Medical science of Uzbekistan

DENTAL STATUS OF PATIENTS WITH MALIGNANT NEOPLASMS

Gulmirakhon Iminjonova — 2025-02-25

This review article is devoted to a topical issue in dentistry and oncology - the dental status of patients with malignant neoplasms. Based on extensive modern domestic and foreign literature, the article analyzes epidemiology, risk factors for development, problems associated with early diagnostic methods, principles of prevention and rehabilitation of oral cancer. It covers modern aspects of the pathogenesis of mucositis, lesions of the oral mucosa and periodontal disease. It presents the importance of socio-biological, socio-economic and environmental factors in the development and prognosis of malignant neoplasms in individuals with oral problems. The summary concludes that the condition of the oral cavity in cancer patients is closely related to the development of complications during treatment. Regular dental examination and timely intervention can reduce the risk of dental problems, improve therapy results and increase the quality of life of patients.

DECODING THE UMOD GENE: IMPLICATIONS FOR CHRONIC KIDNEY DISEASE THROUGH GENETIC MECHANISMS, DIAGNOSTICS, AND THERAPEUTIC INNOVATIONS

Eleonora Tashkenbayeva — 2025-02-25

This review examines recent advances in the study of UMOD genetic variations, their functional consequences, and their impact on CKD pathogenesis. It also discusses the potential clinical applications of UMOD as a predictive biomarker for early CKD detection, risk stratification, and targeted interventions. The development of transcriptomic, proteomic, and metabolomic approaches allows for a more comprehensive study of UMOD function and its interactions with other genetic and metabolic pathways. Chronic kidney disease (CKD) is a growing global health concern, affecting millions of people worldwide. Genetic factors play a crucial role in the etiology and progression of CKD, influencing susceptibility, disease severity, and treatment response. Among these factors, the UMOD gene, which encodes the glycoprotein uromodulin, is recognized as a key regulator of kidney function, tubular integrity, and disease susceptibility. UMOD polymorphisms affect kidney function by altering sodium transport, modulating immune responses, and regulating oxidative stress, thereby contributing to hypertension, nephron damage, and CKD progression.

Recent GWAS (genome-wide association studies) have confirmed the association between UMOD polymorphisms and an increased risk of CKD and its related complications. Additionally, a significant correlation has been identified between UMOD and hyperuricemia, as uromodulin plays a crucial role in uric acid transport and excretion. Conclusion: Personalized medicine based on UMOD genotyping opens new opportunities for individualized risk assessment, tailored pharmacotherapy, and lifestyle modifications to slow CKD progression. Additionally, promising therapeutic strategies are being developed, including pharmacological modulation of UMOD expression and gene therapy.The integration of genetic knowledge with clinical applications highlights the significance of UMOD in CKD pathogenesis and positions it as a promising target for precision nephrology, potentially improving clinical outcomes and optimizing patient management strategies.

CONNECTIVE TISSUE DYSPLASIA AS AN ELEMENT IN THE DEVELOPMENT OF PATHOLOGY OF SOME BODY SYSTEMS (literature review)

Nargiza Abdukadirova — 2025-02-25

The literature review examines connective tissue dysplasia and their role in the pathogenesis of diseases of the cardiovascular, respiratory, immune and other body systems. The etiological and morphological aspects of the development of this pathology, classification, as well as clinical features of the course of certain diseases against the background of connective tissue dysplasia in both adults and children are presented. In conclusion, it should be noted that the relationship between the external phenotypic signs of connective tissue dysplasia and the features of the morphology and function of internal organs has not been sufficiently studied. The issue of the frequency and clinical significance of individual minor developmental anomalies, as well as the combination of external manifestations of dysplastic syndrome with the nature and degree of involvement of the central and autonomic nervous systems and internal organs in systemic pathology of connective tissue remains unclear. The issue of the clinical form of manifestations of lesions on the part of internal organs remains controversial. Based on the above, it seems necessary to further study the role of connective tissue dysplasia in the formation and development of diseases of internal organs for the purpose of its early diagnosis, clinical assessment, prevention and treatment of diseases associated with it.

