Aim. To improve treatment result of patients with liver echinococcosis, complicated by mechanical jaundice of parasitic origin and parasitic cholangitis. Material and methods. The paper observes the treatment outcomes of 19 patients. Laboratory blood tests along with endotoxemia signs, x-ray methods, and endoscopic methods were used to find the diagnosis of parasitic cholangitis. Results and discussion. Patients received two staged treatment. On a first stage, endoscopic decompression and sanation of the biliary tract or echo-controlled decompression of the common bile duct were performed. On the second stage, various options of the operation were considered. All 19 patients were discharged after 1,5-2 months after minimally invasive surgeries in the safe period with positive immediate and long term outcomes. Radical operations were performed in 8 cases and palliative - open echinococcectomy in 11 cases. Conclusion. Two-stage treatment in the case of mechanical parasitic jaundice complicated by parasitic cholangitis is reasonable according to pathogenesis.

Aim. To find features of the frontal asymmetry of an alpha range of EEG during an unconscious shift of the attention to visual stimuli with violence and aggression. Material and methods. The observation included 25 students of the medical university (11 men and 14 women), in an age of 21±2, with a right leading hand and normal or corrected vision. All students approved voluntary participation in the research. The dot-probe test was used as a cognitive task. EEG registration was performed on a “Medicom-MTD” machine complex. Results. It was found that the shift of the attention to the visual stimuli of violence and aggression accompanied expressed left lobe asymmetry of alpha wave range before and during the cognitive test.

Aim. To study features of clinical picture and diagnosis and to evaluate the efficiency of the combined methods of cavernous vascular skin and skin derivatives tumors of the base of the skull, maxillofacial area, and neck treatment. Material and methods. A prospective analysis of clinical data of 65 patients with cavernous vascular skin and skin derivatives tumors of the base of the skull, maxillofacial area neck who received combined treatment in the conditions of the State Institution “Republican Cancer Research Center" of the Ministry of Health and from 2009 to 2017 was conducted. Results. Evaluation of the efficiency of combined treatment of 65 patients with cavernous vascular skin and skin derivatives tumors of the base of the skull, maxillofacial area and neck showed perfect results in 45 (69%) cases, good results in 17cases (26%) and satisfactory results in 3 cases (5%). Conclusion. The combined treatment method of cavernous vascular skin and skin derivatives tumors of the base of the skull, maxillofacial area, and neck allows reaching total regression of the tumor in 69% of patients and in 31% of patients reaching recovery after second and third stages of treatment. This has speeded up medical and social rehabilitation and improved life quality of patients.

Aim. To study diagnosis timeliness o f congenital hypothyroidism and the frequency o f its spread in regions o fTajikistanMaterial and methods. The follow-up analysis o f case histories o f the past 9 years at the pediatric endocrinologydepartment o f Akhmedov City Medical Center was conducted. Such parameters as TSH, free thyroxine fraction, completeblood count, urinalysis, etc. were studied.Results. It was found that the late diagnosis o f the disease varies from 6 months to 16 years. There is a lag o fanthropometric indices in 74% o f patients associated with late diagnosis and inadequate treatment o f the disease.Statistically high prevalence o f congenital hypothyroidism was recorded in the RRS and Khatlon region, which can beattributed to reduced admission o f patients from other regions.

Aim. To study the development and clinical approbation of an approach to the implementation of combined general anesthesia in patients with oncological diseases undergoing advanced surgical interventions. Material and methods. A total of 191 patients with cancer of the stomach, pancreatic head and colon that underwent extended surgical procedures were examined. The patients were divided into 2 groups: patients that received total intravenous anesthesia with propofol (n = 75); patients that received combined anesthesia with propofol + sevoflurane and propofol + isoflurane (n = 116). With combined anesthesia, the concentration of anesthetics was 0.3-0.5 vol.%, Propofol was injected with a syringe pump at a dose of 20-30 ml/h.Results: The average values of central hemodynamic parameters underwent greater changes during the intravenous anesthesia than during combined anesthesia. The combination of anesthetics provided less depression of the contractile ability of the heart. Combined anesthesia provided a greater degree ofprotection from operational stress, which was expressed in a lower content of cortisol in the blood during the intervention. The mean values and variability of the BIS-index were also optimal during combined anesthesia. Conclusion: The use of anesthesia with the combination of propofol + inhalation anesthetic provides an adequate level of analgesia with minimal risk of side effects and post-anesthetic complications in oncological practice.

