№2 (2024)

Introduction. Brain dislocation is an emergency condition in neurology and
neurosurgery, and can develop in various intracranial space-occupying
processes.
The aim of the study is to study the clinical and neurological symptoms of
brain dislocation with determination of the shape and degree of brain dislocation. Develop neurosurgical principles and methods for eliminating brain
dislocation.
Materials and methods. The object of this study was data from a study of
3067 patients with an intracranial space-occupying process of supratentorial
localization. Out of 3067 patients, 143 had brain dislocation of various
shapes and locations.
Results. As a result of studying neurological symptoms, it was possible to
diagnose lesions at various levels of the brain stem.
Conclusions. Brain dislocation indicates the need for emergency neurosurgical interventions and a reduction in postoperative mortality in patients. In addition, the work analyzes the results of the effectiveness of surgical treatment of brain dislocation.

Introduction. Moya-moya disease is a rare cerebrovascular disease characterized by progressive spontaneous bilateral occlusion of the internal cerebral arteries and their major branches. As a result, additional capillary collaterals are formed, which resemble “puffs of smoke” (in Japanese: moya-moya) on
cerebral angiography. When the disease develops in conjunction with other
diseases, it is called moya-moya syndrome (MMS). The aim of the study - To describe clinical observation to improve the diagnosis of rare diseases. Materials and methods. Observation, examination and evaluation of clinical,
laboratory and instrumental data were carried out. Results. A similar case and criteria for diagnosis are described. Conclusions. Moyamoya disease, with an incidence of 0.54 to 0.94 cases per 100,000 people, can be classified as an orphan disease. This highlights
its status as a rare disease that may pose challenges to diagnosis, treatment
and research due to its limited prevalence. The need for a better understanding of this rare disease underscores the importance of research and development of effective treatments to improve patients' quality of life.

Introduction. Treatment of demyelinating diseases is an important task in
the field of clinical neurology. Multiple sclerosis and Devic's neuromyelitis
optica are considered one of the most severe progressive diseases of the central nervous system of young people. Due to the fact that the etiology of
these diseases remains unclear, prevention and, accordingly, etiotropic therapy are impossible. Today, immunomodulatory and immunosuppressive
drugs are the means of choice for pathogenetic therapy of demyelinating diseases.
The purpose of the study is to select the optimal drug for the treatment of
patients with multiple sclerosis and Devic opticomyelitis in the Kyrgyz Republic.
Materials and methods. The study included data from 80 patients with multiple sclerosis and Devic's optimyelitis receiving pathogenetic treatment in
the neurology department of the National Hospital of the Ministry of Health
of the Kyrgyz Republic.
Results. The paper presents the main factors that determine modern approaches to the treatment of these diseases. Based on literature data and the
results of our own observations, the main treatment regimens for demyelinating diseases at various stages of the disease are given, depending on the
type of course and severity of the disease. Prescription of therapy occurs
after establishing a reliable diagnosis and on the basis of individual selection
of a drug depending on the stage and activity of demyelinating diseases, the
benefit-risk ratio in each specific case. DMT therapy is carried out under
regular monitoring of the effectiveness, safety, and tolerability of long-term
therapy
Conclusions. Thus, patients currently have a large choice of pathogenetic
treatment drugs, namely modern DMTs. In general, modern research and approaches to the treatment of demyelinating diseases open new perspectives
for patients, increasing the effectiveness of treatment and their quality of
life.

Introduction. The spectrum of demyelinating diseases, including relapsingremitting multiple sclerosis (RRMS), continues to be the subject of intense scientific research in light of their complex etiology and multifactorial nature. In this context, vitamin D has attracted attention as a potential factor influencing the development and activity of RRMS. Despite some evidence of an association between vitamin D levels and neurological disorders, including RRMS, awareness of its role in the context of mountainous regionssuch as Kyrgyzstan remains limited. The presented study aims to uncover the possible correlation between vitamin D levels and clinical relapses in patients with RRMS living in the mountainous areas of Kyrgyzstan, with the aim of better understanding the effect of this vitamin on the course of the disease and developing effective disease management strategies. The aim of the study. To investigate the correlation of vitamin D levels with the frequency of clinical relapses in patients suffering from relapsing-remitting multiple sclerosis and living in mountainous Kyrgyzstan. Materials and methods. The study included 42 patients diagnosed with RRMS who were analyzed in the neurology department of the National Hospital of the Ministry of Health of the Kyrgyz Republic. Vitamin D levels were measured at baseline and physical disability was assessed using the
Expanded Disability Status Scale (EDSS). Results. Vitamin D levels of less than 30 ng/mL were found in 93% of patients, with 57% of them having an EDSS level of physical disability of 3 orhigher. Only 7% had normal vitamin D levels. The results indicate a significant prevalence of vitamin D deficiency among patients with RRMS and suggest the need for regular monitoring and correction of vitamin D levels.
Conclusion. The study highlights the importance of the role of vitamin D in the context of multiple sclerosis and suggests that correcting vitamin D levelsmay play a key role in improving disease activity. Additional research is recommended to confirm the results and develop recommendations for practical application in clinical practice.

