Aim. To study the medical care of children with hearing pathology in the Sughd region and to develop recommendations for its improvement.

Material and research methods. On the basis of data from the ENT departments of the Central District Hospital of the cities of Isfara, Istaravshan and Aini in the Republic of Tajikistan, active (door-to-door) and passive (admission of patients to a polyclinic) methods were used to study the ENT organs of 400 children.

The research began by determining the availability of audiological institutions in the regions of Sughd and the effectiveness of their dispensary activities. Then the outpatient cards of children with hearing loss registered in the polyclinics were studied. Then, hearing screening was carried out on children from the 1st to the 3rd grade, during which the ear was examined, the condition of the middle ear - tympanometry - and the functional condition of the cells of the inner ear - otoacoustic emission with threshold audiometry - were determined.

Results of the study and their discussion. It was found that about 10% of children with hearing loss receive the necessary medical care according to the “early intervention standard”. The main reasons for the late diagnosis of hearing loss in this group and, consequently, its late rehabilitation were identified.

Conclusions. For early detection of hearing problems in children, the following measures should be taken 1) control of the 1st stage of hearing screening in newborns, transfer of information about children to be examined in the 2nd stage in specialized institutions; 2) use of additional hearing tests in children aged 1 and 7 years; 3) familiarisation of paediatricians, neurologists and the public with the causes, diagnosis and restoration of hearing loss in children.

The purpose of the study. Study of the structure of infant mortality in children’s medical institutions of the Republic of Tajikistan.

Research material and method. To determine the structure of child mortality in the Republic of Tajikistan, in the years 2017-2021 and 9 months of 2022, from the selected cities and districts (the cities of Kulob, Bokhtar, Panjakent, Istaravshan, Khujand, Konibodom, Isfara, Vahdat, Tursunzoda and the districts of Bobojon Gafurov, Rudaki, Rasht, Faizabad and Sh. Shahin) information on child mortality was collected.

Research results. In the structure of infant mortality, 2,138 boys and 1,554 girls made up 2138 boys and 1554 girls. Of this number, 572 are boys and 412 are girls in Dushanbe. A total of 1,530 (41.4%) deaths of newborns in the 1st minute of the Apgar scale, and 1,171 (31.7%) in the 5th minute, or 360 people who were transferred from severe to moderate condition. has been

Conclusion. The results of our research are almost the same as the results of research on the structure of infant mortality in the Commonwealth of Independent States.

Aim. To devise optimal plastic surgery techniques for the eradication of postoperative skin defects following surgeries for tumor pathologies.

Material and methods. he study involved 16 patients (100%) with skin oncological pathologies, of which 7 (43.7%) had benign skin tumors and 9 (56.3%) had malignant skin tumors. Diagnostic confirmation was achieved through cytological examination (using Romanowsky-Giemsa stain under an OLYMPUS CX 21 light microscope at 10-40x magnification) and histological examination (using hematoxylin and eosin stain under an OLYMPUS CX 21 light microscope at 10-40x magnification).

Results. The study observed that all 16 patients presented with tumors varying in size from round to polygonal and irregular shapes, each requiring unique surgical solutions for removal and restoration of the skin surface to its previous state. Based on these findings, we developed various incision techniques surrounding the tumors for their removal, coupled with inconspicuous plastic surgery procedures to address postoperative defects. These techniques resolve the complexity and unresolved issues associated with such defects, potentially reducing significant health risks.

Conclusion. The plastic surgery techniques developed for the eradication of postoperative skin defects in cases of oncological pathologies showed excellent outcomes in 90-95% of cases. This efficacy supports their application in managing complex and large tumor-related skin lesions.

Aim. To study the effect of laparoscopic surgery for endometroid ovarian cysts on the level of anti-mullerian hormone as an indicator of ovarian reserve.

Materials and methods. This prospective study included 25 women with endometrioid ovarian cysts who were admitted to a tertiary-level clinical hospital. All patients underwent laparoscopic cystectomy. Serum levels of anti-mullerian hormone were measured preoperatively and three months postoperatively to assess the impact on ovarian reserve.

Research results. Of the 25 women enrolled in the study, 17 (68.0%) had a unilateral endometrioid cyst, while the remaining 8 (32.0%) had bilateral cysts. The average size of the endometrioid ovarian cysts, measured by transvaginal ultrasound, was 117.71 ± 13.97 mm³. The most common concomitant genital and extragenital pathologies were pelvic adhesions, uterine fibroids, diffuse toxic goiter, and chronic pyelonephritis. The mean preoperative level of anti-mullerian hormone was 5.82 ng/ ml, which slightly decreased to 5.08 ng/ml three months post-surgery.

