LIST of recommended scientific editions for publication of basic scientific results of dissertations by Supreme attestation commission of the Republic of Uzbekistan. Approved by the Resolutions of the Presidium of the Supreme Attestation Commission of the Republic of Uzbekistan. – Tashkent: 2019. – 160 p. The Journal of Biomedicine and Practice is an international, reviewable journal containing comprehensive material on fundamental and clinical medicine. The main topics include and are not limited to: Physiology, Biochemistry, Biophysics, Biotechnology, Molecular Biology, Medical Genetics, Immunology, Microbiology, Virology, Pathology, Hematology, Cardiology, Dermatology, Emergency Medicine, Endocrinology, Gastroenterology, Gastroenterology Nephrology, Obstetrics and Gynecology, Allergology, Oncology, Ophthalmology, Orthopedics, Pediatrics, Pharmacology, Health, Pulmonology, Radiology, Rehabilitation, Surgery, Urology. The international, edited online Journal of Biomedicine and Practice invites experts in the field of theoretical and applied medicine, as well as those interested in the current state and prospects of biomedicine and clinical practice. The publication in the Journal of Biomedicine and Practice provides an opportunity for researchers from local and foreign organizations, as well as all authors interested in publishing themselves and their scientific discoveries.
HYGIENIC ASSESSMENT OF THE ACADEMIC LOAD OF STUDENTS IN MODERN STATE AND PRIVATE SCHOOLS
Objective of the study: To conduct a hygienic analysis of the weekly academic load of students in grades 5–9 of private and state schools in Tashkent. Research materials: Regulations for the daily and weekly educational process in private and state schools located in Tashkent. Results: It was found that a distinctive feature of modern school education is not only an increase in the volume and intensity of academic loads but also the extensive use of innovative pedagogical technologies. It is crucial to adhere to sanitary and hygienic requirements, including those not currently covered by existing regulatory frameworks. Conclusions: The analysis of educational processes and the organization of lesson schedules according to hygienic standards are essential for maintaining student health. Identifying the health impacts of educational innovations prior to their widespread implementation significantly reduces the risk of negative effects on the health of children and adolescents.
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ASSESSMENT OF THE RELATIONSHIP BETWEEN BLOOD BIOCHEMICAL PARAMETERS, COGNITIVE AND PSYCHOEMOTIONAL IMPAIRMENTS, AND REHABILITATION EFFECTIVENESS IN PATIENTS WITH CHEMICAL ADDICTIONS
Purpose: To determine the relationship between blood biochemical parameters (glucose, liver enzymes - ALT/AST, total bilirubin, and cholesterol) and cognitive and psychoemotional status, as well as rehabilitation effectiveness in patients with chemical addictions. Materials and Methods: The study was conducted in 2025-2026 at the Samarkand regional branch of the Republican Specialized Scientific and Practical Center for Mental Health. A total of 200 patients diagnosed with “psychoactive substance dependence” were examined using clinical and psychometric assessments. Cognitive functions were evaluated with the MoCA test, and psychoemotional status with the Beck Depression Inventory and Spielberger-Khanin tests. Blood biochemical parameters (glucose, ALT/AST, total bilirubin, and cholesterol) were measured in laboratory conditions. Results: Mean blood parameters were: glucose 5,8 ± 0,9 mmol/L, ALT 42 ± 12 U/L, AST 38 ± 10 U/L, total bilirubin 18,5 ± 5,2 mmol/L, and cholesterol 5,4 ± 0,8 mmol/L. Patients with elevated glucose and liver enzyme levels showed lower MoCA scores (glucose r= -0,31, ALT r= -0,33, AST r= -0,29, p<0,05). Depressive symptoms in patients with ALT >45 U/L averaged 21.3 ± 4.7 and were also correlated with glucose levels (r= -0,28, p<0,05). During rehabilitation, patients whose biochemical parameters approached normal demonstrated significant improvement in cognitive and psychoemotional functions. Conclusion: Elevated glucose and liver enzyme levels are associated with cognitive decline and increased depressive-anxiety symptoms. These findings emphasize the importance of individualized rehabilitation programs based on the patient’s metabolic profile.
TRENDS IN THE MANAGEMENT OF INTRACRANIAL MENINGIOMA
Introduction. Intracranial meningiomas are the most common primary brain tumors and exhibit substantial clinical and biological heterogeneity. Over the last two decades, management paradigms have shifted: alongside surgical resection, stereotactic radiosurgery, fractionated radiotherapy, and active surveillance have gained increasing importance, particularly for small asymptomatic lesions. Materials and Methods. A retrospective analytical review of population-based cohorts and large oncologic registries was performed. Demographics, tumor characteristics (size, WHO grade), clinical status, treatment strategy (observation, surgery, radiotherapy, combined approaches), and survival-related factors were assessed using descriptive statistics, multivariable regression models, and survival analyses. Results. The cohort was predominantly female, and most tumors were WHO grade I. Over time, an increase in active surveillance and a relative decrease in surgical treatment rates were observed, particularly among patients with small tumors. Surgery remained the primary modality for large and symptomatic lesions, whereas radiosurgery and adjuvant radiotherapy were applied selectively, mainly for challenging skull-base locations, subtotal resection, and WHO grade II–III tumors. Older age, higher comorbidity burden, larger tumor size, and higher grade were associated with worse outcomes. Conclusion. Current intracranial meningioma management is increasingly driven by a personalized, multidisciplinary strategy integrating clinical, radiological, and molecular-genetic parameters (within the WHO 2021 framework) to optimize risk stratification, tailor surgical extent, and justify radiotherapy or surveillance.
FIBULA AUTOGRAFTING AND EXTERNAL FIXATION FOR POST-OSTEOMYELITIC FEMORAL DEFECTS
Post-osteomyelitic diaphyseal defects of the femur are among the most complex complications in traumatology and orthopedic practice, frequently leading to disability. Chronic osteomyelitis in this region is often characterized by significant angiotrophic disturbances, bone tissue deficiency, and technical limitations in the application of classical osteosynthesis and distraction osteogenesis methods. Therefore, the development of biologically grounded and technically accessible methods using external fixators to restore femoral integrity while maintaining its length and function is a critical task of modern reconstructive surgery. This study describes a technique for treating post-osteomyelitic diaphyseal femoral defects using autograft replacement, which ensures the preservation of limb length and reduces the risk of pathological complications.
STUDY OF CHANGES IN THE COMPOSITION OF FOOD INGREDIENTS AND CALORIC CONTENT OF BREAST MILK IN WOMEN WITH ANEMIA
The study involved 241 women with various degrees of iron-deficiency anemia (IDA): Grade I – 132, Grade II – 84, and Grade III – 25 individuals. The degree of IDA was determined based on hemoglobin levels, red blood cell count, serum iron levels, total iron-binding capacity (TIBC), and latent iron-binding capacity (LIBC). Among breastfeeding mothers with Grade I anemia, a category of women was identified who exhibited a decrease in the content of proteins, fats, carbohydrates, and the caloric value of breast milk. Women with Grade II anemia showed a significant reduction in the nutrient content and caloric value of breast milk. This reduction was more pronounced in the group of women over 30 years old, who had given birth 3 or more times, and had been breastfeeding for over 6 months. In such cases, the energy value of breast milk is maintained primarily due to carbohydrates. Women with Grade III severe anemia exhibited a sharp decrease in nutrient content and caloric value across all groups. This can lead to nutrient and energy deficiencies in infants, as well as contribute to the development of nutritional insufficiency.
SHORT BOWEL SYNDROME: CURRENT CONCEPTS OF PATHOGENESIS, DIAGNOSIS AND TREATMENT
Short bowel syndrome (SBS) is a severe form of chronic intestinal failure resulting from significant reduction of the small intestinal length and impaired digestion and nutrient absorption. The aim of this literature review is to systematize current knowledge on the pathogenesis, clinical manifestations, diagnosis, and treatment principles of SBS in both adults and children. The review highlights mechanisms of intestinal adaptation, the role of gut microbiota, biochemical and hormonal alterations, as well as modern approaches to nutritional support, including parenteral nutrition and the use of GLP-2 analogs. Special attention is given to a multidisciplinary approach and emerging perspectives in intestinal transplantation and regenerative medicine. Early diagnosis and comprehensive management significantly improve patient outcomes and quality of life.
COMPARATIVE ANALYSIS OF METHODS OF TREATING HYPERTROPHIC RHINITIS
Regardless of the cause of the enlargement of the nasal concha, difficulty in breathing through the nose and other symptoms of the disease lead to a change in the quality of life of patients, which forces them to consult a doctor and, as a result, often requires surgical intervention. The purpose of the review is to analyze modern data on the prevalence and classification of hypertrophic rhinitis. The review material was compiled from scientific publications on these topics in the international databases E-library, Scopus and Web of Science over the past 10 years. The review showed that it can be concluded that the development of a minimally invasive and effective treatment method for the treatment of hypertrophic rhinitis, taking into account the results of a comprehensive study, is an urgent problem.
