Медицинские науки. Рубрика в журнале - Бюллетень науки и практики
About diversity circulation of the fetus and the newborn. Literature review
Статья обзорная
The article presents a modern understanding of the physiology of the fetal-placental circulation, reflects the characteristics of blood flow in the fetus and the newborn. The anatomical and physiological features of the cardiovascular system in newborns are covered in detail.
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Anxious sexual failure expectation syndrome (fear of sexual failure) in men
Статья научная
Results of the article authors researches are submitted. It is reported that anxious sexual failure expectation syndrome (ASFES) can exist in two forms: the form of anxious apprehension of sexual failure as well as the form of fear of sexual failure (coitophobia). Three variants in the formation of ASFES (premanifest, manifest, postmanifest with respect to the beginning of sexual dysfunctions) are isolated as well as its acute, subacute and gradual development. Some mechanisms of its pathogenesis are revealed (dysfunction of mesodiencephalic structures, which occurs during intimacy, hyposecretion of testosterone, weakening of its transformation into dihydrotestosterone, hyperprolactinaemia, etc.), and its sexological and nonsexoligical manifestations are characterized (sexual dysfunctions, psychoautonomic and psychosensory disturbances, behavioural changes during and outside intimacy). Types of “neurosis of failure expectation” are submitted. Variants of the ASFES course (continual and alternating) and its clinical variants (total, selective, androcentric, feminocentric and mixed) are isolated. Also, different variants of the ASFES influence on sexual harmony (decompensatory, compensatory and the one that does not have any significant effect on the harmony) and common information about therapy for this syndrome (psychotherapy, pharmacotherapy) are submitted.
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Aspects of diagnostics of neonatal pulmonary hypertension in the premature newborns
Статья научная
The formation of the pulmonary vascular system is due to the gradual development and is an integral part of the differentiation of the cardiovascular and pulmonary systems. In children born at a gestational age of 24 weeks, the lungs are at the canalicular stage of formation. At this stage, the alveoli and capillaries are not capable of ensuring proper gas exchange, due to failures in the remodeling of the interstitial extracellular matrix. Hypoxia and, as a result, post-hypoxic changes eventually lead to maladaptation syndrome of the cardiovascular system caused by a cascade of various disorders. One, perhaps, of the most severe clinic-pathogen etic forms of this pathology is neonatal pulmonary hypertension, characterized by the absence of specific manifestations, pathognomonic signs and accompanied by high mortality. The purpose of our study is to analyze the data of ECG and echocardiogram in children with neonatal pulmonary hypertension. We found that with persistent pulmonary hypertension on an ECG, signs of hypoxic-ischemic myocardial damage are more often detected. With persistent pulmonary hypertension, speeds of more than 1.4-1.6 m/s and diagnostically significant regurgitation to the tricuspid valve (++ / +++) are detected.
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Assessment of adaptation potential of foreign students studying in low and midlands conditions
Статья научная
Assessment of the adaptive potential of students studying in low- and midlands conditions is a very important task, since it allows students to timely identify pathological conditions that precede the development of the disease. The goal of this study is to assess the adaptive capabilities of foreign students studying in low- and midlands conditions. The 260 first-course male students aged 19.55±1.31 years from India were examined. The study was conducted in low mountains (760 m ASL) and middle mountains (1650 m ASL). The index of functional changes (IFCh), as calculated by R. M. Baevsky, took into account factors such as age, height, body weight, heart rate, and blood pressure. A comparative analysis of the indicators of the index of functional changes (IFCh) of foreign students studying in lowlands and midlands revealed significant differences in systolic blood pressure (SBP). In the low mountains group, the value of IFCh was higher than in the middle mountains group. The majority of students (77% in the lowlands and 86% in the midlands) demonstrated a satisfactory level of adaptation. However, a small percentage of students in both the lowlands (6%) and midlands (1%) showed unsatisfactory adaptation. Therefore, the educational environment in the midlands was found to be more favorable for the adaptation of Indian students.