Introduction. This article describes a rare clinical case of Wernicke encephalopathy
in a primigravida young woman as a complication of prolon
ged vomiting of pregnancy. Wernicke encephalopathy is a life-threa tening
disease that is caused by acute or chronic deficiency of vitamin B1(thiamine) and can lead to irreversible brain damage.
Purpose of the study. This article describes the case of a 27-year-old patient
with clinical manifestations of Wernicke encephalopathy in order to increase
the awareness of doctors of various specialties regarding this pathology,
since untimely initiation of therapy significantly worsens the prognosis and
increases the risk of disability, and may also lead to death.
Materials and methods. Diagnosis of the disease was based on the collected
medical history (prolonged vomiting of pregnant women with a significant
decrease in body weight, nutritional imbalance) and characteristic clinical
manifestations of the disease, in combination with electrolyte disturbances.
Basic therapy with thiamine and correction of electrolyte disturbances were
carried out.
Results. The importance of timely diagnosis and the validity of early initiation
of treatment with high doses of thiamine are indicated.
Conclusion. The described clinical case is of interest to doctors of various
specialties: obstetricians-gynecologists, neurologists, psychiatrists, anesthesiologists-
resuscitators, since it has a low incidence, a blurred clinical picture
at the onset of the disease and the absence of early specific examination
methods, which significantly complicates timely diagnosis and, as a result,
may influence the effectiveness of therapy.

Introduction. Traumatic brain injury leads to a pronounced remodeling of
the microcirculatory bed of the brain. Currently, the positive neuroprotective
effect of the drug glibenclamide on the microcirculation system of the brain
has been proven. However, the effect of glibenclamide on the condition of
the cerebellum in traumatic brain injury remains a little-studied topic.
The aim of the study was to find out the peculiarities of the effect of glibenclamide
on changes in the cerebellum against the background of traumatic
brain injury.
Materials and methods. The work was performed on 106 white male rats
weighing 200-250 g. The animals were divided into 2 series: 1st without the
use of glibenclamide, 2nd with the use of glibenclamide. The data obtained
in healthy rats were used as a comparison. TBI was reproduced by free fall
of a metal weight on the parietal-occipital region of the animal. After 1 hour
and 24 hours after TBI reproduction, the animals were injected with micronized
glibenclamide at a dose of 0.1 mg / kg per os. After 3 days, the animals
were removed from the experiment by overdosing on chloroform.
Supravitally, the blood vessels were injected with a suspension of black ink.
The cerebellar brain was removed from the skull and the material was taken,
followed by the manufacture of histological preparations stained with hematoxylin-
eosin and Van Gieson. The preparations were examined under an
Olympus B×40 microscope (Japan) with simultaneous logging and microphotography.
Results. The cerebellar vascular bed in traumatic brain injury during treatment
with glibenclamide is characterized by an expansion of the lumen of
its links, which is associated with the effect of the drug on the membrane
channels of endothelial and smooth muscle cells of the vascular wall. At the
level of the capillary link of the MCR, there is no porosity and increased
permeability of the vascular wall, cytotoxic and ionic edema are poorly expressed.
The concentration of basket and stellate cells in the molecular layer
decreases, in the granular (granular, stellate, fusiform) it increases, in the
ganglion (pear-shaped) it does not change relative to the initial data.
Conclusions. Glibenclamide does not completely prevent, but significantly
reduces the degree of remodeling of neurons and neuroglia of the cerebellar
cortex after traumatic brain injury.

