2022

A wide variety of diseases associated with low vitamin D levels are being supported by a growing body of research.
Data are now available on the endocrine, autocrine, and paracrine activities of vitamin D and on the major determinants
of vitamin D decline in humans. Vitamin D deficiency leads to comorbidity, impaired functioning of the human
body, which has its own characteristics depending on age.

Introduction. The coronavirus pandemic (COVID-19) originated in China and affected almost the entire world
in early 2020. To understand and inform about effective public health measures, we conducted a survey of knowledge,
attitudes and practices among the adult population of the cities of Bishkek and Naryn, the Kyrgyz Republic.
Research methods. In August 2021, a cross-sectional study was conducted with a survey of the adult population of the
cities of Bishkek and Naryn, the Kyrgyz Republic. A simple two-stage cluster sampling method was used to recruit study
participants. The analysis was carried out using the statistical software Epi Info 7. The variables were summarized as
frequency and percentage.
Results. The survey was conducted among the adult population of Bishkek 1,390 (86%) and Naryn 234 (14%). A total of
1,624 questionnaires were analyzed, the response rate was 95%, of which 918 (57%) were men and 706 (43%) were
women. The average age of the study participants was 35 years, the standard deviation was 14.9. 1490 (92%) of respondents
knew that COVID-19 can spread from person to person when people are in close contact, 1371 (84%) knew that a
person infected with COVID-19 can transmit the virus to others, not even symptoms. 1446 (89) noted that it is important
to wear a mask, but only 1255 (77) respondents wear a mask, 1440 (89) noted that it is important to observe physical distance
indoors, however, only 955 (59) of the respondents surveyed observe it, 1556 (96) said that it is important to wash
their hands after visiting public places.

Introduction. Despite coronavirus disease (COVID-19) mitigation measures implemented in Kyrgyzstan hospitals,
3,173 healthcare workers (HCW) had been diagnosed with COVID-19 by September 2020, amounting to 17% of
all COVID-19 cases. We aimed to identify risks for COVID-19 among HCW exposed to COVID-19 patients in Bishkek.
Methods. We conducted a nested case-control study of HCW in six hospitals with high COVID-19 incidence among
HCW using incidence-density sampling. HCW in the national COVID-19 registry with SARS-CoV-2 PCR-positive and
SARS-CoV-2 IgG-negative results June 2020-May 2021 were recruited as cases if exposed to COVID-19 patients <14
days. Controls were randomly selected among HCW concurrently working at the same hospitals with SARS-CoV-2 PCRand
IgG-negative results. We collected sociodemographic, work, clinical, and laboratory information, and used logistic
regression to identify factors significantly (p<0.05) associated with COVID-19.
Results. A total of 511 people were included in the study, of which 128 cases and 383 controls. Out of 511 participants:
454 (89%) women and 383 (75%) participants under the age of 50. Of the participants, 118 (92%) cases and 348 (91%)
controls lived in a hostel (not at home) during the shift. Comorbidities were noted in 44 (34%) cases and 56 (15%)controls. According to the results of the analysis, testing for the tightness of the respirator, sharing a hostel for shift work
with other medical workers and the presence of comorbidities served as risk factors for the disease.
Conclusions. Results suggest need for increased quality assurance of and training in correct fitting and donning of personal
protective equipment, especially respirators, and improved communication for HCW promoting personal responsibility
in protecting staff, patients, and themselves.

The occurrence of stroke in patients with COVID-19 infection is relatively rare, but COVID-19 is an important
prognostic marker and indicator of severity. This brief review suggests that ischemic stroke may occur early in the disease
and may also affects patients in younger age groups without comorbidities, causing large vessel occlusion and exhibiting
thrombo-inflammatory neuroimaging. The mechanisms underlying the development of stroke in patients with COVID-
19 may be associated both with the usual factors of increased risk of stroke, traditionally found in patients without COVID-
19, and with the development of coagulopathy induced by infection against the background of a systemic inflammatory
reaction characteristic for coronavirus infection.

This article reviews the literature on the role of private health care organizations in detecting, diagnosing, treating,
and preventing tuberculosis. Literature from 2001 to 2021 was reviewed, including World Health Organization guidelines
and global reports, STOP TB partnership guidelines, and articles by selected foreign and local authors. Publications
of foreign authors were available on-line, there are several publications from the neighboring countries of Kyrgyzstan.
The example of public-private partnership organization in Bangladesh, Vietnam and Georgia was given. In the publications,
most authors agree that it is necessary to involve private health care organizations in TB management to increase
access in the fight against the disease, but there are differences in the organization of public-private partnership model,
in which it is necessary to ensure quality monitoring of diagnosis, treatment and tracking of patients on TB treatment.

For the first time in more than a decade, due to the COVID-19 pandemic, TB deaths have increased due to
limited access to TB diagnostics and controlled treatment. Patient-centered TB treatment should be organized taking into
account the capabilities of patients. In the time of developing innovative, digital technologies in medicine, one of the effective
methods of TB treatment is an approach using digital health elements, in particular, video supported treatment.
Video-supportive treatment is more actual in resource-limited settings, emergencies, and in situations where face-to-face
contact between healthcare workers and patients is difficult and problematic.

In recent years, primary hyperparathyroidism has attracted more and more attention from doctors of various
specialties. Nephrolithiasis is one of the classic manifestations of the disease and is included in the list of absolute indications
for the removal of the formation of the parathyroid glands. The mechanism of development of nephrolithiasis
and nephrocalcinosis in PHPT is not fully understood, many studies are devoted to the study of possible predictors of
their development. It should be borne in mind that this pathological disease in our country was studied more than 30
years ago, when outdated methods of examination were used, but the method of treatment so far remains only operational,
both for the removal of parathyroid adenoma and for the removal of stones from the urinary system. The aim of the study
was to analyze scientific data on the problem of primary hyperparathyroidism. The authors of the article studied 150
sources of domestic and 100 foreign authors. At present, protocols for the diagnosis and treatment of urolithiasis have
been developed and approved. Given the shortage of health care budgeting in the Kyrgyz Republic, it is not possible to
implement all the necessary diagnostic and treatment measures. The main measures should be directed to diagnostic
measures, because urolithiasis is a polyetiological disease. After appropriate treatment of each patient, further monitoring
is necessary to prevent recurrence of stone formation and correct metaphylactic measures. Knowing the individual cause
of each case of this disease, it is possible to take the necessary measures in advance to prevent it, which will significantly
reduce the amount of economic costs and the number of disability among the population, as well as improve the quality
of medical services.

There is an opinion that gynecological and obstetric operations are the main cause of iatrogenic injuries, and
they also occur during operations on the pelvic organs and retroperitoneal space. A literature review was conducted on
iatrogenic damage to the ureter. A search was conducted on the topic of iatrogenic damage to the ureter and the most representative,
cited articles were selected in the Scopus, PubMed and WoS databases.
Methods. The success of treatment of iatrogenic damage to the ureter depends on the period of diagnosis. We have studied
most aspects of iatrogenic damage to the ureter. An unfavorable prognosis for the patient is an unrecognized iatrogenic
injury of the ureter. Delayed diagnosis is an unfavorable prognosis of treatment. Treatment is carried out by an operative
or conservative method.
Results. Iatrogenic injuries may be accompanied by legal consequences. Treatment can be lengthy and accompanied by
financial costs and not always instantaneous. It often leads to depression and stress.
Discussion/Conclusion.Thus, iatrogenic damage to the ureter is still intractable. It is necessary to introduce algorithms
for examining patients and implement a multidisciplinary approach.