of major osteoporotic fractures according to FRAX showed high risk in 2 groups.
Conclusion. Thus, the nature and frequency of risk factors for osteoporosis in patients with RA and OA have their characteristics. A history of fractures in patients with RA is often associated with long-term use of GCS, and the presence of menopause in women and the presence of cardiometabolic concomitant diseases play an important role in the progression of AP in patients with OA.

Aim. To conduct a comparative assessment of the fungicidal activity of widespread and endemic species of the genus Allium growing in Tajikistan.
Material and methods. The initial ethanol extracts were obtained from fresh plants of 15 onion species from different climatic and geographical regions of the Republic of Tajikistan. The antifungal activity of species of the genus Allium was studied against the yeast-like fungi Candida albicans using the disk diffusion method.
Results: The highest fungicidal effect on the reference strain of Candida albicans was demonstrated by alcoholic extracts of the widespread wild species A. elatum Regel, A. oschaninii O. Fedtsch, A. obliguum L, and endemic species A. shugnanicum Vved. Low antifungal activity was found in extracts of 4 widespread wild-growing plant species - A. altaicum Pall, A. suworowii Regel, A. carolinianum DC, A.longicuspis L.
Conclusions. The antifungal activity of 13 species of widespread wild-growing and 2 endemic species (A.shugnanicum Vved and A. pamiricum Wendelbo) was studied for the first time. A. elatum Regel, A. oschaninii O. Fedtsch, A. obliguum L, and endemic species A. shugnanicum Vved had a maximal inhibitory effect on the yeast fungus. The extracts obtained from the bulbs and seeds of the studied plants are characterized by the highest antifungal activity.

Aim. To analyze clinical and bacteriologic factors associated with the occurrence of septic shock and mortality in patients with secondarily generalized peritonitis.
Materials and methods. The analysis of the results of the examination and treatment of 180 patients with generalized peritonitis was carried out. Patients were divided into two groups: the first group of 74 patients (41.1%) who had septic shock and the second group of 106 patients (58.9%) without a record of septic shock. Further, subgroups of patients with community-acquired and postoperative generalized peritonitis were identified in a ratio of 112/68.
Results and discussion. Mortality among patients with community-acquired peritonitis was 21% and among patients with postoperative peritonitis - 16%. 42 (37%) patients with community-acquired peritonitis developed septic shock compared with 32 (47%) cases of shock among patients with postoperative peritonitis. Patients who developed septic shock were significantly older than patients without septic shock in both subgroups. In both types of generalized peritonitis, anaerobes are significantly associated with septic shock.
Conclusions. It was revealed that age over 65 years, two or more microorganisms of the peritoneal fluid, or anaerobes were independent risk factors for the development of septic shock. Peritoneal exudate yeast and enterococci were associated with septic shock in a subgroup of patients with community-acquired peritonitis. Yeast was associated with high mortality in postoperative peritonitis.

Aim. To study the clinical and epidemiological features of typical foodborne botulism in children.
Materials and methods. We conducted an epidemiological investigation of 132 registered cases of typical foodborne botulism in the Republic of Tajikistan in 2019 and 2020. The clinical observation was carried out for 24 sick children in hospitals of the State Institution “City Children’s Clinical Infectious Diseases Hospital” and the Central District Hospital of Gissar. The diagnosis was established based on clinical and epidemiological data with the establishment of patients’ consumption of preservatives prepared from vegetables at home
Research and discussion. In the Republic of Tajikistan, according to the Republican Sanitary and Epidemiological Service for 2019 and 2020, only 132 patients with botulism were registered, with the largest number of diseases, 68 (51.5%), registered in 2019, and in 2021, 64 (48.5%). Analysis of the incidence of botulism for The presented period indicates that the disease in the Republic of Tajikistan was registered in the form of sporadic cases. Botulism disease was of a group (mostly familial) nature and in 2019 19 (14.4%) cases were detected, in 2020 17 (12.8%) cases with the number of victims from 3 to 5. The age structure of patients with botulism was predominantly adults (62%) over children (38%).
Conclusion. Epidemiological features of typical foodborne botulism in children in the Republic of Tajikistan showed that in cases 78 (59.1%) of the disease, it was registered after the consumption of traditional canned homemade products in the form of mixed vegetable spices (shakarob) and the autumn-winter period (100%).

