Objective: to study the pathogenesis of recurrent classical trigeminal neuralgia and to improve the methods of its treatment.

Material and methods: the study included 20 patients of various ages, with a predominance of female participants, diagnosed with recurrent neurovascular compression of the trigeminal nerve based on MRI findings. 17 patients underwent microvascular decompression surgery. To enhance treatment efficacy and reduce recurrence rates, complete separation and isolation of the nerve root were performed using a Teflon pad, TachoComb hemostatic sponge, and adipose tissue.

Results: postoperatively, all operated patients (100%) experienced complete resolution of pain. Three patients were identified as having a neuropathic pain component and responded well to conservative therapy. Surgical efficacy was assessed objectively by the absence of facial pain. Additional assessment tools included the Barrow Neurological Institute Pain Scale (BNI-PS) and the Visual Analogue Scale (VAS). The average postoperative follow-up period was 1.5 years, during which no patient reported recurrence of facial pain.

Conclusions: the most common cause of recurrent neurovascular compression of the trigeminal nerve was postoperative adhesion formation. Other frequent causes include inadequate isolation of the nerve from cerebral vascular structures and displacement of the Teflon implant. To reduce recurrence rates, it is essential to prevent postoperative adhesions at the surgical site and to ensure complete separation and reliable insulation of the nerve not only from the compressing vessel but also from adjacent cerebral structures, including neighboring cranial nerves.

Objective: to study the capabilities of Magnetic Resonance Cholangiopancreatography (MRCP) in the diagnosis of acute cholangitis.

Material and methods: the study included 53 patients who underwent MRCP. The protocol included T2 T2FS, T1 dual Echo 1-2 (IP OP), DWI b (0-1000-2000), using a 24 channels superficial abdominal coil. The field of view extended from the diaphragm to the lower segment of the kidneys (slice thickness 5 mm; FOV 450 mm). Findings were interpreted in conjunction with the corresponding T2 and T2 FS data.

Results: all 53 patients demonstrated areas of hypointensity within thickened bile‑duct walls on MRCP. The altered bile duct walls were visualized immediately caudal to the lower border of the dilated intra- or extrahepatic bile ducts. These altered duct walls were visualised immediately caudal to the inferior margin of the dilated intra- or extrahepatic ducts. Secondary cholangitis arose in the setting of prolonged cholestasis and infection, and in patients with hepaticojejunostomies or choledochoduodenal anastomoses owing to reflux of intestinal contents into the biliary tree. On fat-suppressed T2-weighted images, small (2-8 mm) hyperintense foci were identified along small-caliber intrahepatic bile ducts. DWI IP likewise revealed small foci of diffusion restriction against the background of dilated small-caliber bile ducts.

Conclusions: MRCP combined with post-processing that includes multiplanar and volumetric reconstructions, enhances visualization of biliary duct inflammation. The resulting images are of a higher quality and provide a model for virtual treatment planning.

Objective: to assess the vitamin D status of pregnant women residing in the Republic of Tajikistan across different stages of gestation.

Material and methods: the study was conducted at the clinical base of the SI “ Republican Medical Genetics Center” and included 68 pregnant women from various regions of Tajikistan. Each participant attended a single study visit, during which informed consent was obtained, medical history was collected, and blood samples were drawn for laboratory analysis.

Results: the study cohort included 68 pregnant women from various regions of Tajikistan, who were divided into four groups based on vitamin D status. Analysis of the distribution of vitamin D status in the study population revealed a systemic nature of its deficiency across all surveyed regions.

Conclusion: assessment of vitamin D status in the population of pregnant women of the Tajikistan demonstrated a significant deficiency, with a concerning trend of progressive decline in its level by the third trimester of gestation.

Objective: to improve the immediate results of surgical treatment of postoperative peritonitis (PP) in patients with hepatobiliary disorders.

Material and methods: the study included 54 patients with PP, operated in the clinic for surgical diseases №1 named after Academician K.M. Kurbonov. 83.3% of participants were women. In light of the introduction of new technology and refined surgical techniques, the patients were divided into two groups: a study group of 24 patients (44.4%) and a comparison group of 30 patients (55.6%) who were treated using conventional diagnostic protocols and operative procedures. Generalized peritonitis was observed in 79.6% of cases, whereas localized, non-encapsulated peritonitis in 20.4%.