RESULTS OF THE STUDY OF COMPARATIVE ANALYSIS OF THE DEVELOPMENT OF COMPLICATIONS AFTER COVID-19 VACCINATION WITH DIFFERENT GROUPS (TYPES) OF VACCINES IN THE PRESENCE OF CONCOMITANT CHRONIC DISEASES IN MEN OF DIFFERENT AGES OF THE POPULATION OF THE FERGANA

Shoyadbek Todzhikhazhaev — 2025-02-25

Relevance. The study of the post-COVID state among the vaccinated population of Uzbekistan is important to determine the risk factors characteristic of the local population, as well as to identify the characteristics of the course of the disease and effective preventive strategies in remote areas such as the Fergana Valley. Objective. The objective was to study the preventive strategy in the development of complications after vaccination with Covid-19 with various vaccines in healthy residents and residents with concomitant chronic diseases in different age groups. Materials and methods of research. The work was carried out on the basis of the Andijan State Medical Institute using the registry of patients belonging to the family clinic No. 8. population of the Fergana Valley who had COVID-19. The analyzed population: The sample includes men of different age groups, as well as people with different chronic diseases to take into account risk factors. The age groups of residents were divided into 18-30 years (young), 31-50 years (adults), 50 to 60 years (elderly), 65 and over 65 years (old people). These age groups of participants consisted of 10,835 healthy and 19,006 patients with Covid-19. Results. Analysis of the results showed that the manifestation of AEFI in this group of residents developed regardless of age. Thus, even in the group of young healthy men aged 18-50, complications from all types of vaccines were encountered. The highest percentage (99.4%) of the absence of complications in healthy men was noted in the group of residents aged 18-50. Conclusion. Effective monitoring of the epidemiological situation and the health status of vaccinated patients with post-COVID syndrome plays a key role in the development of timely and effective measures.

RISK FACTORS AFFECTING DOCTORS IN TREATMENT-PROPHYLAXIS INSTITUTIONS

Manzura Salieva — 2025-02-25

Healthcare workers work in conditions of high emotional stress, which leads to rapid fatigue of the nervous system. A questionnaire was conducted among doctors working in departments with a high level of neuropsychiatric fatigue. The survey was conducted simultaneously using specially developed questionnaires that included socio-demographic, professional qualifications, and lifestyle issues of doctors. Purpose of the topic: According to social research [1.2], among the professional factors leading to the occurrence of occupational diseases, the main ones are biological agents (73.9%), antibiotics (16%), chemicals (7.9%), and among professional factors that threaten health, the first place is occupied by the risk of contracting infectious diseases (98%). To conduct an analysis of the medical and social characteristics of doctors in departments with a high level of neuropsychiatric fatigue of a multidisciplinary clinic. Research methods and materials: Questionnaire of 60 doctors working in departments with a high level of neuropsychiatric fatigue of a multidisciplinary clinic of the Medical Institute. The survey was conducted simultaneously using specially developed questionnaires, which included socio-demographic, professional qualifications, and lifestyle issues of doctors. The survey included 70 questions and formalized responses. Results and Conclusions: Improving the system of health protection and strengthening of doctors is of paramount importance based on the formation of a basic model of health protection. It should be noted that the main economic effect of the SS is determined by the struggle to improve the health indicators of working-age individuals, and in the SS system, special attention should be paid to maintaining the health of a doctor resource that is very valuable to society.

DECIPHERING THE IMMUNE LANDSCAPE OF OVARIAN CANCER: AN IN-DEPTH ANALYSIS OF IGCH CD4+, CD8+, AND PD-L1 IN TUMOR MICROENVIRONMENT AND THEIR THERAPEUTIC IMPLICATIONS

Firdavs Ulmasov — 2025-02-25

Relevance. Ovarian cancer is one of the most lethal gynecological malignancies worldwide, with high mortality primarily due to late-stage diagnosis and the lack of effective early screening. The tumor microenvironment (TME) plays a crucial role in cancer progression, immune evasion, and resistance to therapy. Immune cells, particularly CD4+ and CD8+ T cells, along with immune checkpoint proteins like PD-L1, significantly influence tumor behavior and therapeutic response. Understanding their roles in ovarian cancer may provide insights into novel immunotherapeutic strategies. Materials and methods of study. A total of 135 ovarian cancer patients from the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, Samarkand Branch, were included in this study. Tumor samples were obtained through biopsy or surgical resection, and immune profiling was performed using multiplex immunohistochemistry and flow cytometry. The expression levels of CD4+, CD8+, and PD-L1 were quantified, and their spatial distribution within the TME was analyzed. Correlations between immune profiles and clinical outcomes, including survival rates and response to immunotherapy, were assessed. Research results. CD4+ T helper cells exhibited functional diversity, with Th1 cells promoting anti-tumor immunity, whereas Th2 and regulatory T cells (Tregs) contributed to immune suppression in advanced tumors. High CD8+ T-cell infiltration correlated with improved survival; however, elevated PD-L1 expression was associated with T-cell exhaustion (PD-1, TIM-3, LAG-3) and immune evasion. Increased PD-L1 levels were linked to poor prognosis, reinforcing its role as a key immune checkpoint regulator. Conclusion. This study highlights the prognostic significance of CD4+, CD8+, and PD-L1 expression in ovarian cancer. Immune profiling may aid in personalized treatment strategies, optimizing immunotherapy efficacy. Future research should focus on integrating multi-omics approaches to enhance patient stratification and improve therapeutic outcomes.

