№4 (2025)

Introduction. The choice of the optimal method of surgical treatment for liver echinococcosis remains controversial.
Traditionally, organ-preserving surgery has been preferred, but radical methods of treating hydatid echinococcosis are now widely developed and used. While organ-preserving surgery has traditionally been preferred, radical methods of treating hydatid echinococcosis of the liver are now widely developed and used.
The aim of the study was to evaluate the immediate and long-term results of organ-preserving and radical surgical interventions.
Materials and methods. 359 patients with hydatid echinococcosis of the liver were examined. Of these, 299 (83.3%) had primary echinococcosis and 60 (16.7%) had recurrent echinococcosis. There were 176 men (49.0%) and 183 women (51.0%) .
Results. Traditional organ-preserving interventions were performed in 232 (64.4%) patients. The postoperative mortality rate was 0.9% (n=2). Postoperative complications developed in 46 (18.9%) patients. Recurrences of the disease were noted in 12 (5.2%) patients.
The most common complication was residual cavity, which was observed in 28 (12.1%) patients; of these, 10 (4.3%) patients had suppuration.
Radical surgical treatment was performed in 127 patients, with a fatal outcome in 2 (1.6%) patients. Postoperative complications were noted in 14 (11.0%) patients. The most common were hemorrhagic and biliary complications, detected in 9 patients. Intra-abdominal bleeding was observed in 5 patients: in 4 patients, it was moderate and was controlled by conservative hemostatic therapy, and one patient required relaparotomy to stop bleeding in the early postoperative period. Liver failure developed in two patients after extensive liver resections and combined operations, and in both cases it was successfully corrected with drug therapy.
Conclusion. Radical removal of the fibrous capsule along with perikystic tissues (pericystectomy, liver resection) is a technique that improves both immediate and long-term results of surgical treatment of liver echinococcosis.

Introduction. Stevens-Johnson syndrome (SJS) is a rare, predominantly drug-induced, life-threatening, acute skin and mucous membrane disorder classified as an acute, severe toxic-allergic disease. This manifestation of a delayed-type hypersensitivity reaction represents a severe variant of erythema multiforme, in which, along with skin lesions, mucosal lesions (of at least two organs) are observed. The incidence of SSc progressing to a severe form worldwide averages the incidence is 1.3 cases per million population, with a mortality rate reaching 10%. The disease can be triggered by various infections, cancer, and other conditions. In 50% of cases, the cause of SSD remains unknown. Drug allergies are of particular importance in the development of SSc, since for most drugs the risk of sensitization ranges from 1 to 3%. The main drugs that can lead to the development of SSc are antibiotics, non-steroidal anti-inflammatory drugs, local anesthetics, antiepileptic drugs, barbiturates, and vaccines. A drug-related cause can be established if the condition occurs within the first 4 weeks of treatment. Stevens-Johnson syndrome is currently considered a severe pathological process characterizedby high mortality, making it a serious clinical and dermatological problem requiring timely diagnosis and intensive treatment. The mortality rate from Stevens-Johnson syndrome is 5–12%. Advanced age and the presence of comorbidities are significant risk factors that increase mortality.
Study objective: To describe the clinical course and treatment of SSc as a complication following carbamazepine administration and to outline preventive measures.
Materials and methods. Two clinical cases of carbamazepine-induced Stevens-Johnson syndrome are presented in patients treated in the dermatology department of the Republican Center for Dermatovenereology (RCDV). The patients were hospitalized in August–September 2025 (informed consent was obtained from patients).
Results and discussion. Patients were clinically monitored at the Russian
Center for Child Welfare and received treatment for 10 days. Following this, the dynamics of clinical manifestations were described with a detailed photo report. Similar to other countries, in Kyrgyzstan, diagnosis and timely treatment of Stevens-Johnson syndrome are a challenge. Estimating specific statistics and the prevalence of the disease in Kyrgyzstan is difficult due to limited data availability. However, taking into account general global trends, it can be assumed that patients taking certain groups of drugs are at increased risk. It is important for physicians and patients to be aware of the potential
for drug reactions and the need to seek immediate medical attention at the first sign of symptoms.
Conclusion. All healthcare professionals should strictly avoid re-prescribing carbamazepine to patients with a history of Stevens-Johnson syndrome or other severe cutaneous adverse reactions associated with its use.

