Purpose of the study. The study is aimed at assessing the existing regulatory and legal regulation and studying measures aimed at improving the efficiency and accessibility of the social services sector that have undergone significant changes related to the systematization of legal regulation, the introduction of an independent assessment of the quality of work of organizations in the social sphere, subsidizing the state social order and expanding mechanisms for attracting the non-state sector of the economy to provision of social services during the years of gaining state independence.
Material and methods. The materials of the constitutional norms proclaiming the Republic of Tajikistan a social state, the Law of the Republic of Tajikistan on pensions for citizens of the Republic of Tajikistan, international organizations of human rights ombudsmen in Tajikistan, publications of non-governmental organizations involved in the protection of the rights of people with disabilities are analyzed. In the course of the research, analysis and generalization of official documents, comparative, legal and other methods of knowledge were used [4, 6].
Results of the study and their discussion. It turned out that so far in the legislative acts there has not been a mention of a new direction of social services for the population, both social and hospital-replacing services for the elderly and the disabled. The UN Convention on the Rights of Persons with Disabilities, signed by Tajikistan (2018), reflects the main shifts in the global understanding of the problem of disability, as well as the rehabilitation of people with disabilities [7].
The named Convention recognizes the importance of achieving their accessibility to all the benefits and rights provided by society to its free citizens, including health care, education, employment, information and communications, which play a significant role in the development and improvement of the country’s social legislation in accordance with a certain standard of regulation public relations in the social sphere.
After all, the provision of state support for the disabled and the elderly, the development of a system of social services and guarantees of social protection are one of the priorities of state policy. At the level of the Government of the Republic of Tajikistan, the “National Standard of the Republic on Social Hospital-Replacing Services for Elderly and Disabled Citizens” has not yet been adopted and state regulation of prices for social services provided to citizens by state social service organizations has not been extended. Social services are provided at the expense of the recipients themselves (purchase and home delivery of food and other goods, purchase of fuel, payment for utilities and communication services, delivery of things to a dry cleaner or atelier, sending mail).
Conclusion. The results of the analysis of social services for the elderly and disabled people of the republic showed that over the past years, the government of the country has been systematically working to improve legislation aimed at improving the situation and quality of life of people with disabilities, reflecting the fundamental principles and norms of the Convention on the Rights of Persons with Disabilities in the country. Despite the proclamation of the Republic of Tajikistan as a social state, the policy of which is aimed at strengthening the material base of organizations of the social service system, there is still no mention in the legislative acts of a new direction of social services for the population, both social and hospital-replacing services for the elderly and disabled [6]. In this connection, it is necessary in the coming years to gradually amend a number of laws and regulations.
Purpose of the study: To assess the helminthological situation in Tajikistan and to identify the most common types of helminths among people of different ages.
Material and research methods. Helminthological studies were conducted in 2022 in 6 districts of the Khatlon region (Yavan, A. Jomi, Shahritus, Nurek, Dangara, Muminabad), differing in climatic and geographical conditions. We also processed and analyzed data on examined persons for helminthiasis in the parasitological laboratories of the Centers for the Control of Tropical Diseases and the Centers for State Sanitary and Epidemiological Surveillance in the period 2020-2023. Stool studies were carried out using two methods for detecting parasites: scraping from the perianal folds with a cotton swab; the Kato-Katz method.
Results of the study and their discussion. The incidence of helminths, according to the official statistical reports of the State Institution “Republican Center for Tropical Diseases Control” in the republic in 2023 was 37792 cases (of which 14,205 cases (37,5%) are children and adolescents under 18 years of age). Of these, 12905 cases are ascariasis (34,1%), 10092 cases of enterobiasis (26,7%), 3580 cases of hymenolepiasis (9,4%), 17 cases of trichuriasis (0,04%), 28 cases of taeniasis (0,07%) and 155 cases of echinococcosis (0,4%). The results of the study in 2022 showed that the prevalence of helminths among 65,665 examined individuals in the target areas of the Khatlon region averaged 7,5%. The most common helminth is the roundworm (Ascaris lumbricoides) - this parasite was found in 2604 (4.0%) of those examined.