INFORMED CONSENT IN DENTAL SCIENCE: LEGAL ESSENCE AND PRACTICAL ISSUES
This article analyzes informed consent in dentistry not only as a fundamental right of the patient but also as an effective means of practical communication. Based on legal and empirical data, the study shows that the universal recognition of consent in legislation does not automatically ensure its full and systematic application in practice. Particular attention is also paid to important aspects such as written consent forms, a clear description of the treatment steps, transparency of financial terms, and the patient's full understanding of the entire treatment process.
COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF VARIOUS TREATMENT METHODS USED IN THE MANAGEMENT OF POSTPARTUM ENDOMETRITIS
This article examines the specific aspects of a comparative evaluation of the effectiveness of various treatment methods for postpartum endometritis used in primary healthcare institutions. It also presents a comparative assessment of early diagnostic approaches and different treatment strategies aimed at preserving reproductive health and preventing complications. Data from the most recent scientific literature and contemporary sources are included.
CARDIAC-SPECIFIC MARKERS OF MYOCARDIAL INJURY IN CHILDREN WITH COMMUNITY-ACQUIRED PNEUMONIA
Troponin determination as a biochemical marker of cardiomyocyte necrosis is currently of great importance in cardiology. The aim of this study was to determine markers of myocardial injury and identify the most significant ones in children with pneumonia. Patients ranged in age from 7 months to 7 years. Troponin I, α-HBDH, and MVCK were measured. Exclusion criteria included congenital heart defects (CHD), cardiac arrhythmias, and genetic abnormalities, as troponin levels are relatively stable in children with chronic heart failure. This is explained by the absence of episodes of acute hypoxia and cardiomyocyte death.
APPROACH TO TREATING CHILDREN WITH OTOMYCOSIS COMPLICATED BY CHRONIC SUPPURATIVE OTITIS MEDIA
Otomycosis (fungal otitis externa) is usually characterized as a fungal infection of the external auditory canal, but in rare cases, it can also be complicated by the middle ear. Although it is not life-threatening, it is a complex and alarming disease for patients and otorhinolaryngologists, as it often requires long-term treatment and observation. Otomycosis is one of the most common diseases in general ENT practice, its prevalence among patients with symptoms of external otitis can reach from 9% to 27.2%, and in patients with ear discharge - up to 30%. This disease occurs throughout the world, but is particularly common in hot, humid, and dusty tropical and subtropical regions. The most common pathogens are Aspergillus niger and Candida albicans, but many other fungal species can also cause otomycosis. To diagnose, it is necessary to conduct a series of laboratory (microbiological, modern molecular, histological) and clinical studies, evaluate the function of the hearing organs, and identify the disease pathogen. In most cases, the treatment of otomycosis is limited to the use of local antifungal agents. They are prescribed based on laboratory test results. Treatment is conducted in 3 main stages: clearing the external auditory canal, etiological treatment against fungi and secondary infection, bacteria, and support measures for therapeutic procedures.
OPTIMIZATION OF FOCAL PERIODONTAL LESIONS TREATMENT WITH TOOTH-PRESERVING SURGERIES
Objective — to evaluate the clinical efficacy of the modified Widman flap procedure combined with β-tricalcium phosphate application for the treatment of focal periodontal lesions compared to the standard flap surgery. Materials and methods. A total of 74 patients (32 male, 42 female) aged 28–55 years with focal periodontal lesions were divided into two groups: main group (n = 38) — Widman flap surgery with β-TCP; comparison group (n = 36) — standard flap surgery. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), oral hygiene index (OHI-S), and radiographic bone defect reduction were assessed at 3, 6, and 12 months. Results. At 12 months, PD in the main group decreased from 6.4 ± 1.1 to 2.8 ± 0.7 mm (p < 0.001) versus 6.3 ± 1.0 → 3.7 ± 0.9 mm in the comparison group (p < 0.01); CAL gain was 3.2 ± 0.8 mm versus 1.9 ± 0.6 mm (p < 0.001); radiographic bone defect reduction reached 64.3 ± 8.7 % versus 38.2 ± 9.4 % (p < 0.001). Clinical stabilization was achieved in 92.1 % of patients in the main group versus 75.0 % in the comparison group (p < 0.05). Conclusion. The application of β-tricalcium phosphate during flap surgery in patients with focal periodontal lesions significantly improves clinical and radiographic parameters and provides more stable long-term outcomes.
CLINICAL AND IMMUNOHISTOCHEMICAL CHANGES IN THE UPPER EYELID IN BLEPHAROCHALASIS IN WOMEN OF DIFFERENT AGE AND HORMONAL GROUPS
Purpose of study: to evaluate the clinical and immunohistochemical characteristics of the upper eyelid skin in women with blepharochalasis from different age-hormonal groups based on the expression levels of estrogen receptors ER-α and ER-β. Materials and methods: after standart ophthalmological examination, 90 patients with blepharochalasis aged 24 to 67 years were divided into three groups according to age and hormonal status. Additionally, all patients underwent assessment of the condition of the upper eyelid skin, biopsy sampling, and immunohistochemical examination using monoclonal antibodies against estrogen receptors ER-α and ER-β. The level of receptor expression was evaluated using the H-score method. Results: the mean ER-α expression level in patients of reproductive age was 78.4±4.6, in the perimenopausal group 61.2±3.9, and in the postmenopausal group 44.7±3.2. A similar trend was observed for ER-β expression: 72.9±4.1, 58.6±3.4, and 39.5±2.8, respectively. Analysis of variance revealed statistically significant differences between the studied groups in the expression levels of ER-α (p=0.0003) and ER-β (p=0.0001). Conclusion: the obtained results indicate a decrease in estrogen receptor expression with increasing patient age and confirm the involvement of hormonal factors in the development of blepharochalasis.
OPTIMIZATION OF CONSERVATIVE TREATMENT FOR EXUDATIVE OTITIS MEDIA IN CHILDREN: THE SYNERGISTIC EFFECT OF PILN, TOPICAL IMMUNOCORRECTION, AND PLAY AUTOINSUFFLATION
Objective: To conduct a comparative evaluation of the clinical and biochemical efficacy of an optimized three-component treatment regimen for the secretory phase of exudative otitis media (EOM) in children aged 1–5 years, comprising low-intensity laser therapy (LILT), topical immunocorrection, and playful autoinsufflation, compared with standard treatment. Methods: 172 children (ages 1–5 years) were examined: subgroup A (n=40) — LI + lysates + autoinsufflation; subgroup B (n=37) — standard treatment; comparison group (n=60); control group (n=35). Salivary biomarkers (transferrin, ceruloplasmin, sIgA, myeloperoxidase), tympanometry data, OEA, and CSVP were assessed every 5 days. Results: In group A, by day 14, the transferrin level decreased 3.2-fold (to 3.8 ± 0.5 mg/L), while sIgA increased 2.3-fold (to 0.28 ± 0.03 g/L; p < 0.001). By day 30, type A tympanogram was restored in 92.5% of children in group A (OR = 7.8; 95% CI 1.9–31.6; p < 0.05) and in 62.2% in group B. The need for adenotomy in Group A decreased by a factor of 4.9 (5% vs. 24.3%). During the 6-month follow-up, recurrence rates were 2.5% in Group A and 18.9% in Group B (p<0.05). Conclusion: The three-component regimen combined with non-invasive monitoring of biomarkers is an effective non-surgical method for treating ESO. At the 6-month follow-up, the recurrence rate was 2.5% in Group A and 18.9% in Group B (p<0.05).
IMPROVING THE QUALITY OF RESTORATION OF TEETH WITH CROWN DEFECTS USING MODERN POST-CORE CONSTRUCTIONS
The article analyzes modern approaches to improving the quality of orthopedic dental care for patients with partial or complete loss of the tooth crown. Special attention is paid to the use of modern post-core constructions as a key element in restoring the anatomical shape, function, and aesthetics of damaged teeth. A conceptual approach to patient management is substantiated, including standardization of treatment protocols, rational selection of post systems, and individual biomechanical assessment. The role of fiber-reinforced posts, including glass fiber and individualized EverStick systems, in enhancing biomechanical compatibility and long-term clinical outcomes is discussed. The relevance of implementing evidence-based clinical protocols in the dental practice of Uzbekistan is emphasized.
PATHOGENETIC FOUNDATIONS AND EVALUATION OF CLINICAL EFFICACY OF PROBIOTIC THERAPY IN THE COMPLEX TREATMENT OF SUPERFICIAL BLADDER CANCER
The study involved 212 patients with superficial bladder cancer (NMIBC). The objective was to evaluate the impact of perioperative probiotic therapy (Lactobacillus acidophilus and E. coli M17) on urothelial regeneration and local immune status (CD8+, Ki-67). The results demonstrated that correcting immunological imbalance via probiotics significantly reduces recurrence rates. The developed 24-parameter mathematical model allows for the prediction of recurrence risk with an accuracy of over 85%.
