#3 (2021)

COVID-19 disease is characterized by respiratory ways and other organs and system affection. One of frequent clinical
manifestation is neurological dysfunction. There is presented the most known up-to day COVID-19 associated neurological
disorders in this review. Among the most common neurological manifestations are myalgias, headaches, encephalopathy,
dizziness, dysgeusia and anosmia. Other conditions such as meningitis, encephalitis, encephalomyelitis,
hemorrhagic necrotizing encephapathy and Guillain-Barré syndrome can be attributed to COVID-19 associated complications.
The pathophysiological aspects underlying COVID-19 mediated neuroinvasion, which are based on the high
affinity of binding of SARS-CoV2 to the ACE2 receptor, are presented.

Introduction. The severity of neurological disorders in patients with multiple sclerosis (MS) is more closely related to
the general atrophy of the brain, which is manifested by the expansion of the ventricles and subarachnoid spaces and a
decrease in the volume of the parenchyma of the brain.
The aim of the study is to evaluate the morphometric parameters in patients with multiple sclerosis depending on the
type of course, duration of the disease and degree of disability.
Subjects and methods of research. MRI-morphometric study was performed in 25 patients with remitting and secondary
progressive types of MS.
Results. The MRI-morphometric study with MS allowed to assess the degree of brain atrophy depending on the clinical
and neurological features.
Сonclusions in summary. To assess atrophic changes in MS, it is convenient to use linear methods of measurement
(measuring the width of the ventricles, the thickness of the parenchyma of the brain, the area of the calloused body),
which do not require the presence of special equipment, computer programs and personnel training.

The authors conducted an analytical review of literature sources devoted to the pathogenesis and clinical manifestations of brain strokes against the background of coronovirus infection. The predominant pathogenetic mechanism of brain
strokes in SARS-CoV and MERS-CoV was noted. The article presents a clinical case of a patient with a brain stroke,
which appeared in a young woman without risk factors for acute cerebrovascular accident on the background of an infectious process. In addition, many studies have found a decrease in the frequency of ischemic stroke in individuals with risk factors for brain disasters.

The aim of article is surgical treatment patients with epileptic seizures in depend on applied methods of operations.
There is used new algorithm of complex and objective methods of diagnostics which allow to detect epileptogenic focus.
This fact give a chance to plan surgical methods of treatment of pharmacoresistent epilepsy. Results of patients investigation
shown high effectiveness applied methods of treatment in patients with different forms of epilepsy

The morphometry of the cerebral vascular bed was studied throughout, on the side of ischemic stroke (IS) and on the
opposite side to determine the cause of infarction and its progression in 106 deceased patients with progressive ischemic
stroke (PIS) and for comparison in 63 patients of the same age (control group) who died from other causes. The measurement
results showed that in patients with PIS, there is not only a statistically significant decrease in the internal diameter of the intracranial vessels on the side of the ischemic focus, but even more on the opposite, "healthy" side, compared with the internal diameter of the vessels of patients in the control group.

In this work, the pathogenesis of the perifocal edema zone in glioblastomas of the brain was studied according to the
data of MRI of the brain, morphological, morphometric, biochemical and histological studies. The zone of perifocal
edema is the main factor of the dislocation syndrome, leading to an increase in clinical symptoms, sometimes to the
death of patients, therefore, the study of the zone of perifocal edema was of interest not only to clinicians, but also to
radiologists, pathologists and pathophysiologists. Timely recognition of both pre and postoperative treatment to resolve
the edema results in successful tumor removal and early recovery of prolapse symptoms. In our work, for the first time,
a more detailed study and a morphological assessment of the zones of perifocal edema are given and are divided into
parts according to the signs of morphological changes. A detailed study of water, lipids and electrolytes in the intercellular
space and cells was carried out. Histological materials have been studied. In this work, histological materials are thoroughly
studied and a more detailed characteristic is given for pronounced changes in the area of perifocal edema with
division into zones, taking into account reversible and irreversible processes and its pre-, intra-, postoperative correction.

This article presents a clinical case of chronic impairment of the cerebrospinal circulation in patient with combined
pathology. A detailed neurological examination, as well as an analysis of additional laboratory and instrumental investigations
made it possible to identify the leading etiopathogenetic mechanism of damage to nerve structures that underlies
the development of motor deficit in a patient with chronic somatic pathology.

The main causes of epilepsy resistance in general as diseases and factors contributing to the development of «noncurable
» epilepsy in low- and middle-income countries are listed. The analysis of a group of patients with epilepsy
and their dynamic observation highlights the most common causes of pseudo-resistance.

The analysis of electrophysiological and neuroimaging data of 430 patients with a confirmed diagnosis of epilepsy was
carried out. When analyzing the EEG data, it was found that in a routine interictal EEG study, only 60% of cases show
epileptic activity, and in the remaining almost 40% of cases, EEG did not reveal any pathological activity. For this group
of patients, to clarify the diagnosis and correct treatment, it is necessary to conduct video monitoring with EEG registration.
In addition, despite the fact that MRI is a mandatory method of examination in patients with epilepsy, in 13.2%
of cases, patients did not have the opportunity to undergo an MRI examination of the brain. Therefore, equipping public
hospitals in Kyrgyz Republic with modern MRI and EEG devices should be one of the priority directions in the development
epileptology.

