Aim. To evaluate quality of life in women with adenomyosis using the Endometriosis Health Profile-5 questionnaire.

Materials and methods. A total of 127 women with various forms of confirmed adenomyosis were studied. After the evaluation, all participants were divided into four groups according to the treatment method used.

Results and discussion. Each woman was provided with a medical record that included the Endometriosis Health Profile (EHP-5+6) questionnaire, which was completed at the initial visit and again at 6 and 12 months after treatment. Analysis of the patients’ responses revealed differences in the impact of different treatment regimens on quality of life. Specifically, treatment with combined low-dose oral contraceptives (ethinyl estradiol + chlormadinone) and hysterectomy in cases of adenomyosis produced the best results, showing the greatest improvement in most quality-of-life domains. The Mirena LNG IUD was also effective, although to a lesser extent than the other two treatment groups.

Conclusion. The use of standardized questionnaires to assess quality of life is an important tool for monitoring treatment efficacy and improving therapeutic approaches to adenomyosis. The choice of treatment strategy should be based on the woman’s age, reproductive plans and clinical symptoms. It is crucial to initiate treatment at the first clinical manifestation of the disease, with a therapy that is long-term, effective, and safe.

Aim. To study the features of surgical treatment of external fistulas.

Materials and methods. 16 children aged from 9 months to 18 years with external intestinal fistulas were observed in the current study. Among the causes that led to the formation of fistulas, an appendix abscess and peritonitis were the most common, occurring in 12 patients.

Results. In most patients, labiform fistulas were found in the small intestine, whereas tubular fistulas were more common in the colon. The diagnosis was based on the nature of the intestinal discharge, which helped to specify the location of the fistula. For example, discharges from small bowel fistulas contained bile, whereas those from large bowel fistulas more often resembled solid stool. Six patients had solitary fistulas, while the others had two to five fistulas, including combinations of small and large intestinal fistulas. Multiple fistulas were associated with more complex diagnostic and therapeutic challenges. In nine cases, surgical management included resection of the affected segment of small bowel with construction of an end-to-end anastomosis. All surgical procedures were complicated by significant adhesions in the peritoneal cavity, requiring special care and careful planning by the surgeon.

Conclusions. Surgical intervention was complicated in all cases by a pronounced adhesive process in the abdominal cavity.

Aim. To study the characteristics of Doppler ultrasonography in pregnant women with hypertensive conditions and combined micronutrient deficiency.

Material and methods. The study included 200 pregnant women in their third trimester. They were divided into 30 women with normal pregnancy (control group), 70 women with IDD (comparison group 1), 58 women with IDA (comparison group 2) and 42 women with a combination of IDA, magnesium deficiency, calcium deficiency and IDD (main group). Inclusion criteria for all groups were reproductive age and the third trimester of pregnancy; for comparison group 1 - iodine consumption deficiency based on iodine excretion data from a 24-hour urine sample of grade I and II; for comparison group 2 - mild to moderate anemia; and for the main group - a combination of IDD and mild to moderate IDA. The examinations included a general clinical and laboratory assessment, thyroid ultrasound, thyroid palpation, urine iodine measurement, external obstetric examination, and uterine and fetal ultrasound (assessment of fetal dimensions, Doppler ultrasonography, and amniotic fluid volume).

Results and discussion. In cases of hypertensive conditions, women with concomitant micronutrient deficiencies began to develop hemodynamic disorders, which led to a decrease in uteroplacental blood flow. Prognostic indicators for the development of placental insufficiency at 22 weeks of gestation are the average values of systodiastolic ratio, pulsatility index and resistance index in the uterine arteries, which are 4.0, 1.73 and 0.76 or higher, respectively; in the umbilical artery - 5.7, 1.64 and 0.82 or higher; and in the fetal thoracic aorta - 9.0, 2.06 and 0.89 or higher.

