The development of interdisciplinary collaboration between dentists and physicians of other specialties is a pressing issue in modern medicine. A pathogenetic link has been scientifically proven between systemic diseases — including juvenile rheumatoid arthritis (JRA) — and periodontitis and diseases of the oral mucosa. This necessitates a joint professional approach by specialists of different profiles to the comprehensive treatment of patients with combined pathology.

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Pediatric dental diseases—particularly dental caries, early childhood caries (ECC), and gingival inflammation—remain among the most widespread chronic health conditions globally. Their impact extends beyond oral structures, influencing growth, systemic health, nutritional status, school performance, and psychosocial well-being. This article provides an expanded scientific overview of etiological factors, modern prevention strategies, clinical and community-based interventions, and the crucial role of caregivers in oral health promotion. Evidence-based approaches for primary, secondary, and tertiary prevention are highlighted.

In this article, we review common dental hard tissue diseases, such as caries, dental erosion, and endemic fluorosis, highlighting their impact on the oral cavity and the importance of early detection and intervention in maintaining dental integrity. By examining the specific characteristics and treatment options of these hard tissue diseases, we can increase knowledge and awareness of oral diseases that require attention and prompt treatment to maintain healthy teeth and gums.

Regurgitation is one of the most frequently reported concerns among parents of newborns. While most cases are benign and reflect normal physiological processes, certain patterns of vomiting may indicate underlying pathological conditions requiring medical investigation. This article reviews the mechanisms, clinical features, diagnostic criteria, and management strategies for physiological and pathological regurgitation in newborns.

Parkinsonism is a clinical syndrome characterized by bradykinesia, rigidity, resting tremor, and postural instability. While Parkinson’s disease (PD) is the most frequent cause, the term “Parkinsonism” encompasses a broader group of neurological disorders that share similar motor and non-motor symptoms but arise from diverse etiologies. Accurate differentiation between Parkinson’s disease and Parkinsonism is essential, as prognosis and therapeutic responses vary significantly across subtypes.

Orthodontic treatment is widely recognized as an essential intervention for correcting malocclusions, improving facial aesthetics, and enhancing long-term oral health. However, the presence of fixed orthodontic appliances creates new ecological niches that increase plaque retention, impede effective cleaning, and elevate the risk of demineralization, gingivitis, and periodontal complications. Because of these challenges, the development and evaluation of individualized hygiene measures have become a fundamental priority in contemporary orthodontic care. This theoretical review summarizes scientific literature regarding oral hygiene difficulties during orthodontic treatment, the principles of individualized hygiene planning, evidence-based hygiene strategies, and conceptual models for assessing their effectiveness. The review highlights the importance of tailored interventions based on patient-specific risk factors, behavioral considerations, and appliance characteristics. Additionally, contemporary tools such as digital hygiene instruction, motivational interviewing, risk-based recall intervals, and adjunctive hygiene devices are discussed. The paper concludes that individualized hygiene protocols, when properly designed and continuously monitored, improve plaque control, reduce enamel demineralization, and enhance treatment outcomes. The findings emphasize the necessity of patient-centered, preventive approaches within orthodontics and support further development of theoretical frameworks for evaluating hygiene effectiveness.

Long-term use of non-removable dental prostheses represents a significant clinical and biological factor influencing the anatomical and functional state of the oral cavity. Continuous interaction between prosthetic structures and oral tissues gradually alters biomechanical load distribution, mucosal integrity, periodontal conditions, and neuromuscular responses. This theoretical review article synthesizes findings from contemporary literature to provide a comprehensive analysis of how prolonged use of fixed prostheses affects hard and soft oral tissues, salivary parameters, occlusal dynamics, and oral motor function. The review highlights the mechanisms through which prosthetic materials, design quality, and oral hygiene practices influence tissue adaptation or deterioration. Special attention is given to morphological changes in the gingiva, alveolar bone remodeling, prosthesis-induced plaque retention, and shifts in occlusal function. Furthermore, the article discusses long-standing prosthetic-functional correlations, including muscle coordination, mastication efficiency, phonetics, and temporomandibular joint responses. The review emphasizes the importance of early detection of prosthesis-related complications through regular clinical examinations and functional assessment protocols. Ultimately, this paper underscores the need for evidence-based prosthodontic planning, maintenance strategies, and patient education to preserve optimal oral function over extended periods of prosthesis use.

This scientific work provides an in-depth analysis of the epidemiological characteristics of pathogenic microorganisms and highlights the main factors affecting their spread among the population. The study scientifically assesses the biological characteristics of pathogens, their ecological adaptation, sources of infection, reservoirs and transmission mechanisms. It also systematically studies the formation of diseases, the determinants of their epidemic process, the level of virulence of the pathogen and the role of carrier organisms. The work also describes modern epidemiological monitoring methods, the scientific basis for the detection, forecasting and control of infections.

Folate, a water-soluble B-vitamin, is essential for one-carbon metabolism, DNA synthesis, repair, and methylation, and plays a critical role in regulating homocysteine levels. Impaired folate metabolism has been implicated in various uterine pathologies, including fibroids, endometrial hyperplasia, and adenomyosis. This study aimed to investigate the relationship between folate metabolism and uterine tissue alterations in reproductive-age women. A total of 120 participants with confirmed uterine pathology were evaluated for serum folate, vitamin B12, homocysteine levels, and folate-dependent enzymatic activity. Histopathological and molecular analyses of uterine tissues were performed to assess cellular proliferation and DNA methylation. Results demonstrated that folate deficiency and reduced methylenetetrahydrofolate reductase (MTHFR) activity were associated with hyperhomocysteinemia, DNA hypomethylation, increased Ki-67 proliferation index, and structural abnormalities in the endometrium and myometrium. These findings highlight the crucial role of folate metabolism in maintaining uterine tissue integrity and suggest that targeted nutritional and metabolic interventions may contribute to the prevention and management of uterine disorders.

Obesity represents one of the most significant risk factors for perioperative complications due to profound alterations in respiratory, cardiovascular, and metabolic physiology. These changes complicate the administration of anesthesia and increase the likelihood of respiratory and hemodynamic adverse events. The implementation of modern protocols for the anesthetic management of obese patients—encompassing optimized preoperative preparation, advanced airway management technologies, evidence-based ventilation strategies, pharmacokinetically guided dosing of anesthetic drugs, and enhanced monitoring—has considerably improved patient safety. This review summarizes current recommendations for anesthetic care in obese individuals at all stages: preoperative, intraoperative, and postoperative.

Nitenpyram is a rapidly acting neonicotinoid insecticide widely used in veterinary medicine for the immediate elimination of adult fleas in dogs and cats. Owing to its selective mechanism of action and rapid renal excretion, nitenpyram exhibits one of the safest drug interaction profiles among ectoparasiticides. This article evaluates available scientific literature on the pharmacokinetic, pharmacodynamic, and clinical drug interactions of nitenpyram. Findings indicate minimal potential for harmful drug–drug interactions due to its lack of hepatic metabolism, low protein binding, and high specificity for insect nicotinic acetylcholine receptors. However, certain clinical situations—including gastrointestinal irritation, neurological sensitivity, or renal impairment—may influence tolerability when co-administered with other medications. The review highlights the significance of nitenpyram in integrated flea control and underscores the importance of monitoring in special populations.

Left ventricular anomalous chords (LVAC) are picked up surprisingly often in children, usually as a "by-the-way" finding on echocardiography, yet we still don't fully understand what they mean for the child's future health. The main unresolved question is whether these structures are just harmless anatomical quirks or whether, in some children, they help create an arrhythmogenic substrate, especially when they coexist with undifferentiated connective tissue dysplasia (CTD) and a history of perinatal stress. In this article, we pull together current data on how common LVAC are, how they are shaped and located, and how they appear on echocardiography, and we look more closely at the mechanisms that have been proposed to link them with repolarization changes, conduction disturbances, and ventricular arrhythmias. CTD is treated as a systemic "background condition" that may favor the formation of aberrant chords and subtle myocardial remodeling, making the ventricular myocardium electrically more vulnerable, at least in a subset of patients. We also consider how adverse perinatal factors such as intrauterine hypoxia, infection, or prematurity might nudge myocardial maturation and autonomic regulation in an unhealthy direction. On this basis, we outline an integrative, and admittedly still evolving, approach to risk stratification that combines chordal characteristics, clinical markers of CTD, perinatal history, and documented rhythm disturbances to plan more individualized follow-up rather than assuming that all LVAC can be safely dismissed as benign.

Chronic heart failure (CHF) is a progressive clinical syndrome characterized not only by impaired cardiac pump function but also by multi-system vascular abnormalities, among which endothelial dysfunction plays a central role. Increasing evidence indicates that damage to the endothelial glycocalyx (EG)—a highly dynamic layer consisting of glycoproteins, proteoglycans, and glycosaminoglycans—is a key mechanism linking inflammation, microvascular impairment, and organ dysfunction in CHF.

In practical medicine of Uzbekistan, immunohistochemical (IHC) studies have begun to be widely used as an innovative method that allows for more accurate pathohistological diagnostics. This examination allows for the detection of changes at the cellular level in tissues, in particular, the localization and expression of antigens. In our study, the expression of the proliferative marker Ki-67 in the epithelial cells of the large intestine mucosa was studied using an immunohistoprocessor Leica Bond (Austria).

Chemical burns of the gastrointestinal tract not only cause severe local tissue damage but also trigger systemic reactions affecting distant organs. This literature review summarizes current data on morphometric changes in the thyroid gland after corrosive injuries to the gastrointestinal tract, and discusses possible mechanisms of their occurrence and approaches to correction. The introduction describes the prevalence and pathophysiology of gastrointestinal burns with acids and alkalis, emphasizing that the severity of the injury varies from mild mucosal lesions to full-thickness necrosis of the wall with life-threatening complications [6]. The main section analyzes changes in the thyroid gland based on experimental and clinical studies: after severe burn injuries, microstructural rearrangements in the gland (deformation of follicular architecture, lymphomonocytic infiltration) and suppression of its function (euthyroid pathology syndrome) are observed [5]. Key mechanisms include systemic release of inflammatory cytokines (e.g., IL-6, TNF-α) [2], acute stress response with hyperproduction of adrenal hormones, and neuroendocrine disturbances at the level of the hypothalamic-pituitary-thyroid axis. Diagnosis of thyroid changes is based on histological examination (colloid depletion and thyroglobulin aggregation in follicles were detected in burn victims) and determination of hormonal parameters; instrumental methods (ultrasound, scintigraphy) are used limitedly. Various approaches to correcting the identified disorders are discussed in the literature: anti-inflammatory therapy, antioxidants, and hormonal support are considered as ways to mitigate thyroid damage and its dysfunction. However, targeted evidence-based treatments are still lacking. In conclusion, it is noted that chemical burns of the gastrointestinal tract can cause significant morphometric and functional changes in the thyroid gland through complex systemic mechanisms. Early detection and correction of thyroid disorders in burn patients can improve outcomes, but further research is needed to develop effective treatments.

Spinal cord injury (SCI) exerts profound effects on prostate gland morphology, manifesting as reductions in prostate weight, volume, epithelial cell height, and molecular markers across acute (first 2 weeks), subacute (2 weeks to 3 months), and chronic (>3 months) phases. This literature review provides a comparative characterization of these changes, revealing acute atrophy with elevated TRPM-2 mRNA levels (up to 5-fold increase) and transient androgen receptor (AR) mRNA downregulation, progressing to persistent volume reduction (mean 13-19 g in severe SCI vs. 28-40 g in controls) and lowered PSA levels (50% reduction in risk-associated metrics). Drawing from 1997-2023 peer-reviewed sources, findings underscore neuro-hormonal disruptions as causative, with implications for reduced prostate cancer incidence (approximately 50% lower in SCI cohorts). Statistical analyses indicate significant correlations (p<0.02) between injury severity and atrophy extent, predicting sustained hypogonadism-driven morphological stability in chronic phases based on longitudinal rodent and human data.