Conclusions. Laparoscopic cystectomy is a beneficial option for patients with endometrioid cysts larger than 4 cm. This study demonstrates that the procedure effectively and safely minimizes ovarian tissue loss and preserves ovarian reserve. The slight decrease in anti-mullerian hormone levels post-surgery and the sustained rate of pregnancy onset affirm the efficacy of laparoscopic interventions in these cases.

Aim. To study the contamination of the abdominal cavity and the morphological characteristics of the liver in experimental animals when modeling an abscess and after sanitation with antiseptics.

Material and methods. Microbiological studies were carried out on 54 samples of pus and 54 samples of exudate, delivered from the cavity of the SMA, modeled in experimental experimental rabbits - male Chinchillas, to detect strains of microorganisms of the group of enterobacteria and microbes of the coccal flora. The rabbits were divided into 9 groups, each group consisting of 6 rabbits. The morphological characteristics of the liver of 24 rabbits were also studied during sanitation of the abdominal cavity with a solution of 0.1% furagin after 3.5 and 7 minutes of exposure. The 1st group included 8 intact rabbits that were not subjected to any experimental interventions, the 2nd group consisted of 8 rabbits in which an experimental abscess was created, but its sanitation was not carried out. The third group included 8 rabbits where a 0.1% furagin solution was used to sanitation an abscess with different exposure intervals: 3, 5 and 7 minutes.

Results. Studies regarding the growth of microbes after various exposures to sanitation with a 0.1% furagin solution have shown that the antiseptic solution of 0.1% furagin has a detrimental effect on the microbes of the abscess cavity and abdominal cavity, in particular, in an exposure of 5-7 minutes it practically destroys all existing microbes. And microscopic studies of liver tissue after a 7-minute exposure to the use of a 0.1% antiseptic solution of furagin did not reveal any changes.

Conclusion. A 0.1% solution of furagin has bactericidal properties, is the safest and has no toxic effect on liver tissue.

Aim. To study the efficacy of the use of the immunomodulator «Thymocin» in patients with disseminated breast cancer.

Material and Methods. The subject of the study were 36 patients with disseminated breast cancer observed in the conditions of the Department of Mammology and Reconstructive Plastic Surgery and the Department of Chemotherapy of the SI «Republican Cancer Research Center» of the MHSPP of Tajikistan. All patients were prescribed the immunomodulatory drug «Thymocin».

Research results. With the use of Thymocin in patients, indicators of immunity returned to normal, an increase in the concentration of β-endorphin was observed. The physical condition of patients with disseminated breast cancer also improved, as assessed by the modified Karnovsky scale.

Conclusions. The use of thymocin immunomodulator in the complex therapy of patients with BC does not require large material costs, special equipment or tools, is cost-effective and affordable. Does not have toxic properties, can significantly reduce the threshold of pain sensitivity in patients with a generalized tumor process, thereby improving the quality of life of these patients.

Aim. To improve the immediate and long-term results of surgical treatment of postoperative anal stenosis.

Materials and Methods. The study included 92 patients (46 main and 46 control) with postoperative anal stenosis, during 2012-2023. Among all patients, males predominated, accounting for 59 (64.1%) cases, and females - 33 (35.9%) cases in the study.

Results. A large proportion of patients (72.8%) developed anal stenosis in the long-term after surgical treatment of chronic haemorrhoids. Ultrasound and MRI scans were performed. For the surgical treatment of postoperative anal stenosis in patients in the control group, the traditional existing surgical tactics were followed; patients in the main group received developed and improved methods of surgical treatment. The number of recurrences of postoperative anal stenosis in patients in the main group after our surgical treatment tactics decreased in 10.9% of cases (from 17.4% to 6.5%).

Conclusions. The chosen surgical tactics and developed methods of surgical treatment of postoperative anal canal stenosis reduce the number of early postoperative complications in 13.1% of cases and late complications in 10.9% of cases.

Aim. To study the dynamics of morbidity and mortality from lung cancer in the Republic of Tajikistan for the period 2016-2022.

Materials and methods. A statistical analysis of the incidence and mortality from lung cancer was carried out according to the data of the Republican Center for Medical Statistics and Information of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan for 2016-2022.

Results of the study and their discussion. The incidence of lung cancer in the Republic of Tajikistan has a relatively slow growth rate and ranks 9th among all malignant tumors, amounting to 3.6%. High rates of lung cancer incidence were noted in age groups 45-54 (18,8%), 55-64 (33%) and over 65 years old, which is 35.8%. Patients from stage I-II make up 52.9%, from stages III-IV - 47.1%. The one-year mortality rate from lung cancer is 28.8-41.2%.