ASSESSMENT OF THE EFFECT OF MELATONIN ON SLEEP QUALITY AND CARBOHYDRATE METABOLISM IN REPRODUCTIVE-AGED PATIENTS WITH TYPE 2 DIABETES MELLITUS
Цель исследования. Изучить влияние мелатонина в патогенезе нарушений сна и гликемического контроля у пациентов репродуктивного возраста с сахарным диабетом 2 типа (СД2), а также оценить эффективность мелатонинотерапии в коррекции выявленных нарушений. Материал и методы. Обследовано 120 человек в возрасте от 20 до 45 лет. Основную группу составили 80 пациентов с СД2, контрольную группу – 40 практически здоровых лиц. Оценка качества сна проводилась с использованием Питтсбургского индекса качества сна (PSQI) и шкалы сонливости Эпворта (ESS). Выполнялись полисомнография, определение уровня мелатонина, исследование показателей углеводного обмена (глюкоза крови, HbA1c, HOMA-IR). Пациенты с нарушениями сна получали мелатонин в дозе 3 мг на ночь в течение 12 недель. Результаты. Нарушения сна выявлены у всех обследованных пациентов с СД2. Уровень ночного мелатонина был снижен в 16–20 раз по сравнению с контрольной группой. Выявлена достоверная отрицательная корреляция между концентрацией мелатонина и показателями инсулинорезистентности (r=-0,68; p<0,001), а также уровнем HbA1c (r=-0,61; p<0,001). После 12 недель терапии мелатонином отмечено улучшение качества сна по шкале PSQI на 42,3%, снижение уровня HbA1c на 0,9%, уменьшение инсулинорезистентности на 31,4%. Целевые значения HbA1c были достигнуты у 65% пациентов против 20% в группе стандартной терапии. Заключение. Дефицит мелатонина является важным патогенетическим фактором нарушений сна и ухудшения гликемического контроля у пациентов репродуктивного возраста с СД2. Включение мелатонина в комплексную терапию способствует нормализации сна, улучшению углеводного обмена и снижению инсулинорезистентности.
IMPROVEMENT OF DIAGNOSTIC APPROACHES AND CONSERVATIVE TREATMENT OF CHRONIC RHINOSINUSITIS IN CHILDREN WITH CYSTIC FIBROSIS
Chronic rhinosinusitis (CRS) is a common and clinically significant manifestation of cystic fibrosis in children, influencing the course of pulmonary disease and patients’ quality of life. Dysfunction of the CFTR protein leads to mucus dehydration, impaired mucociliary clearance, and persistent bacterial colonization of the paranasal sinuses. Despite the high prevalence of radiological abnormalities, clinical symptoms in children are often mild or underrecognized, complicating early diagnosis. This review summarizes current approaches to the diagnosis of CRS in children with cystic fibrosis, including symptom-endoscopic and imaging techniques, as well as microbiological and molecular methods. Contemporary strategies of conservative management are analyzed, including irrigation therapy, topical corticosteroids, antibacterial treatment, and CFTR modulators. Particular attention is paid to the need for standardized diagnostic criteria, reduction of systemic antibiotic burden, and development of personalized therapeutic approaches.
MODERN TRANSFORMATION OF THE BIOLOGICALLY ORIENTED PREPARATION TECHNIQUE (BOPT): HYBRID ANALOG-DIGITAL APPROACH AND CLINICAL-BIOLOGICAL FOUNDATIONS OF THE FULLY DIGITAL EASYBOPT PROTOCOL
The Biologically Oriented Preparation Technique (BOPT) is recognized in modern prosthetic dentistry as a conceptual approach based on the management of interactions between hard and soft tissues. This article provides a comprehensive analysis of the contemporary evolution of the BOPT technique, including a hybrid analog-digital workflow and the fully digital standardized protocol known as EasyBOPT (eBOPT), focusing on its clinical effectiveness, biological foundations, and practical applications. Studies demonstrate that the hybrid approach enables highly accurate recording of subgingival margins and complete transfer of the emergence profile, while the eBOPT protocol enhances the standardization of clinical procedures, reduces treatment time, and minimizes operator dependency, thereby significantly improving the reproducibility of the BOPT technique.
EPIDEMIOLOGY OF ESOPHAGEAL CANCER IN THE REPUBLIC OF UZBEKISTAN AND THE DEGREE OF HELICOBACTER PYLORI CONTAMINATION IN ESOPHAGEAL CANCER PATIENTS
The article presents an epidemiological analysis of esophageal cancer (EC) in the Republic of Uzbekistan for the period 2001–2024 and evaluates the prevalence of Helicobacter pylori infection among patients with this disease. During the study period, 20,829 EC cases were registered, with a decreasing trend in incidence from 3.9 per 100,000 population in 2007 to 2.0 in 2023. The highest incidence was observed in the Republic of Karakalpakstan, confirming its status as an endemic region. Most patients were over 60 years of age (56.5%), with a peak in the 60–74 age group (43.5%). The incidence among men was higher than among women (2:1). At the same time, 68.3% of cases were diagnosed at stages III–IV, which accounts for the low five-year survival rate (up to 25.4%). Among 93 examined patients, 41 (44%) cases of EC were associated with H. pylori. The geographic distribution of H. pylori-associated EC did not correspond to the overall epidemiology of the disease, with the highest frequency observed in the Surkhandarya region. A predominance of women was noted among infected patients. The obtained data indicate regional characteristics of EC and the possible role of H. pylori in its pathogenesis, which requires further research.
PREDICTION OF RISK FACTORS FOR PARASTOMAL COMPLICATIONS IN THE EARLY POSTOPERATIVE PERIOD
Purpose of the study: to identify risk factors for the development of parastomal complications in the early postoperative period. Materials and methods: The study included 272 patients who underwent surgical treatment in the Coloproctology Department of the University Clinical Hospital No. 1 named after S.R. Mirotvortsev during 2021–2025. As a result of the surgical treatment stage, all patients had an intestinal stoma formed on the anterior abdominal wall. A prospective analysis of patients and medical records was carried out followed by statistical processing of the obtained data. Results: Data analysis revealed several characteristics that significantly differed between the compared groups of patients and may serve as risk factors for the development of early parastomal complications. Conclusion: Risk factors for the development of early parastomal complications were identified.
FIBROLARYNGOSCOPIC MONITORING OF REACTIVE CHANGES IN THE POSTOPERATIVE AREA IN PATIENTS WITH BENIGN LARYNGEAL NEOPLASMS
Benign laryngeal neoplasms are among the most common diseases of the upper respiratory tract and are often accompanied by significant functional disorders of the vocal apparatus, reducing patients’ quality of life. Despite the high effectiveness of modern endolaryngeal surgical methods, the postoperative period is frequently characterized by the development of reactive changes in the surgical area. This article presents an analysis of 84 patients with benign laryngeal neoplasms. The patients were divided into groups depending on the surgical method used: conventional, radiofrequency, and laser techniques. The severity of reactive changes was assessed using fibrolaryngoscopy on postoperative days 3, 5, 7, and 14, as well as after 1 and 6 months. The maximum severity of inflammatory and reactive changes was observed on the third postoperative day in all groups. The most rapid reduction of edema, hyperemia, and mucosal infiltration was noted in patients operated on using semiconductor laser technology. The obtained results indicate the high effectiveness of laser technology, providing faster restoration of the mucous membrane and functional recovery of the vocal folds.
THE VALUE OF QUANTITATIVE MRI METHODS (DIFFUSION TENSOR IMAGING) IN THE EARLY DIAGNOSIS OF THE PRECLINICAL STAGE OF BINSWANGER'S DISEASE
Objective:To study the diagnostic significance of quantitative indices of diffusion tensor imaging (DTI) for detecting microstructural changes in white matter at the preclinical stage of BD. Relevance. Binswanger's disease (BD) is accompanied by progressive cognitive decline. Standard MRI (T1/T2 modes) reveals white matter changes (leukoaraiosis) only at late stages, when treatment is already ineffective. Materials and Methods. The study involved 60 patients (55–70 years old) with arterial hypertension and cognitive complaints but without dementia. All underwent standard MRI and DTI tractography, analyzing fractional anisotropy (FA) and mean diffusivity (MD). Results. In most patients, standard MRI showed minimal changes; however, DTI revealed a statistically significant decrease in FA and an increase in MD in the frontal lobes and internal capsule. These changes correlated with impaired executive functions during neuropsychological testing. Conclusion. DTI is a highly sensitive method that allows for the diagnosis of preclinical white matter disorganization. The use of DTI metrics reveals BD before the formation of pronounced leukoaraiosis, opening opportunities for timely therapy.