Introduction. Guillain-Barré syndrome (GBS) is a rare aberrant autoimmune
reaction that is preceded by infections, accompanied by damage to the peripheral nervous system with demyelination and secondary axonal damage.
The purpose of the study is to describe a clinical case of Guillain-Barré
polyneuropathy, which developed in a young woman of 22 years old with
the identification of a generalized predominantly distal motor-sensory neuritis, with a level of axonal-demyelinating lesion of a significant degree of
severity.
Materials and methods. The article describes a clinical observation of Guillain–Barré syndrome in a 22-year-old young woman. As a result of the infection, she developed symptoms in the form of peripheral tetraparesis,
sensory disorders with gradual regression of neurological symptoms. A differential diagnosis with inflammatory, infectious and neoplastic lesions of
the spinal cord was carried out, magnetic resonance imaging of the spinal
cord was performed, and the cerebrospinal fluid was examined. Data from
an electroneuromyographic study of the patient confirmed damage to the
peripheral nerves. Thus, Guillain–Barré syndrome was verifiedin the patient.
Results. Against the background of the use of specific therapy, including
plasmapheresis and intravenous administration of human immunoglobulins
G at a dose of 0.4 mg per day for 5 days daily, and symptomatic treatment,
the patient’s condition gradually improved, neurological symptoms regressed completely due to the fact that Guillain-Barré syndrome is a rare
disease of the peripheral nervous system; knowledge of the features of its
clinical course allows an earlier correct diagnosis to be made and effective
treatment to be prescribed.
Conclusions. 1. Patients with Guillain-Barré polyneuropathy must be hospitalized in institutions where there is an intensive care unit or intensive care
unit for timely assistance.
2. Quickly started differential diagnosis, laboratory and instrumental tests,
such as cerebrospinal fluid analysis, determination of antibodies to gangliosides and enmg can accurately establish the diagnosis and allow the correct
initiation of therapy.
3. Timely initiation of therapy with plasmapheresis or immunoglobulin will
allow for regression of symptoms and save the patient’s life.

Introduction. Venous cerebral infarction occurs in young patients under the
age of 45, mainly women, and it can develop without manifestations of concomitant sinus thrombosis.
The purpose of the study. To describe the clinical and neuroimaging features
of the course of venous stroke on the example of a clinical case of cerebral
venous thrombosis in a young 41-year-old woman who developed against
the background of oral contraceptives.
Materials and methods. The diagnosis of the disease was based on clinical
data, the results of instrumental and laboratory studies. Treatment was carried out according to the clinical protocol for the management of patients
with ONMC ischemic stroke at the hospital stage.
Results. This clinical case demonstrates the importance of taking into account all risk factors for thromboembolic events in women of reproductive
age taking oral contraceptives.
Conclusion. Greater caution is needed regarding thrombophilic conditions
and careful laboratory and instrumental follow-up of women to identify diseases that may cause complications such as cerebral venous thrombosis
against the background of combined hormone therapy.

Introduction. Transverse myelitis is an extremely rare neuroinflammatory
disorder. Almost half of the affected patients develop para- or tetraplegia associated with urinary tract and intestinal dysfunction. It is believed that intestinal dysfunction can be treated with dietary nutrition and laxatives.
The purpose of the study. Analysis of anamnestic, clinical, laboratory and
instrumental data on the medical history of a 50-year-old woman with diagnosed transverse myelitis complicated by refractory intestinal dysfunction,
which led to intestinal perforation and death.
Materials and methods. The diagnosis of the disease was based on clinical
data, the results of instrumental and laboratory studies. The treatment was
carried out with hormonal and anticholinesterase drugs.
Results. The importance of timely diagnosis of intestinal dysfunction and
neurogenic bladder in transverse myelitis is indicated .
Conclusion. Although constipation is considered benign in transverse
myelitis, complicated forms of constipation in people with transverse
myelitis can be fatal.

Introduction. Opticoneuromyelitis, or Devik's syndrome, is an inflammatory
demyelinating disease of the central nervous system, affecting mainly the
optic nerve and spinal cord. The clinical picture is characterized by a combination of syndromes of optic neuritis and longitudinally transverse
myelitis. Imaging techniques such as optical coherence tomography, evoked
potentials, and magnetic resonance imaging are used for diagnosis. Currently, the key method of making a correct diagnosis is the detection of a
specific serological marker — antibodies to aquaporin-4 (NMO-IgG), the
titer of which correlates with the activity of the disease and helps to conduct differential diagnosis.
The purpose of the study. To analyze the current scientific literature on
Devik's opticoneuromyelitis and present a clinical case report from our clinical practice.
Materials and methods. In the patient whose medical history was described
in this article, the diagnosis was established based on diagnostic criteria for
ONM Devika.
Results. In a 41-year-old young woman, neurological symptoms were represented by optic neuritis, myelitis and pelvic organ dysfunction. The diagnosis was confirmed based on the medical history of the disease, as well as
neuroimaging and laboratory studies.
Conclusion. With timely diagnosis and adequate pathogenetic therapy, Devika's opticoneuromyelitis has a relatively good prognosis and the potential
to restore lost motor and visual functions.

