Objective: to review evidence from high-income countries on HPV vaccination effectiveness and clinical safety to inform the planning of an immunization campaign in the Republic of Tajikistan.
Material and methods. A literature search was conducted to identify clinical and epidemiological studies on the effectiveness and safety of human papillomavirus (HPV) vaccines administered within the past 10–15 years (MEDLINE/ PubMed, WHO sources, and other relevant databases).
Results. HPV vaccines are highly effective (97-100%) at preventing cervical precancer and cancer. Numerous multicenter studies have shown that HPV 16 and HPV 18 infection declined by 90% in age cohorts targeted by routine vaccination. The incidence of anogenital warts among young men and women has decreased by 88%, and the incidence of severe cervical intraepithelial neoplasia (CIN2+) has decreased by 70%. In many countries that introduced the vaccination of adolescent girls, the incidence of invasive cervical cancer has fallen, and in some settings, it has approached near-zero levels among women of reproductive age. In 2017, the WHO Global Advisory Committee on Vaccine Safety issued a statement affirming the safety of HPV vaccines and reaffirming WHO recommendations for their worldwide use.
Conclusion. Inclusion of HPV vaccination in the immunization schedule is an important step towards eliminating cervical cancer in Tajikistan. The quadrivalent vaccine Gardasil, which is intended for the immunization of 10-year-old girls, has demonstrated high effectiveness (over 95–97%) and a well-established clinical safety profile.

Objective: To summarise the steps taken towards implementing a modular, competency-based approach to nursing education in Tajikistan.
Materials and methods: The study comprised an online survey conducted via Google Forms among teachers, medical college students and practising nurses (n = 80), a comparative analysis of nursing textbooks used in post-Soviet countries, and the application of competency-based and blended learning principles to the development of modular content. Additionally, international standards (ICN, WHO) and the level of digital accessibility in educational institutions were examined.
Results: A total of 65% of respondents indicated a preference for printed materials supplemented with QR codes, while 87.5% reported having full or partial internet access. The textbook analysis revealed limited integration of modular and digital components. The developed model incorporates a modular structure and digital tools, such as QR codes, video lessons and online tests, which are aligned with international standards and competency-based learning.
Conclusions: Implementing a modular, competency-based learning model supported by digital tools is a feasible and promising way to advance nursing education in Tajikistan. Most respondents confirmed the convenience of hybrid (print-digital) formats, particularly printed materials with QR codes for accessing online resources. However, successful adoption will require institutional support, improved digital literacy and the development of sustainable educational infrastructure.

Objective. Analysis of the results of echoencephaloscopy of patients with cerebral echinococcosis.
Material and methods. A retrospective study of 45 medical records of patients with cerebral echinococcosis was conducted. The patients’ ages ranged from 19 to 60 years, and they received inpatient treatment at the Department of Neurosurgery and Combined Trauma between 1984 and 2023.
Results. EchoES was performed on 33 out of 45 patients with cerebral echinococcosis. No M-echo shift was observed in four patients (12.1%). Shifts of 2 mm (3.0%), 3–4 mm (6.1%), 5–10 mm (57.6%) and 11–15 mm (21.1%) were noted in one, two and 19 patients, respectively. The most common M-echo displacement was within the 5–10 mm range (in 19 patients, or 57.6%), which corresponds to relatively satisfactory clinical conditions that are rarely observed in other intracranial pathologies. The mean M-echo shift was 7.7 mm.
Conclusion. In most cases, M-echo signal displacement was detected at 5–10 mm (57.6%), indicating a relatively satisfactory condition of the patient, which is rarely observed in other intracranial pathologies. EchoES is a valuable and accessible investigative method of great importance for diagnosing the early stages of disease.

Objective: To evaluate the effectiveness of using the osteotropic material A-OSS in combination with a PRF membrane for the surgical treatment of odontogenic cysts in the maxillofacial region.
Materials and methods: A prospective analysis was conducted on 35 patients treated for odontogenic jaw cysts between 2023 and 2024. Of these patients, 24 (68.6%) had radicular cysts and 11 (31.4%) had follicular cysts. Following cystectomy, bone defects were grafted with A-OSS and covered with a PRF membrane. Statistical analyses were performed using IBM SPSS Statistics version 26.0.
Results: The A-OSS + PRF combination technique achieved complete bone regeneration in 97.1% of cases after 12 months of follow-up. The mean consolidation times were 5.2 ± 1.1 months for radicular cysts and 6.1 ± 1.4 months for follicular cysts (p > 0.05). The complication rate was 5.7%, with no recurrences observed.
Conclusion: Using A-OSS and a PRF membrane together is an effective approach for treating odontogenic cysts of the jaws. It yields a high rate of complete bone regeneration and has a low complication rate.