Objective: To analyze the epidemiological trends of Viral Hepatitis A (HAV) among children in the Andijan region over a 5-year period (2019-2023) and to evaluate the effectiveness of current preventive measures in order to propose an optimized control strategy. Methods: A retrospective descriptive epidemiological study was conducted using official statistical data from the Andijan Regional Service for Sanitary-Epidemiological Welfare and Public Health (SES). The study population included all reported cases of HAV in children aged 0-14 years. We analyzed incidence rates per 100,000 population, age-specific distribution, seasonality, and potential transmission routes. Additionally, a case-control survey of 200 households (100 with a recent HAV case, 100 controls) was performed to identify risk factors related to water supply and hygiene practices. Results: The average annual incidence of HAV in children was 345.2 per 100,000, significantly higher than the national average. A clear seasonal pattern was observed, with 72% of cases occurring between September and December (autumn peak). The age distribution showed a shift: while children aged 3-6 years accounted for 45% of cases, a rising trend (30% increase) was noted in the school-age group (7-14 years). The case-control analysis revealed that consumption of unboiled tap/open-source water (OR=3.8) and lack of indoor plumbing (OR=2.5) were primary risk factors. Vaccination coverage in the target group (18 months) was 92%, yet "breakthrough" outbreaks occurred in unvaccinated older cohorts. Conclusion: Andijan region remains an area of intermediate-to-high endemicity for HAV, driven by water safety challenges and high population density. The current vaccination strategy, focused solely on toddlers, leaves a susceptibility gap in school-aged children. Optimization strategies must include: 1) Catch-up vaccination for children aged 7-10 years; 2) Targeted "WASH" (Water, Sanitation, Hygiene) interventions in schools during the pre-epidemic period (August); and 3) Stricter control of water safety in rural districts.

Objective: The aim of this study is to determine optimal approaches to the treatment of various forms of glomerulonephritis (GN) in children based on an analysis of morbidity in the Andijan region. Methods: The study analyzed the clinical and laboratory characteristics, prevalence, and course of acute glomerulonephritis in 126 children treated at the Andijan Regional Children's Multidisciplinary Medical Center over a 10-year period. Diagnosis was verified based on anamnesis, extrarenal symptoms (edema, hypertension), and renal symptoms (hematuria, proteinuria). Results: A link between GN and previous infection was established in 90.8% of patients, with a confirmed streptococcal etiology in 64.5%. The disease manifested as typical acute nephritic syndrome in 69.1% of patients, while 22% presented with an atypical onset. Treatment involved a combination of antibiotics, anticoagulants (heparin), and antiplatelet agents. For patients with Nephrotic Syndrome (NS), corticosteroid therapy was the standard; however, due to high relapse rates and steroid resistance, cytostatics (such as 6-mercaptopurine) and pulse therapy were employed for optimizing outcomes. Additionally, specific therapeutic regimens were identified for hepatitis-associated nephritis (using interferons) and cases associated with tuberculosis infection.  Conclusion: The study indicates an increase in the number of patients with GN accompanied by nephrotic syndrome, hematuria, and hypertension. Effective management requires an individualized selection of basic therapy, including corticosteroids and cytostatics, as well as screening for hepatitis and tuberculosis to rule out secondary causes.

Chemotherapy of tuberculosis, especially multidrug-resistant forms, remains a complex task due to the development of adverse reactions (ADRs), which often lead to non-compliance with the treatment regimen, its discontinuation and, as a consequence, to the growth of drug resistance of Mycobacterium Tuberculosis . Second-line drugs are the most toxic. This review systematizes the main types of side effects of anti-tuberculosis drugs, examines the pathogenetic mechanisms of their development, and discusses modern approaches to prevention and treatment, including pharmacological and non-pharmacological methods.

Tuberculosis (TB) is caused by the intracellular pathogen Mycobacterium Mtb tuberculosis ( Mtb ) remains one of the leading causes of infectious disease mortality worldwide. The outcome of a host encounter with Mtb is determined by a complex and multifaceted immune response that evolves from initial infection control to the formation of a specific granuloma and, in some cases, to destructive progressive disease. This review systematizes current understanding of the key immunological changes in the human body during pulmonary tuberculosis, encompassing both innate and adaptive immune mechanisms. We examine the role of various immunocompetent cells (macrophages, dendritic cells, neutrophils, T- and B-lymphocytes), cytokine networks, and immunopathological processes that underlie defense against Mtb but also contribute to lung tissue damage. Particular attention is paid to the mechanisms that allow Mtb to evade the immune response and the factors determining the transition from latent infection to active disease.

Objective: To evaluate the clinical efficacy of an optimized therapeutic protocol incorporating an enkephalinase inhibitor (Racecadotril) and Zinc supplementation compared to standard oral rehydration therapy alone in children hospitalized with acute seasonal viral gastroenteritis. Methods: A prospective, open-label, randomized controlled trial was conducted at the [Name of Infectious Disease Hospital] during the peak viral season (November 2023 – March 2024). The study enrolled 200 children aged 6 months to 5 years with confirmed viral gastroenteritis (Rotavirus or Norovirus antigen-positive). Patients were randomized 1:1 into two groups: Control Group (n=100): Received standard World Health Organization (WHO) protocol: Low-osmolarity Oral Rehydration Solution (ORS) and diet. Intervention Group (n=100): Received standard care (ORS) + Pathogenetic Therapy (Racecadotril 1.5 mg/kg TID) + Symptomatic support (Zinc sulfate 20mg OD). Primary outcomes were the duration of diarrhea (time to the last unformed stool) and total volume of ORS consumed. Secondary outcomes included the length of hospital stay (LOS) and the rate of treatment failure requiring IV rehydration. Results: The Intervention Group demonstrated a significantly shorter median duration of diarrhea compared to the Control Group (36.4 hours vs. 58.2 hours; p<0.001). The total recovery time was reduced by approximately 22 hours. Consequently, the mean Length of Stay (LOS) was significantly shorter in the Intervention Group (2.8 ± 0.6 days vs. 4.1 ± 0.9 days; p<0.001). The requirement for unscheduled intravenous fluid resuscitation was lower in the Intervention Group (4% vs. 12%; p=0.03). Subgroup analysis revealed that Racecadotril was equally effective for both Rotavirus and Norovirus etiologies. Conclusion: An optimized treatment strategy combining standard rehydration with pathogenetic antisecretory therapy (Racecadotril) and mucosal regeneration support (Zinc) is superior to rehydration alone. This approach actively reduces fluid loss and shortens disease duration without safety concerns, suggesting it should be the standard of care for seasonal viral gastroenteritis.

Measles, caused by the measles virus, remains a significant cause of morbidity in children worldwide despite the availability of effective vaccines. Infants and young children are especially vulnerable, as their immune systems are still maturing. Breastfeeding provides both nutritional and immunological benefits, potentially influencing disease severity and outcomes in various pediatric infections, including measles. This article examines the clinical course of measles in children who are breastfed compared to those who are not, with a focus on immunological mechanisms, maternal antibody transfer, and implications for disease management and prevention.

Objective: To evaluate the efficacy of an innovative "Active Prevention Protocol" (APP)—incorporating early urinary NGAL biomarker screening and a digital fluid management application—compared to standard clinical care in reducing the incidence of severe complications (AKI and Grade III dehydration) in children hospitalized with severe acute intestinal infections. Methods: A prospective, randomized controlled trial was conducted at the [Name of University Hospital] from January 2024 to October 2024. The study enrolled 240 children (aged 1-10 years) admitted with severe AII (defined by Clark scale >12 points). Patients were randomized 1:1 into: Control Group (n=120): Managed according to standard national guidelines (clinical monitoring of urine output, standard chart-based fluid balance). Intervention Group (n=120): Managed via the "Active Prevention Protocol," which included: (1) Urinary NGAL testing at admission and 24h to detect subclinical kidney stress; (2) Use of a custom "Smart-Hydration" mobile app for real-time calculation of fluid loss vs. intake; and (3) Early targeted intervention (nephroprotective hydration) if NGAL >50 ng/mL. The primary endpoint was the incidence of Acute Kidney Injury (AKI) defined by KDIGO criteria. Secondary endpoints included admission to the Intensive Care Unit (ICU) and duration of hospital stay. Results: The incidence of AKI was significantly lower in the Intervention Group compared to the Control Group (3.3% vs. 11.7%; p=0.015). In the Intervention Group, 18 patients were identified as "NGAL-positive" despite normal serum creatinine; early aggressive fluid resuscitation in this subgroup successfully prevented progression to clinical AKI in 94% of cases. The use of the digital app resulted in higher adherence to prescribed rehydration volumes (92% vs. 74% in controls). Consequently, the rate of transfer to the ICU for shock/instability was reduced by 60% in the Intervention Group (p=0.04). Conclusion: The integration of innovative diagnostic tools (uNGAL) and digital monitoring technologies allows for the detection of complications in the "pre-clinical" phase. This proactive strategy significantly reduces the incidence of renal injury and severe dehydration compared to traditional reactive management, supporting the adoption of precision medicine approaches in infectious disease wards.

Thyroid hormones (THs) profoundly influence cardiac electrophysiology, cellular architecture, and hemodynamic performance. Dysregulation of triiodothyronine (T3) and thyroxine (T4)—whether overt or subclinical—produces multilayer remodeling ranging from ion-channel transcription to autonomic imbalance, creating an arrhythmogenic substrate. Hyperthyroidism accelerates depolarization kinetics, shortens action potential duration (APD), enhances β-adrenergic responsiveness, and increases intracellular Ca²⁺ cycling, predisposing to atrial fibrillation (AF) and supraventricular tachyarrhythmias. Conversely, hypothyroidism prolongs repolarization, disrupts Ca²⁺ reuptake, induces myocardial stiffness, and increases susceptibility to bradyarrhythmias and torsadogenic ventricular arrhythmias. This article integrates genomic, non-genomic, electrophysiological, structural, and hemodynamic pathways linking TH dysregulation to cardiac arrhythmogenesis, bridging molecular physiology with clinical electrophysiology.

Atrial fibrillation (AF) increasingly emerges as a metabolic disease rather than an isolated electrophysiological disorder. Metabolic dysfunction—including obesity, insulin resistance, dyslipidemia, mitochondrial injury, chronic inflammation, and epicardial adipose tissue (EAT) expansion—creates a structural and electrophysiological atrial substrate that predisposes to AF. Etiologic metabolic stressors induce oxidative injury, abnormal intracellular calcium cycling, ion-channel remodeling, gap junction disruption, mitochondrial dysfunction, fibroblast activation, and autonomic imbalance. Together, these mechanisms generate conduction heterogeneity, ectopic firing, rotor stabilization, and progressive atrial cardiomyopathy. This review integrates metabolic etiologies with mechanistic pathways of AF pathogenesis, providing a comprehensive conceptual model linking systemic metabolism to atrial arrhythmogenesis. Understanding AF as a metabolic-inflammatory-fibrotic disorder offers new opportunities for prevention and personalized therapy.

