№3 (2022)

Introduction. Urolithiasis is one of the most common urological diseases with an incidence of more than 5%
of the working-age population. A detailed study of the climatic and geographical features and the structure of calculi in
urolithiasis is an urgent study to address the issue of high-quality treatment and prevention.
The purpose of the work: to conduct a physical and chemical analysis of removed stones and to identify the main patterns
of stone formation in patients operated on for urolithiasis, living in various natural and climatic zones of Kyrgyzstan.
Materials and methods.A study of the structural density and chemical properties of stones was carried out in 119 patients
operated on for urolithiasis for the period of 2019-2022, living in various natural and climatic zones of Kyrgyzstan.
Conclusions. The ratio of patients with urolithiasis living in high mountains to middle mountains was 1:2.8. There was
a predominance of men of working age living in the middle mountains (72.7%) and high mountains (80.7%). The average
structural density of stones in patients living in highlands is 1.5 times less compared to patients in the middle altitude
group. Analysis of the chemical structure of stones in patients operated on for urolithiasis revealed the presence of such
chemical elements and compounds as: MgO, CaO, Na2O, SiO2 in all samples. The content of phosphorus ≥10 was 3.7
times more common in patients of the middle altitude group compared to patients in the high altitude group.

The number of patients with end-stage chronic renal failure requiring kidney transplantation is increasing all
over the world. The relevance of the issue of availability of kidney transplantation and the development of organizational
and methodological approaches in the pre- and post-transplantation period in the conditions of Kyrgyzstan is increasing.
The purpose of the study is to conduct a situational analysis of the state of the kidney donation and transplantation system
in the Kyrgyz Republic. Materials and methods: a comparative retrospective analysis of the outcomes of kidney transplantation
in patients with chronic renal failure who underwent kidney transplantation, living in Kyrgyzstan in the late
post-transplantation period, was carried out. Results and conclusions: Since 1999, kidney transplantation has been performed
in 536 citizens of the Kyrgyz Republic of various age groups, 58% of whom were recipients aged 26 to 45 years,
and 8.6% - children under the age of 18 years. Kidney transplantation was predominantly performed in Turkey - 56.5%,
in Kyrgyzstan - 9%, in Tajikistan - 8.8%. An analysis of the degree of relationship between donors and recipients revealed
the prevalence of 1st and 2nd degrees of kinship in 34.1% and 34.7%, respectively. The share of unrelated transplantation
accounted for 8%, and the minimum figure was cadaveric transplantation - 1.9%. In the late post-transplant period, 82.8%
of recipients had satisfactory renal graft function, and 8.0% of patients had loss of renal graft function. The mortality
rate of patients after kidney transplantation was 9.2%, the main cause of mortality was COVID-19 (26.5%), in 18.4% the
cause was not established, in 12.2% - graft rejection, in 10.2% - sepsis and malignant neoplasms of various localizations.
The results obtained allow us to conclude that transplanted kidney recipients are at high risk due to the existing longterm
state of immunosuppression and the presence of many comorbidities.

Currently, there is insufficient provision and access of citizens to certain groups of vital medicines, which include
narcotic analgesics. The article assesses the availability of these drugs in the Chui region with a high population
and a high incidence of oncology in the republic. The purpose of the study was to assess the physical and economic availability
of narcotic analgesics. Material and methods of research: Desk and field studies were carried out, a number of
regulatory legal acts and a survey among pharmacists were studied, with questions about the assortment, pharmacies dispensing
narcotic analgesics and other factors that affect the level of availability of drugs in this group. Results of the
study and conclusion: Strong narcotic analgesics are sold only in 5 pharmacies throughout the region. Lowest availability
in Kemin, Suusamyr. Of the 25 pharmacies participating in the sale of preferential prescriptions for SGBP, only 5 pharmacies
sell strong narcotic analgesics. Morphine (in the form of short-acting tablets and injectable solution) is fully covered
by the SGBP for cancer patients at the outpatient level. The amount of reimbursement for the tablet form of tramadol
is fully covered, and for the injectable form, on average, 73.1% - 76.5% of the cost, and the remaining 26.9% - 23.5% is paid by the patient himself. Fentanyl patches are not covered under the RCA and cost the patient on average 7,562 somsper month.

