№4 (2022)

Introduction. The use of intravital nephrobiopsy in the Kyrgyz Republic has enriched the understanding of the
features of the morphological picture in various nephropathies. IgA nephropathy (IgAN) is the most common form of
primary glomerulonephritis worldwide.
Purpose of the study - Evaluation of the dependence of heart size restructuring on morphological changes in the kidneys
in IgA nephropathy
Materials and methods of research. 71 patients with IgAN were studied. Of these, 36 men (51%) and 35 (49%) women,
with an average age of 33±1.4 years (18-50). The diagnosis of IgAN was verified according to the Oxford histopathological
classification.
Results. most often in patients with IgAN - 70.4%, mesangial hypercellularity was detected. Endocapillary hypercellularity
was found in 57.7% of patients. At the same time, segmental glomerulosclerosis was found in 54.9% of cases, and tubular
atrophy in 60.5% of patients with IgAN. Mesangial proliferation contributed to changes in the cavities of the heart, an
increase in the size of the left ventricle (R=0.4)
Conclusions. According to the results of our study, a positive correlation was found between changes in the size of the
heart and the pattern of damage in IgAN.

The prevalence of DM has now reached catastrophic proportions, acquiring the character of a non-infectious
epidemic. Providing quality medical care to patients, improving its accessibility, providing medicines, scientific goals
require knowledge of the epidemiology of diabetes mellitus.
Purpose of the study- The aim of our study was to analyze a dynamic of the epidemiological characteristics of diabetes
mellitus in Kyrgyzstan (prevalence, mortality), the prevalence of complications,
Materials and methods. Object of research: database of diabetes mellitus registry.
Results. The total number of diabetes mellitus patients in Kyrgyzstan as of 01.01.2021 was 74801 (1, 12% of the population),
including: type 1 diabetes - 2975, type 2 diabetes — 7183. The dynamics of prevalence was 938, 0→1117, 8/100
ths people. The incidence of diabetic complications in type 1 diabetes and type 2 diabetes patients: neuropathy 59.5%
and 50.8%, nephropathy 21.5% and 7.4%, retinopathy 38.0% and 24.0%, hypertension 18.3% and 32.7%, ischemic heart
disease 5.1% and 11.4%, myocardial infarction 0.8% and 1.8%, cerebrovascular accident 1 .1% and 2.1% respectively.
Conclusions. The performed analysis demonstrates the importance of assessment of epidemiological characteristics and
monitoring of clinical data on patients with diabetes through a registry for assessing the quality of diabetes care and the
prospects for its development.

The article contains a message about morphological changes in regional lung bleeding in deaths from COVID-
19.
The objects of the study were peribronchial inflammatory nodes, subjected to histoprocessing and morphological examination
when stained with hematoxylin and eosin.
It has been established that lymphocytes, plasmocytes, macrophage cells, deposits of fibrin and fibrin-like masses, erythrocyte
sludge and blood clots in the vessels prevail in the inflammatory nodes in the cell section. Such changes are
characteristic of the exudative and proliferative phase of diffuse alveolar damage in the lungs at death from COVID-19.

Introduction. Testing and early detection of hepatitis B and Cinfection determine indications for the services
of prevention and treatment and are akey component for effective response to the epidemic of these infections and receiving
specialized care and treatment.
The aim of the study. Analysis of the state of diagnosis of viral hepatitis B and C in Kyrgyzstan to develop a mass testing
program as a stage towards eliminating the epidemic of blood-borne viral hepatitis in the country.
Materials and methods. State Reporting Forms No. 1 “Report on infectious and parasitic disease” for 2010–2021 were
reviewed. The data of 237 patients with hepatitis B and C were analyzed, who received inpatient treatment in 2007–
2021, Bishkek. The data was processed by Epi Info 3.8.1. Results. The Kyrgyz Republic belongs to countries with high incidence of blood-borne viral hepatitis. The incidence of
acute and chronic viral hepatitis B in 2021 amounted to 29.2 per 100,000 population, and hepatitis C -10.8,cumulative
incidence of hepatitis B and C 40.1 per 100,000 population. The prevalence of the Delta hepatitis among HBV-infected
persons reached 33–47%, which can be estimated to be about 120–160 million patients with hepatitis D. Based on the
results of testing by some healthcare organizations, the hepatitis B virus infection of the population of
varies from 4.6% to 7.3% and hepatitis C - from 3.1% to 7.7%. Data of official statistics (Department of Disease Prevention
and State Sanitary-Epidemiologic Surveillance and the Centre of Electronic Healthcare)on the prevalence of
acute and chronic hepatitis B and C differ considerably. There is no information about the exact number of patients with
all forms of blood borne hepatitis, cirrhosis and liver cancer in their outcome.
Conclusions. To ensure the access of patients with chronic viral hepatitis and cirrhosis in their outcome to the services
of diagnostics, highly effective methods of treatment and preventionit is needed to conduct a phased mass testing of the
adult population for blood-borne viral hepatitis in order to determine the true number of such patients.

