Flexible ureterorenoscopy (URS) is one of the methods of choice for surgical treatment of kidney stones.

The objective of the study was to assess the risk of infectious complications in the postoperative period in patients after flexible URS using the modes «stone dusting» and «fragmentation with lithoextraction».

Material and methods. The study included 148 patients with kidney stones of up to 20 mm in size. The patients underwent flexible URS in the «stone dusting» and «fragmentation with lithoextraction» modes.

Results. The use of the «stone dusting» and «fragmentation with lithoextraction» modes shows good effectiveness in lithotripsy of kidney stones. The risk of infectious complications increases with the duration of the operation ≥ 49 minutes and the size of the concretion ≥ 14 mm by any mode of contact laser lithotripsy.

Conclusions. The «stone dusting» and «fragmentation with extraction « modes during flexible URS have the same risk of infectious complications.

Psoriasis is a chronic immune-related skin disease that not only affects the epidermis, but also contributes to the development of cardiovascular diseases, in particular coronary heart disease (CHD).

The objective was to compare the incidence of adverse cardiovascular events in patients with psoriasis and combinations of CHD and psoriasis in the long term.

Material and methods. 112 patients were studied (60.0 (57.5; 63.5) in 3 groups: 1st - CHD, 47 patients; 2nd - psoriasis, 52 patients; and 3rd - CHD + psoriasis, 13 patients) by risk factors of developing the long-term adverse endpoints in 1 year. The endpoints included hospitalization in case of exacerbation of psoriasis, for cardiovascular reasons, deaths, strokes, and myocardial infarctions.

Results. The CHD and CHD + psoriasis groups did not differ in terms of risk factors, except for the higher incidence of diabetes mellitus in the CHD group (p = 0.021). When comparing the 1st and 3rd groups, arterial hypertension was more common in group 3 (p=0.007), and 1 year after, hospitalizations for all causes (p<0.001) and strokes (p=0.044) were more common in the same group. Conclusion. The presence of psoriasis in combination with CHD significantly increases the risk of hospitalization and stroke in patients in the long-term period.><0.001) and strokes (p=0.044) were more common in the same group.

Conclusion. The presence of psoriasis in combination with CHD significantly increases the risk of hospitalization and stroke in patients in the long-term period.

Chronic myeloproliferative diseases (CMPD) are a group of hemoblastoses that occur with impaired myelopoiesis. Quite often there are mentions of damage to eye tissues in CMPD. But despite this, there is not enough information in the literature about the factors leading to the development of ophthalmological disorders in this pathology.

The objective of the work is to determine the predictors of ophthalmopathology in CMPD.

Material and methods. The study included 78 patients with CMPD (main group) and 61 volunteers without hemoblastoses (control group). The groups were comparable in gender and age. All the examined patients underwent comprehensive ophthalmological and laboratory diagnostics.

Results. Eye pathology in patients with CMPD was significantly more common than in those without hemoblastoses (for the anterior segment it was p<0,05; for the posterior segment it was p><0,01). Platelet levels in CMPD were higher compared to the control group (p><0,05). Eye disorders in patients developed against the background of a significant increase in the age and duration of the disease (p><0,05). Conclusions. Mature age, prolonged course of CMPD, and altered laboratory blood counts may be possible predictors of the development of eye disorders in such patients.><0,05; for the posterior segment it was p<0,01) . Platelet levels in CMPD were higher compared to the control group (p<0,05) . Eye disorders in patients developed against the background of a significant increase in the age and duration of the disease (p<0,05).

Conclusions. Mature age, prolonged course of CMPD, and altered laboratory blood counts may be possible predictors of the development of eye disorders in such patients.

It is known that deworming in chronic opisthorchiasis does not always lead to a complete clinical recovery of a person, and an imbalance in the immune system persists for a long time after getting rid of the invasion.

The objective is to evaluate the clinical and laboratory efficacy of albendazole in the treatment of opisthorchiasis invasion.

