№4 (2023)

Objective. The purpose of the work is to study spirometry indicators in patients with chronic obstructive pulmonary disease (COPD) in high altitude conditions.
Material and methods. The work involved 86 residents of high mountains (group 1) suffering from COPD; 100 patients living in low mountains (group 2) suffering from COPD and 86 people in the control group (healthy patients living in standard geographical conditions). During spirometry, the following parameters were studied: vital capacity, forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow. The analysis of the obtained results was carried out using the program “STATISTICA for Windows Version 10.0” (Statsoft, Inc, USA).
Results. In patients living in high altitude conditions, vital capacity values are significantly lower than in healthy individuals living in high altitude conditions (65.9 ± 1.8 l and 88.4 ± 2.4 l). When analyzing the FEV1 parameter, it was noted to decrease in patients with COPD living in high and low mountains compared to healthy individuals (52.5 ± 2.3 l; 50.8 ± 2.0 l; 72.4 ± 1, 7 liters, respectively), p<0.05. The PEF rate in highland residents was also lower compared to healthy respondents living in similar geographic conditions (53.6 ± 2.3% and 64.4 ± 2.3%, respectively).
Conclusions. 1. The study of spirometry parameters (VC, FVC, FEV1, PEF) in patients with COPD and living in high mountains indicates their significant decrease compared to the results of parameters in healthy individuals living in high mountains (p <0.05; <0.001);
2. In residents of high mountains, the respiratory rate was significantly lower than that of patients with COPD living in low mountains (20.9 ± 0.3 per minute and 22.9 ± 0.3 per minute, p = 0.001).

The article presents the key news and achievements discussed at "THE UNION" conference in 2023. They discussed the reduction of drug prices, the prospects for future treatment, different TB treatment regimens, as well as the results of expanding the use of innovative methods in a number of countries. Particular attention is paid to the role of communities, private organizations and digital technologies, including video treatment support, in improving the effectiveness and accessibility of TB treatment. Literature sources are based on the materials of the conference "THE UNION", Paris, 2023.

Introduction. The problem of undetected cases of tuberculosis is raised annually in WHO global reports. A similar problem is emerging in the Kyrgyz Republic. Thus, according to official WHO reports for 2022 [1] the difference in the estimated number of detected cases and those actually detected was 46.9%.
Materials and methods: Purpose of the study: Study of the level of TBI determined by the QuantiFERON - TB test Gold Plus ELISA among persons who had household and close contact with a patient with active pulmonary tuberculosis identified in health care organizations in Bishkek and Chui region, performed in the private laboratory YRFA. The study is retrospective, secondary data was collected from the “Together against Tuberculosis” project of the Stop TB Partnership from 2021. The study received ethical committee approval.
Study results: a total of 100 studies were conducted using the QuantiFERON - TB test Gold Plus ELISA (QFT). Skin tests (Mantoux test and Diaskin test) were done to 87 children out of 92 (5 refused), Mantoux test was done to 84 children and Diaskin test was done to 3 children, the positive result was in 83 children. Of those positive by skin test, only 18 (20.68%) children had a positive QFT result and 69 (79%) with a negative QFT result. In 1 adult male, the QFT was positive. In 13 children who had contact with a patient with tuberculosis, active tuberculosis was confirmed (7 children with sensitive TB, 6 with drug-resistant TB). In 13 children taken for treatment, both the skin test and QFT were positive. The remaining 5 children, positive for QFT, who were in contact with a patient with a drug-resistant form of TB, were registered and observed, since no signs of active TB process were found, the children were diagnosed with tuberculosis infection.
Conclusion. Using the example of the private laboratory of URFA, other private healthcare organizations can make a significant contribution to the management of tuberculosis in our country. To do this, it is necessary to develop regulatory mechanisms for public-private partnerships in this matter.