Aim. To study the results of the spectral analysis of the cardio interval variations in women with acute myocardium infarction in the climacteric period. Materials and method. The results of the spectral analysis of cardio interval variation of 195 women were analyzed by the method of N.I. Muzalevskaya and V.M. Uritzkiy. The patients were divided into 4 groups: 1 group - 35 (17.9%) practically healthy women; Group 2 - 45 (23.1%) women in menopause; Group 3 - 65 (33.3%) women with acute myocardial infarction in menopause without complications; Group 4 - 50 (25.7%) women with acute myocardial infarction in menopause with complications. Results. Spectral power inhomogeneity was observed in women with acute myocardium infarction in the climacteric period with and without complications. In the third group of women analysis of the power spectrum showed a significant shift in all indicators in comparison to the first and second groups. In fourth group analysis of the power, spectrum showed a significant shift in all indicators more than in patients from a group three. Conclusion. Analysis of the power spectrum in the third group showed a significant shift in all indicators exposing vegetative dysbalance with sympathicotonia dominance, extra-cardial regulation and metabolism disorder, endothelial dysfunction.

Aim. To improve the outcomes of diagnosis, conservative treatment of acute upper gastrointestinal bleeding due to a peptic ulcer. Material and Methods. 178 patients with acute upper gastrointestinal bleeding due to a peptic ulcer were studied to find the state of the peroxide oxidation state of lipids, antioxidant capacity of the blood, oxygen transportation function of blood, acid-base state, and blood gas composition. Patients were divided into three main groups and each group was divided into two subgroups according to the level of blood loss, amount and character of infusion-transfusion therapy. American surgeons board classification (ATLS2012) was used to find the level of blood loss. Results. Subgroup 1a received 0,9% sodium chloride in an amount of 200% out of the level of blood loss. Subgroup 1b received an infusion of a balanced colloid solution of isotonic Sterofundin. Patients of the 2a subgroup received isotonic Sterofundin in the amount of 200% of blood loss. Besides isotonic Sterofundin patients of the subgroup 2a received modified Gelatine solution - Gelofusin. Patients of 3 a subgroup received the same blood group donor blood and isotonic Sterofundin. Patients of 3b subgroup received isotonic Sterofundin, Gelofusin, blood infusions and individually selected for each patient donor blood products, taking in account disorder on recipients blood hemostasis disorder. Conclusion. The study has shown that the most balanced infusion- perfusion therapy is a technology that was used for the 3b subgroup, that included isotonic Sterofundin, Gelofusin, and individually chosen blood products.

Aim. To design and to study the therapeutic efficiency of the bromothiadiazolpyrimidine ointment. Material and methods. Following properties of bromothiadiazolpyrimidine ointment were studied: general toxic, allergenic, hepatotoxic, embryotoxic and teratogen, antimicrobial activity. The efficiency of the external application of the bromothiadiazolpyrimidine ointment was also studied. Results. It was found that bromothiadiazolpyrimidine have a wide spectrum of antimicrobial activity, it is a practically nontoxic substance that doesn’t have teratogen effect. The ointment with bromothiadiazolpyrimidine as the active substance in a concentration of 1% is highly effective antibacterial medicine for surface application treating wound infections. Conclusion. The ointment with bromothiadiazolpyrimidine as the active substance in a concentration of 1% is highly effective antibacterial medicine for the surface application that could be administered for a wide range of medical problems.