Conclusion. The analysis demonstrated a high incidence of perinatal morbidity in children born to mothers in the high-risk group, which is attributed to the complications during pregnancy and the concomitant micronutrient deficiencies.

Aim. To evaluate the association of blood lactate clearance with postoperative complications in elderly patients with metabolic syndrome.

Materials and methods. The study was designed as a retrospective, controlled, single-center, observational study in which seventy-six patients were divided into a metabolic syndrome group (n = 38) and a comparison group (n = 38).

Results and discussion. It was found that the incidence of postoperative complications was significantly higher in the metabolic syndrome group (p = 0.005). In addition, the length of stay in the ICU was significantly longer in patients with metabolic syndrome. Lactate concentrations were also statistically significantly higher in the metabolic syndrome group at the time of admission to the ICU and during the first 24 hours after surgery, associated with a significantly lower lactate clearance rate.

Conclusion: Patients with metabolic syndrome experience a higher frequency of perioperative adverse events and require longer postoperative treatment. This is associated with elevated blood lactate levels, highlighting the importance of lactate monitoring in this patient group

Aim. To evaluate somatic status of pregnant women with SARS-CoV-2-associated pneumonia and its influence on the severity of the course of viral pneumonia

Material and methods. In this study, 70 pregnant women with SARS-CoV-2-associated pneumonia underwent clinical and laboratory examinations, PCR verification of SARS-CoV-2, chest x-ray in two projections, or computed tomography.

Results and discussion. I In the group of pregnant women with SARS-CoV-2-associated pneumonia, urinary tract pathology was detected in 50 patients (71.4%). This is five times higher than the frequency observed in the control group, where 5 pregnant women were diagnosed with urinary tract disease (14.3%; p < 0.001). Furthermore, iron deficiency anemia of varying degrees was observed in 52 pregnant women (74.3%), which was significantly higher than in controls, where it occurred in only 6 patients (17.1%; p<0.001). Cardiovascular diseases were observed in 8 pregnant women (11.4%) of the main group, while respiratory pathologies and allergies were rarely observed - only in 2 patients (2.9%).

Conclusion. Urinary system pathology and iron deficiency anemia were common comorbid conditions in pregnant women with SARS-CoV-2-associated pneumonia.

Aim. To study and determine the characteristics of structural-geometric remodeling of the left heart chambers.

Materials and methods. The study included 102 patients with a confirmed diagnosis of rheumatoid arthritis who were hospitalized in the cardiorheumatology department. Patients were divided into two groups according to the degree of disease activity. The control group consisted of 40 healthy subjects. Disease activity was assessed using the DAS28 index. All patients underwent echocardiography and morphologic evaluation of the blood vessels.

Results and discussion. Significant changes in morphofunctional parameters of the left heart were observed in patients with rheumatoid arthritis, especially in those with systemic manifestations. These changes included increased left ventricular end-diastolic and end-systolic volumes, myocardial hypertrophy, and diastolic dysfunction. An association was found between inflammatory activity and cardiac geometry parameters. In addition, associations were found between cutaneous manifestations of vasculitis and vascular pathologies.

Conclusion. Left ventricular hypertrophy and diastolic dysfunction serve as early markers of cardiovascular complications in rheumatoid arthritis, especially in combination with ischemic heart disease. The progression of the inflammatory process contributes to the development of hypertrophy, and cutaneous manifestations of rheumatoid vasculitis may reflect common pathogenetic mechanisms underlying vascular disorders.

Aim. To examine the functional state of the autonomic nervous system (ANS) in postpartum women with multiple organ/system dysfunction/failure syndrome, depending on the dominant organ damage using non-invasive monitoring of cardiointerval variation.