Introduction. The state of infection control makes it possible to assess the readiness of healthcare organizations to work in conditions of pandemics. In this regard, the Republican Scientific and Practical Center for Infection Control of the NGO Preventive Medicine (NIPH) in 2020 initiated the development of a new guideline for monitoring and evaluating infection control in healthcare organizations (Order of the Ministry of Health No. 1062) and monitored infection control in healthcare organizations of the Ministry of Health that provided COVID-19 treatment services. The development of the guidelines and monitoring were carried out with the technical support of UNAIDS within the framework of the project "Raising awareness and knowledge among medical professionals for effective infectious patient safety in medical institutions in Kyrgyzstan".
The purpose of the study is to assess the readiness of healthcare organizations to work in a pandemic.
Materials and methods: The assessment of infection prevention and infection control was carried out in accordance with the checklist approved by Order of the Ministry of Health No. 1062 dated December 15, 2020. The study was conducted by employees of the Republican Scientific and Practical Center for Infection Control, which has now been renamed the Scientific and Practical Center for Infection Control and Management of Medical Waste at the Research Institute of the Ministry of Health of the Kyrgyz Republic.
Conclusion. The total percentage of compliance with the infection control criteria for all 35 healthcare organizations in the second Monitoring and Assessment was (81.2%), which corresponds to the assessment is a high level of implementation of infection control from 76 to 100%. And above the results at the first Monitoring and evaluation is 78%. The results of the study were provided to the heads of healthcare organizations, infection control specialists, hospital epidemiologists and other partners and stakeholders. The study itself and its results will be useful for organizations planning to carry out monitoring, evaluation and audit of infection control in healthcare organizations of the Ministry of Health of the Kyrgyz Republic.

Arterial hypertension (AH) is the main modifiable risk factor for the development of cardiovascular (CV) complications. Despite the widespread prevalence of hypertension in the world (about 1.4 billion people), its detectability among the population remains low. Despite serious CV and cerebral complications, hypertension is called a "silent killer", as it has been asymptomatic for a long time. In the absence of symptoms, people have no motivation to undergo an examination for the presence of high blood pressure (HBP) and receive hypotensive treatment. Even with the detection of hypertension and the availability of a large number of effective antihypertensive drugs, the number of patients with uncontrolled hypertension continues to grow, especially in low- and moderate-income countries. Only 14% of them have blood pressure controlled during treatment. Poor blood pressure control is associated with poor patient adherence to treatment and, as a result, a large number of cerebral and CV complications are observed. To improve adherence to treatment and, accordingly, blood pressure control, leading professional associations have suggested starting treatment immediately with two antihypertensive drugs of different classes in one tablet.
Combination therapy with antihypertensive drugs of different classes has a greater antihypertensive effect than doubling the dose with monotherapy, while reducing the number of side effects. As an initial double antihypertensive therapy, a combination of ace inhibitors or Angiotensin-II-receptor antagonists (sartans) is recommended + Calcium channel blockers (CCBs) or ACE inhibitors or sartans + diuretics, and the combination of ACE inhibitors or sartans + CCBs is considered preferable. And given that ACE inhibitors cause more side effects, it is possible to start treatment immediately with a combination of s CCBs + Sartan (amlodipine + valsartan). With such therapy, the antihypertensive effect is enhanced due to additive synergism, as well as increased adherence to treatment, as the number of tablets taken decreases.

The pandemic caused by COVID-19 has affected many areas of our lives, and we are still analyzing and systematizing its consequences. Post-COVID syndrome is a global threat to humans. Our task is to understand the mechanisms of development of these symptoms in order to develop effective preventive and therapeutic recommendations for preventing the development of post-COVID syndrome.

Acute appendicitis is the most common surgical disease in children. Complicated forms of appendicitis in children is an urgent problem in pediatric surgery. There are features of the peritoneum characteristic of the child's body in the form of an inability to limit and a greater tendency to spread and generalize purulent processes. In complicated forms, in combination with the main therapy, various types of drains are installed intraoperatively into the abdominal cavity in order to evacuate the exudate. This article describes the method of drainage of the peritoneal cavity in children with peritonitis. The use of this method of drainage allows to improve the course of the postoperative period and reduce intraabdominal purulent complications.