Objective: to study the socio-hygienic aspects of the development of metabolic syndrome, and their impact on the prevalence and course of gout. Material and methods: the study included 80 patients (78 men, 2 women) suffering from gout. The anthropometric and general characteristics of gout patients by gender, age, and duration of the disease are given. 15 patients (18.7%) were diagnosed with type 2 diabetes. The average age of patients with type 2 diabetes was (59.1 ±8.4), and the duration of the gouty history was 7.0. To identify the prevalence of gout, a questionnaire survey was conducted among the population geographically attached to primary health care institutions. Dushanbe, 200 people with a history of clinical signs of joint syndrome of varying severity. Glucose (glucose oxidase method) and uric acid (MC) levels in blood serum (colorimetric enzymatic method) were determined in all patients on an empty stomach. The blood lipid-protein spectrum was also studied – total cholesterol (HC), triglycerides (TG) and high-density lipoprotein cholesterol (HDLC) by colorimetric method. Results: men prevailed among the surveyed (97.5%). At the same time, there has been an increase in the incidence of gout among women, reflecting current annual trends in the growth of gout in women. The age of the patients varied widely, but mostly they were patients aged 40-60 (77.5%). The average age of patients with gout was 51.43±8.29 years. At the same time, the average age of women (52.8 ±2.3) was slightly higher than that of men (49.3±.52). The duration of the disease ranged from 1 month to 18 years, averaging 8.9 ±0.24. In patients younger than 50 years of age, the most common signs of MS were an increase FROM > 102cm (83.3%), an increase in blood pressure (78.2%); a slightly less common increase in serum glucose (54.1%) and a decrease in HDL-C (54.1%). Hypertriglyceridemia was observed in (28.7%). In the age group of 50-60 years, the most common signs of MS were a decrease in serum levels of HDL-C (93.2%) and an increase from > 102cm (76.7%), as well as a slight increase in the number of patients with elevated triglyceridemia (37.2%). Hypertension was more common, and an increase in hypertension, hypertriglyceridemia, and hyperglycemia were much less common than in the groups of younger patients. Naturally, the duration of the disease increased progressively with the age of the examined patients. Nevertheless, the younger the patients were, the earlier the gout debuted. It was found that in patients with gout who consumed alcohol, changes in a number of enzymes were noted: a tendency to increase the activity of transaminases, mainly ASAT, compared with patients who did not drink alcohol and those in the control group. The content of cholesterol and triglycerides in patients who abused alcoholic beverages was higher than in the comparison group. Conclusions: the data of the socio-hygienic analysis indicate a certain influence of certain factors on the prevalence, duration of the disease and the course of gout with components of MS. Among the factors that have an unfavorable value are the following: age, sedentary lifestyle, diet, alcohol abuse, smoking, overweight, obesity. This requires putting this category of people at risk of developing the disease and conducting the necessary laboratory and instrumental studies.

Objective: to study the etiological structure of acute intestinal infections (AII) in children of different ages living in Nukus. Material and methods: the study was conducted from June to July 2024 at the Intestinal Infections Department of the Republican Children’s Infectious Diseases Hospital of the Republic of Karakalpakstan (RCIDH). A total of 3645 patients with clinical manifestations of diarrhea were admitted, 806 adults and 2839 children, of whom 200 were examined. Stool samples were analyzed for bacterial and viral intestinal infections using the PCR method. Statistical analysis methods (P, m, t-values) were used in the study. Results: the highest number of cases occurred in the age groups up to 1 year and 1 to 4 years, in which astrovirus was most frequently detected. Adenovirus and norovirus infections were predominantly among children aged 1 to 4 years. Shigella spp., enteroinvasive E. coli (EIEC), Salmonella spp., and thermophilic Campylobacter spp. were detected in some patients. Shigellosis was detected more frequently in the age groups up to 1 year, 1 to 4 years, and 5 to 9 years. Cases of salmonellosis were recorded in children aged 1 to 4 years and 10 to 16 years, while campylobacteriosis was more frequently diagnosed in children aged 1 to 4 and 10 to 16 years. Mixed forms included viral coinfections (VCOI-virus + virus), bacterial coinfections (BBOI-bacteria + bacteria), and combined viral-bacterial infections (VBOI-virus + bacteria). Single-etiologic viral and bacterial, as well as mixed AIIs, were more frequently recorded in children under 1 year of age   and 1–4 years of age. Conclusions: the analysis showed that acute intestinal infections (AIIs) are most common in young children (under 1 year of age and 1–4 years of age). Viral AIIs were found to be more prevalent than bacterial AIIs. Among mixed forms, virus-associated infections accounted for the largest proportion, a trend toward higher prevalence has been observed in recent years in children under 4 years of age. This should be taken into account when improving laboratory diagnostics and choosing rational therapeutic strategies for this age group.