Material and methods. The study included 100 postpartum women with multiple organ/system dysfunction/failure syndrome (MOSDFS). They were divided into four groups: Group 1 (40 patients) with predominant acute kidney injury; Group 2 (30 patients) with primary manifestations of acute liver failure; Group 3 (30 patients) with dominant acute respiratory distress syndrome; and the control group (30 healthy women of reproductive age). All patients had MOSDFS, with one dysfunction being predominant and the others at various stages and degrees of severity (80% with three affected organs and 20% with two organs). Dysfunction of the central nervous system (CNS) and its autonomic divisions were observed in all cases. An assessment of spectral and fractal analyses was conducted along with an evaluationof the degree of integration of systemic connections forming extracardiac regulation of heart rhythm by the CNS. Additionally, heart rate variability and the state of autonomic balance were also analyzed.

Results and discussion. Non-invasive RR-interval monitoring in the studied postpartum women revealed significant dysfunction of the CNS and ANS in a form of imbalances and various zones of functional states across all groups, regardless of the predominant organ damage and subsequent functional failure. These disruptions manifested.

Conclusion. Among five conditional zones of autonomic states (stable autonomic balance, adaptation, subcritical, critical, and supercritical), 45% of postpartum women were in the critical zone and 55% in the supercritical zone. This necessitates a personalized approach to diagnosis and treatment.

Aim. To study the incidence of metabolic disorders in a random sample of patients.

Materials and method. A total of 733 individuals were studied by means of a random sample survey. The survey included a series of questions designed to identify risk factors for the development of metabolic changes, followed by the identification of respondents.

Results and discussion. Analysis revealed that 16% of the subjects reported high physical activity, 38% reported moderate physical activity, and 56% reported low physical activity. Notably, only 15.7% of the respondents had no disorders, while a high percentage (50.4%) were found to have obesity.

Conclusion. The study showed that 83% of the subjects had changes in body mass index. In addition, impaired fasting glycemia was observed in 33.8% of the subjects, indicating an increased risk of developing type 2 diabetes mellitus.

Aim. To improve the diagnostic outcomes and comprehensive management of patients injured in road traffic accidents.

Material and methods. A retrospective analysis of medical records was conducted on patients injured in road traffic accidents on the Dushanbe–Dangara and Dangara–Vose’ roads. These patients were hospitalized at the Central District Hospital of Dangara, Khatlon region, between 2020 and 2022.

Results and discussion. The retrospective analysis revealed an increasing trend in road traffic injuries. In 2020, 78 cases were reported; in 2021, this number increased to 123 cases, an increase of 36.6% in just one year. In 2022, 95 cases were reported, which may indicate a decrease compared to 2021, but there is still a 17.9% increase compared to 2020. The ages of those injured ranged from 2 to 80 years, with an average age of 31.6 years, indicating that the majority of those injured are young people of working age. Males predominated among the injured, accounting for 62.0% of the cases, while females accounted for 38%.

Conclusion. Train traffic police and car drivers to provide first aid at the scene of an accident.

Aim. To study peripheral blood markers for early diagnosis of non-developing pregnancy.

Material and methods. An analysis of the coagulation system was carried out in 120 women who had experienced a spontaneous abortion. The main group consisted of 80 women with a history of one or more non-developing pregnancies, while the comparison group consisted of 40 women who experienced a spontaneous abortion according to gestational age. Evaluation of the primary mechanism of disruption of the vascular-platelet component of hemostasis - resulting in an increased platelet-to-lymphocyte ratio - was performed using analyses of the extrinsic and intrinsic pathways of blood coagulation.

Results and discussion. The average platelet and hemoglobin levels of women with early pregnancy loss in the main group were within physiological limits. Although the mean leukocyte count was also within the physiological range, it was statistically significantly higher in the main group.

Conclusions. It has been established that the determination of platelet-lymphocyte ratio should be used as a marker of thrombophilia and immune response in non-developing pregnancy, serving as an accessible and cost-effective screening method for diagnosis and prognosis. In addition, it was found that early abortion is characterized by an almost twofold increase in the platelet-lymphocyte ratio, a change that is less pronounced in later stages of pregnancy. These indicators can be used as screening methods for predicting the inflammatory process and disturbances in the blood coagulation system.