Goal. Solving the question of whether there are certain genetic markers that correlate with specific clinical
characteristics of meningiomas, including multiplicity, relapses and erosion of the cranial vault.
Methods. Thirty-eight meningioma patients were selected for this study. During the operation, blood and tumor samples
were taken for histopathological, cytogenetic and molecular analysis. The loss of heterozygosity (LOH) on chromosomes
1p and 22q was investigated, and the NF2 gene on 22q12.2 was tested for the presence of pathogenic mutations.
The results obtained. The most frequent localization of tumors were convexital (25%) and parasagittal (21%). Histology
results showed that 86.8% of patients had grade I tumors, and the rest had grade II tumors. Pathogenic nonsense mutation
R341X in the NF2 gene was detected in only one patient. LOH on each of chromosomes 1p and 22q was observed in
44.7% of patients. Significant associations were found between the presence of certain tumor characteristics and the male
sex (p = 0.0059) and 22q LOH (p = 0.0425). We calculated that the presence of 22q LOH increases the probability of developing
a tumor that exhibits multiplicity, recurrence or erosion of the cranial vault in humans by about four times (OR
= 4.8; 95% CI: 1.2–23.4). The correction for gender increased this effect (OR = 6.1; 95% CI: 1.1–48.7).
Conclusions. The data obtained show that male patients and meningioma patients with 22q LOH are more likely to
develop tumors showing multiplicity, recurrence or erosion of the cranial vault. We recommend that this group of patients
be monitored more closely. Further studies are needed to determine the benefit of adjuvant radiation therapy in this scenario.

The purpose of the work. Meningioma-associated proptosis (MAP) can be a cosmetic and functional disorder
debilitating for patients with wedge-orbital meningioma and other meningiomas of the base of the skull, and there is limited
information on the quantitative improvement of proptosis after surgery. Since less extensive removal of the tumor
affecting the orbit cannot reduce proptosis, the senior author adopted an aggressive surgical approach to the removal of
the tumor affecting the periorbital and orbit. The authors of this study retrospectively reviewed the results of this surgical
approach.
Material and methods. All MAP operations performed by one surgeon from January 1, 2010 to May 1, 2020 were reviewed.
Age, gender, visual symptoms, number and types of surgical interventions, cavernous sinus lesion, complications,
duration of follow-up, residual tumor, use of adjuvant radiation therapy and the degree of resolution of proptosis measured
by the exophthalmos index (IE) before and after surgery, as well as at the last observation.
Results. Thirty-three patients (24 women - 73%) with an average age of 51.6 years underwent treatment for MAP. Of the
22 patients with additional visual symptoms (for example, loss of visual acuity, reduced field of vision or diplopia), 15
had improved vision, and 7 had stable vision. None of the patients had a worsening of proptosis after treatment. The average
preoperative IE was 1.39, the average IE in the immediate postoperative period was 1.23, and the average final IE
at the last observation was 1.13. Thus, the average overall improvement in IE was 0.26, but the average immediate decrease
in IE was 0.16, demonstrating a progressive improvement in proptosis in the postoperative period. Residual cavernous
sinus lesion was present in 17 out of 18 patients who had preoperative cavernous sinus meningioma lesion. Only
2 patients in this series had a recurrent tumor in the eye socket area, and their proptosis improved again after repeated surgery. One case of delayed vasospasm and 2 cases of postoperative trigeminal nerve numbness (V2) were registered.
The average follow-up period was 4.5 years (53.8 months).
Conclusion. In this series of studies, all patients experienced an improvement in proptosis, and none of them had worse
visual symptoms at the last observation, although proptosis disappeared over time. Only 2 patients had a recurrence of
the orbit tumor, which required surgical intervention. Surgical complications were rare. The results of the study show
that aggressive resection of the MAP is well tolerated and provides excellent elimination of proptosis with infrequent relapses
in orbit. It is important to note that there have been no cases of enophthalmos, despite the absence of a formal reconstruction
of the orbit.

The problem of orphan diseases at all times aroused great interest among practitioners, since, despite their
rarity, they are of great importance for a particular patient and his entire family. This article provides a brief description
of the clinical forms and presents a clinical case of spinal muscular atrophy (SMA) type II in a 3-year-old child. SMA in
a child manifested at 13 months of age. Establishing the diagnosis of this pathology requires the joint efforts of neurologists,
orthopedists, and geneticists in order to conduct timely diagnosis, including the use of molecular genetic methods.
The diagnosis of spinal muscular atrophy in a small patient was established on the basis of the clinical syndrome of progressive
muscle weakness and confirmed by laboratory and instrumental methods. In particular: a DNA study was carried
out, as a result of which a deletion of exons 7-8 of the SMN gene was registered in the homozygous state. Electroneuromyography
(ENMG) revealed a generalized lesion of the motor neurons of the spinal cord, which is characteristic of
SMA. MRI of the brain and spinal cord, blood tests for creatine phosphokinase and creatinine showed no abnormalities.
Taking into account clinical, laboratory and instrumental data, the diagnosis was made: G 12. Hereditary neuromuscular
disease. Spinal muscular atrophy, type 2. Peripheral tetraparesis.
Spinal muscular atrophy is, as mentioned earlier, a rare disease and each verified case should be well described and documented.
Patients with severe muscle hypotension syndrome and muscle weakness should be promptly referred for examination
by a geneticist in order to rule out other possible genetic pathologies.
The diagnosis of SMA is always a tragedy for the parents of a child, as there is currently no cure for this disease. Treatment
depends on the type of SMA and symptoms. The little patient was registered for long-term follow-up, an individual program
was developed for the correction of motor and musculoskeletal disorders, as well as for the prevention of secondary
complications.