Aim. The study of anamnestic and clinical-morphological features of the malignant ovarian tumors (MOT) course in children.
Material and methods. Clinical and anamnestic features of 47 cases of MOT in children who received special treatment in the Department of pediatric oncology of the SI “Republican Oncological Scientific Center” for 2005- 2018 were compared. To identify clinical morphological features patients were divided into two groups according to histotypes “teratoblastoma” (17 patients) and “dysgerminoma” (25 patients). The study used anamnestic, physical, clinical-laboratory, sonography, morphological, statistical methods.
Results and discussion. As a result of the study, it was found that the main complaints at admission were pain and palpable formation in the abdomen, which had dimensions of up to 10 cm in 19 (40.4%) cases, and in 28 (59.6%) cases - more than 10 cm. Ultrasound examination revealed a tumor-like formation of a heterogeneous/cystic structure, with dense walls, multiple chambers, with inclusions, tuberous, reaching significant sizes of 40-400 mm. The average values of the AFP onco-marker were 155 U/ml, Ca-125 - 87 U/ml, which exceeded the reference values. Dysgerminoma was found in more than half of cases - 25 (53.2%). There were no statistically significant differences in clinical and anamnestic measures between the different histological variants.
Conclusion. Comparative analysis of peculiarities of the clinical-morphological course of MOT in children depending on histological type showed no statistically significant differences.

Aim. To study the peculiarities of regeneration of fine-gauge reticulated titanium nickelide in near-defective tissues of the palate.
Material and methods. The work was carried out on 10 female rabbits of the Shin Shila breed weighing 2,7-3,0 kg; an experimental investigation was carried out in the Central Research Laboratory of the Avicenna Tajik State Medical University. As the implantation material, we used a fine mesh titanium nickelide with a thickness of 40-50 microns threads and the size of 50x50 microns cells.
Results and discussion. The morphological study revealed that after the surgery the mucous membrane covering the implant was edematous with foci of hyperemia and hemorrhages. Vessels were dilated and full-blooded, small and medium caliber vessels were constricted. In the zone of anastomosis, there were prevailing changes of inflammatory character with slight activation of local immunity. Fifteen days later the mucous membrane in the anastomosis zone partially recovered. Local immunity activation contributes to the restoration of normal structures in the implant area. Later it was noticed that as soon as blood supply to the implant zone was restored almost immediately from the areas bordering the operation zone the sprouting of the covering epithelium cells began.
Conclusion. Regeneration processes in the artificially created defective areas of the palate, at the use of the titanium fine mesh nickelide begin on the border of the implant material contact with the tissues of the peri-defective zone at the expense of the local immune reactions activation with the following gradual transition to the other areas.

Aim. To assess the capabilities of duplex scanning and study the features of hemodynamics in the vertebral arteries before and after surgical treatment.
Material and methods. The results of anatomical and circulatory characteristics of an extracranial segment of the vertebral arteries in 52 patients with various forms of pathological tortuosity were analyzed. Kinking was present in 38 patients, coiling in 8 patients, and Powers anomaly in 6 patients. There were 18 men and 34 women. The mean age of the patients was 45.6±8.7 years.
Results and discussion. In all types of PT of VA with ostium stenosis, the diameter of the artery was decreased, and based on tortuosity it contributed both to the reduction and deterioration of arterial blood flow to the vertebrobasilar basin. The decrease or increase in the linear velocity of blood flow, as well as other blood flow parameters, depended on both the type of pathological tortuosity of the PA and on the vessel diameter and the value of angulation. Hypoplasia of the opposite vertebral artery also occurred in 28 patients, which resulted in impaired blood supply to the brain.
Vascular examination after reconstructive surgeries resulted in normalization of the parameters of arterial circulation and cerebral perfusion. Primary vascular patency was 96.2%, restenosis was not revealed in any observation.
Conclusion. Duplex scanning is a highly informative technique for both diagnosing pathological deformities of the vertebral arteries and assessing the restoration of the hemodynamics of the vertebrobasilar system after reconstructive surgery. This method provides the most accurate information on the anatomical form and localization of pathological deformities of the vertebral artery. It also allows quantitative assessment of cerebral blood flow.

The article presents an analysis of a review of world literature on the diagnosis and treatment of critical lower limb ischemia (CLLI). The concepts and nature of critical lower limb ischemia are analyzed in detail. The main modern examination methods are described, in particular, the assessment of blood circulation through large and peripheral vessels. The work also reflects the modern principles of complex conservative treatment using vasoconstrictive drugs to a new generation of angioprotectors in combination with intravenous laser blood irradiation (ILBI).