MICROALBUMINURIA AS AN INDICATOR OF METABOLIC DISORDERS IN OBESITY CHILDREN

Nargiza Goyibova — 2025-02-25

The original article presents the results of a study of the relationship between microalbuminuria and carbohydrate and lipid metabolism parameters in children with obesity. The results of the study are recommended for widespread implementation in the practical activities of general practitioners and pediatricians. Research objective: To determine the relationship between microalbuminuria and carbohydrate and lipid metabolism parameters in children with obesity. Materials and methods: 55 children with primary exogenous constitutional obesity aged 7 to 18 years, as well as 20 children with normal body weight were studied. A set of anthropometric, clinical, and biochemical studies was conducted. Results of the study: a relationship was found between the degree of obesity and the severity of carbohydrate metabolism disorders and dyslipidemia in children, which was expressed in an increase in the level of cholesterol, triglycerides, LDL and a decrease in HDL, an increase in immunoreactive insulin and an increase in the IR HOMA R index. The study showed a relationship between the pathological level of urine albumin and the degree of pathology of carbohydrate and lipid metabolism, which indicates a significant contribution of the degree of metabolic disorders to the pathology of the functional capacity of the kidneys. Conclusion: in obesity, the kidneys are one of the first and main target organs most susceptible to damage, since they are the first to take on the function of correcting metabolism with an increase in the volume of adipose tissue. Thus, patients with excess accumulation of fat mass in the body should be considered as a group at very high risk of developing chronic kidney disease.

FEATURES OF VITAMIN D METABOLIC METHODS AND ITS CONTRIBUTION TO THE DEVELOPMENT OF METABOLIC SYNDROME IN CHILDREN

Lilya Garifulina — 2025-02-25

The original article presents the results of a study of the metabolic state and cholecalciferol concentration in children and adolescents who are overweight and obese, determining the role of vitamin D in the formation of metabolic syndrome in children and adolescents. The results of the study are recommended for widespread implementation in the practice of general practitioners in central district primary health care clinics. The aim of the study was to determine the state of metabolism and concentration of cholecalciferol in overweight and obese children and adolescents, with the determination of the role of vitamin D in the formation of metabolic syndrome in children and adolescents. Materials and methods: 106 children and adolescents with exogenous constitutional type of obesity, as well as 30 children and adolescents with normal body weight were examined. A complex of anthropometric, clinical, biochemical, enzyme immunoassay studies was conducted to determine the level of carbohydrate and lipid metabolism, as well as vitamin D. Results of the study: it was revealed that the pathology of carbohydrate metabolism in overweight and obese children and adolescents occurs in 47.6% of cases, an imbalance of lipid metabolism – in 38.6%, insufficiency and deficiency of cholecalciferol in blood serum – in 76.9% of cases of severe obesity. The results allowed us to establish the presence of metabolic syndrome in 58.4% of children with signs of abdominal obesity, while its complete variant was observed in 20.9%. Children with metabolic syndrome have the greatest vitamin D deficiency. Conclusion: serum cholecalciferol is a risk factor for the initial imbalance of metabolic processes with the formation of a further symptom complex of metabolic syndrome.