Aim. To study the features of lipid metabolism disorders in non-alcoholic fatty liver disease in patients with
different body weights in the conditions of inhabited highlands. Material and methods. The study was carried out within
the framework of the project "Etiopathogenetic features and rates of development of non-alcoholic fatty liver disease
(NAFLD) in the conditions of Kyrgyzstan" (No. of state registration MHN / TZ-2020-3). An open comparative study of
patients with two forms of NAFLD: fatty liver (FL) and non-alcoholic steatohepatitis (NASH) (n=236) living in low
mountains (Bishkek, altitude above sea level - 750-800 m, n=111) and inhabited highlands (At-Bashy district , Naryn region,
height above sea level - 2046-2300 m, n=125) Kyrgyzstan. The average age of the patients was 55,7±0,95 years.
Given that genetic factors may play a role in the development of NAFLD, we analyzed a population represented only by
ethnic Kyrgyz. Patients in each group were divided into lean (BMI≤23) and obese (BMI≥23) groups. To determine physical
activity, a physical activity questionnaire was used, which was compiled on the basis of the materials of the International
Physical Activity Prevalence Study www.ipaq.ki.se. Physical examination included measurement of anthropometric
parameters (height, body weight, waist circumference (WC)), calculation of body mass index (BMI), skeletal muscle
mass index (SMM), percentage of body fat. According to the grades of the WHO, the degree of obesity was assessed by
BMI for Asians. Blood samples were taken for research in the morning on an empty stomach after at least 12 hours of
fasting. The following indicators were determined: glucose, lipid spectrum (total cholesterol, HDL cholesterol, LDL cholesterol,
triglycerides), ALT, AST levels. The BARD scale was used as a predictor for assessing the development of liver
fibrosis in patients with NAFLD [1]. The scoring system included three variables: BMI, AST / ALT, and the presence of
DM 2.The diagnosis of non-alcoholic fatty liver disease was made on the basis of history, laboratory tests, ultrasound
examination of the liver, and exclusion of other liver diseases. The results were analyzed using the SPSS 16.0 statistical
software package for Windows. A p-value<0.05 was considered statistically significant at the 95% confidence level.
Results. It has been established that residents of highlands with NAFLD are represented by lower BMI relative to residents
of lowlands. In women, the levels of SMM and the percentage of fat are significantly and statistically significantly correlated
(r = - 0.971, p <0.001), while in men these two indicators are not related. Men showed a trend towards higher
percentages of fat, regardless of body weight and region of residence. For women, this indicator was within acceptable
limits and did not exceed 31%. There was found a statistically significant difference in total cholesterol levels between
low and high mountain people in the group of obese patients (p <0.001) suffering from NAFLD. Statistically significant
low ALT indices were revealed in the group of obese patients living in mid-mountain conditions. Conclusions. Taken together,
our results suggest that chronic high-mountain hypoxia may slow down the course of overweight-induced NAFLD.

Introduction. The scientific study is based on the study of long-term results of surgical treatment of 345 patients
with benign prostatic hyperplasia operated by methods adenomectomy and transurethral resection. Of these, 69 individuals
1-1.5 months after surgery had the development of cicatricial-sclerotic complications in the neck of the bladder. For
the treatment and prevention of cicatricial changes after adenomectomy and transurethral resection, the drug
"Bovhyaluronidase azoximer" was gradually introduced into the submucosal layer of the bladder neck - 3000 IU intraoperatively,
transurethral (or through the fistulous tract) and then intramuscularly every 5 days for 1-1, 5 months. In the
postoperative period after 1-6-12-24 months, there was a decrease in the clinical symptoms of infravesical obstruction
and restoration of the urodynamics of the lower urinary tract in 78.8% of cases.
Purpose of the study: the aim of the study was to evaluate the long-term results of the use of the drug "Bovgialuronidase
azoximer" in the prevention and treatment of patients with sclerosis of the bladder neck who underwent adenomectomy
and transurethral resection.
Material and methods. The study criteria included 108 (31.3%) patients operated on by single-stage transvesical adenomectomy
and 237 (68.7%) - by TURP. In 23.1% of cases after adenomectomy and in 44 (18.6%) cases after TURP,
signs of cicatricial-sclerotic changes in the bladder neck area and signs of urodynamic disorders of varying severity were
revealed.
Results. After administration of the drug "Bovgialuronidase azoximer" into the submucosal layer of the bladder neck
membrane, patients who underwent adenomectomy and transurethral resection had persistent relief of symptoms of in fravesical obstruction, restoration of urine passage and the absence of relapses of the disease in the long postoperative
period.