Objective: improving the effectiveness of immediate results of treatment of acute biliary pancreatitis using the developed diagnostic and treatment algorithm. Material and methods: the work is based on the analysis of the results of diagnostics and treatment of 137 patients with acute BP. The age of the patients ranged from 20 to 82 years. and amounted to, on average 62.17±2.83 years. Among the patients, there were 101 women (73.7%), 36 men (26.3%). The average period from the onset of the disease to admission to the clinic was 5.11±1.89 days and ranged from several hours to 24 days. In the diagnosis of acute BP, a comprehensive approach was used, including analysis of complaints, anamnesis data, objective examination, laboratory and instrumental research methods. Results: the study of cytokine status in patients with PD in the presence of purulent cholangitis against the background of conservative therapy revealed an increase in the concentration of TNF-a, IL-6 and IL-8 in the blood plasma in the first 3-4 days, and IL-4-7 on the day after surgery with a further decrease. The combination of minimally invasive interventions with conservative therapy effectively reduced the content of   TNF-a, IL-4 and IL-6 in the bile of patients with forms of PD, which, compared with the preoperative period,   the concentration of TNF-a, IL-4 and IL-6 in bile was significantly lower by 72.0, 47.6 and 80.3%, respectively. In the postoperative period after combined minimally invasive interventions against the background of the therapy, on the first 3 days, an improvement in the condition was noted in all 65 patients. The average bed-day was 8.3±1.1 days, compared with patients of the second group, which was 26.8±2.2 days. Postoperative complications were noted in 4 (6.1%) patients, versus 14 (19.4%) in the group of patients after traditional operations. 2 (2.8%) patients died after traditional surgery from progressive manifestations of multiple organ failure. Conclusion: modern laboratory and instrumental research methods can most accurately verify and predict complications of biliary pancreatitis. And combined minimally invasive interventions can improve the immediate results of treatment of biliary pancreatitis.

Objective: to improve perinatal outcomes in pregnant women with chronic hypertension and complicated miscarriage. Material and methods: a total of 70 women pregnant with of chronic hypertension were examined. Of these, 30 pregnant women with chronic hypertension were prospectively observed from among patients who had undergone pre-pregnancy preparation and had a history of miscarriages and premature births, and 40 pregnant women with chronic hypertension who had not undergone pre-pregnancy preparation (comparison group) were taken for comparative analysis. Results. the analysis showed that among pregnant women using progesterone, the frequency of term births 92,5%, and premature births 5,0%, while among the comparative group this indicator was 70,0% and 25,0%, respectively. Conclusion: the leading role in the successful outcome of pregnancy and childbirth in patients with chronic hypertension who have a history of miscarriageis the use of progesterone from the moment of conception to 36 weeks of pregnancy.

This article examines the nasal microbiota of patients with allergic rhinitis (AR) aged 7–17 years living in the Muynak district of the Aral Sea region. The microbiota plays a crucial role in maintaining homeostasis and the body’s immune and metabolic processes. Its composition depends on the state of the immune system, environmental influences, age, and lifestyle, leading to dynamic changes in the biocenosis. Karakalpakstan is located in the Aral Sea ecological crisis zone: sea desiccation, soil salinization, dust storms, and air pollution are accompanied by an increase in morbidity, including allergic pathologies, which affect one in three residents of the region. Environmental factors contribute to changes in the nasal mucosa and increased bacterial counts. Staphylococcus aureus is particularly significant, as research shows that it increases nasal congestion, aggravates rhinitis and sinusitis, and contributes to chronicity.