Introduction. The choice of treatment methods for injuries of the acromioclavicular joint of the ACJ is an
urgent problem of modern traumatology. The shortcomings of the existing methods of treatment of ACL injuries indicate
the need for in-depth research to find optimal methods for correcting damage to this localization.
Purpose of the study - To present the developed new combined method for the restoration of the acromioclavicular joint.
Materials and methods.A new combined method for restoring the acromioclavicular joint is described, developed by the
authors in the clinic of traumatology and orthopedics, for which a copyright certificate of the Republic of Kazakhstan
No. 27950 dated July 22, 2022 was obtained.
Results. A new combined method for restoring the acromioclavicular joint by forming a new acromioclavicular ligament
and fixing the acromioclavicular joint with a hook-shaped plate excludes the possibility of displacement of the clavicle
both upwards and in the anterior-posterior direction and provides sufficient stability of the acromioclavicular joint, and
also allows removing hook-shaped plate in the early stages (3-4 months), thereby preventing complications associated
with long-term presence of the hook-shaped plate (1 year or more) in the area of the acromioclavicular joint, namely,
subacromial osteolysis of the acromial process of the scapula, subacromial impingement, fracture of the acromial process
and hook plate.
Conclusions. A new combined method for restoring the acromioclavicular joint (copyright certificate No. 27950 dated
July 22, 2022) provides stable fixation of the acromioclavicular joint, early rehabilitation treatment and removal of the
uncinate plate in the early stages (3-4 months), thereby contributing to prevention of complications associated with prolonged
stay of the uncinate plate in the scapula (1 year or more), namely, subacromial osteolysis of the acromial process
of the scapula, subacromial impingement, fracture of the acromial process of the scapula and the hook of the plate.

Introduction. Ultrasound, as a non-invasive and readily available tool, plays an important role in the diagnosis
of non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD has not been previously studied in Kyrgyzstan.
Knowing the incidence of fatty liver infiltration in hospitalized patients is necessary for active diagnosis and timely prevention
of complications of NAFLD.The aim of the study- to determine the prevalence of fatty liver and associated pathologies of the internal organs of the
abdominal cavity in patients undergoing inpatient treatment.
Material and methods. A total of 6,720 visitors to the City Clinical Hospital No. 1 in Bishkek were examined. The mean
age was 45.9 years. Among them, women - 53.8%, men - 46.2%. The inclusion criteria for the examined groups were:
age from 18 to 92 years; consent of the patient to participate in the study. Exclusion criteria: the presence of severe concomitant
somatic, oncological, hematological and mental diseases; refusal to participate in the study. The control group
consisted of individuals without ultrasound signs of fatty liver (2466 people in total). The comparison group included
4254 people with ultrasound signs characteristic of fatty liver. In each study group, two age categories were considered:
older and younger than 45 years. All subjects underwent an ultrasound examination of the abdominal organs. The results
were analyzed using the SPSS 16.0 statistical software package for Windows.
Results. It was found that among patients of a multidisciplinary hospital, the prevalence of signs of fatty liver is 63.3%,
among people under 45 years old - 43%, and in people over 45 years old - 79.1%. Among the comorbid pathology in
persons with fatty liver, signs of chronic cholecystitis, pancreatitis, cholelithiasis and pyelonephritis were statistically
significant. More than 60% of the younger age group with fatty liver have signs of chronic pancreatitis versus 36.2%
without fatty infiltration. In older people, it increases to 81% and 72%, respectively. Among patients under 45 years of
age, I degree of fatty liver prevailed. In patients older than 45 years, grades II and III were statistically significant. A statistically
significant average correlation of fatty liver with pancreatitis was found. A weak direct correlation of fatty liver
with chronic cholecystitis and pyelonephritis was also found.
Conclusions. High prevalence of ultrasound signs of fatty infiltration of the liver (79.1%) among examined patients over
45 years of age who are hospitalized in a multidisciplinary hospital, and the prevalence of signs of chronic cholecystitis,
pancreatitis, cholelithiasis and pyelonephritis highlights the need for careful diagnosis of liver diseases in order to prevent
complications such as cirrhosis of the liver and hepatocellular carcinoma.

Introduction. Endometrial hyperplasia is an abnormal proliferation of the endometrium with an increase in the
glandular component relative to the stroma. Hyperplasia is a precancerous disease. There are no official statistics on the
incidence of endometrial hyperplastic processes in the Kyrgyz Republic
The aim of the study - to determine the prognostic value of risk factors for the development of endometrial hyperplasia
and, on the basis of clinical and anamnestic data, to identify a group of women who are more likely to develop endometrial
hyperplasia.
Materials and methods. A total of 151 multiparous women of reproductive age were examined, including 71 patients
with endometrial hyperplastic processes and 40 healthy women. The average age of women is 28.6 ± 5.7 and 30.9 ± 6.5,
respectively. An assessment was made of the influence of risk factors such as overweight, increased anxiety, inflammatory
diseases of the pelvic organs, extragenital diseases, viral infections on the development of this pathology in multiparous
women of reproductive age in Kyrgyzstan.
Results. In women with HPE, infertility was more often observed 17% and 2.88%, respectively, lipid metabolism disorders
were 65% and 21% in healthy women, women of the main group predominate by 3 times in the number of spontaneous
miscarriages, inflammatory diseases of the pelvic organs were more often noted, 65, 71% of women with HPE had a
high level of anxiety, in contrast to 12.20% of the main group
Conclusions. A retrospective study of the case histories of 71 women with a verified hyperplastic process in the endometrium
was carried out. The control group consisted of 80 women without endometrial pathology, observed in the
clinic. Comparative analysis included the study of risk factors based on obstetric and gynecological history and somatic
status. Patients with menstrual dysfunction, metabolic processes and chronic diseases are at risk of developing a hyperplastic
process in the endometrium.