Introduction. Traumatic brain injury (TBI) is a leading cause of death and
disability. Cognitive impairment is one of the most common consequences
of brain injury.
The aim of the study- Traumatic brain injury (TBI) is a main cause of death
and disability. Cognitive impairment is one of the most common consequences of brain injury. The purpose of this study is to assess the neuropsychological features of cognitive alterations in men and women who have had
a concussion.
Materials and Methods. 136 patients with consequences of concussion were
examined. The average age of the subjects was (32.8±3.6 years). A neuropsychological study was performed: Mini Mental State Examination; Frontal
Assessment Battery; “10 words” test; Schulte test; verbal association test.
Results. In both groups there were no difficulties in the simple choice reaction, in performing dynamic praxis, and in assessing the grasping reflex, but
there were slight difficulties in conceptualization. The differences in delayed
recall scores were significantly different from the control group (P<0,05),
also indicating cognitive deficits. During the attention test, number finding
in the two groups was outside the normal range of the control group.
Conclusions. The identified features of cognitive deficit were in the nature
of neurodynamic disorders in the form of slowed mental activity and lack
of concentration.

Introduction. Of all the victims, only 30% of patients can continue a fullfledged lifestyle, and 10% will remain with severe motor deficits. Motor
deficit is the fundamental cause of disability in patients, however, with appropriate rehabilitation treatment for six months, maximum restoration of
motor activity occurs, helping to improve the quality of life and return to a
full life.
The aim of the study- to evaluate the impact of rehabilitation on the quality
of life of patients with ischemic stroke.
Materials and Methods. 50 patients who suffered an ischemic stroke were
examined, the average age of whom was 59.3±7.1 years, of which 20 were women and 30 were men. All patients were administered a questionnaire on
the SS-QOL scale (stroke scale-quality of life) upon admission and upon
discharge.
Results.Upon admission, patients had an average quality of life value of
134.4±32.4 points, out of a maximum possible 245 points. At discharge, this
indicator increased significantly and amounted to 210.84±27.3 points. During rehabilitation, indicators such as energy, family role, mobility, mood,
self-care, social role, upper limb function and productivity significantly improved (p<0.05).
Conclusions. Quality of life can be considered an integral indicator in the
rehabilitation of stroke patients. Early comprehensive rehabilitation affects
all aspects of life.

Introduction. Tuberous sclerosis (TS), also known as epiloia, is a rare genetic
disorder of autosomal dominant inheritance with a prevalence of one in 6,000
to one in 12,000.
The aim of the study - To analyze the current scientific literature on tuberous
sclerosis and present a case report from our clinical practice.
Materials and methods. The patient whose medical history was described in
this article was diagnosed based on diagnostic criteria for tuberous sclerosis.
Results. We present magnetic resonance imaging (MRI) findings of a thirteen-
year-old boy with multiple facial angiofibromas, epileptic syndrome
and skin pigmentation spots, who was referred to the URFA Medical Center,
followed by DNA testing by clinical sequencing.
Conclusion. Since the disease is rare, doctors in Kyrgyzstan are not entirely
familiar with the clinic and the nuances of diagnosis. However, timely determination
of diagnostic criteria for tuberous sclerosis helps prevent complications
of this disease and improve the quality of life of patients with this
diagnosis.

Introduction. Symptomatic temporal lobe epilepsy is a form of epilepsy that
develops due to the presence of structural pathology in the temporal lobe.
The purpose of the article is to describe a clinical case of symptomatic temporal
epilepsy in a young patient with mesial sclerosis and polymorphic seizures.
Materials and methods. Clinical data, the results of EEG review and threehour
video-EEG monitoring, and brain MRI were used to diagnose this disease.
Brain MRI showed the presence of a structural defect in the form of
temporal mesial sclerosis with subatrophy of the left hippocampus. Carbamazepine
200mg 2tab 2 times a day was recommended for treatment, recommendations
were given to follow the daily regimen, keep a seizure diary,
monitor liver tests once every 3-6 months and follow-up.
Results. The importance of correct and timely diagnosis of temporal lobe
structural epilepsy, which is complicated by polymorphism of convulsive
seizures and presence of postictal symptoms of prolapse, postural dystonic
settings of limbs in this disease in addition to them, was determined in order
to prescribe appropriate conservative or consider surgical treatment.
Conclusions. Temporal lobe epilepsy has its own peculiarities in comparison
with other forms of this disorder and is a difficult-to-cure disease due to its
high pharmacoresistance; however, at the first stage of detection of this
pathology in some cases it is possible to achieve a good effect from the use
of antiepileptic drugs. The development of new technologies and a comprehensive
approach to examination may significantly improve our understanding
of this neurological condition and, consequently, optimize treatment
strategies and patient support.