The article presents a literature review of the current state of the problem of diagnosing intracerebral nontraumatic
hematomas, including diagnostic value, informativeness and sensitivity of clinical, routine laboratory and instrumental
and neuroimaging research methods. Also presented are literature data on controversial issues of the diagnostic efficiency
of MRI in the acute and acute periods of hemorrhagic stroke.

The most important task of modern neurology is to develop and implement highly specific and sensitive biomarkers of
damage to the nervous system. Specific biomarkers of acute cerebral circulatory disorders, chronic cerebral ischemia,
neurodegenerative diseases (diseases: Alzheimer's; Parkinson's; Huntington's, etc.), demyelinating diseases of the central
nervous system (deviolithic de Devika, myelitis, multiple sclerosis), traumatic brain injuries are discussed

An epidemiological study of stroke in Kyrgyzstan (Bishkek) was conducted according to a special program using the
register method in 2017-2018. According to expert estimates of the World Health Organization (WHO), stroke ranks
second in the world among causes of death and second in long-term and severe disability of patients.
In the Kyrgyz Republic, reliable epidemiological data on the prevalence of stroke are lacking. in this regard, the stroke
register is the best method for determining the incidence, mortality, mortality and economic consequences of stroke
In just 2 years, 2589 new cases of stroke were registered (1630 and 1570 cases, respectively). The incidence of stroke
was 2.6-2.67 per 1000 population (mean 2.61). The incidence of strokes in the population increases in each age group
by 2-3 times: at the age of 25 to 40 years - 0.18, from 40 to 49 years - 1.2, from 50 to 59 years - 3.8, from 60 to 69 years
- 10.6, and 70 years and older - 25.4 per 1000 residents of the corresponding age per year.The proportion of people of
working age (25-59 years old) who have suffered a cerebral stroke is 26.3%. The number of people recognized as disabled
for the first time in urban areas was 301 people. It is concluded that a long-term register is needed to obtain data on the
dynamics of the incidence rate and evaluate the effectiveness of reform of medical and social care programs for patients.

POEMS syndrome is a rare multi-system disorder caused by circulating immunoglobulins in the blood due to plasma
cell dyscrasia. POEMS is an acronym that stands for the following symptoms: P –polyneuropathy, O- organomegaly, E
–Endocrinopathy, M- M-protein, S – skin change.
The main clinical feature of this syndrome is a progressive polyneuropathy with predominant motor disturbances. The
disease is potentially fatal, and the quality of the patient's life deteriorates progressive due to neuropathy, massive peripheral
edema, pleural effusion and ascites. Serious complications, such as multiple organ failure, restrictive lung disease
and pulmonary hypertension, lead to an unfavorable prognosis.

Freguency of met of neurogenic acraturesiss is examined in this article, factors resulting in urology complications at a
stroke. The forms of symptoms of lower urinary ways are described. Conservative and operative methods over of
treatment of neurogenic acraturesiss are brought.

Purpose: to present the results of surgical treatment of patients with diabetic foot syndrome (DFS) complicated with
necrotic process. There are given results of treatment of patients with the DFS. The methods of diagnosis and treatment
tactics are presented. Operations in a cases of necrotic process was performed after the treatment complex, aimed at
limiting the process, thus avoiding high amputation of the thigh in a most cases.

This article presents the results studying of biochemical changes in the blood of the manaschi before and after prolonged
telling of epic Manas (on November 12, 2020, manaschi Doolot Sydykov told the epic Manas in 14 hours 27 minutes
without a break and got into the Guinness Book of Records).). This process was viewed as acute psychological and
physical stress. During the study, we studied the main biochemical parameters of the blood that are sensitive to stress,
namely: the indicators of the general blood test and the following biochemical parameters of the blood: troponin I, cortisol, glucose, cholesterol, LDL, VLDL, total protein, lactate. The results of the study showed, that during this process:
cortisol was increased, but at the same time all the indicators of the immune system were increased, which shows that
during the increase in the strength of the immune system, they became synregists; the white blood corpuscles rose,
which proves a powerful mobilization of the immune system; high anaerobic glycolysis, which led to the accumulation
of lactate to a critical level, thabut the buffer systems and defenses of the body protected from negative consequences
for the body; hemoglobin and hematocrit indicators did not go beyond normal values, which was shown by high-quality
erythropoiesis; despite the severe stress of the body, total amount of protein remained normal; the value of platelets did
not exceed the reference values; blood pressure remained normal. All the above indicators prove that the manaschi's
body reacted positively to stressful factors, withstood this test, successfully adapted, since during the telling, he was in
the highest emotional and high spiritual state. This condition saved his body from the negative effects of stressors and
negative consequences.