Peptic ulcer in the aspect of the influence of mountain conditions was studied by various scientists from all
over our planet, but there is still no final answer in the specifics of the course and their mechanisms. Purpose of the study-
To identify differences in the course of the ulcer process in patients with gastric ulcer and duodenal ulcer complicated by
bleeding, in persons living in the conditions of high mountains, middle mountains and low mountains of the Kyrgyz Republic.
Materials and methods of research. A retrospective cohort study of 316 patients with gastric ulcer and duodenal
ulcer, complicated by bleeding, living in various mountainous conditions of the Kyrgyz Republic., whose age ranged
from 17 to 87 years, was carried out. Results. In high-mountain conditions, the gender structure of the incidence of gastric
and duodenal ulcer complicated by bleeding in men is almost 3 times different in comparison with the low-mountain
group (the ratio 4.5:1.0 compared to 1.6:1.0). In the conditions of high mountains, the localization of the ulcerative
process in the stomach significantly predominates, in comparison with representatives of low mountains patients (the
ratio is 1.9:1.0 for the high mountains group and 1.5:1.0 for the low mountains). Higher hemoglobin levels are noted
(6% ), platelets (11.5%), the percentage of platelet mass in the blood volume (8%), the average volume of platelets
(16.5%), platelet heterogeneity indicators (22%) in the group of highlanders. Conclusions. The clinical course of gastroduodenal
bleeding in high altitude patients, despite the severity of blood loss, is characterized by easier tolerance, which
is reflected in the clinical picture and a large number of patients admitted with hemostasis compared to low altitude patients.
A more detailed identification of the features of the course of gastric ulcer and duodenal ulcer complicated by gastroduodenal
bleeding in mountainous conditions will be the subject of our further research.

One of the most common inflammatory diseases among postmenopausal women is cystitis, which accounts
for 30 to 40% of the total number of uropathologies. In this paper, the authors show the main spectra of uropathogens in
postmenopausal women. The aim of the study was to analyze the spectrum of uropathogens in women with cystitis in the
postmenopausal period. Materials and methods.The results of bacteriological examination of urine and PCR from a vaginal
smear for urogenital infections were collected and processed in 150 patients with cystitis in the postmenopausal period
of the tertiary hospital. Research results and conclusion. The main causative agents of cystitis in the postmenopausal period
are E.coli - 62.3%, Candida albicans - 8.7% and Staphylococcus.spp.- 7.2%. A high level of antibiotic resistance of
the isolated Esherichia coli strains was noted for cephalosporins of the second (50%) and third (55%) generations, fluoroquinolones
of the first generation (45%). A high level of sensitivity of Esherichia coli was observed to aminoglycosides
of the second (80%) and third (100%) generations, fluoroquinolones of the second (75%) and third (95%) generations,
carbapenems (100%) and fosfomycin (100%). A positive PCR result for urogenital infections in patients with cystitis
was obtained in 52.7% of cases.