Introduction. Amyotrophic lateral sclerosis (ALS) is a severe rare neurodegenerative
disease that is characterized by clinical and pathogenetic heterogeneity.
Clinical heterogeneity consists in the initial localization of the
pathological process, the variability of symptoms of combined damage to
both upper and lower motor neurons, the age of debut, the rate of progression,
hereditary predisposition and the presence of non-motor symptoms.
The key method of making a correct diagnosis is also the identification of
genes associated with familial forms of the disease.
The purpose of the study: To describe the familial form of amyotrophic lateral
sclerosis, in order to increase the understanding and awareness of doctors
about this disease.
Materials and methods. A patient with amyotrophic lateral sclerosis with a
family history, who underwent genetic analysis to identify mutations in genes
associated with the familial form of the disease.
Results. In a middle-aged 54-year-old woman, the clinical picture is represented
by progressive symptoms of damage, mainly to peripheral motor neurons
of the spinal cord. The diagnosis was confirmed by the detection of a
mutation in the PFNI 1 gene encoding the profilin -1 protein.
Conclusions. The presented case highlights the complexity of diagnosis
caused by genetic and clinical features and limitations in conducting genetic
research. An article about the analysis of familial amyotrophic lateral sclerosis,
a rare neurodegenerative disease with pronounced clinical and pathogenetic
heterogeneity. The article discusses various aspects of familial
amyotrophic lateral sclerosis, including its clinical characteristics, genetic
factors, studies and mutations associated with the development of the disease.
In most cases, familial forms are caused by changes in genes such as
SOD1 (superoxide dismutase), C9orf72 (chromosome 9 open reading frame
72), TARDBP (transactive response protein) and FUS (transcription factor).
The authors emphasize the importance of genetic analysis in diagnosis and
understanding of the molecular mechanisms of the disease. Finally, we provide
our own clinical observation, emphasizing the rarity and complexity of
diagnosing familial amyotrophic lateral disease sclerosis.

Introduction. Due to the widespread introduction of family medicine in Kyrgyzstan,
the issues of management of patients with concomitant neurologic
pathology in many diseases are relevant today. While comorbid patients with
atherosclerosis, diabetes mellitus, GB, coronary syndrome are studied every where, rare pathologies remain poorly studied and unknown to a wide range
of physicians. In this regard, we wanted to present a case of related pathology
of internists, endocrinologists, rheumatologists, orthopedists and neurologists
- Paget's disease.
The purpose of the work is to tell the main clinical and functional manifestations
of the disease, for alert study in the consultation of patients with pain
syndrome in the lower back and joints, in the practical work of the doctor.
Materials and methods. In the materials of work the history of the disease,
somatic and neurological picture of the disease is reported. The main instrumental
method of diagnostics is radiography and analysis of alkaline phosphatase
in blood.
Results. The results show that the main clinical manifestations of the disease
are pain syndrome in the bones and along the spine, bone deformation,
pathologic fractures, deafness and blindness due to lesions of the bones of
the skull, confirmed radiologically. Laboratory confirmation of Paget's disease
is an increase in alkaline phosphatase activity.
Conclusions. The conclusion of the work was that the high prevalence of
pain syndrome in joints, bones and spine among the entire population of
Kyrgyzstan suggests a possible more frequent prevalence of Paget's disease
and dictates the need to inform doctors of this nosology.

Introduction. The absence of an ischemic focus on the MRI of the brain in
ischemic stroke is not uncommon, therefore, when establishing the diagnosis
of ischemic stroke, neurologists should be careful to exclude this diagnosis.
It is known that the role of MRI in the diagnosis of stroke is the "gold standard".
The purpose of the study. To describe clinically the case of MR negative ischemic
stroke in 53-year-old women, based on the analysis, clinical and laboratory
and neuroimaging data of the patient.
Materials and methods. The patient, whose medical history was described
in this article, was diagnosed based on anamnesis, acute focal neurological
deficit, laboratory and instrumental data, and differential diagnosis.
Results. In our patient described in this article, neurological symptoms were
represented by hemispheric symptoms indicating damage to the brain regions
supplied with blood by the middle cerebral artery (SMA) on the left,
against the background of elevated blood pressure (150/90). Additional laboratory
and instrumental studies have revealed vascular risk factors (dyslipidemia,
atherosclerotic vascular damage of the brachiocephalic trunk and
heart valves). With neuroimaging as on a low-floor (1.5 Tesla) Similarly,
high-field MRI (3 Tesla) in DWI and other modes did not produce images
with foci of ischemia in brain structures. Angiography of the cerebral vessels
revealed a variant of the development of the Villisive circle structure according
to the type of incomplete trifurcation of the ICA on the right, which
could not lead to the development of this neurological symptoms, since the
existing symptoms topically did not correspond to this localization.
Conclusion. It is extremely important that clinicians are aware of the current
limitations of the diagnostic sensitivity of DWI for the detection of acute ischemia,
so as not to miss the opportunity to treat patients with acute ischemic
stroke with thrombolysis and endovascular thrombectomy.