Objective: to assess the incidence and mortality of pancreatic cancer in the Republic of Tajikistan for the period 2018–2024. Materials and methods: a total of 646 newly registered cases of pancreatic cancer were studied at the Center for Medical Statistics and Information of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan from 2018 to 2024. The prevalence of incidence and mortality was analyzed by sex, age, and stage. To assess mortality from pancreatic cancer, cases of death among patients recorded at the end of the previous year were studied. Results: it was found that the number of patients with pancreatic cancer has been increasing annually, both among men and women. Among all newly diagnosed malignant neoplasms, pancreatic cancer accounted for 2.0–2.8%. Men (53%) were affected slightly more often than women (47%). The highest incidence was observed in the 55–64 age group, accounting for 39.9%. In both sexes, pancreatic cancer was diagnosed in 73.1% of cases among patients older than 55 years. Analysis of stage distribution in Tajikistan showed that stages I–II were identified in 55.7% of patients, stage III in 14.4%, and stage IV in 29.1%. In the overall cancer mortality structure of the population, mortality from pancreatic cancer during 2018–2024 ranged between 2.22–3.76%. Among patients registered at the beginning of the reporting year, 19.3–51.5% died within the same year. Conclusions: in the Republic of Tajikistan, the incidence and mortality of pancreatic cancer continue to show a high growth rate. Men are affected slightly more often than women (53% vs. 47%), although gender differences are minor (ratio 1.1:1). The highest incidence was observed in patients over 55 years of age (73.1% of all cases). Unlike international data, in Tajikistan more than half of the cases (55.7%) were diagnosed at stages I–II, which may be related to specific features of statistical recording and staging. Mortality from pancreatic cancer in the overall structure of malignant neoplasms in the country ranged from 2.22% to 3.76%, while the annual lethality among registered patients reached 19.3–51.5%.

Objective: to investigate the effectiveness of skinbooster injection in patienys with age-related facial skin changes according to the data of immediate and long-term results. Material and methods: the work was carried out in the SEI“City clinical hospital of skin diseases” c.Dushanbe in the period 2021-2024 years. The study included 96 women permanently residing in Dushanbe, with chrono and photo-aging aged 35 to 65 years(average age 49.54+ 7.57 years) of applying for cosmetology help. The degree of skin aging was determined by visual scale MERZ, the R. Glogau scale used for photo aging and to determine the total aging index the GAIS scale. Skinboosters were injected with a multi-puncture technique in a short linear 0.01-0.02 milliliter an interval between injections from 0.5 to 1 cm. Patients underwent 3 procedures for the introduction of skin boosters in the amount of 2 milliliters with an interval of 1 month D01-M01-M02. Results: our study, which includes several stages of analysis of methods, presents the immediate (3-5 months) and long-term results(12 month from the start therapy). At the first stage, clinical evaluation of patients with involutional skin ganges(ICS)was carried out. At the initial signs of photoaging (stages I and II), skin booster injections can be used, at moderate and severe stages to obtain a pronounced and lasting effect, it is necessary to strengthen filler therapy in combination with hardware methods (fractional erbium or CO₂ laser, RF technology, IPL, Alter therapy, etc.). At the second stage, distribution was prowoked patients are divided into two therapeutic groups. The examined women from group I, using non-surgical methods of cosmetic correction, looked younger than their peers from group II, who applied for cosmetic help for the first time. At the third stage of the study, the clinical efficacy of skinbooster injections was studied according tj the data of immediate and long-term results of use (5 and 12months), with chrono-aging in women in two groups. Research results demonstrated a significant improvement in the quality of the facial skin after injection with staunlized hyaluronic acid (sGC) with liloccann injection methods. Recommended, so that skinbooster therapy with sGC is repeated after 6-12 months for optimal results of correction of signs of photoaging. Conclusion: our modest experience of a differentiated approach of step by step shading course treatment using skinbooster injections, meets modern requirements for entering into daily dermatological practice aimed at improving the quality of medical and cosmetological assistance provided to women.