COMPARATIVE EVALUATION OF THE RESULTS OF TREATMENT OF PATIENTS WITH VARICOSE DISEASE OF THE LOWER EXTREMITIES

Akhmadjon Boltaev — 2025-02-25

Relevance. Of all the vascular systems, varicose veins of the lower extremities rank first. Statistics show that in developed countries the incidence of varicose disease is 25-33% among women and 10-20% among men. In Russia alone, more than 38 million people are officially registered suffering from various forms of varicose disease, of which 15% have trophic disorders. The aim of this scientific work was to improve the treatment results of patients with various forms of varicose disease by using the EVLO method in complex treatment. Materials and methods. The authors analyze the results of treatment of 267 patients with varicose veins of the lower extremities, who were divided into three groups. The first group consisted of 104 (38.9%) patients who underwent traditional phlebectomy, the second group consisted of 107 (40.1%) patients who underwent EVLO + miniphlebectomy of the great saphenous vein simultaneously, and the third (main) group consisted of 56 (20.9%) patients who underwent EVLO and 3 months later underwent sclerotherapy or miniphlebectomy. Conclusions. The authors conclude that the effectiveness of a particular treatment option for varicose veins of the lower extremities should be confirmed by clinical and instrumental diagnostic methods, data on the frequency of complications and relapses. The results of the quality of life study provide valuable additional information that can improve the interaction between the doctor and the patient in achieving better treatment results.

EARLY PROGNOSTIC SIGNS OF DUODENAL ULCER COMPLICATIONS IN CHILDREN

Shoira Ibatova — 2025-02-25

Relevance. Duodenal ulcer bleeding is one of the most severe complications and ranks among the leading causes of mortality associated with duodenal ulcers. Purpose of the study. This study aimed to identify key predictors of a complicated duodenal ulcer course in pediatric patients. Materials and methods. The research included 42 children diagnosed with recurrent duodenal ulcers who received treatment at the 2nd SamMU clinic between 2021 and 2024. The primary group comprised 12 patients (28.6%) with complicated cases involving bleeding, while the comparison group included 30 patients (71.4%) with an uncomplicated course. The study analyzed anamnesis, clinical characteristics, and pH levels in affected children. Several prognostic factors for complicated duodenal ulcers were identified, including gender, age, genetic predisposition, erosive gastroduodenitis, multiple ulcerations, high bacterial colonization, and low pH levels in the antroduodenal region. Results and discussion. Analysis of medical history showed that 75% of children in the primary group had a family history of duodenal ulcer, with 33.3% of relatives experiencing complicated forms of the disease. In the comparison group, hereditary factors were present in 46.7% of cases, though none of their relatives had complications. Helicobacter pylori infection was detected in all patients from the complicated ulcer group (100%), while 80% of the control group tested positive. Additionally, elevated IgG titers against HP were significantly more common in the complicated ulcer group. Conclusions. Key prognostic markers for complicated duodenal ulcers in children include male gender, older school-age status, hereditary factors, extensive ulcerated areas, and multiple ulcerations. Early diagnosis and proactive medical supervision can help minimize the risk of severe complications in these patients.

THE RELEVANCE OF RESPIRATORY DISEASES IN PEDIATRICS: RISK FACTORS FOR BRONCHO-OBSTRUCTIVE SYNDROME

Shoira Ibatova — 2025-02-25

Relevance. Respiratory diseases remain one of the most pressing problems in pediatrics, and in the Republic of Uzbekistan they occupy the first place in the structure of morbidity and mortality in children. Purpose of the study. Assessment of risk factors contributing to the development of broncho-obstructive syndrome in children. Methods and materials. A retrospective analysis of the case histories of 912 children aged 1 to 3 years hospitalized with BOS in the pediatric intensive care unit of the Samarkand branch of the Republican Scientific Center for Emergency Medical Care in the period from 2022 to 2024 was carried out. Results and discussion. In the group of children with BOS associated with AOB, boys significantly predominated - 325 cases (65.8%) compared to 169 girls (34.2%). In contrast, in the second group of children with OB, the gender distribution was more balanced - 215 boys (51.4%) and 203 girls (48.6%), indicating no significant difference in gender prevalence. This study presents a retrospective analysis of 912 cases of children aged 1 to 3 years with a history of broncho-obstructive syndrome (BOS) for the period from 2022 to 2024. Of these, 494 children (54.2%) developed BOS against the background of acute obstructive bronchitis (group 1), and 418 children (45.8%) were diagnosed with acute bronchitis without signs of bronchial obstruction. Conclusions. Key risk factors for BOS in children included perinatal encephalopathy, early transition to artificial feeding, frequent acute respiratory infections, family history of allergy, protein-energy malnutrition, rickets and anemia.