Introduction. Ischemic stroke is characterized by damage to brain tissue, a
violation of its functions due to difficulty or cessation of blood flow through
the vessels to a particular part of the brain. It can be caused by insufficient
blood supply to a certain area of the brain due to a decrease in cerebral blood
flow, thrombosis, embolism or related vascular, heart or blood diseases and
is one of the main causes of mortality among people.
The purpose of this study was to study the effect of the stenosing and occlusive
process of cerebral vessels on the course and outcome of ischemic
stroke.
Materials and methods. We conducted a pathomorphological examination
of the cerebral vessels of 27 deceased patients in the acute period (up to 21
days) from ischemic stroke, the state of the lumen (complete and partial occlusion)
was determined by morphometry.
Results.As a result of the study, we found that atherosclerotic plaques were
the stenosing and occlusive processes of cerebral vessels in ischemic stroke,
and their severity was very diverse. Vessels on their side (infarct hemisphere)
and on the opposite side, along with large and small arteries, were prone to
stenosis. In addition, various vascular anomalies were detected in the nature
of branching, the absence of connective arteries and vascular hypoplasia in
almost all of the examined patients. Plaques were localized in more than
half of the cases in the system of the Willis circle and in the trunk of the
deep branches of the intracerebral arteries.
Conclusion. Acute occlusion of cerebral vessels, with insufficiency, the state
of hemodynamics on the opposite side, affects the course and outcome of
the disease, which is clinically manifested by the progression of neurological
symptoms in response to not only acute ischemia, but also chronic.

Introduction. Stroke is considered the second leading cause of death worldwide
with an annual mortality rate of about 5.5 million people. The burden
of stroke is not only associated with high morbidity and mortality, but also
high disability (up to 50% of stroke survivors become chronically disabled).
The purpose of this study was to assess the epidemiological situation of
stroke with a retrospective analysis of morbidity and mortality data in the
Kyrgyz Republic (KR).
Materials and methods. Statistical indicators such as intensive, extensive,
tendency, average long-term level of morbidity and mortality were calculated
to assess the dynamics of morbidity (first reported cases) and mortality from
stroke for the period 2005-2022 in the republic according to the annual official
statistical collections of morbidity and deaths from stroke of the Electronic
Health Center of the Ministry of Health of the KR.
Results. The analysis of available statistical data has shown that the level of
stroke morbidity (incidence) and mortality in the population as a whole in
the republic from 2005 to 2022 has a positive downward trend. A comparative
analysis of statistical data on stroke morbidity and mortality per 100,000
population shows that the mortality rates significantly exceed the morbidity
rates from 1.3 times to 2.4 in different years. In the structure of strokes according
to postmortem diagnoses, the diagnosis of "Unspecified strokes,
such as hemorrhage or I64 infarction" has a high proportion.
Conclusions. Mortality rates from stroke exceeding the incidence of stroke
require verification of the diagnosis of stroke in people who died on an outpatient
basis based on an analysis of primary medical documentation and
cardinal correction of medical statistics in relation to cerebrovascular diseases
in the KR. A large percentage of unspecified strokes may indicate that
there were doubts when making a post-mortem diagnosis of stroke.

Introduction. One of the most common forms among facial nerve neuropathies
is Bell's palsy (idiopathic facial neuropathy). The pathological process has an acute onset, more often the symptoms of the lesion develop on
one side with a tendency of progression within 48-72 hours. Data on risk
factors, pathogenetic mechanism of Bell's palsy development, drug therapy
and methods of surgical treatment are presented. Basic therapy with a short
course of valacyclovir or acyclovir and a stepwise reduction in the optimal
dose of prednisolone, initiated within three days of symptom onset, increases
the chances of complete recovery.
Purpose of this review. Аims to provide comprehensive information on Bell's
palsy, focusing on anatomy, aetiology, clinical features, diagnosis, clinical
implications and preferred approaches to therapy.
Materials and methods. The materials of the Web of Science Core Collection
database (Science Citation Index Explanded and Social Sciences Citation
Index) were used in this work, as they cover the most important sources in
sufficient quantity to obtain objective information. A comprehensive search
of the databases was conducted, limited to 2002-2021 and including only
original articles and reviews.Results and Conclusions. Having analysed the literature data for 20 years,
it was concluded that the majority of authors adhere to the pathogenesis of
Bell's palsy development associated with compression of the facial nerve in
the phalopian canal as a result of inflammatory oedema. The diagnosis of
idiopathic facial neuropathy is made by exclusion and requires careful history
taking and a thorough clinical examination. If provided by history or
risk factors, the patient should be investigated for Lyme disease, diabetes
mellitus and other conditions. Incomplete eyelid closure followed by dry
eye, dysphagia and slurred speech are common short-term complications.
Contractures and weakness of mimic muscles and hemispasm are not uncommon
long-term complications. Although most patients recover spontaneously,
treatment with a short course of valacyclovir or acyclovir and a
stepwise reduction in the optimal dose of prednisolone, started within three
days of symptom onset, is thought to increase the chances of complete recovery.