Objective: to evaluate the clinical outcomes of various methods of surgical treatment of cervical disc herniation and to identify prognostic factors.
Material and methods. A retrospective study of 42 patients who underwent ACDF, laminectomy or microdiscectomy was conducted. The results were assessed using the JOA, VAS and NDI scales at three stages of observation.
Results. All three methods demonstrated positive dynamics, but the ACDF method was statistically more effective.
Conclusion. ACDF is the preferred method of surgical treatment of herniated discs of the cervical spine.

Objective: To assess the prevalence of dental caries and fluorosis in children living in regions with different levels of fluoride in drinking water.
Materials and methods: A dental examination was conducted on 12-year-old children (n = 261) living in the Tursunzade, Gissar and Shahrinav districts. Of these, 119 (45.6%) were boys and 142 (54.4%) were girls. Drinking water samples (three measurements per district) were collected from the aforementioned districts and analysed. Clinical, laboratory and statistical methods were employed.
Results: Analysis of the drinking water samples revealed fluoride concentrations of 0.93 mg/L in Shirkent and 0.78 mg/L in Karatag, which are within the recommended standard range. However, in the Tuda settlement, the fluoride concentration was 1.98 mg/L, which is approximately 1.65 times higher than the maximum permissible level. The prevalence of dental caries was ‘high’ in the Tursunzade and Shahrinav districts and ‘moderate’ in the Gissar district. The prevalence of dental fluorosis was 6.2%, 10.5% and 42.5% in the Shahrinav, Tursunzade and Gissar districts, respectively.
Conclusion: The fluoride concentration in the water in the Tursunzade district, which is located within the aluminium production zone, was within normal limits. This suggests that the environmental policies implemented by TALCO company help protect the health of nearby populations. Our study established a direct association between elevated fluoride levels in drinking water and an increased prevalence of dental fluorosis. It also revealed a negative correlation between fluoride concentration and caries incidence among the children examined. However, Gissar district, despite being over 30 kilometres from the nearest aluminium production source, showed a high prevalence of fluorosis. This suggests that industrial emissions are unlikely to be the sole cause of this condition in the region.

Objective: To evaluate quality of life in patients with inflammatory bowel disease.
Materials and methods: A prospective cross-sectional study involving 46 patients was conducted with outpatient follow-up.
Results: Crohn’s disease was present in 32 (69.6%) of the total number of patients assessed (n = 46), and ulcerative colitis in 14 (30.4%). Of these patients, 25 (54.3%) were women and 21 (45.7%) were men. The mean patient age was 47.3 years. Non-smokers comprised 95.7% of participants. A history of surgery for the primary disease was noted in 11 patients (23.9%). Twenty (43.5%) patients received combination therapy, 21 (45.7%) received monotherapy, and the remaining five (10.9%) did not receive medical treatment. Significant improvement in quality of life was observed among patients treated with metipred.
Conclusions: Patients who received Metipred had the highest quality of life scores. No other statistically significant correlations with quality of life were found.

Objective: to evaluate testicular function and blood flow in the spermatic cord vessels and testicle in men with inguinal hernia (IH) before and after surgery.
Materials and methods. This prospective study included 60 men with unilateral IH and 30 healthy volunteers. All participants underwent color duplex ultrasonography of the spermatic cord and testicular vessels using a modified technique by I.I. Uspensky. The following parameters were measured: peak systolic velocity (PSV), mean flow velocity (Mean), resistance index (RI), and retrograde venous flow (V ven). In a subgroup of patients (n = 40) and controls (n = 20), circulating sex hormone levels were measured, and semen analysis was performed in 35 patients. Markers of oxidative endotoxemia (MDA, DC) and a marker of hypoxia (lactate) were measured in both serum and testicular venous blood from.
Results. The mean arterial flow velocity on the affected side was significantly lower (11.28 [10.2–12.5] cm/s) than on the contralateral side (14.08 [12.3–15.8] cm/s; p < 0.001) and in healthy volunteers (15.22 [14.5–16.3] cm/s; p < 0.001). A direct correlation was found between hernia size and the degree of blood flow reduction, as well as between the duration of hernia presence and the degree of vascular impairment. Semen parameters and serum testosterone levels decreased in patients with inguinal hernias, especially those with longer duration and larger defects. Markers of oxidative stress and hypoxia were elevated in testicular venous blood. Postoperative follow-up showed improvement in testicular perfusion and function, which was most pronounced after laparoscopic or hybrid hernia repair.
Conclusions. An inguinal hernia in men of reproductive age disrupts blood flow in the spermatic cord and testicular parenchyma vessels, which decreases spermatogenesis and testosterone production. The severity of the changes correlates with the size and duration of the hernia. The underlying causes of this dysfunction are ischemia, hypoxia, and oxidative stress. Atraumatic laparoscopic hernioplasty with intraoperative perfusion control, supplemented by an algorithm for selecting the surgical method and a plan for preventing postoperative testicular dysfunction, reliably restores blood flow and preserves reproductive potential.