Results: the following interventions led to the development of PP in 31.5% of patients: various forms of echinococcectomy (n = 10); atypical liver resection for hepatic haemangioma (n = 2); incision and drainage of a hepatic abscess (n = 3); and repair of liver wounds (n = 2). PP occured in 25 (67.6%) out of 37 cases following conventional open cholecystectomy (n = 14) or cholecystectomy involving the construction of biliodigestive anastomoses (n = 11). In 32.4% of cases, PP occurred as a complication of laparoscopic cholecystectomy involving biliary tract. The effectiveness of the surgical treatment for both patient groups was assessed based on changes in blood leukocyte count and C-reactive protein (CRP) levels on the day of surgery and on postoperative days 2, 4 and 6. On postoperative day 4, the main group had significantly lower CRP levels than the control group.

Conclusion: thus, alongside imaging methods, C-reactive protein (CRP) and interleukin-6 (IL-6) levels are highly informative markers for the early diagnosis of postoperative peritonitis. Using these markers enables timely, pathogenetically guided preoperative management and facilitates the selection of the most appropriate corrective intervention.

Objective: to assess the effectiveness of single-stage minimally invasive surgery in children with Hirschsprung’s disease (HD) and to identify its advantages over traditional multi-stage approaches.

Material and methods: the study was conducted at the Department of Surgery of the Medico-Social Institute of Tajikistan and at the “Istiqlol” Clinical Center between 2016 and 2024. A total of 143 patients with clinically and morphologically confirmed HD were included in the study. The patients were aged between three days and 17 years. The study compared two groups: Group I comprised patients who underwent one-stage surgery (n = 30), while Group II comprised patients who underwent multi-stage interventions involving colostomy (n = 113). The methods used included ultrasonography, contrast enema (irrigography), endoscopy, sphincterometry and histology.

Results: complications occurred significantly less frequently in the one-stage surgery group (2.8% vs. 13.3%; p < 0.01). Normal defecation was also achieved more often in this group (90.7% vs. 69.2%; p < 0.05), as was sphincter function preservation (95.3% vs. 76.9%; p < 0.05). The average length of hospitalization was 7.5 ± 1.2 days compared to 18.3 ± 2.7 days (p < 0.001). Toxic liver injury was detected in 69.2% of patients in the second group (p < 0.01), whereas no such cases were recorded in the first group.

Conclusion: one-stage operations for HD provide superior functional and metabolic outcomes, reduced hospitalization time, and minimize the risk of complications. In the absence of contraindications, this should be considered the method of choice in pediatric surgical practice.

Objective: to conduct a situational analysis of the prevalence of congenital cleft lip and palate and associated risk factors in the pediatric population.

Material and methods: a total of 922 birth and treatment records of children with congenital cleft lip and palate in Dushanbe and the districts of republican subordination were analyzed. The study was based on a retrospective review of archival records from maxillofacial surgery departments and maternity facilities from 2015 to 2024. For the purpose of scientific analysis, a custom-designed outpatient medical record form was employed, which had been specifically developed for children with congenital craniofacial anomalies. This form included a comprehensive set of potential risk factors. Quantitative analysis was carried out using a computerized data processing system.

Results: the study revealed that there were more male than female patients among children with congenital cleft lip and palate. Children with clefts were found to be more likely to be born prematurely than healthy children. Furthermore, the mothers of children with cleft lip and palate experienced a higher frequency of exacerbations of chronic diseases during pregnancy.

Conclusion: the analysis indicates a higher rate of gynecological morbidity among mothers of children with cleft lip and palate than in the control group. These mothers’ medical histories also showed a twofold increase in induced abortions compared to mothers of healthy children.

Objective: to assess the effectiveness of videolaparoscopic interventions in patients with gynecological peritonitis.

Material and methods: a comprehensive evaluation was conducted on all 44 patients diagnosed with gynaecological peritonitis. In most cases (13 patients, or 29.5%), the etiological factor was purulent salpingitis. Pyosalpinx was identified as the cause in 10 cases (22.7%), while rupture of a tubal abscess into the peritoneal cavity was observed in six patients (13.6%). A ruptured tubo-ovarian abscess was recorded in three cases (6.8%), and rupture of an ovarian abscess (piovarium) was identified as the cause in two patients (4.5%). Additionally, peritonitis was caused by rupture of an infected dermoid ovarian cyst in two cases (4.5%).