Conclusions. High prevalence of helminthiasis was found in the examined residents of two districts (A. Jomi and Shahritus) of the plain zone (14,0% and 11,3%, respectively), low prevalence of the population (1,0%) was noted in the city of Nurek. Failure to observe personal hygiene and sanitary standards, as well as the use of water from open water sources unprotected from pollution contribute to the intensive invasion of the population by helminths
Purpose of the study: using of the International Classification of Functioning, Disability and Health (ICF) in the field of rehabilitation and habilitation of disabled people for their maximum integration into society.
Materials and methods of research: The materials of the research a review of the literature, materials of the conference and other events aimed at revealing issues of the need to use the ICF in the field of medical and social rehabilitation, in addition, an analysis of the reporting form 07 was conducted - the annual statistical report of the State Institution “Medical and Social Expertise”
Research results: To assess the functioning of the medical and social rehabilitation model in the republic and analyze the activities of the existing structure of institutions and organizations involved in individual rehabilitation programs (IRP) within the framework of the ICF in 2021-2022, we surveyed 300 disabled people (Sughd - 100, Khatlon - 100 and DRS - 100 people, respectively) about their use of IRP. In the republic, specialists of the State Medical and Social Expertise Service fill out the Individual Rehabilitation Program (IRP) when undergoing examination, and according to the State Medical and Social Expertise Service, more than 25 thousand forms have been filled out from 2014 to 2020. However, their implementation in primary health care institutions and other structures is not carried out, and one of the reasons for the failure to implement this program is the lack of awareness of primary health care specialists in the gradual implementation of the IPR in light of the use of the ICF, as well as the lack of interest of the disabled people themselves in this program due to lack of awareness on this issue.
Conclusion: To implement the IPR, it is necessary to consider in detail the functional limitations of life activity associated with changes in health and functioning, which is possible when using the ICF as a classifier for describing impairments associated with disability. This issue requires the participation of not only medical specialists, but also representatives of other industries.
Aim of the study. Evaluation of hearing in various forms of chronic suppurative otitis media.
Material and methods of the study. In the conditions of the audiology department of the ENT clinic of the National Medical Center of the Republic of Tajikistan, for the period 2021-2024, we examined and operated on 45 patients aged 19 to 45 years (including 18 women and 27 men) suffering from chronic suppurative otitis media with varying degrees of hearing loss.
Results of the study and their discussion. Surgical tactics were determined depending on the degree of destructive changes in various structures of the middle ear, the nature of intraoperative findings, the prevalence of cholesteatoma and the state of the ossicular chain. General cavity sanitizing operation (antromastoidotomy) was performed in 19 patients and antromastoidotomy with one-stage tympanoplasty - 26 patients with chronic purulent otitis media. In the immediate postoperative period, a satisfactory anatomical result was obtained in 28 (62.2%), and in the late postoperative period in 38 (84.4%) patients.
Conclusions. Impairment of the auditory nerve function in chronic suppurative otitis media depends on the clinical form and localization of cholesteatoma in different parts of the middle ear (mesotympanitis - 20.5%, epitympanitis - 30.8%, mesoepitympanitis - 48.7%), frequency of exacerbations, number of operations, outcomes of operations and relapses of diseases after surgery. According to the results of a comprehensive audiological study in patients with chronic suppurative otitis media, conductive hearing loss was diagnosed in 25 (55.6%), mixed hearing loss - in 16 (35.8%), and sensorineural hearing loss - in 4 (8.6%) patients.
Aim of the study. The significance of eosinophils in the peripheral blood of patients with allergic rhinitis.