Introduction. Acute vertebrobasilar insufficiency (IBD) is a condition characterized
by impaired blood supply to the brain due to compression or obstruction
of the vessels of the vertebrobasilar system.
The purpose of the study: To conduct a bibliographic search and an assessment
of the elaboration of the topic of VDNH, in order to expand their research.
Materials and methods. A review of modern literature has been conducted
for the period from 2019-2024. Publications by foreign authors, as well as
from neighboring countries of Kyrgyzstan, were available for study.
Results. Modern research, clinical aspects, including concepts of prevalence,
etiopathogenesis, topographic anatomical features, and diagnostic tools are
presented.
Conclusions. The implementation of diagnostic measures for vertebrobasilar
arterial insufficiency continues to be an urgent task, the solution of which
will increase the effectiveness of the prevention of IBD.

Introduction. At the moment, severe acute respiratory infections remain very
relevant, not only in the world, but also in the Kyrgyz Republic.
Of particular interest are pathogens discovered not so long ago, one of which
is human Metapneumovirus.
Human metapneumovirus was first isolated from a sick person at the end of
2001 in the Netherlands.
Goal. Obtaining more complete information about Metapneumovirus infection
and its clinical and epidemiological characteristics. The epidemiology of human metapneumovirus is not yet fully understood,
but it is known that this virus is distributed throughout the world and can
cause disease in people of all age groups. Such a review has not previously
been conducted in the Kyrgyz Republic.
Materials and methods. In the Kyrgyz Republic, sentinel epidemiological
surveillance of severe acute respiratory infections and influenza-like diseases
has been organized, which is carried out in 3 cities of the republic:
Bishkek, Osh, Tokmak. All data is entered into a single program fly. dgsen.
This database was analyzed from week 40 of 2022 to week 15 of 2024, of
all types of severe acute respiratory infections MP, 270 cases were registered,
all of these cases were included in the analysis.
Results. The results of this review indicate that metapneumovirus infection
can occur in all age groups, but is more common in children under 4 years
of age.
Conclusion. The data obtained clearly show the significance and contribution
of metapneumovirus infection in the development of severe acute respiratory
infections in children.

Introduction. In the Kyrgyz Republic there has been a sharp increase in the
incidence of measles over the past two years. The main reason for the increase
in morbidity is the refusal of preventive vaccinations. Due to the current
situation and in order to stop the further spread of infection, we decided
to make a comparative analysis of measles in Kyrgyzstan.
The aim of the study. To study the comparative clinical and epidemiological
characteristics of measles in Kyrgyzstan.
Materials and methods.The data of the Republican Infectious Diseases Hospital
in Bishkek for the period from 2018 to August 2023 are analyzed. 2,469
cases of measles were registered, of which 1,173 (48%) cases were laboratory
confirmed, 515 (21%) cases were clinically confirmed and 781 (31%)
cases were epidemiologically determined.
Results. In Kyrgyzstan, the incidence of measles continues to grow. The increase
in the incidence of measles in Kyrgyzstan is associated with the refusal
of vaccination.
Conclusions. Measles vaccination is mandatory all over the world, therefore
vaccination is carried out strictly and permissive moments are not allowed
for various reasons, whereas in Kyrgyzstan the population does not comply
with the order of the Ministry of Health and this is due to the high incidence
of measles.

Introduction. Acute flaccid paralysis (AFP) monitoring in the Kyrgyz Republic
aims to detect cases suspected of poliomyelitis and to identify areas
where poliomyelitis may be poliomyelitis circulation. An outbreak of poliovirus
type 2 in a neighboring country in 2021 is a threat to Kyrgyzstan as
well. The outbreak of poliovirus type 2 in a neighboring country in 2021 po
ses a threat to Kyrgyzstan as well, which calls for a study, assessing the surveillance
system to identify the strengths and weaknesses of the system.
Methods and purpose of the study -The purpose of the evaluation of the acute
flaccid paralysis and poliomyelitis surveillance system is to determine the
importance of the system, identify strengths and weaknesses, and develop
recommendations for system improvement. The assessment was conducted
using a descriptive-cross-sectional method according to CDC guidelines,
using data from logbooks and the AFP case database from 2011 through
2022.
Results. The AFP surveillance system was introduced in 1997 and monitors
AFP cases, vaccination. During the Emergency in 2020-2021 in the neighboring
republic, the system was put on high alert to detect signs of poliovirus
transmission, where the indicator for detection of AFP from 1 case was
raised to 2 cases per 100,000 children under 15 years of age. The system is
operational in all regions of the country, detecting an average of 1, 4 to 4, 5
cases of AFP per 100,000 children under 15 years of age at the national level.
But at the sub-regional level for 2021-2022, the detection rates of AFP in
5/9 and 2/9 regions were below the required indicators. In addition, there
are "silent regions" with zero detections for 2021-2022. Timeliness of detection of AFP cases for 2022 was 69% and timeliness of sampling was 77%.
Conclusions. The surveillance system for AFP in the Kyrgyz Republic is
simple, flexible but untimely. Active detection needs to be strengthened in
the system to achieve the detection indicator of AFP. For early referral at
the appearance of symptoms of acute respiratory infection to medical organizations
it is necessary to intensify sanitary education work among the
population.