Introduction. Benign prostatic hyperplasia remains a relevant issue for men over 60, primarily due to lower urinary tract symptoms that reduce quality of life. Traditional monopolar transurethral resection of the prostate (mono-TURP), despite its "gold standard" status, is inherently a tissue resection method, leaving behind hyperplastic tissue, which increases the risk of recurrence and limits functional improvement.
Objective. To conduct a comparative analysis of the effectiveness and safety of monopolar transurethral resection of the prostate, bipolar plasmakinetic enucleation, and Holmium laser enucleation.Materials and methods. A retrospective study was conducted on 320 patients, divided into three groups based on the intervention method. Intraoperative parameters, complication rates, and the dynamics of the International Prostate Symptom Score, maximum urinary flow rate, and post-void residual volume were assessed over a 12-month period.
Results and discussion. Enucleation techniques were found to be more radical. Holmium laser enucleation demonstrated the highest efficiency coefficient (1.02 g/min), provided the maximum improvement in functional outcomes (a 3.1-fold increase in maximum urinary flow rate), the minimumlevel of complications, and a significant reduction in the hospitalization period (2.3 days).
Conclusion. Holmium laser enucleation is the safest, most radical, and effective method, especially for patients with large prostate volumes, and should be considered the priority surgical method and the new "gold standard" for benign prostatic hyperplasia.

Introduction. In the Kyrgyz Republic, andrological diseases occupy one of the leading positions in terms of prevalence in the overall structure of morbidity, with a tendency to increase annually, especially among men of reproductive age, and questions regarding their study as factors negatively affecting fertility remain unresolved.
The aim of the study is to assess male fertility in patients with urolithiasis (ICD), after urethroplasty, with purulent-inflammatory diseases of the genital organs and cystic lesions of the epididymis, as well as to identify key markers of deterioration based on the results of a semen analysis.
Materials and methods. To achieve the set goal, four clinical groups of patients with urological and andrological diseases were formed. Each participant underwent a voluntary ejaculate examination within a month after diagnosis. The results were compared with data from a control group of healthy men living in Kyrgyzstan.
Results. The data obtained indicate a decrease in fertility in men of reproductive age with various urological diseases according to the main parameters of the semen analysis, such as ejaculate volume, proportion of normal sperm forms, their motility, viability, and sperm quality index (Farisa).
Conclusion. Monitoring the fertility of men of reproductive age with urological and andrological diseases will reduce the risk of infertility and preserve reproductive potential.

Introduction. Iatrogenic ureteral injuries are serious complications occurring during pelvic and abdominal surgeries. These injuries significantly affect patients’ quality of life and require timely diagnosis and effective treatment. The study aims to investigate the causes, clinical manifestations, diagnostic approaches, and treatment methods of such injuries.
Materials and Methods. A retrospective and prospective review of medical records of 141 patients with iatrogenic ureteral injuries treated at the National Hospital of the Kyrgyz Republic from 2010 to 2024 was conducted. Diagnosis was based on clinical signs and instrumental methods including ultrasound, CT, and retrograde ureterography. Statistical analysis was performed using SPSS version 24.0.
Results. Of the patients, 87.2% were female and 12.8% male. Most injuries occurred following gynecological surgeries (72.3%) and were localized predominantly in the distal ureter segment (92.2%). Diagnosis was delayed to the postoperative period in 92.9% of cases; only 7.1% were detected intraoperatively. Ureterocystoneoanastomosis was the primary treatment method (68.1%), while 8.5% required nephrectomy.
Discussion. The anatomical position of the ureter and its proximity to pelvic vessels predispose it to injury during surgery. Delayed diagnosis increases complication risks. Minimally invasive and reconstructive surgical techniques improve treatment outcomes.
Conclusions. Early detection and comprehensive management of iatrogenic ureteral injuries reduce complications and improve patients’ quality of life. Preventive measures and diagnostic improvements are essential.

