The purpose of the study is development of ways for comprehensive diagnosis and treatment of acute cholecystitis in patients with high operational risk.

Material and methods The work carried out the results of complex diagnostics and treatment of 68 patients with acute calculus cholecystitis who were admitted from 2014 to 202 to the surgical department Medical sanitary part of the Tajik Aluminum Company (TALCO). A standard examination algorithm was applied to all patients, including clinical and laboratory studies and an ultrasound scan of the abdominal cavity, which was performed during the first 2-3 days.

The result of the study The expected mortality was 9.8 ± 4.9% when evaluating the integral indicators of severity of the condition and postoperative complications could develop to 49.2 ± 5.9%. According to the result of ultrasound, which was performed over the next 2 days after admission, two groups were distinguished from patients. In the 1st group (32 patients) there was a regression of inflammatory changes in the gallbladder, in the 2nd group (60 patients) there was no improvement.

Conclusion Thus, the integral scales of SAPS-II, POSSUM and clinical and instrumental examination at admission and in the dynamics allow to reasonably identify groups of patients with high operational risk and help in determining tactics and choosing the treatment method for acute cholecystitis

Aim. To study the clinical and instrumental characteristics of the course of coronary heart disease in association with type 2 diabetes mellitus.

Material and research methods. The material for the study was 116 patients with coronary heart disease who met the selection criteria. All patients depending on the presence of diabetes mellitus were divided into two groups: group I with type 2 diabetes mellitus (n=44) and group II without type 2 diabetes mellitus (n=72).

Research results. Patients with coronary heart disease in association with type 2 diabetes mellitus were older and accounted for 37.9% of the total group. Among the risk factors, arterial hypertension, hypercholesterolemia and obesity occupied leading positions in the compared groups. An analysis of the course of coronary heart disease in the compared groups showed that nonanginal or other symptoms (shortness of breath) were more often observed in diabetics. According to the results of echocardiography, the size of the atria (left and right) was higher in the group of patients with diabetes.

Conclusions. The study showed that patients with coronary heart disease in association with type 2 diabetes were older, had a higher body mass index and cardiovascular risk factors.

Purpose of the study. Improving medical and organizational aspects of providing care to newborns with congenital malformations in the Republic of Tajikistan.

Material and research methods. The results of diagnosis and treatment of 120 newborns with congenital malformations of the anorectal region were analyzed. Children, depending on gestational age, were as follows: full-term children -59.2%, premature children 40.8%. Of the total number of premature children, there were 6.3% of grades III and IV. In mothers aged 18 to 25 years, children were born with developmental defects 59 (38.7%), from 26 to 34 years old 73 (46.8%), the lowest rate was from 35 to 45 years old 3 (1.9%).

The influence of transportation of newborns on the outcome of treatment of anorectal malformation was studied. Transportation of newborns was carried out in the following order: by ambulance 25%, self-pickup 48%. The remaining 27% of children were in the pediatric surgical department due to intra-hospital transfer.

Results of the study and their discussion. The main issue when organizing the transfer of newborns with anorectal malformations to a specialized pediatric surgical department is solving the issue of transportation at the pre-hospital stage.

In this regard, it should be noted that the most serious task in monitoring newborns at the stages of transportation is the prevention of hypothermia, since newborns experience a process of hypothermia, which leads to metabolic disorders, cellular and tissue metabolism, possibly progressive hemorrhage in the brain and metabolic acidosis. Transportation of newborns with malformations of the anorectal region from maternity hospitals for surgical correction was mainly carried out by self-pickup, by passing car from distant regions of the republic, which is 48%, by an ambulance resuscitation team from hospitals in the city of Dushanbe 35.6%, and by ambulance transport, not provided for transportation of newborns 12.4%, which does not meet the requirements for transportation of newborns.

Conclusions. The leading role in the successful outcome of treatment of anorectal malformations is prenatal diagnosis of congenital malformation and timely hospitalization of pregnant women before delivery in maternity hospitals closer to the place where there are specialized pediatric surgical hospitals. In addition, it is advisable to ensure the organization of surgery departments for congenital pathologies of newborns at the perinatal center and the provision of special transport for transporting newborns. Training of personnel in maternity hospitals and ambulances on the organization of medical care and interhospital transportation of newborns.

Purpose of the study. To study the methodological rationale for plantation cultivation of the damask rose Rosa damfscena Mill in the Shakhrinav region of Central Tajikistan.

Materials and methods of research: the materials for the study were used in the processing of essential oil raw materials, along with essential oils, such valuable biochemical products as bioconcentrates, ursulic acid, aqueous bioextracts, extracts, waxes, hydralates, etc., the waste of which is widely used as an additive in feed in livestock farming, in industrial fish farming.

Results of the study and their discussion: In recent years, in the territory of the Republic of Tajikistan, as a solution to pressing problems of agricultural development, a more complete involvement and effective use of promising species of useful plants has been envisaged.

Due to the fact that in recent years the demand for essential oil products has sharply increased, interest in the plantation cultivation of essential oil plants both in our country and abroad is increasing. One of the valuable essential oil crops, which in recent years has increasingly attracted the attention of scientists and specialists, is Rosa damascena Mill. Rose flower processing products (essential oil, concrete, rose water) are widely used in various sectors of the national economy: in the manufacture of high-quality perfumes and cosmetics, skin care products, oral care products, hair care products, soaps, etc., as well as confectionery production, alcoholic beverage, pharmaceutical, medical, paint and varnish industries, food industry.