Introduction. The article describes the epidemiological and clinical characteristics
of meningococcal infection during the epidemic rise in morbidity
in 2019 -2023. The serogroup landscape of isolated strains of Neisseria me
ningitidis was studied. It is shown that all isolated strains have no resistance
to antibacterial drugs, which are used as first-line and reserve drugs in the
treatment of generalised and localised forms of meningococcal infection.
To study the epidemiological and clinical features of meningococcal infection
(MI) during the 2019 -2023 upsurge and antibiotic sensitivity of N.
meningitidis bacteria isolated from patients.
Materials and Methods.A retrospective analysis of statistical data of the Department
of Disease Prevention and State Sanitary and Epidemiological Surveillance
and case histories of the Republican Clinical Infectious Diseases
Hospital of Bishkek was carried out.
Results.The proportion of adolescents and young adults increased among
the patients. All patients had severe course of the disease, with predominance
of meningococcemia and mixed forms. Serogroup landscape of isolated
strains of meningococci was represented by serogroups B, A, W135, X. All
serogroups of meningococci are sensitive to antibacterial drugs used for
treatment of generalised forms of meningococcal infection.
Conclusions. Serogroup B prevailed among the isolated strains of meningococci.
All isolated strains of Neisseria meningitides are not resistant to antibacterial
drugs, which are used as first-line and reserve drugs in the
treatment of generalised and localised forms of meningococcal infection.

Introduction. People living with HIV are monitored and treated at AIDS
Centres for the rest of their lives, and they have a significant impact on the
health budget. Evaluation of the surveillance system is vital to identify gaps
in the system and ensure that the quality, effectiveness and usefulness of the
system are improved. This study was conducted to assess the HIV epidemiological
surveillance system by attributes in order to identify shortcomings
and develop recommendations for improving the system in the Sughd region.
Materials and methods. A descriptive cross-sectional study was conducted
using updated guidance from the U.S. Centers for Disease Control and Prevention
between January and May 2023. The attributes of the system were
evaluated: usefulness, simplicity, timeliness, acceptability, representativeness,
stability.
Results and discussions. The system is useful because it evaluates the situation
and makes decisions based on it. The timeliness was 54% according
to the reporting form No.4. Only 60 per cent of epidemiological investigati
ons of new HIV cases were conducted on time. The eligibility rate was
100%, and all health facilities are ready to detect HIV cases. The system is
also representative and stable, as it covers all local government districts,
people of all ages, and all institutions have been provided with the necessary
materials and technical means.
Conclusion. The HIV surveillance system in Sughd Oblast is useful, acceptable,
representative and stable, but not simple or timely. Close cooperation
between the staff of the AIDS Center and medical organizations, as well as
the training of responsible persons, can alleviate the complexity of the system
and increase the level of timeliness.

Introduction. The city of Batken is located in the South of the Kyrgyz Republic,
where climatic and geographical conditions contribute to the development
of agriculture. We initiated a study of the health conditions of
women living in this area.
The purpose of this sociological research was to identify the influence of
unfavorable environmental factors on the health of women living in the city
of Batken and its surrounding areas.
Materials and Methods.The research used a standardized questionnaire from
the World Health Organization (2016), which included 7 sections and consisted
of 43 questions. A total of 63 women, over 18 years of age, of reproductive age participated in the research.
Results. The survey revealed a poor diet, since their daily diet includes only
meat/meat products, locally grown rice, as well as vegetables grown on their
own garden. It is not typical for survey participants to consume seafood and
poultry products. All respondents answered that they did not work in the industrial
sector and did not have contact with harmful production factors, including
members of their families, but 5 women noted that they had contact
with pesticides.
Conclusions. The results of the sociological study conducted among women
of Batken city indicated that the negative impact on their health is mainly
due to social and household factors (low income, quality and condition of
the living environment), as well as an unbalanced and insufficient diet.

To reveal the time of education, stages and ways of development improvement connection with the Department of
Histology and Pathological Anatomy of Osh GU.