Recent advances (2024–2025) have fundamentally reshaped our understanding of the role of microorganisms in psoriasis pathogenesis. Cutting-edge studies using Mendelian randomization have provided the first genetic evidence of bidirectional causality between the skin microbiome and psoriasis, demonstrating that dysbiosis not only triggers but is also perpetuated by the disease. Integrated microbiome–metabolome analyses revealed novel inflammatory loops driven by increased Staphylococcus aureus, Corynebacterium spp., arachidonic acid pathway metabolites, and oxidative stress markers, alongside depletion of short-chain fatty acid-producing bacteria. Biologic therapies show differential effects on gut microbiota: secukinumab restores a healthier Firmicutes/Bacteroidetes ratio and boosts Faecalibacterium prausnitzii, whereas ustekinumab may favor Enterobacteriaceae expansion. Emerging preclinical data highlight the therapeutic potential of topical microbiome transplantation and engineered strains (e.g., modified Roseomonas mucosa). Additionally, urban air pollution was shown to exacerbate psoriasis risk up to 3.6-fold through microbiome disruption.

Immunoglobulin M (IgM) is the largest antibody class that plays a leading role in the primary humoral response of the immune system. This review article reviews the biological properties of IgM, modern epidemiology (including the increase in the disease in the younger population), pathogenetic mechanisms (MYD88 L265P, CXCR4 mutations, cryoglobulinemia, autoimmune regulation), diagnostic approaches (immunofixation, NGS, cryoglobulin detection), and the latest treatment strategies (BTK inhibitors, BCL2 inhibitors, rituximab, plasmapheresis, CAR-T and bispecific antibodies). Special attention is paid to the significant increase in Waldenström macroglobulinemia and IgM-related cryoglobulinemia in young patients (up to 50 years old) over the past 5 years, as well as post-COVID-19 autoimmune syndromes. The article is intended for hematologists, immunologists, and internal medicine physicians.

Endemic mumps (rubella, mumps) is the pathology that has decreased most sharply among childhood infectious diseases since the introduction of the MMR vaccine, but in 2023-2025, "breakthrough" infections in vaccinated children (vaccine breakthrough) and the need for a third dose have become an urgent problem. This article highlights the clinical and epidemiological characteristics of the disease in children, unique complications (type 1 diabetes, fetal death, sensorineural deafness), and modern treatment and prevention algorithms from a medical perspective. New medical facts: the mumps virus can cause autoimmune type 1 diabetes by directly cytolytically affecting pancreatic β-cells (2024 cohort studies); also, the oncogenic potential of the virus (association with Warthin tumors of the parotid gland) is being reassessed from the perspective of pediatric oncology.

The normal microflora of the gastrointestinal tract (GI) is one of the most important physiological systems of the human body, and its composition and functional state determine many aspects of the health of the macroorganism. As a result of metagenomic studies (16S rRNA profiling, whole genome sequencing and metabolomics) in the last decade, the phylogenetic and functional diversity of the GI microbiota has been radically reassessed. It is currently established that 90-99% of the intestinal microbiota in healthy adults is composed of the phyla Firmicutes, Bacteroidetes, Actinobacteria and Verrucomicrobia, of which the most important functional representatives are Faecalibacterium prausnitzii, Akkermansia muciniphila, Roseburia intestinalis, Eubacterium rectale, Bifidobacterium longum and Bacteroides thetaiotaomicron species. This complex of microorganisms not only ensures the absorption and metabolism of nutrients, but also forms the mucosal immune system, creates a barrier against the colonization of pathogenic microorganisms, synthesizes short-chain fatty acids (acetate, propionate, butyrate), vitamins (K, group B), neurotransmitters (GABA, serotonin) and other bioactive compounds, and directly affects the activity of the central nervous system through the "gastrointestinal-brain" axis.

This scientific article extensively covers the structural structure of air microbiology, the processes of its enrichment with microorganisms distributed in the form of bioaerosols, and the mechanisms of preservation of microbiological factors in the atmospheric layer. The study analyzes in detail the natural sources, aerodynamic behavior, viability, and hygienic significance of bacteria, fungi, viruses, pollen particles, spores, actinomycetes, and organic residue aerosols. Also, the advantages and limitations of modern microbiological, physicochemical, and molecular biological methods used in the collection and identification of air samples are compared: impaction methods, sedimentation collection methods, volumetric aerosol sampling, qPCR, MALDI-TOF MS, and metagenomic sequencing methods. Ecological, meteorological, and anthropogenic factors (temperature, humidity, wind speed, industrial emissions, biotechnological production, and agricultural activities) affecting the concentration of microorganisms in the atmosphere are explained based on scientific literature and observations.

Severe maxillary atrophy remains one of the most challenging conditions in oral and maxillofacial rehabilitation. Modern implantology has introduced several graftless solutions—including zygomatic, pterygoid, trans-sinus, and trans-nasal implants—which allow immediate or early loading and reduce the need for bone augmentation. This expanded review provides detailed anatomical descriptions, biomechanical principles, surgical protocols, indications, contraindications, survival rates, and complication profiles based on up-to-date peer-reviewed scientific literature.

 Tuberculosis (TB) persists as a significant global health burden, despite substantial advances in diagnostic methodologies and therapeutic regimens.[1] The disease’s epidemiological resilience is driven by a combination of biological, clinical, and socio-environmental determinants. Latent Mycobacterium tuberculosis infection remains widespread, serving as a continuous reservoir for active disease, particularly among individuals with compromised immune function. Moreover, the increasing prevalence of multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) presents a critical challenge to existing treatment frameworks and poses a threat to global TB control strategies[2] Transmission occurs primarily via aerosolized droplets, with clinical manifestations typically including chronic cough, fever, weight loss, and night sweats. Effective TB control mandates integrated approaches encompassing early and accurate detection, strict adherence to prolonged pharmacological therapy, sustained vaccination programs, and targeted interventions addressing structural determinants such as poverty, overcrowding, and limited healthcare access. Strengthening health systems and enhancing population-level awareness are essential to mitigating transmission dynamics and reducing TB-associated morbidity and mortality.[4]

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 SGLT2 inhibitors have been shown to lower the risk of heart failure (HF) in people with diabetes, improving outcomes for HF patients across all levels of left ventricular ejection fraction (LVEF). This is achieved by reducing HF exacerbations and the risk of cardiovascular death. However, there is still uncertainty regarding the mechanisms responsible for these benefits beyond the inhibition of the sodium-glucose cotransporter 2 (SGLT2). Limited studies have explored the effects of SGLT2 inhibitors on cardiac remodeling through imaging and specific biomarkers, particularly in HF patients, with existing findings being inconclusive and primarily focused on those with diabetes and reduced LVEF. Importantly, there is a lack of data examining how SGLT2 inhibitors influence cardiac geometry, function, and biomarkers in the context of HF, regardless of LVEF.

Adverse remodeling of the myocardium, especially in the left ventricle, is a critical factor in the progression of HF, which is typically classified based on LVEF. However, other aspects, such as the left atrium’s role, are often overlooked. The left atrium significantly impacts cardiac function, especially concerning left ventricular filling during the diastolic phase. Dysfunction of the atrium can directly contribute to pulmonary congestion. Atrial remodeling occurs in HF irrespective of the extent of left ventricular systolic dysfunction and can be identified in both preserved and reduced LVEF cases. The morphology of the left atrium has been linked to the risk of developing HF in high-risk individuals and has been associated with increased rates of hospitalization and mortality among HF patients. Consequently, atrial health has become an essential focus in recent European Society of Cardiology (ESC) guidelines for HF. This study aims to examine the effect of SGLT2 inhibitors on cardiac remodeling parameters, with a specific focus on left atrial remodeling, in patients with HF, independent of their LVEF status.

This article examines the impact of psychological stress factors on the course of rheumatoid arthritis (RA) in patients, as well as the effectiveness of an integrated psychotherapeutic approach. The Perceived Stress Scale (PSS-10) and the Beck Anxiety Inventory (BAI) were used to assess the emotional state of patients. Stress-management training, relaxation techniques, and short-term cognitive-intervention therapy were implemented as psychocorrection. The results demonstrated that reducing psychological stress levels in RA patients positively affects disease activity, decreases pain intensity, and improves quality of life.

The causes and clinical and functional parameters of intraocular lens dislocation after cataract phacoemulsification are one of the current problems in ophthalmology. Materials and methods. This study was conducted at the Ophthalmology Department of the Multidisciplinary Clinic of Tashkent State Medical University and “Republican Specialized Scientific-Practical Medical Center of Eye Microsurgery” from September 2024 to September 2025. 21 patients (21 eyes) diagnosed with dislocation of the posterior chamber intraocular lens implanted after cataract phacoemulsification were selected for the study. Patients were divided into two groups. Group 1 (main) - patients with dislocation of the posterior chamber intraocular lens. Group 2 (control) - patients with implantation of the intraocular lens into the posterior chamber. The study included patients (50-80 years old) with posterior chamber intraocular lens dislocation after cataract phacoemulsification. Patients with severe ophthalmological diseases (glaucoma, macular degeneration, diabetic retinopathy) and damage to the organ of vision were excluded. Clinical and instrumental methods were used to comprehensively assess visual functions and the state of eye structures. Results of the study. The study analyzed 21 patients (21 eyes) with posterior chamber intraocular lens dislocation after cataract phacoemulsification. The assessment of clinical and functional indicators made it possible to identify the characteristic features of visual impairment, structural changes in the eyeball, and the frequency of various types of intraocular lens dislocation. Conclusion. The data obtained confirm the leading role of degenerative changes in the bundle of Zinn in the mechanism of intraocular lens dislocation, as well as the importance of early detection and correction of ocular hypertension and macular changes. Optimization of surgical approaches and individual selection of treatment tactics for patients with intraocular lens dislocation are promising areas for further research.

Relevance. During cataract surgeries, the lens capsule is sometimes not preserved, which makes the standard placement of an intraocular lens (IOL) impossible. In such cases, fixation of the lens in the posterior chamber of the eye is necessary.

Aim of the study: To perform a comprehensive assessment of visual function, anatomical condition, and clinical-functional indicators of the eye after fixation of IOL in the posterior chamber in cases without the lens capsule. Materials and Methods: Fifty patients (50 eyes) with cataracts lacking the lens capsule were examined. The patients were divided into two groups: Group 1 (main group) — patients with IOL fixed in the posterior chamber; Group 2 (control group) — patients with IOL fixed in the anterior chamber. All patients underwent a comprehensive ophthalmological examination including visual acuity testing, biomicroscopy, tonometry, ophthalmoscopy, and special diagnostic methods such as autorefractometry, pachymetry, endothelial microscopy, echobiometry, A-scan, B-scan, ultrasound biomicroscopy (UBM), and optical coherence tomography (OCT). Results: The average visual acuity in patients with IOL fixation in the posterior chamber was higher, at 0.6±0.1, while in patients with IOL fixation in the anterior chamber, it was slightly lower, at 0.5±0.1. The main complications included cystoid macular edema (8%), IOL decentration (6%), and inflammatory reactions (12%). Intraocular pressure normalized within one month post-operation in 90% of patients. Conclusion: Fixation of IOL in the posterior chamber in the absence of the lens capsule is an effective method for rehabilitating patients with cataracts. Optimal choice of fixation method helps to minimize the risk of complications and achieve satisfactory functional outcomes.

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Background: The long-term cardiovascular sequelae of SARS-CoV-2 infection have emerged as a significant global health concern. Dilated cardiomyopathy (DCM) is a serious potential complication of the post-acute phase of COVID-19, often resulting from persistent myocardial inflammation or autoimmune dysregulation. Objective: This article reviews current evidence regarding the pathophysiology, diagnosis, and management of post-COVID-19 DCM and highlights the clinical challenges in distinguishing it from idiopathic forms. Methods: A comprehensive review of literature published between 2020 and 2024 was conducted using PubMed, Scopus, and Google Scholar databases. Studies focusing on cardiac magnetic resonance (CMR) findings, biopsy-proven myocarditis, and heart failure outcomes in post-COVID patients were analyzed. Results: Evidence suggests that post-COVID-19 DCM develops through direct viral toxicity, cytokine-mediated injury, and endothelial dysfunction. CMR studies reveal late gadolinium enhancement (LGE) in a subset of recovered patients, indicating myocardial fibrosis. Conclusion: Post-COVID-19 DCM requires a high index of suspicion. Early initiation of guideline-directed medical therapy (GDMT) is crucial. Long-term longitudinal studies are needed to determine the reversibility of this condition.