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Assessment of menstrual hygiene knowledge, attitudes and practice among medical students
Статья научная
Menstrual hygiene is an essential aspect of reproductive health, yet it remains a significant public health concern due to inadequate awareness, limited access to sanitary facilities, and persistent cultural taboos. Medical students, despite their educational background, also face challenges in managing menstrual hygiene effectively. Research objectives: this study aims to assess menstrual hygiene awareness, practices, and associated challenges among female medical students at the International Medical Faculty, Osh State University. A cross-sectional, questionnaire-based survey was conducted among 328 female medical students from first to sixth year. The self-developed, pre-validated questionnaire included questions on menstrual hygiene awareness, practices, product preferences, challenges faced, and the influence of residence and institutional support. Data were analyzed using descriptive statistics, expressed as counts and percentages. Research results: the study found that while most students had a basic understanding of menstrual hygiene, significant gaps existed in awareness, affordability, and accessibility of sanitary products. A considerable proportion of students (42.7%) reported experiencing health issues due to inadequate menstrual hygiene. Hostel residents faced more challenges related to sanitation and pad disposal compared to those living in flats. Period stigma remained prevalent, with 15.2% of students reporting experiences of period shaming. Despite being in a medical environment, only 34.8% of students reported receiving menstrual hygiene awareness from their institution. The study highlights the need for improved menstrual hygiene education, better sanitation facilities, and increased accessibility to affordable menstrual products. Institutional initiatives, such as awareness programs, infrastructure improvements, and policy changes, are crucial in addressing menstrual hygiene challenges and promoting a stigma-free environment.
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Статья научная
Несмотря на появление современных биомаркеров, инновационных методов обследования и лечения, проблемы сердечно-сосудистого риска в клинической медицине по-прежнему остаются достаточно актуальными. Широкое распространение факторов сердечно-сосудистого риска и высокая смертность от болезней органов кровообращения наблюдаются во всех странах мира, в том числе и Киргизской Республике. Цель исследования. Изучить клинико-функциональные значения СРБ и его взаимосвязь с факторами сердечно-сосудистого риска у пациентов с хроническими неинфекционными заболеваниями. Материал и методы. В одноцентровое открытое исследование было включено 290 человек с различными категориями сердечно-сосудистого риска, из них мужчин 150 (51,7%), женщин - 140 (48,3%). У всех участников были проанализированы параметры гемодинамики, показатели клинико-биохимических обследований. Экскреторная функция почек оценивалась по уровню сывороточного цистатина С. Скорость клубочковой фильтрации (СКФ) рассчитывалась по методике F. Hoek. Учитывались размер левого предсердие (ЛП), линейные размеры левого желудочка (ЛЖ) с оценкой структурной модификации миокарда. В зависимости от концентрации СРБ были сформированы две группы: 1А и 1Б. Результаты. У пациентов с высоким уровнем СРБ средний возраст, индекс массы тела, частота сердечных сокращений, число тромбоцитов, лейкоцитов, глюкоза, цистатин С крови были существенно выше, а средний уровень холестерина липопротеинов высокой плотности и СКФ были достоверно ниже. Размер левого предсердия, конечный диастолический размер ЛЖ, величины толщины межжелудочковой перегородки и задней стенки ЛЖ, относительная толщина стенки ЛЖ, масса миокарда ЛЖ, индекс массы миокарда ЛЖ, отношение Е/А правого желудочка, DT (deceleration time) ЛЖ, DT (deceleration time) правого желудочка были значимо выше в группе лиц с высоким содержанием СРБ крови. У пациентов с нормальным (1А) и повышенным (1Б) уровнем СРБ в структуре изменений геометрии ЛЖ значимо чаще выявлялся эксцентрический вариант гипертрофии ЛЖ (74,9% и 66,0% соответственно). Концентрация СРБ крови была положительно связана с размером левого предсердия и толщиной стенок ЛЖ, отрицательно - со скоростью СКФ. Заключение. У лиц с высоким и очень высоким сердечно-сосудистым риском повышенные уровни СРБ ассоциируются с более выраженными факторами сердечно-сосудистых осложнений. В группе пациентов с высоким уровнем СРБ структурная модификация миокарда представлена значимо чаще эксцентрическим вариантом гипертрофии ЛЖ.
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C1Q нефропатия (клинический случай)
Статья научная
С1q нефропатия редкая, недостаточно хорошо изученная патология, характеризующаяся отложением С1q компонента комплемента и иммунных комплексов в мезангии. Постановка диагноза требует выполнения биопсии почки c исследованием иммунных комплексов. При световой микроскопии данная патология проявляется болезнью минимальных изменений (БМИ), фокально-сегментарным гломерулосклерозом (ФСГС) и пролиферативным гломерулонефритом. Клиническая картина разнообразна, колеблющаяся от бессимптомной гематурии или протеинурии до нефротического синдрома. Кортикостероиды являются основой лечения, а иммуносупрессивные агенты зарезервированы для стероидорезистентных случаев. Наличие нефротического синдрома и ФСГС предсказывают неблагоприятные исходы в отличие от благоприятных исходов у пациентов с БМИ. В этой статье мы опишем клинический случай, гистопатологию, клиническую особенность C1q нефропатии.