Introduction. Urolithiasis is a common urological disorder with a progressive increase in incidence, particularly in endemic zones such as the Kyrgyz Republic. Percutaneous nephrolithotomy remains the "gold standard" for the treatment of large and staghorn stones. However, the choice of the optimal access tract (upper vs. lower calyx) continues to be debated within the urological community due to differences in efficacy and risk of complications.
Objective: To conduct a comparative analysis of the efficacy and safety of upper-calyceal and lower-calyceal access during Percutaneous nephrolithotomy in patients with large and complex kidney stones.
Materials and Methods. A retrospective study was conducted on 522 patients (mean age 45.5 ± 10.9 years) with primary nephrolithiasis. Patients were divided into Group I (n=215, upper-calyceal access) and Group II (n=307, lower-calyceal access). Comparative analysis assessed the primary stone-free rate, intra- and postoperative complications (according to the Clavien-Dindo classification), volume of blood loss, and incidence of urinary tract infections.
Results. The primary stone-free rate (SFR) was statistically significantly higher in Group II (91.0% vs. 85.8% in Group I, p<0.05). This was attributed to the higher prevalence of staghorn nephrolithiasis in Group I (27.1%). Lower-calyceal access (Group II) was associated with a significantly higher risk of pelvicalyceal system perforation (5.9% vs. 2.8%). Pleural cavity injury was observed only with upper-calyceal access (1.0%). The need for blood transfusion and the incidence of UTIs were higher in Group I (5.1% and 25.1% respectively), which correlated with the complexity of the stones.
Discussion. Percutaneous nephrolithotomy is a safe and effective procedure (low and comparable rate of Clavien-Dindo grade III–V complications in both groups). Differences in efficacy reflect the higher complexity of stones in the upper-calyceal access group, not the superiority of the access method itself. Upper-calyceal access carries a lower risk of pelvic perforation but a minimal risk of thoracic trauma, while lower-calyceal access carries a higher risk of pelvicalyceal system injury.
Conclusion. Percutaneous nephrolithotomy is a safe method for treating nephrolithiasis, and the choice of access must be strictly individualized. Upper-calyceal access is indicated for stones in the upper calyx/proximal ureter and in cases where reducing the risk of pelvic perforation is critical. The final choice of access is determined by the renal anatomy and the complexity of the stone.

Introduction. This article examines the concept of "compliance" (from English compliance - agreement, correspondence) as an indicator of a patient's agreement and willingness to follow medical recommendations, including pharmacotherapy. Compliance reflects the patient's active participation in the treatment process and depends on many factors, such as motivation for treatment, level of knowledge about disease, psycho-emotional state, and social conditions. The importance of trusting interactions between physician and patient, educational programs, and strategies aimed at improving medical literacy are emphasized.
Study objective. To describe current approaches to assessing compliance in patients with acne and rosacea.
Materials and methods. We used scales and questionnaires, as well as practical methods to improve treatment adherence, such as reminders, individual consultations and illustrative materials (photos, slides, videos), which were sent to patients via WhatsApp messenger when necessary.
Results and discussion. The interdisciplinary nature of the study of compliance in patients with acne and rosacea, the need for joint work of medical and psychological specialists, as well as the impact of adherence to recommendations on the effectiveness of therapy and the economic outcome of treatment are described.
Conclusion. Compliance is considered a key factor in treatment success, requiring a comprehensive approach that includes psychological, educational, and organizational measures.