Aim. To study clinical peculiarities of the course and modern treatment methods of congenital toxoplasmosis in newborns. Material and methods. The paper presents the results of an examination of 18 newborns with congenital toxoplasmosis. Along with general clinical examination methods, enzyme immunoassay analysis of mother and child was conducted. Results. High somatic pathology was found during the analysis of case histories of mothers: anemia in 12 cases - 66,67%; acute respiratory infection in 9 cases - 50%; kidney diseases in 7 cases - 38,89%; hynecologic pathologies like endometritis in 9 cases - 33,33% and colpittis in 5 cases 27,7%; complicated obstetrics history like perinatal loss in 11 cases - 61,1%, spontaneous misscarrige in 7 cases - 38,89% cases, risk of misscariege and hestoses in 5 cases -27,78%, intrauterine fetal hypoxia in 6 cases - 33,33% and polyhydramnios in 4 cases - 22,22%; complications during birth like labor weakness in 10 cases - 55,56%, stimulation during labour in 9 cases - 50% and long dry period in 5 cases - 27,78%. Conclusion. The results have shown that congenital toxoplasmosis in newborns has severe generalized septic process course with a lesion of all organs and systems that causes polyorganic insufficiency. The organs that were involved mostly are lungs, umbilical wound, intestines, brain and bone marrow. The efficiency of the treatment depended on the severity and form of the disease.

Aim. To study the morphological and immunohistochemical picture of benign ovarian tumors in women of reproductive age. Material and methods. We have studied 227 histological subjects of benign ovarian tumors. Immunohistochemical test examination of 32 samples of the ovarian cyst was conducted: 10 serous cyst samples; 7 dermoid cyst samples, 10 endometrioid cyst samples, and 5 border cysts. Results. It was found that among all benign ovarian tumors serous cystadenomas were prevailing, while in a group of retention neoplasms corpus luteum cyst. Conclusion: Thus, modern diagnostics of tumors and tumor-like formations of the ovaries can not be based on any one method of investigation, but requires a whole range of diagnostic measures to establish the presence of ovarian formation in the early stages of development and conduct differential diagnosis of a benign or malignant process, and determine the possible morphological structure of the tumor and clarify the true tumor or non-tumor nature of ovarian formations.

Aim. The choice of approach in the management of the patients with foreign bodies in the esophagus accordingto the state of passage of the esophagus.Material and methods. 49 patients with foreign bodies in the esophagus were studied during 2014-2018 yy. Allpatients were subjected to general clinical examinations, ENT examination and x-Ray. Patients with cicatricial narrowingin a case history had x-ray examination with liquid barium. Removal of foreign bodies was carried immediately afterhospitalization as an emergency after short-term preparation under general endotracheal anesthesia with esophagoscopyusing a Bruenings broncho-esophagoscope.Results. In 35 out of 44 cases, the attempts to extract foreign body with an esophagoscope, in patients withoutcicatricial narrowing were successful. In 6 cases during the attempt to extract foreign body it fell down. In two cases,meat piece left esophagus before the start of anesthesia.Conclusion. Foreign body in the esophagus requires immediate hospitalization to a specialized hospital. Latehospitalization leads to the depletion of patients, complicates the extraction of a foreign body and worsens the prognosis.

The paper presents a literature review on a topic of diagnosis and surgical treatment of nasal septum deformations associated with allergic rhinitis. It discusses issues of etiology, epidemiology and clinical manifestation of various deformations of nasal septum associated with allergic rhinitis. The paper also discusses different approaches to conservative therapy and surgical deformation of nasal septum associated with allergic rhinitis in relation to the severity of the pathology

Current work presents the analysis of the domestic and foreign literature, on issues ofpathogenesis, classification and surgical treatment of nasal septum pathologies combined with sinonasal pathologies. According to literature surgical treatment methods of nasal septum pathologies combined with sinonasal pathologies and the issues ofpost-operational rehabilitation of patients after nasal surgeries require improvements and optimizations.