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CAR T-клеточная терапия как современный метод лечения онкологических заболеваний
Статья обзорная
Ежегодный рост случаев онкологических заболеваний диктует необходимость поиска и разработки новых методов диагностики и терапии онкозаболеваний. В статье представлены результаты анализа современных литературных источников, посвященных CAR T-клеточной терапии, ставшей прорывным направлением в лечении ряда гематологических опухолей. В основе CAR T-клеточной терапии лежит создание пула опухоль-специфичных цитотоксических лимфоцитов путем внесения ex vivo трансгена, кодирующего химерный антигенный рецептор. В статье изложены основные принципы, возможные осложнения, преимущества и недостатки CAR T-клеточной терапии.
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Causes, signs, prevention of thalassemia (genetic anemia)
Статья научная
The medical field has revealed many gene diseases to date. One of these diseases is Thalassemia. This scourge was found about 7 thousand years ago.It was discovered for the first time in the countries of the Mediterranean basin.The word thalassemia is derived from the Greek and means Mediterranean anemia. Thalassemia is one of the most common hereditary blood diseases among different genetic diseases and is inherited by both mother and father. Due to the lack of hemoglobin in the body, the function of erythrocytes is impaired.In this case ,erythrocytes are not disc-shaped, but sickle-shaped. Mutations in our genes produce a protein deficiency in the synthesis of hemoglobin, which leads to the occurrence of thalassemia. This protein contained in erythrocytes gives the blood a red color.Hemoglobin originates in the bone marrow, consists of heme and a globilin (protein) chain.. The iron contained in heme has the ability to combine and separate oxygen into itself. Globulin is composed of 2 alpha, 2 betta,delta or gamma chains. The cause of the occurrence of thalassemia is the absence or partial presence of one of the chains as a result of mutation. In thalassemia, if the synthesis of the “α” chain of hemoglobin is disrupted, it is called “α” thalassemia, and if the synthesis of the ”β” chain is disrupted, it is called “β” thalassemia.
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Cerulein induced acute pancreatitis in experiment
Статья научная
Acute pancreatitis (AP) is an inflammatory disorder of the pancreas, which ranges from mild, self-limiting disease to a severe form that is associated with multiple organ dysfunction syndrome (MODS), high morbidity, and mortality. Unpredictable nature of the disease, heterogeneity of disease presentations, and limited access to human samples, make research on human tissues impractical and often very difficult. We tried to identify crucial events in the pathophysiology of AP, in the course of several in vivo experimental models of the AP induction. In vivo experiment was carried out on rats using the analog of cholecystokinin octapeptide - Cerulein. The rats were divided into groups, in each group there was a different dosing regimen of the drug. As a result of a series of experimental studies, it was found that the interval low-dosage induction of AP causes more severe damage of pancreas tissue than a single administration of higher doses of the test substance.
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Статья научная
One of the factors causing stress in society is exam stress. Taking exams is stressful and quite exciting in itself. However, under the influence of excitement, the student cannot show his little knowledge. From this point of view, the study of psychological and physiological development of students is also of special importance. The study is dedicated to the change of vegetative indicators due to the influence of the exam process depending on the temperament of the nervous system in students of the 5th year of choleric type. In this regard, the main goal of the study was to reveal the age characteristics of changes in vegetative indicators depending on the type of temperament as a result of the effect of emotional stress during the examination. In order to study the effect of the exam process on emotional stress, students were divided into three groups: The first group was students studying on regular school days 2 months before the exam, the second group was 30 minutes before the exam process, and the third group was the group after the exam and 30 minutes after the exam process. First of all, the physiological indicators of different states of excitement of the temperament type and the process of excitement were studied in the experiment. In order to comprehensively evaluate the effect of emotional stress, we measured the main hemodynamic parameters, arterial pressure and number of heart beats per minute. It was determined that, depending on the type of temperament, vegetative indicators before the exam process (heart pressure, systolic and diastolic pressure) of young people on an ordinary day, before and after the exam, are different. However, after the exam, these indicators do not fully return to the norm. The tone of the sympathetic nervous system prevails during the examination process in all age groups.