Background: Broncho-obstructive syndrome (BOS), characterized by wheezing and airflow limitation, is a common complication of acute bronchitis in children. Respiratory Syncytial Virus (RSV) and Rhinovirus (RV) are the predominant etiological agents, yet their pathophysiological mechanisms and long-term prognostic implications differ significantly. Objective: This article aims to analyze the clinical and etiological relationship between BOS and specific viral pathogens (RSV and Rhinovirus) in pediatric patients and to evaluate their differential impact on disease severity and future asthma risk. Methods: A systematic review of studies published between 2019 and 2024 was conducted using PubMed and Scopus databases. The analysis focused on pediatric cohorts presenting with acute wheezing bronchitis, comparing viral prevalence, clinical phenotypes, and inflammatory markers associated with RSV and RV infections. Results: RSV is identified as the primary cause of BOS in infants under 12 months, driving obstruction via direct epithelial necrosis and mucus plugging. In contrast, Rhinovirus is more prevalent in children over 12 months and is strongly associated with atopic predispositions. Children with RV-induced BOS show a significantly higher risk of developing asthma compared to those with RSV-induced episodes. Conclusion: Differentiation between RSV and RV etiologies in BOS is clinically relevant. While RSV management focuses on supportive care for obstruction, RV-associated wheezing may warrant earlier targeted anti-inflammatory strategies and close monitoring for asthma development.

Background: Acute bronchiolitis in infancy is the most common cause of hospitalization worldwide. However, its impact extends beyond the acute phase, with a significant proportion of children developing recurrent post-viral wheezing and asthma in later childhood. Objective: This article aims to evaluate the long-term respiratory sequelae of acute bronchiolitis, focusing on the stratification of risk for developing bronchial asthma versus transient wheezing, and the differential roles of viral pathogens (RSV vs. Rhinovirus). Methods: A systematic review of longitudinal birth cohort studies and clinical trials published between 2018 and 2024 was conducted. Key databases included PubMed, Scopus, and Cochrane Library. The Asthma Predictive Index (API) and lung function trajectories were analyzed. Results: Approximately 40-50% of infants hospitalized with bronchiolitis experience recurrent wheezing. Evidence suggests distinct phenotypes: RSV-induced bronchiolitis is largely associated with "transient early wheezing" due to smaller airway geometry, whereas Rhinovirus-induced wheezing, particularly in atopic infants, is a strong predictor of persistent asthma and allergic sensitization by school age. Conclusion: Post-bronchiolitis wheezing is a heterogeneous condition. Differentiating between transient sequelae and early-onset asthma is crucial for appropriate management. Children with Rhinovirus-induced severe bronchiolitis warrant closer follow-up for asthma prevention strategies.

Every woman has two almond-shaped structures called ovaries on either side of the uterus. In an adult woman who has not gone through menopause, an egg is released from one of these ovaries each month. An ovarian cyst, or ovarian cyst, refers to a fluid-filled cyst that develops on or near the ovary. Many women develop ovarian cysts at some point in their lives. Ovarian cysts are very common and come in two types: functional and abnormal. Functional cysts develop as a result of the normal functioning of the ovary. They are usually smaller than abnormal cysts and go away on their own without treatment.

Uterine cyst is a common pathology in women's reproductive health, occurring in women of different ages. This research work provides an in-depth analysis of modern diagnostic methods and effective treatment strategies for uterine cysts. This article describes in detail the etiology, pathogenesis, and clinical manifestations of uterine cysts. The importance of modern diagnostic methods, including ultrasound, MRI, hysteroscopy, and laboratory tests, is emphasized. The role of differential diagnosis in the diagnostic process is highlighted.

Treatment approaches include conservative and surgical methods. The effectiveness of hormonal drugs, anti-inflammatory drugs and physiotherapeutic methods in conservative therapy was evaluated. Among surgical interventions, the advantages of laparoscopic and open operations were compared. The results of the study proved the high effectiveness of modern minimally invasive methods. An integrated approach was recommended to improve the quality of life of patients and reduce complications. The importance of preventive measures and long-term monitoring programs was emphasized.

Lichen planus is a pressing problem in dermatology due to the presence of severe forms of lichen planus, particularly those with a chronic course. Neoplastic transformation of lesions is possible, which is difficult to diagnose in atypical clinical forms of lichen planus.

 Diabetes mellitus (DM) is a chronic disorder of carbohydrate metabolism and is one of the leading causes of death and disability worldwide. Diabetes induces metabolic stress, which significantly impacts the cardiovascular system. Consequently, a large proportion of diabetic patients die due to cardiovascular complications.

This study experimentally evaluated the effects of a GLP-1 agonist (liraglutide) and metformin, administered separately and in combination, on insulin resistance, glucose tolerance, body weight, and metabolic parameters in a metabolic syndrome (MetS) model. A 12-week high-fat/fructose diet was used to induce MetS, followed by a 4-week pharmacological intervention. The combination of GLP-1 RA + metformin demonstrated a pronounced improvement in OGTT outcomes, a marked reduction in the HOMA-IR index, decreased body weight, regression of hepatic steatosis, and lowered oxidative stress markers. The combined therapy achieved stronger restoration of insulin sensitivity compared to monotherapy with either agent. The findings indicate that GLP-1 RA and metformin exhibit a potent synergistic therapeutic potential when used together for treating metabolic syndrome.

Pregnancy induces a state of unique immunological tolerance to prevent fetal rejection, characterized by a shift from Th1 to Th2 immune responses. In women with Chronic Hepatitis B (CHB), this physiological immunosuppression may synergize with virus-induced T-cell exhaustion, leading to increased viral replication and altered perinatal outcomes. Objective: To investigate the dynamics of immunological markers (cytokines, T-cell subsets) and viral load during pregnancy in women with CHB, and to evaluate their association with perinatal risks such as preterm birth, fetal distress, and postpartum hepatic flares. Methods: A prospective cohort study was conducted at Andijan State Medical Institute involving 120 pregnant women: 60 with HBsAg-positive Chronic Hepatitis B (Main Group) and 60 HBsAg-negative healthy controls (Control Group). Serum levels of HBV DNA, ALT, and cytokines (IFN-γ, IL-10, IL-4) were measured at the 1st, 2nd, and 3rd trimesters and 3 months postpartum. Perinatal outcomes were recorded. Results: Pregnant women with CHB exhibited a profound Th2-shift, evidenced by significantly higher IL-10 and lower IFN-γ levels compared to healthy pregnant controls (p<0.01). This immune tolerance correlated with a significant rise in HBV DNA levels peaking in the 3rd trimester. Postpartum, 28% of CHB women experienced an ALT flare ("immune reconstitution"). High maternal viral load (>10^6 IU/mL) was independently associated with an increased risk of threatened preterm labor (OR=2.4) and lower neonatal Apgar scores. Conclusion: The synergistic immunotolerance of pregnancy and CHB leads to high viral replication in the third trimester. While this protects the liver from inflammation during pregnancy, it increases the risk of perinatal transmission and postpartum flares. Immunological monitoring is essential for timely antiviral prophylaxis.

Background: Microbial eczema is a chronic inflammatory dermatosis closely linked to skin and gut dysbiosis. Emerging evidence regarding the "gut-skin axis" suggests that modulating the intestinal microbiota with probiotics and prebiotics (synbiotics) may influence skin inflammation and immune response to Staphylococcus aureus. Objective: To evaluate the clinical efficacy of adding a synbiotic supplement (containing Lactobacillus rhamnosus, Bifidobacterium longum, and Fructooligosaccharides) to the standard treatment regimen of microbial eczema. Methods: A randomized controlled clinical trial was conducted at Andijan State Medical Institute involving 90 patients with microbial eczema. Patients were divided into two groups: the Control Group (n=45) received standard topical and systemic therapy, while the Main Group (n=45) received standard therapy plus an oral synbiotic complex once daily for 30 days. Efficacy was assessed using the SCORAD index, Dermatology Life Quality Index (DLQI), and recurrence rates over a 6-month follow-up. Results: By day 30, the Main Group showed a significantly greater reduction in SCORAD scores (72% reduction) compared to the Control Group (55% reduction, p<0.05). Patients receiving synbiotics reported faster relief from pruritus and a marked improvement in DLQI. Furthermore, the recurrence rate at 6 months was significantly lower in the synbiotic group (22%) compared to the control group (48%). Conclusion: The inclusion of synbiotics in the treatment of microbial eczema enhances clinical response, accelerates symptom resolution, and reduces the frequency of relapses, likely by normalizing the gut-skin immune axis.

Latin remains a cornerstone of medical education, providing the etymological foundation for much of the terminology used in anatomy, pharmacology, and clinical practice. However, traditional teaching methods often fail to engage modern students, leading to calls for innovative pedagogical strategies. This literature review examines recent advancements in teaching Latin to medical students, drawing on scholarly sources to analyze approaches such as digital tools, gamification, blended learning, and contextual integration. Through a systematic search of academic databases and journals, key studies were identified that highlight the effectiveness of these methods in improving student motivation, retention, and application of Latin-based terms. Results indicate that incorporating technology and interactive elements significantly enhances learning outcomes compared to rote memorization. The discussion explores implications for curriculum design, emphasizing the need for hybrid models to bridge historical traditions with contemporary educational needs. Overall, these new approaches promise to revitalize Latin instruction, making it more relevant and effective for future healthcare professionals.

Normal human spermatozoon morphology is the integrated outcome of precisely regulated maturation processes occurring during spermatogenesis and epididymal transit. This comprehensive review synthesizes ultrastructural, high-magnification, and population-based evidence defining morphological normality according to the strict Tygerberg (Kruger) criteria and WHO 6th edition (2021) reference values. In fertile men, only 4–15% (5th–95th centiles) of ejaculated spermatozoa meet these stringent criteria, reflecting the elimination of >95% of gametes through sequential quality-control checkpoints. Key maturation events include nuclear condensation with near-complete histone-to-protamine replacement, acrosome coverage of 48–70% of the anterior nuclear surface, mitochondrial sheath assembly (9–11 gyres), distal migration and shedding of the cytoplasmic droplet, and remodeling of surface glycoproteins. Spermatozoa classified as morphologically normal exhibit homogeneous chromatin (large vacuoles <0.8%), intact acrosomes (>96%), symmetrical midpieces, and fully developed flagella with characteristic 36-nm fibrous sheath periodicity. Strict morphology remains the strongest single predictor of natural fertility and assisted reproductive outcomes, with each 1% increase above 4% normal forms associated with 7–11% higher live-birth rates in ICSI. Emerging molecular and proteomic data reinforce that structural normality is a reliable proxy for functional competence. This review establishes the current evidence-based benchmarks for normal human sperm morphology and its developmental origins.

The health of individuals is closely linked to the factors of the production environment and socio-economic living conditions. Harmful elements in the workplace and unfavorable socio-economic circumstances significantly impact the deterioration of health, increasing the risk of various diseases. This article analyzes the interrelationship between production environment factors and socio-economic conditions affecting human health. The study emphasizes the importance of creating a safe working environment and improving socio-economic conditions to strengthen public health. The findings highlight the need for effective policies in healthcare and social sectors to promote healthier living and working conditions.

An analysis of the results of a dental examination in Andijan region (2022–2024) showed a high prevalence of signs of periodontal tissue damage. In these conditions, emphasis is needed on the active introduction of prevention at the individual level and the establishment of new forms of organization of specialized periodontic care.