The problem of urination disorders occupies one of the leading positions in the structure of "estrogen deficiency
diseases" in postmenopausal women. In this paper, the authors show a comprehensive assessment of the main forms of
urination disorders in postmenopausal women. The purpose of the study was to analyze urination disorders depending
on the frequency of exacerbations of cystitis in postmenopausal women. Material and research methods. A prospective
study was conducted to analyze urination disorders and the nature of pain syndrome depending on the frequency of exacerbations
in 150 patients with cystitis in the postmenopausal period. Results of the study and conclusion. In patients
with cystitis in the postmenopausal period, in 45.4% of cases, there are from 1 to 4 exacerbations per year, in 37.3%
cases from 4 to 8 exacerbations per year, in 17.3% of cases more than 8 exacerbations per year are noted. With an increase
in the frequency of exacerbations, the average volume of micturitions decreases by 1.5 times, the average number of
micturitions per day increases by 1.5 times, and the number of nighttime urination increases by 2 times, depending on
the frequency of exacerbations of the disease. Expressiveness pain syndrome during urination in patients with cystitis in
the postmenopausal period increased by 1.5 times and 1.9 times, depending on the frequency of exacerbations, more than
8 times a year.

The majority of patients with inflammatory diseases of a scrotum are at the young reproductive age 62.1 %
. During the first 24 hours for medical help treat 39.5 % of patients, in the next 48-72 hours 22.9 % , and after 3 days
37.5 % . The most frequently encountered acute orchiepididymitis 65.4 % of them with post-traumatic orchiepididymitis
were 28 patients ( 9.4 % ). Patients with chronic epididymitis amounted to 6.8 % , with epididymal cysts 11.8 % , with
14.5 % of hydrocele and testicular cysts 20.2 % . Of the 194 patients with acute orchiepididymitis 143 ( 73.7 % ) underwent
surgical treatment and only 51 patients ( 26.2 % ) were treated conservatively . The average hospital stay in the operated
patients was 7.2 ± 0.2, and in the patients who received conservative treatment 12.3 ± 0.2 days. Active surgical
tactic in the treatment of acute orchiepididymitis justified because it reduces the length of service of the sick in the hospital
and has a positive effect in the treatment of this disease.

The article discusses the state of reproductive function in men. In recent years, the state of male reproductive
function has been shown to be of particular medical importance, and the issue of early detection and treatment of diseases
of the male reproductive system treated by surgical interventions of the reproductive system is an urgent problem. It has
also been studied that surgical treatment of diseases of the male reproductive function - varicocele, hydrocele, spermatocele
- improves blood circulation in the blood vessels - by 78%. There is a significant increase in the size of the affected
testis after surgery, the volume of the left testicle increased by an average of 24%, and the right testicle - by 12%. Adolescents
with varicocele, hydrocele and spermatocele need dynamic monitoring by a uroandrologist and testing of testosterone
(ultrasound), gonadotropins, testosterone every 6 months, as well as treatment tactics for early detection of testicular
microcalcinosis. For patients with varicocele, surgical treatment using the Marble method is recommended and its effectiveness
is 91.5%. Patients who have undergone surgery on the reproductive system are recommended to be dynamically
monitored by an urologist-andrologist, endocrinologist, as well as spermogram, gonadotropin levels, testosterone, and
then under the supervision of an andrologist.

Due to the increase in the life expectancy of the male population, there is an increase in the number of patients
with prostatic hyperplasia. The main method of treatment of prostatic hyperplasia is surgical removal of prostate adenomatous
nodes by transurethral resection or adenomectomy. After surgical interventions, patients experience various
changes in the hemostasis system associated with the entry of tissue coagulation activators into the blood. The lack of
compensatory capabilities in patients of the older age group causes a decrease in the activity of the anticoagulation and
fibrinolytic systems of the body. Predicting the risk of complications in the pre- and postoperative periods made it possible
to choose a treatment regimen for patients with prostatic hyperplasia, depending on the method of surgical intervention
and the method of hemostatic therapy. The aim of the study: to substantiate methods of prevention of the risk of thrombohemorrhagic
and thromboembolic complications in patients after adenomectomy and transurethral resection with the
use of low-molecular heparins and modified hemostatic suture on the place of prostate adenomatous nodes at various
times of the period after surgery. Material and methods of research. The study included 80 patients with BPH, operated
on by adenomectomy and TURP. As a choice of method of surgical treatment, 34 (42.5%) patients used a modified method of hemostasis for transvesical adenomectomy (group 1 - main); 46 patients (57.5%) used traditional types of operations
- one-stage transvesical adenomectomy with a removable suture on the prostate adenoma bed in the traditional way (according
to V. N. Evsyukov) and TURP (group 2 - control). As measures to prevent thrombohemorrhagic complications,
each of the groups was additionally divided into two subgroups: subgroup "A" - 38 (47.5%) patients who did not receive
anticoagulants in the pre- and postoperative period; subgroup "B" - 42 (52.5%) patients who received low molecular
weight heparins (LMWH) - fraxiparine at a dose of 0.3 ml per day (2500 IU) 18-20 hours before surgery and on the 4th
day of the postoperative period. Conclusion. Analysis of coagulogram parameters, time of surgical intervention and
degree of blood loss indicates that in the hemostasis system in patients with prostatic hyperplasia there are shifts characteristic
of hypercoagulation with noticeable surgical trauma, hemorrhagic and thromboembolic complications requiring
immediate correction.