Results: all patients underwent surgical interventions of varying scope and nature depending on the cause of the peritonitis. In all cases, videolaparoscopy was initially performed for diagnostic purposes, yielding a sensitivity and specificity close to 100%. Radical source control via laparoscopy was achieved in 39 patients (88.6%). In five cases (11.4%), conversion to laparotomy was necessary due to extensive purulent-fibrinous peritonitis requiring small bowel intubation. Analysis of the postoperative course showed that six patients (13.6%) developed various complications, all of which were successfully managed conservatively without the need for reoperation. No fatalities were registered.

Conclusion: a comprehensive analysis confirms that laparoscopy is an effective diagnostic tool for identifying purulentinflammatory pathologies of the uterine adnexa. Based on these findings, laparoscopy is recommended for all cases of confirmed gynaecological peritonitis. This approach facilitates differential diagnosis from acute surgical abdominal conditions and enables effective source control in patients with gynaecological peritonitis.

Objective: to assess the iodine status of children under six years old and women of reproductive age in the Republic of Tajikistan.

Material and methods: the study was conducted across five regions of Tajikistan. Households were eligible for inclusion if they had at least one non-pregnant woman aged 15–49 years and/or a child aged 6–59 months. Data collection involved administering an updated questionnaire and collecting urine and salt samples. A two-stage random cluster sampling method was employed, consistent with national surveys conducted in 2003, 2009 and 2016. The study surveyed a total of 2,358 households, resulting in the collection of 2,358 salt samples and 4,474 urine samples from women and children.

Results: analysis of 2,358 salt samples revealed that, while 36.6% of households used iodised salt, only 12.8% of these had an adequate iodine content (15–40 mg/kg). Coverage was higher in urban areas (45.1%) than in rural settings (34.2%). Dushanbe had the highest coverage (50.5%, with 19.3% adequately iodised), while the Districts of Republican Subordination (DRS) had the lowest (26.3%, with just 7.3% adequately iodised). The lowest iodine levels were found in loose salt (3.8%) and unmarked packages (3.6%). Only 14% of households that reported having iodised salt actually had adequately iodised salt. The median urinary iodine concentration (MUIC) among women (n = 2,236) was 121.7 µg/L, indicating sufficient iodine intake. By contrast, children aged 6–59 months (2,238 samples) had a MUIC of 48.1 µg/L, reflecting iodine deficiency. While the iodine status of women has improved since 2003, the situation for children remains concerning. The highest MUIC levels among children were observed in Dushanbe and Sughd Region (65.5 and 56.3 µg/L, respectively), while the lowest level was observed in Gorno-Badakhshan Autonomous Region (GBAO) (31.6 µg/L). There was no correlation between household MUIC levels and the degree of salt iodisation.

Conclusion: although the median urinary iodine concentration among women of reproductive age suggests adequate iodine intake, children aged 6–59 months continue to be iodine deficient. Despite legislation mandating universal salt iodisation, household consumption of iodised salt remains low. Salt producers and inspection personnel should undergo training to ensure that salt is properly iodised in accordance with established standards.

Objective: to provide evidence for the use of distraction osteogenesis in orthognathic surgery for children and adolescents.

Material and methods: the study involved the clinical management of 17 pediatric and adolescent patients (nine men and eight women, aged 11–16) who had been diagnosed with micrognathia and retrognathia of the maxilla. The patients were treated at the Department of Maxillofacial Surgery at the Scientific-Clinical Institute of Dentistry and Maxillofacial Surgery using distraction osteogenesis. A combination of clinical and laboratory analyses, diagnostic models, and advanced radiographic imaging modalities were used for diagnostic evaluation, including lateral cephalometric radiography, orthopantomography, and temporomandibular joint radiography.

Results: a comprehensive clinical and radiological assessment was followed by a minimally invasive maxillary osteotomy. The osteotomised segment was then advanced using an external distraction device. This resulted in the correct alignment of the jaw and improved the patients’ facial aesthetics. The patients had maxillary micro- and retrognathia. Long-term follow-up over a two-year period revealed no cases of relapse.