Aim. To determine the iodine content in the hair samples from young men from various regions of the Republic of Tajikistan.

Materials and methods. The study included 111 male students of Tajik State Medical University from Sughd region, Dushanbe city, and Gorno-Badakhshan Autonomous Region (GBAO). The participants voluntarily provided hair samples for analysis. The iodine concentration in the samples was measured by mass spectrometry. The study compared iodine levels among volunteers divided into three groups based on their region of origin. In addition, the percentage of participants diagnosed with iodine deficiency within each group was analyzed.

Results and discussion. Data analysis revealed a statistically significant reduction in hair iodine content among residents of Dushanbe and Sughd regions compared to residents from GBAO. The distribution of iodine deficient participants was uneven: the highest proportion of iodine deficiency cases was observed among residents of Sughd region and Dushanbe, whereas no iodine deficiency was detected among participants from GBAO. The results suggest that iodine deficiency depends on the geographical region of residence.

Conclusion. The results indicate that residents of at least two regions of Tajikistan (Dushanbe and Sughd region) are susceptible to iodine deficiency. These findings underscore the need for continued monitoring of the iodine status of the population.

Aim. To enhance outpatient screening methods for detecting comorbid conditions in adults living with HIV (ALHIV).

Materials and methods. The study analyzed official HIV statistics from Dushanbe for the period 2020– 2023, focusing on the adult population living with HIV. Key indicators assessed included the coverage of antiretroviral therapy (ART), patient mortality rates, and associated factors. Data were examined using descriptive statistical methods, and statistical significance of observed differences was determined by the chi-squared test (χ²).

Results and discussion. ART coverage among ALHIV in Dushanbe was 83.1% in 2020 and 82.3% in 2023 (p>0.05), indicating stagnation over the period analyzed. However, mortality rates significantly decreased from 2.8 per 100 ALHIV in 2020 to 1.8 per 100 ALHIV in 2023 (p<0.05). Analysis of cumulative mortality data (2020–2023), with known causes of death, revealed that comorbid (non-HIV related) diseases represented 75.4% of deaths, significantly surpassing HIV-related causes (24.6%; p=0.005). Among comorbidities causing death, liver cirrhosis was most common (29.8%), followed by cardiovascular diseases (26.9%), tuberculosis (15.4%), and various malignancies (11.5%).

Conclusions. 1) Antiretroviral therapy significantly reduces mortality from HIV-related conditions among ALHIV. 2) To address stagnation in ART coverage, continued integration of HIV care within primary health care systems is essential, improving accessibility and adherence to treatment. 3) The predominance of comorbid diseases as causes of death underscores the necessity for optimized outpatient screening protocols for early identification and management of these conditions.

Aim. To assess the oncological care for patients with endometrial cancer in the Republic of Tajikistan.

Material and methods. he study analyzed statistical data obtained from oncology reporting forms №7 and №35, provided by the Republican Center for Medical Statistics and Information of the Ministry of Health and Social Protection of the Republic of Tajikistan, for the period from 2002 to 2020.

Results and discussion. Over the past decade, a significant increase in endometrial cancer cases has been observed, associated with rising incidence rates and increased life expectancy. Endometrial cancer ranks fourth among malignancies of the female reproductive system, accounting for 10.4% of all cases, and third among all gynecological cancers, accounting for 18.7%.

Conclusion. Over the past decade, there has been a significant 1.5-fold increase in the incidence of endometrial cancer among women in Tajikistan. The rising trend among young women of reproductive age is of particular concern, underscoring the need to implement effective preventive measures and improve early diagnosis. The increasing prevalence of metabolic syndrome, including obesity, adversely affects the incidence, clinical course, and outcomes of patients with endometrial cancer.

Aim. To determine the frequency and characteristics of adherence to orthodontic treatment during different stages of dentofacial development.