Objective: to evaluate the effectiveness of ventilation in patients with acute cerebral circulatory disorders of hemorrhagic type. Material and methods: а retrospective analysis of the medical histories of 480 patients with acute cerebral circulatory disorders by hemorrhagic and ischemic type for 2018-2022 was carried out. The average age of patients was 62.9±11.4 years. Men accounted for 217 (45.2%) patients, and women — 263 (54.8%). The patient’s or relatives’ complaints were collected (in the absence of verbal contact), anamnesis study, general clinical examination, assessment of neurological disorders, neuroimaging research methods (computer and magnetic resonance imaging), ophthalmological studies. Results: depending on the localization, intracerebral hematomas were distributed as follows: in the frontal lobe – 33 (6,9%), in the occipital lobe – 26 (5,4%), in the hemispheres of the cerebellum 43 (9,0%), in the form of ventricular hemorrhages 81 (16,8%), and in the parietal–temporal lobes 297 (61,9%). One of the main symptoms was a violation of the level of consciousness and it was assessed on the Glasgow coma scale. The severity of the hospitalized patients’ condition was assessed according to the following criteria: the depth of the level of consciousness, the height of blood pressure, age and concomitant somatic condition. After a thorough assessment of the general condition, somatic status, age, level of consciousness, as well as according to tomodensitometric data, the patients were sorted depending on the treatment tactics. 157 (32.7%) patients were given an indication for surgery. The mortality rate among young patients was 33.9%, most of the survivors had a relatively favorable outcome of the disease, and in elderly patients the mortality     rate was 66,1%. Most of the patients (73.7%) died within 7 days of respiratory support, which was most often associated with life-incompatible cerebral damage. Conclusion: an adequate assessment of the prognosis of the disease and the expected results in this category of patients who need a ventilator is necessary not only for doctors, but also for the families of patients.

Objective: to establish the etiological structure of microorganisms isolated from nosocomial infections in the region, to present the microbiological characteristics of pathogens of nosocomial infections and to develop a method for indicating hospital strains. Material and methods: a retrospective analysis of data for the past 5 years was conducted. The etiologic structure of nosocomial infections was studied in clinical material obtained from parents, newborns, and postoperative patients, as well as in swabs from environmental objects in healthcare facilities. Identificationof hospital strains was carried out by determining the sensitivity of strains to antibiotics, compiling and comparing antibiograms of bacterial cultures isolated from patients and from environmental objects. Results: the incidence of nosocomial infections showed a downward trend (T sn = 8.6), consistent with the general trend in Uzbekistan as a whole.In isolates of S. aureus, E. coli, P. aeruginosa, and K. pneumoniae, a high frequency of isolation of multidrug-resistant strains was observed, which retained sensitivity only to drugs of the fluoroquinolone group. Conclusions: 1. The incidence of nosocomial infections showed a downward trend (T sn = 8.6), consistent with the general trend in Uzbekistan as a whole. 2. In isolates of S. aureus, E. coli, P. aeruginosa, and K. pneumoniae, a high frequency of isolation of multidrug-resistant strains was observed, which retained sensitivity only to drugs of the fluoroquinolone group.

Objective: study of the characteristics of the main diseases of the larynx in people of voice and speech professions, conducting a comparative analysis of the prevalence, risk factors and clinical picture of diseases. Material and methods: in the conditions of the ENT clinic of the NMC “Shifobakhsh” 163 people of voice and speech professions (78 women and 85 men) with functional and organic diseases of the larynx were examined, the average age of patients was 36.5 years. Patients were divided into 2 groups taking into account laryngeal diseases in vocalists (main group) and in speech professions (comparison group). All examined persons underwent a general ENT examination, video fibrolaryngoscopy and video recording of the patients’ voices. Results: the analysis of the contingent of examined persons by professional characteristics was divided into vocalists and speech-language specialists, whose representatives were singers, teachers, actors, educators of children’s institutions, as well as persons of other professions (housewives, drivers, trade workers, etc.). The most frequent diagnoses in vocalists were: atrophic, hypertrophic and catarrhal laryngitis, phonasthenia. In persons of other professions, we observed mainly vocal fold polyps, functional diseases of the larynx in the form of hypotonic dysphonia, functional aphonia. Conclusion: representatives of voice and speech professions, including singers, announcers, lecturers and teachers, were observed in the ENT clinic. The most common laryngeal pathologies in these patients were minimal morphological changes in the vocal folds, such as functional hypo and hypertonic dysphonia, as well as phonasthenia. Among the pronounced morphological changes, there were vocal nodules, catarrhal and chronic laryngitis, hemorrhages in the vocal folds, and, in some cases, polypoid formations. The data obtained emphasize the importance of prevention and timely treatment of laryngeal disease, especially in representatives of a profession requiring a high vocal load.