Introduction. The most severe course of pertussis occurs in infants and young children, sometimes leading to fatal outcomes. A previously conducted analysis of pertussis incidence among adults, adolescents, and children from 2014 to 2024 in the Kyrgyz Republic showed that the highest disease rate is observed among the latter. Therefore, it was decided to determine the age group of children most susceptible to pertussis.Objective of the study. Study of pertussis incidence in children under 14 years old by age aspect across regions of the Kyrgyz Republic.
Materials and methods. To calculate the incidence rates per 100,000 children, data from the State Report Form No. 1 "Report on Infectious and Parasitic Diseases" for the period 2014-2024 were used.
Results and discussion. The analysis of pertussis outbreaks in Kyrgyzstan reflects global trends: early outbreaks were associated with infants, while in 2018 and especially in 2023-2024, there was an increase in incidence among older children. The widespread involvement of children in 2023-2024 may lead to the formation of a large group with post-infectious immunity, which is likely to reduce the incidence in the following years.
Conclusion. In recent years, Kyrgyzstan, like other countries, has seen an involvement of older children in the epidemic process, which is due to a decrease in post-vaccination immunity and an increase in the number of unvaccinated individuals. This calls for a revision of the immunoprophylaxis strategy and an assessment of the immune status across different age and regional groups.

Introduction. Vertical transmission of hepatitis B virus (HBV) remains a major problem in perinatal medicine, as it determines the risk of chronic HBV infection in the child.
Study objective. To identify the key risk factors for vertical transmission of HBV and to evaluate the effectiveness of different preventive strategies for neonatal infection.
Materials and methods. A retrospective analysis of data from 231 pregnant women with chronic HBV infection was performed. Serological, molecular biological and laboratory parameters, including the APRI index, were assessed. Statistical analysis was carried out using the χ² test and the Mann–Whitney U test.
Results and discussion. An increased APRI index in pregnant women with chronic HBV infection (p < 0.0001) was identified as the main risk factor for HBsAg-positive status in newborns, emphasizing the importance of fibrosis assessment for predicting vertical transmission. Combined prophylaxis (vaccination plus HBIG) provided complete protection against infection, whereas with vaccination alone HBsAg was detected in 13.1% of infants (p = 0.009). Vertical transmission was observed at all stages of chronic infection, including HBeAg-negative forms with low viremia (< 200,000 IU/mL). Early initiation of tenofovir (TDF) in combination with vaccination effectively prevented viral transmission and may serve as an alternative to HBIG-containing regimens.
Conclusion. The combination of antiviral therapy and specific immunoprophylaxis represents the most effective strategy for reducing the risk of vertical HBV transmission.