This article is devoted to the study of the effect of mildronate on the course of myocardial necrosis during the adaptation
of experimental animals to high altitude conditions and readaptation to low altitude conditions on the 30th day. We
found that after treatment with mildronate during 10 days, the content of creatine phosphokinase - MB (CPK-MB), troponin
T (TrT), aspartate aminotransferase (AST), the cardiac form of the protein binding fatty acids (PBFA) in the blood
serum of animals with simulated cardionecrosis on the 30th day of adaptation and readaptation were significantly reduced.

Relevance. Purulent phlegmon of odontogenic nature is a fairly frequent pathology in maxillofacial surgery, from the
point of view of etiology, many components can be traced, mainly anaerobes or facultative anaerobes. Bacteriological
isolation is not always possible, therefore, alternative diagnostic methods must be used.
Purpose of the work. To study the qualitative and quantitative composition of anaerobic microflora in case of purulent
phlegmons of odontogenic nature in maxillofacial pathology to improve diagnostics.
Material and methods. There are examined 36 patients with purulent odontogenic phlegmons of varying severity - patients
of the Department of Maxillofacial Surgery of the National Hospital of the Ministry of Health and Social Development
of the Kyrgyz Republic. The material used for DNA isolation of microbes by PCR using DNA-express tests
and detection using a DENTOSKRIN kit (NPF Litekh, Russia) in accordance with the instructions. A. P. endodontalis,
P. gingivalis, T. forsythia, P. intermedia, F. nucleatum quantitatively are identified. The concentration of pathogens is
measured in number of copies per ml.
Results. The most common representative of anaerobes is F. nucleatum which found in 70% of the samples. In 67% of
cases, there is a joint isolation of P. gingivalis and T. forsythia. In 30% of cases, four pathogens are isolated from
one sample. The presence of P. endodontalis, P. intermedia is at the level of etiologically significant concentrations.
Conclusions. The quantitative determination of microorganisms, especially with anaerobic type of cultivation, taking
into account the numerous factors of pathogenicity, gives more information about the mutual influence of microbes
and the role of each in the development of the pathological process.

The frequency of the Diabetic Foot Syndrome was studied in 222 patients with diabetes mellitus who were under in-patient
therapy in the endocrinology medical units. The examination covered clinical, laboratory and instrumental methods.
The Diabetic Foot Syndrome was diagnosed in 38 patients among 222 patients and 14 of which had the following complications:
trophic ulcers of small size (no more than 2 cm in diameter) in 5, infected wounds in 4, infected fissures and
roughness in 4 and in one wound after exarticulation of the toe. Preventive measures and treatment were used in two
variants (Diabetic Foot Syndrome group without complications and Diabetic Foot Syndrome group with complications)
to prevent the progression of diabetic foot syndrome. Attention is paid to familiarizing patients with complications of
diabetes mellitus and methods of treatment recommended by an endocrinologist and surgeon. By the time of discharge,
all complications have been cured. After discharge, the patients received preventive courses of treatment under the supervision
of a surgeon. The patients were monitored for 2 years. The disease progression was not identified. The devel oped approach to the prevention of purulent-necrotic complications confirmed its feasibility in clinical practice. The
only joint work (endocrinologist, surgeon) and the patient will reduce any complications incidences.

The work is devoted to the study of the spread of сytomegalovirus infection in newborns and children from one to 3
months old from the City Children's Clinical Hospital of Emergency Medical Care in Bishkek in the years 2018-2019
using ELISA. Diagnosis of CMV infection was carried out by determining specific CMV IgG antibodies (AB) in blood
sera using an indirect enzyme-linked immunosorbent assay (ELISA). ELISA is based on the immune reaction of antigen
with antibody. In serodiagnosis, the substance to be determined is the specific immunoglobulin (Ig) of the patient. In
the diagnosis of сytomegalovirus infections, the method according to the instructions is usually used. For the study by
the ELISA method, blood from the lactic vein, obtained on an empty stomach, is used. The advantages of ELISA include
high sensitivity, specificity, reproducibility, uniformity and suitability for mass examinations. The age structure of the
examined children was comprised of 407 sick newborns and children under 3 months of age in 2018-2019, of whom
163 (40.1%) were girls and 244 were boys (59.9%). Among the 407 children examined for сytomegalovirus IgG antibody
high titers were found (1:400 and 1:800) in 87 (46.0%), an average antibody titer of 1:200 in 124 (30,5%), indeterminate
result 1:100 – in 64 (15.6%), and seronegative result only in 32 (7.9%) children

The article shows that a significant proportion of neuroendocrine tumors of the pancreas are non-functional, i.e., not secreting
into the blood a variety of gastrointestinal hormones and polypeptides and as a result, not accompanied by typical
clinical manifestations. Unfortunately, often the scan search starts in the detection of distant metastases of neuroendocrine
tumors. Currently, the only radical method of treatment of hormonally functioning tumors of the pancreas is surgical. It
is indicated that symptomatic therapy can be considered as a stage of preoperative preparation of the patient. The article
examines the rational and integrated use of modern Arsenal of surgical and therapeutic methods, which enable significantly
prolong life, improve its quality in patients with metastatic forms of neuroendocrine tumors of the pancreas.