Material and methods. The study analyzed 477 outpatient medical records of patients who visited the Pediatric Dentistry and Orthodontics Clinic. Patients aged 3 to 18 years were grouped according to the functional and morphologic characteristics of each stage of dentofacial development. Diagnoses were made using standard clinical examination methods proposed by L.S. Persin and F.Ya. Khoroshilkina.

Results and Discussion. Analysis of the effectiveness of orthodontic appliances showed that the best results - represented by the highest number of children completing orthodontic treatment - were achieved with functional appliances, including elastopositioners.

Conclusion. A characteristic feature of adherence to orthodontic treatment in adolescents aged 12-18 years was its dependence on various social and psychological factors.

Aim. To evaluate the effectiveness of different methods of cellular therapy in the postoperative treatment of burn scars of various anatomical locations.

Material and methods. The clinical material included 102 patients who underwent surgical procedures for correction of post-burn scars. Depending on the treatment protocol, the surgical procedures were performed with or without concomitant cellular therapy.

Results and discussion. Patients treated with a combination of surgery and cellular therapy showed significantly better outcomes, as assessed by the Vancouver Scar Scale and Disability of Arm, Shoulder and Hand (DASH) scores, than those who underwent surgery alone. This improvement was seen in both the primary and repeat subgroups. The combination of surgery and cell therapy reduced the average percentage of disability from baseline by more than half. As expected, the results in the primary subgroup were better than those in the repeat subgroup.

Conclusions. Cellular technologies represent a promising component in the integrated management of post-burn scars. The use of platelet-rich plasma (PRP) and autologous adipose tissue in reconstructive and plastic surgery for burn sequelae is safe and effective and significantly reduces the need for repeat surgical interventions.

This article presents a literature review focusing on changes in the species composition of the oral microbiota under different conditions, emphasising the importance of maintaining the microbial balance. The study of the microbiota under normal conditions, pathological conditions and in patients with prostheses is crucial for the development of effective methods for the prevention and treatment of oral diseases. Modern research pays particular attention to the effects of prosthetic materials and strategies to control microbial changes. The oral microbiota is a complex ecosystem that includes hundreds of species of bacteria, fungi and viruses that maintain homeostasis and participate in the body’s immune defence. Under normal conditions, commensal microorganisms such as Streptococcus and Veillonella predominate, providing barrier function and regulating inflammatory processes. However, changes in the composition of the microflora can lead to dysbiosis, which is associated with the development of diseases such as dental caries and periodontitis.

A literature review of data sources from neighbouring and distant countries was conducted, focusing on various aspects of the prevalence, pathogenesis and diagnostic methods of odontogenic perforative maxillary sinusitis (OPMS). The prevalence of OPMS in the Russian Federation is 1,420 cases per 100,000 adults. According to the latest statistics, this disease continues to grow, with odontogenic maxillary sinusitis accounting for between 2% and 77% of all cases. The rate of these patients presenting to maxillofacial clinics is 7.6%. The majority of patients are of working age, between 30 and 50 years. Radiological examination is considered to be the optimal method to study the variations in the anatomical structures of the maxilla, nose and paranasal sinuses; however, to date, there are no studies that have performed a radiological assessment of the entire set of factors influencing the development of mucosal perforation of the maxillary sinus and OPMS. Therefore, a study that objectively analyses individual anatomical-radiological features and their cumulative impact on the development of the pathological process is considered extremely necessary.

This article presents a literature review on the antiviral and antibacterial properties of Ferula L. species. Extracts and gums from different species of this plant genus have been used in traditional medicine since ancient times and are still used today. All relevant databases including Science Direct, Web of Science, Scopus, PubMed, EBSCO were searched without restriction using the terms “Ferula”, “antiviral”, “anti-influenza”, “anti-fungal” up to 01 June 2024. Keywords were also entered into popular search engines such as Google and Google Scholar. According to the literature, it can be concluded that many representatives of this plant species have strong antiviral, antibacterial and antifungal properties. However, there is no information in the literature on the biological activity of Ferula L. species growing in Tajikistan.