Urolithiasis throughout the world and in Kyrgyzstan in particular, ranks second in the structure of urological
morbidity. Prevention of recurrence of stone formation by studying the influence of national nutrition based on the chemical
composition of food products and the biological value of dishes according to the new norms of physiological needs
is of particular importance in the management of patients after the elimination of stones and is a priority in the metaphylaxis
of the disease. The aim of the study was to evaluate the effectiveness of the use of clinical nutrition in the metaphylaxis
of CI based on the biological value of Kyrgyz dishes in accordance with the new norms of physiological needs by
analyzing the results of urine pH-metry of patients living in the Kyrgyz Republic. Materials and methods. The study was
conducted on a case-control basis in 50 patients with staghorn nephrolithiasis in the main and control groups for the
period from 2015 to 2021. The main group included patients who received the developed method of metaphylaxis, taking
into account national nutritional patterns. The control group included patients who used standard metaphylaxis. Conclusion:
Patients living in the Kyrgyz Republic undergo CI metaphylaxis using national nutrition based on the chemical
composition of food products and the biological value of Kyrgyz dishes (soups, main courses, cereals, dessert dishes and
national drinks) in accordance with the new norms of physiological needs for a long time from individual development
for each patient increases its effectiveness and reduces the risk of recurrence of stone formation by 2 times. The criterion
for a properly selected daily diet is urine pH-metry, which is simple and affordable.

Male infertility of various origins in an infertile marriage is 30-40%. An urgent issue in medicine is the restoration
and preservation of male fertility. The article presents the results of cryo-freezing at ultra-low temperatures using
combined cryoprotectors of testicular and epidimal spermatozoa obtained by testicular biopsy. In the course of the work,
histomorphological, morphometric, light-optical methods of microcopying with suprovital examination, biochemical and
cytogenetic research methods were applied. These methods allow a more objective and informative assessment of pathological
changes while preserving the intravital properties of tissue and cells. The work shows the possibility of cryofreezing
of germ cells with the preservation of steroidogenic and proliferative potential for the preservation and restoration of
male fertility. Cryopreserved germ cells during cultivation showed a pronounced preservation of generative and proliferative
potentials. The study showed that testicular and epidimal spermatozoa, early cells of spermatogenesis, as well as
germ cell epithelium cells show good cryo-resistance performance under conditions of ultra-low temperatures. In the future,
cryopreserved sex and germ cells can be used in programs of assisted reproductive technologies, as well as in restoring
the spermatogenic and steroidogenic potential of men.

The article presents the results of an assessment of the state of fertility of Kyrgyz men aged 18 to 40 years
living in Kyrgyzstan for the period 2019-2022. The analysis of the results of spermograms of 1557 men from Chui, Osh,
Nyryn and Batken regions in a comparative aspect was carried out.
The results of the study made it possible to preliminary identify the following features: the concentration of spermatozoa
in the ejaculate increases with age and with the indicators of the comparison group 1.5 times higher; the ratio of progressively
motile spermatozoa is slightly lower in the population and the viability of spermatozoa is higher in the group of
men aged 30 to 40 years, that is, the older the man, the higher the spermogram and fertility. The results obtained will
make it possible to objectively assess the fertility and quality of the spermogram, depending on the characteristics identified
in the context of age and various living conditions in the country.