Introduction. Cholelithiasisis considered one of the most common diseases of the gastrointestinal tract, which
are detected in 20-30% of the population mainly of working age, tends to increase and expand the age range towards rejuvenation.
In this paper, the authors investigated the long-term results of treatment of patients with cholelithiasis after
laparoscopic cholecystectomy.
The purpose of the work. To evaluate the mineral Long-term results of treatment of patients with cholelithiasis after laparoscopic
cholecystectomy water "Jalal-Abad" to improve the results of laparoscopic cholecystectomy in patients with
cholelithiasisin the early postoperative period.
Materials and methods of research. In the Jalal-Abad regional Hospital in the surgical department, 302 patients with
cholelithiasis from 2017 to 2022 were examined. The patients underwent laparoscopic cholecystectomy. All patients were
divided into two groups: control and main.The control group consisted of 104 patients who were received in the postoperative
period – traditional complex treatment. Of these, 68 (65.4%) patients underwent surgery with chronic calculouscholecystitis
and 36 (34.6%) patients with a range of acute calculouscholecystitis. The main group consists of 198 patients, of them with chronic calculouscholecystitis - 124 (62.1%) and 74 (37.9%) patients
with acute calculouscholecystitis. In the early postoperative period after laparoscopic cholecystectomy, the reception
of Jalal-Abad mineral water was additionally connected to the traditional treatment according to the developed scheme.
Long–term results of the study in 45 patients with cholelithiasis, the control group - without the use of mineral water
"Jalal–Abad" in the early postoperative period after laparoscopic cholecystectomy and in 51 patients with cholelithiasis
- the main group with the use of mineral water "Jalal-Abad" in the early postoperative period after laparoscopic cholecystectomy
terms from 6 to 12 months. 68 patients were examined on an outpatient basis and 32% inpatient in the Jalal-
Abad regional Hospital in the surgical department. The quality of life was studied for periods from 3 to 6 and from 6 to
12 months.
Results. Thus, studies have shown that carrying out a rehabilitation course treated in the early stages of the mineral water
"Jalal-Abad" after laparoscopic cholecystectomy contributes to the normalization of liver function, improving well-being.
After discharge of patients from the hospital, sanatorium treatment should be continued, and the main method of treatment
should be the use of mineral waters "Jalal-Abad".

Introduction. Hyperplastic processes of the endometrium are an actual problem of modern gynecology. Тhis
is a different spectrum of morphological changes in the uterine mucosa, with predominant proliferation of glandular and,
to a lesser extent, stromal components.
Objective of the study: optimization of tactics for the treatment of hyperplastic processes in multiparous women with an
assessment of their clinical effectiveness.
Materials and methods. A retrospective analysis of 142 case histories of patients with endometrial hyperplasia from the
city gynecological hospital in Bishkek, the Kyrgyz Republic and 80 medical records of healthy women from outpatient
appointments was carried out. A prospective observation was also carried out. The average age of women is 29, 7 ± 6, 1
years.
Results. The diagnosis of glandular hyperplasia of the endometrium was established on the basis of complaints, ultrasound,
hysteroscopy and confirmed histologically. All patients were treated for 6 months with oral progestogens and using an
intrauterine hormonal levonorgestrel-releasing system. After treatment, there was a regression of endometrial hyperplasia,
an increase in hemoglobin in the blood, and a decrease in menstrual blood loss.
Conclusions. Oral and local intrauterine (LNG-IUD) progestogens are effective in achieving regression of endometrial
hyperplasia without atypia.

Currently, 35-40% of surgical patients are patients with purulent-inflammatory diseases of various localization.
This indicates the relevance of the medical and socio-economic significance of the problem, increasing the effectiveness
of the treatment of purulent wounds.
The purpose of the study was to study the effectiveness of the use of ultrasound diagnostics in patients with inflammatory
processes in the area of surgical wounds. Materials and methods of investigation. The results of ultrasound examination
of 52 patients over 16 years of age with inflammatory complications in the postoperative period were analyzed, of which
24 (46.2%) patients after high amputations of the lower leg or thigh were included in group 1, and 28 (53.8%) patients
with inflammatory process of the area of surgical intervention of a different localization.
Results of the study and their discussion. During ultrasound of the area of surgical intervention, infiltrates (25.0%) and
soft tissue edema (25.0%) were most common, less often - seroma (19.2%) and hematoma (7.7%). In 23.1% of cases,
there were direct indications for repeated surgical interventions: abscesses in the area of surgical wounds were detected
in 13.5%, phlegmon in 9.6% of patients.
Conclusions. In patients with inflammatory processes in the area of surgical intervention, the use of ultrasound can improve
the quality of diagnosis and contribute to the correct choice of treatment tactics.

In this paper, the authors have shown an assessment of the intensity of the pain syndrome and the activation
time of patients with simultaneous surgery of patients with cholelithiasis and gynecological diseases.
The aim of the study was to study the results of the intensity of pain syndrome and the activation time of patients. Materials
and methods of research: A study of the results of the treatment of simultaneous operations with a combination of
cholelithiasis and gynecological diseases in 131 patients in a tertiary-level hospital for the period from 2020 to 2022 was
conducted. Patients were divided into three groups to study the intensity of pain. In the first group, 42 (32.1%) patients
underwent simultaneous operations: laparoscopic cholecystectomy + laparoscopic gynecological surgery , in the second
group – laparoscopic cholecystectomy + open gynecological surgery -52 (39.6%) and in the third group cholecystectomy-
37 (28.3%). To objectify the intensity of pain syndrome in operated patients, a visual analog scale of pain and the
number of analgesics needed in the postoperative period were used. The intensity of pain according to visual analog scale
was assessed 6 hours and 24 hours after surgery (before the appointment of analgesics) in 42 patients of group I, 52
patients of group II and 37 patients from group III.
The results of the study and conclusions. Thus, the intensity of pain syndrome in group I patients (operated for laparoscopic
cholecystectomy and laparoscopic gynecological surgery) was lower due to less traumatization. By 3-4 days after the
surgical period, most of the patients did not actually experience any discomfort associated with the operation. The results of the study show that with a large volume of intervention, in group I, postoperative rehabilitation of patients was faster,
and in group II approximately the same as in group III.