CLINICAL AND ECONOMIC EFFECTIVENESS OF THE SENTIMAG MAGNETIC NAVIGATION SYSTEM IN SENTINEL LYMPH NODE DETECTION IN BREAST CANCER
Objective. To comparatively evaluate the clinical effectiveness, safety, and clinical-economic advantages of the Sentimag + Magtrace magnetic navigation system for sentinel lymph node detection in stage II–III breast cancer versus standard axillary lymph node dissection. Materials and Methods. A retrospective comparative study was conducted. Data from 100 patients with morphologically confirmed stage II–III breast cancer treated at the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology were analyzed. Patients were divided into two groups: Group I (n=50) — sentinel lymph node biopsy using the Sentimag system; Group II (n=50) — standard axillary lymph node dissection. Intraoperative parameters, length of hospital stay, postoperative complications, and economic indicators were assessed. Results. The detection rate of sentinel lymph nodes in the Sentimag group was 100%. The mean number of removed lymph nodes was 1–3, compared to ≥10 in the standard group. A significant reduction was observed in operative time (55 min vs 95 min), length of hospital stay (10 vs 15 bed-days), and postoperative complication rate (6.0% vs 60.0%) in the Sentimag group. Axillary lymph node dissection was avoided in 68.0% of patients. Economic analysis demonstrated savings of 1,125,000 UZS per patient. Conclusion. The Sentimag + Magtrace system demonstrates high accuracy, minimal invasiveness, safety, and cost-effectiveness in sentinel lymph node detection in breast cancer. The method reduces complications associated with axillary lymph node dissection and supports a personalized surgical approach, making it suitable for implementation in clinical practice.
TACTICS OF TREATMENT FOR POSTOPERATIVE VENTRAL HERNIAS
Surgical treatment of postoperative ventral hernias of the anterior abdominal wall remains one of the urgent problems of clinical surgery. According to current statistical data, postoperative hernias develop in 5–14% of patients after laparotomy. Due to the increasing volume and number of abdominal surgical interventions, as well as the growing number of repeated operations, especially among elderly patients, the incidence of postoperative ventral hernias continues to rise annually. Closure of anterior abdominal wall defects using local tissues by traditional methods does not always provide favorable outcomes. This is particularly true in cases of large defects, when repair with local tissues under tension may lead to the development of intra-abdominal compartment syndrome. After such operations, hernia recurrence is observed in approximately 30–60% of cases. It is well known that in recent years, endoprosthetic tension-free methods have been increasingly used for the repair of large hernial defects of the anterior abdominal wall. Following the implementation of these surgical treatment methods, the recurrence rate has decreased to 6–10%. Annotation:According to modern literature data, postoperative hernias develop in 5–14% of patients after laparotomy. With the increasing number of repeated surgical interventions, especially among elderly patients, the incidence of postoperative ventral hernias rises from year to year. A total of 135 patients with postoperative ventral hernias were observed and underwent surgical treatment. Among them, 25 were men and 110 were women. Tension-free hernioplasty using the “inlay” technique was performed in 21 patients, while the “onlay” technique was used in 101 patients. Hernioplasty using local tissues with musculofascial-aponeurotic duplication was performed in 13 patients.
FEATURES OF METABOLIC AND INFLAMMATORY MARKERS IN DIFFERENT CLINICAL AND LABORATORY PHENOTYPES OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Objective. To evaluate the clinical and laboratory characteristics of four chronic kidney disease (CKD) phenotypes in patients with type 2 diabetes mellitus (T2DM) according to estimated glomerular filtration rate (eGFR) and albuminuria status. Materials and Methods. This prospective cross-sectional study included 153 patients with T2DM stratified into four groups: NRF/NA (normal renal function/normoalbuminuria, n=35), DRF/NA (decreased renal function/normoalbuminuria, n=35), NRF/EA (normal renal function/elevated albuminuria, n=35), and DRF/EA (decreased renal function/elevated albuminuria, n=30). The control group consisted of 18 healthy individuals. Demographic, anthropometric, glycemic, lipid, inflammatory, and coagulation parameters were assessed. Results. The groups differed significantly in age (p<0.001), blood pressure levels, markers of renal function, carbohydrate metabolism indices, and inflammatory parameters. The highest C-reactive protein (CRP) levels (24.5±13.1 mg/L) were observed in the NRF/EA group. In the same group, cystatin C reached 5.79±2.0 mg/L despite formally normal eGFR values. The prothrombin index was significantly elevated in groups with albuminuria. BMP-7 levels did not differ significantly between the groups (p=0.080); however, BMP-7 showed a positive correlation with C-peptide (ρ=0.176; p=0.030). Conclusion. CKD phenotyping in T2DM based on two axes (eGFR and albuminuria) reveals heterogeneity of pathogenic mechanisms, which has practical implications for personalized nephroprotective therapy. The NRF/EA phenotype is characterized by a predominance of pro-inflammatory and procoagulant features accompanied by subclinical tubular dysfunction.
IMMUNOLOGICAL AND NEUROSPECIFIC BIOMARKERS IN THE DIFFERENTIAL DIAGNOSIS OF PARKINSON’S DISEASE AND VASCULAR PARKINSONISM
The aim of our study was to investigate the features of systemic inflammatory response and central neurospecific damage in patients with Parkinson's disease and vascular parkinsonism to verify differential diagnostic criteria. A comprehensive clinical and laboratory examination of patients with degenerative and vasogenic forms of parkinsonism was performed. All patients underwent neurological testing using international scales. The immunological profile was assessed by serum levels of interleukin-6 and S100 protein using enzyme-linked immunosorbent assay (ELISA). Intestinal status and infectious trigger were verified by fecal calprotectin excretion and -urea breath test results. In Parkinson's disease, an extensive network of interrelations between interleukin-6, gastrointestinal factors, motor deficit, and non-motor burden was revealed, confirming the activity of the gut-brain axis. Serum hyperconcentration of S100 protein was recorded exclusively in the cohort of patients with Parkinson's disease at advanced stages of the process. In the vascular parkinsonism group, markers of systemic inflammation demonstrated pathogenetic autonomy from enteral triggers, with a complete absence of elevated S100 protein cases. Combined monitoring of interleukin-6 and S100 protein allows distinguishing between primary degenerative and secondary vasogenic forms of parkinsonism.
A POPULATION-BASED APPROACH TO CERVICAL CANCER: THE CONTEMPORARY IMPORTANCE OF CANCER REGISTRIES, SCREENING, AND SURVIVAL ANALYSIS
This narrative review highlights the contemporary importance of a population-based approach to cervical cancer (CC). We summarize global and regional epidemiologic patterns of CC, the etiologic role of high-risk human papillomavirus (HPV), major risk factors, and the prevention framework built on HPV vaccination, organized screening, and early diagnosis. Cancer registries are discussed as the core information infrastructure for cancer control, including their definition, main types, and their value for surveillance, planning, and evaluation. The role of international standards and registry networks (IARC/IACR, ENCR, SEER, NPCR) and global initiatives such as Cancer Incidence in Five Continents (CI5) is outlined with regard to data comparability, quality assurance, and cross-country benchmarking. We also address the organization of oncology services in Uzbekistan and the limitations of aggregated official reporting for robust outcome assessment. Strengthening the population-based cancer registry, implementing systematic data quality control, ensuring continuous follow-up, and integrating registry data with mortality and screening databases are emphasized as prerequisites for valid population survival estimates. Key survival metrics (overall, relative, and net survival), common analytical approaches, and interpretation issues are briefly reviewed. Evidence from EUROCARE and CONCORD demonstrates that international differences in CC survival largely reflect screening coverage and the completeness and quality of registry data.
THE IMPORTANCE OF ORCHIDOMETRY IN ASSESSING MEN'S HEALTH
At the present time, the role of the male factor in infertile marriage is about 40%. To elucidate causes of infertility an important role plays determining the size of the external genitalia (genitometria), and compliance of these dimensions to age norms. Despite the considerable variability in the size of the external genitalia, genitometriya allows in combination with other methods to diagnose hypogonadism and delayed puberty. For this purpose we used the instrument designed by B.J. Krivorutskiy. When the size of the penis or testicles is more than two standard deviation below the average wecan say about pathologic changes. For quick estimating of the testicles size can be also used theorchidometr (testometr) - a set of standards corresponding to a certain age and stage of sexual development.
OPTIMIZATION OF A REGIONAL MODEL OF PERINATAL MONITORING AND MANAGEMENT TACTICS FOR CHILDREN WITH CONGENITAL OBSTRUCTIVE UROPATHY
This article presents an improved three-tier model for perinatal monitoring of congenital obstructive uropathies (COU), adapted for the Samarkand region. The author proposes a transition to a "fetus as patient" paradigm, including the use of a "Prognostic Screening Sheet" at primary care level and the implementation of the "72-Hour Rule" for postnatal ultrasound diagnostics. Implementation of the model has reduced the average age for surgical correction of COU from 8.5±2.1 to 3.2±1.4 months. Early decompression of the urinary tract in the first three days of life for critical defects has been shown to reduce the nephrectomy rate by 18%. Optimization of patient management tactics has yielded significant economic benefits by streamlining hospital bed use and eliminating unnecessary invasive examinations. The proposed algorithm helps prevent early disability in children with urinary tract pathologies.