Material and methods. Taking into account the revealed changes in the immune status in chronic opisthorchiasis, a comparative assessment of the clinical and immunological efficacy of albendazole in chronic opisthorchiasis was carried out. The study involved 2 groups. The first group consisted of 30 patients receiving albendazole. The second group included 32 patients treated with praziquantel. Laboratory diagnosis of opisthorchiasis invasion was carried out using a Kato thick-smear technique with cellophane and/or biliovoscopy.

Results. The clinical effect of albendazole was a threefold decrease in frequency (20% vs. 63%, χ2 =4.2, p=0.04) and a decrease in the duration of asthenovegetative syndrome to three months (χ2=4.5, p=0.03) with a reduction in dyspeptic manifestations (13.3% vs. 37.5%, χ2 =3.9, p=0.04) – in comparison with the group of patients receiving praziquantel.

Conclusions. The clinical and immunological efficacy of albendazole in the treatment of opisthorchiasis invasion has been established: the administration of the drug leads to parasitological recovery, relief of symptoms, and normalization of immune status indicators.

Objective was to analyze the psychological well-being of employees of medical scientific and educational institutions of higher education and to identify the impact of earlier COVID-19.

Material and methods. A one-time online study was conducted (the online questionnaire was posted on the ancetolog.ru platform) during the COVID-19 pandemic (the period of circulation of the delta variant of the virus) from January to March 2022. To assess psychological well-being, the following were used: an online questionnaire; Perceived Stress Scale-10 (PSS); Generalized Anxiety Disorder scale (GAD-2); Patient Health Questionnaire (PHQ-4). The analysis was carried out on 3918 respondents: 1708 (13.6%) of which indicated that they had suffered from COVID-19 and 2210 (56.4%) noted they hadn’t.

Results. Medical providers who had recovered from COVID-19 were statistically significantly more likely to have high PHQ-2 scores, indicating probable depression (17.2% versus 10.2% for those who were not ill, p < 0.001) and high GAD-2 scores, indicating probable presence of anxiety (11% vs. 6.7%, p < 0.001). Earlier COVID-19 increased the chance of depression OR 1.828 (95% CI 1.500-2.227 χ2=36.554; p < 0.001) and anxiety OR 1.721 (95% CI 1.349-2.172 χ2=19.951; p < 0.001).

Conclusion. The study showed a high level of emotional and psychological stress (the presence of anxiety and depression) among medical staff, which was significantly more pronounced in COVID-19 survivors. In this regard, an important task for the administration of medical scientific organizations and educational institutions of higher education should be the development of measures aimed at correcting identified disorders and searching for indicators, influencing which will ensure the most effective positive changes.

Objective. Comparative analysis of anthropometric indicators of BSMU students in the presence of identified smartphone addiction.

Material and methods. The study involved 79 students of the Faculty of Dentistry of BSMU: 35 (44.3%) males and 44 (55.7%) females, whose average age was 21.36±0.26 years. Smartphone addiction was assessed using the computer program called «Identification of smartphone addiction among gadget users» (RF Patent No. 2023666136, date of state registration 08/16/2023). A clinical and anthropometric study was performed with an assessment of postural angles according to the method of L. Straker et al., using a Smart Protractor goniometer.

Results. Studies have shown that all students of BSMU involved in the research revealed the presence of algic syndromes in the head, neck, upper shoulder girdle of varying degrees of severity. The duration of smartphone use was more than 5 years. The use of the gadget for more than 5 hours a day was detected in 60 people (75%), 3-4 hours a day - in 19 people (25%), and the duration of using a text editor did not differ significantly and amounted to up to 70% of the time of a smartphone use. Atropometric examination of postural angles revealed that the angle of inclination of the head was 24.11 ±4.92°, cervical and thoracic - 41.92±8.56° and 39.88 ±8.14°, respectively, shoulder retraction – 105.28±21.49°, shoulder asymmetry - 3.98±0.82°. Headaches were noted by 52 people (74.3%), neck pain – 31 (44.3%), shoulder pain – 19 (27.1%), wrist pain – 13 (18.6%), and in one subject the pain could often be localized in 2-3 departments of the musculoskeletal system.

Conclusion. Smartphone addiction can have an effect on the violation of the postural angles of the cervical-thoracic spine with the early development of musculoskeletal pain and the formation of pathoplastic clinical manifestations.