Objective. Analysis of the microbiota composition of the maxillary sinuses and evaluation of the antimicrobial susceptibility considering the duration of the sinus floor perforation.
Material and methods. A total of 35 patients with chronic odontogenic maxillary sinusitis participated in the study between 2020 and 2024. The patients’ ages varied from 20 to 60 years; 17 of them (48.6%) were men and 18 (51.4%) were women. The patients were divided into two groups. The first group comprised 23 patients (65.7%) whose disease was complicated by the presence of a formed oroantral fistula (lasting from two weeks to two years). The second group comprised 12 patients (34.3%) with foci of inflammation in the periapical tissues of the maxillary molars and premolars.
Results. A microbiological study of 35 patients with chronic odontogenic maxillary sinusitis showed that this group often has coccal flora, particularly gram-positive cocci belonging to the major groups of streptococci, staphylococci and enterococci, as well as Candida fungi. In both groups, the concentration of microbial colony-forming units did not exceed 10²–10⁵ CFU/ml. This suggests that surgical treatment was performed outside the phase of acute inflammation and that all patients received antibacterial and anti-inflammatory therapy, as well as oral cavity sanation, as outpatients before hospitalisation.
Conclusion. The study indicates that surgical treatment can only be performed after the acute inflammatory processes have resolved, and after preoperative antibiotic therapy if necessary. When selecting an antibacterial drug to treat odontogenic sinusitis, protected aminopenicillins, the latest generation of cephalosporins and fluoroquinolones should be preferred.

Objective: To optimise approaches to the diagnosis and management of pregnant women with obstructive uropathy caused by urolithiasis.
Materials and methods: We analysed the pregnancy and delivery of a woman with obstructive uropathy due to urinary stone disease.
Results: The patient underwent multiple percutaneous nephrostomy tube replacements due to internal obstruction. During the postpartum period, computed tomography (CT) of the kidneys revealed incrustation of the internal ureteral stent on the right. Additionally, a dense structure measuring 10.4 × 3.5 mm and exhibiting a Hounsfield unit value of 360 was identified in the lower third of the right ureter. According to the literature, most authors recommend replacing nephrostomy drainage 2–3 months after placement. However, we would like to add that standard schedules and timing for elective replacement of drainage systems should be strictly individualised, considering both the patient’s anatomical and physiological features, as well as her attitudes towards the pathological process.
Conclusions: To prevent complications in pregnant women with urinary stone disease and ensure successful treatment, it is essential to carefully determine the type of upper urinary tract drainage (ureteral stent or nephrostomy) and perform regular ultrasound examinations to clarify the condition and position of the installed drain.

The article presents the results of reviewing periodic correspondence between the State Institution “City Medical Center No. 1 named after Karim Akhmedov” and the Dushanbe City Health Centers to enhance interaction between hospital facilities and city health centers and to optimize patient dispensarization.

The article provides a literature review of the etiological aspects of congenital chest deformities, the characteristics of various sternal curvatures, and the manifestations of decreased thoracic vertebral distance and diaphragm excursions in children. It provides clinical data on restrictive respiratory dysfunction with decreased tidal volume, as well as cardiac dysfunction. The article thoroughly describes the surgical treatment principles for children with congenital chest deformities, depending on the degree of deformation and the patient’s condition severity. Conservative treatment methods, such as vacuum therapy and vacuum bell use, are also covered. Despite the wide range of surgical interventions, the D. Nussa operation with modifications is the most suitable method for correcting congenital chest deformities in children.

This review summarises the factors that contribute to the development of sensorineural hearing loss (SNHL) of vascular and viral origin. It summarises findings from clinical audiological and virological studies of patients presenting with these forms of hearing impairment. The main principles underlying the onset, progression and prognosis of SNHL are outlined. The methods used for comprehensive auditory evaluations are assessed. Certain issues in the diagnosis and rehabilitation of SNHL of vascular and viral aetiology are identified, which warrant further investigation in this area.

Gastric cancer (GC) remains one of the most prevalent malignancies worldwide, with a high mortality rate. Among the many pathophysiological mechanisms involved, endothelial dysfunction (ED) has recently been identified as a key factor in tumour progression, angiogenesis, and postoperative complications. This review summarises the current knowledge regarding the role of ED in the pathogenesis of GC, including its impact on the tumour microenvironment, inflammatory processes, metabolic reprogramming and resistance to therapy. Particular attention is paid to molecular markers of ED, such as nitric oxide (NO), von Willebrand factor (vWF) and circulating endothelial cells (CECs), and their prognostic and diagnostic significance. The impact of surgical intervention and chemotherapy on endothelial integrity is also considered. Additionally, the interrelationship between Helicobacter pylori infection, chronic inflammation, and ED is explored. We believe that targeting ED therapeutically may represent a promising approach to improving outcomes in patients with GC.