Hemorrhoidal disease is one of the most common proctological conditions worldwide, and the last decade has seen a rapid increase in the use of minimally invasive approaches such as laser hemorrhoidoplasty (LHP). This systematic review aimed to compare the clinical efficacy, complication rates, and rehabilitation outcomes of LHP with conventional hemorrhoidectomy using studies published between 2019 and 2024. A total of 15 high-quality sources, including randomized controlled trials, cohort studies, and meta-analyses, were selected from PubMed, Google Scholar, Web of Science, and other indexed journals, focusing on patients with grade II–IV hemorrhoidal disease. The findings indicate that LHP offers notable advantages over conventional hemorrhoidectomy, including shorter operative time (8–15 minutes), minimal intraoperative blood loss, lower postoperative pain scores (VAS 2–3), and faster return to daily activities (2–3 days). Despite these short-term benefits, LHP demonstrated higher long-term recurrence rates (15–20%) compared to conventional surgery (4–5%) over 1–2 years of follow-up. In conclusion, laser hemorrhoidoplasty represents an effective minimally invasive alternative that significantly improves early postoperative outcomes, although further studies are needed to confirm its long-term superiority.

This article examines the system of civil defense in the Republic of Uzbekistan, its main tasks, and the organizational structure at the national and local levels. It highlights the role of civil defense in protecting the population, economic facilities, and cultural values during military operations and emergencies. The functions of emergency management bodies, the establishment of the Ministry of Emergency Situations, and the responsibilities of local authorities are discussed. The paper also emphasizes the importance of readiness, coordination, and proper training of civil defense personnel in preventing and mitigating emergency situations.

Sleep is one of the most essential physiological processes ensuring the homeostatic stability of the human body. It plays a crucial role in the optimal functioning of the central nervous system, endocrine system, immune system, and metabolic pathways. Prolonged sleep deprivation acts as a significant stress factor on the body’s major homeostatic systems. Insufficient sleep enhances systemic inflammation through activation of the hypothalamic–pituitary–adrenal (HPA) axis, continuous stimulation of the sympatho-adrenal system, and disruption of cytokine balance.

This scientific article provides an in-depth analysis of the modern treatment methods for gonorrhea, focusing on their effectiveness and clinical application principles. The increasing drug resistance of Neisseria gonorrhoeae represents a significant global public health challenge. The article examines updated recommendations for antibiotic therapy, contemporary clinical protocols, combination treatment approaches, and effective strategies for managing drug-resistant strains. Additionally, it outlines evidence-based approaches aimed at preventing complications, improving treatment outcomes, and strengthening epidemiological control. The findings presented in this work provide clinically applicable insights that can contribute to reducing gonorrhea incidence and enhancing the quality of medical care.

Background: Operative surgery is a core discipline in medical education that requires mastery of anatomical knowledge, psychomotor skills, and intraoperative decision-making. Traditional teaching approaches often struggle to provide sufficient practice opportunities and personalised feedback for large student groups.Objective: This study aims to identify and summarise effective methods for using artificial intelligence (AI) in teaching operative surgery in higher medical education institutions.Methods: A narrative review of contemporary educational practices and technological innovations was conducted. AI-based tools were classified into practical categories relevant to operative surgery training.
Results: Five groups of effective AI applications were identified: AI-enhanced simulation, computer-vision–based skills assessment, intelligent tutoring systems, adaptive e-learning platforms, and mobile AI tools. These methods improve student engagement, enhance the accuracy of skill assessment, and expand opportunities for independent practice.Conclusion: AI offers promising opportunities to modernise operative surgery education. When integrated into a competency-based curriculum, AI can strengthen student performance, provide personalised training pathways, and support safe skill acquisition.

 Violence-induced injuries remain a major concern in forensic medical practice, characterized by their complexity, variability in causative mechanisms, and significant medico-legal implications. Achieving accurate interpretation requires a multidisciplinary approach integrating clinical examination, radiological imaging, and molecular diagnostics.

Clinical assessment remains the fundamental component in identifying and characterizing both external and internal injuries, determining their severity, and reconstructing the chronological sequence of traumatic events. Advanced imaging modalities—including computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography—enable detailed visualization of overt as well as subtle or occult lesions, thereby enhancing the accuracy, objectivity, and reproducibility of forensic evaluations. Molecular techniques, such as DNA profiling, biomarker analysis, and immunohistochemical assays, contribute to a deeper understanding of tissue alterations, provide reliable indicators of injury vitality, and facilitate differentiation between ante-mortem and post-mortem damage.

This multidisciplinary approach not only improves the accuracy of injury documentation but also strengthens the evidentiary value in legal proceedings. The current review highlights contemporary advancements in forensic methodologies for violence-related injuries, discusses challenges in interpretation, and emphasizes the need for standardized protocols to ensure consistency and reliability in forensic investigations.

This scientific work provides a thorough analysis of not only the clinical and medical aspects of pneumonia, but also its role in nature, ecological systems and microbiological balance. Pneumonia is a complex inflammatory process that can be of bacterial, viral, mycoplasma and fungal origin, which significantly changes the immunological response mechanisms of the organism, microbiocenosis and the ecological pathogen circulation system. During the study, the development, pathogenesis, epidemiological spread of pneumonia, ecological interactions associated with reservoirs and vectors, mechanisms of preservation and spread of pathogens in the natural environment are covered based on scientific sources.

Immunoglobulin E (IgE) is an important antibody that plays a central role in the body's immune response to allergic diseases and parasitic infections. This review article discusses the structural properties of IgE, its synthesis, receptors (high-affinity FceRI and low-affinity Fcell/CD23), protective mechanisms against allergens and parasitic antigens, as well as its pathogenetic role in atopic diseases (atopic dermatitis, allergic rhinitis, bronchial asthma, anaphylaxis).

Population studies conducted in recent years have shown that an increase in the level of total and allergen-specific IgE is a major factor in the epidemiological increase in allergic diseases worldwide. In industrialized countries, sensitization is observed in 25-40% of the population, with total IgE levels exceeding 100-150 kU/L, and this figure is even higher in children and young people. In tropical regions, polyclonal IgE hyperimmunoglobulinemia (up to 10,000-30,000 KU/L) associated with helminth infections is characteristic.

The pathogenesis section provides an in-depth analysis of the relationship between IgE synthesis and genetic (IL4RA, STAT6, FCER1A, IL13 gene polymorphisms), epigenetic and environmental factors (allergen exposure, microbiome disruption, "hygiene hypothesis"), the central role of the Th2-oriented immune response, mast cell and basophil degranulation, eosinophil activation, and mechanisms of late-type allergic reactions. New roles of IgE in neuroimmune and tissue remodeling processes (e.g., autoimmune IgE and anti-FceRl antibodies in chronic urticaria) are also discussed.

The diagnostic department uses modern laboratory methods such as total IgE, allergen-specific IgE (ImmunoCAP, ISAC chip technology), skin prick tests, component diagnostics, basophil activation test (BAT), as well as molecular Allergology approaches (CRD component-resolved diagnostics) and their clinical sensitivity and specificity are described in detail.

The treatment section presents the efficacy, indications, and long-term outcomes of allergen-specific immunotherapy (ASIT/SCIT and SLIT), biological drugs, anti-IgE monoclonal antibody omalizumab (FDA approved in 2003, currently used in children over 6 months of age), new generation anti-IgE drugs (ligelizumab, quilizumab), anti-IL-4Ra (dupilumab), anti-IL-5/IL-5R (mepolizumab, reslizumab, benralizumab), and future potential targets (anti-TSLP, anti-IL-33) based on scientific evidence.

Bacterial infectious diseases remain one of the most significant global health challenges due to their wide distribution, rapid transmission, and potential to cause severe complications. These infections are caused by pathogenic bacteria that enter the human body through various routes such as air, water, food, physical contact, and damaged tissues. Bacterial pathogens can affect different organ systems and lead to illnesses such as pneumonia, meningitis, tuberculosis, and tonsillitis. Early diagnosis, appropriate antibiotic therapy, and preventive measures play a crucial role in reducing morbidity and mortality rates. This article discusses the general characteristics of bacteria, major bacterial diseases, their clinical manifestations, diagnostic approaches, and modern treatment strategies. The importance of hygiene, vaccination, and antimicrobial stewardship inpreventing bacterial infections is also highlighted.

Background: Physiology is a foundational discipline in medical education, providing the scientific basis for understanding human body functions and clinical decision-making. Traditional teaching approaches, although effective, often face limitations related to large student groups, variability in learning pace, and limited opportunities for interactive, data-driven learning. Objective: This study aims to identify and describe effective methods for incorporating artificial intelligence (AI) into the teaching of physiology in higher medical education institutions.Methods: A structured narrative analysis was conducted to examine AI-assisted educational technologies, focusing on simulation-based learning, adaptive e-learning systems, intelligent tutoring platforms, and data-driven assessment tools relevant to physiology instruction.Results: Five categories of effective AI-supported strategies were identified: AI-enabled physiological simulations, intelligent tutoring systems, adaptive learning platforms, predictive learning analytics, and AI-driven virtual laboratory environments. These approaches enhance conceptual understanding, personalise the learning experience, and support competency-based education.
Conclusion: AI provides valuable tools to improve the teaching and learning of physiology. When integrated responsibly, AI enhances interactivity, strengthens analytical thinking, and supports deeper comprehension of physiological principles essential for future medical professionals.

This article discusses the types of headaches, their frequency, causes, and methods of treatment. Nowadays, the symptom that bothers many people is a headache. Headaches have become a background of the disease, and when we have a headache, we are wary of many medications. The medications we take for a simple headache cause serious harm to our body organs. The medicine we take, first of all, affects the gastrointestinal tract, the liver, and even the most harmless drug, of course, causes significant damage to the kidneys. However, this problem can be eliminated without medication, by affecting the reflexes and using light massage techniques. More than 150 different types of headaches are divided into three main categories - primary headaches, secondary headaches, and cranial neuralgia.

This study provides a detailed review of the anatomical structure and hemodynamic function of the aorta and major systemic arteries, including the carotid, subclavian, renal, and iliac arteries. It emphasizes how specific morphological features—such as lumen diameter, wall thickness, histological composition, and elasticity—directly influence blood flow dynamics, vascular resistance, and regional organ perfusion. The analysis highlights the functional significance of elastic arteries, particularly the aorta, in buffering cardiac pulsations and maintaining continuous diastolic flow, as well as the role of muscular arteries, such as the renal and iliac arteries, in regulating regional blood flow through vasomotor control. Additionally, the study explores how variations in arterial geometry, including branching patterns and bifurcation points, affect shear stress distribution and contribute to the localization of vascular pathologies, including atherosclerosis and aneurysm formation. By integrating anatomical and physiological perspectives, this research underscores the clinical relevance of understanding arterial structure–function relationships for the early detection, prevention, and management of cardiovascular diseases.

Tooth enamel is the hardest and most protective layer in the human body. It protects teeth from external harmful factors, including mechanical shock, microorganisms and chemicals. However, enamel can also weaken and break. In recent years, tooth enamel erosion has been increasing - this is the erosion of the tooth surface as a result of acidic exposure. Enamel erosion often develops unnoticed by patients, until pain and sensitivity appear. Therefore, its timely detection and prevention are very important.

Background: Chronic rhinosinusitis (CRS) affects 10-12% of the population and remains difficult to treat due to bacterial biofilm formation in the paranasal sinuses. The role of biofilms in CRS pathogenesis remains incompletely characterized.

Objective: To investigate biofilm formation in CRS patients, identify predominant bacterial species, and correlate biofilm burden with inflammatory markers and clinical outcomes.