ASSESSMENT OF PHYSICAL DEVELOPMENT BY THE “WHO ANTHROPLUS” METHOD IN PRIMARY SCHOOL-AGED CHILDREN
The study results indicate pronounced territorial differences in the physical development indicators of children depending on their place of residence. Children living in rural areas differed from urban schoolchildren by relatively more harmonious physical development parameters. The Bostanlyk district was characterized by a predominance of harmonious physical development and a relatively low prevalence of overweight and obesity, whereas in children from the industrial city of Chirchik the structure of nutritional disorders shifted toward overnutrition and obesity.
CLINICAL AND FUNCTIONAL CHARACTERISTICS AND THE EFFECTIVENESS OF SPECIALIZED NEUROREHABILITATION AFTER SURGICAL TREATMENT OF SPINAL MENINGIOMAS
Introduction. Spinal meningiomas are among the most common benign tumors of the spinal canal and are frequently associated with neurological deficits due to spinal cord compression. Although surgical resection is highly effective, a subset of patients presents with residual functional impairments requiring specialized neurorehabilitation. Objective. To evaluate the clinical and functional characteristics of patients after surgical treatment of spinal meningiomas and to assess the effectiveness of specialized neurorehabilitation using standardized functional outcome measures. Materials and Methods. A retrospective analysis of patients who underwent surgical resection of spinal meningiomas followed by neurorehabilitation was conducted. Functional status was assessed using the Barthel Index, Spinal Cord Independence Measure (SCIM III), and the ASIA Impairment Scale. Results. Most patients exhibited incomplete paraplegia and varying degrees of mobility and sphincter dysfunction. After rehabilitation, significant improvements in functional independence, mobility, and activities of daily living were observed. Changes in ASIA grades were noted in a subset of patients, indicating partial neurological recovery. Conclusion. Specialized neurorehabilitation represents an effective component of comprehensive management in patients with spinal meningiomas and significantly contributes to functional recovery and quality of life. Further multicenter studies are required to optimize rehabilitation strategies.
CYSTIC NEOPLASMS OF THE SCROTUM ORGANS AND MALE REPRODUCTIVENESS
The generally accepted idea of “Cystic neoplasms”, due to the introduction of computed tomography into medical practice, consists of simple cysts, benign cysts, cysts with multiple septa, doubtful cysts (unclear whether they are benign or malignant) and cystic cancer.the features of the above conditions have not yet been studied in relation to the Tcrotal organs. In this direction, although there is certain scientific information regarding their clinic and diagnosis, a specific classification has not been compiled, and there is also no literature data on simultaneous methods in the complex of their treatment. Generalization and development of unified tactics in this direction will improve the provision of urological care to this category of patients.
CLINICAL - ORGANIZATIONAL ASPECTS OF ARTERIAL HYPERTENSION PREVENTION IN THE PRIMARY OUTPATIENT CARE SYSTEM
Arterial hypertension (AH) remains the leading modifiable risk factor for cardiovascular diseases. The aim of the study is to identify gender characteristics of hypertension phenotypes in the working-age population and to develop a screening algorithm for primary healthcare. The cross-sectional study included 1,798 patients with newly detected hypertension (704 men, 1094 women) from 4 clinics in the Navoi region (Uzbekistan). Analysis of clinical-anamnestic, anthropometric, laboratory data, and quality of life was conducted. A screening algorithm questionnaire with weighting coefficients has been developed. "Rejuvenation" of hypertension was identified: 30.1% of patients were aged 25-44. Men were characterized by behavioral risk factors (31.5% smoking, 36.2% alcohol consumption), while women were characterized by metabolic risk factors (42.5% obesity, 68.6% dyslipidemia, 38.8% chronic kidney disease). Depression (HADS ≥8) is associated with obesity (OR=2.22; 95% CI 1.78–2.77) and dyslipidemia. An 11-factor screening algorithm has been developed with risk thresholds: low (0–4), moderate (5–9), high (10–14), and very high (≥15). Two gender phenotypes of hypertension were identified: "behavioral" (men) and "metabolic-psycho-emotional" (women). The proposed screening algorithm is adapted for primary care conditions and requires prospective validation.
NEUROPSYCHOLOGICAL DEVELOPMENT OF INFANTS IN THE FIRST YEAR OF LIFE BORN TO MOTHERS WITH TORCH INFECTION
TORCH infections occupy a leading place among the causes of perinatal pathology and neuropsychological developmental disorders in early childhood. Intrauterine infection has an adverse effect on the formation of the fetal central nervous system (CNS), which may manifest as delayed psychomotor development, muscle tone abnormalities, seizure syndrome, decreased hearing and vision, as well as cognitive impairments. To study the neuropsychological development of children in the first year of life born to mothers with TORCH infection. A total of 40 children were examined. The first group consisted of 17 newborns aged 0–10 days. The second, outpatient group included 23 children: 10 children aged 30 days to 3 months and 13 children aged 9–12 months. Group I (17 newborns) was examined in the neonatal department in Andijan. Group II consisted of preterm infants (32–34 weeks of gestation) examined in a polyclinic setting. In children of the first year of life born to mothers with TORCH infection, signs of perinatal CNS damage of varying severity are frequently detected. The clinical picture may include motor impairment syndrome, delayed development of speech and emotional responses, and impaired adaptive mechanisms. The severity of abnormalities depends on the timing of infection during pregnancy, the type of pathogen, and the timeliness of treatment. Early detection of neuropsychological developmental disorders, dynamic follow-up, and comprehensive rehabilitation are key factors in improving the prognosis in this group of children.
CORRECTION OF MORPHOLOGICAL CHANGES IN THE ADRENAL GLANDS UNDER THE INFLUENCE OF CARBON MONOXIDE USING THE PLANT ASPARAGUS OFFICINALIS
This article is based on the results of an experimental scientific study conducted on 120 six-month-old outbred white rats. During the study, morphological changes in the adrenal glands were identified in rats exposed to carbon monoxide. Following chronic exposure to carbon monoxide, the structural alterations in adrenal gland tissue were subjected to correction using the plant Asparagus officinalis. The obtained results have practical significance and may contribute to solving and preventing current endocrine-related problems, which represent one of the urgent directions of modern medicine.
MODERN METHODS OF APPLYING REHABILITATION AFTER ARTHROSCOPIC REPAIR OF THE ANTERIOR CRUCIATE LIGAMENT OF THE KNEE JOINT (LITERATURE ANALYSIS)
In the article arthroscopic patients with old malignant lesions when the scientific literature devoted to modern rehabilitation treatments applied after repair was analyzed, it was found that the main aspects of restorative treatment depended on the efficient use of physical exercises and physiotherapy procedures. The main way to prevent contracture is to start active movement in the legs early by conditioning muscle tone. The article states that rehabilitation treatment treatments can achieve good results by taking them under the supervision of an outpatient doctor in the basis of recommended home programs.
PATHOPHYSIOLOGICAL RATIONALE AND PERSONALIZATION OF MULTIMODAL ANALGESIA WITH ESP BLOCK IN PURULENT-SEPTIC DISEASES OF THE THORACIC CAVITY
This study is aimed at developing pathophysiologically grounded criteria for selecting multimodal analgesia with the integration of the erector spinae plane block (ESPB) in patients with purulent-septic diseases of the thoracic cavity. The study included 66 patients with mediastinitis, chronic pleural empyema, and rib osteomyelitis who received conventional opioid-centered analgesia. Pain intensity, respiratory function parameters, opioid consumption, and the incidence of postoperative pulmonary complications were assessed.
RETROSPECTIVE ANALYSIS OF THE INHIBITOR FORM OF HEMOPHILIA A IN CHILDREN
Baseline factor VIII activity level cannot serve as a reliable clinical predictor of inhibitor development. Given the high frequency of this complication, regular laboratory screening for antibodies is justified for all patients receiving replacement therapy, regardless of the severity of the disease phenotype.
ASSESSMENT OF THE CYTOLOGICAL STATUS OF ADENOID VEGETATIONS AFTER VARIOUS TREATMENTS
Surgical treatment of children with adenoid vegetations is currently one of the most relevant topics in modern otorhinolaryngology. The aim of the study is to evaluate the results of cytological examination of wound healing after various surgical methods in children living in the Aral Sea region. The study included 110 children aged 3 to 14 years with a diagnosis of adenoid vegetations . The review showed that in the treatment of children with adenoid vegetations , adenotomy performed using a shaver under endoscope control and adenotomy performed using irreversible electroporation have high efficiency.