Introduction. The article presents the modern view of the etiology of chronic polypous rhinosinusitis, associated
with microbial infection especially Staphylococcus aureus, and its ability to secrete enterotoxin, which plays a special
role in the theory of “superantigen” and produces a hyperimmune reaction, which in turn leads to the rapid growth of
nasal polyps inside the nose and the paranasal sinuses.
The research aims to study- microbiological peculiarities of chronic polypous rhinosinusitis in patients residing in the
Kyrgyz Republic.
Materials and methods. For the bacteriologic examination with identification and counting of colonies, the materials obtained
from 30 patients with chronic purulent polyposis inflammation of the maxillary sinus at the age of 20 to 65 years
were used.
Results and discussion. Staphylococcus aureus was isolated in the majority of patients, which was 73%.
Conclusions. There is a coincidence between the data of microbiology testing of foreign authors and the data of our
testing. Staphylococcus aureus plays a leading role in the pathogenesis of the development of chronic polypous rhinosinusitis.

Introduction. Bacteriological verification of species composition of microorganisms and sensitivity to used medicinal
products, which included in drops and mixtures for treatment of chronic purulent-inflammatory diseases of ear,
nasal cavity and paranasal sinuses, palatine tonsils.
The aim of the study is to study microflora and its sensitivity to the medicinal products, recommended for treatment in
patients with chronic inflammation of the middle ear, paranasal sinuses and the nasal cavity, palatine tonsils.
Materials and Methods. Bacteriological verification was carried out on materials obtained from 77 patients with chronic
inflammation of the maxillary sinus cavity, 30 patients with chronic polyposis rhinosinusitis, 126 patients with chronic
middle ear inflammation and 65 patients with chronic tonsillitis.
Results and their discussion. The carried out research allowed the isolation and identification of 316 strains. Among them
48 were of fungal nature and the rest were of bacterial nature. The bacterial microflora in each of the examined groups
of patients had a somewhat different representation of microorganisms.
Conclusions. The suggested mixture on Synthomycin liniment permits when introduced into the crypts of the palatine
tonsils and into the sinus after its puncture and irrigation to achieve a prolonged, rather reliable therapeutic effect, which
permits to recognize it as highly effective and recommend it for alternative treatment.

With volumetric brain lesions, perifocal edema in most cases affects the severity of the clinical picture, especially
in glial tumors of the brain due to the development and growth of tumor cells, toxic effects on the surrounding
brain tissue. We have identified morphological and water-electrolyte disturbances in the zone of perifocal edema in glial
brain tumors and determined the possibilities of its correction in the pre-, intra- and postoperative periods. The study included
534 patients operated on for glial brain tumors (glioblastoma, astrocytoma, oligodendroglioma, and ependymoma).
Preoperative neuroimaging and intraoperative study of tissue structures in the zone of perifocal edema and microcirculation
of the vessels of the cerebral cortex over the healthy and affected zones were carried out. Glial tumors of the temporal
lobe (27.9±1.9 per 100 patients), parietal lobe (22.5±1.8), p<0.05, frontal (21.9±1.7) , p>0.05, occipital (18.3±1.6),
p>0.05, and deep localization accounted for 9.4±1.2 cases per 100 patients, p<0.001. The study gives a morphological
assessment of the zones of perifocal edema and presents a division according to the degree of severity of the zone of perifocal
edema in glial tumors in points. The study showed pronounced morphological changes in the water-electrolyte
composition of brain cells and intercellular space, blood vessels, nerve fibers in the area of perifocal edema in malignant
glial tumors, especially in Grade III-IV. These studies made it possible to prevent complications, conduct adequate dehydration
therapy in the pre- and postoperative periods, as well as correctly plan the course of the operation.

Introduction. Scleroatrophic lichen is a chronic inflammatory fibrous skin disease of unclear etiology of extragenital
and genital localization. With genital sclerotrophic lichen in men with urethral strictures, it manifests itself in
the form of chronic and acute urinary retention. Uncircumcised men are more likely to be affected by scleroatrophic
lichen, manifested by cicatricial phimoses.
The purpose of the study. To provide information on emergency care for patients with urethral strictures and cicatricial
phimoses caused by scleroatrophic lichen.
Materials and methods. Emergency care was provided at the Republican Scientific Center of Urology to 120 patients
with scleroatrophic lichen aged 17 to 85 years. Trocar cystostomy was performed in 70 patients with acute and chronic
urinary retention due to urethral stricture caused by scleroatrophic lichen. The remaining 50 patients with cicatricial phimosis
caused by scleroatrophic lichen underwent circumcision.
Results. Performing circumcision and further conservative treatment for patients with cicatricial phimosis caused by scleroatrophic
lichen makes it possible to solve the problem of this category of men. Trocar cystostomy in acute and chronic
urinary retention in patients with urethral stricture caused by scleroatrophic lichen makes it possible to carry out a planned
and thorough diagnosis of urethral stricture and to choose the optimal tactics for surgical correction of the urethra.
Conclusion. It is advisable to provide emergency care in the form of trocar cystostomy and circumcisio to patients with
urethral stricture and cicatricial phimosis caused by scleroatrophic lichen.