Methods: We prospectively analyzed sinonasal tissue samples from 89 patients with CRS (mean age 52.3±12.4 years, 54% male) and 35 controls during endoscopic sinus surgery. Samples were processed for microbiological culture, bacterial identification via 16S rRNA sequencing, biofilm visualization using scanning electron microscopy (SEM), and histopathological analysis. Inflammatory markers (IL-6, TNF-α, IL-8, IL-17) were quantified in tissue homogenates. Clinical outcome data including symptom scores and recurrence rates were collected over 12 months.

Results: Biofilms were detected in 78.7% of CRS samples compared to 5.7% of controls (p<0.001). Most common biofilm-forming bacteria were Staphylococcus aureus (42.7%), Pseudomonas aeruginosa (31.5%), and Streptococcus pneumoniae (18.0%). Mean biofilm burden (measured by SEM analysis: bacterial cells per μm²) was 287±156 in CRS versus 12±8 in controls (p<0.001). Biofilm presence correlated strongly with elevated tissue IL-6 levels (r=0.72, p<0.001), TNF-α (r=0.68, p<0.001), and IL-8 (r=0.64, p<0.001). CRS patients with high biofilm burden (>300 cells/μm²) showed elevated inflammatory cytokines (mean IL-6: 245±89 pg/mL vs. 78±34 in low biofilm group, p<0.001). At 12-month follow-up, patients with biofilm-positive tissue demonstrated 2.4 times higher recurrence rates (48.3% vs. 20.0%, p=0.002) and worse endoscopic scores compared to biofilm-negative patients. Histopathological analysis revealed increased eosinophil infiltration (mean 52.3±18.6 per high-power field in biofilm-positive vs. 14.2±7.8 in biofilm-negative samples, p<0.001) and enhanced goblet cell hyperplasia in biofilm-positive tissues.

Conclusions: Bacterial biofilms are detected in majority of CRS patients and strongly associate with enhanced inflammatory response and poor clinical outcomes. Biofilm-directed therapeutic strategies warrant investigation as adjuncts to conventional surgical and antimicrobial approaches.

This article examines ecological metaphors in the Uzbek literary language from conceptual and cognitive perspectives. Ecological metaphors express complex meanings through natural imagery, reflecting human psychological states, social processes, and national culture. The study explores ecological metaphors from the perspectives of linguopoetics, cognitive linguistics, and ecolinguistics, detailing their functions and conceptual significance in literary texts.

Drug-resistant tuberculosis (DR-TB), including multidrug-resistant (MDR-TB) and extensively drug-resistant (XDR-TB) forms, is a critical global health challenge. The field of diagnostics is rapidly evolving, moving away from slow, traditional culture methods toward fast, molecular techniques that can identify resistance within hours or days. This review explores the main diagnostic methods for DR-TB, highlighting their strengths, weaknesses, and role in clinical practice. It pays special attention to automated molecular platforms and next-generation sequencing (NGS), assessing their potential for widespread use.

Chronic purulent sinusitis is a long-term inflammatory process in the air-permeable, clear cavities of the face, the main symptom of which is the formation of purulent exudate and a prolonged inflammatory reaction. The disease often develops after incomplete treatment of acute sinusitis or as a result of upper respiratory tract infections, septic conditions, and anatomical discrepancies. The clinical picture is characterized by difficulty breathing, headache, facial pain and heaviness, swelling of the upper lip, purulent discharge, and bad breath.

This study aimed to evaluate the efficacy of micellar vitamin D (Aquadetrim) in correcting vitamin D deficiency in patients with chronic pancreatitis (CP) complicated by exocrine pancreatic insufficiency. A total of 34 patients were examined. Among them, 20 patients with serum vitamin D levels below 20 ng/mL were assigned to the main group and received micellar vitamin D supplementation for 3 months alongside baseline enzyme therapy. The remaining 14 patients received only enzyme therapy. The results showed that enzyme therapy alone partially increased vitamin D levels, whereas patients receiving micellar vitamin D achieved a significant increase in serum 25(OH)D, approaching normal values. Clinical symptoms, including abdominal pain, muscle cramps, fatigue, hair loss, and brittle nails, improved markedly in the main group. No increase in serum calcium levels was observed during therapy, indicating the safety of the preparation. These findings suggest that in patients with chronic pancreatitis, combining enzyme therapy with micellar vitamin D is an effective approach for correcting vitamin D deficiency.

Acute cerebrovascular accident is a very serious and severe cerebrovascular pathology. Based on the latest WHO data, the mortality rate for ischemic stroke is from 10% to 25%, for hemorrhagic stroke - from 45% to 60%. The main complications leading to death include: brain edema, pulmonary edema, various types of heart failure and heart failure. In other cases, the consequences may be irreversible or temporary and are manifested by regression of communication, speech, emotional and other higher functions. A significant deterioration is observed in the first three months after a cerebrovascular accident.

The development of the “Young Women and Their Health” database and the establishment of medical and psychological monitoring at the primary healthcare level provide opportunities to identify the specific characteristics of physical workload among middle-aged women, as well as to determine the relationship between the prevalence of cardiovascular diseases and hypertension occurring against the background of atherosclerosis. Even minor lifestyle modifications can slow cardiac aging. It is never too late to adopt a healthy lifestyle. After the onset of cardiovascular disease symptoms, risk factors continue to contribute to disease progression and worsen the prognosis; therefore, their management must be an essential component of treatment strategies.

This article discusses methods for diagnosing and treating intrauterine pathologies using a hysteroscope.

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the recurrent backflow of gastric contents into the esophagus, leading to inflammation of the esophageal mucosa. The global prevalence of GERD continues to rise, making early detection and the improvement of preventive measures increasingly important. The aim of this study is to identify the risk factors contributing to the development of GERD and to develop a comprehensive prevention system targeted at eliminating these factors.

Early childhood tooth decay is one of the most common dental health problems affecting children worldwide. This study examines the relationship between children’s dietary habits and the development of tooth decay in early childhood. Frequent sugar consumption, sticky foods, nighttime sweetened drinks, irregular meal schedules, and insufficient intake of minerals and vitamins were identified as major risk factors. Family feeding practices and parental guidance were found to significantly influence children’s eating behaviors and oral health outcomes. Preventive measures such as structured meal times, limiting sugary foods, promoting water intake, mineral-rich diets, regular oral hygiene, and routine dental visits were shown to effectively reduce decay risk. The findings emphasize the importance of scientifically informed dietary regulation and parental involvement as key strategies for maintaining oral health and preventing early childhood tooth decay.

Down syndrome (DS) is a congenital genetic condition characterized by complete or partial trisomy of chromosome 21, accompanied by varying degrees of intellectual disability, congenital malformations of various systems, and additional health problems that affect life expectancy. The article analyzes current information on the etiology of the disease (chromosomal mechanisms: complete trisomy, mosaic and translocation forms), molecular pathogenesis (gene dosage effects and some key genes), clinical features, prenatal diagnostic methods and effective preventive measures (genetic counseling, screening and diagnostic strategies). At the same time, recommendations are given that are relevant to the context of literature and practice in Uzbekistan.

Chronic Lymphocytic Leukemia (CLL) is one of the most common neoplastic diseases in clinical practice that belongs to the immunohaematological spectrum and is distinguished by its high degree of heterogeneity. According to research results, not only the clinical course but also the prognosis and mechanisms of response to treatment differ significantly across patients with this disease.The oral cavity microflora is an important biomarker reflecting the internal state of the body; when immunity decreases or against the background of oncohematological diseases, particularly leukemia, the balance of this microflora is disturbed (dysbiosis). This dysbiosis weakens the protective function of the mucosa and increases the susceptibility to the development of inflammation and infection.

Thyroid diseases represent a significant medical problem in modern healthcare, as they affect the regulation of metabolism and the overall state of the body. Among them, hypothyroidism, hyperthyroidism, and autoimmune thyroid disorders are increasingly prevalent worldwide, leading to serious health consequences. Disruption of thyroid function may result in metabolic and mental disorders, as well as other severe complications.

One of the important factors influencing thyroid health is the deficiency of trace elements. Special attention is paid to selenium and zinc, which play a key role in thyroid hormone synthesis, antioxidant protection, and immune system regulation. Deficiency of these trace elements may contribute to the pathogenesis and progression of thyroid diseases.

The purpose of this review is to analyze the current literature on the effects of selenium and zinc concentrations on thyroid function and the development of autoimmune thyroid diseases. Summarizing available data allows us to better understand the role of these trace elements in the etiology and possible treatment of thyroid pathologies, as well as to identify directions for further research and clinical application.

This article examines the important role of the nurse in cardiovascular disease, focusing on key tasks and functions, including patient monitoring, preventive measures, education, emotional support, and documentation. Key aspects that help improve patient care and contribute to increased treatment effectiveness are outlined. It demonstrates how nursing supports a comprehensive approach to treatment and rehabilitation, making it an integral part of the modern healthcare system.

This article examines the molecular mechanisms of the pathogenesis of viral hepatitis A (HAV), an infectious disease that causes acute liver inflammation. HAV is an RNA-containing virus transmitted by the fecal-oral route and is self-limiting in most cases. However, the molecular processes underlying the disease's pathogenesis include complex interactions between the virus and liver cells, activation of the immune response, and the development of inflammation.

This article examines the key stages of hepatocyte infection , the mechanisms of viral entry and viral genome replication, and the influence of viral proteins on cellular metabolism. Particular attention is paid to the body's immune response, including the activation of innate and adaptive immunity, as well as the role of cytokines in inflammation. Describe the molecular mechanisms of liver cell damage and inflammation, which contribute to a better understanding of the pathogenesis of viral hepatitis A and opens new horizons for the development of more effective methods for diagnosis, treatment, and prevention of the disease.

The article also highlights the importance of host genetic factors in the pathogenesis of HAV and examines the prospects for using molecular approaches in therapy and vaccination against the virus.

Viral hepatitis A (VHA) is an acute viral liver disease caused by the hepatitis A virus (HAV), which belongs to the Picornaviridae family. Genetic variability of the virus plays an important role in the epidemiology of the disease, determining its spread, diagnosis and features of the immune response. The article discusses the genetic structure of the hepatitis A virus, its molecular features and variations, as well as the impact of genetic variability on clinical manifestations and epidemiological aspects. Data on the molecular evolution of the virus, its strains and subtypes are analyzed , which is important for the development of diagnostic, treatment and prevention methods. The introduction of vaccines and new therapeutic approaches based on molecular data will help to improve the effectiveness of the fight against the disease.

This study was devoted to studying the dental health status of children aged 3-15 years in Andijan region and identifying opportunities for its improvement. The study analyzed 1250 children in different regions of the region and studied their prevalence of dental diseases, risk factors and their association with family and social factors. The results showed differences between the dental health of children in urban and rural areas, low oral hygiene skills and shortcomings in the use of dental services. Based on the results of the study, comprehensive measures were proposed to improve the dental health of children.

In the simulation, a 30 Hz mechanical component, white noise, fault-interval spectral signatures around 120 Hz, and impulsive rubbing events were introduced. The results show high sensitivity and reliability: ROC AUC ≈ 0.991, precision ≈ 0.894, recall ≈ 1.000, F1 ≈ 0.944—meaning no fault window was missed, and false alarms can be controlled by tuning the threshold.
The proposed architecture is modular, easily deployable on edge devices, and can be extended with adaptive thresholds, online retraining, and multisensor integration (e.g., acoustic emission). It has practical value for early warning and predictive maintenance in industrial drives.