We have presented an algorithm of management and described the cases and outcomes of uretero-vaginal fistulas.
Methods. We registered ureteral-vaginal fistulas in the period from January 2017 to December 2019. We evaluated
the quality of diagnosis and treatment of these fistulas. Results. there were 9 cases of uretero-vaginal fistulas. They all
formed after a hysterectomy. Firstly, we tried to treat them conservatively by ureteral stenting in 6 cases and reimplantation
in 3 cases. Ureteral stenting was successful in 3 (75%) of 4 patients. The duration of stenting averaged 66 days (27-92
days). Ureteral stenting was complicated by pyelonephritis in 1 case (25%) and stricture in 1 case (25%). Thus, conservative
treatment of uretero-vaginal fistulas was successful in 3 (75%) of 4 cases. percutaneous nephrostomy was installed
in 2 patients, and subsequently an operation was performed in the volume of ureterocystoneoanastomosis. 3m patients
with a fully formed fistula after the inflammatory process subsided, on average 46 days later, ureteral reimplantation was
performed as planned. Dynamic observation was carried out by various methods, such as tampon tests, computed tomography
urogram, retrograde pyelogram and ultrasound examination of the kidneys. Conclusions. With the right approach
and selection of patients, ureteral stenting is a successful method of treating post-hysterectomy uretero-vaginal
fistulas and can be used as a first-line therapy.

This article represents the results of the study of the course of the Post-COVID syndrome among students of high medical institutions in Kazakhstan and in Kyrgyz Republic. The pandemic of the new coronavirus infection demonstrates the importance of studying its impact on people of various ages. It is very important to understand the specifics of the manifestations of Post-COVID syndrome in students. The purpose of the study is to study the specifics of the clinical course of post-COVID syndrome in medical university students located in Almaty, Bishkek and Nur-Sultan.
Material and Methods. Over 800 medical university students from the three cities of Central Asia (Almaty, Bishkek and
Nur-Sultan) were surveyed through an online questionnaire using Google Forms. Based on the interview results, 315 students with post-COVID syndrome were selected along with the diagnostic studies supporting the diagnosis. A questionnaire was developed which includes demographic data, clinical and diagnostic traits of post-COVID syndrome among students. Distribution by gender : girls - 69.8% (n-=220), boys - 30.2% (n=95). The mean age of the interviewees was
21 ±1.7 years. Statistical processing was performed by using the SPSS-21 program.
Outcome and discussion of findings. The study found that the majority of patients in the population suffered from mild
and moderate forms of the disease, complaining of headache (79.7%), fatigue and weakness (76.8%), cough (67.3%) , muscular weakness and myalgia (62.2%),high temperature (57.8%), anxiety and depression (43.8%), memory impairment (42.-9%), hair loss (41%), taste disorders (31.4%), shortness of breath (27.9%). Among the total respondents, 36.2% had a chronic illness. At the time of the survey, 79.7% of the student population had already been vaccinated against COVID-
19 infection.

According to the International Association for the Study of Cancer (MAIR), more than 400,000 new cases of
malignant ovarian tumors are registered annually in the world, among which ovarian cancer accounts for about 60% and
more than 180,000 women die from them annually. Thus, with newly diagnosed common forms of malignant ovarian tumors,
accompanied by metastatic lesions of the pleural cavity, systemic chemotherapy with various options for intrapleural
therapy in most cases helps to achieve stabilization of the process with partial or complete regression of metastatic
pleurisy. A retrospective comparative evaluation of the effectiveness of combined methods of local and systemic treatment
of metastatic pleurisy in 60 patients with malignant ovarian tumors was carried out in the thoracic department of the Kyrgyz
National Center of Oncology and Hematology (NCOG). The patients were divided into 3 groups: the control group
included 20 (33.3%) patients who received systemic chemotherapy with symptomatic treatment. the main group included
18 (30%) patients who received systemic chemotherapy with intrapleural chemotherapy. an additional group - 22 (36.6%)
patients who received systemic chemotherapy with intrapleural sclerosing therapy using autoplasma as a biosolvent. our
study showed that the use of systemic chemotherapy in combination with intrapleural sclerotherapy using autoplasma as
a biological solvent contributes to the achievement of long-term stabilization of the process, increasing the 12-, 15- and
18-month survival rates by 31.8%, 18.1% and 13.6% compared to traditional systemic and topical treatment options, improving
patients' quality of life.