The problem of treating patients with OCD remains relevant. Despite significant achievements in emergency
surgery and the introduction of new diagnostic research methods, OCN remains a severe type of acute pathology of abdominal
organs (M.Yu. Andreev, 2004; V.I. Belokonev, 2008.).
The purpose of the study - the state of general and regional microcirculation in patients with acute intestinal obstruction.
Materials and methods of research. The microcirculatory bed of the small intestine has a number of features: the mucous
membrane of the small intestine is largely isolated from the blood vessels in the muscular membrane. The vessels of both
layers receive blood and drain the submucosal vascular plexus. The muscle membrane contains 2 capillary networks: the
outer and inner layers of capillaries located parallel to the smooth muscle bundles of the longitudinal and circular layer
of the muscle membrane, respectively. In the mucous membrane, the bases of the crypts of the rich are supplied with microvessels
forming a basket-like capillary network around the crypts, from which small postcapillaries rise to the intestinal
lumen along the crypts with the formation of a capillary ring around the entrance.Some capillaries located around the
bottom of the crypt carry blood to the venules, which immediately go to the submucosal venous plexus. From the remaining
pericryptal capillaries, blood flows into the microvascular villi. The arteriole, which supplies blood to the microvessels
of the villi, is localized at the center. At the tip of the villi, it passes into the capillary plexus, consisting of
subepithelial exchange microvessels of cylindrical shape, often having a convoluted configuration. The larger ones go
along the crest of the villi . All these capillaries move towards the base of the villi, where it passes into the venules. Thus,
a fountain type of distribution is formed. In the middle of the intestinal villi , this capillary plexus gradually turns into 2
venules on each villi of the proximal part of the small intestine and into 3 venules in the distal part . Venules are located
more or less symmetrically relative to the core of the villi and parallel to the central artery.
Results. Such an organization of blood circulation in the villi of the small intestine ensures the maintenance of a relatively
low partial pressure of oxygen at the tip of the villi. However, the pressure in the lumen of the intestine in acute intestinal
obstruction, given in various works, does not exceed the pressure in the lumen of the capillary (within 30-35 cm vol.ct)
and significantly lower pressure in arterioles. At the same time, the violation of microcirculation in the intestinal wall
with intestinal obstruction is undeniable. The diameter of arterioles and capillaries decreases by about one and a half
times, venules expand almost twice.
Conclusions. Reduction of pressure in arterioles and capillaries, venous stasis, increased permeability of capillary walls
and extravasation of shaped blood elements have been proven. The ratio of the intensity of blood circulation in the submucosal
and external plexuses changes, if they are normally 2:1, then with intestinal obstruction they are defined as 1:4,
i.e. the mucous membrane experiences a large shortage of blood.

Introduction. Stroke is a medical and social problem primarily because of it´s prevalence and the consequences
that it causes. Stroke is the number one cause of disability worldwide. Ischemic strokes account for 80%, and strokes in
the vertebrobasilar region -20%, the clinical picture of which may be unrecognized even in specialized departments.
The aim of the study was to study the features of the etiopathogenesis and clinical picture of ischemic stroke in the vertebrobasilar
region.
Materials and Methods. We examined 106 patients with ischemic stroke in the vertebrobasilar region who received inpatient
treatment at the National Hospital of the MZKR in the period from 2018 to 2022. When the patient was admitted,
the time of onset of the disease, the presence of risk factors for stroke, the level of consciousness according scale Glasgow,
neurological status according to the NIHSS scale (National Institutes of Health Stroke Scale), pathogenetic subtype of ischemic stroke according to TOAST, features of the clinical picture, ultrasound data of brachiocephalic vessels, neuroimaging.
At discharge, an assessment was made according to the NIHSS, Rankin scales.
Results.
1.Taking into account the onset of the disease, the presence of risk factors, the clinical picture of stroke, ultrasound data
of brachiocephalic vessels, brain neuroimaging data, pathogenetic subtypes of ischemic stroke in the vertebrobasilar
region were determined according to TOAST
2. When assessed using the Glasgow Coma Scale, NIHSS, and Rankin, mild and moderate strokes with a favorable functional
outcome at discharge from the hospital predominated.
3. The clinical picture of ischemic stroke in the vertebrobasilar region did not always coincide with the focus of infarction
during neuroimaging, which confirms the importance of the latter in the diagnosis of stroke.
Conclusions.
1. Thus, ischemic strokes in the vertebrobasilar region are heterogeneous in terms of etiopathogenetic subtypes, clinical
course, and outcomes according to the Rankin scale.
2. The clinical picture of stroke in the vertebrobasilar region may not coincide with the localization of cerebral infarction,
so neuroimaging remains the standard for diagnosing stroke.