Material and methods of the study. In the period from 2021 to 2023, 62 patients with a deviated nasal septum combined with allergic rhinitis were under our observation in the Audiology Department of the NMC RT “Shifobakhsh”. The age of the patients ranged from 18 to 48 years. Of these, 38 were men, 24 were women. In addition to the necessary rhino-endoscopic, allergy-immunological examinations, patients underwent a study of eosinophils in a general blood test before and after the complex therapy.
Results of the study and their discussion. All patients complained of impaired nasal breathing, profuse mucous-watery discharge from the nose, itching in the nose, paroxysmal sneezing, olfactory impairment, headaches and long-term use of vasoconstrictor drugs. The results of the general blood test showed a high content of eosinophils in the blood of almost all patients in the main group, the average value of which was 12.3 ± 2.2.
Conclusions. Thus, most patients suffering from a deviated septum combined with allergic rhinitis have a noticeable increase in the content of eosinophils in the blood, which should be taken into account when diagnosing allergic rhinitis and prescribing complex therapy.
Aim of the study. To determine the role of mechanical, respiratory and gas exchange functions of the lungs in victims with traumatic brain compression (TCC) and its dependence on the severity of the injury
Material and methods of the study. The study was performed on 45 patients with TSCM aged 18 to 60 years admitted to the Department of Adult Anesthesiology and Resuscitation of the National Medical Center of Dushanbe (NMC “Shakhraki Shifobakhsh”) for the period from 2015 to 2017. Patients with TSCM, according to the level of loss of consciousness according to Glazko’s coma [4], were divided into 3 groups, 15 people in each. Loss of consciousness according to the Glazko scale in the 1st group was estimated at 13.4 ± 0.76 points, in the 2nd - at 10.4 ± 1.06 points and in the 3rd it was estimated at 6.6 ± 1.03 points. Results of the study and their discussion. During the dynamic assessment of changes in the respiratory mechanical pattern of the lungs and gas exchange, the features of the course of acute respiratory failure were studied depending on the stage in victims with severe cerebral compression (SCCI).
Conclusion. Thus, our studies have shown that with severe cerebral compression, due to changes in the function of external respiration during the development of respiratory failure after severe traumatic injuries, more pronounced changes in the gas exchange and mechanical properties of the lungs are observed compared to healthy contingents, which leads to an increase in respiratory failure, the severity of which depends on the severity of the traumatic brain injury.
Purpose of the study. Study of increasing the effectiveness and continuity of complex treatment and rehabilitation of children with congenital malformations of the maxillofacial region in the Republic of Tajikistan.
Materials and methods of the study: there were both the results of direct observation of patients with a congenital malformation of the maxillofacial region (CMMD), carried out over a period of 5 years from 2015 to 2020, and data from a retrospective copying of information from medical records covering the period from 2010 to 2015 . The subject of the study was the health status of children with congenital defects of the maxillofacial region. The subjects of the study were children aged 1 to 17 years. The main outcome characteristic recorded for each observation unit was the presence of congenital malformations of the maxillofacial region.
The work used a complex of adequate research methods, which included retrospective analysis, clinical and laboratory research, statistical and sociological study, and mathematical simulation.
The study was conducted at the Department of Pediatric Maxillofacial Surgery of the State Institution National Medical Center “Shifobakhsh” of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan. Specially prepared observation cards were used as research materials, and in the case of retrospective collection of material, registration forms of the state statistical observation of the State Institution “RCMS MZiSZN RT”, including 003 - “Medical record of an inpatient”, 020 - “Statistical record of a 24- hour patient leaving the hospital” stay.
Research results and discussion. The principle of surgical treatment for congenital clefts of the upper lip/and or palate is: early age from 3 months, restoration of the anatomical and functional integrity of the defect using techniques that allow the correction of all deformities using local tissues (wing of the nose, end of the nose, myodynamic balance , the correct shape of the Cupid’s line) with a cleft in the primary stage.