Introduction. Cardiovascular diseases develop long before adulthood, with adolescence representing a critical period for the accumulation of risk factors. The use of nicotine-containing products, including electronic cigarettes, as well as sedentary lifestyle and sleep deprivation, adversely affect cardiovascular health. In Kyrgyzstan, data on the prevalence of smoking and vaping among adolescents and their impact on cardiovascular parameters remain limited.
Aim. To assess the prevalence of smoking and vaping among adolescents and their association with cardiovascular parameters, sleep, and physical activity.
Material and Methods. A cross-sectional anonymous survey was conducted among adolescents aged 13–18 years (a total of 68 questionnaires were collected, including 39 boys and 29 girls; mean age 16.2 ± 1.5 years) in shopping centers of the Lenin and Oktyabr districts of Bishkek. The questionnaire included items on habits (vaping, cigarette smoking, duration and frequency), presence of chronic diseases, physical activity, subjective sleep quality, and sleep duration. Heart rate (HR) and blood pressure (BP) were measured in all participants. Data were analyzed using descriptive statistics. Respondents were grouped by age, type and frequency of nicotine use, and sex, and compared according to nicotine use (vaping and/or smoking).
Results and Discussion. Any use of nicotine-containing products was reported by 50.0% of adolescents. Vaping was practiced by 38.2%, cigarette smoking by 35.3%; combined use of vaping and cigarettes by 23.5%; exclusive vaping by 14.7%, and exclusive cigarette smoking by 11.8%. The prevalence of nicotine use was significantly higher among boys (66.7%) compared to girls (27.6%). The relative risk of smoking among boys was 2.4 times higher (RR = 2.42), and the odds ratio for smoking initiation was 5.25 (OR = 5.25) compared to girls; these differences were statistically significant (p ≈ 0.002). The prevalence of nicotine use increased with age, from 0% in the 13–14-year group to 71.4% in the 17–18-year group.
Mean blood pressure (BP) and heart rate (HR) values in the total sample were: systolic BP 116.2 ± 18.1 mmHg, diastolic BP 74.2 ± 16.7 mmHg, and HR 91.2 ± 18.3 bpm. Adolescents using nicotine had higher systolic BP (120.1 vs 112.4 mmHg) and HR (92.6 vs 89.9 bpm). Elevated systolic BP (≥130 mmHg) was observed in 20.6% of respondents; among nicotine users this proportion was 29.4%, compared to 11.8% among non-users. The risk of elevated systolic BP was 2.5 times higher in smokers (RR = 2.5), with an odds ratio of 3.13 (OR = 3.13); these differences were statistically significant (χ² = 4.22, p ≈ 0.04).
Chronic diseases were reported by 13.2% of respondents (including bronchitis, sinusitis, anemia, psoriasis, etc.). More than half of adolescents did not engage in regular physical activity (57.4%), while only 5.9% exercised daily. Mean sleep duration was 7.8 ± 2.2 hours, with some participants reporting severe sleep deprivation (2–4 hours).
Conclusion. This pilot study among adolescents in Kyrgyzstan demonstrated a high prevalence of vaping and smoking, particularly among boys and older adolescents, as well as frequent combined use of nicotine products. Adolescents using nicotine showed higher systolic BP and HR values and a greater proportion of elevated BP. The combination of nicotine exposure, insufficient physical activity, sleep disturbances, and chronic diseases contributes to an unfavorable cardiovascular profile already in adolescence. These findings highlight the need for early preventive programs in schools and colleges, including BP screening, nicotine cessation education, and promotion of regular physical activity.

Introduction. The paper considers current approaches to regulating the radiation technology sector on the territory of the EAEU based on state standard-setting, remote monitoring, and conformity assessment of irradiation services and irradiated products to ensure traceability of circulation, quality, and safety of food and agricultural products when ionizing radiation processing is applied.
Aim of the study. To analyze intergovernmental and state standards of the EAEU member states and international documents reflecting modern approaches to regulating the radiation technology sector based on state standard-setting and remote monitoring, and to conduct experimental research to substantiate optimal processing regimes, in order to justify and develop a Rospotrebnadzor system of standard-setting, control, and traceability in the field of radiation biotechnologies ensuring traceability of circulation, quality, and safety of food and agricultural products treated with ionizing radiation.
Conclusion. Materials and methods. The study was performed through a comparative analysis of the texts of national documents of the EAEU member states and supranational legislation of the EAEU, CU/EAEU technical regulations, and international regulatory documents of the IAEA, WHO, and FAO, as well as an experimental component to substantiate optimal processing regimes, including effective and safe irradiation levels. Product samples used to determine the dependence of quality and safety indicators on the ionizing radiation dose were processed using a UELR-10-10S2 linear electron accelerator with electron energy up to 10 MeV.
Results and discussion. Based on the conducted research, a concept of an effective control and traceability system for ionizing-radiation processing of food and agricultural products was substantiated and developed, and optimal technological regimes and irradiation levels were established for a number of priority product types.
Conclusion. A specialized “Radurization” hardware–software complex was developed using modern remote monitoring tools and artificial intelligence, along with the “Good Practices” voluntary certification system for irradiation processing centers and irradiated products; their key role and the need for industrial implementation were substantiated as the basis control and traceability system in the field of radiation biotechnologies on the territory of the EAEU.