Carrying out cardiopulmonary resuscitation carries the possibility of developing injuries of the abdominal organs.
Intra-abdominal injuries are considered rare and, according to pathological and anatomical studies, reach 2.5%. Intensive
care physicians, if necessary, should take appropriate measures for their early diagnosis and selection of optimal
treatment tactics.
Purpose of the study. A review of the literature data on determining the mechanisms of development, methods for diagnosing
and treating injuries of the abdominal organs after cardiopulmonary resuscitation.
Materials and Methods. To search for scientific publications, we used the PubMed database, the Google Scholar search
engine, as well as reference lists of references for the period from 1960 to 2021 in the following terms: “liver rupture”,
“spleen rupture”, “stomach rupture”, "cardiopulmonary resuscitation". Obtained results and discussions. Carrying out
cardiopulmonary resuscitation can be accompanied by various complications. There are many reports of frequent traumatic
injuries after resuscitation. At the same time, there are few data in the literature on injuries of the abdominal organs as a
result of cardiopulmonary resuscitation due to the rare frequency of detection of these injuries, which, if diagnosed late,
can lead to fatal consequences.
Conclusion. After resuscitation, one should be aware of the possibility of damage to the abdominal organs. Early diagnosis
and timely treatment of these complications contribute to increased survival.

Introduction. According to WHO, myopia in children is 19 million people. people, in Russia, blindness and
poor vision from complications of myopia are stated in 12-18% of cases, worldwide - in 2.2 billion patients. Myopia is
projected to increase by 2050 in 4.8 billion people on the planet, according to studies, about 1 billion patients will have
high myopia.
The aim of the study- to study clinical and structural changes in progressive high myopia.
Material and methods. 145 people (290 eyes) were examined; with mild myopia - 45 patients (90 eyes); moderate - 49
patients (98 eyes) and 51 patients (102 eyes) with high myopia. To diagnose the type of ANS, neuropharmacological
tests of 0.1% adrenaline and 0.05% pilocarpine solution were performed. 92 patients (184 eyes) underwent an examination
of the cervical spine (CS) with various degrees of myopia with a study of hemodynamic parameters in the internal carotid
artery (ICA), vertebral artery (VA), ophthalmic artery (OA) using Doppler ultrasound (DOPSCAN). To determine the
products of lipid peroxidation (LPO) in tears (according to the method of Gavrilov V.B.), 33 people (66 eyes) were examined.
Results. With a high degree of myopia at the age of over 14 years, sympathicotonia prevailed in 66% (26 eyes, 13 patients);
with mild myopia at the age of 6-10 years, the cholinergic system prevailed - in 62% (19 eyes, 10 patients) with the development
of myopia - in 41% (37 eyes, 19 patients). The development of a high degree of myopia was detected in 33.3%
with pathology of the CS III-IV stage. With disorders of hemocirculation in the VA and OA (22.6 cm/s ± 2.18 and 25.0
cm/s ± 2.1; with angiospasms RI up to 0.91 ± 0.16 in OA (p<0.05). In high myopia, a significant increase in the indicators Conclusion. Timely diagnosis and treatment of the main risk factors will help prevent the progression and disability of
the eyes in myopia.

The management of patients with synchronous metastatic colorectal cancer (SMCRC) remains a challenge for
an interdisciplinary team. The results of a simultaneous surgical strategy, in combination with resection of the primary
malignant neoplasm and liver metastases, avoid complications during a major re-operation, theoretically reduce the risk
of dissemination of the disease, and allow adjuvant therapy to be completed in a timely manner. Therefore, it is unclear
to what extent this surgical strategy is applied in the general population and whether comparable results are achieved. Simultaneous
removal of primary colorectal cancer (CRC) and synchronous liver metastases (LIC) is of increasing
interest.The purpose of the study -to conduct a comparative analysis of the immediate results of synchronous and staged
surgical treatment of patients with SMCRC.Material and methods. The results of treatment of 41 patients with MCRC
with synchronous liver damage, who underwent synchronous (group A, n=21) and staged resections (group B, n=20) of
the liver in the department of intestinal tumors of the National Center of Oncology and Hematology of the Ministry of
Health of the Kyrgyz Republic during the period from 2010 to 2020. Results. The total level of postoperative complications
in groups A and B after the completion of the surgical stages did not differ statistically. A shorter duration of surgery was
registered in group A — 316.3±10.3 minutes, while in group B it was 484.1±18.3 minutes (p<0.001). Patients after staged
resections stayed longer in the hospital - 21.1±0.7 bed-days, while after synchronous resections - 10.32±0.6 bed-days
(p<0.001). Conclusions.An analysis of our studies indicates the need to develop a differentiated approach to the surgical
treatment of SMCR.

Introduction. Neck chemodectomas are soft tissue tumors that develop from paraganglia receptor cells, they
represent 18% of extraorganic neck tumors and 40% of all extraorganic tumors. The source of the chemodectome is the
carotid body (glomus).
Objective: Clinical demonstration of the results of two-stage (endovascular and surgical) treatment of a large chemodectoma
in the area of bifurcation of the left common carotid artery.
Results. Partial embolization of the vessels supplying the tumor was performed. The postoperative period of embolization
proceeded without complications. The second stage on the next day was the removal of the tumor by an extended cervical
approach on the left. Intraoperatively, there was a slight bleeding of the tumor, which did not require temporary clamping
of large arteries and made it possible to remove the tumor completely. The postoperative period of the 2nd operational
stage also proceeded without complications.
Conclusions. Due to the large size of the chemodectoma, the patient underwent an effective and safe two-stage operation:
embolization of the feeding vessels of the tumor followed by its total removal by the second stage.