Compliance with consistency contributes to the achievement of both a physiologically functioning organ and a satisfactory aesthetic result close to the norm. The technique used for surgery on the upper lip is performed using the Vissarionovna-Kozin sliding flap according to Millard. Taking into account the type of cleft palate, the supply of local tissues, the width of its base, concomitant diseases, the somatic condition of the child’s ENT organs, palate plastic surgery begins at 10 months. Simultaneous plastic surgery of the hard and soft palate is used according to the gentle Kotov-Muratov method, modified in that with asymmetrical clefts and a shortened soft palate, in the lower third of the soft palate, opposing triangular figures (asymmetrical, symmetrical) are moved.
Conclusions. It has been proven that full-fledged medical and social adaptation can be ensured only if continuity and phasing of treatment are observed. Taking into account the clinical and anatomical forms of defects, environmental factors, the use of our own methods of examination and treatment, a protocol for complex treatment of children with congenital pathology of the maxillofacial region has been developed, which has reduced postoperative complications.
The aim of the study: is to determine the contribution of the institute library as a database of science and knowledge, in facilitating the process of education and science at the institute.
Materials and methods of the research: During the research, the plan, annual reports of the library, regulatory documents, as well as materials of the republican scientific and practical conference, which is held annually in the “State Patent and Technical Library” were used.
Research results and discussion: The research revealed that the institute library started operating in 2019. The library is located in the basement of the main building of the institute and consists of 2 parts. There is a reading room for students with 80 seats and 30 computers connected to the Internet. In 2019, the library reserve fund included only 15,383 books, thus the number of books was increased to 45,551 books, that is, an increase of 30,168 books in 5 years.
Conclusion: The result of the study showed that the number of library users increased by 50% compared to previous years. The library’s reserve fund was replenished with educational literature, and the number of electronic publications increased compared to previous years. The number of students interested in reading fiction increased by 25%.
Purpose of the study. To determine the grammatical and semantic features of normative documents in the field of law on the basis of legal materials, to specify the category of generalization and ambiguity in normative documents in the field of law.
Materials and methods of the study. Analysis of the Laws of the Republic of Tajikistan, the Labor Code of the Republic of Tajikistan, the Criminal Code of the Republic of Tajikistan. And normative legal acts in the field of linguistics, especially the grammatical and semantic features of the Tajik language.
Results of the study and their discussion. The results of the study are focused on the grammatical features of normative documents in the field of law. Normative documents in the field of law differ from normative documents in other fields in their grammatical features, or, one might say, have been discussed in the history of the Tajik language. The results of the study show that most of them are the result of the work of officials in the field and linguists and documentarians of the period of independence, that is, during the country’s independence, the level of documentation in the Tajik language increased and improved both in terms of form and in terms of meaning and content, as well as the style of writing.
Сonclusion. Theoretical and practical studies of normative documents in the field of law with their grammatical and lexical features considered in this article have shown that this field of science was developed during the period of independence and is considered the result of the fruitful work of Tajik linguists and officials in this field, that is, this very important field of linguistics did not exist in previous years and is now being considered and resolved.
The purpose of the research. The analysis of the role of national culture in the formation of the moral foundations of the family, the formation of the younger generation, respect not only for their own traditions, but also for the values of “others” has been considered.
Research material and methods. In the course of research, normative-legal acts regulating education and training, as well as several state-level programs, comparative data were analyzed and used.
The result of the research and its discussion. As a result of the research, there are problems in the direction of society and family, such as insufficient importance of parents in raising children; low level of education of coexistence and tolerance among young people; low resistance of the family to radical non-traditional religious systems, etc. was revealed.
Conclusion. Based on the results, it can be concluded that the family is considered the main cell of the society, and its shortcomings and shortcomings will directly affect the state and the nation. The adoption of the National Concept of Education, the Law of the Republic of Tajikistan “On the Responsibility of Parents in the Education and Training of Children” and “On the Regulation of Traditions and Ceremonies in the Republic of Tajikistan” became the main basis for solving the problems in the family and society, which are monitored by the necessary authorities for the implementation of these laws and documents.