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Статья научная
The article reflects the study of the influence of climatic and seasonal factors on the body of people of middle, elderly and senile age. These factors significantly aggravate the course of many diseases, worsen health and reduce the body's performance. The incidence of cardiovascular disease is often associated with risk factors and seasons. Most people aged 65 years and older often suffer from hypertension. With age, the number of such patients increases significantly. Severe hypertension is rare in humans because patients with hypertension do not live to an advanced age or often develop complications. Changing seasonal factors requires great attention to the functional state of the cardiovascular system. Patients with hypertension are very difficult to adapt to changing weather conditions, which worsens the quality of life of the elderly and leads to various complications. Changes in blood pressure in people of middle, elderly and senile age depending on the season of the year have been established.
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Choice of Pharmacotherapy for Acute Destructive Pancreatitis (Review)
Статья научная
This paper is devoted to a modern, promising, minimally invasive endovascular method for treating acute pancreatitis: prolonged regional arterial pharmacotherapy. The main methodological and technical issues are discussed, on which there is no consensus in the literature. This primarily concerns the purpose and indications of the method in question, the timing of its initiation and duration, the drugs used, and evidence of its effectiveness using modern methods of statistical analysis.
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Статья научная
Young adults experience febrile illnesses (fever) with throat discomfort and exhaustion. Many infections that cause febrile illnesses in young adults also cause symptoms that coincide with bacterial throat infections (pharyngitis/endemic febrile illnesses in India), resulting in many cases of infectious mononucleosis being underdiagnosed. To fully explore how young adults present clinically with fevers and throat symptoms, this project aims to determine the specific clinical presentation, the diagnostic approach taken by doctors, as well as any potential misdiagnosis of infectious mononucleosis among young adults who have had febrile illnesses with throat symptoms. Using a cross-sectional survey, we collected information from 120 young adults (ages 18-30) who had experienced febrile illnesses within the last 6 months. The survey was conducted using anonymous questionnaire items that provided information about symptoms, duration of symptoms, swollen lymph nodes, fatigue, blood tests/investigations completed by the respondents, treatments, and recovery time. All survey response data and results were compiled using descriptive statistics. Fever (90.8%), sore throat (76.7%), fatigue (76%), and neck/lymph node swelling (60%) were the most reported symptoms. The presence of prolonged (longer than 2 weeks) fatigue and lethargy was reported by 40% of the respondents. Thirty percent of respondents had blood tests completed, and 5% completed heterophile/EBV tests. Antibiotics were given in 70% of the cases, and 20% of the respondents experienced a rash following antibiotic administration. Recovery from febrile illnesses took 1 to 2 weeks for 50% of respondents to return to their normal level of activity. Young adults with a febrile illness frequently report prolonged fever, sore throat, lymphadenopathy, and fatigue; understanding these symptoms can aid in the early diagnosis of conditions like infectious mononucleosis (IM) and help avoid misdiagnosis and inappropriate antibiotic use.
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Clinical acute bulbar syndrome in a 6-month-old child with cortical brain dysplasia
Статья научная
The article presents a rare clinical case of Autoimmune brain stem encephalitis of unknown etiology in a 6-month-old girl. The manifestation of the disease began with a subacute growing bulbar syndrome, however, in the clinical picture noted hemiparesis, which was not typical for the brain stem lesions. In the series of examinations, we revealed a concomitant congenital pathology of the cerebral cortex, which was the cause of child hemiparesis. The clinical case shows the importance of differential diagnosis in limited conditions and medical alertness for the correct diagnosis and further treatment.
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Clinical and epidemiological assessment of anthrax
Статья научная
The article presents the results of epidemiological, clinical analysis of the registered incidence of anthrax for the period from 2015 to 2020 in Osh, Jalal-Abad region of the Kyrgyz Republic. There is a pronounced tendency to increase the incidence of anthrax with a wide spread in disadvantaged inpatient facilities.
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Статья научная
It is now known that the SARS-CoV-2 virus can infect cells in the gastrointestinal tract as well as the liver. Liver dysfunction is found in 14-53% of patients with COVID-19. Scientists have found that the SARS-CoV-2 virus can directly infect liver cells and cells lining the intra- and extrahepatic bile ducts (cholangiocytes), since they contain, although in low concentrations, a special enzyme ACE-2, which serves as an entry point into cells of some coronaviruses, including SARS-CoV-2. The next stage in the development of pathology is inflammation and the formation of blood clots. With a violent reaction of the immune system, an excessive release of cytokines occurs, which aggravates the condition and, in some cases, leads to reactive hepatitis.