Objective was to carry out a lifetime comparative analysis of uterine size in women in the first, second period of adulthood, elderly, and senile age according to ultrasound data.

Material and methods. The work is based on the results of ultrasound examination of 102 women who were examined in the Department of Gynecology during the period of 2021 and 2022. All women gave their consent to the study. The ultrasound examination consisted of measuring the longitudinal, transverse, and anteroposterior dimensions of the uterus using transvaginal access. The patients were divided into four groups depending on their age.

Results. When comparing the indicators of uterine dimensions from the first period of adulthood to old age, their statistically significant decrease of both length (t= 24.98; p<0.01) and width of the uterus (t= 44.50; p><0.01), as well as its thickness - (t= 21.84; p><0.01) were revealed. Conclusion. From the first period of adulthood to old age, there is a decrease in the linear dimensions of the female uterus: its length, width, thickness (p><0.01). The obtained results of lifetime comparative analysis of linear dimensions of the uterus in women at the stages of body aging allow us to understand the age-related anatomical features of this organ. Summarizing the above, it should be noted, that the results obtained in the study are the basis for further scientific work and can be demanded by doctors of various clinical specialties.><0.01) and width of the uterus (t= 44.50; p<0.01), as well as its thickness - (t= 21.84; p<0.01) were revealed.

Conclusion. From the first period of adulthood to old age, there is a decrease in the linear dimensions of the female uterus: its length, width, thickness (p<0.01) . The obtained results of lifetime comparative analysis of linear dimensions of the uterus in women at the stages of body aging allow us to understand the age-related anatomical features of this organ. Summarizing the above, it should be noted, that the results obtained in the study are the basis for further scientific work and can be demanded by doctors of various clinical specialties.

The purpose of the study is to identify patterns of structure and interrelation of elements of the thoracic spine and surrounding muscles in mature women.

Material and methods. The study was performed on computed tomograms of the thoracic spine in 117 women aged 36-65 years old. The measurements on the tomograms were carried out in three planes using the RadiAnt program. The median and the interquartile Q1- Q3 range were estimated, and the statistics of the Wilcoxon test was calculated. After clustering, 12 maximum significant parameters were selected in each segment. Between them a factor analysis (FA) was performed using the principal component method.

Results. With an increase in the ordinal number of vertebrae, the size of the vertebral bodies and the paravertebral muscle mass increase non-uniformly. The length of the spinous process and the distance between the transverse processes decrease with an increase in the ordinal number of the vertebra. The width of the paravertebral muscle mass is maximal at the level of 2-4th thoracic vertebrae segments.

Conclusion. FA revealed two factors and allowed us to functionally divide the unified musculoskeletal system "thoracic vertebrae - paravertebral muscles" into four sections.

Objective. Synthesis of new diacylhydrazines based on thietane-containing 2-thiouracil derivatives as a promising direction for the creation of innovative biologically active substances with antimicrobial activity.

Material and methods. Diacylhydrazines based on thietane-containing 2-thiouracil derivatives were obtained by the interaction of 2-[6-methyl-4-(thietan-3-yloxy)pyrimidine-2-ilthio]acetohydrazide with carboxylic acids derivatives. The structure and individuality of the synthesized compounds are confirmed by data from nuclear magnetic resonance and infrared spectra, thin-layer chromatography, elemental analysis, and determination of the melting point. Antimicrobial activity was investigated by agar diffusion and tenfold broth dilution methods.

Results. The conditions of the reactions were selected to achieve the maximum yield of the target products, the structure of the synthesized compounds was established, and some structure-activity patterns were found for further modification of the radical in order to achieve the necessary pharmacological activity.

Conclusions. New O-thietanylthiouracil acetohydrazide derivatives have been synthesized and their antimicrobial activity has been investigated.

The objective of the study is a retrospective analysis of the indicators of the efficiency of the use of material resources in a compounding pharmacy. The results of the content analysis of financial indicators of accounting and operational reporting for the period from 2018 to 2022 are presented; resource efficiency indicators are calculated; a contour is formed and the dynamics of the main indicators are analyzed.