Conclusions: techniques of distraction osteogenesis in orthognathic surgery are less traumatic and minimise postoperative inflammatory complications. They also allow for the simultaneous performance of osteotomy and controlled threedimensional repositioning of the maxilla.

This article describes a clinical case of successful treatment of noma (cancrum oris) in a 51-year-old female patient with late-stage HIV infection. An extensive ulcerative-necrotic lesions of the soft tissues of the lower lip and chin developed against the background of severe immunodeficiency (CD4 count: 25 cells/μL, viral load: 22.4 million copies/ mL). Microbiological testing identified polymicrobial infection with Fusobacterium spp., Staphylococcus aureus, and Candida albicans. A comprehensive treatment strategy included antibacterial and antifungal medications, symptomatic care, nutritional support, and antiretroviral therapy. This approach led to complete clinical recovery of the affected skin restoration without the need for surgical intervention. At six months post-treatment initiation, sustained immunological and virological remission was achieved (CD4 count: 425 cells/μL, viral load: 36 copies/mL). Six months after the initiation of therapy, the patient achieved sustained immunological and virological remission (CD4 count: 425 cells/μL; viral load: 36 copies/mL). This case underscores the importance of timely initiation of ART and an integrated approach to managing severe opportunistic infections in people living with HIV.

In the early stages of the pandemic, most clinical manifestations were observed in adults. Consequently, paediatricians rarely considered the possibility of children having the virus, meaning that the characteristic clinical and radiological signs of a coronavirus infection were often overlooked in paediatric patients. As a result, doctors often failed to perform differential diagnoses between SARS-CoV-2 pneumonia and pneumonias of other aetiologies, whether viral, specific (e.g. bacterial) or non-specific. In this regard, the presented clinical case is valuable. It is clear from this report that characteristic changes in CT and X-ray images of the lungs are necessary for the early diagnosis of coronavirus pneumonia. The report also indicates the potential for a non-specific infection to cause a secondary SARS-CoV-2 infection.

The article provides an analysis of current data on the pathogenesis and diagnosis of postoperative anal sphincter insufficiency (PASI). The primary objectives of the study were to analyze the anatomical and physiological mechanisms contributing to the development of PASI, to review the current diagnostic methods, and to identify risk factors. The research methodology was based on a systematic literature review, incorporating data from PubMed, Web of Science, CyberLeninka, and Cochrane Library, covering the period from 2018 to 2023. The findings highlight the critical role of muscular and neural structure damage to the anal sphincter in the pathogenesis of PASI. Furthermore, the findings underscore the diagnostic value of anorectal manometry, endoanal ultrasonography, and magnetic resonance imaging in ensuring accurate assessment. It has been established that a comprehensive approach to diagnosis and treatment, incorporating minimally invasive technologies and interdisciplinary strategies, contributes to improved functional outcomes and enhanced quality of life for patients. In conclusion, the study emphasizes the importance of further research aimed at minimizing surgical trauma and optimizing rehabilitation protocols for effective condition management.

The article presents a review of literature on pathophysiological, pathomorphological and clinical-biochemical changes observed in moderate to severe obstructive jaundice. This condition is characterized by pronounced manifestations of cholestasis, cholemia and acholia, and is complicated by varying degrees of hepatic insufficiency, hepatic encephalopathy, cholangitis, biliary sepsis, and gastrointestinal bleeding. The principles of surgical management for this patient category are described in detail, focusing on various interventions in terms of scope and nature, within the framework of a two-stage approach. The first stage involves preliminary biliary decompression, followed by either radical or palliative surgical intervention in the second stage, combined with complex intensive conservative therapy.

The diversity of current treatment methods of ovarian cancer (OC) with peritoneal dissemination, such as cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC), complicates the selection of an optimal strategy and may delay the initiation of treatment. This review systematizes current treatment approaches and presents practical recommendations based on an analysis of recent scientific data. A systemic literature search was conducted in MEDLINE, PubMed, and eLibrary for the period from 2015 to 2025 using the keywords like “ovarian cancer,” “peritoneal dissemination,” “cytoreductive surgery,” “HIPEC,” and “PIPAC.” Studies unrelated to the topic were excluded. The review includes primary studies focused on the treatment of ovarian cancer with peritoneal dissemination.