Conclusion. In the Republic of Tajikistan, lung cancer has had a relatively low growth rate over the past 16 years. The highest rates were recorded in 2019 and 2022. Lung cancer is most often suffered by the male population. The peak incidence is over the age of 65, which is 35.8%. The proportion of patients with stages III-IV of the process decreased markedly in 2016- 2022 compared to 2007-2015, respectively from 59.9% to 47.1%. The one-year mortality rate from lung cancer is 28.8-41.2%.

Aim. To conduct a comparative analysis of the population frequency of obesity among women in different regions of Tajikistan.

Materials and methods: An analysis was conducted to determine the prevalence of obesity among women in urban and rural areas. Statistical reporting data were used to inform this analysis, which was conducted using the F 12 “Report on diseases of the service area of health centers” form. A comparative analysis of data on obesity among residents of Dushanbe and the Sughd region was conducted.

Results. Over a five-year period, the incidence of obesity in Dushanbe increased by 948 cases, while in the Sughd region it increased by 1128 cases. The differences between the regions were almost 1.2 times greater.

A comparative analysis of the incidence indicators revealed that the incidence of obesity in Dushanbe increased by 499 units over five years, while in the Sughd region it increased by 505 units. Concurrently, the incidence rate in Dushanbe exhibited a growth of 14.7 over the five-year period, while in the Sughd region, the rate increased by 4.1. A comparative analysis of the T/app. in the two surveyed regions of the country revealed a notable rise in the prevalence of obesity among women. Between 2017 and 2021, the incidence of obesity in Dushanbe increased by 64%. The incidence rate for five years increased by 63%, while the T/app. incidence was equal to +71%.

Conclusions: In all regions of Tajikistan, approximately half or more of the population are women. Over the course of five years, there has been a pronounced upward trend in the incidence of obesity in the studied regions.

Aim. To optimize the surgical treatment of unstable fractures of the pelvic bones in the acute period of combined trauma.

Materials and methods. This study analyzed the treatment outcomes of 57 patients with combined pelvic trauma at City Medical Center No. 3 in Dushanbe and the State Institution “Istiklol Medical Complex” from 2015 to 2019. According to the M.E. Muller-AO/ASIF classification, the types of pelvic injuries were as follows: Type B1 in 18 cases (31.6%), Type B3 in 11 cases (19.3%), Type C1 in 16 cases (28%), and Type C2 in 12 cases (21.1%). Based on the AO Tile classification, Type A fractures (stable with minimal displacement and without disruption of the pelvic ring) were observed in 26 patients (45.6%). Type B fractures (rotationally unstable but vertically stable) occurred in 18 patients (31.6%), and Type C fractures (with rotational and vertical instability and complete disruption of the pelvic ring) were noted in 13 patients (22.8%).

Results. The treatment results indicate that the best functional outcomes were achieved in patients from Group III (13 cases) and those with acetabular fractures (7 cases), where submerged osteosynthesis was performed in 13 (22.8%) and 5 (8.8%) cases, respectively, the latter in combination with external fixation devices. In the second group, the best functional and anatomical results were achieved in 18 patients (31.6%) using external fixation devices.

Conclusion. Early restoration of pelvic integrity through active surgical correction prevents the development of lifethreatening complications during the acute phase, facilitates patient mobilization, and reduces the rehabilitation period. A phased surgical correction of the pelvis, adhering to the principle of “damage under control,” ensures a favorable prognosis and satisfactory outcome.

Aim. To study specific morphological changes in liver tissue associated with fatty hepatosis disease.

Material and methods. The initial data for this study were obtained from forensic autopsy reports and liver tissue samples taken from 40 bodies in which the diagnosis of fatty liver disease was morphologically confirmed. Autopsies were performed between 24 and 48 hours after the official determination of death.

Results. With fatty hepatosis, changes include not only an increase in the volume of the organ with a more rounded shape of the edges, but also the acquisition of a bright yellow hue of the liver both on the outer surface and when analyzing its section, as well as a decrease in tissue density. During the histological analysis, it was noted that in all studied samples of liver tissue, significant blood filling was observed in the central veins and sinusoidal capillaries, as well as in the venous vessels of the portal system.

Conclusion. The results of our study confirm that the detected morphological changes in liver tissue are specific signs of fatty hepatosis, which is characterized by the phenomenon of fatty degeneration, intralobular inflammation, fibrosis, steatonecrosis, and most often the presence of large-lobular degeneration is detected.

Aim. To develop software for monitoring asthma flow using telecommunication technologies.