MODERN APPROACHES TO SURGICAL TREATMENT OF FOCAL PERIODONTAL LESIONS WITH TOOTH-PRESERVING OPERATIONS (LITERATURE REVIEW)
The review article presents an analysis of contemporary scientific publications devoted to the surgical treatment of focal periodontal lesions using tooth-preserving flap surgeries. Epidemiological aspects of periodontal diseases, classification and pathogenetic features of focal periodontitis, and the evolution of flap surgical techniques from the classical Cieszynski–Widman procedure to modern microsurgical approaches are considered. Particular attention is paid to the role of osteoplastic materials, guided tissue regeneration (GTR) membranes, biologically active growth factors (PRF, enamel matrix proteins), and combined protocols in improving the predictability of treatment outcomes. Criteria for selecting the technique depending on the morphology of the bone defect are analyzed, and directions for further research in tooth-preserving periodontal surgery are identified.
EARLY DIAGNOSIS OF OPEN-ANGLE GLAUCOMA USING THE ICARE TONOMETER AND THE MAKLAKOV TONOMETER
Early diagnosis of primary open-angle glaucoma plays a key role in preventing irreversible vision loss and slowing the progression of the disease. Despite the widespread use of modern diagnostic methods in developed countries, a significant number of glaucoma cases remain undetected by physicians. The aim of this study was to improve the processes of early diagnosis of primary open-angle glaucoma by analyzing data from 24-hour intraocular pressure monitoring using the portable Icare tonometer. The study included 80 patients (140 eyes) with early stages of the disease. The participants were divided into two groups: the first group included patients with stage I primary open-angle glaucoma, and the second group included patients with stage II of the disease. All eyes underwent 24-hour tonometry using the Maklakov tonometer and the portable Icare device. In addition, pachymetry was performed to determine the influence of central corneal thickness on intraocular pressure values. Analysis of the obtained data showed that the results of intraocular pressure measurements obtained using the Icare tonometer corresponded to the data obtained with Maklakov tonometry. Minor differences were observed only in some cases, reaching up to 2 mmHg higher and up to 1 mmHg lower according to the Icare measurements. The results of the study indicate that ophthalmotonus measurements using the Icare tonometer in patients with early-stage glaucoma show statistically comparable results to those obtained using the Maklakov method, making this device an effective tool for daily monitoring and diagnosis of glaucoma.
STAGE-BY-STAGE DIAGNOSIS OF EXUDATIVE OTITIS MEDIA IN CHILDREN BASED ON TRANSFERRIN AND CERULOPLASMIN LEVELS IN ORAL FLUID
This study examined the diagnostic significance of transferrin and ceruloplasmin levels in oral fluid (OF) for diagnosing the secretory stage of exudative otitis media (EOM) in children aged 1–5 years. The study included 77 children with EMA and chronic adenoiditis (main group), 60 children without EMA and without adenoid hypertrophy (comparison group), and 35 healthy children (control group). It was found that in the main group, the level of transferrin in the middle ear fluid was 4 times higher than normal (12.4 ± 1.1 mg/L), and the level of ceruloplasmin was also 4 times higher (4.8 ± 0.5 mg/L). A strong positive correlation (r = 0.74; p < 0.01) was identified between transferrin levels and exudate viscosity. When transferrin levels >12 mg/L are combined with sIgA <0.12 g/L, the risk of developing “sticky ear” increases 4.5-fold. These data allow for the implementation of a non-invasive diagnostic algorithm based on oral fluid biomarkers in clinical practice.
APPLICATION OF L-PRF TECHNOLOGY IN THE COMPREHENSIVE SURGICAL TREATMENT OF MEDICATION-RELATED OSTEONECROSIS OF THE JAWS
A retrospective study included 30 patients with stage II MRONJ: 20 patients underwent surgical treatment with L-PRF, while 10 patients received conventional surgical treatment without L-PRF. The groups were comparable in terms of sex, age, lesion localization, and type of antiresorptive therapy. The aim of the study was to evaluate the clinical efficacy of L-PRF as an adjunctive component of comprehensive surgical treatment for patients with medication-related osteonecrosis of the jaws. In the main group, complete mucosal healing after 30 days was achieved in 100% of patients, compared with 70.0% in the control group (p=0.029). No postoperative complications were observed in the L-PRF group, whereas they occurred in 30.0% of patients receiving conventional treatment (p=0.029). The mean healing time was 30.0±0.0 versus 42.0±8.0 days, respectively (p=0.001), confirming the effectiveness of L-PRF in accelerating epithelialization and reducing complications.
RELATIONSHIP BETWEEN BONE MARROW MYELOGRAM PARAMETERS AND PERIPHERAL BLOOD INDICES IN CHEMOTHERAPY-INDUCED LEUKOPENIA
Aim: To analyze contemporary data on chemotherapy-induced leukopenia with a focus on the relationship between bone marrow myelogram parameters and peripheral blood indices, and to assess how accurately peripheral blood reflects the true state of granulopoiesis in the bone marrow. Materials and Methods: A narrative literature review was performed using publications from 2020–2025 in Russian and international journals. Priority was given to studies evaluating mechanisms of chemotherapy-induced myelosuppression, patterns of granulopoiesis disruption, bone marrow morphology (myelogram), and the dynamics of peripheral blood counts (ANC, leukocyte differential) under cytotoxic therapy with or without G‑CSF support. Clinical guidelines, methodological manuals on bone marrow cytology, and works using mathematical modelling of granulopoiesis were also analyzed. Results: Peripheral blood indices (total leukocyte count, ANC, leukocyte differential, and their dynamics between chemotherapy cycles) reliably reflect the clinical severity of myelosuppression, the risk of febrile neutropenia, and the need for G‑CSF prophylaxis or dose modifications. However, identical degrees of leukopenia and neutropenia in peripheral blood may correspond to fundamentally different bone marrow patterns: preserved early myeloid progenitors with a maturation block, depletion of the pool of mature granulocytes, or pronounced hypo-/aplasia with global suppression of myelopoiesis. Myelogram provides a morphological substrate of these states (cellularity, lineage ratios, maturation indices, ineffective granulopoiesis, hypoplasia, infiltration), allowing discrimination between central production failure and redistribution or peripheral destruction mechanisms. Dynamic and modelling studies demonstrate that serial peripheral counts can partially reconstruct granulopoiesis recovery kinetics, yet they remain indirect and do not replace morphological assessment in prolonged or atypical cytopenias. Conclusion: Peripheral blood reflects the clinical manifestation of chemotherapy-induced myelosuppression, whereas the myelogram characterizes the morphological basis of disturbed granulopoiesis; the concordance between these two levels of assessment is incomplete. This discrepancy justifies the need for dedicated correlation studies in homogeneous cohorts of cancer patients to define when peripheral blood can be used as a sufficient surrogate of marrow status and when bone marrow examination is mandatory.
ASSOCIATION OF BMP-7 WITH C-PEPTIDE LEVELS: A MARKER OF β-CELL RESERVE IN TYPE 2 DIABETES MELLITUS
Objective. To evaluate serum BMP-7 levels in patients with type 2 diabetes mellitus (T2DM) and to assess their associations with clinical and laboratory parameters according to chronic kidney disease (CKD) phenotypes defined by glomerular filtration rate (GFR) and albuminuria status. Materials and Methods. A total of 153 patients with T2DM were enrolled and classified into four phenotypic groups: NRF/NA (normal renal function/normoalbuminuria, n=35), DRF/NA (decreased renal function/normoalbuminuria, n=35), NRF/EA (normal renal function/elevated albuminuria, n=35), and DRF/EA (decreased renal function/elevated albuminuria, n=30). Eighteen healthy individuals served as controls. Serum BMP-7 levels were measured using enzyme-linked immunosorbent assay (ELISA). Outliers were excluded before analysis based on Tukey’s method and physiological plausibility assessment. Group comparisons were performed using the Kruskal–Wallis test followed by Dunn’s post-hoc analysis, with Benjamini–Hochberg false discovery rate (FDR) correction for multiple testing. Effect sizes (ε²) were reported. Associations were evaluated using Spearman’s correlation analysis. Results. After FDR correction, no statistically significant differences in BMP-7 levels were observed between the study groups (q=0.092). In the overall T2DM cohort (n=135), the only significant correlation of BMP-7 was found with C-peptide levels (ρ=0.176; p=0.030). No significant associations were observed with GFR, albuminuria, cystatin C, C-reactive protein (CRP), HbA1c, or proBNP (p>0.05). The highest BMP-7 concentrations were detected in the NRF/EA (146±35.9 pg/mL) and DRF/NA (145±31.5 pg/mL) groups. Conclusion. In established CKD, serum BMP-7 is not a discriminative biomarker of renal phenotype in patients with T2DM. Its positive association with C-peptide suggests a potential role of BMP-7 in supporting pancreatic β-cell functional activity.