Material and methods. The information base of the study was data from the accounting and operational reports of a compounding pharmacy; theoretical works of domestic scientists in the field of resource efficiency analysis; web-sites of the Internet information and communication network. Research methods include documents analysis, systematization, generalization, grouping and comparison, content analysis, correlation analysis using Statistica 10.

Results. A very high positive relationship was established between the volume of output and four other key indicators (0.75- 1.00) with confirmation of the normality of the hypothesis distribution. A decrease in the trend is shown for all major indicators from 26% to 42%. The results obtained can be used in the management system of the compounding pharmacy and process modeling.

Objective. To study the state of drug provision for patients with bronchial asthma under a preferential state program in the Kyrgyz Republic.

Material and methods. The research materials were the database of the server of the Compulsory Health Insurance Fund under the Ministry of Health of the Kyrgyz Republic for 2021-2022: the number of insured citizens taking into account the categories and regions of the country, the incidence of bronchial asthma, the number of preferential prescriptions written and reimbursement amounts, the range of medicines prescribed under the program of preferential drug coverage.

To analyze the data obtained as a result of the study, a graphical content analysis method was used. Data processing was carried out using Microsoft Office Excel 2016 software resources.

Results. In terms of the number of preferential prescriptions issued under the State Guarantees Program in Kyrgyzstan as a whole, patients diagnosed with bronchial asthma occupy the second place with a reimbursement amount of 16.5 million soms. The leader in the number of preferential prescriptions issued in 2022 is the category of insured citizens - pensioners - 8261 prescriptions for a reimbursement amount of 4.6 million soms.

It was found that in general, compared to 2021, the number of preferential prescriptions for patients with bronchial asthma in 2022 increased by 8888 prescriptions, and the amount of reimbursement increased by 5.4%.

Objective. To identify and analyze the main barriers for disabled people with limited mobility in pharmacies, and suggest possible ways to eliminate or minimize these barriers.

Material and methods. The texts of sectoral legislation of the Russian Federation have been used as source materials for content analysis. During the research process, grammatical and logical methods of interpreting of the legislation have been used.

Results. For each category of disabled people with limited mobility, the main architectural, space planning, information, and organizational barriers in pharmacies, which impede the accessibility of pharmaceutical services, have been identified. The main differences between pharmacies and medical organizations have been analyzed in relation to factors influencing the presence or absence of such barriers.

Conclusions. The legal and organizational possibilities of creating specially designated places in pharmacies for the providing of pharmaceutical services including consultation and information for people with limited mobility have been shown. The need for a high level of readiness of pharmacists in pharmacies has been identified to eliminate or minimize existing barriers, which makes it important for them to undergo special training and conduct regular additional instructions.

Hybrid operations on the arteries of the lower extremities with their multilevel lesion are currently a dynamically developing direction of vascular surgery. The ability to combine open and endovascular interventions in patients with severe concomitant pathology often makes hybrid operations the only means of saving a limb. However, when performing these operations, a number of issues arise, the main of which is the stage-by-stage performance of manipulations within the framework of hybrid reconstruction.

This article presents clinical examples of proximal and distal variants of hybrid reconstructions in which the intervention stages were uniquely determined by the clinical situation. These examples refute the well-established paradigm of vascular surgery about the need for the primary restoration of the receptive vascular bed.

In the modern world literature, there are various opinions, sometimes contradictory, regarding the tactics of bone replacement of the proximal metaphysis of the tibia as a result of a tumor lesion.

The objective is to demonstrate on a clinical example the method of plasty of a defect in the proximal metaphysis of the tibia by creating a support base for the articular surface in a giant cell tumor of the tibia.

Clinical case. A 39-year-old patient underwent a surgery - marginal resection of the tibia with an original method of bone grafting with a rotated fragment of the fibula on the vascular pedicle.

Results. In the long-term postoperative period, the AOFAS score was 97 points. There are no signs of recurrence or malignancy of the tumor. The patient is satisfied with the surgical treatment performed. With traditional bone grafting, pronounced deformity of the knee joint develops, which complicates the technique of surgery and the selection of a joint implant. The proposed method of replacing an extensive defect formed after resection of the affected area of the tibia involves the creation of a support base for the articular surface, which significantly reduces the risk of deforming osteoarthritis of the knee joint (patent for invention No. 2328237).