Background: Tinea pedis ("Athlete's foot") is the most prevalent fungal infection worldwide, primarily transmitted in communal wet environments. In the Fergana Valley, the increasing popularity of swimming pools, fitness centers, and the high usage of communal ablution areas creates a conducive environment for dermatophyte transmission. Objective: This study aims to investigate the prevalence and etiopathogenesis of Tinea pedis among visitors of public facilities in Andijan and to define hygienic imperatives for effective prophylaxis. Methods: A cross-sectional study involving 450 regular visitors to public swimming pools, gyms, and communal ablution facilities was conducted. Clinical samples were analyzed using microscopy (KOH mount) and culture on Sabouraud dextrose agar. Risk factors were assessed via a structured questionnaire regarding hygienic habits. Results: Clinical signs of Tinea pedis were identified in 28.4% of participants. The highest prevalence was observed among swimming pool users (34%) and frequenters of communal ablution areas (26%). Trichophyton rubrum was the dominant pathogen (72%), followed by T. interdigitale (21%). Key risk factors included walking barefoot on wet surfaces (OR=3.5) and failure to dry interdigital spaces (OR=2.8). Conclusion: Public places with high humidity serve as major reservoirs for pathogenic fungi. Effective prevention requires a multi-level approach: strict disinfection protocols for facilities and personal hygienic imperatives such as wearing protective footwear and thorough foot drying.

Hospital-acquired infections (HAIs) remain one of the most significant healthcare problems, significantly impacting morbidity, mortality, and the economic costs of healthcare facilities. This article presents a comparative review of national and global practices in the prevention and control of HAIs, focusing on current epidemiological trends, risk factors, and common etiologic agents. Particular attention is paid to an analytical study of the situation in Uzbekistan and a comparison with international standards, including recommendations from the WHO, CDC, and European Centers for Infection Control. Successful practices in developed countries, such as the introduction of care bundles, enhanced microbiological monitoring, and programs for the rational use of antibiotics, are analyzed. Based on the identified differences, key areas for improving infection control in healthcare facilities in Uzbekistan are identified. The review emphasizes the need for a comprehensive approach combining clinical, managerial, and educational measures to effectively reduce HAIs.

The article examines medical and social factors that affect the health of women of childbearing age, as well as methods of their correction. The emphasis is on identifying the main factors, such as working conditions, level of health care, lifestyle and socio-economic conditions, which have a significant impact on women's health. The results of studies aimed at identifying the relationship between these factors and the overall level of health are presented. The conclusion provides recommendations for improving the health of women of childbearing age, including comprehensive preventive measures and the implementation of effective strategies for social and medical support.

The article examines the characteristics of children's physical development in the context of the influence of medical and social factors. It is shown that children's health and harmonious growth depend not only on the state of the healthcare system and the level of preventive measures but also on socio-economic conditions, parenting styles, levels of physical activity, and the quality of nutrition. The paper analyzes key medical and social determinants that influence both positive and negative effects on child growth and development. Special attention is given to the role of educational institutions and healthcare professionals in shaping a healthy lifestyle among the younger generation. The results emphasize the need for a comprehensive, cross-sectoral approach to optimize conditions for children's development and to prevent health disorders at early stages.

Children's health is a key indicator of the social and economic development of society and reflects the effectiveness of the national health care system. Current trends demonstrate an increase in chronic diseases in childhood, a growing prevalence of obesity, nutritional disorders, and psycho-emotional disturbances, largely associated with urbanization, lifestyle changes, reduced physical activity, and exposure to stress factors. Additional influences include environmental conditions and digitalization, which, along with positive effects, also create new risks for children's health. This review article analyzes the main challenges and regional differences determined by socio-economic conditions, accessibility of medical care, and the educational environment. Particular attention is paid to the need for developing and implementing regional strategies for strengthening children's health, including preventive programs, the development of school and family medicine, intersectoral cooperation, and systematic monitoring of health status. Such a comprehensive approach will contribute to improving the quality of life of the younger generation and ensuring sustainable development of society.

This article presents a corpus-based analysis of medical vocabulary commonly used in contemporary academic journals. It explores the lexical, semantic, and functional characteristics of key medical terms, examines their frequency and distribution across different journal types, and identifies linguistic patterns that shape scientific communication in the medical field. The study highlights how corpus linguistics contributes to the understanding of terminology usage, variation, and conceptual development within medical discourse. Special attention is given to neologisms, specialized terminology, and multi-word expressions frequently encountered in peer-reviewed publications. The findings demonstrate the importance of corpus-based methods for improving academic writing, enhancing translation accuracy, and supporting the development of medical English teaching materials.

This article examines the central role of empathy and interpersonal communication in the context of Medical English and contemporary healthcare practice. While scientific knowledge and technical expertise constitute the foundation of medical professionalism, effective doctor–patient interaction increasingly depends on the ability to communicate with clarity, emotional sensitivity, and cultural awareness. The study highlights the linguistic, pragmatic, and psychological dimensions of empathy in medical discourse, explores how verbal and non-verbal communication influence diagnostic accuracy and patient satisfaction, and discusses how Medical English teaching can integrate communication skills to prepare future healthcare professionals for real clinical settings. The analysis demonstrates that empathetic communication improves treatment adherence, reduces medical errors, enhances patient trust, and contributes to more ethical and human-centered healthcare.

Bronchial asthma is a chronic inflammatory airway disorder characterized by variable airflow limitation and heterogeneous immunological pathways. Recent developments in molecular immunology, biomarker-oriented diagnostics, and biologic therapies have redefined asthma as a complex set of phenotypes and endotypes rather than a single disease entity. This extended review explores the multifactorial pathogenesis of asthma, including genetic susceptibility, epithelial barrier dysfunction, type-2 and non–type-2 inflammatory pathways, microbiome alteration, and environmental risk factors.

  Hemolytic disease of the newborn (HDN) is a perinatal pathology that develops based on immunological mechanisms, characterized by rapid destruction of erythrocytes, leading to hyperbilirubinemia and anemia. Early diagnosis of the disease is crucial for reducing neonatal complications and lowering the incidence of kernicterus and mortality. This article analyzes the pathogenesis of HDN, modern diagnostic methods, the statistical effectiveness of laboratory and instrumental assessments, prenatal diagnostic opportunities, and prognostic factors.

The involvement of reflex and humoral factors of the autonomic division of the central nervous system in the pathogenesis of intestinal infections, leading to the development of autonomic–visceral dysfunctions, has not been sufficiently studied. According to the theory of H. Selye and A.A. Koltypin, these dysfunctions have a phased nature and, regardless of etiology, are determined by the continuity in the functional activity of the main mechanisms of autonomic regulation of the body: sympatho-adrenal, parasympathetic, and humoral. We found no publications containing data on comprehensive research of these processes in children with intestinal infections, particularly in those with salmonellosis. The present work is a continuation of our previously published results of comprehensive studies.

This article provides an extensive scientific review of the types of antibiotics, their mechanisms of action, pharmacological properties, and the scientific basis of antibiotic resistance. The adaptation mechanisms of microorganisms to antibiotics, mutation processes, formation of genetic resistance, and its impact on the global healthcare system are thoroughly analyzed. The emergence of resistant bacterial strains due to improper use of antibiotics, methods to combat resistance, and modern solutions are discussed based on theoretical and scientific approaches.

 This study examines changes in bradykinin levels and their clinical relevance in children with obstructive bronchitis who remain afebrile yet continue to exhibit bronchial obstruction and wheezing. Thirteen children aged 9 months to 3 years (8 girls, 5 boys) were evaluated. Despite normal ESR and CRP values, obstructive symptoms persisted. Bradykinin levels, measured by ELISA, were 2–3 times above the normal range (56.5–75.6 pg/mL). These findings highlight the pathogenic role of bradykinin in pediatric obstructive bronchitis and support its potential use as a diagnostic biochemical marker. Inhaled budesonide demonstrated noticeable clinical improvement, further implicating the kallikrein–kinin system in symptom persistence.

tevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening severe cutaneous adverse reactions characterized by widespread epidermal and mucosal necrosis. Although clinical scoring systems such as SCORTEN play an important role in severity assessment, they have limited predictive value during early disease stages. Consequently, immunological biomarkers—including cytokines—are being actively investigated to improve early diagnostics and prognostication. Interleukin-15 (IL-15) has emerged as a potent activator of CD8⁺ T lymphocytes and NK cells, enhancing cytotoxic pathways and amplifying keratinocyte apoptosis. This paper reviews the role of IL-15 in SJS/TEN pathogenesis, its association with cytotoxic lymphocyte activity, and its diagnostic and prognostic significance.

Background. Obesity has emerged as one of the most prevalent comorbidities in severe asthma, affecting up to half of patients in some severe asthma cohorts and profoundly modifying disease expression, treatment response and prognosis.

Objective. This narrative review summarizes current evidence on the epidemiology and pathobiology of obesity-associated severe asthma, highlights diagnostic and therapeutic challenges, and discusses emerging pharmacologic and non-pharmacologic strategies with a focus on weight-targeted interventions.

Methods. A non-systematic literature search of PubMed, Scopus and Web of Science was performed for English-language publications from 2010 to November 2025 using terms including severe asthma, obesity, obese asthma, GLP-1 receptor agonists and bariatric surgery. Key guidelines, large observational cohorts, randomized controlled trials, meta-analyses and high-impact narrative reviews were prioritized.

Results. Obesity increases the risk of developing asthma and is over-represented in severe asthma phenotypes. Obese individuals with severe asthma exhibit distinct clinical and inflammatory features, including poorer symptom control, more frequent exacerbations, reduced quality of life, altered lung mechanics and a greater burden of comorbidities. Systemic low-grade inflammation, adipokine imbalance, mechanical constraints, metabolic dysregulation and microbiome alterations contribute to a complex “obese asthma” endotype that is often T2-low and relatively corticosteroid-resistant. Established interventions—structured lifestyle modification and bariatric surgery—can substantially improve asthma control, lung function and quality of life in selected patients. Emerging data suggest that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and other anti-obesity pharmacotherapies may confer additional benefits beyond weight loss, potentially reducing exacerbations and improving asthma control in obese individuals.

Conclusion. Obesity in severe asthma represents a distinct, heterogeneous and therapeutically challenging endotype. Optimal management requires a treatable-traits framework that integrates aggressive weight management, optimization of inhaled and biologic therapy, and targeted use of novel anti-obesity agents. High-quality phenotype-driven trials are needed to define which patients derive the greatest benefit from specific weight-centred interventions.

 Metabolically associated fatty liver disease (MAFLD) is a prevalent liver disorder strongly linked to metabolic dysfunction. Rheumatoid arthritis (RA), a chronic autoimmune disease, is increasingly recognized for its association with metabolic disturbances and hepatic involvement.
Objective: This review explores the pathophysiological interactions between MAFLD and RA, emphasizing shared inflammatory and metabolic mechanisms.
Methods: A narrative literature review was conducted using recent clinical and experimental studies to elucidate common pathways, particularly the role of fibroblast growth factor 21 (FGF21).
Results: Both diseases share key mechanisms including insulin resistance, chronic inflammation, and cytokine-mediated tissue damage. FGF21 emerges as a potential integrative biomarker and therapeutic target due to its dual involvement in metabolic regulation and inflammation.
Conclusion: Recognizing and addressing the bidirectional relationship between MAFLD and RA is essential for effective disease management. Monitoring FGF21 levels may improve risk stratification and guide individualized therapy.

The structure of headache in adolescents with autonomic dysfunction (vegetative dystonia) syndrome is presented, including types, clinical characteristics, associated manifestations, and relationships with other factors. A total of 167 respondents aged 12 to 18 years were observed. The patients had no significant organic neurological or somatic disorders and were not under specialist follow-up. Among the examined individuals, the majority experienced headaches at least once a month or more often, but only 53.3% reported them, which indicates the subjective perception of this condition and adds additional complexity to its analysis and evaluation. Mental load, stress, and physical exertion were identified as headache triggers. In studying the headache syndrome in adolescents with autonomic dysfunction, gender differences were determined.