Introduction. The study of the qualitative and quantitative composition of macro-and micronutrients in the
daily diet according to age and its physiological needs is the main principle of healthy human nutrition.
The aim of the study. Analysis of the actual content of certain minerals in food products of various regions of the KR.
These studies are aimed at creating database on the chemical composition of food products in the KR.
Materials and methods. Studied the content of calcium and iron in the main food products- meat and dairy products, cereals,
vegetables) from five regions of the KR. 1470, studies were conducted. When determining the content of mineral
substances in food products, the AES-ICP method was used on an ICAP 6000/7000 N 51/21 spectrometer according to
GOST 30538-9.
Results. The results of a study of the content of calcium and iron in the main types of food products of the population of
Kyrgyz Republic (meat and dairy products, cereals and vegetables) are presented. A comparative assessment of the actual
content of calcium and iron in the above food products from different regions of KR with the date of Russian scientists
from the Institute of Nutrition, Moscow is given.
Conclusions. More biologically valuable in terms of calcium content is animal meet and all studied dairy products from
all regions of the KR. Batken rice is better, and in terms of Fe content, Uzgen rice is better than rice produced in the
Russian Federation.

Organization of the medical service on remote industrial sites is a complex task. The preparation of the medical
specialists must be focused on education of pre-hospital emergency care. Clinical guidelines of the American Heart Association
and American College of Surgeons must be included into the teaching program as well. Medical professionals
on remote industrial sites must have experience in critical care medicine, they must know basic life support, cardio-pulmonary
resuscitation and advanced cardiac life support. Currently the preparation of the medical staff for the work on
remote industrial sites is ongoing at the state training center for medical workers. According to Labor Code of the
Kyrgyz Republic non-medical workers at remote industrial sites must have first aid medical training too. The National
Red Crescent Society of the Kyrgyz Republic provides first aid medical training to the non-medical people at remote industrial
sites.

Introduction. The Department of Short-term stay (hereinafter referred to as OKP) is a structural subdevision
designed to provide up to daily (within 24 hours) inpatient medical care to the pediatric population in healthcare organizations
that do not require a long stay.
The purpose of the study. To analyze the indicators of the quality of medical services for children in short-stay departments
at the level of health organizations of Batken, Jalal-Abad, Osh regions and Osh.
Materials and methods. The analysis was carried out on the basis of the official statistics of the Health development center(
HDC) and the FOMS under the Ministry of Health of the Kyrgyz Republic on the activities of the Department of
short-stay at the level of 23 health organizations of Batken, Jalal-Abad, Osh regions and Osh for the period from 2018
to 2020years. Results. The analysis of the age composition of children hospitalized in the Department of short-showed a predominance
of children under 5 years of age, who amounted to more than 70%, of whom more than 50% were children under 1 year
of age. Parents applied to the Department of short-stay mostly by self-referral (more than 70%), bypassing PHC for the
compared years. According to the treated cases, the Department of short-stay revealed that children were most often
treated for respiratory diseases (34 - 40%), in second place - diseases of the digestive system (16 – 24%), the third place
was taken by injuries and poisonings (12 – 24%). Comparison of mortality and mortality rates of children in hospitals in
dynamics shows their decrease – mortality of children in 2017 from 1.51% to 0.54% in 2020.
Conclusions. The creation of the department of short-stay (DSS), as an optimization of the children's health care services
has undoubtedly led to a decrease in unnecessarily prolonged hospitalization of children in hospitals, the provision of
timely medical services for acute respiratory infections, acute diseases of the digestive system, trauma and poisoning,
thereby improving the quality of medical care provided to children at the hospital level.

Kyrgyz State Medical Institute of Retraining and Advanced Training named af-ter S.B. Daniyarov the abstract
should be an educational-scientific-clinical complex, representing triad of goals: a) to provide graduates with fundamental
and practical system knowledge, abilities, skills, to form research skills at graduates of universities, to obtain new highlevel
technical knowledge b) to form skills to develop and implement for graduates innovative technologies c) ensure a
high level of professional competence, self-organization and smoother development.

Introduction. The effectiveness of the system of continuing medical education of healthcare workers depends
on many factors. One of them is the attitude of the trainees themselves to the system of continuous medical education.
The purpose of the study is to study the opinions of nurses of healthcare organizations on the state and prospects of continuous
professional education.
Materials and research methods. The study was conducted by the method of questioning nurses of healthcare organizations
(N=507). The age of nurses is from 20 to 70 years and older.
Results. According to personal data, the majority of nurses (72.9%) undergo regular advanced training, the reasons for
untimely training are: family circumstances, lack of vouchers, refusal from the administration. The main motive that motivated
them to undergo training is to improve theoretical and practical skills (52.7%), 91.7% of respondents are satisfied
with the training, more than 1/3 of the respondents offer short-term courses and training aimed at acquiring practical
skills.
Conclusions. The results of the survey indicate that at present, lifelong education does not fully provide high-quality
training of specialists and it needs to be improved and modernized with the introduction of international recommendations,
standards and new innovative approaches.

The article provides informative material on the development of the dermatovenerological service in the Kyrgyz
Republic. The dermatovenerological service is a healthcare organization that provides dermatovenerological assistance
for the timely detection, treatment, rehabilitation and prevention of contagious skin diseases and sexually transmitted infections.
Outbreaks of infections played a role in the development of the dermatovenereological service, for the solution
of which the governing bodies of health care needed to reconstruct the health care system, as a result of which treatment
and prevention measures for STIs were integrated into the vertical network, and a protocol for the treatment of syphilis
with extencillin was developed and introduced into clinical practice. There have been no outbreaks of sexually transmitted
infections over the past five years.

The article provides classification of conflicts, ways and methods of resolving conflict situations in healthcare
management. Conflicts are present in every organization, are an integral part of any team. Consequently, conflict situations have a special impact on the life within the organization.