Conclusion. Our proposed method of replacing a bone defect formed after resection of the affected area of the tibia involves the creation of a support base for the articular surface, which significantly reduces the risk of deforming osteoarthritis of the knee joint. And in cases where there is a need for knee replacement, it facilitates the technique of surgical aids and the selection of an implant.

An urgent topic in the pathology of the abdominal organs remains the issue of differential diagnosis of diseases with different genesis, but the same focal area of the pathological process with similar clinical syndromes. Abdominal pain syndrome in pediatric practice requires a differential approach among surgical, infectious diseases, as well as malignant tumors. This clinical example shows the difficulties of differential diagnosis of Burkitt lymphoma in a patient with a mask of acute appendicitis.

Burkitt lymphoma (BL) is an aggressive malignant neoplasm of immunologically mature B lymphocytes with predominantly extranodal localization of the pathological process, more often affecting the gastrointestinal tract.

The course of chronic myeloid leukemia (CML) can be accompanied by various vascular complications and changes in tissues and organs of the entire body, including the organ of vision.

Оbjective. A clinical case of a patient's initial visit to an ophthalmological clinic with complaints of decreased visual acuity in the onset of chronic myeloid leukemia is described.

Clinical case. A 28-year-old patient with complaints of the appearance of «fog», decreased visual acuity in his left eye came to the emergency department. Ophthalmoscopy revealed moderately dilated and convoluted retinal veins, single variegated retinal hemorrhages along the course of vascular arcades, including the macular area on the left eye. According to the clinical examination, the results of a clinical blood test, morphological and cytogenetic examination of a bone marrow trepanobioptate with the detection of the Philadelphia chromosome in 96% of cells, the diagnosis of CML, chronic phase was verified.

Conclusion. Clinical onset of CML is possible with ocular manifestations, which indicates the need for hematological alertness during ophthalmological examination. The coordinated work of hematologists and ophthalmologists contributes not only to the timely diagnosis and treatment of patients with CML, but also to the assessment of the dynamics and results of systemic and targeted therapy.

Selecting a graft for the surgical treatment of patients with cranial defects continues to remain an important issue in neurosurgery and maxillofacial surgery. Many pathologies of head tissue associated with severe cerebral edema, head wound infection, or decompressive craniotomy require removal of sections of the cranial bone. Defects that are not surgically covered can cause neurological and physiological disorders. Restoring the integrity of the skull is an important part of the rehabilitation of patients from the standpoint of medical, labor, and social rehabilitation.

Bone allografts have traditionally been used as a promising material for restoring cranial bones. They have become an indispensable tool in orthopedics and reconstructive surgery, capable of restoring functionality and quality of life of patients suffering from bone loss due to injury, disease, or congenital deformities.

In our review article, we examine global clinical experience in the use of bone allografts for cranial operations and new trends in their manufacturing. Recent advances in bone allograft manufacture are making a difference in bone allograft surgery, making it a more viable and effective option for patients in need.

Short bowel syndrome (SBS) is a pathological condition that occurs due to a lack of functionally active intestinal epithelium due to congenital absence or subsequent loss of part of it, often resulting from massive surgical resection of the small intestine, which leads to chronic intestinal insufficiency, manifested by malabsorption, maldigestion, malnourishment and homeostasis disorders leading to high disability and mortality.

Among other things, the presence of patients on parenteral feeding entails economic losses (according to various estimates, over 200 thousand rubles per month), including those associated with regular replacement of port systems, purchase and storage of food. High mortality rate remains due to liver failure and catheter-associated sepsis. Among surgical interventions for SBS, operations to reduce intestinal transit and operations to increase the length of the intestine are carried out, as well as transplantation techniques. However, all of them have a number of significant disadvantages, such as a small percentage of restoration of full enteral nutrition, high frequency of postoperative and fatal outcomes, expensive transplantation techniques, surgical manipulations and lifelong immunosuppressive therapy.

Methods of intestinal repair in SBS at the present stage, including tissue engineering techniques, have been analyzed. A promising area is tissue engineering of the small intestine, which is an innovative method of treating patients with SBS.