Introduction. The intensive development of the mining industry in the Kyrgyz Republic requires the recruitment of a large number of shift workers to work in mountainous areas. In the domestic literature, the issues of organizing medical care at remote industrial facilities in mountainous areas in the Kyrgyz Republic have not been sufficiently studied.
Research objective. Search and summarization of data on the features of the organization and key components of emergency medical care at remote industrial facilities in mountainous areas in the Kyrgyz Republic.
Material and methods. A search and analysis of 30 literature sources was conducted. The literature data was taken from electronic databases and conference materials on remote healthcare for the period from 2015 to 2025. The literature sources included data on various types of medical care organization in the Russian Federation and the Kyrgyz Republic. In the analysis of literature data, the authors used methods of abstraction and synthesis to highlight key aspects in order to understand the overall picture and general patterns in the organization of emergency medical care at remote industrial facilities, and then to combine the scattered data into a single, coherent system in order to develop an effective model.
Results and discussion. The organization of medical care at UPO in mountainous terrain should be aimed at creating modern medical infrastructure and logistics at the production site, training medical personnel, shift workers, and first aid groups at the production site, and organizing an emergency medical response plan. Medical professionals should undergo regular training in emergency medical care.
Conclusion. Medical support for shift workers in mountainous areas is part of the rapidly developing medical field of remote healthcare in recent years. The issues of organizing medical care at remote industrial facilities in mountainous areas are important due to the intensive development of the mining industry in the Kyrgyz Republic. Active additional research on this issue is needed.

Introduction. Chronic obstructive pulmonary disease (COPD) is a major global public health problem, affecting more than 380 million people worldwide and being the third leading cause of death. In these circumstances, the concept of self-management becomes important — a process in which the patient learns to independently assess symptoms and adjust lifestyle, recognize exacerbations in a timely manner, and control the course of the disease.
Study Objective. To examine the evolution and contemporary approaches to self-management in COPD, evaluate the effectiveness of educational and digital interventions, and identify barriers to implementation, as well as the prospects for adapting international guidelines (GOLD, WHO) within the healthcare systems of the Republic of Kazakhstan and the Kyrgyz Republic.
Materials and Methods. This review included publications retrieved from PubMed, Medline, the Cochrane Library, and elibrary.ru covering the period from 2000 to 2025. More than 60 sources were analyzed, including Cochrane systematic reviews, GOLD clinical guidelines, WHO reports, and studies on the integration of digital technologies into COPD management. The methodological framework was based on the analysis of randomized controlled trials, meta-analyses, and national self-management programs.
Results and Discussion. Self-management has been shown to reduce hospitalization rates and improve quality of life, with meta-analyses confirming its effectiveness across different age groups and disease severities. Traditional patient education models (“COPD schools”) are increasingly being replaced by digital solutions, such as mobile applications, telemedicine, and wearable devices. Emerging approaches, including virtual reality and gamification, enhance patient motivation and adherence to pulmonary rehabilitation activities. Key barriers to implementation include low digital literacy among elderly patients, poor integration of patient-generated data into electronic medical records, and insufficient coordination between healthcare professionals and IT platforms. In Kazakhstan, COPD prevalence is estimated at 6–8%, yet diagnostic coverage and patient self-efficacy remainlow. At the same time, the country’s developed digital infrastructure (eHealth, Densaulyq, Tunduk) provides opportunities for implementing national digital self-management programs at the level of primary healthcare.
Conclusion. Self-management is a critical component of contemporary COPD care, reducing exacerbations, hospitalizations, and improving patient quality of life. Digital technologies—mobile applications, telemonitoring, and wearable devices—enable personalized care delivery. For Kazakhstan and Kyrgyzstan, strategic priorities include developing national self-management protocols, integrating digital data into eHealth systems, and training healthcare providers in remote patient support.