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Co-infection of hepatitis a and herpes simplex virus: a case report
Статья научная
Hepatitis A is a self-limiting disease where fulminant hepatitis and death occur in a small proportion of patients. Fulminant hepatic failure is more common in patients with underlying liver diseases, such as chronic hepatitis B and C, co-infection with more than one genotype of hepatitis A at the same time, non-alcoholic fatty liver disease or alcoholic steatohepatitis, in advanced age and with dependence on intravenous drugs. We present a case of infection of hepatitis A and herpes simplex virus that lead to acute liver failure. In this rare case, the importance of attention to the first manifestations of the disease in diagnosing severe cases of hepatitis A in adults is emphasized. At the same time, HSV hepatitis can also be the cause of fulminant hepatic insufficiency. Therefore, patients with severe hepatitis A need an early examination for HSV infection, and empirical treatment with acyclovir should begin at early stage.
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Статья научная
This article presents a non-systematic review of the literature focusing on the diagnostic challenges and laboratory differentiation between acute respiratory viral infections (ARVI) and COVID-19 in resource-limited settings of India and Kyrgyzstan. A non-systematic search of PubMed and Google Scholar was conducted for articles published in 2025-2026. The search strategy used the terms “diagnosis” OR “diagnostic” OR “diagnostic tests” OR “tests” AND “COVID-19” OR “SARS-CoV-2” OR “acute respiratory viral infections (ARVI)” in the article title and keywords. Diagnostic tests for respiratory viral infections primarily detect viral nucleic acid or host immune responses. In COVID-19, identification of SARS-CoV-2 RNA by real-time polymerase chain reaction (RT-PCR) from respiratory specimens remains the reference standard, particularly during the early phase of illness. In contrast, ARVI diagnosis in resource-limited settings often relies on clinical features with limited laboratory confirmation due to restricted access to molecular testing. Serological assays are more informative in the later stages of infection and may support retrospective diagnosis or epidemiological assessment. Routine laboratory parameters such as complete blood count, C-reactive protein (CRP), D-dimer, coagulation profile, lactate dehydrogenase (LDH), ferritin, and procalcitonin help assess disease severity, inflammatory status, thrombotic risk, and prognosis rather than providing etiological confirmation. Imaging modalities, particularly chest radiography and computed tomography, can aid diagnosis when clinical suspicion is high and laboratory tests are negative, delayed, or unavailable. Although detection of viral RNA by RT-PCR remains the reference method for confirming COVID-19, its diagnostic yield is influenced by timing, sample quality, and resource availability. Therefore, accurate diagnosis should rely on an integrated approach that combines clinical presentation, epidemiological context, molecular or serological testing, and supportive laboratory and imaging findings, including assessment of complications. The limitations observed in current diagnostic strategies highlight the need for more sensitive, specific, and rapid diagnostic tools, particularly in resource-constrained settings.
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Статья научная
In the length of time, a wide variety of drug combinations emerged in the management of post-transplantation therapy in order to improve the survival of the recipient and graft. However, the efficacy and safety of the applied combinations regarding the rejection and other complications are continuing to be the subject of research. In our study, our aim is to compare the effects of various combinations, namely cyclosporine with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone and tacrolimus with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone in a length of time. Methods. A total of 204 patients included into the study who received post-renal transplantation treatment in Scientific-Research Institute of Heart Surgery and Organs Transplantation and followed-up over a 10-year period. The estimated survival probabilities in the study were determined by the Kaplan-Meier method; whereas intragroup comparisons were evaluated by Log-rang, Breslow, and Tarone-Ware tests. Complications occurred in patients with combinations were analyzed by Chi-square and its alternatives. Hazard risk factors were tested by Cox regression analysis. Results. Of these 204 patients, 36 received Cyclosporin combination (CCG) and 168 Tacrolimus combination (TCG). The estimated life expectancy of the patients of TCG was significantly longer than the CCG ones. Furthermore, gender and age did not have a significant effect on survival depending on time, however, gender and age-related hazard factor showed a significant difference in the groups. It was determined that chronic rejection was significantly different in patients who used tacrolimus combinations, the difference was close to the significant value in acute rejection analysis. Other adverse events, namely, infection, tumour and organ damage were statistically less common in the patient group treated with tacrolimus combinations. Conclusion. In general, TCG showed better results in contrast to CCG.
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