COMPREHENSIVE DIAGNOSIS, TREATMENT AND PREVENTION OF CYSTIC MAXILLARY SINUSITIS
Introduction: Chronic cystic sinusitis is accompanied by the depletion of local protective mechanisms. Cystic sinusitis represents one of the most common clinical variants of chronic sinusitis. Paranasal sinus cysts account for 3.9% of all otorhinolaryngological diseases and 12.6% of chronic sinusitis cases. Objective: To substantiate and implement a comprehensive diagnostic and treatment protocol ensuring timely diagnosis, a personalized choice of surgical strategy, and the realization of a preventive measure system aimed at preventing disease recurrence. Materials and Methods: The clinical study was conducted at the Otorhinolaryngology Department of the Samarkand Regional Medical Center between 2021 and 2024. The study included 230 patients with a verified diagnosis of maxillary sinus cyst. Along with standard management, patients in the main group (n=115) underwent comprehensive diagnosis, differentiated conservative and surgical treatment, and tertiary prevention based on the "staged postoperative rehabilitation protocol." Patients in the comparison (control) group (n=115) received standard diagnostic, treatment, and preventive care. Results: Three infiltration morphotypes were identified: eosinophilic, lymphoc ytic, and mixed leukocytic-lymphocytic with fibrosis. Immunohistochemical (IHC) analysis revealed an imbalance in the immunoregulatory index (IRI), which served as the basis for prescribing personalized therapy. A decrease in the functional activity of T-lymphocytes and the phagocytic system was observed in patients, indicating the suppression of local and systemic immunity. A comparative analysis of treatment outcomes demonstrated a significant advantage of the developed management strategy for patients in the main group compared to the control group. In the long-term period (12 months), the treatment efficiency in the main group reached 100% when using approaches via the inferior nasal meatus and the anterior wall, and 94% via the middle nasal meatus approach. These values significantly exceed the results of the control group, where good sinus pneumatization after a year was maintained in only 87–96% of cases, and the recurrence rate reached 9%. The complete absence of recurrences and surgical failures in the main group confirms the high reliability and radical nature of the chosen approaches. Conclusions: The application of a differentiated surgical approach combined with an optimized postoperative rehabilitation protocol ensures full immunocorrection (normalization of CD3+, reduction of interleukins, and decrease of IgE to 63 IU/ml) and eliminates the risk of postoperative neuropathies (0%). This allows for personalized therapy based on IHC data and achieves full medical and social rehabilitation of patients, with the normalization of the quality of life according to the SNOT-22 questionnaire to 4.1 points (physiological norm) within a year.
ENHANCING THE EFFICIENCY OF MULTIMODAL REGISTRATION OF CBCT AND INTRAORAL SCANS BASED ON ARTIFICIAL INTELLIGENCE
This study aims to evaluate the efficiency of artificial intelligence (AI)-based multimodal registration of cone-beam computed tomography (CBCT) and intraoral scan (IOS) data within the framework of advancing digital technologies in dentistry. In modern implantology, high-precision diagnostics and the development of individualized treatment plans rely heavily on three-dimensional (3D) models. CBCT provides detailed information on bone structures, while IOS accurately captures dental surfaces and soft tissues. The integration of these two imaging modalities significantly improves the quality of clinical decision-making. The study analyzed CBCT and IOS datasets from 23 patients. Registration was performed using three different approaches: manual registration (MR), semi-automatic registration (SR), and AI-based automatic registration (AR). Evaluation metrics included registration time, median surface deviation (MSD), and root mean square error (RMS). The results demonstrated a significant advantage of the AI-based method. The AR approach reduced registration time by more than tenfold and improved accuracy metrics (MSD ≈ 0.04 mm). This approach minimizes human-related errors and enhances the reproducibility of results. In conclusion, AI-based multimodal registration systems exhibit high efficiency in dentistry and play a crucial role in optimizing implantological planning.
DYNAMICS OF CHANGES IN THE CONCENTRATION OF BONE TISSUE DESTRUCTION MARKERS AND PH LEVEL IN THE ORAL FLUID OF PATIENTS WITH ONCOPATHOLOGY DURING CHEMORADIOTHERAPY
The spectrum of dental diseases during chemoradiotherapy includes mucositis of varying severity, xerostomia, caries, periodontitis, fungal infections, and other pathological conditions. The mechanisms for the development of these complications are multifactorial and are related to both the direct cytotoxic effect of chemotherapy drugs and ionizing radiation on the oral mucosa, as well as to secondary effects, including disruption of the microbiocenosis, decreased local immunity, and changes in the composition and properties of saliva. Despite the high clinical and social significance of this problem, the issues of prevention, diagnosis, and treatment of dental diseases in oncology patients remain insufficiently studied and require a further systematic approach.
THE SIGNIFICANCE OF THE C718T (RS713041) POLYMORPHISM IN THE GPX4 GENE IN TYPE 2 DIABETES MELLITUS COMPLICATED BY ANGIOPATHY
The GPX4 gene (located at 19p13.3) is located in the 3' untranslated region (3'UTR), and the functionally significant C718T (rs713041) polymorphism is highly associated with diabetes mellitus. Mutations in this regulatory region are known to affect messenger RNA (mRNA) stability, translation efficiency, and ultimately the concentration of active enzyme in the cell. Substitution of cytosine (C) for thymine (T) is associated with decreased GPX4 enzyme activity. This article presents important aspects of this gene in patients with diabetic angiopathy.
IMPROVING DENTAL CARE IN UZBEKISTAN USING A CONCEPTUAL APPROACH TO IMPROVE ITS QUALITY
Patients with end-stage renal disease (ESRD) face many complications. One of these complications is damage to the auditory system. Several mechanisms for the development of hearing loss in these patients have been proposed. No studies have been conducted in Uzbekistan to determine the degree of hearing loss and audiometric test results in patients with ESRD. The aim of this study was to assess the prevalence, type, and associated factors of hearing complications in patients with ESRD. Fifty-four patients with ESRD underwent clinical examination and audiometric testing. Their medical records were reviewed to identify any factors contributing to the development of hearing complications. A high prevalence of sensorineural hearing loss was found in patients with ESRD. Hearing loss was more pronounced at high frequencies. Its prevalence and severity increased with increasing renal failure and chronicity of hemodialysis. No gender differences were observed. Hearing loss did not affect speech intelligibility or acoustic reflex scores. Sensorineural hearing loss is common in patients with chronic kidney disease and deserves more attention than it currently receives.
A DIFFERENTIATED ALGORITHM FOR PRESCRIBING A REHABILITATION PROGRAM WITH FIVE BASIC PROTOCOLS DEPENDING ON THE TYPE OF ANKLE SURGERY
Introduction. Existing rehabilitation protocols after ankle surgery are often one-size-fits-all and do not take into account the specifics of a particular surgical procedure. A differentiated approach using several basic protocols appropriate to the type of surgery appears to be more scientifically sound and effective. The aim of this study was to substantiate and test a differentiated algorithm for prescribing a rehabilitation program with five basic protocols (A, B, C, D, E) depending on the type of surgery. Materials and Methods. A prospective, controlled study of 132 patients after ankle surgery performed between 2020 and 2025 at the Scientific and Practical Center for Rehabilitation and Rehabilitation at Samara State Medical University was conducted. The comparison group (n=59, 2020–2022) received traditional rehabilitation; the study group (n=73, 2023–2025) received a differentiated program with one of five protocols depending on the type of surgery. Efficacy was assessed using the AOFAS scale at days 14, 28, and 42. Results. The distribution of patients by protocol corresponded to the clinical structure of the surgeries: ORIF (Protocol A) – 78 patients (59.1%), arthroscopy (B) – 28 (21.2%), ligament reconstruction (C) – 17 (12.9%), arthrodesis (D) – 6 (4.5%), and endoprosthetics (E) – 3 (2.3%). The use of a differentiated approach resulted in an increase in AOFAS scores of 16.7–30.9% compared to standard management. The greatest relative increase was achieved in Protocol E (+30.9%) and Protocol C (+26.1%). All protocols showed statistically significant differences from the comparison group (p < 0.001). Conclusion. A differentiated approach with five basic protocols ensures higher rehabilitation effectiveness compared to a universal program and allows for consideration of the specific needs of each type of surgical intervention.
MORPHOMETRIC FEATURES OF THE CERVIX WITH BENIGN LESIONS AND EROSION IN THE PREMENOPAUSAL PERIOD
Cervical diseases, including precancerous lesions, remain a major challenge in modern gynecology and gynecologic oncology. Despite the introduction of screening programs, cervical cancer remains a leading cause of cancer in premenopausal women. In recent years, particular attention has been paid to precancerous changes in the cervical epithelium, which are potentially reversible with timely diagnosis and treatment.