Background: Dental implantation is a leading method for restoring dentition defects, but complications such as peri-implantitis and osseointegration failure remain significant challenges. Predicting these risks requires precise assessment of bone quality and microcirculation. Objective: To evaluate the role of modern diagnostic methods, specifically 3D radiography (CBCT) and Laser Doppler Flowmetry (LDF), in monitoring osseointegration and preventing complications during early functional loading of dental implants. Methods: A clinical study involving 90 patients (aged 25–61) with minor dentition defects was conducted. Patients were divided into three groups: Group 1 (n=28) received two-stage implantation with delayed loading; Group 2 (n=31) received implants with early functional loading (1 month post-surgery); Group 3 (n=38) received traditional bridge prostheses. Diagnostic monitoring included 3D CBCT for bone density and LDF for gingival microcirculation dynamics at 1, 3, 6, 9, and 12 months. Results: 3D radiography revealed that early functional loading (Group 2) stimulates bone density preservation comparable to the delayed loading group. LDF analysis showed that microcirculation in the peri-implant zone recovers faster under controlled early loading compared to traditional bridges, serving as a predictive marker for tissue stability. Conclusion: The combined use of 3D radiography and LDF allows for the objective prediction of complications by detecting early signs of bone loss and ischemia. These diagnostic tools are essential for determining the optimal timing for prosthetic loading and preventing implant failure.

Diabetic Foot Syndrome (DFS) remains one of the most challenging complications of diabetes mellitus worldwide. The high rate of ulcer recurrence, the progression of neuropathic and ischemic changes, and the need for repeated

surgical interventions continue to affect patient outcomes and long‑term quality of life. Although modern surgical and conservative methods have advanced significantly, many patients still experience recurrent ulcers that lead to functional impairment, limb deformity, and major amputations.

This study presents a modified analytical review of ulcer recurrence among patients treated for DFS, focusing on how different types of surgical interventions influence ulcer location, frequency, and long‑term functional outcomes.

Adrenal gland tumors and hyperplasias represent a diverse group of lesions with distinct morphological, functional, and clinical characteristics. Their pathomorphology ranges from benign cortical adenomas to highly aggressive adrenocortical carcinomas, as well as medullary neoplasms such as pheochromocytoma. Hyperplastic conditions, both nodular and diffuse, constitute an important category associated with endocrine disorders including Cushing’s syndrome, primary aldosteronism, and congenital adrenal hyperplasia. This study provides a comprehensive description of the structural and microscopic features of adrenal cortical and medullary tumors and hyperplasias, emphasizing their diagnostic criteria and clinicopathological significance.

Background: Alcohol use disorder (AUD) demonstrates substantial heritability, with genetic factors accounting for approximately 50-60% of risk variance. The GABAergic system plays a critical role in alcohol's acute effects and chronic adaptations, yet specific genetic variants remain incompletely characterized across diverse populations.

Objective: To investigate associations between single nucleotide polymorphisms (SNPs) in GABA receptor genes and AUD susceptibility across multiple ethnic groups, and to examine gene-environment interactions.

Methods: We conducted a case-control study involving 2,847 participants (1,523 AUD cases, 1,324 controls) from four ethnic populations: European-American (n=1,156), African-American (n=742), Hispanic/Latino (n=581), and East Asian (n=368). Genotyping was performed for 47 SNPs across GABRA1, GABRA2, GABRA6, GABRB1, GABRG1, and GABRG2 genes. Logistic regression models adjusted for age, sex, and population stratification were employed. Environmental factors including childhood adversity and peer drinking behavior were assessed.

Results: The GABRA2 rs279858 polymorphism showed the strongest association with AUD across all ethnic groups (OR=1.68, 95% CI: 1.42-1.98, p=3.2×10⁻⁸). Allele frequencies varied significantly between populations: 0.42 (European-American), 0.38 (African-American), 0.45 (Hispanic/Latino), and 0.31 (East Asian). Significant gene-environment interactions were identified between GABRA2 variants and childhood trauma (p=0.003), with effect sizes strongest among individuals reporting severe adversity (OR=2.34, 95% CI: 1.67-3.28). Haplotype analysis revealed a protective combination in GABRG1 (frequency 0.18, OR=0.64, p=0.001). Age at drinking onset partially mediated genetic effects (indirect effect: β=0.42, p<0.001).

Conclusions: GABRA2 polymorphisms confer substantial AUD risk across diverse populations, with effect magnitudes modified by environmental exposures. Findings support precision medicine approaches incorporating genetic profiling and early-life risk factors for AUD prevention strategies.

This article analyzes the relationship between diabetes mellitus (DM) and ischemic heart disease (IHD) from clinical, epidemiological, and pathophysiological perspectives. The study results show that patients with diabetes have a 2–4 times higher risk of developing cardiovascular complications, particularly ischemic heart disease. Dyslipidemia, hyperglycemia, insulin resistance, endothelial dysfunction, and oxidative stress are the main pathogenetic mechanisms of this process.

The human heart is a complex, four-chambered muscular organ responsible for maintaining continuous blood circulation and supporting systemic and pulmonary functions. This descriptive review examines the anatomical structure and functional zones of the heart, including its chambers, myocardial layers, valves, coronary circulation, and conduction system. The study synthesizes current literature to highlight the relationship between structural integrity and functional efficiency, emphasizing the clinical significance of anatomical variations in conditions such as arrhythmias, valvular disorders, myocardial infarction, and heart failure. The findings reinforce the importance of comprehensive knowledge of cardiac anatomy for medical education, early diagnosis, and effective management of cardiovascular diseases. Understanding the interplay between structure and function is essential for optimizing patient outcomes and guiding clinical interventions.

 This article examines humor, satire, literary devices, anthropomorphism, and political symbolism in The Cat in the Hat. Through the Cat and the fish, the narrative addresses morality, responsibility, childhood psychology, and social norms.

This study explores the use of humor and humorous imagery in Miss Billy by Eleanor H. Porter. It examines how Porter employs comedic elements, character contrast, and social-domestic settings to enrich narrative, convey moral values, and shape readers’ emotional involvement. The analysis highlights the novel’s strengths — its vivid characterizations, effective humor, and social-class representation — while also addressing potential weaknesses, such as the protagonist’s inconsistent emotional decisions.

Neurotransmitters are chemical messengers that play a crucial role in the regulation of physiological processes and brain function. This article reviews the biosynthesis of key neurotransmitters, their functional significance, and the pathologies associated with their dysregulation. Emphasis is placed on catecholamines, serotonin, acetylcholine, and gamma-aminobutyric acid (GABA), highlighting their biochemical pathways, regulatory mechanisms, and clinical implications. Understanding the molecular mechanisms of neurotransmitter biosynthesis and function provides insights into the treatment of neurological and psychiatric disorders.

Currently, in most forensic medical laboratories worldwide, only a separate portion of the examined object is used to perform a particular type of analysis. Blood or secretion stains, as well as human tissues discovered on various pieces of physical evidence, are often very small in size. In such cases, “conducting only genetic analyses of micro-objects is not always advisable, as a negative result leaves unresolved the question of whether it was caused by loss of material during sample preparation or by the fact that the examined object does not originate from a human”.

Chronic obstructive pulmonary disease (COPD) represents a heterogeneous condition characterized by persistent respiratory symptoms and airflow limitation. The disease manifests different phenotypes including emphysematous and bronchitic variants, each presenting unique cardiorespiratory challenges.

Based on the morphological analysis of cases of "toxic hepatitis" with jaundice, the development of massive toxic liver dystrophy, complicated by adipose embolism of the lungs and other organs, was identified. Features of the macroscopic and histological patterns of embolic and hemorrhagic syndromes, infarcts, and infarct-pneumonias were revealed.

The article covers a problem of a fatty embolism as a heavy complication of a mechanical trauma that often can be cause of death of the victim or playing a fundamental role in a thanatogenesis. The article briefly clears up the questions of an etiology and pathogenesis, clinical diagnostics and generally touches on an issue of morphological (primary – microscopic) diagnosis of a fatty embolism.

Background: Geriatric tuberculosis (GT) represents a growing public health challenge, complicated by atypical presentations and high mortality. Comorbidity and polypharmacy are ubiquitous in the elderly but their specific impact on TB outcomes in regions like the Fergana Valley, Uzbekistan, is poorly documented. Aim: To evaluate the clinico-epidemiological significance of comorbidity and polypharmacy on the diagnosis, management, and outcomes of geriatric tuberculosis in the Fergana Valley. Methods: A retrospective and prospective cohort study was conducted at the Andijan Regional Phthisiology and Pulmonology Center, analyzing medical records of patients aged 60 and over diagnosed with TB between 2020 and 2024. Data on comorbidities (e.g., cardiovascular disease (CVD), diabetes mellitus (DM)), and polypharmacy (defined as 5+ non-TB drugs) were collected. Statistical analysis employed Chi-square (S2) and Mann-Whitney U tests to assess associations with adverse drug reactions (ADRs) and treatment outcomes. Results: Of the 240 patients analyzed (mean age 68.2 ± 6.1 years), 85% (n=204) had at least one comorbidity, with CVD (75%) and DM (42.1%) being most prevalent. Polypharmacy was present in 65% (n=156) of patients. Polypharmacy was significantly associated with a higher incidence of ADRs (48.7% vs. 20.2%, p<0.001). Uncontrolled DM and polypharmacy were independent predictors of unsuccessful treatment outcomes (p<0.05). Conclusion: Comorbidity and polypharmacy are central, not peripheral, challenges in managing geriatric TB in the Fergana Valley. They are significantly associated with increased ADRs and poorer treatment success, highlighting the need for integrated geriatric-focused TB care and proactive medication management.

Objective: To conduct an experimental analysis of the prophylactic (preventive) efficacy of standardized local phytopreparations (herbal extracts) on the incidence of common inflammatory dermatological conditions (e.g., atopic dermatitis flares, contact dermatitis) in an at-risk population within the Fergana Valley. Methods: A 6-month, prospective, parallel-group controlled experimental study was conducted. A cohort of 900 adult participants (N=900) with a clinical history of mild, recurrent atopic dermatitis or occupational exposure to skin irritants (e.g., agricultural workers) was recruited from primary care centers in the Fergana and Namangan regions. Participants were allocated into three groups: Group A (n=300), receiving a standardized 2% Glycyrrhiza glabra (licorice) root extract cream; Group B (n=300), receiving 5% Nigella sativa (black cumin) seed oil; and Group C (n=300, Control), receiving a standard emollient (placebo base). The primary outcome was the incidence of a "significant dermatological event" (i.e., a physician-diagnosed flare-up or new condition requiring medical intervention) during the study period. Results: The incidence of dermatological events was significantly lower in the phytopreparation groups. The control group (Group C) reported a 28.0% (n=84) incidence rate. In contrast, Group A (G. glabra) had an incidence rate of 14.3% (n=43) (p < 0.001 vs. control), and Group B (N. sativa) had an incidence rate of 17.0% (n=51) (p < 0.01 vs. control). Both interventions were well-tolerated, with no significant adverse events reported compared to the control. Secondary outcomes, such as skin hydration (corneometry) and Dermatology Life Quality Index (DLQI) scores, also showed significant improvement in the intervention groups. Conclusion: This experimental analysis provides strong evidence that local phytopreparations, particularly standardized Glycyrrhiza glabra and Nigella sativa formulations, possess significant prophylactic efficacy in preventing dermatological events in an at-risk population. These findings support the integration of scientifically validated, locally-sourced phytotherapy into preventive dermatology strategies in the Fergana Valley.