Introduction. Despite all the well-known advantages of bariatric surgery, there is a potential risk of complications such as stenosis in the resection area, anastomotic leaks, bleeding or infection, on the one hand, and complications associated with nutritional deficiencies, on the other hand.
The aim of the study is to early diagnostics and timely treatment of Wernicke's encephalopathy in patients with partial malabsorption syndrome.
Subjects and methods of research. A clinical observation of a patient with Wernicke's encephalopathy after laparoscopic
longitudinal resection of the stomach (SLIV resection) is presented. The diagnosis was confirmed by a low level of thiamine in the blood serum and a characteristic picture on magnetic resonance imaging.
Results. The next day after the start of vitamin B1 deficiency replenishment (along with vitamin B12, folic acid and
cerebroprotector Citicoline), the patient's condition quickly improved with a significant regression of symptoms of acute brain damage.
Conclusions of summary. Bariatric surgery is a less common cause of Wernicke-Korsakoff syndrome, but may lead to it due to malabsorption syndrome. In patients undergoing bariatric surgery, clinicians should be vigilant about the possibility of EV and be able to diagnose and manage this complication.

Introduction. Drug treatment with antiepileptic drugs (AEDs) is the mainstay of treatment for epilepsy. However,
in some patients, despite the use by neurologists of drugs with different mechanisms of action, in some patients
with epilepsy, the disease is resistant to drug treatment or pharmacoresistant. In drug-resistant forms of epilepsy, surgery
gives the patient a chance for a complete cure or a significant reduction in the frequency of seizures.
Purpose of the work was to analyze and evaluate the outcomes of treatment in patients with drug-resistant epilepsy with
various methods of their surgical treatment.
Material and methods. A prospective analysis of the results of surgical treatment was carried out. The study included
138 patients with drug-resistant epilepsy who were hospitalized at the neurosurgery clinic of the National Hospital under
the Ministry of Health of the Kyrgyz Republic from 2004 to 2013. We studied the data of neurological, neurophysiological
and neuroimaging examinations, as well as the data of surgical treatment in the near and long term.
Results. The overall level of complications caused by surgeries for epilepsy was quite low (only 2 patients developed
split-brain syndrome after resection surgeries (callosotomy). A more effective and safe operation for the treatment of
drug-resistant epilepsy, according to our observation, was multiple subpial transsection, complete cessation of epileptic
seizures occurred in 20 patients (62.5%).
Conclusions. The effectiveness of the applied methods of surgical treatment in various forms of epilepsy is shown.
Surgical treatment of patients with drug-resistant epilepsy allows to achieve regression of the pathological process or
stabilization of the condition in most cases.

This article presents the results of a study of the early incidence and prevalence of prostate diseases through a
comprehensive survey for 2021-22 in Chui (12%), Issyk-Kul (36%), Talas (32%), Osh (13%) and Jalal- Abad regions
(9%) (a total of 3265 men of various ages were examined) on the basis of an ongoing study of the scientific project "Early
detection of prostate diseases in men living in the Kyrgyz Republic", funded by the KSMA named after I.K. Akhunbaeva
(registration number 4220). Among the men who applied, 37.8% were urban residents and 62.2% were rural residents.
When applying, the features of complaints characteristic of prostate diseases were revealed and actually compared with
the detection of pathology, where there is evidence that such diseases as prostatitis (in the young age group - 27.2%) and
prostate hyperplasia (in the group of middle and old age - 28.4%), as well as prostate cancer are asymptomatic (6.7% in
the whole country). Of particular note are men who are not registered with the dispensary after undergoing surgery on
the prostate or the appearance of the first signs of the disease. A survey conducted on awareness (55.2% not aware) of
prostate diseases, not everyone was able to assess their health (11.3%) and indicated that they did not trust doctors (52.2%),
but were forced to seek medical help, often in neglected conditions and complicated cases, and in 41% the disease was
detected for the first time. The results of the study indicate the need to improve urological care for the population, including
its outpatient level, covering the educational work of the population, the effectiveness of which, first of all, determines
the completeness and timeliness of detection, and hence the effectiveness of the treatment of prostate diseases.