In order to create a favorable environment for the further development of cultivation and processing of Rosa damascena Mill. raw materials, as well as increasing the export potential of the industry, a very promising direction is the creation and expansion of its industrial cultivation area in the republic.

The selected object for wide industrial cultivation in the conditions of the Gissar Valley, its value as a promising essential oil plant, as well as the experience of its introduction ability to grow in the soil and climatic conditions of the region give positive forecasts for its cultivation and wide cultivation in the region.

Conclusion: Creation of high-yielding Rosa damascena Mill plantations. and establishing their integrated use to meet the various needs of society within the framework of organizing multipurpose, rational use of rose essential oil raw materials is the most important principle and priority direction for the development of the agricultural complex, according to the Development Strategy of the Republic of Tajikistan until 2030

The purpose of the study. Study of the characteristics of the hormonal function of the placenta and morphological evaluation of the placenta in women with obesity.

Research materials and methods. A total of 136 patients including 109 pregnant women with obesity (main group) were prospectively observed. This group, in turn, is divided into three groups: obesity in the patient 40 patients, obesity + preeclampsia 39 patients and obesity + insulin resistance 30 patients. The control group consisted of healthy pregnant women. Histological analysis of placentas of women who gave birth (p=24) was performed.

Research results and discussion. The conducted analyzes showed a decrease in the intermediate level of mashima hormones estradiol, PLH, progesterone, which contributes to timely fertilization of the baby’s uterus.

Summary: 1. Hormonal data showed a decrease in the level of hormones in pregnant women with obesity (estradiol, HLP and progesterone), the statistical significance of the decrease in the level of progesterone was found in pregnant women with obesity and SSDBT. 2. Histological assessment of placentas showed that 78.6% of pregnant women with obesity and preeclampsia have chronic placental insufficiency, which is manifested as hypoplastic type (55.5%) and dissociation (45.5%) with the type of placental development. which has a negative effect on the prenatal development of the fetus and perinatal consequences.

Aim. improvement of POVH hernioplasty methods by using endo-mesh with various separation plastics (SP).

Material and methods. Operations were performed on 148 patients with POVH. Patients are divided into 3 groups. Group I included 58 (39,2) patients who underwent anterior SP. Group II included 44 (29,7%) patients who underwent posterior SP. The remaining 46 (31,1%) patients made up group III, who underwent standard “stretch” methods of hernioplasty of the Onlay (n=28) and sublay (n=18) types. Causes of POVH: non-compliance with the work regime in 36 (24.3%); a history of relaparotomy in 25 (16.9%); suppuration of wounds in 18 (12.2); ligature fistulas in 11

(7.4%); causes were not identified in 58 (39,2%) patients. 15 (10.1%) patients underwent CT, while determining the ratio of the size of the hernial sac to the volume of the abdominal cavity, in order to predict and identify the degree of risk of developing the abdominal compartment syndrome.

Results. The choice of the operation method was influenced by the indicators of intraoperative intra-abdominal pressure (IP). In patients of group I, in the immediate postoperative period with the use of an anterior SP, complications from the wound occurred in 10 (17.2%), in group II, in whom a posterior SP was used, a similar complication was noted in 4 (9.1%) patients. In group III, in which tension methods were used, complications from the wound were observed in 7 (15.2%) cases. Relapse within 1 month to 4.5 years was noted in 12 operated patients. Moreover, the frequency of hernia recurrence was high in the first group in 5 (8.6%) and in the third group in 6 (13.0%) patients. In group II, where posterior SP was used, recurrence was observed in 1 (2.3%) patient. Reason: suppuration of wounds, obesity and concomitant diseases. Mortality occurred in 2 (1,3%) patients: 1 patient from the first group (1.7%) and 1 from the third group (2,3%). The latter was caused by the development of abdominal compartment syndrome with the development of PON.

Conclusion. POVH in 25% of cases remains a complication of laparotomy, especially in patients with varying degrees of obesity. The recurrence of hernias and lethality with standard tension methods remains high compared with the proposed variants of the joint venture using endonets.

The review summarizes the data of population studies on the system of perinatal regionalization, outlines the main principles of the formation and development of the system of perinatal regionalization. An assessment of the quality, accessibility and effectiveness of the three-level structure of the perinatal care system is given. Problems and regional differences have been identified regarding the organization of work in institutions of different functional levels, united according to the principles of centralization of assistance.

Purpose of the study. To study and analyze retrospectively the causes of environmental pollution of water and air and its consequences, the formation of elements of environmental education in the audience about anthropogenic pollution of water and air.

Material and research methods. To study the impact of various factors on water pollution and ways to solve environmental water pollution at the regional level, a retrospective information and bibliographic analysis was carried out: analyze domestic and foreign literature, dissertations, Internet resources, domestic statistical compilations.

Results of the study and their discussion. Unfavorable conditions of water supply, sanitation and hygiene have a significant adverse impact on the well-being of the country’s citizens, particularly the rural population, the poor and children. Currently, only 51.4% of Tajikistan’s population, including 86.9% of the urban population, 61.5% of the municipal population and 43.4% of the rural population, have access to drinking water and good sanitation. 49.6% of the population either do not have access to drinking water or the water used is unsafe in terms of sanitation and hygiene. Significant impact on the health of the population is caused by chemicalization of agriculture as a result of increased use of mineral fertilizers and pesticides to control weeds and pests, leading to severe chemical pollution of water bodies.

Conclusion. Thus, the safety of the environment and drinking water is a fundamental factor in maintaining public health and is closely dependent on the work of the country’s environmental services, public health institutions and voluntary public environmental organizations.