FACTORS OF COMPLICATED POSTOPERATIVE COURSE IN ONE-STAGE SURGICAL TREATMENT OF PATIENTS WITH POSTOPERATIVE VENTRAL HERNIAS AND OBESITY
Postoperative ventral hernia (PVH) is commonly observed in patients with obesity. Obesity contributes to increased intra-abdominal pressure, which in turn leads to the development of PVH. The choice of surgical staging and sequence in such patients is often a major challenge and remains a relevant clinical problem. A retrospective analysis of surgical treatment outcomes in 212 patients with obesity and PVH was conducted to identify factors associated with a complicated postoperative course following one-stage surgical treatment. The study demonstrated that the main predictors of complications were body mass index (BMI), duration of surgery, and the patient’s comorbid condition. There is a need to develop a unified prognostic model using statistical processing methods to simplify the application of all interrelated factors.
SENSORINEURAL HEARING LOSS IN TODAY’S OTORHINOLARYNGOLOGY: TRENDS AND LITERATURE INSIGHTS
Sensorineural hearing loss is one of the most common disorders of the auditory system and represents a significant medical and social problem worldwide. According to the World Health Organization, more than 1.5 billion people globally experience some degree of hearing impairment, with a substantial proportion associated with occupational noise exposure and age-related changes. The aim of this review is to analyze current scientific data on the prevalence, risk factors, pathogenetic mechanisms, and modern approaches to the prevention, diagnosis, and rehabilitation of sensorineural hearing loss. The review is based on the analysis of recent national and international publications devoted to the epidemiology of hearing disorders, the impact of occupational noise, the role of neuro-sensory and neuroendocrine mechanisms, as well as the potential of digital technologies for early detection of hearing impairment. Particular attention is paid to the prospects of mobile audiometry and digital health applications for hearing screening and monitoring of auditory function. The findings indicate that the implementation of modern digital technologies and improvement of preventive programs may significantly increase the effectiveness of early diagnosis and rehabilitation of patients with sensorineural hearing loss.
MODERN STRATEGY OF CONSERVATIVE THERAPY OF DEGENERATIVE CERVICAL MYELOPATHY: NEUROPRECOVERY, NEUROREGENERATION AND NEUROMODULATION (LITERATURE REVIEW)
Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord compression and its subsequent degeneration in adults. Despite the fact that surgical decompression is the main method of treatment for severe degrees of compression, conservative therapy plays an important role in the early stages of the disease, as well as in patients with contraindications to surgery or mild compression. The article discusses a modern strategy of conservative treatment of DCM, focusing on the principles of neuroprotection, neuroregeneration and neuromodulation. The evidence base and mechanisms of action of various approaches are analyzed, including medications (neuroprotectors, metabolic activators), physiotherapy, kinesitherapy and the latest methods of non-invasive neuromodulation (transcranial magnetic and electrical stimulation). The possibilities of slowing down the progression of the disease, improving the neurological status and quality of life of patients with the help of complex conservative strategies aimed at maintaining the function of the spinal cord and modulating its excitability are discussed.
THE IMPORTANCE OF ARTIFICIAL INTELLIGENCE TECHNOLOGIES IN THE EARLY DETECTION OF CERVICAL CANCER: INTERNATIONAL EXPERIENCE AND OPPORTUNITIES FOR THE NATIONAL HEALTHCARE SYSTEM
Cervical cancer (CC) remains one of the most serious threats to women’s health, particularly in low- and middle-income countries, where late-stage diagnosis continues to be associated with high mortality rates. According to international epidemiological data, a significant proportion of cervical cancer cases can be prevented through effective screening programs, vaccination against the human papillomavirus (HPV), and timely detection of precancerous lesions. Conventional diagnostic methods currently used in clinical practice—cytological examination, colposcopy, and visual inspection—largely depend on the specialist’s experience, technical capabilities, and the level of healthcare infrastructure, which often leads to subjective diagnostic errors. In recent years, digital transformation and the implementation of artificial intelligence (AI) technologies have opened new scientific and practical opportunities for improving the early detection of cervical cancer. AI-based diagnostic systems enable automated analysis of colposcopic images, improve the accuracy of triage among HPV-positive women, and reduce errors associated with the human factor. This article analyzes current scientific evidence on the application of artificial intelligence technologies in cervical cancer screening, evaluates their comparative effectiveness in relation to traditional diagnostic methods, and discusses prospects for their implementation in the healthcare system of the Republic of Uzbekistan based on international experience.
CLINICAL AND MORPHOLOGICAL PREDICTORS OF PERSISTENT URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY
Objective. To identify clinical and morphological predictors of persistent urinary incontinence after radical prostatectomy based on the analysis of urological and oncological risk factors. Materials and Methods. A single-center retrospective study included 501 patients who underwent radical prostatectomy for prostate cancer. The primary endpoint was clinically significant urinary incontinence 12 months after surgery. Multivariate logistic regression analysis was used to identify independent predictors. Results. Adverse pathological tumor characteristics were associated with a higher incidence of persistent urinary incontinence. Independent predictors of clinically significant urinary incontinence at 12 months were age ≥70 years (OR=1.7; 95% CI 1.2–2.4), pT3–4 stage (OR=1.5; 95% CI 1.1–2.1), pN1 status (OR=1.5; 95% CI 1.0–2.2), and severe early postoperative urinary incontinence with pad-test >18 g (OR=3.8; 95% CI 2.3–6.0). Early postoperative urinary incontinence demonstrated the highest prognostic value. Conclusions. Persistent urinary incontinence after radical prostatectomy is determined by the combined influence of clinical and pathological factors. Age ≥70 years, pT3–4 stage, pN1 status, and pad-test >18 g are significant predictors of unfavorable functional outcomes.
LITERATURE REVIEW OF HELICOBACTER PYLORI GENOME DIVERSITY AND GEOGRAPHICAL DISTRIBUTION
The genomic diversity and geographical distribution of the bacterium Helicobacter pylori, considered to be the oldest companion of humanity, is analyzed. H. pylori has a high level of genetic polymorphism and recombination, which ensures its adaptation to the gastric environment of different populations. The study examines the phylogeographic grouping of bacterial strains into hpEurope, hpAfrica, hpEastAsia and their relationship to human migration
CLINICAL AND NEUROPSYCHOLOGICAL EFFECTIVENESS OF TRANSCRANIAL MICROPOLARIZATION IN THE THERAPY OF CHILDREN WITH DELAYED PSYCHO-SPEECH DEVELOPMENT
Delayed psycho-speech development (DPSD) in children remains one of the most pressing problems in pediatric neurology due to its high prevalence and significant impact on social adaptation. The aim of the study was to evaluate the effectiveness of transcranial micropolarization as part of comprehensive therapy for children with DPSD. A total of 105 children aged 3–7 years were examined. The main group consisted of 80 patients who received standard treatment in combination with transcranial micropolarization, while the comparison group included 25 children who received only standard therapy. The results demonstrated that the use of transcranial micropolarization contributed to a more pronounced positive improvement in clinical, neurological, and cognitive indicators.
OPTIMIZATION OF ENDOVASCULAR STRATEGY IN ACUTE ISCHEMIC STROKE CONSIDERING ANGIOARCHITECTURE AND COLLATERAL CIRCULATION
Acute ischemic stroke remains a leading cause of mortality and long-term disability worldwide despite significant advances in reperfusion therapy. Modern endovascular treatment, particularly mechanical thrombectomy, has demonstrated high efficacy in restoring blood flow in large vessel occlusions. However, clinical outcomes remain heterogeneous, reflecting the complex interaction between vascular angioarchitecture, thrombus characteristics, and collateral circulation status. Aim of the study. To evaluate the impact of angioarchitecture and collateral status on endovascular treatment outcomes and to develop an optimized algorithm for selecting thrombectomy techniques. A prospective cohort study was conducted including 148 patients with acute ischemic stroke who underwent multimodal imaging assessment, including CT, CTA, and CTP, followed by stratification according to the intervention strategy. Results. Algorithm-based approach incorporating collateral circulation and vascular anatomy significantly increased the rate of complete reperfusion (mTICI 3), improved the likelihood of achieving the First Pass Effect, and enhanced functional outcomes at 90 days. Favorable collateral status was associated with reduced infarct growth and a higher probability of functional independence.
RARE TWO CASES FROM UROGYNECOLOGICAL PRACTICE
Injuries and strictures (narrowing) of the female urethra are rare but clinically significant conditions that may be accompanied by impaired urodynamics, chronic inflammatory processes and secondary complications, including vaginal stone formation. Vaginal stones may form due to urine stagnation during urethral obstruction, fistula tracts or foreign body retention. The article discusses the main examples of 83 patients with urogenital fistulas and two rare clinical cases of vaginal stone formation. Causes, clinical manifestations, diagnostic methods (including ultrasound, cystoscopy and MRI) and treatment tactics for these pathologies. Particular attention is paid to surgical correction of urethral strictures, removal of vaginal stones and prevention of relapses.