The purpose of the seroepidemiological study was to assess the population immunity to COVID-19 coronavirus infection in the population of the Kyrgyz Republic, depending on gender, age and geographical distribution to justify
public health responses. Methods. Cross-sectional stratified serological study was conducted from 26.06.2020 through 25.08.2020 in all the regions of Kyrgyzstan. Primary health care organizations were randomly selected from the list of people, enrolled to each primary health care provider for a random selection of participants. Trained health workers interviewed the participants about their age, gender, COVID-19 symptoms, seeking health care behavior and hospital admission. They also collected blood
samples to determine the total amount of SARS-CoV-2 antibodies. Seroprevalence of SARS-CoV-2 antibodies were describedby age groups, gender and region. Results. Among 4691 studied individuals, 1446 -30,8% (95% CI 29,5-32,1) had antibodies to SARS-CoV-2. Seropositivity was lowest in the younger age group 0-9 years (16,5%; 95% CI 13,8-19,2) compared to older age groups,including 45-64 years (36,1%; 95% CI 33,5-38,7), as well as to men (27,2%; 95% CI 24,8-29,4) and women (32,5%; 95% CI 31,0-34,2). Seroprevalence in the southern regions ranged from 13,0 (95% CI 9,7-16,3) to 16,3% (95% CI 14,0 -18,6), and in the north from 46,0 (95% CI 40,7-51,3) to 62,7% (95% CI 59,2-69,2). Of 1446 seropositive individuals, 925 (64%; 95% CI 62,2-65,4) had COVID-19 symptoms, ranging from 45,0 (95% CI 36,1-53,9) in the 0-9 year age group to 71% (95% CI 60,3-81,7) in persons over 65 years old. Of 1446 seropositive - 315 people (21,8%) sought for health care, and a high share of health care seeking is observed in people over 65 years - 19/69 (27,5%). 80 seropositive individuals (5,5%) were
hospitalized. Discussion. The results indicate that 70% of the population remainssusceptible to Coronavirus infection, which necessitated vaccination amongtheadult population. Also, most of children remain SARS-C0V-2 virus seropositive. Low rates of clinical symptoms, health care seeking and hospital admissionsinformed recommendations for treating patients with a mild disease course on anoutpatient basis.

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.

Currently, the relevance of the disease in oncourology - prostate cancer. At the same time, the results of survival
of patients who underwent transurethral resection are different. The aim of the study was to analyze the results of surgical
treatment of elderly patients with locally advanced type of prostate cancer who underwent transurethral resection of the
prostate. The aim of the study was to analyze the results of surgical treatment of elderly patients with locally advanced
type of prostate cancer who underwent transurethral resection of the prostate. Material and methods of research. A retrospective
analysis of the results of treatment of 50 elderly patients with locally advanced prostate cancer who underwent
transurethral resection of the prostate. Results and discussions. After transurethral resection in 94% of patients, urinary
incontinence resolved within a month, in 6% of patients urinary retention was restored within 3-3.5 months. Conclusions.
A comprehensive assessment of preoperative clinical and morphological signs allows determining the appropriateness
of surgical treatment methods. In locally advanced and metastatic forms of prostate cancer, transurethral resection of the
prostate can be performed under the condition of a controlled process of malignant changes in the prostate gland by using
preoperative antiandrogen therapy. The operation of transurethral resection of the prostate is the method of choice for
obstruction of the urinary tract ghb locally advanced and metastatic forms of prostate cancer, is a low-traumatic surgical
method of surgical treatment that improves urodynamic parameters, duration and quality of life of patients.