Materials and methods. A specialised software product “ASTHMATEST” www. asthmatest.ru was developed for remote and timely monitoring of health status of patients with confirmed bronchial asthma. The analysis of the effectiveness of remote monitoring was carried out by comparing the indicators of morning and evening peak flow measurement, data from the symptom control report.

Results. In the main study group, the proportion of patients with severe bronchial asthma decreased to 18.42% due to an increase in the proportion of patients with mild (up to 34.21%) and moderate (47.37%) severity of asthma. In the control group, the proportion of patients with mild bronchial asthma decreased to 40.74% due to an increase in the proportion of patients with moderate (up to 44.44%) and severe (14.82%) severity of asthma.

Conclusion. The survey showed that the majority of patients and their parents/legal representatives are willing to use the developed software product for remote monitoring in the future.

Aim. Improvement of methods of hernioplasty of ventral hernias by using endo-mesh with various types of separation plastics.

Material and methods. The material is based on the result of surgical treatment of 148 patients with POVH. Depending on the method of intervention used, all operated patients were divided into 3 groups. The first group included 58 patients who underwent hernia orifice plasty by the anterior separation method. The second group included 44 patients who underwent posterior separation plasty. The remaining 46 patients made up the third group, who underwent standard “stretch” methods of hernioplasty of the Onlay (n=28) and sublay (n=18) types.

Results and discussion. The main points influencing the choice of the method of surgery in patients of all 3 observed groups were the indicators of intraoperative examination of the level of intra-abdominal pressure. In patients of the first group in the immediate postoperative period with the use of anterior separation plasty, complications from the wound occurred in 10 (17.2%) patients. In the second group of patients who underwent posterior separation plasty, a similar complication was noted in 4 (9.1%) patients. In the examined third group, who used tension methods of hernioplasty, complications from the wound were observed in 7 (15.2%) cases.

Conclusion. POVH in 25% of cases remains a complication of laparotomy, especially in obese patients with a lot of concomitant somatic pathologies. The recurrence of hernias and lethality with standard tension methods of hernioplasty remains high compared with the proposed options for separation plastics using endomesh.

Aim. To improve the outcome of alveolar socket bleeding treatments by simultaneous stimulation of reparative processes using plasma-rich platelets in combination with a dressing material coated with nanoparticles.

Material and methods. This study involved 150 patients experiencing minor socket bleedings post-extraction. To arrest the bleeding, a dressing material coated with iron oxide nanoparticles was applied in conjunction with platelet-rich plasma. To prepare the plasma, 45-60 ml of venous blood was drawn from each patient and subjected to a double centrifugation process. A membrane created from the platelet-rich fraction post-second centrifugation was used to cover the nanoparticlecoated dressing material.

Results. The combined application of these materials in the alveolar defect sites led to earlier detection of osseogenesis via X-ray examinations. This outcome is attributed to the enhanced osseoconductive properties conferred by the thrombocyte factors and the iron oxide nanoparticle-coated dressing material, facilitated by the fibrin network within the thrombocyterich plasma.

Conclusion. The use of autologous platelet-rich plasma in conjunction with nanoparticle-coated dressing materials has shown variability in the density of alveolar bone regeneration, with observed densities ranging from 650 to 800 Hounsfield units during extended follow-up periods.

The review presents a summary of the data from population studies on the system of perinatal regionalization, outlining the main principles of the formation and development of the system of perinatal regionalization. An assessment of the quality, accessibility and effectiveness of the three-level structure of the perinatal care system is provided. Problems and regional differences have been identified regarding the organization of work in institutions of different functional levels, which are united according to the principles of centralization of assistance.

The problem of tuberculosis reactivation after pulmonary tuberculosis is urgent, according to a review of the available literature. There are certain difficulties in the differential diagnosis between a true relapse and a re-infection. The incidence of tuberculosis reactivation varies considerably from country to country. There is no evidence in the literature of a modern, integrated approach to preventing pulmonary tuberculosis relapse. The COVID-19 pandemic has also increased the risk of TB reactivation. There is also a need to make changes in the order of hospital observation of TB patients, which will undoubtedly affect the frequency of tuberculosis relapses.

This article provides a comprehensive analysis of the issues raised, according to both domestic and foreign literature, devoted to some aspects of etiopathogenesis, diagnosis and treatment of postoperative intestinal obstruction. The paper subjected to a substantive analysis the noted controversial issues of studying the etiopathogenetic aspects of adhesion formation in the abdominal cavity after undergoing surgical interventions on the organs of the abdominal cavity and small pelvis, increased intra-abdominal pressure in the postoperative period and the development of postoperative intestinal obstruction, features of clinical manifestations, as well as methods of diagnosis and choice of treatment tactics.